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HomeMy WebLinkAboutR-1993-161 RESOLUTION NO. 161 - 93 A RESOLUTION OF THE CITY OF DANIA, FLORIDA, APPROVING THAT CERTAIN AGREEMENT BETWEEN CITY OF DANIA BROWARD COUNTY AND THE RELATING TO AFTERSCHOOL CARE; AND PROVIDING FOR AN EFFECTIVE DATE. { 1 BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF DANIA, FLORIDA: lion 1• That that certain Agreement between Broward County and the City of Dania relating to afterschool care, a copy of wh ich is attached hereto as Exhibit •1 "A", be and the same is hereby approved, and the appropriate city officials are hereby directed to execute same. lion 2. That Michael W. Smith, as Personnel Director, and Timothy G. Tapp as Recreation Director, are hereby authorized to sign monthly invoices and �- certification statements as required by said agreement. S t That this resolution shall be in force and take effect immediately upon its passage and adoption. PASSED and ADOPTED this 2 s tt�ay of September 993. Mayor- Commissioner i ATTEST: i 4ityC�I�erk - Auditor � l Y• Approved for Form and Correctness: ! -" By: Attorney Frank C. Adler, City i . ri L•r 7�1 AGREEMENT between BROWARD COUNTY and CITY OF DANIA, FLORIDA f I j Contract Number 94-6 Afterschool Care I „ 4 , EXHIBIT "q„ AGREEMENT between BROWARD COUNTY and Y CITY OF DANIA, FLORIDA L This Agreement, entered Into this day of�, 19 , by and ! between BROWARD COUNTY, a political subdivision of the State of Florida, hereinafter referred to as "COUNTY": and CITY OF DANIA, FLORIDA, a political subdivision of the State of Florida, I hereinafter referred to as "PROVIDER". x WHEREAS, this funding Agreement will enable PROVIDER to provide a variety i of structured afterschool day care activities which will focus on enhancing and !. increasing academic and life skills and various recreational activities to Broward Dania of elemeeiibaryle children/ school(s)l,lnotsother se funded five by any other enrolled public or private funding source; and determined t WHEREAS, expenditures given to the PROVIDER b hat and of County ` . and declared to be a county and public purposeY he n oard Commissioners of COUNTY; NOW, THEREFORE, the parties agree as follows: y' FY 1994 CITY OF DANIA 94-6 2 7: t ARTICLE I SCOPE OF SERVICES j The PROVIDER agrees to provide on a monthly basis the services set forth in Exhibit i A attached hereto and made a part hereof. { i ARTICLE II TERM OF SERVICE Services shall be provided under this Agreement from October 1 , 1993 through f September 30, 1994. !� ARTICLE III f FUNDING AND METHOD OF PAYMENT 3.1 The maximum amount reimbursable to the PROVIDER by the COUNTY under 1 this Agreement shall be thirty thousand dollars ($30,000.00) . Ikl 3.2 COUNTY agrees to reimburse for units actually delivered, correctly invoiced and documented at unit price specified in Exhibit A. Original invoice plus one copy are duo on or before the fifteenth of the first month following agreement execution by COUNTY. COUNTY agrees to reimburse the PROVIDER on a monthly billing basis. No monthly bill shall exceed that amount obtained by dividing the maximum amount payable under this Agreement by the number of months set forth in ARTICLE II of this Agreement, "TERM OF SERVICE", except for those agencies whose client flow varies with the funding period and the COUNTY agrees to a monthly payment schedule as specified in the Activity/Payment Schedule in Exhibit A, if applicable. In order to be deemed proper as defined in the Florida Prompt Payment Act, all invoices must comply with the requirements set forth in this agreement and must be submitted on the form and pursuant to instructions prescribed by the COUNTY, attached hereto and incorporated herein. I i COUNTY shall pay PROVIDER within thirty (30) calendar days of receipt of PROVIDER's properly submitted invoice in accordance with the provisions of the COUNTY's Prompt Payment Ordinance 89-49. All amounts not paid within thirty (30) days after the due date shall bear interest at a rate of one percent per month on the unpaid amount. 