HomeMy WebLinkAbout072814_ca04Consent Agenda
Commissioners Office
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Leslie Locke, Deputy Clerk of the Board
DATE: July 21j ,.2014
SUBJECT: AGREEMENT, Subrecipient re: re: 2014 Community Development Block
Grant (CDBG) Public Services Grant; In the Amount of $96,249;
Jefferson County Administrator; Olympic Community Action Program
(OlyCAP)
STATEMENT OF ISSUE:
For several years, Jefferson County has received and administered the Washington State Department of
Commerce's Community Development Block Grant (CDBG). The BOCC also approved a contract between
Department of Commerce and Jefferson County to fund public services for low to moderate income
individuals and families in Jefferson County.
Jefferson County has historically contracted with Olympic Community Action Programs (OlyCAP) as the
Subrecipient who provides the serve directly to the public. This new agreement covers the grant period of
July 1, 2014 to June 30, 2015.
FISCAL IMPACT:
The agreement provides $96,249 to go to Subrecipient for public service program costs. Jefferson County
will receive $3,000 for grant administration.
RECOMMENDATION:
Approve Subrecipient agreement with Olympic Community Action Program (OlyCAP).
ip Mr
t Admi trator Date
SUBRECIPIENT AGREEMENT FOR CDBG PUBLIC SERVICES
SUBRECIPIENT AGREEMENT FOR CDBG PUBLIC SERVICES
THIS AGREEMENT is between the local government CDBG recipient Jefferson County (herein called
the Local Government) and Olympic Community Action Programs (herein called the Subrecipient) for
public services funded by the state Community Development Block Grant (CDBG) Program.
As the Washington State Department of Commerce (Commerce) is authorized by the federal Department
of Housing and Urban Development (HUD) to provide funds to units of local government selected to
undertake and carry out certain activities and projects under the Washington State CDBG Program in
compliance with all applicable local, state, and federal laws, regulations and policies; and
As the Local Government has applied for and received a CDBG award, contract number 14- 65400 -007
to fund public services; and
As it benefits the Local Government to engage the Subrecipient to accomplish the Scope of Work and the
objectives of the local CDBG project;
The parties agree that:
1. SCOPE OF WORK
A. Local Government Responsibilities
The Local Government is responsible for administration of the CDBG contract, and ensuring CDBG
funds are used in accordance with all program requirements [(24 CFR 570.501(b)] and its CDBG
contract with Commerce referenced above. The Local Government will provide such assistance and
guidance to the Subrecipient as may be required to accomplish the objectives and conditions set forth
in this Agreement.
B. Subrecipient Responsibilities
The Subrecipient shall complete in a satisfactory and proper manner as determined by the Local
Government the tasks described in the attached Scope of Work and Budget to accomplish the
objectives of the CDBG project.
The Subrecipient will periodically meet with the Local Government to review the status of these tasks.
2. TIME OF PERFORMANCE
The time of performance for this Agreement will begin the date the parties sign and complete
execution of this agreement for funding available as of the effective date established by the Local
Government's CDBG contract, and will be in effect for the time period during which the Subrecipient
remains in control of CDBG funds or other CDBG assets. The parties to this Agreement acknowledge
that the start date for performance of their obligations under this Agreement shall be July 1, 2014 and
the end date for performance of their obligations under this Agreement shall be June 30, 2015.
Payment to Subrecipient for work performed under this Agreement may occur after the end date
described here.
3. BUDGET
The Subrecipient shall follow the budget approved by Commerce and the Local Government and
attached to this Agreement (Attachment #2). The Local Government may require a more detailed
budget breakdown, and the Subrecipient shall provide such supplementary budget information in a
timely fashion in the form and content prescribed by the Local Government. Any amendments to the
budget must first be determined by the Local Government as consistent with its CDBG contract with
Commerce and then approved in writing by the Local Government and the Subrecipient.
