HomeMy WebLinkAboutC2006-110 - 3/21/2006 - Approved
CONTRACT
(Cover Sheet)
TITLE OF CONTRACT:
CONTRACT NO :
Community Youth Development
CYD 2006-5b
This contract ("Contract") is entered into by the City of Corpus Christi ("City" or "Fiscal Agent") and
the following named Subcontractor:
CITY:
City of Corpus Christl
P,O Box 9277
Corpus Christi, TX 78469-9277
Telephone: (361) 826-3466
FAX: (361) 826-3864
Contact Person: Reba George
SUBCONTRACTOR:
YMCA of Corpus Christi
417 S. Upper Broadway
Corpus Christi, TX 78401
Telephone: (361) 882-1741
FAX: (361) 882-1427
Contact Person: Guy Nickleson
Subcontractor agrees to provide servIces in accordance with the provisions of this Contract and under
the Community Youth Development Program ("CYD") funded by the Texas Department of Family and
Protective Services ("DFPS") This Contract consists of the following attached documents Vvtlich are
Incorporated herein by reference:
Contract (Cover Sheet)
Performance Measures (Attachment A-1)
Statement of Work (Attachment A-2)
Budget, Reimbursement Request Form & Budget Narrative (Attachments B-1, B-2, and B-3)
Standard Terms and Conditions (Attachment C)
Subcontractor Assurances with Certification (Attachment D)
Certification Regarding Debarment (Attachment E)
Certification Regarding Federal Lobbying (Attachment F)
Subcontractor agrees to abide by all terms and conditions specified herein, and it certifies that the
information provided to the City is true and correct in all respects to the best of its knowledge,
information, and belief
The obligations of the City of Corpus Christi under this Contract are expressly contingent upon the
availability offunds for such purpose under the funding sources:
CONTRACT PERIOD: From: March 1, 2006
Through: August 31,2006
FUNDING OBLIGATION:
Not to exceed $27,567.00 for FY 2006 for Contract Period stated
above.
Executed in triplicate, each of which recognized as an original.
IL L 2a:i~~ J.:L. '. ;~,' l'I(~~fl,l,' City of ~orpus Christi
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_,"'_ .__. ............/2 -€reor K. Noe
City Secretary r .,~~'1 ~ ,,-n.t...City Manager
- --', I
Legal form approved _._~ ..~ ! -7 , 2006;
ATTEST:
fo~~
Armando Chapa 'j
2006-110 irrn
03/21106 to.
'\12006-0S3
Subcontractor:
YMCA ~'Forpus Clristi1 / i
By: ,~:~ ~ :.{-1/(A.. /~~
Name. c. '. _I L-, !. j / ,'" '\
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Attachment A-1
CONTRACTED PERFORMANCE MEASURES
(Community Youth Development Program Contracts)
Performance measures typically include outputs and outcomes. Output measures
demonstrate performance in temlS of the quantity or volume of services provided, for
c'xample, the number of clients served, number and types of services, etc. Outcome
measures demonstrate perfomlance in temlS of the quality and impact of services and
whether or not the: have met intended goals/objectives. Outcomes relate to behavior,
Skll1s, knowledge, attitudes. values, etc.
The City of Corpus Christi wi II contract with Service Provlders to meet the following
perfonnance measures begll1ning March 1. 2006:
Output #1: Number of youth served
Indicator: N umber of unduplicated registered youth served during the contract
period as reponed through participation data entered into the Prevention and Early
Intervention Services database, which will be March I, 2006 through August 31,
2006 for the mitial contract period as established through this RFP. Undup1icated
means participants will be counted once only during the contract period to determine
this output, regardless of the number of programs in which they participate or the
number of times they attend each program. A youth is counted the first time s/he
receives a service during the contract period. Any participant who was registered and
counted 10 prevIous years must be counted again when s/he receives her/his first
service during the new contract period.
Target: 25
Note: If adults wil be served, a separate output measure will be included in the
contract for those participants.
Output #2: Timelv submission of Billings and Monthly Reports
Indicator: PercenT of monthly billings and reports submitted within 7 days after the
close of a month or service
Target: 900'0
Output #3: Youth served under the age of 10 years.
Indicator: Percent of youth under the age of 10 years served does not exceed the
contracted percentage cap This cap must be met each month by each individual
service. If the cap is exceeded. those youth may be considered ineligible and costs
may be dlsallO\ved
Target: 300,()
Output #4: Participants involved in mentoring services
Indicator: Percent of youth involved in mentoring services are within the targeted
d "4'h 811
~ra es (' "" L
Target: 900,,)
Output #5: Completed Asset Survey
Indicator: Percent of youth registered by a service provider that complete an initial
I pre) asset survey and a follow-up (post) asset survey. Only those youth who are
mitially regIstered by a provider will be included in the calculation for this output.
Youth served by a provider, but whom another provider initially registered for the
CYD program. wi)) not be included in the calculation for this output.
rarget: 5000
Output #6: Completed SatIsfaction Questions
Indicator: Percell1 of CYD youth that complete the five satisfaction questions at the
end of the follow-up (post) asset survey. Note that the follow-up survey, and not the
milial asset suney. contains the satisfaction questions.
Target: 5000
Outcome #1: CYD youth have increased assets
Indicator: Average increase in the absolute number of assets for youth receiving
(,YO services. Data collected from completed Asset Surveys (see Output #4) will be
Llsed to calculate thiS outcome. The initial (pre) asset survey, to be completed by
v'outh at the beginnmg of the contract period or when services are initiated, will be
compared to the follow-up (post) asset survey Follow-up (post) asset surveys will be
completed at a time based on average length of service (to be determined by DFPS)
or when the youth leaves the program.
Target: Negotiated. During the contract period, collecting and reporting the data for
thIS outcome wdl be a reporting requirement. The data will be used to determine a
henchmark f(Jr the outcome.
Outcome #2: CYD Participants Perceive Services as Effective
Indicator: Percent of youth that report CYD services had a positive impact. For
youth that participate in multiple services, one survey should be completed
corresponding to the first program service in which they participated.
Target: Negotiated. During the contract period, collecting and reporting the data for
this outcome wIll be a reporting requirement. The data will be used to determine a
benchmark for the Dutcome.
Outcome #3: Non-referred CYD youth
I ndicator: Percent of CYD youth report not referred to juvenile probation.
farget: 95%
Vote: Per{onnance measures, ltldicators and targets are set at the discretion of
DFPS and may he changed at am' time, hut lvill not he changed without due notice to
Fiscal Agent.s
Attachment A-2
STATEMENT OF WORK
Subcontractor:
YM CA of Corpus Christi
Program Name
Youth Leadership
l. SERVICES TO BE PROVIDED
al Program Description: The YMCA's Youth Leadership Program's purpose is to help
teenagers become responsible citizens and future leaders. Youth Leadership is a training
program developed to teach high school students life skills and build their self-confidence
through mentoring, education and pre-employment training. Social skills are also developed
through recreational activities and community service projects. The program will focus on
teens 14-17 years 0 rage.
Students from feeder schools (Middle and Elementary) to Carroll High School will be part of
the YM CA Youth Leadership Program in that Carroll High School students will become
mentors to younger students. Mentoring, activity planning/implementation and leadership
skills will be developed while working with younger students. Each Carroll High School
student will be paired with a caring adult Mentor as well. Recreational activities will be
planned by the Y oUlh Advisory Committee (Y AC) assuring that students have fun, socialize
in a wholesome environment and experience situations/activities that help broaden their
vision for their future.
The activities component focuses on social activities, field trips, special events and service
leaming projects which will give each student the opportunity to put into practice the YMCA
values of caring, honesty, respect and responsibility. Activities will be planned and conducted
by students Each activ ty will be evaluated for projected outcomes and student learning.
Educational components include: conflict management; leadership training; the importance
physIcal well being: teen pregnancy.: drug, alcohol. tobacco abuse prevention; and how our
govemment works.
Students wi II also recei ve training in work ethics; preparing for job interviews,
responsibilities to the employer and co-workers; proper work attire; writing resumes; and
career OpportUllltl es
Students wlll also participate in State and District competitions. This is a seven month
process where students prepare to compete in a statewide UIL competition in the areas of
print media; judicial: and legislative. Each student is required to have three hours per week
oftrainmg for competition including the use of materials and visual aids. Each student must
qualify at the district levelm order to compete at the State competition. The State
competItion is a three day event where students receive "hands on" experience in the
governmental process at the State Capital in Austin, Texas.
Additionally, the YAC will delegate two youth to serve on the Community Youth
De' elopment Steering Committee. Youth will attend and participate in annual workshops
and trainings to obtain leadership skills.
The YAC will also be ,.1ctive in planning and participating in community service activities to
benefit the 78415 community. They will provide workshops for 78415 youth at a Youth
SummIt which would bring in interested youth outside of the YAC. The Y AC will provide
leadership and guidance in the areas of job awareness, education, mentoring, and meeting the
expectations of the prof:?;ram. They will address the issues of juvenile crime and
unemp loyment.
Lastly the Y AC will provide a new program this summer focusing on the expanding of self
awareness among the CYD students in which each student will be challenge to chooses and
develop projects and ideas that will bring a sense of artistic accomplishment. Each student
will participate In photo taking and wnting.
b) Inclusive Dates for Service Provision: March I, 2006 August 31,2006
c) Goals of the Program/Service (to include the impact on iuvenile crime): 60% of students will
demonstrate improved leadership skills through their participation in Youth and Government
District and State competitions. Assessment tool: staff, school counselor and self written
evaluation. 50% of students will complete two job interviews. Assessment tool: Job
interview check list will be requested from company conducting interviews.
In order to reduce Juvenile crime, each high school student will be paired with an adult
mentor who wil] be a positive role model and a friend to listen and advise. They will
demonstrate leadership skills by the end of the school year. Service Learning Projects will
teach students the importance of being a part of making their community a better place.
d) Days and Hours of provided services: Students in the YMCA Youth Leadership Program
will meet every day at Carroll High School from 11:45 AM - 130 PM (program orientation;
program and service project planning; business professional to speak to students during this
time; conflict management training, time management, mentors' visits, etc.). Students will
also meet once or twice per week after school for YMCA Youth and Government training.
Community projects, socials and speCial events to take place on weekends. Summer program
will take place at Carroll High School If approved by the Principal. If Carroll High School is
not avaIlable, students will meet at the YMC A
e) Program location where the services will be provided:
. Carroll High School
.\ddress: 5301 Weber Corpus Christi, TX 78411 Phone: (361) 853-0151
Carroll High School will be the main location for the safety and convenience of student
participation.
