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UNIDAD, Inc. Agreement~ OD r- ~ ~ ~~ ys ° PROFESIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI BEACH, FLORIDA AND UNIDAD, INC. FOR YOUTH SERVICES RELATED TO THE CITY'S SERVICE PARTNERSHIP INITIATIVE THIS AGREEMENT made and entered into this 1st day of December, 2007, by and between the CITY OF MIAMI BEACH, FLORIDA (hereinafter referred to as City), having its principal offices at 1700 Convention Center Drive, Miami Beach, Florida, 33139, and UNIDAD, INC., a Florida Corporation, (hereinafter referred to as Contractor), whose address is 1701 Normandy Drive, Miami Beach, Florida, 33141. SECTION 1 1.1 DEFINITIONS , Agreement: This Agreement between the City and Contractor, and any exhibits and/or attachments hereto. City Manager: The Chief Administrative Officer of the City. Contractor: For the purposes of this Agreement, Contractor shall be deemed to be an independent contractor, and not an agent or employee of the City. Services: All services, work and actions by the Contractor performed pursuant to or undertaken under this Agreement, as described in Section 2 and Exhibit "A" hereto. Fee (Compensation): Amount paid to the Contractor to cover the costs of the Services. Risk Manager: The Risk Manager of the City, with offices at 1700 Convention Center Drive, Third Floor, Miami Beach, Florida 33139, telephone number (305) 673-7000, Ext. 6435, and fax number (305) 673-7023. 1 SECTION 2 SCOPE OF WORK (SERVICES) The Contractor will provide intake and assessment services, Family Group Conferencing Services, home visits, outreach and recruitment services, MB Helpers Training and Entrepreneurship Training for up to One Hundred (100) youth and their families in accordance with The Children's Trust Miami Beach Service Partnership Grant, dated June 1, 2008. The scope of work to be performed by Contractor is further detailed in Exhibit "A," entitled "Scope of Services." The Contractor shall report to the City of Miami Beach, Neighborhood Services Department, Office of Community Services, Division Director. SECTION 3 COMPENSATION 3.1 FIXED FEE Contractor shall be compensated for the Services, as set forth in Section 2 and Exhibit "A", as follows: (a) Intakes and assessments of referred families at One Hundred and Forty Dollars ($140) per each intake for up to One Hundred and Twenty (120) families, for a maximum not to exceed Sixteen Thousand Eight Hundred Dollars ($16,800); (b) Family Team Conferencing Contracts for referred families at One Hundred and Fifty Dollars ($150) each, for up to One Hundred (100) families, for a maximum not to exceed Fifteen Thousand Dollars ($15,000); (c) Provision of home visits for referred clients and their families at up to three (3) visits each for up to One Hundred (100) families at One Hundred Dollars ($100) per visit, for a maximum not to exceed Thirty Thousand Dollars ($30,000); (d) Provision of outreach and recruitment services for up to One Hundred (100) youths for up to One and Half Hours (1.5) hours at Forty Dollars per hour ($40.00), for a maximum not to exceed Sixty Dollars ($60); (e) Provision of entrepreneurship training for up to One Hundred (140) youths at Thirty Dollars an hour for up to Twenty-Four (24) hours per week for up to Thirty- Six weeks, for a maximum not to exceed Twenty-Five Thousand Nine Hundred and Twenty Dollars ($25,920); and (f) Provision of MB Helpers training for up to One Hundred (100) youths at Twenty-Five Dollars each, for a maximum not to exceed Two Thousand Five Hundred Dollars ($2,500). Contractor's compensation shall be further subject to and conditioned upon all or any portion of the Services to be provided herein being allowable and within the Scope of Services delineated in Exhibit "A". Notwithstanding the preceding, Contractor's total compensation during the term of this Agreement shall not exceed the maximum allowable sum of Ninety Thousand Two Hundred and Eighty Dollars ($90,280). 2 3.2 INVOICING Contractor shall submit monthly invoices, a Monthly Progress Report, and accompanying Monthly Progress Submissions Checklist & Summary Form, as set forth in Exhibit "B", which includes an itemized, detailed description of the Services, or portions thereof, provided (including the clients served) and cost(s) for same. Invoices and supporting documentation shall be submitted to Maria L. Ruiz, Division Director, Office of Community Services, 1700 Convention Center Drive, Miami Beach, Florida, 33139. 3.3 METHOD OF PAYMENT Payments shall be made within thirty (30) days of the date of invoice, in a manner satisfactory to and as approved and received by the City Manager and/or his designee, who shall be the Division Director, Office of Community Services. SECTION 4 GENERAL PROVISIONS 4.1 RESPONSIBILITY OF THE CONTRACTOR With respect to the performance of the Services, the Contractor shall exercise that degree of skill, care, efficiency and diligence normally exercised by recognized professionals with respect to the performance of comparable services. In its performance of the Services, the Contractor shall comply with all applicable laws, ordinances, and regulations of the City, Miami-Dade County, the State of Florida, and the federal government, as applicable. 4.2 PUBLIC ENTITY CRIMES A State of Florida Form PUR 7068, Sworn Statement under Section 287.133(3)(a) Florida Statute on Public Entity Crimes shall be filed with the City's Procurement Division, prior to commencement of the Services herein. 4.3 DURATION AND EXTENT OF AGREEMENT (TERM) The term of this Agreement shall commence upon execution of this Agreement by all parties hereto, and shall terminate on May 31, 2009. 4.4 TIME OF COMPLETION The Services to be rendered by the Contractor shall be commenced upon receipt of a written Notice to Proceed from the City subsequent to execution of the Agreement by the parties, and shall be completed no later than May 31, 2009. 3 4.5 INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City of Miami Beach and its officers, employees and agents, from and against any and all actions, claims, liabilities, losses, and expenses, including, but not limited to, attorneys' fees, for personal, economic or bodily injury, wrongful death, loss of or damage to property, at law or in equity, which may arise or be alleged to have arisen from the negligent acts, errors, omissions or other wrongful conduct of the Contractor, its employees, agents, sub-consultants, or any other person or entity acting under Consultant's control, in connection with the Contractor's performance of the Services pursuant to this Agreement; and to that extent, the Contractor shall pay all such claims and losses and shall pay all such costs and judgments which may issue from any lawsuit arising from such claims and losses, and shall pay all costs and attorneys' fees expended by the City in the defense of such claims and losses, including appeals. The Contractor's obligation under this Subsection shall not include the obligation to indemnify the City of Miami Beach and its officers, employees and agents, from and against any actions or claims which arise or are alleged to have arisen from negligent acts or omissions or other wrongful conduct of the City and its officers, employees and agents. The parties each agree to give the other party prompt notice of any claim coming to its knowledge that in any way directly or indirectly affects the other party. 4.6 TERMINATION. SUSPENSION AND SANCTIONS 4.6.1 Termination for Cause If the Contractor shall fail to fulfill in a timely manner, or otherwise violate any of the covenants, agreements, or stipulations material to this Agreement, the City shall thereupon have the right to terminate the Services then remaining to be performed. Prior to exercising its option to terminate for cause, the City shall notify the Contractor of its violation of the particular terms of this Agreement and shall grant Contractor seven (7) days to cure such default. If such default remains uncured after seven (7) days, the City, upon three (3) days' notice to Contractor, may terminate this Agreement and the City shall be fully discharged from any and all liabilities, duties and terms arising out of/or by virtue of this Agreement. Notwithstanding the above, the Contractor shall not be relieved of liability to the City for damages sustained by the City by any breach of the Agreement by the Contractor. The City, at its sole option and discretion, shall additionally be entitled to bring any and all legal/equitable actions that it deems to be in its best interest in order to enforce the City's right and remedies against the defaulting party. The City shall be entitled to recover all costs of such actions, including reasonable attorneys' fees. 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For this purpose, the term "non-profit organization" excludes (i) colleges and universities; (ii) hospitals; (iii) State, local, and federally-recognized Indian tribal governments; and (iv) those non-profit organizations which are excluded from coverage of this Circular in accordance with paragraph 5. b. Prior approval means securing the awarding agency's permission in advance to incur cost for those items that are designated as requiring prior approval by the Circular. Generally this permission will be in writing. Where an item of cost requiring prior approval is specified in the budget of an award, approval of the budget constitutes approval of that cost. 5. Exclusion of some non-profit organizations. Some non-profit organizations, because of their size and nature of operations, can be considered to be similar to commercial concerns for purpose of applicability of cost principles. Such non-profit organizations shall operate under Federal cost principles applicable to commercial concerns. A listing of these organizations is contained in Attachment C. Other organizations maybe added from time to time. 6. Responsibilities. Agencies responsible for administering programs that involve awards to non- profit organizations shall implement the provisions of this Circular. Upon request, implementing instruction shall be furnished to OMB. Agencies shall designate a liaison official to serve as the agency representative on matters relating to the implementation of this Circular. The name and title of such representative shall be furnished to OMB within 30 days of the date of this Circular. 7. Attachments. The principles and related policy guides are set forth in the following Attachments: Attachment A- General Principles Attachment B -Selected Items of Cost Attachment C, -Non-Profit Organizations Not Subject To This Circular 8. Requests for exceptions. OMB may grant exceptions to the requirements of this Circular when permissible under existing law. However, in the interest of achieving maximum uniformity, exceptions will be permitted only in highly unusual circumstances. 9. Effective Date. The provisions of this Circular are effective immediately. Implementation shall be phased in by incorporating the provisions into new awards made after the start of the organization's next fiscal year. For existing awards, the new principles maybe applied if an organization and the cognizant Federal agency agree. Earlier implementation, or a delay in implementation of individual provisions, is also permitted by mutual agreement between an organization and the cognizant Federal agency. 10. Inquiries. Further information concerning this Circular maybe obtained by contacting the Office of Federal Financial Management, OMB, Washington, DC 20503, telephone (202) 395- 3993. Attachments Cost Allocation Plan (Circular A-122) 2 Miami Beach Service Partnership ATTACHMENT A Circular No. A-122 GENERAL PRINCIPLES Table of Contents A. Basic Considerations 1. Composition of total costs 2. Factors affecting allowability of costs 3. Reasonable costs 4. Allocable costs 5. Applicable credits 6. Advance understandings 7. Conditional exemptions B. Direct Costs C. Indirect Costs D. Allocation of Indirect Costs and Determination of Indirect Cost Rates 1. General 2. Simplified allocation method 3. Multiple allocation base method 4. Direct allocation method 5. Special indirect cost rates E. Negotiation and Approval of Indirect Cost Rates 1. Definitions 2. Negotiation and approval of rates ATTACHMENT A Circular No. A-122 GENERAL PRINCIPLES A. Basic Considerations 1. Composition of total costs. The total cost of an award is the sum of the allowable direct and allocable indirect costs less any applicable credits. 2. Factors affecting allowability of costs. To be allowable under an award, costs must meet the following general criteria: a. Be reasonable for the performance of the award and be allocable thereto under these principles. Cost Allocation Plan (Circular A-122) 3 Miami Beach Service Partnership b. Conform to any limitations or exclusions set forth in these principles or in the award as to types or amount of cost items. c. Be consistent with policies and procedures that apply uniformly to both federally-financed and other activities of the organization. d. Be accorded consistent treatment. e. Be determined in accordance with generally accepted accounting principles (GAAP). f. Not be included as a cost or used to meet cost sharing or matching requirements of any other federally-financed program in either the current or a prior period. g. Be adequately documented. 3. Reasonable costs. A cost is reasonable if, in its nature or amount, it does not exceed that which would be incurred by a prudent person under the circumstances prevailing at the time the decision was made to incur the costs. The question of the reasonableness of specific costs must be scrutinized with particular care in connection with organizations or separate divisions thereof which receive the preponderance of their support from awards made by Federal agencies. In determining the reasonableness of a given cost, consideration shall be given to: a. Whether the cost is of a type generally recognized as ordinary and necessary for the operation of the organization or the performance of the award. b. The restraints or requirements imposed by such factors as generally accepted sound business practices, arms length bargaining, Federal and State laws and regulations, and terms and conditions of the award. c. Whether the individuals concerned acted with prudence in the circumstances, considering their responsibilities to the organization, its members, employees, and clients, the public at large, and the Federal Government. d. Significant deviations from the established practices of the organization which may unjustifiably increase the award costs. >dd> 4. Allocable costs. a. A cost is allocable to a particular cost objective, such as a grant, contract, project, service, or other activity, in accordance with the relative benefits received. A cost is allocable to a Federal award if it is treated consistently with other costs incurred for the same purpose in like circumstances and if it: (1) Is incurred specifically for the award. (2) Benefits both the award and other work and can be distributed in reasonable proportion to the benefits received, or (3) Is necessary to the overall operation of the organization, although a direct relationship to any particular cost objective cannot be shown. b. Any cost allocable to a particular award or other cost objective under these principles may not be shifted to other Federal awards to overcome funding deficiencies, or to avoid restrictions imposed by law or by the terms of the award. 5. Applicable credits. Cost Allocation Plan (Circular A-122) 4 Miami Beach Service Partnership a. The term applicable credits refers to those receipts, or reduction of expenditures which operate to offset or reduce expense items that are allocable to awards as direct or indirect costs. Typical examples of such transactions are: purchase discounts, rebates or allowances, recoveries or indemnities on losses, insurance refunds, and adjustments of overpayments or erroneous charges. To the extent that such credits accruing or received by the organization relate to allowable cost, they shall be credited to the Federal Government either as a cost reduction or cash refund, as appropriate. b. In some instances, the amounts received from the Federal Government to finance organizational activities or service operations should be treated as applicable credits. Specifically, the concept of netting such credit items against related expenditures should be applied by the organization in determining the rates or amounts to be charged to Federal awards for services rendered whenever the facilities or other resources used in providing such services have been financed directly, in whole or in part, by Federal funds. c. For rules covering program income (i.e., gross income earned from federally-supported activities) see Sec. _.24 of Office of Management and Budget (OMB) Circular A-110, "Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations." 6. Advance understandings. Under any given award, the reasonableness and allocability of certain items of costs maybe difficult to determine. This is particularly true in connection with organizations that receive a preponderance of their support from Federal agencies. In order to avoid subsequent disallowance or dispute based on unreasonableness or nonallocability, it is often desirable to seek a written agreement with the cognizant or awarding agency in advance of the incurrence of special or unusual costs. The absence of an advance agreement on any element of cost will not, in itself, affect the reasonableness or allocability of that element. 7. Conditional exemptions. a. OMB authorizes conditional exemption from OMB administrative requirements and cost principles circulars for certain Federal programs with statutorily-authorized consolidated planning and consolidated administrative funding, that are identified by a Federal agency and approved by the head of the Executive department or establishment. A Federal agency shall consult with OMB during its consideration of whether to grant such an exemption. b. To promote efficiency in State and local program administration, when Federal non-entitlement programs with common purposes have specific statutorily-authorized consolidated planning and consolidated administrative funding and where most of the State agency's resources come from non-Federal sources, Federal agencies may exempt these covered State-administered, non- entitlement grant programs from certain OMB grants management requirements. The exemptions would be from all but the allocability of costs provisions of OMB Circulars A-87 (Attachment A, subsection C.3), "Cost Principles for State, Local, and Indian Tribal Governments," A-21 (Section C, subpart 4), "Cost Principles for Educational Institutions," and A-122 (Attachment A, subsection A.4), "Cost Principles for Non-Profit Organizations," and from all of the administrative requirements provisions of OMB Circular A-110, "Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations," and the agencies' grants management common rule. c. When a Federal agency provides this flexibility, as a prerequisite to a State's exercising this option, a State must adopt its own written fiscal and administrative requirements for expending and accounting for all funds, which are consistent with the provisions of OMB Circular A-87, and extend such policies to all subrecipients. These fiscal and administrative requirements must be Cost Allocation Plan (Circular A-122) 5 Miami Beach Service Partnership sufficiently specific to ensure that: funds are used in compliance with all applicable Federal statutory and regulatory provisions, costs are reasonable and necessary for operating these programs, and funds are not be used for general expenses required to carry out other responsibilities of a State or its subrecipients. B. Direct Costs 1. Direct costs are those that can be identified specifically with a particular final cost objective, i.e., a particular award, project, service, or other direct activity of an organization. However, a cost may not be assigned to an award as a direct cost if any other cost incurred for the same purpose, in like circumstance, has been allocated to an award as an indirect cost. Costs identified specifically with awards are direct costs of the awards and are to be assigned directly thereto. Costs identified specifically with other final cost objectives of the organization are direct costs of those cost objectives and are not to be assigned to other awards directly or indirectly. 2. Any direct cost of a minor amount may be treated as an indirect cost for reasons of practicality where the accounting treatment for such cost is consistently applied to all final cost objectives. 3. The cost of certain activities are not allowable as charges to Federal awards (see, for example, fundraising costs in paragraph 23 of Attachment B). However, even though these costs are unallowable for purposes of computing charges to Federal awards, they nonetheless must be treated as direct costs for purposes of determining indirect cost rates and be allocated their share of the organization's indirect costs if they represent activities which (1) include the salaries of personnel, (2) occupy space, and (3) benefit from the organization's indirect costs. 4. The costs of activities performed primarily as a service to members, clients, or the general public when significant and necessary to the organization's mission must be treated as direct costs whether or not allowable and be allocated an equitable share of indirect costs. Some examples of these types of activities include: a. Maintenance of membership rolls, subscriptions, publications, and related functions. b. Providing services and information to members, legislative or administrative bodies, or the public. c. Promotion, lobbying, and other forms of public relations. d. Meetings and conferences except those held to conduct the general administration of the organization. e. Maintenance, protection, and investment of special funds not used in operation of the organization. f. Administration of group benefits on behalf of members or clients, including life and hospital insurance, annuity or retirement plans, financial aid, etc. C. Indirect Costs 1. Indirect costs are those that have been incurred for common or joint objectives and cannot be readily identified with a particular final cost objective. Direct cost of minor amounts maybe treated as indirect costs under the conditions described in subparagraph B.2. After direct costs have been determined and assigned directly to awards or other work as appropriate, indirect costs are those remaining to be allocated to benefiting cost objectives. A cost may not be allocated to an Cost Allocation Plan (Circular A-122) Miami Beach Service Partnership award as an indirect cost if any other cost incurred for the same purpose, in like circumstances, has been assigned to an award as a direct cost. 2. Because of the diverse characteristics and accounting practices ofnon-profit organizations, it is not possible to specify the types of cost which maybe classified as indirect cost in all situations. However, typical examples of indirect cost for many non-profit organizations may include depreciation or use allowances on buildings and equipment, the costs of operating and maintaining facilities, and general administration and general expenses, such as the salaries and expenses of executive officers, personnel administration, and accounting. 3. Indirect costs shall be classified within two broad categories: "Facilities" and "Administration." "Facilities" is defined as depreciation and use allowances on buildings, equipment and capital improvement, interest on debt associated with certain buildings, equipment and capital improvements, and operations and maintenance expenses. "Administration" is defined as general administration and general expenses such as the director's office, accounting, personnel, library expenses and all other types of expenditures not listed specifically under one of the subcategories of "Facilities" (including cross allocations from other pools, where applicable). See indirect cost rate reporting requirements in subparagraphs D.2.e and D.3.g. D. Allocation of Indirect Costs and Determination of Indirect Cost Rates 1. General. a. Where anon-profit organization has only one major function, or where all its major functions benefit from its indirect costs to approximately the same degree, the allocation of indirect costs and the computation of an indirect cost rate maybe accomplished through simplified allocation procedures, as described in subparagraph 2. b. Where an organization has several major functions which benefit from its indirect costs in varying degrees, allocation of indirect costs may require the accumulation of such costs into separate cost groupings which then are allocated individually to benefiting functions by means of a base which best measures the relative degree of benefit. The indirect costs allocated to each function are then distributed to individual awards and other activities included in that function by means of an indirect cost rate(s). c. The determination of what constitutes an organization's major functions will depend on its purpose in being; the types of services it renders to the public, its clients, and its members; and the amount of effort it devotes to such activities as fundraising, public information and membership activities. d. Specific methods for allocating indirect costs and computing indirect cost rates along with the conditions under which each method should be used are described in subparagraphs 2 through 5. e. The base period for the allocation of indirect costs is the period in which such costs are incurred and accumulated for allocation to work performed in that period. The base period normally should coincide with the organization's fiscal year but, in any event, shall be so selected as to avoid inequities in the allocation of the costs. 2. Simplified allocation method. a. Where an organization's major functions benefit from its indirect costs to approximately the same degree, the allocation of indirect costs maybe accomplished by (i) separating the Cost Allocation Plan (Circular A-122) 7 Miami Beach Service Partnership organization's total costs for the base period as either direct or indirect, and (ii) dividing the total allowable indirect costs (net of applicable credits) by an equitable distribution base. The result of this process is an indirect cost rate which is used to distribute indirect costs to individual awards. The rate should be expressed as the percentage which the total amount of allowable indirect costs bears to the base selected. This method should also be used where an organization has only one major function encompassing a number of individual projects or activities, and maybe used where the level of Federal awards to an organization is relatively small. b. Both the direct costs and the indirect costs shall exclude capital expenditures and unallowable costs. However, unallowable costs which represent activities must be included in the direct costs under the conditions described in subparagraph B.3. c. The distribution base maybe total direct costs (excluding capital expenditures and other distorting items, such as major subcontracts or subgrants), direct salaries and wages, or other base which results in an equitable distribution. The distribution base shall generally exclude participant support costs as defined in paragraph 34 of Attachment B. d. Except where a special rate(s) is required in accordance with subparagraph 5, the indirect cost rate developed under the above principles is applicable to all awards at the organization. If a special rate(s) is required, appropriate modifications shall be made in order to develop the special rate(s). e. For an organization that receives more than $10 million in Federal funding of direct costs in a fiscal year, a breakout of the indirect cost component into two broad categories, Facilities and Administration as defined in subparagraph C.3, is required. The rate in each case shall be stated as the percentage which the amount of the particular indirect cost category (i.e., Facilities or Administration) is of the distribution base identified with that category. 3. Multiple allocation base method a. General. Where an organization's indirect costs benefit its major functions in varying degrees, indirect costs shall be accumulated into separate cost groupings, as described in subparagraph b. Each grouping shall then be allocated individually to benefitting functions by means of a base which best measures the relative benefits. The default allocation bases by cost pool are described in subparagraph c. b. Identification of indirect costs. Cost groupings shall be established so as to permit the allocation of each grouping on the basis of benefits provided to the major functions. Each grouping shall constitute a pool of expenses that are of like character in terms of functions they benefit and in terms of the allocation base which best measures the relative benefits provided to each function. The groupings are classified within the two broad categories: "Facilities" and "Administration," as described in subparagraph C.3. The indirect cost pools are defined as follows: (1) Depreciation and use allowances. The expenses under this heading are the portion of the costs of the organization's buildings, capital improvements to land and buildings, and equipment which are computed in accordance with paragraph 11 of Attachment B ("Depreciation and use allowances"). (2) Interest. Interest on debt associated with certain buildings, equipment and capital improvements are computed in accordance with paragraph 23 of Attachment B ("Interest, fundraising, and investment management costs"). (3) Operation and maintenance expenses. The expenses under this heading are those that have been incurred for the administration, operation, maintenance, preservation, and protection of the organization's physical plant. They include expenses normally incurred Cost Allocation Plan (Circular A-122) Miami Beach Service Partnership for such items as: janitorial and utility services; repairs and ordinary or normal alterations of buildings, furniture and equipment; care of grounds; maintenance and operation of buildings and other plant facilities; security; earthquake and disaster preparedness; environmental safety; hazardous waste disposal; property, liability and other insurance relating to property; space and capital leasing; facility planning and management; and, central receiving. The operation and maintenance expenses category shall also include its allocable share of fringe benefit costs, depreciation and use allowances, and interest costs. (4) General administration and general expenses. The expenses under this heading are those that have been incurred for the overall general executive and administrative offices of the organization and other expenses of a general nature which do not relate solely to any major function of the organization. This category shall also include its allocable share of fringe benefit costs, operation and maintenance expense, depreciation and use allowances, and interest costs. Examples of this category include central offices, such as the director's office, the office of finance, business services, budget and planning, personnel, safety and risk management, general counsel, management information systems, and library costs. In developing this cost pool, special care should be exercised to ensure that costs incurred for the same purpose in like circumstances are treated consistently as either direct or indirect costs. For example, salaries of technical staff, project supplies, project publication, telephone toll charges, computer costs, travel costs, and specialized services costs shall be treated as direct costs wherever identifiable to a particular program. The salaries and wages of administrative and pooled clerical staff should normally be treated as indirect costs. Direct charging of these costs maybe appropriate where a major project or activity explicitly requires and budgets for administrative or clerical services and other individuals involved can be identified with the program or activity. Items such as office supplies, postage, local telephone costs, periodicals and memberships should normally be treated as indirect costs. c. Allocation bases. Actual conditions shall be taken into account in selecting the base to be used in allocating the expenses in each grouping to benefitting functions. The essential consideration in selecting a method or a base is that it is the one best suited for assigning the pool of costs to cost objectives in accordance with benefits derived; a traceable cause and effect relationship; or logic and reason, where neither the cause nor the effect of the relationship is determinable. When an allocation can be made by assignment of a cost grouping directly to the function benefited, the allocation shall be made in that manner. When the expenses in a cost grouping are more general in nature, the allocation shall be made through the use of a selected base which produces results that are equitable to both the Federal Government and the organization. The distribution shall be made in accordance with the bases described herein unless it can be demonstrated that the use of a different base would result in a more equitable allocation of the costs, or that a more readily available base would not increase the costs charged to sponsored awards. The results of special cost studies (such as an engineering utility study) shall not be used to determine and allocate the indirect costs to sponsored awards. (1) Depreciation and~use allowances. Depreciation and use allowances expenses shall be allocated in the following manner: (a) Depreciation or use allowances on buildings used exclusively in the conduct of a single function, and on capital improvements and equipment used in such buildings, shall be assigned to that function. (b) Depreciation or use allowances on buildings used for more than one function, and on capital improvements and equipment used in such buildings, shall be allocated to the individual functions Cost Allocation Plan (Ciroular A-122) 9 Miami Beach Service Partnership performed in each building on the basis of usable square feet of space, excluding common areas, such as hallways, stairwells, and restrooms. (c) Depreciation or use allowances on buildings, capital improvements and equipment related space (e.g., individual rooms, and laboratories) used jointly by more than one function (as determined by the users of the space) shall be treated as follows. The cost of each jointly used unit of space shall be allocated to the benefitting functions on the basis of: (i) the employees and other users on a full-time equivalent (FTE) basis or salaries and wages of those individual functions benefitting from the use of that space; or (ii) organization-wide employee FTEs or salaries and wages applicable to the benefitting functions of the organization. (d) Depreciation or use allowances on certain capital improvements to land, such as paved parking areas, fences, sidewalks, and the like, not included in the cost of buildings, shall be allocated to user categories on a FTE basis and distributed to major functions in proportion to the salaries and wages of all employees applicable to the functions. (2) Interest. Interest costs shall be allocated in the same manner as the depreciation or use allowances on the buildings, equipment and capital equipments to which the interest relates. (3) Operation and maintenance expenses. Operation and maintenance expenses shall be allocated in the same manner as the depreciation and use allowances. (4) General administration and general expenses. General administration and general expenses shall be allocated to benefitting functions based on modified total direct costs (MTDC), as described in subparagraph D.3.f. The expenses included in this category could be grouped first according to major functions of the organization to which they render services or provide benefits. The aggregate expenses of each group shall then be allocated to benefitting functions based on MTDC. d. Order of distribution. (1) Indirect cost categories consisting of depreciation and use allowances, interest, operation and maintenance, and general administration and general expenses shall be allocated in that order to the remaining indirect cost categories as well as to the major functions of the organization. Other cost categories could be allocated in the order determined to be most appropriate by the organization. When cross allocation of costs is made as provided in subparagraph (2), this order of allocation does not apply. (2) Normally, an indirect cost category will be considered closed once it has been allocated to other cost objectives, and costs shall not be subsequently allocated to it. However, a cross allocation of costs between two or more indirect costs categories could be used if such allocation will result in a more equitable allocation of costs. If a cross allocation is used, an appropriate modification to the composition of the indirect cost categories is required. e. Application of indirect cost rate or rates. Except where a special indirect cost rate(s) is required in accordance with subparagraph D.S, the separate groupings of indirect costs allocated to each major function shall be aggregated and treated as a common pool for that function. The costs in Cost Allocation Plan (Circular A-122) 1 Miami Beach Service Partnership the common pool shall then be distributed to individual awards included in that function by use of a single indirect cost rate. f. Distribution basis. Indirect costs shall be distributed to applicable sponsored awards and other benefitting activities within each major function on the basis of MTDC. MTDC consists of all salaries and wages, fringe benefits, materials and supplies, services, travel, and subgrants and subcontracts up to the first $25,000 of each subgrant or subcontract (regardless of the period covered by the subgrant or subcontract). Equipment, capital expenditures, charges for patient care, rental costs and the portion in excess of $25,000 shall be excluded from MTDC. Participant support costs shall generally be excluded from MTDC. Other items may only be excluded when the Federal cost cognizant agency determines that an exclusion is necessary to avoid a serious inequity in the distribution of indirect costs. g. Individual Rate Components. An indirect cost rate shall be determined for each separate indirect cost pool developed. The rate in each case shall be stated as the percentage which the amount of the particular indirect cost pool is of the distribution base identified with that pool. Each indirect cost rate negotiation or determination agreement shall include development of the rate for each indirect cost pool as well as the overall indirect cost rate. The indirect cost pools shall be classified within two broad categories: "Facilities" and "Administration," as described in subparagraph C.3. 