3.3 Monthly invoices submitted by PROVIDER shall include a certification statement signed by an authorized person as referenced in Exhibit B attached hereto and made a part of hereof, that each client served by the PROVIDER is eligible under this agreement. Should it become necessary for PROVIDER to replace signators, a notarized copy of the authorizing resolution as passed by PROVIDER'S Commissioners shall be submitted to COUNTY'S Contract Administrator for this Agreement. A letter from the City Commission setting CITY OF DANIA 94-6 3 FY 1994 s. 1 - i forth the reason for the action must accompany the notarized copy. Both items must be submitted to COUNTY'S Contract Administrator for this I Agreement on or before the fifteenth of the following month. All documentation required by this section shall be reported, maintained and presented upon forms prescribed by or approved by COUNTY Contract Administrator. invoices shall be submitted on Broward County Form #609C-2 revised 1992 as shown in Exhibit C and calendar documentation shall be submitted on Broward !f County Form #609C-3, revised 1992 bearing the appropriate fiscal year designation on its face as shown in Exhibit D attached and made a part hereof, or other such form pre-approved by the Contract Administrator. r 3.4 PROVIDER may choose to document units delivered in excess of contracted ! . levels and not paid by any other source. Units of service so documented may be used to augment subsequent months' billings when service levels are lower 4 than contracted amounts. Written justification for failing to deliver contracted service levels must be submitted with billing whenever this deficit occurs. Adjustments enabling PROVIDER to collect maximum monthly payment(s) for the month(s) showing unit shortages will be made so long as written justification for uneven service delivery is submitted and justification is not in violation of the requirements for delivery of services specified in Exhibit I A. 3.5 Invoices not acceptably submitted within forty-five (45) days of the closing date of this Agreement shall not be reimbursable. Acceptance is within the sole discretion of COUNTY's Contract Administrator for this Agreement. 3.6 PROVIDER shall provide signature authorization to COUNTY as shown in ` Exhibit B attached hereto and made a part hereof. 3.7 Submission of accurate timely documentation, and other requested information as required by COUNTY shall be considered a factor in evaluating future funding requests. Invoices and/or documentation returned to PROVIDER for corrections shall be cause for delay in receipt of reimbursement. 3.8 PROVIDER represents to COUNTY that no other funds are used for services invoiced to the COUNTY constituting duplication of funding, including banked j units and COUNTY has relied upon that representation. - I 3.9 PROVIDER shall keep accurate and complete records of any fee, reimbursement, or compensation of any kind, assessed against or collected from any client or other third party, for any service covered by this Agreement, and shall make all such records available through the COUNTY upon demand. PROVIDER shall report such fee, reimbursement, compensation and funding to COUNTY for such payments received for each unit from all sources (including the COUNTY) to the extent such payments exceed the actual cost per unit. This reimbursement may be deducted from PROVIDER's invoices. CITY OF DANIA 94-6 4 FY 1994 i I' __14 3. 10 PROVIDER shall bill and pursue collection of 3rd party and client payments (where applicable) for services rendered under this Agreement. 3.11 All equipment purchased pursuant to the Agreement shall be reported to the COUNTY on a monthly equipment report, listing in detail the kind and type, designatesbseriaeNo equipment shall ber, cost: an any hdisposed ofer data ew thont COUNTY approval Conct Administrator . ARTICLE IV MONITORING AND REQUIRED REPORTS The PROVIDER agrees: 4. 1 To provide the COUNTY with an overview of their agency's activities including goals and outcome objectives for this Agreement. PROVIDER agrees to submit a mid-term progress report to the Children's Services Section staff, due within thirty (30) days after March 31 and an annual report due thirty (30) days after September 30 in a format approved by Contract Administrator for this Agreement. 4.2 That mid-term and annual reports shall include data on utilization, service delivery levels, compliance with the requirements of Article Ill, FUNDING gress on of objectives esshment AND ETHOD °setfortlh in Exhibit A ENT set forth herein and pro omp attached here o and made acpartthereof. the a and ports 4.3 To that,measureake tthe quality and quantity, for review and of seis rvicesCprov provided pursuant suantrto this Agreement. The data shall be compiled by nROVIDER as set forth in Exhibit A, VI (Other Requirements) or in a form approved by the Contract Administrator. The data will be used for programmatic evaluation of services described in Exhibit A. f 4.4 To assign appropriate staff as necessary to attend meetings with COUNTY fk staff to assess the quality of service and make recommendations for improvements- 4.5 COUNTY and PROVIDER shall maintain the confidentiality of client services and records in full accord with any Federal or State laws or regulations mandating such confidentiality and in full accord with any applicable professional standards of ethics requiring confidentiality. 