HomeMy WebLinkAboutCAG2021-531 - Amendment - #1 - Ubumwe Women Association - CDBG-CV3 Funded Trauma-Informed Support Group - 03/29/20223/31/2022
AMENDMENT NO. 1 TO AGREEMENT - 1
(between City of Kent and Ubumwe Women Association)
AMENDMENT NO. 1 TO CDBG-CV3 AGREEMENT
between the City of Kent and Ubumwe Women Association
for Trauma-Informed Support Group
This AMENDMENT NO. 1 TO THE CDBG-CV3 AGREEMENT (“Amendment No. 1”) is
made between the CITY OF KENT, a Washington municipal corporation (“City”) and
Ubumwe Women Association (“Agency”), collectively the (“Parties”).
I. RECITALS
1.1 The City and Agency entered into a CDBG-CV3 Agreement on November 1,
2021, through which the City contracted with the Agency to use federal grant funds to
respond to the COVID-19 pandemic and carry out eligible community development and
housing activities under the Housing and Community Development Act of 1974 and
through regulations promulgated by the Department of Housing and Urban Development
(“Agreement”).
1.2 The Agency is utilizing these grant funds to convene a trauma-informed
support group for African refugee/immigrant single parents in Kent to help them recover
from the mental and physical repercussions of the COVID-19 pandemic. The original
scope of work for this Agreement did not include a line-item in the budget summary for
food and supplies, but the Agency has since realized the benefit of providing food for
clients who attend the support groups.
1.3 The line-item budget summary detailed in Exhibit A and Exhibit D of the
Agreement allocated $5,000 to Indirect Costs; the Agency is requesting that this line item
be reduced to $1,000 and allocate the remaining $4,000 to a new category titled
“Foods/Supplies.” The total cost of the Agreement will remain the same at $50,000.00.
1.4 The Agency is also requesting that the termination date of the Agreement
be extended from November 30, 2022 to December 31, 2022.
1.5 This Amendment No. 1 is needed to formally adjust the line-item budget
summary, extend the termination date, and to ratify all acts consistent with the authority
of this Amendment No. 1 and prior to its execution.
II. AMENDMENT
NOW THEREFORE, in consideration of the mutual intent, desire, and promises of
the Parties and other good and valuable consideration, the City and Agency each agree
as follows:
2.1 Line-Item Budget Summary. Section 1 of Exhibit A and Section 2 of Exhibit
D to the Agreement are modified to reduce the line item budget for “Indirect Costs” from
$5,000 to $1,000, and to add a new line item budget titled “Food/Supplies” with a budget
amount of $4,000. Exhibit A and Exhibit D to the Agreement are replaced with the
amended exhibits attached and incorporated to this Amendment No. 1.
AMENDMENT NO. 1 TO AGREEMENT - 2
(between City of Kent and Ubumwe Women Association.)
2.2 Termination Date. Wherever in the Agreement the termination date of
“November 30, 2022” appears it shall be replaced with “December 31, 2022,” including
those references made within the exhibits.
2.3 Waiver of Claims Prior to Amendment. The Agency accepts all requirements
of this Amendment No. 1 by signing below, by its signature waives any protest or claim
it may have regarding this Amendment No. 1, and acknowledges and accepts that this
Amendment No. 1 constitutes full payment and final settlement of all claims of any kind
or nature arising from or connected with any work either covered or affected by this
Amendment No. 1, including, without limitation, claims related to contract time, contract
acceleration, onsite or home office overhead, or lost profits.
2.4 Ratification. All acts consistent with the authority of this Amendment No. 1
and prior to its effective date are ratified and affirmed and the terms of the Agreement
and this Amendment No. 1 shall be deemed to have applied.
2.5 Remaining Provisions. Except as specifically amended by this Amendment
No. 1, all remaining provisions of the Agreement shall remain in full force and effect.
The parties whose names appear below swear and affirm that they are authorized
to enter into this Amendment No. 1, which is binding on the parties of the Agreement.
IN WITNESS, the parties below have executed this Amendment No. 1,
which will become effective on the last date written below.
