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HomeMy WebLinkAboutExhibit 1PROFESSIONAL SERVICES AGREEMENT BETWEEN CITY OF MIAMI, FLORIDA AND OPERATION HOPE, INC. This Agreement is entered into this day of , 2013 by and between the City of Miami, a municipal corporation of the State of Florida, whose address is 3500 Pan American Drive, Miami, -Florida 33133 (hereinafter referred to as the "City") and Operation Hope, Inc., a State of Florida non-profit corporation qualified to do business in Florida ("Provider"), whose address is 707 Wilshire Blvd., Suite 3030, Los Angeles, CA 90017 RECITALS: A. WHERAS, the Office of Grants Administration as part of the City of Miami Poverty Initiatives and ACCESS Miami programs, applied for and was awarded a financial literacy and financial empowerment coaching grant from the Citi Foundation, in the amount of $150,000 (the "Grant"), for the purpose of providing oversight, financial empowerment coaching and one-on-one financial consultation to at least 200 individuals (the "Program") as required by the Grant application attached herein as Attachment "A" B. The Commission of the City of Miami, by Resolution No. , adopted on , approved the selection of Provider for the provision of the Services required under the Program, and authorized the City Manager to execute a contract, under the terms and conditions set forth herein. NOW, THEREFORE, in consideration of the mutual covenants and promises herein contained, Provider and the City agree as follows: RSR #13-715L TERMS: 1. RECITALS: The recitals are true . and correct and are hereby incorporated into and made a part of this Agreement. 2. TERM: The term of this Agreement shall commence on June 1st, 2013 through July 31st, 2014 and shall continue until completion of the Program by Provider under the Grant. 3. OPTION TO EXTEND: The City shall have the option to extend the term hereof for two (2) additional similar periods, subject to the availability of funds and Grant requirements. 4. SCOPE OF SERVICE: A. Provider agrees to provide the Services as specifically described, and under the special terms and conditions set forth in Attachment "A" hereto, which by this reference is incorporated into and made a part of this Agreement. B. Provider represents and warrants to the City that: (i) it possesses all qualifications, licenses and expertise required for the performance of the Services; (ii) it is not delinquent in the payment of any sums due the City, including payment of permit fees, occupational licenses, etc., nor in the performance of any obligations to the City, (iii) all personnel assigned to perform the Services are and shall be, at all times during the tetiu hereof, fully qualified and trained to perform the tasks assigned to each; and (iv) the Services will be performed in the manner described in Attachment "A" under the section "Your Program". 5. BUDGET: A. The amount of budget payable by the City to Provider shall be based on the rates and schedules described in Attachment "B" hereto, which by this reference is incorporated into this Agreement; provided, however, that in no event shall the amount of the program's operating com: DRAFT PSA for Operation Hope Services for Citi Foundation grant Legal Dept Edits as of May 7 budget exceed $150,000. The city shall have no liability for any cost, fee, debt, expense or charge in excess of this amount. B. Unless otherwise specifically provided in Attachment "B", payment shall be made within forty five (45) days after receipt of Provider's proper invoice, as such term is defined by Section 218.72 fo the Florida Statutes which shall be accompanied by sufficient supporting documentation and contain sufficient detail, to allow a proper audit of expenditures, should City require one to be performed. If Provider is entitled to reimbursement of travel expenses, then all bills for travel expenses shall be submitted in accordance with Section 112.061, Florida Statutes. 6. OWNERSHIP OF DOCUMENTS: Provider understands and agrees that any information, document, report or any other material whatsoever which is given by the City to Provider or which is otherwise obtained or prepared by Provider pursuant to or under the terms of this Agreement is and shall at all times remain the property of the City. Provider agrees not to use any such information, document, report or material for any other purpose whatsoever without the written consent of City, which may be withheld or conditioned by the City in its sole discretion. 7. AUDIT AND INSPECTION RIGHTS: A. The City may, at reasonable times, and for a period of up to three (3) years following the date of final payment by the City to Provider under this Agreement, audit, or cause to be audited, those books and records of Provider which are related to Provider's performance under this Agreement. Provider agrees to maintain all such books and records at its principal place of business for a period of three (3) years after final payment is made under this Agreement. All audits shall be subject to and made in accordance with, the provisions of Section 18-102 of the Code of the City of Miami of Miami, Florida, as amended. corn: DRAFT PSA for Operation Hope Services for Citi Foundation grant wh Legal Dept Edits as of May 7 B. The City may, at reasonable times during the term hereof, inspect Provider's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods or services required to be provided by Provider under this Agreement conform to the terms hereof and/or the terms of the Grant application, if applicable. Provider shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All tests and inspections shall be subject to, and made in accordance with; the provisions of Section 18-101 of the Code of the City of Miami, Florida, as amended. 8. AWARD OF AGREEMENT: Provider represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Agreement. 9. PUBLIC RECORDS: Provider understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City contracts, subject to the provisions of Chapter 119, Florida Statutes, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable law. Provider's failure or refusal to comply with the provisions of this section shall result in the immediate cancellation of this Agreement by the City. 10. COMPLIANCE WITH PROGRAM REQUIREMENTS AND FEDERAL, STATE AND LOCAL LAWS: Provider shall comply with all requirements imposed by the Grant for the Program, including reporting, record keeping and other requirements. Provider shall also com: DRAFT PSA for Operation Hope Services for Citi Foundation grant wit Legal Dept Edits as of May 7 comply with and observe all applicable federal, state and local laws, rules, regulations, codes and ordinances, as they may be amended from time to time. 11. INDEMNIFICATION: Provider shall indemnify, defend and hold harmless the City and its officials, employees and agents (collectively referred to as "Indemnities") and each of them from and against all loss, costs, penalties, fines, damages, claims, expenses (including attorney's fees) or liabilities (collectively referred to as "Liabilities") by reason of any injury to or death of any person or damage to or destruction or loss of any property arising out of, resulting from, or in connection with (i) the performance or non-performance of the services contemplated by this Agreement which is or is alleged to be directly or indirectly caused, in whole or in part, by any act, omission, default or negligence (whether active or passive) of Provider or its employees, agents or subcontractors (collectively referred to as "Provider"), regardless of whether it is, or is alleged to be, caused in whole or part (whether joint, concurrent or contributing) by any act, omission, default or negligence (whether active or passive) of the Indemnities, or any of them or (ii) the failure of the Provider to comply with any of the paragraphs herein or the failure of the Provider to conform to statutes, ordinances, or other regulations or requirements of any governmental authority, federal or state, in connection with the performance of this Agreement. Provider expressly agrees to indemnify and hold harmless the Indemnities, or any of them, from and against all liabilities which may be asserted by an employee or former employee of Provider, or any of its subcontractors, as provided above, for which the Provider's liability to such employee or former employee would otherwise be limited to payments under state Workers' Compensation or similar laws. 12. DEFAULT: If Provider fails to comply with any term or condition of this Agreement, or fails to perform any of its obligations hereunder, then Provider shall be in default. Upon the com: DRAFT PSA for Operation Hope Services for Citi Foundation grant wig' Legal Dept Edits as of May 7 occurrence of a default hereunder the City, in addition to all remedies available to it by law, may immediately, upon written notice to Provider, terminate this Agreement whereupon all payments, advances, or other compensation paid by the City to Provider while Provider was in default shall be immediately returned to the City. Provider understands and agrees that termination of this Agreement under this section shall not release Provider from any obligation accruing prior to the effective date of termination. Should Provider be unable or unwilling to commence to perform the Services within the time provided or contemplated herein, then, in addition to the foregoing, Provider shall be liable to the City for all expenses incurred by the City in preparation and negotiation of this Agreement, as well as all costs and expenses incurred by the City in the re - procurement of the Services, including consequential and incidental damages. 