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HomeMy WebLinkAboutResolution - 5869 - Contract - TDHS - Summer Lunch Program - 05_28_1998Resolution No. 5869 Item Noy. 21 May .28, J998 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock, a contract for the Summer Lunch Program, by and between the City of Lubbock and the Texas Department of Human services, and related documents. Said contract is attached hereto and incorporated in this resolution as if fully set forth herein and shall be included in the minutes of the City Council. Passed by the City Council this 28th day of May 1998. Vic e` T I�. ATTEST: A AA iAW -A ff-a Darnell " Ci S cretary APPROVED AS TO CONTENT: Tommy CAnzaIezd Director of Civic Services APPROVED AS TO FORM: William de Haas Municipal Contracts Attorney Ccdocs/ Texas Department of Human Services Summer Lunch Program Contract. Res May 14, 1998 DRAFT ul City ojLubbock Regular City Council Meeting May 28,1998 City Council Chambers, 162513th Street City Council Convenes in Chambers 7City Council Recesses to Executive Session City Council / City Manager Conference Room Work Session in Committee Room 103 City Council Regular Meeting Reconvenes City Council Chambers City of Lubbock City Council meetings are available to all persons regardless of disability. If you require special assistance, please contact the City Secretary's office at 775-2025 or write Post Office Box 2000, Lubbock, Texas 79457 at least 48 hours in advance of the meeting. '.` y,. `g a a •',sg xPs° ; fi, ,q« �. fig, nr u 8zQQ A O>�tIfG1 Convenes W lQ�',, :c.:.:r.•u .x'- �,. - au�.,:ut..ux,•.;.-:e�ra�„.�,Y. �:.+:..«c z ( 1.) Hold an executive session in accordance with V.T.C.A. Government Code, Section 551.074(a)(1) to discuss personnel matters (City Manager; Mayor Pro Tempore). ( 2.) Hold an executive session in accordance with V.T.C.A. Government Code, Section 551.071(1)(A) to discuss pending or contemplated litigation (Building Inspection; Facilities Management; Police Department; Water Utilities). ( 3.) Hold an executive session in accordance with V.T.C.A. Government Code, Section 551.074(a)(1) to discuss personnel matters regarding duties, responsibilities, and/or appointments to: Appointments Advisory Board Building Board of Appeals Citizens Traffic Commission Electric Utility Board Neighborhood Redevelopment Commission ( 4.) Hold an executive session in accordance with V.T.C.A. Government Code, Section 551.072 to deliberate the purchase, exchange, lease, or value of real property ( ). ` x ai Count Gntinne �oitecess �rifhVor S�SsOn v.. M.... ...v,. �r� x., o..._ _.�_ ..�a..�r „�.®..� w�......4 I For Discussion Purposes Onh° ( 5.) Presentation on ; City of Lubbock investment portfolio and investment strategy revisions. Linda Patterson, Patterson & Associates, and Betsy Bucy (10 minutes) 3 ( 6.) Invocation by Dr. Rodney Plunkett, Pulpit Minister, Broadway Church of Christ. ( 7.) Pledge of Allegiance to the Flag. 4 Appointments Advisory Board Receiving: Kay Greer Neighborhood Redevelopment Commission Receiving: Melissa Grimes Public Transit Advisory Committee Receiving: Dustin Adling 5 ( 8.) Presentation of annual update of activities of the Firefighter and Police Officer Civil Service Commission by Debra Shepherd, Chair. T A thirty -minute period dedicated to citizens who wish to address the Council. The following items are of a routine or administrative nature. The Council has been furnished with background and support material on each item, and/or it has been discussed at a previous meeting. All items will be acted upon by one vote without being discussed separately unless requested by a councilmember or a citizen, in which event the item or items will immediately be withdrawn for individual consideration in their normal sequence after the items not requiring separate discussion have been acted upon. The remaining items will be adopted by one vote. ( 9.) Approval of Minutes: May 8, 1998 Special City Council Meeting May 14, 1998 Regular City Council Meeting (10.) Consider a resolution authorizing the Mayor to execute a dedication deed in connection with the platting of Lot 1, Lubbock Fire Department Addition (1501 East Ursuline). (11.) Consider a resolution authorizing the Mayor to execute an alley - use license with McLain Oil Company for an underground pipeline (1702 North University). (12.) Consider an ordinance abandoning and closing a portion of a five- foot sanitary sewer line easement located in Section 6, Block E, Lubbock County, Texas (702 East Slaton Road) (first reading). (13.) Consider a resolution authorizing the Mayor to execute a contract with Texas Tech University for campus bus service. (14.) Consider a resolution authorizing and directing the Mayor to execute for and on behalf of the City of Lubbock an Agreement between the City of Lubbock and the YWCA of Lubbock for their Acquisition Project. 0 Consent Agenda (continued) (15.) Consider and vote on approving the acceptance of a donated lot located at 2820 2nd Street to be used as HOME Match. (16.) Consider a motion to approve changing the meeting date for the second Council meeting in June from June 25 to June 18. (17.) Consider a resolution authorizing the Mayor to execute for and on behalf of the City of Lubbock an application for a Law Enforcement and Corrections Family Support Grant. (18.) Consider a resolution authorizing the Mayor to sign the application for the continuation of a grant with the Texas Department of Health (TDH) and any other associated documents to provide HIV counseling services for prevention and education. (19.) Consider a resolution approving the City of Lubbock 1997-98 Revised Budget. (20.) Consider a resolution adopting revisions to the City of Lubbock Investment Policy. (21.) Consider a resolution authorizing the Mayor to execute a Participation Agreement with TexPool. (22.) Consider a resolution authorizing the Mayor to sign an application for the 1998 Summer Food Service Program for Children funded by the Texas Department of Human Services and to execute all related documents with the Department of Human Services. (23.) Consider a resolution authorizing the Mayor to execute a contract with the South Plains Food Bank for the 1998 Summer Food Service Program for Children that is funded by the Texas Department of Human Services. 0 Consent Acienda (continued) (24.) City of Lubbock Wrecker Services, Annual Contract (Police Department) and authorize same (25.) RFP 998025 -- Travel Agent Services (Budget and Finance) and authorize same (26.) BID 998075 -- Mobile Water Treatment Scrubber Systems (Water Treatment) (27.) RFP 498079 -- Lease of Center Pivot Irrigation Systems (Land Application Site) and authorize same (28.) RFP #98086 -- Professional Auditing Services (Finance) and authorize same (29.) BID #98101 -- Monitoring Well Sample Pumps and Controller (Solid Waste) and authorize same (30.) BID #98123 -- 1500 GPM Fire Truck (Fire Department) 10 Zoning (31.) ZONE CASE NO.2813 (2710 34th Street) — Hold a public hearing to consider the request of Brad H. Birdsong (for West Texas Drive Axle) for zoning change from C-2 to C-4 limited to a public repair garage, automobile transmission shop, and all unconditionally permitted C-2 uses on Lots 6, 7 and the west 10 feet of Lot 8, Block 12, College View Addition, and to consider ordinance. (32.) ZONE CASE NO. 2814 (1319-1321-1323 Itasca) — Hold a public hearing to consider the request of John M. Hall (for Charles M. Hall) for zoning change from R-2 to M-1 Specific Use for light manufacturing on Lots 8-11, Block 12, Country Club Addition, and to consider ordinance. (33.) ZONE CASE NO. 2815 (south of 104th Street and west of Wayne) — Hold a public hearing to consider the request of Burl Masters (for Excel Development) for zoning change from R-1 to R-1 Specific Use for garden homes on 3.8 acres of land out of Section 16, Block E-2, and to consider ordinance. (34.) ZONE CASE NO. 2816 (north of 82nd Street and west of Avenue P) — Hold a public hearing to consider the request of Randy Andrews (for Trinity Church) for zoning change from R-1 to R-1 Specific Use, C-3 and GO on 78.395 acres of land out of Section 4, Block E, and to consider ordinance. (35.) ZONE CASE NO. 2212-C (south of Loop 289 and east of Avenue P) — Hold a public hearing to consider the request of Hugo Reed and Associates (for Eddie Bell) for zoning change from C-4 to C4 Specific Use for mini warehouses on 3.07 acres located in Section 5, Block E, and to consider ordinance. 11 Traffic (36.) Consider an ordinance amending the Lubbock Code of Ordinances, Chapter 16, Motor Vehicle and Traffic, by adding a Resident Parking Only Pilot Program (first reading). 12 Cultural Arts Services (37.) Consider a resolution renaming the historic Ft. Worth and Denver Depot as the "Buddy Holly Center". 13 Other I (38.) Consider a resolution designating Mayor Tempore. 14 (39.) Consider two appointments to the METTS, Inc. Board of Directors. IR CITY OF LUBBOCK MEMO TO: Bob Cass, City Manager FROM: Tommy Gonzalez, Director of Civic Services DATE: May 19, 1998 SUBJECT: Summer Lunch Program for Children - Application CITY OF LUBBOCK AGENDA ITEM SUMMARY ITEM# / SUBJECT #Consider a Resolution authorizing the Mayor to sign an application for the 1998 Summer Food Service Program for Children funded by the Texas Department of Human Services and authorizing the Mayor to execute all related documents with the Department of Human Services. BACKGROUND / DISCUSSION The City of Lubbock Parks and Recreation Department is requesting pass -through funds through the Texas Department of Human Services from the United States Department of Agriculture. The City of Lubbock has participated in the Summer Food Service Program for the past eight years, serving approximately 32,500 meals annually to economically disadvantaged children. The program provides a nutritional noon meal Monday through Friday for children ages 1 through 18. Program operates June 1, 1998 through August 7, 1998 inclusive. Any child is eligible to participate in the Summer Food Program. Program meal sites are Trejo, Mae Simmons, Clapp, Woods, and Rawlings Community Centers and Ballenger Elementary School. A daily average of 800 meals will be served at the 6 locations. Direct and indirect costs for the Summer Food Program are reimbursed through the $101,600 grant. Direct costs include the contract with the food vendor, consumable supplies, and salaries for food service personnel and is estimated to be $89,172. Indirect costs include program administration, personnel training, supplies and is estimated to be $12,428. STAFF RECOMMENDATION: Staff recommends contracting with the Department of Human Services to provide free summer lunches for children ages 