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Home My WebLink AboutCommunities in Schools - Intergrated Services for at Risk StudentsCITY OF WASHINGTON CITY OF AUBURN AGREEMENT FOR HUMAN SERVICE ACTIVITIES COSTING $5,000 PER YEAR OR LESS �.►(„.(i Department of Administration Michael Hursh, Community Services Manager 25 West Main Street Auburn, WA 98001 This Agreement is made effective as of January 1, 2012, by and between COMMUNITIES IN SCHOOLS OF AUBURN: INTERGRATED SERVICES FOR AT RISK YOUTH and the CITY OF AUBURN. In this Agreement, the party who is contracting to receive services shall be referred to as "CITY ", and the party who will be providing the services shall be referred to as "AGENCY ". The parties agree as follows: 1. DESCRIPTION OF SERVICES. Beginning on January 1, 2012, the AGENCY agrees to provide services to students in need at schools located in the City of Auburn. Services will be delivered as per the attached Scope of Work. 2. PAYMENT. The CITY will pay a fee to the AGENCY for services provided in the amount of $5,000 per year, paid in semi - annual installments of equal amounts, for services delivered as described in the attached Scope of Work. This fee shall be payable in a lump sum upon receipt of an invoice from the AGENCY with appropriate supporting documentation. 3. EXPENSE REIMBURSEMENT. The AGENCY shall pay all "out-of-pocket" expenses, and shall not be entitled to reimbursement from the CITY except for specific services, items or activities listed in the Scope of Services as reimbursable goods or services. 4. TERMITERMINATION. This Agreement is effective January 1, 2012, and expires December 31, 2012, unless either party terminates the Agreement by notifying the other party in writing within seven (7) days of the intent to terminate. The Agreement may be renewed for one year upon the mutual consent of both parties. 5. RELATIONSHIP OF PARTIES. It is understood by the parties that the AGENCY is an independent contractor with respect to the City of Auburn, and not an employee of the CITY. The CITY will not provide fringe benefits, including health insurance benefits, paid vacation, or any other employee benefit, for the benefit of the AGENCY. 6. EMPLOYEES. The provisions of this Agreement shall also bind the AGENCY employees who perform services for the CITY under this Agreement. 7. INDEMNIFICATION / HOLD HARMLESS. The AGENCY shall defend, indemnify and hold the City, its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or resulting from the acts, errors or omissions of the AGENCY in performance of this Agreement, except for injuries and damages caused by the sole negligence of the City. The City of Auburn shall defend, indemnify and hold the AGENCY, its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or resulting from the acts, errors or omissions of the City in performance of this Agreement, except for injuries and damages caused by the sole negligence of the AGENCY. 8. INSURANCE. The AGENCY shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the AGENCY, its agents, representatives, or employees. City of Aubum Agreement: GF -1216, Communities In Schools — Intergrated Services for at Risk Students January 1, 2012 Page 1 of 4 AUBURN * MORE THAN YOU IMAGINED A. Minimum Scope of Insurance, the AGENCY shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non - owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors and personal injury and advertising injury. The City shall be named as an insured under the AGENCY's Commercial General Liability insurance policy with respect to the work performed for the City. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 4. Professional Liability insurance appropriate to the AGENCY profession. B. Minimum Amounts of Insurance: The AGENCY shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. 3. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. C. Other Insurance Provisions: The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability, Professional Liability and Commercial General Liability insurance: 1. The AGENCY's insurance coverage shall be primary insurance as respect the City. Any insurance, self- insurance, or insurance pool coverage maintained by the City shall be excess of the AGENCY's insurance and shall not contribute with it. 2. The AGENCY's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. D. Acceptability of Insurers: Insurance is to be placed with insurers with a current A.M. Best rating of not less than A: VII. E. Verification of Coverage: The AGENCY shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the AGENCY before commencement of the work. 9. ASSIGNMENT. The AGENCY obligations under this Agreement may not be assigned or transferred to any other person, firm, or corporation without the prior written consent of the CITY. City of Auburn Agreement: GF -1216, Communities In Schools — lntergrated Services for at Risk Students January 1, 2012 Page 2 of 4 AUBURN * MORE THAN YOU IMAGINED 10. NOTICES. All notices required or permitted under this Agreement shall be in writing and shall be 4 deemed delivered when delivered in person or deposited in the United States mail, postage prepaid, addressed as follows: IF for COMMUNITIES IN SCHOOLS: Arlene Pierini, Executive Director Communities In Schools 502 4th St NE Auburn, WA 98002 IF for the CITY: Michael Hursh Community Services Manager 25 West Main Street Auburn, WA 98001 Such address may be changed from time to time by either party by providing written notice to the other in the manner set forth above. 11. ENTIRE AGREEMENT. This Agreement contains the entire agreement of the parties and there are no other promises or conditions in any other agreement whether oral or written. This Agreement supersedes any prior written or oral agreements between the parties. 12. AMENDMENT. This Agreement may be modified or amended if the amendment is made in writing and is signed by both parties. 13. SEVERABILITY. If any provision of this Agreement shall be held to be invalid or unenforceable for any reason, the remaining provisions shall continue to be valid and enforceable. If a court finds that any provision of this Agreement is invalid or unenforceable, but that by limiting such provision it would become valid and enforceable, then such provision shall be deemed to be written, construed, and enforced as so limited. 14. WAIVER OF CONTRACTUAL RIGHT. The failure of either party to enforce any provision of this Agreement shall not be construed as a waiver or limitation of that party's right to subsequently enforce and compel strict compliance with every provision of this Agreement. 15. APPLICABLE LAW. This Agreement shall be governed by the laws of the State of Washington. The undersigned have read the above statements, understand them, and agree to abide by their terms. Signed: Title: Date: Address: Agency LI IA t Signed: \Q_ od]k " °"" 953 5-1 Date: City of Auburn Gf j (i- Address: 25 West Main Street Auburn, WA 98001 Phone: (253) 876 -1964 (Community Services Line) City of Auburn Agreement: GF -1216, Communities In Schools — Intergrated Services for at Risk Students January 1, 2012 Page 3 of 4 AUBURN * MORE THAN YOU IMAGINED HUMAN SERVICES AGREEMENT BETWEEN THE CITY OF AUBURN & COMMUNITIES IN SCHOOLS: INTERGRATED SERVICES FOR AT RISK YOUTH Scope of Work Services to include: • Prepare and distribute approximately 500 backpacks and school supplies to at -risk students. Identify additional needs and distribute accordingly, i.e. grooming supplies, clothes, books, etc. Provide direct financial assistance to identified students in need for items such as: shoes, clothing, camp scholarships, transportation, class fees, alarm clocks and more. ■ Recruit volunteers, train them and acknowledge their contribution to the community. • Comply with applicable health codes, rules and regulations. • Maintain records of residents served and the schools they attend. • Retain the above records for three years and make them available for review upon request by the City and /or its agents or representatives. Reporting Requirements: • With each semi - annual request for reimbursement, COMMUNITIES IN SCHOOLS OF AUBURN: INTERGRATED SERVICES FOR AT RISK YOUTH provide a summary of the number of people served along with the number of clients who are Auburn residents. ■ At the end of each year, a brief report describing the past program, number of clients served along with noteworthy accomplishments and /or challenges. Additional Billable Services, Goods and /or Activities: • None City of Auburn Agreement: GF -1216, Communities In Schools — Intergrated Services for at Risk Students January 1, 2012 Page 4 of 4 AUBURN * MORE THAN YOU IMAGINED Y CITY OF AUBURN - MEMORANDUM OF UNDERSTANDING This Memorandum of Understanding is an addendum to the agreement for services between the City of Auburn and Communities In Schools — Integrated Services for at Risk Students, the original of which was executed on the 2-1 day of "f p JOV'U 3. , 2012. All other terms and conditions of the agreement for services shall remain in full force And effect except as