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HomeMy WebLinkAbout51971' 2 3 4 5 61 7 8 9' 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 ORDINANCE NO. 5 1 9 7 AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF AUBURN, WASHINGTON, AUTHORIZING THE ACCEPTANCE OF A COMMUTER TRIP REDUCTION (CTR) GRANT FROM THE WASHINGTON STATE DEPARTMENT OF TRANSPORTATION TO ENHANCE THE CITY'S CTR PROGRAM. WHEREAS, the City Council of the City of Auburn must adopt and approve all appropriations by ordinance pursuant to Chapter 35A.33 RCW; NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF AUBURN, WASHINGTON, DO ORDAIN AS FOLLOWS: Section 1. Pursuant to Chapter 35A.33 RCW, the City Council hereby approves expenditure and appropriation of a Commuter Trip Reduction (CTR) grant from the Washington State Department of Transportation (WSDOT) which will be used to enhance the City's CTR program, in the amount of $7,635, with no matching City funds required, and authorizes the Mayor to execute Agreement No. GCA-1487 between the City and WSDOT, a copy of which is attached hereto as Exhibit "A" and is incorporated herein by reference. Section 2. The Mayor is hereby authorized to implement such administrative procedures as may be necessary to carry out the directions of this legislation. Ordinance No. 5197 December 8, 1998 Page 1 Section 3. This Ordinance shall take effect and be in force five (5) days from and after its passage, approval and publication, as provided by law. INTRODUCED : December 21. 1998 PASSED: December 21,1998 APPROVED : _December 21, 1998 81 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 6'umAl' 1?0 CHARLES A. BOOTH MAYOR ATTEST: k dl-v D-4 011, E. Daskam, City Clerk APPROVED AS TO FORM: Michael J. Reynolds, City Attorney PUBLISHED: a_02-5--7 6 -------------------------- Ordinance No. 5197 December 8, 1998 Page 2 Washington State Department of Transportation City of Auburn 310 Maple Park Avenue 25 West Main PO Box 47387 Auburn, WA 98001-4998 Olympia, WA 98504-7387 Contact Person: Steve Mullen Contact Person: Hiep Tran, Employer Federal ID # Agreement Start Date Completion Project Amount Project Title Number Date Auburn Vanpool Formation Driver GCA-1487 1 Oct. 1, 1998 1 1 Jun. 30,1999 1 1 $7,635 1 1 Subsidy Project 1 THIS AGREEMENT made and entered into this 1st day of October, 1998, between the Washington State Department of Transportation, acting by and through the Secretary of Transportation, hereinafter called "WSDOT" and the legal entity as shown above hereinafter referred to as the "Contractor". WITNESS THAT: WHEREAS, the 1998 Legislature has provided WSDOT $2.5 million from the High Capacity Transit (HCT) account to enhance the Commute Trip Reduction (CTR) (RCW 70.94.521-551) Program, with $500,000 of this being allocated to the Employer Services Grants Program; WHEREAS, the WSDOT coordinated a work group process to develop criteria to provide funding to employers to support and enhance employers' CTR programs; WHEREAS, the Contractor in response to the WSDOT request for projects, submitted an application for consideration of funding; and WHEREAS, the WSDOT, based on project needs, has selected the Contractor's project as one that best meets the purpose and criteria of the Employer Services Grant Program. NOW, THEREFORE, in consideration of the mutual covenants herein set forth, WSDOT and the Contractor agree as follows: General The purpose of this agreement is for WSDOT to provide funding to enable employers to overcome specific barriers for more successful CTR programs. II Scope of Work The scope of work is described in the Exhibit 1 III Time for Beginning and Completion The work to be performed under this Agreement shall commence on October 1, 1998, and terminate on June 30, 1999, unless terminated sooner as provided herein. IV Termination WSDOT, at its sole discretion, may terminate this Agreement in whole, or from time to time in part, whenever: 1. The Contractor has breached the contract and, after fourteen (14) days written notice, has failed to correct any of the terms and conditions of this Agreement; 2. The requisite state funding is reduced or becomes unavailable through failure of appropriation or otherwise; 3. WSDOT determines that the continuation of the project would not produce beneficial results commensurate with the further expenditure of funds; or 4. A request to terminate in whole or in part has been made in writing by the Contractor. The Contractor may not unilaterally terminate this Agreement. If this Agreement is terminated prior to fulfillment of the terms stated herein, the Contractor shall be reimbursed only for actual and eligible State Share expenses incurred on the Project prior to the date of termination, and only to the extent of appropriated funds. Exhibit "A Ordinance No. 5197 V Project Reimbursement and Payment WSDOT shall reimburse the Contractor for eligible project costs not exceed $7,635. WSDOT will reimburse the Contractor only for actual and eligible direct Project costs. Payment will be made on an incremental, reimbursable basis. Payment is subject to the submission to and approval by WSDOT of properly prepared invoices accompanied by progress reports and financial summaries. The Contractor's final payment request must be received by WSDOT no later than July 15, 1999, or within 30 days of the termination of this Agreement, whichever is sooner. Any payment request received after July 15, 1999, will not be eligible for reimbursement. VI Waiver In no event shall the payment of any reimbursement request by WSDOT to the Contractor constitute or be construed as a waiver by WSDOT of any breach of contract, or any default which may exist on the part of the Contractor. The making of any such payment by WSDOT while any such breach or default exists shall in no way impair or prejudice any right or remedy available to WSDOT with respect to such breach or default. VII Reports The Contractor shall prepare periodic reports as described in the scope of work (Exhibit 1). The Contractor shall deliver the final project report to the WSDOT no later than July 15, 1999. VIII Agreement Modifications Either party may request changes in the scope of work. Such changes which are mutually agreed upon shall be incorporated as written amendments to the Agreement. No variation or alteration of the terms of this Agreement shall be valid unless made in writing and signed by authorized representatives of the parties hereto. IX Compliance with Laws and Regulations The Contractor agrees to abide by all applicable state and federal laws and regulations, including but not limited to those concerning employment, equal opportunity employment, nondiscrimination assurances, project record keeping necessary to evidence agreement compliance, and retention of all such records. The Contractor will adhere to all of the nondiscrimination provisions in Chapter 49.60 RCW. X Project Records The Contractor agrees to establish and maintain for the project either a separate set of accounts or accounts within the framework of an established accounting system, in order to sufficiently and properly reflect all eligible direct Project costs claimed to have been incurred in the performance of this Agreement. Such accounts are referred to herein collectively as the "Project Account". All costs claimed against the Project Account must be supported by properly executed payrolls, time records, invoices, contracts, and payment vouchers evidencing in proper detail the nature and propriety of the charges. XI Audits, Inspections, and Retention of Records WSDOT, State Auditor, and any of their representatives shall have full access to and the right to examine, during normal business hours and as often as they deem necessary, all of the Contractor's records with respect to all matters covered by this Agreement. Such representatives shall be permitted to audit, examine and make excerpts or transcripts from such records, and to make audits of all contracts, invoices, materials, payrolls, and other matters covered by this Agreement. In order to facilitate any audits and inspections, all documents, papers, accounting records, and other materials pertaining to the Project shall be retained by the Contractor for three years from the date of completion of the project. However, in case of an audit, the Contractor must retain all records until the audit is completed. X11 Limitation of Liability No liability shall attach to WSDOT or the Contractor by reason of entering into this Agreement except as expressly provided herein. Each party to this Agreement shall be responsible for damage to persons or property resulting from the negligence on the part of itself, its employees, its agents, or its officers. Except as provided in this Agreement or by applicable law, neither party assumes any responsibility to the other party for the consequences of any act or omission of any person, firm, or corporation not a party to this Agreement. XIII Disputes Any factual disputes between WSDOT and the Contractor with regard to this Agreement not disposed of by this Agreement, shall be referred for determination to the Secretary of the WSDOT, or his/her designee. In the event that either party deems it necessary to institute legal action or proceedings to enforce any right or obligation under this Agreement, the parties hereto agree that any such action shall be initiated in the Superior Court of the State of Washington situated in Thurston County. The Contractor hereby accepts the issuing and service of process by registered mail consistent with RCW 4.28.080 (1). Each party shall bear its own legal costs and expenses, including attorney fees. XIV Independent Contractor The Contractor shall be deemed an independent Contractor for all purposes, and the employees of the Contractor or any of its subcontractors and the employees thereof, shall not in any manner be deemed to be employees of WSDOT. XV Execution and Acceptance This Agreement may be simultaneously executed in several counterparts, each of which shall be deemed to be an original having identical legal effect. The Contractor does hereby ratify and adopt all statements, representations, warranties, covenants, and agreements and their supporting materials contained and/or mentioned herein, and does hereby accept WSDOT's grant and agrees to all of the terms and conditions thereof. XVI Execution This Agreement is executed by the Director of the Public Transportation and Rail Division, State of Washington, Department of Transportation or the Director's designee, not as an individual incurring personal obligation and liability, but solely by, for, and on behalf of the State of Washington, Department of Transportation, in his/her capacity as Director of the Public Transportation and Rail Division. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written. STATE OF WASHINGTON DEPARTMENT OF TRANSPORTATION By: JAMES H. SLAKEY, Director Public Transportation and Rail Division CONTRACTOR BY: (I , 'Date: Approved as to form Date: I ?[ - C) -a -/,9" By: ANN E. SALAY Assistant Attorney General September 28, 1998 EXHIBIT I Scope Of Work Employer Services Grant Auburn Vanpool Formation Driver Subsidy Project WORK PLAN: An Employer Services Grant of $7,635 is awarded to the contractor to enhance its CTR program. This grant must be expended, in its entirety, on the Auburn Vanpool Formation Driver Subsidy Project and evaluation. In return for the grant, the contractor will complete the tasks and provide the information described below. CONTRACTOR TASKS: The contractor agrees to: 1. Develop and implement the Auburn Vanpool Formation Driver Subsidy Project designed to increase the use of non-single occupant vehicle commuting. 2. Promote and market the program, assist employees in forming vanpools, and provide financial subsidies or incentives to employees who drive vanpools to the contractor's worksite. 3. Maintain records of all expenditures for the Auburn Vanpool Formation Driver Subsidy Project, including the total dollar amount expended on each element of the program, and the number of employees who receive subsidies or incentives. 4. Maintain records of the total number of single occupant vehicles and vehicle miles traveled eliminated through the Auburn Vanpool Formation Driver Subsidy Project. 5. Write and submit quarterly progress reports, including the specific strategies and incentives used to increase non-SOV commuting. The quarterly report shall be delivered to WSDOT by the 15' of the month following the end of each calendar quarter. 6. Write and submit a final report describing the Auburn Vanpool Formation Driver Subsidy Project and evaluating its impact. The final report shall be delivered to WSDOT no later than July 15, 1999. FINANCIAL SCHEDULE: 1. The contractor will submit signed and approved invoice vouchers to WSDOT no later than 15 days following the end of December, 1998, March, 1999; and June, 1999. 2. WSDOT will reimburse the contractor for actual project costs within (30) days of receiving each signed and approved invoice voucher, and supporting documentation. TIMELINE: Tasks December March June 1998 1999 1999 Submit Progress Report and Invoice Voucher X X X Submit Final Report and X Final Invoice d. Formal grievance proceeding. i. Time limits. Except for a grievance that alleges fraud or criminal activity, a grievance must be made no later than one year after the date of the alleged occurrence. If a hearing is held on a grievance, it must be conducted no later than 30 calendar days after the filing of such grievance. A decision on any such filed grievance must be made no later than 60 days after filing. _ ii. Effect of informal process. In the event an aggrieved party files a grievance after participating in an informal dispute resolution process, the neutral party may not participate in the formal grievance proceeding. In addition, no communication or proceeding of the informal dispute resolution process may be referred to or introduced into evidence at a grievance or arbitration proceeding. e. Arbitration. i. Selection of arbitrator. If there is an adverse decision against the party who filed the grievance, or no decision has been reached after 60 calendar days after the filing of a grievance, the aggrieved party may submit the grievance to binding arbitration before a qualified arbitrator who is jointly selected and who is independent of the interested parties. If the parties cannot agree on an arbitrator, within 15 calendar days after receiving a.request from one of the parties, the Corporation will appoint an arbitrator from a list of qualified arbitrators. ii. Time limits. An arbitration proceeding must be held no later than 45 days after the request for arbitration, or if the arbitrator is appointed by the Corporation, the proceeding must occur no later than 30 calendar days after the arbitrator's appointment. A decision must be made by the arbitrator no later than 30 calendar days after the date the arbitration proceeding begins. iii. Cost. In accordance with 42 U.S.C. §12636(f)(4)(D), the cost of the arbitration proceeding must be divided evenly between the parties to the arbitration unless the party requesting a grievance proceeding prevails. If the grievant prevails, the Grantee must pay the total cost of the proceeding and reasonable attorney's fees of the prevailing party incurred in connection with the ADR proceeding. iv. Effect of noncompliance with arbitration. Pursuant to 42 U.S.C. §12636(f)(7), a suit to enforce an arbitration award may be brought in any Federal district court having jurisdiction over the parties without regard to the amount in controversy or citizenship. FINAL - August 1, 1997 45 EXHIBIT "D" Washington Service Corps Evaluation Plan City of Auburn Evaluation Plan The Washington Service Corps hereby approves the Evaluation Plan submitted by City of Auburn for the 1998-99 Program Year. Reviewed By: Eugene Suzaka, Local Area Coordinator Date Approved By: Nancy Pringle, Director Date tom- ,..