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Home My WebLink About2007-06-05-9:00AM-REGULARoR nF 1 Y OF 9 �� BRAZOSCOUNTY BRYAN,TEXAS NOTICE OF MEETING AND AGENDA BRAZOS COUNTY COMMISSIONERS COURT THE COMMISSIONERS COURT OF BRAZOS COUNTY WILL MEET IN REGULAR SESSION ON 5 JUNE 2007 AT 9:00 A.M. IN THE COMMISSIONERS COURTROOM OF THE BRAZOS COUNTY COURTHOUSE, 300 E. 26Tn STREET, SUITE 115, BRYAN, TEXAS. 1. Invocation and Pledge of Allegiance — Commissioner Cauley. 2. Call for citizen's input and /or concerns. 3. Presentation of the 49h Annual County Judges & Commissioners Continuing Education certificates to the Commissioners Court. Consider and take action on agenda items 4 —18: 4. Budget Amendment 06/07 -30.1 thru 06/07 -30.9. 5. Personnel Change of Status. 6. Out of state travel for Jail Administrator Wayne Dicky to attend the American Jail Association conference in Nashville, Tennessee on 18 -25 May 2007. Travel was not approved in advance. 7. Payment of Claims. 8. Ratify the authority of the County Judge to sign on behalf of Brazos County for the sale of approximately 10 acres to the City of Bryan, previously approved. 9. Reappointment of Dr. Roland Haden to the Research Valley Partnership Board of Directors. Term of appointment is 1 June 2007 through 31 May 2010. Office of the County Judge . 300 East 26'" St. • Suite 114 • Bryan, Texas 77803 • Fax: (979) 361 -4503 V005 PAGE I Commissioners Court Agenda 5 June 2007 Page 2 10. Contract with John R. Clark & Associates for assistance in the identification and purchase of property appropriate for the joint relocation of the Brazos County Tax Office and the Appraisal District. 11. Renewal of the Brazos County District Clerk's Depository Contract with Citibank N.A.; contract term is 1 June 2007 through 31 May 2009. 12. Renewal of the Brazos County District Clerk's Depository Contract with Wells Fargo Bank; contract term is 1 June 2007 through 31 May 2009. 13. Contract renewal with the Department of Health and Human Services for the National School Lunch Program at the Brazos County Juvenile Center and the Brazos County Academy for the 2007 -2008 academic year. 14. Permission for the City of Bryan to fill a pond on Brazos County property at 1835 Sandy Point Road to facilitate the maintenance of a new sanitary sewer line. 15. Out of state travel request for Judge Steve Smith, 361 st District Court, to travel to Reno, Nevada to attend the Scientific Evidence and Expert Testimony course offered at the National Judicial College; dates of travel are 16 -19 July 2007. 16. Out of state travel request for one MPO staff member to attend the National Transportation Public Affairs Workshop on 7 -10 August 2007 in Seattle, Washington. 17. Reimbursement of $107.50 to the Justice of the Peace Pct. 4 account 61801000 (travel) from the Justice of the Peace Technology Fund for attendance at a seminar that included technology training. 18. Requisition 00014170 to Alamo Iron Works for the capital purchase of a Pallet Jack for the Exposition Complex. 19. Acknowledgement of the Monthly Reports submitted in May 2007. These reports are available for review in the County Judge's Office. 20. Announcement of interest items and possible future agenda topics. 21. Citizens input on the Brazos Valley HOME Consortium 5 -year strategic plan. 22. Call for citizen input and/or concerns. 23. Agency / Board / Committee reports by Court members. 24. Adjourn The Brazos County Courthouse is wheelchair accessible. Handicap parking spaces are available. Any request for sign interpretive services must be made two business days before the meeting. To make arrangements, call (979) 361 -4102. VOL q5 PAGE COMMISSIONERS' COURT REGULAR MEETING JUNE 5, 2007 A regular meeting of the Commissioners' Court of Brazos County, Texas was held in the Brazos County Commissioners Courtroom in the Courthouse in Bryan, Brazos County, Texas, beginning at 9:00 a.m. on Tuesday, June 5, 2007 with the following members of the Court present: Randy Sims, County Judge, Late; Lloyd Wassermann, Commissioner of Precinct 1; Duane Peters, Commissioner of Precinct 2; Kenny Mallard, Commissioner of Precinct 3; Carey Cauley, Jr., Commissioner of Precinct 4, Presiding; Karen McQueen, County Clerk. The attached sheet contains the names of the citizens and officials that were in attendance. Commissioner Cauley asked the Reverend Jones to give the invocation and then he led the pledge of allegiance. Under citizen input /and or concerns, the following spoke: Rev. Robert Wilson a) Announced that a dedication ceremony will be held for the Pruitt family. The renaming ceremony of 20th street to Pruitt Street will be at 10:00 a.m. on June 23 at the African American Museum. At this point, the County Judge came in, but allowed Commissioner Cauley to continue presiding over the Commissioners Court meeting. Vol q5 Page 3 Commissioners Court meeting June 5, 2007 2 The next matter before the Court was the presentation of the 49th annual County Judges & Commissioners Continuing Education certificates to the Commissioners Court. Ag Extension Agent Dr. Alma Fonseca presented the certificates to the Court. The Court next considered Budget Amendment #06/07 -30.1 through 30.9 that would reallocate funds for the Clear Team, Court Support Costs, General Capital Improvements, Justice of the Peace, Precinct 1, Road and Bridge Department, Jail Administration, TEEX -State Homeland Security and County Court at Law #1; transfer funds from Contingency to County Clerk Records Management. On motion by Commissioner Peters, seconded by Commissioner Wassermann, the Court voted unanimously to approve the budget amendment as submitted, a copy of which is attached hereto. The Court proceeded to consider the change of status of employees as submitted on the attached Personnel Action Requests. On motion by Commissioner Peters, seconded by the County Judge, the Court voted unanimously to approve the changes as submitted. The next matter for consideration by the Court was a request submitted by the Jail Administrator seeking approval for out of state travel for himself to attend the American Vol Q5 Page q- Commissioners Court meeting June 5, 2007 3 Jail Association Conference in Nashville, Tennessee May 18 -25, 2007. On motion by the County Judge, seconded by Commissioner Peters, the Court voted unanimously to grant the request from the Jail Administrator and approved payment of out of state travel expense for Wayne Dicky. The Court next considered the following Claims as submitted by the County Treasurer for payment: 7031811 through 7031992 On motion by Commissioner Mallard, seconded by Commissioner Peters, the Court voted unanimously to approve the Claims as submitted. The Court next considered ratifying the authority of the County Judge to sign on behalf of Brazos County, for the sale of approximately 10 acres to the City of Bryan. This had been approved previously. On motion by Commissioner Peters, seconded by Commissioner Wassermann, the Court voted unanimously to ratify the authority of the County Judge to sign on behalf of Brazos County. The next matter before the Court was the appointment of an individual to serve on the Research Valley Partnership Board of Directors. On motion by Commissioner Cauley, seconded by Commissioner Mallard, the Court voted unanimously Vol q5 Page S Commissioners Court meeting June 5, 2007 q to reappoint Dr. Roland Haden to serve on the board for a term beginning June 1, 2007 through May 21, 2010. The Court next considered entering into a Commercial Buyer /Tenant Representation Agreement with John R. Clark and Associates for assistance in the identification and purchase of property appropriate for the joint relocation of the Brazos County Tax Office and the Appraisal District. The term of the agreement begins June 6, 2007 and ends May 31, 2008 or the closing of the transaction of the last property that the client intends to acquire. The County Judge moved to approve. Commissioner Cauley seconded the motion. If the County purchases a property, Mr. Clark will receive a commission of 2.5 percent of the gross sale price. If Brazos County has not closed on a property as of December 1, 2008, Brazos County shall pay broker $5,000.00 for services rendered to date. If one of the alternative properties is purchased, broker shall deduct $5,000.00 from any commission earned. Commissioner Peters clarified with Mr. Clark that if the property is already listed with him as listing agent there will be no additional charge. Mr. Clark will accept the co- broker price. Commissioner Peters asked that the lease commission on page 3, item number 11 be stricken of the County to lease property There is no intent on the part Vol RS Page (P The purpose is to purchase Commissioners Court meeting June 5, 2007 5 property. On motion by the County Judge, seconded by Commissioner Peters, the Court voted unanimously to approve the amendment here. Then on motion by the County Judge, seconded by Commissioner Cauley, the Court voted unanimously to approve the agreement. A copy is attached. The Court next considered renewal of the Brazos County District Clerk's Depository Contract with Citibank N.A. This will renew for a term of two (2) years and not extend beyond May 31, 2009. On motion by Commissioner Wassermann, seconded by Commissioner Mallard, the Court voted unanimously to renew the District Clerk's Depository Contract with Citibank N.A. and authorize the County Judge to execute the document. The next matter before the Court was consideration of the extension of the District Clerk's Depository contract with Wells Fargo Bank for the term of June 1, 2007 through May 31, 2009. Commissioner Cauley moved to approve the extension and authorize the County Judge to execute the document. The County Judge seconded the motion. Commissioners Wassermann, Mallard, Cauley and the County Judge voted "Aye ". Commissioner Peters abstained because his cousin is the CEO of the bank. The Court next considered renewal of the contract with the Department of Health and Human Services for the National School Lunch Program at the Brazos County Juvenile Center and Vol qty Page ? Commissioners Court meeting June 5, 2007 6 the Brazos County Academy for the 2007 -2008 academic year. On motion by Commissioner Mallard, seconded by Commissioner Cauley, the Court voted unanimously to approve the renewal and authorize the County Judge to execute the document. The next matter before the Court was a request submitted by the City of Bryan for permission to fill a pond on Brazos County property at 1835 Sandy Point Road to facilitate the maintenance of a new sanitary sewer line. On motion by Commissioner Cauley, seconded by Commissioner Peters, the Court voted unanimously to approve the request. The next matter for consideration by the Court was a request submitted by the 361st District Judge, Steve Smith seeking approval for out of state travel for himself. Judge Smith would be traveling to Reno, Nevada to attend a "Scientific Evidence and Expert Testimony" course being offered at the National Judicial College on July 16th through the 19th, 2007. On motion by the County Judge, seconded by Commissioner Peters, the Court voted unanimously to grant the request from the 361st District Judge and approved payment of out of state travel expense for Judge Steve Smith. The next matter for consideration by the Court was a request submitted by Linda LaSut, Director of the Metropolitan Planning Office seeking approval for out of state travel for Vol 9.5 Page 9 Commissioners Court meeting June 5, 2007 7 herself. Ms. LaSut would be traveling to Tacoma - Seattle, Washington to attend the "National Transportation Public Affairs Workshop" the week of August 7 through the 10, 2007. On motion by the County Judge, seconded by Commissioner Peters, the Court voted unanimously to grant the request from Ms. LaSut and approved payment of out of state travel expense for her. The next matter before the Court was a request from Justice of the Peace, Precinct 4, Ramiro Quintero for reimbursement of $107.50 from the JP Technology fund for attendance at a seminar that included technology training. On motion by Commissioner Cauley, seconded by the County Judge, the Court voted unanimously to approve the request. The Court next considered requisition #0014170 to Alamo Iron Works, Inc. in the amount of $343.40 for the purchase of Pallet Jack for the Exposition Center. On motion by Commissioner Peters, seconded by Commissioner Cauley, the Court voted unanimously to approve the requisition. The Court acknowledged receipt of the Extension Service reports for April 2007 and acknowledged receipt of reports from the following County and Precinct Offices showing revenues collected and remitted to the County Treasurer: County Clerk District Clerk Vol 95 Page q Commissioners Court meeting June 5, 2007 Justice of the Peace Precinct 1 Justice of the Peace Precinct 2, Place 1 Justice of the Peace Precinct 2, Place 2 Justice of the Peace Precinct 3 Justice of the Peace Precinct 4 Constable Precinct 1 Constable Precinct 2 Constable Precinct 3 Constable Precinct 4 S A copy of the Officials' reports can be viewed in the County Auditor's office. Under announcement of interest items and possible future agenda topics the following spoke: Commissioner Mallard a) He requested a workshop meeting to discuss radios with the consultant, the Information Technology Department representative and others involved. The Court next heard from Paul Turney Executive Vice President of the BVCOG, who discussed the Brazos Valley HOME Consortium 5 year strategic plan. There were no citizen input and /or concerns. Under Agency /Board /Committee reports by Court members, the following spoke: Commissioner Mallard a) Commended the Sheriff on the color guard for the conference opening and he expressed his appreciation. Vol q5 Page 10. Commissioners Court meeting June 5, 2007 b) He also expressed his appreciation to the Sheriff and Constables, in providing security at the bank tragedy. Commissioner Wassermann a) He thanked the County for its contribution of $5,500 towards funding the Keep Brazos Beautiful Trash Off. There were 362 people working the Trash Off. They collected 15.5 tons of trash and over 4,800 tires. There being no further business to come before the Court, the meeting was adjourned. Vol R5 Page 11 The foregoing minutes of the Commissioners Court meeting held June 5, 2007 have been examined and are approved in open Court this the 1k41 day of �COL -n hee 2007, in Bryan, Brazos I` County, Texas. °� tj Duane Peters Commissioner, Precinct 2 'Carey C9-uley, Jr. Commissioner, Preci c 4 �Attest: j Karen McQueen County Clerk Vol R5 Page 19 �� vv Lloyd Wassermann Commissioner, Precinct 1 Kenny Malla Commissione Precin t 3 Pg I o f _;L' BRAZOS COUNTY COMMISSIONER'S COURT DAY OF i 1- �. Name (PLEASE PRINT) Organization (PLEASE PRINT) &kcKa c. fG : N C VOL 9,5 PAGE 13 BRAZOS COUNTY COMMISSIONER'S COURT + DAY Name (PLEASE PRINT) OF �� 1 • * �I I _ _ Organization (PLEASE PRINT) Pg Zof Z, i s 0k4 C v 4Lc 9- C�AtrL d jTSJ'_� l u,VC� AW Zaa aZlt �y s -c Ill