. 'y'MeA of Corpus Christi
Address: 4] 7 S. Upper Broadway Corpus Christi, TX 78401
Phone: (361) 882- 741
rhe YMCA will be used to help students in the development of healthy lifestyles
and be the weekend gathering site ifneeded.
t) How services will be available to vouth and/or families without transportation: Youth
Leadership Program's home base is Carroll High School. Transportation, if needed will be
arranged by the '{ AC ('oordinator through public transportation.
g) "Safe passage" plan for youth and/or families without transportation: Students will meet in
designated classroom or approved area at Carroll High School. During school days they will
go to classroom at designated program time. Students will always be supervised by Y AC
Coordll1ator when participating 1I1 classroom sessions or activities outside of Carroll High
School. Field trip transportation w1l1 be secured through Corpus Christi Independent School
District (CCISD) 01 local bus servIce When traveling by bus, students will be supervised by
the YAC Coordinator. Every precaution will be taken to assure the safety of all students.
h) Population to be served by the program: Eligible Carroll High School students ages 14-17
years of age plus youth who reside or attend a school in the 78415 ZIP code who would like
to partIcipate in the program held at Carroll High School.
r) The number of youth and/or familv members to be served: approximately 25 students for the
contract period. Total tor Fiscal Veal' 2005-2006: approximately 50 students.
An explanation of howCYD funds will be used to enhance existing services, if applicable:
Continued service to the youth who attend Carroll High School. Services extended to 78415
youth who may not attend Carroll HIgh School but who would like to participate in the Youth
Leadership progranL
k) Description of how service programs will be culturallv diverse: The YMCA Y AC
Coordll1ator will market program to all Carroll High School students. Diversity is a key
component in all YMCA programs. The Y AC Coordinator will make every effort to draw in
a di verse group of students and schedule discussions on the importance of diversity and
tolerance in allllldividuals.
I) Staffing plan, with personnel qualifications, iob descriptions, criminal check verification, and
training: A TT ACHMENTS OF JOB DESCRIPTIONS INCLUDED - Recruitment of staff
and volunteers is done by public announcements (Help Wanted Ads) through the local
newspaper (Corpus Christi Caller Times); YMCA announcement to current YMCA staff; and
postlllg Job openings at T AMU-CC and Del Mar College.
Screenlllg of staff and \olunteers involves: Employment/Volunteer application required;
Minimum of three (3) reference checks documented; Criminal Background Check; Require
Firsl AId and CPR: and Interview process. Training of staff and volunteers involves: Child
Abuse Prevention; Character Development: YMCA Group Work; Characteristics of youth
ages 14 17: Transportation policies: and Supervision training and policies.
The YMCA Community Development Director -- Guy Nickleson, has been employed with
the YJ\1CA of Corpus Christi for 13 years. Prior to his employment with the YMCA he taught
in the C'orpus Christi Independent School District for ten (10) years. Mr. Nickleson started
the YM CA' s High School Youth and Government 12 years ago and has been directly
responsible for the success this program has achieved. His students (those in the Youth and
Government Program) credit him with being a good role model; teaching and demonstrating
the ,alues of caring, honesty. respect and responsibility; being "there" for them; providing
trainll1g that has increased their confidence and encouraged them to expand their vision of
possibilities. Mr 1\ickleson has accomplished the following: Business/Marketing degree
from Texas A&M Corpus Chnsti in 1991; Received the "Living the Dream" award by KIll
TV C' :n 1996; and Education Director for his church.
II. CYD CLIENT REGISTRATION AND TRACKING SERVICES
a) c\ (onsent Form must be explained to every individual participating in every CYD Program.
rhlS forn1 authorizes participation in CYD Programs and allows the Fiscal Agent,
subcontractor(s), TDFPS, and the state agency responsible for evaluating the Community
Youth Development Program to use the information provided by the participants for
,~valuation purposes
b) \ RegIstratIOn Form must be completed for every individual participating in any CYD
Program lor each fiscal year. The Registration Forms must be submitted monthly to the
Fiscal Agent with the monthly billing.
c)\ Monthly Partlcipant Summary Sheet must be completed for every participant receiving
servlces(s) on a monthly basis. The Monthly Participant Summary Sheet must be submitted
monthly to the Fiscal Agent with the monthly billing.
Registration forms and Monthly Participant Summary Sheets must be submitted for each
month for which the subcontractor(s) request reimbursement for service/program costs.
III. DOCCMENTA TION OF SERVICES
Documentation ofal I services provided to each Community Youth Development participant must
be maintained, All of the servIces listed on a Monthly Participant Summary Sheet must be
documented.
IV. BILLING REQUIREI\1ENTS
The Subcontractor will submit monthly billings specifying the costs incurred for each month of
service to the City representative lIsted below:
Parks & Recreation Department
A TTN: CYD Project Coordinator
City of Corpus Christi
P. O. Box 9277
Corpus Christi, Texas 78469-9277
The monthly billing will consist of the followll1g documents:
a. Budget Information Summary and Reimbursement Request.
b. Copies of invoices and bills.
c. Monthly ParticIpant Summary Sheet.
d. Registration/Consent Form (to inc Jude accurate and complete information prior to submitting
to the Fiscal Agent)
e. Any Change of Information to participants registration/consent form
Subcontractor will adhere to the following billing schedule:
-------
EXPENDITURES THROUGH MONTHLY BILLING DUE DATE
March I. 2006 April 7, 2006
i
! April 30, 2006 May 7, 2006
i -.
i May 3 I , 2006 June 7, 2006
i --.,
f June 30, 2006 July 7, 2006
--- ----
i July 31, 2006 August 7, 2006
I- -.--------...-
l August 3 \ , 2006 September 7, 2006
-
V EXPENDITURE SCHEDULE
Subcontractor agrees that if funds are not expended in accordance with Schedule A -
Subcontractor Estimate of FY 2005-2006 Expenditures by June 30, 2006, Subcontractor will lose
any uncommitted funds in excess 01'$2.500, subject to reinstatementthrough the appeals process
set out below. Fiscal Agent will notify Subcontractor in writing ofthe pending budget reduction
in Subcontractor's budget and give Subcontractor ten (10) business days to respond. If
Subcontractor does 110t respond within ten (10) business days, then the budget adjustment will be
made and Subcontractor must submit an adjusted budget to Fiscal Agent that reflects the reduced
budget amount wlthll1 ten (10) business days thereafter. However, if Subcontractor disagrees that
excess funds are available, then Fiscal Agent and Subcontractor will meet at an agreed upon time
and Subcontractor will be given the opportunity to present their case. Fiscal Agent will make the
final decision whether to reinstate or forfeit any of Subcontractor's excess uncommitted funds.
Any excess funds forfeited by any Suhcontractor will he used for other CYD programs.
Schedule A - Subcontractor Estimate of FY2006 Expenditures
- ---"-
Month Estimated Percent of Total
Expenditures Bud2:et
--
March 2006 55,56"""' 20.3%
-.-. --- _.
April 2006 $4,000 14.5%
Mav 2006 $4,500 16.3%
--=--.---- _.
June 2006 $4,500 16.3%
July 2006 $4,500 16.3%
-
August 2006 $4,500 16.3%
~ TT ACHMENT B-1
YMC A of Corpus Christi
Budget Information Forms
Contract Period: March. 1,2006 -Aug. 31. 2006
Summary Budget
FY06
COST CATEGORY TOTAL
1 (A) Personnel - Salaries $14,746.00
(B) Personnel - Fringe Benefits 2,317.00
(C) Personnel - Travel 2,828.00
2. Matelials and Supplies 905.00
3. Equipment 0.00
4 Other Costs 6,771.00
TOT AL BUDGET $27,567.00
Cash Match
$0.00
In-kind Match
$24,854.00
ATTACHMENT B-1
YMCA of Corpus Christi
Budget Information Forms
Contract Period: March 1,2006 - August 31,2006
(1 a) Personnel - Salaries
FY06
r A B C D E F
Posltiun or Title Number of Average Full Percent of Number of Cost
I Staff for Time Monthly Time on Months (BxCxDxE)
Position S al ary Budgeted Employed (Total)
I Position
YAC Coordinator I 3,276.88 75% 6 14,746.00
TOTAL SALARIES Total 14,746.00
ATTACHMENT B-1
YMCA of Corpus Christi
Budget Information Forms
Contract Period: March 1,2006 - August 31,2006
(1 b) Personnel - Fringe Benefits (Employer's Share)
FY06
I
,
Fringe Benefits Based
Fringe Benefits Based on (1a) Salaries Paid* on (1 a) Salaries Paid
FICA (a~ 7 65% $1,128.00
sur A icu 0384';,'0 56.50
Worker's Compensation (a 3.48% 513. 00
Retirement (Ji.! 4.2% 619.50
-
TOTAL FRINGE BENEFITS $2,317.00
ATTACHMENT B-1
YMCA of Corpus Christi
Budget Information Forms
Contract Period: March L 2006 - August 31,2006
(1 c) Personnel - Travel
FY06
! Type of Expense (transportation. Purpose (Destination and Total
food, lodging, mileage) Benefits to Proeram)
local mileage YAC Coordinator mileage to campus & $1,060.00
meetings: 2380 miles x $0.445/mile
Statewide Meetings. TNOYS
Food (out-of-town) Conference 468.00
-.
Lodging Statewide Meetings. TNOYS ConferenCt 765.00
--"'-"-"
TransportatiOlI Statewide Meetings. TNOYS Conferenct 535.00
~OTAL TRAVEL .-
-- $2,828.00
ATTACHMENT B-1
YMCA of Corpus Christi
Budget Information Forms
Contract Period: March 1,2006 - August 31,2006
(2) Materials and Supplies
FY06
! Description and Basis for Cost Total
Office supplies 65.00
Training supplies 75.00
Community Service Projects 75.00
Program Supplies 690.00
i
TOTAL CONSUMABLE SUPPLIES $905.00
ATTACHMENT B-1
YMCA of Corpus Christi
Budget Information Forms
Contract Period: March 1,2006 - August 31,2006
(.3) Rental, Lease, or Purchase of Equipment
FY06
Method Used
Description and Basis for Valuation (lease, rent, purchase, Total
-. etc.)
NONE $0.00
I TOTAL RENTAL, LEASE, OR PURCHASE $0.00
ATTACHMENT B-1
YMC A of Corpus Christi
Budget Information Forms
Contract Period: March 1,2006 - August 31, 2006
(4) Other Costs
FY06
Description and Basis for Cost Total
Pager $52.00
Telephone 225.00
Moonwalk Rental: Spring Festival 1,600.00
Professional Services: Sunmler Program 2,600.00
Bus Rental - College visits 1,200.00
YMCA Van Operational Costs - Community Projects (4) 190.00
Van Rental - CYD educational field trips 125.00
Postage 88.00
Admission Fees for Art Institutions 110.00
Criminal Background Checks 156.00
Liability Insurance 125.00
CYD College Visits - Meals 300.00
TOT AL OTHER COSTS $6,771.00
SUBCONTRACTOR:
CONTRACT PERIOD:
TITLE:
YMCA of Corpus Christi
3/(.1/2006 10 8 i~ 1 2006
Cummunity y!outh Development Program
Request No.
