HomeMy WebLinkAboutPK04-069 - Change Order - #1 - Pioneer Human Services - Multicultural Supervised Visitation & Exchange Center - 01/01/2004 ecords M eme
KENT Document
WASHINGTON
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission to City Clerks Office. All
portions are to be completed, if you have questions, please contact City Clerks Office.
Vendor Name: Yt fJ/ 4i Ae::n �LW 4C-z- Vendor Number: �W
JD Edwards Number
Contract Number. O
This is assigned by Deputy City Clerk
Description: 6 (up Q 4U'01 d ZI
Detail: S6,4irNM'L�
Project Name: � [ 'tV �TY Cr p, a�✓
Contract Effective Date: �' �' r9'[ _ Termination Date: 19''71 "O]`
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager. +` Gy�LSti- Department: A4^C1- Jam'
Abstract:
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5 Publc\RecordsManagemenf\Forms\ContractCover\ADCL7832 07/02
KENT
H/A$NIN6TON
CHANGE ORDER NO. 1
NAME OF CONTRACTOR, CONSULTANT, OR VENDOR: Pioneer Human Services ("Contractor")
CONTRACT NAME &PROJECT NUMBER: Safe Havens Grant Evaluator
ORIGINAL CONTRACT DATE: August 14,2003
This Change Order amends the above-referenced contract; all other provisions of the contract that are
not inconsistent with this Change Order shall remain in effect. For valuable consideration and by mutual
consent of the parties, the project contract is modified as follows:
1. Section I of the Agreement, entitled"Description of Work,"is hereby modified as follows:
Provide all labor, materials, and equipment necessary to:
Continue to evaluate the process for planning and implementing the opening
of a multicultural supervised visitation and exchange center for family
violence victims within the City of Kent. Evaluator(s) shall be approved by
the City of Kent. Contractor shall notify the City of Kent within ten (10)
days of any changes in evaluator personnel. No changes in evaluator
personnel shall be binding unless in writing and signed by a duly authorized
representative of the City and the Contractor. Dinah R. Wilson shall
continue as the City's Grant Manager on this Agreement. A revised Scope of
Work for 2004 is attached and incorporated as Exhibit A. A revised
Compensation and Payment Schedule for 2004 is attached and incorporated
as Exhibit B. A revised Billing Voucher a p V u her is attached and incorporated as
Exhibit C.
2. The contract amount and time for performance provisions of Section II "Compensation," and
Section III, "Time for Completion,"are hereby modified as follows:
Original Contract Sum, $11,000 for 2003 services
including applicable alternates and WSST.
Net Change by Previous Change Orders $0
(incl. applicable WSST)
Current Contract Amount $119000
(incl. Previous Change Orders)
Current Change Order $24,000 for 2004 services
Applicable WSST Tax on this Change Order $n/a
Revised Contract Sum $359000
CHANGE ORDER- 1
` t
Original Time for Completion December 31,2003
(insert date)
Days Required t for this Change Order 365 calendar days
Revised Time for Completion December 31,2004
(insert date)
The parties whose names appear below swear under penalty of perjury that they are authorized to enter
into this contract modification,which is binding on the parties of this contract.
3. Contractor will renew its insurance coverage in the types and amounts required under the
original agreement to cover the term extension granted by this Change Order. Upon its execution of this
Change Order, Contractor shall provide the City with an updated Certificate of Insurance and endorsement
evidencing coverage and naming the City as an additional insured.
4. Except as specifically amended, all remaining provisions of the Contract shall remain in full
force and effect
IN WITNESS, the parties below have executed this Agreement,which will become effective on the
last date written below.
CONTRACTOR: CITY OF NT:
By. By:
(signture) (signature)
Print Name: Micifael J.Burns Print N e: Jim White
Its: President/CEO Its: Mayor
ule)
DATE: DATE: ti3-ate=�s�
f
APPROVED AS TO FORM:
�Cr
Kent Sty Attorney
As yr
CHANGE ORDER-2 OF 2
EXHIBIT A
SCOPE AND SCHEDULE OF WORK
2004
CONSULTANT SERVICES AGREEMENT
Pioneer Human Services—Consulting Services Division
Safe Havens Grant Evaluator
SCOPE OF WORK
The purpose of this agreement is to contract for services to evaluate the process for planning and
implementing the opening of a multicultural supervised visitation and exchange center for family
violence victims within the City of Kent. This project is funded by U.S. Department of Justice, Office
of Justice Programs, Office on Violence Against Women. During the term of this agreement, the
Contractor(evaluator)shall:
A. Gather and manage data collected for the planning and opening of a supervised visitation and
exchange center. Instruct staff in methods of qualitative data gathering to document the
process of program development.
