HomeMy WebLinkAboutR34-Economic Development Agency
CITY OF SAN BERNARDINO
ECONOMIC DEVELOPMENT AGENCY
FROM: Emil A. Marzullo
Interim Executive Director
SUBJECT:
Old timers Foundation Agreement Extension
and Amendment No.2 (Elderly/Special Needs
Minor Home Repair Grant Program)
DATE:
December 9,2009
SvnoDsis of Previous Commission/CounciVCommittee Action(s):
At a Special Redevelopment Committee on December 3, 2009, Redevelopment Committee Members Johnson, Brinker and
Shorett unanimously voted to recommend that the Community Development Commission consider this action for approval.
-
Recommended Motion(s):
(Community Develooment Commission)
Resolution of the Community Development Commission of the City of San Bernardino approving and
authorizing the Interim Executive Director of the Redevelopment Agency of the City of San Bernardino
("Agency") to execute Amendment No.2 to the Contractor Services Agreement Minor Grant Repair Program
(Elderly/Special Needs) between the Oldtimers Foundation and the Agency, amending and extending said
Agreement and authorizing the amount of$102,655 for a six month term commencing in 2010, subject to annual
funding availability
Contact Person(s):
Project Area(s):
Supporting Data Attached:
Funding Requirements:
Lisa A. Connor/Carey K. Jenkins
Phone:
(909) 663-1044
All
All
Ward(s):
1;"1 Staff Report Ii!l Resolution(s) Ii!l Agreemcnt(s)/Contract(s) 0 Map(s) 0 Letter(s)
Amount: $
102,655
Source: 2009-2010 Agency's Housing (LowlMod) Fund
Budget Authority:
N/A
Signature:
Emil A. Marzullo, Interim Executive Director
~
~~~.
Fiscal Review:
/
Ive Services Director
Commission/Council Notes:
Pc\AjenduIComm o.:vCommissionlCDC 2009\12-21-09 Oldl:imcrs FOlIndalion Agr=ncnt htcnsion & Amcndmatt No. 2 SR.dcx:
COMMISSION MEETING AGENDA
Meeting Date: 12/2112009
Agenda Item Number: P.3'I
ECONOMIC DEVELOPMENT AGENCY
STAFF REPORT
____________~_u.___________________n..___________d_____________________n_______________.________________.._.___-------------------------------------------------------
OLDTIMERS FOUNDATION AGREEMENT EXTENSION AND AMENDMENT NO.2
(ELDERLY/SPECIAL NEEDS MINOR HOME REPAIR GRANT PROGRAM)
BACKGROUND:
The Oldtimers Foundation ("Foundation") is a non-profit charitable and educational organization serving
the needs of senior citizens within San Bernardino County. The Foundation was created in 1964 for the
purpose of maintaining and improving the physical, psychological and social well-being of older low-
income and handicapped persons. This is accomplished through comprehensive and coordinated
programs that provide congregate and home-delivered meals, minor home repairs, transportation,
volunteer opportunities, supportive services and affordable.housing. Currently, the Foundation works in
cooperation with the County of San Bernardino Department of Aging & Adult Services, the Cities of
Rialto, Rancho Cucamonga, Fontana and San Bernardino ("City").
On January 6, 2003, the Community Development Commission of the City of San Bernardino
("Commission") approved an Agreement between the Redevelopment Agency of the City of San
Bernardino ("Agency") and the Foundation in the amount of $75,000 with fifteen percent allowed for
administration, renewable annually for three years and conditioned on availability of funds to operate and
administer the Elderly/Special Needs Minor Home Repair Grant Program ("Program") in the City.
On November 20, 2006, the Commission approved Amendment No. 1 to the Agreement between the
Agency and the Foundation in the amount of $100,000 with fifteen percent allowed for administration,
renewable annually for an additional three years. The amount allocated to the Foundation was increased
from $75,000 to $100,000 due to the rising costs in materials. The grant amount was also increased from
$750 to $1,000 per household. During the current three-year contract period, the Foundation assisted over
two hundred fifty senior households.