--1 A U G 7 1998 VVAW11NU1U11 Ju,,-v, U r Aubum's AmeriCorps Team "keeping.4uburn agreat place to raise kids" Dept. of Planning & Community Development 25 West Main Street, Auburn, WA 98001 phone: 253-804-5029 DATE: August 4, 1998 TO: Eugene Suzaka & Tom Heavey FROM Bill Marxie-,,ille RE: PY1998-99 Con Tact: Cbanges to the Objectives and Evaluation Plan I reviewed PY1997-98's contract for changes which we need to make to next year's contract. Most of the changes I addressed in my memorandum of December 26, 1997 which was attached to our renewal application. Regarding changes to the objectives and evaluation plan, only two changes are necessary. Attached are copies of the revised Obective 42 and Evaluation Plans for Objective 42 and Objective 43. Getting, Thines Done: Objective #2: References to the "Re-Entry Program" should be changed to the "Muckleshoot Tribal School". We will have four members placed at the Tribal School. Three of them will be serving grades 5 through 10. One member will work half a day at the Re-Entry Program and the other half at the normal school. The performance measures and outcomes will remain the same. Getting Things Done: Objective 9F3: In the evaluation plan under item #7, I deleted references to the "Program Assessment Worksheet", "Leader Rating Form" and "Project Report Card". These documents were meant to be optional. The Service Learning Coordinators will continue to maintain project portfolios which include their written journals, attenance sheets and questionaires. I really need to get the contract approval process rolling. The start date for PY 1998-99 is September 16. This means the City Council must approval the contract no later than September 8. In order to get it on their Sept 8`h agenda, I must present it to their Planning and Community Development Committee no later than August 13. If I miss any of these dates, then I will need to postpone my start date until October 1 or later. A postponment will greatly disrupt my recruitment process and most likely cause me to lose members. Given the few changes that are necessary, I am hoping that you can prepare next year's contract documents rather quickly. I plan to fax, email and mail you copies of this memo and revisions. Please call me if you have questions, need more information or can not meet the above target dates. Program Name Washington Service Coras Project Name Auburn Youth Participation Initiative Getting Things Done SEfIl1 CEPS Objective 1 *rnmnnnPnt m,mhem hetnw refer to the objectives worksheets included with your AmeriCorps Renewal Application. Activity: AmeriCorps members assigned to Auburn Police Dept. will help organize or From Component 1 on the objectives worksheet* reactivate 20 block watch and apartment watch programs and present three crime ("Describe briefly the service activity you will prevention workshops be evaluating.") 1. Who will receive services? Block / Apartment Watch precincts throughout Auburn will be offered May be included in either Component 1 or 5 on opportunities for training and technical assistance to help organize their worksheet. ("Describe briefly the service neighborhoods and increase community vigilance against crime. activity you will be evaluating." or "Estimate the number of people this activity will serve.") 2. Number served Block watch precincts will be organized in various neighborhoods throughout From Component 5 on worksheet. ("Estimate the Auburn. Approximate half of Auburns residents are low income and one out of number of people this activity will serve.") three families with children have single parents. Each block watch consist of approximately ten households and crime prevention workshops have an average attendance of 25 people. Total participants will be approximately 400 people 3. Desired result Reduction in crime rates in the neighborhoods within the block watch or apartment From Component 2 on worksheet. ("Explain what watch precincts and an increase in the feeling of safety/security by the participants change the described activity will produce.") in each block watch precinct. 4. Indicators Change in the number of police reports filed by Auburn police officers during the (What concrete, observable things will you project period and participant's reaction to crime prevention workshops, seminars, look at to see whether you are making newsletters and precinct meetings. progress toward your desired result?) 5. Method of measure A comparison of neighborhood police reports on serious crimes before, during and From Component 3 on worksheet. ("Describe the after the AmeriCorps program. Reported change in knowledge and sense of method you will use to determine if the described safety/security following participation in the program. change occurs.") 6. Level (standard) of success 25% reduction in serious crimes reported in the targeted neighborhoods and 70% of Form Component 4 on worksheet. ("Try to participants reporting that they learned something and/or feel more safe/secure in define a level of success you hope to their neighborhoods achieve.") 7. Name/title of instruments used "Event Summary by Reporting District Report" prepared upon request by the From Component 3 on worksheet. ("Describe the Auburn Police Department; Post Block Watch Participant Questionnaires method you will use to determine if the described change occurs.") 7a. Who and how many people will Event Summary Report is prepared by the Auburn Police Department and heads of respond/fill out the instruments? households participating in the Block Watch program fill out the questionnaire. (Note: this may not apply for all instruments, for example, testing water quality.) 8a. Who is to collect the data? Event Summary Reports will be prepared at the beginning and end of the program 8b. How often? year; the questionnaires will be complete at the end of the program year. 9a. Who will aggregate the data? Statistical unit of the Auburn Police Department and the AmeriCorps members. (tally on paper or enter into computer) 9b. How often? 10a. Who will analyze the data? Police Dept.'s manager of community policing programs, Deputy Chief and the 10b. How often? AmeriCorps members. 11. Who will turn the data into a AmeriCorps Coordinator will incorporate the findings from the Event Summary report? Report and questionnaire into his quarterly progress report. DATE: September 4, 1997 FROM: Bill Mandeville Neighborhood Family Center 620 37th Street S.E., Auburn, Washington More INFO? -- contact: Bill Mandeville -- 804-5029 RE: "Event Summary by Reporting District" Reports An Event Summary Report will be prepared to compare prior and post crime rates relative to the AmeriCorps program. Event Summaries are used to measure and compare crime rates within the city limits of Auburn. These reports are prepared by the statistical unit of the Auburn Police Department. It listhe number of police reports by reporting district. A police report is prepared by officers each time a crime is reported and/or evidence indicates a crime occurred. This information is then plotted onto a map using the City's GIS system. The map shows each reporting districts by their respective high crime rates. A reporting district that has twice the number of crime reports than average is considered an area with a high crime rated Attached is a sample of the Event Summary Report and the subsequent map it produced. 61-1 mI*1t &Y r?Ei'ING LI1=i IF\ 1l T r=,tP RI 1Oil TU 13 31! c r: D r?lt) rtlii3 N1i? H1?)6 N 1 1 i:) E?111 x+11 B113 8115 C1(;) C1 i C1?3 +_ 1 i + C 12:5 C1 b CiZ? C1 C 13' C13?i X131 I:13:1 C 133 0134 0135 0136 0137 C 13B D14 [1140 D147 D 148 D 14':i D150 [1151 El 15:: D153 D154 D155 U156 D 1 =',8 i_i 159 Li 160 E16 Ei67 6168 Elo3 TOTAL EVENTS 4 17 3 1 1 ti c 1 99 19 4 6 13 3 3( i 9 35 lii 45 56 b 11 11 47 .3: ?34 167 48 15 b .. 1 73 43 18 94 14 63 44 38 11 66 1C) h 13 lii 14 PH r+ i 1 EVENTS 1 1 11 14 o4 3i; 4 22 c J 1 ?? .4 3 11 19 68 19 51 .j b 1 15 11 .33 10 145 `r 1 3 `c 3 11 1 o Pa; h' i EVENTS _3 1 G1 3 3c 16 17 14 i i) 1 i, 0 ,3 lJ 1?± l4 1 3 6 3 C 33 13 4 1U o 1 13 3 3! .3 51 13 15 4 :3(.) 4 3 1 3 TRHr=FiC EVENTS b iI 1 lti 11 1 7 1 1 ii ii Q 4 0 6 1 ii 1 6 1 32 6 1 l) ti 8 1 o i) 18 1 ii 1 1 U i? ?i OTHER EVENTS 118 4 (i (1 C 14 39 19 11 ?7 8 i. 7) 4 3 11 r 1 r_ 4 9 1 9 54 11 16 ii 2 14 4 ?9 1 49 8 4 l) 3 1 i 51 9 nECPRTPEVENT =UI+It+lt-,n`r B-t r.:EPORi ING DISTRICT ;EPORT .-Rill TO RU E 17C, E1 2 E173 E. C 1 76 Ei77 E 1 ";3 E179 E 1,;3 EIal E 18.3 F L??k i r 1 '? i Fi1L F194 F 1 F 197 ? 1 F'e F199 F 66 F2, Q1 F ? o2 F203 F,-7(--)4 F205 F ?Ci6 F Ci7 F()y. F2l:!9 F F 11 F 1Z' F 13 F314 G215 G 16 !-x.' 17 G,sic, G219 u- --l !3322' 6224 G225 H23i ) H231 H3 H233 TOTAL EVENTS 0 6 ti 18 L4 .34 64 34 1 4.j 14 22 r. 180 144 4- 97 38 164 110 141 1,194 53 66 3 8 74 ?3 61 58 95 54 9 3 . 11 47 17 1 Z96 1 120 1o8 X28 104 PART 1 EVENTS 1 1 1 a 1 l_; a i1 9 ( 3 1 1r 1 1: 519 e9 46 14 47 37 54 78 18 4 1 47 22 16 14 :38 a 1 11 13 3 a 9 tj 1 17 8 l_l J5 38 117 43 FART EVENTS 1 4 1 ii 4 3 7 7 ._' 3 1 46 .33 64 14 47 ;.r_? 4o 1 ot) 15 17 1 3 13 14 3 2 4 3C.) 2- 5 6 6 t; lj 76 3 o 35 23 61 2 7 TRAFFIC.: EVENTS t? ?i li 1 (i 1 ii 1 ti 1 7 5 r 11 1 i, 3 1?> 1: 1 t) 14 6 15 18 9 0 l•i 4 a 3 b 5 'r 1 7 19 1 5 3 l? 11 9 7 12 UTHER EVENT 1 1 i 3 4 7 3 J 14 31 -.9 3 11 421 56 24 1U 56 33 32 998 11 1 i 18 19 18 1 16 4 a 1 i 18 5 1 38 8 1 39 38 43 22 HS ?JF L?. i t00 0 -! )755 11 1c 17 3c 41 3 1' pLCpRTP06 • EVENT WMMiRY BY REPORTING DISTRICT REPORT kOM 000liM TO 12/'31 RU H234 H235 H236 H23 H38 H39 H24G H241 H42 H243 H244 H245 H246 H247 H248 H-49 H250 H252 H253 1155 j260 J261 3262 326.3 3264 J26c 5266 J267 K270 K271 K272 K 7:3 K274 K 275 K276 X77 K278 K279 K280 K281 2 K282 K283 K284 K285 K286 K287 K288 KX89 K296 K291 TOTAL EVENTS 33 10.3 IW ,E1 70 110 4 39 11 29i i 9 252 11 61 1d6 71 46 5 7 lo 3 9 1 i 102 9 44 43 16O 5o 33 32 185 80 164 45 18 11 39 41 38 18 85 gii 3 65 PART 1 EVENTS 0 4:3 35 24 (:) 36 15 7 145 86 4 Ali o 27 15 Z5 ?F 1 Il ii 1 o 42 3 13 7 67 26 17 9 so 26 78 14 7 5 7 0 4 1 35 28 27 FART 3 EVENTS 14 12 8 6 22 21 27 15 14 4 48 69 2 zo 50 16 9 15 l? 1 it o 1 2 1 21 14 11 40 7 6 12 43 24 36 11 J 5 16 1 11 5 17 24 1 23 TRAFFIC EVENTS i 4 6 0 16 8 16 3 28 ii 1 1 o 1(:4 9 3 3 1 1:l 2 1 0 1 i? 8 1 4 1 9 0 o 20 9 2 1 1 o 1 7 14 3 1 4 0 3 OTHER EVENTS 27 11 26 35 18 21 31 10 16 69 1 76 4 1 11 52 19 19 14 r_ 1 5 o 1:/ 2 0 1 31 3 13 4 44 17 1o 9 42 21 48 19 5 1 15 `2 • i 9 9 32- 34 0 12 AS OF 11 2 jt':PFTW-t, EVENT UfrMORi Nr REPORTING DISTRICT REPORT =ROM opul/55 TO W/W05 RU '292 .295 .296 L297 L98 L299 i300 .301 30 1310 1311 Y1:31' 1+131,:.3 A314 M315 QI b '•1;317 1320 N321 Q22 N323 iN324 5- N326 N327 N328 N329 N 33o N331 N332 0340 0343 0344 0346 0348 0350 0351 0352 0353 P370 P371 P372 P373 P376 TOTAL EVENTS 2 32 166 198 4 38 78 3 16 107 117 14 6 23 11 85 17.x:; 74 37 90 86 1 14 46 3 219 loo 62 4 18 a 4 1 3 6 12 11 22 59 1 1 FART 1 EVENTS g 57 9(j 2 15 40 1 6 34 42 6 3 16 20 6 41 71 2 23 33 38 3 8 17 13 103 46 2i; 1 3 1 t? 1 C 4 17 30 tj 1 Q TOTAL 11.840 4.438 PART EVENTS 8 11 48 56 15 14 1 48 55 3 4 1 17 25 51 34 6 18 29 4 11 11 56 39 13 1 6 3 1 o o 1 3 6 15 o 0 1 .863 TRAFFIC EVENTS O 21 11 1 , 1 4 3 1 1 i; 1 2 1 3 17 ij 1 i, 11 ij 6 i, ci 1 i? ij 4 1 1 , 82 OTHER EVENTS r_ 11 40 41 (; 7 22 1 4 21 17 3 0 1 13 3 18 48 24 5 22 19 4 4 18 b 49 23 3 0 9 i, t1 7 1 3 10 0 o 0 3.717 4S OF 10- EV 0000-0759 11 9 59 68 ll 9 3 1 3 38 4 4 (r 4 i, 18 4 30 47 12 3 19 22 1 11 9 45 31 14 0 9 1 1_1 13 3.109 I TOTAL CRIMES ANNUALIZED BASIS City of Auburn PJJjffff 100• p*r yoor School 176 r 203 V V7 =! PAO b" l SG S* 2n os 212 .ca S j / I?I f- v 2 2 2 7 - 236 r Q 220 ' / a x {7!g 2g lM+ademriiucs, wet 247 251 257 ? , cou 28 - ,? - 253 %/. 29' 296 Ellm l 179 281 28A 206 301 302 =87 29t 299 ' a 341 t milt vs>yt: 320 323 ' h I - 324 328 329 • 3y l/ w ti 3?S 3?4 345 316 t J!Z • ? •` 3e6 347 344 - - 3 3 350 SSI n` 373 SS7 v 352 no ,n 1Q I - 1 X22 _- _ - - 'V >u ? j 147 n I i SS Lt i I T ?! Lb s E2 <3 ui ` i 155 E ?yy EStii 47 !iii/,? i 63 i m r z ,1J r-3; r - ! i 1000 0 ^00 2000 JC00 +000 5000 sxc 'Y•: !-l'•: ?C00 OWNER °-- Caro amicm m _an m4 s rr. wr%n. M+ 0- 5 0 r a w5 :S '++wdw tar "- q onmet q 'lra?ew no" a"- ory. vet s MDT f4"9RMa ro ro. saran me wvrwa ••••••••• •••_ %ILES Block Watch Participant Questionnaire NAME: DATE: BLOCK WATCH PRECINCT: A. Please give us your reactions to the following Block Watch programs or events Block Watch Workshops 1 2 3 4 5 6 7 was not very was very informative informative Block Watch Newsletters 1 2 3 4 5 6 7 was not very was very informative informative B. Did you attend the Block Watch meetings ? yes no If yes, how useful was the information and ideas presented at the meetings ? 1 2 3 4 5 6 7 not useful very useful C. Compared to this time last year, please give us your impression on the following conditions in your neighborhood? TRUE FALSE I can safely walk the streets around my house at any time during the day. TRUE FALSE I was the victim of a crime within the past year. TRUE FALSE I am not aware of any crime committed within my neighborhood. TRUE FALSE All of my best friends live outside of my neighborhood. TRUE FALSE I talk to my next door neighbor at least once a month. TRUE FALSE I know at least one person within my immediate neighborhood that I can contact for help or for assistance. TRUE FALSE I think Block Watch prevents crime within my neighborhood. Program Name Washington Service Carps Project Name Auburn Youth Participation Initiative Getting Things Done Objective 2 S&Wcfts Activity: AmeriCorps members will provide one-on-one tutoring and mentoring to 20 at-risk From Component 1 on the objectives worksheet* students per trimester at the Muckleshoot Tribal School. ("Describe briefly the service activity you will be evaluating.") 