AGENCY:
Ubumwe Women Association
By:
(signature)
Print Name:
Its
DATE:
CITY:
City of Kent
By:
(signature)
Print Name:
Its
DATE:
CDBG CV-3
FIRST AMENDMENT TO
EXHIBIT A
CDBG-CV3 PROJECT SCOPE OF SERVICES
UBUMWE WOMEN ASSOCIATION
Project Title: Trauma-Informed Support Group Start Date: 11/1/2021
Project No.:BGCV27-Ro3-2122 End Date: 12/31/2022
City of Kent Federal Award Identity Numbers (FAIN) B-20-MW-53-001
Funds will be used to convene a trauma-informed support
group for African refugee/immigrant single parents in Kent to
help them recover from the mental and physical repercussions
of the COVID-19 pandemic.
Grant
Amount:
$50,000.00
Funding
Budget
CDBG-CV3
Total City
of Kent
Funds:
$50,000.00
Project Manager: Divine Mutesi, Executive Director
Telephone: 480.886.7961 E-mail: ubumwe.together@gmail.com
City Contact: Merina Hanson, Human Services Manager
Telephone: 253.856.5077 Fax: 253.856.6070 E-mail: mhanson@kentwa.gov
Ubumwe Women Association (hereinafter referred to as "the Agency") shall
utilize City of Kent CARES Act funds (hereinafter referred to as CDBG-CV3) to perform the
activities specified below. Such services shall be provided in a manner which fully complies
with all applicable federal, state, and local laws, statutes, rules and regulations, as are now
in effect or may be hereafter amended.
1) Project Budget
The Agency shall apply the following funds to the project in accordance with the Line-Item
Budget Summary:
LINE ITEM BUDGET BUDGET AMOUNT
Personnel (attach timesheets) $35,000.00
Administrative $10,000.00
Indirect Costs $ 1,000.00
Food/Supplies $ 4,000.00
TOTAL $50,000.00
CDBG CV-3
2) Performance Measures
A. Number Served
The Agency agrees to serve, at minimum, the following unduplicated number of persons
during the term of the CDBG-CV3 Agreement:
Reporting Periods 1st
Quarter
JAN
MARCH
2nd
Quarter
APRIL
JUNE
3rd
Quarter
JULY
SEPT
4th
Quarter
OCT
DEC
Total
Number of unduplicated
persons assisted 5 5 5 5 20
B. Units of Service
The Agency agrees to provide, at minimum, the following units of service by quarter:
Reporting Periods 1st
Quarter
JAN
MARCH
2nd
Quarter
APRIL
JUNE
3rd
Quarter
JULY
SEPT
4th
Quarter
OCT
DEC
Total
Per
Year
Support Group Sessions 50 50 50 50 200
C. Definition of Services
Support Group Sessions: Defined as a gathering of people facing common issues to share
, and coping strategies. Through the
sharing of experiences, individuals offer support, encouragement, and comfort to the other
group members, and receive support in return. Sessions are measured in one-hour
increments.
Unduplicated Count of Households/Persons Assisted/Units of Service: This is the
unduplicated number of clients served during the reporting period. Unduplicated number
means that a person or a household served by your agency may be counted only once
during the calendar year. Calendar year is from January 1st to December 31st.
Duplication of benefits (DOB) is prohibited.
Federal financial assistance is provided to a person or entity through a program to address
losses resulting from a Federally-declared emergency or disaster, and the person or entity
has received (or would receive, by acting reasonably to obtain available assistance) financial
assistance for the same costs from any other source (including insurance), and the total
3) Records
A. Project Files
CDBG CV-3
The Agency shall maintain files for this project containing the following items (all Agency
files must contain items 1 7, however items 8 12 are required only if the costs
are paid for by the CDBG-CV budget. If clients are not presumed eligible; e.g.,
homeless, #16 client income must be documented):
1. Notice of Grant Award.
2. CDBG-CV Agreement and all contract exhibits.
3. Motions, resolutions, or minutes documenting Board or Council actions.
4. A copy of thi
5. Correspondence regarding budget revision requests.
6. Copies of all invoices and reports submitted to the City for this project.
7. Bills for payment.
8. Lease agreement with client name; Agency/Client/Landlord Assistance
Agreement with monthly rent, amount owed, amount paid, client signature,
landlord name/address and signature; assessment of whether the use of
CDBG-CV funds will duplicate financial assistance that is already received or is
likely to be received by evaluating the need and the resources available to
meet that need; and a client statement certifying that if duplicative assistance
was received it will be repaid.
