HomeMy WebLinkAboutC2010-406 - 9/1/2010 - NATITLE OF CONTRACT:
CONTRACT NO.:
CONTRACT
(Cover Sheet)
Community Youth Devepment
CYD 2011 -4
This contract ( "Contract ") is entered into by
the following named Subcontractor:
CITY:
City of Corpus Christi- P &RD - CYD
606 N. Carancahua, Ste 105
Corpus Christi, TX 78401
Telephone: (361) 826 -4028
FAX: (361) 826 -4038
Contact Person: Celina Pulcher
the City of Corpus Christi ( "City" or "Fiscal Agent ") and
SUBCONTRACTOR:
Corpus Christi All -Star Gym, LLC
3126 Holly Road
Corpus Christi, TX 78415
Telephone: (361) 361 - 852 -5333
FAX: (361) 361- 854 -1984
Contact Person: Carol Creely
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 which are
incorporated herein by reference:
Contract (Cover Sheet)
Performance Measures (AttachmentA -1)
rk (Attachment A -2) P 1 A1-1
Budget, Reimbursement Request Form & Budget Narrative (Attachments B -1, B -2, and B -3)
Standard Terms and Conditions (Attachment C)
Subcontractor Assesses -with Certification (Attachment D) ( i,-, 4-1 n
entlAttachment-E)
- -.. •
Subcontractor agrees to abide byall 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 of funds for such purpose under the funding sources:
CONTRACT PERIOD: From: September 1, 2010 Through: August 31, 2011
FUNDING OBLIGATION: Not to exceed $35,000.00 for FY 2011 for Contract Period
stated above.
Executed in triplicate, each of which recognized as an original.
Armando Chapa
City Secretary
Legal form approved* ; 4 , 2010;
By:
Name: ; .� .
2010 -406 omej
09/01/10
CC All -Star Gym
City o /Corpus Christi
le
'Ar eVEscobar
C y Manager
Subcontracto
Cor
Date:
INDEXED
78415 COMMUNITY YOUTH DEVELOPMENT PROGRAM
Corpus Christi All -Star Gym, LLC
TABLE OF CONTENTS
Page No.
Contract Cover Sheet
Table of Contents
Contracted Performance Measures (Attachment A -1) 1
Plan of Operation (Attachment A -2) 6
Program Requirements (Attachment A -3) 14
Budget Information Forms (Attachment B -1) 16
Reimbursement Request Form (Attachment B -2) 23
Budget Narrative (Attachment B -3) 24
Standard Terms and Conditions (Attachment C) 25
Sections
1. Legal Authority
2. Independent Contractor
3. Financial Limitation
4. Liability for Payment
5. Changes and Amendments
6. Accounting Requirements
7. Record Keeping /Reporting Requirements
8. Subcontracting
9. Publicity
10. Technical Assistance
11. Monitoring and Assessment
12. Property
13. Taxes
14. Disputes
15. Independent Audit
16. Prevention of Conflicting Interests
17. Fraud and Abuse Prevention
18. Indemnification
19. Sectarian Involvement Prohibited
20. Political Activity /Lobbying
21. Non- Discrimination and Equal Opportunity
22. Reporting Abuse, Neglect, or Exploitation
23. Health and Safety Standards
24. Insurance
25. Debarment and Suspension
26. Notice and Assistance Regarding Patent and Copyright Infringement
27. Disclosure of Confidential Information
28. Communications
29. General Standards of Performance
30. Entire Agreement
31. Contingent on Funding
32. Trainer Qualifications
33. Termination
34. Force Majeure
35. Monthly Performance Review
36. Suspension of Payments
37. Repayment of Funds
38. Subcontractor Compliance with Primary Contract
Subcontractor Certification, Form 4733 (Attachment D) 41
Attachment 1 - Performance Measures
Attachment A -1
Contractor: City of Corpus Christi
Program Name: Community Youth Development (CYD)
Contract Number: 23792861
Contract Period: September 1, 2010 - August 31, 2011
Page 1 of 5
Performance Measures:
Pursuant to Texas Human Resources Code §40.058 all contracts for client services must include clearly
defined goals and outcomes that can be measured to determine whether the objectives of the program
are being achieved. The Department will use the following Performance Measures to evaluate the
success of the Contractor's performance of services under this contract.
Goal of the Contract: To prevent delinquency in Target Youths
Output Measures
Output #1: Average number of Target Youths served monthly in the Contractor's CYD Program
Output Performance Period: Contractor performance for this output is determined for each month of the
contract period, either wholly or partially, depending on the contract start and end dates.
Output Indicator: Average number of unduplicated Target Youths served in the Contractor's CYD Program each
month
Output Target: 650
Purpose: To evaluate the Contractor's effort at providing services to youths in the CYD Program
Data Source: PEIS Database
Methodology: Count all unduplicated Target Youths who were served during the output performance period,
add that number to the number of unduplicated Target Youths served during each previous output performance
period (if any), and divide by the total number of completed output performance periods. For the initial
performance period, the actual number served will be considered the average number served.
Output #2: Number of Target Youths served during the contract period in the Contractor's CYD Program
Output Performance Period: Contractor performance for this output is determined annually but measured
throughout the contract period.
Output Indicator: Total number of unduplicated Target Youths served in the Contractor's CYD Program during
the output performance period.
Output Target: 2150
Purpose: To evaluate the Contractor's effort at providing services to youths in the CYD Program
Data Source: PEIS Database
Methodology: Count all Target Youths with unique client ID numbers who were served during the output
performance period.
Output #3: Completed Pre - Service Protective Factors Survey Questionnaires are obtained from 6 -9 year
old Target Youths served in the Contractor's CYD Program.
Output Performance Period: Contractor performance for this output is determined annually but measured
throughout the contract period.
Output Indicator: Percentage of eligible 6 -9 year old Target Youths served in the Contractor's CYD Program
from which a completed Pre - Service Protective Factors Survey Questionnaire is obtained by the Contractor
Output Target: 100%
Purpose: To evaluate the Contractor's effort at obtaining outcome data
Data Sources: Pre - Service Protective Factors Survey Questionnaires and PEIS Database
Methodology: The numerator is the number of eligible 6 -9 year old Target Youths served in the Contractor's
CYD Program during the output performance period from which a completed Pre - Service Protective Factors
t
Attachment 1 - Performance Measures
Page 2of5
Survey Questionnaire was obtained. The denominator is the total number of eligible 6 -9 year old Target Youths
served in the Contractor's CYD Program during the output performance period. Divide the numerator by the
denominator, multiply by 100 and state as a percentage.
Output #4: Completed Pre - Service Protective Factors Survey Questionnaires are obtained from 10 -17
year old Target Youths served in the Contractor's CYD Program.
Output Performance Period: Contractor performance for this output is determined annually but measured
throughout the contract period.
Output Indicator: Percentage of eligible 10 -17 year old Target Youths served in the Contractor's CYD Program
from which a completed Pre- Service Protective Factors Survey Questionnaire is obtained by the Contractor
Output Target: 100%
Purpose: To evaluate the Contractor's effort at obtaining outcome data
Data Sources: Pre - Service Protective Factors Survey Questionnaires and PEIS Database
Methodology: The numerator is the number of eligible 10 -17 year old Target Youths served in the Contractor's
CYD Program during the output performance period from which a completed Pre - Service Protective Factors
Survey Questionnaire was obtained. The denominator is the total number of eligible 10 -17 year old Target
Youths served in the Contractor's CYD Program during the output performance period. Divide the numerator by
the denominator, multiply by 100 and state as a percentage.
