HomeMy WebLinkAbout2002-05-07-0900AM-Regular0-
FILED
t941 SAY - 2 P 4 4 5
AS
BRAZOS COUNTY C A7 .0S ERYAN.TE CLERK
BRYAN. TEXAS °Y DEPUTY
~
NOTICE OF MEETING
AND AGENDA
BRAZOS COUNTY COMMISSIONERS COURT
THE COMMISSIONERS COURT WILL MEET IN REGULAR SESSION ON
• TUESDAY, MAY 7, 2002 AT 9:00 A.M. IN THE COMMISSIONERS COURTROOM OF
THE BRAZOS COUNTY COURTHOUSE, 300 EAST 26M STREET, SUITE 115,
BRYAN, TEXAS.
1. Invocation and Pledge of Allegiance - Commissioner Thornton.
2. Call for citizen input and/or concerns.
Consider and take action on agenda items 3 -16:
3. Budget Amendment 01/02-23.
4. Payment of Claims.
5. Personnel Changes of Status.
6. Tax Exemption Request from the Wheelock SPJST Lodge No. 94.
7. Juvenile Services' Application for Participation in the National School Lunch
• Program and School Breakfast Program.
8. Agreement for Extended Service for the maintenance and support of the MAKO
Software in the Sheriff's Department.
9. Authorization for the Sheriff's Department to apply to the U.S. Department of
Justice for a "Sex Offender Management Discretionary Grant."
10. Request by the Road & Bridge Department for adjustment of salary schedule for
seasonal mowing staff.
Commissioners Court Meeting Agenda
May 7, 2002
Page Two
11. Recurring Payment Requests for First Star Transport.
12. Award of Bid #2002-047, Poly Jute Annual Bid, and subsequent requisition.
13. Renewal of Long Distance Service Contract with NTS Communications.
14. Award of Bid #2002-046RB - Sheriffs Department Uniforms.
15. Blanket Purchase Orders for the following:
a. $1,000.00 to Lowe's for the Brazos Center
b. $1,000.00 to Green Teams for the Brazos Center
c. $1,000.00 to Bryan 800 Communications for the County for vehicle equipment
transfers.
16. Approval of minutes from the following Commissioners Court meetings:
a. Regular meetings conducted on January 8, January 15, January 22, and
January 29, 2002.
b. Special meeting conducted on January 2, 2002.
C. Public Hearings conducted on January 8 and January 29, 2002.
d. Workshop Session conducted on January 8, 2002.
17. Announcement of interest items and possible future agenda topics.
18. Call for citizen input and/or concerns.
19. Convene into Executive Session pursuant to §551.071 of the Texas Government
Code to discuss privileged matters with legal counsel regarding acquisition of real
estate.
20. Consider and take action on Executive Session.
21. Adjourn.
The 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.
•
COMMISSIONERS' COURT
REGULAR MEETING
MAY 7, 2002
A regular meeting of the Commissioners' Court of Brazos
u
County, Texas was held in the Commissioners' Courtroom in the
Courthouse in Bryan, Brazos County, Texas, beginning at 9:00
a.m. on Tuesday, May 7, 2002, with the following members of
the Court present:
Alvin W. Jones, County Judge, Presiding;
Tony Jones, Commissioner of Precinct 1;
Wm.S. Thornton, Commissioner of Precinct 2;
C. B. Jones, Commissioner of Precinct 3;
Carey Cauley, Jr., Commissioner of Precinct 4, Absent;
Karen McQueen, County Clerk.
The attached sheet contains the names of the citizens and
officials that were in attendance.
Commissioner Thornton gave the invocation and led the
pledge of allegiance.
There was no citizen input/and or concerns.
The Court next considered Budget Amendment #01/02-23.1
•
through 23.3, which would transfer funds to all departments
from Contingency, and reallocate funds for Constable, Precinct
1 and the Courthouse Security Fund. On motion by Commissioner
Thornton, seconded by Commissioner Tony Jones, the Court voted
unanimously to approve the budget amendment as submitted, a
copy of which is attached hereto.
Vol .301 Page 35
0
Commissioners' Court meeting May 7, 2002
2
The Court next considered the following Claims as
submitted by the County Treasurer for payment:
20030309 through 20030527
On motion by Commissioner Tony Jones, seconded by Commissioner
Thornton, the Court voted unanimously to approve the Claims as
submitted.
The Court proceeded to consider the change of status of
employees as submitted on the attached Personnel Action
Requests. On motion by Commissioner Tony Jones, seconded by
Commissioner Thornton, the Court voted unanimously to approve
the changes as submitted.
The next matter before the Court was a Tax Exemption
Request from the Wheelock SPJST Lodge #94. The Texas
Comptroller of Public Accounts has determined that SPJST Lodge
#94 is a charitable organization eligible for property tax
exemption. On motion by Commissioner Tony Jones, seconded by
Commissioner Thornton, the Court voted unanimously to approve
the Tax Exemption Request from the SPJST Lodge #94 of Bryan,
Texas.
The Court next considered approval of Juvenile Services'
Application for Participation in the National School Lunch
Program and School Breakfast Program. On motion by
Commissioner Thornton, seconded by Commissioner Tony Jones,
Vol 3a Page 34'
•
Commissioners' Court meeting May 7, 2002
3
the Court voted unanimously to approve the Juvenile Services'
Application for Participation in the National School Lunch
Program and School Breakfast Program.
The next matter for consideration was approval of an
Agreement for Extended Service for the maintenance and support
of the MAKO Software in the Sheriff's Department. Term of the
Agreement is from May 1, 2002 through April 30, 2003 at a cost
of $1,138.00. On motion by Commissioner Tony Jones, seconded
•
by. Commissioner Thornton, the Court voted unanimously to
approve the Agreement for Extended Service for the maintenance
and support of the MAKO Software.
Agenda item 9, Authorization for the Sheriff's Department
to apply to the U.S. Department of Justice for a "Sex Offender
Management Discretionary Grant" was removed by request of the
Sheriff.
The Court next considered a request by the Road & Bridge
Department for adjustment of salary schedule for seasonal
mowing staff. The County currently pays mowers $7.64 per hour
• and is asking that it be increased to $8.23 per hour. On
motion by Commissioner Tony Jones, seconded by Commissioner
Thornton, the Court voted unanimously to approve the request.
Vol 3Z Page 37
i
~00*1
Commissioners' Court meeting May 7, 2002
4
The Court next considered authorizing the Auditor's
office to process recurring a payment request for the
following:
a) First Star Transport, for armored car
services to First American Bank $200
per month.
On motion by Commissioner Tony Jones, seconded by Commissioner
Thornton, the Court voted unanimously to authorize the
Auditor's office to process the previously noted recurring
payment.