9. Utility bill with client name; Agency/Client/Utility Company Agreement with
monthly charge, amount owed, amount paid, client signature, utility company
name/address and signature; assessment of whether the use of CDBG-CV
funds will duplicate financial assistance that is already received or is likely to be
received by evaluating the need and the resources available to meet that need;
and a client statement certifying that if duplicative assistance was received it
will be repaid.
10. Copies of approved invoices and warrants.
11. Payroll time sheets for actual salary and fringe benefit costs. Time sheets must
be signed by a supervisor and annotated to document percent of time charged
against this project if less than full time.
12. Documentation of office costs (e.g., log sheets of copy machine use, postage,
telephone use, costs of office supplies, etc.) when these costs are shared with
other programs and no invoice is available. As an alternative, annotated
invoices may be used to document charges as appropriate.
13. Documentation of mileage charges for private auto use must include: a)
odometer reading at beginning and end of trip, b) destination and starting
location, and c) purpose for trip.
14. Documentation of the solicitation process used to select vendors and
subcontractors with original purchase orders and subcontracts.
15. Documentation required by Part IV, Paragraph 5, if any funds provided under
this Scope are used to acquire equipment.
16. Documentation of client income. Unless clients are presumed eligible based on
CDBG regulations, the Agency shall screen all clients served with funds
provided under this Contract to ensure that at least 51% of the total number of
clients served do not have a gross annual family income in excess of the limits
specified in Exhibit B.
Adjusted gross income as defined by the Internal Revenue Service Form 1040
sha
methods may be used to determine income eligibility:
a) IRS income tax return;
b) Client income certification on a form approved by the City; or
CDBG CV-3
c) Documentation of qualification for participa -
federal or state program at least as restrictive as CDBG with regard to
Income Guidelines.
Income guidelines may be adjusted periodically by HUD. The Agency agrees to
use updated Income Guidelines, which will be provided by the City.
B. Record Retention Period
All records required by this Scope shall be retained by the Agency for the period specified
in the Agreement - Part IV. The period shall commence on January 1 of the year
following the year in which the final invoice was paid.
4) Reports, Invoicing and Reporting Schedule
A. Reports
The Agency shall collect and report client information to the City quarterly on the Service
Units section of Exhibit D (Billing Voucher and Service Report) to be provided by the City.
Exhibits D and D-1 (including backup documents) shall be submitted electronically to
in accordance with the schedule outlined in Paragraph 4.B below.
Copies of supporting documents shall be emailed as well, or sent via the U.S.
Postal Services and postmarked within two days of the due dates listed below.1
B. Invoicing and Reporting Schedule
The Agency shall submit Billing Vouchers and Service Reports to the City in accordance with
the following schedule:
1st 2nd & 3rd Quarter Billing Voucher &
Service Report (Exhibit D)
15th day following each quarter
CDBG Public Services Project Time
Sheet
(Exhibit G, if applicable)
15th day following each quarter
4th Quarter Billing Voucher & Service
Report (2021)
December 10, 2021
Final Service Report for 2021 (Exhibit
D-1)
January 7, 2022
4th Quarter Billing Voucher & Service
Report (2022)
December 9, 2022
Final Service Report for 2022 (Exhibit
D-1)
January 6, 20232
1 If the due date falls on a Saturday or Sunday, Billing Vouchers and Service Reports are
due on the prior Friday. If the due date falls on a City holiday, Billing Vouchers and Service
Reports are due the next working day following the holiday.