Output #5: Completed Post - Service Protective Factors Survey Questionnaires are obtained from 6 -9 year
old Target Youths served in the Contractor's CYD Program.
Output Performance Period: Contractor performance for this output is determined annually but measured
throughout the contract period.
Output Indicator: Percentage of eligible 6 -9 year old Target Youths served in the Contractor's CYD Program
from which a completed Post - Service Protective Factors Survey Questionnaire is obtained by the Contractor
Output Target: 60%
Purpose: To evaluate the Contractor's effort at obtaining outcome data
Data Sources: Post - Service Protective Factors Survey Questionnaires and PEIS Database
Methodology: The numerator is the number of eligible 6 -9 year old Target Youths served in the Contractor's
CYD Program during the output performance period from which a completed Post- Service Protective Factors
Survey Questionnaire was obtained. The denominator is the total number of eligible 6 -9 year old Target Youths
served in the Contractor's CYD Program during the output performance period. Divide the numerator by the
denominator, multiply by 100 and state as a percentage.
Output #6: Completed Post- Service Protective Factors Survey Questionnaires are obtained from 10 -17
year old Target Youths served in the Contractor's CYD Program.
Output Performance Period: Contractor performance for this output is determined annually but measured
throughout the contract period.
Output Indicator: Percentage of eligible 10 -17 year old Target Youths served in the Contractor's CYD Program
from which a completed Post - Service Protective Factors Survey Questionnaire is obtained by the Contractor
Output Target: 60%
Purpose: To evaluate the Contractor's effort at obtaining outcome data
Data Sources: Post - Service Protective Factors Survey Questionnaires and PEIS Database
Methodology: The numerator is the number of eligible 10 -17 year old Target Youths served in the Contractor's
CYD Program during the output performance period from which a completed Post- Service Protective Factors
Survey Questionnaire was obtained. The denominator is the total number of eligible 10 -17 year old Target
Youths served in the Contractor's CYD Program during the output performance period. Divide the numerator by
the denominator, multiply by 100 and state as a percentage.
Output #7: Completed Prevention and Early Intervention Youth Satisfaction Survey Questionnaires are
obtained from 10 -17 year old Target Youths served in the Contractor's CYD Program.
Output Performance Period: Contractor performance for this output is determined annually but measured
throughout the contract period.
Attachment 1 - Performance Measures
Page 3 of 5
Output Indicator: Percentage of eligible 10 -17 year old Target Youths in the Contractor's CYD Program from
whom a completed Prevention and Early Intervention Youth Satisfaction Survey Questionnaire is obtained by the
Contractor
Output Target: 50%
Purpose: To evaluate the Contractor's effort at obtaining outcome data
Data Sources: Prevention and Early Intervention Youth Satisfaction Survey Questionnaires and PEIS Database
Methodology: The numerator is the number of eligible 10 -17 year old Target Youths served during the output
performance period from whom a completed Youth Satisfaction Survey Questionnaire is obtained. The
denominator is the total number of eligible 10 -17 year old Target Youths served during the output performance
period. Divide the numerator by the denominator, multiply by 100 and state as a percentage.
Outcome Measures
Outcome #1: 6 -9 year old Target Youths report an increase in the protective factors.
Outcome Performance Period: Contractor performance for this outcome is determined annually but measured
throughout the contract period.
Outcome Indicator: The change in the aggregate number of protective factors, as determined by comparison of
the Pre - Service Protective Factors Survey Questionnaires to the Post - Service Protective Factors Survey
Questionnaires
Outcome Target: The target for this measure will be negotiated after baseline data are collected from the 6 -9
year old Target Youths receiving services during Fiscal Year 2011.
Purpose: To evaluate the Contractors success at increasing protective factors in the 6 -9 year old Target Youths
who are served by the Contractor's CYD Program
Data Sources: Pre - Service and Post - Service Protective Factors Survey Questionnaires and PEIS Database
Methodology: The methodology for this outcome will be developed by DFPS when the survey tool has been
validated.
Outcome #2: 10 -17 year old Target Youths report an increase in the protective factors.
Outcome Performance Period: Contractor performance for this outcome is determined annually but measured
throughout the contract period.
Outcome Indicator: The change in the aggregate number of protective factors, as determined by comparison of
the Pre - Service Protective Factors Survey Questionnaires to the Post - Service Protective Factors Survey
Questionnaires
Outcome Target: The target for this measure will be negotiated after baseline data are collected from the 10 -17
year old Target Youths receiving services during Fiscal Year 2011.
Purpose: To evaluate the Contractor's success at increasing protective factors in the 10 -17 year old Target
Youths who are served by the Contractor's CYD Program
Data Sources: Pre - Service and Post - Service Protective Factors Survey Questionnaires and PEIS Database
Methodology: The methodology for this outcome will be developed by DFPS when the survey tool has been
validated.
Outcome #3: 10 -17 year old Target Youths are satisfied with the Contractor's CYD Program services
received.
Outcome Performance Period: Contractor performance for this outcome is determined annually but measured
throughout the contract period.
Outcome Indicator: Percentage of Prevention and Early Intervention Youth Satisfaction Survey Questionnaires
completed by 10 -17 year old Target Youths with average scores of five or higher for the first eight items
Outcome Target: 80%
Purpose: To evaluate the Contractor's success at providing services that are perceived as satisfactory by the
10 -17 year old Target Youths receiving the services
Data Sources: Prevention and Early Intervention Youth Satisfaction Surveys and PEIS Database
Methodology: The numerator is the number of completed Questionnaires for the outcome performance period
Attachment 1 - Performance Measures
Page 4 of 5
with an average score of five or higher for the first eight items. The denominator is the total number of completed
Questionnaires for the outcome performance period. Divide the numerator by the denominator, multiply by 100
and state as a percentage. (The Contractor must meet or exceed the target for Output #7 in order to achieve the
target for this outcome.)
Outcome #4: 10 -16 year old Target Youths served in the Contractor's CYD Program will not engage in
delinquent behavior.
Outcome Performance Period: Contractor performance for this outcome is determined annually but measured
throughout the contract period.
Outcome Indicator: Percentage of 10 -16 year old Target Youths that are not referred to a county juvenile
probation program while registered in and receiving services from the Contractor's CYD Program
Outcome Target: 95%
Purpose: To evaluate the Contractor's success in providing services that deter delinquent behavior in 10 -16 year
old Target Youths receiving services from the CYD Program
Data Sources: Texas Juvenile Probation Commission and PEIS Database
Methodology: The numerator is the total number of unduplicated 10 -16 year old Target Youths served in the
Contractor's CYD Program during the outcome performance period who were also referred to a county juvenile
probation program while registered in and receiving services from the Contractor's CYD Program. An existing
protocol for matching youth data maintained in the CYD database with youth data maintained by the Texas
Juvenile Probation Commission will be used to establish the numerator. The denominator is the total number of
unduplicated 10 -16 year old Target Youths served in the Contractor's CYD Program during the outcome
performance period. Divide the numerator by the denominator, subtract this number from one, multiply by 100
and state as a percentage.
Definitions
Aggregate — The sum of the numbers of protective factors identified by all 6 -17 year old Target Youths who
• completed a Protective Factors Survey Questionnaire (for Age 6 -9 or Age 10 -17, as appropriate) during the
outcome performance period.
Average Score (for the Satisfaction Survey Questionnaire) — For each completed Youth Satisfaction Survey
Questionnaire, add the scores for the first eight items and divide by five.
