HomeMy WebLinkAboutLR Pickleweed Preschool Funding 2021-22E--
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FIRST 5 MARIN
Learn Grow Thrive
Program Contract Amendment
For Fiscal Year: 2021-2022
Project Name: Pickleweed Preschool
Contractor: City of San Rafael
Start/End Dates of Original Contract: July 1, 2021 through June 30, 2022
Budget for Current Fiscal Year: $106,098
Contract Number: 21-009-10
This Contract Renewal Amendment is between First 5 Marin Children and Families
Commission and City of San Rafael This Contract Amendment amends only the revised Exhibits
A, (Attachments Al and A2) and Exhibit B, Attachment B. All and any other agreements executed
under the original contract signed 6/22/11 are binding.
The timelines of this contract amendment are from July 1, 2021 to June 30, 2022
Revised Exhibit A ? YES [Z NOF -1
• Attach Exhibit A/ Attachment Al & A2/ Scope of Work & Performance Measures
Revised Exhibit B? YESIZ NO ❑
• Attach Exhibit B/Attachment B1/ Program Budget changes
Current Liability and Workers' Compensation Policies: Expiration Date -
Will the Project involve use of a vehicle? YES ❑ NO [/
• If yes, proof of automobile insurance is required immediately.
The "Contractor" agrees to the following terms and conditions in order to receive funds from
Marin Children and Families Commission.
• The "Contractor" will maintain a tobacco -free workplace
• The "Contractor" will not accept any funding from the tobacco industry, including event
sponsorship and in-kind contributions.
• The "Contractor" will purchase equipment that meets all applicable safety laws and
standards.
Both parties confirm their acceptance of this Contract Amendment by signing below.
CITY OF SAN RAFAEL
Jim Sc
FIRST 5 MARIN CHILDREN & FAMILIES
City Manager
Date
94-6000424
Contractor Federal Tax ID Number
ATTEST:
� •N„cwn.a
ef, r Lindsay Lara, City Clerk
APPROVED AS TO FORM:
T 44 � (Q W - &-'—
Robert F. Epstein, City Attor ey
Executive Director, First 5 Marin
Title
06-21-21
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Exhibit A- A2
Fiscal Year: 2019-2020
Contract Number: 21-009-10
First -5 3's Program Performance Measures
1) By the end of the year 100% of students will advance at least one developmental level in their
social and emotional understanding. (Social and Emotional Development Domain: Measure
SED 2 DRDP2019)
2) By the end of the year 100% of students will advance at least one developmental level in their
self-control of feelings and behavior. (Approaches to Learning -Self -Regulation Domain:
Measure ALT -REG 5)
3) By the end of the year 100% of students will advance at least one developmental level in both
their curiosity & initiative in learning, and engagement & persistence. (ALT -REG 5 & 7)
4) By the end of the year 100% of students will advance at least one developmental level in their
relationships and social interactions with peers—which will become increasingly cooperative.
(SED 4)
5) By the end of the year 100% of students will advance at least one developmental level in their
ability of shared use of space and materials. (ALT -REG 7)
6) By the end of the year 100% of students will advance at least one developmental level in their
ability to express themselves through language and their use of language in conversation.
(Language and Literacy Development Domain: Measure LLD 3 & 4)
7) By the end of the year 100% of students will advance at least one developmental level in
symbol, letter, and print knowledge in English. (English Language Development Domain:
Measure ELD 4)
8) By the end of the year 100% of students will advance at least one developmental level in their
ability to classify objects and pattern. (Cognition- Including Math and Science Domain:
Measure 2 & 6)
9) By the end of the year 100% of students will move up at least one developmental level in all
measures of Physical Development- Health Domain DRDP2015. (Gross Motor Movement &
Manipulative Skills, Fine Motor Skills, Active Physical Play, etc.)