4.6 To make all records pertaining to eligible clients subject at all times to inspection, review and/or audit by the COUNTY. Required internal documentation may consist of, but not be limited to the items shown in Exhibit E attached hereto and made a part of hereof. Client case files shall not be accessible to the COUNTY to the extent such access is in violation of Federal and State law. 4.7 That monitoring reports originated periodically by designated COUNTY staff and all the performance requirements of this Agreement and timeliness of requested information shall be considered a factor in evaluating future j funding requests. FY 1994 CITY OF DANIA 94-6 5 i ' I i . ". � f 1 .8 To give representatives of the COUNTY full access to PROVIDER's facilities for announced and unannounced site visits for the purpose of observation f { services and examination of all records and data covered by providedi the ext nit such access istinervices violati n ofl not be Federalaccessieor Statbel la the COUNTY to w � ARTICLE V i f RETENTION OF RECORDS The PROVIDER shall preserve and make available all financial records, supportingF: documents, statistical records, and any other documents pertinent to this Agreement rs after termination for a Period of three (3) yea tion of the term of service specified in Article I1, oeaatsdthe records shallbeh ave not been r, if any nadir has been ini d until reta[ne resolved at the end of those three (3) y resolution of the audit findings. ARTICLE VI INDEPENDENT CONTRACTOR I ' The PROVIDER is an independent contractor under this Agreement. Services loyees of the PROVIDER and subject to provided by the PROVIDER shall be by emp e R an d not as officers, employees, or agents of the PROVIDER,e PR al supervision m the personnel policies, tax responsibilities, social COUNTY. Employee compensation, p security and health insurance, employee benefits, travel, per diem policies and other similar administrative procedures applicable to services rendered under this Agreement shall be those of the PROVIDER. ARTICLE VII FINANCIAL STATEMENTS 7. 1 The PROVIDER shall provide the COUNTY a special report by a Certified specified in the finanor by the entity's internal aud Public Accountant, cial presentation described in Section 7.3 belowlitor on the ements 7.2 If the special report is prepared by an independent Certified Public Accountant, it shall be in accordance with Section 623 of the Codification of Statements on Auditing Standards as promulgated by the American Institute of Certified Public Accountants. If the special report is prepared by an ly in accordance with that Section as the internal auditor, it shall be as near s, realizing that the internal auditor may status of the internal auditor permit not issue the opinions required therein. 7.3 The financial presentation shall show all revenues, by source and all a jj expenditures to include the classification set forth in Exhibit "A" for each funds we pnancial resentation Program/Projectecific hal pecifically d scllosetany funds received ed which rovided. The were not CITY OF DANIA 94-6 6 FY 1994 �.N. \ \ l: .f 1 I t ( expended in accordance with the Agreement (or with any regulations j incorporated by reference therein) . It shall specifically disclose the interest I . computed as earned on these funds. It shall identify the total of noncompliant expenditures and interest earned as due back to the COUNTY. 7.4 The reporting period for the financial disclosure information described in 7.1 and 7.2 above shall be the PROVIDER's fiscal year. The information shall be filed with the COUNTY within sixty (60) days after the close of each of the PROVIDER's fiscal years in which the PROVIDER accounts for funds under , this Agreement. 7.5 Late submission of the financial statement shall result in suspension of payment under this Agreement until the financial statement is received and accepted by the COUNTY, and shall be a factor in evaluating future funding requests. Suspension of payment shall not excuse PROVIDER from continued delivery of services although COUNTY will not accept invoices until financial jstatements are received and accepted by the COUNTY. I � ARTICLE VIII MANAGEMENT LETTERS 8. 1 PROVIDER shall provide to COUNTY's Contract Administrator for this ` Agreement any and all management letters arising from audited financial statements within sixty (60) days of receipt by PROVIDER. I . 8.2 PROVIDER shall provide to COUNTY's Contract Administrator for this 4 Agreement the schedule of corrections developed in response to said k management letter(s) within sixty (60) days of development. ( - r 8.3 PROVIDER shall provide to COUNTY's Contract Administrator for this Agreement any compliance audits required by law within one hundred twenty (120) days after the close of each of the PROVIDER's fiscal years in which PROVIDER accounts for funds under this Agreement. ARTICLE IX {i EQUAL OPPORTUNITY FOR El\1PLOYMENT OR SERVICES 9. 1 PROVIDER shall not discriminate against any employee or applicant for employment because of race, age, religion, color, gender, stational origin, marital status, physical or mental disability. PROVIDER shall take affirmative action to insure applicants are employed and employees treated during employment without regard to race, age, religion, color, gender, national origin, marital status, physical or mental disability. Such actions shall include, but not be limited to, the following: employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff, termination, rates of pay, other forms of compensation, terms and conditions of employment, training, including apprenticeship, accessibility, reasonable accommodation or other considerations arising from the Americans with j Disabilities Act. CITY OF DANIA 94-6 7 FY 1994 s 9.2 Decisions regarding client eligibility sheill be made without regard to, or consideration of race, age, religion, color, gender, national origin, marital status, physical or mental disability or other factor which cannot be lawfully i or appropriately used as basis for service delivery, as specified under the is x Americans with Disabilities Act. 9.3 PROVIDER shall comply with Title I and Title II of the Americans With Disabilities Act regarding nondiscrimination on the basis of disability in employment and in state and local government services, in the course of providing any services funded in whole or In part by IIroward County. I ARTICLE X INDEMNIFICATION CLAUSE Any PROVIDER who is a state agency or subdivision, as defined in Chapter , or it, Florida Statutes, agrees to be fully responsible for its acts of negligence, or it, agents acts of negligence when acting within the scope of their employment or agency, and agrees to be liable for any damages resulting from said negligence. Nothing herein Is intended to servo as a waiver of sovereign immunity by any i PROVIDER to which sovereign immunity may be applicable. Nothing herein shall be construed as consent by a state agency or political subdivision of the State of Florida to be sued by third parties in any matter arising out of any contract. ARTICLE XI INSURANCE As the PROVIDER is a State Agency as defined by Section 768.28, Florida Statutes, the PROVIDER shall furnish the COUNTY with written verification of liability protection in accordance with Section 768.28, Florida Statutes, prior to final execution of said Agreement. ARTICLE XII i { TERMINATION OF AGREEMENT 12.1 This Agreement may be terminated by either party upon thirty (30) days written notice. 12.2 COUNTY's Board of County Commissioners shall be the final authority as to . the availability of funds and the allocation of available funds among social service providers. The COUNTY reserves the right to terminate the services covered by this Agreement in the event funds are unavailable. 12.3 If the PROVIDER fails to provide services called for by this Agreement within the time specified herein or any extension thereof, or if the PROVIDER fails to perform any of the other provisions of this Agreement, the COUNTY may, by written notice of breach to the PROVIDER, terminate this Agreement. CITY OF DANIA 94-6 8 FY 1994 yY " )i.. .. 