HomeMy WebLinkAboutNew Connections GF-1225Department of Administration
Michael Hursh, Community Services Manager
25 West Main Street
Auburn, WA 98001
CITY OF AUBURN AGREEMENT FOR HUMAN SERVICE ACTIVITIES
COSTING $5,000 PER YEAR OR LESS
This Agreement is made effective as of January 1, 2012, by and between New Connections — Stop
the Cycle of Re- Offending 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 helping low income individuals and families with emergency rental and utility assistance,
eviction prevention and service referrals located in the City of Auburn Services will be delivered as per
the attached Scope of Work
2. PAYMENT. T e C a fee to the AGENCY for services provided in the amount of $5,000
per year, paid in inssallments 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. TERM/TERMINATION. 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
City of Aubum Agreement GF -1225, New Connections — Stop the Cycle of Re- Offending
January 1, 2012
Page 1 of 4
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10. NOTICES. All notices required or permitted under this Agreement shall be in writing and shall be
deemed delivered when delivered in person or deposited in the United States mail, postage prepaid,
addressed as follows
IF for the New Connections
May Miller, Executive Director
New Connections
412 West Titus
Kent, WA 98032
IF for the CITY
Michael Hursh
Community Services Manager
City of Auburn
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 wntten 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 7\
Printed'
Title'
A encv City of Auburn
Date. 3 ` ` _ ke `),
Address
Phone co.3 �s - 9 op
Signed
Printed
Title:
Date.
u.ct- Ul‘-F.tit 14-144-sGx
t'io�tti tn^ . $ ✓c, s
Address 25 West Main Street
Auburn, WA 98001
Phone' (253) 876 -1964 (Community Services Line)
City of Aubum Agreement GF -1225, New Connections — Stop the Cycle of Re- Offending
January 1, 2012
Page 3 of 4
HUMAN SERVICES AGREEMENT BETWEEN THE
CITY OF AUBURN & NEW CONNECTIONS — STOP THE CYCLE OF RE- OFFENDING
Scope of Work
Services to include:
■ Serving clients involved in the Criminal Justice System or recently released from Jail or Prison to
receive services
■ A one -stop of services include, but are not limited to, access to new voice mail, housing referrals,
hygiene pac's, maps, bus passes and lists of resources.
■ Clients are given assistance to obtain identification cards through the DOL
• Provide resume and job assistance so clients will be able to return to work, including clothing, eye
glasses, bus passes and work tools.
Reporting Requirements:
• With each semi - annual request for reimbursement, New Connections — Stop the Cycle of Re-
Offending services will provide a summary of the number of people served along with the number
of unduplicated 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 Aubum Agreement GF -1225, New Connections — Stop the Cycle of Re- Offending
January 1, 2012
Page 4 of 4
CITY OF AUBURN - MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding is an addendum to the agreement for services
betsfien the City of Auburn and New Connections, the original of which was executed on the
- day of MAYt; , 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 a`re 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 Aubum residents, who are victims - of , domestic
violence, that make the transition to a 'safe environment and self - determining lifestyles 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 comAgiNniofaitreatmentliprograms by Auburn
residents who have,'se ?ion`s behavioral and health pcobibitivcctuehlesubsrance abuse and
chemical dependency by 15% within a three (3)jreamp jamb i W 1.31 9J 3
ZW3HTAM J3AHOIM
Physically and Mentally Fit: The City of Au -durnlivr�riti an service providers that
increase the availability, accessibility and use tulip►nettailtsilpviNtricoifie residents by
15% within a three (3) year period
City of Aubum Agreement GF -1225, New Connections — Stop the Cycle of Re- Offending
January 1, 2012
Page 1 of 2
ATTEST
CITY OF AUBURN
PETE: :. LEWIS
AYOR
Danielle E. Daskam,
City Clerk
APPROVED AS TO FO
Daniel B Held
City Attorne
STATE OF WASHINGTON
COUNTY OF KING
BY
'Ilk 1.
New Connections
1_
TITLE Qt i (1. elk)
)ss
)
On this //"?I'' day of `1%,.fi -„
Notary Public in, and for the State
/ 0( a// .),,., ,
i
, 2012, before me, the undersigned, a
of Washington, personally appeared
to me known to be the p-- ,c4.4-,,--/
of New Connections, 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.
ommimmmlllllllnummuuuunlg
• Notary Public
State of Washington =_
• MICHAEL MATHEWS I
• MY COMMISSION EXPIRES =
Juno 12,2013 =
IulummffinlHlmilmllllnlmm a
N •TARY PUBLIC in and for the State of
Washington, residing in /6ct, i'
MY COMMISSION expires s i,2 zy ?
