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HomeMy WebLinkAbout2005-328e INDIAN RIVER COUNTY W' GRANT CONTRACT This Grant Contract ("Contract") entered into effective this St day of October 2005 , by and between Indian River County, a political subdivision of the Sate a of Florida ; 184 to 0 25 Street , Vero Beach , Florida , 32960-3365 ; and Gifford Youth Activity Center ( Recipient) , of: Gifford Youth Activity Center 4875 43`d Avenue Vero Beach , Florida 32967 GYAC Teens 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 - } 1 4 . Grant Funds and Payment. The approved Grant for the Grant Period is : FIFTY ONE THOUSAND , FOUR HUNDRED FIFTY ONE DOLLARS ($51 , 451 . 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 ; 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 Worker's Compensation and Employer's Liability (current Florida statutory limit. ) . 5 . 6 . Insurance Administration The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30) calendar days prior written notice having been given the County. In addition , the County may request such other proofs and assurances as it may reasonable require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract, except Worker's Compensation Insurance . The Recipient shall , upon ten ( 10 ) days prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business , of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option , terminate this Contract. 5. 7 . Indemnification . The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses , damage, or causes of action which may arise from any misconduct, negligent act, or omissions of the Recipient, its agents , officers , or employees in connection with the performance of this Contract. 5 . 8 . Public Records . The Recipient agrees to comply with the provisions of Chapter 119, Florida Statutes ( Public Records Law) in connection with this Contract . 6 . Termination . This Contract may be terminated by either party, without cause, upon thirty (30 ) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7 . Availability of Funds The obligations of the County under this contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . - 3 - IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS By: , Thomas S . Lowther, Chairman BCC Approved : Aq_ "/ — D Attest: J . K. Barton , Clerk Deputy Clerk Approved ' Joseph A. Baird �.0 County Administrator T to f rm and legal sufficiency:E . Fell , Assi an u y Attorney RECIPIENT: By: ki E. k Gifford Youth Activity Center - 4 - , EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River County Children 's Services Advisory Committee PROGRAM COVER PAGE Organization Name : Gifford Youth Activities Center. Executive Director: Michael S . Hubler E-mail : mhublerngyac cc Address : 4875 43 `d Ave . Telephone : _ (772 ) 794- 1005 x22 Vero Beach FL 32967Fax : (772) 569-5563 Program Director: Jerome Gavmon E-mail : jzg@aol . com Address : 4875 43 `d Ave. Telephone : (772) 794- 1005 Vero Beach FL 32967 Fax : (772 ) 569- 5563 Program Title: Frontline—GYAC Teens Program Priority Need Area Addressed: Promoting both school success and healthy lifestyles Brief Description of the Program : Frontline-GYAC_ is a prevention and intervention after-school program for adolescents in grades 6 throught 12 who when given comprehensive support to insure their healthy personal development have an increased possibility of being ry accepted into a ost- secondaor vocational training program of their choice The goal of the program is to provide the ongoing leadership direction and support that is often lacking for "at risk" students during their most difficult years of development. SUNEMIARY REPORT — (Enter Information In The Black Cells Only) Amount Requested from Funder for 2005 / 06 : $ 103 , 299 . 83 Total Proposed Program Budget for 2005 / 06 : $ 357 , 405 . 00 Percent of Total Program Budget : Current Program Funding ( 2003 / 04 ) : 28 . 9 % Dollar increase / ( decrease ) in request : $ 103 , 300 Percent increase / ( decrease ) in request * * Unduplicated Number of Children to be servedIndividuall # DIV / 0 ! Unduplicated Number of Adults to be served Individually : y 300 Unduplicated Number to be served via Group settings : Total Program Cost per Client : * *If request increased 5 % or more, briefly explain why : 1 191 . 3 5 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 on (date). John Dean Name of President/Chair of the Board S a ' Michael S . Hubler Name of Executive Director/CEO Signatur 3 The Gifford Youth Activity Center, Inc . — Frontline-GYAC Indian River County Children ' s Services Advisory Committee PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1 . Provide the mission statement and vision of your organization . The mission of the Front line/Gifford Youth Activity Center is to provide leadership , direction and support to ensure that all adolescents have an equal opportunity to succeed , follow their own right path and become community assets . Our vision is grand . . . to create a successful Frontline program in Gifford -Indian River County . To accomplish this great task, a concentrated effort must be provided to our core groups of teens , along with committed resources , skills , support , time and energy . By committing to these teens and their families up until graduation from high school and enrollment into a post- secondary education and vocational training, there is a greater likelihood that many success stories will result and the communities will reap the benefits of these now productive members and assets to our society . 