4. Direct allocation method. a. Some non-profit organizations treat all costs as direct costs except general administration and general expenses. These organizations generally separate their costs into three basic categories: (i) General administration and general expenses, (ii) fundraising, and (iii) other direct functions (including projects performed under Federal awards). Joint costs, such as depreciation, rental costs, operation and maintenance of facilities, telephone expenses, and the like are prorated individually as direct costs to each category and to each award or other activity using a base most appropriate to the particular cost being prorated. b. This method is acceptable, provided each joint cost is prorated using a base which accurately measures the benefits provided to each award or other activity. The bases must be established in accordance with reasonable criteria, and be supported by current data. This method is compatible with the Standards of Accounting and Financial Reporting for Voluntary Health and Welfare Organizations issued jointly by the National Health Council, Inc., the National Assembly of Voluntary Health and Social Welfare Organizations, and the United Way of America. c. Under this method, indirect costs consist exclusively of general administration and general expenses. In all other respects, the organization's indirect cost rates shall be computed in the same manner as that described in subparagraph 2. 5. Special indirect cost rates. In some instances, a single indirect cost rate for all activities of an organization or for each major function of the organization may not be appropriate, since it would not take into account those different factors which may substantially affect the indirect costs applicable to a particular segment of work. For this purpose, a particular segment of work maybe that performed under a single award or it may consist of work under a group of awards performed in a common environment. These factors may include the physical location of the work, the level of administrative support required, the nature of the facilities or other resources employed, the scientific disciplines or technical skills involved, the organizational arrangements used, or any combination thereof. When a particular segment of work is performed in an environment which appears to generate a significantly different level of indirect costs, provisions should be made for a separate indirect cost pool applicable to such work. The separate indirect cost pool should be Cost Allocation Plan (Circular A-122) 11 Miami Beach Service Partnership developed during the course of the regular allocation process, and the separate indirect cost rate resulting therefrom should be used, provided it is determined that (i) the rate differs significantly from that which would have been obtained under subparagraphs 2, 3, and 4, and (ii) the volume of work to which the rate would apply is material. E. Negotiation and Approval of Indirect Cost Rates 1. Definitions. As used in this section, the following terms have the meanings set forth below: a. Cognizant agency means the Federal agency responsible for negotiating and approving indirect cost rates for anon-profit organization on behalf of all Federal agencies. b. Predetermined rate means an indirect cost rate, applicable to a specified current or future period, usually the organization's fiscal year. The rate is based on an estimate of the costs to be incurred during the period. A predetermined rate is not subject to adjustment. c. Fixed rate means an indirect cost rate which has the same characteristics as a predetermined rate, except that the difference between the estimated costs and the actual costs of the period covered by the rate is carried forward as an adjustment to the rate computation of a subsequent period. d. Final rate means an indirect cost rate applicable to a specified past period which is based on the actual costs of the period. A final rate is not subject to adjustment. e. Provisional rate or billing rate means a temporary indirect cost rate applicable to a specified period which is used for funding, interim reimbursement, and reporting indirect costs on awards pending the establishment of a final rate for the period. f. Indirect cost proposal means the documentation prepared by an organization to substantiate its claim for the reimbursement of indirect costs. This proposal provides the basis for the review and negotiation leading to the establishment of an organization's indirect cost rate. g. Cost objective means a function, organizational subdivision, contract, grant, or other work unit for which cost data are desired and for which provision is made to accumulate and measure the cost of processes, projects, jobs and capitalized projects. 2. Negotiation and approval of rates. a. Unless different arrangements are agreed to by the agencies concerned, the Federal agency with the largest dollar value of awards with an organization will be designated as the cognizant agency for the negotiation and approval of the indirect cost rates and, where necessary, other rates such as fringe benefit and computer charge-out rates. Once an agency is assigned cognizance for a particular non-profit organization, the assignment will not be changed unless there is a major long- term shift in the dollar volume of the Federal awards to the organization. All concerned Federal agencies shall be given the opportunity to participate in the negotiation process but, after a rate has been agreed upon, it will be accepted by all Federal agencies. When a Federal agency has reason to believe that special operating factors affecting its awards necessitate special indirect cost rates in accordance with subparagraph D.S, it will, prior to the time the rates are negotiated, notify the cognizant agency. b. A non-profit organization which has not previously established an indirect cost rate with a Federal agency shall submit its initial indirect cost proposal immediately after the organization is advised that an award will be made and, in no event, later than three months after the effective date of the award. c. Organizations that have previously established indirect cost rates must submit a new indirect cost proposal to the cognizant agency within six months after the close of each fiscal year. Cost Allocation Plan (Circular A-122) 12 Miami Beach Service Partnership d. A predetermined rate may be negotiated for use on awards where there is reasonable assurance, based on past experience and reliable projection of the organization's costs, that the rate is not likely to exceed a rate based on the organization's actual costs. e. Fixed rates maybe negotiated where predetermined rates are not considered appropriate. A fixed rate, however, shall not be negotiated if (i) all or a substantial portion of the organization's awards are expected to expire before the carry-forward adjustment can be made; (ii) the mix of Federal and non-Federal work at the organization is too erratic to permit an equitable carry- forward adjustment; or (iii) the organization's operations fluctuate significantly from year to year. f. Provisional and final rates shall be negotiated where neither predetermined nor fixed rates are appropriate. g. The results of each negotiation shall be formalized in a written agreement between the cognizant agency and the non-profit organization. The cognizant agency shall distribute copies of the agreement to all concerned Federal agencies. h. If a dispute arises in a negotiation of an indirect cost rate between the cognizant agency and the non-profit organization, the dispute shall be resolved in accordance with the appeals procedures of the cognizant agency. i. To the extent that problems are encountered among the Federal agencies in connection with the negotiation and approval process, OMB will lend assistance as required to resolve such problems in a timely manner. ATTACHMENT B Circular No. A-122 SELECTED ITEMS OF COST Table of Contents 1. Advertising and public relations costs 2. Alcoholic beverages 3. Bad debts 4. Bid and proposal costs (reserved) 5. Bonding costs 6. Communication costs 7. Compensation for personal services 8. Contingency provisions 9. Contributions 10. Defense and prosecution of criminal and civil proceedings, claims, appeals and patent infringement 11. Depreciation and use allowances 12. Donations 13. Employee morale, health, and welfare costs and credits 14. Entertainment costs 15. Equipment and other capital expenditures 16. Fines and penalties 17. Fringe benefits 18. Goods or services for personal use 19. Housing and personal living expenses 20. Idle facilities and idle capacity 21. Independent research and development (reserved) 22. Insurance and indemnification Cost Allocation Plan (Circular A-122) 13 Miami Beach Service Partnership 23. Interest, fund raising, and investment management costs 24. Labor relations costs 25. Lobbying 26. Losses on other awards 27. Maintenance and repair costs 28. Materials and supplies 29. Meetings and conferences 30. Memberships, subscriptions, and professional activity costs 31. Organization costs 32. Overtime, extra-pay shift, and multi-shift premiums 33. Page charges in professional journals 34. Participant support costs 35. Patent costs 36. Pension plans 37. Plant security costs 38. Pre-award costs 39. Professional service costs 40. Profits and losses on disposition of depreciable property or other capital assets 41. Publication and printing costs 42. Rearrangement and alteration costs 43. Reconversion costs 44. Recruiting costs 45. Relocation costs 46. Rental costs 47. Royalties and other costs for use of patents and copyrights 48. Selling and marketing 49. Severance pay 50. Specialized service facilities 51. Taxes 52. Termination costs 53. Training and education costs 54. Transportation costs 55. Travel costs 56. Trustees ATTACHMENT B Circular No. A-122 SELECTED ITEMS OF COST Paragraphs 1 through 56 provide principles to be applied in establishing the allowability of certain items of cost. These principles apply whether a cost is treated as direct or indirect. Failure to mention a particular item of cost is not intended to imply that it is unallowable; rather, determination as to allowability in each case should be based on the treatment or principles provided for similar or related items of cost. 1. Advertising and public relations costs. Cost Allocation Plan (Circular A-122) 14 Miami Beach Service Partnership a. The term advertising costs means the costs of advertising media and corollary administrative costs. Advertising media include magazines, newspapers, radio and television programs, direct mail, exhibits, and the like. b. The term public relations includes community relations and means those activities dedicated to maintaining the image of the organization or maintaining or promoting understanding and favorable relations with the community or public at large or any segment of the public. c. The only allowable advertising costs are those which are solely for: (1) The recruitment of personnel required for the performance by the organization of obligations arising under a sponsored award, when considered in conjunction with all other recruitment costs, as set forth in paragraph 44 ("Recruiting costs"); (2) The procurement of goods and services for the performance of a sponsored award; (3) The disposal of scrap or surplus materials acquired in the performance of a sponsored award except when organizations are reimbursed for disposal costs at a predetermined amount in accordance with OMB Circular A-110, Sec._.34, "Equipment"; or (4) Other specific purposes necessary to meet the requirements of the sponsored award. d. The only allowable public relations costs are: (1) Costs specifically required by sponsored awards; (2) Costs of communicating with the public and press pertaining to specific activities or accomplishments which result from performance of sponsored awards (these costs are considered necessary as part of the outreach effort for the sponsored awards); or (3) Costs of conducting general liaison with news media and government public relations officers, to the extent that such activities are limited to communication and liaison necessary to keep the public informed on matters of public concern, such as notices of contract/grant awards, financial matters, etc. e. Costs identified in subparagraphs c and d if incurred for more than one sponsored award or for both sponsored work and other work of the organization, are allowable to the extent that the principles in paragraphs B ("Direct Costs") and C ("Indirect Costs") of Attachment A are observed. f. Unallowable advertising and public relations costs include the following: (1) All advertising and public relations costs other than as specified in subparagraphs c, d, and e; (2) Costs of meetings or other events related to fund raising or other organizational activities including: (i) Costs of displays, demonstrations, and exhibits; (ii) Costs of meeting rooms, hospitality suites, and other special facilities used in conjunction with shows and other special events; and (iii) Salaries and wages of employees or cost of services engaged in setting up and displaying exhibits, making demonstrations, and providing briefings; Cost Allocation Plan (Circular A-122) 15 Miami Beach Service Partnership (3) Costs of promotional items and memorabilia, including models, gifts, and souvenirs; (4) Costs of advertising and public relations designed solely to promote the organization. 2. Alcoholic beverages. Costs of alcoholic beverages are unallowable. 3. Bad debts. Bad debts, including losses (whether actual or estimated) arising from uncollectible accounts and other claims, related collection costs, and related legal costs, are unallowable. 4. Bid and proposal costs. (reserved) 5. Bonding costs. a. Bonding costs arise when the Federal Government requires assurance against financial loss to itself or others by reason of the act or default of the organization. They arise also in instances where the organization requires similar assurance. Included are such bonds as bid, performance, payment, advance payment, infringement, and fidelity bonds. b. Costs of bonding required pursuant to the terms of the award are allowable. c. Costs of bonding required by the organization in the general conduct of its operations are allowable to the extent that such bonding is in accordance with sound business practice and the rates and premiums are reasonable under the circumstances. 6. Communication costs. Costs incurred for telephone services, local and long distance telephone calls, telegrams, radiograms, postage and the like are allowable. 7. Compensation for personal services. a. Defmition. Compensation for personal services includes all compensation paid currently or accrued by the organization for services of employees rendered during the period of the award (except as otherwise provided in subparagraph b). It includes, but is not limited to, salaries, wages, director's and executive committee member's fees, incentive awards, fringe benefits, pension plan costs, allowances for off-site pay, incentive pay, location allowances, hardship pay, and cost of living differentials. b. Allowability. Except as otherwise specifically provided in this paragraph, the costs of such compensation are allowable to the extent that: (1) Total compensation to individual employees is reasonable for the services rendered and conforms to the established policy of the organization consistently applied to both Federal and non-Federal activities; and (2) Charges to awards whether treated as direct or indirect costs are determined and supported as required in this paragraph. c. Reasonableness. (1) When the organization is predominantly engaged in activities other than those sponsored by the Federal Government, compensation for employees on federally- sponsored work will be considered reasonable to the extent that it is consistent with that paid for similar work in the organization's other activities. Cost Allocation Plan (Circular A-122) 16 Miami Beach Service Partnership (2) When the organization is predominantly engaged in federally-sponsored activities and in cases where the kind of employees required for the Federal activities are not found in the organization's other activities, compensation for employees on federally-sponsored work will be considered reasonable to the extent that it is comparable to that paid for similar work in the labor markets in which the organization competes for the kind of employees involved. d. Special considerations in determining allowability. Certain conditions require special consideration and possible limitations in determining costs under Federal awards where amounts or types of compensation appear unreasonable. Among such conditions are the following: (1) Compensation to members ofnon-profit organizations, trustees, directors, associates, officers, or the immediate families thereof. Determination should be made that such compensation is reasonable for the actual personal services rendered rather than a distribution of earnings in excess of costs. (2) Any change in an organization's compensation policy resulting in a substantial increase in the organization's level of compensation, particularly when it was concurrent with an increase in the ratio of Federal awards to other activities of the organization or any change in the treatment of allowability of specific types of compensation due to changes in Federal policy. e. Unallowable costs. Costs which are unallowable under other paragraphs of this Attachment shall not be allowable under this paragraph solely on the basis that they constitute personal compensation. f. Fringe benefits. (1) Fringe benefits in the form of regular compensation paid to employees during periods of authorized absences from the job, such as vacation leave, sick leave, military leave, and the like, are allowable, provided such costs are absorbed by all organization activities in proportion to the relative amount of time or effort actually devoted to each. (2) Fringe benefits in the form of employer contributions or expenses for social security, employee insurance, workmen's compensation insurance, pension plan costs (see subparagraph h), and the like, are allowable, provided such benefits are granted in accordance with established written organization policies. Such benefits whether treated as indirect costs or as direct costs, shall be distributed to particular awards and other activities in a manner consistent with the pattern of benefits accruing to the individuals or group of employees whose salaries and wages are chargeable to such awards and other activities. (3) (a) Provisions for a reserve under aself-insurance program for unemployment compensation or workers' compensation are allowable to the extent that the provisions represent reasonable estimates of the liabilities for such compensation, and the types of coverage, extent of coverage, and rates and premiums would have been allowable had insurance been purchased to cover the risks. However, provisions for self-insured liabilities which do not become payable for more than one year after the provision is made shall not exceed the present value of the liability. (b) Where an organization follows a consistent policy of expensing actual payments to, or on behalf of, employees or former employees for unemployment compensation or workers' Cost Allocation Plan (Circular A-122) 17 Miami Beach Service Partnership compensation, such payments are allowable in the year of payment with the prior approval of the awarding agency, provided they are allocated to all activities of the organization. (4) Costs of insurance on the lives of trustees, officers, or other employees holding positions of similar responsibility are allowable only to the extent that the insurance represents additional compensation. The costs of such insurance when the organization is named as beneficiary are unallowable. g. Organization-furnished automobiles. That portion of the cost oforganization-furnished automobiles that relates to personal use by employees (including transportation to and from work) is unallowable as fringe benefit or indirect costs regardless of whether the cost is reported as taxable income to the employees. These costs are allowable as direct costs to sponsored award when necessary for the performance of the sponsored award and approved by awarding agencies. h. Pension plan costs. (1) Costs of the organization's pension plan which are incurred in accordance with the established policies of the organization are allowable, provided: (a) Such policies meet the test of reasonableness; (b) The methods of cost allocation are not discriminatory; (c) The cost assigned to each fiscal year is determined in accordance with generally accepted accounting principles (GAAP), as prescribed in Accounting Principles Board Opinion No. 8 issued by the American Institute of Certified Public Accountants; and (d) The costs assigned to a given fiscal year are funded for all plan participants within six months after the end of that year. However, increases to normal and past service pension costs caused by a delay in funding the actuarial liability beyond 30 days after each quarter of the year to which such costs are assignable are unallowable. (2) Pension plan termination insurance premiums paid pursuant to the Employee Retirement Income Security Act (ERISA) of 1974 (Pub. L. 93-406) are allowable. Late payment charges on such premiums are unallowable. (3) Excise taxes on accumulated funding deficiencies and other penalties imposed under ERISA are unallowable. i. Incentive compensation. Incentive compensation to employees based on cost reduction, or efficient performance, suggestion awards, safety awards, etc., are allowable to the extent that the overall compensation is determined to be reasonable and such costs are paid or accrued pursuant to an agreement entered into in good faith between the organization and the employees before the services were rendered, or pursuant to an established plan followed by the organization so consistently as to imply, in effect, an agreement to make such payment. j. Overtime, extra-pay shift, and multi-shift premiums. See paragraph 32. k. Severance pay. See paragraph 49. 1. Training and education costs. See paragraph 53. m. Support of salaries and wages. (1) Charges to awards for salaries and wages, whether treated as direct costs or indirect costs, will be based on documented payrolls approved by a responsible official(s) of the Cost Allocation Plan (Circular A-122) 18 Miami Beach Service Partnership organization. The distribution of salaries and wages to awards must be supported by personnel activity reports, as prescribed in subparagraph (2), except when a substitute system has been approved in writing by the cognizant agency. (See subparagraph E.2 of Attachment A.) (2) Reports reflecting the distribution of activity of each employee must be maintained for all staff members (professionals and nonprofessionals) whose compensation is charged, in whole or in part, directly to awards. In addition, in order to support the allocation of indirect costs, such reports must also be maintained for other employees whose work involves two or more functions or activities if a distribution of their compensation between such functions or activities is needed in the determination of the organization's indirect cost rate(s) (e.g., an employee engaged part-time in indirect cost activities and part-time in a direct function). Reports maintained bynon-profit organizations to satisfy these requirements must meet the following standards: (a) The reports must reflect an after-the fact determination of the actual activity of each employee. Budget estimates (i.e., estimates determined before the services are performed) do not qualify as support for charges to awards. (b) Each report must account for the total activity for which employees are compensated and which is required in fulfillment of their obligations to the organization. (c) The reports must be signed by the individual employee, or by a responsible supervisory official having first hand knowledge of the activities performed by the employee, that the distribution of activity represents a reasonable estimate of the actual work performed by the employee during the periods covered by the reports. (d) The reports must be prepared at least monthly and must coincide with one or more pay periods. (3) Charges for the salaries and wages of nonprofessional employees, in addition to the supporting documentation described in subparagraphs (1) and (2), must also be supported by records indicating the total number of hours worked each day maintained in conformance with Department of Labor regulations implementing the Fair Labor Standards Act (FLSA) (29 CFR Part 516). For this purpose, the term "nonprofessional employee" shall have the same meaning as "nonexempt employee," under FLSA. (4) Salaries and wages of employees used in meeting cost sharing or matching requirements on awards must be supported in the same manner as salaries and wages claimed for reimbursement from awarding agencies. 8. Contingency provisions. Contributions to a contingency reserve or any similar provision made for events the occurrence of which cannot be foretold with certainty as to time, intensity, or with an assurance of their happening, are unallowable. The term "contingency reserve" excludes self- insurance reserves (see subparagraphs 7.f (3) and 22.a(2)(d); pension funds (see subparagraph 7.h); and reserves for normal severance pay (see subparagraph 49.b(1)). 9. Contributions. Contributions and donations by the organization to others are unallowable. Cost AllocaUOn Plan (Circular A-122) 19 Miami Beach Service Partnership 10. Defense and prosecution of criminal and civil proceedings, claims, appeals and patent infringement. a. Definitions. (1) Conviction, as used herein, means a judgment or a conviction of a criminal offense by any court of competent jurisdiction, whether entered upon as a verdict or a plea, including a conviction due to a plea of polo contendere. (2) Costs include, but are not limited to, administrative and clerical expenses; the cost of legal services, whether performed by in-house or private counsel; and the costs of the services of accountants, consultants, or others retained by the organization to assist it; costs of employees, officers and trustees, and any similar costs incurred before, during, and after commencement of a judicial or administrative proceeding that bears a direct relationship to the proceedings. (3) Fraud, as used herein, means (i) acts of fraud corruption or attempts to defraud the Federal Government or to corrupt its agents, (ii) acts that constitute a cause for debarment or suspension (as specified in agency regulations), and (iii) acts which violate the False Claims Act, 31 U.S.C., sections 3729-3731, or the Anti-Kickback Act, 41 U.S.C., sections 51 and 54. (4) Penalty does not include restitution, reimbursement, or compensatory damages. (5) Proceeding includes an investigation. b. (1) Except as otherwise described herein, costs incurred in connection with any criminal, civil or administrative proceeding (including filing of a false certification) commenced by the Federal Government, or a State, local or foreign government, are not allowable if the proceeding: (1) relates to a violation of, or failure to comply with, a Federal, State, local or foreign statute or regulation by the organization (including its agents and employees), and (2) results in any of the following dispositions: (a) In a criminal proceeding, a conviction. (b) In a civil or administrative proceeding involving an allegation of fraud or similar misconduct, a determination of organizational liability. (c) In the case of any civil or administrative proceeding, the imposition of a monetary penalty. (d) A final decision by an appropriate Federal official to debar or suspend the organization, to rescind or void an award, or to terminate an award for default by reason of a violation or failure to comply with a law or regulation. (e) A disposition by consent or compromise, if the action could have resulted in any of the dispositions described in (a), (b), (c) or (d). (2) If more than one proceeding involves the same alleged misconduct, the costs of all such proceedings shall be unallowable if any one of them results in one of the dispositions shown in subparagraph b.(1). Cost Allocation Plan (Circular A-122) 20 Miami Beach Service Partnership c. If a proceeding referred to in subparagraph b is commenced by the Federal Government and is resolved by consent or compromise pursuant to an agreement entered into by the organization and the Federal Government, then the costs incurred by the organization in connection with such proceedings that are otherwise not allowable under subparagraph b may be allowed to the extent specifically provided in such agreement. d. If a proceeding referred to in subparagraph b is commenced by a State, local or foreign government, the authorized Federal official may allow the costs incurred by the organization for such proceedings, if such authorized official determines that the costs were incurred as a result of (1) a specific term or condition of afederally-sponsored award, or (2) specific written direction of an authorized official of the sponsoring agency. e. Costs incurred in connection with proceedings described in subparagraph b, but which are not made unallowable by that subparagraph, maybe allowed by the Federal Government, but only to the extent that: (1) The costs are reasonable in relation to the activities required to deal with the proceeding and the underlying cause of action; (2) Payment of the costs incurred, as allowable and allocable costs, is not prohibited by any other provision(s) of the sponsored award; (3) The costs are not otherwise recovered from the Federal Government or a third party, either directly as a result of the proceeding or otherwise; and, (4) The percentage of costs allowed does not exceed the percentage determined by an authorized Federal official to be appropriate, considering the complexity of the litigation, generally accepted principles governing the award of legal fees in civil actions involving the United States as a party, and such other factors as maybe appropriate. Such percentage shall not exceed 80 percent. However, if an agreement reached under subparagraph c has explicitly considered this 80 percent limitation and permitted a higher percentage, then the full amount of costs resulting from that agreement shall be allowable. f. Costs incurred by the organization in connection with the defense of suits brought by its employees or ex-employees under section 2 of the Major Fraud Act of 1988 (Pub. L. 100-700), including the cost of all relief necessary to make such employee whole, where the organization was found liable or settled, are unallowable. g. Costs of legal, accounting, and consultant services, and related costs, incurred in connection with defense against Federal Government claims or appeals, antitrust suits, or the prosecution of claims or appeals against the Federal Government, are unallowable. h. Costs of legal, accounting, and consultant services, and related costs, incurred in connection with patent infringement litigation, are unallowable unless otherwise provided for in the sponsored awards. i. Costs which maybe unallowable under this paragraph, including directly associated costs, shall be segregated and accounted for by the organization separately. During the pendency of any proceeding covered by subparagraphs b and f, the Federal Government shall generally withhold payment of such costs. However, if in the best interests of the Federal Government, the Federal Government may provide for conditional payment upon provision of adequate security, or other adequate assurance, and agreements by the organization to repay all unallowable costs, plus interest, if the costs are subsequently determined to be unallowable. 11. Depreciation and use allowances. Cost Allocation Plan (Circular A-122) 21 Miami Beach Service Partnership a. Compensation for the use of buildings, other capital improvements, and equipment on hand may be made through use allowances or depreciation. However, except as provided in subparagraph f, a combination of the two methods may not be used in connection with a single class of fixed assets (e.g., buildings, office equipment, computer equipment, etc.). b. The computation of use allowances or depreciation shall be based on the acquisition cost of the assets involved. The acquisition cost of an asset donated to the organization by a third party shall be its fair market value at the time of the donation. c. The computation of use allowances or depreciation will exclude: (1) The cost of land; (2) Any portion of the cost of buildings and equipment borne by or donated by the Federal Government irrespective of where title was originally vested or where it presently resides; and (3) Any portion of the cost of buildings and equipment contributed by or for the organization in satisfaction of a statutory matching requirement. d. Where the use allowance method is followed, the use allowance for buildings and improvement (including land improvements, such as paved parking areas, fences, and sidewalks) will be computed at an annual rate not exceeding two percent of acquisition cost. The use allowance for equipment will be computed at an annual rate not exceeding six and two-thirds percent of acquisition cost. When the use allowance method is used for buildings, the entire building must be treated as a single asset; the building's components (e.g., plumbing system, heating and air conditioning, etc.) cannot be segregated from the building's shell. The two percent limitation, however, need not be applied to equipment which is merely attached or fastened to the building but not permanently fixed to it and which is used as furnishings or decorations or for specialized purposes (e.g., dentist chairs and dental treatment units, counters, laboratory benches bolted to the floor, dishwashers, carpeting, etc.). Such equipment will be considered as not being permanently fixed to the building if it can be removed without the need for costly or extensive alterations or repairs to the building or the equipment. Equipment that meets these criteria will be subject to the six and two-thirds percent equipment use allowance limitation. e. Where depreciation method is followed, the period of useful service (useful life) established in each case for usable capital assets must take into consideration such factors as type of construction, nature of the equipment used, technological developments in the particular program area, and the renewal and replacement policies followed for the individual items or classes of assets involved. The method of depreciation used to assign the cost of an asset (or group of assets) to accounting periods shall reflect the pattern of consumption of the asset during its useful life. In the absence of clear evidence indicating that the expected consumption of the asset will be significantly greater or lesser in the early portions of its useful life than in the later portions, the straight-line method shall be presumed to be the appropriate method. Depreciation methods once used shall not be changed unless approved in advance by the cognizant Federal agency. When the depreciation method is introduced for application to assets previously subject to a use allowance, the combination of use allowances and depreciation applicable to such assets must not exceed the total acquisition cost of the assets. When the depreciation method is used for buildings, a building's shell maybe segregated from each building component (e.g., plumbing system, heating, and air conditioning system, etc.) and each item depreciated over its estimated useful life; or the entire building (i.e., the shell and all components) may be treated as a single asset and depreciated over a single useful life. Cost Allocation Plan (Circular A-122) 22 Miami Beach Service Partnership f. When the depreciation method is used for a particular class of assets, no depreciation maybe allowed on any such assets that, under subparagraph e, would be viewed as fully depreciated. However, a reasonable use allowance maybe negotiated for such assets if warranted after taking into consideration the amount of depreciation previously charged to the Federal Government, the estimated useful life remaining at time of negotiation, the effect of any increased maintenance charges or decreased efficiency due to age, and any other factors pertinent to the utilization of the asset for the purpose contemplated. g. Charges for use allowances or depreciation must be supported by adequate property records and physical inventories must be taken at least once every two years (a statistical sampling basis is acceptable) to ensure that assets exist and are usable and needed. When the depreciation method is followed, adequate depreciation records indicating the amount of depreciation taken each period must also be maintained. 