1. Who will receive services? Members will mentor and tutor approximately 20 at-risk students per trimester May be included in either Component 1 or 5 on resulting in a 25% increase in attendance and an 80% increase in the student's worksheet. ("Describe briefly the service performance of basic reading, writing and mathematical skills as measured by a activity you will be evaluating." or "Estimate teacher survey. the number of people this activity will serve.") 2. Number served Assuming each Mentor/Tutor is assigned four to five students, then approximately From Component 5 on worksheet. ("Estimate the 20 students per trimester will be served. number of people this activity will serve.") 3. Desired result During the student's association with the AmeriCorps Team, each student will From Component 2 on worksheet. ("Explain what improve their daily attendance and basic skills in reading, math computation and change the described activity will produce.") writing skills. 4. Indicators Improved daily attendance, participation in school activities, increase in the number (What concrete, observable things will you of school assignments completed by the participating students, advancement to the look at to see whether you are making next grade level or graduation. progress toward your desired result?) 5. Method of measure Survey teachers to determine changes in student's academic performance, behavior From Component 3 on worksheet. ("Describe the and attendance. method you will use to determine if the described change occurs.") 6. Level (standard) of success At the end of the school year, 80% of the assigned students will demonstrate an Form Component 4 on worksheet. ("Try to increase in basic skills and 25% of the population will increase regular attendance define a level of success you hope to in school. achieve.") 7. Name/title of instruments used Quarterly Teacher Evaluation Reports that indicate changes in the student's From Component 3 on worksheet. ("Describe the academic performance, behavior, and attendance. method you will use to determine if the described change occurs.") 7a. Who and how many people will The student's teachers and teaching assistants along with the appropriate respond/fill out the instruments? administrative personnel. (Note: this may not apply for all instruments, for example, testing water quality.) 8a. Who is to collect the data? With the cooperation of the teachers and members, the AmeriCorps Coordinator 8b. How often? will gather the data at least once each trimester. 9a. Who will aggregate the data? AmeriCorps Coordinator with help and cooperation from an assigned school (tally on paper or enter into computer) district administrator. 9b. How often? 10a. Who will analyze the data? Principal of the Tribal School, school district administrators and the AmeriCorps 10b. How often? Coordinator 11. Who will turn the data into a report? Associate Planner assigned to act as the AmeriCorps Coordinator TEACHER EVALUATION FORM NAME OF STUDENT: NAME OF TEACHER: 1. Why did you refer this child to the AmeriCorps tutor ? GRADE: SCHOOL: 2. Has the reason for your request been addressed? (__) YES L_) NO 3. During the past trimester approximately how many hours of assistance did this student receive from an AmeriCorps member? Less than one hour per week Between 2 to 3 hours per week Between 1 to 2 hours per week More than 3 hours per week 4. Is the student's attitude towards school: when he or she started the program. 5. Are the student's homework habits: when he or she started the program. 6. Is the student's classwork: when he or she started the program. 7. Is the student's classroom behavior: when he or she started the program. 8. Are the student's social skills with peers: when he or she started the program. 9. Are the student's social skills with adults: when he or she started the program. 10. Is the student's attendance: when he or she started the program (_) Better Than (__j Worse Than (_) Same As (__) Better Than Worse Than (_) Same As (__) Better Than (_) Worse Than (_) Same As (__) Better Than (_) Worse Than (__) Same As (__) Better Than (_j Worse Than (_) Same As (__j Better Than (__) Worse Than (_) Same As (__) Better Than (__) Worse Than Same As Please put anything else you would like to tell us on the back of this form Program Name Washington Service Corps Project Name Auburn Youth Participation Initiative Getting Things Done Objective 3 S We s NEENMNNW? *('mmnnnent nnmhers helnw refer to the obiectives worksheets included with your AmeriCorps Renewal Application. Activity: AmeriCorps members will be assigned to selected "partners" of the City's From Component 1 on the objectives worksheet* Neighborhood Family Center to organize programs and events that train young ("Describe briefly the service activity you will be people how to develop effective leadership skills and organize service projects. evaluating.") 1. Who will receive services? The Neighborhood Family Center serves approximately 12,000 residents in south May be included in either Component 1 or 5 on Auburn. More than half of these residents are low income and one out of three worksheet. ("Describe briefly the service families with children have single parents. Estimate approximately 300 youth will activity you will be evaluating." or "Estimate receive the Peers Educating Peers curriculum during the program year. the number of people this activity will serve.") 2. Number served The Family Center has approximately two events per month with an average From Component 5 on worksheet. ("Estimate the attendance of 20 people per event. A combined total of 360 youth and adults number of people this activity will serve.") participate in Family Center events and the Peers Educating Peers curriculum. 3. Desired result Improved neighborhood organization and interaction demonstrated by an increase From Component 2 on worksheet. ("Explain what in locally initiated, community service projects. change the described activity will produce.") 4. Indicators Regular attendance at Family Center events will increase and youth groups will (What concrete, observable things will you begin planning, preparing and implementing a variety of community service look at to see whether you are making projects during the course of the program year. progress toward your desired result?) 5. Method of measure Completion of project portfolios by AmeriCorps members and participants.. From Component 3 on worksheet. ("Describe the method you will use to determine if the described change occurs.") 6. Level (standard) of success Attendance at the Neighborhood Family Center will increase 25% from the Form Component 4 on worksheet. ("Try to previous year and at least five youth groups will address youth needs and provide define a level of success you hope to approximately 100 hours of service to the larger community. achieve.") 7. Name/title of instruments used project Portfolios that include: Structured Journal, Attendance Sheets, Project From Component 3 on worksheet. ("Describe the Evaluation and Post-Project Questionnaire. method you will use to determine if the described change occurs.") 7a. Who and how many people will Each and/or service learnin project will have a portfolio prepared primarily group g respond/fill out the instruments? by the assigned AmeriCorps with help and cooperation from the participants (Note: this may not apply for all instruments, engaged in the group or project. for example, testing water quality.) 8a. Who is to collect the data? AmeriCorps members assigned as Service Learning Coordinators 8b. How often? 9a. Who will aggregate the data? AmeriCorps members with assistance from the AmeriCorps Coordinator (tally on paper or enter into computer) 9b. How often? 10a. Who will analyze the data? AmeriCorps Coordinator 10b. How often? 11. Who will turn the data into a AmeriCorps Coordinator will incorporate it into his quarterly reports. report? CORPORATION FOR NATIONAL ©5ERVICE PR mAR Check How You're E SECONOAR Identify Stakeholders & N Structured Journal Structured Journals provide feedback from participants about their service experience. Participants are asked to write in their journals on a regular basis (at least bi-weekly), responding to basic, open-ended questions posed by their supervisor to encourage reflec- tion. Structured journals help you understand the impact your program is having on partic- ipants (changing attitudes towards service, life, different types of people, etc.); receive feed- back on program activities; and glean insights into project development that might not oth- erwise be observed. They also help participants get more out of their service experience by encouraging them to reflect on what they've learned about themselves and others. In turn, this will help them become better service providers and citizens by heightening their aware- ness of and sensitivity to service issues. Uses • To learn about issues your participants are facing so you can better address these issues. • To receive a first-person account of site activities and glean insights on what works well and what needs to be re-worked. _ • To gain insight into relationships at sites and flag possible areas of conflict that need to be addressed. • To obtain."stories" to enhance your reports, storyboards, etc.. Benefits • Heightens understanding of participants' needs. • Enhances the participant's learning experience. • Improves the ability of participants to express themselves on paper. • Provides participants with a personal record of their feelings/experiences during their service. • Builds an extensive resource of descriptive information on your program, its impact, and its specific projects. • Requires little "set-up" time and is inexpensive. • Encourages reflection: The process of thinking through the questions you pose will teach participants to reflect on what they've learned and what they value. Limitations May seem like a personal intrusion to participants: Journals that are required, structured, and read by others may stifle participant honesty and enthusiasm. Before assigning jour- nals, make sure your participants-are willing to share their thoughts with you. Consider making journals voluntary or giving participants a choice of topics to write on (including whatever is on their minds). One problem with voluntary journals is that you may not hear from the participants you most need to understand better - those who are unhappy in the program. Also, if participants write on topics of their choice, it is difficult to spot changes in attitudes, etc.. • Takes time to read participants' journals and devise a system to synthesize and act on the information gathered. Implementation Tips 3 _ Y? • Have participants buy their own journal notebooks so they make a personal monetary investment and feel more of a commitment to writing in the notebooks. • Discuss the usefulness of structured journals with participants. Get their feedback on how they feel about writing in the journals, and if they feel comfortable sharing their thoughts with you. Also discuss how you will use the journal entries. • Try using diff erent approaches-to see what generates the most open feedback (d. g., have-- one group respond to questions while another free-writes). • Decide how often you want participants writing in the journals. Be careful about asking them to write too frequently, as they may burn out and pay less attention to what they are writing. Conversely, encourage them to write as frequently as they like and not to limit themselves solely to the questions you pose. • Determine what you want to know about participants' service experience: ask some questions repeatedly to monitor change in attitudes, e.g., what was the best and worst thing about your service experience this month or what did you team about yourself and/or others this month (see Attachment) introduce new questions to spark reflection on a certain issue (e.g., you might ask participants involved with a homeless shelter such questions as what do you think are the causes of homelessness, how do you think we should address this issue, how has your service experience affected the way you act toward homeless people. 2 Handbook for Continuous Improvement • Collect journals regularly, and return them promptly. You may want to add comments that encourage participants to expand further on a particular issue or to consider another perspective. Or, leave the jour- nals blank so as not to alter their entries. Talk to your participants and ask them what they would like you to do. ALWAYS ask permission before sharing a participant's writing with • Develop a system for keeping track of the entries (e.g., copying sec- others. tions and keeping them in a binder, entering them in to a computer file). Always ask permission before sharing a participant's writing with others. • Ask participants to review their journals at the end of their term of service and write a final entry (to be given to the program) on what they've seen, done and felt over the past months. Have them reflect on what changes they've noted in themselves and the effect they've had on others. Keep a binder of these final entries so that other participants can learn from their experiences. Attachment Z Possible Topics for Journal Reflection Tools & Practices: Structured Journal I Structured Journal Possible Topics for Journal Reflection Possible Topics for Journal Reflection • What was hard or easy about this week/month? (Think about the people you serve, the people you work with, your service activities are; you can write about an ongoing problem or a particular incident) • What is getting harder/easier about being a Corpsmember? Why? • What have you accomplished? • What have you learned? • What conclusions have you drawn? • What have you "given" of yourself to others this week? • What have others "given" of themselves to you? What have you learned because of it? • Describe a particularly difficult situation. How did you deal with it? Were you a "leader"? How would you approach it differently if it were to happen again? • How is this experience changing you? 4 Handbook for Continuous Improvement .r r 1 .mot u u VI u u Ix Ci u Q L u E u Ci u r O U u a E ea M _ u 33 CL L O A O C px L u S 0 u E u s w L O u E C L O O A O K u u w c u u E 0 L u C L as Jv V u t V u IM u 4 u c c 'v ? u 0. Q 00 c a? ? La 04 C . O r 6u 00 C • ? V F 00 c 1 ? a?+ Cl* Q oD C ?A C . O r rO ?G Q 00 c u ?C 00 c JU a? ? A u z L. s u N X u N a°i 00 U • 0 O = O O .r O m ? r y I..i s r * r_ i•• a Q s Q s cc o U cn ( F 3 -3 hu 1UU! CB#t Community Service Project Evaluation 21st Century Scholars AmeriCorps Program SECTION 1: TO BE COMPLETED BY VOLUNTEERS Project Location: Date: City: I am a: 21 st Century Scholar Parent of a 21 st Century Scholar 1. What type of service did you complete? 