10) By the end of the year 100% of students will move up at least one developmental level in their
healthy lifestyle choices. (PD-HLTH 10)
Projected Program Budget H I I Hll'iMtIV I t3
Reporting Period FY: 2021-2022
Agency Name: City of San Rafael
Project Name: Pickleweed Preschool
Funding Allocation from MCFC: $106,098
Revenues
Total Cash Expenses
$36,378
Total Cash Income
Expense/Revenue Diff
First 5 Marin
$106,098.001
Bil lingual Pay
1
Other income, list
Overtime Pa
$949.00
sll(,lowl. Personnel Costs
104,105.00
131. Benefits, as %salary
28 032.00
132. Wrkrs Comp Ins & Taxes
-
Total. Pensoluwl Cods
$
132,137.00
Project Operating E.rpenses:
TOTAL INCOME
$
$106,098.001
Maintenance building and improvement
$3 8,874
Expense Categories
A. Project P-,csonnel, list lloyi!jon, 141 U(fil llilnw, (Intl monthh.,
wlfth
Classified Personnel
Total Cash Expenses
$36,378
Ternp Help
$12,000
Fixed Term, Head Teacher, Instructor I
$54,058
Bil lingual Pay
$770
Overtime Pa
$949.00
sll(,lowl. Personnel Costs
104,105.00
131. Benefits, as %salary
28 032.00
132. Wrkrs Comp Ins & Taxes
-
Total. Pensoluwl Cods
$
132,137.00
Project Operating E.rpenses:
C. Professionial dues
$
250.00
Maintenance building and improvement
3,535.00
Rapair and Maint
1,000.00
Contractual Sery
650.00
Licensing fee
200.00
Office supplies
Recreation supplies
6,000.00
Utiliites
1,200.00
Subtotal Operating LXpellaes
$
12,835.00
Total Personnel & Operating E.vpenses
$
144,972.00
.f. Indirect, not to e.ve•eed 10% of bu(l,et
10'b
TOTAL EXPENSES
$
144,972.00
comments
https:llcityofsanrafael-my.sharepoint.com/personal/kellya_cityofsanrafael_org/Documents/Documents/Excel Folder/First 5
Budget/First 5 budget 21-22Project Budget
GRANT NO. 21-009-10
AGREEMENT BETWEEN
THE MARIN CHILDREN AND FAMILIES COMMISSION
AND
CITY OF SAN RAFAELICHILD CARE DIVISION
THIS AGREEMENT is entered Into between the Marin Children and Families Commission, hereinafter
called "Commission," and City of San Rafael Childcare Division hereinafter called "Contractor." (This
Agreement replaces any previous contracts between the Commission and the Contractor.)
WITNESS:
WHEREAS, pursuant to Health and Safety Code 130100, the Commission may contract for services to the
community; and
WHEREAS, the Exhibit A, Project Services and Exhibit B, Payments, Exhibit C, Tobacco Control Policy and
Exhibit D, Acknowledgement of Funding are attached hereto and incorporated by reference herein;
WHEREFORE, the Commission and Contractor agree as follows:
1. Services to be Performed
In consideration of the payments hereinafter set forth in Exhibit B, attached hereto and incorporated by
reference herein, Contractor under the general direction of the Executive Director of the Commission, or
his/her authorized representative, with respect to the product or result of Contractor's services, shall perform
services as described in Exhibit A and Exhibit D, attached hereto and incorporated by reference herein.
Contractor shall ensure compliance with all state, federal and local laws or rules applicable to performance
of the work required under this contract which includes the program for Pickleweed Preschool.
Exhibits A and B and their attachments reflect the scope of work, performance measures and budget for
the current fiscal year of the contract. It is understood and agreed that Contractor will submit to the
Marin Children and Families Commission a scope of work and budget for each subsequent year by Mav
1St' and receive written approval from the Executive Director, prior to commencing subsequent
Years of funding. The scope of work and/or budget may be amended, with written approval of the
Executive Director, upon review of the prior year's progress reports; however, that there shall be no
change in the maximum amount payable under this Agreement.