1-18 at the stated city sites. CITY OF LUBBOCK MEMO TO: Bob Cass, City Manager FROM: Tommy Gonzalez, Director of Civic Services DATE: May 19, 1998 SUBJECT: Summer Lunch Program for Children - Application CITY OF LUBBOCK AGENDA ITEM SUMMARY ITEM# / SUBJECT #Consider a Resolution authorizing the Mayor to sign an application for the 1998 Summer Food Service Program for Children funded by the Texas Department of Human Services and authorizing the Mayor to execute all related documents with the Department of Human Services. BACKGROUND / DISCUSSION The City of Lubbock Parks and Recreation Department is requesting pass -through funds through the Texas Department of Human Services from the United States Department of Agriculture. The City of Lubbock has participated in the Summer Food Service Program for the past eight years, serving approximately 32,500 meals annually to economically disadvantaged children. The program provides a nutritional noon meal Monday through Friday for children ages 1 through 18. Program operates June 1, 1998 through August 7, 1998 inclusive. Any child is eligible to participate in the Summer Food Program. Program meal sites are Trejo, Mae Simmons, Clapp, Woods, and Rawlings Community Centers and Ballenger Elementary School. A daily average of 800 meals will be served at the 6 locations. Direct and indirect costs for the Summer Food Program are reimbursed through the $101,600 grant. Direct costs include the contract with the food vendor, consumable supplies, and salaries for food service personnel and is estimated to be $89,172. Indirect costs include program administration, personnel training, supplies and is estimated to be $12,428. STAFF RECOMMENDATION: Staff recommends contracting with the Department of Human Services to provide free summer lunches for children ages 1-18 at the stated city sites. Office of Accounting City of Lubbock P.O. Box 2000 Lubbock, Texas 75457 606-767-2156 March 25, 1998 Texas Department of Human Services Special Nutrition Programs, Operations Division 2109-Avenue Q Lubbock, Tx 79405 To whom it may concern: We are in the process of compiling information for the single audit report, which is performed in accordance with the Single Audit Act of 1984 and OMB Circular A-133. We anticipate that this will be completed and published in July of this year. If you have any questions, please feel free to contact me at (806) 775-2147. Sincerely, Brack Bullock Senior Accountant Xc: Angela Hobbs Texas Department Form ISSS of human services SPECIAL NUTRITION PROGRAMS September isin SINGLE AUDIT IDENTIFICATION DATA (For Contract Year 1998 'ontraGor Name Contact Person f Address (Street Cc PA. Box, City, State, ZIP) P.O. Box 2000, Lubbock, Tx 79457 Telephone No. Payee ID No. Contract No. 806 ) 775-2678 1-75-6000590-6000 Tax Esem t Contractor Fiscal Year End (mnydd/yyyy) Type of Contract 9/ 3 0, 1 9 9 8 For Profit ❑ Non -Profit Governmental Check the appropriate box(es) to Indicate the type(s) of program(. COMMODITY ASSISTANCE PROGRAMS AGREEMENT NOS. A — National School Lunch B —Charitable Institutions C — Area Agency on Aging G —Summer Camps H —Summer Food Service J — Jails 1—TEXCAP s) in which you currentiv participate or for which you are ennivina- CASH REIMBURSEMENT PROGRAMS AD — Adult Day Care TX- BL— National School L.unch[Brealdast TX - CC — CACFP Center TX- DH — CACFP Day Home TX- SF— Summer Food F TX- SM — Special Milk TX- TE—TEXCAP TX- ive the source ana amount oT any Teaerai Tunas that your agency expenas other than Troml those programs nstea above: SOURCE I AMOUNT ❑ SINGLE AUDIT EXEMPTION-1 certify brat I am not required to submit an audit under the Single Audit Act for the following ❑ 1 am a for -profit organization. ❑ 1 expend less than $300,000 annually In total federal funding. ❑ SINGLE AUDIT ASSURANCE-1 understand that If 1 meet the requirements of the Single Audit Act I will agree to submit an audit as a condition of erigibTty to participate In the Special Nutrition Programs, and that failure to do so as required could result in adverse action. including the withholding of my claim for reimbursement payments and tremination of my contract 1 also understand that if 1 am a private non-profit organization subject to the requirements of the Single Audit Act and have a financial audit performed annually, I must also obtain a single audit on an annual basis. d Representative e Name (please"or prim E CERTIFICATE OF AUTHORITY This is to certify that Name of Authorized Official (please type or print) Title Robbie Johnson 77 Youth coordinator Signature —Authorized Official is designated as the authorized representative of Name of Contracting Organization City of Lubbock (address (Street, City, State ZIP) PO Box �®oo, Lubbock, Texas 79457 The representative designated above Is authorized on behalf of the contracting organization to make written agree- ments with the Texas Department of Human Services to operate a food program, to sign documents or reports about the agreement, and to present claims for reimbursement, when appropriate, to the department. ATTEST: r'==1 " Ds ZB 19 mature—Ohfidal ency Date Um of Ofrrclat (please type or print) Title Mayor APPROVED AS TO CONTENT: Kayo Aii Darnel mmy Gonjalez Citl Hecretary Director of Civic Services MR WVARTMENT OF HUMAN SERVICES USE ONLY: APPROVED AS TO FORM: William de Haas Municipal Contracts Attorney AQ"wnent No. — deceived By OM TX- Texas Department of Human Services Form C: July P CERTIFICATE OF AUTHORiTY This is to certify that Name of Authorized Official (please type or print) Title Angela L. Hobbs I I Indoor Supervisor Signature —Authorized Official Is designated as the authorized representative of Name of Cortigcting Organization City Of Lubbock Address (Street. City, State, ZiP) P.O. Box 2000, Lubbock Texas 79457 The representative designated above Is authorized on behalf of the contracting organization to make written agree- ments with the Texas Department of Human Services to operate a food program, to sign documents or reports about the agreement, and to present claims for reimbursement, when appropriate, to the department. Sip �clal of Cutting Agency Date Name of Official (please type or prat) Tdle W*-!S��� Mayor ATTEST: APPROVED AS TO CONTENT: APPROVED AS TO FORM: �K the Darnell Tommy Goniviez V William de Haas City retary Director of Civic Services Munidipal Contracts Attorne FOR DEPARTMENT OF HUMAN SERVICES USE ONLY: Dale Teas Department of Human Services Form July CERTIFICATE OF AUTHORITY This is to certify that Name of A .Oorized Official (please type or print) Title Parks Manager Rusty Black 64r4wre—Authorized official Is designated as the authorized representative of Name of Contncting Organization City of Lubbock Address (Street. City. State, ZIP) P.O. Box 2000. Lubbock. Texas 79457 The representative designated above is authorized on behalf of the contracting organization to make written agree- ments with the Texas Department of Human Services to operate a food program, to sign documents or reports about the agreement, and to present claims for reimbursement, when appropriate, to the department. Sign ,efk1 of Conte Apenry [We Name of Otfitial (please type or pring Title r,; .,air c; }ton I Mayor ATTEST: APPROVED AS TO CONTENT: AIA i ay Darnell -k-----Tommy Gonzolez Cit ecretary' Director of Civic Services FOR DEPARTMENT OF HUMAN SERVICES USE ONLY: APPROVED AS TO FORM: illiam de Haas Municipal Contracts Attorney Resolution No. 5869 Item No. 21 May 28, 1998 FoanUrIft 8. Indicate the system to be used for the servbV d meats and the aupeMslon d children durinp meal s wvte period. (SFSP Handbook. Chapter 11 ❑UW Servkee ❑� sre c an eels ElandSetted Pick ' Up � 000W. 10, List site personnel who WM be trnotved to any extent In the meal service. (SFSP Handbook. OM ter 10: ZrT1.E OF resrnON NO. W pasnm sPECM0 R= tEAWE ►ROORM DUM Tainch Assistant 1 ssi st wi thmeal service itp Supervisor 1 Supervise meal service 11. b4cate what provisions will be made torn" service during periods d inclement weather. (SFSP Handbook, Chapter 11) ❑Service ❑will se estmii+d ❑Other. 12 tt the she teeds pt= ty homeless d*lmn, what methods are used to ensure #0 money, food stamps, a, kAft services are not required for mesas? I& Are meals delivered to the site? .......................................................................... ............ QY" ❑ N IF YES. COMPLETE ITEMS 14,15. & IL IF NO. FORM IS COUPLEcTE EXCEPT FOR CERTIRCATION AT 80TTOIL 14. tndsrate the means of commurnicabon with the vendor which will be used to a4ust meal deliveries. (SFSP Handbook Chap. 0) Site Personnel WM Cortad Adminlsbratiw Sltt Personnel Will Cot munIcsb I Staff; Who WM Cw tad Vendor ❑ Dhelly 1lllth Vendor 15. Will delivery be within one hair of the food service period? (SFSP Handbook Chapter 0)...................................... Oyes ❑ N 0 no. describe arrangements within standards p ucribed by kxW left authorities for Wimy and ti**0 d meals urd time d service. IL 0 there is an excess of meals delivered. meats WM be (SFSP Handbook Chspbr al) ❑a R Day ❑21ft n�wrsy ❑ Ufa Vsn6or ❑ 1 CERTIFY that the iaformallon on this fomr Is true and correct to the best d my knowledge. I ceffly that this sloe has been visited and that has the cspabft and facirties for the meal service planned for the number d d4dren antcipated. I k ww that deliberate mix+eprese=9on vftft t DM d Worrnation may result In prosecution under applicable slate and federal statutes. Marsrr ton City of Lubbock SOMWO Offiow d ConaW=V Orion Oaf - •--- •---------�.. see. FM Un MY C7A ❑ . 60aw:-cfz A.�rs«saous o o' rvisor To= Dep w wit Form IW7pwwW or human serv1=2 SUMMER FOOD SERVICE PROGRAM FOR CHILDREN ' FOA uM USE ONLY SITE INFORMATION rh---+ -OM w Food berows SAS two. Im /Vy Ballan er Elementary 766-1047 Acts" of am (su..L cry. sum. ZIP) 1110 4 th wood or op«aoon or Food sw„ " tmoidro r. nz ibrmber of OP. may A saw Feom: through: Gy9ertting 1 2 0 1 ATTACH A &W WITH THE SITE SERVIbE AEA IDENTIFIED ReslderttlalCsrMp Sb Serety Pdmvty i vwd chum other Sib 1. wacate Type of Site: ❑ A. (Ufvkv one to three Moak) ❑ C. (s ft* one to three Mztals) E3E. (urYtng one to three Meals) Nonresidential Camp Site Ser ft Pdma* i winless ChBdren ❑ I3.(aerirlrg one b three Meals) ❑ o.(servlrig one to thou a�eala) 2 List ALL counties served by this alte: 3. A. Is your she open: ❑No 8. Is your eke enrailed?................................................................................................. ❑Yes [D No G. Site EHg>bti'ity timber the pertwar d children dg bie for free sndWmivaed price Moak brt o the WW Hwd=k. Mapter Kj ... 9 8 . 2 % % D. If open sites. submit docwmerttation suppor&V tttiis pert erdape figure (such as census data, school data}. For open sites using school dm fist the schools used to document site eLgWV.. attach formula used by school first. to establish percentage d tree & reduced price u' Adren. Ea?langer Elementary E. For enrolled Mutes, Fa m 1531 will be used to d=mwnt *BgtbMV. (National Youth Sports Pmpram•ieier to SFSP Handbook Chapter 2.) It the enrolled site used sahoot dais. Fist the school used to doamient the site: F. VAW is the percentage of free and roduced-price meals for the site? .................................................... % d. Did the site partiapate In Wevious years SFSP? (SFSP Handbook Chapter 8) ........... . ............. ❑Yes No i U Yes. give name of eontracft orgaNrstion: NA ; f 5. irtonhoring Plan (SFSP Handbook Chapter pry: Ender date of moNmring review to be conducted w1ttftf 6/1/98 — 6/5/981 6/1/98 — 6/26/9 S. Meal SSerAw Period Information (SFSP Handbook. Chapter Il): NWaEA taf T"MS of ME11tS E1.Ifi1eLE pitL DRfN "DE e>:RYED' Brealdast A.M. Supplement Lurch 1 0 0 PJL Supplement Supper is Warffmboe a mnsidsr.d by ohs rrwn t.mv to am 6/1/98 — 6/26/98 WAL SErtYft:E TAM �Et1DtlIIii0 1:NDfiiG '1 11: 1. Do you plan to feed ctIldren under one (1) Year old?............................................................... 8. Uethod of Food Preparation by Contracting OrpaNxation (SFSP Handbook Chapter 0) s+e•�av�a«+ v'rfdi0 Using Iiehool Usk, Food urom Ban> "W4 tl w non site ❑ Centre Food Arthoettt► ® e mm" Melud" War Cw aeb) ❑ oro — i Form 1 3.d the contracting organhaiton Is spoasorknp a G i.. , or other enrolment program that dwps separately for meals, the oar&= organization has read ArIchtnent 6 to tuts WdWonal Assurances for Carnes and Other Enrollment Programs that Ct, Separately for Meats`. and assures DHS that all w-c-raments have been orwIS be meL B. Pubile Release 1.The amtr acting organization wM make efforts to ensure that the local Dews media wine make a public announcement of the program a wW supply them witty a news release: 0 the contracting orgar&atton Is sponsoring a camp or other enrolment program, thus release must corolm ai a minimum, a Est of approved sttes, a Est of the =, rit standards for determining free and reduced price efgtbtiity. and the.toilowing statement -Ile* EM of" ant announces tine sponsomhfp of the Summer Food Service Progra: Income eligiblifty will be based on family size and biome using the Standards for Determining Free and Reduced-Pri Eligibility, Provided by the United Status Department of Agriculture. Meals wM be provided at the site(&) listed. People who a eligible to participate In the program must not be discriminated against because of race, color, national origin, sex, a9 e lsabMW, religion, or poMical belief. Anyone who believes that they have been discriminated against should wmtte Immediate to: Director, Civil Rights Division, MC W-106, Texas Department of Human Services, P.O. Box 149=, Austin, Texas 76714 a or the Secretary of Agriculture, Washington, O.C. 2=W. NOTE: Dlscriminstlon complaints based on religion or pontical bell* must be referred only to the DlnmWr, Chril Rights Division, Texas Department of Human Services.' For all other programs the announcement must oonteln4 at a ff**mmm. a Est of ate approved ohm, and the following statement: w1bo INV"+ofri eenmcft oA 0, FF tsont announces the spormmhlp of the Summer Food Service Program. Mes will be provided at the stWs) listed. People who are eligible to participate In the program must not be discriminated again because of race, color, national origin, sax, age, disability, religion, or political belief. Anyone who believes that they have bet discriminated against should write Immediately to: Director, Civil Rlghta Dlvlston, MC W-106, Texas Department of Hurrm Services, P.O. Box 149=, Austin, Texas 787144= or the Secretary of Agriculture, Washington, D.C. 2MW. NOTi Discrimination eomptalyds based on reilglon or political beliefs nuM be referred only to the Director, Chrli Rights Division, Teas Department of Human Services.' 2. This public release was or wM be published In the too news media s . NAME of um i ovn.eT DATE of RELEASE Avalanche Journal El Editor MM of UM A ovr6,ff CAM of Rfs.EAsi All Radio and TV 5 9. Atta,ch a copy of the contracting organizabon's public release statement as vjm tad t to news media and any other materials used pubGaze the program's availability and r.reQvUemenh. SECTION W- CERTMCAMON (see Form 1b06, Attachment C) I certify that the Information on this application Is true and correct to the best of cry bmwiedge. I eerilly that relmnbumenw4 will 1 claimed orgy for approved meals served to eligible children during the hours they are In attendance at approver! altos. I bx w th deilberate misrepresentation or withholding of IMormation may result In prosecution under appilcab a slate and federal statutm sure-oth" or C MWOV orpvtua*M wi Anaela L. Hobbs _ Indoor Supervisor FOR VHS USE ONLY APPROVED ❑DMM It denied, reason: Yes U to date Form I WS sent to MI). sow.-offow at coves oepanaaoon form lSo6 P"3 Are children charged separately for meals? ............. ................ ............... ........ ............. ................ [3Yes ®No H yes. see Form 1508. Attad ment 8. Q. Do you want to recelve advance payments?................................................................................QYes (D No ayes,1. For Operational Costs?..................................................................................0........ ❑Yes ®fi0 2. For Adrrh*trative Costs?......................................................................................... Oyes ® No D. ff meal service Is slot! do wan! to receive carrxnodities? -preparation. yW ..Aa.......................... Oyes ®No es. 0 yForm 1 f08. AppficiWw and Apreerr:est for C*=wcfts. must be ocmpieted. SECTION N-PROGRAM OPERAMON A.I. SegrWng and Erhding Data d Meat Service. Fern June 1 , 1 9 9 8 ugh A„ „ c t . 7. 1 9 9 R 2. Number of sttex.......................................................................................................... 6 L Ust dates and tonics of SFSP trainino: DATES TOPICS May 11-15' 8 Explanation of Pro r Meal Requirements Inventory, Non ' tas ttha oManlzabm ptanning to contract with a food service aw agernent oampany for the preparation of unI ized meals?...................................................................................... QYes ❑ No If yes. and the contract wM exceed $10.000. attach a Copy of the krvttafon to W Also ' at ad PaN amn ea. 3 27 98 Lubbock Avalnche Journal `/-29f? /o:oo a as ra to es i h00.000 «a7 r rs. a.. puo� or bd fie: Ayes 0No Also. attach a copy of an t t-fty-cyde menu Including of specific menus lo be used. 0.a the organization contracft with a year-round food seMae management company? ..................................... ❑Yes ©No d yes. subs* a copy of your pmm ement procedures. bid. contract and all amwwm*nts. E.Attach a copy of the fetter which has been (or wM be) sent by the organization to the Health Department notifying thorn of Intent m operate a Food Service Ptogram at the slte(s) kmlicated on fhe attached Sate Information sheet (Form 1504 SECTION V-ASSURANCES A.Free Meal POW Statement 1.Tihe contracting 0 ant"tton assures the Texas Department of Human Services (DHS) that an dhlldren at the sites described on the She(s) informatiorh Sheets for the Summer Food Service Program wM be offered the same meals with no physkai segregation of. or otther drsai nk atireh against any dhnd because of rave, color. disability. ape, sm national wigh reogbN or polka] beliefs. No separate Gorge wM be made for any meal except In accordance with attachment 8 of this application. 2.The contracting organization assures DHS that it 4 is sponsoring camps or other enrollment progran • The contracting organization has or wtil obtain family size and ktoome data about 0 ditmn whose meals wm be reported as free or reducedixice: and . • The children datmed as free or reduced -price meet the current family Sbw and khoorr>a standards set by the Untted Stapes Department of Agricuttum. DHS Form 4504. Standards for DetemYnt Frye and Aeduaed d6a EgWty. SECTION li-BUOGET A. Estimate al SFSP costs which wM be chimed for ngntbursement for 1 IL UTED CPM� COST: ESTGp,,,,� PROGP":M Casio , Labor' / az .OG / Frtnpe Seneft Food 7 � G� bo NoMood Supplies UWW" EquOmrtt Use Fee tlerttai of Equipment rta. Fr en'. Transportation tsvdhs: TOTAL 1: g � � 6D NFA _. 9%7W=aDiMtTMTW COl7's PROGUM YEAR COLT `�t� IY. sM&e Ubor m gS (Management. f> amor. Cbrical) Fringe Bermft taMW a Office Space UttT�ties office OOw d 0 EqWpTgwd Use Fee Audit Fees L&9W Few W mi 7rartsportatlon onvopmoyp TOTAL B. tper=w projected ted income to the food service from an sources other than SFSP roimbzmMSr%L kkmt fy exadiy be costs t b hcorrte w Amer.fDo not k=Wa state or federal funds.) NA is of 6 Ca war to u..a AI T SECTION 11i—iJ1AN1►GBAENT PLAN A. aves List adn*dstratnre lpersautal wm wm De nesponstoie for managemem wm mceuts mg ut um arar. tw am mono wm wjpm es - cooks. Janitors or other personnel involved in orr4he food service.) TnU of ►O$ff= NJER W POSMON pf: m FOOD s>zRt m NtOGIR" DUTm qiipprvi cnr Dirpntnr nf City of Tmhhnnk SPER Youth rt-nr of QPQP Monitor Secreja PrgnnnPl Tra i ni na - Mnnaae Pnnr9 Ppr-pnnnpl. Rprnrd-, Tow Crpw"Wt of"Urm'SOCAM SUMMER FOOD SERVICE PROGRAM APPLICATION FOR PARTICIPATION NOTE: Gin as mulch information as posalble. Attach additional sheets N needed; ptaasa Identify each aftsdunent with the name of the contracting organbatiom SECTION i-SPONSOR INFORMATION 1 FOR PM STAFF W&Y I ❑B=Mad ❑AJLSUPP. .❑trvh A. Contractor pa3sUkabon (Check an that apW: t3estdeMisiJNonralderdfat ® National Youth Sports Program ❑ Summer Camp C4nUnu= Calendar School Food Authority ❑ School Y Unit of oerWies that d food service sites are operated daectly by the oor>:ra x. ❑ Prtriis Nw prailt 8. Is you program a year-round program?................................................................................... [Dyes Q No C. Type of Contractor. X7 Public ::nt1ty(=*M): Is yoar agency oonsiderad to be state ownedle..................................................................... ❑Yes ® No Do you deposit yaw pmgmm r6wbmwwt &OcUy into the State T 01qA Y» 12NO ADo you depose your program reimbursement into a beat bank?...................:.... ............................. ❑Nl ®Yes []No SYes, Is k d� deposit?........................................................... ............................... ❑ Y» ®No ❑ Private Nonprofit Or+ganbatiorr-Tax-exempt status established. Attach fever d detemmndm PM SOS d tmcomcampt status from FM Oo you deposit your program mbTbur wAM Into a bcal bw?..................................................... ❑ NJA Q Y» [:]No d yes. IS A dsnd deposii??....................................................... .....:...... ........ ....... ............. ❑Yes ®No D. Does the organtzatioon pmvtde an ongoing year-round service in the aonunuaglytlti d Is lobe served by the Summer Food Service Program(SFSI)?..............................................................................Sy" ❑No d ao, which of the following d=mWances applies? Rssldertiial Camp ❑ Fall= to operate would deny program to a pooram Sevres Wgrant ChIldren ❑ Failure to operate would deny a algniticsnt number of cMmn access to program Does the organbmtion tncehre $100.000 or morn in federal funds yearn/L.................................................0 Yn ❑ No Z. Does the organization receive more than S?5.000 but Tess than $100,000 In federal funds yearit/t........................ [:]Yes ❑ No a.Attach a copy of the audit cave ft last year's program operation or documentation that an audd confo m V wdh SFSP poL-y will be conducted. Inducing ttae date li wm be conducted. dit eASWA'° SUMMER FooD SERVICE PROGRAM FOR CHILDREN SITE INFORMATION (FoMally Rodgers Community Center) (806)767-2702 Flaw 6/ 1 T 9 8 �� H`Vtrou lL 8/ 7/ 9 8 Iweft Wx P P'2 2 P' 2 3 ¢'5 P' I ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED • Reslderttis! Camp Sb Ser by Pdma* ttt3ynw amfl a outter Stb I. Indicate Type of Site: 0 A.(sertV one to thm stale) ❑ C.(s01 tg one to fuss Mk) E@E(Mndrtp ooeb v M anab) Nonrtesid"dw Camp Sb Serav PdmaftyIloeeeless Cwwm , ❑ L(sefft one to em male) ❑ D.(Mrtrtnp one to brM rags). 2 Us1 ALLcoumes served try *Js stte:. Tj» b bnrk 3, A. Is your site open: ElYes ❑ No ..................................................................................................... LIs your site enroibd?................................................................................................. ❑ Yes E]No C. 86.3 % D. a open sites, subrnti documentation sappor*V Oft percentage figure (such as census data: school data). For open sites using school data, 99 the schools used to document she eligibW.. attach k=W a used by Wtool dust. to astaDtnh pera►ntage d free b reduced price d0dn n. McWhorter (95.3) Tubbs (77.3) E. For enrolled sites. Form 1531 wM be used to document *%tbtUty. (Nationaf Youth Sports Pnognun-r to SFSP handbook atiaptnr 2) s the enrolled the used school data. Est ttte school used to document the N6e: F. What is the percentage of tree and reduced Vice meats for the the? .......................... ..................... <. Did the cite participate In previous years' SFSP? (SFSP Handbook Chapter to ................ .......... ..... ®Yes ❑ No N Yes, Qrve name of ambacWV opantaban: City of Lubbock S. Monitoring Plant (SFSP Handbook, Chapter tit): Enter date of mw torhtg review to be conducted wiCttrt: A. RMWo" a ope & FM Fax w«U of ov«saon A / 1 /AR 6, Meat Service Period MfoffnMon (MP handbook Chapter ti): TYPES OF MEALS MM ER OF UXUBLE CHILORErn TC at: 5MVED' REAL aFRYtCE Tt1LE aEoansrrct tt tteo Breaidast A.M. Supplement ct net : 20 rt PJ& Suppterrtent Supper !. Do you Ptah to feed ctftmn under one (1) Year old?.....................................................................[3Yes © No of Food Preparation by CarttradM Organization (SFSP handbook Chapter 1) sso+ranon v 9 tislrt9 Food Sella Wasgeu»ent using Fib hw4l otft Bout site Dcatt i -od from SAYarcouttraets Downbatba that b seff-PM Fmm 13071Pac 9. Indicate the system to be usad for the serving d meals and the stgmvWort a dtttdren & trip meal service period. (SFSP Handbook Chapter III Q se and am c 1 IY7 am Stewd �" up pp u� ❑ 0thw. 10, Ust stte personnel wtto wtu be ktv W to any extent to the meal sarvioe. (5FEP Handbook, Chapter tl): THE OF POsrnON ND. N POSrItOM SPECW C FOOD t:E V= PROORM Dum Center Supervisoz 1 Supervise Meal Service Assistant Center Sup 1 Help to serve meals JTPA 4 help to serve meals Summer Rec. Work r 2 help to serve meals 11. bxr= a what pmvW*rts wM be made for meal sarvloe during periods of itdemerd wuftr. (SFSP Handbook. Chapter fl) busolorMew Serdw 0,Serrice� 1:1tiW1 Be CwweWd 000w. 1L Oft site beds pfr=* homeless && mt, what methods ate used to ensure that n aey, food stamps, arb Idnd servfoes ate trot requitsd for meals? NA I& Am meals deli"red to ttte site?........................................................................................... LjYes ❑ No IF YES, COMPLETE ITEMS 14,1S, & IL IF NO, FORM IS COMPLETE EKCEPT FOR CERTIFICATION AT BOTTOM. 14. kWcate the means oI communkabon with the vendor whiff *2 be used to a4tat meal deVories. (SFSP Handbook Chap. eQ IDPersontwl Wit[ Contsd AdmWsbathre SIb Personnel AVID Corm udcals U Stith. Who Witt C ftd Vendor ❑ f? MCVy whh Vendor 1S. VO deLv" be sunhat one hour of the loud serAw period? (SFSP Handbook. Chapter it) ...................................... ©Yes [:]No d no. describe wrangenat wbttin standards prescrtbed by Ioeal health au:rtorides br deii wy and hoidtnp d meals wd gm of serAW. IL Qf there b an excess of meals deWered. meals wffi be (SFSP Handbook Cdtapter M) Dand Smvd Ined � Qstaw sb plafor Thro= Am poew to dor I CERTIFY that the kJocmabon on thb form b true and cored m the best d my Ietowledge. I oer* that thb site has been VWW and that I has the capability and f e ties for the meal service planned for the number of d9dren an*# abd. I tmow that defiberale n9sre;xwanta5w a wtthhddmg of Wwmabon may result at prwecutiort under appBcabie state and federal sUl tee. me= City of Lubbock of Conaaoor>o Oepaamon Dom - - ---- TM. FM VM JJSE ONLY 1� 69ma", -o+s A.Pss.astrr+ ---- Indoor Supervisor I&=, Form IW 1lS7 of "a n fOtJ SUMMER FOOD SERVICE PROGRAM FOR CHILDREN �Foa ° orZY SITE INFORMATION nmu ..am of Fa d Woods Community Center 806 767-2704 AMMU Of Sea PV"L Coy. Slaw. >P ErskineZenith S Fsnat: 6 % 1 m 9 8 ooa s«,tio. ttu�a�yh: mjdxybT.8 /%7 % 9 8 UmberDrnO�� �2 2 �� 2 3 4� 5 ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residenw Camp Shb Servlrp Primarty mgmd Chum Dow Sib 1. Mdcate Type of Site: ❑ A.(s*m4 one b @use mah) ❑ torwi g one to bee arub) E]Epp one b flute arch) NornddenU Camp Shb S@rAnp Prb vy Homoleu ChImm ❑ 8.(MY4 one b flute mob) ❑ O.perri:g one lob" Moab) 2. Ust AIL cormties served by this she: Lubbock 9. A. 13 your site open:.....................................................................................................El Yes ❑ No B. Is your site orzoDed? ...................... ❑Yes [Duo ..............................................................:............ C. She Eiiglbliity.� Ever the peraentrpe of dh0dren eerie for too ender aduaed price meals for the sb (SFSP Hvd=i4 omprar �.... 9 F _ 7 5 % D. tt open sites. submit dommwntation supporting this percentage figure (such as census data, sdoot dada). For open sties using school data fist the schools used In do=mnt she sWbMty. altach formula toed by school dat. fo estalfth percentage d free b reduced price shitdrm Him- ( qS _ S9, I Parkway (98%) E For enroW sites. Form 1531 wm be used to d=m*M eiigWly. (NWJonal Youth Sports Program -refer to SFSP Handbook Ou ptar2) a the enrolled slte used school data. Est the school used to document fhe site: F. What is the percentage d free and mduced-price meals for the she? .................................................. % 4. Ord the she pa rtdpate In previous years' SFSP? (SFSP Handbook Chapter 0) ..................... ®Yap ❑ No VYes. "name of contracting orpanizabon: City of Lubbock 5. Monhorirg Plan (SFSP Handbook Chapter 111): Enter babe d monttoft mvbw to be wndus:ted wbh% A. Fist we" d oawimn B. First Far W"U d OpwaWn G Aditarw RrAMS 6/1/98 - 6/5/98 1 6/1/98 - 6/26'98 6/1/98 - 8/7/98 & Rfeal Servke Period Information (SFSP Handbook Chapter 11): TI(M Of &MUS MUSEROF tQ.MLF CsLOREu aE tiERYEif' HElut.ttERY1C IM HammMomTO Brealdast AAA Supplement Lunch 100 2: 0 5 P 1: 3 m PJ& Supplement Supper 'iM iy0ltf11a0r:0 W�1a W �v.n.w..uRy ��.w.....,.....� ....,.. �... r. �. .� �--► -,. !. Do you plan to feed children under one (1) year WY? ....................... .................................. 0........... QYes low eviod of Food Preparation by Contracting Orpanbz*m (SFSP Handbook Chapter 0) vW4.d9 Scrod Us&g Food Servke lfane9eaxnt n on Sits ❑ Cenbrs] Kitchen ❑ Food Aworlly ® Compantr pnduda U Year Copt IJAV Psh tim*rofh 0mmnbatfoa Aar b S4* Form 15070* 8. k4cata the system to be used for the saMrp of meals and the sWervfsbn of dak en &ft meal wvloe period. (SFSP Handbook C t meter in 10 ❑Meat ❑ and are Gtvm Yeah Q wW Pbck Up Msds ❑ Over: last one personnel who wW be VMWed to any extent an tie meal saMce. (SFSP Handbook Chapter IQ: Tnu of PosrnoN WM I(Pasnm 9P£CW C FOOL? a£RV= MOOR" CUM Asst- Center Sup 1 Supervise Meal Service Summer Rec. Worker 1 help serve 11. Indicate what provisions wm be made for meat service during periods of krdement weather. (SFSP Handbook ChapW 1) ®busooir" Meal Service Service ❑ Be taheet ld ❑Other: 12 I tine site feeds primarily homeless ch8d m whet methods am used to eruure that money, food stamps, orkWdhd services are not mgt*W br meats? 13. Are means de6verod to the sft?........................................................................................... ®Yes ❑ Nc IF YES, COMPLETE ITEMS A 15, & IL IF NO, FORM IS COMPLETE EXCEPT FOR CERMCATJON AT BOTTOM. 14. indicate the means of canxminication wtih the vendor which wM be wed to adjust meat deliveries. (SFSP Handbook. Chap.11) M Pasonsef W!n Coetact Adminkbativa Sib PertanrW WM C mmurico ®Strait. Who WID Contact Vendor ❑Qhcdy WHh Wndor 15. Wit[ deWery be within one hour of the food service period? (SFSP Handbook, Chapter t)...................................... ®Yes ❑ Nc U no. describe anwWments within standards prescribed by IoW health authorities for deanery and hotdnp of meek unfit time of service. IL a there Is an ex0m of meab delivered. meek w0l be (SFSP Handbook Chapter IQ Q Senvd the Ned Doy Q � 'Awty he a �toY.ndor aovw-. t CERTIFY that the inforrnatiorr on this form b bve and correct to the best d my bwwtedpe. f certify that ft site has been vfsited and that t has ttre capabnitY and faciRties for the meal sarvice planned for the number of children articipWad. f meow that deliberate misrepresentation a wimhol&V of information may result to prosecution under apple able state and federal stables. 1"�'City of Lubbock g;qn coGor:racsnp orrvrttraon Don �---- h%. FM CHS USE O LY [3Awoved OWd4mam 1>0. Dow Indoor Supervisor Tam Orpartr�rnt Y�"�. Form 1507�1a�ry 1Q97 Of r'`=!an Sere"s SUMMER FOOD SERVICE PROGRAM FOR CHILDREN FOA 011S tISE OIQ.Y ... SITE INFORMATION _=, y R ; u ..rma of Food So W—' sift No. (ram NQ CommunitySimmons Center (806)767-2700 of S" (sv"?. calY. Stan. ZAP) 23rd & OAK F a o4«aaon a Food s«,dn VWAWyhT '9'n�rtrr N=bef87 � �'2 2 2 3 ��o• 5 1' s•� ATTACH A MAP WrrH THE SITE SERVICE AREA IDENTIFIED Rssldefdisl Camp Slbr Snhv p v vy f,4p w 00dM Ww slb I. Induxte Type of Site: ❑ L(Sofvhv ON to Mm malt) Q C.