Completed Protective Factors Survey Questionnaire — A definition for this term will be developed by DFPS
when the respective survey tools (Age 6 -9 or Age 10 -17) are made available to the Contractor.
Completed Youth Satisfaction Survey Questionnaire — A 10 -17 year old Target Youth responds to a number from
the 7 -point Likert scale for each of the first eight items on the Questionnaire.
Contract Period — The total length of this time frame is limited to all or part of the current fiscal year and shall not
exceed 12 months.
Eligible (to respond to the Post - Service Protective Factors Survey Questionnaire) — A 6 -17 year old Target Youth
that has completed a Pre - Service Protective Factors Survey Questionnaire and;
• Completed the prescribed CYD Program; or
• Participated in the CYD Program for 12 months from the date the Pre - Service Protective Factors
Survey Questionnaire was completed.
The Post - Service Protective Factors Survey Questionnaire must be the same version (Age 6 -9 or Age 10 -17) that
was administered to the youth as the Pre - Service Protective Factors Survey Questionnaire. The youth's age is
calculated as of the date of registration or September 1st of the current fiscal year if the youth was registered in a
previous fiscal year.
Eligible (to respond to the Pre - Service Protective Factors Survey Questionnaire) — A 6 -17 year old Target Youth
that is newly registered into the CYD Program during the current contract period. The youth's age is calculated as
of the date of registration in the contract period assessed.
Eligible (To respond to the Youth Satisfaction Survey Questionnaire) — A 10 -17 year old Target Youth that has:
• Completed the prescribed CYD Program; or
• Participated in the CYD Program for 12 months; or
• Exited the CYD Program.
Exited — A Target Youth stopped accepting services during the output performance period without completing the
program.
Attachment 1 - Performance Measures
Page 5 of 5
Likert scale — A linear set of responses often used in questionnaires.
Post - Service Protective Factors Survey Questionnaire — A tool identical to the Pre - Service Protective Factors
Survey Questionnaire administered to the 6 -17 year old Target Youth following the receipt of services and
designed to assess changes in the levels of the Target Youth's protective factors.
Pre - Service Protective Factors Survey Questionnaire — A tool administered to the 6 -17 year old Target Youth
prior to the receipt of services and designed to assess the levels of the Target Youth's protective factors.
Protective Factors — Personal characteristics or environmental conditions that interact with risk factors to reduce
the likelihood of problem behaviors.
Satisfied — A response of five or higher on the 7 -point Likert scale.
Target Youths — Youths through 17 years of age who live in and/or attend school in one of the designated ZIP
Code areas or attend school at another eligible public middle or high school located outside of the designated ZIP
Code area that has at least 30% enrollment from the designated ZIP Code area as determined by DFPS.
Unduplicated Target Youth — A Target Youth with a unique client ID number who receives at least one service
is only counted one time during the performance period.
Community Youth Development Program
FY 2011 Subcontractor Plan of Operation
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Fiscal Agent/Primary Contractor: City of Corpus Christi
Subcontractor Name: Corpus Christi All -Star Gym, LLC
Total CYD Funding Amount: $35,000
Program Name: Kids In Motion
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Name:
Title:
E-mail: Phone Number:
Carol Creely
Owner
carolcreelvaaol,com 361- 852 -5333
Address: 3126 Holly Road, Corpus Chr'sti, Texas 78415
Contract Period: From: Sept 1, 2010 To: Aug 31, 2011
(Inclusive Dates of Service): Same as contract period
Yes: ❑ No: 41 If not, From: Sept 1, 2010 To: June 10,
2010
Funding Priority(ies): #2 Life Skills and #3
Recreational Services
All addresses (locations) where services will be provided, (p ease use full address):
1. Corpus Christi All Star Gyrn, 3126 Holly Road, Corpus Christi, Texas 78415
2.
3.
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Output #1:
Average number of unduplicated
youth served monthly* :
21
3g
Output #3:
Average number of
unduplicated adults served
monthly *:
0
Output #2:
Number of unduplicated youth
served during the fiscal year * *:
138
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Output #4:
Number of unduplicated
adults served during the
fiscal year * *:
0
Calculate the cost of the overall program per youth (Cost per = $Contract amount /# youth served annually.): $253.62
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Please fill in the following chart to explain how you will reach your target outputs during the fiscal year. If clients
will be served only in individual or group services, add the Annual Outputs for both services and enter the sum
above. On the other hand, if clients will be served by BOTH individual AND group services, the annual outputs
should be identical and that number should be entered above. Be sure to include all services that will be
provided. Copy and paste multiple rows as needed.
Individuals:
6
Maximum
Number
Total number
Number of
Average number
Annual Output
Caseload
of staff
of youth
program cycles
of youth served
(monthly output x
per staff
served per
program cycle
per year
monthly
(caseload x staff
number of cycles per
year)
(caseload x #
- 10 %)
6
of staff)
Groups:
1. Is this CYD Program a stand -alone program or component of a larger program? The program is the amalgam
of all the separate services provided.
Stand -alone
❑ Component of a larger program (Name of the larger program --All -Star Gym Cheerleading Program)
2. Check the services to be provided:
❑ Youth -Based Curriculum Activity
❑ Family -Based Curriculum Activity
❑ Family Focused Service
® Recreational Services
❑ Academic Support Services
Life Skills Classes
❑ Mentoring
❑ Youth Leadership Development
El Youth Advisory Committee Business (only one provider may
provide the YAC business service type)
3. Check the protective factors this program will identify for change:
❑ Involvement with positive peer group activities and norms
® Social competencies such as decision making skills, assertiveness and interpersonal skills
❑ Parental /guardian supervision
['Caring adults other than parent
❑ Strong bond between children and parents
❑ Emotional support and absence of severe criticism
❑ High parental expectations
® Clear rules and expectations
❑ Involvement with school /community
® Friendship network
® Positive perception of self and others
® Places high values on helping others
® Sense of purpose
„gar
4. Describe the services to be provided. Be sure to include every service indicated In the check box above.
Indicate the time of day that services will be provided (e.g. afterschool, weekends, during the school day)
Services are offered twice weekly after school for 32 weeks. At the start of each session, youth are introduced to a
Nutrition Training Program which consists of 15 minutes of nutrition education, review of healthy and unhealthy eating
habits and factors affecting eating habits, maintaining a food journal to assist in identifying triggers for unhealthy eating
practices and role - playing / skills training on how to practically maintain a nutritional diet and eating habits on a daily
basis. The goal of this program is to assist youth in changing their basic habits and making better choices whenever
possible about what they eat and why.
For the next 15 minutes youth undergo Physical Fitness Development and evaluation. This helps us assess ability and
development of basic skills. Youth will undergo a series of assessments based on traditional physical fitness tests
7
Maximum
group size
Number of
group
sessions
running
concurrently
Total number of
youth served per
program cycle
(group size x # of
concurrent
group sessions)
Number
of
program
cycles
per year
Average
Monthly
Output:
(group size
x # of group
sessions -
10 %)
Annual Output
(monthly output x
number of group
cycles per year)
Life Skips &
Recreational
Services
11
14
11 x 14 = 140
1 (32
weeks)
1 x 14 = 140
— 10% = 138
138 x 1 = 138
1. Is this CYD Program a stand -alone program or component of a larger program? The program is the amalgam
of all the separate services provided.