13. RESOLUTION OF AGREEMENT DISPUTES: Provider understands and agrees that all disputes between Provider and the City based upon an alleged violation of the terns of this Agreement by the City shall be submitted to the City Manager for his/her resolution, prior to Provider being entitled to seek judicial relief in connection therewith. In the event that the amount of compensation hereunder exceeds Twenty - Five Thousand Dollars and No/Cents ($25,000), the City Manager's decision shall be approved or disapproved by the City Commission. Provider shall not be entitled to seek judicial relief unless: (i) it has first received City Manager's written decision, approved by the City Commission if the amount of compensation hereunder exceeds Twenty -Five Thousand Dollars and No/Cents ($25,000), or (ii) a period of sixty (60) days has expired, after submitting to the City Manager a detailed statement of the dispute, accompanied by all supporting documentation ninety (90) days if City Manager's decision is subject to City Commission approval); or (iii) City com: DRAFT PSA for Operation Hope Services for Citi Foundation grant wigi Legal Dept Edits as of May 7 has waived compliance with the procedure set forth in this section by written instruments, signed by the City Manager. 14. CITY'S TERMINATION RIGHTS: A. The City Manager shall have the right to terminate this Agreement, by giving Provider at least five (5) business days prior written notice, upon discontinuance, modification or termination of the Program, unavailability of funds under the Grant, or if the City Manager determines, in its sole discretion, that continuation of the Program or of Provider's services are no longer in the best interest of the City. In such event, the City shall pay to Provider compensation for services rendered and expenses incurred prior to the effective date of termination. In no event shall the City be liable to Provider for any additional compensation, other than that provided herein, or for any consequential or incidental damages. B. The City Manager shall have the right to terminate this Agreement, without notice or liability to Provider, upon the occurrence of an event of default under the Grant or under this Agreement. In such event, the City shall not be obligated to pay any amounts to Provider and Provider shall reimburse to the City all amounts received while Provider was in default under this Agreement. 15. INSURANCE: Provider shall, at all times during the term hereof, maintain such insurance coverage as may be required by the City. All such insurance, including renewals, shall be subject to the approval of the City for adequacy of protection and evidence of such coverage shall be furnished to the City on Certificates of Insurance indicating such insurance to be in force and effect and providing that it will not be canceled during the performance of the services under this contract without thirty (30) calendar days prior written notice to the City. Completed com: DRAFT PSA for Operation Hope Services for Citi Foundation grant wii Legal Dept Edits as of May 7 Certificates of Insurance shall be filed with the City prior to the performance of services hereunder, provided, however, that Provider shall at any time upon request file duplicate copies of the policies of such insurance with the City. If, in the judgment of the City, prevailing conditions warrant the provision by Provider of additional liability insurance coverage or coverage which is different in kind, the City reserves the right to require the provision by Provider of an amount of coverage different from the amounts or kind previously required and shall afford written notice of such change in requirements thirty (30) days prior to the date on which the requirements shall take effect. Should the Provider fail or refuse to satisfy the requirement of changed coverage within thirty (30) days following the City's written notice, this Contract shall be considered terminated on the date that the required change in policy coverage would otherwise take effect. 16. NONDISCRIMINATION: Provider represents and warrants to the City that Provider does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with Provider's performance under this Agreement on account of race, color, sex, religion, age, handicap, marital status or national origin. Provider further covenants that no otherwise qualified individual shall, solely by reason of his/her race, color, sex, religion, age, handicap, marital status or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. 17. ASSIGNMENT: This Agreement shall not be assigned by Provider, in whole or in part, without the prior written consent of the City's, which may be withheld or conditioned, in the City's sole discretion. 18. NOTICES: All notices or other communications required under this Agreement shall be in writing and shall be given by hand -delivery or by registered or certified U.S. Mail, return com: DRAFT PSA for Operation Hope Services for Citi Foundation grant wgi Legal Dept Edits as of May 7 receipt requested, addressed to the other party at the address indicated herein or to such other address as a party may designate by notice given as herein provided. Notice shall be deemed given on the day on which personally delivered; or, if by mail, on the fifth day after being posted or the date of actual receipt, whichever is earlier. TO PROVIDER: TO THE CITY: Operation Hope, Inc. 707 Wilshire Blvd., Suite 3030 Los Angeles, CA 90017 City Manager, City of Miami 444 SW 2°d Ave., 10th Floor Miami, FL 33130 19. MISCELLANEOUS PROVISIONS: A. This Agreement shall be construed and enforced according to the laws of the State of Florida. B. Title and paragraph headings are for convenient reference and are not a part of this Agreement. C. No waiver or breach of any provision of this Agreement shall constitute a waiver of any subsequent breach of the same or any other provision hereof, and no waiver shall be effective unless made in writing. D. Should any provision, paragraph, sentence, word or phrase contained in this Agreement be determined by a court of competent jurisdiction to be invalid, illegal or otherwise unenforceable under the laws of the State of Florida or the City of Miami, such provision, paragraph, sentence, word or phrase shall be deemed modified to the extent necessary in order to com: DRAFT PSA for Operation Hope Services for Citi Foundation grant wii Legal Dept Edits as of May 7 conform with such laws, or if not modifiable, then same shall be deemed severable, and in either event, the remaining terms and provisions of this Agreement shall remain unmodified and in full force and effect or limitation of its use. E. This Agreement constitutes the sole and entire agreement between the parties hereto. No modification or amendment hereto shall be valid unless in writing and executed by properly authorized representatives of the parties hereto. 20. SUCCESSORS AND ASSIGNS: This ' Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives, successors, or assigns. 21. INDEPENDENT CONTRACTOR: Provider has been procured and is being engaged to provide services to the City as an independent contractor, and not as an agent or employee of the City. Accordingly, Provider shall not attain, nor be entitled to, any rights or benefits under the Civil Service or Pension Ordinances of the City, nor any rights generally afforded classified or unclassified employees. Provider further understands that Florida Workers' Compensation benefits available to employees of the City are not available to Provider, and agrees to provide workers' compensation insurance for any employee or agent of Provider rendering services to the City under this Agreement. 22. CONTINGENCY CLAUSE: Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and the Agreement is subject to amendment or termination due to lack of funds, reduction of funds and/or change in law, rules, regulations, upon thirty (30) days notice. 