2. Why did you choose to participate in this community service project? 3. How did you feel after you completed your service? unsatisfied somewhat satisfied satisfied very satisfied 4. How do you feel about the impact of your service? I made no impact. I helped make a small impact on individual(s) or the environment. I helped make a satisfactory impact on individual(s) or the environment. I helped make a significant impact on individual(s) or the environment. Community Member extremely satisfied 5. Have you ever volunteered before today? -Yes No If yes, when was the last time you volunteered? 5. How interested are you in volunteering again? not at all interested -somewhat interested interested very interested extremely interested Thank you for your service! Please return to the 21st Century Scholars Coordinator or AmeriCorps Member. SECTION 2: TO BE COMPLETED BY AGENCY LEADERS/SERVICE RECIPIENTS Project Location: 1. What service(s) did the AmeriCorps Members and volunteers perform? Date: City: 2. How would you rate the organization of the service project? unsatisfactory weak satisfactory excellent superior 3. How satisfied were you with the results of the service project? unsatisfied somewhat satisfied satisfied very satisfied extremely satisfied 4. Briefly explain the impact of the project on the community, your organization, individuals, or the environment: Thank you for your comments! Please return to the 21st Century Scholars Coordinator or AmeriCorps Membe) Your Name Teacher's Name Please tell us about your service learning experience This is the second part of our project concerning how people can help improve their communities. Please tell us what you think. There are no right or wrong answers. Whatever you say we will take seriously as something to which we should pay attention; and it won't affect your grade. We appreciate your help. 1. Please describe what you did for your service learning assignment: 2a. Did you complete the service learning assignment? ? Yes [] No 2b. If you didn't complete it, was there anything that could have helped you get it done? 3 What do you think about the Service Learning Project the teacher assigned: . each linebelow Mark the best response Not Maybe Probably Ho w much do you agree with the following: at all a Little Definitely a) I liked doing it O b) c) I learned something useful from it I'd done something like this before, but this was different (D O O d) I already knew all I needed to before the assignment O © 03 e) I would tell a friend this was a useful assignment . Q © 03 f) I was able to have a positive impact on my community ( OO O or neighborhood as a result of doing this assignment g) I can see that I can change things in my community or neighborhood more than before I worked on the assignment( O (D a h) I would do it again, even if it were not absolutely required0 O © a O Draft Post Student SL Assessm, Prepared by Dr. Jo Ann Intili, Project STAR, for LA Partnership for Service Learning, CRF Pave Your Name Teacher's Name 5. Please tell us a little about yourself - Mark the Not Do you feel you can at all a) change how things are in your neighborhood? (D b) have a positive effect on your community? (D c) be part of a project that has a positive impact on people? O best response for A A Little Lot O O p (z p O ,ach line below A real Lot 6. What do you think about the Service Learning Project the teacher has described: How much do you agree with the following: a) I think I'll like doing it b) I think I'll have fun doing it c) I think I'll learn something useful from it d) I've already done something like this before e) I already know all I need to about the assignment f) I think I'll be able to complete it g) It's too much work I don't think I'll complete it h) Would you do this if it was an optional assignment? Mark the best response for each line below Not Maybe Probably at all a Little Definitely (D O O p p O p p O p p O p O O p O p p p p p O 7. If you were to guess or predict what you would learn from the assignment, what would you guess? Please list what you think you will learn from completing the assignment. Please be serious with your answer 8. If you and your classmates completed this assignment successfully, what do you think the community or the people receiving the service would get out of it or learn from it? What the community would get out of this service Draft Pre Student SL AssessmE Prepared by Dr. Jo Ann Intili, Project STAR, for LA Partnership for Service Learning, CRF Page Gen- Post-project (luestionnaire - Community Improvement Projects Name Birthdate Sex (M or F) Date INSTRUCTIONS To answer these questions, there are two steps. 1) First, decide whether YOU are more like the kids on the left side QE the kids on the right side. Don't mark any thing down yet. 2) Second , decide whether that statem ent is almost always true for you or someti mes true for you. Now, put an X in the proper box. IMPORTANTI Ma rk exactly one of the four boxes for each question. ALMOST SOME- SCME- ALMOST ALWAYS TIMES TIMES ALWAYS TRUE TRUE TRUE TRUE FOR ME FOR ME FOR ME FOR ME :---- :---: Some kids feel bad Other kids don't let ----; ;---; when they let people BUT it bother them that 1. 1___1 1___1 down who depend on much when they let them. people down. Some kids think it's Other kids think that :---- :---: the responsibility of BUT everyone should just :---- ----- • the community to take take care of them- , care of people who can't selves. take care of themselves. ----- ----- Some kids let others Other kids help in a ----: ;---; • do most of the work BUT group all they can. 3. In a group. :---- ----- Some kids seem to find Other kids find taking :---:----- • time to work on other BUT care of their own 4. people's problems. problems more than enough to do. ?---- :---: Some kids are inter- Other kids are not :---- :---- • ested in doing some- BUT that interested in 5. 1---1 1---? thing about problems working on problems In the community. in the community. Some kids will volun- Other kids will not ?---- :---: teer to help with some- volunteer to help with :---: :---: ' thing because they BUT something because feel , 6. feel they have a lot they have nothing to ---1 to offer. offer. ----: :---: Some kids don't think Other kids think they ----: :---- ' they have much to say BUT can pretty much con- ,. about what happens to trol what will happen them in their lives. to them in their lives. PLEASE GO ON TO PAGE 2. 2 ALMOST SOME- SOME- ALMOST ALWAYS TIMES TIMES ALWAYS TRUE TRUE TRUE TRUE FOR ME FOR ME FOR ME FOR ME ----: ----: Some kids work as Other kids usually ----- hard as they can on don't put much effort g, s___s s___s their volunteer BUT into their volunteer assignments. assignments. ----- :---: Some kids would rather Other kids feel com- ;---: :---; not present ideas in BUT fortable in presenting g, a group discussion. ideas in a group discussion. Some kids think they Other kids don't think ----- ----- should let others they need to let ----- ;---- know when they can't BUT others know when they , 10.1---1 1---i keep an appointment. can't keep an appointment. Some kids think people Other kids think people ----- ----: should only help should help people in :---- ;---: people they know-- BUT general--whether they like close friends know them personally and relatives. or not. ----- :---: For some kids, it Other kids somehow ----- ----- seems too difficult BUT manage to keep to keep commitments. commitments. ----- :---: Some kids' ideas are Other kids have a hard :---: :---: almost always BUT time getting the group 13.1___1 listened to in a to pay attention to group. their ideas. ----- Some kids believe Other kids believe volunteering should BUT volunteering should be 14.1--_s be done by adults done by kids as well and not kids. as adults. Some kids don't think Other kids think you :---: :---: it makes much sense should volunteer :---: :---- . to volunteer because BUT although you don't 15.1---s---j you don't get paid get paid for it. _---? 1---1 for it. :---: :---: Some kids are good Other kids don't see :---: :---: . at helping people. BUT helping others as one 16.1--_s of their strong points. PLEASE GO ON TO PAGE 3. 3 ALMOST SOME- SOME- ALMOST ALWAYS TIMES TIMES ALWAYS TRUE TRUE TRUE TRUE FOR ME FOR ME FOR ME FOR ME When working with a Other kids don't feel :---: ----- group, some kids feel they have to perform :---- they have to perform BUT the tasks their group , 17.1___1 1___1 the tasks they get assigns to them. 1---1 1---? assigned to do. ----- ----: Some kids think when For other kids, there ----: ;---; good things happen BUT seem to be no reasons-- 18.1 --- 1 1--_i it's because of it's just luck when something they did. things go well. ----- :---: Some kids would Other kids would ----- ----- rather have someone BUT rather make up their 19.1___s 1___s tell them what their own lists of jobs to assignments are. do. ----- ----: • Some kids aren't that Other kids would feel :---: :---: worried about BUT really bad about not 20.-L --- 1___1 finishing jobs they finishing a job they promised they would do. promised they would do. Some kids think they Other kids don't think ----- ----: are able to help they can do anything :---: :---: solve problems in BUT about them because a 21.1--_i 1--_i the community. few powerful people 1--_i 1---1 decide everything. Please be sure you have marked only one box for each question. Thank you. PLEASE GO ON TO PAGE 4. Program Name Washington Service Corps Project Name Auburn Youth Participation Initiative Community Strengthening Objective 1 ZU tv?i??--A *Component numbers below refer to the obiectives worksheets included with your AmeriCorps Renewal Application. Activity: AmeriCorps members will plan, prepare, implement, reflect and celebrate various From Component 1 on the objectives worksheet* types of service learning projects while at the same time, recruit and train local ("Describe briefly the service activity you will residents to perform similar projects at Auburn's Late Program or comparable be evaluating.") events. 1. Who will receive services? At the City's Late Night program or comparable events, the AmeriCorps Team will May be included in either Component I or 5 on model effective service learning projects, offer workshops and/or entertainment to worksheet. ("Describe briefly the service youth and participating sponsors who may, in turn, want to continue similar activity you will be evaluating." or "Estimate projects, workshops or entertainment on their own. the number of people this activity will serve.") 2. Number served Approximately 300 youth attend each Late Night Program. From Component 5 on worksheet. ("Estimate the number of people this activity will serve.") 3. Desired result Increase in the number of youth and civic groups participating in the Late Night From Component 2 on worksheet. ("Explain what program, or comparable events, that provide organized youth activities in a drug- change the described activity will produce.") free and violence-free environment. 4. Indicators An increase in the number of youth and civic groups that are sponsoring activities (What concrete, observable things will you at Late Night events and/or other youth oriented events. look at to see whether you are making progress toward your desired result?) 5. Method of measure Completion of project portfolios by AmeriCorps members and participants. From Component 3 on worksheet. ("Describe the method you will use to determine if the described change occurs.") 6. Level (standard) of success 80% of the participants will indicate a change in knowledge regarding service Form Component 4 on worksheet. ("Try to learning and an increase in satisfaction with their participation in service learning define a level of success you hope to projects. achieve.") 7. Name/title of instruments used Project Portfolios that include: Structured Journal, Attendance Sheets, Program From Component 3 on worksheet. ("Describe the Assessment Worksheets, Project Evaluation, Post-Project Questionnaire, Leader method you will use to determine if the Rating Form, and Project Report Card. described change occurs.") 7a. Who and how many people will Auburn's 10 AmeriCorps members along with the participants engaged in their respond/fill out the instruments? service learning projects. (Note: this may not apply for all instruments, for example, testing water quality.) 8a. Who is to collect the data? AmeriCorps Coordinator will collect the data following each event. 8b. How often? 9a. Who will aggregate the data? AmeriCorps Coordinator (tally on paper or enter into computer) 9b. How often? 10a. Who will analyze the data? AmeriCorps Coordinator 10b. How often? 11. Who will turn the data into a AmeriCorps Coordinator will incorporate it into his quarterly reports. report? f' 1 ., DATE: September 4, 1997 FROM: Bill Mandeville RE: Project Portfolios: Neighborhood Family Center 620 37th Street S.E., Auburn, Washington More INFO? -- contact: Bill Mandeville -- 804-5029 Project Portfolios is an administrative instrument that helps identify, organize, track and evaluate meaningful service projects. It was designed primarily for the Auburn AmeriCorps Team. Its intended use includes, but is not limited to, measuring the impact of community service projects on the participant's ethic for community service and on the development of their leadership skills. AmeriCorps members, along with other staff members, must maintain a Project Portfolio on each group to which they are assigned to provide technical assistance, leadership training, and coaching. PROJECT PORTFOLIO CONTENTS: Structured Journal: Narrative account of the staff member's involvement with their assigned group. Makes the member focus on what they are learning and the impact that the experience is having upon them and their leadership/coaching skills. Attendance Sheet: Tracks the volunteers who participated in the group and/or activity. 3. Program Assessment Worksheet tracks the projects and activities undertaken by the group along with the skills and protective facts they offered. 5. Community Service Project Evaluation: Completed by each volunteer who participated in a community service project 6. Post Project Questionnaire: Completed by each volunteer who participated in a community service project. It measures the impact of the project on the participant's ethic for community service. It may be used as both a pre- and post-project questionnaire in order to measure changes in the participant's community service ethic. 7. Youth Leader Rating Form: {optional} Participants citculate this questionnaire among their colleagues, teachers and/or mentors to measure various aspects of their leadership skills. 