2 . Provide a brief summary of your organization including areas of expertise, accomplishments , and population served . The Frontline program was incorporated on November2 , 2000 in Fort Pierce, FL . Several men and women with a vision who believed there was a better, more preventative way to insure the personal success of our youth established the organization . Armed with extensive skills and research-based methodologies , they develop Frontline ; a program on the Frontlines of the fight to save our youth . One of the more unique aspects of the Frontline program is the application of Reality Therapy ; a behavioral intervention strategy that is typically used in residential treatment program . In its third year of operation, FPM has experienced some very terrific successes . A really great partnership has been maintained with the School Board and the Superintendent of Schools , which continued the multiple in-kind resources and a great location for the Frontline program . Lincoln Park Academy is not only a magnet high school but also one of the three (3 ) 21 " Century Community Learning Center sites . In January 2004 , FPMC presented its first USSSA tournament and more than seven cities attended . The event was meant to encourage youth to follow their dreams and to never give up . The GYAC was established in 1998 to meet the educational needs of community ' s children supplemental education services . Also , the GYAC has developed a network of programs to enhance behavioral outcomes of these children 4 The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River County Children 's Services Advisory Committee 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 . According to Bell South Foundation ' s Gaining Ground report (www. bellsouthfoundation . org) , students from lower income families ; racial minority groups and immigrant families continue to lag behind their peers, with limited access to technology . And , instead of preparing our high school students to meet the demands of our rapidly changing society and economy , education reform has all but bypassed the high school level . "Instead, uninspiring curriculum fails to engage students achievement, gaps increasing among students groups , and attenuated connections between high schools and the world beyond add up to serious disadvantages for students in pursuing postsecondary education and a skills gap for businesses that seek to hire them . . For many, especially students of color and certain ethnic groups , chances of college success are limited by their personal experience , compounded by a lack of technological resources and sills . "The deficits and obstacles these students encounter inhibit our society from developing the well -trained flexible , cable workers that the economy needs and the informed, active citizens our democracy requires . " Schools are not the only place for students to learn and it is vital that community-based, social service organizations support the educational (mental) development of every child , as they simultaneously promote healthy physical , emotional , social and spiritual development . Encouraging "after school/out of school" programs to join with schools in addressing the needs of adolescents are not only a good idea, it is imperative . A great number of our children are living with single parents , are from "broken" families and have parents who work outside the home , yet only about 6 million children in grades K- 8 participate in after school program (Bureau of Labor Statistics , ' 97 : USDOE National Center for Education Statistics , " 99) . 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) 5 The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River County Children ' s Services Advisory Committee C . PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages) 1 . List Priority Needs area addressed . The funding priorities that his proposal addressed in "promoting school success by providing programs that support and educate parents and encourage academic achievement for children "promoting healthy lifestyles to strengthen children ' s resiliency to meet the challenges of life by providing programs for both the physical and mental health of children . " 2 . Briefly describe program activities including location of services . This first FRONTLINE program is in a great location in the heart of Indian River County at Gifford Youth Activity Center . Youth are referred to the program by parents , neighborhood association , social service organizations , First Stops, school guidance counselors , school resource officers, civic organizations and local churches . Every candidate must complete an application and be accepted into the program . Upon acceptance into the program, each participant is assigned to a Frontline/GYAC counselor. Within the first few weeks , all participants complete a number of written and verbal assessments to evaluate their current levels of psycho -social functioning , their interest, and their performance and skills in a variety of areas to include physical fitness , cognitive/academic ability, technology skills , leadership , vocational , etc . The counselor works very closely with the schools ' guidance counselors , teachers and family members . Then, based on these formal and informal assessments , each participant with their counselor develops their own Success Plan . 