HomeMy WebLinkAboutAgenda - 08-18-1998 - 8kOrange County Board oT Commisaiovers
Agenda Item Abstract
Meedvg Date: August I8, 1998
Acfiov Agenda
Item # ETk
SUBJECT: Work First lob Development and Plammevt
Convect
Public Hearlvg Yee-No-X-
ATTACHMENT (S): INFORMATION CONTACT:
Marti Pryor-Cook D'veetor
lob Development & Placement
Contract TELEPHONE NUMBERS:
HiWboroogh-]32-8181
Durham -688-]JJI
Mebvve -23]-2031
Chapel Hill -96]-9231/968J501
Pvrpm .
To aDPmve the Job Development and Placement Conaac[ with the local Employment
Security Commission OIDce.
Baekgrouvd:
The Wark First Program is one ofNe mart comprehensive welfi refavn pmgmms N
the nation. Work First requves pmmtsto work mdtake responsibility for the'vf ''lies.
The Employmmr Secwiry Commission is the smm'sjob placmnmt emboriry offering
technical assistance, labor mmkm dam and mrtsaving servicememPloYers. As Blob
placement authority, Ne Employment Secmiry Commission cart mamh Work First
participant wiN emPloYers. This mntran will amble m EmPloymem Security
Commission Job Development Spaialiv m be smuonM CWI-time m the Depmvnevt of
Social Service. The lab Development Spxialirt will provide the following services on
site:
• Vocational Assessment and Employment Couweling,
• lob Readiness Trawng and lob Clnb,
• First Stop Regisaation,
• Process Unemployment Insurance Claims,
• Job Development and Placement( dude direct and entered employment),and
• Follow-up Services.
Orange Cowty's smm goal for fiscal year 1998-99 is m place 168 paricipwts in fill-time
employment. Promotion of the Work Fvst Program and positive employer relariorvs me
crucial to Ne success of Orange Cowty's welfine reform efforts wd ability m melt Ne
state gnat. Thefollowing perfbrmwce oumomes ere exp tad from this contract with
esc:
• Locale fWl-time employment for 125 Work First participants.
Visil45 employers m developjob openings for Work First paricipnts.
• Condwr monthlyjob readiness workshops.
• Mainuwr monddy wnmct wiN participwrs and employers for tlnee months after
plazemenl.
The raml wsr ofthe lob Development and Placement Contract wirb Employment
Secmity Commission is 532,916. Theo federal and state fwds me included in the
Depmmrwt's FY 1998-99 budges
Recommeodariov:
The Manager recomrvevda approval of the Contract wiN the Employment Security
Commrssron.
STATE OF NORTH CAROLINA
DIVISION OF SOCIAL SERVICES
PURCHASE CONTRACT
ID q 68E01
This Covtmct k mtered Nm betwcen the Department and a Provider idrntified on
Atachmmt A. This contract shall coazist of faun DSS-249], Atachmrnt A (DSS-1292) and
Budget (DSS-6844).
The Depeevnent will pwchaze specific xrvicn Gom Ne Provider az xt [oM in she
Contract N order to make optimal use ofthe facilities, smffmd programs of Ne Provider.
psis l:On28ct is subject to she provisions of all applicable Fedeml mgWadom and Smre
policies.
Subject to iss oNer provisions, the tams of Wis contract shall be N effect m and ficm
Ne dazes specifiM on Artachmens A.
SECThOH [: RESPONSIBILITIES
A. The Depertrnrnt will: '
1. De[emiive climt eligibiliry for service(s) W accordance wish Federal and
Stale regWalions; and
2. Infoms Ne Provider on Form DSS-1360 covicemivg the eligibility of each
individual for the service, Ne period ofame for wldch xrvices are authorved,
and any changes in the individual's eligibility nanrs; and
3. Reimbwx Nc Providcr for urvicc(s) purchased az dexribed in Attachment A
of Nis Cono-azt for eligible dirnss; avd
4. Keep Ilse Provider vJvrmed of my Wterazions N mNw to Ne regulaziovs
govemmg Ne service program; and
5. Ameps fiscal responsibiliry for deviador v Gom Ne terms of W s Contact as a
resWt o[acts of the Depamnrnt or any of its officers, employees, agents ar
ttpttsP118hVCS.