8. Program/Project Report Card: Staff person uses this report card to report on the group's progress and/or accomplishments. Program Name Washington Service Corps Project Name Auburn Youth Participation Initiative Community Strengthening Objective 2 Cas *C'omnonent numbers below refer to the obiectives worksheets included with your AmeriCorps Renewal Application. Activity: Build strong communities by engaging non-member volunteers from local From Component 1 on the objectives worksheet* communities in which projects are conducted to cooperate in national service ("Describe briefly the service activity you will efforts to achieve lasting and constructive change. be evaluating.") 1. Who will receive services? The volunteers, the projects and local communities will benefit. May be included in either Component 1 or 5 on worksheet. ("Describe briefly the service activity you will be evaluating." or "Estimate the number of people this activity will serve.") 2. Number served Auburn's AmeriCorps will recruit a total of approximately 50 volunteers to From Component 5 on worksheet. ("Estimate the participate in their service learning projects. number of people this activity will serve.") 3. Desired result An increase in the number of volunteers serving on AmeriCorps-sponsored service From Component 2 on worksheet. ("Explain what activities with emphasis on contributions by a diverse group of citizens who might change the described activity will produce.") not otherwise serve, work, or learn together. 4. Indicators An increasing number of volunteers participating in service learning projects. (What concrete, observable things will you look at to see whether you are making progress toward your desired result?) 5. Method of measure We will track the number of hours of service contributed by non-member From Component 3 on worksheet. ("Describe the volunteers using a Volunteer Sign-In Sheet. The quality of the volunteer's service method you will use to determine if the described experience with emphasis on satisfaction and willingness to serve will be tracked change occurs.") using a Volunteer Survey. 6. Level (standard) of success The standard of success is 50 volunteers contributing 100 hours of service. Form Component 4 on worksheet. ("Try to define a level of success you hope to achieve.") 7. Name/title of instruments used We will track the number of hours of service contributed by non-member From Component 3 on worksheet. (Tescribe the volunteers using a Volunteer Sign-In Sheet. The quality of the volunteer's service method you will use to determine if the experience with emphasis on satisfaction and willingness to serve will be tracked described change occurs.") using a Volunteer Survey. 7a. Who and how many people will Auburn's 10 AmeriCorps members. respond/fill out the instruments? (Note: this may not apply for all instruments, for example, testing water quality.) 8a. Who is to collect the data? AmeriCorps Coordinator will collect the data at least once during program year. 8b. How often? 9a. Who will aggregate the data? AmeriCorps Coordinator will tabulate the data at least once during program year. (tally on paper or enter into computer) 9b. How often? 10a. Who will analyze the data? AmeriCorps Coordinator. 10b. How often? 11. Who will turn the data into a AmeriCorps Coordinator will incorporate it into his quarterly reports. report? Washington Service Corps/AmeriCorps Site Name Volunteer Survey (For ongoing volunteers) Dear volunteer: Thank you for taking the time to help serve and improve your community. We would like to know about the experience of the volunteers they help recruit, train and/or supervise. Please take a few minutes to provide us with the following information. (Return Directions 1. Please briefly describe the volunteer work you do: 2. What role did the AmeriCorps Member play in your volunteer participation? (_) Provided information to me. (_) Supervised me. (_) Recruited me. (_) No role. (_) Trained me. (_) Other role (please specify) 3. Would you have volunteered if the AmeriCorps Member were not involved? Definitely (_) Probably (_) Not Sure (_) Probably Not (_) Definitely Not 4. What have you gained from doing this volunteer work? (Please check all that apply.) (_) Personal satisfaction Increased knowledge U Increased skills (_) Career contacts Social contacts (_) Other (Please specify) 5. Do you plan to continue volunteering in the coming year? (Please check one.) (_) I will definitely volunteer. What has influenced this decision? (_) I will probably volunteer. (_) I may or may not volunteer. I will probably not volunteer. I will definitely not volunteer. Comments: Thank you for your help! • • • • • • Sample Volunteer Sign in Sheet (For one-time events) Event Date Volunteer Name Time in Time out Total volunteers this page Total hours contributed, this page Note: this sample can be modified with columns containing other relevant information such as volunteer phone numbers or addresses to keep better track of walk in volunteers, or with a column to keep track of tasks or sites at which volunteer work is being done. Program Name Washington Service Corps Project Name Auburn Youth Participation Initiative Community Strengthening Objective 3 ScS * C'omnonent numbers below refer to the obiectives worksheets included with your AmeriCorps Renewal Application. Activity: Initiate and participate in regional collaborative activities with other AmeriCorps From Component 1 on the objectives worksheet* National Service programs and traditional volunteer organizations within the ("Describe briefly the service activity you will region. be evaluating.") 1. Who will receive services? The AmeriCorps members, the projects, volunteers and local communities will May be included in either Component 1 or 5 on benefit. worksheet. ("Describe briefly the service activity you will be evaluating." or "Estimate the number of people this activity will serve.") 2. Number served 10 AmeriCorps members, local volunteers and the local community From Component 5 on worksheet. ("Estimate the number of people this activity will serve.") 3. Desired result Regional activities allow National Service members to network, collaborate and From Component 2 on worksheet. (`Explain what share experiences with their colleagues. As a result, AmeriCorps members and change the described activity will produce.") sponsor organizations may partner on community service projects, join together for training and gain an increased understanding of the capacity of the region to meet its needs. 4. Indicators Increased communication with other programs in the region. (What concrete, observable things will you look at to see whether you are making progress toward your desired result?) 5. Method of measure Using a CNS Organization Contract Sheet, we will document community From Component 3 on worksheet. ("Describe the strengthening activities occurring within the region to build capacity, facilitate method you will use to determine if the described sharing of information and resources, and developing members. change occurs.") 6. Level (standard) of success projects sponsored by the WSC will participate in one or more collaborative efforts Form Component 4 on worksheet. ("Try to each quarter. define a level of success you hope to achieve.") 7. Name/title of instruments used CNS Organization Contact Sheet From Component 3 on worksheet. ("Describe the method you will use to determine if the described change occurs.") 7a. Who and how many people will Auburn's 10 AmeriCorps members. respond/fill out the instruments? (Note: this may not apply for all instruments, for example, testing water quality.) 8a. Who is to collect the data? AmeriCorps Coordinator will collect the data at least once during program year. 8b. How often? 9a. Who will aggregate the data? AmeriCorps Coordinator will tabulate the data at least once during program year. (tally on paper or enter into computer) 9b. How often? 10a. Who will analyze the data? AmeriCorps Coordinator. 10b. How often? 11. Who will turn the data into a AmeriCorps Coordinator will incorporate it into his quarterly reports. report? • • • • . • Site Name Name Date Collaboration Tracking Form (Short Version) Quarter (circle one): 1 2 3 4 Dear Site Supervisor: Washington Service Corps would like to know the efforts that you made to collaborate with other CNS sponsored and traditional volunteer organizations in your community. Please indicate below how many other CNS sponsored organizations exist in your community, and provide the requested information about your collaboration efforts. Please complete one row for each organization you collaborated with or attempted to collaborate with this quarter. How Many CNS Sponsored Organizations Operate In Your Community? Other AmeriCorps'State /National Grand Parents, Senior Companions) NCCC Education/K.121 Community Based VISTA Contact Sheet Senior Corps (RSVP, Foster Learn and Serve Higher Type Organization Contacted through: What type of collaboration did you plan? Contacted apply. Check all that apply: (_) Recruitment and training (_) Participation in joint servic (_)CNS (_) LETTER (_) FAX (_) Advise/Information (_) Planning /Networking (_) EMAIL (-)PHONE (_) Media/Marketing (_) Other. (-)Other {_) IN PERSON (_) OTHER: Initial Contact Date (_) Recruitment and training (_) Participation in joint servo (_)CNS (-)LETTER {_) FAX (_) Advise/Information (_) Planning /Networking (J EMAIL (-)PHONE (_) Media/Marketing (-J Other: (-)Other (J IN PERSON (_) OTHER: Initial Contact Date (J Recruitment and training U Participation in joint servil (_)CNS (J LETTER (J FAX (-J Advise/Information Planning /Networking (J EMAIL (JPHONE (J Media/Marketing Other. (-)Other U IN PERSON U OTHER: Initial Contact Date U Recruitment and training U Participation in joint servi (_)CNS (J LETTER (J FAX (J Advise/Information (-J Planning /Networking (J EMAIL (JPHONE (_) Media/Marketing Other. (-)Other (J IN PERSON (J OTHER: Initial Contact Date Washington Service CorpslAmeriCorps Site Name Collaboration Tracking Form (Long Version) Dear Site Supervisor: Washington Service Corps would like to know about the efforts that you have made to collaborate with other CNS sponsored and traditional volunteer organizations in your community. Please indicate below how many other CNS sponsored organizations exist in your community. On the following sheets, please provide the requested information about your collaboration efforts with other CNS and traditional volunteer organizations. Please complete one sheet for each organization you attempt to collaborate with each quarter. How Many CNS Sponsored Organizations Operate In Your Community? Other AmeriCorps*State /National Grand Parents; Senior Companions) Senior Corps (RSVP, Foster NCCC EducationlK•121 Community Based Learn and Serve Higher VISTA Washington Service Corps/AmeriCorps Site Name Name Your Date Started Complete one sheet for each organization you collaborate with each quarter. Please provide the following information about the organization you are working with: Organization Name: CNS Sponsored:(-) Yes (_) No E-mail: Contact Name: Contact Phone: (_) Fax: (_) Address: Notes on organization: What type of collaboration do you plan to conduct with this organization? Recruitment and training (_) Participation in joint service (_) Advise/Information (_) Planning /Networking (_) Media/Marketing (_) Other: (Please specify) Contact Date Contacted through: Notes on Collabor,? Check one: (-)LETTER (J FAX (J EMAIL (-)PHONE {J IN PERSON (J OTHER: Contact Date (J LETTER (J FAX (_) EMAIL (JPHONE (J IN PERSON (J OTHER: Contact Date (J LETTER (J FAX (J EMAIL (JPHONE (J IN PERSON (J OTHER: Contact Date (-)LETTER (J FAX (J EMAIL (JPHONE (_) IN PERSON (J OTHER: Contact Date What was the outcome of this collaboration effort? (_) No Response U Collaboration is planned to occur (_) Collaboration has not occurred (_) Collaboration has occurred Program Name Washington Service Corps ake Project Name Auburn Youth Participation Initiative Cms Member Development Objective 1 *Component numbers below refer to the objectives worksheets included with your AmeriCorps Renewal Application. Activity: AmeriCorps members will receive training regarding community mobilization and From Component 1 on the objectives worksheet* neighborhood development strategies resulting in neighborhood action plans and a ("Describe briefly the service activity you will resource inventory of selected neighborhoods. be evaluating.") 1. Who will receive services? Auburn's 10 AmeriCorps members will receive approximately 100 hours of May be included in either Component 1 or 5 on training regarding community mobilization, crime prevention, and neighborhood worksheet. ("Describe briefly the service development. activity you will be evaluating." or "Estimate the number of people this activity will serve.") 2. Number served 10 AmeriCorps members. From Component 5 on worksheet. ("Estimate the number of people this activity will serve.") 3. Desired result Members will gain skills to organize and revitalize neighborhoods. From Component 2 on worksheet. ("Explain what change the described activity will produce.") 4. Indicators Auburn's AmeriCorps members will begin demonstrating the skills they learned (What concrete, observable things will you through the service learning projects they plan, prepare and implement. look at to see whether you are making progress toward your desired result?) 5. Method of measure Members will demonstrate completion of training elements by submitting records From Component 3 on worksheet. ("Describe the of successful completion and/or through appropriate feedback forms. method you will use to determine if the described change occurs.") 6. Level (standard) of success Ninety percent (90%) will indicate an enhanced awareness of neighborhood Form Component 4 on worksheet. ("Try to development and organization. define a level of success you hope to achieve.") 7. Name/title of instruments used Records of successful completion or certification and completion of a Member From Component 3 on worksheet. ("Describe the Development Feedback Form. method you will use to determine if the described change occurs.") 7a. Who and how many people will Auburn's 10 AmeriCorps members. respond/fill out the instruments? (Note: this may not apply for all instruments, for example, testing water quality.) 8a. Who is to collect the data? AmeriCorps Coordinator will collect the data at least once during program year. 8b. How often? 9a. Who will aggregate the data? AmeriCorps Coordinator will tabulate the data at least once during program year. (tally on paper or enter into computer) 9b. How often? 10a. Who will analyze the data? AmeriCorps Coordinator. 10b. How often? 