HomeMy WebLinkAboutCC Resolution 11601 (Preschool Services; First Five Marin)RESOLUTION NO. 11 601
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL
AUTHORIZING ENTERING INTO A TWO YEAR CONTRACT WITH
FIRST FIVE MARIN (MARIN CHILDREN AND FAMILIES
COMMISSION) FOR EXPANDED PRESCHOOL SERVICES IN THE
CANAL AND AUTHORIZING THE CITY MANAGER TO SIGN
CONTRACT DOCUMENTS IN THE AMOUNT OF $1429518.00
WHEREAS, the City of San Rafael has been awarded a two-year contract with the First
Five Marin (Marin Children and Families Commission) in the amount of $142,518.00;
and
WHEREAS, the City Council approves the contract and authorizes the City Manager to
sign designated contract documents with First Five Marin (Marin Children and Families
Commission),
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of San Rafael
enter into a contract in the amount of $142,518.00 with First Five Marin (Marin Children and
Families Commission) for preschool services, a copy of which is hereby attached and by this
reference made a part thereof.
I, JEANNE M. LEONCINI, Clerk of the City of San Rafael, hereby certify that the
foregoing Resolution was duly and regularly introduced and adopted at a regular meeting of the
City Council of said City held on Mondav, the 19'' day of Julv. 2004 by the following vote, to
wit:
AYES: COUNCILMEMBERS: Cohen, Heller, Hiller, Phillips & � layor Boro
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: None
JEA E�v1. LEONCINI, City Clerk
OGINA �'� o\L. �
N\
GRANT NO. 20-009-05-01
AGREEMENT BETWEEN
THE MARIN CHILDREN AND FAMILIES COMMISSION
AND
City of San Rafael, Child Care Division
Pickleweed Children's Center — School Readiness
THIS AGREEMENT is entered into between the Marin Children and Families Commission, hereinafter called
"Commission," and City of San Rafael, Chid Care 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, are attached hereto and incorporated by
reference herein;
WHEREFORE, the Commission and Contractor agree as follows:
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, 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 Children's Center - School Readiness
Exhibits A and B and their attachments reflect the scope of work and budget for the entire term of the contract,
July 1, 2004 through June 30, 2006 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 April 15, and
receive written approval from the Executive Director, after consultation with the Chair of the Commission, 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, 2004 through June 30, 2006, subject to annual review of
performance measures specified in Exhibit A. 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 furtherto paragraphs
3.0 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 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.
Pavments
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 shall
not exceed One hundred forty-two thousand, Five Hundred Eighteen dollars ($142,518.00)[ (Fiscal Year
2004/2005 Seventy thousand, Four hundred Seventy-two dollars ($70,472.00), Fiscal year 2005/2006,
Seventy-two Thousand, Forty-six thousand dollars ($72,046.00)] payable based on quarterly invoices per
established Commission payment procedures.
B. Rate of Payment. Payrr shall be as specified in Exhibit B. Each 1 lent shall be conditioned on the
performance of the services described in Exhibit A.
C. Time Limit for Submittinq. Contractor shall submit quarterly progress reports within 30 days of the
completion of every quarter starting October 30, 2004 (i.e., July 30, October 30`x', January 30", April 30°i,) 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.
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
The Contractor shall not commence work or be required to commence work under this Agreement unless and until
all insurance required under this paragraph has been obtained and the Executive Director of the Commission has
approved such insurance and Contractor shall use diligence to obtain such insurance and to obtain such approval.
The Contractor shall furnish the Commission with certificates of insurance evidencing the required coverage within
ten (10) days following the execution of this contract, and there shall be a specific contractual liability endorsement
extending the Contractor's coverage to include the contractual liability assumed by the Contractor pursuant to this
Agreement and documentation that the Commission is an additional insurance holder. These certificates shall
specify or be endorsed to provide that thirty (30) days' notice must be given, in writing, to the Commission of any
pending change in the limits of liability or of any cancellation or modification of the policy.