Stand -alone
❑ Component of a larger program (Name of the larger program --All -Star Gym Cheerleading Program)
2. Check the services to be provided:
❑ Youth -Based Curriculum Activity
❑ Family -Based Curriculum Activity
❑ Family Focused Service
® Recreational Services
❑ Academic Support Services
Life Skills Classes
❑ Mentoring
❑ Youth Leadership Development
El Youth Advisory Committee Business (only one provider may
provide the YAC business service type)
3. Check the protective factors this program will identify for change:
❑ Involvement with positive peer group activities and norms
® Social competencies such as decision making skills, assertiveness and interpersonal skills
❑ Parental /guardian supervision
['Caring adults other than parent
❑ Strong bond between children and parents
❑ Emotional support and absence of severe criticism
❑ High parental expectations
® Clear rules and expectations
❑ Involvement with school /community
® Friendship network
® Positive perception of self and others
® Places high values on helping others
® Sense of purpose
„gar
4. Describe the services to be provided. Be sure to include every service indicated In the check box above.
Indicate the time of day that services will be provided (e.g. afterschool, weekends, during the school day)
Services are offered twice weekly after school for 32 weeks. At the start of each session, youth are introduced to a
Nutrition Training Program which consists of 15 minutes of nutrition education, review of healthy and unhealthy eating
habits and factors affecting eating habits, maintaining a food journal to assist in identifying triggers for unhealthy eating
practices and role - playing / skills training on how to practically maintain a nutritional diet and eating habits on a daily
basis. The goal of this program is to assist youth in changing their basic habits and making better choices whenever
possible about what they eat and why.
For the next 15 minutes youth undergo Physical Fitness Development and evaluation. This helps us assess ability and
development of basic skills. Youth will undergo a series of assessments based on traditional physical fitness tests
7
including flexibility, endurance, strength and ability. Each session we build on these components and it also serves as a
warm -up period prior to any exercises.
For the last 30 minutes, youth are exposed to Skills Building — this is a variety of skills including cheerleading, dance,
Rockwall, tumbling, and/or trampoline. As interest and talent in each area develops, students will be allowed to access the
facility for two -hour bonus periods to engage in the desired activity during a two -hour "free" period.
a. Cheerleading Module — consists of a general warm -up and then instruction in the basic categories of Cheerleading;
Motions, Jumps, Tumbling and Stunts. The instructors are certified through either AAU, UCA, ACA or NCA
Cheerleading Associations and the students will be evaluated and promotion is based on an individual basis.
Students receive certificates and chevrons when skills are mastered. Divided into different age groups, the students
would learn the basics needed to perform a competition routine that they will perform at an AAU sanctioned
Cheerleading Meet. As an option for boys that do not wish to participate in cheerleading, they will be able to do
additional work in any of the other categories or an additional program may be added to peak their interest.
b. The Dance module is a nontraditional Hip Hop Jazz Funk class consisting of a warm -up routine followed by
instruction in basic dance moves and skills. Students receive certificates and chevrons when skills are mastered in
areas of Dance Moves, Jumps & Leaps and Turns. The goals include learning basic skills that would lead to a
competition routine that would be performed at an AAU Dance competition.
c. The Speed Climbing — Indoor Rock Climbing module would allow children instruction in rock climbing, rope and
belaying techniques as well as repelling. The instructors are Certified Ropes Course Instructors. This program
benefits strength, strategy, social interaction, self - esteem and self -worth building skills.
d. The Tumbling. and Trampoline Module consists of learning basic gymnastic and acrobatic skills and techniques
utilizing in- ground trampolines and the spring - loaded gymnastics floor. Basic tumbling and trampoline skills are the
foundational skills needed for all gymnastics programs and are required to be mastered prior to advancement to other
gymnastic activities and can be used to enhance performance in and mastery of other sports.
5. Describe what startup activities will be necessary, including but not limited to hiring and training staff,
publicizing your program in the community, and recruiting youth to the program. Provide a brief timeline for all
activities. The program is continually running so to prepare for CYD youth, we already have the staff trained and
available. We already have a relationship within some of the schools so we will begin our publicizing there. We are
prepared to send information out into the 78415 Community to make them aware of the program as soon as we are
approved. Most of the other start-up is familiarizing staff with paperwork, scheduling and structuring the classes.
6. Identify the frequency, intensity and duration of services fora client:
Life Skills Nutrition Trainin•
Recreation Services (Fitness Development
& Skills Buildin• Pro•ram
Copy and paste additional rows if needed.
8
7. identify the target population to be served:
� � C i
VIMPN� :. - .� i�� ,r,� V °i , $ i -, � �i#i;�3 Eda.° f 'r .mss' I P der; ° l { J lei ., - : �, '�' ��j ;,;+1, it re
Is any part of the program designed to serve ages other than the CYD target population of 10 -17?
Yes /:1 No NI
If yes, please describe:
The program is designed to serve all ages of youth from 6 -17, The youth are broken up in to different groups to
accommodate the ages and the skill levels, but there is a cap to the number of younger youth that the program will
allow to participate.
Is any part of the program specifically designed to serve only males or females? Yes 0 No /1
If yes, please describe: -
Is any part of the program specifically designed to serve a specific racial or ethnic group? Yes ❑ No a1
If yes, please describe:
8. If applicable, identify any program model or curriculum to be implemented and include the developer of the
program (e.g. All Stars Curriculum by Tanglewood). The curriculum that will be utilized by the Kids in Motion program
was developed by the CC All Star Gym staff and nutrition experts based on the nutrition and athletic principles supported
by the USA Gymnastics Association and sanctioned by the Amateur Athletic Union (AAU). These principles include
education on the science of nutrition that can facilitate athletic success and tips on nutrition and healthy eating habits that
enhance positive self image and physical well being. Participants will learn how to develop wellness through physical
activity, self monitoring and assessment, specific skills development in tumbling, trampoline, cheerleading and Rockwall.
Participants will also be required to maintain a record of eating habits and explore the relationship between those habits
and their behavior and sense of well being. Participants will also learn practical ways to make healthy eating choices as
well as increasing physical activity in their daily lives.
9. Identify the CYD Program's goals and objectives. All goals and objectives should address the impact on
juvenile delinquency. Goals are broad statements of what your program is intended to achieve. Objectives are
specific, measurable, achievable, relevant and time- focused statements.
Goal(s):
To provide an athletic program to at -risk youth residing in the 78415 community that will increase their athletic skills
•
and abilities and teach them positive nutrition habits.
Objective(s): Within a 32 -week period, participant's will have increased knowledge of positive eating habits and will
exhibit measurable improvements in their physical fitness. (This will be measured by the participant's completion of
the entire 32 -week program)
10. Describe the evaluation plan for the program to include: staff responsible for evaluation, how evaluation
data will be collected, how evaluation data will be conveyed to relevant staff and how evaluation data will be used
to revise or improve the program, to include at least the results of the satisfaction surveys. Include a list of
measurement tools that will be collected, if applicable, to demonstrate on -going program effectiveness and
implementation of the program design. The Program is evaluated by the owner of the gym through observation and by
talking with staff and participants. Each day, the owner meets with the staff to discuss issues that may have arisen and
discuss if changes need to be done. We also review the Satisfaction Surveys that are submitted to the CYD program. We
review the comments that were made and have open discussions with the staff to review. We also work closely with the
CYD Program Manager to review reports from the data that was entered in the database and discuss possible revisions if
needed.