l- �, m VOL 9,5 PAGE 14 BRAZOS COUNTY, TEXAS BUDGET AMENDMENT(S) FOR THE 2006 -2007 BUDGET YEAR NO. 06/07-30.1 thru 06/07 -30.9 On this the 5h day of June 2007 at a regular meeting of the Commissioners' Court, the following members were present: Randy Sims, County Judge, Presiding Lloyd Wassermann, Commissioner, Precinct 1 E. Duane Peters, Commissioner, Precinct 2 G. Kenny Mallard, Commissioner, Precinct 3 Carey Cauley, Jr., Commissioner, Precinct 4 Karen McQueen, County Clerk The following proceedings were held: THAT WHEREAS, on 5 June 2007 the Court heard and approved a budget amendment for the 2005- 2006 budget year for Brazos County, Texas; and WHEREAS, an expenditure is necessary due to the necessity to meet unusual and unforeseen conditions which could not be reasonably included in the original budget adopted 12 September 2006, the following amendment(s) to the original budget are hereby authorized, as described on the attached page(s). ADOPTED AND APPROVED this the 5'h day of June 2007. THE COMMISSIONERS COURT OF BRAZOS COUNTY, TEXAS. By: Rand} Sims, County Ju ge Original: County Clerk's Office and attached to the original budget Copies: County Auditor County Treasurer Commissioners' Court Minutes VOL q5 PAGE 16 BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 06/07 - 30.1 6/5/2007 FD DIV ACCT PROJ DR/CR ACCOUNT NAME Increase Decrease 3201 282200 65950000 CR Vehicle Maintenance 2,500.00 3201 282200 71400000 CR Peace Officers 41,490.00 3201 282200 67230000, CR Copier 700.00 3201 282200 80890000 CR Vehicles 60.00 32011 282200 1 61801000 1 DR Travel 2,500.00 3201 282200 60400000 DR Investigation Supplies 700.00 3201 282200 60500000 DR Office Equipment 790.00 3201 282200 67203000 DR Minor Computer Hardware 10,300.00 3201 282200 67281000 DR Equipment Electronic 16,360.00 3201 282200 67286000 DR Minor Equipment - Other 6,100.00 3201 282200 1 80286000 DR Equipment - Other 8,000.00 CLEAR Team- To reallocate budget for various purchases. Approved by CJ D 5/25/07 44,750.00 44,750.00 VOLbPAGE 1� BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 06/07 - 30.2 6/5/2007 FD DIV ACCT PROJ DR/CR ACCOUNT NAME Increase Decrease 0100 11010000 67286000 DR Equipment - Other 2,000.00 0100 11010000 72207000 CR Court Appointed Att s - 361st 1,900.00 0100 11010000 61225000 CR 2nd Administriative Region 100.00 Court Support Costs - To move moneys to allow for the purchse of 2 tasers with practice cartridges and service cartridges. These are for the bailiffs in the Magistrate court and the 361st Court. Additionally, the request included costs for training the bailiffs. The training is $300 each however, an adjustment was done moving $600 from the 2nd Administrative Region support line to the conference and seminar line leaving the $100 above. There is money left in the 2nd Administrative Region line item because we bud eted $7,000 however the annual cost was only $6,300 this ear. 2,000.00 21000.00 BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 06/07 - 30.3 6/5/2007 r6A 95 pA t / 9 11 � 111 11 .1 11111 -m• - . � - 111 - General CaRital IpWovements - To move moneys from the capital line item to the office equipment line item for the purchase of a pallet jack and lecterns. -- r6A 95 pA t / 9 BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 06/07 - 30.4 SIP1lZlyl iYlAELa= s L . I 111 11 111 � 1111 -m � - 1 11 111 1 1 1 v0L q5 PAGE Jq BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 06/07 - 30.5 silo-1IZIYI VOL q5 PAGE oZ6 BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS 30.6 rIMP- 1li:yA o. 1 11 .11 111 1 1111 -m .111 I I -' 1 11 X11 111 1111 _m ' C .111 11 VOL q5 PAGE ;/ BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS 30.7 6/5/2007 m�� 1 11- 1 cl3a VOL q6 PAGE 9,;2- BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS 30.8 6/5/2007 VOL q6 PAGE o2-J 111 'll :1 111 -m � � - - • 1�� 11 111 'll � 111 _m • � � �-� 1�• 11 _ • �• - • • • • .� • - • -� i• - 111 - - - - -_ 1 � • 11 1 � • 11 VOL q6 PAGE o2-J BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS 30.9 6/5/2007 �� I' • 1 11 111 11 X1.11111 •' • .� - 11 11 - 1 11 111 11 . 11111 •� � - 1111- 1 11 111 11 . '1111 -m . 11 - 1 11 111 11 ' 11111 -m • • � III l .. VOL 9-5 PAGE )-4 PERSONNEL CHANGE OF STATUS REQUESTS Commissioner Court Date: June 5, 2007 Department Providing Information: Human Resources Purpose: Consider and Take Action on Change Requests Department Submitting Employee Name Action Requested Request(s) Brazos Center County Clerk County Judge McCain, Christopher Resignation Sustaita, Miguel J. Step Increase Schumann, Jessica Resignation Jett, Irene Cell Phone Allowance Approved in Commissioners' Court: June 5, 2007 r 1) County Judge's or Commissioner's Signature: 0 r (This copy to be attached to minutes) VOL g5PAuE �5 TEXAS ASSOCIATION OF REALTORS® COMMERCIAL BUYER/TENANT REPRESENTATION AGREEMENT USE OF THIS FORM BY PERSONS WHO ARE NOT MEMBERS OF THE TEXAS ASSOCIATION OF REALTORS® IS NOT AUTHORIZED. OTexas Association of REALTORS®, Inc. 2006 1. PARTIES: The parties to this agreement are: Client: BRAZOS Address City, St, Phone: E -Mail: Broker: JOHN R. CLARK AND ASSOCIATES Addn City, Phon E -Ma 2. APPOINTMENT: Client grants to Broker the exclusive right to act as Client's real estate agent for the purpose of acquiring property in the market area, For, rfa CA b A -J+ T.4-x oFFtcf_ o>_L y t 3. DEFINITIONS: A. "Acquire" means to purchase or lease. KI B. "Closing" in a sale transaction means the date legal title to a property is conveyed to a purchaser of property under a contract to buy. "Closing" in a lease transaction means the date a landlord and tenant enter into a binding lease of a property. C. "Market area" means that area in the State of Texas within the perimeter boundaries of: CITY LIMITS OF BRYAN D. "Property" means any interest in real estate. Client intends to acquire ONE properties in the market area. If Client intends to acquire more than one property, the terms "property ", "price ", "purchase ", and "lease" will be read to include the plural. 4. TERM: This agreement begins on June 6, 2007 and ends at the earlier of: A. 11:59 p.m. on May 31 2008 ; or B. the closing of the transaction of the last property that Client intends to acquire. 6. BROKER'S OBLIGATIONS: Broker will: A. use Broker's best efforts to assist Client in acquiring property in the market area; B. assist Client in negotiating the acquisition of property in the market area; and C. comply with other provisions of this agreement. (TAR -1502) 1 -23 -06 Initialed for Identification by Broker /Associate �L, and Client y L, John R. Clark and Associates 3828 S. College, Bryan TX 77801 U Phone: 268 -6841 Fax: John R. Clark Produced with ZipForm- by RE FormsNel, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035 www.zioforon corn VOL a5 PAGE o2 � Page 1 of 6 CAD.zfx Buyerrrenant Representation Agreement with BRAZOS COUNTY , 6. CLIENT'S OBLIGATIONS: Client will: A. work exclusively through Broker when acquiring property in acquisition of property in the market area only through Broker; B. inform other brokers, salespersons, sellers, and landlords with Broker exclusively represents Client for the purpose of acquiring all such persons to Broker; and C. comply with other provisions of this agreement. the market area and negotiate the whom Client may have contact that property in the market area and refer REPRESENTATIONS: A. Each person signing this agreement represents that the person has the legal capacity and authority to bind the respective party to this agreement. B. Client represents that Client is not now a party to another buyer or tenant representation agreement with another broker for the acquisition of property in the market area. C. Client represents that all information relating to Client's ability to acquire property in the market area Client gives to Broker is true and correct. 8. INTERMEDIARY: (Check A or B only.) Q A. Intermediary Status: if Client wishes to acquire one of Broker's listings, Client authorizes Broker to act as an intermediary and Broker will notify Client that Broker will service the parties in accordance with one of the following alternatives. (1) If the owner of the property is serviced by an associate other than the associate servicing Client under this agreement, Broker may notify Client that Broker will: (a) appoint the associate then servicing the owner to communicate with, carry out instructions of, and provide opinions and advice during negotiations to the owner; and (b) appoint the associate then servicing Client to the Client for the same purpose. (2) If the owner of the property is serviced by the same associate who is servicing Client, Broker may notify Client that Broker will: (a) appoint another associate to communicate with, carry out instructions of, and provide opinions and advice during negotiations to Client; and (b) appoint the associate servicing the owner under the listing to the owner for the same purpose. (3) Broker may notify Client that Broker will make no appointments as described under this Paragraph 8A and, in such an event, the associate servicing the parties will act solely as Broker's intermediary representative, who may facilitate the transaction but will not render opinions or advice during negotiations to either party. ❑ B. No Intermediary Status: Client does not wish to be shown or acquire any of Broker's listings. Notice: If Broker acts as an intermediary under Paragraph 8A, Broker and Broker's associates: • may not disclose to Client that the seller or landlord will accept a price less than the asking price unless otherwise instructed in a separate writing by the seller or landlord; • may not disclose to the seller or landlord that Client will pay a price greater than the price submitted in a written offer to the seller or landlord unless otherwise instructed in a separate writing by Client; • may not disclose any confidential information or any information a seller or landlord or Client specifically instructs Broker in writing not to disclose unless otherwise instructed in a separate writing by the respective party or required to disclose the information by the Real Estate License Act or a court order or if the information materially relates to the condition of the property; • shall treat all parties to the transaction honestly; and • shall comply with the Real Estate License Act. 9. COMPETING CLIENTS: Client acknowledges that Broker may represent other prospective buyers or tenants who may seek to acquire properties that may be of interest to Client. Client agrees that Broker may, during the term of this agreement and after it ends, represent such other prospects, show to the other prospects the same properties that Broker shows to Client, and act as a real estate broker for such other prospects in negotiating the acquisition of properties that Client may seek to acquir . (TAR -1502) 1 -23 -06 Initialed for Identification by Broker/Associate �IL_, and Client ` V � Page 2 of 6 Produced with Zipfom- by RE FormsNet, LLC 18025 Fifteen Mile a Clinton Township Michigan 48035 www.zioform corn CAD.zfx V�JL qJ PAGE -,�X Buyerfrenant Representation Agreement with BRAZOS COUNTY , 10. CONFIDENTIAL INFORMATION: Broker may not knowingly disclose information obtained in confidence from Client except as authorized by Client or required by law. Broker may not disclose to Client any information obtained in confidence regarding any other person Broker represents or may have represented except as required by law. 11. BROKER'S FEES: A. Broker's fees under this agreement are as follows: (Check all that apply.) e al (1) Commission: Broker will receive a commission calculated as follows: if Client purchases a property: aalf Client leases a property: l ® 2.500 % of the gross sales price; or 9.000 o II base re<bejzaW-vVe'r the term is Ir "rA iro r. - of the lease and t e e following IV,SL. �,, , 1'.sk � items to be paid over t expense urse tV� ❑ or (a) Source of Commission Payment: x❑ (1) Broker will seek to obtain payment of the commission specified in Paragraph 11A(1) first from the seller, landlord, or their agents. If such persons refuse or fail to pay Broker the amount specified, Client will pay Broker the amount specified less any amounts Broker receives from such persons. ❑ (2) Client will pay Broker the commission specified in Paragraph 11A(1). (b) Earned and Payable: A person is not obligated to pay Broker a commission until such time as Broker's commission is earned and payable. (1) Broker's commission is earned when Client enters into an agreement to acquire property in the market area. (2) Broker's commission is payable, either during the term of this agreement or after it ends, upon the earlier of: (A) the closing of the transaction to acquire property in the market area; (B) Client's breach of a written contract to acquire property in the market area; or (C) Client's breach of this agreement. (3) If Client acquires more than one property, Broker's commissions for each property acquired are earned as each property is acquired and are payable at each closing. (c) Additional Compensation: If a seller, landlord, or their agents offer compensation in excess of the amount stated in Paragraph 11A(1) (for example, marketing incentives or bonuses to cooperating brokers) Broker may retain the additional compensation in addition to the commission specified above. Client is not obligated to pay any such additional compensation to Broker. (d) Acquisition of Broker's Listing: Notwithstanding any provision to the contrary, if Client acquires a property listed by Broker, Broker will be paid in accordance with the terms of Broker's listing agreement with the owner and Client will have no obligation to pay Broker unless specified by a subsequent separate agreement. ❑ (2) Hourly Fees: Client will pay Broker fees at the rate of $ N/A per hour. If Broker also receives fees under Paragraph 11A(1) or if Client acquires one of Broker's listings, Broker will refund the hourly fees upon receipt of the fees under Paragraph 11A(1) or the listing. Broker's hourly fees are earned when Broker's services are rendered and are payable when billed. (TAR -1502) 1 -23 -06 Initialed for Identification by Broker /Associate and Clien r � Page 3 of 6 Produced with ZipFon -n— by RE FormsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035 www.ziofo m.com CAD.z& VOL q 5 PAGE I& Buyerrrenent Representation Agreement with BRAZOS COUNTY ❑ (3) Advance Fee: Before this agreement begins, Client will pay Broker an advance fee of $ N/A . The advance fee is earned at the time it is paid. Broker will credit the advance fee against any other fee Broker receives under this agreement at the time Broker receives the other fee. ❑ (4) Client's Purchase of Property Leased by Client: If Client agrees to lease property in the market area during the term of this agreement or any applicable protection period, and subsequently, during the term of the lease, including any renewal, extension, or expansion of the lease, Client agrees to purchase all or part of the property in which the leased property is located by oral or written agreement or option, Client assures Broker that the seller or Client will pay Broker, at the time the sale closes, a fee of: ❑ (i) N/A % of the sales price; or ❑ (ii) N/A This Paragraph 11A(4) survives termination of this agreement. This Paragraph 11A(4) does not apply if another Texas - licensed real estate broker represents Client in the negotiations for the purchase and the other broker receives a fee for negotiating the purchase. ❑ (5) Renewals Extensions or Expansions of Property Leased by Client: If Client agrees to lease property in the market area during the term of this agreement or any applicable protection period, and subsequently, during the primary term of the lease, Client and the landlord agree to renew, extend, or expand the lease, Client assures Broker that the landlord or Client will pay Broker, at the time the renewal, extension, or expansion becomes effective, a fee of: ❑ (i) N/A % of all base rents to be paid over the term of the renewal, extension, or expansion and the same percentage of the following items to be paid over the same term: ❑ expense reimbursements ❑ N/A ; or ❑ (II) N/A This Paragraph 11A(5) does not apply if another Texas - licensed real estate broker represents Client in the negotiations for the renewal, extension, or expansion and the other broker receives a fee for negotiating the renewal, extension, or expansion. In addition to their ordinary meanings, "extensions, "renewals," and "expansions" include new leases for more, less, or different space in the building or complex in which the property is located. ❑ (6) Construction: If Client uses Broker's services to procure or negotiate the construction of improvements to property that Client owns or may acquire, Client will pay Broker at the time the construction is substantially complete a fee equal to: N/A . This Paragraph 11A(6) does not apply if the contractor pays Broker the amount specified in this paragraph under a separate agreement. ❑ (7) Service Providers: If Broker refers Client or any party to a transaction contemplated by this agreement to a service provider (for example, mover, cable company, telecommunications provider, utility, or contractor) Broker may receive a fee from the service provider for the referral. ❑x (8) Other: IF CLIENT HAS NOT CLOSED ON A PROPERTY BY DECEMBER 1, 2008, CLIENT SHALL PAY BROKER $5,000.00 FOR SERVICES RENDERED TO DATE, IF ONE OF THE ALTERNATIVE PROPERTIES IS PURCHASED BROKER SHALL DEDUCT $5 ,000 FROM ANY COMMISSION EARNED B. Protection Period: "Protection period" means that time starting the day after this agreement ends and continuing for 360 days. Not later than 10 days after this agreement ends Broker may send Client written notice identifying the properties in the market area called to Client's attention during this agreement. If during the protection period Client agrees to acquire all or part of any such property, Client will pay Broker, upon closing, an amount equal to the fees Broker would have been entitled to receive had Client acquired the property during the term of this agreement. This Paragraph 11B survives termination of this agreement. (TAR -1502) 1 -23 -06 Initialed for Identification by Broker /Associate and Client, Page 4 of 6 Produced with ZipForm- by RE FonnsNet, LLC 18025 Fifteen Mille ad, C&tpgjOw _„Michigan 48035 www. i f r .wm CAD.zfx BuyerfTenant Representation Agreement with BRAZOS COUNTY C. Excluded Properties: Under a prior representation agreement Client is obligated to pay another Texas licensed broker a fee if Client acquires, before N/A any of the following properties in the market area: N/A (excluded properties). If Client enters into a contract to acquire all or part of an excluded property before the date specified, Broker will not be entitled to receive the compensation specified in this agreement, but Client will pay Broker, upon closing, a fee equal to N/A % of the sales price if Client buys an excluded property and N/A % of all rents to be paid for the term of the lease if Client leases an excluded property. D. County: All amounts payable to Broker are to be paid in cash in BRAZOS County, Texas. E. Escrow Authorization: Client authorizes, and Broker may so instruct, any escrow or closing agent authorized to close a transaction for the acquisition of property contemplated by this agreement to collect and disburse to Broker all amounts payable to Broker. 12. MEDIATION: The parties agree to negotiate in good faith in an effort to resolve any dispute that may arise related to this agreement or any transaction related to or contemplated by this agreement. If the dispute cannot be resolved by negotiation, the parties will submit the dispute to mediation before resorting to arbitration or litigation and will equally share the costs of a mutually acceptable mediator. 13. DEFAULT: If either party fails to comply with this agreement or makes a false representation in this agreement, the non - complying party is in default. If Client is in default, Client will be liable for the amount of compensation that Broker would have received under this agreement if Client was not in default. If Broker is in default, Client may exercise any remedy at law. 14. ATTORNEY'S FEES: If Client or Broker is a prevailing party in any legal proceeding brought as a result of a dispute under this agreement or any transaction related to or contemplated by this agreement, such party will be entitled to recover from the non - prevailing party all costs of such proceeding and reasonable attorney's fees. 15. LIMITATION OF LIABILITY: property. 16. ADDENDA: This agreement will be automatically amended to include the legal description of any properties Client acquires or attempts to acquire under this agreement. Addenda and other related documents which are part of this agreement are: ® Information about Brokerage Services ❑ 0 TASK AND SCOPE OF WORK ❑ 17. SPECIAL PROVISIONS: (TAR -1502) 1 -23 -06 Initialed for Identification by Broker /Associate and Client, Page 5 of 6 Produced with ZipForm- by RE FormsNet, LLC 18025 Fifteen Mile Road, Clinton Towns , Michigan 48035 f m. m CAD.zfx VOL 06 PAGE �C7 Buyerrrenant Representation Agreement with BRAZOS COUNTY 18. AGREEMENT OF THE PARTIES: A. Entire Agreement: This document contains the entire agreement of the parties and may not be changed except by written agreement. B. Assignment: Neither party may assign this agreement without the written consent of the other party. C. Binding Effect: (1) Client's obligations to pay Broker earned fees are binding upon Client and Client's heirs, administrators, executors, successors, and permitted assigns. (2) If Client does not acquire a property under this agreement, but a related party of Client acquires (within the applicable periods under this agreement) a property that Broker brings to Client's attention, Broker will be entitled to all compensation under this agreement as if Client had acquired property. "Related party" means any assignee of Client, any family member or relation of Client, any officer, director, or partner of Client, any entity owned or controlled, in whole or part, by Client, and any entity that owns or controls Client, in whole or part. D. Joint and Several: All Clients signing this agreement are jointly and severally liable for the performance of all its terms. E. Governing Law: Texas law governs the interpretation, validity, performance, and enforcement of this agreement. F. Severability: If a court finds any clause in this agreement invalid or unenforceable, the remainder of this agreement will not be affected and all other provisions of this agreement will remain valid and enforceable. G. Notices: Notices between the parties must be in writing and are effective when sent to the receiving party's address, fax, or e-mail specified in Paragraph 1. 19. ADDITIONAL NOTICES: A. Broker's fees and fees between brokers are not fixed, controlled, recommended, or suggested by the Association of REALTORS® or any listing service. Broker's fees are negotiable. B. Broker's services are made available without regard to race, color, religion, national origin, sex, disability, or familial status. Local ordinances may provide for additional protected classes. C. Sellers or their agents may not treat the existence, terms or conditions of offers as confidential unless confidentiality is required by law, regulation, or agreement between the parties. D. Broker is not a property inspector, surveyor, engineer, or environmental assessor. Client should seek experts to render such services for any property Client seeks to acquire. E. If Client purchases property, Client should have an abstract covering the property examined by an attorney of Client's selection, or Client should be furnished with or obtain a title policy. Broker cannot give legal advice. This is a legally binding agreement. READ IT CAREFULLY. If you do not understand the effect of this agreement, consult your attorney BEFORE signing. Clle 0 Prit Titli Printed Name: Title: Broker: JOHN R. CLARK AND ASSOCIATES By: Printed N�l 3oy__A P,. 6,L_444 Date: 5/31/b7. Date: (TAR -1502) 1 -23 -06 Page 6 of 6 Produced with ZipFonn^ by RE FonsNel, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035 www ziofornn.com CAD.z& VOL q5 PAGE 31 Task and Scone of Work Task: This contract applies only to the possible acquisition of a site for the Central Appraisal District and Tax Office. It is understood that the Brazos County Commissioner's Court (Court) has decided to either: 1) acquire land and build a new facility or 2) acquire and redevelop existing building(s). John R. Clark and Associates (JRC) is requested not to present lease or lease- purchase alternatives. The task is to locate all reasonable alternatives for acquisition within the target area. Target Area: South: Bryan City limit North: Villa Maria corridor to FM 158 East: FM158 West: Texas Avenue. Scope or Work: A) Locate and summarize all reasonable alternatives. B) Present and discuss summary with the Court and its Ad Hoc Committee. C) At the their direction, complete a detailed report on the best alternatives. Including more analysis of each as to: price, existing infrastructure, advantages, constraints, and other pertinent factors. D) Be prepared to present and discuss these with the Court and Committee E) Once site(s) are chosen, initiate acquisition at the Court's direction . JRC shall have access to County's legal counsel as needed. F) Once a site is under contract, to coordinate and expedite all due diligence towards a successful closing. It is understood that JRC shall not be involved in any site development and /or construction decisions, after acquisition. Time Frame: A, B, C, & D above: To be concluded no later than July 15th, unless otherwise extended by the Court. E & F above: under whatever time frame directed by the Court. I ue 5 Frstit J°2 Approved by the Texas Real Estate Commission for Voluntary Use Texas law requires all real estate licensees to give the following information about brokerage services to prospective buyers, tenants, sellers and landlords. Information About B efore working with a real estate broker, you should know that the duties of a broker depend on whom the broker represents. If you are a prospective seller or landlord (owner) or a prospective buyer or tenant (buyer), you should know that the broker who lists the property for sale or lease is the owner's agent. A broker who acts as a subagent represents the owner in cooperation with the listing broker. A broker who acts as a buyer's agent represents the buyer. A broker may act as an intermediary between the parties if the parties consent in writing. A broker can assist you in locating a property, preparing a contract or lease, or obtaining financing without representing you. A broker is obligated by law to treat you honestly. IF THE BROKER REPRESENTS THE OWNER: The broker becomes the owner's agent by entering into an agreement with the owner, usually through a written - listing agreement, or by agreeing to act as a subagent by accepting an offer of subagency from the listing broker. A subagent may work in a different real estate office. A listing broker or subagent can assist the buyer but does not represent the buyer and must place the interests of the owner first. The buyer should not tell the owner's agent anything the buyer would not want the owner to know because an owner's agent must disclose to the owner any material information known to the agent. IF THE BROKER REPRESENTS THE BUYER: The broker becomes the buyer's agent by entering into an agreement to represent the buyer, usually through a written buyer representation agreement. A buyer's agent can assist the owner but does not represent the owner and must place the interests of the buyer first. The owner should not tell a buyer's agent anything the owner would not want the buyer to know because a buyer's agent must disclose to the buyer any material information known to the agent. IF THE BROKER ACTS AS AN INTERMEDIARY: A broker may act as an intermediary between the parties if the broker complies with The Texas Real Estate License Services Act. The broker must obtain the written consent of each party to the transaction to act as an intermediary. The written consent must state who will pay the broker and, in conspicuous bold or underlined print, set forth the broker's obligations as an intermediary. The broker is required to treat each party honestly and fairly and to comply with The Texas Real Estate License Act. A broker who acts as an intermediary in a transaction: (1) shall treat all parties honestly; (2) may not disclose that the owner will accept a price less than the asking price unless authorized in writing to do so by the owner; (3) may not disclose that the buyer will pay a price greater than the price submitted in a written offer unless authorized in writing to do so by the buyer; and (4) may not disclose any confidential information or any information that a party specifically instructs the broker in writing not to disclose unless authorized in writing to disclose the information or required to do so by The Texas Real Estate License Act or a court order or if the information materially relates to the condition of the property. With the parties' consent, a broker acting as an intermediary between the parties may appoint a person who is licensed under The Texas Real Estate License Act and associated with the broker to communicate with and carry out instructions of one party and another person who is licensed under that Act and associated with the broker to communicate with and carry out instructions of the other party. If you choose to have a broker represent you, you should enter into a written agreement with the broker that clearly establishes the broker's obligations and your obligations. The agreement should state how and by whom the broker will be paid. You have the right to choose the type of representation, if any, you wish to receive. Your payment of a fee to a broker does not necessarily establish that the broker represents you. If you have any questions regarding the duties and responsibilities of the broker, you should resolve those questions before proceeding. Real estate licensee asks that you acknowledge receipt A this information about brokerage services for the licensee's records. Texas Real Estate Brokers and salespersons are licensed and regulated by the Texas Real Estate Commission (TREC). If you have a question or complaint regarding a real estate licensee, you should contact TREC at P.O. Box 12188, Austin, Texas 78711 -2188 or 512- 465 -3960. 