B. Conduct individual and focus group interviews and/or community needs assessment if called
for in an evaluation plan developed in collaboration with the local program and Safe Havens
partners.
C Work collaboratively and cooperatively with national evaluators, other local evaluators, Office
on Violence Against Women (OVW) and technical assistance providers to design and
implement local and national evaluation plans.
D. Work with Multi-Cultural Project Coordinator to design evaluation methods that are accessible
to limited English proficient and non-English speaking clients.
E. Document access of services for underserved populations.
F. Evaluate the effectiveness of guidelines, standards, training and/or promising practices
implemented in Safe Havens project in evaluation studies developed in collaboration with the
local program, National Evaluation Coordinators, and other partners.
G Help to design evaluation toots for the project if necessary.
H. Conduct surveys of client perceptions of program if not performed through national evaluation.
I. Attend regularly scheduled Safe Havens Advisory Committee meetings.
J. Meet with Safe Havens Grant Manager on a regular basis, at least quarterly
K. Maintain ongoing communication with Safe Havens Grant Manager, i.e., telephone and
electronic.
L. Provide written/oral updates on work to Safe Havens Grant Manager, Advisory Committee,
Kent City Council Committee or Full Council, and other City Departments as requested.
M. Participate in technical assistance and consultation via meetings and conference calls.
N. Participate in conference calls with national evaluators, at least quarterly.
O. Participate in site specific and project director conference calls as needed.
P. Participate in site visit meetings.
Q. Participate in training as designated by the City. At least 20 hours of training shall be
domestic violence training sponsored by a local or regional domestic violence service
agency or related domestic violence entity.
R. Coordinate evaluation process with the community safety audit process.
S. Submit draft written research reports and other materials produced pursuant to the Safe
Havens Grant Project to City, OVW, and national evaluators for review and approval.
T. Adhere to ethical and legal safeguards that must be applied when conducting research and
evaluations in the area of violence against women and children. Protect the confidentiality of
identifiable research and statistical information in compliance with 28 CFR Part 22 and have
1
evaluation plans approved by appropriate Human Subjects Committees prior to gathering
data.
Note: This program does not provide direct services to clients; however outcomes will be
measured by whether the evaluator's activities assist in accomplishing grant objectives.
Outcome(s)
• Increase access to supervised visitation and exchange services for low and moderate-income
victims of family violence who reside in the Kent/South King County area.
• Increase access to culturally sensitive visitation and exchange services for ethnictracial minorities.
• Identify model standards of practice for supervised visitation and exchange services that are
responsive to the needs of women and children victims of family violence.
• Identify security procedures to create a visitation and exchange center that is safe for victims of
family violence.
• Increase communication between the court and the supervised visitation and exchange program
to ensure court compliance and victim safety.
• Increase referral to appropriate ancillary services.
Budget:
Contractor Activities $17,000
Travel $ 4,400
Clerical Support $ 1,500
Supplies $ 700
Phone/Fax $ 200
Postage $ 112
B & O Tax $ 88
Total $24,000
Reporting Reouirements and Timeline
The agency will be reimbursed on a quarterly basis, upon submittal of appropriate documentation. Such
documentation will include the following (as applicable): Billing Voucher (Exhibit C) itemizing the work that was
done, number of hours worked, the hourly rate charged, etc . Billing must be submitted on forms provided by the
City by the 10th of the following month for the previous quarter of service. The reporting timeline is as follows:
Billing Voucher(Exhibit C) 10T"day following each quarter
Final Billing Voucher(December Exhibit C) December 31,2004
Annual Report: Describing Activities Accomplished& January 31,2005
How the Evaluator's Activities Assist in Accomplishing
Grant Objectives(Written Report)
Pursuant to Item I. of Change Order No. 1 executed in March 2004, PHS shall submit the following
supplemental reports to demonstrate increased safety for family violence victims:
Supplemental Reports
The Consultant shall submit quarterly reports to the City summarizing activities accomplished and
progress toward meeting the outcomes outlined above (written report).