The Foundation provides repair assistance to eligible senior homeowners that include, but is not limited
to, plumbing, heating, electrical, carpentry and general minor repairs. The maximum that may be
expended is $1,000 per housing unit and limiting service visits to twice a year per housing unit. The
Program is offered to residents on a first-come, first-served basis. In order to be eligible for the Program,
an applicant must meet the following basic criteria: I) be an owner occupant for a minimum period of one
year; 2) meet the applicable income criteria which shall not exceed eighty percent of the 2009 Area
Median Income (AMI) for San Bernardino County (i.e., family of 1, $37,300; family of2, $42,650); and,
3) be an elderly person, aged sixty or above, or be disabled, handicapped or a recipient of Social Security
Income (SSI).
The Foundation must submit quarterly reports on Program accomplishments to the Agency and Agency
Staff conducts an annual on-site Program visit to evaluate Program performance and records per the
requirements under the Agreement.
P:\AgendasIConvnDev CommissionlCDC 2009\12-21.09 Oldtimers Foundation Agreement Extension & Amendment No.2 SRdoc COMMISSION MEETING AGENDA
Meeting Date: 12/21/2009
Agenda Item Number: -.fl. ,1.4
Economic Development Agency Staff Report
Oldtimers Foundation
Page 2
CURRENT ISSUE:
The Agreement between the Agency and the Foundation will expire in January 2010. The Agency is
requesting two minor changes to the existing contract. First, the Agreement between the Agency and the
Foundation is based on a calendar year which does not coincide with the Agency's fiscal year. Agency
Staff is requesting that the existing Agreement be extended for six months through June 30, 2010.
Secondly, due to an increase in the cost of materials and supplies, the Foundation is requesting that the
service grant amount of $1,000 per housing unit be increased to $1,600 per housing unit. The increase in
funding will allow the Foundation to continue to provide its current level of minor senior home repairs
with the addition of subflooring as part of its scope of services.
Agency Staff is requesting that the Redevelopment Committee approve the above changes in the current
Program.
ENVIRONMENTAL IMPACT:
This item does not meet the definition ofa "project" under Section 15378 of the California Environmental
Quality Act (CEQA) and therefore there is no environmental impact.
FISCAL IMPACT:
There is no general fund impact. Funds are currently available for Program activities in the amount of
$102,655 and budgeted in the 2009-2010 Agency's Housing (Low/Mod) Fund.
RECOMMENDATION:
That the Community Development Commission adopt the attached Resolution.
~
Emil A. Marzullo, Interim Executive Director
P:\A&~ndas\C"nn De\' Commission\CDC 1009"12-21.09 Oldlimers Foundation Agreement hlensicm&. Amendment No.2 SR.doc
COMMISSION MEETING AGENDA
Meeting Date: 12/21/2009
Agenda Item Number: JIL?,LJ
1
2
3
RESOLUTION NO.
RESOLUTION OF THE COMMUNITY DEVELOPMENT COMMISSION OF
THE CITY OF SAN BERNARDINO APPROVING AND AUTHORIZING THE
INTERIM EXECUTIVE DIRECTOR OF THE REDEVELOPMENT AGENCY
OF THE CITY OF SAN BERNARDINO ("AGENCY") TO EXECUTE
AMENDMENT NO. 2 TO THE CONTRACTOR SERVICES AGREEMENT
MINOR GRANT REPAIR PROGRAM (ELDERLY/SPECIAL NEEDS)
BETWEEN THE OLDTIMERS FOUNDATION AND THE AGENCY,
AMENDING AND EXTENDING SAID AGREEMENT AND AUTHORIZING
THE AMOUNT OF $102,655 FOR A SIX MONTH TERM COMMENCING IN
2010, SUBJECT TO ANNUAL FUNDING AVAILABILITY
4
5
6
7
8
9
10
WHEREAS, the Oldtimers Foundation, a California non-profit corporation ("Foundation")
11 administers the Elderly/Special Needs Minor Repair Grant Program ("Program") on behalf of the
12 Redevelopment Agency of the City of San Bernardino ("Agency") and the Agency and Contractor
13 desires to continue making the Program available to elderly/special needs homeowners; and
14
WHEREAS, on January 6, 2003, the Community Development Commission
15 ("Commission") approved the Contractor Services Agreement Minor Grant Repair Program
16 (Elderly/Special Needs) between the Agency and the Foundation ("Agreement") in the amount of
17 Seventy-Five Thousand Dollars ($75,000) with fifteen percent (15%) allowed for administration,
18 renewable annually for three (3) years and conditioned on availability of funds to operate and
19 administer the Program in the City of San Bernardino ("City"); and
20
WHEREAS, on November 20, 2006, the Commission approved Amendment No. I, to the