01A (TAR -2501) 1/1/96 John R. Clark and Associates 3828 S. College, Bryan TX 77801 Phone: 268 -6841 Fax: John R. Clark Produced with ZipForm- by RE FornsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035 www zioform com VOL PA(A E00.1l IeaiP10 OPPORNNIrY TREC No. OP -K Page 1 of 1 CAD.zfx This renewal of the Depository Contract between the Brazos County District Clerk, Texas and Citibank N.A . dated June 1 2007 will renew for a term of two years and not to extend beyond May 31, 2009_. This renewal is agreed to by representative of the BANK, and BRAZOS COUNTY as evidenced by their signatures below, executed this 23 day of May, 2007 by the duly authorized officers of the parties hereto. Citibank N. A, in Name: Clay Riebe Title: Vice President Market President Date: May 23, 2007 BRAZOS COUNTY, TEXAS By: Randy 6s, Brazos C unty Judge Date: ��US/cs7 VOL J- PAGE A CERTIFICATE OF SECRETARY I certify that the following resolutions were duly adopted by the Board of Directors of Citibank Texas, N. A. on March 31, 2005, that the resolutions are still in full force and effect, and that Clay Riebe is an employee at the level of vice president (or equivalent) or higher of Citibank Texas N. A. and are therefore authorized to sign the types of documents described in such resolutions. ja� (,- lvtz- J hn E. Gunther ecretary February 17, 2006 RESOLVED, that any officer of the Bank at the level of Vice President (or equivalent) or higher, or the designee(s) of any such officer, is hereby authorized to sign, execute, acknowledge, verify, deliver, or accept on behalf of the Bank agreements, contracts, indentures, mortgages, deeds, conveyances, transfers, certificates, declarations, receipts, discharges, releases, satisfactions, settlements, petitions, schedules, accounts, affidavits, bonds, undertakings, proxies and all other instruments or documents, and be it further RESOLVED, that in the signing of any instrument or document under this resolution it shall not be necessary to affix the corporate seal of the Bank, and such signing shall have the same effect as if the corporate seal had been affixed. VQLbPAGE 26 /.1. WELLS FARGO BANK, NATIONAL ASSOCIATION SECRETARY'S CERTIFICATE I, Robert S. Singley, Secretary of Wells Fargo Bank, National Association, a national banking association (the "Bank "), hereby certify as follows: 1. The following is a true and correct extract from resolutions duly adopted by the Board of Directors of the Bank on November 25, 2003, and no modification, amendment, rescission or revocation of such resolutions has occurred affecting such extract as of the date of this certificate. RESOLVED, that any Signing Officer, acting alone, may execute on behalf of the Bank, whether acting for its own account or in a fiduciary or other representative capacity: Agreements, instruments and other documents establishing or relating to any deposit account or the collateralization thereof. 2. Carol Gravis is a duly appointed and acting Vice President of the Bank as of the date hereof and is a "Signing Officer" within the meaning of the foregoing resolution. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of the Bank this 21st day of February 2007. Robert S. Singley Secretary VOL 0/-�) PAGE 3� This renewal of the Depository Contract between the Brazos County District Clerk, Texas and Wells Fargo Bank, N.A., dated June 1, 2005, will renew for a term of two years and not to extend beyond May 31, 2009. This renewal is agreed to by representative of the BANK and BRAZOS COUNTY, as evidenced by their signatures below, executed this 22nd day of May , 2007, by the duly authorized officers of the parties hereto. By Bank: I,2 �— Name: Carol cravis Title: Vice President, Community Banking President Date: May 22, 2007 BRAZOS COUNTY, TEXAS Lm Randy Sims, Brazos Date: 406-510 �� Public Funds Administration MAC: A0119 -173 333 Mmkc[ 17i°Fluor San Francisco, CA 94105 Publicfimds:awcllsts,uo.cnm May 15, 2007 Brazos County 300 East 26th Street Bryan, TX 77803 Dear Wells Fargo Customer, Please find enclosed two copies of a Depository Pledge Agreement for Brazos County covering deposits held at Wells Fargo Bank, National Association. The Federal Reserve Bank will act as custodian._ Please review, execute, and return both orieinals of the Deoository Pledge Agreement to this office. You will note that the Federal Reserve Bank is not a party of the enclosed Depository Pledge Agreement. This is because the Federal Reserve Bank uses its own form of Custody Agreement, which is separate from the Depository Pledge Agreement. The Custody Agreement is published by the Federal Reserve Bank as Appendix C to its Operating Circular 7, entitled "Book Entry Securities Account Maintenance and Transfer Services ". A copy of the Operating Circular incorporating the Custody Agreement(Pledgee Agreement Form) is enclosed for execution. Please note: Should you have questions regarding the Pledgee Agreement Form' please call the Federal Reserve Bank at 1- 800 - 327 -0147 option I, for further assistance. The Federal Reserve Bank has added a new form, FEDMAIL REQUEST FORM that requires completion. The Federal Reserve Bank will not process the Pledgee Aereement unless it is accompanied by the FEDMAIL REQUEST FORM. In accordance with the Federal Deposit Insurance Act (12 U.S.C. 1823), a collateral agreement must be approved by the bank's board of directors or loan committee, the approval must be reflected in the applicable meeting minutes, and the agreement must be continuously, from the time of it's execution, as an official record of the bank. After signature is completed and Wells Fargo Board or Loan Committee approval is obtained, we will forward you one of the original documents for your records. If you have any questions or concerns, please contact Kathy Chen directly at (415) 371 -3272. Sincerely, Charlene Blount Public Funds Administration Q ?,5 PACE 38 , , r 4L 95PAu- .3v DEPOSITORY PLEDGE AGREEMENT BRAZOS COUNTY ( "Pledgee ") has selected WELLS FARGO BANK, NATIONAL ASSOCIATION ( "Pledgor") as a depository for certain of its funds and Pledgor has agreed to act as the depository for those funds in accordance with applicable laws, which require that Pledgor secure the deposited funds, to the extent not insured by the Federal Deposit Insurance Corporation ( "FDIC "), by pledging book -entry securities ( "Eligible Securities ") of any type permitted by the provisions of the Public Funds Collateral Act, Title 10, Chapter 2257 of the Texas Government Code, as in effect from time to time (the "Goveming Statutes "), which are eligible to be held in a Securities Account at a Federal Reserve Bank under Federal Reserve Bank Operating Circular 7. Pledgee and Pledgor have selected THE FEDERAL RESERVE BANK ( "Custodian ") to hold the pledged securities in custody and safekeeping pursuant to the terms of the Governing Statutes, Federal Reserve Bank Operating Circular 7 as in effect from time to time ( "Circular 7 "), and the Custody Agreement for Book -Entry Securities, Appendix "C" to Circular 7 (the "Custody Agreement "), the provisions of which are incorporated herein by reference. NOW, THEREFORE, in consideration of the mutual promises and covenants in this Agreement, Pledgee and Pledgor agree as follows: 1. Grant of Security Interest Instructions Regarding Collateral. Pledgor hereby grants to Pledgee a security interest in all Eligible Securities held by Custodian and reflected on Custodian's records as being pledged to Pledgee (the "Collateral "). Addendum "A" contains the names and specimen signatures of individuals authorized to act on behalf of Pledgee, and Addendum "B" contains the names and specimen signatures of individuals authorized to act on behalf of Pledgor. Either Pledgee or Pledgor may add or remove authorized representatives without the consent of the other at any time. 2. Amount of Collateral. The aggregate market value of Eligible Securities held by Custodian at all times during the term of this Agreement must be in an amount not less than one hundred percent (100 %) of (a) the amount of Pledgee's collected funds on deposit with Pledgor, increased by (b) the amount of accrued but uncredited interest on such deposited funds, (c) reduced by that portion of the funds insured by the FDIC. Such amount is hereinafter called the "Required Collateral Value ". 3. Substitutions and Withdrawals of Collateral. If the aggregate market value of Collateral held by Custodian at any time exceeds the Required Collateral Value, Pledgor may withdraw any excess Collateral by providing Custodian with a withdrawal notice signed by an authorized representative of both Pledgor and Pledgee. Pledgee agrees to promptly sign the withdrawal notice if the market value of the remaining Collateral equals or exceeds the Required Collateral Value. Additionally, Pledgor may substitute Eligible Securities for any of the Collateral held by Custodian at any time by providing Custodian with a substitution notice signed by an authorized representative of Pledgor alone, provided that the market value of the Collateral following such substitution would equal or exceed the Required Collateral Value. This paragraph constitutes Pledgee's written standing instructions, within the meaning of Section 4.3 of the Custody Agreement, to permit substitutions of like par value amounts of pledged Eligible Securities without the consent of Pledgee. Substitutions of securities not of like par value shall require Pledgee's written consent. To the extent that Pledgee's consent is required for any substitution of collateral securities, Pledgee shall upon Wells Fargo's request promptly furnish such consent in the form required by the Custodian, so long as the requested substitution will not reduce the value of pledged securities below the Required Collateral Value. 4. Pledgoe's Obligations. Pledgor shall perform all of the duties and obligations required of a depository under applicable law with respect to collateralization of the funds of Pledgee on deposit with Pledgor, including the duties and obligations required under the Governing Statutes. At the expiration of the term of this Agreement, Pledgor shall turn over to any successor depository designated by Pledgee all funds held by Pledgor as depository. Pledgor will furnish to Pledgee a monthly statement listing a description of the Collateral. The statement will specify the par value, market value, and maturity date of each component of the Collateral. Upon request, Pledgor shall provide to Pledgee a copy of Pledgers most recent publicly available quarterly or annual financial statement. S. Custodian's Obligations. The duties and obligations of Custodian with respect to the Collateral shall be as set forth in the Custody Agreement. - 1 - VOL 95 FADE 4d 6. Default and Remedies. If Pledgor fails to perform its obligations under Paragraph 4 above, or if Pledgor is declared insolvent, or N a receiver is appointed for Pledgor (each an "Event of Default "), Pledgee may instruct Custodian to dispose of the Collateral in accordance with the provisions of the Custody Agreement, but only after Pledgee has provided Pledgor written notice of the Event of Default and at least three (3) business days after such notice to cure the Event of Default. If, after receipt of such notice, Pledgor fails to cure the Event of Default within the required period of time, Pledgee shall thereupon become authorized to certify in writing to Custodian that Pledgor is in default under this Agreement, and to instruct Custodian to dispose of an amount of Collateral sufficient to satisfy any indebtedness owed by Pledgor to Pledgee, in accordance with Pledgee's instructions. 7. Termination of Agreement. Any party to this Agreement may terminate this Agreement by giving thirty (30) days prior written notice of termination to the other parties. 8. Applicable Law: Other Agreements. This Agreement is governed by the laws of the State of Texas. All deposit accounts of Pledgee will be subject to Pledgor's Commercial Account Agreement, Business Account Agreement, or other applicable deposit account agreement, as in effect from time to time. 8. Miscellaneous. The headings in this agreement are for convenience of reference only and should not be used in interpreting this Agreement. If any provision of this agreement is illegal or unenforceable under applicable law, that provision should be deemed reformed so as to be enforceable to the extent permitted by applicable law, or if that is not possible, then this Agreement should be read as if that provision was never a part of it, and the remainder of the Agreement will be enforceable. THIS AGREEMENT REPRESENTS THE FINAL AGREEMENT OF THE PARTIES AND MAY NOT BE CONTRADICTED BY EVIDENCE OF PRIOR, CONTEMPORANEOUS OR SUBSEQUENT ORAL AGREEMENTS OF THE PARTIES. THERE ARE NO ORAL AGREEMENTS OF THE PARTIES. Notices given under this Agreement must be addressed as set forth below the signature of each party, and will be effective upon actual receipt by the addressee or upon refusal of delivery during the normal business hours of the addressee. Date of Agreement: S Sum, 2007. PLEDGEE: BRAZOS COUNTY By PLEDGOR: WELLS FARGO BANK, NATIONAL ASSOCIATION Name: I(Ll �&h % Name: Title: &XVIty Tcle 0 eJ Title: Address Address: : j�Qn� � 775J3 DepPledgeAgmt- TX- FRB.doc (Rev. 0307 -02) _2_ 333 Market St, W Floor MAC A0119 -173 San Francisco CA 94105 P U B LIC FU N DSCrDwelisfaMo.com YOL-q5PA &E 411 ADDENDUM "A" (Authorized Officers of Pledgee) One signature of any of the following authorized officers of Pledgee is required to authorize actions to be taken pursuant to the foregoing Depository Pledge Agreement: 1. Name: _ Phone/ Fax: 2. Name: _ Phone/ Fax: 3. Name: _ Phone/ Fax: 4. Name: _ Phone/ Fax: Signature: , ■ Email: (5 t 7h.1 E�- &D bra -.ns . - -x us Signature: Email: Signature: Email: Signature: Email: -3- - ADDENDUM "B" (Authorized Officers of Pledgor) one signature of any of the following authorized officers of Pledgor is required to authorize actions to be taken pursuant to the foregoing Depository Pledge Agreement: 1. Name: 2. Name: 3. Name: 4. Name: Signature Signature Signature Signature -4- VOL b PAGE. Y3 AFFIDAVIT TEXAS LOCAL GOVERNMENT CODE, CHAPTER 171 STATE OF TEXAS COUNTY OF BRAZOS BEFORE ME, the undersigned authority, on 7 personaally appeared i/ LCl/Ltzz� who being duly sworn, deposes and says: 1. That he /she has a substantial interest in a business entity or real property. Official action taken by the Commissioners Court of Brazos County, Texas concerning Agenda / Item No. /Z of the Court Agenda dated�� Q. Az"''Zdescribedas kAz " a' -- �/Aza i would have a special economic effect on that business entity or a specia economic effect on the value of the real property, that is distinguishable from the effect on the public. 