Reporting Month
,\ttachment B-2
Bl DGETED INFORMATION SUMMARY AND REIMBURSEMENT REQUEST
Personnel- Salaries
Y AJ' Coordinalor
Tcn -'\l
PerSOlmel - Fringe
FIC,\
SlTA
Worker's Comp
Retirement
TOTAL
Personnel- Travel
Local Mileage
Food i out-of-town
Lodglllg
Transportati011
TOTAL
Matenals and Supplies
Office supplies
Training supplies
Comlllunity Service Supplies
Program Supplies
TOTAL
Rental. Lease or Purchase
of Equipment
TOTAL
Other Costs
Pager
Telephone
Moonwalk Remal festival
Professional Services
Bus Rental - College visits
YMCA Van Operational Costs
Van Rental - ("YO educ tripS
Postage
Admission Fees-An Institution
Criminal Background Checks
Liability Insurance
CYO College Visits - Meals
TOTAL
TOT 4. L
\mount
Budgeted
1) YTO
Expended
(2) YTO
Invoiced
14,746.00
14,74600
1.12800
50.50
513.00
619.50
2.3)7 00
1. 060 00
46800
765 00
53500
2,82800
6500
7500
7500
690.00
905 00
0.00
000
5200
22500
1.600 00
2,600.00
1,20000
]90.00
12500
8800
11000
15600
125 00
300.00
6,77100
.~ 7,567. 00
(1)-(2)
Amount
Requested*
*City Use
Only
Amnt. Paid
* Amounts expended cannot exceed amount budgeted
I cel11fy that the expenditures shown above are tlUe and that supporting documentation
is attached to substantiate them
Subcontractor's Authorized Signature
Date
Payment Authorization Signature
Date
Attachment B-3
Budaet Narrative
1 a) Personnel - Salaries
YMCA Y AC Coordinator - $39,322.56/year
$3,276.88/mo x 6 months = $19.661.28 x 75% = $14,746
TOTAL
$14,746
1 b) Personnel- Frinqe Benefits (Employer's Share)
FICA: 7.65% of 14,746 = $1,128
SUTA: 0.384% of 14,746 = 56.50
Worker's Compensation: 3.48% of 14.746 = 513
Retirement: 4.2% of 14,746 = 619.50
TOT AL
$ 2,317
1c) Personnel- Travel (mileaqe, food. lodqinq)
Local mileaqe
Travel to Carroll High School for
13 weeks during the school year
1190 miles X $0.445/per mile = $530
Travel to Carroll High School for
12 weeks during the summer
1190 miles X $0.445/per mile = $530
$ 1,060
Out-of-town mileaqe
No mileage here.
Food
YMCA YAC Coordinator Statewide Meetings: $36 x 3 days $108
YMCA YAC Coordinator TNOYS State Conference: $36 x 4 days $144
CYO Statewide meeting: 2 youth at $36 per day = 36x 3x 2 $216
Lodqinq
CYD State meeting: 2 nights x $85/night $170
CYD Statewide meeting, 2 CYD Youth: 2 night x $85 x 2 youth $340
TNOYS State conference: 3 nights x $85/night $255
Transportation
Car rental for TNOYS State conference:
4 days at $40/day $160
Van rental for CYD State meeting:
3 days: 3 X $125 per day $375
Sftldents benefit bv attendina CYD State meetina:
Students will participate in CYD Conference, which will allowed each student to
demonstrate their skills in, debate, knowledge on Teen leadership marketing/media
skills and organizational skills learned through the CYD Leadership Program.
2. Materials and Supplies
Office supplies: new program start-up supplies
(Paper, folders, pens, etc...) $ 65
Training supplies: YMCA Youth & Government Leadership
Manual and presentation materials (newsprint, videos, etc...) $ 75
Community Service Project supplies $ 75
Community Service Projects: Painting over graffiti; beach clean up;
Parks trash pick-up; reading to children at Driscoll Children's Hospital;
Easter egg hunts for underprivileged children; games & gifts & singing at nursing
Homes and Senior Centers.
Program Supplies:
T -shirts for Y AC $400
Awards for youth competition at CYD Spring Festival $50
Cameras 20 x$7= 140 $140
Photos Development 20 x $5 $100
3. Rental. Lease, or Purchase of Equipment
NONE
4. Other Costs
Telephone expense:
· YMCA YAC Coordinator - pager $11.50/month X 6 months = 69
(75% of total cost is requested for reimbursement
75% X 69 = 51.75)
· YMCA Y AC Coordinator cell phone
Average $50 per month X 6 mo. = 300
(YMCA requesting 75% reimbursement 75% X 300)
$52
$ 225
Moon Walk rental for CYD Spring Festival in March 2006
$1600
Professional Services: $2,600
Program coordinator for a new summer Art and Writing program ($2000). The program
will educate the students of 78415 on self- awareness and self esteem building through
art. Publication of pictures and writings will be published by each student ($600)
Bus Rental:
Bus rental for one day college educational visits
San Antonio and Austin areas:
$1200
YMCA Van for Community Service Project trips:
Operational cost (gas, oil, etc...) 4 projects X $47.50/project
$ 190
Van rental for CYD educational field trip to art museums during summer art program:
1day X $125 = $125
Postage: Newsletters and misc. mailings
$88
Admission fees:
Art center and museums $5/per student X 20 students
2 adults X 5.00
$100
$10
Criminal background checks (adults & high school student mentors)
$3.12/per Background Check X 50
Liability Insurance
$156
$125
$300
CYD College Visits. 2 meals out of town 2 X 30 youth X $5
TOTAL BUDGET:
$27,567.00
In-Kind Match (6 months)
Office space, furniture, copier, computer, printer, telephone,
Reception staff, Custodial, YMCA Fitness Specialist, and
YMCA facility use
$ 17,354
YMCA Youth Membership for 50 H.S. Students
$25/per month X 6 months X 50 students = 7,500
7,500
Total In-Kind Match
J 24.854
Attachment C
STANDARD TERMS AND CONDITIONS
(Community Youth Development Program Contracts)
Parties, For the purposes of this document, the Texas Department of Family and
Protective Services will hereinafter be referred to as the Department. The City of
Corpus Christi will hereinafter be referred to as the Fiscal Agent. YMCA of Corpus
Christi will hereinafter be referred to as the Subcontractor, The Community Youth
Development Program will hereinafter be referred to as CYD Program.
SECTION 1. LEGAL AUTHORITY
Subcontractor assures and guarantees that it possesses the legal authority to enter into
this Contract, to receive the funds authorized by this Contract, and to perform the
services Subcontractor has obligated itself to perform under this Contract. The person
signing this Contract on behalf of Subcontractor hereby warrants that he/she has been
fully authorized by Subcontractor to execute this Contract on behalf of Subcontractor
and to validly and legally bind the Subcontractor to all the terms, performances, and
provisions herein set forth.
Acceptance of funds under this contract acts as acceptance of the authority of the State
Auditor's Office, HHSC Office of Inspector General, or any successor agency, to audit
or investigate the expenditure of funds under this contract or any subcontract.
Subcontractor further agrees to cooperate fully with the State Auditor's Office or its
successor, including providing all records requested. Subcontractor will ensure that this
clause concerning the authority to audit funds received indirectly by subcontractors
through Subcontractor and the requirements to cooperate is included in any
subcontract it awards.
The Subcontractor agrees to be in compliance with all applicable Federal, State and
local laws, including but not limited to, the following: 45 Code of Federal Regulations
("CFR") Part 92, Office of Management and Budget ("OMB") Circulars A-87, A-122, A-
110, and 40 Texas Administrative Code ("TAC") 732.240-256 as applicable and
amended, In the event of any conflict or contradiction between or among the
regulations referenced in this Contract, the regulations shall control in the following
order of precedence: 45 CFR Part 92, OMB Circulars A-87, A-122, A-110, and 40 TAC
732.240-256.
SECTION 2. INDEPENDENT CONTRACTOR
It is expressly understood and agreed that the Fiscal Agent is contracting with
Subcontractor as an independent contractor. No provision of this Contract or act of the
Fiscal Agent in performance of this Contract shall be construed as making
Subcontractor the agent, servant, or employee of the Fiscal Agent; employees of
Subcontractor are not employees of the Fiscal Agent; and Subcontractor is solely
responsible for employee payrolls and claims arising therefrom.
SECTION 3. FINANCIAL LIMITATIONS AND CONSIDERATIONS
A. This Contract is for the second six (6) months of the Department's fiscal year
contingent upon the availability and receipt of State or Federal funds that has been
allocated to the Fiscal Agent of this Contract.
B. This Contract is at all times contingent upon the availability and receipt of State or
Federal funds that has been allocated to the Fiscal Agent of this Contract and, if
funds for this Contract become unavailable during any budget period, this Contract
may be immediately terminated or reduced at the discretion of the Fiscal Agent.
C. The Fiscal Agent agrees to pay the Subcontractor from available funds for each
service rendered in accordance with the terms of this Contract upon receipt of a
proper and verified statement and after deducting any known previous
overpayment made by the Fiscal Agent. If program income accrues, the
Subcontractor agrees to return to the Fiscal Agent any income that exceeds actual
costs incurred for services rendered under this Contract. In no event shall
payments exceed the total budgeted amount as originally approved in this
Contract or as subsequently amended by both parties.
D. The basis for payment for services rendered under this Contract is indicated in the
service terms in the budget. The Subcontractor agrees to this basis for payment
and to adhere to the fiscal and billing policies and procedures of the Fiscal Agent.
The Fiscal Agent is not obligated to pay unauthorized costs or to pay more than
the Subcontractor's allowable and actually incurred costs consistent with Federal
and State regulations.
The method of payment is cost reimbursement. This means that costs should only
be billed after they have actually been incurred and have been paid by the
Subcontractor. Costs should be billed to the month in which they were incurred,
either on the primary billing voucher for that month or on a supplemental billing, if
they are not paid in time to include them on the primary voucher. Costs should not
be billed to the Fiscal Agent if they have not yet been paid.
E. Payment for services rendered under this Contract will be made in accordance
with the documentation outlined in the Budget Information Summary and
Reimbursement Request, as set out in Attachment B-2 to this Contract. Payment
shall be authorized only upon the submittal of an appropriate invoice and
supporting documentation to the Fiscal Agent.