21 2003 Agreement, extending the Agreement for an additional three (3)-year term commencing
22 January 7, 2007; and
23
WHEREAS, during the three (3)-year contract period which would otherwise terminate on
24 January 7, 2010, the Foundation will assist over two hundred fifty (250) senior households; and
25
WHEREAS, the Foundation is requesting an increase in the service amount from One
26 Thousand Dollars ($1,000) per housing unit to One Thousand, Six Hundred Dollars ($1,600) due to
27 an increase in the cost of materials; and
28
1
P\AgendasIResolutionsIResolulions\2009\12-21-09 Oldtimcrs Foundation AglftlTlCnt Extension & Amendment No Z CDC Resodoc
1 WHEREAS, the Agency and the Foundation desire to amend the Agreement ("Amendment
2 No.2") to extend the Agreement, increase the service amount from One Thousand Dollars ($1,000)
3 to One Thousand Six Hundred Dollars ($1,600) per housing unit and provide an amount not to
4
exceed One Hundred Two Thousand, Six Hundred Fifty-Five Dollars ($102,655), for a six month
5
(6) term during commencing January 1, 2010 and terminating June 30, 2010, subject to availability
6
7 of the Redevelopment Low- and Moderate-Income Housing Funds ("Housing Fund") and
8 performance by the Foundation; extension of the Agreement until June 30, 2010, will allow the
9 Contractor to expend the remainder of funds available under their current Agreement for which no
10 new funds have been allocated.
11
NOW, THEREFORE, THE COMMUNITY DEVELOPMENT COMMISSION OF THE
CITY OF SAN BERNARDINO DOES HEREBY RESOLVE, DETERMINE AND ORDER, AS
FOLLOWS:
12
13
14
Section 1.
The Commission hereby approves Amendment No.2 to the Agreement and
15
extends the Agreement as of the date of said Amendment No.2. The Commission authorizes and
16
directs the Interim Executive Director of the Agency to execute, on behalf of said Agency,
17
Amendment No.2 to the Agreement between the Agency and the Foundation, in the amount not to
18
exceed One Hundred Two Thousand, Six Hundred Fifty-Five Dollars ($102,655) for a period of six
19
(6) months, subject to the availability of the Housing Fund for the administration and provision 0
20
the Program to eligible single-family homeowners within the City limits, in accordance with the
21
provisions of the Agreement, a copy of which is on file with the Agency Secretary and incorporated
22
herein by reference as though fully set forth at length.
23
Section 2.
The Interim Executive Director of the Agency is hereby authorized to make
24
minor corrections, additions and clarifications to Amendment NO.2 to the Agreement, provided said
25
changes are not substantive in nature and do not increase the monetary impact to the Agency.
26
Section 3.
For purposes of satisfying the requirements of Health and Safety Code
27
Section 33413(b), the Commission hereby finds and determines that the Program as previously
28
2
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1 approved by the Agency under the extension of the termination date of the Agreement expands and
2 preserves the community's supply of affordable housing.
3
Section 4.
The Resolution shall become effective immediately upon its adoption.
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P:\Agendas\Resolulions\Resolutions\2009\12_21_09 01dtimers Foundation Agreement Extcll$ion & Amendment l'o 2 COC Reso.OO<:
1
RESOLUTION OF THE COMMUNITY DEVELOPMENT COMMISSION
OF THE CITY OF SAN BERNARDINO APPROVING AND
AUTHORIZING THE INTERIM EXECUTIVE DIRECTOR OF THE
REDEVELOPMENT AGENCY OF THE CITY OF SAN BERNARDINO
("AGENCY") TO EXECUTE AMENDMENT NO. 2 TO THE
CONTRACTOR SERVICES AGREEMENT MINOR GRANT REPAIR
PROGRAM (ELDERLY/SPECIAL NEEDS) BETWEEN THE OLDTIMERS
FOUNDATION AND THE AGENCY, AMENDING AND EXTENDING SAID
AGREEMENT AND AUTHORIZING THE AMOUNT OF $102,655 FOR A
SIX MONTH TERM COMMENCING IN 2010, SUBJECT TO ANNUAL
FUNDING AVAILABILITY
2
3
4
5
6
7
8
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Community
9 Development Commission of the City of San Bernardino at a
,2009, by the following vote to wit:
Navs
Abstain
Absent
20
Secretary
21 The foregoing Resolution is hereby approved this
22
23
day of
24
Patrick J. Morris, Chairperson
Community Development Commission
of the City of San Bernardino
25
Approved as to Form:
26 f I
27 By: C-7:"~~
~;nrJ'ctJ;lmSel
28
4
P\Agendas\Resolutions\Resolulions\2009\ 12,21-09 Oldtimers Foundation Agreement E..ttnsion & Amendment:-.ro 2 COC Resodoc
meeting
,2009.
