United Way Funded Partner Agreement Name of Organization The Agreement includes the following sections: I. Overview II. The Spirit of the Agreement III. The Letter of Agreement IV. Deliverables/Monitoring and Evaluation of Programs V. Extensions Exemptions Sanctions and Terminations VI. General Provisions VII. Addendums A & B, Patriot Act Compliance Form I. Overview United Way of Lake and Sumter Counties, Inc. (hereafter United Way) efforts are focused in three Impact Areas: Health, Income and Education. United Way is an organization that changes community conditions. To do so, United Way engages in research and measures results that identify best practices, mobilizes policy change, raises awareness through marketing/media, engages the business community, generates and leverages resources and provides financial support. Our respective organizations share a mutual responsibility to work together to build a better community. Two important sections will help to accomplish this goal: The Spirit of the Agreement, which includes expectations of Funded Partners and United Way, and the Letter of Agreement, which outlines specific requirements of each. II. The Spirit of the Agreement This agreement is predicated on creating a spirit of partnership based on mutual respect, cooperation, and support that will enable United Way and Funded Partners to improve the quality of life across our community. A Partner is defined as a not-for-profit organization or collaborative partnership meeting certification standards, receiving discretionary funding from or through United Way to provide local services that assist in achieving significant impact in the established impact areas. This agreement governs partners receiving funding through United Way s Community Impact process. With a realization that both United Way and the Funded Partner face increasingly difficult challenges and increasing demands, the Agreement presents opportunities for the organizations to work together cooperatively rather than separately, to achieve the overall goal of building a better community. Within the Spirit of Agreement, United Way and Funded Partners agree: To provide/support local services that are oriented to the achievement of measurable outcomes; To assist each other in achieving community change through the community impact areas; To actively engage in community conversations/roundtables to explore and expand community impact initiatives; To communicate to each other any issue or problem that potentially could have a negative impact on the working relationship; 1
To actively and enthusiastically promote the partnership between United Way and the Funded Partner, and vice versa, to the public in a positive manner. Recognizing that this agreement does constitute a contractual relationship between the United Way of Lake and Sumter Counties, Inc. and Funded Partners, the spirit inherent in the Agreement will ultimately determine its effectiveness. III. The Letter of Agreement This section of the United Way Funded Partner Agreement requires cooperation based on mutual respect, need, and collaboration between United Way and its Funded Partners to fulfill and abide by the following requirements to ensure that funds provided by the public through United Way are used in an effective and efficient manner. A. Expectations of Funded Partners 1. Funded Partner Status Once funded through the community impact process, each awarded organization agrees to become a Funded Partner and to sign the United Way Funded Partner Agreement. (Addendum A: Funded Partner Agreement Signature Page). Partner status does not constitute a commitment to funding beyond the current funding cycle. 2. Promotion of United Way As competition for limited charitable dollars increases, United Way and Funded Partners should utilize every possible opportunity to increase mutual visibility, promote the partnership and comarket with each other. Therefore, Funded Partners will include the United Way logo on newsletters and websites. Use of the logo should be discussed with United Way Resource Development Director prior to publication. 3. Internal United Way Campaign One method that United Way uses to achieve its outcomes is by raising and disbursing funds to support programmatic efforts within our impact areas. While Funded Partners board and staff members concentrate their efforts on the services their organization provides, they should acknowledge the interdependence and should understand the need to support United Way. Therefore, Funded Partners should conduct an internal United Way campaign among employees, and should promote and support the campaign including distributing pledge forms. An internal campaign must be completed and reported by November 1, 2015. 4. Program Changes a. Funded Partners agree to inform United Way in writing of any program changes in the United Way-funded program(s) including: change in program location, change in program director, change in major program components/service delivery mechanism, etc. within ten (10) business days of the major change. 2