12.4 Termination, pursuant to Section 12.2 or 12.3 shall be upon no less than twenty-four (24) hours notice, in writing, delivered by registered mail with � .i return receipt requested or in person, with proof of delivery to the address specified in Article XIX. ARTICLE XIII i AMENDMENTS. ASSIGNMENTS 13.1 No modification, amendment nor alteration in the terms or conditions contained f herein shall be effective unless contained in a written document executed with the same formality and of equal dignity herein. ; 13.2 The PROVIDER shall not transfer nor assign the performance of services ce called for in the Agreement without the prior written consent of the COUNTY. ARTICLE XIV WAIVER OR BREACH Waiver or breach of any provisions of this Agreement shall not be deemed to be a i waiver of any other subsequent breach and shall not be construed to be a modification of the terms of this Agreement. ARTICLE XV RENEWAL PROVIDER understands and acknowledges that, although its successful and scrupulous performance under this Agreement will be a factor considered by the y ' COUNTY in evaluating future funding requests, COUNTY funding under this f Agreement relates exclusively to the term of service specified in ARTICLE II herein and that the COUNTY, by entering into this Agreement with the PROVIDER, assumes no obligation whatsoever with respect to further or future funding to this r' PROVIDER. Notice of renewal shall be given to PROVIDER in writing no later than thirty (30) days before the expiration of the initial term. , j CITY OF DANIA 94-6 9 FY 1994 i j . . ice' ... .... _ . ._.._. ._ ._ . ARTICLE XVI RENEGOTIATION The parties agree to renegotiate this Agreement If COUNTY revisions of any applicable law, regulation or Increase/decrease in allocations make changes in this Agreement necessary. ARTICLE XVII REPRESENTATION AND ACKNOWLEDGEMENTS 17. 1 PROVIDER acknowledges that: a) There have been no irregularities involving its management and iel affect on PROVIDER'S operations or employees that could have mater stability. b) There are no violations or possible violations of laws or regulations the j effects of which should be considered. c) There are no material transactions that have not been properly recorded in the appropriate document(s) . d) Related party transactions that have not been receivable or payable have been properly recorded or disclosed. 17.2 PROVIDER acknowledges that: a) In order to obtain execution of this Agreement by the Board of County Commissioners, PROVIDER's most recent audited financial statements, i compliance audit as required by law and management letter, if generated, must be provided to, and reviewed and accepted by COUNTY. b) Submission of audited financial statements, compliance audit as required i by law and management letter(s) , if generated, to any Department, Division, Office or other entity of Broward County as a requirement for f ', i any transaction or agreement with that Department, a requ Office or t other entity does not constitute compliance with the requirements of this Agreement insofar as submission of material to the Contract j Administrator for this Agreement is concerned. C` ; i as c) The Certificate of Insurance and the Authorized Invoice Signatory of shown in Exhibit B shall accompany the Agreement upon execution of said contract by PROVIDER. - d) Information, guidance and technical assistance offered by COUNTY's Contract Administrator for this Agreement, the Contract Monitor and any other staff, whether written or verbal, in no way constitutes a guarantee of execution of this Agreement by the Board of County lI Commissioners. i FY 1994 CITY OF DANIA 94-6 10 _ . ;._.�_ • " ..-.t. .' - ' ,. may.` y 1 I NW e) Information, guidance and technical assistance provided prior to contract execution should not be relied upon as a basis for doing { delivering service, expending financial resources or business, g q expectation of reimbursement or receipt of payment. ARTICLE j DESIGNATED REPRESENTATIVES AND EMPOWERMENT { w 18. 1 The Contract Administrator for the COUNTY for this Agreement is the reau of Children's Services Director of the Bu or designee. The representative of the PROVIDER responsible for the administration of the F program under this Agreement is the title r y" 18.2 The empowered signator of this contract for PROV1DEettached R is e e as referenced in Exhibit B, page yt>, I Title b hereto and made a part hereof. r ARTICLE XIX t REIMBURSEMENTS AND NOTICES ever either party desires to give notice unto the other The parties agree that when i under the terms of this Agreement, it must be given by written notice, sent by certified United States mail, with return receipt requested, addressed to the party for whom it is intended, in this case designated Contract Administrator for the COUNTY and representative for the PROVIDER as set forth in Article XVIII Designated Representatives and Empowerment at the place last specified and