11. Who will turn the data into a AmeriCorps Coordinator will incorporate it into his quarterly reports. report? Washington Service Corps/AmeriCorps Site Name AmeriCorps Member Development Feedback Form Name: Date: Quarter: 1 2 3 4 Please indicate whether or not you participated in each training and rate the effectiveness of each training. Did the training improve your ability to provide AmeriCorps services? Check One Conflict Resolution YES NO Not at all Date Provided (__) Somewhat Source/Title Yes, definitely Communication Skills YES C_) Not at all Date Provided NO Somewhat Source/Title (__) Yes, definitely First Aid/CPR YES NO Not at all Date Provided (_} Somewhat Source/Title (__) Yes, definitely Career Development YES Not at all Date Provided NO (j Somewhat Source/Title Yes, definitely Service Leaming YES Not at all Date Provided NO Somewhat Source/Title Yes, definitely Risk Prevention YES U Not at all Date Provided NO Somewhat Source/Title Yes, definitely YES U Not at all Leadership Skills NO C_) Somewhat Date Provided (j Yes, definitely Sourcefritle Team Building YES Not at all Date Provided NO U Somewhat Source/Title (j Yes, definitely Did the training improve your ability to further your career goals? Check One Not at all U Somewhat U Yes, definitely (__) Not at all C_) Somewhat U Yes, definitely U Not at all C_j Somewhat (_) Yes, definitely U Not at all (__) Somewhat U Yes, definitely (J Not at all U Somewhat U Yes, definitely Not at all Somewhat Yes, definitely U Not at all (__) Somewhat (_j Yes, definitely (_) Not at all U Somewhat U Yes, definitely Participated? Did the training Did the training improve your ability improve your ability to provide to further your AmeriCorps services? career goals? Check One Check One Community Mobilization YES Not at all Not at all Date Provided NO Somewhat Somewhat Source/Title (__) Yes, definitely Yes, definitely Resource Inventory YES Not at all Not at all Date Provided NO Somewhat { Somewhat Source/Title C_) Yes, definitely U Yes, definitely Neighborhood Planning YES U Not at all Not at all Date Provided NO U Somewhat U Somewhat Source/Title Yes, definitely (_j Yes, definitely Neighborhood Strategies YES Not at all Not at all Date Provided NO C_) Somewhat C__) Somewhat Source/Title (_) Yes, definitely C_) Yes, definitely YES Not at all C._) Not at all Date Provided NO Somewhat Somewhat Source/Title Yes, definitely Yes, definitely YES U Not at all U Not at all Date Provided NO U Somewhat (_) Somewhat Source/Title Yes, definitely U Yes, definitely Comments: Washington Service Corps/AmeriCorps Site Name AmeriCorps Member Development-Completion Criteria Name: Date: Quarter: 1 2 3 4 Dear Site Supervisor: Please describe your site's criteria for completing each of the following trainings, the date offered, and records of completion to be maintained for each. You have the option of completing this form once, at the beginning of the program year, or updating it quarterly. Criteria for Completion? Record of completion? (For example, hours of attendance, (For example, instructor certification, post course test certification record, test passed at 84% or better.) scores, instructor sign- off, member portfolio.) Conflict Resolution Date Planned Source/ Title Communication Skills Date Planned Source/Title First Aid/CPR Date Planned Source/Title Career Development Date Planned Source/ Title Service Learning Date Planned Source/Title Risk Prevention Date Planned Source/Title Leadership Skills Date Planned Source/Title Washington Service Corps/AmeriCorps Team Building Date Planned Source/Title Community Mobilization Date Planned Source/Title Resource Inventory Date Planned Source/Title Neighborhood Planning Date Planned Source/Title Neighborhood Strategies Date Planned Source[Title Program Name Washington Service Corps Project Name Auburn Youth Participation Initiative Member Development Objective 2 Zf1 taacfts *Comnonent numbers below refer to the objectives worksheets included with your AmeriCorps Renewal Application. Activity: During their term of service AmeriCorps members will participate in activities that From Component 1 on the objectives worksheet* will enhance their ethic of service and help them continue to develop a lifelong ("Describe briefly the service activity you will commitment to service. be evaluating.") 1. Who will receive services? Auburn's 10 AmeriCorps members will receive training on how to organize, May be included in either Component 1 or 5 on implement and recruit volunteers for service learning projects. worksheet. ("Describe briefly the service activity you will be evaluating." or "Estimate the number of people this activity will serve.") 2. Number served 10 AmeriCorps members. From Component 5 on worksheet. ("Estimate the number of people this activity will serve.") 3. Desired result As a result of participating in AmeriCorps, members will enhance or develop their From Comnonent 2 on worksheet. ("Explain what ethic of service and participate in community and volunteer activities. change the described activity will produce.") 4. Indicators Auburn's AmeriCorps Team will identify, plan, prepare and implement at least five (What concrete, observable things will you service learning projects that provide a meaningful service to the Auburn look at to see whether you are making community. progress toward your desired result?) 5. Method of measure pre- and post-service surveys will be given to members. From Component 3 on worksheet. ("Describe the method you will use to determine if the described change occurs.") 6. Level (standard) of success Ninety percent (90%) of the members who successfully complete their term of Form Component 4 on worksheet. ("Try to service will indicate the development or enhancement of an ethic of service and define a level of success you hope to increased commitment toward continuing community and/or volunteer service in achieve.") the future. 7. Name/title of instruments used Civic Service Reflection Form From Component 3 on worksheet. ("Describe the method you will use to determine if the described change occurs.") 7a. Who and how many people will Auburn's 10 AmeriCorps members. respond/fill out the instruments? (Note: this may not apply for all instruments, for example, testing water quality.) 8a. Who is to collect the data? AmeriCorps Coordinator will collect the data at least once during program year. 8b. How often? 9a. Who will aggregate the data? AmeriCorps Coordinator will tabulate the data at least once during program year. (tally on paper or enter into computer) 9b. How often? 10a. Who will analyze the data? AmeriCorps Coordinator. 10b. How often? 11. Who will turn the data into a AmeriCorps Coordinator will incorporate it into his quarterly reports. report? Washington Service Corps/AmeriCorps Site Name AmeriCorps Member Pre-Service Reflection Form Name: Date; Dear AmeriCorps Member: Washington Service Corps would like to know about your community' participation during your non-AmeriCorps time, and how you approach community service. Please take a few minutes to complete this and return it to (Return Directions) 1. I am a registered voter or plan to (_) Yes (_) No register when I turn 18. 2. 1 am aware of my community's needs. (_) Frequently (_) Occasionally (_) Rarefy (_) Never 3. 1 provide solutions or services to help (_) Frequently (_) Occasionally (_} Rarely (_) Never meet m community's needs. 4. 1 participate in community boards, Frequently (_) Occasionally (_} Rarely (_) Never government or community forums. 5. 1 volunteer my time to community (_) Frequently (_) Occasionally (_) Rarely Never organizations and events. 6. 1 look for ways to express my opinions (_) Frequently Occasionally (_) Rarely Never in the community (e.g. writing letters, making phone calls and attending meetings.) 7. 1 look for ways to preserve and protect (_) Frequently (_) Occasionally (_) Rarely (-j Never m environment. 8. 1 assist my neighbor:, when they need Frequently (_) Occasionally (_) Rarely (_) Never help. 9. 1 find ways to give back to the (?} Frequently {_) Occasionally (_) Rarely Never community. 10. 1 am aware of community resources. (.j Frequently (_) Occasionally {_) Rarely (_) Never 11. What does the term "ethic of service" mean? 12. How strong do you feel your ethic of I (_-) very U Strong (,--) Not very service is? Strong Strong Comments: (-)Not At All Strong " Please note: For the purpose of this survey, community is a group of individuals bound together by a common geographic location, goal, issue or belief. Thank you for your help! Stan Service Cerns/AmeriiCnrr Site Name AmeriCorps Member Post-Service Reflection Form Name: Date: Dear AmeriCorps Member: Washington Service Corps would like to know about your community participation during your non-AmeriCorps time, and how you approach community' service. Please take a few minutes to complete this and return it to (Return Directions) 1. I am a registered voter or plan to (_) Yes (_) No register when I turn 18. 2. 1 am aware of my community's needs. (_) Frequently (_y Occasionally (_) Rarely (_) Never 3. 1 provide solutions or services to help (_) Frequently (_) Occasionally (_) Rarely (_) Never meet m community's needs. 4. 1 participate in community boards, (_) Frequently (_) Occasionally (_) Rarely (_) Never government or community forums. 5. 1 volunteer my time to community (_) Frequently Occasionally (_) Rarely Never organizations and events. 6. 1 look for ways to express my opinions (_) Frequently (_) Occasionally (_) Rarely Never in the community (e.g. writing letters, making phone calls and attending meetings.) 7. 1 look for ways to preserve and protect (_) Frequently (?} Occasionally (_) Rarely (_) Never m environment. 8. 1 assist my neighbors when they need (_) Frequently Occasionally (_} Rarely U Never help. 9. 1 find ways to give back to the (_) Frequently (_) Occasionally (_) Rarely (_) Never community. 10. 1 am aware of community resources. (_) Frequently (_) Occasionally (_) Rarely (_} Never 11. What does the term "ethic of service" mean? 12. How strong do you feel your ethic of Very (_} Strong U Not Very (_} Not At All service is? Strong Strong Strong 13. How has your experience with Washington Service Corps affected your ethic of service? Comments: • Please note: For the purpose of this survey, community is a group of individuals bound together by a common geographic location, goal, issue or belief. Thank you for your helpl Program Name Washington Service Corps Project Name Auburn Youth Participation Initiative Member Development Objective 3 SM&CORN *(..mmnonent numbers below refer to the objectives worksheets included with your AmeriCorps Renewal Application. Activity: During their term of service, AmeriCorps members will complete training activities From Component 1 on the objectives worksheet* in the following areas: 1. conflict resolution; 2. communication skills; 3. first aid ("Describe briefly the service activity you will and CPR; 4. career development; 5. service-learning/reflection; 6. risk be evaluating.") prevention and the enhancement of protective factors as a strategy to improve themselves and communities; 7. leadership skills; 8. teambuilding 1. Who will receive services? Approximately twice per month, Auburn's 10 AmeriCorps members will receive at May be included in either Component 1 or 5 on least one day training on the above topics. Training will not exceed 20% of the worksheet. ("Describe briefly the service member's total number hours of community service. activity you will be evaluating." or "Estimate the number of people this activity will serve.") 2. Number served 10 AmeriCorps members. From Component 5 on worksheet. ("Estimate the number of people this activity will serve.") 3. Desired result The training will increase AmeriCorps members' effectiveness in their service From Component 2 on worksheet. ("Explain what assignments and help further their career goals. change the described activity will produce.") 4. Indicators Auburn's AmeriCorps members will begin demonstrating the skills they learned (What concrete, observable things will you through training in their routine performance of their work. look at to see whether you are making progress toward your desired result?) 5. Method of measure Members will demonstrate completion of training elements by submitting records From Component 3 on worksheet. ("Describe the of successful completion or certification and completion of a member development method you will use to determine if the described feedback form. change occurs.") 6. Level (standard) of success Ninety percent (90%) will indicate an increase in their effectiveness in their Form Component 4 on worksheet. ("Try to AmeriCorps service assignment and indicate that the training was helpful to further define a level of success you hope to their career goals. achieve.") 7. Name/title of instruments used Records of successful completion or certification and completion of a Member From Component 3 on worksheet. ("Describe the Development Feedback Form. method you will use to determine if the described change occurs.") 7a. Who and how many people will Auburn's 10 AmeriCorps members. respond/fill out the instruments? (Note: this may not apply for all instruments, for example, testing water quality.) 8a. Who is to collect the data? AmeriCorps Coordinator will collect the data at least once during program year. 8b. How often? 9a. Who will aggregate the data? AmeriCorps Coordinator will tabulate the data at least once during program year. (tally on paper or enter into computer) 9b. How often? 10a. Who will analyze the data? AmeriCorps Coordinator. 10b. How often? 