23. REAFIRMATION OF REPRESENTATIONS: Provider hereby reaffirms all of the representations contained in the Solicitation Documents. corn: DRAFT PSA for Operation Hope Services for Citi Foundation grant willr,egal Dept Edits as of May 7 24. ENTIRE AGREEMENT: This instrument and its attachments constitute the sole and only agreement of the parties relating to the subject matter hereof and correctly set forth the rights, duties, and obligations of each to the other as of its date. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. 25. COUNTERPARTS: This Agreement may be executed in two or more counterparts, each of which shall constitute an original but all of which, when taken together, shall constitute one and the same agreement. IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed by their respective officials thereunto duly authorized, this the day and year above written. "City" CITY OF MIAMI, a municipal ATTEST: corporation By: Todd Hannon, City Clerk Johnny Martinez, P.E. By: APPROVED AS TO FORM AND CORRECTNESS: APPROVED AS TO INSURANCE REQUIREMENTS: com: DRAFT PSA for Operation Hope Services for Citi Foundation grant with1Legal Dept Edits as of May 7 Julie O. Bru Calvin Ellis City Attorney Director Risk Management Operation Hope, Inc ("Provider") Attest: By: Authorized Corporate Officer Corporate Secretary (Corporate Seal) com: DRAFT PSA for Operation Hope Services for Citi Foundation grant willr�T_.egal Dept Edits as of May 7 ATTACHMENT A - SERVICES corn: DRAFT PSA for Operation Hope Services for Citi Foundation grant wi1I3Legal Dept Edits as of May 7 Dear Grantseeker, Thank you for your submission. For your records, here is a copy of the contents of your application. If the contents of your application do not appear below, please contact FoundationSupporticDciti.com immediately. Please note that no changes can be made to your application now that it has been submitted. Please note that the e-mail address and password you use for this account will be what you use to access submitted applications, pending interim/final reports, and submitted reports. Please make sure to share this information with any additional individuals at your organization who may need access to the account. Sincerely, Citi Foundation 84307 2013 Citi Foundation Direct Service Application Form (non-501(c)(3)) Your Organization Submission Information Please note that you are required to submit a draft of your application to the Citi Foundation for review before you are authorized to officially submit your application for funding consideration. Once you complete the.application and upload the required documentation, please use the 'E-mail Draft for Preview" button and send a draft of your full application to the Citi Foundation at CCDGrantsOciti.COrn.,:please note that all draft applications must be received by the CitiFpUndatipp no later than No\reinber 19 2012 The Citi Foundation will review yobr:draft application and documentation:and-Will contact you directly ifadditional information is required beforeyou are authorized to submit Your final application. : = THE DEADLINE FOR DRAFT SUBMISSIONS IS NOVEMBER 19, 2012 AT LOCAL COB THE DEADLINE FOR OFFICIAL SUBMISSIONS IS:JANUARY 18:2013 AT.LOCAL: COB, Organization's General Information Organization Name City of Miami Orgatuzation I,egal Name . : , : • • (The name that appears on your IRS determination letter) City of Miami Acronyms, DBA or other names by which organization is known N/A Mailing Address 444 SW 2nd Ave, 5th Floor City • Miami State FL Postal Code 33130 Country United States Website http://www.miamiaov.com/home/ What is your orgamzation's current mission? Guidance: Describe the overall focus and objective of your organization. If the mission includes serving low- to moderate -income individuals or communities, please include this information in your response. The City of Miami's mission is to facilitate a comprehensive and coordinated effort to affect and improve the self-sufficiency and financial empowerment of its low/moderate income working families and business entrepreneurs. Through intentional efforts, ACCESS Miami (Assets, Capital, Community, Education, Savings, and Success), a strategy of four focused areas, was created: access to existing benefits, access to capital, building wealth and accumulating assets, and improving financial literacy. It is a citywide, comprehensive and intentional empowerment strategy aimed at increasing low and moderate income working families and low income small business owners' access to the financial tools and education that are fundamental to economic prosperity and success. The ACCESS model aspires to equip the entire City of Miami community with the wealth -building tools necessary for economic self-sufficiency. Is your organization a certified Community Development Financial Institution (CDFI)? Guidance: To qualify as a CDFI, your organization must be certified by the Community Development Financial Institutions Fund of the United States Department of the Treasury. No Board of Directors and Organization's Senior Staff List Guidance: This attachment is REQUIRED upon submission for your application to be processed. Please download and complete the template in its required format by clicking the link below and saving the document on your computer. You can attach the completed document by clicking the "Browse" button to locate the saved document on your computer and then clicking the "Upload" button to attach document to your application. Click here to download REQUIRED template Board of Directors.xls Primary Contact Prefix Ms. First Name Lillian Last Name Blondet Title Director of Grants Administration E-mail Iblondetmiamioov.com Direct Phone 305-416-1536 Financial Officer Prefix Ms. First Name Janice Last Name Larned Title . . Chief Financial Officer E-mail JLarnedna,miamigov.com Direct Phone 305)416-1011 Financial infoiuiation If a grant to your organization is approved, the funds will be sent via ACH electronic payment (not wire transfer). Please provide your bank account information for ACH electronic payments below. You are required to attach either a: copy of a voided. checkor a letter from your:bank confirming the account and routing numbers. The Citi Foundation will use this to validate the information that you provide below.:If the document that you attach (the voided check or bank letter) does not validate the information below. the Citi Foundation will contact you for clarification. Bank Name Wells Fargo Bank Bank Code/Routing Transit Number/ABA # for ACH Electronic Payments This is a NUMBER field only. Please include all 9-Digits including leading zeros. The Citi Foundation transfers funds via ACH electronic payment, so please make certain to confirm that the number you provide here is for ACH electronic payments and not wire transfers. The Citi Foundation requires you to attach a copy of your organization's voided check or a letter from your bank confirming your organization's bank account information. The bank account number you provide below must match against the documentation you attach below. 063000021 Bank:Account Number This is a NUMBER field only. Please include all digits including leading zeros. The Citi Foundation requires you to attach a copy of your organization's voided check or a letter from your bank confirming your organization's bank account information. The bank account number you provide below must match against the documentation you attach below. 2696204833948 Copy_ of Cancelled Check or Bank Letter for Verification,of Depository;Account Guidance: Please scan a copy of a voided check from your organization's checking account or a bank verification letter confirming your depository account information. The account name that appears on the document should be your organization's legal name and the routing and account numbers on the check should verify the information you provided above. This attachment is REQUIRED upon submission for your application to be processed. You can attach the document by clicking the "Browse" button to locate the saved document on your computer and then clicking the "Upload" button to attach document to your application. Bank Information.odf By checking this box, I verify that the above bank account informationis for the applying organization; and that the information provided is correct. I understand that providing the bank account information for the applying organisation does not constitute an offer, promise or guarantee of funding from the Citi Foundation, Citigroup Inc., or any: of its subsidiaries. If.. a grant is awarded and funds from the Citi Foundation are deposited into theapplymg organi7ation's bank account, I verify that the funds will only be used for charitable purposes: as described within this online application. Yes Annual Operating Budget What is your organization's total annual operating budget for the current year? (Whole numbers only. Include commas.) $469,797,554 For what year is your most recent, completed audit? This audit should have been completed in at least 2011 and should be the audit attached to this request. 