Okaloosa County BOCC — November 16, 2013 — Final Payment Ben Gordon Jr Family Visit Ctr — reading text

CONTRACT CLOSE-OUT CHECKLIST {To Be Prepared by the Purchasing Services Coordinator) DATE: August 12, 2013 TO: Contracts & Grants Manager, Finance Department Contracis & Grants Office SUBJECT: ContractNo. C12-1997-CA MANAGING DEPARTMENT: = Court Administration CONTRACTOR'S NAME: Ben Gordon Jr. Family Visitation Center PROJECT TITLE: Children Exposed to Crime Prevention Project The attached has met the final payment contract requirement in subject contract. Yes No 1, Final Invoice x] im 2. Completed Contract/Lease Payment Approval Form yd 3. Close-Out Documents Yes No N/A a. Signed Release of Lien im LJ XX] b, Proof of Completion Advertisement CJ im x c, Certificate of Insurance L] Lj d. Consent of Surety to Final Payment C] C] x) e. Proof of Performance/Payment Bond Cj O x Continuation 12 Months Following Final Payment Yes No 4, Agenda Request IX | 5. Remarks S/e0/3 e asing Services Coordinator DATE ‘ i | . GORD-01 OP ID: EM ASOR” _ CERTIFICATE OF LIABILITY INSURANCE oar aon THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of tha policy, certain policles may require an endorsement. A statement on thls certiftcate dogs not confer rights to the certificate holder in eu of such endorsemant(s). PRODUCER Phone: 850-581-4925] ¢Ouee™ WaldorffIns & Bonding - FWB Beene 45 Eglin Parkway NE, Ste 202 Fax; 850-881-4930) TOON, ev: TAG, No}: Fort Walton Beach, FL 32548 EMAIL | K, Wayne Walker ” ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # insurer a: Western World Ins. Co. INSURED Judge Ben Gordon, Jr. INSURER B pam ily Visitation Center INSURER ¢: Shalimar, FL 32579 INSURER D: INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLIGIES 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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDL |SUET POLIGY EFF | POLICY EXP Nee TYPE OF INSURANCE INSR [WD POLICY NUMBER (MMIDDIYYYY) | (MM/DDIYYYY) LIMIrs GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000) 2105/9 DAMAGE TO RENTED A. |X | CoMMERCIAL GENERAL LIABILITY INPP8055446 02/05/2013 | 02/05/2014 | BAMices eeoreaience) [4 100,000 | CLAIMS-MADE, OCCUR MED EXP {Any one person) | & 5,000 | | PERSONAL & ADV INJURY ¥ 1,000, 000} X |Professional Liab GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMPIOP AGG | $ Included POLICY HEC toc $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY eee E $ ANY AUTO BODILY INJURY (Per person] | § [| ALL OWNED SCHEDULED 5 jaar [ee sora ee HIRED ALTOS AUTOS (Por accident) $ $ UMBRELLA LIAB occUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS. MADE AGGREGATE $ ven |_| rerenrions $ WORKERS COMPENSATION WCSTATU. Orr AND EMPLOYERS’ LIABILITY YIN TORY LIMIT ER ANY PROPRIETOR/PARTNERVEXE CUTIVE ELL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) ELL, DISEASE - EA EMPLOYEE] $ Ifyes, deserlbo under DESCRIPTION OF OPERATIONS below ELL, DISEASE - POLICY LIMIT | $ DESCRIPTION OF OPERATIONS / LOCATIONS f VEHICLES {Attach ACORD 104, Additional Remarks Schedule, if more space la required) CERTIFICATE HOLDER CANCELLATION OKALDO1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Okaloosa County Department of Growth Management y AUTHORIZED REPRESENTATIVE 600 Transit Way Fort Walton Beach, FL 32547 Alou Abla— © 1988-2010 ACORD CORPORATION. All rights reserved, ACORD 25 (2010/05) Thea ACORD name and logo are registered marks of ACORD Judge Ben Gordon, Jr. Family Visitation Center P.O. Box 436, Shalimar, Florida 32579 Phone: 850-609-1850 Fax: 850-609-1851 July 17, 2013 Catherine White Drug Court Manager 100 West Maxwell Street Pensacola, FL 32501 Reimbursement Invoice for: FDLE Ed Byrne Justice Assistance Grant Program American Recovery Act Grant number: 2013-JAGC-OKAL-2-D7-009 Contractual Services: $20,859.00 Period of Performance: October 1, 2012 through September 30, 2013 The unit of cost used at the Judge Ben Gordon, Jr, Family Visitation Center is'one supervised visit. Services include the provision of trained staff, security, and a nurturing setting. Grant funds will provide for 200.567 units of service at the current level of staff and facility. 