F Invoices must be submitted at least once a month as set forth in the Payment
Schedule as per Attachment A-2 of this Contract. Failure to comply with this
requirement will result in a delay in payment and will be subject to the provisions
concerning changes and amendments in this Contract.
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G. Funds under this Contract cannot be earned prior to the first day nor after the last
day of the Contract Period.
H. The Fiscal Agent shall not be liable to Subcontractor for any charges under this
Contract which exceed the total funding amount specified.
i. All funds unearned or unexpended in the performance of this Contract shall be
retained by the Department.
J. The Subcontractor is responsible for submitting bills in an accurate and timely
manner by the 7th day following the month in which services are provided. The
Fiscal Agent will make reasonable efforts to process all bills received in an
accurate and timely manner but does not warrant immediate payment.
Reimbursements to Subcontractor will be paid by the Fiscal Agent when payment
is received from the Department.
K. The Subcontractor understands and agrees that prior written approval must be
secu red:
1. For transfers between line items for any dollar amount. Lack of prior
approval in these instances will be grounds for nonpayment of the item or
items involved;
2. When transfers, regardless of the amount, would result in a significant
change in the character or scope of the programs. Lack of prior approval
in these instances will be grounds for recovery of unapproved payments
and termination of this Contract at the option of the Fiscal Agent; and
3. When needing to add a line item, cost, or expenditure to the budget.
Approval must be obtained in writing prior to incurring the expense/cost.
L For unit rate Contracts only: The Subcontractor shall provide the Fiscal Agent a
total bill each month in the format prescribed by the Fiscal Agent and shall accept
as payment in full the Contracted unit rate reduced by an amount equivalent to the
required percentage of certified local resources as applicable.
SECTION 4. LIABILITY FOR REPAYMENT
A. Fiscal Agent retains the right to suspend financial assistance, in whole or in part,
to protect the integrity of funds or to ensure proper operation of programs,
provided Subcontractor is given prompt notice and the opportunity for a hearing
within thirty (30) days from such suspension.
B. All payments under this Contract are subject to audit by the Department and the
Fiscal Agent. Subcontractor shall assume liability for repayment of funds
disbursed where such disbursement is subsequently determined to be improper or
unauthorized Subcontractor shall provide the Fiscal Agent with a feasible plan for
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repayment of disallowed costs with non-Federal funds. Repayment of such funds
to the Fiscal Agent shall be in accordance with the Prompt Payment Act.
Subcontractor shall also repay to the Fiscal Agent any funds found to have been
paid for the same service from funds other than CYD Program funds. In the case
of duplicate payments, the Fiscal Agent may also withhold any earned funds of
Subcontractor under this Contract or any other Contract pending satisfaction of
any repayment obligations under this Contract or any other Contract due to
payments which were improper or unauthorized.
SECTION 5. CHANGES AND AMENDMENTS
The Subcontractor agrees to notify the Fiscal Agent immediately of any significant
change affecting the Subcontractor including, but not limited to, change of
Subcontractor's name or identity, ownership or control, governing board membership,
personnel, or payee identification number. Subcontractor shall provide notice in writing
to Fiscal Agent within ten (10) working days of change.
No changes or amendments to this Contract shall be made except in writing and signed
by both parties hereto, unless such change is in the form of a written notice of
modification or directive issued by the Fiscal Agent as described below.
A. The Fiscal Agent may give a notice of modification or directive in the event any
alterations, deletions, or additions are required due to changes in Federal or State
laws or regulations applicable to CYD programs, which changes shall take effect
automatically upon the effective date of such Federal or State laws or regulations.
B Reimbursement made to the Subcontractor shall not exceed the Subcontractor's
actual costs to provide the services under this Contract and that the
Subcontractor's actual costs, both direct and indirect, must be allowable,
reasonable and allocable according to 45 CFR Part 92, OMS Circulars A-8?, A-
122. A-110, 40 TAC 732.240-256, and any other applicable regulations.
C The Fiscal Agent may give a notice of modification or directive to reduce the level
of funding under the Contract in the event of a reduction of funding to the Fiscal
Agent under any Federal, State or local program.
D. The Fiscal Agent may issue a policy directive that shall have the effect of
establishing, interpreting, clarifying or qualifying the terms of this Contract. Such
policy directives may not alter the terms of this Contract in order to relieve the
Fiscal Agent of any obligation to pay for performance rendered or costs incurred
by Subcontractor prior to the date of such directive.
E The Fiscal Agent may give a notice of modification to increase the amount of
funds available under this Contract if such funds become available and it is in the
best interest of the Fiscal Agent to do so without the solicitation of additional
proposals.
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SECTION 6. ACCOUNTING REQUIREMENTS
The Subcontractor agrees to adhere to Generally Accepted Accounting Principles
promulgated by the American Institute of Certified Public Accountants and to follow
Fiscal Agent and Department fiscal management policies and procedures in submitting
timely billing and maintaining financial records required to be kept under this Contract.
SECTION 7. RECORD KEEPING/REPORTING REQUIREMENTS
A. The Subcontractor agrees to submit service delivery reports required by this
Contract, self-evaluations of performance, and other reports requested by the
Fiscal Agent or Department in appropriate format and on a timely basis; and make
available at reasonable times and for reasonable periods client records and other
programmatic or financial records, books, reports, and supporting documents for
reviewing and copying by the Fiscal Agent, the Department, the U.S. Department
of Health and Human Services ("DHHS"), or their authorized representatives.
B. The Subcontractor agrees to maintain financial, programmatic, and supporting
documents, statistical records, inventories of nonexpendable property acquired,
and other records pertinent to claims submitted during the Contract Period for a
minimum of five (5) years after the termination of the Contract Period, or for five
(5) years after the end of the Federal fiscal year in which services were provided if
this Contract has no specific termination date. If any litigation, claim, or audit
involving these records begins before the five (5) year period expires, the
Subcontractor will keep the records and documents for not less than five years
and until all litigation, claims, or audit findings are resolved. The case is
considered resolved when a final order is issued in litigation, or a written
agreement is entered into between the Department/Fiscal Agent and the
Subcontractor, Contract Period means the beginning date through the ending
date specified in the original Contract; extensions are considered to be separate
Contract periods.
C. Subcontractor shall complete and submit all necessary data on participants
enrolled in its program and must do so according to instructions and definitions
prescribed by the Department and the Fiscal Agent.
D. Failure to submit required reports to the Fiscal Agent may result in withholding by
the Fiscal Agent of any payments otherwise due until such time as the
Subcontractor meets the delinquent obligations.
E, Subcontractor shall submit a self-evaluation report within 45 days following the end
of the Contract Period. The self-evaluation report should address the
accomplishments of the program/services, the effectiveness of the services
provided, and the attainment of output measures, evidence-based performance
measures and program goals listed in this Contract.
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SECTION 8. SUBCONTRACTING
A. Subcontractor agrees not to sublet, assign, transfer, conveyor otherwise dispose
of this Contract or any right, title, obligation or interest it may have therein to any
third party without prior written approval of the Fiscal Agent, which includes full
disclosure of the particulars of such agreement and special assurances that such
third party shall comply with all provisions of the governing laws, the terms and
conditions of this Contract, State of Texas policies, Federal regulations and Fiscal
Agent policies, including the qualifications of the Subcontractor to perform and
meet standards of this Contract and the Community Youth Development Plan of
Operation. A non-governmental Subcontractor shall assume full liability for any
third party actions and shall hold harmless the Fiscal Agent, the Department, and
the State of Texas from the actions of any third party. Failure by a non-
governmental Subcontractor to inform the Fiscal Agent of the intent to involve any
third party shall relieve the Fiscal Agent, the Department, and the State of Texas
of any and all liability and may result in initiation of procedures to terminate this
Contract, among other remedies that Fiscal Agent or Department may be entitled
to seek. The Fiscal Agent shall not be obligated or liable under this Contract to any
party other than Subcontractor for payment of any monies or for provisions of any
goods or services unless the Fiscal Agent in writing specifically agrees to such
liability
B. The Subcontractor further agrees to provide statements from Sub-subcontractors
signed by an offiCial duly authorized to legally obligate the Sub-subcontractor and
attest to the fact that it shall provide the services as represented in this Contract,
including the incorporated documents, with no disruption to service delivery. A
similar statement must be signed by each Sub-subcontractor who will provide
services as part of this Contract. Each Sub-subcontractor may be required to
submit ownership information and other information related to this Contract. The
Subcontractor must disclose to Fiscal Agent any and all information regarding the
Sub-subcontractors as it pertains to this Contract, during the Contract Period.
C. Subcontractor shall have protest procedures in place to handle and resolve
disputes relating to its procurement.
D. Any of the work or services specified in this Contract which shall be performed by
other than Subcontractor shall be evidenced by a written Contract specifying the
terms and conditions of such performance. Subcontractor shall maintain and
adhere to an appropriate system, consistent with Federal, State, and local law, for
the award and monitoring of Contracts which contain acceptable standards for
ensuring accountability.
E. Subcontractor shall ensure that the performances rendered under all subcontracts
are rendered so as to comply with all the terms and provisions of this Contract as if
the performances rendered were rendered by Subcontractor.
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SECTION 9. PUBLICITY
The Subcontractor agrees to place prominent notices acknowledging the funding it
receives from the Fiscal Agent and Department in all of its literature that describes
services covered by this Contract. This notice will also appear in the Subcontractor's
annual financial report, if any is issued. Additionally, the Subcontractor agrees to the
following
A. When issuing statements, press releases, requests for proposals, bid solicitations,
and other documents describing projects or programs funded in whole or in part
with CYD Program funds, Subcontractor shall state the percentage of the total
costs of the program or project which will be financed with those CYD Program
funds.
B. Subcontractor shall give credit to the Department and Fiscal Agent as the funding
source in all oral representations, written documents, publicity and advertisements
regarding any CYD activities. Wording shall be as follows: A Program Funded
through the City of Corpus Christi by the Texas Department of Family and
Protective Services.
C. Subcontractor shall not publish or cause to have published the results of its
function and partiCipation in the program activity without prior review and approval
by the Fiscal Agent and Department.
SECTION 10. TECHNICAL ASSISTANCE
A. The Fiscal Agent will provide a central information system for complete information
on each participant and will maintain a central communication system for the
proper and timely disbursement of information and resource documents. The
Fiscal Agent will provide technical assistance found to be needed through
performance reviews or monitoring reports.
B. The Fiscal Agent may schedule staff meetings, other meetings or training sessions
to assist in the administration of this Contract. Subcontractor shall ensure the
attendance of its director or other specified personnel at such meetings.
SECTION 11. MONITORING AND ASSESSMENT
A.. The Subcontractor agrees to provide services in accordance with the provisions of
this Contract and to allow the Fiscal Agent and Department, and their
representatives, to monitor, audit, evaluate, and otherwise review the services
provided and related documentation.