specifically amended by this Memorandum of Understanding. I. It is the goal of the City of Auburn to improve the living conditions of all Auburn residents. II. The grant funds provided to the Agency during the 2012 year are provided with the objective of achieving the results established by the City Council in the areas of Abused and Neglected Children, Victims of Domestic and Sexual Assault, Poverty Reduction, Substance Abuse and Health Fitness. III. Agencies receiving funding from the City of Auburn agree to participate in the conceptual development of the One Stop Center and to collaborate with other agencies concerning the delivery of services to clients when the Center is operational. The nature and extent of the collaboration to be determined when the One Stop Center is operational. IV. The City of Auburn will utilize the following performance measures in evaluating the effectiveness of reaching this goal. Abused and Neglected Children: The City of Auburn will fund human service providers that increase supportive services to children who are neglected and abused, specifically the number of children who are victims of on -going and repeated neglect and abuse, within the city of Auburn by 15% over the next three (3) years. Victims of Domestic and Sexual Assault: The City of Auburn will fund human service providers that increase the number of Auburn residents, who are victims of domestic violence, that make the transition to a safe environment and self- determining lifestyle by 15% within the next three (3) years. Poverty Reduction: The City of Auburn will fund human service providers who increase the number of Auburn residents no longer living in poverty by 15% within the next three (3) years. Substance Abuse: The City of Auburn will fund human service providers to develop strategies that increase the successful completion of treatment programs by Auburn residents who have serious behavioral and health problems due to substance abuse and chemical dependency by 15% within a three (3) year period. Physically and Mentally Fit: The City of Auburn will fund human service providers that increase the availability, accessibility and use of health care to its low income residents by 15% within a three (3) year period. CITY OF AUBURN City of Auburn Agreement: GF -1216, Communities In Schools — Intergrated Services for at Risk Students January 1, 2012 Page 1 of 2 ATTEST: Danielle E. Daskam, City Clerk APPROVED AS TO FORM: s PETER B. L WIS MAY Daniel B. Heid, City Attorney STATE OF WASHINGTON COUNTY OF KING )ss On this -MC day of, o , 2012, before me, the undersigned, a Notary Public in and for the State of Was ;ngt , personally appeared(2. h.,.e of Communities,In Schools, the .non- profit corporation that executed the. within and foregoing instrument;_ and acknowledged said instrument to be the free and voluntary act and deed of said non- profit corporation for the uses and purposes therein mentioned, and on oath stated that he /she is authorized to execute said instrument on behalf of said non - profit corporation. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the date hereinabove set forth. to me known to. be the • "_ NOTARY PUBLIC,in and •r the State of Washington, residing in # MY COMMISSION expires:4, City of Auburn Agreement: GF -1216, Communities In Schools — lntergrated Services for at Risk Students January 1, 2012 Page 2 of 2 EXHIBIT COVER PAGE GF•1216 HUMAN SERVICE AGREEMENT 2012 INVOICE FOR CONTRACTED SERVICES To: CITY OF AUBURN, ATTN: COMMUNITY SERVICES 25 WEST MAIN STREET, AUBURN WA 98001 Agency: Communities In Schools 502 -4 St NE Auburn WA 98092 Program: Integrated Services for AT RISK students Contact, Title: Arlene Pierini, Program Mgr. Phone: 253 - 288 -7659 Email: cisauburn @comcast.net Amount Requested: $ 2,500.00 Invoice for: Attachments: ❑ 1St and 2nd Quarters, January to June — Due: July 13, 2012 ❑ 3'd and 4th Quarters, July to December— Due: January 31, 2013 ❑ Quarterly Service Report (due semi - annually) - Exhibit 1 ❑ Quarterly Financial Report (due semi - annually) — Exhibit 2 ❑ Demographic Report (due semi - annually) — Exhibit 3 ❑ Outcomes Report (due semi - annually) — Exhibit 4 ❑ Proof of Insurance (1St Quarter or if expired) I certify to the best of my knowledge that this invoice and attachments reflect actual service provided to Auburn residents. Signature of Authorized Representative Date The City of Auburn will issue payment upon this invoice within forty -five (45) business days of receipt. To ensure prompt payment, please submit this form and