1 Unit = $104 $104 per unit @ 200.567 units = $20,859.00 Reimbursement Period: January 1, 2013 — May 31, 2013 Reimbursement Funding Requested: $104 X 200.567 units = $20,859.00 Remaining Ed Byrne Grant funding: $20,859.00 - $20,859.00 = $0.00 A list of Supervised Visitations for this period is attached. Please.call if you have any questions. Thank you, Crystal Melton Financial Manager |, Sharon Rogers, Executive Director of the Judge Ben Gordon, Jr. Family Visitation Center, certify that the above invoice is correct and that is does not duplicate reimbursement of costs or services received from other sources. In addition, | certify that reimbursement is requested only for expenditures on items approved by the terms and conditions of the agreement with the County. 4 Approved by Executive one Baap . y { YU 2012 ate Sharon G Rogers Judge Ben Gordon Family Visitation Center Executive Director~ Sharon Rogers - Payroll Expense Pay Period Worker's FUTA/ Total Total Ed Byrne Ending Date Salary FICA Comp Ins SUTA Admin Fee | Compensation | Ed Byrne %. Relmbursed 1/s/2013| 2,384.64 182.43 59.85 164.54 76.34 2,867.77 47.00%! 4,347.85 1/19/2013 2,384.64 182.43 59.85 164,54 76.31 2;867.77 47.00% 1,347.85 2/2/2013| 2,984.64 182.43 59.85 162.23 76.34 2,865.46 47.00% 1,346,77 2/16/2013 2,384.64 182.43 59.85 45.69 76.31 2,748.92 47.00% 4,291.99 3/2/2013 2,384.64 482.43 5.85 - 76.31 2,703.23 47,00% 1,270.52 3/16/2023| 2,384.64 182.43 58.85 > 76,31 2,703.23 47.00% 1,270.52 3/30/2013} 2,384.64 182,43 59.85 - 76.31 2,703,283 47.00% 1,270.52 4/13/2013 2,384.64 182.43 59.85 * 7631 2,703.23 47.00% 1,270.52 4/27/2013} 2,384.64 182.43 59.85 - 76.31 2,703.23 47.00% 1,270.52 5/41/2013] 2,384.64 182.43 59,85 - 7631 2,703.23 47.00% 1,270.52 5/25/2013| 2,384.64 182.43 59.85 - 76.31 2,703.23 47.00%! 1,270.52 26,231.04 2,006.73 658.35 537,00 839.41 30,272.53 14,228,09 Program Manager ~ Ken Tate - Payroll Expense Pay Period Worker's FUTA? Total Total Ed Byrne. Ending Date Salary FICA Comp Ins SUTA Admin Fee | Compensation ] Ed Byrne % Reimbursed 1/5/2013) 960.00 73.44 24.10 66.24 30,72 1,154.50 50.00% 577.25 1/19/2013 1,035.00 79,48 25.98 7144 33.12 ©,244,69 50.00%] 622,35 2/2/2013 1,020.00 78.03 25.60 70.38 32,64 1,226.65 26.00% 245.33 3,045.00 230.65 75.68 208.03 96.48 3,625.84 1,444.93 Case Monitor - Jeannette Debs ~ Payroll Expense Pay Period Worker's FUTA?/ Total Total Ed Byrnie Ending Date Salary FICA Comp Ins SUTA Admin Fee | Compensation | Ed Byrne % Reimbursed 1/5/2013. 725.00 $5.46. 18.20 50.03 23.20 871.89 100,00%| 871.89 4/19/2013 725.00 55.46 18.20 50.03 23.20 871.89 100,00%: 871.89 2/2/2013 725.00 55.46 18.20 $0.03 23,20 871.89 100.00% 871,89 2/16/2013. 725.00 55.46 18.20 50.03 23,20 871.89 100.00% 871,89 3/2/2013 739.50. 56.57 18.56 51.02 23.66 889.31 0.00% ~ 3/16/2013 725.00 55.46 18.20 50.03 23.20 871.89 0.00%, - 3/30/2013 728,00 55.46. 18.20 50.03 23.20 871.89 0,00% . 4/13/2013. 725.00 55.46 18,20 50.03. 23.20 871.89 0.00%, - 4/27/2013 72500 55.46 12.20 50,03 23.20 871.89 0.00%) . 5/41/2013 725,00 55.46 18.20 46.06 23.20 867.92 100.00%: 867.92. 5/28/2013 725,00 55.46 18.20 39,15 23.20 861.01 100.00% 861.01 7,989.50 611,17 200.56 536,47 255,66 9,593.36 5,216.49 .