2011 What were reported revenues as it appears in the attached audited financials? Whole numbers only. Include commas. 676,255,525 What were reported expenses as it appears in the attached audited financials? Whole numbers only. Include commas. 763,191,492 What were net assets (or equity) for your organization as it appears m the attached audited fmancials?,• Whole numbers only. Include commas. 447,843,412 What were liabilities for your organization as it appears -in the attached audited financials? Whole numbers only. Include commas. 1,241,334,514 If your organization has excessive liabilities, please provide a detailed explanation and your plan to resolve the cause of the excessive liabilities. If applicable, pleaselalso address why expenses exceed revenues, and/or if there are any legal or fiduciary issues highlighted in -the auditor's notes. If these scenarios are applicable, we respectfully ask that you provide the ' auditor's -opinion in �nglish, if �``\��!'�� The City ofMiami experienced revenue decreases inthe following areas: Pub|ioFoci|itiennndPub|in Safety Departments, property tax revenues, Public Services Tax, investment income, and oone-timo contribution to the State of Florida for the Port Tunnel's construction. Expenses also exceeded revenues due to an increase in the following expenses: General Government, Community Development and Interest onLong-term debt. For the 2012fiscal year, the City of Miami has improved its financial condition and achieved a balanced budget. Organizati:on's Most Recent Audite.d.Financial Statements (two years of comparative i-:-� -.z:�,,:- Guidance: This attachment is REQUIRED upon submission for your2pplication to be processed. You oenattaohthedocumontbydioNngthe"Bmwse,buttonto|ocatethaaaveddooumontonyour computer and then clicking the "Upload" button to attach document to your application. Audit-2O11.odf Most Recent Form 99O Guidance: This attachment is REQUIRED upon submission for your application to be processed. You can attach the document by clicking the "Browse" button to locate the saved document on your computer and then clicking the "Upload" button to attach document to your application. gQOExemotion.pdf Prior Citi Foundation ��`-- _ - `... A) Has Ci� �ot�� ' No .... .... `-_,-~~ B\If- ~ -was-funded bv the Citi Foundation in 2012 ��� Your Program Program Overview Investment Type Direct Service 1. Program Title Guidance: The program title should be no longer than 7 words. Financial Empowerment Center Coaching 2. Focus Area for the Program Guidance: If you are uncertain, please ask your Citi Contact. Financial Capability & Asset Building 3. What is the community need or issue you seek to address'? Guidance: If your organization operates at the local level, clearly state the local community need or issue affecting low- to moderate -income individuals or small businesses. If your organization operates on a national level, please include national needs, trends and statistics that relate to the issue you seek to address. Low- to moderate -income is defined as individual household income that is less than 80% of the Area Median Income (AMI). Small businesses are defined as businesses having annual revenues of $1,000,000 or less. The City of Miami is the largest municipality in Miami Dade County with 409,000 residents according to the 2011 census. Miami has an overwhelming amount of poverty affecting low to moderate income individuals, many of whom are low income small business owners. In 2006-2010, the median household income was only $29,621, versus $47,661 nationally and 27.3% of residents were living below the poverty level, double the 13.8% national level. Further, 42% of households had a net worth, insufficient to support them at the federal poverty level for 3 months without income; 12% were unbanked. The net worth was less than $4,577 for families of 3 in 2009. Also, 33% of residents do not have a high school diploma, which directly contributes to the high rate of poverty. The Financial Empowerment Center (FEC) sites will address the poverty experienced by low and moderate income Miami residents and low income small business owners by increasing their access to the financial tools and education that are fundamental to economic prosperity and success. Example: In just the past seven years, the household debt of residents in Bronx, New York has almost doubled and earning power per household has dramatically diminished over the course of the last two years. As a result,more families are in financial distress, the middle class is shrinking auicklv;and foreclosure and bankruptcy levels in this community are up 33% in the last year. The low to moderate -income individuals served through our program will learn strategies to help them retain their financial assets and leam to better manage their household needs 4; Program Summary Guidance: Provide a summary of the program in no more than five sentences. The Financial Empowerment Center sites will provide free individualized financial coaching to 200 residents annually to empower them to play a more proactive role in their economic independence and self-sufficiency. The coaching will address establishing a budget, evaluating debt and creating a debt elimination plan, establishing an emergency fund, understanding and reducing expenses, funding saving accounts and planning for the future. The free financial counseling will assist clients in improving their credit score, increasing their savings and improving their money management skills. Additionally, the FEC will also provide interactive educational classes on topics such as budgeting, credit and money management. Example: Through our Financial Capability Program, we will conduct financial assessments, education and one-on-one coaching for 450 low- to moderate -income individuals facing the threat of foreclosure, bankruptcy or income loss. Counselors will work with them to help establish a plan to stabilize their financial situation and provide long-term support in order to meet their financial goals. By the end of the grant period, we anticipate at least 250 participants will become financially stable through debt reduction, increased savings, improved credit scores and foreclosure prevention. 5. Total Program Budget Guidance: This must equal the dollar amount stated in the required program budget that you will attach to this application. (Whole numbers only. Include commas.) $150,000 6. Amount Requested Guidance: This must equal the dollar amount stated in the required program budget that you will attach to this application as agreed upon with your Citi Contact. (Whole numbers only. Include commas.) $150,000 Program Budget Guidance: This attachment is REQUIRED upon submission for your application to be processed. Please download and complete the template in its required format by clicking the link below and saving the document on your computer. You can attach the completed document by clicking the "Browse" button to locate the saved document on your computer and then clicking the "Upload" button to attach document to your application. Click here to download REQUIRED template 2013 Program Budget .xis 7. How will Citi Foundation funds be used? Guidance: Please limit your description to no more than 5 sentences. Grant funds will be used to pay for the following: The salary of two (2) full-time financial coaches and one (1) part-time clerical/administrative assistant, local travel, program supplies, printing, design, data mining training, administrative and other miscellaneous expenses. Example: Funds will be used to purchase program materials and support staff time for our financial counselors. 