b. When program changes are material, the Funded Partner agrees to inform United Way in writing in advance of the program change, and agrees to submit a revised program proposal. 5. Financial Responsibility Funded Partners agree to maintain financial records on accrual basis in accordance with the standards of accounting and financial reporting for voluntary health and welfare organizations. B. Expectations of United Way 1. Outcomes Based Commitment United Way will require Funded Partners to attend Performance Outcomes Measurement Training Sessions to achieve measurable outcomes in the impact areas. Training dates will be notified in advance during the grant period. 2. Support of Funded Partners a. United Way will monitor and share the results of the Funded Partner program and client outcomes with, i.e. United Way staff, volunteers, media, public officials, businesses, and citizens of the local community. b. United Way commits to providing support beyond financial assistance as well when available. If allowed by the donor, Funded Partners are given preference in the distribution of other resources. These may include: 1. Gifts-in-kind from local businesses and individuals such as donated computers, office supplies, furniture etc. 2. Philanthropic funds, special gifts and grants contributed by foundations, businesses, service clubs, and individual donors. 3. Technical assistance requests include preparing proposals, creating systems to track information, and tracking and reporting client outcomes. 4. Volunteer recruitment for boards, committees and projects. 3. Financial Accountability a. United Way will keep financial records, according to GAP standards that show how funds are disbursed in order to demonstrate its accountability to Funded Partner. b. United Way will complete an independent annual CPA audit of its accounts and to make the audit available to Funded Partner upon request, within 9 months of the close of the United Way fiscal year. 3
IV. Deliverables/ Monitoring and Evaluation of Programs United Way agrees only to request reports and information that support one of its three primary emphases: agency financial or program accountability, information and data for planning/needs assessment, and information to support Resource Development. 1. Funded Partner will report on the outcomes of the program funded in a narrative report according to the outcomes outlined in the grant proposal at the dates required by this agreement. 2. Funded Partners expenditures must reflect items listed on the approved grant budget. Any changes to the budget must be reported and approved by United Way before expense is made. Adjustments are not guaranteed until approved by United Way. 3. Funded Partner must submit reports as defined in Addendum D: memorandum of understanding 4. Site visits offer an opportunity for United Way and Funded Partners to interact and learn about programs. United Way volunteers and/or staff reserve the right to visit each funded program at least once during the funding cycle in order to accomplish our due diligence. V. Extensions, Exemptions, Sanctions and Terminations A. Extensions Funded Partners needing an extension of a noted delay agree to submit its request in writing 15 days prior to the noted deadline. The request should include an explanation of the circumstances which necessitate the extension and the day/date when their required information will be submitted. United Way will review the request and may grant an extension in writing. B. Exemptions A Funded Partner that is unable to comply with a mandatory item may, at the time the agreement is signed, request an exemption. The request should include an explanation of the circumstances, which necessitate the exemption, and any alternative plan the agency has put in place to ensure future compliance. C. Sanctions A Funded Partner that has elected not to submit mandatory information or participate to United Way s satisfaction in all the provisions described in Sections III. A. and that has not been granted a written extension in the submission date or exemption for the requirement will have its service grant funds automatically withheld beginning with the first payment following the respective deadline of each mandatory item. The agency is afforded ten days to become compliant or the funding for that cycle will be forfeited. Once funding is forfeited, the agency must submit a written plan of action for correction within ten days or all future funding is forfeited. Funded Partner understands that there are few, if any circumstances under which an exemption would be granted for a mandatory requirement. 4
D. Terminations 1. Reasons for Agreement Termination a. Nonperformance or inability to meet program goals for a United Way Funded program. b. Provision of poor quality of service; c. Poor accountability of funds; d. Decision not to submit required reports and supplemental information; e. Decision not to participate in required trainings; f. United Way s inability to fund at the level determined through the Community Investment RFP process. g. Decision not to provide reports of outcomes. h. Decision not to provide receipts for items purchased. i. Decision not to inform UWLS of program changes. 2. Notification of Agreement Termination Both United Way and the Funded Partner agree to give a minimum 30 days written notice of intent to sever the agreement. VI. General Provisions 1. Funding Commitment This United Way Funded Partner Agreement cannot constitute a funding commitment since available service allocation funds are contingent upon the United Way Board s designation of unrestricted funds for service allocations. Therefore, this agreement creates no obligation on the part of United Way to guarantee funding in any portion of the funding cycle. The agreement is, however, a statement of intent to fund. 2. Continued Funding At its sole discretion, United Way may elect to extend this contract, or require new application for funding with a new funding cycle. 3. Nondiscrimination, Equal Opportunity, Employment and Affirmative Action Funded Partners, in their employment policies and practices, in their public accommodations and in their provision of services, agree to comply with the applicable regulations of the Civil Rights Act of 1964 regarding equal employment opportunities and reaffirm their institutional nondiscriminatory policy. 4. Conflict of Interest Funded Partner agrees to establish safeguards and to prohibit its employees, board members, advisors and agents from using their position for any purposes that are, or give the appearance of being, motivated by a desire for private gain for themselves or others, particularly those with whom they have family, business or other ties. Said safeguards should be substantially designed and executed to prevent actual violations of applicable conflicts of interest laws. Funded Partner agrees to disclose in writing to United Way any conflict of interest or potential conflict of interest described above, immediately upon discovery. 5