'VOW evortowitir
11. Recruitment
a. Describe the process for recruitment of at -risk youth and their families. Provide a description of any
outreach strategies used to encourage referrals and collaboration. Include recruitment efforts to address
cultural diversity. Identify those agencies and organizations which are likely to refer clients. The plan for
recruiting youth for the Kids in Motion Program is:
9
• referrals made by school personnel including PE instructors, Teachers, Counselors and any staff who has
direct contact with a student
• community professionals such as social Workers, counselors, Communities In Schools personnel, Parks
and Recreation personnel and other partners with direct access to information concerning the student's
status and need.
• Parents and family members of the student who express a need for the student to participate
• Self- referral by the student him / herself
The program will be introduced to parents, students and community partners through a mail -out campaign to
explain the benefits and parameters of the program and with school permission, an exposition of the program
activities may be conducted at the school. The gym will feature an open house to allow all interested parties to
see what there is to offer and local ads / publicity will be utilized to recruit youth. If preliminary recruiting does not
produce the required number of youth, we will then directly contact community partners and school personnel for
assistance in identifying targeted youth and make contact with those families directly to encourage the student's
participation.
b. Describe any community based outreach and awareness events or activities your program will
implement or participate in this year. Each year we participate in the Fall Fire Expo, AngelTree at Christmas
and Summerpalooza. We use the events to showcase some of the youth's skills that they have developed. It is a
great way to bring awareness to the program. We are working on a Spring Performance and also performing in
the Junior Buc Parade that is held in February.
12. Retention
a. Describe strategies used to engage youth and their families. Describe any techniques you will
implement to establish trust, build rapport, and maintain relationships with your target population. The
coaches talk with the youth everyday and quickly build a rapport by challenging them to make changes to their
daily routines and working on their fitness. The youth discuss with the coaches the challenges they face and what
they would like to change. In addition, the owner will talk with the families members as they wait for their youth.
This helps to build a relationship with the family and not just the youth and helps to discover how the youth is
interacting at home with their new skills,
b. Will your program offer incentives for participation? ® Yes ❑ No
If yes, describe the types of incentives and how they will be used (Note: Please refer to the PEI policy on
incentives). Participants will be rewarded with certificates and ribbons for reaching physical fitness milestones. In
addition, participants will earn opportunities to participate in competition for the opportunity to earn trophies for
participation and skill.
c. Describe your plans to retain youth in the program and ensure youth complete the program. Describe
how you will recover youth who stop attending services to return to the program. Participant's retention
depends primarily on showing individual progress, measurable improvement in ability and performance, and
recognition and reward through individual progress and team competition in the athletic activity. Each participant
will be responsible for maintaining a record of his / her own progress in addition to records kept by the program.
As the student progresses and sees improvement he / she will be rewarded through certificates and ribbons for
reaching physical fitness milestones. In addition, the participant will earn opportunities to participate in competition
for the opportunity to earn trophies for participation and skill. The positive aspects for participating in team sports,
building close relationships with teammates and working toward a common goal, in addition to the activities being
fun, fast -paced and novel to the participant will produce the desired retention. Students will be allowed to progress
at their own pace and be measured primarily by their own improvements rather than be in competition with peers
inside the gym. This will reduce if not eliminate the need to be in competition with peers and foster a sense of
group pride and teamwork. Attendance will be taken of the youth each week and for those youth that stop
attending, phone calls will be made to the home.
=ET MENA
13. Will this program use volunteers? El Yes ® No
If yes, describe the procedures for recruiting and screening volunteers and what criteria will be used to ensure
they are a good fit to deliver the proposed services. N/A
14. Explain the tasks which will be assigned to volunteers (mentoring, tutoring, presenting), how they will be
trained, supervised, and retained (once a month supervision is required per the RFP). N/A
10
15. If volunteers will serve as mentors, state the adult to youth ratio. N/A
EMMA
Po
16. Discuss potential barriers (e.g. transportation, child care, etc.) to providing services to program participants
and how you will overcome those barriers. If transportation will not to be offered, identify the processes that are
used to ensure that these factors are not obstacles to accessing services. It is the goal of the Kids In Motion
program to use Grant funds to purchase bus passes for distribution to qualified families for the purpose of assisting in
transportation to and from the facility for classes. As Gym staff will not be transporting youth, written parental consent
must be given to allow the youth to ride on the bus or youth must wait to be picked up by an authorized relative.
17. Describe the "safe passage" plan for youth /families without transportation. Participant's safety is vital to the
success and continuance of the Kids in Motion program. The building is 18,000 ft with a security alarm and 11 video /
surveillance cameras inside and outside the facility monitoring the entire complex 24 hours a day 7 days a week. The
facility is located directly in the middle of the 78415 Community with ease of access from all areas. There is a large, well -
lit parking area with a bus stop within a few feet of the facility. Students will also be under constant supervision and will not
be allowed to leave the facility without the supervision of an authorized adult. The students utilizing the city's
transportation system would be allowed to leave the facility with visual observation to the bus stop and entrance onto the
bus.
18. Use the table below to describe the staffing plan, including the back up staffing plan in the event of
vacancies or extended absences. (What staff positions will work directly on the CYD contract and which position
will supervise whom and provide coverage, if necessary). These five positions will work directly with the CYD
contract youth. All have had a background check completed and we have also included additional staff just in case of
vacancies.
Position title (indicate if a
volunteer)
Services for which this
position is responsible
Position supervised by:
Position has backup by
this position:
Program Director
Responsible for maintaining
the paperwork and
scheduling
Owner
Owner
Nutritionist
Responsible for facilitating
Healthy Living program
Owner
Staff
Coach #1
Responsible for teaching
the youth the program skills
Owner
Additional Staff
Coach #2
Responsible for teaching
the youth the program skills
Owner
Additional Staff
Assistant Coach
Responsible for teaching
the youth the program skills
Coach 1 & 2
Additional Staff
Describe staff supervision and support. We have several levels of support and staff supervision. All staff
is trained and experienced in tumbling and cheerleading. They are also cross - trained on the CYD
paperwork in the case of vacancies. The Owner is present everyday to watch interactions and to keep
an eye on the facility and classes. Brief meetings are held with the staff everyday to go over any
issues that may be occurring and discussion is had on any necessary changes. The staff always have
back -up help to assist in case there is a need in order to ensure the safety of the youth.
11
Signatu
fPers
Plan of Operation for the Subcontractor:
arol Creel
Printed Name
Signature of Contractor Staff App oving the Plan of Operation:
L46z Dll.� -���r
Signature
Celina Pulcher
Printed Name
9
Date
Date
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7
7
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ut an, •aste additional rows if needed
Attachment A -3
Program Requirements - FY2011
78415 Community Youth Development
Plan changes. Plan changes to budgets and plan of operation are each limited to three
during the fiscal year with the final plan change to be submitted no later than June 1. Any
additional request for plan changes will require a waiver prior to requesting the change. All
waiver requests must be submitted to the CYD Program Manager with the original signature of the
contract's authorized signatory and must completely document specific compelling reasons
for the request. Waiver requests must be submitted at least 30 days in advance of the
anticipated plan change and are subject to DFPS's approval.
Automated Background Checks. All staff and volunteers that work or will work on the
contract are required to have background checks conducted through the Automated
Background Check System (ABCS) who have contact with client or client information or if
salary is reimbursed through the contract. It is assumed that staff including, but not limited to,
Executive Directors and Chief Financial Officers will have access to clients or client records
due to their oversight roles; therefore, require a cleared background check.