12. Donations. a. Services received. (1) Donated or volunteer services maybe furnished to an organization by professional and technical personnel, consultants, and other skilled and unskilled labor. The value of these services is not reimbursable either as a direct or indirect cost. (2) The value of donated services utilized in the performance of a direct cost activity shall be considered in the determination of the organization's indirect cost rate(s) and, accordingly, shall be allocated a proportionate share of applicable indirect costs when the following circumstances exist: (a) 'The aggregate value of the services is material; (b) The services are supported by a significant amount of the indirect costs incurred by the organization; (c) The direct cost activity is not pursued primarily for the benefit of the Federal Government, (3) In those instances where there is no basis for determining the fair market value of the services rendered, the recipient and the cognizant agency shall negotiate an appropriate allocation of indirect cost to the services. (4) Where donated services directly benefit a project supported by an award, the indirect costs allocated to the services will be considered as a part of the total costs of the project. Such indirect costs maybe reimbursed under the award or used to meet cost sharing or matching requirements. (5) The value of the donated services may be used to meet cost sharing or matching requirements under conditions described in Sec._.23 of Circular A-110. Where donated services are treated as indirect costs, indirect cost rates will separate the value of the donations so that reimbursement will not be made. (6) Fair market value of donated services shall be computed as follows: Cost Allocation Plan (Circular A-122) 23 Miami Beach Service Partnership (a) Rates for volunteer services. Rates for volunteers shall be consistent with those regular rates paid for similar work in other activities of the organization. In cases where the kinds of skills involved are not found in other activities of the organization, the rates used shall be consistent with those paid for similar work in the labor market in which the organization competes for such skills. (b) Services donated by other organizations. When an employer donates the services of an employee, these services shall be valued at the employee's regular rate of pay (exclusive of fringe benefits and indirect costs), provided the services are in the same skill for which the employee is normally paid. If the services are not in the same skill for which the employee is normally paid, fair market value shall be computed in accordance with subparagraph (a). b. Goods and space. (1) Donated goods; i.e., expendable personal property/supplies, and donated use of space maybe furnished to an organization. The value of the goods and space is not reimbursable either as a direct or indirect cost. (2) The value of the donations may be used to meet cost sharing or matching share requirements under the conditions described in Sec._.23 of Circular A-110. The value of the donations shall be determined in accordance with Sec. .23 of Circular A-110. Where donations are treated as indirect costs, indirect cost rates will separate the value of the donations so that reimbursement will not be made. 13. Employee morale, health, and welfare costs and credits. The costs of house publications, health or first-aid clinics, and/or infirmaries, recreational activities, employees' counseling services, and other expenses incurred in accordance with the organization's established practice or custom for the improvement of working conditions, employer-employee relations, employee morale, and employee performance are allowable. Such costs will be equitably apportioned to all activities of the organization. Income generated from any of these activities will be credited to the cost thereof unless such income has been irrevocably set over to employee welfare organizations. 14. Entertainment costs. Costs of amusement, diversion, social activities, ceremonials, and costs relating thereto, such as meals, lodging, rentals, transportation, and gratuities are unallowable (but see paragraphs 13 and 30). 15. Equipment and other capital expenditures. a. As used in this paragraph, the following terms have the meanings set forth below: (1) "Equipment" means an article of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of (a) the capitalization level established by the organization for the financial statement purposes, or (b) $5000. The unamortized portion of any equipment written off as a result of a change in capitalization levels may be recovered by continuing to claim the otherwise allowable use allowances or depreciation on the equipment, or by amortizing the amount to be written off over a period of years as negotiated with the Federal cognizant agency. (2) Acquisition cost means the net invoice unit price of an item of equipment, including the cost of any modifications, attachments, accessories, or auxiliary apparatus necessary to Cost Allocation Plan (Circular A-122) 24 Miami Beach Service Partnership make it usable for the purpose for which it is acquired. Ancillary charges, such as taxes, duty, protective in-transit insurance, freight, and installation shall be included in or excluded from acquisition cost in accordance with the organization's regular written accounting practices. (3) Special purpose equipment means equipment which is usable only for research, medical, scientific, or technical activities. Examples of special purpose equipment include microscopes, x-ray machines, surgical instruments, and spectrometers. (4) General purpose equipment means equipment which is usable for other than research, medical, scientific, or technical activities, whether or not special modifications are needed to make them suitable for a particular purpose. Examples of general purpose equipment include office equipment and furnishings, air conditioning equipment, reproduction and printing equipment, motor vehicles, and automatic data processing equipment. b. (1) Capital expenditures for general purpose equipment are unallowable as a direct cost except with the prior approval of the awarding agency. (2) Capital expenditures for special purpose equipment are allowable as direct costs, provided that items with a unit cost of $5000 or more have the prior approval of awarding agency. c. Capital expenditures for land or buildings are unallowable as a direct cost except with the prior approval of the awarding agency. d. Capital expenditures for improvements to land, buildings, or equipment which materially increase their value or useful life are unallowable as a direct cost except with the prior approval of the awarding agency. e. Equipment and other capital expenditures are unallowable as indirect costs. However, see paragraph 11 for allowability of use allowances or depreciation on buildings, capital improvements, and equipment. Also, see paragraph 46 for allowability of rental costs for land, buildings, and equipment. 16. Fines and penalties. Costs of fines and penalties resulting from violations of, or failure of the organization to comply with Federal, State, and local laws and regulations are unallowable except when incurred as a result of compliance with specific provisions of an award or instructions in writing from the awarding agency. 17. Fringe benefits. See subparagraph 7.f. 18. Goods or services for personal use. Costs of goods or services for personal use of the organization's employees are unallowable regardless of whether the cost is reported as taxable income to the employees. 19. Housing and personal living expenses. a. Costs of housing (e.g., depreciation, maintenance, utilities, furnishings, rent, etc.), housing allowances and personal living expenses for/of the organization's officers are unallowable as fringe benefit or indirect costs regardless of whether the cost is reported as taxable income to the employees. These costs are allowable as direct costs to sponsored award when necessary for the performance of the sponsored award and approved by awarding agencies. b. The term "officers" includes current and past officers and employees. Cost Allocation Plan (Circular A-122) 25 Miami Beach Service Partnership 20. Idle facilities and idle capacity. a. As used in this paragraph, the following terms have the meanings set forth below: (1) Facilities means land and buildings or any portion thereof, equipment individually or collectively, or any other tangible capital asset, wherever located, and whether owned or leased by the organization. (2) Idle facilities means completely unused facilities that are excess to the organization's current needs. (3) Idle capacity means the unused capacity of partially used facilities. It is the difference between that which a facility could achieve under 100 percent operating time on a one-shift basis less operating interruptions resulting from time lost for repairs, setups, unsatisfactory materials, and other normal delays, and the extent to which the facility was actually used to meet demands during the accounting period. Amulti-shift basis maybe used if it can be shown that this amount of usage could normally be expected for the type of facility involved. (4) Costs of idle facilities or idle capacity means costs such as maintenance, repair, housing, rent, and other related costs, e.g., property taxes, insurance, and depreciation or use allowances. b. The costs of idle facilities are unallowable except to the extent that: (1) They are necessary to meet fluctuations in workload; or (2) Although not necessary to meet fluctuations in workload, they were necessary when acquired and are now idle because of changes in program requirements, efforts to achieve more economical operations, reorganization, termination, or other causes which could not have been reasonably foreseen. Under the exception stated in this subparagraph, costs of idle facilities are allowable for a reasonable period of time, ordinarily not to exceed one year, depending upon the initiative taken to use, lease, or dispose of such facilities (but see subparagraphs 48.b and d). c. The costs of idle capacity are normal costs of doing business and are a factor in the normal fluctuations of usage or indirect cost rates from period to period. Such costs are allowable, provided the capacity is reasonably anticipated to be necessary or was originally reasonable and is not subject to reduction or elimination by subletting, renting, or sale, in accordance with sound business, economics, or security practices. Widespread idle capacity throughout an entire facility or among a group of assets having substantially the same function maybe idle facilities. 21. Independent research and development. [Reserved] 22. Insurance and indemnification. a. Insurance includes insurance which the organization is required to carry, or which is approved, under the terms of the award and any other insurance which the organization maintains in connection with the general conduct of its operations. 'This paragraph does not apply to insurance which represents fringe benefits for employees (see subparagraphs 7.f and 7.h(2)). Cost Allocation Plan (Circular A-122) 26 Miami Beach Service Partnership (1) Costs of insurance required or approved, and maintained, pursuant to the award are allowable. (2) Costs of other insurance maintained by the organization in connection with the general conduct of its operations are allowable subject to the following limitations: (a) Types and extent of coverage shall be in accordance with sound business practice and the rates and premiums shall be reasonable under the circumstances. (b) Costs allowed for business interruption or other similar insurance shall be limited to exclude coverage of management fees. (c) Costs of insurance or of any provisions for a reserve covering the risk of loss or damage to Federal property are allowable only to the extent that the organization is liable for such loss or damage. (d) Provisions for a reserve under aself-insurance program are allowable to the extent that types of coverage, extent of coverage, rates, and premiums would have been allowed had insurance been purchased to cover the risks. However, provision for known or reasonably estimated self-insured liabilities, which do not become payable for more than one year after the provision is made, shall not exceed the present value of the liability. (e) Costs of insurance on the lives of trustees, officers, or other employees holding positions of similar responsibilities are allowable only to the extent that the insurance represents additional compensation (see subparagraph 7.f(4)). The cost of such insurance when the organization is identified as the beneficiary is unallowable. (f) Insurance against defects. Costs of insurance with respect to any costs incurred to correct defects in the organization's materials or workmanship are unallowable. (g) Medical liability (malpractice) insurance. Medical liability insurance is an allowable cost of Federal research programs only to the extent that the Federal research programs involve human subjects or training of participants in research techniques. Medical liability insurance costs shall be treated as a direct cost and shall be assigned to individual projects based on the manner in which the insurer allocates the risk to the population covered by the insurance. (3) Actual losses which could have been covered by permissible insurance (through the purchase of insurance or aself-insurance program) are unallowable unless expressly provided for in the award, except: (a) Costs incurred because of losses not covered under nominal deductible insurance coverage provided in keeping with sound business practice are allowable. (b) Minor losses not covered by insurance, such as spoilage, breakage, and disappearance of supplies, which occur in the ordinary course of operations, are allowable. Cost Allocation Plan (Circular A-122) 27 Miami Beach Service Partnership b. Indemnification includes securing the organization against liabilities to third persons and any other loss or damage, not compensated by insurance or otherwise. The Federal Government is obligated to indemnify the organization only to the extent expressly provided in the award. 23. Interest, fundraising, and investment management costs. a. Interest. (1) Costs incurred for interest on borrowed capital or temporary use of endowment funds, however represented, are unallowable. However, interest on debt incurred after the effective date of this revision to acquire or replace capital assets (including renovations, alterations, equipment, land, and capital assets acquired through capital leases), acquired after the effective date of this revision and used in support of sponsored agreements is allowable, provided that: (a) For facilities acquisitions (excluding renovations and alterations) costing over $10 million where the Federal Government's reimbursement is expected to equal or exceed 40 percent of an asset's cost, the non-profit organization prepares, prior to the acquisition or replacement of the capital asset(s), a justification that demonstrates the need for the facility in the conduct offederally-sponsored activities. Upon request, the needs justification must be provided to the Federal agency with cost cognizance authority as a prerequisite to the continued allowability of interest on debt and depreciation related to the facility. The needs justification for the acquisition of a facility should include, at a minimum, the following: A statement of purpose and justification for facility acquisition or replacement A statement as to why current facilities are not adequate A statement of planned future use of the facility A description of the financing agreement to be arranged for the facility A summary of the building contract with estimated cost information and statement of source and use of funds A schedule of planned occupancy dates (b) For facilities costing over $500,000, the non-profit organization prepares, prior to the acquisition or replacement of the facility, alease/purchase analysis in accordance with the provisions of Sec. _.30 through _.37 of Circular A-110, which shows that a financed purchase or capital lease is less costly to the organization than other leasing alternatives, on a net present value basis. Discount rates used should be equal to the non-profit organization's anticipated interest rates and should be no higher than the fair market rate available to the non-profit organization from an unrelated ("arm's length") third-party. The lease/purchase analysis shall include a comparison of the net present value of the projected total cost comparisons of both alternatives over the period the asset is expected to be used by the non-profit organization. The cost comparisons associated with purchasing the facility shall include the estimated purchase price, anticipated operating and maintenance costs (including property taxes, if applicable) not included in the debt financing, less any estimated asset salvage value at the end of the period defined above. The cost comparison Cost Allocation Plan (Circular A-122) 2g Miami Beach Service Partnership for a capital lease shall include the estimated total lease payments, any estimated bargain purchase option, operating and maintenance costs, and taxes not included in the capital leasing arrangement, less any estimated credits due under the lease at the end of the period defined above. Projected operating lease costs shall be based on the anticipated cost of leasing comparable facilities at fair market rates under rental agreements that would be renewed or reestablished over the period defined above, and any expected maintenance costs and allowable property taxes to be borne by the non-profit organization directly or as part of the lease arrangement. (c) The actual interest cost claimed is predicated upon interest rates that are no higher than the fair market rate available to the non-profit organization from an unrelated ("arm's length") third party. (d) Investment earnings, including interest income, on bond or loan principal, pending payment of the construction or acquisition costs, are used to offset allowable interest cost. Arbitrage earnings reportable to the Internal Revenue Service are not required to be offset against allowable interest costs. (e) Reimbursements are limited to the least costly alternative based on the total cost analysis required under subparagraph (b). For example, if an operating lease is determined to be less costly than purchasing through debt financing, then reimbursement is limited to the amount determined if leasing had been used. In all cases where a lease/purchase analysis is performed, Federal reimbursement shall be based upon the least expensive alternative. (f) Non-profit organizations are also subject to the following conditions: (i) Interest on debt incurred to finance or refinance assets acquired before or reacquired after the effective date of this Circular is not allowable. (ii) For debt arrangements over $1 million, unless the non-profit organization makes an initial equity contribution to the asset purchase of 25 percent or more, non-profit organizations shall reduce claims for interest expense by an amount equal to imputed interest earnings on excess cash flow, which is to be calculated as follows. Annually, non- profit organizations shall prepare a cumulative (from the inception of the project) report of monthly cash flows that includes inflows and outflows, regardless of the funding source. Inflows consist of depreciation expense, amortization of capitalized construction interest, and annual interest expense. For cash flow calculations, the annual inflow figures shall be divided by the number of months in the year (usually 12) that the building is in service for monthly amounts. Outflows consist of initial equity contributions, debt principal payments (less the pro rata share attributable to the unallowable costs of land) and interest payments. Where cumulative inflows exceed cumulative outflows, interest shall be calculated on the excess inflows for that period and be treated as a reduction to allowable interest expense. The rate of interest to be used to compute earnings on excess cash flows shall be the three month Treasury Bill closing rate as of the last business day of that month. (iii) Substantial relocation of federally-sponsored activities from a facility financed by indebtedness, the cost of which was funded in whole or part through Federal reimbursements, to another facility prior to the expiration of a period of 20 years requires Cost Allocation Plan (Circular A-122) 2(~ Miami Beach Service Partnership notice to the Federal cognizant agency. The extent of the relocation, the amount of the Federal participation in the financing, and the depreciation and interest charged to date may require negotiation and/or downward adjustments of replacement space charged to Federal programs in the future. (iv) The allowable costs to acquire facilities and equipment are limited to a fair market value available to the non-profit organization from an unrelated ("arm's length") third P~Y• (2) For non-profit organizations subject to "full coverage"' under the Cost Accounting Standards (CAS) as defined at 48 CFR 9903.201, the interest allowability provisions of subparagraph a do not apply. Instead, these organizations' sponsored agreements are subject to CAS 414 (48 CFR 9903.414), cost of money as an element of the cost of facilities capital, and CAS 417 (48 CFR 9903.417), cost of money as an element of the cost of capital assets under construction. (3) The following definitions are to be used for purposes of paragraph 23: (a) Re-acquired assets means assets held by the non-profit organization prior to the effective date of this revision that have again come to be held by the organization, whether through repurchase or refinancing. It does not include assets acquired to replace older assets. (b) Initial equity contribution means the amount or value of contributions made bynon- Federal entities for the acquisition of the asset or prior to occupancy of facilities. (c) Asset costs means the capitalizable costs of an asset, including construction costs, acquisition costs, and other such costs capitalized in accordance with GAAP. b. Costs of organized fundraising, including financial campaigns, endowment drives, solicitation of gifts and bequests, and similar expenses incurred solely to raise capital or obtain contributions are unallowable. c. Costs of investment counsel and staff and similar expenses incurred solely to enhance income from investments are unallowable. d. Fundraising and investment activities shall be allocated an appropriate share of indirect costs under the conditions described in subparagraph B.3 of Attachment A. 24. Labor relations costs. Costs incurred in maintaining satisfactory relations between the organization and its employees, including costs of labor management committees, employee publications, and other related activities are allowable. 25. Lobbying. a. Notwithstanding other provisions of this Circular, costs associated with the following activities are unallowable: (1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity; Cost Allocation Plan (Circular A-122) 3 Miami Beach Service Partnership (2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign, political action committee, or other organization established for the purpose of influencing the outcomes of elections; (3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or modification of any pending Federal or State legislation through communication with any member or employee of the Congress or State legislature (including efforts to influence State or local officials to engage in similar lobbying activity), or with any Government official or employee in connection with a decision to sign or veto enrolled legislation; (4) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or modification of any pending Federal or State legislation by preparing, distributing or using publicity or propaganda, or by urging members of the general public or any segment thereof to contribute to or participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing or telephone campaign; or (5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering information regarding legislation, and analyzing the effect of legislation, when such activities are carried on in support of or in knowing preparation for an effort to engage in unallowable lobbying. b. The following activities are excepted from the coverage of subparagraph a: (1) Providing a technical and factual presentation of information on a topic directly related to the performance of a grant, contract or other agreement through hearing testimony, statements or letters to the Congress or a State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented request (including a Congressional Record notice requesting testimony or statements for the record at a regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant staff member thereof; provided such information is readily obtainable and can be readily put in deliverable form; and further provided that costs under this section for travel, lodging or meals are unallowable unless incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee conducting such hearing. (2) Any lobbying made unallowable by subparagraph a(3) to influence State legislation in order to directly reduce the cost, or to avoid material impairment of the organization's authority to perform the grant, contract, or other agreement. (3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other agreement. c. (1) When an organization seeks reimbursement for indirect costs, total lobbying costs shall be separately identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in accordance with the procedures of subparagraph B.3 of Attachment A. (2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the requirements and standards of this paragraph have been complied with. Cost Allocation Plan (Circular A-122) 31 Miami Beach Service Partnership (3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being allowable or unallowable pursuant to paragraph 25 complies with the requirements of this Circular. (4) Time logs, calendars, or similar records shall not be required to be created for purposes of complying with this paragraph during any particular calendar month when: (1) the employee engages in lobbying (as defined in subparagraphs (a) and (b)) 25 percent or less of the employee's compensated hours of employment during that calendar month, and (2) within the preceding five-year period, the organization has not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs. When conditions (1) and (2) are met, organizations are not required to establish records to support the allowabliliy of claimed costs in addition to records already required or maintained. Also, when conditions (1) and (2) are met, the absence of time logs, calendars, or similar records will not serve as a basis for disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month. (5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any significant questions or disagreements concerning the interpretation or application of paragraph 25. Any such advance resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant or contract for purposes of interpretation of this Circular; provided, however, that this shall not be construed to prevent a contractor or grantee from contesting the lawfulness of such a determination. 26. Losses on other awards. Any excess of costs over income on any award is unallowable as a cost of any other award. This includes, but is not limited to, the organization's contributed portion by reason of cost sharing agreements or any under-recoveries through negotiation of lump sums for, or ceilings on, indirect costs. 27. Maintenance and repair costs. Costs incurred for necessary maintenance, repair, or upkeep of buildings and equipment (including Federal property unless otherwise provided for) which neither add to the permanent value of the property nor appreciably prolong its intended life, but keep it in an efficient operating condition, are allowable. Costs incurred for improvements which add to the permanent value of the buildings and equipment or appreciably prolong their intended life shall be treated as capital expenditures (see paragraph 15). 28. Materials and supplies. The costs of materials and supplies necessary to carry out an award are allowable. Such costs should be charged at their actual prices after deducting all cash discounts, trade discounts, rebates, and allowances received by the organization. Withdrawals from general stores or stockrooms should be charged at cost under any recognized method of pricing consistently applied. Incoming transportation charges may be a proper part of material cost. Materials and supplies charged as a direct cost should include only the materials and supplies actually used for the performance of the contract or grant, and due credit should be given for any excess materials or supplies retained, or returned to vendors. 29. Meetings and conferences. a. Costs associated with the conduct of meetings and conferences include the cost of renting facilities, meals, speakers' fees, and the like. But see paragraph 14, Entertainment costs, and paragraph 34, Participant support costs. Cost Allocation Plan (Circular A-122) 32 Miami Beach Service Partnership b. To the extent that these costs are identifiable with a particular cost objective, they should be charged to that objective (see paragraph B of Attachment A). These costs are allowable, provided that they meet the general tests of allowability, shown in paragraph A of Attachment A to this Circular. c. Costs of meetings and conferences held to conduct the general administration of the organization are allowable. 30. Memberships, subscriptions, and professional activity costs. a. Costs of the organization's membership in business, technical, and professional organizations are allowable. b. Costs of the organization's subscriptions to business, professional, and technical periodicals are allowable. c. Costs of meetings and conferences, when the primary purpose is the dissemination of technical information, are allowable. This includes costs of meals, transportation, rental of facilities, and other items incidental to such meetings or conferences. d. Costs of membership in any civic or community organization are allowable with prior approval by Federal cognizant agency. e. Costs of membership in any country club or social or dining club or organization are unallowable. 31. Organization costs. Expenditures, such as incorporation fees, brokers' fees, fees to promoters, organizers or management consultants, attorneys, accountants, or investment counselors, whether or not employees of the organization, in connection with establishment or reorganization of an organization, are unallowable except with prior approval of the awarding agency. 32. Overtime, extra-pay shift, and multi-shift premiums. Premiums for overtime, extra-pay shifts, and multi-shift work are allowable only with the prior approval of the awarding agency except: a. When necessary to cope with emergencies, such as those resulting from accidents, natural disasters, breakdowns of equipment, or occasional operational bottlenecks of a sporadic nature. b. When employees are performing indirect functions, such as administration, maintenance, or accounting. c. In the performance of tests, laboratory procedures, or other similar operations which are continuous in nature and cannot reasonably be interrupted or otherwise completed. d. When lower overall cost to the Federal Government will result. 33. Page charges in professional journals. Page charges for professional journal publications are allowable as a necessary part of research costs, where: a. The research papers report work supported by the Federal Government; and b. The charges are levied impartially on all research papers published by the journal, whether or not by federally-sponsored authors. 34. Participant support costs. Participant support costs are direct costs for items such as stipends or subsistence allowances, travel allowances, and registration fees paid to or on behalf of participants or trainees (but not employees) in connection with meetings, conferences, symposia, or training projects. These costs are allowable with the prior approval of the awarding agency. Cost Allocation Plan (Circular A-122) 33 Miami Beach Service Partnership 35. Patent costs. a. Costs of (i) preparing disclosures, reports, and other documents required by the award and of searching the art to the extent necessary to make such disclosures, (ii) preparing documents and any other patent costs in connection with the filing and prosecution of a United States patent application where title or royalty-free license is required by the Federal Government to be conveyed to the Federal Government, and (iii) general counseling services relating to patent and copyright matters, such as advice on patent and copyright laws, regulations, clauses, and employee agreements are allowable (but see paragraph 39). b. Cost of preparing disclosures, reports, and other documents and of searching the art to the extent necessary to make disclosures, if not required by the award, are unallowable. Costs in connection with (i) filing and prosecuting any foreign patent application, or (ii) any United States patent application, where the award does not require conveying title or a royalty-free license to the Federal Government, are unallowable (also see paragraph 47). 36. Pension plans. See subparagraph 7.h. 37. Plant security costs. Necessary expenses incurred to comply with Federal security requirements or for facilities protection, including wages, uniforms, and equipment of personnel are allowable. 38. Pre-award costs. Pre-award costs are those incurred prior to the effective date of the award directly pursuant to the negotiation and in anticipation of the award where such costs are necessary to comply with the proposed delivery schedule or period of performance. Such costs are allowable only to the extent that they would have been allowable if incurred after the date of the award and only with the written approval of the awarding agency. 39. Professional service costs. a. Costs of professional and consultant services rendered by persons who are members of a particular profession or possess a special skill, and who are not officers or employees of the organization, are allowable, subject to subparagraphs b and c when reasonable in relation to the services rendered and when not contingent upon recovery of the costs from the Federal Government. b. In determining the allowability of costs in a particular case, no single factor or any special combination of factors is necessarily determinative. However, the following factors are relevant: (1) The nature and scope of the service rendered in relation to the service required. (2) The necessity of contracting for the service, considering the organization's capability in the particular area. (3) The past pattern of such costs, particularly in the years prior to Federal awards. (4) The impact of Federal awards on the organization's business (i.e., what new problems have arisen). (5) Whether the proportion of Federal work to the organization's total business is such as to influence the organization in favor of incurring the cost, particularly where the services Cost Allocation Plan (Circular A-122) 34 Miami Beach Service Partnership rendered are not of a continuing nature and have little relationship to work under Federal grants and contracts. (6) Whether the service can be performed more economically by direct employment rather than contracting. (7) The qualifications of the individual or concern rendering the service and the customary fees charged, especially on non-Federal awards. (8) Adequacy of the contractual agreement for the service (e.g., description of the service, estimate of time required, rate of compensation, and termination provisions). c. In addition to the factors in subparagraph b, retainer fees to be allowable must be supported by evidence of bona fide services available or rendered. 