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 . Frontline is concerned with the development of the "whole" child and therefore seeks to comprehensively "wrap itself" around around the participants . The carefully developed program components and activities work in combination to address the multiple needs of each adolescent . The program, therefore, offers a long-term commitment to participants (until graduation from high school and/or through G . E . D . attainment) , in a structured environment, utilizing a comprehensive Reality Therapy approach to teach appropriate behavior and coping skills . In addition, with the help of collaborative partners , the following is provided to create resiliency in the participants : A personal Success Plan : Informal and formal assessments help to evaluate strengths , weaknesses , resources and barriers to success , then with the help of the participant ' s counselor a Personal Success Plan is developed which identifies goals and a specific plan of activities for success . Personal growth and Development : Student will participate in multiple activities to learn new skills and reinforce strategies that will foster success . Activities such as daily reality groups, daily individual reality counseling, attendance at and facilitating mini -workshops help participants make healthy decisions and improve communication and coping skills . 6 The Gifford Youth Activity Center, Inc . — Frontline-GYAC Indian River County Children ' s Services Advisory Committee Academic Enhancement : Not only do participants identify their academic goals , but also they firmly established their "why" for improving their performance . In addition, volunteers and staff help with homework and classroom projects and tutorial services are provided to each participant . Pre -vocational and career development is also an integral part of the program . Well -Rounded Development : Our youth must be equipped with all the skills to live a health, happy, and prosperous life . For this reason, there are opportunities for physical/health development such as recreation , sports , fitness and health activities . Also , participants are encouraged to include leisure activities in their Success Plan, along with activities that development their talents . And , all important to teens , lots of social opportunities are offered to help them develop their social and relationship skills . 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) . This application request an additional fiill -time counselor to add to the existing staff of one Program Director Counselor and one part-time counselor. Volunteer are crucial to the success of the program and assistant Board Member, career mentors and program aides . At present, the number of volunteers is 5 and the average number of hours volunteered per month is 20 . 5 . How will the target population be made aware of the program ? The targeted population will be made aware of the program via the Youth Summit, court system, sheriff, a radio talk show, basketball tournament, the school district, social workers , counselors guidance , deans , school resources officer, and faith based organizations and by word of mouth . 7 The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River Comity Children ' s Services Advisory Committee 6 . How will the program be accessible to target population (i . e. , location , transportation , hours of operation) ? The Frontline program targets the "at risk" population of teens living in Indian River County . There is a great deal of crime in the Gifford . A great deal of crime stems form the lack of constructive activities for youth who are at the poverty level or near it . Frontline/GYAC offers opportunities for all youth to succeed by improving their grades , exploring new avenues and making them conscience of life opportunities . The program operates 2 - 8 p . m . Monday — Thursday . The school district will provide bus transportation form school to the GYAC complex . Parents will pick up children from GYAC . 8 The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River County Children ' s Services Advisory Committee Do MEASURABLE OUTCOMES (Description of Intent) Use the Measurable Outcomes form. This description page does not need to he 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.- 0 ncluded:• Direction of change • Time frame • Area of change • As measured by • Target population • Baseline : The number that you will he • 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 (B1 ) . 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 . 9 The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River County Children ' s Services Advisory Committee D . MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements for the Measurable Outcome(s) Add the tasks to accomplish the Outcome(s) 1 . 60% of participants will decrease 1 . Provide a very available and accessible their referrals by 50 % in one year as program and staff for participants and evidenced by discipline referrals , their parents/guardians most every day will demonstrate improved behavior of the year, after school and out-of- and academic performance and in school times , on holidays and during and out of the school setting, by the the summer. end of the contract period , as 2 . Each participant will develop a measured by the number of Personal Success Plan that identifies discipline referrals in school . personal goals , actions needed to achieve successful outcomes and 2 . 