2. Contract Term
The term of this Agreement shall be from July 1, 2011 through June 30 2012. This contract is
renewable annually, subject to: availability of funds, annual review of performance measures
(specified in Exhibit A), financial reports (specified in Exhibit B), any required revisions, and
approval of the Executive Director of the Commission and approval by the City Manager of
Contractor. This Agreement is also subject to the termination provisions noted in paragraph 7, and subject
further to the agreement provided for in paragraph 7 and is subject further to paragraphs 3.13 and 11, that
there are reports due followed by final payment and evaluation required which occur after 30 days of the
termination letter. Contractor further agrees that the requirements of this Agreement pertaining to release
22-1-22 Page 1
J
of records in paragraph 12, and retention of records in paragraph 13 shall survive the termination of this
Agreement. Contractor retains professional and administrative responsibility for the services rendered
during the term of the contract.
3. Payments
A. Maximum Amount. In full consideration of Contractor's performance of the services
described in Exhibit A, the amount that the Commission shall be obligated to pay for services rendered
under this Agreement for shall not exceed Seventy-three thousand, Two -hundred and Eighteen Dollars
($73,218), payable based on quarterly invoices per established Commission payment procedures.
B. Rate of Payment. Payment shall be as specified in Exhibit B. Each payment shall be
conditioned on the performance of the services described in Exhibit A.
C. Time Limit for Submitting. Contractor shall submit quarterly progress reports within 15
days of the completion of every quarter starting October 15, 2011 (i.e., July 15, October 15, January 15,
April 15,) of each funded year under this Agreement for services to the Commission for payment in
accordance with the provisions of Exhibits A and B, unless otherwise determined by the Commission.
Guidelines for progress reports will be provided by Commission staff. Any substantial changes to the
approved project objectives and performance measures must be approved by the Commission or its
representative. Guidelines for such changes will be provided by Commission staff.
D. Availability of Funds. Payment for all services provided pursuant to this Agreement is
contingent upon the availability of funds under Proposition 10. In the event such funds are not provided or
not available to the Marin Children & Families Commission, the Commission shall not be liable for any
payment whatsoever, including, but not limited to, payments that are based on Commission funds. The
Commission may terminate the agreement for unavailability of State funds. In this event, the Commission
shall, through its Executive Director, inform Contractor of such unavailability as soon as it is known, and to
the extent legally possible pay all outstanding amounts due.
E. Supplantation. Funds pursuant to this Agreement are provided pursuant to Proposition 10
and are intended to supplement, expand upon, and enhance activities funded from existing sources.
Contractor shall not use funds under this Agreement to supplant existing resources or services.
4. Relationship of Parties
It is expressly understood that this is an agreement between two (2) independent contractors and that no
agency, employee, partnership, joint venture or other relationship is established by this Agreement. The
intent by both the Commission and Contractor is to create an independent contractor relationship.
Contractor expressly acknowledges and accepts his/her tax status as, and the tax consequences, of an
independent contractor.
5. Hold Harmless
Contractor shall indemnify and save harmless the Commission, its officers, agents, employees, and
servants from all claims, suits, or actions of every name, kind and description, brought for, on account of. (A)
injuries to or death of any person, including Contractor, or (B) damage to any property of any kind
whatsoever and to whomever belonging; or (C) any other loss or claim, including but not limited to, injuries
resulting from the concurrent active or passive negligence of the Commission, its officers, agents,
employees, or servants resulting from the performance of any work required of Contractor or payments
made pursuant to this Agreement, provided that this shall not apply to injuries or damage for which the
Commission has been found in a court of competent jurisdiction to be solely liable by reason of its own
negligence or willful misconduct.
Page 2
The duty of Contractor to indemnify and save harmless as set forth herein, shall include the duty to defend
as set forth in section 2778 of the California Civil Code.