B. The Provider will:
1. Provide xrvice(s) az specified N Anachmrns A of Nis Contract in accordance
wiN applicable standards for Ne service(s); avd
2. Famish information to Ne Depwhnrns az regsdrcd to support Ne fidI cos[ of
xsvicKs) provided pursuant w Ws Cono-act; and
3. Comply with all State li<evsing standards, all applicable accrediting srandards and
any older standards or criteria mablished by~he Division of Social Services to
assme quality o[services; and
4. Restrict the use or diulasurc of information obtained iv cowectiov with the
admwstratiov ofNonh Carolina's programs for Ne provision of services
con<eming applicants for and recipirnts ofthvu smites ro purpose directly
cormected wiN the admivistration of the xrvice program; and
5. Comply with the arms of Section 504 of the Rehabilimtion Act of t9]3 and all
requirements impoud by or pursuant to the regulations of the Depadmrnr of
HeWN and Human Smias issued pursuant to that Section, which prohibit
diunminetiov against havdicapped peruns N wployment and in the operation
of programs end activities receiving Federal funds; and
6. Comply with Title VI and VII of Ne Civil Rights Act of 1964 and ell requirements
'unposed by oc pursuavt to the regWetiovs ofNe Deparmsevt of Health and Human
Service issued pursuant to Nat Title;aM
]. Aaept fiscal respovsibility for deviations fiom the teems of this Contract asaresWc
of acts ofthe Provider or any of its officers, employees, agevts oc repreuntazives.
SEC~TI 'y IL RE9PONSBILI'fY FOR LLIBILIT[23
Each parry hereto egrets tv be rcspomible for its owm liabilities end that of its affcers,
emplcyees, agents, or represrntative arising wt ofthis Covtract.
SECTION Ig: 2BEATh1ENT OF ASSETS
Treatment of assets acquved undo this Cavtract shall be subject to the following:
A. Ownenbip otproperty purchaud by the Provider under the terms ofthis Contract or
which reimburxmmt by the Department is based upov Ne actual pmchaze cost of Ne
property shell immediately van wild the Department of Human Resourtes upon such
reimburumevt
B. The NoM lkroWta Depar~ent of Human Reumces shall have no claim w property
purehesed by the Provider msdm the teens ofthis Contract for which reimbursement by
the Department is based upon approved depreciation xhedWe or use allowance.
C. The Provider shall mehrt°;" erW admivitter N eccordavice with sound business pmtice a
program for the mWvtevan<e, rcpav, prohctiov and preservative ofpmperty pmchazN
undo the temu ofthis Contract to assure its continued availability.
D. Property purohaze uvda Netermsofthis Caveat[ shall be ash Daly for Ne perfomiarsce
ofthis Conbact.
sec rv: RECORDS AND g~Qg$TS
A. The Provider agrees to maintain clirnt records which date erM document, in mcordmce
with established polity, Ne service delivered for the individual, a valid authorization (or
urvice, programs racoMs, documents and other evidence which reflect progrun
opera[ioru.
B. The Provider agrees to fiwish ivfortnation m Ne Department, as requested, W support
provision of service(s) pursuant to Nis Convect and the full cos[ of the xrvice; and
submit chmges, needed or required, in this Connm4 Anmlunrnt A or approved
supporring infommtiov for review and approval by Ne Deparmsent.
C. The Provider agrees to maintain books, records, dopumrnts and oNa evidence and
owting procedures which reflect all direct and indirect costs expended mdec tens
Contract. A<urtent,<omplete inventory of ell equipment purchazed under the terms of
Nis Contract must be kept.
