Purchase of Services Substance Abuse Services Ctr
DU~~JE
~~~
MEMORANDUM
May 27,2005
TO:
The Honorable Mayor and City Council Members
FROM:
Michael C. Van Milligen, City Manager
SUBJECT: Purchase of Service Agreement -
Substance Abuse Services Center
During the Fiscal Year 2006 budget process, the Mayor and City Council provided
$12,762 for a Purchase of Services Agreement with the Substance Abuse Services
Center.
Budget Director Dawn Lang is recommending execution of the attached agreement with
Substance Abuse Services Center to provide funding for the operation of a program
which provides for a substance abuse counselor to work with youth in the City who are
referred to any of their high risk youth programs.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
10J~AIL
Michael C. Van Milligen
McVM/ksf
Attachment
cc: Barry Lindahl, Corporation Counsel
Cindy Steinhauser, Assistant City Manager
Dawn Lang, Budget Director
,.., ~ ,
".,
, '~J
I : l
, " ..J
~~j/ -,i._ ,._j ._~ cJ
D;)~~
~~~
MEMORANDUM
May 27, 2005
TO:
Michael C. Van Milligen, City Manager
FROM:
Dawn Lang, Budget Director
SUBJECT: Purchase of Service Agreement -
Substance Abuse Services Center
Attached for City Council approval is the Purchase of Services Agreement with
Substance Abuse Services Center for the City's financial support for Fiscal Year 2006.
The adopted Fiscal Year 2006 operating budget provides a payment of $12,762 to help
fund the Substance Abuse Services Center. The City's contribution funds a half-time
substance abuse counselor to work with youth in the City who are then referred to any
of the Center's high risk youth programs. The agency provides a number of services
including early outpatient substance abuse treatment for troubled adolescents and their
parents.
It is my recommendation that the City Council approves the attached purchase of
services agreement with Substance Abuse Services Center and authorizes the Mayor
to execute the contract on behalf of the City.
D L/ksf
Attachment
AGREEMENT
BETWEEN
CITY OF DUBUQUE, IOWA,
AND
SUBSTANCE ABUSE SERVICES CENTER
THIS AGREEMENT, dated for reference purposes the 1 st day of July 2005, is
made and entered into by and between the City of Dubuque, Iowa, (City) and
Substance Abuse Services Center, (Agency).
WHEREAS, Agency represents itself as technically and professionally qualified to
provide early substance abuse outpatient treatment to troubled adolescents and their
parents; and
WHEREAS, City has deemed it to be in the best interest to provide financial
assistance for a half-time adolescent specialist to work in the City of Dubuque.
NOW THEREFORE, the parties hereto agree as follows:
1 . Scope of Service
The Agency shall:
a. provide an early intervention program and outpatient treatment for troubled
adolescents in the area of substance abuse within the City of Dubuque.
2. Time of Performance
The term of this Agreement shall be from July 1, 2005, through June 30, 2006.
3. Compensation
City shall pay Agency $12,762 as compensation for the services provided by
Agency, which payment shall constitute full and complete compensation for such
services. The compensation shall be paid by City to Agency within 10 (10) days
after the execution of this Agreement by both parties and upon receipt by City of a
requisition for such sum from Agency. Payment will be made in four quarterly
installments of $3,168, beginning with the first payment on October 1, 2005.
4. Audit and Evaluation
Inasmuch as the funds to be provided Agency by City are public funds, Agency
agrees that it will maintain books of account in accordance with generally accepted
accounting standards together with necessary documentation to support all
expenditures.
Agency shall provide the City quarterly written reports detailing its activities
beginning for the quarter ending September 30, 2005. Such report shall be due
1
ten days after the end of each quarter. Accompanying each quarterly report shall
be copies of any studies, brochures, or other non-confidential documents, which
Agency has produced during the relevant quarter.
5. Discrimination
In carrying out the services of this Agreement, Agency shall not discriminate
against any employee or applicant for employment because of race, creed, color,
sex, age, national origin, religion, or disability. Agency shall take affirmative action
to ensure that applicants for employment are employed and that employees are
treated during employment without regard to race, creed, color, sex, age, national
origin, religion, or disability.
Such action shall include, but not be limited to, the following: employment,
upgrading, demotion or transfer; rates of payor other forms of compensation; and
selection for training, including apprenticeship.
Agency agrees and will undertake whatever affirmative measures are necessary so
that no person shall be excluded from participation in, be denied the benefits of, or
be subjected to discrimination under any program or activities funded in whole or in
part with any of the funds made available to Agency under the terms of this
Agreement because of race, creed, color, sex, age, national origin, religion, degree
of handicap or disability.
6. Interest of Members. Officers. or Employees of the City of Dubuque; Members of
the Dubuque City Council; or Other Public Officials
No member, officer, or employee of City or their designees or agents; no member
of the Dubuque City Council; and no other public official of City who exercises any
function or responsibilities with respect to the program during his/her tenure shall
have any interest, direct or indirect, in this contract or the proceeds thereof for work
to be performed in connection with the program assisted under this Agreement.
7. Termination of Contract
This contract may be terminated by either party by giving the other party a written,
ninety (90) day notice of such termination or upon such other terms as may be
mutually acceptable.
If, through any cause, Agency shall fail to fulfill in timely and proper manner its
obligations under this Agreement or if Agency shall violate any of the covenants,
agreements, or stipulations of this Agreement, City shall have the right to terminate
this Agreement by giving written notice to Agency of such termination at least five
(5) days before the specified effective date of such termination.
2
8. AssiQnabilitv
Agency shall not assign any interest in this Agreement and shall not transfer any
interest in the Agreement without prior written approval from of City.