6. Insurance
A. Liability Coverage. Contractor is self-insured and participates with other cities and public
entities in the California Joint Powers Risk Management Authority ("CJPRMA") for excess liability
coverage in the amount of $40,000,000 with a $500,000 self-insured retention. Contractor shall provide
to Commission a Certificate of Coverage, within thirty (30) days after execution of this Agreement,
naming the Commission, its officers, and employees, as additional insureds in the amount of
$1,500,000 above the Contractor's self-insured retention amount for liability arising out of the
Contractor's activities under this Agreement.
B. Worker's Compensation and Employer's Liability Coverage. Contractor shall have In
effect during the entire life of this Agreement Worker's Compensation and Employer's Liability providing
full statutory coverage. In signing this Agreement, Contractor makes the following certification, required
by California Labor Code Section 1861:
1 am aware of the provisions of Section 3700 of the California Labor Code, which requires every
employer to be insured against liability for Worker's Compensation or to undertake self-insurance in
accordance with the provisions of the Code, and I will comply with such provisions before commencing
the performance of the work of this Agreement.
C- Breach. If Contractor, for any reason, fails to maintain the insurance coverage which is
required pursuant to this Agreement, the same shall be deemed a material breach of this Agreement.
7. Non -Discrimination
Contractor shall comply with the non-discrimination requirements described below:
A. Non -Discrimination - General. No person shall, on the grounds of age (over 40), ancestry,
creed, color, disability, marital status, medical conditions, national origin, political or religious affiliation, race,
sex, sexual orientation or any non -job-related criteria be excluded from participation in, be denied the
benefits, or be subjected to discrimination under this Agreement.
B. Non -Discrimination - Emaloyment. Contractor shall ensure equal employment opportunity
based on objective standards of recruitment, selection, promotion, classification, compensation,
performance evaluations, and management relations, for all employees covered under this Agreement.
Contractor's equal employment opportunity policies shall be made available to the Commission upon
request.
Violation of the non-discrimination provisions of this Agreement shall be considered a breach of this
Agreement and subject the Contractor to penalties, to be determined by the Executive Director, after
consultation with the Chair of the Commission, including but not limited to:
i). termination of this Agreement;
ii) disqualification of the Contractor from bidding on or being awarded a Commission contract for a period of
up to 3 years.
The prohibitions and penalties contemplated by this section apply only to discrimination which results from,
or arises in the context of, the provision of services provided pursuant to the terms and conditions of the
Agreement, including but not limited to the provision of services to the general public and the employment of
persons to provide the services herein contemplated.
Page 3
8. Child Abuse Prevention and Reporting NOTE: APPLICABLE FOR DIRECT SERVICES
GRANTEE ONLY
Contractor agrees to ensure that all known or suspected instances of child abuse or neglect are
reported to a child protective agency as defined in Penal Code Section 11165.9. This responsibility
shall include:
A. A requirement that all employees, consultants, or agents performing services under this
contract who are required by Penal Code Section 11166(a), to report child abuse or neglect, sign a
statement that he or she knows of the reporting requirement and will comply with it.
B. Establishing procedures to ensure reporting even when employees, consultants, or
agents who are not required to report child abuse under Penal Code 11166(a), gain knowledge of, or
reasonably suspect that a child has been a victim of abuse or neglect.
C. Contractor agrees that its employees, subcontractors, assignees, volunteers, and any other
persons who provide direct services under this contract and who will have supervisory or disciplinary
power over a minor or any person under his or her care (Penal 11105.3) will be fingerprinted in order to
determine whether they have a criminal history which would compromise the safety of children with whom
Contractor's employees, subcontractors, assignees or volunteers have contact. All fingerprinting services
will be at the Commission's discretion and the Contractor's expense.
9. Tobacco Control Policy
All Contractors will implement and enforce the revise Tobacco Control Policy adopted by the
Commission December 3, 2003 (Exhibit C, signature required).