¢ Total Ed Byrne Reimbursement: 20,889.50 OPEN during this period (1/1/2013 to 5/31/2013) Service |Case name Opened Closed Kids {Type |Cancel{P) |Cancel(Q) [NoShow |Completed |Units E $05-421 10/8/2010 1jNon 10 1 0 51 25.5 E $07-512 10/13/2010 1jNon 1 0 0 16 8 E $11-682 4/1/2011| 1/8/2013 3]Non 0 0 0 0 E $11-698 9/8/2011] 6/14/2014 2|Non 0 0 0 1 0.5 E $12-718 2/1/2012 1]Non 4 2 0 39 19.5 E $12-732A 5/10/2012] 1/8/2013 3}Non 0 0 ) 0 E $12-740 10/4/2012] 6/14/2013 2|Non 0 0 0 11 5.5 E 512-744 11/2/2012 1)Non 8 1 1 14 7 E $12-750 12/21/2012| 6/14/2013 1}Non 3 1 1 8 4 Vv $11-684 1/12/2011] 6/14/2013 1|Non 12 1 0 25 25 Vv $11-700 9/21/2011] 6/14/2013 i}Non 0 0 0 0 v $11-702 10/4/2011| 6/14/2013 ijNon 0 0 0 15 45 Vv $11-704 11/4/2011} 1/8/2013 2jNon 0 0 (6) ie) Vv $11-705 11/18/2011] 1/8/2013 2)Non 0 0 0: 0 Vv $12-720 2/3/2012| 5/15/2013 1)Non 1 0 1 25 25 Vv $12-728 5/1/2012] 1/8/2013 1j}Non 0 0 0 0 Vv $12-730FFN 5/10/2012) 2/5/2013 2|Dep 0 5 ie} 9 9 Vv §12-733A 8/16/2012) 1/8/2013 2|Non 0 0 0 0 Vv $12-738 8/21/2012 2|Non 2 0 0 13 13 Vv $12-739 9/6/2012] 5/15/2013 1|Non 1 0 0 16 16 Vv $12-741 9/21/2012 2{Non 0 ie} 1 1 1 Vv $12-742 10/5/2012] 3/27/2013 2|Non 0 0 0 0 Vv $12-745FFN 11/20/2012| 3/27/2013 1|Dep 0 i} 0 0 Vv $12-746FFN 11/20/2012} 3/26/2013 3/Dep 0 0 0 0 Vv $12-747FFN 11/20/2012] 3/26/2013 5|Dep 0 4 0 ie) Vv $12-748 12/4/2012] 3/27/2013 1|Non 0 0 1 4 4 Vv $12-749FFN 12/18/2012} 1/17/2013 1)Dep 0: 3 0 0 Vv $13-751 1/15/2013 1}Non 0! 0 0 1 1 Vv $13-752 1/17/2013 3)Non 0 0 0 4 4 Vv $13-753 1/17/2013] 5/15/2013 1)Non 2 0 3 1 1 v $13-754FFN 1/22/2013] 1/29/2013 2|Dep 0 0 0 0 Vv $13-755FFN 1/25/2013} 3/27/2013 3|Dep i} 0 0 4 4 Vv $12-730A 2/5/2013} 2/12/2013 2|Dep 0. 0 0 3 3 Vv $12-730A 2/12/2013 2|Non 2 0 0 32 32 Vv $12-728A 2/15/2013] 6/14/2013 1|Non 0 0 ) 1 4 v $13-757 2/19/2013 1}Non 0 0 0 8 8 Vv $13-759FFN 3/12/2013] 4/16/2013 2|Dep 0 4 0 7 7 Vv $13-760 3/12/2013} 6/14/2013 2|Non 1 ie) 0 3 3 Vv $13-761 4/2/2013] 6/14/2013 1}Non 2 0 0 3 3 Vv $13-762 4/26/2013 1)Non 0) 2 0 0 Vv $13-763 4/26/2013 2|Non 1 0 0 1 1 Vv $13-765FFN 5/2/2013 3]Dep 0 0 0 2 2 Vv $13-766FFN 5/10/2013 7|Dep 1 0 0 1 1 Vv $10-661A 5/14/2013 2|Non 1 0 0 1 1 250 Judge Ben Gordon Jr Family Visitation Profit & Loss January through May 2013 Ordinary Income/Expense Income Client Fees Contributions Income United Way Unrestricted Total Contributions Income Grants Reimbursement Families First Network Funds Impact 100 Total Reimbursement Unrestricted OK Cty Walton County Total Unrestricted Total Grants Total Income Expense Crestview Center Closing Costs Electric Maintenance Miscellaneous OVW Safe Havens Grant OVW Conference Total OVW Safe Havens Grant Safe Haven Grant Reimbursement Total Crestview Center General & Administrative Audit Bank Service Charges Consultants Dues & Licenses Insurance Interest Expense Office Supplies & Expense Payroll Expenses Director - Health Insurance FICA Expense Payroll Admin Fee SUTA Expense Workers Compensation Insurance Total Payroll Expenses Online Services Wages Salaries Total Wages 7:00 PM 06/18/2013 Accrual Basis Shalimar Defuniak Crestview Jan - May 13 47% 20% 7,591.74 2,133,00 16,375,00 18,508.00 16,192.00 72,272.73 88,464.73 3,125.00 12,500.00 ~_18,625.00_ 104,089.73 130,189.47 1,172.73 37.81 90,00 1,250.00 344.07 344,07 1,951.15 4,845.76 325.00 45,95 3,306.00 369,25 4,181.97 8.99 787.44 753.00 2,008.71 839,41 537.00 §58.35 4,794.47 74,80 26,231,04 26,231.04 33% Page 1 of 3 Judge Ben Gordon Jr Family Visitation Profit & Loss January through May 2013 (Total General:& Adminis Shalimar Center Bank Charges Cleaning Expense Computer supplies/upgrades Copier