Quarterly Reports and Corrective Action Plans. Each quarter the Subcontractor is required to submit a
Quarterly Report no later than 30 days after the end of the first, second and third quarters. The Quarterly
Report must include information on the program, how the subcontractor is performing and any corrective
action plans that are required. At the end of the year the subcontractor is required to submit a Fourth
Quarter /Annual Report that provides ongoing_ information regarding achievements and challenges in
implementing the CYD program during the 4m quarter and the full contract year.
A corrective action plan must include a statement of the problem, proposed steps to be taken,
timeline for each step, person(s) responsible for implementing each step, and person
responsible for oversight of the plan to ensure it is implemented correctly. Corrective action
plants must be submitted on the required template and must outline the measures that will be
taken by subcontractor to address each performance measure that is off track.
Program Services. Youth may not participate solely in one -time activities. If one -time activities are
planned as a service, they should be an added value for youth already participating in other CYD
Program Services and cannot be a stand -alone service.
Direct service staff of the Subcontractor must be at least 18 years of age, have a High School Diploma or
GED, and 1 year of experience in the health and human services field to include work with youth.
Program Forms and Social Security Numbers. Contractors are required to complete all
fields of the program form such as the registration form, in its entirety including the social
security numbers field. If a client refuses to provide their social security number, contractors
must document refusal in the case file. The expectation is that contractors make a good faith
effort to obtain social security numbers and other information listed on the program form,
Sections of the program registration forms that have an asterisk are required fields in the
database; however, the expectation is that the form is completed thoroughly.
All services provided in accordance with the Subcontractor's approved Plan of Operation must be tracked
using the appropriate documentation forms. Service documentation must be complete, accurate and
14
maintained in an organized fashion. Subcontractor must maintain records in a manner which protects the
confidentiality of the clients being served. Service documentation must include, but is not limited to:
Sign -in sheets, particularly for group activities
Monthly Service Tracking Forms
Satisfaction Surveys
Documentation may also include, if applicable:
Service plans
Referral logs
Case notes, including phone logs, home visit notes, office visit notes, etc
All services provided by subcontractor must have valid documentation that supports verification of
participant attendance, such as sign -in sheets or attendance rolls, including a signature certifying the
validity of the information, individual /group progress notes, materials /hand -outs used and additional
documentation as appropriate to the program.
Client files must include, at a minimum, the following forms completed:
The DFPS Registration Form
CYD Risk Factor Survey
Pre - service Protective Factors Survey
Post - service Protective Factors Survey
Cost Reimbursements. Subcontractors must submit reimbursement requests by the 5th of each month.
The City nor DFPS is obligated to pay unauthorized costs or to pay more that Subcontractor's allowable
and actually incurred costs consistent with federal and state regulations. The reimbursement made to
Subcontractor will not exceed actual costs to provide the services under this Contract and
Subcontractor's actual costs, both direct and indirect, must be allowable, reasonable, and allocable.
Subcontractor must submit supplemental bills quarterly, (December 30, March 30, June 30 or September
30) to submit costs not included on the main monthly bill. Only one supplemental bill may be submitted for
each month, so all additional costs must be included.
Reallocation of Funds. Subcontractor agrees that if after careful review by the Fiscal Agent it does not
appear that the subcontractor will utilize all funding by the end of the third quarter (April 30), the
Subcontractor could lose uncommitted funds in excess of $2,500, subject to reinstatement through the
appeals process set below. Fiscal Agent will notify Subcontractor in writing of the pending budget
reduction to Subcontractor's budget and give Subcontractor fourteen (14) calendar days to respond. If
Subcontractor does not respond within fourteen (14) calendar days, then the budget adjustment will be
made and Subcontractor must submit an adjusted budget to Fiscal Agent that reflects the reduced budget
amount within fourteen (14) calendar 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 Subcontractor will be used for other CYD programs.
Controlled Assets. Subcontractors must complete an inventory list of any controlled assets (ex.
computers, furniture, etc) purchased either in part or in full by DFPS funds using an inventory list
form. A new inventory list will need to be submitted to the City during each contract renewal
cycle.
15
B1 - Budget Information Forms
Corpus Christi All -Star Gym, LLC
Contract Period: Sept. 1, 2010 - Aug. 31, 2011
Summary Budget
FY2011
COST CATEGORY
TOTAL
1. (A) Personnel - Salaries
$32,745.00
(B) Personnel - Fringe Benefits
982.35
(C) Personnel - Travel
0.00
2. Materials and Supplies
1,272.65
3. Equipment
0.00
4. Other Costs
0.00
TOTAL BUDGET
$35,000.00
Cash Match
In -kind Match
$0.00
$0.00
B1 - Budget Information Forms
Corpus Christi All -Star Gym, LLC
Contract Period: Sept. 1, 2010 - Aug. 31, 2011
(1 a) Personnel - Salaries
FY11
A
Position or Title
B
Number of
Staff for
Position
C
Average Full
Time Monthly
Salary
D
Percent of
Time on
Budgeted
Position
E
Number of
Months
Employed
F
Cost
(BxCxDxE)
(Total)
Program Director
1
2,678.57
30%
7
5,625.00
Nutritionist
1
2,000.00
100%
7
14,000.00
Coach
2
800.00
100%
7
11,200.00
Assistant Coach
1
640.00
100%
3
1,920.00
TOTAL SALARIES
Total
32,745.00
BI - Budget Information Forms
Corpus Christi All -Star Gym, LLC
Contract Period: Sept. 1, 2010- Aug. 31, 2011
(1h) Personnel - Fringe Benefits (Employer's Share)
FY11
Fringe Benefits Based on (la) Salaries Paid*
Fringe Benefits
Based on (la)
Salaries Paid
Program Director ($5,625 x 3 %)
$168.75
Nutritionist ($14,000 x 3 %)
420.00
Coach ($11,200 x 3 %)
336.00
Assistant Coach ($1,920 x 3 %)
57.60
TOTAL FRINGE BENEFITS
$982.35
B1 - Budget Information Forms
Corpus Christi All -Star Gym, LLC
Contract Period: Sept. 1, 2010 -Aug. 31, 2011
(1c) Personnel - Travel
FY11
Type of Expense
(transportation, food, lodging,
mileage)
Purpose (Destination and
Benefits to Program)
Total
$o.00
TOTAL TRAVEL
$O.D0
B1 - Budget Information Forms
Corpus Christi All -Star Gym, LLC
Contract Period: Sept. 1, 2010 - Aug. 31, 2011
(2) Materials and Supplies
FY11
Description and Basis for Cost
Total
Uniforms (Participants) $7.26 per person x 138
$1,002.27
Office Supplies ($90.131staff x 3)
$270.38
TOTAL CONSUMABLE SUPPLIES
$1,272.65
B1 - Budget Information Forms
Corpus Christi All -Star Gym, LLC
Contract Period: Sept. 1, 2010 -Aug. 31, 2011
(3) Equipment
FY11
Description and Basis for
Valuation
Method Used
(lease, rent, purchase, etc.)
Total
$0.00
TOTAL TRAVEL
$0.00
B1 - Budget Information Forms
Corpus Christi All -Star Gym, LLC
Contract Period: Sept. 1, 2010 - Aug. 31, 2011
(4) Other Costs
FY11
Description and Basis for Cost
Total
0.00
TOTAL OTHER COSTS
$0.00
SUBCONTRACTOR: Corpus Christi All -Star Gym, LLC Request No.