60% of the participants will pass consequences/rewards for behaviors . test administered during class mini 3 . Provide a healthy, safe, productive and workshops and increased in structured environment/program that knowledge and ability in personal offers a variety of participants- desired development and decision-making activities : personal plan goal- setting, skills , by the end of the contract personal growth and development, period, as measured by pre/post test daily reality therapy groups daily at classes/mini workshops . individual reality counseling, homework help/tutorial , social skill 3 . 60% of the students will reduce development recreation, sports and illegal activities by 50 % as fitness activities, leisure skill and talent compared to the previous year as development activities , art and cultural evidenced by police reports , activities , field trips and special measured by reports from school projects . resource officers , Indian River 4 . Counselors will establish a relationship Sheriff Office , Vero Beach Police with the teens and the family and Department and/or Juvenile Justice - ,develop a plan to reduce and/or Department . : y"eliminate delinquent behaviors . If poor choices or decisions are made, the 4 . 60 % of the students ' parents will participant will identify a better choice participate in family activities held or decision in either an individual by Frontline staff as evidenced by a counseling session or reality group, or sign-in roster . both and then implement/employ this new strategy, including making amends to any individual (s) who may have been adversely affected . 5 . All with participate in leadership opportunities and skill -building tasks such as : interview candidates for the program , evaluate program activities and services , develop programs and community projects, lead workshops 10 The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River County Children ' s Services Advisory Committee and teach peers , maintain and beautify the site , and help support Frontline/GYAC. 1 . Frontline/GYAC Counselors will communicate regular with parents/guardians of participants . 2. Quarterly family sessions will take place with participant ' s Frontline/GYAC Primary Counselor. 3. Quarterly Assemblies will be held to recognize participant accomplishments , and a family members will be given incentives to attend . 4. Monthly programs to assist and educate parents in supporting their child ' s development and school success . OUTCOMES ACTIVITIES Add all of the elements for your Measurable Outcome(s) Add the tasks to accomplish the Outcome(s) 11 The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River County Children ' s Services Advisory Committee 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 database of previous campers, provide database County of previous staff, identify appropriate arts disciplines, identify appropriate arts teachers . Youth Guidance Referrals of teen volunteers , provides expertise and consulting on teen training and volunteering issues . Indian River County School Assist in identifying appropriate children for the Specialists program Environmentall:earning Center Facilities for instruction Instructors Ongoing communication & assessment of project Vero Beach Museum of Art Facilities for Field Trip Docents for tours United for Children : Foster Care Provide children for camp Children Hiz Kidz Provide children for camp Truancy Prevention Program Provide children for camp 12 The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River County Children 's Services Advisory Committee 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 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 camp . The presence of risk factors will be documented and shared with staff, as deemed appropriate by the Camp Director . 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 ? A monthly report is comprised of the following information to evaluate the quantitative and qualitative aspects of Frontline-GYAC . a. Attendance report that includes daily attendance , monthly attendance , and each teen ' s times attending the program and the percentage of registered teens being served . b . An evaluation of each Success Plan that includes % of activities participated in, number of discipline referrals , number of privileges earned, progress on report cards , any incidents with law enforcement or the judicial system , the number of times/hours of parent involvement . c . Results of pre-tests administered at classes and mini -workshops . Results of random surveys completed by at least 10% of average daily program (i . e . if daily average attendance is 20 , 2 teens will complete the survey) . These surveys will ask the teens to evaluate the program, specifically measuring what level of quality they perceive the program is offering . 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 ? Participant information will be documented . This documentation will be used to improve the quality of the program and develop [ quarterly reports to be shared will all program funders . 