AMENDMENT NO.2 TO THE
CONTRACTOR SERTICES AGREEMENT
MINOR GRANT REPAIR PROGRAM
(ELDERLY/SPECIAL NEEDS)
This Amendment No. 2 to the Contractor Services Agreement Minor Grant Repair
Program (Elderly/Special Needs) (this "Amendment No.2") is dated as of the 1st day of January
2010, by and between the Redevelopment Agency of the City of San Bernardino, a public body,
corporate and politic (hereinafter the "Agency"), and the Oldtimers Foundation, a California
non-profit corporation (hereinafter the "Contractor"). The Agency and the Contractor are
sometimes hereinafter individually referred to as "Party" and hereinafter collectively referred to
as the "Parties."
RECITALS
WHEREAS, the Parties have previously entered into an Agreement entitled "Contractor
Services Agreement Minor Grant Repair Program (Elderly/Special Needs)" (the "Agreement")
dated January 6, 2003, in which the Contractor desires to perform, assume responsibility and
obligations for the affordable housing grant administration and maintenance services (the
"Services"), on the terms and conditions set forth herein; and
WHEREAS, on November 20, 2006, the Community Development Commission
approved Amendment No.1 to the 2003 Agreement effective January 7, 2007, by Resolution No.
CDC/2006-55, to increase the Agreement amount from Seventy-Five Thousand Dollars
($75,000) to One Hundred Thousand Dollars ($100,000) due to an increase in the cost of
materials; and
WHEREAS, the Agency and CONTRACTOR desires to amend the Agreement as set
forth in this Amendment No.2 to extend Contract for an additional six (6) months terminating on
June 30, 2010, increase the grant amount to One Thousand, Six Hundred Dollars ($1,600) and to
modify the Scope of Services; and
WHEREAS, as of the effective date of this Amendment No.2, the Contractor has agreed
to provide the Services as described in the terms and conditions as set forth in the Agreement
with funds from the Redevelopment Low- and Moderate-Income Housing Fund ("Housing
Fund") in the amount not to exceed One Hundred Two Thousand, Six Hundred Fifty-Five
Dollars ($102,655) for a period of six (6) months, subject to availability of the Housing Fund;
and
WHEREAS, extension of the Agreement until June 30, 2010, will allow the Contractor to
expend the remainder of funds available under their current Agreement; no new funds have been
allocated under this Agreement.
NOW, THEREFORE, IN CONSIDERATION OF THE MUTUAL COVENANTS AND
CONDITIONS CONTAINED HEREIN, THE AGENCY AND THE CONTRACTOR AGREE
AS FOLLOWS:
Section 1. (a) Unless the context of the usage of a term or phrase in this Amendment
No.2 may otherwise require, the meaning of words and phrases in this Amendment No.2, which
are indicated by an initially capitalized letter, shall be the same as set forth in the Agreement.
(b) The Recitals contained in this Amendment NO.2 are true and correct.
Section 2. This Amendment No. 2 sets forth the terms and conditions of an
amendment to the text of the Agreement. This Amendment No.2 integrates all of the terms and
conditions mentioned herein and supercedes all negotiations, discussions and understandings
between the Parties with respect to the Agreement as hereby modified by this Amendment No.2,
including all items of assistance, which the Agency shall provide to the Contractor, under the
Agreement, as modified by this Amendment No.2.
Section 3. The Effective Date of the Agreement occurred on January 1, 2007, and
shall expire pursuant to the terms on January 7, 2010, but for this Amendment No.2. This
Amendment No.2 extends the Agreement to June 30, 2010, as herein provided.
Section 4. The text of the following specified Sections of the Agreement are hereby
amended to include the following, within the scope of the Agreement as amended pursuant to
this Amendment No.2.