5. Indemnification Under the terms of this Agreement, Funded Partner agrees to defend, indemnify and hold harmless United Way and its officers, directors, employees, independent contractors, agents and representatives, appointed boards and commissions, officials, officers, employees and insurance carriers, individually and collectively, from all losses, claims, suits, demands, expenses, subrogation s, attorney s fees or actions of any kind and nature resulting from personal injury to any person, including clients, officers, directors, independent contractors, agents representatives and employees of the Funded Partner or damages to any property, arising or alleged to have arisen out of the work to be performed in conjunction with this Agreement. Attachments: Addendum A: Funded Partner Agreement Signature Page Addendum B: Award Amount, Payment Schedule, Special Provisions, Report Dates Addendum C: Funded Partner Outcomes Addendum D: Patriot Act Compliance Forms 6
Addendum A: Funded Partner Agreement Signature Page NAME OF ORGANIZATION: 1. This Funded Partner Agreement, upon its approval by both United Way and the Funded Partner, shall supersede any previous signed agreements executed between the United Way and the Funded Partner. All addendums are an integral part of this agreement and must be submitted together with the signed agreement. 2. This Agreement shall be binding from to. 3. Should the Partner withdraw from its funding relationship with the United Way or refuse to sign the Funded Partner Agreement, organization program funding shall cease and the Partner shall not be entitled to draw the remainder of its approved allocation unless the Board of Directors has negotiated otherwise. 4. No allocation shall be released until the Agreement is signed by both parties. In witness of approval of the Funded Partner Agreement the undersigned have affixed their signatures: Organization Name: BY Executive Director/ Authorized Signature DATE UNITED WAY OF LAKE & SUMTER COUNTIES, INC. BY Dr. Alan Holden President/CEO DATE 7
Addendum B: Award Amount, Payment Schedule, Special Provisions, Report Dates Award Amount: $ Payment Schedule: The grant will be dispersed in two payments. First payment of $ before, upon submission of a signed Agreement, and any other required documents. The second payment of $ will be on upon satisfactory submission of the required reports and documents. Payments will be made via check. Report Dates: Mid-Term narrative and financial report is due June 24, 2015 Final Report is due August 14, 2015 ORGANIZATION BY Executive Director/ Authorized Signature DATE UNITED WAY OF LAKE & SUMTER COUNTIES, INC. BY Dr. Alan Holden, President/CEO DATE 8
Addendum C: Funded Partner Outcomes Form-Please return with signed agreement to UWLS. Program Goal(s) Output(s) Measurement Tool(s) Outcome(s) 9
Addendum D: USA PATRIOT ACT COUNTERTERRORISM COMPLIANCE In compliance with the spirit and intent of the USA PATRIOT ACT and other counterterrorism laws, United Way of Lake & Sumter Counties, Inc. requests that each funded agency ( Organization ) certify that it is in compliance with the United Way of Lake & Sumter Counties, Inc. and United Way Worldwide s ( UWW ) compliance program. Organization Name: Check the Appropriate Box to Indicate Your Compliance with Each of the Following: This Organization is not on any federal terrorism watch lists, including the list in Executive Order 13224, the master list of specially designated nationals and blocked persons maintained by the Treasury Department, and the list of Foreign Terrorist Organizations maintained by the State Department. This Organization does not, will not and has not knowingly provided financial, technical, in-kind or other material support or resources* to any individual or entity that is a terrorist or terrorist organization, or that supports or funds terrorism. This Organization does not, will not and has not knowingly provided or collected funds or provided material support or resources with the intention that such funds or material support or resources be used to carry out acts of terrorism. This Organization does not, will not and has not knowingly provided financial or material support or resources to any entity that has knowingly concealed the source of funds used to carry out terrorism or to support Foreign Terrorist Organizations. This Organization does not re-grant to organizations, individuals, programs and/or projects outside of the United States of America without compliance with IRS guidelines. This Organization takes reasonable, affirmative steps to ensure that any funds or resources distributed or processed do not fund terrorism or terrorist organizations. This Organization takes reasonable steps to certify against fraud with respect to the provisions of financial, technical, in-kind or other material support or resources to terrorists and terrorist organizations. Comply Do Not Comply *In this Form, material support and resources means currency or monetary instruments or financial securities, financial services, lodging, training, expert advice or assistance, safe houses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials. I certify on behalf of the Organization listed above that the foregoing is true. Print Name: Signature: 10 Title: Date: