03-642COUNCIL FILE #: O3"��Z,
GREEN SHEET #: 205554
RESOLUTION
SAINT PAUL, NIINNESOTA
Presented By:
Referred to:
Committee Date:
II
1 WHEREAS, the City of Saint Paul, Paz s�anc �ecrearion has been norified that the Martin Luther King and Jimmy Lee
2 Recreation Centers qualify for Weed and Seed grant funds to be admuustered by the Amherst H. Wilder Foundation; and
3
4 WHEREAS, both recrearion centers have been offered $5,000 allocarions; and
5
6 WHEREAS, it is the desue of Pazks and Recreation to set up a fmancing and spending plan for said Weed and Seed funds; and
7
8 WHEREAS, the Mayor, pursuant to Section 10.071 of the Charter of the City of Saint Paul, does certify that there aze
9 available for appropriarion, funds of $10,000 in excess of those estimated in the 2003 budget; and
10
11 WHEREAS, the Mayor recommends that the following addirions be made to the 2003 budget:
12
13 CURRENT AMENDED
14 FINANCING PLAN: BUDGET CHANGES BUDGET
15 325 - Pazks Enterprise Fund
16 23102 - Recreation Program Support
17 3600 - Other Grants-in-Aid 0 1Q000 1Q000
18 0 10,000 10,000
19 SPENDING PLAN:
20 325 - Pazks Enterprise Fund
21 23102 - Recreation Program Support
22 0299 - Misc. Services 37,000 10,000 47,000
23 37,000 10,000 47,000
24
25 BE IT RESOLVED, that the City of Saint Paul, Parks and Recreation is authorized to enter into the attached agreements;
26 both which include an indemnification clause, with the Amherst H. Wilder Foundarion to provide Safe Haven Activiries at the
27 Martin Luther King and 7unmy Lee Recreation Centers. A copy of said agreements are to be kept on file and on record in
28 the Office of Financial Services.
G:IFMIQTWW31Resolutions, AOs, G�een SheefslResolutionslResolution Template.xls Page: 1 of 2
03-19.�8Z
COUNCIL FILE #:
GREEN SHEET #:
RESOLUTION
CTTY OF SAINT PAUL, MIlVNESOTA
205554
Presented By:
Referred to: Committee Date:
Requested by:
Adopted by Council: Date: � y y'O�'
Adoption Certified by Council Secretary
_ Date: � / ° J °
Division of Parks and Recrearion
2 �'�u�
By: �,7 : ��L
Approval Rec9�en ed by Financial Services D'uector:
By:
Form Approved by City
for
G:IFMIQTJW3�Resolutions, AOs, Green SheetslResolutionslResolufion Template.xls Page: 2 of 2
a3- �Z
� Green Sheet Green Sheet Green Sheet Green Sheet Green Sheet Green Sheet
PR - rarks ana Recreatiol,
Contact Person 8 Phone:
LINDA FLYNN
266-6443
qqenda by
Green Sheet NO: 205554
0&APR-03
�►
Assign
Number
For
Routing
Order
0
2 "tv Attom
3 insncial Serv��s
4 a or' ��
5 ouncil
6 erk
7 ioancial Se �ces
InitiaVDate
Total # of Signature Pages _ (Clip All Loptions for Signature) " ' "' ' "` � "
Action Requested:
Approval of resol to enter into agee w/Amherst H Wilder Fdn for Martin Luther King Rec Ctr & Jimmy I.ee Rec Ctr to receive $5,000
each from "Weed & Seed" grant
Recommendations: Approve (A) or Reject (R):
Planning Commission
� CIB Committee
Civil Service Commission
� ST.A�F'
Service Contracts Must Mswer the Following
1. Has this person/firm ever worked under a contract for this department?
Yes No
2. Has this person/flrm ever been a city employee?
Yes No
3. Does this person/firm possess a skill not normally possessed by any
current city employee?
Yes No
Explain all yes answers on separate sheet and attach to green sheet
Initiating Problem, Issues, Opportunity (Who, What, When, Where, Why):
Grant is for after school programs -$10,000 total.
� �
AdvanWpes If Approved:
DisadvanWges If Approved:
Disadvantages If Not Apqroved:
. ! �,
7ota� Amount ot �� 0 OD a Cast/Revenue Budgeted: �{ b
Transaction: �
Funding Source: w, �.D Activiry Number: 3�S �� �Q�
Fi nancial IMormation:
(6cplain)
� DEPARTMENT/OFFICFJCAUNCIL DATEINRIATED GREEN SHEET ��� NO. 2 05554 Z
Parks & Recreation 03/20/03
CANrACTPERSONANDPHONE INITIAVDATE INRINL/DATE
. Linda Flynn 66443 � H � DEPARTMENTDIRECTO / 5 cmcouNCa
UMBERF9 2 cmarrorsrvEV cmc�wc
MUSTBEONCAUNGLAGENDABY(DAiF ROER� 3 FINANCIALSERVICESDIR._ 6 FINANCIALSERV/ACCTG
MarCh 26, 2003 4 ennroRroRnssisrnrrn 7 a�are�«�
TOTAL # OF SIGNANRE PAGES �(CLIP ALL LOCATIONS FOR SIGNATUR�
, ACTIOq REQU��:
Approve Council Resolution for Saint Paul Parks and Recreation to enter into an agreement with Amherst H. Wilder
Foundation for Martin Luther King Recreation Center and Jimmy Lee Recreation Center to receive $5000.00 each from
a"Weed and Seed" grant for after school programs.
RECOMMENDATIONS: Approve (A) ar Re�ect (R) PERSONAL SERNCE CONTF2ACT5 MUST ANSWER THE FOLLOWING QUFSTIONS:
. _PLANNINGCOMMISSION _CNILSERVICECAMMISSION �. HasNispersoNfirmeverxroticetluntleracontracttorNisdeparOnenl?
CIBCAMMITTEE _ VES NO
A STAFF 2. Has this peaon/firtn ever Eeen a city employee?
DISTRICTCOUNCIL YES NO
� — — 3. Doesihisperson/frmpossessaskillnotnomalrypossessetlbyanycurrenldtyemployee?
SUPPORTSWHICHCOUNCILOBJECTIVE? YES NO
� �plain all yes arewers on separate sheet antl attach M 9�^ sh¢et
„ INITIATING PROBLEM, ISSUE, OPPORTUNIN (VJho, Whaq When, Where, Why).
Amherst H. Wilder Foundation is providing the money from the Weed and Seed grant for use at Martin Luther King
Recreation Center and Jimmy Lee Recreation Center for after school programs.
a
.�j � ADVANTAGESIFAPPROVED:
� Martin Luther King Recreation Center and Jimmy Lee Recreation Center will receive money otherwise not available for
�, after school programs.
� � 01SADVANTAGES IF APPROVED: NO(le [ �■ ° � � � � ! k
� l �% �
� APR 0 � 2qQ3
�I�Y �4�"t�����'
� DISADVANTAGES IF NOTAPPROVED:
' Martin Luther King Recreation Center and Jimmy Lee Recreation Center will not receive money for after school
programs.
TOTALAMOUNTOFTRANSACTION��O.00O.00 COST/REVENUEBUDGETE�(GIRCLEONE) YES NO
FUNDINGSOURGE P3/325 ACTMTYNUMBER 23102-33431
FINANpAL INFORMP.TION: (EXPL4IN)
03-1��12-
Jimmy I.ee Recreation Ceuter
PROFESSIONAL SERVICE AGREEMENT
Summit University Weed and Seed Contract
Tltis Contract is entered into ttus first day of January 2003, by and between Amherst H Wilder FoundaTion,
hereafter referred to as "Wildei" and the City of Saint Paul, MN, a municipal corporation, hereafter referred to as
("Provide�").
Whereas, Wilder has entered into an a�eement with the State of Minnesota ("Ageemenf'), dated 7anuary 1", 2003
to cazry out responsibilities associated with the Summit University Weed and Sced Progran�
Whereas, Provider desires to Contract with WIlder to undertake obligations under the Ageement to provide: Safe
Haven progxamnting, per the attached workplan, Attachment A and Budget, Attachment B.
Now, therefore, in consideration of ihe mutual promises, covenants, and conditions set forth herein, the parties agee
as follows:
1. Term. The term of tltis Contract shall be for the period begnning on January 1, 2003 and ending November
30`", 2003.
2. Services. During the Term of this Contract, the Provider agees to provide a work plan and budget to meet ihe
compietion of the foIlowing services: Safe Haven Activities as set forth in Attachment A
3. Pavment. In exchange for providing services, Wilder will pay Provider a total maximum cost of $5,000.00. An
invoice must be submitted fo: payment to Wilder and to the Weed and Seed Coordinator no later than the
second Monday of every month and mus[ adhere to approved work plan and budget. Payments will be made to
Provider within three weeks of approval of Monthly Program RepoR from the Weed and Seed Seeding
Committee. The Steering committee will review the report at its montlily meeting. Payment may be withheld for
non-compliance with reporting. The Provider agees tt�at Wilder shall have no obligalion to pay Provider from
any funds other than those received by Wilder pursuant to the Agreement
4. Monthlv Pro�am Reports. Provider shall complete a Montl�ly Progam Report addressing services. The report
shall be submitted to Wilder and to the Weed and Seed Coordinator no later tlian the second Monday of every
month. The Steering committee will review the report ai it's montiily meeting for approval of payment
5. Meefing Attendance. Provider agrees to provide a representa6ve to attend monthly Seeding Committee
meetings.
6. Documentation Provider agees to maintain books, records, documents aad other evidence of activities
associated with performance of this Contrad. These books, records, documents and other evidence st�all be
subject at all reasonable times to in�ction and review by Wilder personnel.
7. Comnliance with Laws. Provider agrees to comply with all federal, state, county and local laws, regulations,
ordinances, rules and certifications as pertaiiwig to setvices provided under this Contract Any failure to
comply with these requirements shall consti[ute cause for cancel]ation of this Contract by Wilder.
8. Indenendent Provider StaNS. It is agreed that nothing contained in this Contract is intended or should be
construed as creating the relationship of co-parmers, joint ventures, or an association with Wilder and Provider.
Provider is an independent contract and neither it, its employees, agents nor representafives shall be considered
employees, agents or representafives of Wilder. Except as othenvise provided herein, Provider shall maintain in
all respects its present control over the means and personnel by which the Contract is performed.
9. Hold Harmless and Indemnificarion. Provider agrees to defend, hold harailess and indemnify Wilder, iu
directors, officers, empioyees and agents from any and all liabilifies, losses, damages they may suffer as a result
of any claims, demands, judgmenu or costs, including anomeys' fees, arising out of or related to Provider's
performance of this Conhact
10. Background Checks. Provider agrees to comply with the State of Minnesota Weed and Seed background Check
Yolicy, Attactunent B. Documentation of completed backgound checks mus[ be made available upon request.
Funds from tltis contract may be utilized to pay for backgound checks on any Safe Havens personnei.
11. ConfidenUaliri. a) The parties acknowledge that certain confidential informalion may be transmitted or
disclosed by the parties to each other in connecflon with their perforcnance under this Contract For purposes of
this Contract, "confidential infomiation" includes financial informaflon, parient records and accounu, trade
SiJWS — JIMMY LEE Contract 2003
03 -��z
secreu, and all other information designated by the Weed and Seed progcam, Wilder or the Provider (and
communicated to other parties) as confidential. Generic lmowledge or information puhlicly known tkiat is
generally employed by the tmde shall not be deemed part of tLe confidential informafloa
b) The parties sLall not, at any time, directly or indirectly, use, copy, reveal, report, memoriali��e, publisL,
duplicate or otherwise disclose to any third party in any way wLatsoever any confidential information without
written consent of the other party, wluch conseni st�all be exercised in the sole discretion of such party. The
parties st�all receive, maintain and sue ihe confidential infom�ation in ihe strictest of confidence and use bes[
efforts to keep the confidential information shictly confiden$al and to preserve disclosure thereof.
12. Insurance. Provider shall self insure or purchase and maintain such i�c�,rance as will protect Wilder from
cl aimc, which may arise out o� or result from the Provider's operations under this Contract
13. Assignment The rights, interests and obligations of the Provider under the provisions of the Contract shall not
be assignable without the prior written consent of WIlder.
14. Amendments or Changes to AQreement. Wilder or the Provider may reques[ ctianges that would increase,
decrease, or othenvise modify the Scope of Secvices. Such changes and method of compensation must be
authorized in writing in advance by Wilder and the Provider. Budget adjustments do not require a contract
amendment unless ctianging the entire amount of the contract or unless they substantially alter the scope of
secvices to be provided.
15. No waiver. Failure of either paity to enforce any term or provision shall not be construed as a waiver of such
term or provision or the right to enforce such term or provision.
16. Entire Contract This Contract constimtes the entire understanding and agreements between Wilder and the
Provider and supersedes all cral agreements and negotiations relating to this subject matter.
17. Cancella[ioa Provider or Wi.der may teacw�ate this Contract upon riventy- (20) days written noUce to the other
party. Ttus Contract st�all tenninate immediately and without notice in the event the Agreement is canceled.
18. Supplant. The Grantee assures lktat Federal funds made available under tlris formula grant will not be used ro
supplant state or local funds bn: will be used to increase the amounu of such funds that would in tha absence of
Federal funds, be made available for activities.
IN WITNESS Wf�ROF, the parties hereto have executed this agreement, the day and the year first written above.
City of St Paul
Tom Kingston, Execulive D'uector Date
Amherst H. WIIder Foundation
919 Lafond Avenue St Paul MN 55104
Address
Mayor
Director of Financial Services
Date
Date
Director of Pazks and Recreation Date
Approved as to form:
Assistant City Attomey Date
SLTWS — JIMMY LEE Contract 2003 2
03 -l�Ni
Attachment A
Timmy LeQ Recreation Center
Safe Haven Workplan
Contact Person:
Phone:
' .u.�� . .�•�
Lorrie Brown
298-5760
1063 Iglehart Avenue, St. Paul, IvL�T 55104
Jimmy Lea Arfs and Tutoring Program
The arts and tutoring program will begin January 2, 2003 and nm until December 31,
2003 the initial focus on art. The focus of the arts program is to provide opportunifies to
expand the individual creativity of youth through many different mediums of art and
divert youth from becoming involved in the wrong groups or committing crimes. Staff
and volunteers will be on hand to assist all youth in various subjects. All activities wiil
take p2aoe at the Jimmy Lee Recreation Center. The hours of operntion are Monday
through Friday beginaing at 2 p.m. through 8 p.m. Youth participating in the Jimmy Lee
sports will be tatgeted to participate in the tutoring program as well as other youth who
use the building. ,
ProjecY 3us�cation
There are often not enough activities for youtfi to be invoived in and they soon start
hanging out with the wrong crowd. At 7immy Lee, we work to provide sports, academic
and artistic programs for youth to be involved in. The arts and cra$s program will be
used in an avenue for youth to release this frustration. Youth wiil explore art by using
many different types of inedium while expressing their individual creativiTy. Fieldtrips
will be used as incentives to paracipating in the tutoring and art programs. Jimmy Lee is
lrnown for their sports program we want to connect the youth who come in for sports
pro,gr�mming into academic and art progcams. Youth who receive scholarships from us
that allow tliem to play sports will be required to be actively involved with the academic
and art pmgruus.