all required attachments by the date listed above. FOR CITY OF AUBURN USE ONLY: Contract Amount: $5,000.00 Payments Year to Date: Payment this invoice: Contract Balance: Authorized to Pay: Signature Date CITY OF AUBURN COVER PAGE — MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT REQUEST 2012 Exhibit 1 GF -1216 HUMAN SERVICE AGREEMENT 2012 SCOPE OF SERVICES AND QUARTERLY. SERVICE UNIT REPORT Agency Information Communities In Schools 502 -4 ST NE Auburn WA 98092 Contact, Title: Arlene Pierini, Program Mgr. Phone: 253- 288 -7659 Email: cisauburn @comcast.net Are professional services (e.g., counseling, case management) provided as part of this Agreement? • Contract Information Contract Amount: $5,000 Program Name: Integrated Services for AT RISK students Description of Service to be provided: Reporting Information Report for _ 1st Qtr /Jan -Mar & 2nd Qtr /Apr -Jun 2012 Service Units _ 3`d Qtr /Jul -Sep & 4th Qtr /Oct -Dec Narrative: Please attach other relevant information, including. current trends, program developments, special events, publicity, community education, etc. Ifactu al service units are lower than anticipated, please 'explain. City Funding . Only . . _An Funding Sources Actual Service Units to Date Service Unit Description: Auburn Residents Only Total Projected Annual Units Actual Units by Quarter Service Unit/Performance Measure • -- 1St nd 3`d 4th Unduplicated Number of Auburn Clients Served ,21.i' . Narrative: Please attach other relevant information, including. current trends, program developments, special events, publicity, community education, etc. Ifactu al service units are lower than anticipated, please 'explain. CITY OF AUBURN 2012 Quarterly Financial Report Agency: Communities In Schools Program: Integrated Services for AT RISK students Report for _ 1st Qtr /Jan -Mar & 2nd Qtr /Apr -Jun Date: 2012 Exhibit 2 GF -1216 _ 3'd Qtr /Jul -Sep & 4th Qtr /Oct -Dec Requested Reimbursement: Detail as Applicable: Cost Categories Budget Award This Request Cumulative to date Award • Balance 1 Personal /Agency Services Office /Operating Supplies 3 Consultant or. Purchased Services 4 Direct Client Assistance 5 Communications 6 Travel & Training 7 Intra- Agency Support . 8 Other per - Detail Grand Total $5,000.00 Requested Reimbursement: Detail as Applicable: CITY OF AUBURN 2012 Demographic Report Agency: Communities In Schools Program: Integrated Services for AT RISK students Date: 2012 Exhibit 3 OF -1216 -_.. ae•o. .- _,,:.: ._:-. " 2 ^' :----7-7.r. 3.0. . �4�. Total YT Client' -_ _ Residence".-" 'y;= "List�all:clients = served.in'.this.. ,_ . jcalego h : c -cat el other 9 r s cafe ones list; - Auburn;clients°' only - __ __ __ ":' -_' _ = ,� _ _- _,;;4,.i° _ ?�; AI•ona • - -- 1 Auburn Black Diamond = -- Burien • Covin•ton -= Des Moines - - -- Enumclaw -- Federal Wa -- . Kent Ma .le Valle - = =- Normand Park -- - Pacific - - -- Renton -- SeaTac - - -_ Seattle - -- Tukwila . : Uninco •orated. Kin• Count - -- Other: Unknown - - -- TOTAL = - - -_ =- Client:' = _' Income :_ Level '` ; , = _ -_ = =T, 30% of median or below 50% of median or below 80% of median alow = == Above 80% of median ' Unknown - -_ -- - -_ TOTAL _. _= ;Client' ; , -Gender° : __ = Female _-- __ Male Client-- = =:�': Age' ` . - _ ' '' 0-4 - 13-17 =- 18 -34 - -- 35 -54. -- 55 -74 -- _ Unknown - -- -.: TOTAL - EtFinicity!` ";_:- Asian/Pacific Islander - = - -- _Cultural == Black/African American -- Ba: c k_ g rou_ n d r Ni e Lrico A Native merican / Alaskan Native White /Caucasian - -- - - -- - + Other { Unknown - -- -- - _ -fY =... TOTAL Con'ditionv'_' - - .r Disablin• Condition ESL ^ =: -:: �', ` Limited En•lish S.eakin• =---- Household -: Female- Headed Household CITY OF AUBURN Funder Re ortin • to: Cit of Auburn Re ortin ' Period: OUTCOMES REPORT - EXHIBIT 4 Date Forme Com s leted: Agency: Program: Contact Person: E -mail: Phone: dltL tr: D.ue s:Outcomes dentif ed indicat'ors(g ven datascollecfion method`(s)oexplained 4ihuOtr:,D'uei Outcoine4r_esults OUTCOME: (What change do you expect to see ?) MEASURABLE INDICATORS: (How will you know change has occurred ?) DATA COLLECTION MET OD(S): OUTCOME RESULTS: (Narrative) highlight your .data, include your interpretation of the data and attach any graphics if available. CITY OF AUBURN Funder Re s ortin . to: Cit of Auburn Re s ortin ' Period: to LOGIC MODEL REPORT - suggested Template 1 . • , ii i,I s • •I Agency: Program: Contact Person: E -mail: Phone: Program Evaluation Logic Model PROCESS RESOURCES ACTIVITIES OUTPUTS • OUTCOME OUTCOMES INDICATORS GOAL