10. Assignments and Subcontracts
Without the written consent of the Executive Director of the Commission or his/her designee, this
Agreement is not assignable in whole or in part. Any assignment by Contractor without the written
consent both parties is void and shall automatically terminate this Agreement. All assignees,
subcontractors, or consultants approved in writing by the Executive Director of the Commission or
his/her designee shall be subject to the same terms and conditions applicable to Contractor under this
Agreement, and Contractor shall be liable for the assignee's, subcontractor's or consultant's acts and/or
omissions.
11. Termination of Agreement
The Executive Director, after consultation with the Chair of the Commission, may at any time from execution
of Agreement, terminate this Agreement, in whole or in part, without cause and for the convenience of the
Commission, by giving written notice specifying the effective date and scope of such termination.
Termination shall be effective on a date not less than thirty days from notice. In the event of termination, all
finished or unfinished documents, data, studies, maps, photographs, reports, and materials (hereafter
referred to as materials) prepared by Contractor under this Agreement shall be promptly delivered to the
Commission. In the event of termination, with the exception of the stipulations in paragraph 3D, the
Contractor shall be paid for all work performed until termination. Such payment shall be that portion of the
full payment that is determined by comparing the work/services completed to the work/services required by
the Agreement.
Page 4
12. Release of Records
All data produced, compiled, and obtained in connection with the performance of this contract shall not
be disclosed to any third party without notification to the Commission staff. All data produced or
compiled by Contractor shall be considered confidential unless it shall constitute a public record under
the current California law and shall not be shared with a third party without notification and approval
from the Commission staff. The term 'data' in this section shall refer generally to aggregate information
complied for the purpose of program evaluation, and shall not include any information otherwise
privileged under the laws of the State of California.
Each party shall maintain the confidentiality of medical records as required by law, including but not limited
to the Health Insurance Portability and Accountability Act (HIPPA) (45 C.F.R. Part 160, et seq.) and the
Confidentiality of Alcohol and Drug Abuse Patient Records Act (42 C.F.R. Part 2), as amended from time to
time.
Notwithstanding any provision of this Agreement to the contrary, neither party shall be obligated to disclose
or make available for review to the other party any patient -specific information where such disclosure would
violate applicable provisions of federal and state law regarding the confidentiality of medical records. The
Commission will not at any time, either during or subsequent to the term of this Agreement, disclose to
others, use, copy or permit to be copied, without express written consent of the Contractor, except pursuant
to Commission's duties herein, any confidential or propriety information of the Contractor, including but not
limited to costs, patients, and/or treatment methods.
13. Records
Contractor agrees to provide to the Commission, to any Federal or State department having monitoring
or reviewing authority, to Commission's authorized representatives and/or their appropriate audit agencies
upon reasonable notice, access to and the right to examine and audit all records and documents necessary
to determine compliance with relevant Federal, State, and local statutes, rules and regulations, and this
Agreement, and to evaluate the quality, appropriateness and timeliness of services performed.
Contractor shall maintain and preserve all records in its possession of any third party performing work
related to this Agreement for a period of three (3) years from the termination date of this Agreement, or until
audit findings are resolved; however, the maximum period will not exceed three (3) years from termination of
this agreement.
14. Title
All new products and concepts, however recorded, prepared or generated by the Contractor in the
performance of this Agreement shall be the exclusive property of the Marin Children and Families
Commission. The term "product" as used in the Agreement shall include, but is not limited to,
documentation, findings, design, report, form, evaluation, method of analysis, system, software
developed, design documents and concepts related to the work under this Agreement. This Agreement
shall preclude Contractor from using or marketing products developed or originated for the Commission
hereunder unless and until the parties execute a marketing agreement. All products, inventions, and
discoveries developed in the performance of this Agreement while using Commission facilities, including
hardware and software shall be the property of the Commission. If such product, invention, or discovery
shall be determined to be the property of Contractor, Commission shall be granted a nonexclusive,
Irrevocable, royalty free license to use said invention or discovery. Notwithstanding the foregoing,
Contractor may retain and use copies of new or unique work completed with the support of this
Contractor for its reference, use and documentation of its experience and capabilities.