Outcomes: To provide a variety of programming for youth to become involved in and to
interact with adults who will redirect iheir energy into positiva ouflets.
Specific Activifies to Fuifill Goals: Provide tutoring by utilizing staff, college students,
volunteers, educational computer so$ware, and books. DeveIop individual creativity
through expression of art. Build teamwork and social sldils of youth through various
field trips and activities.
Partner Contributions: Providing space, staff and volunteers.
Anricipated number of participants: 100 youth
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03-�NZ
Attachment C
STATE OF MINNESOTA
Weed and Seed Site
Background Check Policy
As a Weed and Seed Site, we agree to meet the following poticy and mandatory
guidelines regarding background checks of atl ofi our organization's paidlunpaid
staff and contractors:
1. Application Fortn
Each applicant for paid and unpaid employmenf will complete and sign
comprehensive job application that contains the following:
Name, including maiden names
Current address and city, county/states lived in during the last 10 yrs.
Citizenship, or visa, which allows applicant to work in US
Criminal arrests/ convictions for misdemeanors/felonies
Driving record, any moving violations?
Education
Employment record (volunteer wor�nternships, etc.)
Account for unemployment over lasf 10 yrs., since leaving school
Personal and professional references, including the 2 rnost recent former employers.
The appiicatian shali also contain a statement, which the applicant signs that verifies
that the applicant understands that falsifying information on the application is
gsounds for immed+ate dismissat and/or other action.
2. Release Forms
Each applicant for paid and unpaid employment will complete and sign a multi-
purpose (criminal history, driving, employment, military records) release as well as a
sex offender registry release form. (While aspects of both releases may not be used,
many inappropriate applicants are deterred from applying when there is a possibility
that the agency could receive information from these sources.) See sample forms
attacfied.
3. Personal Interview
Each applicant for paid and unpaid employment will be given a comprehensive
personal interview intended to probe for more in-depth information that may not be
available through other screening methods.
4. Reference Check
At least two employment and one personal reference listed by an applicant wil} be
contacted by the agency.
5. Contractors
Agencies contracting to provide Weed and Seed funded services/activities shall
certify to the Weed and ho Seed sife that they comply with this policy and all
mandatory guidelines.
03-1��1.
Attachment C
Supplemental checks shaii aiso be conducted as detailed below:
Checks of the state criminal database and the sex offender registry will be conducted on ail
paid or unpaid employees who might have any of the following contacts with children, youth
or vulnerable adults:
One-on-one contact
Day-long confact
Overnight trips
Contact accompanied
by little or no supervision by other staff
Volunteers/staffi who will transport children/vuinerable aduits shall have a valid drive�s
license.
Educafion/licensing verification will be completed for all paid/unpaid positions, which
specifically require a certain educationai background or license.
Mandatory Guidelines
Disqualify all potential volunteerslpaid staffi who have committed any crime against a child
or vulnerable adult regardless of the age of the conviction.
Disqualify ail registered sex ofFenders.
Disqualify al4 potential volunteers/paid staff who have committed a violent crime of any level
in the last 10 yrs.
Results of screening will be held in confidence by the agency and wili not by shared outside
the agency wi#hout an independent release from the applicant.
Additional Suggestions
Any costs associated with background checks artd screening can be passed along to the
appiicant.
Designate a person(s) in the agency to handie the background checic review process.
Develop standard interview and reference check questions.
Utilize a team interview process or have multiple staff inferview each applicant personally.
Provide designated staff with training on interviewing techniques and reference checking
methods.
Limit access to the results of background screening to necessary staff only.
o3-t�4.Z
Attachment C
Sample Predatory Offender Registry Release
Authorization to Reiease lnfiormation
To
(Insert Agency Name/address/logo)
Current
Sociai Security Number
Agency Contact Person
Authorization expiration date
1 authorize the Minnesota Bureau of Criminal Apprehension to release any information
about me that is contained in the Minnesota Predatory Offender Registry, including, but no
limited to, any information regarding registration for offenses committed as a juvenile.
Date
Signature of Prospective Employee
Date
Witness to Signature
o3-t��iZ
Martin Luther King Recreafion Center
PROFESSIONAL SERVICE AGREEMENT
Summit University Weed and Seed Contract
Tfris Contract is entered into ttris first day of January 2003, by and between Amhecst H �VIlder FoundaTioa,
hereafter referred to as "Wilde�' and the City of Saint Paul, MN, a municipal coiporation, hereafter referred to az
("Provide�').
Whereas, Wilder l�as entered into an agreement with the State of Minnesota ("Ageement'), dated January 1", 2003
to carry out responsffiilities associated with the Sunwvt University Weed and Seed Prograza
Whereas, Provider desires to Conuact with Wilder to undertake obligations under the Ageement to proc�de: Safe
Haven progcactw�ing, per the attached workplan, Attachment A and Budgei, Attaclunent B.
Now, therefore, in consideration of the mutual promises, covenants, and conditions set forth herein, the parties agree
as follows:
1. Term. "I'he term of this Contract shall be for the period beginning on January 1, 2003 and ending November
30 2003.
2. Services. During the Term of Uils Contract, the Provider agrees to provide a work plan and budget to meet the
completion of the following services: Safe Haven Activities as set forth in Atiachment A
3. Payment. In exchange for providing services, Wilder will pay Provider a total ma�imum cost of $5,000.00. An
invoice must be submitted for payment to Wilder and to the Weed and Seed Coorciinator no ]ater than the
second Monday of every month and must adhere to approved work plan and budget. Payments will be made to
Provider within three weeks of approval of Monttily Progiam Report from the Weed and Seed Seeding
Commiuee. The Steering committee will review the report at its montlily meeting. Payment may be withheld for
noncompliance with reporting. The Provider agrees that Wilder shall have no obligation to pay Provider from
any funds other than those received by Wilder piusuaz�t to the Agreement
4. Monthlv Proeram Reports. Provider sliall compiete a Monthly Program Report addressing services. The report
shall be submitted to Wilder and to the Weed and Seed Coord'uiator no later than ihe second Monday of every
month The Steering crommittee will review the report ai iYs montlily meeting for approval of payment
5. Meetine Attendance. Provider agees to provide a representaUVe to attend montiily Seeding Comuuttee
meetings.
6. Documentafion Provider agrees to maimain books, records, documents and other evidence of acfl��ues
associated with performance of this Contract. These books, records, documents and other evidence shall be
subject at all reasonable times to inspecUon and review by Wilder personnel.
7. Compliance with Laws. Provider agees to comply with all federal, state, county and local laws, regulations,
ordinances, rules and certifications as pertanung to services provided under this Conirac[ Any failure to
comply with these requirements shall constihrte cause for cancellation of this Contract by Wilder.
8. Indeuendent Provider Status Ii is agreed that nothing contained in this Coniract is intended or should be
construed as creating the relationship of co-partners, joint ventures, or an association with Wilder and Provider.
Provider is an independent coniract and neither it, its employees, agents nor representarives shall be considered
employees, agents or representatives of Wilder. Except as othenvise provided herein, Provider stiall ataintain in
all respects its present conirol over the means and personnel by which the ConVact is performed.
9. Hold Harmless and Tndemnification. Provider agrees to defend, hold harn�less and indenuiify Wilder, its
directors, officers, employees and agents from any and all liabIlities, losses, dazc�ages they may suffer as a result
of any claims, demands, jud�nents or costs, including attomeys' fees, arising out of or related to Provider's
performance of this Contract
10. Backeround Checks. Provider agcees to comply with the State of Minnesota Weed and Seed background Check
Policy, Attachment B. Documentation of completed background checks must be made available upon request.
