I COUNCIL AGENDA REPORT MEETING DATE: 12/ 15/ 15 ITEM NO: I I DATE: DECEMBER 10, 2015 TO: MAYOR AND TOWN COUNCIL FROM: SUBJECT: LAUREL PREVETTI, TOWN MANAGER COMMUNITY GRANTS PROGRAM UPDATE A. RECEIVE THE COMMUNITY GRANTS PROGRAM UPDATE B. PROVIDE DIRECTION ON POTENTIAL MODIFICATIONS TO THE COMMUNITY GRANT PROCESS, FUNDING CATEGORIES, EVALUATION CRITERIA, BUDGET ALLOCATION, OR OTHER ELEMENTS RECOMMENDATION: 1. Receive the Community Grants Program Update; 2. Provide direction on potential modifications to the Community Grant process, funding categories, evaluation criteria, budget allocation, or other elements. BACKGROUND: During the June 2, 2015 budget hearing, the Council expressed an interest in receiving a report on the Community Grant process that included background information, an overview of the grant process, and a summary of past funding allocations. Additionally, Council directed staff to bring requests for one -time Community Grant funding for the Council' s review and consideration during the fiscal year FY) 2015/ 16 mid -year budget review. DISCUSSION: For the last two decades, the of Los Gatos has granted approximately $ 100,000 in General Fund monies annually to approximately forty local nonprofit organizations offering a variety of programs and services to Los Gatos residents that maintain or improve their quality oflife. Until FY 2011/ 12, community grants were administered by the Community Services Department (CSD). This department also administered approximately $36,000 of federal Community Development Block Grant (CDBG) funding to local non - profit agencies each year. In FY 2011 / 12, the CSD was dissolved and the administration of the community grant program transitioned to the Manager' s Office, PREPARED BY: CHRISTINA GILMORE Assistant to the Mana r Reviewed by: rvassistant Manager Attorney Council Reports\December 15 \Community Grants \Community Grants 12. 15. 15.doc
PAGE MAYOR AND TOWN COUNCIL SUBJECT: COMMUNITY GRANTS PROGRAM UPDATE DECEMBER 10, 2015 DISCUSSION (cont' d): and CDGB funds administered by the were diverted to the County of Santa Clara' s Housing and Community Development Advisory Committee for distribution. Community Grant Funding Criteria Community Grants are administered on a one -year cycle with applicants for both the human services, and art, cultural, and educational grants applying for funds that meet one of four funding categories: 1. Seed Program funding to fund the start-up of new programs designed to meet a significant community need or problem; 2. Project funding to fund one -time projects designed to address a significant community need or problem; 3. Emergency funding to fund operational programs in the community which meet an existing need; and 4. Community programs funding to fund programs and services to address identified community needs or problems as stated in the ' s General Plan, action plans, or other policies. To be eligible for Community Grant funding, agencies must: 1. Demonstrate the benefits of program and project services to Los Gatos citizens; 2. Be incorporated as a tax - exempt nonprofit corporation and/or exist as another governmental entity; 3. Demonstrate the managerial and financial capability to receive and expend grant funds; 4. Assure compliance with all applicable local, state, and federal laws; and 5. Demonstrate good faith efforts to secure funding for programs and services from other sources. Attachments 1 and 2 contain the draft Community Grant General Instructions and Grant Application for FY 2016/ 17, which outlines in detail the evaluation criteria, grant process, and a proposed timeline. Community Grant Evaluation Process Community Grants are allocated through a competitive process. Applications are made available at the beginning of the calendar year. Funding availability for Community Grants is based on the amount of funds allocated by the Council in the prior budget year. Attachment 3 contains historical data for the last ten budget years of Community Grant allocations. The Community and Senior Service Commission (CSSC) and the Arts and Culture Commission (ACC) each appoints a Commission member to a Grant Evaluation Committee to review applications to evaluate eligibility, review past performance, examine the quality and quantity of services to be provided, ensure that the proposed program or project services will be of benefit to Los Gatos residents, and make preliminary funding recommendations to the Commissions in their respective area. CSSC considers human services applications and ACC considers art, cultural and educational applications.