4. PAYMENT
The Local Government shall reimburse the Subrecipient in accordance with the public services
payment procedures provided by the CDBG Program for all allowable expenses agreed upon by the
parties to complete the Scope of Work.
In no event shall the total amount to be reimbursed by the Local Government to the Subrecipient
exceed the sum of Ninety -Six Thousand Two Hundred Forty -Nine Dollars Even ($96,249.00).
Reimbursement under this agreement will be based on billings, supported by appropriate
documentation of costs actually incurred. It is expressly understood that claims for reimbursement will
not be submitted in excess of actual, immediate cash requirements necessary to carry out the
purposes of the Agreement. Funds available under this Agreement will be utilized to supplement
rather than supplant funds otherwise available.
The Local Government may pay the Subrecipient for overtime, extra -pay shifts, and multi -shift work
only with prior approval. Exceptions are as follows:
1) When necessary to cope with emergencies, such as those resulting from accidents, natural
disasters, breakdowns of equipment, or occasional operational bottlenecks of a sporadic
nature.
2) When employees are performing indirect functions, such as administration, maintenance, or
account.
3) In the performance of tests, laboratory procedures, or other similar operations which are
continuous in nature and cannot reasonably be interrupted or otherwise completed.
4) When lower overall cost to the federal Government will result.
It is understood that this Agreement is funded in whole or in part with CDBG funds through the
Washington State CDBG Program as administered by Commerce and is subject to those regulations
and restrictions normally associated with federally- funded programs and any other requirements that
the state may prescribe.
Subrecipient shall be entitled to payment for any work performed between July 1, 2014 and June 30,
2015 pursuant to the terms and conditions of this Agreement regardless of the effective date of this
Agreement.
5. PERFORMANCE MONITORING
The Local Government will monitor the performance of the Subrecipient as outlined in the Scope of
Work (Attachment #1 to this Agreement) by tracking project progress, reviewing payment requests for
applicable costs, managing the timely pass- through of CDBG funds, overseeing compliance with
CDBG requirements, and ensuring recordkeeping and audit requirements are met. Substandard
performance as determined by the Local Government will constitute noncompliance with this
Agreement.
If action to correct such substandard performance is not taken by the Subrecipient within a reasonable
period of time after being notified by the Local Government, contract suspension or termination
procedures will be initiated.
6. SPECIAL CONDITIONS
In addition to the requirements and obligations imposed upon the Subrecipient by Section 7.F below,
the parties agree the following requirements and obligations with respect to insurance are made part
of this Agreement and apply to the Subrecipient and where applicable, the COUNTY:
The Subrecipient shall obtain and keep in force during the terms of the Agreement, policies of
insurance as follows:
Commercial Automobile Liability Insurance providing bodily injury and property damage liability
coverage for all owned and non -owned vehicles assigned to or used in the performance of the
work for a combined single limit of not less than $500,000 each occurrence with the COUNTY
named as an additional insured in connection with the SUBRECIPIENT'S performance of the
contract.
General Commercial Liability Insurance in an amount not less than a single limit of one million
dollars ($1,000,000) per occurrence and a aggregate of not less than two (2) times the occurrence
amount ($2,000,000.00 minimum) for bodily injury, including death and property damage, unless a
greater amount is specified in the contract specifications. The insurance coverage shall contain no
limitations on the scope of the protection provided and include the following minimum coverage:
a. Broad Form Property Damage, with no employee exclusion;
b. Personal Injury Liability, including extended bodily injury;
C. Broad Form Contractual /Commercial Liability — including completed operations;
d. Premises — Operations Liability (M &C);
e. Independent Contractors and subcontractors;
f. Blanket Contractual Liability.
Such insurance coverage shall be evidenced by one of the following methods:
* Certificate of Insurance;
* Self- insurance through an irrevocable Letter of Credit from a qualified financial
institution.
Certificates of coverage as required by this section shall be delivered to the County within fifteen
(15) days of execution of this agreement.