D. The Provide agrees to retain ell books, records arW oNer docwnrnis relevmt to Nis
Convect far Nree years afltt final payment or mdl all audits continued beYVnd Nis period
art completed Federal auditors end my persons auWOdzed by Ne Division of Social
Services or Ne Department sbdl have the right to examine my of Neu mmerials. In
records Produced under dus Contract will be lamed ovtt to Ne Depazwmt.
SECTION V: SUBCONTRACTING
The Providtt shall not subcontract my of We work covtempiazed mdec Nis Contract wiNOUt
abmiviug prioc wrinen approval from Ne Department AnY approvM subconvact shall be
subject to all conditions ofthis Covtmct. The Provider shall be responsible for the
performmu of any sub<ormacbr.
SECTION VL MAMTENANCE OF EFFORT
The Provider certifies Naz Ne fends to be used under this Contract do not replace or mpplmt,
in mY waY. Federal, Stm<m local Omds for already existing services..
SECTION VD: MONITORMG AND EVALUATION
A. The Provider agrees to partrcipam m program, final and admirdsvative moniroring or
audits, making records m staff time available [o Fedeml, Smte arW comry staff.
8. The Provider agrees [o take nmessary steps for cortective e<tiom as negotiated witldn a
corrective acvon plaq for any itevu found to be out of compliance wiN Fedeml end State
laws, regulations, stmdaMS md/or terms o(this Contract.
SECTION VIB: AMENDING THE CONTRACT
This content[ in whole or m my part may be amended at my fine:
A. By the Depmmsevt iv the event that such amendment is necessary m comply with
applicable laws, regulefions, policies and standards; and by mutual covxnt of bath parties.
B. Psch party to this connect will notify the older immediately fr writing if m amendment
biomes necessary due to alremtiovs in the activities dncribN N Attachment A or for any
other reason.
SE~T~QN' ]Y: TERMINATION
A. This connect, in whole or m my pan, may be cancelled et my time:
1. BY any Party. wdth mnq upon at least 30 days notice, m writing, and delivered by
registered mail with rensrv receipt reyuestN or in person, or
2. By the Depatmevt in the even[ reimbutsemevt m the DepamveM is not available
mNor continued et m aggregate level sufficient [o allow for Ne purchase of the
indicated qumfity of service. The obligations ofeach party shall be tertninated to Ne
crtent specified N the notce of tesminatiom immedimely upon receipt of Ne notice of
terminerion from the Depemvevn or
3. By th<Depattrnentin the<vmtthet the Division of Social Services/Depertrnent
dnentdnea that We Provides is N violation ofmy or etl of fie terms of this Contract.
The obligation ofeach party shall be temunmcd to Ne extent specified in the notice
of renvinmion immedimely upon receipt ofthe notice fiom the Department, or
4. By mutud consent of all pertin.
B. In the event oftemiidafiov N pert, ell ponies shall continue the pertbtmmce of this
Contract to the anent not rermintm.
C. If this Contrmct is tervuvatN, iv whole or N part, [he Provider may be required to deliver
and trenfrr Title or assigmnmt otinterest to the Division of Social Services or dispose of
my pmperry specifically produced or acquired for the pertbnrimsce of such part of Ws
Contract az taus been temdnated and the Pmvider shell, upon the direction of the Division
of Social Service, pro[at end preserve property iv the possession ofthe Provider in
which Ne Division of Social Services has m imcrest.
D. After receipt of a notice of temusmtioM and except n otherwise duetted by the
Department, the Provides shall cease work under the Contrac[ ov the date, an W the
extent specified, in the notice of terminatlon. The Depemnent shall pay the Provider the
agreed upon amount for tM dehverY of services under the terms ofthis Contmm up to the
effective date of rerminadon. Reimbusxment shall not be made for equipment or supplies
pwchned after Ne notice oftemdwtion is rcceivedcxcept n approved by the
Depactrnmt.