8. Program Start Date • Guidance: Indicate the date that you will begin to use the requested funds. Note that the Citi Foundation requires the funds to be used within a 12-month period and that the deadline for your interim and final reports will be based on this date. 03/30/2013 9. Program Narrative Guidance: Describe your program in detail. Outline the key elements of your program, interaction with participants, and provide any additional information that is pertinent to successful implementation. The Financial Empowerment Center coaches will primarily serve low to moderate income residents and low income small business owners of the City of Miami but will be open to the general public. This additional funding will enable the city to leverage and take its existing financial literacy program which has served over 11,000 residents and low income small business owners to the next level of individualized coaching. This direct funding will enable the city to add two (2) Coaches and one (1) administrative staff to expand the group financial literacy trainings to personalized one-on-one coaching. The enhanced program will be promoted through a variety of channels, from our housing program to our successful tax preparation sites where attendees will be encouraged to take advantage of their tax refunds and create an emergency fund or pay off debt. In the tax preparation sites alone, the City of Miami provides services to more than 1,200 City residents. The short term group sessions will provide a financial literacy training curriculum regarding credit and money management. These group trainings will be conducted by either VISTAs, the Financial Coaches and/or volunteers recruited by the VISTAs depending on the coaches' workload and availability. A dedicated program manager/coordinator will implement the financial coaching model with fidelity. The city proposes one centrally located hub at its administrative offices and three satellite locations established with local partners. The program will be enhanced by the support of two (2) AmeriCorps VISTA's (Volunteers In Service to America). The City of Miami has maintained this AmeriCorps VISTA grant for the last 5 years. Contingent on continued national program funding, each VISTA will support each coach and develop new group instructional and referral opportunities. The group trainings will cover lessons on credit and/or money management which will steer attendees to more in-depth one- on-one coaching and development of personal goals. These financial literacy group classes are given on a bi-weekly or monthly basis in cooperation with various partner sites. These group settings will be crucial to providing the initial point of contact to increase the awareness and need for financial discipline. The Financial Coaching and one-on-one session will be heavily promoted and encouraged at these group trainings which will act as a primary referral source for the coaches. Each of the coaches will also be able to provide group trainings and one-on-one counseling sessions at each of the other satellite locations on an as needed basis and make adjustments to services such as housing assistance, and work supports to meet the needs of the constituents and/or of the referral partners. The group training sessions will be used as a recruitment tool for the one-on-one coaching sessions. The experience of other nationally established financial coaching programs indicates that approximately 50%of the attendees will prescribe to the individualized coaching. Therefore, although a large pool of about 400 to 500 individuals will be recruited for the group sessions and obtained through referrals, only about 200 will utilize the one-on-one ongoing counseling. The FEC program will serve a total of 200 participants in a 12 month period) who will develop a more detailed financial plan and will be followed up at 4 prescribed intervals to help them achieve financial self-sufficiency. Most of these outcomes can take more than one session to achieve. They will also have at least one of the following outcomes: create a budget, open a bank account or transition to a better account; begin saving, increase income, reduce expenses, establish a credit history, increase their credit score, decrease debt or use a budget to manage income and expenses. During the first 12 months, each participant will attend at least one individualized (1) coaching session and will return and generate additional sessions via telephone, email and face to face. It is estimated that these 200 initial coaching clients will generate at least 4 additional sessions during which the coaches will address behavioral changes needed to achieve financial empowerment. There will be follow-up connections made with this cohort, either in -person, by email, or phone at 1, 3, 6 and 9 month intervals to encourage and reinforce their personal goals. Additional sessions will occur over a one to two year period depending on complexity. Each initial coaching session will be marked with the completion of a financial health assessment. This assessment or "financial triage" will capture demographic information and baseline data such as education level, employment, income, services that interest participants such as, banking and financial services, budgeting, credit score improvement and debt reduction. It will also be used to determine immediate needs like housing and to refer them to providers for assistance. Providers will be entities such as, social service programs, the city's Benefit Bank and tax sites, faith -based organizations, the 3-1-1 Call Center, Neighborhood Enhancement Teams (city satellite offices), community college partners, Legal Services of Greater Miami, the City of Miami's workforce center, city programs and community based organizations providing essential services citywide. The counselors will coordinate with those organizations to facilitate access by clients by ensuring that staff is aware of the available financial counseling services and how their clients can benefit. 10.-Program Timeline Guidance: We do not need a list of every activity you will undertake, but are looking for major activities of your program. Ensure that the timeline you provide covers the entire duration of the requested grant and that at least one activity focuses on program evaluation activities. Month 1: At award confirmation, City of Miami is to produce and schedule a legislative resolution to be presented to the City of Miami Commission for approval and acceptance of the grant funds. Month 2-3: Recruit, interview and hire new financial coaches and administrative assistant. Set up grant award in city financial system. Month 3: Train staff on city processes and financial counseling model, client continuum and reporting. Execute agreements with financial coaching partner. Month 4-16: Implement program, set up referral system and procedures, conduct financial literacy classes and initial coaching sessions. Month 4-16: Capture data points to track clients' continuum of improving their financial standing. Evaluate data and report final findings of program's results for evaluation. Month 16: Complete the provision of at least 200 individualized coaching sessions to City of Miami residents and businesses. Example: (Month 1) 1) Work with partner agencies, to conduct outreach to introduce community to program Enroll 450 potential participants in the program (Months 2-5) 3) Conduct eight financial capability classes and an initial coaching session.4) 400 participants'attend all courses and develop a financial plan based on course !earnings and individual coaching received..: ; (Month 6):5). Submit Interim grant report. (Months 741.1): 6) 375 participants attend six monthly financial coaching sessions as theyimplemenf their plan.;7) Coaches track progress and evaluate client outcomes (Month 12): 8) Analyze data on, client results and identify at least one change in program to improve participant outcomes. (Month 13): 9) Submit Final grant report. 11. What are the strengths, expertise and track record of your organization and the key individual(s) leading the program that will ensure successful implementation? The City of Miami has an established legacy in implementing financial empowerment and asset - building initiatives. This funding will enable the city to add two (2) coaches and one administrative staff to enable us to go from just group financial literacy trainings to a more personalized long-term one-on- one coaching geared towards financial empowerment. Beginning ten (10) years ago, in 2002, the City of Miami established its Anti -Poverty Initiative, which the city augmented in 2003 by offering free income tax preparation assistance at various locations throughout the city. In 2005, the more comprehensive ACCESS Miami program was launched and continues to operate. To date, we have accomplished the following: - Over 85,000 tax returns completed, generating over $188 million in tax refunds. - Started over 4,000 Individual Retirement Accounts and new bank debit cards generating over $6 million in new deposits. Saved residents over $3.6 million in tax preparation fees. - Committed over $245,000 in funds and generated a 2:1 IDA Matched Savings Fund to over 100 clients who purchased homes totaling $12 million in assets. - Generated over 350 micro business loans totaling $2.2 million which produced 31 jobs and retained an additional 79. - Started a small business center as a cost share partner with the Department of Commerce which now serves over 300 businesses each year, generating over $18 million in contracts, and $12 million in financial awards and over $2 million in increased sales. - Created www.AccessMiamiJobs.com workforce site which has generated over 800,000 unique visits, over 6 million page views and over 48,000 live jobs. - Our financial literacy efforts have impacted over 11,000 attendees and residents. William Porro, Special Projects Administrator, is a bilingual Spanish and English speaker with over 25 years