B. The Subcontractor agrees to cooperate fully in any social studies or fiscal and
programmatic monitoring, auditing, evaluating, or other reviews pertaining to
'-7
services rendered by the Subcontractor which may be conducted by the Fiscal
Agent, the Department or DHHS, or their authorized representatives; and to be
responsible for any audit exception or other payment irregularity regarding this
Contract or subcontracts, which may be found after review by the Fiscal Agent, the
Department or DHHS; and to be responsible for the timely and proper collection
and reimbursement to the Fiscal Agent and the Department of any amount paid in
excess of the proper billing amount.
C. Representatives of the Fiscal Agent and Department may periodically, without
advance notice, monitor Subcontractor for compliance, financial management and
performance of the terms and conditions of this Contract. The monitoring process
will include an analysis of program data provided by the Subcontractor to assess
the performance of this Contract and the quality of services. Monitoring shall
Include review of results of criminal background checks and affidavits required
under this Contract of all Subcontractor employees or volunteers in direct client
contact.
D. Upon conclusion of a monitoring review, the Fiscal Agent or Department will
present all findings and recommended corrective actions, if applicable, to
Subcontractor.
E. Unless otherwise directed, Subcontractor shall respond in writing to the Fiscal
Agent within thirty (30) calendar days after receipt of the monitoring report with all
corrective actions planned or taken and specific detailed procedures and actions
initiated to preclude any recurrence of the practices, discrepancies, and
irregularities identified in the monitoring report.
F. The Fiscal Agent or Department, as may be applicable, upon receipt of
Subcontractor's written response to the monitoring report, shall evaluate the
corrective action plan and determine whether the corrective action plan shall be
undertaken, whether an alternative plan is needed, or whether the goals or
standards need to be modified. Regardless of the course of action taken, the
Fiscal Agent shall ensure that positive actions, procedures, and practices are
initiated to preclude recurrence or non-compliance. Upon written request, the
Fiscal Agent shall provide technical assistance to Subcontractor in correcting the
deficiencies noted Fiscal Agent shall conduct follow-up visits to review pending
deficiencies and to assess the efforts made to correct them. If such deficiencies
persist, Fiscal Agent may withhold funds and move to terminate this Contract.
G. All such corrective actions shall remain open pending completion and issuance of
a written statement of closure by the Fiscal Agent or Department, as applicable.
SECTION 12. PROPERTY
A. The Subcontractor agrees to assume responsibility for the protection of all physical
property and equipment used at facilities being maintained to carry out this
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Contract and take appropriate measures to meet this obligation. All such property
will be adequately safeguarded against vandalism, loss, damage, or theft.
Subcontractor must acquire and maintain property insurance for any and all
equipment purchased with CYD Program funds. The Fiscal Agent, the
Department. and the appropriate authorities shall be notified in writing in the case
of theft, or suspected theft, within twenty-four (24) hours of discovery. Any
missing, damaged, or destroyed property will be reported immediately in writing to
the Fiscal Agent and the Department and will include the circumstances
concerning the loss. An investigation shall be conducted by the Subcontractor to
determine the cause, and the results shall be reported in writing to Fiscal Agent
and the Department. Any property missing, damaged or destroyed shall be
replaced by the Subcontractor, at Subcontractor's own expense. In addition, in the
event of any theft. vandalism, or other offense against the property or equipment,
the Subcontractor shall notify the appropriate local law enforcement authorities.
B. The Subcontractor agrees to adhere to the provisions of 45 CFR Part 92 regarding
the return to the Department of any equipment bought under this Contract with
funds allocated to the Fiscal Agent or the Subcontractor. The Subcontractor
agrees that it will not give any security interest, lien, or otherwise encumber any
item of equipment purchased with Contract funds. The Subcontractor agrees to
permanently identify all equipment with appropriate tags or labels affixed to the
equipment and to maintain a current inventory record of the equipment which must
be made available to the Fiscal Agent and the Department upon request.
C. The property shall be maintained in good condition at all times. Unless waived by
the Fiscal Agent and Department, all maintenance and repair costs associated
with any property shalr be borne by the Subcontractor. All property must be
returned to original condition, except for normal wear and tear, prior to return of
the property to the Fiscal Agent
SECTION 13. YEAR 2000 COMPLIANCE
Subcontractor has full responsibility to anticipate and mitigate any four-digit-year
related events that could adversely affect the timely performance of this Contract
or the date-related operations of any goods, files, or services provided pursuant to
it Subcontractor warrants the fault free performance in the processing of date and
date-related data by any product developed and delivered to Fiscal Agent
pursuant to this Contract. Fault-free performance includes manipulation of data
with dates prior to through, and beyond January 1, 2000, and during leap years.
Subcontractor agrees that all software developed and delivered pursuant to the
contractual requirements herein shall use four-digit-year elements. Subcontractor
further agrees that four-digit-year elements will be used in any electronic data
interchange that may occur with the Fiscal Agent as a result of this Contract.
Subcontractor shall not be entitled to additional compensation or additional time to
perform these obligations
SECTION 14. TAXES
The Fiscal Agent and the Department will not be liable for Federal, State, or local excise
taxes incurred by or assessed against Subcontractor. The Subcontractor must be able
to demonstrate on-site compliance with the Federal Tax Reform Act of 1986, Section
1706, amending Section 530 of the Revenue Act of 1978, dealing with the issuance of
Internal Revenue Service Form W-2s to common law employees. The Subcontractor is
responsible for both Federal and State unemployment insurance coverage and
standard workers' compensation insurance coverage. The Fiscal Agent and
Department will not be liable to the Subcontractor or its employees for any
unemployment or workers' compensation coverage, or Federal or State withholding
requirements. The Subcontractor must comply with all Federal and State tax laws and
withholding requirements. The Subcontractor shall indemnify the Fiscal Agent and
Department and pay to the Fiscal Agent or Department all costs, penalties, or losses
whatsoever occasioned by the Subcontractor's omission or breach of this section.
SECTION 15. DISPUTES
The Fiscal Agent is responsible for hearing any grievances, including disputes, claims
or protests, arising out of the administration and operations of programs funded under
CYD Program. Non-discrimination complaints alleging a violation of the CYD Program
must be initiated by filing a Grievance Information Form within 365 days of the action
complained of. Non-discrimination complaints that do not allege a violation of the CYD
Program may be initiated by filing a Grievance Information Form within 30 days of the
action complained of. Correspondence regarding a complaint or grievance should be
directed to the attention of the Fiscal Agent.
SECTION 16. INDEPENDENT AUDIT
The Subcontractor agrees to submit an annual financial and compliance audit of the
Subcontractor's fiscal year-end in accordance with the Single Audit requirements of
OMS Circular A-133 (Audits of State Local Government, and Non-Profit Organizations).
A Subcontractor understands and agrees that it shall be liable for all costs
associated with said audit.
B. Subcontractor understands and agrees that it shall be liable to the Fiscal Agent for
any costs disallowed as a result of said audit in accordance with the "Liability for
Repayment" provisions of this Contract, as set out in Section 4 of these Standard
Terms and Conditions.
C. The Fiscal Agent and Department reserve the right to conduct an independent
audit of all funds received under this Contract. The audit may be performed by the
Fiscal Agent, a certified public accounting firm, or other auditors as designated by
the Fiscal Agent or the Department. Such audit will be conducted in accordance
with applicable professional standards and practices.
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D. In the event a final audit has not been performed prior to termination of this
Contract, the Fiscal Agent shall retain the right to recover funds after fully
considering the recommendations on disallowed costs resulting from such final
audit
E. Subcontractor and auditors performing monitoring or audits of Subcontractor or its
Sub-Subcontractors shall immediately report to the Fiscal Agent and the
Department any incidents of fraud, abuse, or other criminal activity in the relation
to the provisions of this Contract or applicable State Regulations.
SECTION 17. PREVENTION OF CONFLICTING INTERESTS
A. Every reasonable course of action shall be taken by the Subcontractor to maintain
the integrity of this expenditure of public funds and to avoid favoritism and
questionable or improper conduct. This Contract shall be administered in an
impartial manner, free from personal, financial, or political gain. Subcontractor, its
executive staff, and employees, in administering this Contract, shall avoid
situations that give an appearance or suggestion that any decision was influenced
by prejudice, bias, special interest or desire for personal gain.
8. No member, officer, agent, or employee of the Fiscal Agent or the Department
who exercises any functions or responsibilities in the review or the approval of the
undertaking or carrying out of this Contract shall participate in any decision relating
to this Contract which affects his/her financial interest.
C. Executives and employees of Subcontractor shall be particularly aware of the
varying degrees of influence that can be exerted by personal friends and
associates and shall exercise due diligence to avoid situations which give rise to
an appearance or assertion that favorable treatment is being granted by friends
and associates who are also members, officers, agents, or employees of the
Fiscal Agent or the Department. A permanent record of any transaction involving a
Subcontractor who is also a friend or associate of a member, officer, agent, or
employee of the Fiscal Agent or the Department shall be retained when it is in the
public interest for the Fiscal Agent or the Department to conduct business with
such person.
D. Members, officers, agents, and employees of the Fiscal Agent or the Department
and elected officials shall not solicit nor accept money or any other consideration
from Subcontractor or any other third person for the performance of an act
reimbursed in whole or in part by the Fiscal Agent or the Department. Supplies,
materials, equipment, or services purchased with Contract funds shall be used
solely for the purposes allowed under this Contract. No member of the Fiscal
Agent or the Department shall cast a vote on the provision of services by that
member or by any organization which that member represents or vote on any
matter which would provide direct financial benefit to that member or any business
or organization which the member directly represents.
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SECTION 18. FRAUD AND ABUSE PREVENTION
A. Subcontractor shall establish, maintain, and utilize internal program management
procedures sufficient to provide for proper and effective management and the
prevention of fraud and abuse in all activities funded under this Contract.
B. Failure on the part of Subcontractor to comply with the provisions of this Contract
or with the Department, or applicable regulations, when such failure involves fraud
or misappropriation of funds, may result in immediate withholding of funds and
termination of this Contract for cause.
C. Subcontractor shall ensure diligence in maintaining programs under this Contract
including the carrying out of appropriate monitoring activities and in taking
immediate corrective action against known violations of Department regulations.