2. That the substantial interest is (check the following as is appropriate): O a. Ownership of 10 percent or more of the voting stock or shares of the business entity or either 10 percent or more or $15,000 or more of the fair market value of the business entity; or () b. Funds received by me from the business entity exceed 10 percent of my gross income for the previous year; or () c. An equitable or legal ownership in real property with a fair market value of $2,500 or more; or () d. A person related in the first degree by either affinity or consanguinity to me has a substantial interest as defined above; or / / 4 1 1 (r? e. othe � 6o /� �./A —& Y� *w 6'4461 -u ) 3. That I will abstain from participation in the matter re rr o in It= 1 unless authorized by law. Signature I _ a� SWORN TO AND SUBSCRIBED BEFORE ME this the -_ft _ day of 20j0J "' :tw BEATRIZ D. GREEN a o: Notary Public in and to ?' Notary PuUic. Stets of Texas _'. My comrinion Expires The State of Texas JUNE 11, 2010 ` ,Tr<, • .t County Clerk Texas Health and Human Services Commission National School Lunch Program and School Breakfast Program Application for Participation and Policy Statement School Program Year: July 1, 2007 through June 30, 2008 Form H1610 April 2007 Part I — Application Texas ID No, Contract No. Program No. 07/01/2007 17480004330000 75 61001 TX 21 — 2001 Name of School Food Authority Contact Person Brazos County, Texas Patrick Munoz 8 a.m. Address (Street or P.O. Box, City, State, ZIP) 1904 SH 21 West Bryan, Tx. 77803 Telephone Number Fax Number Email Address ( 979 ) 823 -3544 1 ( 979 ) 823 -4211 pmunoz@co.brazos.tx.us Name of School /Facility (If more than one site, complete HHSC Form H1609 for each site.) Brazos County Juvenile Detention Center School Address (if different from School Food Authority address) Telephone Number Type of School/Facility (check all that apply) ❑ Day School ❑ Boarding School ❑ Combination Day School ® Residential Child ❑ Combination Day School and and Boarding School Care Institution Residential Child Care Institution ❑ Special Education School ❑ Afterschool Care Snack Site ® Other (specify): Day school- residents are court ordered to attend. School /Residential child care institution (RCCI) is: ® Public ❑ Private b If "Private,' is the school /RCCI nonprofit and tax exempt ❑ Yes ❑ No A If 'Yes," attach copy of under the Internal Revenue Code of 1954? letter from the IRS. Total Enrollment for All Schools /RCCls Administered b Food Authority: 78 Total Number of All Schools /RCCIs Administered by School Food Authority: C> 02 Average Daily Participation Current Prior Year Average Daily Attendance 42 30 Average Daily Enrollment 55 32 Percentage 76% 93 °/. 1. Is the above school /residential child care institution licensed? (If yes, attach copy of license.) ........................ ............................... ® Yes ❑ No 2. Program(s) that you are applying for: ® National School Lunch Program ❑ Afterschool Care Snack program (must be participating in National School Lunch Program) ® School Breakfast Program ® Severe Need School Breakfast Program Rates' ' Available to schools/residential child care Institutions meeting the following eligibility criteria: 1. 40% or more total lunches served in second preceding year were free or reduced price. 2. Breakfast costs exceed the regular reimbursement rates available under the School Breakfast Program. ❑ Seamless Summer Program — Specify Program Year: May 1, through September 1, Note: Form H1612 must be completed for each Seamless Summer Site. 3. Number of months the school will be operating a food service program: .............. 4. Number of children enrolled at school /residential child care institution: .... — ............ 5. Number of Months Beginning Date of Operation 1 Ending Date of Operation 1 07/01/2007 06/30 /2008 ... I..... 78 A. Age Range of Children Enrolled B. Grade Levels Taught (schools only) From: 10 To: 16 From: 5 To: 12 Food Service: Average Daily Participation of Children in Program Times of Food Service Free Reduced Price Paid Beginning Ending Breakfast 7 a.m. 8 a.m. Lunch 12 p.m, i P.M. Area Eligible Afterschool Care Snack Not Area Eligible Afterschool Care Snack VOL U PAGE �� 6. Attendance (for residential child care institutions only) 7. Form N1610 Page 2/04 -2007 A. Are all of the children at the institution all day? ...................................................................................... ............................... ® Yes ❑ No If no, do all or some of the children attend public school? ..................................................................... ............................... ❑ All ❑ Some If only some attend public school, how many? ...................................................................................... ............................... If some or all attend public school, which meals do these student eat at the institution? ....... ❑ Breakfast ❑ Lunch ❑ Afterschool Snack B. Check if the children attend the institution on holidays and /or weekends ............................................. ............................... ® Holidays ® Weekends i ype ui meal oerwue A. Meal Preparation ® On -Site Kitchen ® Central Kitchen ❑ Food Service Management Company ❑ Vended Meals (submit copy of contract and checklist) (submit copy of agreement) ❑ Other (explain): B. Meal Planning System ❑ Enhanced Food Based ® Traditional Food Based ❑ Nutrient Standard Menu ❑ Assisted Nutrient Standard Menu Planning Planning (NSMP or NuMenus) (ANSMP or Assisted NuMenus) (See instructions for documents to submit.) ❑ Other(explain): Note: Snacks served in the Afterschool Care Snack program must follow the food based supplement pattern regardless of your menu planning method for breakfast and/or lunch. 8. TvDe of Program El ❑ Separate Charges ® No Separate Charge; Cost of Meals is Included Made for Meals in Required Payment Plan/Fee ❑ Combination of Separate Charges and No Separate Charges Elementary (optional) Preschool (optional) Daily Price Charged for Each Meal (for programs that will charge separately only): ® Yes CHILDREN ADULTS I ❑ Yes ❑ No Reduced Price Paid Breakfast Lunch Not Area Eligible Afterschool Care Snack Note: Area Eligible Afterschool Care Snack program sites must provide snacks free of charge to all students participating in the after school pre program. 10. A. If applying for the National School Lunch Program, indicate whether Offer versus Serve will be implemented: High School (mandatory) Junior High (optional) Elementary (optional) Preschool (optional) Residential Child Care Institution (optional) ® Yes 1 ® Yes ❑ No ❑ Yes ❑ No I ❑ Yes ❑ No I ❑ Yes ® No B. If applying for the School Breakfast Program, indicate whether Offer versus Serve will be implemented: High School (optional) Junior High (optional) Elementary (optional) Preschool (optional) Residential Child Care Institution (optional) ❑ Yes ® No ❑ Yes ® No 1 ❑ Yes ❑ No ❑ Yes ❑ No I ❑ Yes ® No 11. Describe your training in food service program requirements for personnel (use an attachment if necessary): Kitchen staff trained annually with NSLP and USDA Civil Rights curriculum. They are also provided food handlers training through the local health department. There is also specific training completed in areas of safety, equipment maintenance as well as any NSLP updates. Staff are all trained in areas of meal patterns, portion sizes and meal count production documentation, record keeping, and other areas deemed necessary. 12. Will supplemental (a la carte or snack bar) food service be available in addition to the school lunch? ........... ............................... ❑ Yes ® No Questions 13 through 18 apply only to the Afterschool Care Snack program. 13. How will the school food authority operate the after school care program? If non - school personnel, what organization is responsible for day - today operations? ❑ Will Use School Personnel ❑ Will Use Non - school Personnel: 14. Total number of sites administered by School Food Authority offering the Afterschool Care Snack program ........... _ ..................... 15. Is attendance in after school care program limited to students enrolled in your school /RCCI? N no: In which individual public school attendance area (not district) is the site located? _ Note: You must attach an information statement from the ISD (see instructions). VOL �5 PAGE 1� .............................. ❑ Yes ❑ No Form H1610 Page 3/04 -2007 16. Indicate your school /RCCI or the public school free or reduced -price enrollment percentage: ................................... Free or Reduced Price: % 17. Which required activities are included in your after school program? ......... ............................... ❑ Educational Activities ❑ Enrichment Activities 18. Licensing (for schools only) A. Is a Texas Child Care License required for your after school care program? ....................................... ............................... ❑ Yes ❑ No If yes, attach copy of license. If no, attach wriften confirmation from TDFPS that your facility is not subject to licensure. B. If after school care site is not on a school campus and is exempt from licensure, are all state and local health and safety standards met? (Attach copy of most recent inspections.) ......................... -... ...................... .... ................ ......................... .. ❑ Yes ❑ No Part II — Policy Statement for Free and Reduced -Price Meals If the school food authority operates a program that requires separate charges for meals, it must comply with Sections A and B. If the school food authority operates a program that does not require separate charges for meals, it must comply with Sections B and C. If the school food authority operates a program that requires both a separate charge and no separate charge for meals, it must comply with Sections A, B, and C. Section A — Programs that Charge Separate ONLY 1. The school food authority accepts responsibility for providing free and reduced -price meals to eligible children. 2. The school food authority assures HHSC that it will uniformly implement the following policy to determine children's eligibility for free and reduced -price meals in the National School Lunch Program and School Breakfast Program. In fulfilling its responsibilities, the school authority agrees to: a. Serve free meals to children from households whose income is equal to or less than the income eligibility standard for free meals on Form H4504, Income Standards for Determining Free and Reduced -Price Eligibility, applicable to the contract period, or to children from food stamp households or TANF assistance units that provide a case number. b. Serve reduced -price meals to children from households whose income is above the income eligibility standard for free meals but equal to or less than the standard for reduced -price meals on Form H4504, Income Standards for Determining Free and Reduced -Price Eligibility, applicable to the contract period. C. Provide these benefits to children from families submitting completed applications whose incomes meet the criteria on Form H4504, and to foster children and children from families whose incomes meet the criteria on Form H4504 because of strikes, layoffs, or unemployment. d. Designate to review applications and determine eligibility. This official must use the criteria in this policy to determine which children are eligible for free or reduced -price meals. e. Prohibit physical segregation of, or any other discrimination against, any child because of his eligibility for free or reduced -price meals. The names of these children must not be published, posted, or announced in any manner. They must not be overtly identified by special tokens or tickets or by any other means. They must not be required to (1) work for their meals; (2) use a separate lunchroom; (3) go through a separate serving line; (4) enter the lunchroom through a separate entrance; (5) eat a meal different from the one sold to children paying the full price; or (6) eat meals at a different time from the other children. I. Establish and use a fair hearing procedure for parents who appeal the school's/RCCI's decisions on applications and for officials of schools/RCCIs who dispute information in an application or the eligibility of children for free or reduced -price meals. During the appeals and hearing, the child must continue to receive free or reduced -price meals. Records must be kept according to record retention requirements in the National School Lunch /School Breakfast Program Handbook and agreement. Before beginning the hearing procedure, the parent or local school /RCCI official may request a conference. The conference should provide an opportunity for the parent and school/RCCI official to discuss the situation, present information, and obtain an explanation of data submitted in the application and decisions made. A conference must not prejudice or diminish the right to a fair hearing. VOL q-5 PAGE � Form H1610 Page 4104 -2007 The hearing procedure must provide: (1) A simple, publicly announced method for making an oral or written request for a hearing. (2) An opportunity to be assisted or represented by an attorney or other person. (3) An opportunity to examine, before and during the hearing, the documents and records presented to support the decision being appealed. (4) Reasonable promptness and convenience in scheduling a hearing and adequate notice of the time and place of hearing. (5) An opportunity to present oral or documentary evidence and arguments supporting a position, without undue interference. (6) An opportunity to question or refute testimony and evidence and to confront and cross - examine adverse witnesses. (7) A decision made by a hearing official conducting the hearing who was not involved in the decision being appealed or in any previously held conference. (8) A decision by the hearing official based on oral and documentary evidence presented at the hearing that is made a part of the hearing record. (9) Written notification of the hearing official's decision, including the household's right to reapply any time during the year, provided to the parties concerned and their designated representatives. (10) A written record that includes the decision being appealed, documentary evidence, and a summary of oral testimony presented at the hearing, the hearing official's decision and the reasons for the decision, and a copy of the notification of the hearing official's decision to the parties concerned. (11) Record retention of the hearing for three years and 90 days after the end of the fiscal year to which it pertains. If audit findings have not yet been resolved, the records must be kept until the audit issues are resolved. The record must be available for examination by the parties concerned, or their representatives, at any reasonable time and place during the retention period. g. Submit information for public release to the news media, local unemployment offices, and major employers contemplating large layoffs in the area served by the school /RCCI. The school food authority must send the information for public release by letter at the beginning of each school year and when eligibility standards change. All changes in eligibility criteria must be publicly announced. The school food authority must keep a copy of the letter transmitting the public release information for three years and 90 days after the end of the fiscal year to which it pertains or until audit issues are resolved. The public release must include: (1) A sample of the letter to the parents (Form H4524). (2) Form H4504. The information for public release was or will be provided to the organizations on the dates that follow (attach a sheet if more space is needed): Public News Media VOL 95 � Form H1610 Page 5104 -2007 h. Establish a procedure to collect money from children who pay for their meals and a procedure to accurately record the number of free, reduced -price, and full -price meals served. The procedure described in this item must be used so that children will not be aware of who is receiving free and reduced -price meals. Check the collection procedure the school food authority uses. ❑ Collection Procedure 1 — Each day children can buy tickets in the cafeteria manager's office but they do not receive the tickets. The cafeteria manager then sends the purchased tickets and the tickets for free or reduced -price meals to the classroom. The teacher distributes the tickets just before meat time. The tickets are coded for accounting purposes. ❑ Collection Procedure 2 — Each day children pay for their meals in the office. A list of all children who paid or are eligible for free or reduced -price meals is prepared and sent to the cafeteria. A cashier familiar with the children checks names as children pass through the line. After the meal service, the list is returned to the office for accounting purposes. This method works only in a small school /RCCI where the cashier knows all the children. ❑ Collection Procedure 3 — The homeroom teacher gives each child an envelope for daily, weekly, or monthly payments. Children return the envelopes with the payments enclosed or empty if eligible for free meals. The envelopes are collected in the office and coded tickets are issued to each child. ❑ Collection Procedure 4 — Parents pay in advance by the month. Each teacher receives a list of those children who have paid. Children who receive free meals are marked paid, so only the bookkeeper knows which children receive a free meal. Teachers keep daily records of each child served and send the records to the office for accounting purposes. ❑ Collection Procedure 5 — Meal payments are collected in the secretary's office. Payments can be made by children or parents daily, weekly, or monthly. The secretary records payments and knows which children qualify for free or reduced -price meals. In the classrooms, the secretary distributes identical tickets labeled only with the children's names. Since the parents may pay, even the children may not know whether their meals are free, full - priced, or reduced -price. ❑ Collection Procedure 6 — Parents are billed monthly for full -priced or reduced -price meals their children are served. All payments are mailed in. All participating children receive a coded ticket each month, which is punched at each meal service. At the end of the month, the tickets are collected and a clerk calculates the amount to be billed. ❑ Collection Procedure 7 — Other. Explain in detail. (Use an attachment if necessary.) I. Describe how the daily numbers of free, reduced -price, and full -price meals are identified and counted, and the numbers recorded. (Use an attachment W necessary.) j. Describe how daily point -of- service counts are taken. The point -of -service in the food service operation is the point at which it can be accurately determined that a meal is reimbursable. This is usually the end of the line. If tickets or tokens are collected at the beginning, explain how you assure that a reimbursable meal was taken. (Use an attachment if necessary.) VOL 95 PME Form H1610 Page 6104 -2007 Section B — Programs that Charge Separately AND Programs that DO NOT Charge Separately In fulfilling its responsibilities, the school food authority agrees: 1. In accordance with federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age or disability. To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250 -9410 or call 800- 795 -3272 or 202.720 -6382 (TTY). USDA is an equal opportunity provider and employer. 2. (Applicable only if operating day schools and boarding schools) — Develop and distribute to each child's parent or guardian a letter, according to the sample attached, and an application form for free or reduced -price meals. These must be distributed at the beginning of each year and when eligibility criteria change. a. The school food authority must complete (1) or (2) as applicable: (1) Form H4524 is a sample of the letter to parents whose children are in a program that charges separately for meals. Is the school food authority using the attached sample? .......................................... ............................... ❑ Yes ❑ No (2) Form H4524 is a sample of the letter to parents whose children are in a program that does not charge separately for meals. Is the school food authority using the attached sample? ................... ............................... ❑ Yes ❑ No If the answer to either (1) or (2) is "No," the school food authority must submit to HHSC, with this application form, a copy of the letter they send to parents. HHSC must approve this letter before the school food authority sends it to parents. On approval, the school food authority must attach Form H1625 -A to the letter and send both documents to parents. b. Form H4524 is a sample of the application for free and reduced -price meals. Is the school food authority using the attachedsample? ........................................................................................................................... ............................... ❑ Yes ❑ No The school food authority must ask parents to complete the application and return it to the determining official named in Section A of this form. Applications and documentation of action taken are kept for three years and 90 days after the end of the fiscal year to which they pertain. If audit findings are not resolved, the records are kept until the issues are resolved. Applications may be filed at any time during the year. The school food authority must supply an application to parents enrolling a child in a schoollRCCI for the first time (at any time during the year). If a child transfers from one schoollRCCI to another under the jurisdiction of the same school food authority, his/her eligibility for a free or reduced -price meal is also transferred. Note — Programs that Charge Separately ONLY: All children from the same family must receive the same benefits. Within 10 workdays of receiving applications, parents or guardians must be notified individually of the decision on their applications. Children are served meals as soon as they are determined eligible. Form H1623 is a sample of the notification letter to the parents about the application for free and reduced - price meals. Is the school food authority using the attached sample? ................................. ............................... ❑ Yes ❑ No If "No," the school food authority must attach a copy of the letter being sent to parents. When an application if denied, parents or guardians are informed in writing of the reason for denial and the hearing procedure. The designated hearing official is Name Title This person must be someone not involved in the original eligibility determination. It is suggested that the hearing official hold a higher position than the determining official. The hearing official and the determining official cannot be the same person. 3. Submit to HHSC any proposed changes to this policy statement before it is implemented. Changes are effective only when they are approved by HHSC. 4. Verity eligibility according to the National School Lunch/School Breakfast Program Handbook and program regulations. Form H1610 Page 7/04 -2007 Indicate which of the provisions of this section, if any, the school food authority wants to participate in for free and reduced -price meals. Three special provisions are available to school food authorities that affect free and reduced -price meal policy and procedures. a. Provision 1— The annual certification of children eligible to receive FREE meals may be reduced to once every two years in schools/RCCIs. This period can be reduced if 80% of the children in attendance are eligible for free and /or reduced -price meals based on data from March of the previous year. Applications must still be sent annually to students who pay full -priced or reduced -price or who are newly enrolled. For claiming purposes, school staff must continue to keep a daily record of the number of paid, free, and reduced -price meals served to children. ® We choose NOT to participate in Provision 1. ❑ We will participate in Provision 1, and certify that the following schools had 80% or above free and/or reduced -price recipients participating: Our first year under Provision 1 will be school year ................................................................ ............................... b. Provision 2 — School food authorities may choose to serve all children at no charge. Any school /RCCI that chooses to serve all children meals at no charge may reduce the frequency of certification for children eligible for free and /or reduced -price meals to once every four years. School food authorities must submit socioeconomic data from an approved source with their base year (first year) application to implement Provision 2, and socioeconomic data from the same source with their application for extension at the end of the four -year cycle. The base year, or first year, that a school is on Provision 2 is part of the four -year cycle. If HHSC determines at the and of the four -year cycle that there has been negligible improvement (five percent or less improvement after adjusting for inflation) in the socioeconomic status of that school food authority's population, the Provision 2 period may be extended another four years. School food authorities choosing Provision 2 must use local sources other than federal reimbursement to absorb the cost of (1) meals served to children not eligible for free or reduced -price meals; and (2) the difference between the cost of the meal and the federal reimbursement received for each free or reduced -price meal served to children eligible for meals. School food authorities of schools/RCCIs using Provision 2 are required to send letters and applications to parents only at the beginning of the four -year period. School food authorities must maintain all approved applications and eligibility documentation from the designated base year at least three years and 90 days after the final Claim for Reimbursement of the final school year that employed base year data, or longer if required for audit resolution. Schools /RCCls are required to determine daily during the first year of the four -year period the actual number of meals served to all attending children by type (free, reduced- price, and paid). In the second, third, and fourth years, monthly claims for meals served by type (free, reduced -price, and paid) are based on a percentage of the total number of meals served by type in the corresponding month of the first year. ® We choose NOT to participate in Provision 2. ❑ The following schools /RCCls will participate in Provision 2: Our base year or first year under Provision 2 will be school year ............................................. ............................... Provision 2 will be in effect for three successive school years after the base year, including school years , and The school year that we will be reconsidered for an extension for Provision 2 is in the fourth year or school year VUL-95 PAGE 51 Form H1610 Page 6/04 -2007 We will use and submit the following approved source of socioeconomic data with our application for our base year and when being considered for an extension (check source being used): ❑ Local data collected by the city or county zoning and economic planning office. ❑ Unemployment data. ❑ Local Food Stamp Program certification data. ❑ Temporary Assistance for Needy Families (TANF) data (provided that eligibility standards were the same or more restrictive in the base year as current year with allowance for inflation). Form H4524 is a sample of the letter to parents whose children are in programs with no separate charges for meals. It can be sent to parents for Provision 2 participants. If participating in Provision 2, you must answer the following question: Is the school food authority using the attached sample Form H4524? .............................. ............................... ❑ Yes ❑ No If "No," the school food authority must attach a copy of the letter being sent to parents. Provision 3 — School food authorities may choose to serve all children meals at no charge. Any school/RCCI which chooses to serve all children meals at no charge will conduct certification of children eligible for free and /or reduced -price meals during a designated base year and will not conduct eligibility certification during the successive four -year period following the base year. The school food authority must submit socioeconomic data from an approved source with their base year application, and from the same source with their application for extension at the end of the four -year cycle. If HHSC determines after the initial four -year period of Provision 3 that there has been negligible change (five percent or less improvement after adjusting for inflation) in the socioeconomic status of that school food authority's population, the Provision 3 period may be extended an additional successive four years. School food authorities choosing Provision 3 must use local sources other than federal reimbursements to absorb the cost of (1) meals served to children not eligible for free or reduced -price meals; and (2) the difference between the cost of the meal and the federal reimbursement received for each free or reduced -price meal served to children eligible for meals. School food authorities of schools /RCCIs using Provision 3 are required to send letters and applications to parents only at the beginning of the designated base year. School food authorities must notify households of enrolled students that all meals will be available at no charge to students during the Provision 3 four -year period. School food authorities must maintain all approved applications, eligibility documentation, and enrollment data from the designated base year at least three years and 90 days after the final Claim for Reimbursement of the final school year that employed base year data, or longer