Page 5
Contractor agrees to credit Commission for funding support on all materials developed through this
Agreement.
15. Audit
If applicable, a copy of the agency's annual report shall be submitted with the agency's annual report to the
Commission. For the purposes of this contract, in lieu of submitting the entire City of San Rafael Child
Care Division, fiscal audit for each year of this agreement, City of San Rafael Child Care Division will
submit the Agency's specific audit reports of all revenues received from all budgeted sources, all
expenditures made, and remaining encumbrances that are related to this specific contract's budget
obligations.
16. Compliance with Applicable Laws
All services to be performed by Contractor pursuant to this Agreement shall be performed in accordance
with all applicable Federal, State, County and Municipal laws, ordinances, regulations, including but not
limited to appropriate licensure, certification regulations, confidentiality requirements and applicable quality
assurance regulations.
Contractor shall ensure that its services are accessible to people with disabilities as per DHEW Regulations,
Section 504 of the Rehabilitation Act of 1973.
17. Monitoring/Evaluation
Contractor shall retain professional and administrative responsibility for services rendered.
Contractor shall track achievement of program objectives and the process, impact and outcome measures
for this project as they are described in Exhibit A and included herein, or as revised in collaboration with the
Commission's Evaluator and approved in writing by the Executive Director, after consultation with the Chair
of the Commission, during the term of this contract. Contractor shall reasonably participate in a countywide
evaluation of the effectiveness of Proposition 10 efforts, whether it occurs during the term of this contract or
after, provided that such evaluation shall commence within twelve months following termination of the
Contract. Participation in the countywide evaluation may require Contractor to, among other things, prepare
and present an evaluation of the Grant Program's effectiveness in addressing and meeting its purpose.
18. Alteration of Agreement
This Agreement is entire and contains all the terms and conditions agreed upon by the parties. No
alteration or modifications shall be valid unless made in writing and signed by the parties hereto, or as
permitted by the terms of this Agreement, and no oral understanding or agreement shall be binding on the
parties hereto.
19. Notices
A. Any notice, request, demand or other communication required or permitted hereunder shall
be deemed to be properly given when deposited in the United States mail, postage prepaid, addressed:
1) In the case of Commission, to:
Amy Reisch, Executive Director
First 5 Marin Children and Families Commission
1101 5t' Avenue, Suite 215
San Rafael, CA 94901
Page 6
Phone: (415) 257.8555
2) in the case of Contractor, to:
William Scharf
City of San Rafael
Assistant Director, Community Services
PO Box 151560, San Rafael, CA 94915-1560
(415) 485.3338
B. Controllinq Law
The validity of this Agreement and of its terms or provisions, as well as the rights and duties of the parties
hereunder and In any action at law or in equity, including an action for declaratory relief, brought to enforce
or interpret provisions of this Agreement, the interpretation and performance of this Agreement shall be
governed by the laws of the State of California.
IN WITNESS WHEREOF, the parties hereto, by their duly authorized representatives, have affixed their
hands.
CITY OF SAN RAFAEL FIRST 5 MCFC
NANCY MACKLE, Ci try Manage►• Amy L. Reisch
PRINT Contractor Authorized Name and Title Executive Director
qLaAco - e�" �- va.4"t
I
SIGNATURE OF ONTRACTOR SIGNATUAt OF EXECUTIVE DIRECTOR
li/15/201]
Date
94-6000424
Contractor Federal Tax ID Number
APPROVED AS TO FORM:
ROBERT F. EPST IN, ity Attorney
G
Date
Page 7
EXHIBIT A
PROJECT SERVICES
Pursuant to the Agreement for Services between the Marin Children and Families Commission and City
of San Rafael entered onto on July 1, 2011, the Contractor shall provide the following services as
described in Attachment A, attached hereto and incorporated by reference herein, over the term of this
contract from July 1, 2011 through June 30, 2012.