The content of SECTION II, Item 4 Time of Performance shall be amended to read as
follows:
The Services to be performed by the Contractor under and pursuant to Amendment No.2
to this Agreement shall be for a period of six (6) months, from January 1, 2010 through
and including June 30, 2010 (the "Completion Date"). The Executive Director of the
Agency is authorized to extend the Completion Date for not to exceed six (6) months,
subject to Housing Fund availability.
The content of SECTION IV, Item 1 Compensation shall be amended to read as
follows:
In consideration of the performance by the Contractor of the Services, the Agency shall
pay to the Contractor up to fifteen percent (15%), Fifteen Thousand, Three Hundred
Ninety-Eight Dollars ($15,398) for administrative fees and Eighty-Seven Thousand, Two
Hundred Fifty-Seven Dollars ($87,257) for program labor and material costs for a total
sum of not to exceed One Hundred Two Thousand, Six Hundred Fifty-Five Dollars
($102,655) for the term of this Agreement. Subject to availability of the Housing Fund,
the total amount of compensation (the "Compensation") shall not exceed One Hundred
Two Thousand, Six Hundred Fifty-Five Dollars ($102,655) to the Contractor during the
term of this Agreement as modified by Amendment No.2 to this Agreement.
The content of SECTION V, Item 1 Termination shall be amended to read as follows
(subsections b. and c. of SECTION V. 1. shall remain unchanged):
2
P'.Agcndas\Agcnda AnachmentslAgenda AltachmemslAgrmts-Amend 2009\12-21-09 Oldlimen FOllndalion Agreement ExtC1\Sion &. Amendment No 2 doc
a. Termination bv Written Notice of Ag:encv: The Agency may, by written notice to the
Contractor, terminate the whole or any part of this Agreement at any time and without
cause by giving written notice to the Contractor of such termination. In the event of
termination without cause, the Contractor shall be compensated for the work
performed up to that date of termination. Payment for work completed under this
Agreement to the date of termination shall be made strictly on the basis of work
actually completed by the Contractor to the satisfaction of the Agency. In no event
shall the total compensation for services performed under this Agreement exceed One
Hundred Two Thousand, Six Hundred Fifty-Five Dollars ($102,655) per year. The
Contractor shall be entitled to no further compensation after the effective date of any
termination of this Agreement.
The content of SECTION B, Expenditures and Proeram Limitations under Exhibit
"A" Scope of Services shall be. amended to change One Thousand Dollars ($1000) to One
Thousand, Six Hundred Dollars ($1,600) where noted.
All other conforming changes to reflect this Amendment No.2, as to the terms within the
Agreement shall be deemed to be made and are hereby authorized to be made to conform to the
Agreement to the later adopted provisions of this Amendment No.2.
Section 5. Except as modified or amended by this Amendment No.2, all of the
provisions of the Agreement shall remain in full force and effect following the effective date of
this Amendment No. 2 and the Agreement as amended by this Amendment No.2, is hereby
reinstated and shall be in full force and effect as of the date of this Amendment No.2.
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P:\Ag~nd&$\Agenda AttachmentslAsenda AttachmnU\Agrmts-Amend 2009\12-21-09 Oldtimers Foundation Agreement EXlension & Amendment No. 2.doc
IN WITNESS WHEREOF, the parties hereto have accepted and made and executed this
Agreement upon the terms, conditions and provisions set forth above and as of the date first
written above.
AGENCY
Redevelopment Agency of the City of San Bernardino,
a public body, corporate and politic
Date:
By:
Emil A. Marzullo, Interim Executive Director
Approved as to Form and Legal Content:
~/~elrl
Agency Counsel:
CONTRACTOR
Oldtimers Foundation,
a California non-profit organization
Date:
By:
Title:
4
P:\Agendas'Agenda Anaclimenls\Agenda Attachmenn\Agrmts-Amend 2009\12-2]-09 Oldtimers Foundation Agreement Extension & Amendment No_ 2.doc
--<
EXHIBIT A
SCOPE OF SERVICES
AGENCY AND OLDTIMERS FOUNDATION AGREEMENT
ELDERLY ISPECIAL NEEDS MINOR HOME REPAIR GRANT PROGRAM
The Contractor shall provide minor home repair services to lower income senior citizen (as
defined in C below) homeowners within the City of San Bernardino in order to maintain the
existing affordable single-family housing stock through compliance with municipal health and
safety codes. The minor home repairs includes, but is not limited to the following:
A. ALLOWABLE REPAIRS
I. Plumbing & Heating
Repair/Replace: Tank and commode parts, faucet washers, showerheads, outside water
faucets, adjust lawn sprinkler heads.