(.eMnp one to b" mak) aye to Im mail) wottrakkathd Carty . 6b Serft Prlmv2y Iicmelra ChBdna ❑ L(:eft ofr to 2M mods) ❑11D. *rrw* one m duce meek) . 2. Ust ALL counfts senrod by aft: �d 3. A. is your aft open:....................................................................................................®Yes []No Lb your a}te enroDed?................................................................................................. Elyse ®No C. Site EB�IbIIity: Erfteerthe peroermpe d d�0dtert e6pble mrfres aadlorredixed price meals forthe siDe (5F5P11sndbaok, Chaplet �.... _.. ���K D. If oven aloes. submit doarmentabon supporWV ttfs percentape fpum (such as cemn data.:drool data). for open slurs ustnp school data. Est ow schools used to docunwnt ab eGgibIIity.. smach tonnula used by school &L to esUbilsh peexr ape of free A reds price d0dren. Posey Elementary E. For enrolled sorts. Form 1531 WM be Used to dommar t etlgWty. (National Youth Sports Progwmfefer to SFSP Hvxnxx*. Chapter 2.) C the enrolled site usad school data. fat the school used to doc n wfd the the: F. What b the percentage of Tree and reducedVice meads for the sb?................................................... % 11 4. Did the alto participate In Vevb= yearn SFSP? (SFSP Hornbook Chapter It) ..................a . ............... E]Yes ❑ No Id Yes. Dive dame of Ong orgarambon: City of Lubbock S. Monitoring Plan (SFSP Handbook. Chapter IM: Enter date of moNtwtV review to be conducted wSrioY A Wa W a Ration a FourWMksaOpacamnC.Auocaonatiiwrs6/1/98 — 6/5/98 IFig6u /1/98 — 6/26/98 6/1/98 — 8/7/98 6. Meal Service Period Worrnation (SFSP Handbook. Chapter 0): T"4M of UE= MAMER of E3.rt3lat.E CHLO EN To aE SERVED' arM vvty= Tw BEGROM MC94 Breakfast . A.N. Supplement Lunch 220 11:Spam — 1:.7Opm P.N. Supplement - Supper t: Do your plan to feed children under one (1) year old?..................................................................... Yes [ON* eshod of Food Preparation by Cor�rac8np Orpanttabon (SFSP Chapter tlj ,.rt v� WingSchoot FoodSerriaWnagtmett t1s>upt�t�W= ikon sits �Cetttral then �( Food Authority �Comparttr M w YearCofttrsets) Form 13071PIK G. tt4cde the system to be used for the servtnp d meals and the supetvWon of dlridren during meal service period. (SFSP Handbook, Mi;ur 11, ❑mofe m rvited*ce ❑ Chndren and are Ginn Meat: fl anted Pick W Nags ❑ O0W. 10, list arts personnel wno WM be tmotved to any extent in the meal service. (SFSP KandbooK Cr apur ai): Tn1E OF POSMON m et rosrnw SPEC= FOOD SERV= PROOPAM DLTM Center Supervi or 1 Supervise Meal Service Asst. Center Sup 1 Help to serve meals JTPA 4 Help to serve meals. Summer Rc. Works .2 Help to serve meals 11. kdcate what provisions writ be made for meal service dw*V 4xiods of kidete we&w. (SFSP Handbook Chapter 0) ©Service ❑WMBeCw=eB*d La. jOew. 12 H the site feeds primarily homeless ditr . what methods are tned to ensue ft money. food stamps, or h4cind aetvioes are not req*ed for meats? II& Are mesh delivered to the site?........................................................................................... Ely" ❑ No IF YES, COMPLETE 11TEMS 14,15, k 1L IF NO, FORM fS COMPLETE EXCEPT FOR CERTIFiCAT10N AT BOTTOM. 14. kxrcm the means of cunra rk abon with the vendor which wM be used to adjust meal deliveries. (SFSP Handbook Ctwp. 8) Site Personnel Will Untad Admlaistratiw Sibs Personal Will Commumlcate ®Still, Who Writ Contad Yar4& ❑Dinctty iftb Vwdor 15. WM deWM be within one hour of the food service period? (SFSP Handbook Chapter fl)...................................... ©Yas t_l No a no. describe arrangements within standards presabed by local health authorities for de0my and holding d meats unA time of service. 16. If there h an excess of meats delivered, meals will be (SFSP Harbbook, Chapter UD StcRW ❑ caveRd Cox � Dy ❑ Brie ft ❑ wq Ito Yendor ❑OVW. 1 CENTiFY that the Mforrna&M On fhh fix= Is true and oorred to fhe best Df nny imowiedge. l certify that thh site has been MSW and that n has the capWft and faa rties for the meat service ptanmd for the number of &Mren armdpated. I know that &Mxwate Misrepresentation or wthhot&V of Wormation may result in prosecution under ap;Xmble state and federal statutes. N.rn. City of Lubbock sue+-orrdw a Unni v oryanwow ["60-orortroM0ra WMorvm4 ��� Indoor Supervisor FOR CJ ❑Deaied.ttiaso L as USE To ONLr Sgnaaara-ONS RaDrasar7strr* � tans Drpartnrx < .�� qw arsm Of "Wrap " SUMMER FOOD SERVICE PROGRAM FOR CHILDREN ''F UW ONLY SITE INFORMATION ttx . �x,:��- .. R '..rna d Foos fise"M sm Nphoro 1+0. 0= AQ CnnnPr Rawlinas Community Center_ 1 (806)767-2704 /98 Va wW 8/7/98 : I OWN tx T T 22 T 2 ATTACH A NAP WITH THE SITE SERVICE AREA IDS Rssfderdisl Camp ` Slte Servlrg Prttarlfy tilww CNidrnt liteSi#e 1. Indicate Type of Site: ❑ A.(servtrg ow to thra mats) ❑ C.(wft one to thra ate) ElLOoftw ln�rea to #Mate) Camp Sits S+rAv Primavy H=elea Chum ❑ f3.(sertrimQ one to three mats) ❑ D.(eeMrsp one to three e�ak) 2 Ua ALL oounbes served by fibs aft: Lubbock �r� U 3. A. ks your site open: ...................... I ............................................................................... GY" ❑ No & Is your the enrolled?..........................:..................................................................... [-]Yoe ®No C. Sity oapw ir.... ' 96 .9 % 0. &A the schopen ols used domownt she shad orcentap � (=hoot dhL to eslaD�s2� percentage ndu� chAdren. Harwell Elementary E. For enrolled sites. Fomn 1531 w0 be used to dommxft e>ipWty. (NatforW YoM Sports Program -refer to SFSP Handbook. Chapter p it the enroUed site used school data. 69 Me schoot used to doamxw:t the site: F. What Is"percentage of tree and reduced -price meals for the sits? ................... % 4. Did the alto parWpate In previow yuW SFSP? (SFSP Handbook Chapter 18).............ir........................... ®Yss [:]No S. 0Yes. VWS name of conbactinp organhag=_ City of Lubbock Mon>tarsnp Plan (SFSP Handbook Chapter GQ.* Enter date of awhoft review to be oortdut ted w *,C A. Fist Ws" a e. Fist FW Wei a oP@Mwn G A* ttsonN FW wrf 6/1/98 - 6/5/98 6/1/98 - 6/26i9 6/1/98 - 8/7/98 G. Meat Service Period IMorrnaton (SFSP Handbook Chapter 11): TYM OF MEAL$ MMM OF CJ=LE CH LOREM Yo OE 3MVEV IWAL s>: t= TM � Et31�01lMG EMatNG Breatdast A.M. Supplement Lsmch 60 11 :x P.M. Supplement Supper ■ = WOMM M a cor i+gur10 Qi bowaa In OR s Ivy Y w fi3w- ....i w.......... !. Oo you plan to feed chBftn under am (1) year totd?.....................................................................DYes © No LN Method of Food Preparation by Ccntracdnp O manizfon (SFSP Handbook. Chapter u) s•a + Vii0i0 L4 "School Uft Food SmW Wre9emad tW% hh to IlorrProdt ❑ on sne ❑ Central Iat m 1 0 Food AdMr!!y 91Company Qndw" A9 Year Coatret:ts) ❑ oww n5on w Is Self44" Form IW?IPat 9. indicate the system to be used for the seMng of meals and the supeMsbn of dtdren during meal service period (SFSP Handbook, Cttiapter ll, ❑maat Stake ❑ and ue Gunn Yeafa Una UpPlcic Up Yale D OttMr: 10 . List Brie personnel who wm be Involved to any extent In the meal ser4m. (SFSP Handbook, Chapter 11): T= OF POSMON No. N POSri= SPECVW FOOD SMIM PROOPAU DUMS Center Su ervi or 1 Su ervise.Meal Service Asst. Center Sup. 1 Help serve meals JTPA 4 Summer Rec. Worke.r 2 Help serve meals w 11. lndcate what provisioru wM be made for meal service during periods of inclement weather. (SFSP H&x book. Chapter 0) s erviol lose ❑wm Be CmeWd ❑other: 12. ff the site feeds pfmarity tameless dWmn what methods are used b ensue that money. food stamps, or tend services are rat roctuired br meats? 19. Are meals delivered to the site?........................................................................................... Ljyes ❑ No IF YES, COMPLETE ffEMS 14.15, & 1 fi. if NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 14. irdftate the means of eammunicabon wtth the vendor which wM be used to 14ust meat deliveries. (SFSP Handbook Chap. 9) Sf6e Personnel will CwW Itdffanh ttfve Sh Pvr:onrkf Wm Communicata IDS W%who wm eonted vendor ❑IwsdlyWb YKdor I& WID delivery be within one hour of the food service period? (SFSP Handbook Cnaptar1)...................................... ©Yes ❑ Nc a no, descrbe anangements wtttm standards prescribed by burl heft autta tbes for derrmy and hoidmg of meals until time of service. IL If there b an exam of meab defrvemd, meats wM be (SFSP Handbook. thapter M) , Q Served � Day a d t* Sberay a etc YKdor ❑ t CERTIFY that the information on this form b true and coned to fie best of my knowledge. I cerdly that fhb site has been visited and bat I has the capabMty and facrUbW for the meal service planned for the number of chUmn annlickmte& i brow fiat ftMxwain misrepnW nUlJW a whhhoi&V of intortnation may rewft in prnsecation under applicabb state and federal shWas. Nam City of Lubbock or cawamg omw tta m Dair Indoor Fm ❑ Appoved ❑ova USE 1ti. ONLY 11. lndcate what provisioru wM be made for meal service during periods of inclement weather. (SFSP H&x book. Chapter 0) s erviol lose ❑wm Be CmeWd ❑other: 12. ff the site feeds pfmarity tameless dWmn what methods are used b ensue that money. food stamps, or tend services are rat roctuired br meats? 19. Are meals delivered to the site?........................................................................................... Ljyes ❑ No IF YES, COMPLETE ffEMS 14.15, & 1 fi. if NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 14. irdftate the means of eammunicabon wtth the vendor which wM be used to 14ust meat deliveries. (SFSP Handbook Chap. 9) Sf6e Personnel will CwW Itdffanh ttfve Sh Pvr:onrkf Wm Communicata IDS W%who wm eonted vendor ❑IwsdlyWb YKdor I& WID delivery be within one hour of the food service period? (SFSP Handbook Cnaptar1)...................................... ©Yes ❑ Nc a no, descrbe anangements wtttm standards prescribed by burl heft autta tbes for derrmy and hoidmg of meals until time of service. IL If there b an exam of meab defrvemd, meats wM be (SFSP Handbook. thapter M) , Q Served � Day a d t* Sberay a etc YKdor ❑ t CERTIFY that the information on this form b true and coned to fie best of my knowledge. I cerdly that fhb site has been visited and bat I has the capabMty and facrUbW for the meal service planned for the number of chUmn annlickmte& i brow fiat ftMxwain misrepnW nUlJW a whhhoi&V of intortnation may rewft in prnsecation under applicabb state and federal shWas. Nam City of Lubbock or cawamg omw tta m Dair Indoor Fm ❑ Appoved ❑ova USE 1ti. ONLY Tans Deprin x d human Servicm SUMMER FOOD SERVICE PROGRAM FOR CHILDREN SITE INFORMATION ..a,» of F•ooe Sov+o. Sant Clapp Park AWr"s a SU (So"?. fW. . Zln 46th & Ave. U Number cf Op• ''FOR DM USE OWY (806)767-3706 22 V 23 V 5 ATTACH A MAP WiiH THE SRE SERVICE AREA IDENTIF= Rnfde lkI CBm Sib stag Pafrs3 * mw� Chum odw it b 1. Indicate Type of Site: IDA.