PAGE MAYOR AND TOWN COUNCIL SUBJECT: COMMUNITY GRANTS PROGRAM UPDATE DECEMBER 10, 2015 DISCUSSION (cont' d): After listening to the agencies explain their proposals and conducting public hearings in their respective grant area, each Commission makes recommendations to the Council. The Council makes the final determination on all funding recommendations through the adoption of the ' s General Operating Budget, and has the discretion to accept, modify or decline the recommendations for the allocation of Community Grant funds. Community Grant Process Improvements Even though the no longer administers CDBG funding, the uses a federal framework to administer the community grants program, which is time consuming and resource intensive given the small grant amounts. Staff proposes to work with each Commission and to request comments from community agencies to identify potential process improvements for the Community Grant programs, such as: revising the grant application; revising the grant funding cycle from fiscal year to a calendar year; revising the quarterly reporting to include more meaningful performance metrics; revising the agreement for services to assist in expedition of contracts; and digitizing the application to an esignature platform such as SeamlessDocs. Proposed process improvements will be returned for Council consideration and would be implemented in FY 2017/ 18 pending Council approval. Staff also intends to conduct broader outreach to local agencies and organizations who may meet the eligibility criteria to encourage a diverse pool of applicants for Community Grants through the ' s website and social media channels. Community Grant Questions The Community Grants program has not been revised since FY 2011/ 12. As Council expressed an interest in reviewing the grant process, staff seeks direction on the following questions: 1. What changes, if any, are needed to the existing funding categories, evaluation criteria, and budget allocation to meet the Council' s priorities and objectives for the Community Grants program? Staff recommends a Community Grant funding allocation for FY 2016/ 17 based on the prior year allocation estimated at $ 109, 800. 2. What other input or direction would the Council like to offer regarding the Community Grants process?
PAGE 4 MAYOR AND TOWN COUNCIL SUBJECT: COMMUNITY GRANTS PROGRAM UPDATE DECEMBER 10, 2015 CONCLUSION: Based on the information contained in this report on the Community Grants Programs, staff recommends that the Council: 1. Receive the Community Grants Program Update, and 2. Provide direction on potential modifications to the Community Grant process, funding categories, evaluation criteria, budget allocation or other elements. ALTERNATIVES: The Council may choose to receive the report and not provide specific direction at this time. Options for process improvements will come before Council after community outreach is completed, as described in this report. COORDINATION: This report was coordinated between the Manager' s Office, Attorney, and the Finance Department. This report will be made available to the CSSC, ACC and past grant applicants. FISCAL IMPACT: If the recommendations are approved, the Council can provide direction for the budget allocation of Community Grant Funds for FY 2016/ 17. ENVIRONMENTAL ASSESSMENT: This is not a project defined under CEQA, and no further action is required. Attachments: 1. Draft FY 2016/ 17 Community Grant General Instructions 2. Draft FY 2016/ 17 Community Grant application 3. Historical data on Community Grant allocations from FY 2005 /06 through FY 2015/ 16
TOWN OF LOS GATOS * FY 2016/ 17 APPLICATION FOR COMMUNITY GRANT FUNDING GENERAL INSTRUCTIONS Complete this application in full to be considered for FY 2016/ 17 Community Grant funding. Please provide current information most crucial to the evaluation process, including: Agency and Project Information, Budget Data, and Certification. As in prior years, funding is contingent upon the Council' s General Fund allocation to the program and the applicant' s previous program performance. P ose: The purpose of this application is to: 1. Substantiate demographically the assessed need for the project; 2. Gather required data in order to determine eligibility under the Community Grant Program; 3. Document the quality and quantity of services to be provided; and 4. Demonstrate benefit of program /project services to Los Gatos citizens. Eligibility: To be eligible for Community Grant funding, agencies must: 1. Submit a separate, completed application form for each project; 2. Be incorporated as a tax- exempt nonprofit corporation ( IRS 501 -C. 3.) and /or exist as another governmental entity; 3. Demonstrate the managerial and financial capability to receive and expend grant funds; 4. Assure compliance with all applicable local, state, and federal laws including the nondiscrimination requirement; and 5. Demonstrate good faith efforts to secure funding for programs and services from other sources. Funding Categories: Programs for which funding is requested must qualify under one of the categories below. Proposals not fitting into one of these categories will not be considered for funding. Applicant services must directly benefit residents within the incorporated limits of the of Los Gatos. I. Seed Program: Funding for start -up of new programs designed to meet a significant community need or problem. Proposers must demonstrate a high probability that funding can be sustained beyond the commitment of funds. 2. Project: Funding for one -time projects designed to address a significant community need or problem. funding shall be limited to a specific time - frame, usually not more than one year. 3. Emergency: Funding for operational programs in the community which meet an existing need. Applicants must demonstrate that: 1) current programs meet stated goals and objectives; 2) financial constraints will significantly curtail services to residents; and 3) future funding to continue the program can be obtained from other sources. Funding for programs shall be limited to one year. 4. Community Programs: Funding for programs and services to address identified community needs or problems ( as stated in the ' s General Plan, action plans, or other policies). N:\MGR \CSD \GRANTS\ FY 2016-17\ Community Great FY 2016-17 General InswctionsAocx ATTACHMENTI
Evaluation Criteria: Human Service Programs: Evaluation criteria for agencies providing human services include, but are not limited to, the following: Community need for the program Uniqueness of program, lack of duplications in service Qualifications and experience of the agency and its staff Past performance in providing established services and meeting requirements Effectiveness in serving an identified audience Community involvement in program, including volunteers Number of Los Gatos clients served vs. total clients served ( unduplicated clients) Cost per Los Gatos resident vs. cost per non -Los Gatos resident Number of low and very low income clients served Percent of total program budget requested from Reasonable cost Clarity, completeness, and accuracy of grant proposal Arts, Cultural, Educational Programs: Evaluation criteria for arts /cultural/ educational programs include, but are not limited to, the following: Community need for the program Uniqueness of program, lack of duplications in service Qualifications and experience of the agency and its staff Past performance in providing established services and meeting requirements Number of Los Gatos clients served vs. total clients served ( unduplicated clients) Cost per Los Gatos resident vs. cost per non -Los Gatos resident Target audience for program ( e. g., youth, seniors, students) Percent of total program budget requested from Reasonable cost Clarity, completeness, and accuracy of grant proposal Process To assure that all applications receive due consideration and that the Council is provided with all information necessary to make appropriate funding decisions, all grant applications are first reviewed by an Evaluation Committee, consisting of either members of the Community and Senior Services Commission ( which reviews Human Service program applications) or members of the Arts and Culture Commission ( which reviews Arts, Cultural, Educational program applications). The Evaluation Committees determine proposal eligibility based on the Eligibility Guidelines listed in this application, and make funding recommendations to the Community and Senior Services Commission or Arts and Culture Commission based on the Evaluation Criteria listed above. The Commissions, in turn, make funding recommendations to Council. Applicants will be invited to attend Commission meetings to present their applications and answer Commission member questions. Attendance at these meetings is not mandatory, but is recommended. Ineligible proposals will be rejected. The Council makes the final determination on all funding allocations through the adoption of the 2 NA MGR\AdminWorkFi1cs\2015 Council Reports\ Decemba 15 \Community Grants\ Comrounity Grant FY 2016-17 General Instructions Attachment l.pdfdocx
' s Operating Budget. DRAFT Schedule: The schedule for the funding process is as follows: Human Services Timeline* Fr 18, 2015 January 22, 2016 January 25-27, 2016 Task Applications available Applications due by 4: 00 p.m. Staff review applications and prepare summary documents, then distribute to CSSC members. February 1-12, 2016 CSSC Evaluation Committee reviews applications and summary documents, and contacts applicants as needed. Committee meets to consider allocation recommendations. February 16, 2016 CSSC will submit draft funding allocation recommendations for Council consideration during the FY 2015-16 Mid -Year Budget Session. March 1, 2016 11, 2016 CSSC meeting packet mailed to Commissioners and applicants. Packet will include draft funding allocation recommendations. March 22, 2016Ti CSSC Public Hearng CSSC Meeting: brief presentations (3 minutes each) by applicants and questions of applicants by Commissioners. After conclusion of presentations and questions, the Commission will develop its final allocation recommendations to Council. May 2016 Council meeting: Public Hearing to consider FY 2016/ 17 Preliminary Operating Budget. June 2016 Council meeting: adoption of FY 2016/ 17 Operating Budget. All dates are tentative and subject to change. 3 N:\MGR \AdminworkFi1es\2015 Council Reports\ December 15\ Community Grants \Community Grant FY 2016-17 General Instructions Attachment l. pdfdocx
Arts, Cultural, Educational Timeline* Date December 18, 2015 January 22, 2016 January 25-27, 2016 Task Applications available Applications due by 4: 00 p.m. Staff review applications and prepare summary documents, then distribute to ACC members. February 1-12, 2016 February 16, 2016 Arts and Culture Commission Evaluation Committee reviews applications and summary documents, and contacts applicants as needed. Committee meets to consider allocation recommendations. CSSC will submit draft funding allocation recommendations for Council consideration during the FY 2015-16 Mid -Year Budget Session. March 1, 2016 FY 2015-16 Mid -Year Budget Session March 7, 2016 ACC meeting packet mailed to Commissioners and applicants. Packet will include draft funding allocation recommendation. Applicants invited to attend meeting, for brief presentation and question/answer eriod. ACC meeting: brief (3 minutes each) presentation by applicants, March 16, 2016 questions of applicants by Commissioners. After conclusion of ACC Public Hearing presentations and questions, the Commission will develop its final allocation recommendations to Council. May 2016 Council meeting: Public Hearing to consider FY 2016/ 17 Preliminary Operating Budget. June 2016 Council meeting: adoption of FY 2016 /17 Operating Budget. All dates are tentative and subject to change. 4 NAMGR\AdminWorkFiles\2015 Council Reports\ December MCommunity Grants \Community Grant FY 2016-17 General Instructions Attachment I. pdfdocx
Tyne of Contract: This application does not commit the to award a contract, pay any costs incurred in preparing the application, or procure or contract for services or supplies. The reserves the right to accept or reject any or all applications received, to negotiate with all qualified applicants, or to cancel in part or in its entirety the application if it is in the best interest of the. The may also negotiate with qualified agencies to meet community needs. Copies of the standard contract are available for review at the of Los Gatos Manager' s Office. Please be advised that the ' s designee and auditors have the right to access the contracted agency' s records. Proof of client participation is required and must be made available for review by the ' s designee during the course of the contract period ( see sample Participation Agreement, Attachment 2). If funding is awarded, the will also require verification of worker' s compensation and appropriate insurance documents. Funding Availability: Community Grant funds amounting to $ 109, 800 were allocated in FY 2015/ 16 as follows: $ 90,000 to Human Service programs; and $ 19, 800 to Arts, Cultural, and Educational programs. Application Requirements: 1. 2. 3. 4. 5. Completed applications are due by 4:00 p.m., January 22, 2016, at the of Los Gatos Manager' s Office, 110 East Main Street, Los Gatos. Applications will not be accepted after the deadline. One ( 1) copy of the documents listed on the Applicant Agency/Program Documents Checklist and three ( 3) copies of the completed application form must be submitted. Electronic copies will not be accepted. Please do not include literature or attachments beyond those required or necessary to present a complete and effective application. Failure to submit a concise, complete application shall be evidence of the proposer' s inability to undertake program objectives. All applications must be submitted on the forms provided and in a manner consistent with the instructions. Applications must be word processed or typed. All supplemental materials shall be returned to agencies not selected for funding upon request only. For additional information, please contact: Via Phone: Shelley Neis, Clerk Administrator 408) 354-6834 Via Email: sneis@losgatosca.gov In Person: of Los Gatos Manager' s Office 110 East Main Street Los Gatos, CA 95030 5 NAN4GR\ AdminWorkFi1es\2015 Comcil Reports\December 15 \Community Grants \Commmity Grant FY 2016-17 General Instructions Attachment I. pdfdoex
II ;. 1 of Los Gatos FY 2016/ 17 Community Grant Program Application Summary Project: Project/Program: Program Manager: Agency: Name of Agency Site Address: Name of Executive Director Project Description: Provide brief description of agency, agency goals, and agency services. List direct services and quantity below. Direct Services Service FY 2016/ 17 FY 2015/ 16 proposed) ( actual) Program Funding: Provide prior year fiscal year actual budget amounts and proposed amounts for new fiscal year. Program Funding: FY 2016/ 17 FY 2015/ 16 Clients: FY 2016/ 17 FY 2015/ 16 requested) adopted) proposed) actual) annual funding amount Total annual program budget Unduplicated annual Los Gatos clients Total unduplicated annual clients $ as % of annual Los Gatos total clients as % of annual total Annual services per Los Gatos client N: NGR \CSD \GRANTS\ FY 2016-17 \One Year Grant Application.2016-17 rev. 2. docx ATTACHMENT
TOWN OF LOS GATOS e FY 2016/ 17 APPLICATION FOR COMMUNITY GRANT FUNDING APPLICANT AGENCY /PROGRAM DOCUMENTS CHECKLIST Please submit one copy of each of the documents listed below with your completed application. This page should serve as the cover sheet for that section of your submittal. I. PROGRAM/PROJECT INFORMATION Fee Schedule, Membership, or other fees II. AGENCY INFORMATION Current Board of Directors Articles of Incorporation Bylaws Organizational Chart Brochures, Flyers, Promotional Materials III. FISCAL INFORMATION Audit or Financial Statement plus Letter of Auditability Organizational Budget Internal Revenue Service Ruling Letter ( Section 501 c. 3) California Revenue Code ( Section 23701 d) N:\MGR \CSD \GRANTS\FY 2016-17\One Year Grant Application.2016-17 rev. 2. docx 2
TOWN OF LOS GATOS %% FY 2016/ 17 APPLICATION FOR COMMUNITY GRANT FUNDING GRANT APPLICATION I. PROGRAM/PROJECT INFORMATION A. Contact Information B. Community Need Statement Describe briefly the demonstrated need in the Los Gatos community for the program. Cite data sources as appropriate. C. Program Statement Describe your program briefly, including the following: who benefits from your program; what direct services will be provided through the program; how, when, and where services are to be delivered; and why these services should be provided in Los Gatos. NAMGR\ CSD\ GRANTSTY 2016-1T0ne Year Gmt Applicati 0 3 on.216-17 rev.2.dox
D. Direct Services For Human Services and Arts, Culture and Education grant requests, list, describe, and quantify each direct service to be provided annually from July 1, 2016 through June 30, 2017. A Direct Service is a service for which there is an identifiable client. A Participation Agreement ( Attachment 2) must be completed by each client receiving the direct services described below. FY 2016/ 17 FY 2016/ 17 1. Description of Service Number of Services Provided Annually Number of Unduplicated Los Gatos Residents served Annuall 2. 3. 4. 5. Average number of direct services received by each unduplicated client: _ Average number of direct services received by each unduplicated Los Gatos client: _ E. Indirect Services List, describe, and quantify each indirect service to be provided annually from July 1, 2016, through June 30, 2017. An Indirect Service is a service for which there is no identifiable client; for example, information and referral that is given over the phone. N:\MGR\CSD \GRANTS\FY 4 2016-17 \One Year Grant A PP lication. 2016-17 rev.2.docx
F. Demographic Information Provide demographic breakdown of unduplicated Los Gatos residents to receive direct services. G. Client Participation Requirements Attach appropriate fee schedules, membership requirements, or other fee listings. II. AGENCY INFORMATION A. General Information Legal Name of Organization Address of Organization Name of Executive Director Date of Incorporation Insurance/ Tax Information Federal Employer Tax Number State Employer Tax Number WorkWs Compensation Carrier/ Policy Number N:\ MGR \CSD \GRANTS\FY 2016-17 \One Year Gant Application.2016-17 rev.2.docx
Insurance Carrier Amount of Liability Coverage Property Damage ( combined with liability) Combined Single Limit Policy Period B. Staffing Profile Please complete the chart below for your organization as it will be staffed during FY 2016/ 17. Identify the volunteers. hours to be devoted to the program for which you are requesting funding, for both employees and Employees Position Title Number in Approximate Hours Worked Percent of Time Classification Hourly Rate per w k to Program Volunteers C. Agency Experience -- Describe the experience of your Agency in providing program services. D. Staff Experience -- Describe the experience of key staff assigned to the program. E. Staffing Plan -- Describe any anticipated staffing changes to occur during FY 2016/ 17. N:\ MGR \CSD \GRANTS\ FY 2016-17 \One Year Grant Application.2016-17 rev. 2. docx
III. FISCAL INFORMATION A. Program Budget Please complete the following summary tables to reflect the FY 2015/ 16 budget for your organization and program. All amounts should be rounded to the nearest dollar. Alternatively, please attach single page revenue for the organization. /expense summary sheets for the program for which funds are requested and a separate summary Budget Data FY 2016/ 17 Los Gatos grant funding Total Program budget $ $ Los Gatos grant as percentage of % total Program budget Total Organization budget $ $ Cost per year per unduplicated $ $ Los Gatos client Requested: Received: FY 2015/ 17 FY 2016/ 17 FY 2016/ 17 FY 2015/ 16 FY 2015/ 16 Organizational Program Organizational Revenue Source Program Budget Budget Budget Budget Los Gatos grant Other municipal funding please specify: ) County funding please specify:) State funding please specify:) Federal funding please specify:) Otherjurisdiction funding please specify:) Fees for services Donations Reserve contingency fund All other sources please specify:) g Total N:\MGR \CSD \GRANTS\FY 2016-17 \One Year Grant Application. 2016-17 rev.2.docx N:\MGR \CSD \GRANTS\FY 2016-17 \One Year Grant Application. 2016-17 rev.2.docx
Personnel Expense Category Facility Overhead f $ Materials /Supplies Professional Services Fundraising Capital Projects Other please specify) Total FY 2016/ 17 Organizational Budget FY 2016117 FY 2015/ 16 FY 2015/ 16 Program Organizational Program Budget Budget Budget B. B. Organization Organization Contracts Contracts - - - - Has Has your your organization organization ever ever had had funds funds withdrawn withdrawn or or aa contract contract terminated terminated for for cause, cause, unsatisfactory unsatisfactory performance, performance, or or questionable questionable costs costs on on any any financial financial statements statements or or audit. audit. If If so, so, please please describe. describe. C. C. Organization Organization Investigations Investigations - - - - Is Is your your organization organization currently currently on on probation probation or or under under investigation investigation by by any any agency agency which which is is or or was was aa funding funding source source within within the the past past two two years? years? If If so, so, please please describe. describe. D. D. Budget Budget Alternatives- Alternatives- - - What What alternatives alternatives will will your your organization organization consider consider if if the the requested requested Community Community Grant Grant funding funding is is not not provided, provided, or or provided provided at at aa reduced reduced level? level? Describe Describe how how aa reduction reduction will will affect affect the the achievement achievement of of stated stated goals. goals. E. E. Funding Funding Sources Sources -- -- Describe Describe your your organization' organization' ss efforts efforts in in pursuing pursuing other other funding funding sources. sources. F. F. Supplies Supplies Disclosure Disclosure - - - - If If any any non non - - expendable expendable supplies supplies with with aa unit unit cost cost of of $ $ 100 100 or or more more are are to to be be Purchased Purchased with with Community Community Grant Grant funds, funds, please please describe. describe. G. G. please please describe. Travel describe. Travel Expense Expense Disclosure Disclosure - - - - If If Community Community Grant Grant funds funds are are to to be be used used for for staff staff travel travel expenses, expenses, N:WGRICSD \GRANTS\ FY 2016-17 \One Year Grant Application.2016-17 mv.2.docx N:WGRICSD \GRANTS\ FY 2016-17 \One Year Grant Application.2016-17 mv.2.docx
N:NGR \CSD \GRANTS\ Fy 2016-17\ One Year Gant Application.2016-17 rev. 2. DRAFT CERTIFICATION The applicant hereby proposes to provide the services as listed in this proposal. If this proposal is approved and funded, it is agreed that relevant federal, state, and local regulations, including nondiscrimination laws and other assurances as required by the of Los Gatos, will be adhered to. Furthermore, as the duly authorized representative of the applicant organization, I certify that the applicant is fully capable of fulfilling its obligation under this proposal as stated herein. knowledge. This application and the information contained herein are true and correct and complete, to the best of my Date: 2016 Organization Name Executive Director Print Name)
ATTACHMENT SAMPLE PARTICIPATION AGREEMENT Over the course of the contract period, a grantee may be required submit Participation Agreements similar to this sample. Do not submit this Sample Participation Agreement with your completed application. a nonprofit corporation and families in Santa Clara County. Partial funding (subsidy) forth se services is provided under duals contract by the of Los Gatos to this Agency. This information is reviewed for quality control and/or auditing purposes only. Therefore it is held in Information." confidence by the Agency, the, and the Federal representatives and not considered " Public The purpose of this Participation Agreement is as follows: 1. 2. 3 4. with To have an opportunity the client acknowledge to evaluate such the request services. and receipt of needed services and provide the client To have the client authorize the release of demographic information to the Agency /the. To assure the client that information about them is held in confidence and not considered public information and that only statistical information about all clients served is reported. To have the client hold harmless and release from liability the Agency, the, and their respective employees, officers, and agents in the event of any suit, claim, loss, damage, or obligation arising out of/or attributed to any of the Agency' s programs. Please complete the following: Name Address: Age: Phone: Sex ( check one): Male Female Disability Status ( check one): Disabled Not Disabled Female Head of Household ( check one): Yes No Income Level ( check one): 30% of median and below 31 % - 50 % of median 51 % - 80 % of median 81 % - 100% of median Above 100% of median complete. I understand that this agreement is an affidavit and certify that the information provided above is true and Signature Date NAMGR \CSD \ GRANTSWY 2016-17 \One Year Cn t Applica[ion.2016-17 rev.2.