E. Waiver ofmy default sball not be deemed[o beawaiver of any subsequent defaut.
Waivtt of breach ofmy provision of the Cantrac[ shall not be deemed W to a waiver of
my oWtt subsequent breach and shall vat be construed to be a modification ofNe terms
of Ws Contract uNeu sNted to be such N writing, signed by m auNorizN repreunmtive
of the Deparunmt and attached m the Contract.
SECTION X: CONCLUSION
It is expressly mderstood m agreed that Ne ucvices provided to eligible clients pursuant m
this Cmnact shell <onia exclwively of thou smites specified m Ne attached program
deudptiov incorporated into this Contract az Altxhmmt A.
It is fiuther wderstmd and agreed thu Ne provision of services pursuant to this Contract
shell be subjat m the limimtion and mnditian mntaived ta Ne laws. rcgWazion,
guidelines and pins cited N this Contut and Nat tbis Connect is subject to renegoGetion or
evision to meet my new or reviud rules, regulation, or policies that may be issued by the
Deparmtmt of Hea1N end Hwvm Services, or Ne North Carolina Social Serrices
Comminiom or the Ilepartment of Humm Resources and Nat are conlmmi<azed to Ne
Provider.
PROVIDER DEPARTMENT
Employment Secwiry Commission Orange Comty Depertrnmt of Social Services
Date:
This Agreement Ins been preauditN N the mamtt required by Ne local Govmwmt Budgtt
and FiuW Conwl Act.
ATTEST:
Cowry: Ornge
Title: Finmce Director
Date:
SECTION XI' CERTIFICATION
The Orange Cowty Board of Soclel Services supports d,e need for This performanco-
based convazt wiN the Employment Security Commission m providejob search, wdjob
development and plamment for Work Fint participants.
Irr' "'
Boaem Moore, Acrin CAeir
Orange County Bov of Social Servien '
Assisting f flies make the vwsition from welf m work is a priority in Oronge
Cowty. l'he Orange Cowty Board ofCowty Commissioners, in response to nc~ needs
of the Work Firs[ population, supports approves the wnvact forjob search wdjob
development and placement services from the Employment Security Commission.
Margaret Brewn, Cbvirpenoo
Onvge County BOerd of County Commiuiooen
ATTACHMENTA
State ofNorN Carolina
Divisicu of Social Serrices
Contract Applicafion
I. Contract Summary
A. Itis agreement is between the Orange County Departmnt of Sxiel
Services (hereirtaftm referred m u the "Department")and the Employment Sauriry
Commiuion (heretofore end hereinafter referred to as fie"Provider").
B. This agreement shall be in effect from g/1/98 to 6/30/99
C. Services to be Provided:
p)
Service (2)
Service Code (3)
Nwvber of
PersoasSmed (4)
Number of UNts
of Service (5)
Defividon of
Unit of Service
lob Development
and Placement 546 125 125 One Pasucipm[
lob Readiness/
lob Search 54] 250 250 One Penicipmt
Any additiaval services should be listed n IB. - Sersdce Program Description
D. Aran W be Served: Orange Comty
ip
Score of Notth Carolina
Division of Social Services
Contract Application
E. Contract lndentifirarion:
i. Provider
a Neme of Connect Administrator Dorothy Pewell
Tel.k: (919) 96]-01]]
b. Name ofPromsm Courser Person:
Tel. M:
Same
c. Program Name, Location and Mailing Address: Employmrnt Security Commission
d. Additional Service Delivery Sires:
e. Spvu : (X) Public O Pdvaz<, non-profit
( )Private, for Profit ( )Individual
E Provider Contrsm tD N: 68E01
2. Cowry Deoemvent of Social Servius
a. Name of Covtrad Admwstrabn Marri Pryor-Cook
Tel. k: (919)]32-8181
b. Nemrnf Scrrims Progam Covtect Person: Gxrendolyn Price
Tel. k: (919) ]32-8181
<. Address ofCowrv Deoarmrmt of Soc'el Services:
P.O. Box 8181
300 W.
Hillsborougb, NC 2]2]8
li
State of North Carolina
Division of Social Services
Contract Applicafiov
II. EiscalProvisions
A. Am9nn fR' b
Reimbursement wda the terms ofthis agreement will be limited to a maximw of:
$ J2,916 TOTAL=$ SSBG+g IV-B+$ Rpp+
8 Smtc+$ Cowry+$ ONer (identify): Federal, grate
aM LacW TANF Dollars
(Optiowl : Cowry fund3 mmist of $ for and S
(funding source)
for )
B. MetMdof Reimbursement
1. For Purehaze Contract (DSS-249]) Toml wd UNt Cort:
(m e. Reimbursemev[ will be made m accordance wiN the murevt budget approved by
the Deparvnent erW on file with boN parties. l'he amowt ofreimbursemmt will be
bazN on allowable expendinues made in behalf of eligible climcq determined in a
acwrdev<e with accepmble tort aliocatiw methods. the Provider will repro[ all
expeMimres made under Ne tmre of the connect.
O b. Reimbursement wvl be made ataurdt cost rote of8 per wit of
reimbursement delivered to eligible clients for w estimated number o£
wits. The Provider will documem total expendinves made wder the terms ofthe
contract t0 the Depmtrvevt witlsin tarty days attar the tenvirmfion of Nis contract
or az instructed by the Depertrvent Reimbursement which exceeds actual allowable
mu will be adjunW m acuml allowable cost
2. For Vendor Agreements (DSS-2252) Fixed Rate
Reimbursement will be hazed on:
O a a stmdmd fixed mro or
O b. wlndividval fixed rote.
c. Reimbursement will be made atafixed rate ofSper unit of
(define)forazestuneted number of units.
Reimbursemen[ will be baud ov the acutal nwvbm of wits delivered wheNer over
or wder Ne es[imated number. If mWfiple components me being purchased,
edNtiorui rotes and wits cm be identified as follows:
12
State ofNoM Carolina
Division of Saciel Services
Contract Application
C. Reimbursement Reposing:
1. Expenditures
The Provider will raptor expeMimres monlldY W accordance wiN policy set font by
the Conuollers Offices, Division of Social Services, issued vie the Fiual Manual.
Ezpenditures ere to be reproted av Ne DSS Admwso-ative Cost Aepon (Porto DSS-
15]I, Part]Il). Reports are b be submited to We Deparvnent by the fifth working
day ofthe month following the month in wbich services were delivered. The
Deparimmt will reimbmu the Provider monody, usually by chink, upon receipt of a
comyletM and correctly filed repmL
2. Reporting for Ne Statewide Services Wovneuon System (SI$)
In edditiov to the AdmisdstreUVe Cort Report (DSS-1571, Part III), the Provider will
submit to Ne Depamvmt the Montldy Report of Service Iklivery (DSS Fonn IS]t,
Part IV). This should be submitted along with dse Admitdavative Cast Report by the
fitN working day of tM month fogowing the mouth N which services were delivered
The uvin reported N Column 12 of the 1$]t Pan IV are Ne utdts of service defined in
Column 5 of I.C. of ttds Attachment. Service deEnition end reporting hcmuctiore are
fount iv Family Services Manual, Volume VI, Chapter IV.
D. Adwt Aaryirwmts
The Provider shall be responsible for complimce with the audit regairemevts of
Deparvemt ofHealN and Humor Servicea fedemi regulation 8$ CFA Part ]4,
Adminstrmion of Grano, or Smte Admmisvaave Procedures Manuel tar Fetleml Block
Grant Fords, whichever is aPPlicable. Theo rcgulaaore stipulate that m annual audit be
performed for the fiscal year iv which mvtmct funds were rettived.
O1. NA
Privace, non-profit ifemoum ofrohnbursevunt received is undo S 1,000; private,
for profit or individual
O 2. (Applicabel m Psivete, Nan-Profit Providers i£reimh $1,000 w war)
An annual audit is m be petfatmetl iv eaordmce wiN OMB Circular A-110 by m
"vMryisent auditor." Independent auditor' means either. (a) a sate government
auditor horn the Department of Human Resources or the Department of
AdmitdstraUOm Office m the State Auditor; oc (b) a certified public accountant.
Upon completion of the audio a ropy of the audit report mull be forwarded [o Ne
comty depanmmt of sacul services.
13
Smte of NaM Caroline
Divivon of SxiW Services
Cocmact Applicaiton
O 3. (Applipble m Publi<HOSptrals, Collages, and UNversifies)
The ecmuel audit most be performed in accordance with OMB CircWar A-I 10.
It is not necessary for dse ivstimtion of program audits performed xpam¢ly
from mall-inclusive single audit wldcb mtWls all revenues and expenditures
of she public agency. However, it is Ne responsibiliry of the contmcmc to
ensure tbet the conimtt program is included N Ne institution's single amuW
audit.
A copy of dse audit mpon must be previded to the Coonry department of
Social Services upon completion of the amual audit.
OC) <. (Applicable to State mLaval GOVemmera Agencies)
Av awual audit is to be perfomred in az<ordance with OMB CircWar A-128 by
m independent auditor. Upon completion of the audit, a copy of Ne audit
report must be forwarded m Ne county Department of Social Services.
B. Client Fees f Service
(~ 1. No ftts will be cbaged m individuals determir¢d to be eligible for xrvices
by the deparmrevt of social services.
() 2. The service(s) under contract with dse Pmvider are xnc~es for which a client
fm may be assessed. Policy regarding the assessment and mllecaon of fees is
contained yr Family Services Manuel, Volume VI, Chapter III. If a client is to
to be chaged a fce, Ne deparvvent will iN'ocm the Provider ofthe amomt of
ftt b be charged and of my subxquevt chmges by way of dre Purebese of
Service Referral and AuNOrimdon (DSS Form 1360). The Provider will
esmblish a play with the client forcolle<tmg the fx on az lest a monthly basis;
end when fees are not paid within ten days of the due date, will bill the client in
wri4vg and send a copy of We bill b the Deparmrevt. NO OTHER FEES FOR
SERVICES MAY BE CHARGED TO THE CLIENT. Client fees ace b be
repotted on We Monthly Report of Service Delivery (DSS Form 15]1, Part
IV).
F. Mmegement ofNe FmdiriglMemhing Share Requirement
() 1. A cazh transfer of We matching share will be made m the county department of
social services m accordance wish the terms spxified iv the Donation
Agreement (DSS-1319),.
:,
State ofNarth Caroline
Divisiov of Saciel Services
Contrac[AppGcaion
O 2. The provider certifies through Ne contract budget anached m Nis contract Naz
Ne matching share in available. Fuller, it is agreed that Ne provider will
report all program costs incurred each monN relating to Ws conVan on Ne
DSS-ISII. Howevev reimbursement will be limited to Ne federal/state
financial pericipaHOn rate.
(~ 3. Thecouvty d<paruvevt of social servicesiaproviding Ne match.
D. Provider Pees (Pot Purchase Contracts lhdy)
() 1. The Provider ages to Pay Ne DeparvnrnVDivision up to S
Administraive Fm a9 paymrnt in fWl for the administration of Ne wntrect.
Th<amowr of Ne fee in five pemrnt of the matching share contrbumd by dse
Provider.
O 2. The Provider ogees m pay Ne Deparlmrnt up to S Ceriificatron Ftt
az payment m fWl for Ne determiruiGov and certification of clievt eligibility.
The amouvt of Ne fee is five pemevt ofthe memlwrg share contributed by the
Provider.
Monitoring and Ceertrficatron Fees, wbw applicable, will be deducted from the
amount to be reimbursed.
15
Stain of North Carclvta
Division of Social Services
Contract Applicafiw
III. Servme Program Dmenptiav
Orange Cowty Department of S«ial Services (D5S) is pmchazing the services of a lob
Development Specialist firm the Employment Security Commission of North Carolina.
The General Assembly considers the Employment Security Commission the state's
primaryjob placement authority. The lob Development Specialist will be sutioned et the
DSS and will be providing services ro Work First participants. The fallowing services
arc included in this contr«t
Vocatiowl Assessment and Employment Counxling,
• lob Readiness Training and lob Club,
• First Stop Regisvation,
• Process Unemployment Insurance Claims
• lob Development and Placement (placements include direct placements and
entered employments),
• Follow-up Servims
Job Dwelovment Scee'al's[ Duties
The lab Development Specialist will azsess and cowxl Work First participwts who are
reterrN with w objective of lora[ing employment Job readiness wd job club activities
will include but are not limited to infowation about employe expegatiom, appmpriare
dress and grooming, resume prepemtioq goal setting, and networking.
Other duties of the ]ob Development Specialist are az follows:
• Interview applicants/participants to determine work history, education, trawng, and
skills,
• Conduct fle searches of suicobl<job openings,
• Reftt applic~ntm employers,
• Pertonn job developmrnt concocts with employers to obminjob orders,
• Provide labor market infomcotion m employers, applicwts, and other agencies,
• Determine eligibility for wemploymrnt insurance, and
• Follow-up wiN applicants and employers in an effort a impactjob retention.
Perdormance Measures
North Carolina's Work Firrt Pmgcom, implemented iv July 1995, is one of the most
omprehetnive welfare reform etiorts m We natiov. The guiding principles of Work First
requires pmen[s to coke personal responsibilityfor Nee children, limits the receipt of
Work First Cash Assistance (temporary and short-term), wd requires parents to work.
The Orwge County Department of S«ial Services, in conjwctian with the Employmem
Security Commission have identified 0e follow performance meazwes.
• Locate full-time employmrnt for 125 Work Firer participants.
• Per[orm 45 employer visits to developjob ocenivgs for Work Eirst parti<ipwts.
• Cond«t monWyjob readiness workshops.
• Maintain contact with patricipwrs and employers for tlvee months after pl«emen[.
STATE OF NORTH CAROLMA
DIVISION OF SOCIAL SERVICES
PURCHASE CONTRACT BUDGET
g(~.pyARY Effective
Provider Emplvymrnt Security Commission ID# 68EO1 Period 811/98 durough 6130/99
Par[ 1- Extimared Expenditures
Objem of Expenditwe Tord
Pmgmm Nom Masbeble
Costs Toml Mm<bable
Costs
Costs (2) (3)
(I)
A. Salaries $23.353
B. Fringe Benefits 6,028
C. StaffDevelopment-Services 100
D. Tmvel 500
E. Equipment PUrcfuse-Tangible Property
F. Transportation-Recipirnt ,
G. Medical Supplies and Expe~tse
H. Cost of Space-Nov-Residential
1. Aoom & Board-Residmtial Treatment
]. Service Payments
K O[her
L. Ivdirem Costs
S Q,936
M. Totals 532,916
Part II - Computation of Urd[ Uort or [namauat nxev ua[e