if required for audit resolution. School food authorities must determine any increase or decrease in enrollment each year of Provision 3 based upon the school's enrollment on October 1 annually. Schools/RCCls are required to determine daily during the designated base year for Provision 3 the actual number of meals served to all attending children by type (free, reduced -price, and paid). During the four successive years after the designated base year, schools will prepare monthly claims for meals served by type (free, reduced -price, and paid) based on the total meals claimed for the corresponding month of the designated base year and reflecting the percent increase or decrease of the school's /RCCI's enrollment on October 1 of the current school year, and must take total meal counts of reimbursable meals served to participating children at the point of service. ® We choose NOT to participate in Provision 3 ❑ The following schoolslRCCls will participate in Provision 3: Our first year under Provision 3 will be school year .................................................................. ............................... Our designated base year will be school year .......................................................................... ............................... Provision 3 will be in effect for four successive school years after the base year, including school years and The school year that we will be reconsidered for an extension for Provision 3 is in the fourth year or school year V11 PN^F DA Form H1610 Page 9/04 -2007 We will use and submit the following approved source of socioeconomic data with our application for our base year and when being considered for an extension (check source being used): ❑ Local data collected by the city or county zoning and economic planning office. ❑ Unemployment data. ❑ Local Food Stamp Program certification data. ❑ Temporary Assistance for Needy Families (TANF) data (provided that eligibility standards were the same or more restrictive in the base year as current year with allowance for inflation). Form H4524 is a sample of the letter to parents whose children are in programs with no separate charges for meals. It can be sent to parents for Provision 3 participants. If participating in Provision 3, you must answer the following question: Is the school food authority using the attached sample Form H4524? .............................. ............................... ❑ Yes ❑ No If "No," the school food authority must attach a copy of the letter being sent to parents and describe how it will notify households that meals will be available free of charge to all enrolled students. Section C — Programs that DO NOT Charge Separately ONLY 1. The school food authority is responsible for providing program benefits to eligible children. 2. The school food authority assures HHSC that although no identifiable charge is established for meals, it will uniformly implement the following policy. In fulfilling its responsibilities, the school food authority agrees to: a. Claim as free meals only those meals served to children from families whose income is equal to or less than the income eligibility standard for free meals on Form H4504, Standards for Determining Free and Reduced -price Eligibility, applicable to the contract period, or to children from food stamp households or TANF assistance units that provide a case number. b. Claim as reduced -priced meals only those meals served to children from families whose income is above the income eligibility standard for free meals but equal to or less than the standard for reduced -price meals on Form H4504, Standard for Determining Free and Reduced - priced Eligibility, applicable to the contract period. C. Keep documentation to support individual eligibility decisions for three years and 90 days after the end of the fiscal year to which they pertain. If audit findings are not resolved, the records must be kept unfit audit issued are resolved. d. Prevent physical segregation of, or any other discrimination against, any child. The names of the children eligible for free or reduced -price meals may not be published, posted, or announced in any manner and children must not be overtly identified. Children must not be required to (1) work for their meals; (2) use a separate lunchroom; (3) go through a separate serving line; (4) enter the lunchroom through a separate entrance; (5) eat meals at a different time; or (6) eat a different meal. e. Designate Patrick Munoz Superintendent to determine eligibility for free and Name Title reduced -price meals. This official will use the criteria outlined in this policy to determine which individual children's claims may be made for free or reduced -price meals. f. Develop and keep a list with the following information about each child (for school food authorities operating RCCIs only): (1) name; (2) birth date; (3) dates of admission and release; (4) income; and (5) eligibility determination and data (initialed by official making determination). Note: Children at RCCIs are considered a family of one. Exceptions to this are children of house parents living at the institution. These children must have an application on file as described in Section B, number 2. g. Describe how daily point -of- service counts are taken. The point -of -service in the food service operation is the point at which it can be accurately determined that a meal is reimbursable. This is usually the end of the line. If tickets or tokens are collected at the beginning, explain how you assure that a reimbursable meal was taken (attach a sheet if needed). Resident are only served meals that are reimbursable by our kitchen staff. A final count is made by the child care staff member when resident exit the serving line and are seated. 141JL �51RAc= 53 Form H1610 Page 10104 -2007 SECTION D — The following attachments are a part of the policy statement for free and reduced-price meals: Form H1623, Notification Letter to Parents (regarding application for free and reduced -price meals) Form H1625A, Standards for Determining Free and Reduced -Price Eligibility, to be provided to parents (will be forwarded as soon as USDA publishes) Form H4524, Application for Free and Reduced -Price Meals and Letter to Parents Form H4504, Standards for Determining Free and Reduced -Price Eligibility (will be forwarded as soon as USDA publishes) A sample Press Release (see page 10 of this form) I CERTIFY that the information on this form is true and correct to the best of my knowledge. I understand that deliberate misrepresentation or withholding of information may result in prosecution under applicable state and federal statutes. If our school food authority has applied and is approved to participate in one of the Provisions, I certify that our school food authority will follow all rules and regulations for the Provision for which we have been approved. Title — Official a-cZk L County Judge — Official D.. t.,,, . Date For HHSC Use Only Title — HHSC Representative Signature — HHSC Representative Date . 9s .1; 5Y Form H1610 Page 11/04 -2007 Sample Public Release for Free and Reduced -Price Meals (Make appropriate changes as applicable to reflect the programs operated.) This is the public release that we will send to (names of news media outlets and major employers contemplating layoffs) on These groups must be advised of program availability, new programs, or changes in existing programs. today announced its policy for (Name of local school food authority) free and reduced-pdce meals served under the (Insert National School Lunch Program and /or School Breakfast Program.) Each school and the office of the which anyone may review. The following household size and income criteria will be used to determine eligibility: (Insert income eligibility criteria as announced by USDA for free and reduced -price meals.) Children from households whose income is at or below the levels shown are eligible for free or reduced -price meals. has a copy of the policy, Application forms and a letter to parents or guardians are being sent to all homes. To apply for free or reduced -pdoe meals, households should fill out the application and return it to the school. Additional copies are available at the principal's office. The information provided on the application will be used to determine eligibility; it may be verified any time during the school year by school or other program officials. Households must provide the following information on the application: all household members' names; total household income by source and the Social Security number of the adult household member signing the application, or an indication that the household member does not possess a Social Security number, OR the household's food stamp or TANF case number, if appropriate; and the signature of an adult household member certifying that the information is correct. Applications may be submitted any time during the year. According to the free and reduced -price policy, will review applications and (Name of Determining Official) determine eligibility. Parents or guardians dissatisfied with the ruling of the official may discuss the decision with the determining official. Parents may request a formal appeal either orally or in writing to: (Name, Address, and Telephone Number of the Hearing Official) Households approved for free or reduced -price meals are not required to report changes in income status, household size, or when the household is no longer eligible for food stamps or TANF. This provision does not apply to a household provided with "temporary" approval for meal benefits. Some foster children are also eligible for free or reduced -price meals. A household with foster children should contact the school for more information. The information that households provide is confidential and will be used only to determine eligibility and for verifying data. In accordance with federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age or disability. To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250 -9410 or call 800- 795 -3272 or 202 - 720 -6382 (TTY). USDA is an equal opportunity provider and employer. `Texas Health and Human r; Services Commission f� This is to certify that the following person(s): Special Nutrition Programs Certificate of Authority Form H4508 February 2007 Name of Authorized Representative (Type or print in the following order: prefix, Title first name, middle name or initial, last name and suffix.) contracting organization to make written agreements with the Texas Health and Human Services Commission (HHSC) to operate Patrick Munoz Superintendent E -mail Address Area Code and Telephone Number pmunoz@co.brazos.tx.us 979- 823 -3544 M"t,n s /, 3 /C ? Sign ture - Authori ed Representative Date of Signature Name of Authorized Representative (Type or print in the following order: prefix, Title first name, middle name or initial, last name and suffix.) contracting organization to make written agreements with the Texas Health and Human Services Commission (HHSC) to operate Collin Coker Assistant Director E -mail Address Area Code and Telephone Number cooker co.brazos.tx.us 979- 823 -3544 Signature - is (are) designated as an Authorized Representative of nepresentanve z3. Date of Signat re Name of Contracting Organization Address (Street, City, State, ZIP Code) The representative(s) designated above, and myself, acknowledge that each is individually authorized on behalf of the contracting organization to make written agreements with the Texas Health and Human Services Commission (HHSC) to operate a food program, to sign documents or reports about the agreement and to present claims for reimbursement, when appropriate, to the agency. By signing this document, we certify individually and collectively that to the best or our knowledge and belief, all documents submitted physically or electronically on behalf of the above named contracting organization pursuant to our participation in any and all programs administered by Special Nutrition Programs, HHSC, are/will be true and correct in all respects, that they are/will be completed according to the terms and conditions of existing agreements, including amendments, that records are/will be available to support any and all claims and that we will not submit claims (excluding amended /adjusted claims) for goods or services for which we have already received payment. We recognize that we are fully responsible for any excess amounts which may result from errors made in relation to the completion and submission of claims. We are also aware that deliberate misrepresentation or withholding of information may result in prosecution under applicable state and federal statutes. Name of Official of Contracting Organization (Type or print in the following order: Title prefix, first name, middle name or initial, last name and suffix.) Randy Sims County Judge E -mail Address Area Code and Telephone Number r 5 979- 361 -4102 Date of Signature Deleted Authorized Representatives: A contracting organization may not have more than three (3) authorized representatives, including the official of the contracting agency. If you are deleting an authorized representative, list the name(s) of the individual(s) to be removed as authorized representative(s) below: Name of Deleted Representative Name of Deleted Representative Name of Deleted Representative ror ritib ; use unl - Contract No. Received By Date Received VA Texas Health and Human Services Commission f National School Lunch Program and School Breakfast Program Individual Site Information Form H1609 April 2002 Name of School /RCCI /Afters chool Care Feeding Site Beginning Date of Operation 1 Telephone Number razos County Juvenile Detention Center 07/012007 ( 979 ) 823 -3544 Address (Street or P.O. Box, City, State, Zip) Ending Breakfast 1904 SH 21 West Name of Person in Charge of Food Service Program 7:30 a.m. Name of School Food Authodty 48 Patdck Munoz Brazos CountyJuvenile Services 1:00 P.M. Type of Feeding Site (check all that apply) ❑ Day School ❑ Boarding School ❑ Combination Day School ® Residential Child ❑ Combination Day School and and Boarding School Care Institution Residential Child Care Institution ❑ Special Education School ❑ Afterschool Care Snack Site ❑ Other (specify): 1. Is the above school /residential child care institution licensed? (If yes, attach copy of license.) ........................ ............................... ® Yes ❑ No 2. Program(s) that you are applying for: ® National School Lunch Program ❑ Afterschool Care Snack program (SFA must be participating in National School Lunch Program) ® School Breakfast Program ® Severe Need School Breakfast Program Rates' * Available to schools/residenfiel child care institutions meeting the following eligibility criteria: 1. 400h or more total lunches served In second preceding yearwere free or reduced price; and 2. Breakfast costs exceed the regular reimbursement rates available under the School Breakfast Program. 