40. Profits and losses on disposition of depreciable property or other capital assets. a. (1) Gains and losses on sale, retirement, or other disposition of depreciable property shall be included in the year in which they occur as credits or charges to cost grouping(s) in which the depreciation applicable to such property was included. The amount of the gain or loss to be included as a credit or charge to the appropriate cost grouping(s) shall be the difference between the amount realized on the property and the undepreciated basis of the property. (2) Gains and losses on the disposition of depreciable property shall not be recognized as a separate credit or charge under the following conditions: (a) The gain or loss is processed through a depreciation reserve account and is reflected in the depreciation allowable under paragraph 11. (b) The property is given in exchange as part of the purchase price of a similar item and the gain or loss is taken into account in determining the depreciation cost basis of the new item. (c) A loss results from the failure to maintain permissible insurance, except as otherwise provided in subparagraph 22.a(3). (d) Compensation for the use of the property was provided through use allowances in lieu of depreciation in accordance with paragraph 11. (e) Gains and losses arising from mass or extraordinary sales, retirements, or other dispositions shall be considered on a case-by-case basis. b. Gains or losses of any nature arising from the sale or exchange of property other than the property covered in subparagraph a shall be excluded in computing award costs. 41. Publication and printing costs. a. Publication costs include the costs of printing (including the processes of composition, plate- making, press work, binding, and the end products produced by such processes), distribution, promotion, mailing, and general handling. Cost Allocation Plan (Circular A-122) 3 5 Miami Beach Service Partnership b. If these costs are not identifiable with a particular cost objective, they should be allocated as indirect costs to all benefiting activities of the organization. c. Publication and printing costs are unallowable as direct costs except with the prior approval of the awarding agency. d. The cost of page charges in journals is addressed paragraph 33. 42. Rearrangement and alteration costs. Costs incurred for ordinary or normal rearrangement and alteration of facilities are allowable. Special arrangement and alteration costs incurred specifically for the project are allowable with the prior approval of the awarding agency. 43. Reconversion costs. Costs incurred in the restoration or rehabilitation of the organization's facilities to approximately the same condition existing immediately prior to commencement of Federal awards, fair wear and tear excepted, are allowable. 44. Recruiting costs. a. Subject to subparagraphs b, c, and d, and provided that the size of the staff recruited and maintained is in keeping with workload requirements, costs of "help wanted" advertising, operating costs of an employment office necessary to secure and maintain an adequate staff, costs of operating an aptitude and educational testing program, travel costs of employees while engaged in recruiting personnel, travel costs of applicants for interviews for prospective employment, and relocation costs incurred incident to recruitment of new employees, are allowable to the extent that such costs are incurred pursuant to awell-managed recruitment program. Where the organization uses employment agencies, costs that are not in excess of standard commercial rates for such services are allowable. b. In publications, costs of help wanted advertising that includes color, includes advertising material for other than recruitment purposes, or is excessive in size (taking into consideration recruitment purposes for which intended and normal organizational practices in this respect), are unallowable. c. Costs of help wanted advertising, special emoluments, fringe benefits, and salary allowances incurred to attract professional personnel from other organizations that do not meet the test of reasonableness or do not conform with the established practices of the organization, are unallowable. d. Where relocation costs incurred incident to recruitment of a new employee have been allowed either as an allocable direct or indirect cost, and the newly hired employee resigns for reasons within his control within twelve months after being hired, the organization will be required to refund or credit such relocation costs to the Federal Government. 45. Relocation costs. a. Relocation costs are costs incident to the permanent change of duty assignment (for an indefinite period or for a stated period of not less than 12 months) of an existing employee or upon recruitment of a new employee. Relocation costs are allowable, subject to the limitation described in subparagraphs b, c, and d, provided that: (1) The move is for the benefit of the employer. (2) Reimbursement to the employee is in accordance with an established written policy consistently followed by the employer. Cost Allocation Plan (Circular A-122) 36 Miami Beach Service Partnership (3) The reimbursement does not exceed the employee's actual (or reasonably estimated) expenses. b. Allowable relocation costs for current employees are limited to the following: (1) The costs of transportation of the employee, members of his immediate family and his household, and personal effects to the new location. (2) The costs of finding a new home, such as advance trips by employees and spouses to locate living quarters and temporary lodging during the transition period, up to maximum period of 30 days, including advance trip time. (3) Closing costs, such as brokerage, legal, and appraisal fees, incident to the disposition of the employee's former home. These costs, together with those described in (4), are limited to 8 per cent of the sales price of the employee's former home. (4) The continuing costs of ownership of the vacant former home after the settlement or lease date of the employee's new permanent home, such as maintenance of buildings and grounds (exclusive of fixing up expenses), utilities, taxes, and property insurance. (5) Other necessary and reasonable expenses normally incident to relocation, such as the costs of canceling an unexpired lease, disconnecting and reinstalling household appliances, and purchasing insurance against loss of or damages to personal property. The cost of canceling an unexpired lease is limited to three times the monthly rental. c. Allowable relocation costs for new employees are limited to those described in (1) and (2) of subparagraph b. When relocation costs incurred incident to the recruitment of new employees have been allowed either as a direct or indirect cost and the employee resigns for reasons within his control within 12 months after hire, the organization shall refund or credit the Federal Government for its share of the cost. However, the costs of travel to an overseas location shall be considered travel costs in accordance with paragraph 55 and not relocation costs for the purpose of this paragraph if dependents are not permitted at the location for any reason and the costs do not include costs of transporting household goods. d. The following costs related to relocation are unallowable: (1) Fees and other costs associated with acquiring a new home. (2) A loss on the sale of a former home. (3) Continuing mortgage principal and interest payments on a home being sold. (4) Income taxes paid by an employee related to reimbursed relocation costs. 46. Rental costs. a. Subject to the limitations described in subparagraphs b through d, rental costs are allowable to the extent that the rates are reasonable in light of such factors as: rental costs of comparable property, if any; market conditions in the area; alternatives available; and the type, life expectancy, condition, and value of the property leased. b. Rental costs under sale and leaseback arrangements are allowable only up to the amount that would be allowed had the organization continued to own the property. Cost Allocation Plan (Circular A-122) 37 Miami Beach Service Partnership c. Rental costs under less-than-arms-length leases are allowable only up to the amount that would be allowed had title to the property vested in the organization. For this purpose, ales-than-arms- length lease is one under which one party to the lease agreement is able to control or substantially influence the actions of the other. Such leases include, but are not limited to those between (i) divisions of an organization; (ii) organizations under common control through common officers, directors, or members; and (iii) an organization and a director, trustee, officer, or key employee of the organization or his immediate family either directly or through corporations, trusts, or similar arrangements in which they hold a controlling interest. d. Rental costs under leases which are required to be treated as capital leases under GAAP, are allowable only up to the amount that would be allowed had the organization purchased the property on the date the lease agreement was executed, i.e., to the amount that minimally would pay for depreciation or use allowances, maintenance, taxes, and insurance. Interest costs related to capitalized leases are allowable to the extent they meet criteria in subparagraph 23.a. Unallowable costs include amounts paid for profit, management fees, and taxes that would not have been incurred had the organization purchased the facility. 47. Royalties and other costs for use of patents and copyrights. a. Royalties on a patent or copyright or amortization of the cost of acquiring by purchase a copyright, patent, or rights thereto, necessary for the proper performance of the award are allowable unless: (1) The Federal Government has a license or the right to free use of the patent or copyright. (2) The patent or copyright has been adjudicated to be invalid, or has been administratively determined to be invalid. (3) The patent or copyright is considered to be unenforceable. (4) The patent or copyright is expired. b. Special care should be exercised in determining reasonableness where the royalties may have arrived at as a result ofless-than-arm's-length bargaining, e.g.: (1) Royalties paid to persons, including corporations, affiliated with the organization. (2) Royalties paid to unaffiliated parties, including corporations, under an agreement entered into in contemplation that a Federal award would be made. (3) Royalties paid under an agreement entered into after an award is made to an organization. c. In any case involving a patent or copyright formerly owned by the organization, the amount of royalty allowed should not exceed the cost which would have been allowed had the organization retained title thereto. 48. Selling and marketing. Costs of selling and marketing any products or services of the organization (unless allowed under paragraph 1 as allowable public relations costs) are unallowable. These costs, however, are allowable as direct costs, with prior approval by awarding agencies, when they are necessary for the performance of Federal programs. Cost Allocation Plan (Ciroular A-122) 3 g Miami Beach Service Partnership 49. Severance pay. a. Severance pay, also commonly referred to as dismissal wages, is a payment in addition to regular salaries and wages, by organizations to workers whose employment is being terminated. Costs of severance pay are allowable only to the extent that in each case, it is required by (i) law, (ii) employer-employee agreement, (iii) established policy that constitutes, in effect, an implied agreement on the organization's part, or (iv) circumstances of the particular employment. b. Costs of severance payments are divided into two categories as follows: (1) Actual normal turnover severance payments shall be allocated to all activities; or, where the organization provides for a reserve for normal severances, such method will be acceptable if the charge to current operations is reasonable in light of payments actually made for normal severances over a representative past period, and if amounts charged are allocated to all activities of the organization. (2) Abnormal or mass severance pay is of such a conjectural nature that measurement of costs by means of an accrual will not achieve equity to both parties. 'Thus, accruals for this purpose are not allowable. However, the Federal Government recognizes its obligation to participate, to the extent of its fair share, in any specific payment. Thus, allowability will be considered on a case-by-case basis in the event or occurrence. c. Costs incurred in certain severance pay packages (commonly known as "a golden parachute" payment) which are in an amount in excess of the normal severance pay paid by the organization to an employee upon termination of employment and are paid to the employee contingent upon a change in management control over, or ownership of, the organization's assets are unallowable. d. Severance payments to foreign nationals employed by the organization outside the United States, to the extent that the amount exceeds the customary or prevailing practices for the organization in the United States are unallowable, unless they are necessary for the performance of Federal programs and approved by awarding agencies. e. Severance payments to foreign nationals employed by the organization outside the United States due to the termination of the foreign national as a result of the closing of, or curtailment of activities by, the organization in that country, are unallowable, unless they are necessary for the performance of Federal programs and approved by awarding agencies. 50. Specialized service facilities. a. The costs of services provided by highly complex or specialized facilities operated by the organization, such as electronic computers and wind tunnels, are allowable, provided the charges for the services meet the conditions of either subparagraph b or c and, in addition, take into account any items of income or Federal financing that qualify as applicable credits under subparagraph A.5 of Attachment A. b. The costs of such services, when material, must be charged directly to applicable awards based on actual usage of the services on the basis of a schedule of rates or established methodology that (i) does not discriminate against federally-supported activities of the organization, including usage by the organization for internal purposes, and (ii) is designed to recover only the aggregate costs of the services. The costs of each service shall consist normally of both its direct costs and its allocable share of all indirect costs. Advance agreements pursuant to subparagraph A.6 of Attachment A are particularly important in this situation. c. Where the costs incurred for a service are not material, they maybe allocated as indirect costs. Cost Allocation Plan (Circular A-122) 39 Miami Beach Service Partnership 51. Taxes. a. In general, taxes which the organization is required to pay and which are paid or accrued in accordance with GAAP, and payments made to local governments in lieu of taxes which are commensurate with the local government services received are allowable, except for (i) taxes from which exemptions are available to the organization directly or which are available to the organization based on an exemption afforded the Federal Government and in the latter case when the awarding agency makes available the necessary exemption certificates, (ii) special assessments on land which represent capital improvements, and (iii) Federal income taxes. b. Any refund of taxes, and any payment to the organization of interest thereon, which were allowed as award costs, will be credited either as a cost reduction or cash refund, as appropriate, to the Federal Government. 52. Termination costs. Termination of awards generally give rise to the incurrence of costs, or the need for special treatment of costs, which would not have arisen had the award not been terminated. Cost principles covering these items are set forth below. They are to be used in conjunction with the other provisions of this Circular in termination situations. a. Common items. The cost of items reasonably usable on the organization's other work shall not be allowable unless the organization submits evidence that it would not retain such items at cost without sustaining a loss. In deciding whether such items are reasonably usable on other work of the organization, the awarding agency should consider the organization's plans and orders for current and scheduled activity. Contemporaneous purchases of common items by the organization shall be regarded as evidence that such items are reasonably usable on the organization's other work. Any acceptance of common items as allocable to the terminated portion of the award shall be limited to the extent that the quantities of such items on hand, in transit, and on order are in excess of the reasonable quantitative requirements of other work. b. Costs continuing after termination. If in a particular case, despite all reasonable efforts by the organization, certain costs cannot be discontinued immediately after the effective date of termination, such costs are generally allowable within the limitations set forth in this Circular, except that any such costs continuing after termination due to the negligent or willful failure of the organization to discontinue such costs shall be unallowable. c. Loss of useful value. Loss of useful value of special tooling, machinery and equipment which was not charged to the award as a capital expenditure is generally allowable if: (1) Such special tooling, machinery, or equipment is not reasonably capable of use in the other work of the organization. (2) The interest of the Federal Government is protected by transfer of title or by other means deemed appropriate by the awarding agency; d. Rental costs. Rental costs under unexpired leases are generally allowable where clearly shown to have been reasonably necessary for the performance of the terminated award less the residual value of such leases, if (i) the amount of such rental claimed does not exceed the reasonable use value of the property leased for the period of the award and such further period as maybe reasonable, and (ii) the organization makes all reasonable efforts to terminate, assign, settle, or otherwise reduce the cost of such lease. There also maybe included the cost of alterations of such leased property, provided such alterations were necessary for the performance of the award, and of reasonable restoration required by the provisions of the lease. e. Settlement expenses. Settlement expenses including the following are generally allowable: Cost Allocation Plan (Circular A-122) 40 Miami Beach Service Partnership (1) Accounting, legal, clerical, and similar costs reasonably necessary for: (a) The preparation and presentation to awarding agency of settlement claims and supporting data with respect to the terminated portion of the award, unless the termination is for default (see Sec. _.61 of Circular A-110); and (b) The termination and settlement of subawards. (2) Reasonable costs for the storage, transportation, protection, and disposition of property provided by the Federal Government or acquired or produced for the award, except when grantees or contractors are reimbursed for disposals at a predetermined amount in accordance with Sec. _.30 through _.37 of Circular A-110. (3) Indirect costs related to salaries and wages incurred as settlement expenses in subparagraphs (1) and (2). Normally, such indirect costs shall be limited to fringe benefits, occupancy cost, and immediate supervision. f. Claims under subawards. Claims under subawards, including the allocable portion of claims which are common to the award, and to other work of the organization are generally allowable. An appropriate share of the organization's indirect expense maybe allocated to the amount of settlements with subcontractors and/or subgrantees, provided that the amount allocated is otherwise consistent with the basic guidelines contained in Attachment A. The indirect expense so allocated shall exclude the same and similar costs claimed directly or indirectly as settlement expenses. 53. Training and education costs. a. Costs of preparation and maintenance of a program of instruction including but not limited to on-the job, classroom, and apprenticeship training, designed to increase the vocational effectiveness of employees, including training materials, textbooks, salaries or wages of trainees (excluding overtime compensation which might arise therefrom), and (i) salaries of the director of training and staff when the training program is conducted by the organization; or (ii) tuition and fees when the training is in an institution not operated by the organization, are allowable. b. Costs of part-time education, at an undergraduate orpost-graduate college level, including that provided at the organization's own facilities, are allowable only when the course or degree pursued is relative to the field in which the employee is now working or may reasonably be expected to work, and are limited to: (1) Training materials. (2) Textbooks. (3) Fees charges by the educational institution. (4) Tuition charged by the educational institution or, in lieu of tuition, instructors' salaries and the related share of indirect costs of the educational institution to the extent that the sum thereof is not in excess of the tuition which would have been paid to the participating educational institution. (5) Salaries and related costs of instructors who are employees of the organization. Cost Allocation Plan (Circular A-122) 41 Miami Beach Service Partnership (6) Straight-time compensation of each employee for time spent attending classes during working hours not in excess of 156 hours per year and only to the extent that circumstances do not permit the operation of classes or attendance at classes after regular working hours; otherwise, such compensation is unallowable. c. Costs of tuition, fees, training materials, and textbooks (but not subsistence, salary, or any other emoluments) in connection with full-time education, including that provided at the organization's own facilities, at apost-graduate (but not undergraduate) college level, are allowable only when the course or degree pursued is related to the field in which the employee is now working or may reasonably be expected to work, and only where the costs receive the prior approval of the awarding agency. Such costs are limited to the costs attributable to a total period not to exceed one school year for each employee so trained. In unusual cases the period maybe extended. d. Costs of attendance of up to 16 weeks per employee per year at specialized programs specifically designed to enhance the effectiveness of executives or managers or to prepare employees for such positions are allowable. Such costs include enrollment fees, training materials, textbooks and related charges, employees' salaries, subsistence, and travel. Costs allowable under this paragraph do not include those for courses that are part of adegree-oriented curriculum, which are allowable only to the extent set forth in subparagraphs b and c. e. Maintenance expense, and normal depreciation or fair rental, on facilities owned or leased by the organization for training purposes are allowable to the extent set forth in paragraphs 11, 27, and 46. f. Contributions or donations to educational or training institutions, including the donation of facilities or other properties, and scholarships or fellowships, are unallowable. g. Training and education costs in excess of those otherwise allowable under subparagraphs b and c may be allowed with prior approval of the awarding agency. To be considered for approval, the organization must demonstrate that such costs are consistently incurred pursuant to an established training and education program, and that the course or degree pursued is relative to the field in which the employee is now working or may reasonably be expected to work. 54. Transportation costs. Transportation costs include freight, express, cartage, and postage charges relating either to goods purchased, in process, or delivered. These costs are allowable. When such costs can readily be identified with the items involved, they maybe directly charged as transportation costs or added to the cost of such items (see paragraph 28). Where identification with the materials received cannot readily be made, transportation costs maybe charged to the appropriate indirect cost accounts if the organization follows a consistent, equitable procedure in this respect. 55. Travel costs. a. Travel costs are the expenses for transportation, lodging, subsistence, and related items incurred by employees who are in travel status on official business of the organization. Travel costs are allowable subject to subparagraphs b through e, when they are directly attributable to specific work under an award or are incurred in the normal course of administration of the organization. b. Such costs maybe charged on an actual basis, on a per diem or mileage basis in lieu of actual costs incurred, or on a combination of the two, provided the method used results in charges consistent with those normally allowed by the organization in its regular operations. c. The difference in cost between first-class air accommodations and less than first-class air accommodations is unallowable except when less than first-class air accommodations are not reasonably available to meet necessary mission requirements, such as where less than first-class Cost Allocation Plan (Ciroular A-122) 42 Miami Beach Service Partnership accommodations would (i) require circuitous routing, (ii) require travel during unreasonable hours, (iii) greatly increase the duration of the flight, (iv) result in additional costs which would offset the transportation savings, or (v) offer accommodations which are not reasonably adequate for the medical needs of the traveler. d. Necessary and reasonable costs of family movements and personnel movements of a special or mass nature are allowable, pursuant to paragraphs 44 and 45, subject to allocation on the basis of work or time period benefited when appropriate. Advance agreements are particularly important. e. Direct charges for foreign travel costs are allowable only when the travel has received prior approval of the awarding agency. Each separate foreign trip must be approved. For purposes of this provision, foreign travel is defined as any travel outside of Canada and the United States and its territories and possessions. However, for an organization located in foreign countries, the term "foreign travel" means travel outside that country. 56. Trustees. Travel and subsistence costs of trustees (or directors) are allowable. The costs are subject to restrictions regarding lodging, subsistence and air travel costs provided in paragraph 55. ATTACHMENT C Circular No. A-122 NON-PROFIT ORGANIZATIONS NOT SUBJECT TO THIS CIRCULAR Aerospace Corporation, El Segundo, California Argonne National Laboratory, Chicago, Illinois Atomic Casualty Commission, Washington, D.C. Battelle Memorial Institute, Headquartered in Columbus, Ohio Brookhaven National Laboratory, Upton, New York Charles Stark Draper Laboratory, Incorporated, Cambridge, Massachusetts Environmental Institute of Michigan, Ann Arbor, Michigan Hanford Environmental Health Foundation, Richland, Washington IIT Research Institute, Chicago, Illinois Institute for Defense Analysis, Alexandria, Virginia Mitre Corporation, Bedford, Massachusetts National Radiological Astronomy Observatory, Green Bank, West Virginia National Renewable Energy Laboratory, Golden, Colorado Oak Ridge Associated Universities, Oak Ridge, Tennessee Rand Corporation, Santa Monica, California Research Triangle Institute, Research Triangle Park, North Carolina Riverside Research Institute, New York, New York Southern Research Institute, Birmingham, Alabama Southwest Research Institute, San Antonio, Texas SRI International, Menlo Park, California Syracuse Research Corporation, Syracuse, New York Universities Research Association, Incorporated (National Acceleration Lab), Argonne, Illinois Non-profit insurance companies, such as Blue Cross and Blue Shield Organizations Other non-profit organizations as negotiated with awarding agencies Cost Allocation Plan (Circular A-122) 43 Miami Beach Service Partnership Cost Allocation Plan (Circular A-122) 44 Miami Beach Service Partnership m /V,I~JJ~IBEACH Child Abuse and Incident Reporting Guidelines Child Abuse Reporting - As an employee/contractor providing services to the City of Miami Beach's Success University Program, you shall immediately report knowledge or reasonable suspicion of abuse, neglect, or abandonment of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number 1-800-96-ABUSE. Incident Reporting - An employee/contractor of the City of Miami Beach's Success University Program shall complete an incident report within 24 hours in the event of any serious bodily injury of a program participant. An employee/contractor of the City of Miami Beach's Success University Program shall complete an incident report within 24 hours in the event a client or employee makes an allegation of sexual harassment, sexual misconduct or sexual assault by an employee/contractor of the City of Miami Beach's Success University Program. Compliance with these guidelines is a condition of employment and/or contract. I hereby agree to comply with the Child Abuse and Incident Reporting Guidelines. Print Name Signature Date Rev 3/08 Confidentiality Agreement The City of Miami Beach, the Miami Beach Service Partnership and The Children's Trust understand that during the course of your employment you may have access to certain confidential information in order to further the performance of the services to clients. The City of Miami Beach requires all employees who may come in contact with such information to sign the statement below indicating compliance with the Confidentiality Agreement. Compliance is a condition of employment and/or contract. I agree to: • Protect confidential information and comply with applicable federal and state laws on confidentiality to prevent unauthorized use, dissemination, or publication of confidential information. • Prevent the disclosure of confidential information to any third party, or to any employee or agency that does not have a need to know such information, which need is related to my current employment or contractual status. • Ensure that any employee or agency that receives confidential information received by you, on behalf of the City of Miami Beach, the Miami Beach Service Partnership, and Partnering agency agrees to the same restrictions and conditions that apply through this agreement with respect to such information. Document such disclosures of confidential information as would be required by the City of Miami Beach, the Miami Beach Service Partnership, and Partnership agency to respond to a request by an individual for a disclosure. This Confidentiality Agreement imposes no obligation upon the employee/contractor with respect to confidential information which is disclosed under the operation of law and/or disclosed by the receiving party with the client's prior written consent. This Confidentiality Agreement shall remain in full force and effect after your term of employment or contract with the City of Miami Beach, the Miami Beach Service Partnership and Partner agency. I hereby agree to comply with this Confidentiality Agreement. Print Name Signature Date ~~Iiat~l Beach Se2~~ice I'arl;nersl~ii~ ~ _ Ern}~I<jyee I~'iie t~e:~~iseci USi"Of~ Training Evaluation Form Presenter: Training: Date: Location: Please take a moment to evaluate today's training. Rat e each item from poor to excell ent. Your information is used to better improve services. Thanks in advance for your feedback. Content N/A Poor Fair Good Excellent Objective and scope of training ^ ^ ^ ^ ^ Organization of presented material ^ ^ ^ ^ ^ Understandability of presented material ^ ^ ^ ^ ^ Relevance of material to training objectives ^ ^ ^ ^ ^ Instructor N/A Poor Fair Good Excellent Presentation of information ^ ^ ^ ^ ^ Participation by attendees encouraged ^ ^ ^ ^ ^ Discussions managed well ^ ^ ^ ^ ^ Questions responded to satisfactorily ^ ^ ^ ^ ^ Facility N/A Poor Fair Good Excellent Facility's conduciveness to learning ^ ^ ^ ^ ^ Video/visual presentation quality ^ ^ ^ ^ ^ Use of technology to enhance the training experience ^ ^ ^ ^ ^ Accessibility to training site ^ ^ ^ ^ ^ Overall Experience NIA Poor Fair Good Excellent Overall experience to training ^ ^ ^ ^ ^ What was best about the trainin ? What as ect of the trainin did not meet our ex ectations? What other trainings would you be interested in attending? Please mark all that apply. Service Evaluation Form Presenter: Training: Date: Location: Please take a moment to evaluate today's service. Rate each item from poo r to excellent. Your information is used to better improve services. Thanks in advance for your feedback. Content N/A Poor Fair Good Excellent Objective and scope of service ^ ^ ^ ^ ^ Organization of event and agency staff ^ ^ ^ ^ ^ Understandability of communications with staff ^ ^ ^ ^ ^ Relevance of eventlservice to your objectives ^ ^ ^ ^ ^ Instructor N/A Poor Fair Good Excellent Presentation of information ^ ^ ^ ^ ^ Participation by attendees encouraged ^ ^ ^ ^ ^ Discussions managed well ^ ^ ^ ^ ^ Questions responded to satisfactorily ^ ^ ^ ^ ^ Facility N/A Poor Fair Good Excellent Facility's conduciveness to service ^ ^ ^ ^ ^ Use of technology to enhance the training experience ^ ^ ^ ^ ^ Accessibility to service site ^ ^ ^ ^ ^ Overall Experience N/A Poor Fair Good Excellent Overall experience ^ ^ ^ ^ ^ What was best about the service? What as ect of the service did not meet our ex ectations"? ^~ ^~ ^~ ^~ r Z `W W i.~.I W V .7+ ..~ 1"' L. O a . ~ c d .~ N ... U ~ w a° a~ a N N L Q .~ W C 0 t fl. d ~'~' 0 d C ~ G _ ~"' d Z fi ~. ~, ~,...; y . .. .. .. ,w,. ~ ~..,.... w:: v.,«.. .. Grant Number: Reporting Period: O June 2008 O August 2008 O October 2008 O December 2008 O February 2009 O April 2009 O July 2008 O September 2008 O November 2008 O January 2009 O March 2009 O May 2009 Title: Signature: Vendor Agency: Telephone: E-Mai I: ress Narrative Please describe any difficulties encountered in providing services this month. Please describe any success stories achieved this month. Miami Beach ::.:.:.:.:..:: .:.: ' ..::..... ...:. Success University Initiative Reporting Date: Person Submitting Report: Please provide any additional observations or comments related to Success University, your service goals or (general operations. C,. ?xis^;.. x+w ~ titr'e,V•i :: ~ „ r. ;; Grant Number: Reporting Period: O June 2008 O August 2008 O October 2008 O December 2008 O February 2009 O April 2009 O July 2008 O September 2008 O November 2008 O January 2009 O March 2009 O May 2009 Reporting Date: Person Submitting Report: Title: Signature: Vendor Agency: Telephone: E-Mail: Population Served U Q ~ t C 0 ~ r + ~ U ~ ~' a~ 'o ~ Po ulation Se ment ~ a` j Youth 0 Parents 0 Other Famil 0 Others 0 Staff 0 TOTALS 0 PLEASE NOTE: Service Units should reflect hon-duplicated persons. The infromation provided here enables documentation for the total number of people benefitting from services: i3acic-up documentation must be submitted. Financial Summary ~ ~ o ~ m 'a 'C ~ N 0 ~ C ~ v = O Q ~_ Q O d L V ~ ~ Service Provided a a` V ~ m ~ Communit Service 0 0 Entre reneurshi Trainin 0 0 Famil Conferences 0 0 Health Screenin s 0 0 Home Visits 0 0 Intakes & Assessments 0 0 MB Hel ers Trainin 0 0 Meals 0 0 MDTA Tokens 0 0 Tutorin 0 0 TOTALS 0 0 0 Miami Beach ~...........,..:>~`'........ . Success University Initiative Office Use Only Date Received: Date Processed for Payment: Service Evaluation Form Presenter: Training: Date: Location: Please take a moment to evaluate today's service. Rate each item from poor to excell ent. Your information is used to better improve services. Thanks in advance for your feedback. Content N/A Poor Fair Good Excellent Objective and scope of service ^ ^ ^ ^ ^ Organization of event and agency staff ^ ^ ^ ^ ^ Understandability of communications with staff ^ ^ ^ ^ ^ Relevance of event/service to your objectives ^ ^ ^ ^ ^ Instructor Presentation of information Participation by attendees encouraged Discussions managed well Questions responded to satisfactorily Facility Facility's conduciveness to service Use of technology to enhance the training experience Accessibility to service site Overall Experience Overall experience What was best about the service? N/A Poor Fair Good Excellent ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ N/A Poor Fair Good Excellent ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ N/A Poor Fair Good Excellent ^ ^ ^ ^ ^ What aspect of the service did not meet our ex ectations? Training Evaluation Form Presenter: Training: Date: Location: Please take a moment to evaluate today's training. Rate each item from poor to excell ent. Your information is used to better improve services. Thanks in advance for your feedback. Content N/A Poor Fair Good Excellent Objective and scope of training ^ ^ ^ ^ ^ Organization of presented material ^ ^ ^ ^ ^ Understandability of presented material ^ ^ ^ ^ ^ Relevance of material to training objectives ^ ^ ^ ^ ^ Instructor Presentation of information Participation by attendees encouraged Discussions managed well Questions responded to satisfactorily Facility Facility's conduciveness to learning Video/visual presentation quality Use of technology to enhance the training experience Accessibility to training site Overall Experience Overall experience to training N/A Poor Fair Good Excellent ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ N/A Poor Fair Good Excellent ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ N/A Poor Fair Good Excellent ^ ^ ^ ^ ^ What was best about the trainin ? what as ect of the trainin aia not meet our ex ectauons r What other trainings would you be interested in attending? Please mark all that apply. ^~ Z v ~~ ~~ r Z `W W W d D u O >+ C cQ H c ~ ~ 0 I • ~ •~ ~ U wa a~ a. N M L Q .