CONTRACT PERIOD: 09 /01 /2010 to 08/31/2011 Reporting Month
TITLE: Community Youth Development Program
Attachment B -2
BUDGETED INFORMATION SUMMARY AND REIMBURSEMENT REQUEST
(1) -(2) *City Use
Amount (1) YTD (2) YTD Amount Only
Budgeted Expended Invoiced Requested* Anmt. Paid
Personnel - Salaries
Program Director $ 5,625.00
Nutritionist $ 14,000.00
Coaches $ 11,200.00
Assistant Coach $ 1,920.00
TOTAL $ 32,745.00
Personnel - Fringe
Program Director $ 168.75
Nutritionist $ 420.00
Coaches $ 336.00
Assistant Coach $ 57.60
TOTAL $ 982.35
Personnel - Travel
TOTAL $
Materials and Supplies
Uniforms $ 1,002.27
Office Supplies $ 270.38
TOTAL $ 1,272.65
Rental, Lease or Purchase
of Equipment
TOTAL $
Other Costs
Bus Passes $
Insurance $
Awards, chevrons, certificates $
TOTAL $
TOTAL $ 35,000.00
* Amounts expended cannot exceed amount budgeted.
I certify that the expenditures shown above are true and that supporting documentation
is attached to substantiate them.
Subcontractor's Authorized Signature Date
Payment Authorization Signature
- 23 -
Attachment B -3
Corpus Christi All -Star Gym, LLC
Budget Narrative — FY11
The budget for the Kids in Motion Program for the 2010 -2011 school year is $65,000.
This is the entire budget and will be all inclusive covering all expenses; personnel,
materials and other costs. The Kids in Motion is prepared to offer $2,880 in cash match
and $23,000 in In -Kind Match funds towards the program for a total grant request of
$35,000.
(la) PERSONNEL — SALARIES - $32,745.00
The total amount of salaries for this budget is $32,745. This represents the costs of
$5,625 for the Program Director charged at 30% for 7 months, $14,000 for the
Nutritionist charged at 100% for 7 months, $11,200 for two Coaches charged at
100% for 7 months and $1,920 for an Assistant Coach charged at 100% for 3
months.
(1 b) PERSONNEL - FRINGE BENEFITS - $982.35
Fringe benefits for the Program Director, Nutritionist, Coaches and Assistant Coach
are charged at 3% of the allotted salary.
(1 c) PERSONNEL — TRAVEL - $0
There is no travel budget
(2) SUPPLIES - $1,272.65
This budget includes materials and supplies in the amount of $1,272.65. These
costs include uniforms for the children in the program (t- shirts) in the amount of
$1,002.27 and $270.38 for office supplies for the staff.
(3) EQUIPMENT - $0
There is no equipment purchased
(4) OTHER - $0
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. "Corpus Christi All -Star Gym, LLC." 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 74, Office of Management
and Budget ( "OMB ") Circulars A -133, A -110, A -21, A -87 and A -122 as applicable, the Uniform Grant
Management Standards (UGMS) as applicable 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 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.
B. 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
— 2 5 —
parties.
C. 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.
D. 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.
E. Funds under this Contract cannot be earned prior to the first day nor after the last day of the
Contract Period.
F. The Fiscal Agent shall not be liable to Subcontractor for any charges under this Contract which
exceed the total funding amount specified.
G. All funds unearned or unexpended in the performance of this Contract shall be retained by the
Department.
H. The Subcontractor is responsible for submitting bills in an accurate and timely manner by the 5th
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.
I. The Subcontractor understands and agrees that prior written approval must be secured:
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.
J. 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.
K. Buy Texas. In accordance with Texas Government Code § 2155.4441, the State of Texas requires
that during the performace of a contract for services, Contractor will purchase products and
materials produced in the State of Texas when available at a price and time comparable to
products and materials produced outside the state.
— 26 —
SECTION 4: LIABILITY FOR REPAYMENT
A. 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 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. 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.
C. 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.
D 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.
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
— 27 —
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.
D. Subcontractor shall submit a self- evaluation report within 30 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.
SECTION 8. SUBCONTRACTING
A. Subcontractor agrees not to sublet, assign, transfer, convey or 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.
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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.
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 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
— 29 —
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 in
accordance with Section 33.
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 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
— 30 —
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 shall 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. 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 14. 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 15. 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 OMB 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.
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.
— 31 —
SECTION 16. 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.
B. 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.
SECTION 17. 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 18. 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,
— 32 —
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.
SECTION 19. 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 20. 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 ("USG")
1352, as amended. Subcontractor shall comply with the certification and disclosure requirements in
Attachment F to this Contract.
SECTION 21. 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 1962 (Public Law 88 -352)
Section 504 of the Rehabilitation Act of 1973 (Public Law 93 -112)
Americans with Disabilities Act of 1990 (Public Law 101 -336)
Age Discrimination Act of 1975
Title IX of Education Amendments of 1972
Food Stamp Act of 1977; and
The HHS agency's administrative rules, as set forth in the Texas Administrative Code, to the
extent applicable to this Agreement.
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;
- 33 -
4. Establish a method to ensure the confidentiality of records and other information relating to
clients according to applicable Federal and State laws, 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;
7. 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 TDPRS;
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 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
— 34 —
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 22. REPORTING ABUSE, NEGLECT, OR EXPLOITATION.
Subcontractor will promptly report any suspected case of abuse, neglect, or exploitation to the
appropriate authority as required by the Texas Family code, Chapter 261. All reports must be made within
twenty -four (24) hours of the discovery of abuse, neglect, or exploitation.
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 -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
— 35 —
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.
C. 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 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
— 36 —
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.
B. 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 subject 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 (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. In some instances,
email correspondence may be utilized and this communication is to be treated as having received a
written correspondence.
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, Plan of Operation, Attachment A -2 to
this Contract, Budget, Attachment B -1 to this Contract, Budget Narrative, Attachment B -3 to this
— 37 —
Contract and Program Requirements, Attachment C -1 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.
C. 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, 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, with opportunity to
cure within 30 to 60 days, 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, upon written notice of default to the Subcontractor
and opportunity to cure within 30 to 60 days, or take other actions, including, but not limited to:
— 38 —
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 party to this
Contract may consider it to be canceled by giving 14 calendar days advance written notice to the
other party. This Contract will be terminated at the end of the 14 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 Subcontractor's 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.
SECTION 35. MONTHLY PERFORMANCE REVIEW
Subcontractor will be notified monthly and/or quarterly by written correspondence to identify the
Subcontractor's performance in accordance with the performance measures identified in Attachment A -1.
These reviews will be considered as Notice of Performance and may be used as a determination of
performance.
SECTION 36. SUSPENSION OF PAYMENTS.
If the Fiscal Agent determines in its sole discretion that Subcontractor is not meeting all performance
39
measures in Attachment A -1, or if Fiscal Agent determines in its sole discretion that Subcontractor is not
in compliance with all provisions of the Contract, the Fiscal Agent shall provide written notice of such
deficiency to Subcontractor and Fiscal Agent may suspend payments to Contractor until such time as
Contractor is in full compliance with the performance measures and all other provisions in this contract.
Subcontractor will be given prompt written notice and the opportunity for a hearing within fourteen (14)
calendar days from such suspension.
SECTION 37. REPAYMENT OF FUNDS.
Subcontractor shall issue repayment of funds to Fiscal Agent within 14 calendar days of Fiscal Agent's
written demand for repayment if Fiscal Agent determines in its sole discretion that Subcontractor has not
met the Performance Measures identified in Attachment A -1..
SECTION 38. SUBCONTRACTOR COMPLIANCE WITH PRIMARY CONTRACT
Subcontractor accepts and agrees to abide by all terms and conditions of the primary contract between
the City of Corpus Christi and the Texas Department of Family and Protective Services regarding the
Community Youth Development Program.
Texas Dept. of Family
and Protective Services
Certifications
Form 4733
February 2010
The certifications enumerated below represent material facts upon which DFPS relies when
accepting a bid for this solicitation. If the Department later determines that Potential Contractor
knowingly rendered an erroneous certification, DFPS may pursue all available remedies in
accordance with Texas and U.S. law. Signor further agrees that it will provide immediate written
notice to DFPS if at any time Signor learns that any of the certifications provided for below were
erroneous when submitted or have since become erroneous by reason of changed
circumstances. If the Signor cannot certify the accuracy of all the statements contained in
this section. Signor must provide written notice to DFPS detailing which of the below
_statements it cannot certify and why.
A. Certification Regarding Debarment,
Suspension, Ineligibility, and Voluntary
Exclusion. Executive Orders 12549 and
12689 require DFPS to screen each covered
Signor to determine whether each has a
right to obtain a contract in accordance with
federal regulations on debarment,
suspension, ineligibility, and voluntary
exclusion. Signor certifies the following:
1. That Signor is, to the best of its
knowledge and belief, not debarred,
suspended, declared ineligible, or voluntarily
excluded from participation in this solicitation
or any resulting contract.
2. That Signor will not knowingly enter into
any subcontract with a person who is
debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this
covered transaction, unless authorized by
DFPS or the U.S. Department of Health and
Human Services.
3. That Signor will include this section
regarding debarment, suspension,
ineligibility, and voluntary exclusion without
modification in any subcontracts or
solicitations for subcontracts.
B. Certification Regarding Lobbying.
State and federal law place restrictions on
the use of state and federal funds in regard
to lobbying. The Signor certifies, to the best
of its knowledge and belief, that:
1. In accordance with 31 U.S.C. §1352, no
federal appropriated funds have been paid
or will be paid, by or on behalf of the Signor,
to any person for influencing or attempting to
influence an officer or employee of an
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 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.
2. If any funds other than federal
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 federal
contract, grant, loan, or cooperative
agreement, the undersigned shall complete
and submit Standard Form -LLL, Disclosure
Form to Report Lobbying, in accordance
with its instructions.
3. The Signor shall require that the language
of this certification be included in the award
documents for subcontracts and that all
subcontractors shall certify and disclose
accordingly.
4. Payments of appropriated or other funds
to Signor under any resulting agreement are
not prohibited by Texas Government Code
§556.005 or §556.008.
C. Certification Regarding Child Support.
Under Texas Family Code Section 231.006,
the vendor or applicant certifies that the
individual or business entity named in this
contract, bid, or application is not ineligible to
Page 1 of 3
Texas Dept. of Family
and Protective Services
Certifications
receive the specified grant, loan, or payment
and acknowledges that this contract may be
terminated and payment may be withheld if
this certification is inaccurate.
D. Drug -Free Workplace Certification.
Signor certifies that it will or will continue to
provide a drug -free workplace by:
1. Publishing a statement notifying
employees that the unlawful manufacture,
distribution, dispensing, possession, or use
of a controlled substance is prohibited in the
grantee's workplace and specifying the
actions that will be taken against employees
for violation of such prohibition;
2. Establishing an ongoing drug -free
awareness program to inform employees
about —
a. The dangers of drug abuse in the
workplace;
b. The grantee's policy of maintaining a
drug -free workplace;
c. Any available drug counseling,
rehabilitation, and employee assistance
programs; and
d. The penalties that may be imposed upon
employees for drug abuse violations
occurring in the workplace;
3. Making it a requirement that each
employee to be engaged in the performance
of the grant be given a copy of the statement
required by paragraph (D)(1);
4. Notifying the employee in the statement
required by paragraph (D)(1) that, as a
condition of employment under the grant, the
employee Will-
a. Abide by the terms of the statement; and
b. Notify the employer in writing of his or her
conviction for a violation of a criminal drug
statute occurring in the workplace no later
than five calendar days after such
conviction;
5. Notifying the agency in writing, within ten
calendar days after receiving notice under
paragraph (D)(4)(b) from an employee or
Page
Form 4733
February 2010
otherwise receiving actual notice of such
conviction. Employers of convicted
employees must provide notice, including
position title, to every grant officer or other
designee on whose grant activity the
convicted employee was working, unless the
federal agency has designated a central
point for the receipt of such notices. Notice
shall include the identification number(s) of
each affected grant;
6. Taking one of the following actions, within
30 calendar days of receiving notice under
paragraph (D)(4)(b), with respect to any
employee who is so convicted —
a. Taking appropriate personnel action
against such an employee, up to and
including termination, consistent with the
requirements of the Rehabilitation Act of
1973, as amended; or
b. Requiring such employee to participate
satisfactorily in a drug abuse assistance or
rehabilitation program approved for such
purposes by a federal, state, or local health,
law enforcement, or other appropriate
agency;
7. Making a good faith effort to continue to
maintain a drug -free workplace.
E. Anti -Trust Certification. Pursuant to 15
U.S.C. Sec. 1, et seq. and Tex. Bus. &
Comm. Code Sec. 15.01, et seq., Signor
certifies that neither the Signor nor the firm,
corporation, partnership, or institution
represented by the Signor, or anyone acting
for such a firm, corporation, or institution has
violated the anti -trust laws of this state,
federal anti -trust laws, nor communicated
directly or indirectly the bid made to any
competitor or any other person engaged in
such line of business.
F. Deceptive Trade Practices. Signor
certifies that it has not been found guilty or
liable of a Deceptive Trade Practices Act or
any unfair business practice either in an
2 of 3
Texas Dept. of Family
and Protective Services
Certifications
administrative hearing or court suit within the
last 5 years. Signor certifies that it has no
officers who have served as officers of other
entities who have been found guilty or liable
of a Deceptive Trade Practices Act or any
unfair business practice either in an
administrative hearing or court suit within the
last 5 years. Signor represents and
warrants that within the last five years it has
not been found guilty or liable of any
investigation or proceeding by any federal or
state securities regulator under any federal
or state securities laws or regulations.
G. Prohibited Responses and Contracts.
Pursuant to Texas Government Code
§2155.004 -006, Signor certifies that the
individual or business entity named in this
form is eligible to receive the specified
contract and acknowledges that any contract
Farm 4733
February 2010
concerning this certification may be
terminated and payment withheld if this
certification is inaccurate.
H. Financial Interests: Gifts. Signor
certifies that neither Signor nor any person
or entity that will participate financially in a
contract has received compensation from
DFPS for participation in preparation of
specifications for a contract. Signor certifies
that it has not given, offered to give, and
does not intend to give at any time, any
economic opportunity, future employment,
gift, loan, gratuity, special discount, trip,
favor, or service to any public servant or
employee in connection with a contract.
As the duly authorized representative (Signor) of the Pot
that the Potential Contractor will comply w
e ab
c - rtif a ' 0,
actor,
reby certify
Carol Creely (C2vIsiira
Itiii �- ' _:_i„,_2-----
Printed Name of Authorized Representati
Sigma e of Aut ..ri ed-- epresentativ
Owner /CEO
Title of Authorized Representative
Date 7 _ 0_9___,c-_,
Corpus Christi All -Star Gym, LLC
23792861
Legal Name of Potential Contractor
Procurement or Contract Number
Page 3 of 3