D. Subcontractor shall notify the Fiscal Agent and Department immediately, by the
fastest means available, upon discovery of any incident of fraud, or suspected
fraud, involving this program
SECTION 19. INDEMNIFICATION
The Subcontractor shall indemnify and hold harmless the Fiscal
Agent and the Department, their officers, agents, representatives, and
employees, from and against any and all claims or losses for physical
damage to property or injury to persons resulting from negligence,
misconduct, or any act or omission on the part of the Subcontractor,
its officers, agents, employees, representatives, or Sub-
subcontractors. In the event of loss, damage, or destruction of any
property due to the negligence, misconduct, act or omission of the
Subcontractor, the Subcontractor shall indemnify and pay full cost of
repair, reconstruction, or replacement, at the discretion of the Fiscal
Agent and Department. Such cost shall be due and payable by the
Subcontractor within ten (10) calendar days after the date of receipt of
written notice from the Fiscal Agent or Department of the amount due.
The State of Texas, Department, and Fiscal Agent, and their
respective employees, officers, agents, and representatives can
neither agree to hold the Subcontractor harmless nor agree to
indemnify the Subcontractor and any provisions to the contrary are
void.
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SECTION 20. SECTARIAN INVOLVEMENT PROHIBITED
Subcontractor shall ensure that no funds under this Contract shall be used directly or
indirectly in the support of any religious or anti-religious activity, worship, or instruction.
SECTION 21. POLITICAL ACTIVITY/LOBBYING
The Subcontractor will not use any funding under this Contract to influence the outcome
of elections or the passage or defeat of any legislative measures.
No funds provided under this Contract may be used in any way to influence or attempt
to influence in any manner a member of Congress to favor or oppose any legislation or
appropriation by Congress or for lobbying with State or local legislators. Subcontractor
shall comply with the requirements of New Restrictions on Lobbying imposed by 29
CFR 93, dated February 26, 1990, clarified by Notice in the Federal Register, Vol. 55,
No. 116, dated June 15.1990, and codified at 31 United States Code ("USC") 1352, as
amended. Subcontractor shall comply with the certification and disclosure requirements
in Attachment F to this Contract.
SECTION 22. NON-DISCRIMINATION AND EQUAL OPPORTUNITY
A. Subcontractor shall comply with all applicable Federal and State regulations and
with Department policies and procedures regarding services delivered under this
Contract including, but not limited to, the following:
1 Title VI of the Civil Rights Act 1964 (Public Law 88-352), Section 504 of the
Rehabilitation Act of 1973 (Public Law 93-112), The Americans with
Disabilities Act of 1990 (Public Law 101-336), and all amendments to each,
and all requirements imposed by the regulations issued pursuant to these
Acts. In addition, the Subcontractor agrees to comply with Title 40, Chapter
73, of the Texas Administrative Code, as amended. These laws provide in part
that no persons in the United States shall, on the grounds of race, color,
national origin. sex, age, physical/mental disability, drug or alcohol abuse or
alcoholism, political beliefs, or religion be excluded from participation in or
denied any aid. care, service or other benefits provided by Federal or State
funding or otherwise be subjected to discrimination;
2 Texas Health and Safety Code, Section 85.113, as amended, relating to
workplace and confidentiality guidelines regarding AIDS and HIV);
3 Immigration Reform and Control Act of 1986, as amended, regarding
employment verification and retention of verification forms for any individuals
who will perform any labor or services under this Contract;
4 Establish a method to ensure the confidentiality of records and other
information relating to clients according to applicable Federal and State laws,
- 1
rules, and regulations. This provision does not limit the Fiscal Agent's or the
Department's right of access to client case files or other information relating to
clients served under this Contract. The Department shall have an absolute right
of access to and copies of such information, upon request;
5. Promptly report any suspected case of child abuse or neglect to the
appropriate Child Protective Services offices within the Department as
required by the Texas Family Code, Chapter 261, as amended. All reports
must be made within 24 hours of the discovery of abuse or neglect;
6 If specific qualifications are set forth in job descriptions required by the
Department, only personnel with the required qualifications will be assigned to
fill functions unless a written waiver is granted by the Department;
1 Verify and disclose, or cause its employees and volunteers to verify and
disclose criminal history and any current criminal indictment involving an
offense against the person, an offense against the family, or an offense
involving public indecency under the Texas Penal Code as amended, or an
offense under Chapter 481 of the Texas Health and Safety Code. This
verification and disclosure will be required of all who have direct contact with
clients or who have access to personal client information prior to such contact
or access, and shall be accomplished through use of (a) a criminal history
background check and (b) a signed declaration by each employee or volunteer
testifying to this information, both of which shall be maintained by the
Subcontractor available for review by the Fiscal Agent or the Department and
renewed every two years.
8 Comply with Federal ,State and local licensing and certification requirements,
health and safety standards, and regulations prescribed by the DHHS and
TOPRS;
9 All applicable standards, orders, or regulations issued pursuant to the Clean
Air Act, 42 USC 7401 et seq., as amended, and the Federal Water Pollution
Control Act, 33 USC 1251 et seq., as amended;
10 Immediately remove any agent, officer, employee, representative, or volunteer
from direct client contact who is alleged to have committed child abuse,
neglect, or exploitation, or an offense against the person, an offense against
the family, or an offense involving public indecency under the Texas Penal
Code, as amended, or an offense under the Texas Controlled Substances Act.
If it is determined that the employee or volunteer has not committed such
offenses, the employee or volunteer may again be assigned to direct client
contact; provided however, the Subcontractor shall notify the Fiscal Agent and
the Department of its intent to reassign within ten (10) working days prior to the
reassignment. The Subcontractor must provide the Fiscal Agent and the
Department with further information concerning the reasons for the
- 14
reassignment upon the request of the Fiscal Agent or the Department. If the
employee or volunteer is found to have committed any of the offenses listed in
this paragraph, the employee or volunteer shall not be reassigned to duties
Involving any direct contact with clients. Subcontractor may request that the
Fiscal Agent and Department waive this Contract provision with respect to a
specific employee or volunteer and specific misdemeanor charges;
11. Federal Financial Participation (FFP) requirements in accordance with Titles 45
and 48 of the Code of Federal Regulations and Federal circulars, as amended;
12. Allow any of Subcontractor's employees to testify in judicial proceedings and
administrative hearings, at the request of the Department or Fiscal Agent; and,
13. Mandatory standards and policies relating to energy efficiency which are
contained in the State energy conservation plan issued in compliance with the
Energy Policy and Conservation Act (Public Law 94-163), as amended.
B. The Subcontractor shall have written participant and employee grievance
procedures consistent with applicable Federal and State requirements. The
Subcontractor shall establish and maintain complaint procedures to resolve all
complaints arising directly or indirectly out of this Contract.
C. As subcontracts and supplier contracts become necessary to carry out the
requirements of this Contract, Subcontractor covenants to make a good faith effort
to contract with historically underutilized or disadvantaged businesses certified as
such by the State of Texas. Subcontractor shall make a good faith effort to
contract at least thirty (30) percent of the total value of all subcontracts and
supplier contracts for the performance of the activities required by this Contract to
historically underutilized or disadvantaged businesses.
SECTION 23. HEALTH AND SAFETY STANDARDS
Health and safety standards established under Federal, State and local laws are
applicable to working conditions of participants in programs under this Contract. With
respect to any participant in a program conducted under this Contract who is engaged
in activities which are not covered by health and safety standards under the
Occupational Safety and Health Act of 1970, as amended, the Fiscal Agent and the
Department may prescribe such standards as may be necessary to protect the health
and safety of such participants
SECTION 24. INSURANCE
A. When Subcontractor is not a governmental entity with taxing authority, the following
provisions shall apply: Insurance shall be provided for direct delivery of protective
services and other services under this Contract. The Subcontractor shall obtain
and furnish proof of the following bonding and insurance coverage within forty-
_ 1 c.:,
..L ._'
eight (48) hours of the award of this Contract or at such other time as may be
specified by the Fiscal Agent or the Department:
1 Dishonesty bonding under a commercial crime policy or business services
bonding, at a $10,000.00 minimum or up to the Contract amount, whichever is
greater;
2 Commercial General Liability Coverage at a five hundred thousand dollar
($500,000) minimum for each occurrence limit and one million dollars
($1,000,000) minimum aggregate limit. The Fiscal Agent and Department shall
be provided with at least 30 days notice of policy or bond cancellation, intent to
not renew, or material change in the policy or bond;
3 Automobile liability insurance in the broad form, applicable if Subcontractor
uses an automobile, whether owned, leased, or non-owned in conducting its
performance under this Contract, is required which shall have a minimum
required coverage of $500,000 combined single limit. In the event
Subcontractor requires its employees, trainees, volunteers, or other agents to
utilize their own automobiles in the performance of this Contract, Subcontractor
shall secure and maintain on file from all such persons a self-certification of
such coverage: and
4 Workers' compensation and adequate on-site medical and accident insurance
shall be required for all of Subcontractor's employees and enrolled participants,
respectively, appropriate to participant activity. Workers' compensation
coverage shall be required of all organizations serving as employers of record
for any participant, whether that organization is the Subcontractor or a third
party; on-site medical and accident insurance shall be required for all non-work
setting and classroom training activities for participants not qualifying as
employees under the workers' compensation laws. Participants who are
employees must be given comparable benefits afforded by the employer to
other employees of similar standing in the employer's workforce.
B
All coverage must be with insurance companies or carriers rated for financial
purposes "A" or better whose policies cover risks located in the State of Texas. All
bonds, policies, and coverage described above shall be maintained during the
entire term of Contract awarded. Lapse of any coverage or bond required herein
shall be considered breach of Contract and Contract awarded shall be immediately
cancelled.
r
v.
The Department may waive all or part of these insurance requirements at its
discretion.
D.
When Subcontractor is a governmental entity with taxing authority, Subcontractor
shall be required to provide only the workers' compensation insurance coverage,
as set out above, but shall also be subject to the indemnification provisions
- 16
contained in Section 19 (Indemnification) of these Standard Terms and
Conditions.
E. The Fiscal Agent shall be named as a Certificate Holder on all policies named
above and such coverage shall not be canceled or materially changed unless, 30
days prior to the effective date, a written notice is sent to the Fiscal Agent at the
address specified In this Contract. Unless waived by the Fiscal Agent, the Fiscal
Agent shall not be responsible for the payment of premiums or assessments on
such policies
SECTION 25. DEBARMENT AND SUSPENSION
.A. The Subcontractor shall comply with the Federal regulations implementing
Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, as
amended, and, in so doing, provide to the Fiscal Agent and the Department, upon
Subcontractor's signature and execution of this Contract and prior to Fiscal
Agent's execution of this Contract, a certification bearing the following statement:
Subcontractor certifies that neither it nor its principals are presently
debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal
department or agency.
A copy of this certificate and regulations shall be provided to Subcontractor by
Fiscal Agent.