Funds from iltis contract may be utilized to pay for backgound checks on any Safe Havens personnel.
11. Confidentialirv. a) The parties acknowledge ttiat certain confidential information may be transmitted or
dixlosed by the paities to each other in connection with their perforroance under this Contrac[ For purposes of
this Contract, "confidenfial infomiation" includes financial inforntaflon, paflent records and accounts, trade
SiJWS -MI,K 2003
o3-��z
secreu, and all other information designated by the Weed and Seed prograiq Wilder or the Provider (and
communicated to other parties) as confidential. Generic Imowledge or information publicly known thai is
generally employed by the trade shall not be deemed part of the confidential informarion.
b) The parties st�all not, at any time, directly or indirectly, use, copy, reveal, report, memorialize, publish,
duplicaTe or otherwise disclose to any third party in any way whatscever any confidential informarion without
written consent of the other pariy, wlrich consent shall be exercised in the sole discrerion of such party. The
parties shall receive, maintain and sue the confidential information in the strictest of confidence and use best
efforts to keep the confidenfiai infonnation strictly confideatial and to prese:ve disclosure thereof.
12. Insurance. Provider sliall self insure or purchase and maintain such ina,rance as will protect WIlder from
cl aimc, wluch may arise out of, or result from the Provider's operations under tivs Contract.
13. Assi�unent The rights, interests and obiigations of the Provider under the provisions of the Contract shall not
be assignable without the prior written consent of Wilder.
14. Amendments or Chan�es to A�eement Wilder or the Provider may request ct�anges tliat would increase,
decrease, or othenvise modify the Scope of Services. Such clianges and method of compensafion must be
authorized in writing in advance by Wilder and the Provider. Budget adjustments do not require a contract
amendment unless changing the entire amount of the contract or unless they substantially alter the scope of
services to be provided.
15. No waiver. Failure of either party to enforce any term or provision shall not be consVued as a waiver of such
term or provision or the right to enforce such term or provision.
16. Enfire Contract This Contiact constitutes the entire undecstanding and agreemenu between Wilder and the
Provider and supersedes all o�al ageements and negotiations relating to this subject matter.
17. Cancellation. Provider or Wilder may terminate this Contract upon tcventy- (20) days written notice to the other
party. This Contract sttall temiinate immediately and without nofice in the event the Ageement is canceled.
18. Sunulant. T'he Grantee assurES that Federal funds made available under this formula gant will not be used to
supplant state or local funds but will be used to increase ihe amounts of such funds Uiat would in the absence of
Federal funds, be made available for activities.
IN WI'I'NESS WHEROF, the par:ies hereto have executed this agreement, the day and the year first written above.
City of St. Paul
Tom Kingston, Execu6ve Director Date
Atnhers[ H. Wilder Foundation
919 Iafond Avenue, S[ Paul. MI� 55104
Address
Mayor
Date
Director of Financial Secvices Date
Director of Pazks and Recreation Date
Approved as to form:
Assistant City Attomey Date
SUWS - MLK 2003 2
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Attachment C
STATE OF MINNESOTA
Weed and Sesd Site
Background Check Policy
As a Weed and Seed Site, we agres to meet the foliowing policy and mandatory
guidelines regarding background checks of all of our organization's paid/unpaid
statf and confractors:
1. Application Form
Each applicant for paid and unpaid employment will complete and sign
comprehensive job application that contains the following:
Name, including maiden names
Current address and city, county/states lived in during the last 10 yrs.
Citizenship, or visa, which allows applicant to work in US
Criminal arrests/ convictions for misdemeanors/felonies
Driving record, any moving violations?
Education
Employment record (volunteer wor�nternships, etc.}
Account for unemployment over last 10 yrs., since leaving school
Personal and professional references, including the 2 most recent former employers.