The Subrecipient shall include all subcontractors as insured under its insurance policies or shall
furnish separate certificates and endorsements for each subcontractor. All insurance provisions
for subcontractors shall be subject to all of the requirements stated herein.
Failure of the Subrecipient to take out and /or maintain any required insurance shall not relieve The
Subrecipient from any liability under the Agreement, nor shall the insurance requirements be
construed to conflict with or otherwise limit the obligations concerning indemnification.
It is agreed by the parties that insurers shall have no right of recovery or subrogation against the
County (including its employees and other agents and agencies), it being the intention of the
parties that the insurance policies so affected shall protect both parties and be primary coverage
for any and all losses covered by the above described insurance. It is further agreed by the parties
that insurance companies issuing the policy or policies shall have no recourse against the County
(including its employees and other agents and agencies) for payment of any premiums or for
assessments under any form of policy. It is further agreed by the parties that any and all
deductibles in the above described insurance policies shall be assumed by and be at the sole risk
of the Subrecipient.
It is agreed by the parties that judgments for which the County may be liable, in excess of insured
amounts provided herein, or any portion thereof, may be withheld from payment due, or to become
due, to the Subrecipient until such time as the Subrecipient shall furnish additional security
covering such judgment as may be determined by the County.
The County reserves the right to request additional insurance on an individual basis for extra
hazardous contracts and specific service agreements.
Any insurance coverage for third party liability claims provided to the County by a "Risk Pool'
created pursuant to Ch. 48.62 RCW shall be non - contributory with respect to any policy of
insurance the Subrecipient must provide to comply with this Agreement.
If the proof of insurance or certificate indicating the County is an "additional insured" to a policy
obtained by the Subrecipient refers to an endorsement (by number or name) but does not provide
the full text of that endorsement, then it shall be the obligation of the Subrecipient to obtain the full
text of that endorsement and forward that full text to the County.
The County may, upon the Subrecipient's failure to comply with all provisions of this contract
relating to insurance, withhold payment or compensation that would otherwise be due to the
Subrecipient.
7. GENERAL CONDITIONS
A. General Compliance
The Subrecipient agrees to comply with:
a) The requirements of Title 24 of the Code of Federal regulations, Part 570 (HUD regulations
concerning CDBG); and
b) All other applicable Federal, state and local laws, regulations, and policies, governing the funds
provided under this Agreement.
B. CDBG National Objective
The Subrecipient certifies the activities carried out under this Agreement will meet a CDBG
Program National Objective as defined in 24 CFR 570.208.
C. "Independent Contractor"
Nothing contained in this Agreement is intended to, or shall be construed in any manner, as
creating or establishing the relationship of employer /employee between the parties. The
Subrecipient shall at all times remain an "independent contractor" with respect to the services to be
performed under this Agreement. The Local Government shall be exempt from payment of all
Unemployment Compensation, FICA, retirement, life and /or medical insurance and Workers'
Compensation Insurance, as the Subrecipient is an independent contractor.
D. Hold Harmless
The Subrecipient shall hold harmless, defend and indemnify the Local Government from any and
all claims, actions, suits, charges and judgments whatsoever that arise out of the Subrecipient's
performance or nonperformance of the services or subject matter called for in this Agreement.
E. Workers' Compensation
The Subrecipient shall provide Workers' Compensation Insurance Coverage for all of its
employees involved in the performance of this Agreement.
F. Insurance & Bonding
The Subrecipient shall carry sufficient insurance coverage to protect contract assets from loss due
to theft, fraud and /or undue physical damage, and as a minimum shall purchase a blanket fidelity
bond covering all employees in an amount equal to cash advances from the Local Government.
For purposes of commercial general liability insurance (or similarly named insurance intended to
insure Subrecipient against tort or personal injury claims from or by third parties) "sufficient
insurance" is deemed to mean insurance having a liability cap in the amount of $1 million per
occurrence, $2 million aggregate. Said commercial general liability insurance shall be primary.
G. Funding Source Recognition
The Subrecipient shall insure recognition of the roles of Commerce, the WA State CDBG program,
and the Local Government in providing services through this Agreement. All activities, facilities
and items utilized pursuant to this Agreement shall be prominently labeled as to funding source. In
addition, the Subrecipient will include a reference to the support provided herein in all publications
made possible with funds made available under this Agreement.
H. Amendments
The Local Government or Subrecipient may amend this Agreement at any time provided that such
amendments make specific reference to this Agreement, and are executed in writing, signed by a
duly authorized representative of each organization, and approved by the Local Government's
governing body. Such amendments shall not invalidate this Agreement, nor relieve or release the
Local Government or Subrecipient from its obligations under this Agreement.
I. Suspension or Termination
In accordance with 24 CFR 85.43, the Local Government may suspend or terminate this
Agreement if the Subrecipient materially fails to comply with any terms of this Agreement, which
include (but are not limited to) the following:
a) Failure to comply with any of the rules, regulations or provisions referred to herein, or such
statues, regulations, executive orders, and HUD guidelines, policies or directives as may
become applicable at any time;
b) Failure, for any reason, of the Subrecipient to fulfill in a timely and proper manner its
obligations under this Agreement.
c) Ineffective of improper use of funds provided under this Agreement; or
d) Submission by the Subrecipient to the Local Government reports that are incorrect or
incomplete in any material respect.
In accordance with 24 CFR 85.44, this Agreement may also be terminated for convenience by
either the Local Government or the Subrecipient, in whole or in part, by setting forth the reasons
for such termination, the effective date, and, in the case of partial termination, the portion to be
terminated. However, if in the case of a partial termination, the Local Government determines that
the remaining portion of the award will not accomplish the purpose for which the award was made,
the Local Government may terminate the award in its entirety.
8. ADMINISTRATIVE REQUIREMENTS
A. Financial Management
1. Accounting Standards
The Subrecipient agrees to comply with 24 CFR 84.21 -28 and agrees to adhere to the accounting
principles and procedures required therein, utilize adequate internal controls, and maintain
necessary source documentation for all costs incurred.
2. Cost Principles
The Subrecipient shall administer its program in conformance with OMB Circulars A -122, "Cost
Principles for Non - Profit Organizations," or A -21, "Cost Principles for Educational Institutions," as
applicable. These principles shall be applied for all costs incurred whether charged on a direct or
indirect basis.
3. Duplication of Costs
The Subrecipient certifies that work to be performed under this Agreement does not duplicate any
work to be charged against any other contract, subcontract or other source.
B. Documentation and Record Keeping
1. Records to be Maintained
The Subrecipient shall maintain all records required by the Federal regulations specified in 24 CFR
570.506 that are pertinent to the activities to be funded under this Agreement. Such records shall
include but not be limited to:
a) Records providing a full description of each activity undertaken;
b) Records demonstrating that each activity undertaken meets one of the National Objectives
of the CDBG program;
c) Records required to determine the eligibility of activities;
d) Records required to document the acquisition, improvement, use or disposition of real
property acquired or improved with CDBG assistance;
e) Records documenting compliance with the civil rights components of the CDBG program;
f) Financial records as required by 24 CFR 570.502, and 24 CFR 84.21 -28;
g) Other records necessary to document compliance with Subpart K of 24 CFR Part 570.
2. Access to Records and Retention
All such records and all other records pertinent to this agreement and work undertaken under this
agreement shall be retained by the Subrecipient for a period of six years after final audit of the
Local Government's CDBG contract, unless a longer period is required to resolve audit findings or
litigation. In such cases, the Local Government shall request a longer period of record retention.
All records provided to, generated by or held by the Local Government may be "Public Records" in
accordance with Ch. 42.56 RCW and as such subject to production to a requesting person unless
otherwise exempt from production.
3. Audits and Inspections
All Subrecipient records with respect to any matters covered by this Agreement shall be made
available to the Local Government, Commerce, and duly authorized officials of the state and
federal government, at any time during normal business hours, as often as deemed necessary, to
audit, examine, and make excerpts or transcripts of all relevant data.
Any deficiencies noted in audit reports must be fully cleared by the Subrecipient within 30 days
after receipt by the Subrecipient. Failure of the Subrecipient to comply with the above audit
requirements will constitute a violation of this Agreement and may result in the withholding of
future payments.
The Subrecipient hereby agrees to have an annual agency audit conducted in accordance with
current Local Government policy concerning subrecipient audits and OMB Circular A -133. The
Catalog of Federal Domestic Assistance (CFDA) number is 14.228.
C. Reporting and Payment Procedures
1. Program Income
The Subrecipient shall report annually all program income (as defined at 24 CFR 570.500(a))
generated by activities carried out with CDBG funds made available under this Agreement. The
use of program income by the Subrecipient shall comply with the requirements set forth at 24 CFR
570.504.
2. Periodic Reports
The Subrecipient, at such times and in such forms as the Local Government may require, shall
furnish the Local Government such periodic reports as it may request pertaining to the work or
services undertaken pursuant to this Agreement, the costs and obligations incurred or to be
incurred in connection therewith, and any other matters covered by this Agreement.
D. Use and Reversion of Assets
The use and disposition of real property and equipment under this Agreement shall be in
compliance with the requirements of 24 CFR Part 84 and 24 CFR 570.502, 570.503, 570.504, as
applicable, which include but are not limited to the following:
1. The Subrecipient shall transfer to the Local Government any CDBG funds on hand and any
accounts receivable attributable to the use of funds under this Agreement at the time of
expiration, cancellation, or termination.
2. Real property under the Subrecipient's control that was acquired or improved, in whole or in
part, with funds under this Agreement in excess of $25,000 shall be used to meet one of the
CDBG National Objectives pursuant to 24 CFR 570.208 until ten (10) years after the contract
between Commerce and the Local Government is closed. If the Subrecipient fails to use
CDBG- assisted real property in a manner that meets a CDBG National Objective for this 10-
year period of time, the Subrecipient shall pay the Local Government an amount equal to the
current fair market value of the property less any portion of the value attributable to
expenditures of non -CDBG funds for acquisition of, or improvement to, the property after the
CDBG program's approval. Such payment shall constitute program income to the Local
Government. The Subrecipient may retain real property acquired or improved under this
Agreement after the expiration of the ten -year period.
3. In cases in which equipment acquired, in whole or in part, with funds under this Agreement is
sold, the proceeds shall be program income. Equipment not needed by the Subrecipient for
activities under this Agreement shall be (a) transferred to the Local Government for CDBG-
eligible activities as approved by the CDBG program or (b) retained after compensating the
Local Government.
9. PERSONNEL & PARTICIPANT CONDITIONS
A. Civil Rights
Title VI of the Civil Rights Act of 1964:
Under Title VI of the Civil Rights Act of 1964, no person shall, on the grounds of race, color, creed,
religion, sex or national origin, be excluded from participation in, be denied the benefits of, or be
subjected to discrimination under any program or activity receiving federal financial assistance.
Section 109 of the Housing and Community Development Act of 1974:
No person in the United States shall on the grounds of race, color, creed, religion, sex or national
origin be excluded from participation in, be denied benefits of, or be subjected to discrimination
under any program or activity funded in whole or in part with funds made available under this title.
Age Discrimination Act of 1975, as Amended
No person shall be excluded from participation, denied program benefits, or subjected to
discrimination on the basis of age under any program or activity receiving federal funding
assistance. (42 U.S.C. 610 et. seq.)