9. Insurance
At the time of execution of this Agreement by Agency, Agency shall provide City
copies of the agency's insurance certificates showing general liability, automobile
liability, and workers compensation insurance coverage to the satisfaction of City
for the term of this Agreement.
WITNESSED:
~Litt nt thutl '2tz44J
Karen M. Chesterman,
Deputy City Clerk
Date June 6, 2005
CITY OF DUBUQUE
Joyce E. Connors
Mayor Pro-Tem
Date: June 6, 2005
/s/ Diane K. Thomas
Executive Director
Date 6/20/2005
,. · 8/26/2005 Time: 1:08 PM To: Kevin @ 1-563-589-4149
~. ~ Insurance Page: 001
. .
. . Client#: 30467 SUBAB
. ~CORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMJDDlYYYY)
08126/05
"'KDDUCE.K THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Molyneaux Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
100 Kirkwood Blvd. ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW.
P.O. Box 939
Davenport, IA 52805 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A. Philadelphia Indemnity Insurance Co
Substance Abuse Service Center INSURER B; First Comp Insurance
Nesler Centre; 799 Main Street INSURER c;
Dubuque, IA 52001-6825 INSURER D;
INSURER E.
Mol
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR N~~~ TYPE OF INSURANCE POLICY NUMBER Po";~~~ri~~~~~I~IE Pg~~~ ti,~~~~I~ LIMITS
LTR
A GENEKAL LIABILII Y PHPK098344 12/09/04 12/09/05 EACH OCCURRENCE $1,000,000
- DAMAGE 10 RENH,-D
X- OMERCIAL GENERAL LIABILITY $100 000
- CLAIMS MADE CiI OCCUR MED EXP (Anyone person) $5 000
PERSONAL & ADV INJURY $1 000,000
-
GENERAL AGGREGATE $3,000,000
-
GEN'l AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $3 000 000
Xl n PRO- nlOC
POLICY JEC I
A AUTOMOBILE LIABILITY PHPK098344 12/09/04 12/09/05 COMBINED SINGLE LIMIT
- $1,000,000
ANY AUTO (Eil ac;c;;ident)
-
- ALL OWNED AUTOS BODll Y INJURY
(Per person) $
SCHEDULED AUTOS
-
.!.... HIRED AU ros BODll Y INJURY
$
X NON-OWNED AUTOS (Per aCCident)
-
- PROPERTY DAMAGE $
(Por accident)
=rAGE LIABILITY AUTO ONl Y - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONl Y; AGG $
A ~ESS/UMBRELLA LIABILITY PHUB037320 12/09/04 12/09/05 EACH OCCURRENCE $1 000000
X OCCUR D CLAIMS MADE AGGREGATE $1 000,000
$
~ OEDUCTIBL F $
X RETENTION $ 10000 $
B WORKERS COMPENSATION AND WC001990501 12/09/04 12/09/05 X I. WC STATU-.I 10J~-
EMPLOYERS' LIABILITY $100,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.l. EACH ACCIDEN r
OFFICER/MEMBER EXCLUDED? E.l. DISEASE - EA EMPLOYEE $100,000
If yes, describe under E.l. DISEASE - POLICY LIMIT $500 000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT J SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Dubuque DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL -3D- DAYS WRITTEN
Office of City Manager NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
50 W. 13th St. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Dubuque, IA 52001 REPRESENT A TIVES.
AUTHO:.pD REPRESENT A TIVE
\~ Mkl1i;2~.---._._~
... ~ . ...-" ~~.,.
ACORD 25 (2001/08) 1 of 2
#M22858
KAY
€l ACORD CORPORATION 1988
FROM :SASC
FAX NO. :5635824600
Jun. 29 2005 03:40PM P2
e9
Philadelphia Insurance Companies
One Bala Plaza. Suite 100, Bala Cynwyd. Pennsylvania 19004
PHILADELPHIA INDEMNITY INSURANCE COMPANY
COMMERCIAL LINES POLICYCOMMON POLICY DECLARATIONS
Policy Number: PHPK098344
Named Insured and Mailing Address:
~ SUBSTANCE ABUSE SERVICES CENTER
799 MAIN STREET
DUBUQUE, DUBUQUE, IA 52001
Agenl:
Policy Period: From: 12/09/2004 To: 12/09/2005 at 12:01 A.M. Standard Time at your mailing address shown 9tlOve.
Business Description: NON PROFIT ORGANIZATION
IN RETURN FOR THE PAYMENT OF THE PREMIUM. AND SUBJECT TO ALL THE TERMS OF THIS POLICY. WE
AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED,
THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
\.
Commercial Property Coverage Part
Commercial General liability Coverage Part
Commercial Crime Coverage Part
Commercial Inland Marine Coverage Part
Commercial Auto/Garage Coverage Part
Businessowners
Workers Compensation
PREMIUM
$ 1,197.00
$ 876.00
$ 776.00
$ 558.00
$ 184.00
Professional Liability
$
2,477.00
TOTAL $
6,068.00
Total Includes Federal Terrorism Risk Insurance Acr Coverage
14.00
FORM(S) AND ENDORSEMENT(S) MADE A PART OF THIS POLICY AT THE TIME OF ISSUE:-
Refer To Forme Schedule
'Omits applicable Forms and Endorsements if shown in specirt<'. cov9rage Part/Coverage Form De
10/26/2004
R}~GDNC Countersignalure Date
.....-.... .
late: 8/26/2005
.neaux Insurance
Time: 1:08 PM
Page: 002
To: Kevin @ 1-563-589-4149
Mo]
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (2001/08) 2 of 2
#M22858