~ W d C 0 Z fl. Q~ O m H C ~ _ 1- I t0 Z m ~,,,,,'r"JJJBEACH Case Worker Lead Agency Data Tracker Date Data Tracker # Client Name First I~iiddle Last Client Address Apartment ## Zip Code Home Telephone Cellular Telephone E-Mail Address Service Checklist Please ensure that the client is provided with the information noted below during the intake visit. Form/Information Yes No NIA Intake & Assessment Form ^ ^ ^ Consent Form ^ ^ ^ Teen Job Cor s Hold Harmless & Release ^ ^ ^ Photo Release Form ^ ^ ^ Pro ram Brochure Review each service com onent! ^ ^ ^ Pro ram Graduation Re uirements ^ ^ ^ SHARE Food Pro ram Order Form ^ ^ ^ Food Stam Information, if a licable ^ ^ ^ Pros erit Cam ai n Brochure ^ ^ ^ KidCare Insurance Information ^ ^ ^ Transit Discount Pro ram Information, if a licable ^ ^ ^ Famil Grou Conferencin Partici ants Identified ^ ^ ^ Famil Grou Conferencin Date & Location Confirmed ^ ^ ^ Other Other Other E-Mail Contact Lists Client's E-Mail ^ Program Updates ^ Job List ^ Community Resources & Events Mother's E-Mail ^ Program Updates ^ Job List ^ Community Resources ~ Events Father's E-Mail ^ Program Updates ^ Job List ^ Community Resources 8~ Events Other E-Mail ^ Program Updates ^ Job List ^ Community Resources 8~ Events I confirm that the information above was provided to me and my family. Parent Signature Date Success University Intake Checklist 1 Revised May 2008 Date of Enrollment: Data Tracker Date: Success University Client Intake Data Tracker Number: Client Profile Client Name First Middle Last Client Address Apartment # Zip Code Home Telephone Cellular Telephone E-Mail Address Date of Birth CitylState/Country of Birth Social Security Number M-DCPS Student ID Number Client Legal Status ^ llS Citizen ^ US Resident ^ Visitor's Visa # ^ Student Visa ^ C?ther Sex ^ Male ^ Female ^ Transgender Race ^ Amer, indiar~%Alaska Ptiative ^ BlacklAfrican American ^ Pacific (slander ^ White ^ Other Ethnicit ^ His anic ^ Haitian ^ Other Preferred Language (Primary Lan ua e S oken in Home ^ English ^ Spanish ^ Haitian Creole ^ Other (S ecif School Attended ^ Nautilus Middle ^ Miami Beach Senior High School Current Grade Level ^ 7"Grade ^ g 'Grade ^ 11 '' Grade ^ 8~'' Grade ^ 10", Grade ^ 12t~' Grade School Attendance (M-DCPS provided) Prior School Year Gurrent School Year GPA (M-DCPS provided) Prior School Year Current School Year ESE Status (M-DCPS provided) ^ Specific Learning Disabled ^ Trainable Mentally Handicapped ^ Speech Impaired ^ Autistic ^ Emotionally Handicapped ^ Hospital/Homebound ^ Educable Mentally Handicapped ^ DeaflHard of Hearing ^ Language Impaired ^ Orthopedic-Irr~paired ^ Gifted ^ Developmentally Delayed ^ Other Healtl~~ impaired ^ Visually impaired ^ Severel Mentall Handica ed ^ Profound Mental Handica Is Child Disabled? ^ Yes ^ No Disability Type ^ Autism ^ Hearing impairment ^ Physical Disability ^ Chronic Medical Condition ^ Learning Disability ^ Visual impairment ^ Emotional Disorder ^ Mental Retardation ^ Other (Specify} ^ Behavioral Disorder Miami Beach Service Partnership/Universal Intake Form Revised June 2008 Parental/Guardian Profile Mother's Name First iUiiddle Last Mother's Address If Different from Client Apartrnant # Zip Code Home Telephone Cellular Telephone E-Mail Address Date of Birth City/State/Country of Birth Social Security Number Driver's LicenseJState ID Number Client Legal Status Ci U5 t;itizen ^ visitor`s vi:>a © US Fesident # _.-.~ # ^ Student Visa ^ Other # Preferred Language (Primary Language ^ English CJ Haitian C~reale S oken in Home L"1 S anish ^ Other (S ecif ) Preferred Days/Time for Contact ^ Sunday ^ IVlonday ^ Mornings ^ Afternoons ^ Tuesday ^ Wednesday ^ Evenings ^ Thursday ^ Friday ^ Saturda Father's Name First Middle Last Father's Address If Different from Client Apartment # Zip Code Home Telephone Cellular Telephone E-Mail Address Date of Birth City/State/Country of Birth Social Security Number Driver's License/State ID Number Client Legal Status ^ US Citizen ^ Visitor's Visa ^ US Resident # ^ Student Visa ^ Other # Preferred Language (Primary Language ^ English ^ Haitian Creole Spoken in Home) ^ S anish ^ Other (Specif Preferred Days/Time for Contact C3 Sunday ^ Monday C1 Mornings ^ Rfternoor7s C'.1 Tuesday ^ Wednesday ^ Evenings C] Thursday i_l Friday CI Saturday Guardian's Name First Middle Last Guardian's Address If Different from Client Apartment # Zip Cade Home Telephone Cellular Telephone E-Mail Address Date of Birth City/State/Country of Birth Social Security Number Driver's License/State ID Number Client Legal Status ^ i_#S C"rtizen ^ Visitor's visa ^ US Resident # _ -^ # LI 5tudent visa CJther Preferred Language (Primary Language t~l Engiisf~ Cl Haitian Creaie S oken in Home C7 Spanish 11 Other (Sped#yj Preferred Days/Time for Contact ^ Sunday ^ Monday r'7 Mvrnirujs ^ Afternaons © Tuesday ^ Wednesday ^ Evenings C7 Tfrursday ^ Friday Saturda Miami Beach Service Partnership/Universal Intake Form Revised June 2008 Household Members' Profile Additional Household Members Date of Birth Relation to Client ^ Ste Parent ^ Sigrtiticant nther(Parent ^ Siblin ^ Adult Relative ^ Otrter ^ Sibling ^ Adult Relative ^ Other ^ Siblin ^ Adult Relative ^ Other ^ Slblinq ^ Rdult Relative ^ Other ^ Sibling ^ Adult Relative ^ Otr,er ^ Siblin ^ Adult Relative ^ Other ^ Siblin ^ Adult Relative ^ Other ^ Slblinq ^ Adult Relative ^ Other ^ Siblin ^ Adult Relative ^ Otr,er Total # in Household ^ 1 ^ 2 ^ 3 ^ 4 ^ 5 ^ 6 ^ 7 ^ 8 ^ _.__.._..._.... Housing Profile Housin Unit ^ Apartment ^ Single Home ^ Mobile Harne ^ C3ther Housing Type ^ Rent ^ Own ^ Other: ^ Lives wiather family ^ Lives w/friends ^ Otk~er # of Bedrooms ^ 1 ^ 2 ^ 3 ^ 4 ^ 5 ^ 6/more Housing Adequacy Are there more than 2 people per bedraarr,? ^ Yes D No Does pausing meet safety requirements? ^ Yes ^ No Has client moved more than twice ir, past 12 months? ^ Yes ^ No Qoes client spend more than 50"l0 0. income nn housing? ^ Yes ^ NO is client at-risk of losing pausing? (i.e, late in rent} ^ Yes ^ No Housing Profile Narrative - Miami Beach Service Partnership/Universal Intake Form Revised June 2008 Household Financial Profile Income Profile Income Source Detail Monthl Benefit/Earnin s Parent/Guardian Employment Earnin s Employer: Parent/Guardian Employment Earnin s Employer: SpouselSignificant Other Earnings Employer: Parent SSA Benefits ©SS[ t=S SSDI ~ SS retirement Spouse/Significant SSA Other Benefits f~ SSI Cl SSDI D SS retirement} S ouse/Si nificant Other Pension Source: Client SSA Benefits Cl SSI ®Suruivor's Benefits Dependent SSI Benefits Dependent: De endent SSI Benefits Dependent: De endent SSI Benefits Dependent: De endent SSI Benefits De endent: Household Food Stam Benefits ~ of Persons Covered: Tem orar Aid for Need Families Date of Expiration: General Public Assistance Source: Ex iration: Child Su ort Dependent: Child Su ort De endent: Child Su ort Dependent: Allmon Source: Allmon Source: Allmon Source: Investment Income Source: Investment Income Source: Other: Source: Other: Source: Other: Source: Monthl Household Income Total _ Monthly Expenses Ex ense Source Detail Monthl Ex ense/Cost Housing Utilities D Electricity I iVatural Gas Utilities ©Telephone ©Cellular Utilities ©Cable ©Satellite Seruice Utilities ©Internet Prouider Household Insurance ©Renters ©Property Insurance Medical Insurance ©Medicaid/Medicare ©Private Medical Expense ©Co-pay D Prescription D Niedicai dare Food Expense WaterlSanitation Vehicle Loan/Lease Expense ©Crwn ©I-ease Vehicle Insurance Vehicle Operating Cost ©Gasoline 1=l Repairs Transportation Expense ©Public Transportation ©School Transport Child Support/Alimony C:1 Child Support ©Alimony Other: Source: Other: Source; Other: Source: Monthly Household Expenses _ _ _ __ _ _'i Miami Beach Service Partnership/Universal Intake Form Revised June 2008 Client & Youth Household Members Profile Current Services Matrix Indicate all services receivedlobtained by the youth members of the client's household. Service Received Client: Child # 1: (Name) Child #2: (Name) Child # 3: (Name) Day Care/ Childcare ravr er tour er ravtaer rovurE~r Counseling Services ravr er rnw er rovr er rtrvraer Disability Benefits Educational Services ravr er rout er ravr er rovr er Food Stamps Food Subsidy ravr er rovr er rovr er rovraer Home Care Assistance ravr er rovr er rovraer mvraer- Legal Assistance ravr er ravtaer ravr er rovraer Medicaid ~~ Medicare ~ Rehabilitation Services ravr er ravr er rovr ar rovraer Survivors Benefits SSA TANF ravr er rovr er rovr er rovr er Transportation Services ravr er ravr er rovraer rovraer Tutoring ravr er ravr er ravr er rovraer Vocational Training ravr er ravr er rovr er rovraer Other: ravr er ravr er rovr er rovr er Other: rovr er ravr er rowt er rovraer Other: ravr er ravr er ravr er rovraer Youth Services Narrative - Miami Beach Service Partnership/Universal Intake Form Revised June 2008 Adult Services Profile Current Services Matrix Indicate all services received/obtained by the adult members of the client's household. Service Received Mother/Female Guardian Father/Male Guardian Other: (Name) Other: (Name) Adult Day Care ravr er rovr cr YpVI er ravraer Counseling Services rovr er rovr er ravr er ravr er Disability Benefits _ Educational Services rovr er rovr er ravr er ravr er Elder Services ravr er ravr er ravr er ravr er Food Stamps ------ Food Subsidy ravr er rovr er ravr er ravraer Home Care Assistance aw er ravr er ravraer ravraer Housing Assistance rave er rovr ar• ravr er ravr er Legal Assistance ravr er rovr er rovr er ravr er Medicaid Medicare i Rehabilitation Services ravraer rovr er ravr er ravr er Survivors Benefits SSA TANF rovr er ravr er row er ravr er Transportation Services rovr er rovr er ravr er ravraer Utility Assistance ravr er rour er ravr er ravr er Vocational Training raw er rovr er ravr er ravr er Other: ravr er rovr er row er raw er Other: ravr er row er raw er ravr er Adult Services Narrative - Miami Beach Service Partnership/Universal Intake Form Revised June 2008 Household Health Profile Adult Health Profile Service Inquiry Mother/Female Father/Male Guardian Spouse/Significant Other: (Name) Guardian Other: (Name) When was your last Medical: Medical: Medical: Medical: visit with a doctor? Dental: Dental: Dental: Dental: E e: E e: E e: E e: tither: Other: Other: Other: Have you been ^Yes ^Yes ^Yes ^Yes hospitalized in the past ^ hia ^ No ^ Na ^ Na 12 months? ^ Don't Knaw ^ Don't Knaw ^ Don't Know ^ Don't Knaw Do you currently have ^Yes ^Yes ^Yes ^Yes any medical ^ No ^ No ^ No ^ Na roblems? ^ Don't Know ^ Don't Know ^ Don't Know ^ 1:3an't Know Do you have any ^ Medicaid ^ Medicare Cl Medicaid ^ Medicare ^ Medicaid ^ Medicare ^ Medicaid ©Medicare medical insurance? ~ Private ^ Private ^ Private ^ Private Ll Other ©tither ^ Other L:l Other Have you been ^Yes ^Yes ^Yes ©Yes diagnosed with a ^ No ^ No ^ No ^ No mental illness? ^ Don't Know ^ Don't Knaw ^ Don't Knaw ^ l3on't Know Do you have a history ^Yes ^Yes ®Yes ^Yes of alcohol or drug ^ Na ^ No ^ No ^ No abuse? ^ Don't Know ^ Dan't Know ^ Don't Knaw ^ I'3on't Know Are you currently ^Yes ^ Na ^Yes ^ No ^Yes ^ Na ^Yes ^ Na using? if yes: If yes: if yes: if yes: Substance of choice: Substance of choice: Substance of choice: Substance of choice: ^ AiCOhol ©Cocaine ©AICOht}! ©~QCaine ©AICflhII{ ^ t.OGalne ^ Alcohol ^ E'iOCalne ^ Marijuana ©Neroin CI tifiarijuana ^ Heroin ^ Nlari)uana ^ Hernin ^ Marijuana ©lieroin ^ Other ©tither ^ Other ®Other Adult Health Profile Narrative - Youth Health Profile Service Inquiry Client: Child # 1: (Name) Child # 2: (Name) Child # 3: (Name) Last visit with a doctor Medical: Medical: Medical: MedicaE: Dental: Dental: Dental: Dental: E e: l"ye: e: e: Other: Other; Other: Other: Has child been ^Yes ^Yes ^Yes ^Yes hospitalized in the past ^ No ^ Na ^ No ^ No 12 months? ^ Don't Know ^ Don't Know ^ Dan't Knaw ^ Don't Know Does child currently ^Yes ^Yes ^Yes ^Yes have any medical ^ No ^ No ^ No ^ No roblems? ^ Don't Know ^ Cion't Knaw ^ Don't Know ^ Don't Knaw Does child have any ^ Medicaid ^ Medicare ^ Medicaid ^ Medicare ^ Medicaid ^ Medicare ^ Medicaid ^ Medicare medical insurance? ^ Private CCVI Private ^ Private ^ Private ^ Other ci Other ^ Other ^ tither Has child been ^Yes ^Yes ^Yes ^Yes diagnosed with a ©Na ^ hio ^ No ^ No mental illness? ^ Don't Know ^ Dan't Knaw ^ Don't Knaw ^ Dan't Knaw Youth Health Profile Narrative - Miami Beach Service Partnership/Universal Intake Form Revised June 2008 Youth Risk Factor Profile Factor Client: Child # Child is performing ^ Yes ^ No ^ Yes below school level ^ NIA ^ unknown ^ NlA Child has been ^ Yes ^ No ^ Yes diagnosed with a ^ NIA ^ unknown ^ NIA learnin disabilit Child is having ^ Yes ^ No ^ Yes behavior problems in ^ NIA ^ unknown O NIA school Child has a poor ^ Yes ^ No ^ Yes attitude towards school ^ NIA ^ unknown ^ NIA Child has chronic ^ Yes ^ No ^ Yes medical roblems ^ NIA ^ unknown ^ NIA Child has been a ^ Yes ^ No ^Yss victim/witness of ^ NIA ^ unknown ^ N!A domestic violence Child has experienced ^ Yes ^ No ^ Yes economic deprivation in ^ NIA ^ unknown ^ N/A the ast 12 months Child lives in a single- ^ Yes ^ No ^ Yes arent home ^ NIA ^ unknown ^ NIA Child has sibling who ^ Yes ^ No ^ Yes dro ed out of school ^ NIA ^ unknown ^ N1A Child or sibling is ^ Yes ^ No ^ Yes involved in a an ^ NIA ^ unknown ^ NIA Client is exposed to ^ Yes ^ No ^ Yes drug use in home or ^ NIA ^ unknown ^ NtA nei hborhood Child has a parent or ^ Yes ^ No ^ Yes caregiver who has ^ NiA ^ unknown ^ hllA been arrested Child has access to ^ Yes ^ No ^ Yes after-care services or ^ NIA ^ unknown ^ NIA adult su ervision Child is experiencing ^ Yes ^ No ^ Yes ne lect ^ N1A ^ Unknown ^ NIA Child has been ^ Yes ^ No ^ Yes involved in the juvenile ^ N1A ^ unknown ^ N!A 'ustice s stem Child has missed 10 or ^ Yes ^ No ^ Yes more school davs ^ NtA ^ Unknown ^ NfA Narrative of identified risk factors - Child #2: (Name) ^ No ^ Yes ^ Unknown ^ NIA ^ No ^ Yes ^ Unknown ^ N1A ^ No ^ Yes ^ Unknown ^ hllA ^ No ^ Yes ^ Unknown ^ NIA ^ No ^ Yes ^ Unknown ^ N1A ^ No ^ Yes ^ Unknown ^ NiA ^ No ^ Yes ^ Unknown ^ NlA ^ lvo ^ Yes ^ Unknown ^ NIA ^ No ^ Yes ^ Unknown ^ NIA ^ No ^ Yes ^ Unkncawn ^ NIA. ^ No ^ Yes ^ Unknown ^ N!A ^ No ^ Yes ^ Unknown ^ NJA ^ No ^ Yes ^ unknawn ^ NIA ^ No ^ Yes ^ unknown ^ NIA ^ Na ^ Yes ^ Unknown ^ NIA ^ No ^ Yes ^ unknown ^ NIA ^ No ^ Yes ^ Unknown ^ N/A ^ No ^ Yes ^ Unknown ^ NIA ^ No ^ Yes ^ Unknown ^ NIA ^ Na ^ Yes ^ Unknown ^ NIA ^ NO ^ Ye5 ^ Unknown ^ N(A ^ No ^ Yes ^ Unknown ^ NIA ^ No ^ Yes ^ Unknown ^ N(A ^ No ^ Yes ^ unknown ^ NIA ^ No ^ Yes ^ Unknown ^ NIA ^ No ^ Yes ^ Unknown ^ N(A ^ Na ^ Yes ^ Unknown ^ NIA ^ No ^ Yes ^ Unknown ^ NlA ^ No ^ Yes ^ unknown ^ N/A ^ No ^ Yes ^ unknown ^ NIA ^ No ^ Yes ^ unknown ^ NIA ^ No ^ Yes ^ unknown ^ NtA ^ No ^ unknown ^ No ^ unknown ^ No ^ unknown ^ No ^ unknown ^ No ^ unknawn ^ No ^ unknown ^ No ^ unknown ^ No ^ Unknown ^ No ^ unknawn ^ tdo ^ unknawn ^ No ^ unknown ^ No ^ unknown ^ No ^ Unknown ^ No ^ Unknown ^ No ^ Unknown ^ No D Unknown Miami Beach Service Partnership/Universal Intake Form g Revised June 2008 Referral Needs Profile Housing Services Client household in need of affordable housin (housing cost exceeds 50% of income) ^ Yes ^ No Client household in need of rent assistance 3-da notice, eviction notice received ^ Yes ^ No Client household in need of other housin inade uate, unsafe, etc. ^ Yes ^ No If es to an above, lease indicate re ferral rovided: A enc Referred To Date of Initial Referral Date of Follow-u Financial Services Client household in need of food assistance inadequate food for famil ^ Yes ^ No Client household in need of clothin assistance includin school uniforms ^ Yes ^ No Client household in need of utilit assistance late notice, final notice ^ Yes ^ No Client household in need of trans ortation assistance (bus tokens for school, work, etc.) ^ Yes ^ No Client household in need of em to ment referral em to ment for adults, outh ^ Yes ^ No Client household in need of and eli ible for entitlements food stamps, TANF, etc. ^ Yes ^ No If es to an above, lease indicate referral rovided: AQencv Referred To Date of Initial Referral Date of Follow-up Medical/Counseling Services Client household in need of medical assistance evaluation, intervention, etc. Client household in need of mental health assistance evaluation, intervention, etc, Client household in need of counselin services individual, famil , marria e, etc.) If es to an above, lease indicate re ferral rovided: A enc Referred To Date of Initial Referral Date of Follow-u Legal Services Client household in need of immi ration services residenc , as lum, etc. Client household in need child su ort enforcement services Client household in need of landlord/tenant le al services eviction If es to an above, lease indicate referral rovided: A enc Referred To Date of Initial Referral Date of Follow-u Miami Beach Service Partnership/Universal Intake Form 9 Revised June 2008 Miami Beach Service i'artnershi~ Authorization for Release and Exchange of Information The purpose of this Authorization Form is to enable Miami Beach Service Partnership agencies to better serve you and/or your children through coordinated service planning and delivery. Representatives of these agencies may share information in order to arrange for the appropriate and prompt delivery of services as planned. The following Partner agencies may provide you or your family services: ^ Aspira of Florida ^ Choices et al, Inc. ^ Jewish Community Services ^ Junior Achievement of Greater Miami ^ Miami Beach Community Health Center • Miami-Dade County Public Schools ^ National Foundation for Teaching Entrepreneurship ^ Ayuda, Inc. ^ Teen Job Corps ^ Unidad/ Hispanic Community Center ^ South Florida Center for Family Counseling ^ City of Miami Beach Please indicate which information, if any, you do not want to be shared. Note that some agency referrals require the prior release of information to determine eligibility. Please mark all appropriate. ^ Client Demographic Information ^ Education/Training/Skills Background ^ Employment Background & Information ^ Support Service Information tf~d~dingentiuementsaourrernservices) ^ Financial Eligibility Information ^ Housing Information ^ Medical Eligibility Information ^ Legal Background Screening Information ^ Services History Information ^ Other Is there any agency that you do not want us to share your information with? ^ Yes ^ No If yes, please list the agency/agencies below: I understand that this release authorizes an exchange of information between Service Partnership agencies in order to provide me and/or my child(ren) with the most complete and thorough services available. It does not authorize release to any other person or agency except those agencies which are Partnership members or to those agencies to which I am being referred for services. Unless revoked in writing, this release shall remain in force for a period of 24 months from the date of authorization. My signature below indicates that I have been informed of and understand the eligibility information provided within this form and certify that it is true and correct and subject to verification. Any false or misleading responses or submissions on my part may lead to the refusal of services. Parent Signature Witness Signature Date Date Parent Name -Printed Witness Name -Printed Client Name Miami Beach Service Partnership/Universal Intake Form 1 ~ Revised June 2008 CITY OF MIAMI BEACH, FLORIDA RELEASE AND HOLD HARMLESS AGREEMENT MINOR Teen Job Corps VOLUNTEER This Release and Hold Harmless Agreement is executed by and on behalf of a minor, by the minor's parent or legal guardian, hereinafter referred to as "Releasor". The undersigned Releasor represents that he/she is the parent and next of kin and/or legal guardian of the person of a minor by virtue of a Court order. The undersigned Releasor, on behalf of himself or herself, and on behalf of the above minor, specifically and expressly acknowledges that the minor will be acting as a volunteer for the City of Miami Beach and Teen Job Corps for on-going community service projects by performing various tasks including but not limited to clean up and/or removal of litter and exotic plants from designated beach /park/ canal areas, located in Miami Beach, Miami-Dade County, Florida. The undersigned Releasor, on behalf of himself or herself, and also on behalf of the above minor, and the minor's personal representative, heirs, next-of-kin and assigns, freely and of his or her own volition, specifically agrees to remise, release, forever discharge and hold the City of Miami Beach and Teen Job Corps, its successors assigns, servants, employees, elected and appointed officials, all hereinafter collectively referred to as "Releasee", harmless from any and all claims, actions, demands or damages, including but not limited to, accidents, injury, death or damage to the minor's person or property, arising or resulting from the minor's participation as a volunteer to the extent such is not covered by Chapter 440, Florida Statutes. Releasor, on behalf of himself or herself, and on behalf of the above minor, expressly agrees that this Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Florida and that, if any portion thereof is held invalid, it is agreed that the balance shall, not withstanding, continue in full legal force and affect. Releasor, on behalf of himself or herself, and on behalf of the above minor, further gives permission for first aid to be rendered, if necessary, and further releases Releasee from any claim whatsoever on account of said first aid, treatment, or services rendered to the child during his/her participation in the aforestated activities/event. This Release contains the entire agreement between the parties hereto and the terms of this Release are contractual and not a mere recital. Release and Hold Harmless Agreement Teen Job Corps /City of Miami Beach RELEASOR FURTHER STATES THAT HE/SHE HAS CAREFULLY READ THIS AGREEMENT AND UNDERSTANDS ITS CONTENTS AND MEANING AND FULLY REALIZES THAT PARTICIPATING IN THE AFORESTATED ACTIVITIES MAY EXPOSE HIM OR HER TO DANGERS AND HAZARDS WHICH MAY ARISE IN CONNECTION WITH THE AFORESTATED ACTIVITIES AND SIGNS THIS RELEASE AS HIS/HER OWN FREE AND VOLUNTARY ACT. Dated this day of , 2008. Releasor Print Name Address Telephone Number Witness Print Name Witness Print Name ~"l~~ ~l'~ild~e~`s~'e"~fi STATEMENT OF PURPOSE FOR COLLECTION OF SOCIAL SECURITY NUMBERS FROM PARTICIPANTS IN PROGRAMS FUNDED BY THE CHILDREN'S TRUST Florida Law requires The Children's Trust of Miami-Dade to state in writing the purposes for which it collects social security numbers and to provide a copy of that statement of purpose to individuals from whom it collects social security numbers. Since this program is funded in whole or in part by The Children's Trust, this agency may share with The Children's Trust the social security number of an individual child or youth who participates in the program or service. This document signifies notice to you that the social security. number of the program participant may be provided to The Children's Trust. The Children's Trust of Miami-Dade collects the social security numbers of child participants of funded programs and services for the following purposes: To research, track and measure the impact of The Children's Trust's funded programs and services so that these programs and services may be maintained and improved in the future (individual identifying information will not be disclosed). To identify and match individuals and data within and among various systems and other agencies for research purposes. The Children's Trust does not collect social security numbers for adult participants. The Children's Trust of Miami Dade 3150 SW 3 Avenue (Coral Way) Miami, Florida 33129 305-571-5700 www.thechildrenstrust.org 1/31/2008 .;:y, , ~~~ C~aidr~n'sT~~4 NOTICE TO ALL PROVIDERS FUNDED BY THE CHILDREN'S TRUST Statement of Purpose for the Collection of Social Security Numbers February 1, 2008 Since you receive funds from The Children's Trust for programs or services, you share social security numbers of children participating in these programs with The Children's Trust. We in turn use the social security numbers to research, track and measure the impact of The Children's Trust's funded programs and services. Florida Law now requires The Children's Trust to state in writing the purposes for which it collects social security numbers and to provide a copy of that statement of purpose to individuals from whom it collects social security numbers. In order to comply with Florida law, a statement of purpose for the collection of social security numbers must now be given to each individual from whom the social security number is collected. We ask your co-operation in providing this written statement to each individual. Letters further explaining the requirement and the statement that must be given to the individual providing the child's social security number are being mailed to each Provider of Trust funded programs that are contracted for Type 1 activities. Upon receipt of this letter, you are asked to provide current participants in Trust- funded programs with a copy of the enclosed written statement, and at the time you collect the social security number of an individual child or youth as they enroll in your program or service. We are working on having the statement translated into Spanish and Creole. Once completed, we will post on the web site . More information on the change in statute will be made available on our website soon and discussed at future provider meetings. The ChildrensTrust Adult Information Form Are you a Parent, Guardian or Primary Caregiver?* If yes, how many children are in your care?* Participant's* Last Name: Street Address*: Home Phone: Work Phone: Email: ZIP Code*: Gender* ^ Male ^ Female Date of Birth (mo/day/yr)* Race*: ^ American Indian or Alaskan ^ Asian ^ Black or African American ^ Pacific Islander ^ White ^ Other, please specify: Ethnicity*: ^ Hispanic ^ Haitian ^ Other, please specify: Country of Origin: Are You Proficient in English?* ^ Yes ^ No Additional/Other language(s) spoken in the home*: ^ Spanish ^Haitian-Creole ^ Other: What is the Highest Grade You Completed?*: I give my permission for this information to be submitted to The Children's Trust for program monitoring and evaluation purposes. __ _ __ PARTICIPANT'S SIGNATURE*: DATE: For Staff Use Only (MUST BE COMPLETED) ORGANIZATION: SITE LOCATION: Participant must complete the Voluntary Consent for Photography and Communication. Enter responses in Data Tracker System. VOLUNTARY CONSENT RESPONSES: 1. Photography ^ Yes ^ No 2. Communication ^ Yes ^ No 3. Mailing List ^ Yes ^ No 4. Release & Waiver ^ Yes ^ No ^ Yes ^ No First Name: City* Middle Initial: *Required fields Rev 04/07/08 ~~ The Children'sl"rvst Child's*: Last Nam Mother's: Last Nam Father's: Last Nam First Nam First Nam First Nam Middle Initial Middle Initial Middle Initial Does child live with a legal guardian other than mother or father? ^ Yes ^ No If yes, Guardian's: Last Name First Name Middle Initial- Street Address* City* ZIP Code* Parent/Guardian Phone Child Information Form Work Phone Email Child's Gender* ^ Male ^ Female Child's Date of Birth (mo/day/yr)* Child's Race*: ^ American Indian or Alaskan ^ Asian ^ Black or African American ^ Pacific Islander Child's Ethnicity*: ^ Hispanic Child's Country of Origin: Is Child Proficient in English?* ^ Yes ^ No Additional/Other language(s) spoken in the home* Child's Social Security number*: MDCPS ID Number*: ^ Spanish ^Haitian-Creole ^ Other, ^ No SSN; ^ prefer not to give SSN ^ No MDCPS ID; ^ prefer not to give MDCPS ID Child's Current Grade*: Child's Current School*: Does child have health insurance (ex., private insurance, KidCare, Medicaid)?* ^ Yes ^ No (If not, The Children's Trust may be able to help you find affordable coverage-call 211) Does child have a documented disability?* ^ Yes ^ No If yes, do you have (check all that apply): ^ an Individualized Family Service Plan (IFSP; if under 3 years old) ^ an Individualized Education Plan (IEP) from the school system ^ a Section 504 Plan ^ a medical diagnosis from a doctor ^ other documentation If yes, how would you best classify the type(s)? (check all that apply): ^ Autism Spectrum Disorders ^ Learning Disability ^ Chronic Medical Condition ^ Physical Disability ^ Developmental Delay (under 5 only) ^ Speech/Language Impairment ^ Emotional and/or Behavioral Disorder ^ Visual Impairment (or blind) O Hearing Impairment (or deaf) ^ Other Disability ^ Intellectual Disability (or mental retardation) I give my permission for this information to be submitted to The Children's Trust for program monitoring and evaluation purposes. PARENT/GUARDIAN SIGNATURE*: DATE:_ For Staff Use Only (MUST BE COMPLETED) ORGANIZATION: ^ White ^ Other, please specify O Haitian ^ Other, please specify, SITE LOCATION: Parent must complete the Voluntary Consent for Photography and Communication. Enter responses in Data Tracker System. VOLUNTARY CONSENT RESPONSES: 1. Photography ^ Yes ^ No 2. Communication ^ Yes ^ No 3. Mailing List ^ Yes ^ No 4. Release & Waiver ^ Yes ^ No *Required fields. Revised 04/07/08 The Children'sTrust FUNDED CONTRACT AGENCY: PROGRAMlSITE NAME: CONTRACT NUMBER: THIS SECTION TO BE COMPLETED BY PROGRAM PROGRAMS SHALL RETURN THIS COMPLETED FORM TO THE CHILDREN'S TRUST VOLUNTARY CONSENT for PHOTOGRAPHY and COMMUNICATION The Children's Trust funds this program. Demographic and service information on program participants will be provided to The Children's Trust. We ask your permission to make photos and/or videos during program activities and to communicate with you. Name of Child Participant: Last First MI Child's Date of Birth: Month Day Year Parent /Guardian's Name: Last First MI Parent /Guardian's Address: Apt.# City, Home Phone E State Zip Code Cell/Other Phone PROGRAM PARTICIPATION WILL NOT BE AFFECTED OR DENIED IF YOU CHOOSE NOT TO CONSENT. 1. Consent for Photography: I consent to allow the taking of photos or videos of my child and/or me during program activities. Photos/videos may reveal my child's and/or my identity without any compensation paid to my child, to me or to others. All photos and videos shall be the sole property of The Children's Trust and may be used for educational and/or promotional purposes. Circle one: YES, 1 consent NO, I do not consent 2. Consent for Communication: I consent to allow The Children's Trust or others acting for The Children's Trust to contact me about services received. Circle one: YES, I consent NO, I do not consent Today's Date: Signature -Parent or Legal Guardian 3. Consent to be placed on mailing list: I want to receive information about The Children's Trust, child and youth issues, parenting Information, and other topics. Circle one: Yes No 4. RELEASE AND WAIVER Personal identifying information of a child, or a child's parent or guardian, that is in the possession of The Children's Trust is private information and cannot be given to anyone by The Children's Trust without consent or permission. I have the right to have The Children's Trust keep my name and address from being given to anyone. By voluntarily signing below I waive my right for The Children's Trust to keep my name and address private and I give my consent and permission for The Children's Trust to release ONLY my name and address, phone and email address to children's interest groups, including any group formed under state law to advocate for the reauthorization and continued funding of The Children's Trust. By voluntarily signing below I release and discharge The Children's Trust and its agents, employees, and servants from any and all claims, demands, rights, damages, costs whatsoever, in any way growing out of the release of my name, address, phone and email address to children's interest groups as described in the paragraph above. I have read the above and I agree to allow The Children's Trust to release ONLY my name, address, phone and email address to children's interest groups. Signature -Parent or Legal Guardian Today's Date For questions go to www.thechildrenstrust.ora or call The Children's Trust at 305-571-5700. TheChildre~l'sTrust AGENCIA PATROCINADA / CONTRATADA: NOMBRE DEL PROGRAMA / SITIO: NUMERO DEL CONTRATO: PARA USO EXCLUSIVO DEL PROGRAMA. LOS PROGRAMAS DEBEN COMPLETAR Y DEVOLVER ESTE FORMULARIO A THE CHILDRENS TRUST. CONSENTIMIENTO VOLUNTARIO Para FOTOGRAFIA y COMUNICACION The Children's Trust patrocina este programs. The Children's Trust proveera informacion demografica y sobre los servicios de los programas participantes. Solicitamos su autorizacion pars tomar fotos y/o videos durante las actividades del programs y pars comunicarnos con usted acerca de los servicios que recibio. Participante: Apellido Nombre Fecha de nacimiento: Mes Dia Nombre del padre o guardian: Apellido Direction del padre o guardian Ciudad Telefono de la Nombre Estado Celular u otro Inicial Ano Inicial Apto # Codigo Postal Email ___ La participation en el programs NO se very afectada ni denegada si usted no consiente. 1. Consentimiento pars Fotoarafia: Consiento en que se tomen fotos o videos a mi hijo y a mi durante las actividades del programs. Las fotos y los videos pueden revelar la identidad de mi hijo y la mia sin pagar ninguna compensation a mi hijo, a mi o a otras personas. Todas las fotos y videos son de la exclusiva propiedad de The Children's Trust, y podran ser utilizadas con fines educativos o promocionales. Circule uno: SI, consiento NO, no consiento 2. Consentimiento pars Comunicacion: Consiento en que The Children's Trust u otros actuando en Hombre de The Children's Trust se pongan en contacto conmigo sobre los servicios recibidos. Circule uno: SI, consiento NO, no consiento 3. Consentimiento oars ser colocado en la lists de direcciones: Deseo recibir informacion sobre The Children's Trust, sobre la ninez y la juventud, consejos a los padres y otros temas. Circule uno: SI NO FECHA DE HOY: FIRMA DEL PADRE O GUARDIAN LEGAL DIVULGACION Y RENUNCIA La informacion personal de un Wino, de su padre o guardian que este en poder de The Children's Trust es privada y no puede darsele a nadie sin consentimiento o permiso. Tengo derecho a que The Children's Trust no reveae mi Hombre ni mi direction a nadie. AI firmar voluntariamente mss abajo, renuncio a mi derecho de que The Children's Trust no divulgue mi Hombre y mi direction, y doy mi consentimiento y permiso a The Children's Trust a revelar SOLAMENTE mi Hombre, direction, numero de telefono y direction de correo electronico a los grupos con interes en los Winos, incluyendo a cualquier grupo formado bajo ley estatal con el proposito de abogar por la reautorizacion y continuation de financiacion de The Children's Trust. AI firmar voluntariamente mss abajo, libero a The Children's Trust y a sus agentes, empleados y personal a su servicio de toda reclamation, demands, derechos, danos, costos y cualquier otra Cosa que surja por la divulgacion de mi Hombre, direction, numero de telefono y direction de correo electronico a los grupos descritos en el parrafo anterior. He leido todo to anterior y accedo a que The Children's Trust divulgue SOLAMENTE mi Hombre, direcci6n, numero de telefono y direction de correo electronico a los grupos con interes en los Winos. FECHA DE HOY~ FIRMA DEL PADRE O GUARDIAN LEGAL Para preguntas, visite nuestro website www.thechildrenstrust.ora o (lame a The Children's Trust al 305-571-5700. The ~i~iidr"eri"sTr~tst AJANS NOU BAY ED LAJAN AN: NON PWOGRAM NAN: NIMEWO KONTRA A: SE MOUN PWOGRAM NAN KI DWE RANPLI SEKSYON SA A PWOGRAM YODWE VOYE FOM SA A TOUNEN TOU RANPLI BAY THE CHILDRENS TRUST KONSANTMAN VOLONTE POU PRAN FOTO AK KOMINIKASYON Oganizasyon "The Children's Trust" finanse pwogram sa a. Y ap bay "The Children's Trust" done ak enfomasyon sou sevis moun ki patisipe nan pwogram nan resevwa. Nap mande w pemisyon you nou fe foto ak/oubyen videyo pandan n ap fe aktivite pwogram nan epi you nou kominike ave w sou sevis ou resevwa yo. Non patisipan an: Siyati No Dat li fet: Mwa Jou Ane Non paran/Reskonsab: Siyati N Adres paran/Reskonsab: Telefon kay # Apatman Eta Zipkod Potab/lot telefon INB INB Sa PAP fe w pa patisipe nan pwogram nan si w Beside you w pa bay konsantman ou. 1. Konsantman you foto: Mwen dako you w kite yo fe foto oswa videyo petit mwen ave m oubyen foto/videyo pa m pandan nou nan aktivite pwogram nan. Nenpot foto/videyo ka bay non petit mwen ave m oubyen non pa m san yo pa peye ni petit mwen, ni mwen, ni lot moun. Tout foto ak videyo yo, se pwopriyete "The Children's Trust". Yo kapab sevi ak yo you pwogram edikasyon oswa you fe reklam. Ansekle voun: WI, M dako NON, M pa dako 2. Konsantman you kominikasvon: Mwen dako you w kite "The Children's Trust" oswa moun k ap aji o non "The Children's Trust" kontakte mwen konsenan sevis mwen resevwa yo. Ansekle voun: WI, M dako NON, M pa dako 3. Dwa you mete non m nan lis moun v ag voye let ba yo: Mwen vle resevwa enfomasyon sou "The Children's Trust", sou kesyon timoun piti ak jen moun, enfomasyon sou wol paran nan leve timoun, ak lot sije. Ansekle voun: WI NON DAT JODI A: SIYEN -PARAN OSWA RESKONSAB LEGAL WETE RESKONSABLITE SOU DO MOUN AK RENONSYASYON Enfomasyon sou idantite yon timoun, yon paran oswa reskonsab timoun nan, ki nan men "The Children's Trust", tout se enfomasyon prive. "The Children's Trust" pa kab bay nenpot lot moun enfomasyon sa yo san pemisyon. Se dwa mwen you m mande "The Children's Trust" pa bay nenpdt moun non mwen ak adres mwen. Le m siyen anba paj sa a, mwen renonse dwa'm you The Children's Trust kenbe non'm ak adres mwen prive, epi mwen bay yo pemisyon you yo mete SELMAN enfomasyon sa-a, ak telefon a adres elektwonik mwen deyo ba gwoup ki interese ede ti moun e ak lot gwoup ki fome an ba la Iwa lets Floride kap travay kankou defanse you reotorizasyon existans The Children's Trust ak kontiniasyon fon yo. Le m siyen anba paj sa a, mwen wete tout responsablite sou do "The Children's Trust" ansanm ak ajan li, anplwaye li, ak sevite li, you tout reklamasyon, demann, dwa, domaj, lajan sa koute, sou kelkeswa fom, poutet yo voye non m ak adres mwen bay gwoup ki travay sou koze timoun, dapre deskripsyon ki nan paragraf anwo-a" Mwen li sa ki ekri la a e mwen dako kite "The Children's Trust" voye non mwen ak adres mwen SELMAN bay gwoup ki travay sou koze ki an rapo ak timoun. Pa siyen si w pa vle yo bay non w ak adres ou. DAT JODI A: SIYEN -PARAN OSWA RESKONSAB LEGAL Si w gen kesyon, ale sou sit web nou an www.thechildrenstrust.oro oubyen telefone The Children's Trust nan 305-571-5700. ~'~ 1 ': f ~ ~ ~ aacx .P _. ',,y~' ~~~~ Data Tracker Date Client Name First Pviiddie Last Client Address Apartment # Zip Code Home Telephone Cellular Telephone E-Mail Address Contact Date Contact Location O Home O Other Indicate Persons Present O Client O Mother/ Step-Mother O Father/ Step-Father (Check all that apply) O Other Females # O Other Males # Referral Follow-up Please indicate the service needs recognized in prior visits and their subsequent toi Service Need Agency Referred Current Status Current Home Status Plaaca nrnvirtP an unrtatP nn the client and family's status for each cateaorv below. Housing (Housing situation includin affordabilit Financial (Employment, living costs, etc. Familial (Family dynamics, relationshi s, etc. Educational (Academic progress, school attendance, etc. Health (Physical, mental and dental Success University Audit Indicate the Success University components/services that have been accessed by client as of this contact. O Intake & Assessment O Referral Services O Family Conferencing O 7 Habits -Families O 7 Habits -Teens OMB Helpers -Client OMB Helpers -Parents O Entrepreneurship O Tutoring O Community Service Success University Client Contact Form 1 Revised May 2008 Additional Narrative/Observations Indicate any additional comments including observations regarding the client and~or tam New Needs Identified Indicate any new needs tnat require reterrai services. Need Identified Referral Provided/Agency Service Reminders Ploasa Pnciira vnii raviaw all of tha itPmc hPlnw with rliPnt and family Service Reminder Yes No Did ou ensure that all contact information is accurate and u -to-date? O O Did ou remind client to adhere to Success Universit service schedule? O O Did ou rovide famil with SHARE Food Pro ram information? O O Did ou advise client of current month's raffle rize? ~ ~ Next Scheduled Encounter Indicate vour next scheduled encounter with client and location. Date Time Location Purpose O Family Conferencing O Follow-up Home Visit O Final Home Visit O No follow-up expected Success University Client Contact Form 2 Revised May 2008 School Self-Esteem Scale The next set of questions will ask you how you feel about school. Please mark the response that best describes your sentiment for each statement. Strongly Disagree Agree Strongly Disa ree A ree M teachers ex ect too much of me. ^ ^ ^ ^ In the kinds of things we do in school, I am at ^ ^ ^ ^ least as ood as other eo le in m classes. I often feel worthless in school. ^ ^ ^ ^ I am usual) roud of m re ort card. ^ ^ ^ ^ School is harder for me than for most other ^ ^ ^ ^ eo le. My teachers are usually happy with the kind ^ ^ ^ ^ of work I do. Most of m teachers don't understand me. ^ ^ ^ ^ I am an im ortant erson in m classes. ^ ^ ^ ^ It seems that no matter how hard I try, I ^ ^ ^ ^ never et the rades I deserve. All and all, I feel I have been very fortunate ^ ^ ^ ^ to have had the kind of teachers I have had since I started school. There is no penalty for missing class at my ^ ^ ^ ^ school. School truancy rules are enforced at my ^ ^ ^ ^ school. My parents are concerned about my ^ ^ ^ ^ performance in school. Name Date Data Tracker Date Entered By JA Com~arry Program T"' Student Pre-Test I .What are the first three letters of your last name? 2. When were you born? I 9 Month Day Year 3. Are you (please check only one): ^ ~ Female ^z Male 4. Where was the jA Company Program you participated in located? (Please write the name of'the school, organization, or community center where you attended the program): 5. What grade are you in? (Please check only one) ^ ~ 9~' Oz 10~' ^n I I ~' ^, 12~' ^s Other b. What is your ethnic background? (Please check all that apply ^ White/Caucasian ^ Hispanic/Latino ^ Black/African American ^ Asian ^ Paafic Islander ^ American Indian/Alaskan Native ^ Other (please specl(y): 7. NOT including this session, how many times have you participated in JA before? ^~ I ^z 2 ^a 3 ^, 4 ^5 5 or more ^b This is my first time Please Continue on the Next Page Evaluation and Training Institute l . Company values represent: ^ ~ how much companies are worth ^z a set of ethical behavior standards ^3 the prices for multiple shares of stock in a company ^, fees paid to start up new businesses 2. Which of the following represents the company's dream of where it wants to go and what it wants to be- lts ideal. ©~ vision statement ^: finanaal report ^3 mission statement O, business principle 3. A mission statement describes how a company plans to accomplish their vision and clearly explains what a company seeks to accomplish day to day and over the long term. ^ ~ True O~ False 4. The Board of Directors of a company are not allowed to own stock in that company. ^ ~ True LIZ False 5. According to the Rules of Parliamentary Procedure, once someone makes a motion, if no one offers a second, the desired statement of policy is "dead" and discussion ends. ^~ True ^~ False 6. Selling shares of stock to get start-up money for a new company is called O. liquidation ^~ bankruptry ^3 capitalization ^, dividends 7. Which department in a company is typically responsible #or overseeing material purchases, production standards, safety guidelines, inventory tracking and quality control? ^~ Human Resources ^: Marketing ^3 Production ^, Public Relations S. Which department in a company is typically responsible for identifying customers, designing advertising strategies, and setting sales goals? ^~ Human Resources ^z Marketing ^3 Production ^, Public Relations Please Continue on the Next Page Evaluation and Training Institute 9. Which of the following is a way to gain the opinion of potential buyers. D. customer satisfaction survey ^~ market survey ^3 cold call ^a telemarketer 10. Double-entry bookkeeping is a standard business practice that helps prevent mistakes and tracks errors by requiring that each transaction be entered twice. How is the information entered? ^~ Once in the Finance department records, and once in the Production department records. ^~ Once in the company s checkbook, and once on the bank reconciliation statement. ^3 Once in the debit column of a record, and once in the credit column. ^, First in pencil, then in pen once calculations are verified. 1 I .What is NOT induded in a business plan for a company? ^, the mission and goals ^: list of stockholders ^3 marketing plans O, finance details 2. Which of the fallowing costs are business expenses that remain the same, regardless of the number of products produced or services provided. ^~ Retail ^z Variable ^3 Constant ^, Fxed 13. Which are examples of typical fixed costs encountered by small businesses? (Please thetk al! that apply) ^ employee wages ^ company officers' wages O rent O marketing supplies The Bright Ideas company has decided to sell specialty high tech light bulbs that use;a clew. infrared :. ,.. ,.. technology. This new.-light Bulb will be made by their existing lighting division. that.#~as total. fixed costs of ' '$270. The projected #otal cist of materials.to make i 00'of these IighE..bulbs is $100. The President of .Bright Ideas values his salespeople;'and rewards them with a I O percent sales commission The salesaax rate is 5percent. ~ . 4. Which of the fallowing are included in the description above? ^ sales tax rate ^ materials costs per light bulb ^ employee sales commission ^ all of the above 15. In addition to the information provided in the description above, what additional information would you need to be able to calculate the number of units that must be sold to cover its costs? ^~ the number of salespeople employed by Bright ideas ^~ the net price of the light bulbs C1a the state where Bright Ideas is located ^, information on the retail company buying Bright Ideas' light bulbs Evaluation and Training Institute 16. Please select the best definition of the break-even point. ^, when a campany begins to make a profit ^z employees' salaries are lower production costs ^a the number of units that must be sold to cover all costs ^, none of the above 17. "Our new infrared light bulb is small, but it will light up an entire room" is an example of a safes tactic known as the "yes, but" technique. ^~ True ^x False i 8. Salespeople should not: ^, smile and shake hands when greeting a potential customer ^z use all their selling points at the beginning of their presentation 03 ask questions that will elicit positive responses from customers ^< ask for an order as soon as the customer appears convinced of the product's value I4. Art activity or procedure that is more efficient and effective than others that exist is called a: ^~ break-even point ^z capita! asset ^a best practice O, opportunity cost 20. The process of converting company assets into cash, settling all accounts, and distributing the remaining cash to company stockholders in the form of a stockholder dividend is called: ^~ filing bankruptry ^z a hostile takeover ^3liquidation ^, stock manipulation Yhe;Brighr deas;company-.has decided to doseshop after 30 years in~the bus~ness:despife: record sales gf;its newest product--an infrared lightbulb. Their financial. records reveal that there~is a net profit of .$75,000 after .. company boriuses`are..paid. Capital stock totafs~$3 0,000 and:there are 250 shares of stock'soid in.`:the aornpany.; 21. What is the formula used to calcuiate the book value of the Bright Ideas company stock upon liquidation? ^ ~ (capital stock + shares of stock)/net profit after bonuses ^: net profitlnumberof years in business ^3 (net profit after bonuses + capital stock)/shares of stock ^, number of employeesl(number of years in business/shares of stock) Please Continue on the Next Page Evaluation and Training Institute Student Attitude Questionnaire . Do you like going to school? ^~ All die time ^z Most of the time ^a Some of the time ^. Never 2. Do you feel safe after school? ©~ All the time ^z Most of the time ^a Some of the time ^a Never 3. Do you study hard for tests? ^~ All the time ^z Most of the time ^3 Some of the time ^, Never 4. How often are you in trouble at school? ^~ All the time ^z Most of the time ^3 Some of the time D4 Never 5. Do you feel comfortable talking to teachers or other school staff? ^, All the time ^z Most of the time ^a Some of the time D, Never 6. Do you get your homework done on time? ^~ All the time ^z Most of the time ^s Some of the time ^, Never 7. On a typical day, how much time do you spend studying or doing homework outside of lass time? ^, More than 2 hours ^z I -2 hours ^3 30 minutes -under an hour ^, Under 30 minutes ^S None 8. How often do you feel good about school? ^, All the time ^z Most of the time ^3 Some of the time ^+ Never 9. How well do you get along with others, including other students or adults? ^, Very well ^z Okay, but could be better ^3 Not at all well 10. How do you feel about yourself? ^~ I'rn great ^z I'm OK ^a I'm not doing very well I I . How are your grades on average? ^~ Very high (A} ^z Above average (B) ^a Average (C) ^. Below average (D) ^s Failing (F) 12. What is your overall grade point average (GPA) for high school? ^z I don't know Please Continue on the Next Page Evaluation and Training Institute 13. What do you usually do after school (check a!! that apply)? ^~ Watch N ^: Play video or computer games ^3 Surf the Internet or chat online ^, Tack on the phone/text message ^s Listen to music ^b Hang out with friends ^~ Hang out with boyfriend or girlfriend ^e Go to the mall ^9 Play sports ^.o Martial arts ^ ~ ~ Dance lessons ^~~ Volunteer Oia Work (including part-time or an internship) 14. Have you ever had a full or part-time job? 15. What is your current work status? ^~ Full time job ^~ Part time job ^~, Chores ^is Babysitting ^~b Do homework ^~~ Participate in an after school program ^ie Eat snacks ^~9 Play board games ^w Work on hobbies ^: ~ Art ^u Band/Orchestra/Choirpmctice ^~ Read ^s, Spend time with my family ^~s Other: ^ ~ Yes ^a Internship ^, Volunteer Thank you!!! ^a No ^s None Evaluation and Training I~rstitate JA Company Progrom TM Student Post-Test 1. What are the first three letters of your last name? 2. When were you born? 3. Are you (Tease check only one}: ^ ~ Female ^z Male I 9 Month Day Year 4. Where was the fA Company Program you participated in located? (Please write the name o f the school, organization, or community center where you offended the program}: ~. What grade are you in? (Please check only one.J ^ ~ 9~' O~ 10"' ^3 I I "' ^, 12'" ^s Other 6. What is your ethnic background? (Please check all that apply.} 0 White/Caucasian ^ Hispanic/Latino ^ BIacWAfrican American ^ Asian ^ Padfic Islander © American Indian/Alaskan Native ^ Other (please specify}: 7. NOT including this session, how many times have you participated in JA before? ^~ f 0: 2 ^a 3 ^4 4 ^5 5 or more ^e This is my first time If your parent/guardian submitted the "Opt Out Form" please DO NOT complete the address section below and continue on the next page to complete the survey. For those students whose parerntlguard'ran DID NOT complete an "Opt Out Form," )A really wants to know what you gain from the program over time. Please provide your name and mailing address so that we can send afollow-up survey to you. This information is strictly confidential and will only be used for a mailing label. THANK YOU! Your name: FIRST Address: LAST STREET NUMBER STREET NAME APT. NUMBER CITY STATE ZIP CODE EvaluaSon and Training 1'nstitute t I .Company values represent O. how much companies are worth ^z a set of ethical behavior standards ^3 the prices for multiple shares of stock in a company O, fees paid to start up new businesses 2. Which of the following represents the company's dream of where it wants to go and what it wants to be- ns ideal. ^~ vision statement ^z financial report I]3 mission statement ^, business principle 3. A mission statement describes how a company plans to accomplish their vision and clearly explains what a company seeks to accomplish day to day and over the long term. ^ ~ True ^z False 4. The Board of Directors of a company are not allowed to own stock in that company. ^~ True ^z False 5. According to the Rules of Parliamentary Procedure, once someone makes a motion, if no one offers a second, the desired statement of policy is "dead" and discussion ends. ^ ~ True O: False b. Selling shares of stock to get start-up money for a new company is called ^~ liquidation ^z bankruptcy ^a capitalization ^, dividends 7. Which department in a company is typically responsible for overseeing material purchases, production standards, safety guidelines, inventory tracking and quality control? ^, Human Resources ^z Marketing ^3 Production O, Public Relations 8. Which department in a company is typically responsible for identifying customers, designing advertising strategies, and setting sales goals? ^~ Human Resources ^z Marketing ^a Production ^, Public Relations Evaluation and 7Y~aining Institute 9. Which of the fo{lowing is a way to gain the opinion of potential buyers. O. customer satisfaction survey ^~ market survey ^3 cold call D, telemarketer 0. Double-entry bookkeeping is a standard business practice that helps prevent mistakes and tracks errors by requiring that each transaction be entered twice. How is the information entered? ^~ Once in the Finance department records, and once in the Production department records. ^z Once in the company's checkbook, and once on the bank recondtiation statement. ^a Once in the debit column of a record, and once in the credit column. ^, First in pencil, then in pen once calculations are verified. I I. What is NOT included in a business plan for a company? ^~ the mission and goals ^z list of stockholders ^3 marketing plans ^, finance details 12. Which of the following costs are business expenses that remain the same, regardless of the number of products produced or services provided. D~ Retail ^~ Variable ^3 Constant O, Fixed i 3. Which are examples of typical faced costs encountered by small businesses? (Please check afl that apply} ^ employee wages ^ company officers' wages ^ rent ^ marketing supplies The Bright Ideas company has deeded to'sell specialty:high tech light bulbs.that'use.ahew infrared :: . ,. ,. technology This new l~ghtbulb wrll:.be made by theNr existing lighting.divis~on.tfiat has total fixed costs of $270. The projected .total cost of materials to make 100,of theselight bulbs is$i 00. The Presiderrt of B,r~ght•ldeas values his.salespeople, and rewards them with a 10 percent sales commission. The sales tax rate is_5.,percent. • 14. Which of the following are included in the description above? ^ sales tax rate ^ materials costs per light bulb ^ employee sales commission ^ ail of the above I5. In addition to the information provided in the description above, what additional information wouid you need to be able to calculate the number of units that must be sold to cover its costs? ^~ the number of salespeople employed by Bright Ideas ^z the net price of the light bulbs ^3 the state where Bright Ideas is located ^, information on the retail company buying Bright Ideas' light bulbs Evaluation and Traintn Instdtute 6. Please select the best definition of the break-even point. ^ ~ when a company begins to make a profit ` ^z employees' salaries are lower than production costs 03 the number of units that must be sold to cover all costs O, none of the above 17. "Our new infrared light bulb is small, but it will light up an entire room" is an example of a sales tactic known as the "yes, but" technique. ^~ True ^z False l $. Salespeople should not: ^~ smile and shake hands when greeting a potential customer ^z use all their selling points at the beginning of their presentation ^a ask questions that will elicit positive responses from customers ^, ask for an order as soon as the customer appears corninced of the product's value t 9. An activity or procedure that is more efficient and effective than others that exist is called a: O. break-even point ^~ capital asset ^a best practice ^, opportunity cost 20. The process of converting company assets into cash, settling all accounts, and distributing the remaining cash to company stockholders in the form of a stockholder dividend is called: ^~ filing bankruptry ^~ a hostile takeover ^3 liquidation ^, stock manipulation The Bright lcleas company has decided :to close shop after 30 years in the business :despite record sales of its newest product--an infrared light bulb. Their financial records reveal that there is'a.;net profit of $75,000.aftet: company:bonuses~are paid, Capital. stock totals $I 0,000. and:there are 250 shares :of stock sold in:the company. 2 I . What is the formula used to calculate the book value of the Bright Ideas company stock upon liquidation? ^ ~ (capital stock + shares of stock}/net profit after bonuses ^: net profit/number of years in business ^3 (net profit after bonuses + capital stock}/shares of stock O, number of employees/(number of years in business/shares of stock) (Please continue on the next page, j Evaluation and Training Institute Student Attitude Questionnaire I. Do you like going to school? ^, All the time ^z Most of the time ^3 Some of the time ^, Never 2. Do you feel safe after school? ^, All the time ^z Most of the time ^3 Some of the time ^< Never 3. Do you study hard for tests? ^, All the time ^z Most of the time ^a Some of the time ^+ Never 4. How often are you in trouble at school? ^, All the time ^z Most of the time ^3 Some of the time ^+ Never 5. Do you feel comfortable talking to teachers or other school staff? ^ ~ All the dme ^z Most of the time ^3 Some of the time ^+ Never 6. Do you get your homework done on time? ^, All the dme ^z Most of the time ^a Some of the time ^a Never 7. On a typical day, how much time do you spend studying or doing homework outside of class time? ^, More than 2 hours ^z 1-2 hours ^3 30 minutes -under an hour ^. Under 30 minutes ^s None $. How often do you feel good about school? ' ^, All the dme ^z Most of the time D3 Some of the time ^, Never 9. How well do you get along with others, including other students or adults? ^, Very well ^z Okay, but could be better ^3 Not at all well 10. How do you feel about yourself? ^, I'm great ^z I'm OK ^3 I'm not doing very well I I . How are your grades on average? ^~ Very high (A) ©z Above average {B) ^3 Average (C) ^< Below average (D) ^s Failing (F) 2. What is your overall grade point average (GPA) for high school? ^z I don't know Please continue on the next gage. Evaluation and Traininglnstitute 13. What do you usually do after school? (Please check a!1 that apply) ^ Watch TV ^ Play video or computer games D Surf the Internet or chat online ^ Talk on the phone/text message ^ Listen to music ^ Hang out with friends O Hang out with boyfriend or girlfriend ^ Go to the mall ^ Play sports ^ Martial arts ^ Dance lessons ^ Vdunteer ^ Work (including part-time or an internship) 14. Have you ever had a full or part-time job? ! 5. What is your current work status? ^~ Full time job ^2 Part time job ^ Chores ^ Babysitting ^ Do homework ^ Participate in an after school program ^ Eat snacks ^ Play board games ^ Work on hobbies ^ Art ^ Band/Orchestra/Choiryractice ^ Read ^ Spend time with my family ^ Other: ^ ~ Yes ^; Internship Thank you!!! ^~ No O, Volunteer 05 None Emluation and Training Institute = Strong - --/--/--/--/-- =Stressed = Weak - - =Absent Natural Support Map O =Female =Male Q =Provider Name T e of Su ort/Relationshi s, etc. T:CHOICES/MB2UU7trngEcomap Eco-map An ecomap is structural assessment tool used to visualize family member's contact with the larger systems. In our case, with the child(ren) it is used to illustrate the current relationships and systems of support. - In pictorial for, outlines relationships between individuals; - The flow of resources and support (in & out) can be shown. - Shows dynamics between the subject child and their family support system/agency support, etc... 1. Solid lines ( )indicate strong relationships (the thicker the line the stronger the tie); 2. Dotted lines (- - - - - -) indicate weak relationships; 3. Crossbars (--/--/--/--/-) on the line indicate stressful relationships; 4. Absence or distance of lines ( ;- )indicate no or distant connection; 5. Arrows signify energy or resource flow (~,); 6. O=female; ~ =male; Q=provider; T/7A-CHOICES: MB2007tTrngEcomap a 0 a a r.., a~ ;~ '°' a: b a~ ,~' .~ ~ a a ~. ~: ~ UI a o. ~, ~ . a~ ~ ~, _W ~' a~ ':~ .~ ~ a o ~ ~, ~ U --~ ~ N ~ Q U ~ ~" U w O U U A ~i 0 v y,L N 'fi- N v~ q I ~ Q ~ U z r.., 00 ~y I~ ., W d a a b U w W U O x U [- z 0 N V w V 0 v N A A W N U' 0. 0] G A U w w U O x H 00 O~ O .-~ N M ~Y V~ ~D l~ 00 O~ O r-i N M C N ~ ti rl N N N N N N N N N N M M M M M M M W H 'A a~ b ~' 0 U 0 ~ H wz a.aWn- H ~ ~ a~ a~ W z O ~' z a W V U ,~ v~ 0 a a x H L7 Z W a E~ v~ z 0 c~ z w x H w U C7 W r%~ W U .. O x U F 0 V a~ e~ A a~ Z O N c«. 0 N on a C7 z 0 v z w E- 8 .° U V w w _U O U Miami Beach Service Partnership Project INVITED PARTICIPANTS OF THE FAMILY GROUP CONFERENCE (FGC) Youth's Name: Student #: Parent's/Guardian's Name: Preferred Location, Date & Time of FGC: Mother: Father: Gaurdian: Care Giver: T:CHOICESDesktop-FGCMinvite/2007 Page Of •~ i, ~ ~~ Names ~ Address(es) Include Zipcodes Phone #'s Relationship , •4Codes T:Desktop-FGCMinvite/2007 Page_ of CODES: C=Attendance Confirmed N=Unable to Attend C") x 0 m oa A W N ;-~ O n ~D K O b z ~' ~ ,~. ~~ ~ Cy y r r ~ ~ rr~~ rr~~ rr~~ 1t`M o~ ~ ~ ~~ ~ ~ A~++ ~ F. ~ ~ y QQ rfr y C~ ~D C~ OQ ~Q fD C~ .. O C ~' v~' z c a C~ v h ~ h b ~0 ,~ • •~ -1 CO C~ '~1 00 ~ 1 O~ C/1 0 A tD 0 M~.r b r~ ~ A w ~ ~ ~ ~ v y r r~~ r r~~ r r~~ r r ~~ rryg o~ ~m ~~ p A '~ pD O ~. ~ m QQ y ~"'3 H H Yl m N O W -~ n n r.~ N ~ i-+ ~ O ~p O ''d A r+. ~''C3 J y rr~•~ rr~•~ rr~•~ rr~•g ~-=~ ~~ ~ ~, ~~ p t9 "C AD p ~ ~t ~• m C y 7Q CONTRACT NO. 903-109 BETWEEN THE CHILDREN'S TRUST AND The City of Miami Beach FOR The Miami Beach Service Partnership 2008-09 THIS CONTRACT, made and entered into by and between The Children's Trust whose address is 3150 S.W. 3`d Avenue, 8th Floor, Miami, Florida 33129 and The City of Miami Beach hereinafter referred to as the "Provider" whose address is 555 17th Street, Miami Beach, FL. 33139 states the conditions and covenants for the rendering of services to children and families (hereafter referred to as "Services") for The Children's Trust. In consideration of the mutual covenants herein, The Children's Trust and the Provider (sometimes hereafter referred to as "Parties") agree as follows: A. EFFECTIVE TERM The effective term of this Contract shall be from June 1, 2008 through May 31, 2009, subject to funding availability and Provider's performance as expressly provided below. B. TERMS OF RENEWAL, if applicable In the sole discretion of The Children's Trust this Contract may be renewed twice and with the acknowledgement of the Provider, each renewal may not exceed a term equal to the term of the initial contract, for a total maximum of three (3) terms. In considering the exercise of any contract renewal The Children's Trust in its sole discretion will consider, but is not limited to, the following: 1. Provider meeting the performance requirements specified in this Contract. 2. Continued demonstrated and documented need for the services funded; 3. Program performance and fiscal compliance by the Provider that is deemed satisfactory in The Children's Trust's sole discretion; and 4. The availability of funds from The Children's Trust. The Children's Trust is prohibited from creating obligations in anticipation of budgeted revenues from one fiscal year to another without year to year extension provisions in the contract. 5. If applicable, The Children's Trust in its sole discretion will initiate re-negotiation of this Contract before the contract term expires. C. SCOPE OF SERVICES 1. Provider agrees to render services in accordance with the Scope of Services, Attachment A, to this Contract. Provider shall implement the Scope of Services, Attachment A, in a manner deemed satisfactory to The Children's Trust. Any modification to the Scope of Services shall not be effective until approved, in writing, by The Children's Trust and the Provider. 2. Provider agrees that all funding provided by The Children's Trust, pursuant to this Contract will be used exclusively for Services in and for the benefit of Miami-Dade County residents. D. TOTAL FUNDING Subject to the availability of funds, the maximum amount payable for Services rendered under this Contract shall not exceed $499,550.83. The Parties agree that should available funding to The Children's Trust be reduced, the amount payable under this Contract will be proportionately reduced at the sole option of The Children's Trust, with a proportionate reduction in the Services. Provider agrees to adhere to the Budget and Method of Payment outlined in Attachment B to this Contract. E. FISCAL MANAGEMENT 1. Double Payments Provider costs or earnings claimed under this Contract may not also be claimed under another contract or grant from The Children's Trust or, unless such claim is denied by The Children's Trust, from any other agency. Any claim for double payment by Provider shall be a material breach of this Contract. 2. No Supplanting of Existing Public Funds The Children's Trust funding may not be used by any provider as a substitute for existing resources or for resources that would otherwise be available for children's services, or to replace funding previously provided The City of Miami Beach Contract #903-109, Resolution 2008-22 1 by and currently available from local and state funding sources for the same purpose. Government agencies must certify that they have maintained their previous funding level when applying for additional funding from The Children's Trust. A violation of this section shall be considered a material breach of this Contract. 3. Use of Cost Allocation Methodology Provider attests that no other reimbursement is available or used for invoiced Services unless expressly authorized in writing by The Children's Trust. Provider shall develop and maintain a cost allocation methodology and a copy shall be submitted to The Children's Trust. 4. Capital Equipment Capital equipment is included in the definition of "property" under Florida Statutes, Chapter 274, and Florida Administrative Code, Section 69I-73.002, and is defined for purposes of this Contract as individual items with a value of $1,000 or greater which have a life expectancy of more than one year. Capital equipment purchased with Trust funds by Provider become assets of The Children's Trust; are intended for The Children's Trust funded programs; are owned by The Children's Trust; and must be tagged at the time of purchase as an asset of The Children's Trust. The Children's Trust will work with Provider to tag the asset and receive all information regarding the capital equipment. Provider must maintain a record of any capital equipment purchased with funds provided by The Children's Trust. When Provider is no longer funded by The Children's Trust, the equipment will be returned to The Children's Trust for use by another funded program unless it is fully depreciated. Provider must initiate return of such capital equipment to The Children's Trust. Ownership of capital equipment will be transferred to Provider and removed from The Children's Trust's fixed asset system if the capital equipment is fully depreciated and in the possession of Provider unless The Children's Trust has approved the retainage of any fees collected by Provider. 5. Assignments and Subcontracts Neither Provider nor The Children's Trust shall assign this Contract to another party. Provider shall not subcontract any Services contemplated under this Contract without prior written approval of The Children's Trust. Provider shall incorporate appropriate language from The Children's Trust contract into its .subcontract and shall require that all subcontractors providing services shall be governed by the terms and conditions of this contract. All sub-contracted providers must agree to be monitored by or on behalf of The Children's Trust in the same manner as Provider under the terms of this contract. Provider shall be responsible for all services performed and all expenses incurred with this Contract, including services provided and expenses incurred by any and all subcontractors. It is understood by Provider that The Children's Trust shall not be liable to a subcontractor for any expenses or liabilities incurred under any subcontract and Provider shall be solely liable under the subcontract. Provider agrees, at Provider's sole expense, to hold harmless and defend The Children's Trust against any such claims, demands or actions related to any subcontract. In no event shall The Children's Trust directly provide funds to any subcontractor. All payments to any authorized subcontractor shall be paid directly by Provider to the subcontractor. 6. Religious Purposes Organizations and their faith-based community partners shall not use funds provided under this Contract to support inherently religious activities, such as religious instruction, worship, or proselytization. 7. Lobbying Provider shall not use any funds provided under this Contract or any other funds provided by The Children's Trust for lobbying any federal, state or local government or legislators. 8. Adverse Action or Proceeding Provider shall not utilize the funds provided under this Contract or any other funds provided. by The Children's Trust to retain any legal counsel for any action or proceeding against The Children's Trust or any of its agents, employees or officials. F. INDEMNIFICATION BY PROVIDER 1. Government Entity Subject to the limitations and sovereign immunity provisions of Florida Statute, Sec. 768.28, Provider shall indemnify and hold harmless The Children's Trust and its officers, employees, agents and instrumentalities from any and all liability, losses or damages, including attorneys' fees and costs of defense, which its officers, employees, agents or instrumentalities may incur as a result of claims, demands, suits, causes of actions or The City of Miami Beach 2 Contract #903-109, Resolution 2008-22 proceedings of any kind or nature arising out of, relating to or resulting from the performance of this Contract by Provider or its employees, agents, servants, partners, principals or subcontractors. Subject to the limitations and sovereign immunity provisions of Florida Statutes, Sec. 768.28, Provider shall pay all claims and losses in connection therewith and shall investigate and defend all claims, suits or actions of any kind or nature in the name of The Children's Trust, where applicable, including appellate proceedings, and shall pay all costs, judgments, and reasonable attorney's fees which may issue thereon. 2. All Other Providers Provider shall indemnify and hold harmless The Children's Trust and its officers, employees, agents and instrumentalities from any and all liability, losses or damages, including reasonable attorneys' fees and costs of defense, which The Children's Trust or its officers, employees, agents or instrumentalities may incur as a result of claims, demands, suits, causes of action or proceedings of any kind or nature arising out of, relating to or resulting from the performance of this Contract by the Provider or its employees, agents, servants, partners, principals or sub contractors, except to the extent arising from The Children's Trust's willful or wanton acts or omissions, or those of its employees or principals. To the extent arising from a liability that is covered by the foregoing indemnification, Provider shall pay all claims and losses in connection therewith and shall investigate and defend all claims, suits or actions of any kind or nature in the name of The Children's Trust, where applicable, including appellate proceedings, and shall pay all costs, judgments, and reasonable attorney's fees which may issue thereon. Provider expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by Provider shall in no way limit the responsibility to indemnify, keep and save harmless and defend The Children's Trust or its officers, employees, agents as herein provided. The provisions of this section on indemnification shall survive the expiration or termination of this Contract. G. COPYRIGHTS AND RIGHT TO DATA/MATERIALS Where activities supported by this Contract produce original writing, data, sound recordings, pictorial reproductions, drawings or other graphic representations and works of similar nature, The Children's Trust has a license to reasonably use, duplicate and disclose such materials in whole or in part in a manner consistent with the purposes and terms of this Contract, and to have others acting on behalf of The Children's Trust to do so, provided that such use does not compromise the validity of any copyright, trademark or patent. If the data/materials so developed are .subject to copyright, trademark or patent, legal title and every right, interest, claim or demand of any kind in and to any patent, trademark or copyright, or application for the same, will vest in the Provider or with any applicable third party who has licensed or otherwise permitted the Provider to use the same. Provider agrees to allow The Children's Trust and others acting on behalf of The Children's Trust to have reasonable use of the same consistent with the purposes and terms of this Contract, at no cost to The Children's Trust, provided that such use does not compromise the validity of such copyright, trademark or patent. H. OWNERSHIP AND LICENSING OF INTELLECTUAL PROPERTY RIGHTS The Parties understand that this Contract is subject to the provisions, limitations and exceptions of Chapter 119, Florida Statutes, regarding public records. Accordingly to the extent permitted by Chapter 119, Florida Statutes, the Provider retains sole ownership of intellectual property developed under this Contract. It is the responsibility of the Provider to pay all required licensing fees if intellectual property owned by other parties is incorporated by the Provider into the services required under this Contract. Such licensing should be in the exclusive name of the Provider. Payment for any such licensing fees or costs arising from the use of others' intellectual property rights must be made by the Provider from funds available under this Contract As applicable under Fla. Stat. Section 768.28, and to the extent permitted by and within the limitations of Fla. Stat. Section 768.28, the Parties shall indemnify and hold each other harmless from liability of any nature or kind, including costs and expenses for or on account of third party allegations that use of any intellectual property owned by the third party and provided, manufactured or used by the indemnifying Party in the performance of this Contract violates the intellectual property rights of that third party. BREACH OF CONTRACT AND REMEDIES 1. Breach A material breach by the Provider shall have occurred under this Contract if the Provider through action or omission causes any of the following: a. Fails to provide the Services outlined in the scope of services (Attachment A) within the effective term The City of Miami Beach 3 Contract #903-109, Resolution 2008-22 of this Contract; b. Ineffectively or improperly uses The Children's Trust funds allocated under this Contract; c. Does not furnish the certificates of insurance required by this Contract or as determined by The Children's Trust; d. Does not meet or satisfy the conditions of award required by this Contract; e. Fails to submit or submits incorrect or incomplete proof of expenditures to support disbursement requests or advance funding disbursements, or fails to submit or submits incomplete or incorrect detailed reports of requests for payment, expenditures or final expenditure reports; f. Does not submit or submits incomplete or incorrect required reports pursuant to the scope of Services in this Contract; g. Refuses to allow The Children's Trust access to records or refuses to allow The Children's Trust to monitor, evaluate and review the Provider's program, including required client data; h. Fails to comply with child abuse and incident reporting requirements; i. Attempts to meet its obligations under this Contract through fraud, misrepresentation or material misstatement; j. Fails to correct deficiencies found during a monitoring, evaluation or review within a specified reasonable time; k. Fails to meet the terms and conditions of any obligation or repayment schedule to The Children's Trust or any of its agencies; I. Fails to maintain the confidentiality of client files, pursuant to Florida and federal laws; m. Fails to fulfill in a timely and proper manner any and all of its obligations, covenants, contracts and stipulations in this Contract; n. Fails to comply with Background Screening, as required under this Contract. Waiver of breach of any provisions of this Contract shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of this Contract. 2. Remedies If the Provider breaches this Contract, and fails to cure any such breach within thirty (30) days after receiving written notice from The Children's Trust identifying the breach, The Children's Trust may pursue any of the following remedies: The Children's Trust may, at its sole discretion, enter into a written performance improvement plan with the Provider to cure any breach of this Contract as may be permissible under state or federal law. Any such remedial plan shall be an addition to this Contract and shall not affect or render void or voidable any other provision contained in this Contract, costs, and any judgments entered by a court of appropriate jurisdiction. The Children's Trust may suspend payment in whole or in part under this Contract by providing written notice to the Provider of such suspension and specifying the effective date thereof, at least five business days before the effective date of suspension. On the effective date of suspension the Provider may (but shall not be obligated to) continue to perform the services provided for in this Contract, but the Provider shall promptly cease using The Children's Trust's logo and any other reference to The Children's Trust in connection with such services. All payments to the Provider as of this date shall cease, except that The Children's Trust shall continue to review and pay requests for payment for services that were performed and/or for deliverables that were substantially completed at the sole discretion of The Children's Trust, prior to the effective date of such suspension. If payments are suspended, The Children's Trust must specify in writing the actions that must be taken by the Provider as condition precedent to resumption of payments and shall specify a reasonable date for compliance. The Children's Trust may also suspend any payments in whole or in part under any other contracts entered into between The Children's Trust and the Provider by providing separate written notice to the Provider of each such suspension and specifying the effective date thereof, which must be at least five business days before the effective date of such suspension, in any event The Children's Trust shall continue to review-and pay requests for payment as provided for in such other contracts for services that were pertormed and/or for deliverables that were substantially completed at the sole discretion of The Children's Trust prior to the effective date of such suspension. The Provider shall be responsible for all direct and indirect costs associated with such termination including reasonable attorney's fees. The Children's Trust may terminate this Contract by giving written notice to the Provider of such termination and specifying the date thereof at least five (5) business days before the effective date of termination. In the event of such termination, The Children's Trust may (a) request the Provider to deliver to The Children's Trust clear and legible copies of all finished or unfinished documents, studies, surveys, reports prepared and secured by the Provider with Trust funds under this Contract subject to the rights of the Provider thereto as provided for in Paragraphs G and H above; (b) seek reimbursement of any Trust funds which have been The City of Miami Beach ~} Contract #903-109, Resolution 2008-22 improperly paid to the Provider under this Contract; (c) terminate further payment of Trust funds to the Provider under this Contract, except that The Children's Trust shall continue to review and pay requests for payment for services that were performed and/or deliverables that were substantially completed at the sole discretion of The Children's Trust prior to the effective date of such termination; and/or (d) terminate or cancel any other contracts entered into between The Children's Trust and the Provider by providing separate written notice to the Provider of each such termination and specifying the effective date thereof, which must be at least five business days before the effective date of such termination, in which event The Children's Trust shall continue to review and pay requests for payment as provided for in such other contracts for services that were performed and/or for deliverables that were substantially completed at the sole discretion of The Children's Trust prior to the effective date of such termination. The Provider shall be responsible for all direct and indirect costs associated with such termination, including reasonable attorney's fees. The Children's Trust may seek enforcement of this Contract including but not limited to filing an action with a court of appropriate jurisdiction. The Provider shall be responsible for all direct and indirect costs associated with such enforcement, including reasonable attorney's fees, costs, and any judgments entered by a court of appropriate jurisdiction, including all direct and indirect costs and reasonable attorneys' fees through conclusion of all appellate proceedings, and including any final settlement. The provisions of this Paragraph I shall survive the expiration or termination of this Contract. J. INSURANCE REQUIREMENTS *Note: City of Miami Beach is entirely self-insured. Except as required by Florida law for government entities, prior to execution of this Contract and as a condition to execution, Provider shall provide to The Children's Trust Certificates of Insurance or, as applicable, a letter of self- insurance indicating coverage applicable to a Florida municipal corporation or written verification (binders) required under this section or as determined by The Children's Trust. The Children's Trust shall be named as an additional insured on all applicable policies. The Children's Trust shall not disburse any funds until The Children's Trust is provided with the necessary Certificates of Insurance, letter of self-insurance or written verification (binders) and The Children's Trust has approved such documents. The Children's Trust shall have the rights to review said certificates or letters and if applicable, reasonably require updating of types and amounts of coverage provided upon any renewal of this Contract. Provider will carry insurance policies in the amounts and with the requirements indicated below: 1. Worker's Compensation Insurance for all employees and non-incorporated independent contractors and or consultants of the Provider, as required by Florida Statutes, Chapter 440. The employer's liability portion will be $500,000/$500,000/$500,000 as a minimum. 2. Comprehensive General Liability insurance in an amount not less than $500,000 combined single limit per occurrence and $1,000,000 aggregate in a policy year. Deductibles exceeding $ 1,000 are discouraged, unless Provider can provide financials to support a higher deductible. The general liability policy must contain coverage for the following: a) Bodily Injury; b) Property Damage; c) No exclusions for Abuse, Molestation or Corporal Punishment; d) No endorsement for premises only operations. The Children's Trust must be designated and shown as an "Additional Insured as Their Interest May Appear" with respects to this coverage. 3. If applicable, Special Events Coverage, as determined by The Children's Trust. The liability coverage will be the same as the coverage and limits required for comprehensive general liability and The Children's Trust must be designated and shown as "Additional Insured as Their Interest May Appear." Special Events policies are for short term functions and not meant to replace annual liability policies. The coverage is for the day or days of the event and must provide coverage the day prior and the day following the event. 4. Automobile liability coverage for all owned and/or leased vehicles of the Provider and non-owned coverage for their employees and /or sub-contractors transporting program participants. The amount of coverage is $1,000,000 combined single limit per occurrence for bodily injury and property damage. The Children's Trust must be designated and shown as an "Additional Insured as Their Interest May Appear" with respects to this coverage. Coverage can be purchased as non-owned without hired auto coverage, but rental cars can not be The City of Miami Beach 5 Contract #903-109, Resolution 2008-22 used in the course of the Provider's regular operations. Rental cars may be used for travel to attend conferences outside the tri-county area. 5. Automobile liability coverage for all owned and/or leased vehicles of the Provider and non-owned coverage for their employees and /or sub-contractors not transporting program participants. The minimum amount of coverage is $300,000 combined single limit per occurrence for bodily injury and property damage. The Children's Trust must be designated and shown as an "Additional Insured as Their Interest May Appear" with respects to this coverage. Coverage can be purchased as non-owned without hired auto coverage, but rental cars can not be used in the course of the Provider's regular operations. Rental cars may be used for travel to attend conferences outside the tri-county area. 6. If applicable, Professional Liability insurance, as determined by The Children's Trust, with coverage amounts determined by The Children's Trust but not less than $250,000 per claim and in the aggregate. Defense costs may be inside the limits of liability and the policy can be written on claims made form. The Children's Trust is not required to be named as an Additional Insured. 7. If applicable, Proof of Property Coverage is required when the Provider has capital equipment paid for by The Children's Trust and said capital equipment is under the care custody and control of the Provider. The Children's Trust must be shown on the evidence of property coverage as a Loss Payee. Certificate holder must read: The Children's Trust 3150 SW 3~d Avenue, 8th Floor Miami, Florida 33129 Classification and Rating All insurance policies required above shall be issued by companies authorized to do business under the laws of the State of Florida, with the following qualifications: The company must be rated no less than "B" as to management, and no less than "Class V" as the financial strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent, subject to the reasonable approval of The Children's Trust's Risk Management Division, or The company must hold a valid Florida Certificate of Authority as shown in the latest "List of All Insurance Companies Authorized or Approved to Do Business in Florida" issued by the State of Florida Department of Insurance and are members of the Florida Guaranty Fund. The Provider shall notify The Children's Trust, in writing, of any material changes in insurance coverage, including, but not limited, to any renewals of existing insurance policies, not later than thirty (30) days prior to the effective date except for ten (10) days for lack of payment changes. In the event of any change in the Provider's Scope of Services, Attachment A, The Children's Trust may increase, waive or modify, in writing any of the foregoing insurance requirements. Any request by a Provider to decrease, waive or modify any of the foregoing insurance requirements shall be approved, in writing, by The Children's Trust prior to any such decrease, waiver or modification. In the event that an insurance policy is canceled during the effective period of this Contract, The Children's Trust shall withhold all payments from the Provider until a new Certificate of Insurance or written verification (binders) of insurance required under this section is submitted and approved by The Children's Trust. The new insurance policy shall cover the time period commencing from the date of cancellation of the prior insurance policy. The Children's Trust may require the Provider to furnish additional and different insurance coverage, or both, as may be required from time to time under applicable federal or state laws. Provision of insurance by Provider, in no instance, shall be deemed to be a release, limitation, or waiver of any claim, cause of action or assessment that The Children's Trust may have against the Provider for any liability of any nature related to pertormance under this Contract or otherwise. All insurance required hereunder may be maintained by the Provider pursuant to a master or blanket policy or policies of insurance. K. PROOF OF TAX STATUS Provider is required to keep on file the following documentation for review by The Children's Trust. The Internal Revenue Service (I.R.S.) tax status determination letter; The most recent (two years) I.R.S. form 990 or applicable tax return filing within six (6) months after the Provider's fiscal year end or other appropriate filing period permitted by law; If required by applicable law to be filed by the Provider, IRS 941 -quarterly federal tax return reports within thirty- The City of Miami Beach 6 Contract #903-109, Resolution 2008-22 five (35) calendar days after the quarter ends and if the 941 reflects a tax liability, proof of payment must be submitted within sixty (60) calendar days after the quarter ends. L. NOTICES All notices pursuant to this Contract shall be in writing and sent by certified mail to the addresses for each Party appearing on the first page of this Contract, and in the case of notices to The Children's Trust, marked to the attention of its President and CEO. It is each Party's responsibility to advise the other Party in writing of any changes in name, address and/or telephone number. M. AUTONOMY Both Parties agree that this Contract recognizes the autonomy of, and stipulates or implies no affiliation between, the contracting parties. It is expressly understood and intended that Provider is only a recipient of funding support and is not an agent or instrumentality of The Children's Trust, and that Provider's agents and employees are not agents or employees of The Children's Trust. N. RECORDS, REPORTS, AUDITS AND MONITORING 1. Accounting records Provider shall keep accounting records which conform to generally accepted accounting principles. All such records will be retained by Provider for not less than five years beyond the last date that all applicable terms of this Contract have been complied with and final payment has been received and appropriate audits have been submitted to and accepted by the appropriate entity. However, if any audit, claim, litigation, negotiation or other action involving this Contract or Modification hereto has commenced before the expiration of the retention period, the records shall be retained until completion of the action and resolution of all issues which arise from it or until the end of the regular retention period, which ever is later. 2. Financial audit Within 180 days of the close of its fiscal year, Provider agrees to submit to The Children's Trust an Annual Financial Audit performed by an independent audit firm of all its corporate activities and any accompanying management letter(s) or report(s) on other matters related to internal control, for each year during which this Contract remains in force and until all funds expended from this Contract have been audited. This audit shall be conducted in accordance with auditing standards generally accepted in the United States of America and standards contained in the Government Auditing Standards issued by the Comptroller General of the United States. If Provider receives a combined total of $300,000 or more from The Children's Trust from this or any other The Children's Trust contract, related to the fiscal year under audit, the Provider agrees to have aerogram-specific audit relating to The Children's Trust contracts, in addition to the annual financial audit of the Provider's entire organization. This program-specific audit is to encompass an audit of The Children's Trust contract amounts and requires: • Submission of: (a) schedule of total expenditures, reflecting expenditures during the audit period for each The Children's Trust contract by contract number, (b) summary of schedule of prior audit findings, (c) disclosure of any significant finding(s) relating to The Children's Trust contract(s), (d) disclosure of all questioned costs and liabilities due to The Children's Trust, with a reference to the contract number involved, and (e) a recommendation for a corrective action plan on any finding; • Report whether the schedule of expenditure(s) is fairly stated; • Provide notes to the schedule of expenditures that describe the significant accounting policies used in preparing the schedule; • Report whether contractual matching requirements were met, if applicable; • Report whether the provider has internal controls in place to provide reasonable assurance of compliance with The Children's Trust applicable contractual requirements and on the reliability of financial operations. Format of report is provided in Attachment D. A provider that does not meet the program-specific audit threshold requirement of a combined total of $300,000 or more from The Children's Trust, in the fiscal year being audited, will be exempt from the program-specific audit requirement in the fiscal year that the audit threshold is not met. Providers that are required to have a single audit conducted under OMB Circular A-133, Audit of States, Local Government and Non-Profit Organizations or the Florida Single Audit Act, Florida Statutes 215.97 agree to submit The City of Miami Beach Contract #903-109, Resolution 2008-22 the schedule of expenditures pertaining to awards, summary schedule of prior audit findings, applicable auditor's reports and the corrective action plan when the schedule of findings and questioned costs prepared by the independent auditor discloses audit findings. In the event that the independent auditor does not disclose audit findings, Provider shall provide written notification to The Children's Trust that an audit of Provider was conducted in accordance with applicable laws and regulations and that the findings and questioned costs disclosed no audit findings related to this Contract; and, that the summary schedule of prior audit findings did not report on the status of any audit findings relating to awards that The Children's Trust provided. Audit extensions may be granted in writing by The Children's Trust, after proper approval has been obtained from The Children's Trust's Finance Department, upon receipt in writing of such request with appropriate justification by the Provider. 3. Access to records The Children's Trust reserves the right to require Provider to submit to an audit by an auditor of The Children's Trust's choosing at The Children's Trust's expense. Provider shall provide access to all of its records which relate to this Contract at its place of business during regular business hours. Provider agrees to provide such assistance as may be necessary to facilitate their review or audit by The Children's Trust to insure compliance with applicable accounting and financial standards, including access by The Children's Trust or its designee, to Provider's independent auditor's working papers for complying with federal, state or local requirements. 4. Monitoring Provider agrees to permit The Children's Trust personnel or contracted agents to perform random scheduled and/or unscheduled monitorings, reviews, and evaluations of the program which is the subject of this Contract including any subcontracts under this Contract using The Children's Trust approved monitoring tools. The Children's Trust or contracted agents shall monitor both fiscal/administrative and programmatic compliance with all the terms and conditions of the Contract. Provider shall permit The Children's Trust or contracted agents to conduct site visits, client interviews, client assessment surveys, fiscal/administrative review and other techniques deemed reasonably necessary in The Children's Trust's sole discretion to fulfill the monitoring function. A report of monitoring findings will be delivered to Provider and Provider will rectify all deficiencies cited within the period of time specified in the report. _ 5. Client Records Pursuant to Florida Statute 119.071(5), The Children's Trust collects the social security numbers of child participants of funded programs and services for the following purposes: (a) to research, track and measure the impact of The Children's Trust funded programs and services in an effort to maintain and improve such programs and services for the future (individual identifying information will not be disclosed); (b) to identify and match individuals and data within and among various systems and other agencies for research purposes. The Children's Trust does not collect social security numbers for adult participants. Provider shall maintain a separate file for each child/family served. This file shall include all pertinent information regarding program enrollment and participation. At a minimum, the file will contain enrollment information (including parent registration consents and child demographics), service plans, outcome measures (as set forth in Attachment A), and notes documenting referrals, special needs, or incident reports. These files shall be subject to the audit and inspection requirements under this Contract, subject to applicable confidentiality requirements. All such records will be retained by the Provider for not less than five calendar years after the participant is no longer enrolled. Provider agrees to comply with all applicable state and federal laws on privacy and confidentiality. 6. Internal Documentation/Records Retention Provider agrees to maintain and provide for inspection to The Children's Trust, during regular business hours the following as may be applicable, subject to applicable confidentiality requirements: (1) personnel files of employees which include hiring records, background screening results, job descriptions, and evaluation procedures; (2) authorized time sheets, records, and attendance sheets to document the staff time billed to provide Services pursuant to this Contract; (3) daily activity logs and monthly calendars of the provision of Services pursuant to this Contract; (4) training modules; (5) pre and post session questionnaires; (6) participant consent and information release forms; (7) agency policies and procedures; and (8) such other information related to Service provision as described in Attachment A; all upon request by The Children's Trust. Provider shall retain all records for not less than five years beyond the last date that all applicable terms of this Contract have been complied with and final payment has been received, and appropriate audits have been submitted to and accepted by the appropriate entity. The City of Miami Beach $ Contract #903-109, Resolution 2008-22 7. Confidentiality Provider and The Children's Trust understand that during the course of performing the Services hereunder, each party may have access to certain confidential and proprietary information and materials of the other party in order to further performance of the Services. The Parties shall protect confidential information and comply with applicable federal and state laws on confidentiality to prevent unauthorized use, dissemination or publication of confidential information as each party uses to protect its own confidential information in a like manner. The Parties shall not disclose the confidential information to any third party (except that such information may be disclosed to such Party's attorneys), or to any employee of such Party who does not have a need to know such information, which need is related to pertormance of a responsibility hereunder. However, this Contract imposes no obligation upon the Parties with respect to confidential information which (a) was lawfully known to the receiving party before receipt from the other, (b) is or becomes a matter of public knowledge through no fault of the receiving party, (c) is rightfully received by the receiving party from a third party without restriction on disclosure, (d) is independently developed by or for that party, (e) is disclosed under operation of law, (f) is disclosed by the receiving party with the other party's prior written approval or (g) is subject to Chapter 119 of the Florida Statutes or is otherwise required to be disclosed by law. The confidentiality provision of this Contract shall remain in full force and effect after the termination of this Contract. 8. Security Obligation Provider shall maintain an appropriate level of data security for the information Provider is collecting or using in the performance of this Contract. This includes, but is not limited to, approving and tracking all Provider employees who request system or information access and ensuring that user access has been removed from all terminated employees of Provider. O. MODIFICATIONS Any alterations, variations, modifications, extensions or waivers of provisions of this Contract including but not limited to amount payable and effective term shall only be valid when they have been reduced to writing, duly approved and signed by both Parties. P. GOVERNING LAW & VENUE This Contract shall be interpreted and construed in accordance with and governed by the laws of the State of Florida without regard to its conflicts of laws provisions. Any controversies or legal problems arising out of the terms of this Contract and any action involving the enforcement or interpretation of any rights hereunder shall be submitted to the jurisdiction of the state courts of the Eleventh Judicial Circuit, in and for, Miami-Dade County, Florida. Q. EMPLOYEE BACKGROUND SCREENING In accordance with Sections 943.0542, 984.01, Chapter 435, 402, 39.001, and 1012.465 Florida Statutes, as applicable, employees, volunteers and subcontracted personnel who work in direct contact with children must complete a satisfactory Level 2 background screening. Level 2 Background screenings must be completed through the Florida Department of Law Enforcement (FDLE), VECHS Program. Satisfactory background screening documentation will be accepted for those agencies that already conduct business with either the Department of Children and Families (DCF) or the Department of Juvenile Justice (DJJ) or the Miami Dade County Public School System (MDCPS). A clearance letter from MDCPS Office of Employment Standards indicating the person has successfully completed a Level 2 screening will be accepted. In addition, an Attestation of Good Moral Character must be completed annually for each employee, volunteer, and subcontracted personnel who work in direct contact with children. The Provider shall re-screen each employee, volunteer and/or subcontractor every five years. All provider personnel or sub-contracted agency personnel assigned to work at a site where they have access to children shall have a Level 2 screening. R. CHILDREN WITH DISABILITIES AND THEIR FAMILIES Provider understands that The Children's Trust expects Provider to meet the federal standards under the Americans with Disabilities Act. By policy of The Children's Trust, providers must also implement reasonable programmatic accommodations to include children with disabilities and their families, whenever possible. Notwithstanding anything to the contrary, the Provider shall not be required to make any alteration to any public school building or other building or structure which is not owned by the Provider. S. REGULATORY COMPLIANCE The City of Miami Beach 9 Contract #903-109, Resolution 2008-22 1. Non-discrimination and Civil Rights Provider shall not discriminate against an employee, volunteer, or client of the Provider on the basis of race, color, gender, pregnancy, marital status, familial status, sexual orientation, religion, ancestry, national origin, disability, or age, except that programs may target services for specific target groups as may be defined in the competitive solicitation. Provider shall demonstrate that it has standards, policies, and practices necessary to render services in a manner that respects the worth of the individual and protects and preserves the dignity of people of diverse cultures, classes, races, religions, sexual orientation, and ethnic backgrounds. Provider agrees to abide by Chapter 11A of the Code of Miami-Dade County ("County Code"), as amended, which prohibits discrimination in employment, housing and public accommodations; Title VII of the Civil Rights Act of 1968, as amended, which prohibits discrimination in employment and public accommodation; the Age Discrimination Act of 1975, 42 U.S.C. Section 6101, as amended, .which prohibits discrimination in employment because of age; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794, as amended, which prohibits discrimination on the basis of disability; and the Americans with Disabilities Act, 42 U.S.C. §12101 et seq., which prohibits discrimination in employment and public accommodations because of disability. It is expressly understood that upon receipt of evidence of discrimination under any of these laws, The Children's Trust shall have the right to terminate all or any portion of this Contract. If Provider or any owner, subsidiary, or other firm affiliated with or related to Provider, is found by the responsible enforcement agency or the courts to be in violation of these laws, said violation will be a material breach of this Contract and The Children's Trust will conduct no further business with Provider. 2. Public Entities Crime Act Provider will not violate the Public Entities Crimes Act (Section 287.133, Florida Statutes), which essentially provides that a person or affiliate who is a Provider, consultant or other provider and who has been placed on the convicted vendor list following a conviction for a Public Entity Crime may not submit a bid on a contract to provide any goods or services to The Children's Trust, may not submit a bid on a contract with The Children's Trust for the construction or repair of a public building or public work, may not submit bids on leases of real property to The Children's Trust, may not be awarded or perform work as a Provider supplier, sub Provider, or consultant under a contract with The Children's Trust, and may not transact any business with The Children's Trust in excess of the threshold amount provided in Section 287.017, Florida Statutes, for category two purchases for a period of thirty-six (36) months from the date of being placed on the convicted vendor list. Violation of this section shall result in cancellation of this Contract and recovery of all monies paid hereto, and may result in debarment from The Children's Trust's competitive procurement activities. 3. Conflict of Interest Provider represents that the execution of this Contract does not violate Miami Dade County's Conflict of Interest and Code of Ethics Ordinance, www.miamidade.gov/ethics/library/Ethics-Brochure-2005.pdf and Florida Statutes §112 as amended, which are incorporated herein by reference as if fully set forth herein. Provider agrees to abide by and be governed by these conflict of interest provisions throughout the course of this Contract and in connection with its obligations hereunder. 4. Compliance with Sarbanes-Oxley Provider shall comply with the following provisions of the Sarbanes-Oxley Act (SOX) that apply. Provider agrees not to alter, cover up, falsify, or destroy any document that may be relevant to an official investigation (SOX, Section 1512 of Title 18, USC). Provider agrees not to punish whistleblowers or retaliate against any employee who reports suspected cases of fraud or abuse (SOX, Section 1513 of Title 18, USC). 5. Licensing The Provider shall obtain and maintain in full force and effect during the term of this Contract any and all licenses, certifications, approvals, insurance, permits and accreditations, required by the State of Florida, Miami-Dade County, The Children's Trust or the federal government. 6. Proof of Policies Provider shall keep on file copies of its policies on non-discrimination, equal opportunity and/or affirmative action, Americans with Disabilities Act, and drug-free workplace. 7. Incident Reporting Provider shall immediately report knowledge or reasonable suspicion of abuse, neglect, or abandonment of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number (1-800-96-ABUSE). As required by Chapters 39 and 415, Florida Statutes, this is binding upon both the The City of Miami Beach 10 Contract #903-109, Resolution 2008-22 Provider and its employees. Provider shall complete an incident report in the event of any serious bodily injury to anyone within the scope of this Contract or arising out of the performance of this Contract. Provider shall provide written notification of the incident together with a copy of the incident report to The Children's Trust within three (3) working days after Provider is informed of such incident. Provider shall provide written notification to The Children's Trust, within seven (7) days after service on Provider of any legal action which is filed as a result of such an injury. 8. Sexual Harassment Provider shall complete an incident report in the event a client or employee makes an allegation of sexual harassment, sexual misconduct or sexual assault by a Provider employee arising out of the performance of this Contract and the Provider has knowledge thereof. Provider shall provide written notification to The Children's Trust within three (3) business days after Provider is informed of such an allegation. Provider shall provide written notification to The Children's Trust, within seven (7) business days after service on Provider of any legal action which is filed as a result of such an alleged incident. T. CONSENT Demographic and service information on program participants will be provided to The Children's Trust as part of The Children's Trust's research mission. Provider will ask participants to sign a voluntary Consent to Photograph and for Communications. The form is available in English, Spanish, and Creole and must be downloaded from www.thechildrenstrust.org. All signed Consent forms will be submitted to the Contract Manager, with a copy filed in the participant's record. Any refusal of consent must be properly documented and signed by the parent or legal guardian on the Consent form. Provider will exercise its best efforts to have each program participant's contact information is current and updated upon exiting the program. U. PROGRAMMATIC DATA REPORTING Provider agrees to comply and participate in any data collection reporting, including participant data as required by The Children's Trust and described in Attachment C to this contract, Programmatic Data Reporting Requirements, subject to confidentiality requirements. In addition, Provider agrees to furnish The Children's Trust with quarterly program narrative reports in the format to be reasonably specified by The Children's Trust. V. PUBLICITY Provider agrees that events funded by this Contract shall recognize The Children's Trust as a funding source. Provider shall ensure that all publicity, public relations, advertisements and signs within its control recognize The Children's Trust for the support of all contracted activities. The use of the official The Children's Trust logo is permissible. Provider shall use its best efforts ensure that all media representatives, when inquiring with the Provider about the activities funded by this Contract, are informed that The Children's Trust is a funding source. Provider shall distribute a press release announcing that it has been awarded funding by The Children's Trust. Provider shall, if it possesses the appropriate technology, provide a link between the website and The Children's Trust's website. W. PUBLICATIONS Provider agrees to supply The Children's Trust, without charge, up to three copies of any publication developed in connection with implementation of programs addressed by this Contract. Such publications will state that the program is supported by The Children's Trust. Provider agrees that The Children's Trust will have use of copyrighted materials developed under this Contract to the extent provided in, and subject to, the provisions of Paragraphs G and H above. To the extent permitted by the applicable journal or other publication source, Provider shall include The Children's Trust logo and the following paragraph in all materials featuring programs funded by The Children's Trust, including but not limited to newsletters, press releases, brochures, fliers, homepage of websites or any other materials for dissemination to the media or general public: English: The City of Miami Beach -Success University is funded in part) by The Children's Trust. The Children's Trust is a dedicated source of revenue established by voter referendum to improve the lives of children and families in Miami-Dade County. The City of Miami Beach 11 Contract #903-109, Resolution 2008-22 Spanish: The City of Miami Beach -Success University esta financiado por EI Fidecomiso de los Ninos (The Children's Trust). EI Fidecomiso de los Ninos es una fuente de financiacion, establecida por referendum para mejorar las vidas de Winos y familias en el Condado de Miami-Dade. Kreyol: The City of Miami Beach -Success University finanse ("in part" or equivalent to be translated into Creole) pa "The Children's Trust". Trust la, ce yon sous lajan ke gouvenman amerikin vote an referandom you ke' li investi bien Wan pwogram kap ameliore la Vi Ti Moun ak fanmi yo Wan Miami Dade. Note: In cases where funding by The Children's Trust represents only a percentage of the Provider's overall funding, the above language can be altered to read "The (organization) is funded in part by The Children's Trust..." X. HEADINGS, USE OF SINGULAR AND GENDER Paragraph headings are for convenience only and are not intended to expand or restrict the scope or substance of the provisions of this Contract. Wherever used herein, the singular shall include the plural and plural shall include the singular, and pronouns shall be read as masculine, feminine or neuter as the context requires. Y. TOTALITY OF CONTRACT/SEVERABILITY OF PROVISIONS This Contract with its attachments as referenced below contains all the terms and conditions agreed upon by the parties: Attachment A: Scope of Services Attachment B: Budget & Method of Payment Attachment C: Reporting Requirements Attachment D: Financial Audit and Financial Report Requirements Attachment E: Performance Improvement Plan No other contract, oral or otherwise, regarding the subject matter of this Contract shall be deemed to exist or bind any of the parties hereto. If any provision of this Contract is held invalid or void, the remainder of this Contract shall not be affected thereby if such remainder would then continue to conform to the terms and requirements of applicable law. [Agency Name] CITY OF 1'4IL~~'II BEACH The Children's Trus MFI At~l-I ~BA B-€~ GAIJ-N~YT-F L-A RtBA- By:' bY: ( ign u e of Authorized r ntative) M desto . A resid nt/CEO JORGE M. GONZALEZ ~ Type or Print Name Date: Date: ©~ Approved as to form and legal sufficiency ~- /l7~/~ ' ~/ r Date: <~ ~!i~00~' County Attorney This contract is not valid until signed by both parties APPROVED AS TO FORM & LANGUAGE N The City of Miami Beach Contract #903-109, Resolution 2008-22 at ATTACHMENT A: Scope of Services The City of Miami Beach 13 Contract #903-109, Resolution 2008-22 Attachment A Scope of Services -Service Partnership Agency Name: City of Miami Beach Program Name: Success University 1. Program Summary: Success University is an integrated service program that partners 11 community agencies to provide Miami Beach youth entrepreneurship training with personal and academic supports, while providing their families with holistic, comprehensive services to ensure family stability and youth success. Success University utilizes the principles of the 7 Habits of Highly Successfully People to create an operating platform that seeks to prepare youth and families for personal success, positive cohesion and economic betterment. Service components include: tutoring, family assessments, home visits, 7 Habits training for youth and their families, Family Conferencing, community service opportunities, MB Helpers training, and entrepreneurship training. 2. Program Schedule: Success University provides after-school and evening programming beginning June 1, 2008 and continues through the end of the school year. Services will be provided after-school at Miami Beach Senior High School, evenings at Biscayne Elementary and evenings and weekends in the participants' homes. 3. Target Population (Include numbers in table and a narrative description of participant characteristics, including ages, geography, disabilities, etc.): ` Total 'number of unduplicated .Populations- , ~ ~~,~` E fig y part~c,p ntst ,'~ ;(descrrbe:~ t ~ 1~ ~ } ~ „ ~~ 7, ~ ~k '~~ =', ~ ~ ~~~; ~ ~ ~5 ~ ~' ~- ~ bl'e +-.,. w th l ~b'~el '~-o ~ o t r , . ~ : ~ , . Kf i o e ,u ~ a, t Children/Youth 240 Parents/Prima Care fivers ~ 300 Other populations (e.g., staff professionals, general 120 ublic - Children/Youth -Participants attend Miami Beach Senior High School and reside within the City's North Beach neighborhood (33141). Participants are aged 13 to 18 and predominantly have indicators showing them to be at-risk as demonstrated by school absences, family stability, and economic/social attachment to community. - Parents/Primary Caregivers -Represent the parents and/or caregivers for the targeted children/youth. These adults serve as head of household and/or live within the participants' home. - Other Populations -Participants are encouraged to include friends, extended family, teachers and others in addition to their family members when engaging in the Family Team Conferencing. For the home visits and 7 Habits f Highly Effective Families programming, services will be provided to everyone that resides in the home with the youth clients. 4. Service Locations: Pr do iviv er Name- Site Name Address ~ City State ZIP,:; ~ Choices Et AI, City of Biscayne Elementary 800 - 77"' Street Miami Beach Florida 33141 Miami Beach, South Florida Center for Family Counseling &Unidad of Miami Beach Aspira of Florida, Miami Beach Senior 2231 Prairie Avenue Miami Beach Florida 33139 Junior Achievement, & High School Unidad of Miami Beach The City of Miami Beach 14 Contract #903-109, Resolution 2008-22 5. Service Delivery: TYPE 1 ACTIVITIES (3 or more contacts with participants) Activities/Service Name & ~ Provider Name Total # _;~ ~ Mimm~u'm # Expected ~~ Descri tion Include=-~:~ ~• n~ ~ ~ 1 un~duplicated~': ~9t {~,} participants t M ~ Dosage ?~ ~ ~.~~ >ir t x frequency; length & durati n 1 `{" ~~ ~~` ~ ~ ` ~ ` ~ ; part~apants to~~~ ` ~'" to be served ~ Minimum # " ' A.. of sessions as well as the" ~ ~ ? ' , ~ be, served { ", .. w., ~ aN~F ` (guideline is ~ ~' '~ Q., f I of sessions ~,~ 4 number Hof cycles expectedxto ~ ~ r:w ~+q ` ~ '' '' ; `(spec~fy~~~f~ ~~g;~ti ~ e ~np less than~y, a/o a participant: T. l ~~'~'"' `~"' ~, ~ F ~ ,, be offered ~ '~ ;~ ,- , ~ ;~. , ~ < ;;, ~ ~ :~~, - ~ ' n%youth,,~ childr pa'rents`,or~ ~ ~ ~ 85 of;, A, ; total) ~ ~ wi l , complete . , ~~° ~ ~., _ }~.1 ~~ r` ~~ ~~~' x others ~' ~'~ , ,_~'f~ ,'~ ~ Home visits (1 home visits p/month x 1 hour each x every 3 months for a total of 4 visits per year): Case worker home visits, intake & South Florida Center for 240 youth, 300 parents 204 youth, 255 assessment, development case plan, provision Family Counseling & & 120 siblings or other parents, 102 2 of referrals when applicable and educate family Unidad of Miami Beach family members siblings on service elements of program, Visits 2-4 to asses family progress, service audit, and identif and identif follow-u issueslneeds 7 Habits of Highly Effective Families (Two modalities are offered. 4 sessions x 2 hours each) -Sessions will be offered Monday through Thursday, 7pm - 9pm and will address content as indicated below: * The 7 Habits of Highly Effective Families are: 1. Be Proactive -The idea is to base your reaction on principles and values rather than on moods and conditions. 2. Begin With the End -The creation of a family mission statement and values. 3. Put First Things First -The focus is to have behavior driven by purpose instead of agendas or external forces. 120 youth, 150 parents 102 youth, 127 4. Think Win-Win -The goal is to City of Miami Beach; & 60 siblin s or other g arents, 51 p 3 (2-hour cooperate and find solutions that Maggie Pacheco sessions) incorporate the "we" instead of the "I.° family members siblings 5. Seek First to Understand and Then to Be Understood -This habit enforces the need to understand each other prior to pushing forth one's own agenda or values. 6. Synergize -Synergy follows the win- win mindset and adheres to the need to first understand to then be understood. With synergy, differences are celebrated. 7. Family Renewal - The focus is to promote family time and bonding to renew the spirit of family and, therefore, keep it from growing apart. *Because services are being offered during traditional mealtimes, meals will be provided to encoura a full famil artici ation. 7 Habits of Highly Effective Families (Two modalities will be offered: 1 session x 7 hours. Sessions will be offered all day Saturday and will address content as indicated below" 120 youth, 150 parents 102 youth, 127 City of Miami Beach; & 60 siblings or other parents, 51 1 * The 7 Habits of Highly Effective Families Maggie Pacheco family members siblings are: 1. Be Proactive -The idea is to base your reaction on principles and values rather than on moods and conditions. The City of Miami Beach 1Jr Contract #903-109, Resolution 2008-22 2. Begin With the End -The creation of a family mission statement and values. 3. Put First Things First -The focus is to have behavior driven by purpose instead of agendas or external forces. 4. Think Win-Win -The goal is to cooperate and find solutions that incorporate the "we" instead of the "I." 5. Seek First to Understand and Then to Be Understood -This habit enforces the need to understand each other prior to pushing forth one's own agenda or values. 6. Synergize -Synergy follows the win- win mindset and adheres to the need to first understand to then be understood. With synergy, differences are celebrated. 7. Family Renewal - The focus is to promote family time and bonding to renew the spirit of family and, therefore, keep it from growing apart. *Because services are being offered during traditional mealtimes, meals will be provided to encoura a full famil artici ation. Entrepreneurship Training - (Junior Achievement/Aspira) - 12 sessions x 1 hour each after school) The Miami Beach Service Partnership is offering the Signature Program entrepreneurship curricula by Junior Achievement. The curriculum is Junior Achievement provided by Junior Achievement and the instruction is provided by Aspira of Florida , As ira of Florida &Unidad of p 240 outh Y 204 outh Y 7 of 12 sessions and Unidad of Miami Beach. The Signature Miami Beach Program offers entrepreneurship, financial literacy, work readiness, life roles, public speaking, communications/presentations, etc. Junior Achievement has been recognized nationally for its impact and success with outh. Community service -Participants will complete a minimum of 10 hours of service. Multiple events will be available for youth to complete their required hours (commencing July 2008). The organization of community service events/activities for students to meet/exceed community service graduation requirements. Teen Job Corps 240 youth 204 youth 2 sessions Service activities are done in conjunction with the MB Chamber of Commerce (Chamber sponsored events) and Miami Dade DERM (environmental impact studies). It is anticipated that the community service activities will occur after youth have received the 7 Habits of Highly Effective Teens and Families. FCAT Preparation - Provision of tutoring services for FCAT preparation. Services will be offered after school 3 times per week, 2 hrs per day, for 18 weeks prior FCAT. Preference will be given to youth participating in the Success 120 youth 100 youth 18 out of 54 University program. However, other youth will sessions be allowed to participate. Attendance will be tracked for all youth attending, but outcomes will be documented solely for those Success Universit students. The City of Miami Beach 16 Contract #903-109, Resolution 2008-22 TYPE 2 ACTIVITIES (less than 3 contacts with participants) Activities/Service Name < & L Provider Name Total,` # participants to Total # of sessions _ R `~, " , b Description"° ~ S; ~ , :. be served (specify if_ to,. tie° offered by w , (Include, frequency, ,length & children/youth; parents .: ~ ' ' provider :` , across _~_ , "' - ~- duration'of.'sessions~_ _ or otFiers) _ ' ` cycles and, sites Family Conferencing (1 session x 2 hours+ each by December 1, 2008). Family Conferencing engages youth, parents, siblings, friends, teachers and others to identify and qualify ways in which they could support the youth's personal goals. This process has been successfully used Choices Et AI, Inc., by the state's juvenile judicial system to reduce South Florida Center for 240 youth, 300 parents & 120 recidivism and promote positive behaviors. Family Counseling &Unidad other family members 240 During the conferences, priorities and values of Miami Beach are defined and roles are ascribed to attendees to ensure achievement or support of identified goals and values. The resulting contract establishes the framework upon which all subsequent services are provided. 7 Habits of Highly Effective Teens (1 session x 8 hours by March 1, 2009). 7 Habits of Highly Effective Teens is a one day, 8-hour training that addresses the 7 Habits as they relate to City of Miami Beach & 240 youth 15 teenagers and their goals, values and Maggie Pacheco aspirations. Its language is geared towards teenagers. MB Helpers Training (youth). MB Helpers, modeled after Natural Helpers, addresses empowering people to become change agents within their homes, neighborhoods and schools by recognizing when someone is in trouble, knowing where needed resources are located within the community, and connecting needy people to needed services/resources. The training, utilizing the 7 Habits as a training Aspira of Florida & 240 youth 8 platform, covers empathic listening, referrals Unidad of Miami Beach and cultural competence in service delivery. The youth program focuses on youth issues such as addiction, relationship problems, familial problems, etc. "Because services are being offered during traditional mealtimes, meals will be provided fo encourage full famil arfici ation. MB Helpers Training (caregiver). Me Helpers, modeled after Natural Helpers, addresses empowering people to become change agents within their homes, neighborhoods and schools by recognizing when someone is in trouble, knowing where needed resources are located within the City of Miami Beach 24 parentslcaregivers 2 community, and connecting needy people to needed services/resources. The training, utilizing the 7 Habits as a training platform, covers empathic listening, referrals and cultural competence in service delivery. The adult program focuses more time on economic roblems. The City of Miami Beach 17 Contract #903-109, Resolution 2008-22 Health screenings for youth participants (1 medical encounter per participant) Miami Beach Community "Because services are being offered during Health Center 240 youth 240 traditional mealtimes, meals will be provided to encoura a full fami! artici ation. TYPE 3 ACTIVITIES (Other deliverables that are not direct services) .. Activities Name & Description , _ Provider Name ,, ~ ,,~ , ,_ Count , (umber, _ Public Service Announcement. One PSA will be developed and broadcast on City of Miami Beach Channel 77 for a month. The purpose is to bring awareness about the program 1 and recruit artici ants. Recruitment events at youth-serving organizations/locations with the objective of Aspira of Florida recruiting eligible youth for the program. It is expected that Aspira will complete Unidad of Miami Beach 18 events 17 resentations/recruitment events antl Unidatl 1. 6. Performance Measure: Provider shall measure outcome achievement and report on a basis as outlined in Attachment C of this contract. Service Provision Outcomes: e t I d t rs t O Measurement Timing (when will ' fie tools ~ Associated Activities ~ Service' (from ~ Ou com s t ~- a . ~.. ,~ ~~ . ~: n ica o u come ,w , ~ ~ r ~_ , " ~~..~~' '`_ = ,.~; .. ~~ Tool" ~: _ , .a; , ~ <•; . ~~, , ~ ~ 'administered -_~~, ~~ t *;~ F.. ~-. ,Deliv. Increase school 75% of youth wdl experience a School Attendance Prior school year 7 Habits of Highly Effective attendance 10% reduction in school absences Report (benchmark); Teens; 7 Habits of Highly compared to prior school year (M-DCPS) Every 9 weeks; Effective Families; Family End of school year Team Conferencing; FCAT Pre aration Increase 75% of youth will experience a 5% Report cards Prior school year 7 Habits of Highly Effective academic increase in academic achievement (M-DCPS) (benchmark); Teens; 7 Habits of Highly achievement as measured by Grade Point Every 9 weeks; Effective Families; Family Average End of school year Team Conferencing; FCAT Pre aration Increase family 85% of youth and parents will 7 Habits of Highly Before and after trainings 7 Habits of Highly Effective attachment experience at least a 10% Effective Families People; 7 Habits of Highly increase in resiliency and family Pre- & Post Test Effective Families; Family attachment Team Conferencin Enhanced 85% of youth will increase Entrepreneurial Before and after trainings Entrepreneurship training; MB entrepreneurial entrepreneurial skills and knowledgelskills Helpers Training; 7 Habits of antl leadership community resource knowledge surveys; MB Helpers Highly Effective Teens; skills skills surve Communi Service Partnershi Outcomes: Outcomes r ~° ~ s ~ ~ ~. „s ~ Outcome Indicators ~ ~' ~ " ~ ~ 4 ~ f r a ~~~~ ~` ~`,'.; z~~~t fi r _ :Measurement ;-: Tool ` ~ ~,' ~- ~ ' . e* C r i ~ 7 ~ , , ~~~~,w ~~~~ ~'`3 __~ _ ,._ Timing (when will tools '~' ~'~ T° b`e ~ ,r ~_fi ~ ~: ~~ ~admin~stered ~z~.~` ~-_ Associated Activities (fr6m ~ ~_; 7 ~ Service; a ..Derive "'`i _ Improved systems • 100% of Partnership members ^ Executed MOUs Upon execution of ^ Intake & assessment of care within North will have an executed contracts Family Team Beach Memoranda of Understanding Conferencing neighborhood ^ A Governance Structure is Adopted Policies & Upon creation of 7 Habits of Highly established Procedures & Partnership Effective Families Governance Structure ^ Home visits ^ The Partnership will meet Governance Board Monthly Governance regularly to address collective meeting attendance Board meetings concerns via its Governing sheets Board meetings • 100% of Partners will have at Me Helpers me Helpers trainings least one staff member trained in Training Attendance offered at least once each Me Helpers sheets quarter The City of Miami Beach I$ Contract #903-109, Resolution 2008-22 ^ 100% of Partners will receive a Partnership ^ Quarterly (using monthly Partnership Performance Rating Performance Ratings progress reports) of 80% or greater at least 3 of 4 (measuring service quarters of operating year levels, partnership artici ation, etc. 7. Staff Qualifications: Provider represents that all persons delivering the Services required by this Contract have the knowledge and skills, either by training, experience, education, or a combination thereof, to adequately and competently perform the duties, obligations, and Services set forth in the Scope of Services (Attachment A) and to provide and perform such Services to The Trust's satisfaction. # & Positfion . - ~ Qualrfications: Duties r ' ~ z Statu (specify staff Re wired Education & ~' r~r ~ `~ `° ~ ° ~_~''~4 ~~~ ~ " ~ '~ ~ ' s~, ~ ,, volu~~~teer.or Experience ~~ ~` s~#-' ~_ ~`~' k ~~~~ '; FT P / sub ° t ~" ~ ~ ~ ~ : ~ x ' E1 ~ ~ ~ K ~~.~ V ~~ ~ ~' i yYk ~~ ~ ' ~ ° ` ~ ti ~ confractor) ~ ' ~ , ~ 3 ~~ ~~aw ~~~~ ~~E~r ~; ~" ~~~~ ~ ' T ~ ~ , ; , ra ~ ;; , ~ ~,,r ,.< ,~;, v x .t ? . t ,. , 1 - FT Division Director Bachelor's or greater in Public Overall project management; vendor contract Administration or other related field management; 7 Habits of Highly Effective Families and at least one year community training; 7 Habits of Highly Effective Teens training; involvement experience. MB Helpers training 1-FT Program Coordinator Bachelor's or greater in Public Day-to-day program supervision, contractor Administration or other related field supervision, and program report preparation. and at least one year community involvement experience. 1 - FT Case Worker 2 See attached job description. Data Tracker management, referral tracking, client file verification & auditing 2- PT Case Worker 2 See attached description. Position will provide transportation to youth and their families to Family Team Conferencing and 7 Habits of Highly Effective Families as well as: pick-up and deliver participant meals, ensure document completion by attendees during aforementioned sessions, provide supervision and activities for family members between 3 and 6 years of age, and man a referral services desk during these events to facilitate access to community-based services for participating families. 1-PT Employment/Job See attached description. Position will provide transportation to youth and their Specialist families to Family Team Conferencing and 7 Habits of Highly Effective Families as well as: pick-up and deliver participant meals, ensure document completion by attendees during aforementioned sessions, provide supervision and activities for family members between 3 and 6 years of age, and man a referral services desk during these events to facilitate access to community-based services for participating families. 8. Best practices Activity Narrne ~ _ __ ~ _Related Best Pira`ctice `Model ___ Famil Trainin 7 Habits of Hi hl Effective Families Youth Trainin 7 Habits of Hi hl Effective Teens Famil Em owerment/Su ort Famil Team Conferencin Entre reneurshi Trainin Junior Achievement Si nature Pro ram The City of Miami Beach 19 Contract #903-109, Resolution 2008-22 ATTACHMENT B: Budget & Method of Payment The City of Miami Beach 2~ Contract #903-109, Resolution 2008-22 ATTACHMENT B FISCAL REQUIREMENTS, BUDGET & METHOD OF PAYMENT Advance aavment reauests The Children's Trust offers advance payments up to 15% of the total contract amount. Advance requests shall be limited to governmental entities and not-for-profit corporations, in accordance with subsection 216.181 (16) (b), F.S. The advance request is to include the amount requested and the justification. Advance payment requests must be submitted using the designated form and must be approved in writing by The Children's Trust's Contract Manager and Chief Financial Officer or their designee(s). Advanced funds if not used shall be invested by the provider in an insured interest bearing account, in accordance with subsection 216.181 (16) (b), F.S. Interest earned on advanced funds shall be returned to The Children's Trust on a quarterly basis or applied against the amount of the contract owed by The Children's Trust. Advance aavment Within 60 calendar days of receipt of an advance, Provider shall report the actual expenditures paid by or charged to the advanced funds using the reporting "invoice" form provided by The Children's Trust. If the "invoice" amount is less than the amount advanced, The Children's Trust will deduct the difference from the next applicable monthly payment request. Provider may request, in writing, an extension of the repayment of the advance. A fiscal need must be clearly demonstrated and substantiated by the Provider in order for an extension request to be considered by The Children's Trust. Bud4et revisions Budget revision(s) require prior written approval from the Contract Manager and The Children's Trust's Chief Financial Officer or their designee(s). Request for budget revisions must be submitted to the Contract Manager using the appropriate form, as determined by The Children's Trust. The Provider must request a budget revision to add, delete, and/or modify any line item(s). Budget revisions can not exceed the contracted amount. Budget revisions will be incorporated into the Contract. Indirect Administrative Costs In no event shall The Children's Trust fund indirect administrative costs in excess of ten (10%) percent of the total contract award. Cost Reimbursement Method of Payment The parties agree that this is a cost reimbursement method of payment contract; the Provider shall be paid in accordance with the approved budget and/or approved budget revision as set forth in this Attachment. Invoice Requirements The Provider shall submit an original request for payment, in the format prescribed by The Children's Trust and in accordance with the approved budget or approved budget revision. The request for payment is due on or before the fifteenth (15~h) day of the month following the month in which expenditures were incurred (exclusive of legal holidays or weekends). The Children's Trust agrees to reimburse Provider on a monthly billing basis. The Children's Trust reserves the right to request any supporting documentation. A final request for payment (last payment) from the Provider will be accepted by The Children's Trust up to forty-five (45) days after the expiration of this Contract. If Provider fails to comply, all rights to payment shall be forfeited. If The Children's Trust determines that Provider has been paid funds not in accordance with this Contract, and to which it is not entitled, Provider shall return such funds to The Children's Trust or submit appropriate documentation to support the payment. The Children's Trust shall have the sole discretion in determining if Provider is entitled to such funds in accordance with this Contract and The Children's Trust's decision on this matter shall be binding if in accordance with this Contract. The City of Miami Beach 21 Contract #903-109, Resolution 2008-22 If the Provider fails to serve the number of participants and/or fails to utilize the funds in accordance with the Contract, The Children's Trust may amend the Contract to reduce the amount of dollars. Any delay in amendment by The Children's Trust is not deemed a waiver of The Children's Trust's right to amend or seek reimbursement for under-serving participants in accordance with the Contract. In order for a request for payment to be deemed proper as defined by the Florida Prompt Payment Act, all requests for payment must comply with the requirements set forth in this Contract and must be submitted on the forms as prescribed by The Children's Trust. Requests for payment and/or documentation returned to Provider for corrections may be cause for delay in receipt of payment. Late submission may result in delay in receipt of payment. The Children's Trust shall pay Provider within thirty (30) calendar days of receipt of Provider's properly submitted Request for Payment and/or other required documentation. In the event that Provider, its independent auditor or The Children's Trust discovers that an overpayment has been made, Provider shall repay said overpayment within thirty (30) calendar days without prior notification from The Children's Trust. The Children's Trust shall retain any payments due until all required reports or deliverables are submitted and accepted by The Children's Trust. Supporting Documentation Requirements Provider shall keep accurate and complete records of any fees collected, reimbursement, or compensation of any kind received from any client or other third party, for any Service covered by this Contract, and shall make all such records available to The Children's Trust upon request. The Provider shall maintain records documenting actual expenditures and services provided according to the approved budget and scope of services as required. The City of Miami Beach 22 Contract #903-109, Resolution 2008-22 GENERAL INFORMATION Organization Name: Agency Fiscal Year Begins: Program Title: City of Miami Beach Success University Areas in Blue to be completed by the Agency 1-Oct (for example: July 1) Agency Source of Funding Program Budget Agency Budget % of Agency Budget Trust Grant Amount Rested _ __ 499550.83 499,550.83 84.2% Trust Other Fundi~ _ _ _ 0.0% Miami-Dade Coun~_Grants(Local) _ _ ___ 0.0% Federal Grants _ _ __ 0.0% State Grant __ _ _ _ 0.0% -- - Foundations/Charitable Funds _ _______ 0.0% -- Cash/Fees/Other Revenue _ 0.0% - -- -Kind Contributions In 931891.70 _ ___.__ 931891_70 15.8% _ 0.0% - 0.0% 0.0% Total Annual A enc Bud et 593 442.53 593 442.53 100.0% 23 Attachment B, Contract #903-109, Resolution #2008-22 t+ ~ _T _~ O O V O N L _~ ~N ~_~ x t Ol O'O~ C ~ ~~ w C O W O O L V1 O C 1n 1011 W d a 10 L ~ N L ~ 10 f`'1 C W ~N ~ ~'a+ W ~= O~ ~= o~U U M ~ p ~ ~ L 1n II m N w^ c ~^ ~ in v A ~+ ~ in ~ U u°i c , , >' me on~L E mi°w°'~ ~10y°'a°y N c L ~ 01 C d t'+ H w H 01 P n~ t C J O1 [T n~ ~ C ~ C O 1`0 C ~ O~ n O ~ 0 0 d N /1 O 10 1 C a O O N 1 n J G y Y y - n 1 v 1 W V 10 _ N O. 01 ~1 O W C~ C C 01 ~ y Gl 0 ` C~ 1` E 0 Q ~ '~E °~~~ T v °~°Tw ~nE Q~~awu'.'-. o~o=u v o ` 1 00`1 m°'~' ° m v00 y ~o a ~ °n °'w~ ~ mEmty mE~tv~~ E ° m ~' U ~ H w m e ` H ° v ~ w c c w w c v -~ + m o ~ ~`o~'L'' ~c ~>m~° ~>m~E~ii1 c ~ C 1p = O V, L a+ o C t' N 0 >, ~ ~ O 0 T Y .D 0 ~ ~ m ~o p C oZ~3 '~' na d om ~ E $,LLV v ~ ~= d iO n1LV °'in1O c ~.- y.A :o v 1 p oo c o uJi N 1~ axow '°~ ~ m Eur N ~ m E ~'m'° °u 1 " Y . , E E . > 0o m - W oti• ry C n> ~ ni ~ v~ c n °v vomo m ~m~ Em ~m~.ErtOi~v o w we v.uvlu +n0 anw:°.in aaw,'~°vi•u E 0 O 0 o 0++ o O a .~ o O t+l fy o O 0 O 0 O 0 o 0 0 0 0 0 0 0 0 0 0 o O to (q o n o 0 ' o 0 n ~O o O 0 0 o 0 n fy 00 0 ~ o n o ,fj o 0 0 0 0 0 0 0 0 p frj ~ v o o o 0 o ap ~.. 0 O vl ~ N ^ -~ ~ O ~ l \ M N ~ l M t0 ,~ C ~ n n ;~ LL C A N C C C v u a ± '~ A ~ o ~ o ~ ~ o ln Z o 0 0 0 1n .~ O .y 1n u1 rj O ti o o ~o t .+ o o o+ ~ n o o ..l ,y 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o .~ ,y v co a ln o o ln v N rn o o o o m ~ ' o a+ o o ao 0 ap 0 0 0 0 0 0 0 0 0 0 ,p ap of oi o vi m 0 0 ap ~ * pl C o n ~n vl c O r+ Irl ,y lh v .-1 .~ O ro M o+ M a ~ '.~ ~ ~ 'V ti Vl n ~ n lf1 N to ~ ~ N ~ _ {~ L G ~ 9 0 ~ E E ' ^ ~ a _v ~ - ~ ~ ~ e ~ o 0 0 'J In O' o 0 o 0 0 1n 0 •~ f0 N O f0 i N .+ . k, ~ O e ;- o O ~ M M ~ O - O 0 O~ 0 O ~ O ~ n v F4 L o N ~E o v M m ~ a 1°~no o c~ a N .y W ' ~O O O E M ~ n M OD a+ iR es .] a ~ o; u; c; ui o v v „ F F~ .°, ~, a°~i [. ~ u ~~~~ ~ rr~ ~ Z c c _ o g ~' v m 1 ~ _F ~ N N o F ~ Q1 C ~ G ~ ~ o E LL ril G c E o .~ -' to L1' fn .y ~ ~ ia- p w ~ ~ w 0 d a a to v ~ m d E ~ v o ~ to E lL w ~ t/l.F v ~ ~j ` ` v H f0 ~n ~, c vi m~ ~ ~Q a c ~ o ~ 3 3 oT a = f o E v w ~° O J N J d d fall J a ~ 0 o a ~ V N U n w N J .. m V w ~- L m y LL ii ~ 7~ O S a '-' c f^ ~ X O~ c c '~ m n u u n c p oa N ax 'u vi t' m a~ 0 O 1+1 o x ~ C ~ .C ~' A m a+ v n D L ~~ c ~ d w '^ a C N v F- W ~. x ^ ~ ], C N O O - o m - °a E v 'E NN~ w i w G ^ ~ \ d 'i w O n v T 4F a a ~ N N !!1 = L ~ x ..Ea°r L a > C ~ C N j V1 ;~ '~ ' ~ of o ° ~ 3 a ,•l a o C w ~ ~ v r~ ~ ~. 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O O O P O YF N O~ W ~ ~ w I P .+ O O N M N ~ O~ I~ O V N O N O O O O O ti W O~ ~O O ~ .-i N Q~ M O N ~ a o; d C U - y c ~ 7 E w U c •v • Li _« ~ ` ~ o m v '~ a 2 U Z m y C 2 m W 7 = C a c E ~ n Z o .. u O v E v m o y V F ~ .. ~ N " + m ~ > U E a ` A t d ~ ~ u v r u 1p O rn a+ u 1n W a x d u v £ U ° v a 10 ~ C O w ~ ~ ° ¢ m ~ ^ J C c° ' ' o •E v c H ~d R H c E c U 'c ~ m E ~ w H ~ LL rn t f 0 F ,~ Q d E Z a .~ v c m rn d c W n V 7 T n w J a O F N ATTACHMENT C Reporting Requirements The City of Miami Beach 27 Contract #903-109; Resolution 2008-22 Attachment C Programmatic Data Reporting Requirements Contract No. Agency name: The City of Miami Beach Program name: Success University The Provider shall submit to The Children's Trust individual participant demographics, attendance, additional output information, and outcome data, as noted in the Scope of Service (Attachment A). Reporting will include direct submission of information into the electronic web-based reporting application (Data Tracker), as well as standard paper reports, as noted below. DEMOGRAPHICS ATTENDANCE & OTHER OUTPUTS (electronic reporting in Data Tracker; requires attendance at training and user login) Activities with 3 or more contacts with the same participant will enter: Participant Demographics (including all the items noted below), shall be entered within seven (7) days of entry into the program. All participant demographics shall be updated on an ongoing basis if and when new information is collected. Participant Attendance shall be entered by the fifteenth (15th) day of the month following the end of each month, exclusive of legal holidays or weekends. Activities with less than 3 contacts per participant: • Dates, number served, and locations (address and zip code) for each service activity delivered. Monthly updates on the status or percent achieved toward other products or materials noted in the Scope of Service. Demographics required for participants with 3 or more contacts: • Is participant a parent? (yes/no) • Name (last, first, middle initial) • Street Address, City, and Zip Code • Gender (male, female) Date of Birth • Race (American Indian/Alaska Native, Asian, Black/African American, Pacific Islander, White, Other) • Ethnicity (Hispanic, Haitian, Other) • Preferred Language (primary spoken in home) (English, Spanish, Haitian Creole, Other) • Adult's Highest Grade Completed • Child's Social Security # (n/a for adult participants) • Child's Miami-Dade County Public Schools ID Number (n/a for adult participants) • Child's Current Grade Level (n/a for adult participants) • Child's Current School (n/a for adult participants) • Does child have a disability? (yes/no) • If disabled, what type? (Autism, Chronic Medical Condition, Emotional and/or The City of Miami Beach 28 Contract #903-109; Resolution 2008-22 Behavioral Disorder, Hearing Impairment, Learning Disability, Mental Retardation, Physical Disability, Visual Impairment, Other) OUTCOMES & NARRATIVE REPORTS (Paper Reporting -Excel and Word Documents) • Outcomes Measurement and Results (Excel spreadsheet reports customized for each program/provider, based on current contract Scope of Service)-due monthly by the 15th of each month for the previous month. • Quarterly Program Narrative Report (using standard Word document format provided by The Trust) captures a BRIEF report of successes, challenges and supports needed-due quarterly by the 15th of the month following the end of the quarter. SCHEDULE OF REPORTS DEADLINES Required Report Reporting ~ Due Date Frequency Outcomes Measurement and Monthly ' By 15th of each month for the previous Results (Excel) ' ~ month Data Tracker Electronic Reporting Monthly gy 15th of each month for the previous of Demographics, Attendance, ' month and other outputs _ - - Quarterly Program Narrative Quarterly For June, July and August- Report (Word) DUE September 15th, 2008 For September, October, and November - DUE December 15th, 2008 ' For December, January, and February- DUE March 15th, 2009 For March, April, and May - DUE June 15th, 2009 The City of Miami Beach 29 Contract #903-109; Resolution 2008-22 Attachment D Financial Audit and Financial Report Requirements The auditor's report(s) as to the program specific audit shall state that the audit was conducted in accordance with the program specific audit requirements listed in The Children's Trust contract and include the following: An opinion (or disclaimer of opinion) as to whether the financial statement(s) of the provider is presented fairly in all material respects in conformity with the stated accounting policies; An opinion (or disclaimer of opinion) as to whether the schedule of expenditures is presented fairly in all material respects in conformity with the stated accounting policies; A report on internal control related to The Children's Trust contract, which shall describe the scope of testing of internal control and the results of the tests; A report on compliance which includes an opinion (or disclaimer of opinion) as to whether the auditee complied with laws, regulations, and the provisions of contract(s) with The Children's Trust which could have a direct and material effect on the program; and A schedule of findings and questioned costs that includes a summary of the auditor's Trust and findings and questioned costs. The City of Miami Beach Contract #903-109; Resolution 2008-22 for The Children's Trust contract results relative to The Children's 30 Attachment E Performance Improvement Plan The City of Miami Beach 31 Contract #903-109; Resolution 2008-22