13 The Gifford Youth Activity Center, Inc . — Frontline-GYAC Indian River County Children ' s Services Advisory Committee 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 Plan logistics and curriculum content • Develop and send out informational flyer through the school system • Assemble referrals form schools , courts , social workers and collaborative partners . • Create database • Assemble staffing • Secure classroom space for program • Finalize staffing and plans September 2005 Begin program October 2005 Conduct pre-tests • Continue work with partners to identify potential program participants • Complete monthly report • Adjust program based upon report and feedback December 2005 Conduct post-tests to achieve quarterly benchmarks March 2006 Continue work with partners to identify potential program June 2006 participants • Complete monthly report • Adjust program based upon report and feedback 14 The Gifford Youth Activity Center, Inc. — Frontline-GYAC Indian River County Children ' s Services Advisory Committee II . PROJECTIONS FOR UNDUPLICATED CLIENTS Number of Unduplicated Clients by Location Last Tfi sca1F ear Current Fiscal Year Next' FYsca1 dear ' N v . qty ` tt Location Actua12003/2004 Budget 2004/OS Projections 2005/0`6 Unduplicated Clients Unduplicated Clients Unduplicated Clients N. Indian River County 50 S . Indian River County 50 Indian River Co. Total - - 100 Greater Stuart Hobe Sound _ Indiantown _ Jensen Beach _ Palm City Martin County Total Fort Pierce _ Port Saint Lucie St. Lucie Co. Total Other Locations _ TOTAL SERVED - - 100 Number of Unduplicated Clients by Age n Ud ` rst ..�ss`.t� ' '� 4Wq y . k p�j ����' '�'s� , r Lastsca year ° Current Fiscal Year leg icaea .� tk �' iy2ty r ti 2ai ,>< � �s v t Y a�a,i ✓F F # � w, Location zr , z > Actt�a1 �2003/204 ` : Budget 2004/05 w ...... .k �� ..R, .� � � �, � Pro�ecti'ons2 �05/OG� s }r sF C sy s } r`*gyr3 kr '. w ir ; _*,jq , T �didiialsNro p� Individual t+ Group IndYu�,cl �a.1` , Gr06"` I' nl { ket�..'�v: Rx. y�aeF✓�� y , wiyi �[ ! ^s_ .;"' ' .` ' ':Y.'Ci> nt A.i�{y=1 ` n w.� L h Gn . . 0 to 4 - (Pre-school) 5 to 10 - (Elementary) 11 to 14 - (Middle) - - - 55 15 to 18 - (High School) - - - 45 Total Children - - - - - 100 19 to 59 - (Adults) 60 + ( Seniors) Total Adults TOTAL SERVED - - - - - 100 15 Gifford Youth Activity Center Frontline-GYAC UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET WPORTANT: 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 : 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 Abe used for calculations and to write information only. GRAY FOR AGENCY USE ONLY Proposed Total Program Funder Specific Total Agency REVENUES (SHOW DETAIL & Budget Budget Budget CALCULATIONS) 1 Children 's Services Council-St. Lucie 2 Children 's Services Council -Martin 3 Advisory Committee-Indian River 357 ,405 . 00 103 ,299 . 83 676 ,602 . 83 4 United Way-St. Lucie County 5 United Way-Martin County 6 United Way-Indian River County 7 Department of Children & Families 8 County Funds 9 Contributions-Cash 10 Program Fees 11 Fund Raising Events-Net 2 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) $357,405. 00 $ 103, 299 . 83 $676 , 602 . 83 A B C D EXPENDITURES GRAY AREAS FOR Proposed Total Program Funder Specific Total Agency AGENCY USE ONLY (SHOW CALCULATIONS) Budget Budget Budget 21 Salaries - ( must complete chart on next page) 285 ,200 . 00 90 ,450. 00 285 , 200 . 00 0 Salary 22 FICA - Total salaries x 0 . 0765 7 . 65% 5 ,205. 83 Retirement - Annual pension tor qualified 23 staff 0 . 00 Life/Health - Medical/Dental/Short-term 24 Disab . 0. 00 Workers Compensation - # emp oyees x 25 rate 3, 744. 00 loncla unemployment - # projected 26 employees x $7 , 000 x UCT-6 rate 0. 00 SALARIES A B POSITION LISTING Gross Annual Program C % of Gross Annual Salary Portion of Salary m Proposed Funder Specific Budget Salary Position Title / Total HrsAvk (Agency) Requested(CIA) Example: Executive Director / 40hirs 70, 000. 00 10, 000. 00 51000.00 7. 14% 5/1912005 a-1 Gifford Youth Activity Center Frontline-GYAC Teachers ( 3) 34 , 200 . 00 34 , 200 . 00 8 , 550 . 00 25 . 00% Social Wroker ( 1 ) 17 , 100 . 00 17 , 100 . 00 8 , 550 . 00 50 . 00% Activities Director (3) 171100 . 00 17 , 100 . 00 8 , 550 . 00 50 .00% Food Service Manager ( 1 ) 111400 . 00 11 , 400 . 00 5 , 700 . 00 50 . 00% Administrative Assistant ( 1 ) 16 , 300 . 00 16 , 300 . 00 81150 . 00 50 . 00 % Custodial Maintenenace ( 1 ) 10 , 700 . 00 10 , 700 . 00 51350 . 00 50 . 00 % Fine Arts Instructor ( 1 ) 13, 700 . 00 13 ,700 . 00 0 . 00 0 . 00% Music Instructor ( 1 ) 131700 . 00 13 , 700 . 00 0. 00 0 . 00% Drama Instructor ( 1 ) 13, 700 . 00 13 , 700 . 00 0 . 00 0 . 00% Swim Instructor ( 1 ) 13, 700. 00 13 , 700 . 00 0 . 00 0 . 00% Dance Instructor ( 1 ) 131700 . 00 13 ,700 . 00 0 . 00 0 . 00% Radio/TV Instructor ( 1 ) 18, 700 . 00 18 , 700 . 00 0 . 00 0 . 00% Program Director 91 ) 459600 . 00 45 , 600 . 00 22 , 800 . 00 50 . 00% Counselor (2) 45, 600 . 00 45 , 600 . 00 22 , 800 . 00 50 . 00% #DIV/0 ! #DIV/0 ! #DIV/0 ! #DIV/0 ! #DIV/0 ! #DIV/0 ! Remaining positions throughout the agency Total Salaries $285 ,200 .00 $2853200. 00 $90,450 . 00 31 . 71 % FRINGE BENEFITS DETAIL A (Funder Specific Budget Funder B c o E F c Specific FICA 7. 65% Pension Worker's Unemployme Total Fringes Funder Column C only, from line 22 to 27 Health Ins. y ) Budget (A x /) Compens, nt Compens. Specific Position Title / Total Hrs/wk Example: Case Manager / 40 hrs 51000.00 382. 50 200. 00 500. 00 414.00 200. 00 11696. 50 Teachers ( 3) 8 ,550 .00 654 .08 354. 00 13008 . 08 Social Wroker ( 1 ) 81550.00 654 .08 354. 00 11008 . 08 Activities Director (3) 81550. 00 0. 00 354 .00 354 . 00 Food Service Manager ( 1 ) 51700. 00 0. 00 236 . 00 236 . 00 Administrative Assistant ( 1 ) 81150.00 0 .00 337 . 00 337 . 00 Custodial Maintenenace ( 1 ) 5 , 350 .00 409 .28 221 . 00 630 . 28 Fine Arts Instructor ( 1 ) 0 . 00 0 . 00 1 0 . 00 Music Instructor ( 1 ) 0. 00 0. 00 0 . 00 Drama Instructor ( 1 ) 0 .00 0 .00 0 .00 Swim Instructor ( 1 ) 0 . 00 0 .00 0.00 Dance Instructor ( 1 ) 0 . 00 0 .00 0. 00 Radio/TV Instructor ( 1 ) 0. 00 0 . 00 0 .00 Program Director 91 ) 22 , 800. 00 11744 . 20 944 . 00 21688 . 20 Counselor (2) 22 , 800.00 1 ,744 . 20 1 944 .00 21688 . 20 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 1 0 . 