A. Worker's Compensation and Employer's Liability Insurance. The Contractor shall have in effect during
the entire life of this Agreement Worker's Compensation and Employer's Liability Insurance providing full
statutory coverage. In signing this Agreement, the Contractor makes the following certification, required by
section 1861 of the California Labor Code:
I 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
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comply with such p dons before commencing the performanc the work of this
Agreement.
B. Liability insuranGe. The G9AtFaGtGF shall mcintcin
Injufy ! QUity c cc chall
h incumnse shall he nnmhined single limit bodily inii y and nrepeFty
c then the
For purposes of this contract between Marin Children and Families Commission and the City of San
Rafael, Child Care Division, for the Pickleweed Children's Center — School Readiness Program, it is
understood that requirements for 6(B) Liability Insurance will be covered under the City of San Rafael's
self-insured status and membership in the CJPRMA insurance pool.
Such insurance shall include:
(a) Comprehensive General Liability $1,000,000
(b) Motor Vehicle Liability Insurance $1,000,000
In the event of the breach of any provision of this section, or in the event any notice is received which indicates any
required insurance coverage will be diminished or canceled, the Commission at its option, may, notwithstanding
any other provision of this Agreement to the contrary, immediately declare a material breach of this Agreement and
suspend all further work and payments pursuant to 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 - Employment. 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.
8. Child Abuse Prevention and Reportinq. 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.
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C. Contractor agrees that it iployees, subcontractors, assignees, volt :rs, and any other persons who
provide direct services under this contract and who will have supervisory or disuplinary 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 Policv
All Contractors working at the Citv of San Rafael, Pickleweed Children's Center will implement and enforce the
revise Tobacco Control Policy adopted by the Commission December 3, 2003 (Exhibit C, signature required).
10. Assianments and Subcontracts
A. 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.
B. 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 Aareement
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., 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.
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.
Page 4
Contractor shall maintain and erve all records in its possession of any tl )arty 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.
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.
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. Mon itorinq/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 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.
Page 5
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
Marin Children and Families Commission
5234 th Street, Suite 210
San Rafael, CA 94901
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. Controllina 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.
Citv of San Rafael, Child Care Division
Rod Gould;
City ManaEer _
City of San ael
SIGN RE OF CONTRACTOR
July 19, 20
Date
ATTEST:
,je ad A e.r•i. -Leon*, L.izy Clerl<
94-6000424
Contractor Federal Tax ID Number
Marin Commission On Children And Families
Amy L. Reisch,
Executive Director
Marin Commission on Children and Families
SIGNATURE OF EXECUTIVE DIRECTOR
Date
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EXHIBIT A
PROJECT SERVICES
Pursuant to the Agreement for Services between the Marin Children and Families Commission and City of San
Rafael, Chid Care Division onto on July 1, 2004. Contractor shall provide the following services as described in
Attachment 1, attached hereto and incorporated by reference herein, over the term of this contract from July 1,
2004 through June 30, 2006
Attachment 1 reflects the Scope of Work and Performance Measures for the entire term of the contract.
1 . It is understood and agreed that Contractor will submit to the Marin Commission on Children and
Director, after consultation with the Chair of the Commission, 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.
2. Contractor will submit the MCFC Quarterly Progress Report to Commission Staff within 30 days of
completion of each quarter, starting with the first quarter of this contract. Reports shall include a descriptive
narrative, tracking of the approved Scope of Work and Performance Measures, Data Collection Report, and
a detailed financial accounting of all grant funds spent in comparison with the approved budget.
3. 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.
4. All reporting to the Commission shall comply with established Commission policies, procedures,
and protocols.