11. Who will turn the data into a AmeriCorps Coordinator will incorporate it into his quarterly reports. report? Washington Service Corps/Ameri Corps Site Name AmeriCorps Member Development Feedback Form Name: Date: Quarter: 1 2 3 4 Please indicate whether or not you participated in each training and rate the effectiveness of each traininq. Did the training improve your ability to provide AmeriCorps services? Conflict Resolution Date Provided Source/Title Check One YE O (_) Not at all U Somewhat (._) Yes, definitely Communication Skills YES Date Provided NO Source/Title First Aid/CPR Date Provided Source/Title Career Development Date Provided I NO SourcefrKle Service Learning Date Provided I NO Source/Title Risk Date Provided I NO Source/Title YES Leadership Skills NO Date Provided Sourcefritle Team Date Provided I NO Source/Title U Not at all U Somewhat U Yes, definitely NO U Not at all U Somewhat U Yes, definitely Not at all Somewhat Yes, definitely Not at all Somewhat U Yes, definitely lj Not at all Somewhat Yes, definitely U Not at all U Somewhat U Yes, definitely U Not at all (_j Somewhat U Yes, definitely oid the training improve your ability to further your career goals? Check One C_) Not at all U Somewhat U Yes, definitely Not at all Somewhat Yes, definitely (__) Not at all U Somewhat U Yes, definitely Not at all Somewhat U Yes, definitely UNot at all U Somewhat U Yes, definitely (_) Not at all U Somewhat U Yes, definitely U Not at all U Somewhat U Yes, definitely (_) Not at all U Somewhat U Yes, definitely Participated? Did the training Did the training improve your ability improve your ability to provide to further your AmeriCorps services? career goals? Check One Check One Community Mobilization YES Not at all Not at all Date Provided NO Somewhat U Somewhat Source/Title U Yes, definitely Yes, definitely Resource Inventory YES Not at all U Not at all Date Provided NO Somewhat U Somewhat Sourcef7itle U Yes, definitely (__) Yes, definitely Neighborhood Planning YES Not at all Not at all Date Provided NO C_) Somewhat Somewhat Source/Title Yes, definitely Yes, definitely Neighborhood Strategies YES Not at all U Not at all Date Provided NO (_) Somewhat U Somewhat Source/Title C_) Yes, definitely Yes, definitely YES i) Not at all (._) Not at all Date Provided NO Somewhat U Somewhat Source/Title (__) Yes, definitely Yes, definitely YES U Not at all (j Not at all Date Provided NO C_) Somewhat U Somewhat Source/Title (, Yes, definitely U Yes, definitely Comments: Washington service Corps/AmeriCorps Site Name AmeriCorps Member Development Completion Criteria Name: Date: Quarter: 1 2 3 4 Dear Site Supervisor: Please describe your site's criteria for completing each of the following trainings, the date offered, and records of completion to be maintained for each. You have the option of completing this form once, at the beginning of the program year, or updating it quarterly. Criteria for Completion? Record of completion? (For example, hours of attendance, (For example, instructor certification, post course test certification record, test passed at 80% or better.) scores, instructor sign- off, member portfolio.) Conflict Resolution Date Planned Source/Title Communication Skills Date Planned Source/Title First Aid/CPR Date Planned Source/Title Career Development Date Planned Source/Title Service Leaming Date Planned Source/Title Risk Prevention Date Planned Source/Title Leadership Skills Date Planned Source/Title Team Building Date Planned Source/Title Community Mobilization Date Planned Source/Title Resource Inventory Date Planned Source/Title Neighborhood Planning Date Planned Source/Title Neighborhood Strategies Date Planned Source/Title GENERAL TERMS AND CONDITIONS INDEX ITEM Part I - Definitions Part II - General Conditions 3 A. Access to Records and Facilities ---------------------------------------------------- 3 B. Advance Payment Prohibited -------------------------------------------------------- 3 C. Assignability --------------------------------------------------------------------------- 3 D. Assurances------------------------------------------------------------------------------3 E. Attorney Fees and Costs -------------------------------------------------------------- 3 F. Audits ------------------------------------------------------------------------------------ 4 G. Changes and Modifications ---------------------------------------------------------- 4 H. Commencement of Contract Work ------------------------------------------------- 4-5 1. Conflict of Interest---------------------------------------------------------------------- 5 J. Contractor Registration ---------------------------------------------------------------- 5 K. Covenant Against Contingent Fees ------------------------------------------------- 5 L. Disallowed Costs ---------------------------------------------------------------------- 5 M. Disputes -------------------------------------------------------------------------------- 6 N. Duplication of Billed Costs ---------------------------------------------------------- 6 0. Indemnification and Bonding-------------------------------------------------------- 6-7 P. Independent Capacity of Contractor ------------------------------------------------ 7 Q. Industrial Insurance Coverage ------------------------------------------------------- 7-8 R. Jurisdiction------------------------------------------------------------------------------ 8 S. Licensing and Accreditation---------------------------------------------------------- 8 T. Lobbying Activities ------------------------------------------------------------------- 8 U. Maintenance of Effort ----------------------------------------------------------------- 8 V. Nondiscrimination--------------------------------------------------------------------- 8-9 W. Patent Rights--------------------------------------------------------------------------- 9 X. Payment Parameters------------------------------------------------------------------- 9 Y. Pell Grants ------------------------------------------------------------------------------ 9 Z. Price Warrant --------------------------------------------------------------------------- 9 AA. Record Retention--------------------------------------------------------------------- 9-10 BB. Rights in Data-------------------------------------------------------------------------10 CC. Safeguarding of Client Information ----------------------------------------------- 10 DD. Small, Minority, and Women-Owned Business Enterprises --------------------------------------------------------------------- 10 EE. Subcontracting ------------------------------------------------------------------------10-11 FF. Suspension, Termination and Remedies-------------------------------------------11-12 GG. Termination Procedure ------------------------------------------------------------- 12-13 HH. Taxes----------------------------------------------------------------------------------- 13 II. Treatment of Assets -------------------------------------------------------------------- 13-14 JJ. Use of Name Prohibited--------------------------------------------------------------- 14 KK. Waiver --------------------------------------------------------------------------------- 14 Exhibit E PAGES --------------- 2 Exhibit E PART II - GENERAL CONDITIONS A. ACCESS TO RECORDS AND FACILITIES The Office of the State Auditor, federal auditors, and any persons duly authorized by the Department shall have full access to and the right to examine and copy any or all books, records, documents and other material regardless of form or type which are pertinent to the performance of this Contract, or reflect all direct and indirect costs of any nature expended in the performance of this Contract. Access shall be at all reasonable times during the record retention period. 2. The Office of the State Auditor, federal auditors, and any persons duly authorized by the Department shall have the right of access at all reasonable times in order to examine and inspect any site where any phase of the program is being conducted, controlled or advanced in any way. Such sites may include the home office, any branch office, or other locations of the Contractor if such sites or the activities performed thereon have any relationship to the program covered by this contract. B. ADVANCE PAYMENTS PROHIBITED No payment in advance or in anticipation of services or supplies to be provided by this Contract shall be made by the Department. In cost reimbursement contracts, the Contractor shall be entitled only to reimbursement for expenses incurred during the contract period for work accomplished as provided elsewhere in this Contract. In fixed unit price contracts, the Contractor shall be entitled only to payment for work accomplished during the contract period and in accordance with the terms of this Contract. C. ASSIGNABILITY Neither the Department nor the Contractor shall assign this Contract nor any claims arising therefrom, either in whole or in part without the prior approval of the other party. Said approval shall not be unreasonably withheld. D. ASSURANCES The Department and the Contractor agree that all activity pursuant to this Contract will be in accordance with all applicable current or future federal, state or local laws, rules and regulations. E. ATTORNEY FEES AND COSTS If any litigation is brought to enforce this Contract or any litigation arises out of any contract term, clause or provision, each party shall be responsible for its own expenses, costs and attorney fees. F. AUDITS The Office of the State Auditor, federal auditors and any persons duly authorized by the Department may examine and audit at all reasonable times, the Contractor and its books and records, and Exhibit E L CONFLICT OF INTEREST Every reasonable course of action will be taken by the Contractor in order to maintain the integrity of this expenditure of public funds and to avoid any favoritism or questionable or improper conduct. This Contract will be administered in an impartial manner, free from personal, financial, or political gain. The Contractor, its executive staff and employees, in administering this Contract will avoid situations which give rise to a suggestion that any decision was influenced by prejudice, bias, special interest, or personal gain. Gratuities in the form of entertainment, gifts or otherwise offered by the Contractor, or an agent or representative of the Contractor, to any officer or employee of the Department, with a view toward securing this Contract or securing favorable treatment with respect to the awarding or amending or the making of any determination will render this Contract voidable at the option of the Department and may justify further action under RCW 42..52. J. CONTRACTOR REGISTRATION The Contractor agrees to complete registration with the Department of Revenue, Department of Labor and Industries New Account Division and Employment Security Tax Administration by having filed a master business application prior to the execution of this Contract and to pay any taxes, fees, or deposits required by the state as a condition of providing services under this Contract. Contractor will provide the Department with its Washington Unified Business Identifier (UBI) number/or its Washington Department of Revenue tax account number, and, if applicable, its Labor and Industries account number and its Unemployment Insurance tax number, if registration with these agencies occurred prior to January 2, 1987. Required information will be provided prior to the Contractor commencing services under this Contract. K. COVENANT AGAINST CONTINGENT FEES The Contractor warrants that no person or selling agency has been employed or retained to solicit or secure this Contract upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, excepting bona fide employees or bona fide established commercial or selling agency maintained by the Contractor for the purpose of securing business. The Department shall have the right, in the event of breach of this clause by the Contractor, to annul this Contract without liability or, in its discretion, to deduct from the contract price or consideration or otherwise recover the full amount of such commission, percentage, brokerage or contingent fee. In no event shall the Department be liable for any brokerage or contingent fee. L. DISALLOWED COSTS The Contractor is responsible for any audit exceptions or disallowed costs incurred by its own organization or that of its Subcontractors. M. DISPUTES Except as otherwise provided in this Contract, when a dispute concerning a question of fact arises between the Department and the Contractor and it cannot be resolved, either party may request a dispute hearing with the Department's Contracts Office. The parties agree that this resolution process shall precede any action in a judicial or quasi judicial tribunal. Either party's request for a dispute Exhibit E Department has title in order to perform the responsibilities under the Contract, the Contractor shall ensure that: a. Every officer, director or employee who is authorized to act on behalf of the Contractor or any Subcontractors for the purpose of receiving or depositing funds into program accounts or issuing financial documents, checks or other instruments of payment for program costs is bonded to provide protection against loss. 1) Fiduciary bonding secured pursuant to this Contract must have coverage of $100,000 or the highest planned advance or reimbursement for the program year. 2) The Department will require proof of fiduciary bonding and insurance coverage. The Contractor will provide copies of bonding and insurance instruments or certifications of same from the bonding/ insurance issuing agency. The copies or certifications will show the bonding or insurance coverage, who is covered, and the amounts. If self-insured, the Contractor warrants that it will maintain coverage sufficient to cover any liability specified above that may arise from the performance of this Contract, and that the Contractor's Risk Officer or appropriate individual will provide to the Department evidence of such insurance. 