00 0 .001 0. 00 0 0 .00 0.001 1 0.00 Total Funder Request Fringe Benefits $900450.00 $5,205. 831 $ 0. 001 $0 .00 $3 ,744. 00 $0. 00 $83949 . 83 A B C D EXPENDITURES GRAY AREAS FOR Proposed Total Program Funder Specific Total Agency AGEETO SHOW DETAILTAIL Budget Budget Budget SHOW 27 Travel -Daily - Bus Transportation 4 , 500 . 00 0 . 00 4 , 500 .00 # of Staff x average # of miles/wk x 50 wks x $ = Estimated Daily Travel/Mileage Reimb . 28 Travel/Conferences/Training 1 11 ,655 . 001 11500 .00 11 , 650 . 00'. 5/19/2005 B•1 Gifford Youth Activity Center Frontline-GYAC • National Conference (cost per staff) • Training/Seminar (cost per staff) • Other Trainings (cost of travel , lodging , registration , food ) 29 Office Supplies - Art Supplies 1 , 200 . 00 0 . 00 1 , 200 . 00 • Office supplies (monthly average x 12 months = estimated cost of office supplies based on present history. 30 Telephone 750. 00 0 . 00 750 . 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 150 . 00 0 . 00 150 . 00 • Quarterly Mailing of Newsletter • Special events , etc. • Bulk mailings - appeals 32 Utilities 3 , 000 . 00 0 . 00 3 , 000 . 00 • Electricity ( $ x 12 months) • Water/Sewer ( $ x 12 months) • Garbage ( $ x 12 months) 33 Occupancy ( Building & Grounds) 51000. 00 0 . 00 59000 . 00 • Mortgage/Rent ($ x 12 months) • Janitorial ($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes 34 Printing & Publications 1 , 700 .00 500 . 00 1 , 700 . 00 • Quarterly Newsletter ($ x 4) • Letterheads , Envelopes , etc. • Fundraising materials • Other 15 Subscription/Dues/Memberships 450.00 0. 00 450. 00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, etc. 36 Insurance 4 , 000. 00 0.00 4 , 000 . 00 • Directors/Officers Liab . • Commercial/General Insurance • Bond Ins . • Auto Insurance 37 Eq u ipment: 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 38 Advertising 11000 . 00 0 . 00 13000 . 00 • Newspaper ads • Fundraising ads/promotions • Other (vacancies) 39 Equipment Purchases : Capital Expense 2 ,400 . 00 0. 00 2 ,400 . 00 • Computer/monitor (# x $) • Laser Printer 40 Professional Fees ( Legal , Consulting ) 2 , 500. 00 0 . 00 2 , 500. 00 • Legal advice ( estimated #hrs x $) • Consultant fees • Other 41 Books/Educational Materials 21900. 00 400 . 00 21900 . 00 • Books/videos • Materials ($ x staff) 5119/2005 e-i Gifford Youth Activity Center Frontline-GYAC 42 Food & Nutrition 5 , 300 . 00 500 . 00 5 , 300 . 00 • Meals ( # meals x clients x 5days x 50 Wks) • Snacks 13 Administrative Costs 0 . 00 0 . 00 0 . 00 • Admin . Cost ( % of total budget) 44 Audit Expense 4200 . 00 0 . 00 4 , 200 . 00 Independent Audit Review 45 Specific Assistance to Individuals 27000 . 00 11000. 00 2 , 000 . 00 • Medical assistance • Meals/Food • Rent Assistance • Other 46 Other/Miscellaneous 11000 . 00 0 . 00 11000 . 00 • Background check/drug test • Other 47 Other/Contract 18 ,500 . 00 0 . 00 18 , 500. 00 Sub-contract for program services 481 TOTAL EXPENSES $357 ,405 . 00 $ 1031299 .83 $ 357 ,400 . 00 5/19/2005 B-1 omora roum n sway �enmr PronOine-GYAC UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME : Gifford Youth Activity Center/Frontline 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. Gcol. B)/col. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 0.00 #DIV/Ol 2 Children's Services Council-Martin 0.00 #DIV/01 3 Advisory Committee-Indian River 70 000.00 3000000 103 299 .83 244. 33% 4 United Way-St. Lucie County0.00 #DIV/01 5 United Way-Martin County 0.00 #DIV/01 6 United Way-Indian River County 0.00 #DIV/01 7 Department of Children & Families 0.00 #DIV/01 8 County Funds 120 513 . 00 122A43 . 00 1262000.00 2.91 % 9 Contributions-Cash 45 000.00 136 750. 00 165, 000 .00 20.66% 10 Program Fees 0.00 #DIV/O ! 11 Fund Raising Events-Net 57500.00 7000 .00 61000. 00 -14. 29% 12 Sales to Public-Net 0. 00 #DIV/01 13 Membership Dues 21000.00 71500.00 600000 20.00% 14 Investment Income 100 000. 00 3 000.00 -97.00% 15 Miscellaneous 0.00 #DIV/01 16 Legacies & Bequests 0. 00 #DIV/01 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/01 19 In-Kind Donations (Not Included In total( 0.00 #DIV/01 20 TOTAL 517 558.00 603 193. 00 676 602.83 12. 17% EXPENDITURES 21 Salaries 242;058.00 294, 226 . 00 374,098.00 27. 15% 22 FICA 22 508.00 22, 919. 00 28,205.83 23.07% 23 Retirement 81827.00 81983.00 99000.00 0. 13% 24 Life/Health 27 363 .00 28 184.00 30, 000.00 6.44% 25 Workers Compensation 12 626.00 12 853.00 169744.00 30.27% 26 Florida Unemployment 11182.00 12194. 00 1150 .00 -3.69% 27 Travel-Daily 5p738.00 11 , 358. 00 6P500. 00 -42.770/6 28 Travel/Conferences/Training 14,655.00 #DIV/01 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/Shipping 3 300. 00 3 501 .00 31700.00 5.68% 32 Utilities 36 000.00 37 900. 00 35 000.00 -7. 650 33 Occupancy (Building & Grounds 25 800.00 27; 900. 00 6; 500.00 -76.70% 34 Printing & Publications 0.00 #DIV/01 35 Subscription/Dues/Memberships 21 404.00 3565400 37 500. 00 5. 18% 36 Insurance 0. 00 #DIV/0! 37 E ui ment: Rental & Maintenance 0.00 #DIV/O! 38 Advertising0.00 #DIV/01 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/Ol 42 Food & Nutrition #DIV/Ol 43 Administrative Costs 61 087. 00 811000. 00 32.60% 44 Audit Expense 41650. 00 6; 500. 00 5,000.00 -23.08% 45 Specific Assistance to Individuals 9 086. 00 0.00 #DIV/01 46 Other/Miscellaneous 81815 .00 881500 0. 00 -100.00% 47 Other/Contract 0.00 #DIV/01 48 TOTAL 460 917.00 597 083.00 676,602.83 13.32% 49 REVENUES OVER/ UNDER EXPENDITURES 56p641 .00 61110 .00 0.00 -100.00% - s-z Type the Organaaltm ar Program Name UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME : Gifford Youth Activity Center-Frontline-GYAC 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. C-col. B)ycal. 