ChecklMaintain: Thermostats, swamp and water coolers (filters and motors replaced as
needed) kitchen & bathroom sinks for leaks, garbage disposals for foreign objects and
debris. Unclog sink, shower, bath, toilet and laundry drains, cover and uncover turbines,
water heater replacement, minor heating and cooling systems malfunctions.
2. Electrical
Repair and Replace: Switches, outlets, cartridge type fuses
Check and Maintain: Oven and range hood, fan and vents, bathroom vents for proper
operational functions, existing smoke detectors. Install smoke detectors.
3. CARPENTRY
Repair/Replace/Realign: Cabinet and door hinges, binding doors, damaged door
hardware, worn and damaged window or door screens, broken windows. Build and
install medical or handicapped ramps with handrails. Install hand-held bath or shower
rails. Floor joist and sheathing locations as needed.
4. GENERAL
Repair/Replace: Towel racks, shower curtain rods, soap and toilet tissue holders,
window glass and door replacement, damaged floor tiles. Patch minor roofleaks. Install
deadbolt or security locks on doors, windows, patio doors and windows. Install garage
door springs, carpet, medical and or handicapped ramps.
Exhibit "A-I"
P\Agendas\Agenda Attachmc:nls\Agenda Attachmc:nts\Agmtls_Amend 2009\ 12-21-09 Oldlimc:rs Foundation Agreemenl Scop<: ofScrviccsdoc
B. EXPENDITURES AND PROGRAM LIMITATIONS
Agency funds will be used to reimburse Contractor for services and repair costs incurred
under this Agreement. In no event shall the repair costs for anyone single-family housing
unit exceed $1,600. The Contractor shall charge their expenses in accordance with the
hourly wage noted in Exhibit "B," Section 2. The Contractor shall be limited to
providing services to an eligible applicant not more than twice a year. Thereafter, an
Applicant may not apply for additional assistance until three (3) years following the date
of the last assistance. Contractor will schedule its own staff to make necessary repairs in
a timely manner. All work performed by Contractor shall be completed within 45 days
from date of commencement. The Contractor shall maintain accurate records for
inspection by the Agency of each applicant obtaining services by the Contractor. The
contractor will provide all services, materials, parts, and labor required for the
performance of the minor home repairs necessary to maintain decent, safe, and sanitary
residential units. Contractor shall submit monthly invoices with supporting
documentation of expenditures to be maintained in Contractor's files, and made available
to Agency upon request, and such invoices shall be billed consistent with Exhibit "B" of
the Agreement. The Contractor shall provide assistance to a minimum of 64 households
per this six month period.
C. APPLICANT ELIGIBILITY REQUIREMENTS
1. An applicant must be an owner occupant for a minimum period of 1 year; on a case-by-
case basis, and depending on the circumstances, this requirement may be waived by the
Interim Executive Director of the Agency or hislher designee; Applicant must provide
evidence of ownership and length of residency.
2. Applicant must complete a Grant Application and meet the applicable income criteria
(Exhibit "C"). The applicant's annual income shall not exceed 80% of the median
income for San Bernardino County. The Agency shall provide the Contractor with the
income limits for the current year. Contractor is required to use Exhibit "C" attached
herein for all participants in the Program and to retain all applications in the possession of
the Contractor's file.
3. Applicant applying for the Program must be a senior, age 62 or above, or disabled,
handicapped,. or a recipient of S.S.I.; on a case-by-case basis, depending on the
circumstances, this requirement may be waived by the Interim Executive Director of the
Agency or his/her designee.
The Contractor shall maintain accurate records for inspection by the Agency concerning income
and program eligibility of all persons obtaining assistance from the Contractor pursuant to this
Agreement.