2
. e
Contract Administration and Manataement
The Contractor shall notify the City, in writing, within ten (10)days of any changes in evaluator
personnel. No changes in evaluator personnel shall be binding unless in writing and signed by a duly
authorized representative of the City and the Contractor.
The above services shall be provided by December 31, 2004.
2004 Reimbursement: $24,000
Please sign to indicate acceptance of the Year 2004 Performance Measures listed above.
Michae r residentlCEO Date
eri rWohns , Human Services Manager Date 2 - 2510
3
EXHIBIT B
COMPENSATION AND PAYMENT SCHEDULE
A. Amount of Compensation': Total compensation payable to Contractor for
satisfactory performance of work under this Agreement is a maximum of
$24,000 2 Funds are awarded under this Agreement from the Office on
Violence Against Women (Department of Justice, Office of Justice
Programs), Award Number 2003-CW-BX-KOO1. The Project Title is Safe
Havens: Supervised Visitation and Safe Exchange Program. Contractor's
compensation for services rendered under this Agreement shall be based on
the following rates or in accordance with the following terms:
• Evaluation Activities: $50 per hour for evaluation activities (i.e., managing
and gathering data,focus group interviewing, needs assessments,
conducting and designing client surveys,written research reports,
training/instruction, evaluation design, documentation of service access,
development of collection tools/evaluation methods, designing evaluation
methods that are accessible to limited English proficient and non-English
speaking clients, evaluation of promising practices, and coordination of
evaluation process with safety audit process).
• Coordination Activities: $50 per hour for coordination activities (i.e.,
working collaboratively with national evaluators, other local evaluators,
OVW, and technical assistance providers, attending Safe Havens
Advisory Committee meetings/site visit meetings, participating in
conference calls scheduled by the national evaluators3, site-specific
conference calls, project director conference calls°, and technical
assistance and consultation via phone and electronic mail).
• In-Person Consultations/Meetings: $50 per hour for in-person
consultations with Safe Havens Program Manager, up to a maximum of
four,two-hour consultations.
• Written/Oral Updates: $45 per hour to prepare/present written/oral
updates on work to Safe Havens Grant Manager, Advisory Committee,
Kent City Council Committee or Full Council, and other City Departments,
up to a maximum of seven hours per quarter.
• Telephone and Electronic Communication: $40 per hour for telephone
and electronic communication with Safe Havens Grant Manager, up to a
maximum of two hours per month.
• Training: $30 per hour to attend training, plus training costs. At least 20
hours of training shall be domestic violence training sponsored by a local
or regional domestic violence service agency or related domestic violence
' Invoices/receipts shall be submitted when applicable.
2 Pursuant to federal regulations,consultant rates shall not exceed$450 per day without prior
approval from the Department of Justice.
3 When applicable,the City will compensate for up to one hour(1.0)of document review in
preparation for conference calls with national evaluators.
°When applicable,the City will compensate for up to thirty minutes(.50)of document review in
preparation for other conference calls and meetings.
1
entity-5 Contractor shalt seek the City's approval before attending
training.
• Clerical: $30 per hour for clerical support,up to a maximum of 15 hours
per quarter.
• Travel Time: $20 per hour travel time up to a maximum of six hours per
day.
• B&O Tax: Compensated up to 0.415% of total quarterly voucher charge.
B. Expenses: Contractor shall receive reimbursement for travel and other
expenses as identified below or as authorized in advance by the City as
reimbursable. The maximum amount to be paid to Contractor for such
expenses is$4,400,which amount is included in the contract total in
Paragraph A. Such expenses include: airfare(economy or coach class only),
airport parking, ground transportation (maximum of$85 per out of town trip),
lodging (costs exceeding OVW negotiated rate, shall be pre-approved by
Safe Havens Grant Manager), meals (maximum of$50 per day), supplies,
phone/fax, and postage. Contractor shall be reimbursed for mileage at the
federal reimbursement rate,currently 37.5 centsimile. A travel/mileage and
expense voucher with receipts (when applicable)shall be submitted.
C. Movement of Funds: Contractor may move up to ten percent(10%) of the
total compensation awarded under this Agreement between budget
categories provided there is no change in the scope of the evaluation project.