3. Number of months the school will be operating a food service program: 4. Number of children enrolled at school /residential child care institution: . A. Age Range of Children Enrolled From: 10 To: 16 5. Number of Months Beginning Date of Operation 1 Ending Date of 0peration 1 12 07/012007 0613012008 B. Grade Levels Taught (schools only) From: To: Food Service: AVERAGE DAILY PARTICIPATION OF CHILDREN IN PROGRAM TIMES OF FOOD SERVICE Free Reduced Price Paid Beginning Ending Breakfast 48 6:30 a.m. 7:30 a.m. Lunch 48 11:30 a.m. 1:00 P.M. Area Eligible Afterschool Care Snack Not Area Eligible Afterschool Care Snack 6. Attendance (for residential child care institutions only) A. Are all of the children at the institution all day? ...................................................................................... ............................... ® Yes ❑ No Ifno, do all or some of the children attend public school? ..................................................................... ............................... ❑ All ❑ Some Ifonly some attend public school, how many? ...................................................................................... ............................... If some or all attend public school, which meals do these student eat at the institution? ....... ....................- ....................... ❑ Breakfast ❑ Lunch B. Check if the children attend the institution on holidays and /or weekends . ....... ......... ................... - ...... ............................... ® Holidays ® Weekends FA 8. i ype or meal oennce A. Meal Preparation ® On-Site Kitchen ❑ Other (explain: ❑ Central Kitchen ❑ Food Service Management Company ❑ Vended Meals (submit copy of contract and checklist) (submit copy of agreement) B. Meal Planning System ❑ Enhanced Food Based ® Traditional Food Based ❑ Other(explain: NOTE: Snacks served in the Afterschool Care Snack ype of Program ❑ Separate Charges Made for Meals ❑ Nutrient Standard Menu ❑ Assisted Nutrient Standard Menu Planning Planning (NSMP or NuMenus) (ANSMP or Assisted NuMenus) (See instructions for documents to submit.) food based supplement pattem regardless of your menu planning method for breakfast and/or lunch. ® No Separate Charge; Cost of Meals is Included ❑ Combination of Separate Charges and in Required Payment Plan /Fee No Separate Charges a Y Q Form H1609 Page 2/04 -2002 Daily Price Charged for Each Meal (for programs that will charge separately only): CHILDREN ADULTS Reduced Price Paid Breakfast ❑ Yes ❑ No I ❑ Yes ❑ No ❑ Yes ❑ No Lunch ❑ Yes ❑ No I ❑ Yes ® No NOTE: You must attach an information statement from the ISO (see instructions). Not Area Eligible Afterschool Care Snack 13. Indicate your school /RCCI or the public school free or reduced price enrollment percentage: .., .......... .................... Free or Reduced Price: % NOTE: Area Eligible Afterschool Care Snack program sites must provide snacks free of charge to all students participating in the afterschool care program. 10, A. If applying for the National School Lunch Program, indicate whether Offer versus Serve will be implemented: High School (mandatory) I Junior High (optional) Elementary (optional) Preschool (optional) Residential Child Care Institution (optional) ❑ Yes ❑ Yes ❑ No I ❑ Yes ❑ No ❑ Yes ❑ No 1 ❑ Yes ® No B. If aovIvina for the School Breakfast Proaram. indicate whether Offer versus Serve will be implemented: 11. Will supplemental (a la cane or snack bar) food service be available in addition to the school lunch? ........... ............................... High School (optional) Junior High (optional) Elementary (optional) Preschool (optional) Residential Child Care Institution (optional) 12. Is attendance in afterschool care program limited to students enrolled in your school /RCCI? ........................ ............................... ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No I ❑ Yes ® No 11. Will supplemental (a la cane or snack bar) food service be available in addition to the school lunch? ........... ............................... ❑ Yes ® No Questions 12 through 15 apply only to the Afterschool Care Snack program. 12. Is attendance in afterschool care program limited to students enrolled in your school /RCCI? ........................ ............................... ❑ Yes ❑ No N no: In which Individual public school attendance area (not district) is the site located? NOTE: You must attach an information statement from the ISO (see instructions). 13. Indicate your school /RCCI or the public school free or reduced price enrollment percentage: .., .......... .................... Free or Reduced Price: % 14. Which required activities are included in your after school program? ......... ............................... ❑ Educational Activities ❑ Enrichment Activities 15. Licensing (for schools only) A. Is a Texas Child Care License required for your after school rare program? ....................................... ............................... ❑ Yes ❑ No If yes, attach copy of license. If no, attach written confirmation from TDPRS that your facility is not subject to licensure. B. If after school care site is not on a school campus and is exempt from licensure, are all state and local health and safety standards met? (Attach copy of most recent inspections.) .................................................................... ............................... ❑ Yes ❑ No I CERTIFY that the information on this form is true and correct to the best of my knowledge. I understand that deliberate misrepresentation or withholding of information may result in prosecution under applicable state and federal statutes. r Title _(,5 County Judge nature — Official rCkY St 1�s Date VOL 9s PAGE_5� VTexaa Hefth and Human Services Caommission National School Lunch Program and School Breakfast Program Individual Site Infortnation Form H1609 April 2002 Name of School /RCCI /Afterschool Care Feeding Site Beginning Date of Operation Telephone Number Brazos County Academy 08/14/2007 ( 979 ) 846 -4842 Address (Street or P.O. Box, City, State, Zip) Ending Breakfast 623 Mary Lake Bryan, Tx. 77803 Name of Person in Charge of Food Service Program 8 a.m. Name of School Food Authority 30 Patrick Munoz Brazos CountyJuvenile Services 1 P.M. Type of Feeding Site (check all that apply) ® Day School ❑ Boarding School ❑ Combination Day School ❑ Residential Child ❑ Combination Day School and and Boarding School Care Institution Residential Child Care Institution ❑ Special Education School ❑ Afterschool Care Snack Site ❑ Other (specify): 1. Is the above school /residential child rare institution licensed? (If yes, attach copy of license.) ........................ ............................... ® Yes ❑ No 2. Program(s) that you are applying for: ® National School Lunch Program ❑ Afterschool Care Snack program (SFA must be participating in National School Lunch Program) ® School Breakfast Program ® Severe Need School Breakfast Program Rates" ' Available to schools/residenfial child care institutions meeting the following eligibility criteria: 1. 40% or more total lunches served in second preceding year were free or reduced price; and 2. Breakfast costs exceed the regular reimbursement rates available under the School Breakfast Program. 3. Number of months the school will be operating a food service program: .................. 4. Number of children enrolled at schoollresidential child care institution: ........................................................ ............................... A. Age Range of Children Enrolled B. Grade Levels Taught (schools only) From: 10 To: 16 From: 5 Number of Months Beginning Date of Operation Ending Date of Operation 9 08/14/2007 05/30/2008 5. To: Food Service: AVERAGE DAILY PARTICIPATION OF CHILDREN IN PROGRAM TIMES OF FOOD SERVICE Free Reduced Price Paid Beginning Ending Breakfast 30 7 a.m. 8 a.m. Lunch 30 12 p.m. 1 P.M. Area Eligible Afterschool Care Snack Not Area Eligible Afterschool Care Snack 6. Attendance (for residential child care institutions only) A. Are all of the children at the institution all day? ...................................................................................... ............................... ® Yes ❑ No If no, do all or some of the children attend public school? ..................................................................... ............................... ❑ All ❑ Some If only some attend public school, how many? ...................................................................................... ............................... If some or all attend public school, which meals do these student eat at the institution? ...................... ............................... ❑ Breakfast ❑ Lunch B. Check if the children attend the institution on holidays and /or weekends ............................................. ............................... ❑ Holidays ❑ Weekends 7. Type of Meal Service A. Meal Preparation ❑ On -Site Kitchen ❑ Other(explain: 8. ® Central Kitchen ❑ Food Service Management Company ❑ Vended Meals (submit copy of contract and checklist) (submit copy of agreement) B. Meal Planning System ❑ Enhanced Food Based ® Traditional Food Based ❑ Other (explain: NOTE: Snacks served in the Aterschool ype of Program ❑ Separate Charges Made for Meals ❑ Nutrient Standard Menu ❑ Assisted Nutrient Standard Menu Planning Planning (NSMP or NuMenus) (ANSMP or Assisted NuMenus) (See instructions for documents to submit.) must follow the food based supplement pattern regardless of your menu planning method for breakfast and/or lunch. ® No Separate Charge; Cost of Meals is Included ❑ Combination of Separate Charges and in Required Payment Plan /Fee No Separate Charges it ��JJ FF 'r 9. Form H1609 Page 2/04 -2002 Daily Price Charged for Each Meal (for programs that will charge separately only): CHILDREN ADULTS Reduced Price Paid Breakfast ® Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Lunch Not Area Eligible Afterschool Care Snack NOTE: Area Eligible Afterschool Care Snack program sites must provide snacks free of charge to all students participating in the afterschool pre program. 10. A. If applying for the National School Lunch Program, indicate whether Offer versus Serve will be implemented: High School (mandatory) Junior High (optional) Elementary (optional) Preschool (optional) Residential Child Care Institution (optional) 1 ® Yes ® Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ® No If applying for the School Breakfast Program, indicate whether Offer versus Serve will be implemented: High School (optional) Junior High (optional) Elementary (optional) Preschool (optional) I Residential Child Care Institution (optional) ❑ Yes ® No ❑ Yes ® No 1 ❑ Yes ❑ No ❑ Yes ❑ No I ❑ Yes ® No 11. Will supplemental (a Is carte or snack bar) food service be available in addition to the school lunch? Questions 12 through 15 apply only to the Afterschool Care Snack program. 12. Is attendance in aterschool rare program limited to students enrolled in your school/RCCI? H no: In which individual public school attendance area (not district) is the site located? NOTE: You must attach an information statement from the ISD (see instructions). ................ I ..... ... ❑ Yes ® No ...................... ❑ Yes ❑ No 13. Indicate your school /RCCI or the public school free or reduced price enrollment percentage: .. ................................ Free or Reduced Price: 14. Which required activities are included in your after school program? ... ...... ............................. - ❑ Educational Activities ❑ Enrichment Activities 15. Licensing (for schools only) A. Is a Texas Child Care License required for your after school rare program? ....................................... ............................... ❑ Yes ❑ No If yes, attach copy of license. If no, attach written confirmation from TDPRS that your facility is not subject to licensure. B. If after school care site is not on a school campus and is exempt from licensure, are all state and local health and safety standards met? (Attach copy of most recent inspections.) .................................................................... ............................... ❑ Yes ❑ No I CERTIFY that the information on this form is true and correct to the best of my knowledge. I understand that deliberate misrepresentation or withholding of information may result in prosecution under applicable state and federal statutes. Title County Judge Si ature— Official r2,;CE y 5,rnS Date ,�exas Health and Human Services Commission Part l Special Nutrition Programs Single Audit Identification Data For Program Year 2007 -2008 (SNP Use Only) Form H1569 July 2006 Name of Contracting Organization Contact Person Cash Reimbursement Programs Brazos County, Tx Patrick Munoz 021187A Address (Street or P.O. Box, City, State, ZIP Code) TX - 1904 SH 21 West Bryan, Tx. 77803 Area Code and Telephone No. Texas ID No. Contract No. ( 979 ) 823 — 3544 17460004330000 175-61001 TX - Contractor Fiscal Year End (mm /dd /yyyy) Type of Contract ❑ DH - CACFP Day Care Homes 09/30/2007 ❑ For Profit ❑ Nonprofit ❑ State Agency ® Other Part II Check the appropriate box(es) to indicate the type(s) of program(s) in which you currently participate or for which you are applvinq: Commodity Assistance Programs Program Nos. Cash Reimbursement Programs Program Nos. ® A - National School Lunch/Breakfast 021187A ❑ AD - CACFP Adult Day Care TX - [I B - Charitable Institutions ® BL- National School Lunch/Breakfast TX - 021 -2001 ❑ C - Area Agency on Aging ❑ CC - CACFP Child Care Centers TX - ❑ G - Summer Camps ❑ DH - CACFP Day Care Homes TX - [I H - Summer Food Service Program ❑ SF - Summer Food Service Program TX - El J -Jails ❑ SM - Special Milk Program TX - ❑ 1- TEXCAP ❑ TE - TEXCAP ITX - ❑ CS - Commodity Supplemental Food Frog. I ❑ CS - Commodity Supplemental Food Frog. JTX - Part III A. Does your agency expend federal funds from programs other than those listed above? ❑ Yes ❑ No If yes, complete Part III, B. B. Give the source and amount of any federal funds that your agency expended in your most recent completed fiscal Year. IBrazos County Juvenile Service annual budget 2006 -2007 expenditures I $3,021,234.84 Part IV Single Audit Exemption - I certify that I am not required to submit an audit under the Single Audit Act for the following reason. Check only one choice. ❑ I am a for - profit organization. ❑ 1 am a military base. ❑ I am a nonprofit organization and expend less than $500,000 annually in total federal funding. ❑ I am an Indian Reservation. I understand that if I meet the requirements of the Single Audit Act, now or in the future, I must submit an audit as a condition of eligibility to participate in the Special Nutrition Programs, and that failure to do so as required could result in adverse action, including the withholding of my claim for reimbursement payments and termination of my contract. I also understand that if I am a private non- profit organization subject to the requirements of the Single Audit Act and have a financial audit performed annually, I must also obtain a single audit on an annual basis. - „ / type or print) Munoz Superintendent VOL q_6 PAGE s %3/c, 7 Date