the place for giving of notice shall remain such until it shall have been changed by written notice in compliance with the provisions of this paragraph. For the present, the parties designate the following as the respective places for giving of notice, to- wit: COUNTY: Children's Services Section Broward County Governmental Center 115 South Andrews Avenue, Annex Room A-300 Fort Lauderdale, Florida 33301 PROVIDER: City of Dania, Florida Post Office Box 1708 Dania, Florida 33044 CITY OF DANIA 94-6 11 FY 1994 I -- — _ - w ARTICLE. XX ATTORNEY FEES The PROVIDER understands and acknowledges that if COUNTY incurs any expenses in enforcing the terms of this Agreement, whether suit be brought or not, PROVIDER agrees to pay all such costs and expenses including, but not limited to, court costs, interest and reasonable attorneys fees. ARTICLE XXI I GOVERNING LAW AND VENUE This Agreement shall be governed, construed, and controlled according to the laws of the State of Florida. Any claim, objection or dispute arising out of the terms of ,»=a this Agreement shall be litigated in the Seventeenth Judicial Court in and for Broward County, Florida. "p ARTICLE XXII s SEVERABILITY Should any part, term or provision of this Agreement be by the courts decided to be - invalid, illegal or in conflict with any law of the State, the validity of the remaining { portions or provisions shall not be affected thereby. i � t l � 4 FY 1994 CITY OF DANIA 94-6 12 ,i IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement on the respective dates under each signature: COUNTY through its BOARD OF COUNTY COMMISSIONERS, signing by and through the County t Administrator, authorized to execute same by Board action on the _ day of 119 and PROVIDER, signing by and through its { duly authorized to execute same. j COUNTY WITNESS: BROWARD COUNTY, through its BROWARD COUNTY ADMINISTRATOR County Administrator day of , 19_ Approved as to form and legality by the Office of County Attorney , Broward County, Florida - JOHN J. COPELAN, JR. County Attorney Governmental Center, Suite 423 115 South Andrews Avenue Fort Lauderdale, Florida 33301 By Assistant County Attorney PROVIDER City Name Mayor l i Print Name and Title APPROVED AS TO LEGAL FORM: City Manager City Clerk (CITY SEAL) 1 City Attorney — 19 day of , _ i' f CITY OF DANIA 94-6 13 FY 1994 i i . �+t i EXHIBIT A Page 1 j fk i 1. Scope of Service: (Reference Article I, Page 3) The PROVIDER agrees to provide a variety of structured afterschool day care activities which will focus on enhancing and increasing academic and life skills and various recreational activitieseligible to Broward County ' children/siblings, Pre through five (5) enrolled in any City of Dania elementary school(s) . II. Definition of Units of Service: I A. A unit of service is defined as attendance to a session of one (1) to four (4) hours of daily afterschool day care by an eligible child and his/her sibling(s) if enrolled in area schools in grades K-5 or in a Pre-K program. B. Subject to the deductions provided for in Subsection (C) below, the COUNTY agrees to reimburse the PROVIDER for each unit of service during TERM OF forth in ART ICLE ICLE II of this Agreement at a cost not to exceed SERVICE set for tenth 1/10) $3.75 per unit/session at a maximum of $3,000.00 monthly or one ( • . the amount of this Agreement. C. Li the event the PROVIDER collects any fee or collects any reimbursement from a third party for services provided under this Agreement, PROVIDER shall keep accurate and complete records of all such fees collected and report such collection to COUNTY and reimbursement to PROVIDER. 111 . Project Pro ,rE am Information As defined in Exhibit A, Pages 2 and 3 (IIroward County Form #609C-113) . IV. Internal Documentation Required for Monitoring (see Exhibit E) I { V. Monthly Invoices: (Reference Funding and Method of Payment ARTICLE III) i VI . Other Requirements: Client Case Files: The PROVIDER agrees to maintain professional standard updated case files on all clients. Files shall include, but not be limited to: tatement verifying client eligibility for name, date of birth, entry date, s service, progress notes, exit date and time, and follow-up results. t intain a formal Tracking Tracking System: The PROVIDER agrees to ma System (if applicable) of all clients referred to and from program, identifying bs services referred for, services received, unavailability of services, and x r feedback from agency client was referred to. ? s Statistical Demographic Records: The PROVIDER agrees to maintain (if d applicable) information on overall client demographics which includes age, gender, race, ethnic origin, parental marital status, education levels and ; t status. PROVIDER agrees to track overall client household income, other provided and satisfaction survey results benefits received, types of services . E c FY 1994 CITY OF DANIA 94-6 14 t i Exhibit A- page 2 P.ROJECl/iKG(;i.AX INFORMATION FPROJr.CT/PR0GR,,`1 TITLE: City of Dania - Afterschool Care � Notd: These objectives may be used as part of the criteria in the monitoring of f v_....r orrantznr nn Outt.ume/Baneflt ObJeccive(s) Activity Component(s) Units of Service (Measurable if 1 . Educational Homework 50 children at 1 unit a. Quarterly Progresr. Enrichment Helper per day. Report through School system. Minumum of one Week to week con- hour of struc- tact with pupil and tared homework teacher. time. b. Measure Report cart improvement from It report to last of 1 the year. { c. Attendance per j child. i d. Attrition per chile. a. Demographics 2. Skills a. Arts 6 Crafts a. All 60 children a. Each child will cur Special/Holiday plete one project I 30-45 minutes a week. Best will ` be kept for display F I � b. Reading Club. b. 40 children b. Child will improve Grades 1-5 his/her reading all( Twice weekly comprehension skill Monthly report fror School Teachers on Improvement or pro- gress. c. Drama Club c. 24 children Twice weekly c. Develop self-expre- ssion and learn to cope with others. Christmas and Easter Holiday pro- grams. d. Dance Athletics d. All 60 children. d. Develop motor skil and cooperation wit j others. e. Sewing Club e. 30 children e. Build self-reliance and ability to com- N, ;. plate projects. FY 3 CITY OF DANIA 94-6 -15- )944 y, w — Note: lticse objectives may be used as part of the criteria in the monitoring of voor nrs•..aafzat1 1) Outcome/Benefit Objective s) Activity Component(s) Units of Service (Measurable if -_ 1 3. Other Misc. Daily: Games-Movies ] - Free Play - All children Activity Schedule ){ posted daily. 4. Networking Collaboration Referrals a. 0 of referrals j Activities Efforts b. Type of referrals + c. Outcome of referral - i 5. Client Administer a satis- 100% of the parents A mimimum if 90% of Satisfaction faction survey to of the children en- the parents will re parents. rolled during 3/94 fleet satisfaction will complete a with after school cart (; client satisfaction in client satisfaction4, survey in 9/94. survey. 4? CITY OF DANIA 94-6 FY 1994 3 EXHIBIT B AIJTHORi•LED lNVO10E SIGNATORS FOR MUNICIPALITIES r � i ys tures authorized by the City Commission of Appearing below are samples of signa ' as required by Broward County. Signature i Signature ! J i Type Name jType Name j STATE OF FLORIDA COUNTY OF j Before me personally appeared i Name and Title and Name and Title to me well known and known to me to be the person described in and who executed the foregoing instrument, and acknowledged to and before me that and Executed said instrument for the purpose therein expressed. i WITNESS my hand and official seal, I this day of { I Notary Public State of Florida Notary Seal Name of Notary printed/typed t Commission No. �— i I � ` FY 199-4 CITY OF DANIA 94-6 17 ._- -- Boer,-of Cavev Ccm�tluow Co&riy.Fbr" NTRACTEDSERVICESIHVOICE ?ureau of C.::i.d:en' a Services/ChUdnen'eflnevlowSKtbn 2 Fedwar KlanUtKaebn NUMbW i ion-Prom Orgar izaoan of Governer"Emery :.OriIISGt Number 4 Name d Contracted Provam r 6. For the Month and Yew 7. Annual Hartman Contact AmourN rUrKory gb. Month Maximum Un b of Sery to9. Tout Units of Service Provided This Month imum ConVacl Amount b ollected Divided by Untl Cost Equals rR Units d Service Mmus Convened Units hemEBanked Date t3. Ban�ke�U�nnB Appliedit.of Sernco Collected(A appticablelanation of Under Penormttnce or r Reimbursement This Month bursement Requested e or - 5% _ FOR COUNTY USE ONLY CERTIFICATION: The undersigned, as an authorized '^ signature for this contract between Broward County,and t7. ,nit —_— Agency hereby affirms and certifies that the service billed here- with have been rendered on behalf of Broward County, ; yanizalion _ Object that all clients served have met program eligibility requirements,that all fees collected have been duly ate Invoice Received by County Contract Administrator. deducted,and that sufficient written information is available to document services and fees reported. ite or Inaccuracy Penalty Applied: ❑ Yes ❑ No Approved Signature: - jice Received By Date tg• Type N.rrie voice Reviewed By Date 19. Date Type Too a �, voice Approved By __ : Signature 20. O ale Forwarded to Accounting Date: 21. t 0 F , -q V 1, r EXHIBIT C PAGE 2 v, w' ep Human Services Dartment/Bureau of Children's Services Children's Services Section Instruct ions for Contracted Services Invoice -- Form 609C-2 f 1 . Legal name/legal address of agency under contract with Broward County. I 2• Agency's Federal Identification number. 