Attachment A reflects the Scope of Work and Performance Measures for the entire term of the contract.
A. It is understood and agreed that Contractor will submit to the Marin Children and Families
Commission Executive Director, prior to commencing the subsequent year of funding a Scope of Work,
Performance Measures, Data Collection Report, and budget. The Scope of Work, Performance
Measures, Data Collection Report and/or budget may be amended, with written approval of the
Executive Director, upon review of the prior year's progress reports; however, that there shall be no
change in the maximum amount payable under this Agreement.
B. Contractor will enter First 5 Marin Quarterly Data in Persimmony within 15 days of completion of
each quarter, starting with the first quarter of this contract. Mid -year and End -of -year reports shall
include a descriptive narrative, Performance Measures, and a detailed financial accounting of all grant
funds spent in comparison with the approved budget.
C. Contractor will submit a copy of a Memorandum of Understanding (MOU) or contract will any
and all assignees, subcontractors, or consultants included as part of the Budget, Scope of Work or
Performance Measures before commencing work under this Agreement.
D. All reporting to the Commission shall comply with established Commission policies, procedures,
and protocols.
Page 8
EXHIBIT B
PAYMENTS
Pursuant to the Agreement for Services between the Marin Children and Families Commission and City
of San Rafael entered onto on July 1, 2011, the Commission shall pay, as described In Attachment B,
attached hereto and incorporated by reference herein, to City of San Rafael for services rendered, over
the term of this contract from July 1, 2011 through June 30, 2012.
Attachment B reflects the anticipated budget for the entire term of the contract. It is understood and
agreed that Contractor will submit an updated budget for each subsequent Year by May 15 of each
fiscal year and receive written approval from the Executive Director, prior to commencing the
subsequent year provided that annual performance measures (Attachment 1) have been adequately
met; however, that there shall be no change in the maximum amount payable under this Agreement It
is anticipated that the budget may be amended, with the written approval of the Executive Director, upon
review of the prior year's progress reports. It is also understood that contractor may earn money from
funds received under this contract. Any monies earned from investments or otherwise shall be
expended on services provided under this contract. Provision for expenditure of this money shall be
included in subsequent year budgets.
1. The Commission shall pay Contractor on a quarterly basis following receipt of the required
quarterly reporting forms. Guidelines for the progress reports will be provided by the Commission staff
and shall include a descriptive narrative, an updated Scope of Work, an updated Performance
Measures, submission of required Demographic and Service Data, and a detailed financial accounting
of all grant funds spent in comparison with the approved budget.
2. Payment shall be conditioned on the performance of the services described in Exhibit A.
3. The amount that the Commission shall be obligated to pay for services rendered under this
Agreement shall not exceed Seventy-three thousand, Two -hundred and eighteen dollars ($73,218)
for the contract term, July 1, 2011 through June 30, 2012.
4. Contractor shall expend funds received, in accordance with the budget as described in
Attachment B, attached hereto and incorporated by reference herein, or as approved later by the
Executive Director, in writing, on behalf of the Commission.
5. Contractor will submit a copy of a Memorandum of Understanding (MOU) or contract will any
and all assignees, subcontractors, or consultants included as part of the Budget, Scope of Work or
Performance Measures before commencing work under this Agreement.
6. All reporting to the Commission shall comply with established Commission policies,
procedures, and protocols.
Page 9
EXHIBIT C
TOBACCO CONTROL POLICY
A. Attach proof of a Comprehensive Tobacco -Free Environment Policy
All agencies receiving grant funding over $10,000 annually from the Marin Children and Families
Commission will provide to the Commission a written copy of an established comprehensive tobacco -
free policy. This policy shall prohibit the use of tobacco products at any time in agency vehicles or
buildings, or 20 feet from entrances, windows or outdoor common areas. The policy shall have clear
procedures for implementation, protocols for monitoring compliance, reporting of violation and
instituting sanctions. The following activities should be included in the implementation of the policy:
a) Information about the policy and enforcement procedures shall be communicated by
administration clearly to staff, parents, and/or clients with in the larger community.
b) Signs stating "NO SMOKING" shall be prominently displayed at all entrances of building
property. Additional "NO SMOKING' signs shall be posted in restrooms and other areas as
appropriate, such as windows through which secondhand smoke can enter.