(s fft one to am a.h) ❑ C.(..* ores to titre asap) ©E.(serrirrg am to ttsrse mail) Worduldelod Cam Sib semg Psfes- a' Norss,issi Chum ❑ e om*,g f tee mans Moak ) ❑ a(srMrg puss m tfsns awik) 2 UstALL counties servedbyOft she: Lubbock 1997 8. A. Is your site open:.....................................................................................................©Yes ❑ No S. Is your she enroAed?................................................................................................. Des Q No C. Sibs E3igtbmty: Ensar the per>:erstaQe of c3siidren et,�+e tior tree arxQor tsdueed prtas aseauis for trio s� RFSP tianctbook, ctaapter t} ... 85.5 % D. If open sites. subunit documentation supporting ft pementage figure (such as oerssus data school data). For open sttas using school darts. W the sctxxgs used to do urnent she eliglb r, attach formula used by school 64 to establish percentage of free & reduced price d-Adrea Brown E. For enrolled sites. Form 1531 will be used to doamwm e%Wfty. (NatlorW Youlh Sports Prng woorefer to SFSP Handbook Chapter 2) tf the enrolled site used sdhool data. fist the school used to dof xm*nt the site: F. What Is the percentage of free and reducadVioe mealsfor the sloe? ....................................... ... .... % 4. Did the a3te Participate in previous years' SFSP? (SFSP Handbook Chapter Q)....... .... ........ ...�l.................. ©Yes []No N Yes. on reams of contracting organization: r i t- V n f T. i i h h n r-k 5. MonhodM Plans (SFSP Handbook. Chapter pik Enter date of rnoNto ft review to be conducted wMft A. Fist We" of Op VWM s. FM Fair w.tU of Qpvz: om C. A*Xxntf FW-w rt 6/1 /98 — 6/5/98 1 6/1 /98 — 6/26LQR_ r,1 11aA _ 8/7/98 6. Meal SerAce Period !reformation (SFSP Handbook Chapter ll : Tym or lwj" NUMBOOF EUMILE CiOe.teREN To fDE SERVED IfEa1t EERYlCE TYiE tiEGl10aH0 iT3IDraa0 - Sma)dast . A.M. Supplement Lunch 120 11 :3,am — 1 - 05 m PAL Supplement Supper -is= a*ORAam" A W.iak+... W v W w...........r ......� _......� -.. -- --- e-" -- • _ !. Do you plan to feed children under one (1) year old?.....................................................................QYes El No & Method of Food Preparation by Contracting Organization (SFSP Handbook Chapter II) "C4—"pwzwn vOMW Wing t;choof lbbv Food se wke Uft Prints Nou►*roflt M Cke Site ❑ cetstral muhene ❑ Foos Acrtisoruy Compuuey pndudes I Ul liar Corssr»cbs) _ ❑ QKgsnt>slious es:t Is Self Fom+1307ps S. tndcaW the system to be used for trte serving of meals and Me sopervtslon of dttsdren durinp Meat service perkxL (SFSP Handbook. Chapter n Meal servS00 and are Given Moab Eland P4k Up UWs 000w. 10, t3st stte personnel who ww be atvoW to any extant In the Meat servioe. (SFSP Handbook Chapter u): TITLE OF PCSMON N0. w Posnm SPEC= FOOD MVICE PROGRAM OUT= Center Supervisor 1 Supervise Meal service Summer Rec. Worke 2 Help Serve meals 11. kxft to what provisions wW be made for meal serAw during periods of kciemertt weather. (SFSP Handbook Chapter 1) Wloor Ya d Yost Service SQrviCe ❑ Yi m fie clam d ®Qthw. P e p d at C l a p p P a r t g ii C1 u c P 12 a the site be& primonly homeless ct>adrm what methods are used to ermn that money. food stamps, orh4dnd sentioes are not roq*W for Meals? 13. Am nwah deWered to the tite?........................................................................................... Ely" ❑N, IF YES, COMPLETE ITEMS 14,15, & IL IF NO. FORM IS COMPLETE EXCEPT FOR CERTWICAMON AT BOTTOM. 14. kxrcate the Mears d corr mogedon with the vendor whkh wM be used to adjust meal deWerlm (SFSP Handbook Chap. 1) Site Personnel Wm Car ad Administrstiw Ste Ptrsanw WM Commun Bate 13 Sta% Who WW Cor>bct Venda ❑ Oit+ectly Whh Vendor 1& wm deovety be wltrun one hour d the food wrvke period? (SFSP Handbook. Chapter Il)...................................... Ely" ❑ u tt M descxtbe anangements within standards prescribed by local health auettorbies for deWery AM N*IhV of meals Undl time of service. 1tf. N them b an excess of Meals debarad, meals wM be (SFSP Har>ebook. Ch:pta tM Stared In Yador. Ornd y S❑ t CERTIFY that the kdormation on tih farm b true and correct to the but of my knawWge. I cerdfy that 1* aft has been vbhed and that has tide capabMty and faairties for the meal service phmrod for the number d dAdren antidpated. I know that deliberate misrepresentation c wfthhckUrV of frdonnation may result in prosecution under appUmble state and federal statutes. Nrm - City of Lubbock ' � a cona,canp oeyanit�son '"_'�'�_ FCA I ❑ ❑ . tm OwIf --- 7 7 - - s�a,►;.��s A.v�aM. om ?1R.i.�tr1RK ; 0 k Ave. G. Lubbock: `FCC f9a04 j Sf�so� Savuq Xarsc;e3 3a:rs FAX Phouc: Fax otiose: CC: Date. N=bcr of pag= including cover shr_s: Phoce: 306 i6&1223 Fax ohone: 306 766-12"— RENLARKS: ❑ U ..=t b►For.v= =cw Cl Pgly ASAP Q Puss: co=cut i APR=24-98 THU 01 :28 PM ARAMARK._! ? ZD 766 1222 P.02 City of Lubbock Purchasing Department 1625 136' Street Lubbock, Texas 79401 Attached are the official free and reduced meal numbers for the School Year 97-98 for Lubbock Independent School District. 3 � �(, -114r W� � � Barbara Flanagan Director of Food Service 04-24-98 13:00 RECEIVED FROM:766 1222 P•02 CAMPUS Free Reduced Enrollment Arnett 231 24 266 Ballenger 344 45 396 Bayless 371 100 806 Bean 529 32 574 Bowie 73 47 289 Bozeman 283 22 309 Brown 362 82 519 Dupre 251 42 333 Guadalupe 195 19 253 Hardwick 151 58 593 Harwell 399 35 448 Haynes 37 25 292 Hodges 465 72 594 Honey 29 14 464 Hunt 195 15 220 lies 216 36 301 Jackson 341 20 377 McWhorter 462 50 537 Maedgen 173 44 410 Martin 258 41 308 Murfee 15 4 267 Overton 143 64 281 Parkway, 189 10 203 Parsons 190 60 545 Posey 253 17 270 Ramirez 611 49 722 Rush 184 91 597 Smith 20 1$ 779 Stewart 100 70 328 Stubbs 217 60 387 Tubbs 220 42 339 Waters 100 51 608 Wester 180 61 384 Wheatley 232 10 247 Wheelock 214 51 389 Whiteside 56 37 732 Williams 92 40 339 Wilson 127 64 458 Wolifarth 325 50 387 Wright 106 14 145 Alderson 331 33 396 Atkins 221 60 546 Cavazos 538 79 794 Dunbar 429 56 581 Evans 139 51 839 Hutchinson 439 91 860 Irons 36 18 746 TAAP 80 9 109 Mackenzie 175 71 593 Staton 360 80 865 S. Wilson 194 100 633 Total Percent New Directions 75 10 99 • : ; . = 8 _ `' .. 85.9% Project Intercept 118 10 175 i28731'l0 Homebound ' . = 0 Matthews 137 0;0 JJAEP 14 04; Coronado 189 72 1,515 261 ` •.': Estacado 536 64 .. _ 766 :: ; -600. ''. 83 6 Lubbock High 533 128 1,755 Monterey 338 76 1,539 414 '.26:96% All District 13.664 . ; 2,694 = ' _,°29,64 •16,378.: ; '-55:3% V /I Unww SL ! t7 LOOp 239 4 6• S aSL 40 1. Hodges/Clapp 46th & Ave U t9ssc v 2. Ballenger Elementary 1110 40th 3. Pawliw 40th & Ave B � sr. `� 4. Simmons Community Center 23rd & oak 2 •3 1 S. Trejo Supercenter 3200 Amherst 6. Woods Community Center Erskine & Zenith Srxn7 Note: Each circle has a 1 mU radius a Loop 2w aarSL e < e 9aYSc New Release FOR IMMEDIATE RELEASE: Contact: Robbie Johnson, 775-2685 The City of Lubbock is pleased to announce the Summer Food Program for Children, sponsored by the Texas Department of Human Services. This program is provided through the City of Lubbock Parks and Recreation Department, under the direction of Civic Services. The program will provide a nourishing noon meal to youngsters age one through eighteen. Meals will be served Monday through Friday, beginning June 1 and ending August 7, at six locations. Call 775-2685 for more information. * Ballenger Headstart - 1110 40th - Meal Service, 11:05am Copper Rawlings Community Center - 40th & Ave. B -Meal Service, 1 l :20am Clapp Party House - 46th & Ave U. - Meal Service, 11:35am Mae Simmons Community Center - 23rd & Oak- Meal Service, 11:50am Woods Community Center - N. Zenith & Erskine - Meal Service, 12:05am Maggie Trejo Supercenter - 3200 Amherst - Meal Service, 12:20pm Some of the City of Lubbock Programs receive Federal Funds from the U.S. Department of the Interior. Accordingly, all its programs and activities must be operated free from discrimination, on the basis of race, color, national origin, age, religion, sex, disability, or political beliefs. Any person who believes he or she has been discriminated against, or who would like further information regarding the prohibition of discrimination should write locally to: Mary Andrews - Personnel Director, P.O. Box 2000, Lubbock, Tx 79457; or to: Department of Interior Director - Office For Equal; Opportunity, U.S. Department of Interior, Washington, D.C. 20240. * Lunch served June 1 - June 26 CITY OF LUBBOCK MEMO TO: Mark Keefer, Supervising Sanitarian FROM: Angie Hobbs, Indoor Supervisor DATE: 4/13/98 RE: Summer Lunch Program The City of Lubbock will once again be participating in the Summer Lunch Program for Children. The program will begin on Monday, June 1, 1998 and will end on Friday, August 7, 1998. Following you will find the meal service times, sites and addresses: 11:05am Ballenger Elementary - 1110 40th 11:20am Rawling Community Center - 40th & Ave. B 11:35am Clapp Party House - 46th & Ave. U 11:50am Simmons Community Center - 23rd & Oak 12:05pm Woods Community Center - Zenith & Erskine 12:20pm Trejo Supercenter - 3200 Amherst TOM Dep""Ov. •Y••Yi•i••r• SUMMER FOOD SERVICE PROGRAM FOR CHILDREN CIVIL RIGHTS QUESTIONNAIRE L CtWiL FOG= Ater OF 19U . rem 18WAtbcfk a.&. A.1. Es ti au, by raoWathrik group, the ourW*r of children that wM particfpffie In the program at each she. If the program a of emraf drip sessions, spectty the projecm sucnber at cnuaren oy axe ano am of session: (roan. of". school. stew. ov-) gem KAWa• WANDO Rawlings community Center 6 6 , 35 1 605 76 Cla Park 55 400 Simmons Community Center 3 0 783 237 87 Trejo Supercenter 7 *18 45 1 Ballanger Elemenatry 1 10 1 1* 7 27A 136O 767 2. Describe howthis projection was made (LA.. ntsurnames B. Does.�the organization !have "elkmernbenship rvquiremants which result In the denial of program benerns; to ic'g'our7............................................................... 0Yes If yes, desertbe those raqukernerft C. What ebris wkl be made by Me organkationto amtacact minorkyand grass roots orgarftfons about the opportunity to participate In to pros publicity, psa, fliers, word of mouth D. What other outreach Stops Will be taken by the organization to ensure that nunork9es In the area trorn which It draws Its attendance v4 an equal opportunity to participate in the program? E Has any federal agency notified the organization of non compU= with the Civil Rights act of 19647 .............. ❑ Ye: I It yes, give detalfs indading dates, sarnes, and results: L REHABIUTATION ACT OF 1973 (Section Wq A. Does Me contracting organization have any policies. practices. or archhemnl barrier.; that &A deny. or f=ourage participation in the program or smptoyment by the contracting organaation because of disabiety7 ........ O Ye: If Yes. ezptatn: f ISM / Ataefr.r pa B. Aye then any porkies or practices that result In tmegW trestment in the dernmry of benefits or services to pslticipania, applicsrtta, or ernpk7 a aecordav to dkablit)?.................................. [Dyes tf Yes, explain: C. Dose the contracIft organization ernploy 15 or nxx peoplo7..:...................................... ®Yes ❑ tf yos: I. Eater the mine and trite cf the t, r, r, ristor who will work with DHS to ensure that Section 504 mquirernenis are met • • Itrrr Tlu Mary Andrews Director of Personnel ■ I I 2. Has titre organization extablrahed grievance procedures that k=porate appropriate due prncesa standards?..................................................................... ® Yes ❑ 1 If yes, do these procedures provide for the prorropt and equhable resolution of complaints that allege an action prohlbked by Section SN of the Rehab+lrtaataon Act of 19737 ......... � Yes ❑ f 3. Has the contracting organization b*ni*d the public of the right to fie a oornplatrd and of the fling prti+cedum?.................................................................. ®Yes ❑ t Hyes, briefiydescribe how the public was tnfvi, d: The section 504 information is published in the Leisrue Guide and in other city publications D. Has the organtWon taken steps to notIfy employees. participants, and appfcaruts that ftre organization ^ does not discriminate on the basis of disability? ..................................................... El Yes If yes, do the people notified indude tMse with impaired vision or hearing and members of unions or professional organizations holing caileolve bargaining or professional &;reernents with the contracting organization? ........... ® Yes ❑ h If yes, briefly describe how they am notified: They are notified through the Employee Handbook, in all recruiting publications, and on the application E. Do on organtzation fomYs, publications. and tscruitrrient materials which tMorm'the public of program benefits and employment opportunities contain the assurance that the organtzatmndoes not discriminate on the basis ofdsabfl'rti/1......................................................................... .........� Yes ❑ h tf no, tnditcate steps being taken to comply with Ws mquirement F. Does the organization have a procedure to ensure tint the remedial or Corrective action has been or will be taken It non-Compliancedi with non scrimm inaiton requireents is found by DHS. USDA, or the contracting ®Yes 0 F Organization kwff?.............................................................................. ff yes, e:cptain: All non—compliance complaints will be handled through the Personnel Department Tony Or�+irinrnr , * tsavuta�,e SUMMER FOOD SERVICE PROGRAM FOR CHILDREN ahn"w CIVIL RIGHTS QUESTIONNAIRE L CIVIL RIGHTS ACT OF 1964 A.1. EsMr, =tn. by me iallethi c ofotrp. the number of children that will vertici=e in the program at cash site. If the prwrasn co of seJerai Camp fa scions, specify file projected ntaAber of enuioren oy site ana Wn of cession: CrM (resew of she, achoo4 nmG. otr-) AiIERlCAN MAN AtAsxAN KATIVE' r� ELLAM001 ZLACK NWARC wrcT 2 2. Describe howthis projection was made (Le..based on cornparaisve enrollment in shes. cbservation of students. student sumarr es, B. Does the organization have speclfic rnambership requirements which result In the denial of tr— program benefits to specific grmrps?............................................................... ❑ Yes I: If yes, describe these requirements: C. What efforts will be rnade by the organization to contact nftrhy and grass roots organb atirns tWut the opport Alty to participate in fhe prop publicity, psa, sliers, word of mouth D. What other outreach stops vAl be taken by the organization to ensure that minorities in the area from which it drays its attendance w91 an squat opportunity to participate In the program? E. Has any federal agency notified the organization of non-compliance with the Civil Rights act of 1964? .............. ❑ Yes it yes. give detats including dates. narnes, and results: IL REHABILITATION ACT OF 1973 (Section 504) A. Does the contracting organization have any policies. practices, or architectural barriers that limit, deny. or discourage participation In the program or employment by the eommedng organaation because of disability? ........ Dyes I If yes, ezptain• Frew teoe 1 As�.er,..ri A B. M there any poticiea or practices that rem In unequal bostrnsnt In the doGvery of bewefcs or Mrvices to pa tiaparits, appticertta..or ernpioyees aocording to disab):W ................................. ❑Yea E3 If Yes, eVlafn: C. Does the Ong crpsnlzatbn erMby 15 or more people? ..:............. .......................... ❑ Yes ❑ K yes: 1. Enter the name and title of the coordinator wto will work with DHS to ensure that Section SU requirements are rrie: TM Mary -Andrews Director of Personnel 2. Has the organization establistied grievance procedures that incorporate appropriate due process standards?..................................................................... © Yea ❑ I If yes. do these pnoceduras provide for the prompt and equitable resolution of corttah is that allege an action prohibited by Section 5W of the Rehabilitation Act of 1973? ................. ❑ Yes ❑ b S. Has the contracting organization Irdortired the public a the tight to file a Complaint and ❑ ofthe filing prooedum?.................................................................. DYes h If yes, briefly describe how the public was Intarned: The section 504 information is _published in the Leisure Guide and in other city publications D. Has the organbaton taken steps to Wily ermpleyees, participants, and applicants that the organization does not discriminate on the basis of d'sabitity?..................................................... © Yes L It yes. do the people notified Include those with impaired vision or hearing and members of unions or professional organizations holding collective bargaining or professional agreements with the contracting organization? ........... ® Yes ❑ h If yes. briefly descnbe haw they are notified: _ They are notified through the Employee Handbook, in all recruiting publications, and on the application E. Do all organization Corms. publications, and mcruitrnerd materials which krtform the pubrrc of program benefits and employment opportunities contain the assurance that the "organaationdoes not dscri W=s on the basis ❑ otdisabirnyt...................................................................................[19 Yea h ft no, indicate steps being taken to comply with this requirement: F. Does the organization have a procedure to ensure that the remedial or corrective action has been or will be taken it noncompliance with non discrimination requirements is found by DHS. USDA, or the Contracting organization Itself?..............................................................................� Yea ❑ F ftyes. explain: All. non-compliance complaints will be handled through the personnel Department Resolution No. 5869 Item No. 21 May 28, 1998 SUMMER FOOD SERVICE PROGRAM AGREEMENT STATE OF TEXAS COUNTY OF TRAVIS The Texas Department of Human Services, hereinafter referred to as TDHS, WWI City of Lubbock Name of Organization hereinafter referred to as the contractor, do hereby make and enter into this contract, as required by the National School Lunch Act (Section 13) and the Summer Food Service Program, hereafter referred to as the SFSP, Federal Regulations (7 Code of Federal Regulations (CFR], Part 225). L MUTUAL AGREEMENTS The Parties mutually agree: A. If the contractor fails to provide services in accordance with the provisions of this contract, the Department may, upon written notice of default to the contractor, immediately terminate the whole or any part of this contract and refuse to pay claims for reimbursement. Such termination and/or refusal to pay claims for reimbursement shall not be exclusive remedy but shall be in addition to any other rights and remedies provided by law under this contract. B. In federal and state laws or other requirements are amended or judicially interpreted so that the continued fulfillment of this contract, or the part of either party, is substantially unreasonable or impossible, or if the parties are unable to agree upon any amendment which would therefor be needed to enable the substantial continuation of the services contemplated by this contract, then the parties shall be discharged from any further obligations created under the terms of this contract, except for the equitable settlement of the respective accrued interest or obligations, including audit findings, incurred up to the date of termination. C. This contract may be canceled by mutual consent. However, if such mutual consent cannot be attained, then and in that event, either party to this contract may be consider it to be cancelled without cause by giving (30) days notice in writing to the other party and this contract shall be thereupon be canceled upon the expiration of such (30) day period. Nothing in this paragraph shall be construed to prohibit immediate cancelation pursuant to above paragraphs A and/or B. Rev 2/98 H. CONTRACTOR PROGRAM ADMINISTRATION AND FINANCIAL MANAGEMENT A. The contractor will comply with the SFSP Federal Regulations (7 CFR, Part 225, as amended), Uniform Federal Assistance Regulation (7 CFR, Part 3015, as amended), and state policies and procedures as issued and amended by TDHS. The contractor further agrees to perform as described in its application (including supporting documents and approved amendments to the application) for participation in the SFSP. B. The contractor accepts final administrative and financial responsibility for food service operations at each site sponsored by the contractor. This responsibility includes the perfonnance of the conditions of settlement of any audit exceptions or payment deficiency in the program and the collection and repayment of any amount paid in excess of the proper claim amount which are found after monitoring or auditing by TDHS or the United States Department of Agriculture (USDA). This responsibility applies to this contract, and all subcontracts hereunder. C. The contractor will apply to TDHS for approval of changes to its original application and for prior authorization for field trips if meals served on the field trips will be claimed for reimbursement. Requests for changes and field trip authorization must be received by'IDHS at least five (5) calendar days before the requested