of financial planning expertise. Mr. Porro also has over 8 years' experience creating and administering the city's anti -poverty program. William's career in the financial services industry spans more than 20 years, including positions of high level responsibility in both international and domestic financial services and marketing for such Fortune 500 Companies as American Express Financial Advisors, Citibank and CIGNA. A financial advisor by trade, William and his wife have helped countless people "get their financial house in order" by offering free seminars on everything from budgeting to eliminating debt. Demographic Data Gui,dance:�,Ajsearch. box. it provi.d.e� so t at you May.eatily Take your sefecbon(s)� In the-searc., box, you MaV enter, the full. name of. the state county. o hot include the -word c66h� n itt e� Are:_a'�IVISA). Select the correct 6 rareaserved from this list an inc ude the percentage OT: If the program is se rving a national or statewide audience, please select the state\countyWSA of your Headquarter office. You may enter upto1Ocounties. Ifyour program serves more than 1Ocounties, please select 0 counties Yo h /d list additional counties in question_#l, IIf the area(s) where your program will take place. have not yet been determined please select "Other". You will baasked to provide this information when, it is available. If the program is serving -ap area outsid,e of. the-Unite8 states, select, ".*International"� If you-sel'ect . ' Served: UNITED STATES -United States -United S��s-:F|ohda'Miami-Dade\ 3124(10096) er Click here to find the Metropolitan Statistical Area (MSA) code based on the address of where this program will beimplemented. Not applicable 14. Area Median Income and Census Tracts A) Provide the Area Median Income (AMI) for e.achIyletropolitan Statistical Are you provided in questions #12and #13 If you answered *Other" in question #12 because the geographical area(s) sewed by this program is unknown at this time, please when you anticipate you will be able to:provide ovide this information You will be asked to provide the AMI when the geographical ai ea(s) sewed information is available. - Guidance: In order to find the AMI data for each MSA you provided in questions #12 and #13, please access the 2012 FFIEC Estimated Metropolitan Area Median Family Income listing found here.The listing is sorted by MSA name and you should indicate the FFIEC Estimated Median Family Income for each MSA you provided in questions #12 and #13 in your response. According to the 2012 FFIEC Estimated Metropolitan Area Median Family Income listing, the AMI in this MSA is $52,600. Example: According to the 2012 FFIEC Estimated Metropolitan Area Median Family Income listing, the AMI in this MSA is $67,400. B) If this program is serving small businesses, please provide the census tract income level for the address of each business served. If the businesses being served have not yet been identified, please provide the census track income level for the location where the program will be implemented Similarly, i f the program will be implemented m a government designated redevelopment zone, empowerment zone or disasterarea, please include the census tract data for each MSA provided in questions #12 and #13 -` Guidance: For programs serving small businesses that are located in low- to moderate -income geographies or that will take place in government -designated redevelopment, empowerment zones or disaster areas, you will also need to provide the census tract data for each MSA. To do this, please visit the FFIEC website by clicking here. Once you access this page, you will be able to enter a street address along with either a city and state or a zip code. Entering this information will take you to the Geocode page for the specific MSA. In order to find the census tract for the MSA, click on "Get Census Demographic" and include the Tract Code and Tract Income Level in your answer. Be certain to include this information for each MSA you provided in questions #12 and #13. This program will be open to the general public and low income small business owners throughout the City of Miami. Those that are low income small business owners will meet the same criteria as our low & moderate income residents Example: According to the FFIEC website, the small businesses we will serve are located in tract code'1408.00 and the tractincome level for this MSA is"Low' 15.: Describe the individuals, micro and small businesses and/or organizations thatyou will serve during this program The Financial Empowerment Center will serve low to moderate income residents and low income small business owners in the City of Miami. These residents have experienced an overwhelming amount of poverty and have median household incomes which are well below the national average. Furthermore, many residents do not have a high school diploma, are financially illiterate, English is their second language and in general are not familiar with the US banking/financial system. The Financial Empowerment Center will address the poverty experienced by these residents by increasing their access to the financial tools and education that are fundamental to economic prosperity and success. Example: The populationserved is largely low- to moderate income. individuals in Bronx, New. York who have an urgent need and a strong desire to improve their financial management skills so that they may avoid and/or break the cycle of over-indebte dness and ultimately build end: preserve assets and family wealth. Many have recently lost their jobs, have significant debt issues, and most have no long-term financial plans to build or preserve their wealth. 16. Ethnicity Served by Program (The majority served by this program) All (not specified by ethnicity) 17. Gender Served by Program (The majority served by this program) General Population 18 Population Served byProgram (The majority served by this program) General Population 19 Is the,population or area served by. this grant priinanly (51% or more) low ao moderate mcome and/or, if applicable, small busmesses7 Low. to moderate-mcome is defined as individual' annual household mcome that is less than 80% of the Area Medianlncome (AMI): A small business is defined as a business with revenues of $1,000;000 or: less and, for our purposes,:is located in a low to moderate mcome census tract Yes 20 How do you verify the percentage of low- to in moderate come individuals and businesses that have annual revenues of $1,000,000_or less and are locatedin low ,1 moderate incomecensus tractsive a specific description of how you determined answer provided in the previous question (Please use the examples provided to=guide you as ?: you answer this question:) Guidance: Acceptable forms of data used to verify this percentage are: client intake forms that capture information related to household income and address of each participant; data that verifies the annual revenue and/or address of each small business served; client income verification; and federal free or reduced cost lunch data. If you are using household income to determine this percentage, include how you will verify that the participants or small business owners served will meet the less than 80% AMI criteria. If you are using federal free or reduced cost lunch data to determine this percentage, include the name(s) of the target school(s) and the percentage of students that qualify for free or reduced lunch at each school. If you are using census tract information, include how you will verify that the participants or small businesses served are located within a low- to moderate - income census tract(s). At intake clients will complete forms capturing their household income, address and other demographic data. Clients will be asked to provide information indicating household members who receive free or reduced lunch, Medicaid, cash assistance, or SNAP (food stamps). Staff will use this information to determine that 51 % or more of the clients served have an annual household income that is less than 80% of AMI. Examples: Financial Capability & Asset Building: NFCi will determine the number of participants who are classified as low- to moderate -income by collecting client intake forms from each participant which will capture data related to household income. Based on the client intake forms, we will determine that 51 % or more of our program participants have annual household income that is less than 80% of the AMI. Microfinance/Enterprise Development:. We' obtain_ client intake forms from each small business - owner which captures information related to the small business, including address and annual revenue. Based on the client intake forms, we will determine that 51% or more of small businesses served by this program have annual revenue of $1 million or less and are located Within a HUD classified low to moderate -income