City of Aubum Agreement GF -1225, New Connections — Stop the Cycle of Re- Offending
January 1, 2012
Page 2 of 2
CITY OF_-j
giVIN3
WASHINGTON
HUMAN SERVICE AGREEMENT
2012 INVOICE FOR CONTRACTED SERVICES
To: CITY OF AUBURN, ATTN COMMUNITY SERVICES
25 WEST MAIN STREET, AUBURN WA 98001
Agency New Connections
412 West Titus
Kent, WA 98032
Program Stop the Cycle of Re- Offending
Amount Requested: $ 1,250.00
Invoice for:
Attachments:
EXHIBIT COVER PAGE
GF•1225
Contact, Title: May Miller, Program Mgr
Phone: (253) 631 -0351 or (360) 866 -2560
Email: mmiller @ci blackdiamond wa us
❑ 15' Quarter, January to March — Due April 15, 2012
❑ 2nd Quarter, April to June — Due July 15, 2012
❑
3rd Quarter, July to September — Due October 12, 2012
❑ 4th Quarter, October to December— Due January 31, 2013
❑ Quarterly Service Report - Exhibit 1
❑ Quarterly Financial Report — Exhibit 2
❑ Demographic Report (2nd and 4th Quarters only) — Exhibit 3
❑ Outcomes Report (4th Quarter only) — Exhibit 4
❑ Proof of Insurance (15t Quarter or if expired)
❑ Logic Model (1st Quarter only) — Suggested Template
I certify to the best of my knowledge that this invoice and attachments reflect actual service provided to
Auburn residents
Signature of Authonzed 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
HUMAN SERVICE AGREEMENT
2012 SCOPE OF SERVICES AND QUARTERLY SERVICE UNIT REPORT
Agency Information
New Connections
412 W Titus
Kent, WA 98032
Contact, Title: May Miller, Program Mgr
Phone: (253) 631 -0351 or (360) 866 -2560
Email: mmiller @ci blackdiamond wa us
Are professional services (e g , counseling, case management) provided as part of this Agreement? y
Contract Information
Contract Amount 15S____=
Program Name Stop the Cycle of Re- Offending
Description of Service to be provided
Reporting Information
Report for _ 1st Qtr /Jan -Mar
2012 Service Units
2 "d Qtr /Apr -Jun
3rd Qtr /Jul -Sep _ 4th Qtr /Oct -Dec
Narrative: Please attach other relevant information, including current trends, program developments,
special events, publicity, community education, etc If actual service units are lower than anticipated,
please explain.
Cit Fundin• Onl
Actual Service
Units to Date
Service Unit Description
Auburn Residents Only
Total
Projected
Annual Units
Actual Units by Quarter
Service Unit/Performance Measure
1st
2nd
3rd
4th
Unduplicated Number of Auburn
Clients Served
180
Narrative: Please attach other relevant information, including current trends, program developments,
special events, publicity, community education, etc If actual service units are lower than anticipated,
please explain.
CITY_OF AUBURN
2012 Quarterly Financial Report
Agency New Connections
Program. Stop the Cycle of Re- Offending
Report for _ 1st Qtr /Jan -Mar
2nd Qtr /Apr -Jun
2012 Exhibit 2
Date
3rd 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
2
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
Agency New Connections
2012 Exhibit 3
CITY OF,AUBURN
2012 Demographic Report
Date
Program. Stop the Cycle of Re- Offending
Cate • o
is
2 "'
3
4
Total YTD
Client
Residence **
**List all clients
served in this
category
In all other
categories list
Auburn clients
only.
Al.ona
--
f
Auburn ` -
-
-
-
--
Black Diamond
-
--
- Bunen
-
--
Covin.ton
-
-
--
Des Moines
-
--
-
Enumclaw
-
--
Federal Wa ,
-
-
-
--
Kent
-
--
• le lie
-
-=
Normand
Normand nd Park
_
=
=
Pacific
-
-
-
--
-
--
Renton
SeaTac
-
-
-
--
Seattle
-
-
--
Tukwila
-
-
-
- '
-
-
-
-
-
-
-
-
-
-
--
--
--
--
--
Uninco •orated Kin. Count
Other
Unknown
TOTAL
-
Client
_Income
Level
30% of median or below
-
-
-
-
-
-
-
-
-
-
--
--
--
--
50% of median or below
80% of median or below
Above 80% of median
Unknown
-
-
-
--
TOTAL -
-
-
-
-
-
-
-
-
-
-
-
--
--
--
--
Client
Gender
Female
Male
Client
Age
0-4
5 -12
-
-
-
--
13 -17
-
-
-
-
-
-
-
-
-
--
--
--
18-34
35-54
55-74
-
-
-
--
75+
-
-_
-_
--
Unknown
_
TOTAL
TOTAL
Ethnicity/
Cultural
Background
Asian
-
-
-
--
Asian / White '
-
-
-
--
American Indian / Alaskan Native
-
-
-
--
American Indian / Alaskan Native & White
-
-
-
--
American Indian / Alaskan Native & Black
/ African American '
Black /African American
-
-
-
--
Black / African American & White.
--
His • anic / Latino
-
-
-
--
Native Hawaiian / Other Pacific Islander
--
--
White/Caucasian
-
--
Unknown / No Res•onse
=
-
TOTAL
-
--
Condition
Disablin• Condition
- -
ESL
'Limited Fimited Headed n•
Household
Female- Headed Household
Household
-
CITY OF AUBURN
Funder Reporting to: City of Auburn
Agency:
Reporting Period:
Program:
OUTCOMES REPORT - EXHIBIT4
to Date Form Completed:
Contact Person:
E -mail:
Phone:
4St Qtr Due: Outcome identified, indicators given, data collection method(s) explained
4t1, Otr. Due: Outcome results
OUTCOME: (What change do you expect to see?)
MEASURABLE INDICATORS: (How will you know change has occurred ?)
DATA COLLECTION METHOD(S):
OUTCOME RESULTS: (Narrative) highlight your data, include your interpretation of the data and attach any graphics if available
Funder Re ortin ' to: Cit of Auburn
Re I ortin . Period:
to
Date Form Com leted:
Agency:
Program:
Contact Person:
E -mail:
Phone:
CITY OF AUBURN
LOGIC MODEL REPORT - suggested Template
Program Evaluation Logic Model
PROCESS
RESOURCES
ACTIVITIES
OUTPUTS
OUTCOME
OUTCOMES
INDICATORS
GOAL