2 These funds may be spent before the Agreement end date.
CDBG CV-3
First Amendment To
Exhibit D
UBUMWE WOMEN ASSOCIATION
Billing Voucher & Service Report
2021-2022
To: Merina Hanson, Human Services Manager
Housing & Human Services
Parks, Recreation & Community Services
220 4th Ave. South, Kent, WA 98032
mhanson@kentwa.gov
Phone: 253.856.5076
From: Divine Mutesi, Executive Director
Agency: Ubumwe Women Association
ubumwe.together@gmail.com
Phone: 480.886.7961
Reporting
Period Program Amount
Requested
Trauma-Informed Support Group $
SEC. 1: BUDGET SUMMARY
For Department Use Only Total Contract Amount $ 50,000.00
Amount Requested This Qtr. $
Amount Requested YTD $
Amount Remaining (subtract
amount requested YTD from
total contract amount)
$
SEC.2: LINE-ITEM BUDGET SUMMARY
COST CATEGORIES
ORIGINAL
BUDGET
TOTAL
REQUESTED REVISED
BUDGET
CUMULATIVE
TO DATE
1
Personnel (attach
timesheets)
$35,000.00
2 Administrative $10,000.00
3 Indirect Costs $ 1,000.00
4 Food/Supplies $ 4,000.00
GRAND TOTAL
$50,000.00
CDBG-CV3
SEC. 3: PERSONNEL FUNDED IN WHOLE OR IN PART BY CDBG GRANT
SEC. 4: PERFORMANCE MEASURES 2021-2022 KENT FUNDED SERVICE UNITS
Note: Unduplicated client counts must be reported both quarterly and year-to-date
Service Unit Description Contracted to
Serve
Clients Actually
Served
Year to Date
Total
Service Unit/Performance
Measure 1st 2nd 3rd 4th
Total
Contracted
to Serve
1st 2nd 3rd 4th
Unduplicated # of Kent clients
(persons) served 5 5 5 5 20
Support Group Sessions 50 50 50 50 200
Sec. 5: NARRATIVE
Provide a narrative explanation if you are behind in either progress toward meeting performance
measures or projected expenditure rate.
Sec. 6: DEMOGRAPHIC INFORMATION
Number of Households or Persons Assisted (please specify "H" or "P"):
Race Unduplicated
Quarter
(All)
Unduplicated
Quarter
(Hispanic)
Undup.
Year to
Date
(All)
Unduplicated
Year to Date
(Hispanic)
1 2 3 4 1 2 3 4
White
Black/African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native AND
White
Asian AND White
Black/African American AND White
American Indian /Alaska Native AND
Black/African American
Other Multi-Racial
GRAND TOTAL CLIENTS
Income Level Unduplicated Quarter Unduplicated
Year to Date
1 2 3 4
Extremely Low Income 0-30% of MFI
Low Income 31-50% of MFI
Moderate Income 51-80% of MFI
Above Moderate Income 81% + of MFI
GRAND TOTAL CLIENTS
Homeless * Complete only for individuals & families
who have been assisted with transitional and
permanent housing
Unduplicated Quarter Unduplicated
Year to Date
1 2 3 4
Individuals
Families
Total Homeless
By signing this report, I certify to the best of my knowledge and belief that the report is true, complete,
and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives
set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or
fraudulent information, or the omission of any material fact, may subject me to criminal, civil
or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title
18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812).
Agency Authorized Signature
____________________________________
Print Name
Date
Payment Authorization (this section to be completed by City of Kent only)
Contractual Obligations Met?
YES NO (Circle one)
Enter notes if Agency underperformed:
Authorized
By: Date:
Instructions
Refer to: Accomplishments by Performance Measures in your CDBG Contract.
Sec. 1: BUDGET SUMMARY
Enter the amount requested this quarter, Year to Date (YTD) and the budget balance.
SEC. 2: LINE ITEM BUDGET SUMMARY:
Enter the amount requested by budget line item quarterly and YTD.
SEC. 3: PERSONNEL FUNDED IN WHOLE OR IN PART BY CDBG GRANT
Enter the names and titles of personnel being charged to the CDBG grant. Remember all hours charged to CDBG must
be tracked and a timesheet certifying the hours worked were to directly support the CDBG funded program must be
signed by the employee and supervisor and submitted to the City with the request for reimbursement.
SEC. 4: PERFORMANCE MEASURES
Unduplicated Count of Households/Persons Assisted
Projections: Circle either persons or households according to the method of counting clients specified in your CDBG
Contract Scope. Insert the projected number of clients to be served as specified in your CDBG Contract Scope.