The Court next considered awarding the following bid:
Bid No. 2002-047, Poly Jute Annual bid
Becky Stephens, Senior Buyer, recommended
acceptance of the bid submitted by
Contech Construction Products. On motion
by Commissioner Tony Jones, seconded by
Commissioner Thornton, the Court voted
unanimously to accept the recommendation
of the Senior Buyer and award the
contract to Contech Construction
Products. A copy of the bid tabulation
is attached.
The next matter before the Court was the Renewal of Long
Distance Service contract with NTS Communications. The rates
remain at .0794 Switched Inter/ Intrastate; .25 Travel Card and
.60 Directory Assistance and will remain so through May 9,
2003. On motion by Commissioner Tony Jones, seconded by
Commissioner Thornton, the Court voted unanimously to renew
the Long Distance Service contract with NTS Communications.
Vol 32- Page 39
•
Commissioners' Court meeting May 7, 2002
a copy is attached.
The Court next considered awarding the following bid:
Bid No. 2002-046RB, Sheriff's Department Uniforms
u
Pat Howard, Purchasing Agent, recommended
acceptance of the bid submitted by Skaggs
Uniform and Equipment. On motion by
Commissioner Tony Jones, seconded by
Commissioner Thornton, the Court voted
unanimously to accept the recommendation
of the Purchasing Agent and award the
contract to Skaggs Uniform and Equipment.
5
The Court proceeded to consider the following blanket
Purchase Order:
Lowe's Brazos Center $1,000
Green Teams Brazos Center $1,000
Bryan 800 Purchasing $1,000
On motion by Commissioner Tony Jones, seconded by Commissioner
Thornton, the Court voted unanimously to approve the Blanket
Purchase Orders as submitted.
The Court next considered approval of the minutes of the
Commissioners' Court meetings held in January 2002 on the
following dates: Regular Meetings Ben, 15th, 22"d, 29`h; Special
Meeting 2"d; Public Hearings 8th and 29th; and Workshop Meeting
th 8 On motion by Commissioner Thornton, seconded by
Commissioner Tony Jones, the Court voted unanimously to
approve the minutes as submitted.
Vol 3,9- Page 39
0
I
Commissioners' Court meeting May 7, 2002
6
Under announcement of interest items and possible future
agenda topics the County Judge made the following comments:
a) There will be a meeting this evening in
Hearne concerning the Groundwater
District and how it relates to the Brazos
Valley. He encouraged people to attend.
b) There will be a ribbon cutting and grand
opening at the intersection of Greens
Prairie and Rock Prairie Road at 9:00
a.m. on May 15, 2002.
c) He received correspondence on Public
Health Regions and West Nile Virus. He
has made the Health Department aware of
this information.
d) The Texas Association of Counties (TAC)
sent out a brochure on "Best Practices".
The District Clerk submitted information
to TAC on the Collections Department for
inclusion in the next publication. The
publication also announced locations
around the state for Leadership Forums.
e) He received a phone call from the
Architect on the Exposition Center saying
that the Bienski family would like to
salvage the old Smetana store on the
property and move it. The County Judge
stated that we would do everything
possible to accommodate them.
f) Fred Forsthoff is retiring from his
position in Emergency management. ,--o~
g) Legislation passed dealing with
hotel/motel taxes. This could be used to
help with funding the Exposition Center.
He will be asking the cities of Bryan and
College Station for financial help to
fund the Center.
h) The Workforce Commission announced the
unemployment rate for Brazos County is
1.6% which is far below the state level.
Vol 3 2- Page '-'O
Commissioners' Court meeting May 7, 2002 7
There was no citizen input and/or concerns.
There was no requirement to meet in Closed Executive
Session. The county Judge did announce that survey work was
being done on the property for the Exposition Center.
The County Judge reminded the Commissioners of the Public
Hearing scheduled for 10:00 a.m.
There being no further business to come before the Court,
• the meeting was adjourned.
Vol 3,9- Page 4I
0
The foregoing minutes of the Commissioners Court meeting held_
May 7, 2002 have been examined and are approved in open Court
this the AZ day of ,ALPAj,z= , 2002 in Bryan, Brazos County,
Texas.
Alvi W. Jones
County Judge
4,W
To y Jo
Commis ioner, Precinct 1
m. S . Thorn ton
Commissioner, Precinct 2
C. B. J es
Commissioner, Precinct 3
Carey Ca ey, Jr. aren McQueen
Commissi ner, Precinc 4 County Clerk
Vol 3a- Page `--Z
C7
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BRAZOS COUNTY COMMISSIONERS COURT
MEETING ON `A~200 AT La, 4,vt
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BRAZOS COUNTY COMMISSIONERS COURT P`,/ 7,f
MEETING ON Ram -7 200L AT too ,+m
/loft"
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENT(S) FOR THE 2001-2002 BUDGET YEAR
NO. 01/02-23.1 through 23.3
On this the 7th day of May 2002 at a regular meeting of the
Commissioners' Court, the following members were present:
Alvin W. Jones, County Judge, Presiding
Tony Jones, Commissioner, Precinct 1;
Wm. S. Thornton, Commissioner, Precinct 2;
C. B. Jones, Commissioner, Precinct 3;
Carey Cauley, Jr., Commissioner, Precinct 4;
Karen McQueen, County Clerk..
is The following proceedings were held:
THAT WHEREAS, on May 7, 2002 the Court heard and approved a budget
amendment for the 2001-2002 budget year for Brazos County, Texas.
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 September 4, 2001 the following
amendment(s) to the original are hereby authorized, as described on the
attached page(s).
ADOPTED AND APPROVED this the 7th day of May 2002.
THE COMMISSIONERS' COURT OF BRAZOS COUNTY, TEXAS.
is By: Alvin W. Jones, County Judge
Original: County Clerk's Office and attached to the original
budget
Copies: County Auditor
County Treasurer
Commissioners' Court Minutes
0
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 01/02 -424- A 3.1
5/7 -4PA/2002
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
01
301011
678900
Dr.
Vehicle equipment
$ 300.00
01
301011
659500
Cr.
Vehicle Maintenance
300.00
Constable
Precinct 1
To reclassi bud et to allow the purchase of vehicle equipment for a used vehicle.
0~
5-7 -o a
•
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 01/02 - 23.2
5/7/2002
•
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
01
100001
538000
Dr.
Worker's Compensation
$ 30.00
01
110001
538000
Dr.
Worker's Com ensation
40.00
01
120001
538000
Dr.
Worker's Compensation
50.00
01
125001
538000
Dr.
Worker's Compensation
20.00
01
130001
538000
Dr.
Worker's Compensation
180.00
01
140001
538000
Dr.
Worker's Compensation
1,520.00
01
150001
538000
Dr.
Worker's Compensation
30.00
01
160001
538000
Dr.