effective date for the change for the field trip. Contractors will notify TDHS within five (5) days of the termination of an approved food service site. SFSP RECORD KEEPING A. The contractor will keep financial and supporting documents, statistical records, and any other records pertaining to the services for which a claim is submitted. The records and documents will be kept for at least three (3) years and ninety (90) days after the termination of the contract period If any litigation, claim, or audit involving these records begins before the stipulated time period expires, the contractor will keep the records and documents for not less than three (3) years and ninety (90) days after the termination of the contract period and until all litigation, claims or audit findings are resolved. The case is considered resolved when a final order is issued in litigation or a written agreement is signed by TDHS and the contractor. Extensions are considered as separate contract periods. B. The contractor and its subcontractors will allow TDHS and'USDA officials and other appropriate officials determined by TDHS to inspect facilities and records and to audit, examine, and copy records at any reasonable time. This includes access to all records of costs paid, even in part, by TDHS. Schools - Page 2 IV. CIVIL RIGHTS POLICY COMPLIANCE A. The contractor agrees to comply with Title VI of the Civil Rights Act of 1964 (Public Law 88-352), and all requirements imposed by the regulations of the United States Department of Agriculture (7 CFR, Parts 15,15a and 15b) Department of Justice (28 CFR, Parts 42 and 50) and USDA and TDHS directives or regulations issued pursuant to that Act or the regulations, Section 504, FNS of the Rehabilitation Act of 1973 (Public Law 93-112), The Americans with Disabilities Act of 1990 (Public Law 101-336), Title IX ofthe Education Amendments of 1972 (7 CFR Part 15a), the Age Discrimination Act of 1975 (Public Law 94-135), and all amendments to each, and all requirements imposed by the regulations issued pursuant to these acts. In addition, the contractor agrees to comply with Title 40, Chapter 73, of the Texas Administrative Code. These provide in part that no persons in the United States shall, on the grounds of race, color, national origin, sex, age, disability, political beliefs or religion be excluded from participation in, or denied, any aid, care, service or other benefits provided by federal and/or state funding, or otherwise be subjected to discrimination under any program or activity for which the contractor receives federal financial assistance from TDHS and USDA: and hereby gives assurance that it will immediately take any measures necessary to effectuate this agreement. The contractor also agrees to comply with Health and Safety Code Section 85.113 (relating to workplace and confidentiality guidelines regarding AIDS and HIV). The contractor hereby gives assurance that it will immediately take any measures necessary to effectuate this agreement. B. This assurance is given in consideration of and for the purpose of obtaining any and all federal financial assistance, grants and loans of federal funds, reimbursable expenditures, grant or donation of federal property or interest in such property, the detail of federal personnel, the sale and lease of, and the permission to use, federal property or interest in such property or the fiunishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale, lease or furnishing of services to the recipient, or any improvement made with federal financial assistance extended to the contractor by TDHS. This includes any federal agreement, arrangement, or other contract which has as one of its purposes the provision of assistance such as food, cash assistance for the purchase of food, rental of food service equipment or any other financial assistance extended in reliance on the representation and agreements made in this assurance. C. The contractor agrees to compile'data, maintain records, and submit reports as required, to permit effective enforcement of the above Acts and permit authorized TDHS, USDA, and FCS (Food and Consumer Service) personnel during normal working hours to review such records, books, and accounts as needed to ascertain compliance with the above Acts. If there are any violations of this assurance, TDHS, USDA, and FCS has the right to seek judicial enforcement of this assurance. This assurance is binding on the Contractor, its successors, transferees, and assignees as long as it receives assistance or retains possession of any assistance from the department. The person whose signature appears on this contract is authorized to sign this assurance on behalf of the Contractor. Schools - Page 3 Rev 2/98 V. TDHS CLABIS PAYMENT TDHS will, subject to the federal appropriation and availability to TDHS of sufficient funds for the SFSP, make program payments to the contractor in accordance with the terms of this contract. No reimbursement shall be made for performance under this contract occurring prior to (a) the beginning effective date of this contract or (b) a later date established by TDHS based on the date of receipt of a fully executed copy of this contract. VL CERTIFICATIONS. A. Immigration Reform and Control Act of 1986 - The contractor agrees to comply with the requirements of the Immigration Reform and Control Act of 1986 regarding employment verification and retention of verification forms for any individuals hired after November 6, 1986, who will perform any labor or services under this contract. B. Regarding Debarment, Suspension, Ineligibility, or Voluntary Exclusion For Covered Contracts - The contractor certifies, by execution of this agreement, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in this contract by any federal department or agency or by the State of Texas. By making this certification the contractor agrees to the following terms: 1. The above certification is a material representation of fact upon which reliance was placed when this contract was entered into. If it is later determined that the contractor knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the Department of Health and Human Services, United States Department of Agriculture or other federal department or agency, or the Texas Department of Human Services may pursue available remedies, including suspension and/or debarment. 2. The contractor shall provide immediate written notice to the person to which this certification is submitted if at any time the contractor learns that the certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 3. The words "covered contract," "debarred," "suspended," "ineligible," "participant," `person," "principal," "proposal," and "voluntarily excluded," as used in this certification have meanings based upon materials in the Definitions and Coverage sections of federal rules implementing Executive Order 12549. Usage is as defined in the attachment. 4. The contractor agrees by submitting this certification that, should the proposed covered contract be entered into, it shall not knowingly enter into any subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the Department of Health and Human Services, United States Department of Agriculture or other federal department or agency, and/or the Texas Department of Human Services, as applicable. Schools - Page 4 CERTIFICATIONS (Continued) 5. The contractor further agrees by submitting this certification that it will include TDHS Form 2046 titled "Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion for Covered Contracts" without modification, in all covered subcontracts and in solicitations for all covered subcontracts. 6. A contractor may rely upon a certification of a subcontractor that is not debarred, suspended, ineligible, or voluntarily excluded from the covered contract, unless it knows that the certification is erroneous. A contractor must, at a minimum, obtain certifications from its covered subcontractors upon each subcontract's initiation and upon each renewal. 7. Nothing contained in all the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this certification document. The knowledge and information of a contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 8. Except for contracts authorized under paragraph 4 of these terms, if a contractor in a covered contract knowingly enters into a covered subcontract with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, Department of Health and Human Services, United States Department of Agriculture, or other federal department or agency, as applicable, and/or the Texas Department of Human Services may pursue available remedies, including suspension and/or debarment. C Regarding Federal Lobbying - This certification applies only to this contract and is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than 5100,000 for each such failure. The contractor certifies, to the best of his or her knowledge or belief, that: 1. No federally appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, or the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 2. If any fimds other than federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this federally funded contract, subcontract, subgrant, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. Schools - Page 5 Rev 2/98 3. The contractor shall require that the language of this certification be included in the award dais for all covered subawards at all tiers (including subcontracts, subgrants, and contracts underVmis,loans, and cooperative agreements) and that all covered subrecipients shall certify and disclose accordingly. The contractor certifies that all information submitted pursuant to this agreement is true and correct. The contractor understands that the deliberate misrepresentation or withholding of information is a violation of this contract and may result in prosecution under applicable state and federal statutes. VII. EFFECTIVE DATE AND SIGNATURES For the faithful performance of the terms of this contract, the parties hereto in their capacities stated, affix their signatures and bind themselves. ('lt'cr of T.»hhne-k Name of the Contracting Organization (Please Print or Type) Original signature of the Authorized Representative of the contracting organization Angie Hobbs Name of the Authorized Representative of the contracting organization (Please Print or Type) Indoor Supervisor Title of the Authorized Representative of the contracting organization Please print or type, in the spaces provided above, the name and title of the authorized representative signing this agreement on behalf of the contracting organization. Effective Dates: DEPARTMENTF EUMAhT SERVICES through: By. Date: TDHS Representative Schools - Page 6