Section 504 of the Rehabilitation Act of 1973, as Amended
No otherwise qualified individual shall, solely by reason or his or her disability, be excluded from
participation (including employment), denied program benefits, or subjected to discrimination under
any program or activity receiving Federal funds. (29 U.S.C. 794)
Public Law 101 -336, Americans with Disabilities Act of 1990
Subject to the provisions of this title, no qualified individual with a disability shall, by reason of such
disability, be excluded from participation in or be denied the benefits of the services, programs, or
activities of a public entity, or be subjected to discrimination by any such entity.
B. Section 3 of the Housing and Community Development Act of 1968
Compliance in the Provision of Training, Employment, and Business Opportunities:
The work to be performed under this agreement is on a project assisted under a program
providing direct federal financial assistance from HUD and is subject to the requirements of
Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701 u.
Section 3 requires that to the greatest extent feasible opportunities for training and employment
be given lower- income residents of the project area; and contracts for work in connection with
the project be awarded to business concerns which are located in, or owned in substantial part,
by persons residing in the area of the project.
2. The parties to this contract will comply with the provisions of said Section 3 and the regulations
issued pursuant thereto by the Secretary of HUD set forth in 24 CFR 135, and all applicable
rules and orders of HUD and Commerce issued there under prior to the execution of this
contract. The parties to this contract certify and agree that they are under no contractual or
other disability that would prevent them from complying with these provisions.
3. The Subrecipient will send to each labor organization or representative of workers with which
he has a collective bargaining agreement or other contract or understanding, if any, a notice
advising the said labor organization or workers' representative of his commitments under this
Section 3 clause and shall post copies of the notice in conspicuous places available to
employees and applicants for employment or training.
4. The Subrecipient will include this Section 3 clause in every subcontract for work in connection
with the project and will, at the direction of the applicant, or recipient of federal financial
assistance, take appropriate action pursuant to the subcontract upon a finding that the
subcontractor is in violation of regulations issued by the Secretary of HUD, 24 CFR Part 135.
The Subrecipient will not subcontract with any subcontractor where it has notice or knowledge
that the latter has been found in violation of regulations under 24 CFR Part 135 and will not let
any subcontract, unless the subcontractor has first provided it with a preliminary statement of
ability to comply with the requirements of these regulations.
5. Compliance with the provisions of Section 3, the regulations set forth in 24 CFR Part 135, and
all applicable rules and orders of HUD and Commerce issued hereunder prior to the execution
of the contract, shall be a condition of the federal financial assistance provided to the project,
binding upon the applicant or recipient for such assistance, its successors, and assigns.
Failure to fulfill these requirements shall subject the applicant, or recipient, its consultants and
subcontractors, its successors and assigned to those sanctions specified by the grant or loan
agreement or contract through which federal assistance is provided, and to such sanctions as
are specified by 24 CFR Part 135.
C. Conduct
1. Assignability
The Subrecipient shall not assign or transfer any interest in this Agreement without the prior written
consent of the Local Government thereto; provided, however, that claims for money due or to
become due to the Subrecipient from the Local Government under this contract may be assigned
to a bank, trust company, or other financial institution without such approval. Notice of any such
assignment or transfer shall be furnished promptly to the Local Government and Commerce.
2. Conflict of Interest
No member of the Local Government's governing body and no other public official of such locality,
who exercises any functions or responsibilities in connection with the planning or carrying out of
the project, shall have any personal financial interest, direct or indirect, in this agreement; and the
Subrecipient shall take appropriate steps to assure compliance.
The Subrecipient agrees to abide by the provisions of 24 CFR 84.42 and 570.611, which includes
maintaining a written code or standards of conduct that shall govern the performance of its officers,
employees or agents engaged in the award and administration of contracts supported by Federal
funds.
The Subrecipient covenants that its employees has no interest and shall not acquire interest, direct
or indirect, in the study area or any parcels therein or any other interest which would conflict in any
manner or degree with the performance of services hereunder. The Subrecipient further
covenants that in the performance of this Agreement, no person having such interest shall be
employed.
3. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower
Tier Covered Transactions
a) The lower tier contractor certifies, by signing this contract that neither it nor its principals is
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department or agency.
b) Where the lower tier contractor is unable to certify to any of the statements in this contract,
such contractor shall attach an explanation to this contract.
c) The contractor further agrees by signing this contract that it will not knowingly enter into
any lower tier covered transaction with a person who is debarred, suspended, declared
ineligible, or voluntarily excluded from participation in this covered transaction.
D. Copyright
If this Agreement results in any copyrightable material or inventions, the Local Government and/or
Commerce reserves the right to royalty -free, non - exclusive and irrevocable license to reproduce,
publish or otherwise use and to authorize others to use, the work or materials for governmental
purposes.
E. Religious Activities
The Subrecipient agrees that funds provided under this Agreement will not be utilized for inherently
religious activities prohibited by 24 CFR 570.2000), such as worship, religious instruction, or
proselytization.
10. SEVERABILITY
If any provision of this Agreement is held invalid, the remainder of the Agreement shall not be affected
thereby and all other parts of this Agreement shall nevertheless be in full force and effect.
11. PERFORMANCE WAIVER
The Local Government's failure to act with respect to a breach by the Subrecipient does not waive its
right to act with respect to subsequent or similar breaches. The failure of the Local Government to
exercise or enforce any right or provision shall not constitute a waiver of such right or provision.
12. ENTIRE AGREEMENT
This Agreement constitutes the entire agreement between the Local Government and the Subrecipient
for the use of funds received under this Agreement and it supersedes all prior or contemporaneous
communications and proposals, whether electronic, oral, or written between the Local Government
and the Subrecipient with respect to this Agreement. The attachments to this Agreement are identified
as follows:
Attachment #1, Scope of Work, consisting of 2 pages.
Attachment #2, Budget, consisting of 1 page.
IN WITNESS WHEREOF, the Local Government and the Subrecipient have executed this agreement as
of the date and year last written below.
Jefferson County
a
Title John Austin, Chairman Title M r k16kkj4t-
Date
Ap roved As To I agal Form:
David Alvarez, Deputy Pr6secuting Attorney
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Attachment V -Scope of worlgERVICES BUDGET Page: 2
COST
CATEGORIES
AMOUNT
DESCRIPTION
Staffing
$ 47,761
Emergency Food - $9,186
Senior Nutrition - $5,850
Home Care - $15,032
Emergency Subsistence - $17,693
Senior Nutrition Food - $10,000
Goods and
$ 10,000
services
Equipment
$
Travel
$
Emergency Food - $1,148
I Indirect Costs
$ 38,488
Energy - $32, 519
Senior Nutrition - $731
Home Care - $1,879
Emergency Services - $2,211
TOTAL
$ 96,249
Attachment A2 - Budget
9,
National Objective:
® Principally benefits low- and moderate - income persons or households.
10.
Project Budget:
CDBG
$99,249
Includes County Administration 3,000
CDBG Program Income
$
CSBG
$111,435
TOTAL
$210,684
11.
Project Beneficiaries:
o
(N) # of persons - new or continuing access to a service: 6098
U
(1) # of persons - improved access to a service: 0
—10
(S) # of persons - service that is no long substandard: 0
# of Persons
6098
# of LMI Persons
6098
LMI Percentage: 100%
12.
How were the numbers of beneficiaries
® LMI Limited Clientele
determined?
13.
Street address, city and zip code of primary location of CAP services (if different than 4.):
823 Commerce Loop, Port Townsend, WA 98368 -2904
14.
Provide the census tract and block number(s) for the primary location(s) of CAP services.
Census Tract Number: 9506.01 Census Block Number(s): 6025
15.
Certification of Chief Administrative Official: The information provided in the application is true and
correct to the best of the government's belief and knowledge and it is understood the state may verify
information, and that untruthful or misleading information may be cause for rejection of this application
or termination of any subsequent grant contract.
Signature Date
Phillip Morley County Administrator
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