B. Additionally, the Subcontractor shall comply with this regulation and requirement
with regards to its subcontractors. Subcontractor shall require the same
certification from its subcontractors, which shall be forwarded to Fiscal Agent along
with the request for Sub-subcontractor approval as required by Section 8
(Subcontracting) of these Standard Terms and Conditions.
SECTION 26. NOTICE AND ASSISTANCE REGARDING PATENT AND COPYRIGHT
INFRINGEMENT
A. In developing, copying, and disseminating reports or other information under this
Contract, the Subcontractor agrees to the following:
1 Grant to the Department the right to copyright, use, reproduce, and distribute any
material written or produced by the Subcontractor that is the subject of this
Contract; and
2 Defend any claims, suits, or proceedings brought against the State of Texas,
the Department or the Fiscal Agent on the issue of infringement of any
copyright by any product, or any product part, supplied by the Subcontractor to
the Fiscal Agent or Department under this Contract. The Subcontractor will
pay, subject to limitations specified in this section, any final judgment entered
against the State of Texas, the Department, or the Fiscal Agent on this issue
in any suit or proceeding defended by the Subcontractor. The Subcontractor
will be relieved of this obligation if, within 30 days after the Fiscal Agent and
Department receive notice, the Fiscal Agent or Department fails to notify the
Subcontractor in writing of any claim, suit, or proceeding and, at the
Subcontractor's expense, give the Subcontractor all information needed to
defend any claim, suit. or proceeding subject to the jurisdiction of the Attorney
General of Texas.
8. With respect to any invention resulting from this Contract, the Fiscal Agent and the
Department have a nonexclusive, non-transferable, irrevocable, paid-up license to
practice or have practiced the subject invention throughout the world.
C. The Subcontractor shall report to the Fiscal Agent and the Department within 30
days and in reasonable written detail each notice or claim of patent or copyright
infringement based on the performance of this Contract of which the
Subcontractor has knowledge
D. In the event of any claim or suit against the Fiscal Agent or the Department on
account of any alleged patent or copyright infringement arising out of the
performance of this Contract or out of the use of any supplies furnished or work or
services performed under this Contract, the Subcontractor shall furnish to the
Fiscal Agent and the Department, when requested, all evidence and information at
the expense of the Fiscal Agent or the Department except where the
Subcontractor has agreed to indemnify the Fiscal Agent or the Department.
E. The Subcontractor agrees to include, and require inclusion of, this clause in all
subcontracts at any tier for supplies or services expected to exceed $15,000.
SECTION 27. DISCLOSURE OF CONFIDENTIAL INFORMATION
Subcontractor agrees to maintain the confidentiality of any information regarding
applicants, program participants, and their immediate families which may be obtained
through application forms, interviews, tests, reports from public agencies or counselors,
or any other source. Without the permission of the applicant or participant, such
information may be disclosed only as necessary for purposes related to the
performance or evaluation of this Contract and to persons having responsibilities under
this Contract. However, Subcontractor's information may be subiect to required public
disclosure under the Texas Public Information Act. Chapter 552 of the Texas
Government Code.
SECTION 28. COMMUNICATIONS
All notices and requests given to or made to the parties must, except as otherwise
specified. be in writing and delivered or mailed at the notice addresses specified on the
Cover Sheet of this Contract. The parties may change their notice addresses upon five
- 12
(5) written days notice to the other party. Any notices or requests are deemed given
upon actual delivery or depositing the same with the U.S. Postal Service, properly
addressed, postage prepaid, certified mail, return receipt requested.
SECTION 29. GENERAL STANDARDS OF PERFORMANCE
A. Subcontractor agrees that the level of services and activities performed shall be
maintained in accordance with the terms and conditions of this Contract.
B. The Performance Measures, Attachment A-1 to this Contract, Statement of Work,
Attachment A-2 to this Contract, Budget, Attachment B-1 to this Contract, and
Budget Narrative, Attachment B-3 to this Contract, constitute promised
performance under this Contract. If Subcontractor fails to meet the performance
goals for any monthly period as specified under this Contract, this Contract is
subject to obligation or termination in accordance with this Contract.
SECTION 30. ENTIRE AGREEMENT
A. All oral or written agreements between the parties relating to the subject matter of
this Contract made prior to the execution of this Contract have been incorporated
herein.
B. Subcontractor understands and agrees that the Attachments designated on the
Cover Sheet of this Contract are a part of this Contract and constitute promised
performance by Subcontractor under this Contract.
SECTION 31. CONTINGENT ON FUNDING
This Contract is at all times contingent upon the availability and receipt of Federal or
State funds that the Fiscal Agent and Department have allocated to this Contract; and if
funds for this Contract become unavailable during any budget period, this Contract may
be immediately terminated or reduced at the discretion of the Fiscal Agent or
Department.
The Fiscal Agent's obligation is contingent upon the availability of funds from which
payment for the Contract can be made. No legal liability on the part of the Fiscal Agent
for payment of any money arises unless and until funds are made available to the
Fiscal Agent
SECTION 32. TRAINER QUALIFICATIONS
A. Subcontractor agrees to ensure that instructors, trainers, counselors and other
professional and paraprofessional staff shall be properly certified where required
by the Federal, State or local laws. Subcontractor agrees to ensure that
instructors" trainers, counselors professional and paraprofessional and other staff
shall possess education, training, and or experience to provide the skills,
- 19 -
knowledge, and abilities necessary to perform the duties of the position. The
Fiscal Agent or Department reserves the right to review and approve all staff
qualifications and certifications
B. Staffing personnel must be maintained at the level negotiated and contracted for
between the Subcontractor and the Fiscal Agent. Changes in staff positions or
reduction in hours shall be immediately reported to Fiscal Agent for review and
approval.
C. Subcontractor agrees and understands the performance of work proposed"
negotiated, and contracted for must be maintained at the level agreed upon at
initiation of this Contract. Any deviation from these requirements must be reported
to Fiscal Agent. Failure to maintain qualified personnel, the required level of
performance, approved curriculum, and other pertinent quality control standards
required by the Fiscal Agent and Department may constitute a breach of this
Contract, grounds for termination of this Contract by the Fiscal Agent or the
Department, and refund of amounts to Fiscal Agent or Department.
SECTION 33. TERMINATION
A. If the Subcontractor fails to provide services according to the provisions of this
Contract, the Fiscal Agent or Department may, upon written notice of default to the
Subcontractor, terminate all or any part of the Contract. Termination may be
exercised in addition to any other rights and remedies provided by law or under
this Contract
B. The Fiscal Agent or the Department, based on information from monitoring or
other verifiable sources, may terminate this Contract for cause or take other
actions, including, but not limited to:
1 requiring the Subcontractor to take specific corrective actions in order to remain
In compliance with any contractual provision;
2 to recoup payments made to the Subcontractor or impose administrative error
sanctions based on audit findings of violations of Contract requirements; and,
3 to suspend, place into abeyance or remove any contractual rights to include,
but which are not limited to, withholding of payment, cessation of placement
and removal of all Contract rights.
C. If Federal or State laws or other requirements are amended or judicially interpreted
so that either party cannot reasonably fulfill this Contract, and if the parties cannot
agree to an amendment that would enable substantial continuation of the services,
the parties shall be discharged from any further obligations under this Contract.
D. This Contract may be terminated at any time by mutual consent. In addition, either
- 2
party to this Contract may consider it to be canceled by giving 30 days advance
written notice to the other party. This Contract will be terminated at the end of the
30 day period, Nothing in this section shall be construed to prohibit immediate
termination of the Contract pursuant to the sections above. This Contract shall
otherwise terminate by the date specified in the Contract Cover Sheet.
E. At the end of the Contract term or other Contract termination or cancellation, the
Subcontractor, in good faith and in reasonable cooperation with the Fiscal Agent
and the Department, shall aid in the transition to any new arrangement or provider
of services. The respective accrued interests or obligations incurred to date of
termination must also be equitably settled.
F. The Department shall suspend or revoke this Contract if the Subcontractor is
found liable for or has a contract, license, certificate or permit of any kind revoked
for Medicaid fraud The Fiscal Agent shall also suspend or revoke this Contract if
the Subcontractors license, certificate or permit has been revoked by any agency
listed in Article II of the General Appropriations Act passed by the 75th Legislature
of the State of Texas, as it may be amended.
SECTION 34. FORCE MAJEURE
The Subcontractor agrees to be financially liable for undue delays or failures in Contract
performance except for any delay in or failure of performance of any requirement
caused by force majeure (i.e., those causes generally recognized under Texas law as
constituting impossible conditions). Such delays or failures to perform shall extend the
period of performance at the discretion of the Department, in the exercise of reasonable
diligence, until these exigencies have been removed. The Subcontractor shall inform
the Fiscal Agent and the Department in writing of proof of such force majeure within
three (3) business days or otherwise waive this right as a defense. The Subcontractor
agrees that breach of this provision entitles the Fiscal Agent or Department to reduce or
stop payments, immediately terminate this Contract, collect partial or whole payment for
services not timely delivered, collect other liquidated damages including the amount of
any bond for Contract amount, and any other remedies available to the Fiscal Agent
and Department under the terms of this Contract, in equity, or under Texas law.
- 21
Texas Dept of Family
and Protective Services
Contractor Assurances
(with Certification)
Form 4733
September 2004
Failure to respond "yes" to all applicable assurances could result in no award or the nonrenewal of your
contract with the Department.
GrYes 0 No
Contractor has no unresolved audit exception(s) with the Department. An unresolved
audit exception is an exception for which the Contractor has exhausted all
administrative and/or judicial remedies and refuses to comply with any resulting
demand for payment
2 The amounts listed below are the only amounts that the Contractor owes to the ~~s 0 No
Department for audits or recoupment: (If none, mark "yes' and indicate "0' or "none" in
the space below.)
(~)
3 Contractor has not sold or transferred ownership of any Department payments due to
Contractor to any third party. which would result in such payments being made to the
third party
4. Contractor agrees to accept training, technical assistance and monitoring from the
Department and/or its authorized representatives.
5. Contractor certifies that the Contractor's staff or governing authority has not
participated in the development of specific criteria for award/renewal of this contract,
and will not participate in the selection of applicants awarded contracts
6. Contractor has not retained or promised to retain an agent or utilized or promised to
utilize a consultant who has participated in the development of specific criteria for the
award/renewal of this contract, nor will participate in the selection of successful
applicants awarded this contract.
~'DNO
/
1iJX'~~ 0 No
~
DNo
/
~es 0 No
//
7 Contractor agrees to provide the Department with information necessary to validate any G:}Ves 0 No
statements made in this contracting/renewal process if requested by the Department.
This may include, but is not limited to, allowing access for on-site observation, granting
permission for the Department to verify information with third parties, allowing
inspection of Contractor records, and allowing inspection of plans for compliance.