CDBG Total CDBG 36, 681 36, 681 35,564 32, 720 27, 050 24, 640 20,464 20,358 COMMUNITY GRANTS SUMMARY Human Services Source 2005/ 06 Actuals 2006/07 Actuals 2007/ 08 Actuals 2008/ 09 2009/ 10 2010/ 11 2011/ 12 2012/ 13 2013/ 14 2014/ 15 2015/ 16 Actuals Actuals Actuals Actuals Actuals Actuals Estimated Budgeted Catholic Charities/ LTC Ombudsman CDBG 7, 680 7, 680 7,680 7, 680 7, 370 7, 370 7, 370 Live Oak Adult Day Services CDBG 12, 988 12, 988 12, 988 12, 980 12, 470 12, 470 13, 094 Second Harvest Food Bank CDBG 3, 802 3, 802 3, 802 3, 800 4, 800 4, 800 7, 370 12, 988 SJSU Foundation/ The Health Place CDBG 12, 211 12, 211 11, 094 8, 260 2,410 Emergency Housing Consortium 1, 574 1, 574 1, 574 Live Oak Adult Day Services Live Oak Sr. Nutrition and Service 27, 456 27,456 27,456 27, 456 26, 360 26, 360 26,360 Next Door Solutions Dom. Violence 12, 000 12, 000 8, 903 12, 000 11, 520 11, 520 LGS Recreation Department Case Management 26, 360 Helping 000 13, 094 13, 000 13, 000 26,360 26, 500 26,500 11, 520 11, 520 15, 000 15, 000 15, 000 Parents Hel rn Parents 1, 920 7, 000 1, 920 1, 920 1, 920 1, 840 1, 840 A Place for Teens 1, 840 1, 840 2, 000 10, 840 2, 000 13, 340 2, 000 13, 340 14, 975 10, 950 10, 950 Support Network 8, 213 4, 800 4, 800 4,800 4, 800 4, 600 4, 600 4,600 SJSU Foundation/ The Health Place 4, 600 6,000 4, 681 6,000 4, 681 6,000 5, 798 8, 630 13, 810 16, 220 16,220 16,220 Teen and Family Counseling Center 27,044 27,044 27, 044 27, 050 9,975 1, 890 United Way - 211 Funding 2, 500 2,400 2, 400 Teen Force 2,400 2, 400 2,4, 00 200 5, 2 500 5, 000 5, 000 Santa Clara Family Health Foundation 1, 100 Counseling and Support Services for Youth 1, 100 10,000 10,000 15, 000 West Valley Community Services 16,800 15, 000 Total Human Services Grants 3, 146 12_ 6 10, 000 10, 000 129,496 126, 399 132, 051 108, 505 100,420 107,717 106, 398 83, 000 98,800 90,000 Art, Cultural, Educational Art Docents of Los Gatos Festival Theatre Ensemble Los Gatos Community Concert Photographic Guild of Los Gatos 4, 500 4, 500 4,500 4, 500 4, 260 4, 260 4,000 4, 000 4, 000 4,000 3, 000 1, 000 870 1, 000 St. Luke' s /Sunset Concert Series 500 500 Forbes Mill Cat Walk Arts Comission Cinecats 500 870 1, 000 1, 000 900 900 1, 000 1, 000 1, 400 1, 400 1, 400 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 1, 000 2, 236 4, 200 3, 000 8, 000 4, 200 4,400 2, 000 Community Contributions Los Gatos Museum Association Total Community Contributions Total Art, Cultural, Educational Grants 6,870 7 370 8, 500 8,500 8, 160 8, 160 8,000 8, 000 17,636 15,800 14,800 12,430 12, 430 12, 430 12, 430 12, 430 12,430 12, 430 12, 430 4. 000 5, 000 12,430 12,430 12, 430 12, 430 12,430 12,430 12, 430 12 430 4, 000 5, 000 ' s General Fund Total 109, 615 112, 615 111, 765 120,261 102,045 96,370 107,683 106, 470 100, 636 118, 600 109, 800 N: N: WGR\ WGR\ AdminWorkFiles\ AdminWorkFiles\ 2015 2015 Council Council Reports Reports \ \ December December 15 15 \ \ Community Community Grants\ Grants\ Attachment Attachment 33 Commuity Commuity Grants Grants Summary Summary FY FY 2005 2005 - - 2016 2016 ATTACHMENT ATTACHMENT