Cumulative changes which exceed 10%of the total compensation amount
require prior approval from the City.
D. Budget:
Contractor Activities (See A) $17,000
Travel and Per Diem $ 4,400
Clerical Support(See A) $ 1,500
Supplies $ 700
Phone/Fax $ 200
Postage $ 112
B &O Tax $ 88
Total $24,000
5 Training refers to events sponsored by OVW,national technical assistance partners,the City of
Kent, grant collaborators,Iocallreglonal domestic violence service agencies,or approved
domestic violence entities.
2
EXHIBIT C - SAFE HAVENS GRANT
Billing Voucher
TO: FROM:
Dinah Wilson Hallie Goertz
Housing& Human Services Pioneer Consulting Services
Parks, Recreation&Community Services 7440 W Marginal Way S
220 4th Ave.South, Kent,WA 98032 Seattle,WA 98108
drwilson@ci.kent.we.us hallie.goertz@p-h-s.com
253.856.5076 206.766.7050
Reporting Period(QtrNear) I Program Amount Requested
EVALUATI N -
Budget Summary
Total Contract AmountCurrent Request Balance
24, 00 -
Itemized Billing
I. Contractor Activities(evaluation,coordination and in-person consultation/meetings)
Date Work Performed Hours Rate Total
50.00
50 00 -
50.00 -
50.00 -
50.00 -
$ 50.00 -
50.00 -
$ 50.00 -
50.00 -
$ 50.00
50.00 $ -
50.00 s -
7 50.00 -
50.00 $TOTAL If -7
II.Travel
Date Purpose Hours Rate Total
$ 20.00 $ -
20.00
20.00
20.00
20.00
20.00 $
$ 20.00
20.00
TOTAL
Ill. Clerical Support
Date Work Piftmod Hours Rate Total
$ 30.00 -
30.00 -
30.00 $ -
mr 30.00 -
TOTAL is -
IV. Written/Oral Updates(prepare and present, 7 hours/qtr.)
Date Work Performed Hours Rate Total
45.00 $ -
45.00 -
45.00 -
$ 45.00 TOTAL -
V. Telephone/Electronic Communication with SH Grant Manager(2 hours/mth)
Date Work Performed Hours Rate Total
40.00 -
$ 40.00 -
40.00 $ -
$ 40.00 $ -
TOTAL -
VI. Supplies
Date Item Amount
TOTAL b -
VII. Phone/Fax
Date Purpose/City&State Amount
TOTAL $ -
Vill. Postage
Date Description Amount
TOTAL -
Authorized Signature Date
FOR DEPARTMENT USE ONLY
Authorized for Payment
By: Date:
- � r
March 10, 2004
Dear WOCN Resource Guide Subscriber,
Enclosed is the much anticipated Women of Color Network Resource Guide Update
Women of Color published in February,2003. As stated in the preface of the Update, it is intended to
Network serve as an addition to the original WOCN Resource Guide, published in 1999. In spite
(WOCN) of the delay, this publication contains valuable information that deserves to be shared
with the membership and supporters of WOCN.
The Resource Guide Series is one of the fundamental tools that WOCN offers to
women of color activists and advocates in the fields of domestic violence and sexual
assault to foster networking, alliance-building, and peer mentoring within and across
communities. The aim is to continue offering updates every few years to provide
6400 Flank Drive current information for those listed in the guide and to allow additional individuals and
culturally specific programs to be included.
Suite 1300
Harrisburg If you or your culturally specific program is not currently listed in the guide, please fill
out the forms in the back of the Resource Guide Update and your information will be
Pennsylvania included in the next update.
17112
PLEASE NOTE: Women of Color Network is no longer located in Columbus,
Ohio. Mail or fax your forms to the following address:
Women of Color Network
6400 Flank Drive, Suite 1300
Harrisburg, PA 17112
800-537-2238 Phone (800) 537-2238,ext. 137
Fax (717) 545-9456
TTY 800-553-2508 Email: tonya lovelace .yahoo.com
Fax 717-545-9456
Please direct all phone calls and written correspondences to our new location.
If you would like to purchase a photocopy of the original Resource Guide, please call
the National Resource Center on Domestic Violence at 1-800-537-2238 for further
details.
www.nrcdv.org I hope that you will find this Resource Guide Update to be useful in your daily
endeavors.