Worker's Compensation
90.00
01
165001
538000
Dr.
Worker'$ Compensation
30.00
01
170001
538000
Dr.
Worker's Compensation
-
01
180001
538000
Dr.
Worker's Compensation
4,010.00
01
190001
538000
Dr.
Worker's Compensation
2,030.00
01
200001
538000
Dr.
Worker's Compensation
100.00
01
200100
538000
Dr.
Worker's Compensation
10.00
01
200200
538000
Dr.
Worker's Compensation
20.00
01
210001
538000
Dr.
Worker's Compensation
100.00
01
210020
538000
Dr.
Worker's Compensation
220.00
01
220001
538000
Dr.
Worker's Compensation
20.00
01
221001
538000
Dr.
Worker's Compensation
10.00
01
222001
538000
Dr.
Worker's Compensation
20.00
01
225001
538000
Dr.
Worker's Compensation
20.00
01
230001
538000
Dr.
Worker's Compensation
60.00
01
231001
538000
Dr.
Worker's Compensation
40.00
01
241011
538000
Dr.
Worker's Compensation
20.00
01
242011
538000
Dr.
Worker's Compensation
20.00
01
242012
538000
Dr.
Worker's Compensation
20.00
01
243011
538000
Dr.
Worker's Compensation
30.00
01
244011
538000
Dr.
Worker's Compensation
30.00
01
280001
538000
Dr.
Worker's Compensation
3,050.00
01
280020
538000
Dr.
Worker's Compensation
22,860.00
01
301011
538000
Dr.
Worker's Compensation
270.00
01
302011
538000
Dr.
Worker's Compensation
210.00
01
303011
538000
Dr.
Worker's Compensation
-
01
304011
538000
Dr.
Worker's Compensation
-
01
310001
538000
Dr.
Worker's Com ensation
860.00
kp! s b
/'r041\
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 01/02 - 23.2
5/7/2002
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
01
310100
538000
Dr.
Worker's Compensation
$ -
01
355001
538000
Dr.
Worker's Compensation
10.00
01
365001
538000
Dr.
Worker's Compensation
2,130.00
01
370001
538000
Dr.
Worker's Compensation
150.00
01
560010
538000
Dr.
Worker's Compensation
1,210.00
01
110015
611300
Cr.
Contingency
39,220.00
All Departments
To adjust the budget for the Worker's Compensation based on the actual rate which was
not available at the time of the Budg
et process. The insurance has ex erienced a considerable
increase.
i to
NEW
017 &`~I!
loww\
•
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 01/02 - 233
5/7/2002
•
•
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
22
510001
538000
Dr.
Workers Compensation
$ 230.00
22
510001
606000
Cr.
Office Supplies
230.00
Courthouse Security Fund
To adjust the budget for the Worker's Compensation based on the actual rate which was
not available at the time of the Budget process. The insurance has ex erienced a considerable
increase.
'^nvl -';z to 17 ,
a. aw.. •4~'S:.ei•jM1'k Y~J "~J y4
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?5xR NN'0111
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U
PERSONNEL CHANGE OF STATUS
page 1 of 1
COURT DATE: May 7, 2002
DEPARTMENT: Personnel
PURPOSE: Approve Personnel Change of Status
DEPARTMENT NAME EMPLOYEE NAME ACTION REQUESTED
TAX OFFICE ARREDONDO, APRIL
SHIRLEY, MARQUEL L.
SHARP, JIMMY W.
DELIRA-ARREDONDO, :
MARSH, MARY C.
SCHUETZE, KATHY
COUNTY ATTORNEY
DANIELS, STEPHANIE
JADLOWSKI, MELISSA
JUVENILE SERVICES - TYC
ROAD AND BRIDGE
VANCE, ROSEANN
DECLINED EMPLOYMENT OFFER
NEW HIRE/FULL-TIME
NEW HIRE/PART-TIME REGULAR
VIONICA NEW HIRE/FULL-TIME
RESIGNATION
PROMOTION
CURTIS, ALFRED W.
ODSTRCIL, LARRY W.
WEEKS, JR., EDWARD N.
Approved in Commissioners' Court: May 7.2002
County Judge's or Commissioner's Signature:
(This copy to be attached to minutes)
/11 -
TEMPORARY POSITION ENDED
RETURN FROM LEAVE OF ABSENCE
RESIGNATION
PROMOTION
NEW HIREJFULL-TIME
NEW HUGIrEMPORARY
•
COUNTY OF BRAZOS
STATE OF TEXAS
RESOLUTION
WHEREAS, Wheelock SPJST Lodge No. 94 is an integral part of this county and community;
and
WHEREAS, Wheelock SPJST Lodge No. 94 has incorporated into its Bylaws a requirement to
encourage benevolence and humanity; and
WHEREAS, the Texas Comptroller of Public Accounts has deemed the Wheelock SPJST
• Lodge No. 94 eligible for property tax relief;
NOW, THEREFORE, BE IT RESOLVED that the Commissioners Court of Brazos County
does hereby support Wheelock SPJST Lodge No. 94 in its application for
exemption from Ad Valorem taxation and recommend the Brazos County
Appraisal District grant such exemption.
PASSED this 7th day of May, 2002, at a regular meeting of the Commissioners Court of Brazos
County, there being a quorum present by yeas and o nays and
approved by the County Judge on the date above set out.
APPROVED:
6L-- -A-0L,
Alvin W. Jones, Co y Judge
ATTEST:
G
Karen McQueen, County Jerk
U
Texas Departmertt
of Human Services
SPECIAL NUTRITION PROGRAMS
SINGLE AUDIT IDENTIFICATION DATA
For Program Year le?603
(SNP Use Only)
• Form 1569
March 2001
~rr"arzos County, Texas Olivia M. Body
Address (Street Or P.O. Bo; Gy. State, ZIP)
1904 West SH 21, Bryan, Texas 77803
Telephone No. Texas 10 No. (Payee 1D W.) Contract No.
( 979) 823-3544 1746004330000 175-61001
Contractor Fiscal Year Ford (w.Wddlyyyy) Type of Contract
For Profit U Non-Profit
Check the appropriate box(es) to indicate the type(s) of program(s) In which you currant participate or forwhich you am applying:
COMMODITY ASSISTANCE PROGRAMS
PROGRAM NOS.
A - National School Lunch
C22L 1 (93 R-
8 - Charitable Institutions
❑ C - Area Agency on Aging
❑ G - Summer Camps
❑ H - Summer Food Service
❑ J - Jails
❑ I - TEXCAP
CS - Commodity Supplermntal Food Prog.
CASH RSM13URSFMEWT PROGRAMS
PROGRAM NOS.