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 Advisory Committee-Indian River 103P299.83 #DIV/01 4 United Way-St. Lucie County #DIV/01 5 United Way-Martin County 0.00 #DIV/01 6 United Way-Indian River County 0. 00 #DIV/01 7 Department of Children & Families 0.00 #DIV/01 8 County Funds 0 .00 #DIV/01 9 Contributions-Cash 0.00 #DIV/01 to Program Fees 0.00 #DIV/01 11 Fund Raising Events-Net 0.00 #DIV/01 12 Sales to Public-Net 0 . 00 #DIV/01 13 Membership Dues 0.00 #DIV/01 14 Investment Income 0.00 #DIV/01 15 Miscellaneous 0. 00 #DIV/01 16 Legacies & Bequests 0. 00 #DIV/01 17 Funds from Other Sources 254 105. 17 #DIV/01 18 Reserve Funds Used for Operating 0.00 #DIV/01 19 In-Kind Donations (root Included In total) 0.00 #DIV/01 20 TOTAL 3579405. 00 #DIV/01 EXPENDITURES 21 Salaries 375. 00 375. 00 285 200.00 75953.33% 22 FICA 28.69 28.69 0.00 -100.00% 23 Retirement 0.00 #DIV/01 24 Life/Health 0.00 #DIV/01 25 Workers Compensation 0.00 #DIV/01 26 Florida Unemployment 0.00 #DIV/01 27 Travel-Daily 41000. 00 49000. 00 41500.00 12. 50% 28 Travel/Conferences/Training 11 655.00 #DIV/01 29 Office Supplies 100.00 80.00 1t200. 00 1400.00% 30 Telephone 11140 .00 11140.00 750.00 -34.21 % 31 Postage/Shipping 148 . 00 148. 00 150.00 1 .35% 32 Utilities 3 000.00 #DIV/01 33 Occupancy (Building & Grounds 117111 .00 11111 .00 51000.00 350.05% 34 Printing & Publications 90 .00 90. 00 17700. 00 1788.89% 35 Subscription/Dues/Memberships 70.00 450.00 #DIV/01 36 Insurance 91000.00 51000.00 49000.00 -20.00% 37 E ui ment: Rental & Maintenance 0.00 #DIV/01 38 Advertising 11000.00 #DIV/01 39 Equipment Purchases : Ca ital Expense 21400.001 #DIV/01 40 Professional Fees (Legal , Consulting) 22 537.00 22 537.00 27500.00 -88.91 % 41 Books/Educational Materials 4p750 . 00 21286.31 21900.00 26.84% 42 Food & Nutrition 5, 300.00 #DIV/01 43 Administrative Costs 67528.00 0.00 0.00 #DIV/01 44 Audit Expense 11250 .00 1 250.00 42200.00 236. 00% 45 Specific Assistance to Individuals 29000.00 #DIV/01 46 Other/Miscellaneous 11000.00 #DIV/01 47 Other/Contract 14 425.00 14P425.00 18 500.00 28.25% 48 TOTAL 652552 . 691 52 471 .00 3571405. 001 581 . 15% 49 REVENUES OVER/ UNDER EXPENDITURES -65 , 552 . 69 -520471 .00 0.00 -100. 00% 5/192005 BJ Type the Organization and Program Name UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : Gifford Youth Activity Center- Frontline/GYAC FUNDER : Indian River County Children 's St A B c FY 04/05 FY 04/05 % OF TOTAL FUNDER TOTAL VS . PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col . B/col . A) EXPENDITURES 21 Salaries 285 , 200 . 00 909450 . 00 31 .71 % 22 FICA 0 .00 51205 . 83 #DIV/0 ! 23 Retirement 0 .00 0 . 00 #DIV/0 ! 24 Life/Health 0 . 00 0 . 00 #DIV/0 ! 25 Workers Compensation 0 . 00 39744 . 00 #DIV/01 26 Florida Unemployment 0 . 00 0 . 00 #DIV/0 ! 27 Travel -Daily 4, 500 .00 0 . 00 0 .00 % 28 Travel/Conferences/Trainin 11 , 655 . 00 11500 . 00 12.87% 29 Office Supplies 1 , 200 .00 0 . 00 0 .00% 30 Telephone 750 . 00 0 .00 0 .00% 31 Postage/Shipping 150 . 00 0 . 00 0 .00% 32 Utilities 31000 . 00 0 . 00 0 .00% 33 Occupancy ( Building & Grounds 5 ,000 . 00 0 . 00 0 .00% 34 Printing & Publications 11700 . 00 500 . 00 29 .41 % 35 Subscription/Dues/Memberships 450 . 00 0 . 00 0 .00% 36 Insurance 49000 . 00 0 . 00 0 .00% 37 Eq ui ment : Rental & Maintenance 0 . 00 0 . 00 #DIV/0 ! 38 Advertising 11000 . 00 0 . 00 0 .00% 39 Equipment Purchases : Capital Expense 2 ,400 . 00 0 . 00 0 .00% 40 Professional Fees ( Legal , Consulting ) 29500 . 00 0 . 00 0 .00% 41 Books/Educational Materials 21900 . 00 400 . 00 13 .79 % 42 Food & Nutrition 51300 . 00 500 . 00 9 .43% 43 Administrative Costs 0 . 00 0 . 00 #DIV/01 44 Audit Expense 41200 . 00 0 . 00 0.00% 45 Specific Assistance to Individuals 2 , 000 . 00 1 , 000 . 00 50 .00% 46 Other/Miscellaneous 11000 . 00 0 . 00 0.00% 47 Other/Contract 18 ,500 . 00 0 . 00 0.00% 48 TOTAL $ 357 ,405 . 00 $ 103 , 299 . 83 28.90 % 5/19/2006 e-a Type the Organ¢abon and Program Name UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME : FUNDER : s 213 s. LINE ITEM EXPLANATION FOR VARIANCE #DIV/0 ! #DIV/01 #DIV/0! #DIV/O! #DIV/O! #DIV/0 ! #DIV/0 ! #DIV/0 ! #DIV/0 ! #DIV/0 ! #DIV/O ! #DIV/01 #DIV/0 ! #DIV/0 ! #DIV/0 ! #DIV/01 #DIV/01 #DIV/01 #DIV/0 ! Salaries New program expenses. #DIV/O ! #DIV/O! #DIV/0 ! #DIV/0 ! #DIV/01 Office Su lies New program , all paid by GYAC #DIV/O! Occu anc (Building & Grounds All paid by GYAC Printing & Publications Most paid by GYAC #DIV/0! #DIVI01 #DIVIO! #DIV/01 Books/Educational Materials New program . #DIVI01 #DIVI01 Audit Expense #DIV/01 #DIV101 Other/Contract 5/1912005 s-s Type the Organeabon and Program Name UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCY/PROGRAM NAME : FUNDER : LINE.. TEM `EXP.LANATIQN FOR VARIANCE- Previously paid staff all as contractual, will begin paying partial staff as hired staff, contractual instructors are also incorporated in this Salaries total. #DIV/01 #DIV/0! #DIV/0! #DIV/0! #DIV/0! Printing & Publications GYAC paying for most of this. #DIVIO ! #DIVIO ! Specific Assistance to Individuals 5/19/1005 8-5 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 - 11 / 04 ' 2005 09 : 24 FAX 772 562 3466 SID BANACK INS . 0001 5m N ACDRD CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDNYYY} TM. PRODUCER NOV 4 05 THIS CERTIFICATE Is ISSUED A$ A MATTER OF INFORMATION 2045 4TH AVE,S HOBBS OF FLA INC lSID BANACK INS. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2043 14TH AHOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE E AFFORDED BY THE POLICIES BELp, VERO BEACH FL 32061 INSURERS AFFORDING COVERAGE MAIC N INSURED INSURER A. GRANITE STATE INS — - GIFFORD YOUTH ACTIVITY CENTER INSURER B: Progressive AmBrlcan Insurance Co. 24252 487S 43RD AVE VERO BEACH FL 329ST INSURER C: INSURER D: I INSURER E: COVERAGES TFC POUC198 Of INSURANCE LISYEO BELOW HAVE BEEN RISUED TO THE INSURED NAMED ABOVE FOR THE POLICY PQRgD INDICATED. NOTIMTHSTANDING ANY REGUIRaWNT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCLWENIT WITH RESPECT TO WHICH TMS CERTIFICATE MAY Be ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLK;WS DESCRIBED HURON IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CCNDITIQNS OF SUCH POLCIES. AGGREGATE LIMITS SHOWN MAY HAVE BFgN REDUCED BY PAID 0 AWN, InSRA TYPE OfNSURANCE POLICYNUYBER POUQYEFFWCTNE FOUCYNKINVATION I1 . LIMITS LTR INCR GATE FIIO OATS GBNeaAL UA.OITY 024mXw 489J30.0l000 MAY 15 05 MAY 93 06 EACH OCCURRENCE s 1 , 0 , 000 X 4 COMMERCIAL GENERAL LIABILITI; OAwAo[ T� � S 100, 000 CLAMS MADE X I occuR MED. Ev (Ary Ona WrscN _ s 5,000 PERSONAL S ADV INJURY 3 10000,000 A _ I GENERALAGGReQAnz s 3,000 000 GEMLAGGREGATELIMITAPPLIESPERI PRODUCTSC01wlOPAGG s 10000.000 POLICY F7 PROJECT LOC . .. _..-' - --- - I AUTOMOBILE LIABILITY 026283054 APR 23 OS APR 23 06 COMBINED SINGLE LIMIT ANY AUTO (Eaawklmw} s 1 , b00,Ob0 ALL OWNED ALTO$ BOOILr INJURY B I_� SCHEDULED AUTOS I I (Pa Parem) I S X MR6DAVTOS I i BODILY INJURY NON-"EDAUTOS J ������ /Par 4049 n) I -- PROPERTY DAMAGE S Pr wzidorx) eARAGE UA UIV i ANY AUTO I AUTO ONLY - EA ACCIDENT I i OTHER THAN EA ACC ' f AVTG ONLY; Is EXI ESS r pMeREL LUIt1UTY EACH OCCURRENCE S I� OCCUR CLAIMS MADE AGGREGATE _ OfDUCYIELE - -- s - RETENTICN S I - is WORKERS COMPENSATION AND VVOaTATII- EMPLOYERi LAY,LITY a_ AV FROFMETOMPARTN9140MCUTNE 6,L, BACH ACCIDENT OFnCERA*Nm ENC,.umgm I •yea dm aeunow E.L. DLSFASEFA EMPLOYEE I S &PIMALFROW10NaOeNw E.L. DISEASE-POLICY LIMIT 13 OTHER: DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS S1 ,000 DEDUCTISLI! BODILY INJURY AND PROPERTY DAMAGE COMBINED PER OCCURRENCE INDIAN RIVER COUNTY 15 NAMED AS AN ADDITIONAL INSURED WITH REGARDS TO THE GENERAL LIABILITY ANO AUTO POLICIES WITH RESPECTS TO THE OPERATIONS OF THE NAMED INSURED, CERTIFICATE HO DERCANCELLATION SHOULD ANY OF TH6 ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EIIFIRATK)N DATE THEREOF, TMH INUING COMPANY WILL ENDEAVOR TO MP.IL 10 DAYS ARITTEN NOTICE TO THE CERTIFICATE MOLDER NAVEO TO THE LEFT, BUT FAILURE TO 00 SO SHALL IIPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INDIAN RIVER COUNTY INsuRER, Irs AGENTS OR REPRESENTATIVES. 1 "0 25TH STREET AUTHORIZED REPRESENTAT;VE VERO BEACH, FL. 32960 Attention: Idney V aa 0/7 ACDRD 25 (2001108) Certificate # 90774 M ACORD CORPORATION 1988 Pi C®RD DATE (MM/DDtYY) ACORDTM. CERTIFICATE OF LIABILITY INSURANCE OCT 170S PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 4PAT O'CONNELL IN URANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ` 148 VISTA ROYALE :,QUARE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR VERO BEACH FL 329.,2 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE : 772567-7774 FAX: 7724674166 Agency Lic#: A194679 INSURERS AFFORDING COVERAGE MAIC # _ 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 OF INSURANCE LISTED SCOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOb'E FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITI01. OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE A.FFORDEL BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY 1AVE BEEN REDUCED BY PAID CLAIMS. --� W • TYPE OF INSURANCE i POLICY NUMBER POLICY SFFECTWE I POLICY EXPIRAnoN LIMITS LT DATE NM/DD1YY I DATE EMID= GENERAL LIABILITY I '{—EACH OCCURRENCE - r� COMMERCIAL GENERAL LIABILITY i DAM4GETORENTED — i �ISFS (ia rxulrznoel $ �7 - j CLAIMS MADE I� OCCUR I ( LSEO. EXP (Any One Peraec ) $ I i- - -- —+--- --- - . _ . ' PERSONAL & ADV INJURY $ -- 1 GENERAL AGGREGATE $ GENTAGGREGATE LIMIT APPLIES PER i PRODUCTS-COMP/OP AGG . S l POLICY ` PROAFCT I nc iI ---- -- ' ----- AUTOMOBILE LIABILITY _ COMBINED SING( E LIMIT I ilia ecc:dent) $ ANY AUTO — F ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person ) -- i I HIRED AUTOS BODILY NJUP,Y $ i NON-OWNEDAUTOS i (Perocudetl) 1 -- ---- i iPROPERn DAMAGE iS GARAGE LIABILITY ! ! AUTO ONLY - EA ACCIDENT 5 - --- - -- - - - ANY I I OTHER THAN EA ACC S AUTO ONLY: AGG S � EXCESS / UMBERELLALIABILITY I - EACH OCCURRENCE Is — I—� I � OCCUR CLAIMS MADE i AGGREGATE ! $ _— _- S f� DEDUCTIBLE i RETENTION $ ( S I WORKERS COMPENSATION AND —Y WLX297281 JAN 4 05 wC STAr1 OTME� ' ! JAN 4 06 X i EMPLOYERS LIABILITY I JMITS t A � ANYPROPPJETOR+PARTNER=ECUTIVE I { ELL, EACH ACCIDENT ; S 1OO,QOU OFFICERN91AIER EXCLUDED? III E.L DISEASE,EA EMPLOYEE S __ SOU ,000 It ym desefte Under —�--- SPECIAL PROVISIONS Cebu E.L. DISEASE-POLICY LIMIT "a 500 ,000 ( OTHER: DESCRIPTION OF OPERATIONSILOC rIONIVEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITION LINSURED; INSURERLETTER: _ CANCELLATION INDIAN RIVER COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE BOARD OF COUNTY COMiNiSS ) OU FXPiRATIOPI DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO NAIL ID DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 1840 25TH STREET FAILURE T 0 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE VERO BEACH, FL 32964 INSURER, IIS AGENTS OR REPRESENTATIVES. AU"fHORIZEO REPRESENTATIVE Attention : ACORD 25 (2001108) Cerdflcats # 1144 David O' Connell