Exhibit "A-2"
P\Agtndas\Agenda Anachments\Agenda Allachments\Agm1.s_Amend 2009\12.21.09 Oldlimers Foundation Agreement Scope of Service5.doc
EXHIBIT B
CITY OF SAN BERNARDINO
REDEVELOPMENT AGENCY
REQUEST FOR MONTHLY REIMBURSEMENT
Agency/Organization:
Oldtimers Foundation - Fed. ID #95-6126109
Address:
8572 Sierra Avenue, Fontana, CA 92335-3840
Reimbursement for the Month of:
,200_ Invoice No.:
Amount of Reimbursement: a. Administration
b. Job Service - Labor from Exhibit B
c. Job Service - Material and Supplies from Exhibit B
Total
The undersigned hereby certifies that the expenditures identified on the attached "Budget
Summary Form" are true and correct, and that said expenditures were incurred and paid within
the month designated above in accordance with the agreement identified herein. Evidence of all
payments (bills and/or receipts and check copies) for each of the expenditures listed is attached
hereto.
(Authorized Signature)
(Type Name and Title)
(Date)
FOR OFFICE USE ONLY
Reviewed by:
Approved by:
Exhibit "B-1 "
P:\Agendas\Agenda Anachmenu\Agenda Atlachmenl$\Agrmts-Amend 2009\12-21-09 Qldlimers Foundation Agreement Scope or Services doc
REIMBURSEMENT REQUEST
Budgeted Current Month Year to Date Balance
A. EXPENDITURES Amount Cumulative Available
1. Wages - Administration
a. Administrator/ Acct. (a) $16.83/hr.
b. Disnatcher (a) $9.50/hr
fringe Benefits
a. Administrator/Accountant
b. Disnatcher
Wa~es alld Frill~es Subtotal
2. Consultant - Audit
3. Travel ( miles (a:) $0.55)
4. Rent
5. Payroll Service
6. Vehicle Maintenance
7. Auto and Misc. Insurance
8. Cell Photte and Radio
Total Maximum Program
Admb.istratioll Expense
(.15 x $102,655) $ 15,398
9. Job ServicelWages
a. Working foreman hrs. x $17.00
b. Maintettance Worker hrs. x $13.00
c. Material and Suoolies
fringe Benefits
a. Working foreman
b. Maintenance Worker
Total Job Service/Labor
Total $ 87,257
10. Minimum Households Assisted Per
Year at a Maximum of $1600 64
B. # of Individuals Assisted Monthly # Female Head of Household:
1. # Low Income Level
2. # Verv Low Income Level
Total (1 + 2 = B)
Please attach supporting invoices and documentation.
Revised: 11/2009
Exhibit "B-2"
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EXHIBIT C
City of San Bernardino OLDTIMERS FOUNDATION
Redevelopment Agency
SENIOR CrnZEN MINOR REPAIR PROGRAM APPLICATION - 2009/2010 YEAR
Applicanes Name (Last, First, MI)
Social Security Number
Applicanes Name (Last, First, MI)
Applicanes Date of Birth - Age
Street Address
Applicant's Phone Number
San Bernardino
Oly/Zip
Years at Residence:
Number of Minor Children (If Applicable):
Household Size:
Head of Household: 0 Male 0 Female
L' t II
I" .
'd
th th
If
IS a persons IVlnq In resl ence 0 er an y ourse :
Employed
Name Relationship Aae Social Security # Yes I No
All income of all household occupants must be shown here. Applicant must attach proof of income and
ownershi .
TOTAL MONTHLY INCOME:
$
TOTAL ANNUAL
INCOME:
$
Exhibit "C-1 "
P\AgendaslAgenda Anachmenls\Agenda AltachrllC'TllslAgrmts-Amc:nd 2009\12.21-09 Oldlimers Foundation Agreement Scope of Services doc
2009 I ncome Level
8+
1
Household Annual Income May Not Exceed:
Lower Income 80%
70,350
Ethnicity: (Please check all that apply)
o Sr. Citizen(s) - 62 or Older
o Black
o American Indian
o Female Head of Household
o Hispanic
o While
o Disabled One or More
o Other
o Asian or Pacific Islander
I certify under penalty of perjury that the information provided above is correct to the best of my knowledge. I understand that the
inclusion of any willful misrepresentation on this form constitutes ground for rejection of this application and recapture of any
financial benefit I may have received. I authorize the Oldtimers Foundation to examine and verify any and all infonnation provided
in this application.
Date:
Signature
Date:
Signature
Exhibit "C-2"
P\Agendas\Agcnda Anachments\Agcnda Attachmenu\Agrmts-Amend 2009\12-21-09 QldtilTlC.'rs Foundation Agreement Scopc-ofServiccsdoc