The appfication shall also contain a statement, which the applicant signs that verifies
that the appiicant understands that faisifying information on the appiication is
grounds for immediate dismissal and/or other action.
2. Release Forms
Each applicant for paid and unpaid employment will complete and sign a muiti-
purpose (criminal history, driving, employment, military records) release as weil as a
sex offender registry release form. (While aspects of both releases may not be used,
many inappropriate appiicants are deterred from applying when there is a possibilifij
that the agency could receive information from these sources.) See sampie forms
attached.
3. Personal Interview
Each appiicant for paid and unpaid ernployment will be given a comprehensive
personal interview intended to probe for more in-depth information that may not be
available through other screening methods.
4. Reference Check
At least two employment and one personal refierence listed by an applicant wii! be
contacted by the agency.
5. Contractors
Agencies contracfing to provide Weed and Seed funded services/activities shall
certify to the Weed and ho Seed site that they comply with this policy and ail
mandatory guidelines.
b3
Attachment C
Suppiemental checks shall also be conducted as detailed below:
Checks of the state criminal database and the sex ofFender registry wiil be conducted on all _
paid or unpaid empioyees who might have any of the following contacts with chiidren, youth
or vulnerable adults:
One-on-one contact
Day-long contact
Overnight trips
Contact accompanied by liitle or no supervision by other staff
Volunteerslstaff who will transport children/vulnerable adults shall have a valid driver's
(icense.
Education/licensing verification will be completed for all paid/unpaid positions, which
specifically require a certain educational background or ficense.
Mandatory Guidetines
Disqualify all potential volunteers/paid staff who have committed any crime against a chiid
or vulnerabie adult regardless of the age of the conviction.
Qisqualify all registered sex offenders.
Disqualify all potential volunteers/paid staff who have committed a violent crime of any level
in the Jast 10 yrs.
Results of screening will be held in confidence by the agency and will not by shared outside
the agency without an independent release from the appiicant.
Additionai Suggestions
Any costs associated with background checks and screening can be passed along to the
applicant. •
Designate a person(s) in the agency to handle the background check review process.
Develop standard interview and reference check questions.
Utiiize a team interview process or have muitiple staff interview each appiicant personaliy.
Provide designated statfi with training on interviewing techniques and reference checking
methods.
Limit access to the results of background screening to necessary staff only.
03- ��Z
At#achment C
Sample Predatory Offender Regis#ry Release
Authorization to Release information
To
(Insert Agency Name/address/logo)
Name
Current Address
Social Security Number
Agency Contact Person
Authorization expiration date
I authorize the Minnesota Bureau of Criminal Apprehension to release any information
about me that is contained in the Minnesota Predatory Offender Registry, including, but no
limited to, any information regarding registration for offenses committed as a juvenile.
Date
Signature of Prospective Employee
Date
Witness to Signature
o3-�KZ
Aitachment C
Sample Multi-Purpose Release
Authorization To Release Information
To
(Insert Agency Name/address/logo)
Current Address
Social Security Number
Agency Contact
Authorization expiration
1, the undersigned, authorized and consent to any person, firm, organization or corporation
to provide a copy (including photocopy or facsimile copy) of this Authorization to Release
Information by the above-stated agency to release and disclose to such agency any and all
information or records requested regarding me, including but not necessarily limited to my
employment records, volunteer experience, military records, criminal information records, if
any, and educational background. I have authorized this information to be released, either
in writing or by telephone, in connection with my application for employment or to be a
volunteer at the agency.
Any person, firm, organization or corporation providing information or records in
accordance with this aufhorization is released from any and aii claims or liabili#y for
compliance. Such information will be held in confidence in accordance with agency
guidelines.
This aufhorization expires on the date stated above.
(Signature of Prospective EmpioyeeNolunteer)
Date
�tness to Signature
4