4. The Contractor will provide the Department with a copy of the applicable insurance facesheet(s) or certification of self-insurance reflecting these coverage's. Insurance coverage(s) must be effective no later than the effective date of the Contract and for the term of the Contract. P. INDEPENDENT CAPACITY OF CONTRACTOR The parties declare that the Contractor, and any agents and employees of the Contractor, in the performance of this Contract, are acting as independent contractors and not in any manner as officers or employees or agents of the Department. Q. INDUSTRIAL INSURANCE COVERAGE The Contractor shall provide or purchase industrial insurance coverage for staff members prior to performing work under this Contract. The Department will not be responsible for payment of industrial insurance premiums or for any other claim or benefit for this Contractor, or any Subcontractor or employee of the Contractor, which might arise under the industrial insurance laws during the performance of duties and services under this Contract. Should the Contractor fail to secure industrial insurance coverage or fail to pay premiums on behalf of its employees, the Department may deduct the amount of premiums owing from the amounts payable to the Contractor under this Contract and transmit the same to the Department of Labor and Industries, Division of Industrial Insurance. AmeriCorps members serving under the provisions of this contract, for the purposes of Industrial Insurance coverage only, shall be considered employees of the Department, pursuant to RCW 50.65.110. Exhibit E but not limited to 29 CFR part 34. The United States has the right to seek judicial enforcement of this assurance. The Contractor shall promptly notify the Equal Opportunity (EO) Office of the Employment Security Department of any administrative enforcement actions or lawsuits filed against it alleging discrimination on the ground of race, color, religion, sex, national origin, age, disability, political affiliation or belief, and for beneficiaries only, citizenship or participation in a federal assistance funded program. The Equal Opportunity Office will notify the Director, Directorate of Civil Rights (DCR), Office of the Assistant Secretary for Administration and Management, U.S. Department of Labor. W. PATENT RIGHTS The Department retains the entire right, title and interest to each invention developed during the performance of Contract services. The Contractor may retain a nonexclusive royalty free license in each subject invention to which the Department retains title. The license is transferable only with the approval of the Department. The Department shall receive prompt, written notice of each notice or claim of patent infringement received by the Contractor with respect to patents developed during its performance of Contract services. X. PAYMENT PARAMETERS It is understood and agreed by and between the Department and the Contractor that the Contractor's payment is conditioned upon satisfactory performance and acceptance by the Department. Y. PELL GRANTS If this Contract is JTPA funded and involves participant training at institutions that are certified to participate in student financial aid, as appropriate the Contractor shall incorporate the use of Pell Grants to offset the costs of training, such as tuition, books, supplies, transportation, child care, miscellaneous expenses, and/or special costs for disabled participants. (Department of Labor Information Notice 25-89, dated April 9, 1990.) Z. PRICE WARRANT The Contractor warrants that the cost charged for services under the terms of this Contract are not in excess of those charged any other client for the same services performed by the same individuals. AA. RECORD RETENTION Contractor shall retain all books, records, documents and other material which reflect all direct and indirect costs of any nature expended in the performance of this Contract, including participant data for a period of three years after final payment under this Contract if JTPA funded, or six years from termination of the Contract if non-JTPA funded. Records shall be retained beyond the above referenced retention periods if litigation or audit is begun prior to the end of the period referenced above, or if a claim is instituted prior to the end of the period referenced above involving the Contract covered by the records. In these instances, the records will be retained until the litigation, claim or audit has been finally resolved. Exhibit E 2. Ensure that the Subcontractor follows the Department's reporting formats and procedures as specified by the Department. FF. SUSPENSION TERMINATION AND REMEDIES In the event the Contractor fails to comply with the conditions of this Contract, the Department at its discretion may either suspend or terminate the Contract as follows: Suspension In the event the Department determines that a breach of contract has occurred in the Contractor's compliance with the conditions of this Contract, and the situation is deemed by the Department to merit corrective action, the following sequential suspension procedure will be implemented: a. The Department will notify the Contractor in writing by registered mail to the Contractor's last known address with a return receipt to the Department of a perceived compliance breach describing the Department's concerns. b. The Contractor will respond to the Department's concerns by letter describing proposed corrective actions and proposing completion dates for bringing the Contract into compliance. Such response will be sent by registered mail and delivered to the Department within ten (10) calendar days of the date of receipt of the Department's letter. C. The Department will notify the Contractor in writing by registered mail to the Contractor's last known address with a return receipt to the Department as to the Department's final disposition of the Department's concerns. d. Upon receipt of notice of final disposition by the Contractor, the Department reserves the right to suspend all, or part of, the Contract, and to withhold further payments, or to prohibit the Contractor from incurring additional obligations of funds during investigation of the alleged compliance breach and pending corrective action, if necessary, by the Contractor or a decision by the Department to terminate in accordance with paragraph FF(2) below. e. The Department reserves the right to immediately undertake actions under us en ion L d. above, when it has reason to believe that fraud, abuse, malfeasance, misfeasance or nonfeasance has occurred on the part of the Contractor under this Contract. 2. Termination for Cause The Department may elect not to invoke the Suspension (Section FF.1, above) clause and may terminate this Contract in whole, or in part, at any time before the date of completion whenever it is determined that the Contractor has failed to comply with the conditions of the Contract. The Department shall promptly notify the Contractor in writing of the termination Exhibit E Department may require, which approval or ratification shall be final for all purposes of this clause; 5. Transfer title to the Department and deliver in the manner, at the times, and to the extent, if any, as directed by the Department, any property which, if paid for by the Department, would have been required to be furnished to the Department; 6. Complete performance of such part of the work as shall not have been terminated by the Department; and, 7. Take such action as may be necessary, or as the Department may direct, for the protection and preservation of the property related to this Contract which is in the possession of the Contractor and in which the Department has or may acquire an interest. HH. TAXES It is mutually agreed and understood that all payments accrued on account of payroll taxes, unemployment contributions, any other taxes, insurance or other expenses for the Contractor staff be the sole liability of the Contractor. Il. TREATMENT OF ASSETS Title to all property furnished by the Department shall remain in the Department. Title to all property purchased by the Contractor the cost of which the Contractor has been reimbursed as a direct item of cost under this Contract, shall pass to and vest in the Department upon delivery of such property by the vendor. Unless the Department specifically agrees to grant title in this Contract for asset(s) purchased, in that case only shall title pass to the Contractor. 2. Any property of the Department furnished to the Contractor shall, unless otherwise provided herein, or approved by the Program Manager in writing, be used only for the performance of this Contract. Property will be returned to the Department in like condition to that in which it was furnished to the Contractor, normal wear and tear excepted. The Contractor shall be responsible for any loss or damage to property of the Department in the possession of the Contractor which results from the negligence of the Contractor or which results from the failure on the part of the Contractor to maintain said property in accordance with sound management practices. 4. If any Department property is damaged or destroyed, the Contractor shall notify the Department and shall take all reasonable steps to protect that property from further damage. 5. The Contractor shall surrender to the Department all property of the Department upon completion, termination or cancellation of this Contract. 6. All reference to the Contractor under this clause shall include any employees, agents or Subcontractors. 5YR16lt "F'' TRAVEL REIMBURSEMENT INFOIZMATIO\ GENEILML: Contractors may only be reimbursed for travel expenses that are both necessary and reasonable to carry out the terms of this contract. VEHICLE EXPENSES, LODGING AND SUBSISTENCE: Privnte vehicle mileage, meals and lodging will be paid at the rates sho%m in the Attached Schedul-.s A and B as published by the State of Washington Office of Financial Management. Fates paid will be those in effect at the time the travel occurred. FIFTH' NTILE RULE FOR LODGING: Lodging may not be reimbursed if the lodging expense is incurred at n facility that is within fifty (50) tulles of the contractor's home or office, whichever is closer, except that the contractor will be reimbursed for lodging expenses incurred within 50 chiles if olle of the following conditions apply: 1) 1'ilc C0IItI'1Ct0r 1llLISt attend late,light/cart}, wornin?, bath to back lllcctin-_s. Lntc night is defined as ending after 7:00 p.m. Early mornim, is defined as startint on or before the traveler's normal work shill. 2) Inclement wcathcr I)I-CCILldC.S the contractor from retllrllill`, to the office or lulnlc Without risk to personal salcty. I f !od`,in?? 1'cilllbClrscincilt is claimed llllder either of 1110 above Cxceptiolls, it limis to be fully cxpl:lllicd wllell the i'Cgllest for IcImbllriCIIICnt IS Sllblllltte(l. I:\CEI'TION TO STANDARD REINIBURSEIIIWY FOR LODGING: Udder ccrtlin conditions, lodging may be reimbursed at rates higher than those listed in SCI1Cdlilcs A and B. The exceptions are: 1) The Contractor Stays at the specific lodging facility whcre the Ilicetill C/Collferellce is being held in order to gain maximum benefit from the meeting/conference. 2) Affordable lodging accommodations tare not available or cannot be obtlined Within a reasonable conulluting distance from the meeting/conference site. 3) The contractor, because of special duties associated with carrying out the terms of this contract, necessarily incurs unusually high lodging expenses, e.g., rents a suite that is also used as a meeting room. If lodging reimbursement is claimed under any of the above exceptions, a full explanation must accompanying the request for reimbursement. 03/9S All requests for lodging relnibllrsenient must include a receipt from tile facility where the expense was incurred. RENTAL CARS: Contractors may rent vehicles when riecessary to earn' out the terms of this contract and when no other more cost effective means of transportation is available. Reimbursement will not be made to the contractor for any rental car expenses that are incurred to conduct personal business. Requests for reimbursement must be accompanied by a receipt from the rental car agency. MISCELLANEOUS TRAVEL EXPENSES: Contractors may also request reimbursement for miscellaneous travel expenses, including parkin` fees, ferry tolls, ground transportation, bridge tolls and teleplione calls. Any single charge of S25.00 or more requires a receipt. REQUESTING REIMBURSEMENT: To be reimbursed for travel, the contractor must submit a log that details: The beginniiia and ending dates of each trip. 2. The Hour of departure and return. 'File specific mails being claimed per trip, i.e., breakfast, lunch a11d;'Or dillllel'. 4. A111011nt of ,1111' lod`,ing being claimed and the I1anic of the lodglll`, facility per trip. Tile a111Ollilt 01 ally private vehicle milcage being claimed per trip and the rcinlbursCnlcnt C1111011nt, i.e., the mileage multiplied by the current private vehicle rate. 6. lie: aniount and description of any miscellaneous expenses being, claimed per trip. Rental car expenses should be included as a miscellaneous expense and requires an explanation of why a rental car Nvas needed. 7. An explanation oC the purpose of the trip and ho%,.- it contributed to the objectives of the contract. If the contractor prefers, he/she may use travel documentation forms supplied by the department. Forms may be requested from the Fiscal Office by calling the Travel Desk at 753-4250. 03/98 2 8b PART 4: GENERAL ADMINISTRATION Chapter 2: Trati•cl and Transportation Regulations (4.2) Section 7: Travel Regulations (4.2.7) Subsection 2: Lodging, Subsistence, and Nt lileage Rates (-1.2.7.2) 2. Schedule A. (4.2.7.2.2) - continued SCHEDULE A FOOTNOTES 1/ The source document for these rates is the U.S. General Sen-ices Administration's Federal Travel Regulations, contained in Appendix A of Chapter 301, Subtitle F, Title 41, of the Code of Federal Regulations dated December 3, 1996. 2/ This is the m:1xinlunl allowable lodging rate for all in-state and out-of-state non-high cost locations in the continental USA. Refer to SCHEDULE B for the specific maximum lodging rates for individual high cost locations in the continental USA. 4/ Refer to SCHEDULE B for the specific high cost locations of the continental USA to determine which subsistence rate (530, 534, S3S, or S42/dav) is applicable. ALL OTHER AREAS: Includes all non-higli cost areas in the continental USA v;hcre the daily set subsistence rate is 530. 61 NON HIGH COST PER DIEM PATE: The daily total is arrived at by adding the non-111_Ii cost location lodging rate to the non-high cost areas subsistence rate (S50 + 30 = S80). The Ilourly rate is then arrived at by dividing the daily total by 24 hours (SSO/ 24 = 53.33). Toth the daily and hourly rates are used for certain types of boards and commissions (refer to Subsection 4.2.3.1), and the hourly rate is used when a state traveler is authorized to use :t privately-owned travel trailer or camper (refer to Subsection 4.2.2.2.2.c). 7/ POV MILEAGE REIMBURSEMENT RATE: IRS Revenue Procedure 96-63 is the source document for this rate. S/ PRIVATE AIRCRAFT MILEAGE REIMBURSEMENT RATE: The source document for this rate is the Federal Register Doc. 96-12785 filed on May 22, 1996. 9/ PRIVATE MOTORCYCLE MILEAGE REIMBURSEMENT RATE: The source document for this rate is the Federal Register Doc. 96-12785 filed on May 22, 1996. Lrrective Datc: July 1, 1997 st:ite orWashindton Policies, Regulations, anti Proceclcres I,suc(i by: orfice or i in:cnci:cl i1l:uia, rn;rr PART 4: GENERAL ADMINISTRATION Chapter 2: Travel and Transportation Regulations (4.2) Section 7: Travel Regulations (4.2.7) Subsection 2: Lodging, Subsistence, and Mileage Rates (4.2.7.2) 2. Schedule A. (4.2.7.2.2) SCHEDULE A Lodging, Subsistence, and Private Vehicle Mileage Reimbursement Rates For the Continental USA . ' (48 Contiguous States and District of Columbia) LODGING RATES 1/ NON HIGH COST HIGH COST LOCATIONS LOCATIONS $50/night 2/ 3/ NON HIGH COST EXCEPTION TO MAXIMUM LODGING $120.00 PER DAY 2/ MEALS BREAKFAST LUNCH SUBSISTENCE RATES 1/ NON HIGH COST ----------HIGH COST AREAS----------- AREA 4/5/ 4/ 4/ 41 $7.00 $8.00 $9.00 $10.00 9.00 10.00 11.00 13.00 DINNER 14.00 16.00 18.00 19.00 TOTALS 3$ 0.00 3? 4.00 3$ 8.00 4$ 2.00 as NON HIGH COST PER DIEM RATE 6/ $80.00 PER DAY (or $3.33 PER HOUR) PRIVATELY OWNED VEHICLE MILEAGE REIMBURSEMENT RATE 7/ $315/MILE PRIVATE AIRCRAFT MILEAGE REIMBURSEMENT RATE 8/ $.85/STATUTE MILE PRIVATE MOTORCYCLE MILEAGE REIMBURSEMENT RATE 9/ $.25/MILE Effective Date: July 1, 1997 state of Washington Policies, Regulations, and Procedures Issued by: Office of Financial Management h p N N ~ V 0 ?0 O h .? 0 O ?+ Q 1f7 ? ? %p ey h N Q N f'1 V [? 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