C) When appropriate, information about smoking cessation and support programs shall be
made available and promoted for staff, parents and/or clients.
d) The agency shall encourage families with small children to not allow smoking in their
homes and cars whenever and wherever children are present, including outdoors.
B. Submit Disclosure of Tobacco Industry Funding or Attach Proof of Non -Acceptance
All agencies receiving grant funding over $10,000 annually from Marin Children and Families
Commission will be required to disclose in writing the known acceptance of funds, goods or services
from any tobacco company or its subsidiaries.
C. Attach Proof of Divestment from Tobacco Companies
Before receiving grant funding over $10,000 annually from the Commission, agencies will be required
to divest any investments in companies that are known to the Contractor to derive more than 15% of
their revenues from tobacco products. A list of such companies will be provided with all applications
and/or proposals for funding that are submitted to the Commission.
1. 1 have attached a copy of a Comprehensive Smoke-free Environment Policy for my
agency.
2. 1 have attached a board policy of Non -Acceptance of Tobacco Company Funding.
OR I have attached a copy of my agency's financial records indicating all income sources.
3. 1 have attached a board policy of Non -investment in Companies that are Known to Derive
Greater than 15% of Profits from Tobacco Products.
OR I have attached a copy of my agency's financial records/audit/investment portfolio as
proof that
our agency does not receive over 15% of revenue from tobacco products.
Name of Authorized Signer, Title Date
Name of
Contractor
Page 1
RAFq�`
1
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y WITH P'
CONTRACT ROUTING FORM
INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below.
TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER:
Contracting Department: Library and Recreation
I Project Manager: Kelly Albrecht Extension: 3386
Contractor Name: First 5 Marin Program Contract Amendment FY 2021-2022
Contractor's Contact: Marin First 5 Contact's Email: Pegah Faed pegah@first5marin.org
❑ FPPC: Check if Contractor/Consultant must file Form 700
Step RESPONSIBLE
DESCRIPTION
COMPLETED
REVIEWER
DEPARTMENT
DATE_
Check/Initial
1 Project Manager
a. Email PINS Introductory Notice to Contractor
❑
6/28/2021
b. Email contract (in Word) and attachments to City
Attorney c/o Laraine.Gittens@cityofsanrafael.org
❑
a. Review, revise, and comment on draft agreement
2 City Attorney
(. I
and return to Project Manager
II
❑
b. Confirm insurance requirements, create Job on
PINS, send PINS insurance notice to contractor
❑
3 Department Director
Approval of final agreement form to send to
❑
contractor
4
Project Manager
Forward three (3) originals of final agreement to
❑
contractor for their signature
S
Project Manager
_
When necessary, contractor -signed agreement
❑ N/A
agendized for City Council approval *
'City Council approval required for Professional Services
❑
Agreements and purchases of goods and services that exceed
Or
$75,000; and for Public Works Contracts that exceed $175,000
Click here to
Date of City Council approval
CONTINUE ROUTING PROCESS WITH HARD COPY
Forward signed original agreements to City
enter a date
PRINT
_
6
Project Manager
Attorney with printed copy of this routing form
7
City Attorney
Review and approve hard copy of signed
agreement
8
City Attorney
Review and approve insurance in PINS , and bonds
_(for Public Works Contracts)
9 City Manager/ Mayor
Agreement executed by City Council authorized
official
10 City Clerk
Attest signatures, retains original agreement and
forwards
'
copies to Project Manager
l