A. 1. Total Matchable COSU $ NIA
2. Less: Eamed Income for Udt Con Method S
3. Net Maz<habl<Costa 5
B. 1. Told Smice Unit Cepeciry, or
2. Told Anticipated Utilimtion Capacity
McWod of Computation or Sowce of DaU
D. Estimmed Unit Con or lndividud Fined Rate: S per
Pen BI - Distribwon of EsomaW Revevue for Tool Cast Reimbwsement Method
C) (b)
A. Estimated Eligible end Matchable Com Nwvbu Ratio
L Estimated Eligible Cliwa 250 100%
2. Esimatcd ineligible Cliwa 0 0%
3. Total Clirna 250 100%
B. Eligible Costs
b Program Costs Am°wt Sacme nfFwds
L FedemVStam Fwds g Wock Fvrt
2. Local Matching Share S Cowty
3. Other Budgeted Funds $
4. TOTAL REVENDE $ 32.916
B. Pees (IfApplbable)
1. AdmiWstrative Fee S
2. CertiSratiovFtt $
3. TOTAL FEES $
Pan V- Reimbmsavrnt Pcojecuovs (For Title XX Providers OWy)
AwualProjection 1Wy-September October-Jwe
Projasion Projettion
(p Mamheble (2) [.ass (3) Nat (4) (E) Cosa Eligble
Casts Eemed Matchable Esimaed% for Financial
[Pert 1, Line M, hsome Costs of Eligibles Participation
ml. Pj [B. P) L<ss 2 j [A. L Cb)j [B. C31 x 14)1
S E S E E
Signed:
Provider/AUNoriud OfB<W
Cowry Director or Designtt
ld
Purchase Covrcvct Budget
Supposing Budget Schedules
A. Salary EchedWe
~
CI) C2) I3) (4) l5) C6) (~
Nmnber Pay % of No. of Armual Total
of Petsomt Posiciov or Title Grade Time Months Salary Cost
Employed
1 ]ab Developmrnt SpaiAist N/A 100 % 11 $23.353 $23,353
total - Sa laries
B. Frivge Benefits
(1) (2)- (3)
Total
Type Metlwd of Computation Cost
FICA ].65X23.353 1]8]
Health Ims. 158.16 X I I Months 1]40
Refirem<nt 10.461%X23.353 2,463
Worker's Compensation .10%X33.353 S 2I
Onemploymevt lnsumnm .1E%X23,]53 E 35
Toml ~ Frin¢e Benetib
19
0. Sra9'Developmenr-Service Fmds SChedWe
(1)
Item (2)
Total
Coo
Sniff Developmmtavd Training $100
Toml Sniff Developmem -Service Funds 8100
D. Travel SchedWe
(p (2) (3) (4) (5) Dail Subsinenoe (g)
No. of
Persons
Position or iitie No, of
MilesNays Rnte per
Mile No. of
Deys (6)
Rate p)
Deys Total
Cost
~ Iob
Developmmt
SpecWut Il
Months 5500
Toml - Travel $500
E. Equipm ent -Tangible Property SchedWe
(1)
No. of
Units (2)
item (3)
Cost per Usdt (4j
Toml Cost
N/A
Toni Equi pment -Tangible Property
m
F. Recipient Travspormtion Schedule
Ip
Item R)
Method ofCOmputatiov (3)
ToW
Con
N/A
la Salaries
# of
Persons Position or Title Pay
Grade % of
Time # of MonNs
Employed Amoral
Salary
N/A
Ib. Fringe Benefits
Type Method of Campumtiav
N/A
Tornl Recipirnt Tmnsponatiov
n
ouyyuaa mu cnpevses.lcnMWe
O) (~7
rorw
Itcm Con
N/A
Total -Medical Supplies and Expense
H. Con of Space -Nov-Aesidenml Schedwe
P)
Item [2)
Total
Con
N/A
Total Cost of Space ~ Non-Residential
I. Room and Board Cons - Aesidrnual ireetment
0)
Item (~)
Method of Compumtion (3)
Total
Cost
N/A
Toml Room esW Hoard Costs - Residrntiel Treatment
J. Smice Paymevt SchedWe
(1)
No. of
UWn C2)
Item (3)
Cosupn ONt (4)
Toml
N/A
Total -Service Payrnmt
K. Oder Experue Scheudle
P)
Item Q)
Total
Cost
N/A
total -Other Expevse
L. Indirect Cost SchedWe
(D
Rate (2)
Rate Applied To: (31
Amouvt Rate Applied To: (4)
rorel
12.56]% Salary 823,353 52,935
Total -Indirect Cast 82,935