8 Contractor understands that failure to substantiate any statements made in the
contracting/renewal process, when substantiation is requested by the Department, could
cause the Contractor to fail to receive a contract or to fail to have its contract renewed.
9. Contractor agrees to comply with regulations, policies and procedures as specified by
the Department as they relate to particular programs or services under this contract.
10 Contractor will submit any bills required on a calendar-month basis.
11 Contractor has written, or will have written by the effective date of this contract, or its
renewal, Personnel Policies that comply with federal and state regulations and policies.
12. Contractor agrees to comply with Title VI of the Civil Rights Act of 1964 (Public Law 88-
352), Section 504 of the Rehabilitation Act of 1973 (Public Law 93-112), the Americans
with Disabilities Act of 1990 (Public Law 101-336), and all its amendments to each, and
all requirements imposed by the regulations issued pursuant to these acts. In addition,
the Contractor agrees to comply with Title 40, Chapter 73, of the Texas Administrative
COde. These provide in part that no persons in the United States shall, on the grounds
of race, color, national origin, sex, age, disability, political beliefs or religion be
excluded from participation in, or denied, any aid, care, service or other benefits
provided by federal and/or state funding, or otherwise be subjected to discrimination.
Contractor further agrees to comply with Health and Safety Code Section 85.113
~es DNa
///
~es DNo
~ DNo
Yes DNo
~. DNa
Texas Dept of Family
and Protective SefVices
Contractor Assurances
(with Certification)
relating to workplace and confidentiality guidelines regarding AIDS and HIV.
13 Contractor uses generally accepted accounting procedures for fiscal management.
14 Contractor certifies that the Contractor's organization has not had a contract terminated
or been denied the renewal of any contract for noncompliance with policies or
regulations of any state or federally funded program within the past 24 months.
15 Contractor will make available, at reasonable times and for reasonable periods, client
records, books and supporting documents pertaining to services provided for
inspecting, monitoring. auditing, or evaluating by Department personnel or their
representatives.
16. Contractor certifies that funds requested in this contracting/renewal process will not be
used to replace federal, state or local funding
17 Contractor will maintain case records and statistical information as required by the
Department.
18 If Contractor plans to utilize a subcontractor, the written subcontract will comply with
this contract and other relevant Department policies/procedures and will be approved
by the Department in accordance with the Department's subcontract approval
procedures for residential child care contracts.
19 Contractor has written, or will have written by the effective date of this contract/renewal,
plans for the handling of client complaints and grievances.
20. Contractor will establish a method to ensure confidentiality of records and other
information relating to clients according to applicable federal and state law, rules, and
regulations. This provision does not limit the Department's right to access records
under this contract.
21. Contractor will comply with all requests of the Department to meet federal regulations
and with all terms of the contract.
Form 4733
September 2004
~es
~s
DNo
DNo
~~ 0 No
~es DNo
~: DNo
~. DNo
//
~Yes 0 No
/
g4;s 0 No
~ DNo
CERTFICA TION: I certify that the information reported in this contract/renewal is, to the best of my
knowledge, complete and accurate; that the named legal entity has authorized me, as its representative,
to su....it this contract/renewal; and that the legal entity will comply with all terms of the
contract/renewal, including meeting all screening criteria. I have attached a Corporate Board of
Directors Resolution, or similar document authorizing me to enter into contracts on behalf of this legal
entity.
I~ I! .(^
~.UV~
3 - 1- 0 tJ
Date
(~r'-'\.M V l.., -
Title of Authori
IV. C-. /-.- i -{ ~ L II
horized Representative (Printed)
Texas Dept of Famliy
and Protective Services
Certification Regarding Debarment,
Suspension, Ineligibility and Voluntary
Exclusion for Covered Contracts
Form 2046
May 2004
Federal Regulations (45 CFR part 76) require the Texas Department of Family and Protective Services
(DFPS) to determine whether each potential contractor has been debarred or suspended or proposed
for debarment or suspension under 48 CFR part 9, are ineligible, as defined in 45 CFR ~76.105(i) or
has accepted a voluntary exclusion. Each covered contractor must also make the same determination
for each of its covered subcontractors. Contractors and subcontractors are both referred to as lower
tier participants in this Certification
InstrutJions for Certification
By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below:
1 The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into. If it is later determined that the prospective lower tier
participant knowingly rendered an erroneous certification, in addition to other remedies available to
the Federal Government, the department or agency with which this transaction originated may
pursue available remedies. including suspension and/or debarment.
2 The prospective lower tier participant shall provide immediate written notice to the person to which
this proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances, whether the circumstances occur before the contract begins, during the term of the
contract. or during the term of an extension of the contract.
3. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction,
participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as
used in this clause, have the meaning set out in the Definitions and Coverage sections of federal
rules implementing Executive Order 12549. You may contact the person to which this proposal is
submitted for assistance in obtaining a copy of those regulations.
4. The prospective lower tier participant agrees by submitting this proposal that, should the proposed
covered transaction be entered into, it shall not knowingly enter into any lower tier covered
transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4,
debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered
transaction. unless authorized by the department or agency with which this transaction originated.
Do you have~do you anticipate having subcontractors under this proposed contract?
DYes aNo
5 The prospective lower tier participant further agrees by submitting this proposal that it will include
this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion-Lower Tier Covered Transaction," without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
6 A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart
9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it
knows that the certification is erroneous. A participant may decide the method and frequency by
which it determines the eligibility of its principals. Each participant may, but is not required to, check
the List of Parties Excluded from Federal Procurement and Nonprocurement Programs.
Texas Dept of Family
and Protective Services
Certification Regarding Debarment,
Suspension, Ineligibility and Voluntary
Exclusion for Covered Contracts
Form 2046
May 2004
7 Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render In good faith the certification required by this clause. The knowledge and
information of a participant is not required to exceed that which is normally possessed by a prudent
person In the ordinary course of business dealings.
8 Except for transactions authorized under paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or
voluntarily excluded from participation in this transaction, in addition to other remedies available to
the Federal Government, the department or agency with which this transaction originated may
pursue available remedies, including suspension and/or debarment.
CertifICation Regarding Debannent, Suspension, Ineligibility and Voluntary Exclusion-Lower
Tier Covered Transactions
Indicate in the appropriate box which statement applies:
~The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its
principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
OR
[J Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant has attached an explanation to this certification.
rl\ C A
of Potential Contractor
/ D (/ if ~ 3 ,___
VendOr 10' No. or Social Security No
DFPS Contract No. (if applicable)
\
ilL,
3- I - 0 G
Date
.;
G / ".J
'-' f IV. c I-! i -f \ a Vl________~__
Printed/T ped Name of Authorized Repres'Mtative
('c.... )k U ~ :; 7 [l eN ~~ (le cJc <-
Title
Texas Dept of Family
and Protective Services
Certification Regarding Federal Lobbying
(Certification for Contracts, Grants, Loans, and Cooperative Agreements)
Form 2047e
May 2004
PREAMBLE
Federal legislation, Section 319 of Public Law 101-121 generally prohibits entities from using federally appropriated funds
to lobby the executive or legislative branches of the federal government. Section 319 specifically requires disclosure of
certain lobbying activities. A federal government-wide rule, "New Restrictions on Lobbying," published in the Federal
Register. February 26,1990, requires certification and disclosure in specific instances and defines terms:
Covered Awards and Subawards - Contracts, grants, and cooperative agreements over the $100,000 threshold need
(1) certifications, and (2) disclosures, if required. (See certification term number 2 concerning disclosure.)
Lobbying - To lobby means "to influence or attempt to influence an officer or employee of any agency (federal), a
member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with
any of the following covered federal actions:
. the awarding of any federal contract.
. the making of any federal grant,
. the making of any federal loan ,
. the entering into of any cooperative agreement, and
. the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan or
cooperative agreement"
Limited Use of Appropriated Funds Not Prohibited - The prohibition on using appropriated funds does not apply to
activities by one's own employees with respect to:
. liaison activities with federal agencies and Congress not directly related to a covered federal action;
. providing any information specifically requested by a federal agency or Congress;
. discussion and/or demonstration of products or services if not related to a specific solicitation for a covered
action: or
. professional and technical services in preparing, submitting or negotiating any bid, proposal or application for a
federal contract, grant loan or cooperative agreement or for meeting legal requirements conditional to receipt of
any federal contract, grant, loan or cooperative agreement. (The prohibition also does not apply to such
services provided by nonemployees for the same purposes.)
Professional and Technical Services - Professional and technical services shall be advice and analysis directly
applying any professional or technical expertise. Note that the professional and technical services exemption is
specifically limited to the merits of the matter
Other Allowable Activities - The prohibition on use of federally appropriated funds does not apply to influencing activities
not in connection with a specific covered federal action. These activities include those related to legislation and
regulations for a program versus a specific covered federal action
Funds Other Than Federal Appropriations - There is no federal restriction on the use of nonfederal funds to lobby the
federal government for contracts, grants, and cooperative agreements.
Applicability of Other State and Federal Requirements - Neither the government-wide rule nor the law affect either (1)
the applicability of cost principles in OMS circulars A-8? and A-122, or (2) riders to the Texas State Appropriations Acts
which disatlow use of state funds for lobbying
TERMS OF CERTIFICATION
This certification applies only to the Instant federal action for which the certification is being obtained and is a material
representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this
certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any
person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more
than $100,000 for each such failure
The undersigned certifies, to the best of his or her knowledge and belief, that:
No federally appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person
for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer
or employee of Congress, or an employee of a member of Congress in connection with the awarding of any
Texas Dept of Family
and Protective Services
Certification Regarding Federal Lobbying
(Certification for Contracts, Grants, Loans, and Cooperative Agreements)
Form 2047e
May 2004
federal contract, the making of any federal grant, the making of any federal loan, the entering into of any
cooperative agreement, orthe extension, continuation, renewal. amendment, or modification of any federal
contract. grant, loan, or cooperative agreement
2 If any funds other than federally appropriated funds have been paid or will be paid to any person for influencing
or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee
of Congress, or an employee of a member of Congress in connection with this federally funded contract,
subcontract, subgrant, or cooperative agreement, the undersigned shall complete and submit Standard
Fonn-LLL, "Disclosure Fonn to Report Lobbying," in accordance with its instructions. (If needed, contact your
Texas Department. of Family and Protective Services procurement officer or contract manager to obtain a copy
of Standard Fonn-LLL.)
3 The undersigned shall require that the language of this certification be included in the award documents for all
covered subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all covered subrecipients shall certify and disclose accordingly.
Do you have or do you anticipate having covered subawards under this transaction?
o Yes ~
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Vendor10 No. or Social Security N-o.--'-- ..-
DFPS Contract No.
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n___._____n
orized Representative
Date
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