census tract. College,Success: As outlined in our mission, we only serve students from low -to moderate.income communities This program will take place at the Stadium School, where 66% of the students'are eligible for federal free or reduced cost lunch, and the Heritage School,: where,8% of students are eligible for free Cr reduced cost lunch. This program will serve:50 students from the Heritage School , and 50 students from the Stadium School; therefore, we can confirm that this program: will primarily serve students who are classified as low -to moderate -income Neighborhood Revitalization We require a copy of federal income tax returns, pay stubs and the most recentutilitybill of each program participant in order to determine. -the percentage of low- to moderate -income participants served by. this program; Since this program will serve the same; participants as served in 2011, we know that 51 % or more of ourrparticipants have annual household Incomethat is less than 80% of the AMI } Results 21 Results Statement Guidance: The fact that the participants in your program have completed the activities you implemented, read your materials, and sat through counseling or a workshop is not the result. Do not focus on activities, programs implemented or levels of participation satisfaction. The results we are referring to are the changes in the behaviors or conditions of your participants during the 12-month duration of the requested grant based on your program's activities, services, and support. For additional reference materials for defining your program results, review Defining Direct Service Program Results and Program Results Examples. Any numbers provided in your statement must be consistent with those you provide below. Use the example as a guide in providing your response. Note that your results statement should be 100 words or Tess. You will not be able to submit your application if your answer exceeds 100 words. 90% (180 participants) will create a budget to follow, 25% (50 participants) will open a bank account or transition to a better account, 10% (20 participants) will begin a savings plan, 20% (40 participants) will begin a debt reduction plan, 10% (20 participants) will improve their credit score, 20% (40 participants) will establish an emergency fund, and 20% (40 participants) will increase their income to expense ratio. Example: By the end of the grant period, of the 450 participants: 1) 54% (245 participants) will reduce their debt by at least 15%; 2) 42% (187 participants) will start an emergency savings account; 3) 31% (140 participants) will improve their credit score; 4) 17% (75 participants) will avoid foreclosure and remain in their homes. How many individuals (including microentrepreneurs or small business owners) will this program serve directly during the grant period? (Whole numbers only. Include commas.) 200 If the goal of this program is tobuild the capacity of other' organizations (i e microfinance institutions, community development financial institutions', community development organisations, etc.), how many do you plan on serving directly during the grant -period? Guidance: Exclude your own organization and any with which you will partner to provide services. 0 Quantify your results Guidance:Participants may achieve more than one result within a grant period and therefore;: it is possible that the sum ofyour entries may exceed the number of participants served . Providea response for only those questions. that apply to your program ,Numbers provided must_be consisten withyour resultstaternent;_ As a result of this program, by the end of the grant period (whole numbers only); How many:. individuals will demonstrate financial knowledge and skills? 180 How many individuals will change and maintain changes to their financial behavior? (Use a budget, improve credit score, reduce debt, pay bills on time, use a bank account) 100 How many individuals will build fmancial assets? (Accumulate savings) 60 How many individuals' will preserve financial assets as -a result of this program? (Protect assets against financial loss through foreclosure prevention and/or insurance) 0 How many individuals will begin to use financial products to help improve their financial stability? (Products include: savings, credit, insurance) 50 How many students will be better prepared to enroll in postsecondary education? 0 How many students will enroll in postsecondary education? (Only applicable to high school seniors) 0 How many students will continue postsecondary. education? (Only applicable if your program will provide services to students already enrolled in postsecondary education) 0 How many students will graduate with a postsecondary degree? (Only applicable to students in their final year of postsecondary education) 0 How many new micro or small enterprises will be created? 0 How many existing micro or small enterprises will be improved or expanded?- 0 How many new jobs will be created? (Creation of a new enterprise must also result in the creation of at least one new job) 0 How many -on,ts of affordable housing will be created For predevelopment projects, please enter the anticipated number of affordable housing units that will be created/made available upon completion of the development. 0 How many•nntsof affordable housing will be rehabilitated or preserved? 0 How many community facilities will be created or revitalized? 0 Of the organizations served, how many will be better able to provide services to clients? Only applicable if the goal of your program is to build the capacity of other organizations 0 22. What data_ will you collect to verify your program's results? What specific tools will you use to collect this data? Guidance: Evaluation tools may include: randomized control trials, third -party evaluation, pre- and post-tests, surveys, focus groups, site visits, client follow-ups, etc. You may be able to use existing data sources, rely on existing measurement instruments, or use observations and reports by others and, in some cases, self -reported behaviors. Our financial assessment tool (Client Registration Form) will provide an overall view of each participant. This form will be used with every participant that is seen by the financial coaches. This form contains demographic and income based background information. The second section contains questions that relate to services in which the participant is interested, such as obtaining a bank account, benefit screening and credit score improvement. It also identifies the referral source and captures whether or not the counseling mode is "one-on-one", on the phone, or in a group setting. A topline view of their budget including (savings, monthly income, expenses, debt and debt payments) will be obtained and debt to income ratios will be calculated. Probing questions such as "did you ever default on a loan", "feel short on cash before payday" and "do you have a budget" will be utilized. A deeper investigation of an individual's use of financial services is also conducted by querying them regarding their use of these services. To that end, they are asked if they have a bank account, a savings account, if they have been rejected for a bank account, their use of ATM and debit cards and if they have health insurance. Finally, an ongoing service plan is created for clients using the Financial Health Assessment and focuses on various elements such as, opening a bank account, credit score improvement, savings and debt reduction. The City of Miami will attempt to mirror the reporting system used by New York's Financial Empowerment Centers, but will capture the data points described above in Miami's database. The financial coaches will be accessible and help each participant with each step of the service plan to ensure success. Each Financial Coach will follow up and set up predetermined calls/emails/meetings in months 1, 3, 6, and 9 to make each participant accountable for their own success. These follow up sessions will allow the Financial Coaches to assess and gather data to help direct each client towards their stated goal(s). The administrative staff will help set up these follow up sessions with each clients and report the successes achieved along the way. The forward looking plan will encourage "baby steps" which consist of 1. Completing and understanding their budget 2. Developing an emergency fund 3. Eliminating debt, via a debt reduction plan 4. Developing a savings and retirement fund 5. Savings vehicles such as, taking advantage of 401 k and employer sponsored savings. 