3. Agency's contract number, as stated on title page of contract. ` z I 4• Name of contracted program. 5. Funding category, i.e. continuing, one-time/capital, one-time emergency and NPO. Il request only 6. Month and year for reimbursement Y 7. Maximum contract dollar amount, as stated in the contract. 1 8• a) Monthly maximum contract amount. j b) Monthly maximum units of service. 9. Total units of service provided this month (including banked units). 10. Total fees collected divided by unit cost to equal converted units of service. 11. Total units of service minus converted units from fees collected (if applicable) . 12. Banked units Y-T-D (cumulative total) . 4 units applied this month. 13. Banked pP th r , c 14. Total units for reimbursement this month including banked units (not to exceed monthly maximum units of service). 15. Reimbursement request in dollars not to exceed monthly maximum contract amount. errmance or over p 16 eComm xplanation on eddtional sheedt/sheets to monthly invoicerformance. Attach 17. Certification: Legal name of agency under contract with Broward County. 18. Name of authorized signator as stated in Exhibit B-1 of contract. `y`• 19. Title of authorized signator. a 20. Signature of person, as authorized in Exhibit B-1 of contract. kHT 21. Date invoice was signed by authorized signator. rt; FY 199.1 i .'•:'. ,r CITY OF DANIA 94-6 19 d --- — �- •- — — — vti�b 1 Boa,j a County Conrrraegr»n. Br rd C4.1%y cronda Month ._ 19 ---. CALENDAfRDOCUMENTATIONcc1:iCES, C: E..' c CFF:TCES ScC .^ti F.Y. 19 9 Location of Services c. 3 I \ Total Units: Fees CoNsefsd: Eyt Cam Cayvtod by Name--- -------` 1 3 1 6 7 1 1111211 11 1 1 17 1 1 1 1 7 311 li B,Mdate Entry Data Comments ' Total Units: Fees Collected: i Exit Date Certdred By Off Name 1 2 1 3 1 J 1 5 1 6 1 7 1 8 1 9 110111112113114115116117118119120121 4 7 31 of(t( _— Brrthdatn Entry Date Comments N I Total Units: Fees Collected: 4( Earl Date Certified By f t I 11 213 1 4 15 16 1 7 18 1 9 110111112113114115116117118119120121122123124125126127128129130 31; Bethd:ne Entry Date Comments Total Units: Fees Collected: -- Ead Dale --------Certified By _— .n t tJann` ------"--- --- ------ 1 2 1 3 14 15 1 6 1 7 1 8 19 11011111211311411511611711811912012112212312412S 1 26127 28 29 30 31 rn .V _.__.___- _ Birurdatc EnlryDatc Lj Comments A ' Total Units: _ Fees Collected:__ w E.'t Dale Ced,fied By -- Grand Total Units: Grand Total Fees Collected: U s Aa EXHIBIT D, PAGE 2 Human Services Department/Bureau of Childron's Services a x firm.; Children's Services Section { Instructions for Calendar Documentation -- Form 609C-3 1 . Invoice month and year. ! 2. Location of service. ;j 3. Name of client. 4. Date of birth of client. 5. Date of client's entry into contracted program. f 6. Exit date of client (only if terminated or discharged). 7. Original initials of authorized signator for certification. f 8. Each block represents a day of the month. Indicate days or hours, per day, that services were rendered (as per Contractual Agreement -- Exhibit A) . 9. Total units (for the month). 10. Fees collected (for the month) . 1 11 . Grand total units (for the whole page) . 12. Grand total fees collected (for the whole page) . ! i is a - CITY OF DANIA 94-6 21 FY 1994 i r EXHIBIT E INTERNAL DOCUMENTATION REQUIRED FOR MONITORING Days/flours/Sessions of child day and afterschool care Client/parent (authorized) signature daily sign-in and sign-out attendance sheets. Client file as required; client registration form, and any other pertinent information. Hiring records (personnel file; personnel education requirements, staff medical statement, criminal records clearance, and any other pertinent information. Daily routine and program log. { Occupational license and other necessary license and permits displayed. Client billing and payment records to include third party reimbursement, if l applicable. I r Agency policy and procedures handbook. '41 l4 1 r } FY 1994 CITY OF DANIA 94-6 22 •A:. ijo Y 1 ;C. a" uY r i .. .-..�..... n.:e.' _ [�. e'✓ _„'xn>r-;�::— a-�c, +r.:`•'fir' ,'n•�ry,e�, y'�• ..