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EXHIBIT B
PAYMENTS
Pursuant to the Agreement for Services between the Marin Children and Families Commission and City of San
Rafael, Chid Care Division entered onto on July 1, 2004 the Commission shall pay, as described in Attachment 2,
attached hereto and incorporated by reference herein, to City of San Rafael, Chid Care Division for services
rendered, over the term of this contract from July 1, 2004 through June 30, 2006
Attachment 2 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 and receive written approval from the
Executive Director, after consultation with the Chair of the Commission, prior to commencing the subsequent year
provided that annual performance measures (Attachment A) 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 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 One hundred forty-two thousand, Five Hundred Eighteen and 00/100 dollars ($142,518.00) {Fiscal Year
2004/2005 Seventy thousand, Four hundred Seventy-two dollars ($70,472.00)„ Fiscal year 2005/2006, Seventy-
two Thousand, Forty-six thousand dollars ($72,046.00)] for the contract term, July 1, 2004 through June 30,
2006.
4. Contractor shall expend funds received, in accordance with the budget as described in Attachment 2, 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.
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ATTACHMENT 2
YEAR 1 PROJECT BUDGET
Agency Name: Citv of San Rafael, Child Care Division
Project Name: Pickleweed Children's Center — School Readiness
Total Dollar Amount Requested:$70,472
Length of funding requested, in months: July 2004 — June 2005
Applicant may use alternative format to submit budget information but all information requested below must be include
Revenues Cash Revenues In-kind Revenues Total Project Revenues
First Five
Marin CFC 70,472 70,472
Other income, list �,;K1
City of San Rafael, Child Care Div. 10,200 10,200
TOTAL INCOME $70,472 $10,200 $80,672 �l
Expense Categories I Cash Expenses I In-kind Expenses I Total Project Expenses
A. Project Personnel, list position, % of
full time, and monthly salary
Center Director 7812 7812
Head Teacher 31248 31248
Asst Teacher 9600 9600
Supervisor 6000 6000
B. Fringe, as 23.2 % salary
---
11332
11332
Subtotal, personnel costs
C. Rent
3000
3000
D. Other Operating Expenses
`5980
5980
E. Equipment, over $500
**3000
3000
F. Travel & Training
1000
1000
G. Consultants
500
H. Subcontractors
500
I. Other Costs
1200
1200
Subtotal
70472
70472
J. Indirect, % of budget
TOTAL EXPENSES
$70,472 I $10,200 I
$80,6721
*Includes Utilities, building maintenance,
recreation and office supplies, snacks/food.
**Classroom furnishings (Bookcases, shelves, tables and chair), some Montessori classroom materials.
ATTACHMENT 2
YEAR 2 PROJECT BUDGET
Agency Name: Citv of San Rafael. Child Care Division,
Project Name: Pickleweed Children's Center — School Readiness
Total Dollar Amount Requested:$72,046
Length of funding requested, in months: July 2005 -June 2006
Applicant may use alternative format to submit budget information but all information requested below must be include
Revenues Cash Revenues In-kind Revenues Total Project Revenues
First Five Marin CFC $72,046
Other income, list
City of San Rafael, Child Care Div. 10410 10410
+I
I
TOTAL INCOME $72,046 $10,410 $82,456
Expense Categories Cash Expenses In-kind Expenses Total Project Expenses
A. Project Personnel, list positions, %
of full time, and monthly salary
Center Director 20% FTE
8202
8202
Head Teacher 80% FTE
32810
32810
Asst Teacher 50% FTE
10080
10080
Supervisor
6000
6000
B. Fringe, as 22% salary
11899
11899
Subtotal, personnel costs
C. Rent
3150
3160
D. Other Operating Expenses
*6555
6280 �
E. Equipment, over $500
500
1000
F. Travel & Training
1000
1250
G. Consultants
525
H. Subcontractors
500
I. Other Costs
500
1260
1260 1
Subtotal
I
J. Indirect, % of budget
TOTAL EXPENSES I
$72,046 I
$10,410
$$82,4561
`Includes Utilities, building maintenance, recreation and office supplies, snacks/food.
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.
I 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
Name of Contractor
Date
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