Achievements: Insert the unduplicated number of clients served during the reporting period. Unduplicated number
means that a person or a household served by your agency may be counted only once during the calendar year. You
may report only those persons or households for which you maintain written records. This record must be established
at the time the person or household is first served by your agency.
Year to Date: Insert the total unduplicated number of clients served to date.
Service Units
Insert the service unit measures specified in your CDBG Contract Scope. Insert the projected number of service units
for the reporting period. Insert the actual number of service units provided during the Reporting Period. The actual
number of service units provided may be duplicated counts. Duplicated means that a client served by your agency
may receive service one or more times during the calendar year in one or more of the service unit categories.
SEC. 5: NARRATIVE EXPLANATION
You must provide a narrative explanation if your agency is behind in meeting either performance measures specified
in your CDBG Contract Scope or your expenditure rate. Your expenditure rate should equal approximately one quarter
of your HHS contract amount per quarter.
SEC. 6: DEMOGRAPHIC INFORMATION
Race: You are required to collect racial and ethnic information for the clients served. There are 10 race categories to
select from. Each client should select one of these categories. Clients identifying themselves as
Hispanic also need to select from the race categories.
Example: A client selects Hispanic as his ethnicity and white as his race. The grand total in the first column will not
match the grand total in the second column. You may only have a few clients who identify as Hispanic.
Female Head of Household: Insert the unduplicated number of single female head of households with dependents
served during the reporting period.
Income Only for Non-presumed Benefit Projects which require income screening : Insert the unduplicated
clients served who are Low Income (51 80%), Very Low-Income (31-50%) and Extremely Low-Income (0-
30%). You do not have to complete if your CDBG project directs services toward the following clients: abused
children, elderly persons, DV victims, homeless persons, those meeting the federal definition of severely disabled
persons, illiterate adults, persons living with aids, or migrant farm workers.
Homeless: For prog
First Amendment To
Exhibit D-1
Final Service Report
UBUMWE WOMEN ASSOCIATION
2021-2022
To: Merina Hanson, Human Services Manager
Housing & Human Services
Parks, Recreation & Community Services
220 4th Ave. South, Kent, WA 98032
mhanson@kentwa.gov
Phone: 253.856.5077
From: Divine Mutesi, Executive Director
Agency: Ubumwe Women Association
ubumwe.together@gmail.com
Phone: 480.886.7961
Reporting Period Program
Final Q4 2021/Final
2022 Report1 Trauma-Informed Support Group
SEC. 1: PERFORMANCE MEASURES 2021-2022 KENT FUNDED SERVICE UNITS
Note: Unduplicated client counts must be reported both quarterly and year-to-date
Service Unit Description Contracted to
Serve
Clients Actually
Served
Year to
Date
Total
Service Unit/Performance
Measure 1st 2nd 3rd 4th
Total
Contracted
to Serve
1st 2nd 3rd 4th
Unduplicated # of Kent clients
(persons) served 5 5 5 5 20
Support Group Sessions 50 50 50 50 200
CDBG-CV3
Final Service Report Review (this section to be completed by City of Kent only)
Contractual Obligations Met?
YES NO (Circle one)
Agency Paid in Full?
YES NO (Circle one)
Enter explanation if Agency underperformed and paid in full:
Reviewed
By: Date:
Signature: Signature: Meliss�iA446ck 0r0zz�7:26PDT)
Email: rlashley@kentwa.gov Email: cityclerk@kentwa.gov
1 st Amd CDBG-CV3 - Ubumwe Women Assoc.
- Trauma Counseling
Final Audit Report
Created: 2022-03-28
By: KateLynn Jennings (kjennings@kentwa.gov)
Status: Signed
Transaction ID: CBJCHBCAABAA91IYuNFEStcesZFeNMTKJHYx2ZuToc2q
2022-03-31
"1st Amd CDBG-CV3 - Ubumwe Women Assoc. - Trauma Coun
seling" History
Document created by KateLynn Jennings (kjennings@kentwa.gov)
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Document emailed to divine Mutesi (ubumwe.together@gmail.com) for signature
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fJp Document e-signed by Melissa McCormick (cityclerk@kentwa.gov)
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Q Agreement completed.
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