6. The financial coaches and the administrative staff will input the data on a timely basis to adhere to the grant requirements and program goals. The rate of improvement for participants and how many outcomes they are able to achieve will also are monitored. A "next step" plan of action will be noted and agreed upon after each session with the participant. These "next steps" i.e. baby steps will drive the participant towards true behavioral change. These small steps in one direction, such as establishing an emergency fund are both a behavioral change and an increase in assets at the same time. Both will be monitored via scheduled follow ups established by the financial coaches and confirmed by the administrative staff and then input into a database. Example: Our counselors will review the financial goals set by the participant and then ask for/use copies of documents that show they have achieved those goals. Examples of documents may include credit reports, savings or checking account statements, bill statements and budgeting sheets. These. will be obtained during their monthly check in. session to confirm success. We also captureclient information that will help to inform program decision and refinements aswell as marketing efforts; this.. includes demographic data, perceptions about banks and banking products, method of entry (marketing data), debt levels, numbers of credit cards,' and more. At the end of each workshop: module, trainers enter test scores for all participants. All of this data is available online in our.,secure client management database for both trainers and counselors to use. Counselors will.also review, module test scores to provide additional support where needed. If participants are not making strong ..' progress towards their goals, counselors canuse this information to help participants.identifyivhere they are. stuck and provide additional resources/perspectives to help them get back on track towards their goals. Additional Information Program Visibility 23. How will this program be communicated to the public,.professional peers: and thought _ . leaders? Be specific and include details such as press releases, social media, convenings, web postings, ,brochures or other related matenals. If applicable, please ensure that acknowledgement of our grant funding credits the Citi Foundation. The FEC program will be communicated using the following: A kickoff event attended by City of Miami Mayor and press. Radio advertisement and distribution via City of Miami neighborhood satellite offices. Showcase kick-off on TV channel and Public Service Announcement. Through the use of an extensive database, emails will be sent to residents, homeowners' associations and community based groups and colleges citywide. Brochures and program materials will be provided to selected partners to ensure the neediest residents are also informed of the program. The City of Miami will utilize its own radio and TV broadcasting capabilities, coverage via its partnership with the public radio station WLRN, and the Haitian Creole and Hispanic radio stations to inform residents of the FEC. 24. Will this program include publication of any reports and/or research white papers? No If yes, when is this report expected to be produced? And, if known, specify the anticipated • title of the publication. Note: The Citi Foundation would like to highlight the accomplishments of our nonprofit partners on the Citi Foundation website by featuring any reports and/or white papers that are produced as a result of our funding. If your program will produce a publication, please complete a licensing agreement, the form of which is available for download in the link below, and attach the signed agreement to the last page of this application. Please ensure that the agreement is reviewed and signed by an individual with the authority to enter into a legal agreement on behalf of the organization that is producing the publication. Signing this agreement does not constitute an offer, promise or guarantee of funding from the Citi Foundation, Citigroup Inc., or any of its subsidiaries or affiliates. The Citi Foundation reserves the right to determine, in its sole discretion, whether or not to feature the publication on the Citi Foundation website. Click here to download the agreement form. Licensing Agreement You can attach the document by clicking the "Browse" button to locate the saved document on your computer and then clicking the "Upload" button to attach document to your application. Citi Engagement 25.-Will Citi employees participate/volunteer in this program? No If yes or if there are opportunities, please indicate how many and describe in what capacity Please note that although we encourage the engagement of Citi employees in Citi Foundation funded programs, the involvement of Citi employees is not a determining factor for funding consideration. 26. Is there a Citi employee on the Board of the organization If there is a Citi employee on the Board of your organization, provide the Citi employee's full name, Citi business, and title as well as board position and/or whether the Citi employee serves in an advisory capacity regarding the finance, governance, or fundraising for the organization. Please note that the involvement of Citi employees is not a determining factor for funding consideration. No Citi Contact Information 27. Citi Inviter Name Provide the name of the Citi Contact who invited your organization to apply for a grant. Enter the name exactly as it appears in the Invitation to Apply that your organization received. Do not include title or address. Patricia Algaze 28. Grant Program South Region (Business Partner Sourced) Compliance 29 Group _Exemption Is your organization an affiliate of a large, national parent organization and does that organization have an IRS group tax exemption ruling? No If yes, please include a scanned.copy of the -page from the most recent published directory or;; online database, which identifies your organization' as an affihhate_inember of the parent organ»ation Please upload this document here You can attach the document by clicking the "Browse" button to locate the saved document on your computer and then clicking the "Upload" button to attach document to your application. . .. .., .... .................:..,...„ __.. ...........:. - . . . . ..... ._, . ' . -:.,-_-: :.,- ......: --.•..-.:::., 30. Fiscal Sponsorship Is your organization acting as an official Fiscal Sponsor for this project/program? No If yes, please review the fiscal sponsorship guidelines by clicking. here and attach the required You can attach the document by clicking the "Browse" button to locate the saved document on your computer and then clicking the "Upload" button to attach document to your application. 31: Supporting Organi7ation „:_- z-.- As a 501 (c)(3), your organization may be further classified by the Internal Revenue Service (IRS). Is your organization a supporting organization as described in section 509 (a)(3)? (You can find this classification in your organization's IRS determination letter.) No If yes, please note that you are required to complete and attach the Supporting Organization Form here. Click here to download the required form.. You can attach the document by clicking the "Browse" button to locate the saved document on your computer and then clicking the "Upload" button to attach document to your application. 32. Public Schools and School Districts • r • • . ' • . " • • If youT organi7ation is a public school or school district, please locate your or6anization On one of the. following web sit0'. You will be asked to include a scanned copy here Public Schools Search Public School Districts Search Public Colleges and Universities By checking this box, 1 understand that submission of an applicationdoes �tconstittite an offer, promise or guarantee of funding from the Citi Foundation, Citigroup Inc., or any of its subsidiaries. Yes Please note that you are, required to e-maila draft of the completed application to the Citi. Foundation for preview before you can officially submit this application -for funding consideration When you have completed the entire application and attached all required documentation to the application form,°please select "E-mail Draft' at the bottom of,this screen and Send `a draft of the application to CCDGrants@citi.com._The Citi Foundation will review the draftapplication ..: and contact you if additional information is required before: submission Once the Pit' Foundation authorizes the official submission of the_ application form, you wi receive a: Submission. Code to` enter in question #32` Please note that the deadline to submit a draft application to the Citi Foundation for. authorization is November 19, 2012. 33. Submission Code Once the Citi Foundation authorizes the official submission of this application form, you will be provided with a Submission Code. Please enter this Submission Code exactly as it appears in the authorization e-mail sent to you by the Citi Foundation. 8040 ATTACHMENT B - BUDGET PER ATTACHED, SUBJECT TO FINAL NEGOTIATION com: DRAFT PSA for Operation Hope Services for Citi Foundation grant will- Legal Dept Edits as of May 7