Sincer y,
Tonya ove lace,/✓PPrro'-gram Manager
A Project of the Women of Color Network
National Resource Center
on Domestic Violence
The mission of the WOCN is to support and promote the efforts of women of color activists in the United States
and Territories to develop culturally relevant approaches that address domestic violence and sexual assault.
,ALAOR �,. CERTIFICATE OF LIABILITY INSURANCE o6/3o/2004 07108 20031
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Companies ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Three City Place Drive,Suite 900 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
St.Louis MO 63141-7081ALTER THE COVERAGE AFFORDED BY THEPOLICIFS RF1 OW.
(314)432-0500 INSURERS AFFORDING COVERAGE
INSURED Pioneer Human Services
A W LInsurance
1044216 Attn• Tracey Groscost INSURER
7440 W.Marginal Way South INSURER C
Seattle WA 98108
COVERAGES 62
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
P
OLICIES AGGREGATELIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POU DATE(MMfDDNYj Y EXPIRATION LIMITS
GENERAL UABIUTY EACH OCCURRENCE S 1000 000
X COMMERCIAL GENERAL LIABILITY TC3259276 06/30/2003 06/3012004 FIRE DAMAG_E_ An oneirm t 1000000
CLAIMS MADE E OCCUR MED EXP(Any one eraon $ 5 GOO
X INCL PROFESSIONAL PERSONAL&ADV INJURY $ 1,000,000
X INCL SEXUAL ABUSE GENERAL AGGREGATE $ 3,000,000
OENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGO $ 3 000 000
POLICY PR 7 Loc
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S XXXXXXX
ANY AUTO NOT APPLICABLE (Ea accident)
ALL OWNED AUTOS BODILY INJURY $ XXXXXXX
SCHEDULED AUTOS (Per peBon)
HIRED AUTOS
s BODILY INJURY $ XXXXXXX
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $ XXXXXXX
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S XXXXXXX
ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX
AUTO ONLY AGG $ XXXXXXX
EXCESS LIABILITY EACH OCCURRENCE S XXXXXXX
OCCUR CLAIMS MADE NOT APPLICABLE AGGREGATE S XXXXXXX
UMBRELLA $ XXXXXXX
DEDUCTIBLE FORM XXXXXXX
RETENTION $ S xxxx}{XX
WORKERS COMPENSATION AND NOT APPLICABLE WC STATU• OTH-
go
EMPLOYERS'LIABILITY M
E L EACH ACCIDENT $ XXXXXXX
EL DISEASE-EA EMPLOYEE $ XXXXXXX
E L DISEASE•POLICY LIMIT I $ XXXXXXX
OTHER
DESCRIPTION OF OPERATIONS,LOCATKNISNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CITY OF KENT IS ADDITIONAL INSURED UNDER GENERAL LIABILITY AS REQUIRED BY WRITTEN CONTRACT AS RESPECTS RESEARCH
AND EVALUATION SERVICES
ADDITIONA INS R D•INSURER LETTER ANCELLATION
1834351 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
HUMAN SERVICES DIVISION
220 4TH AVE.,SOUTH r rJ / /) GATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ DAYS WRITTEN
KENT WA 98032 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES
AUTHORIZED REPRESENTATIVE �n
ACORD 25S(7/97) ®ACORD CORPO ATION 19M
THIS ENDORSEMENTtMAN6ES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED- DESIGNATED PERSON OR
ORGANIZATION
1-h1s endorsernsi t modifies 1nswance provided under the tollowing:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Nome of person or Drgankation:
City of Kent
Human Services Division
220 4th Avenue South
Kent, WA 98032
(if no entry appears above,information required to complete this endorsement will be shown in the Dedaratioals
as applicable to this endorsement.)
WHb IS AN INSURED(Section lt)is arnendad to inrludt as an insured the person or organization shown in the
Schedule as an insured but only with respect,to liability arising out of your oparalions or premises owned by or
rented to you.
Insured: Pioneer Human Services ETAL, Pioneer Printing & Mailing
Carrier: Westport Insurance Corporation
Policy Number: TC3259276-2
Polity Term: 6/30103 - 6/30/04
Endorsement Effective Date: 6/30/03
Authorized Representative: I`1j1
Tom Natoli
Ca 20 26 1185 Capyor,ex.t,Insurance�emces office,Inc„ 1994 q