❑AD -Adult Day Care
TX-
BL- National School LunchBreakfast
TX- 021-2001
CC - CACFP Center
TX-
DH - CACFP Da Home
TX-
SF- Food
TX-
❑ SM - Special Wk
TX-
❑ TE- TEXCAP
TX-
CS - Conunodty Supplemental Food Prog.
TX-
rave fha an, vin and aerie, inf of env fadaml /..nde that veer ananev arnnnds ether than from those oroarams listed above:
SOURCE - - - -
AMOUNT
Criminal Justice tN ,;I ,T N a " ;~pf~~{S
300,000.00
Mtn L N a 1
®
'
t;oko
Al MAY 1 2002
❑ SINGLE AUDIT EXEMPTION-1 certify that I am not requtr~ti ohs &6Lt a audit uunider the Single Audit Act for the following reason(s):
❑ I am a for-profit organization. ❑ I expend less than $300,000 annually In total federal funding.
SINGLE AUDIT ASSURANCE-1 understand that if I meet the requirements of the Single Audit Act,,l will agree to submit an audit
as a condition of eligibility to participate in the Special Nutrition Programs, and that failure ~~~ti'sbla; regiirred;E6iilG{esuR ir„
adverse action, including the Nnthhotding of my claim for reimbursement payments and,tteminotion of my'~xtintrad~t-afso -
understand that if I am a private non-profit organization subject to the requirements of the Single Audit Ac4 and.have a,finariftaf ;
audit performed annually, I must also obtain a single audit on an annual basis.
MAY 2 3 2002
naUrre-ulnonZed Re nheYe Date
Namo (Please type or print) Tab -
Alvin W. Jones County Judge
,,.ems
•
#Tmras Deperbnent
Of Human Services - National School Lunch Program and School Breakfast Program
APPLICATION FOR PARTICIPATION AND POLICY STATEMENT
Form 1610
Apri12002
School Program Year. July 1, 2002 Through June 30, 2003
is
•
PART I APPLICATION
Texas ID Number
1
Contract Number
I
Program Number
17460004330000
75- 61001
TX 021 - 2001
Name of School Food Authority
Contact Person
Brazos County, Texas
Olivia M. Body
Address (Street or P. 0. Box, City, State, Zip)
1904 West SH 21, Bryan, Texas 77803
Telephone Number
Fax Number
Email Address
l
( 979 ) 823-3544
( 979 ) 824-4211
olivia@co.brazos.tx.us
Name of School/Facility (I more than one site, complete a DHS Form 1609 for each site.)
Brazos County Juvenile Detention Center
School Address (d different from School Food Authority address)
Telephone Number
1904 West SH 21, Bryan, Texas 77803
( 979 ) 823-3544
Type of SchootlFacilly (check all that apply)
❑ Day School ❑ Boarding School ❑ • Combination Day School' EF Residential Child
❑ Combination Day School and
and Boarding School Care Institutlon
Residential Child Care Institution
❑ Special Education School ❑ Afierscod Care Snack She ❑ Other (specify):
SchcoIlResidential child care insbti bon (RCCQ is:
M Pubic ❑ Private b ff private,' Is the sdrooI RCCI nonprofit and tax exempt ❑ Yes ❑ No b I('Yes,' attach copy of
under the Internal Revenue Code of 1954?
letter from the IRS.
Total Enrollment for Ag SchodslRCCls
b 44
Total Number of Ali SchodslRCCls
b 01
Administered food A
Administered School Food
Authorhy;
1. Is the above schooUresidential child care Institution licensed? (If yes, attach copy of license.)....... ❑ Yes 1K-k No
2 Program(s) that you are applying for.
IM National School Lunch Program
❑ Afterschool Care Snack program (must be participating In National School Lunch Program)
IM School Breakfast Program
In Severe Need School Breakfast Program Rates' ' Available to sdro Wrasldential child rare khslt ftm meettrg the b5mirg etigibLty aledr.
1. 40% or more btal lurches served in seoxhd premdn year were he or reduced price: and
2 Brealdast costs exo* the regular reknbtasemerht rates available under the Scrod Brhatdast Program.
fkff,W-dmontia-• ftimhkvDate of Operation Errdng Date d 0peration
3. Number of months the school wild be operating a food service program:................ 12 07/01/2002 6/30/2003
4. Number of children enrolled at school/residential child pre institurtm:.... 44
A. Age Range of Children Enrolled B. Grade Levels Taught (schools orgy)
From: 10 To. 16 From: TO:
5.
AVERAGE DAILY PA
RTICIPATION OF CHIL
DREN IN PROGRAM
TIMES OF FOOD SERVICE
Food Service:
Free
Reduced Price
Paid
Beginning
Ending
Breakfast
43
7:00am
8:00am
Lunch
43
12 noon
1:00pm
Area Eligible Afterschoot Care Snack
Not Area Eligible Afterschod Care Snack
6. Attendance (for residential child care institutions only)
.
A. Are all of the children at the institution all day?
if no, do all or some of the children attend public school?
If only some attend public school, how many?
10 Yes ❑ No
❑ All ❑ Some
H some or all attend public school, which meals do these student eat at the institution? ❑ Breakfast ❑ Lunch ❑ Aftersc od Snack
B. Check if the children attend the institution on holidays andlor weekends UHdidays 19Weekends
Form 1610
Page 2
7.
1 ype or Meal service
A. Meal Preparation
OnSite nchen ❑ Central Kdcherh ❑ 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 E7 Traditional Food Based ❑ Nutrient Standard Menu ❑ Assisted Nutrient Standard Menu Planning
Planning (NSMP or NuMenus) (ANSMP or Assisted NuMenus)
(See lnstrtrcicns for doaxnents to submit)
❑ Other (explah
NOTE: Snada served In the Af isdWl Cam Snack program must blow the food based supplement pattern regardless of your menu plan ft i eOhod for breafdast ardor lunch.
8.
9.
Type of Program
❑ Separate Charges U No Separate Charge; Cost of Meals is Included ❑ Combination of Separate Charges and
Made for Meals in Required Payment PlarvFee No Separate Charges
Daily Price Charged for Each Meal
CHILDREN
(for programs that will charge separately only):
Reduced Price
Paid
ADULTS
Breakfast
Lunch
Not Area Bigible Aftersdad Care Snack
NOTE: Area ENRAs Aftersdvol Care Snack program awes must provide made free of dome lo all students partidpaiV in ft after school care progran
10. A. N eool m for the National School Lunch Protram. ther=e whether Offer versus Serve will be Imrlerne<hted
High School (mandatory)
Junior High (opfionaq
Elementary (optional)
Preschool (optional)
Residential Child Care Instihttion (optional)
❑ Yes
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes UK No
S. If applying for the School Breakfast Pro9 m Indicate whether Offer versus Serve will be implemented:
High School (optional)
Junior High (o ft*
Elementary (optional)
Preschool (optimal)
Rmidentiai Child Care bhstibrtion (optional)
❑ Yes [I No
[3 Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes =K No
11. Describe your training in food service program requirements for personnel (use an attachment If necessary):
Kitchen staff is trained annually with the NSLP handbook and USDA Rights. They are also
provided food handler's training from the local health department. There is also specific
site raining comp e e t e areas_o sa ety, equipment maintenance as well as NSLP updatt
12. Will supplemental (a la carte or snack bar) food service be available in addition to the school lunch? ❑ Yes YJY 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? tt non-school personnel, what organization is responsible for day-to-day operations?
❑ Will Use School Personnel ❑ tKil Use Non-school Personnel:
14. Total number of sites administered by School Food Authority offering the After School Snack program?
15. Is attendance In after school care program limited to students enrolled in your schooURCCl7 ❑ 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 ISD (see Instructions).
16. Indicate your sd=URCCI or the public school free or reduced price enrolment percentage: Free or Reduced Price: %
17. Which required activities are included in your after school program? . ❑ Educational Aclivitiies ❑ Enrichment Activities
18. Licensing (For schools only)
A. Is a Texas Child Care License required for your after school care program?
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
❑ Yes ❑ No
Form 1610
Page 3
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 require 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 DHS 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 he meals on Form
4504, Standards for Determining Free and Reduced oce 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 4504, 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 income meets the criteria on Form 4504, and to
foster children and to children from families whose income meets the criteria on Form 4504, because of strikes, layoffs, or unemployment.
d. Designate to review applications and determine
NAME Trn.E
eligibility. This official must use the criteria in this policy to determine which children are eligible for tree or reduced-price meals.
e. Prohibit physical segregation of, or any other discrimination against, any child because of his efigibi7ity 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 sdiod's/RCCI's decisions on applications and for officals of
schools/RCCIs who dispute Information in an application or the eligibility of children for free or reduced-•prtee meats. 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 LunchBreakfast Programs 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.
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.
(1) 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.
(B) 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 officials
decision to the parties concemed.
65
E
Form 1610
Page 4 ^^1\
(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 c r,emplating large layoffs in
the area served by the schooVRCCI. The school food authority must send the information for public release b••',aher at the beginning of
each school year and when eligibility standards change. All changes in eligibility criteria must be publidy announced. The school food
authority must keep a copy of the letter transmitting the pubric 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 1625•VV).
(2) Form 4504.
The information for public release was or wig be provided to the organizations on the dates that follow (attach a sheet ff more space is
needed):
Public News Media Date
Organzaton Date
Organization Date
h. Establish a procedure to collect money from children who pay for their meals and a procedure to accurately record the number of free,
reduoed-price, and fug-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 meal 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 dti mn who paid or are eligible for he or
reduced-price meals is prepared and sent to the cafeteria. A cashier familiar with the children doecks names as children pass
through the line. After the meal service, the fist is returned to the office for accounting purposes. This method works only in a small
schoollRCCI where the cashier knows all the children.
❑ Collection Procedure 7= The homeroom teacher gives pe-6om weekly; or monthly payments. Children
retirm 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- or reduced-price.
❑ Collection Procedure 6 - Parents are billed monthly for full- or reduoedixice meals their children are served. Ali 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.)
. OL- 3;
Form 1610
Page 5
Describe how the daily numbers of free, reduced-price, and full-price meals are identified and counted, and the numbers recorded. (Use an
attachment 9 necessary.)
Describe how daily point-of-service counts are taken. The point-0f--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 9 necessary.)
~J
•
SECTION B - Programs that Charge Separately AND Programs that DO NOT Charge Separately
In fulfilling its responsibilities, the school food authority agrees to:
1. Prohibit discrimination against people who are eligible to participate in the child nutrition programs because of race, color, national origin, sex,
age, disability, religion, or political belief. Anyone who believes that they have been discriminated against should write immediately to: Director,
Civil Rights Division, MC W-206, Texas Department of Human Services, P. 0. Box 149030, Austin, Texas 78714-9030 or to USDA, Director,
Office of Civil Rights, Room 326-W, Whitten Buflding,1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call (202) 720-5960
(voice and MD). Note: Discrimination complaints based on religion or political beliefs must be referred only to the Director, Civil Rights Division,
Texas Depw1ment of Human Services.
2. (Applicable only if operating day schools and boarding schools) - Develop and distribute to each child's parent or guardan a letter, according to
the sample attached, and an application form for free or reduced-price meats. 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 1625-W is a sample of the letter to parents whose children are it a program that charges separately
for meals. Is the school food authority using the attached sample? ❑ Yes ax No
(2) Form 1626-W 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? ❑ Yeses No
If the answer to either (1) or (2) is *No.*, the school food authority must submit to DHS, with this application form, a copy of the letter they
send to parents. DHS must approve this letter before the stool food authority sends it to parents.
b. Form 4524 is a sample of the application for free and reduced-price meals. Is the school food authority using the
attached sample? ❑ Yes JOK 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 documentatiorr of acborrhaken m keptiorthree yearsand 99 daysatterthe-end ofihe fisratyear to-which they pertain. If audit
findings are not resolved, the records are kept until the issues are resolved.
Applications may be fried at any time during the year. The school food authority must supply an application to parents enrdlirig a child in a
scooVRCCI for the first time, at any time during the year. If a child transfers from one schooURCCI to another under the jurisdiction of the same
school food authority, his/her eligibility for a free or reduced-price meat 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 1623 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 4 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
position superior to the determining official's. The hearing official and the determining official cannot be the same person.
Submit to DHS any proposed changes to this policy statement before it is implemented. Changes are effective only when they are approved by
DHS
0
Form 1610
Page 6 ,..,R
4. Verity eligibility according to the National School Lunch/School Breakfast Program Handbook and program regulations.
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 reduoe"doe 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/RCCls. 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 annuatiy to students who pay full- 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.
XM We choose NOT to participate in Provision 1.
❑ We will participate In Provision 1, and certify that the following schools had 80°b 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 which 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 socoe=xxnic 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 the Department deterrrfm at the end of the four year
cycle that there has been negligible improvement (5 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 tb children not eiigble for free or reducedixice 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 schoolsJRCC1s 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 an approved applications and efigihIlty documentation from the designated base year at least three
years and 90 days after the final Claim for Reimbursement of the final School Year which employed base year data, or longer If required for
audit resolution.
SchootslRCCls are required to determine daily during the,firstyear of the bur-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, redubed-pricd, and paid), are based on a percentage of the total number of meals served by type in the corresponding month of-the
first year.
1MK We choose NOT to participate in Provision 2.
❑ The following schools/RCCIs 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
3a- s8
•
Form 1610
Page 7
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 (fANF) data (provided that eligibility standards were the same or more
restrictive in the base year as current year with allowance for inflation).
Form 1626•W 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 1626-W? ❑ Yes ❑ No
ff'No; the school food authority must attach a copy of the letter being sent to parents.
c. Provision 3 - School food authorities may choose to serve all children meals at no charge. Any schooURCCI which chooses to serve all
chfidren 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 sodoeconomic 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 the Department determines after the Initial four year period of Provision 3 that there has been
negligible change (5 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 kcal sources other than federal reimbursements to absorb the cost of (1) meals
served to children not eligible for free or reduced Vice 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 schods/RCCls 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 Clain for Reimbursement of the final school year which employed base year data, or
longer N 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 31 annually.
Schoots/RCCIs 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 in enrollment based on the schoors/RCCI's enrollment
• on October 31 of the current school year, and must take total meat counts of reimbursable meats served to participating children at the
point of service.
XUK We choose NOT to participate in Provision 3.
❑ The following schools/RCCls 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
59
0
Form 1610
Page-8
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 1626-W 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 1626-W? ❑ Yes ❑ No
If 14o,* the school food authority must attach a copy of the letter being sent to parents and describe how it will notify households that
meals Heil 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 toeligible children.
2. The school food authority assures DHS that although no identifiable charge is established for meads, 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 4504, 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. Clain as reduced-priced meals only those meals served to children from families whose income is above the income eligibility standard for
free meats but equal to or less than the standard for reduoed-price meals on Form 4504, 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 until audit issued are resolved.
d. Prevent physical segregation of, or any other discrimination agalnsL any child. The names of the children eligible for free or reduced-price
meats 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 meats at a different time; or (6) eat a different meal.
e. Designate Olivia M. Body Food Service Manager to determine eligibility for free and
Name Tide
reduced-price meats. This official wit use the criteria outfined In this policy to determine which individual children's daims 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; (5) eligibility determination and data (Initialed by official making determination).
Note: Children at RCCls are considered a (amity 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 pant-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 V needed).
Residentsate only served reiumbursable meals by kitchen staff. A final count is
made by child care staff when residents exit the line and are ae tpd
0 _;3`2
•
•
•
Texas Human DOPOMT*nt
of Human Sen SPECIAL NUTRITION PROGRAMS
SINGLE AUDIT IDENTIFICATION DATA
For Program Year 043
(SNP Use Only)
Form 1368
March 2001
Contractor Name
Brazos County, Texas
ntact Person
rol ivia M. Body
Aodtass (Street or P.O. Box Cdy. State. ZiP)
1904 West SH 21, Bryan,
Texas 77803
Telephone No.
Texas tD No. (Payee ID No)
Contract No.
( 979 ) 823-3544
17460004330000
75_ 61001
Contractor Fueal Year End (mmrd ftM)
Type of Contract
09/30/02
For Profit ❑ NotrPwfd ®Goveramtrital
Check am appropriate box(as) fo indicate the typets) of programis
COMMODITY ASSISTANCE PROGRAMS PROGRAM NOS.
)EFA - National School Lunch
B - Charitable Institutions
C - Area Agency on Aging
❑ G -Summer Camps
n H - Summer Food Service
LJJ -Jails
❑ I -TEXCAP
CS - Commodity Supplemental Food Prog.
r.. -htwh vnrr c.erranfly narfirinnfa nrfnr which vau are aoalvina:
CASH REIMBURSEMENT PROGRAMS
PROGRAM NOS.
❑ AD - Adult Day Care
TX-
Q$L- National School Lunch/Breakfast
TX- 021-2001
CC - CACFP Center
TX-
DH - CACFP Day Home
TX-
SF- Summer Food
TX-
❑ SM - Special Miik
TX-
TE- TEXCAP
TX-
CS - Commonly Supplemental Food Prog.
TX-
Give the source and amount of any federal funds that your agency expenas omer titan rrom tnose programs eaceu auv.a:.
SOURCE AMOUNT
Criminal Justice 300,000.00
❑ SINGLE AUDIT EXEMPTIONA certity that I am not required to submit an audit under the Single Audit Act for the following
❑ I am a for-profit organization. ❑ I expend less than $300,OOD annually in total federal funding.
SINGLE AUDIT ASSURANCE-1 understand that if I most the requirements of the Single Audit Act, I will agree to 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
I adverse action, including the withholding of my claim for reimbursement payments and tremination of my contract. I also
I{ understand that if 1 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.
5- 3 -r~2
Sg uthonzed Repro Date
1Name (please type J or pmt Idle
Alvin W. ones County Judge
0
/-001111
Texas Department
Form 4308
Or numan - May zyw
SPECIAL NUTRITION PROGRAM
CERTIFICATE OF AUTHORITY
Is aredesignated as an Authorized Representative of
Name of Contracting Organization
Brazos County, Texas
Address (Street, City, State, ZIP)
1904 West SH 21, Bryan, Texas 77803
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 Department of Human Services to operate a
food program, to sign documents or reports about the agreement, and to present claims for reimbursement, when
appropriate, to the departrnent
By signing this document, we certify Individually and collectively that to the best of 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, TDHS, aretMll be true and
correct In all respects, that they arehMll be completed according to the terms and conditlons of existing agreements
Including amendments, that records araWill be avallaMe to support any and all claims, and that we will not submit
claims (excluding amendedfad)usted dahns) for goods or services for which we have already mcehved 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 Agency (please type or print) Title
Alvin W. Jones County Judge
DELETED AUTHORIZED REPRESENTATIVES: A contracting organization may not have mote than three (3)
Authorized Representatives, Including the Official of the Contracting Agency. If you are replacing or 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 Deioted Representative Name of Deleted Representathre
FOR DHS USE ONLY
Contract No Recenred By Oale Retxned
75-
This Is to certify that the following person(s):
32
• Texas Department Form 19
4
of Human Services SepWmtwr 19994
NONGOVERNMENTAL CONTRACTOR CERTIFICATION
The Texas Department of Human Services (DHS) has adopted rules pertaining to contracting with organizations in which a former
board member or employee (whose last day of duty was within the past two years) has any ownership or control, or who Is an
employee or consultant of such organization. Also, Human Resources Code §22.0033 prohibits fe..+ie year after employment
former DHS employees In pay grades equivalent to or above pay grade 17, Step 1, from helping (for pay) another entity obtain a
contract with DHS in an area for which the former employee was directly concerned or had administrative responsibility.
Additionally, DHS has adopted standards for contracting with contractors associated with current or former employees and board
members, and their relatives. This form is necessary to help the Department determine compliance with those rules.
All potential non-governmental contractors for any type of contract must complete this certification. The contract, N awarded, may
be terminated for cause If
(1) the contractor knowingly provides Incorrect information in its certification; or
(2) the contractor uses a subterfuge, such as a subcontract arrangement, to avoid the application of state laws or DHS rules.
Does the potential contractor have as an officer, director, employee, consultant, or owner (in whole or in part):
1. A person who is currently a DHS employee or DHS board member? ❑Yes 95No
2. A person who was a former DHS employee or board member whose last day of duty with DHS 6&~~Ag~~~~
was within the past two years? ❑ Yes F04No
• 3. A person who is related (see Relationship key below) to a current DHS employee or OHS ❑YeMNo
board member?
4. A person who is related (see Relationship key below) to a former DHS employee or DHS board F]Yes lTnlNo
member whose last day of service to OHS was within the past two years7 L~
Wife
Brother
Stepdaughter Spouse's Sister
Husband
Sister
Stepson Spouse's Brother
RELATIONSHIP
Father
Son
Mother-In-law
KEY
Mother
Daughter
Father-in-law
IF YOU ANSWERED -'YES" TO ANY OF THE ABOVE QUESTIONS, YOU MUST COMPLETE AND ATTACH FORM 4732,A.
CERTiFICATfON'
•
1 certify that the Information above is complete, true and correct to the best of my knowledge. I understand that lack of full,
true and complete disclosure may be grounds for withholding payment for delivered services and may cause contract
termination.
Name of Potential Non-gowrnmental Contractor r75 ra Socrel Seamy No. Or VIN
Brazos County, Texas -61001 17430004330000
Print or Type Name
Z Alvin W. Jones
nature.Author¢ad Re esentaLve Date
5
0
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TIBURON, INC.
AGREEMENT FOR EXTENDED SERVICE
This Agreement is entered into this 1" day of May, 2002, by and between Brazos County Sheriffs
Department (hereinafter referred to as "CLIENT") having its primary place of business at 202 East 271' Street,
Suite 102, Bryan, Texas 77803 and Tiburon, Inc. (hereinafter referred to as 'TIBURON"), having its primary
place of business at 39350 Civic Center Drive, Suite 280, Fremont, California 94538.
IT IS HEREBY AGREED:
WHEREAS, CLIENT has determined that it requires the categories of application software maintenance on
the software systems which have been provided to CLIENT by TIBURON under a separate agreement
(hereinafter the "PROGRAM'. These software systems are identified in Exhibit A, which is attached hereto
and hereby incorporated by reference, and
WHEREAS, CLIENT requires the provision of professional and technical services and materials as specified
in this Agreement, and
WHEREAS, TIBURON is qualified to provide the services and materials required by CLIENT as specified in
this Agreement.
NOW THEREFORE, in consideration of the mutual covenants contained herein, CLIENT and TIBURON
agree as follows:
PERIOD OF PERFORMANCE
The term under which TIBURON shall be obligated to perform under this Agreement shall be for the
time period specified in Exhibit A, and shall continue for this time period or until this Agreement has
otherwise been terminated as provided herein.
2. STATEMENT OF WORK
With respect to the PROGRAM, TIBURON shall perform the following maintenance services:
a. TIBURON shall retain a copy of the PROGRAM source code.
b. If during the term of this Agreement, (1) CLIENT discovers defects in the PROGRAM
such that the PROGRAM will not perform in accordance with the specifications as
previously accepted by CLIENT, (2) CLIENT notifies TIBURON of such defects in
writing; and (3) such defects are reproducible, then TIBURON shall provide timely
corrections of such defects. 1006#11,
c. If problems arise concerning the PROGRAM, TIBURON shall provide telephone
assistance and support via remote dial-in.
d. If remote support is available, but an on-site visit is required to correct the defect,
TIBURON will travel to the site at no additional charge if the problem lies solely with
TIBURON application software. If CLIENT is unable to provide remote dial-in and an
on-site visit is necessary to correct the problem, TIBURON will bill for travel and per
diem costs. If the problem is CLIENT generated, CLIENT is responsible for all fees
and expenses and will be billed at TIBURON's current service rate in addition to all
travel costs.
e. TIBURON shall provide CLIENT with a quarterly status report to include a summary
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of site activity and client requests.
f. TIBURON shall provide a toll-free telephone service for routine operational and
technical assistance.
Technical and operational service shall be available during TIBURON's normal
support hours of 8.00 a.m to 5:30 p.m. Central Time (excluding weekends and
TIBURON holidays) and at additional times according to the terms defined in the
Schedule of Services and Charges in Exhibit B which is attached hereto and hereby
incorporated by reference.
g TIBURON shall provide software upgrades and enhancements as per the Schedule of
Services and Charges attached hereto as Exhibit B. Any installation and special
tailoring required shall be charged at the Technical Service Rate as identified in
Exhibit B. All such software provided by TIBURON shall be covered by the terms of
this Agreement.
If CLIENT has source code on-site, and corrections for reported problems or defects are due
substantially to CLIENTs errors or CLIENT's changes to the system environment, or relate to
• CLIENT-modified portions of the PROGRAM or to portions of the PROGRAM affected by CLIENT-
provided software, or if diagnosis of problems reported erroneously shall be performed by TIBURON,
CLIENT will be charged at the Technical Service Rate, plus applicable travel and per diem expenses.
3. CLIENT RESPONSIBILITIES
CLIENT agrees to provide those services and facilities defined below which are necessary for the
provision of services by TIBURON under this Agreement. CLIENT and TIBURON agree that the
scope and schedule of services to be provided by TIBURON under this Agreement depend upon the
timely fulfillment of CLIENT responsibilities.
a. CLIENT shall assign a coordinator to ensure that CLIENTs duties set forth in this
Agreement are met, to coordinate appropriate schedules in connection with
TIBURON's services hereunder, and to provide other coordination activities which are
necessary for TIBURON to perform its services hereunder. CLIENT shall maintain
performance logs documenting trouble calls and availability of on-line systems
according to procedures provided by TIBURON.
b. CLIENT shall assign individuals who are familiar with the PROGRAM, and who are
able to provide on-site technical assistance as required by TIBURON to aid TIBURON
in performing its services. CLIENT personnel will screen operational assistance calls
and handle operational problems where appropriate.
• c. CLIENT shall ensure that appropriate maintenance activities are carried out on a
regularly scheduled basis in accordance with site documentation. This includes but is
not limited to backing up the database and journal logs, purging out of date records
and running reports and performing diagnostics as requested by TIBURON.
d. CLIENT shall provide dial-in access to CLIENTs computer, making it accessible by
TIBURON for remote service. CLIENT is responsible for the provision of all local
equipment (dial-up modems, telephone termination, communications port, etc )
required to support access by TIBURON. If CLIENT has source code on-site, CLIENT
shall also compile programs and run appropriate tests following each remote access
as requested by TIBURON. In the event that CLIENT does not comply with these
provisions, Technical Service charges as specified in Exhibit B shall apply
e. CLIENT shall meet with TIBURON as may be reasonably required to discuss
Brazos County ESA Page 2 of 5
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operational issues and the status of the PROGRAM and provide timely responses to
issues related to maintenance and PROGRAM performance raised in writing by
TIBURON.
CLIENT shall update and maintain the input data as may be required for satisfactory
PROGRAM operation, and be responsible for the accuracy of CLIENT-provided data.
If CLIENT has source code, CLIENT shall provide TIBURON with a complete copy of
the production source code in a format compatible with TIBURON's support
environment so that TIBURON has ready access to the code for maintenance work.
Complete replacement copies shall be made available on a timely basis upon request
by TIBURON.
h. If CLIENT has source code, CLIENT shall be responsible for storing a complete copy
of the production source code off site as an emergency back up.
4. PAYMENT
CLIENT shall make payments to TIBURON based on invoices submitted. Schedules and amounts of
invoices shall be determined in accordance with Exhibit B.
5. INDEPENDENT CONTRACTOR
Each party hereto, in performance of this Agreement, will be acting in its own capacity. The
employees or agents of one party shall not be deemed or construed to be the employees or agents of
the other party for any purpose whatsoever. TIBURON will be responsible for payment of payroll
taxes, unemployment insurance, and similar obligations with respect to its own employees, and no
deductions shall be made from payments due under this Agreement for that or any other related
reason.
6. LICENSE
With respect to each change, correction, or enhancement to PROGRAM furnished to CLIENT under
this Agreement, TIBURON grants to CLIENT a perpetual, non-exclusive, non-assignable, non-
transferable license to use such change, correction, or enhancement solely as part of the
PROGRAM.
CLIENT MODIFICATIONS
If CLIENT has source code on-site, CLIENT shall not make any changes or modifications to
TIBURON application software or to application software operating environment without TIBURON's
prior written authorization. Any such changes without TIBURON's prior written authorization shall be
deemed unauthorized and in violation of the terms and conditions of this Agreement.
At no additional cost to CLIENT, TIBURON shall provide updates to the TIBURON External Interface
Software and/or documentation, including all existing screen formats currently supported by
TIBURON, for all legal requirements or modifications mandated by NCIC, or the CLIENTs respective
State, when such requirements or modifications require a programming/source code change to the
Licensed Software. Changes mandated or offered by CLIENT's respective City and/or County are
not covered. Changes to State and/or NCIC protocols are considered outside the scope of this
Agreement.
Brazos County ESA Page 3 of 5
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8. CONFIDENTIAL INFORMATION
TIBURON shall regard all CLIENT files and data as CLIENT's confidential information. TIBURON
shall not release said data to outside parties without written consent of CLIENT. To the extent
allowed by law, CLIENT shall regard all software and documentation provided by TIBURON as
confidential information. CLIENT shall not release or provide access to said software and
documentation to outside parties without written consent of TIBURON.
9. TERMINATION
This Agreement may be terminated by either party by giving at least a ninety (90) day advance
written notice to the other party.
Upon termination of this Agreement for any reason, the provisions relating to Confidential Information
and License shall survive.
•
10. INSURANCE
TIBURON shall, at its own expense, at all times while TIBURON is performing services at CLIENT's
facilities, maintain in force:
a. A comprehensive general liability insurance policy including coverage for contractual
liability for obligations assumed under the contract documents, blanket contractual
liability, products and completed operations and owner's and contractor's protective
insurance; and
b. Comprehensive automobile liability insurance policy including owned and non-owned
automobiles; and
c. Liability coverage shall be equal to or greater than the limits for claims made under
the California Tort Claims Act with minimum coverage of $500,000 per occurrence
(combined single limit for bodily injury and property damage claims) or $500,000 per
occurrence for bodily injury and $100,000 per occurrence for property damage.
Liability coverage shall be provided on an "occurrence" basis. "Claims made"
coverage will not be acceptable.
Certificates of insurance acceptable to CLIENT shall, upon request, be filed with CLIENT, prior to the
commencement of any services at CLIENT facilities by TIBURON. Each certificate shall provide that
coverage under the policy cannot be canceled and restrictive modifications cannot be made until at
least 30 days prior written notice has been given to CLIENT.
•
11. AMENDMENTS
This Agreement may be amended upon mutual written agreement by CLIENT and TIBURON to
include, but not be limited to, additional services and support, continuation of maintenance of the
equipment and software, replacements, and upgrades.
12. APPLICABLE LAW
This Agreement shall be construed in accordance with and governed by the laws of the State of
California.
Brazos County ESA Page 4 of 5
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109"611
13. LIMITATION OF LIABILITY AND REMEDIES
a. Limited Warranty
While this Agreement is in effect, TIBURON warrants that all computer programs
developed or provided under this Agreement will conform to such applicable
specifications as may be developed under this Agreement.
THE ABOVE WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESS
OR IMPLIED, INCLUDING ANY WARRANTY OF MERCHANTABILITY OR FITNESS
FOR A PARTICULAR PURPOSE.
b. Limitation of Damages and Remedy
TIBURON's liability hereunder for damages shall not exceed the annual maintenance
charge paid to TIBURON for the period in which the cause of action occurred. In no
event shall TIBURON be responsible for any indirect, consequential, incidental, or tort
damages.
14. ENTIRE AGREEMENT
This Agreement sets forth the entire understanding between the parties as to the subject matter
hereof and merges all prior discussions between them, and neither party shall be bound by any prior
representations, conditions, understandings, or warranties except for original system warranties or
those expressly provided herein, or in any surviving terms of prior written agreements between the
parties hereto, or in any written agreements signed by representatives of the parties on or
subsequent to the date of this Agreement. No provision appearing on any form originated by CLIENT
shall have any force or effect unless such provision is expressly accepted in writing and signed by a
representative of TIBURON.
IN WITNESS WHEREOF, the parties have hereunto set their hands on the dates set forth below.
CLIENT
Signatur f Authorized presentative
TIBURON
Cie-0- K-
Signature of Authorized esentative
Alvin W. Jones
Name
County Judge
Title
May 7, 2002
Name
Title
Date Date
Brazos County ESA Page 5 of 5
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F-1
EXHIBIT A
TO THE AGREEMENT FOR EXTENDED SERVICES
SOFTWARE SUPPORT AND MAINTENANCE FEES
CLIENT CONTACT - Emie Laney
Brazos County Sheriffs Department CLIENT # U1220-02
202 East 271" Street
Suite 102
Bryan, TX 77803
Support and Maintenance provided to the CLIENT listed above shall be pursuant to the terms and conditions of
the TIBURON Agreement for Extended Service dated May 1, 2002 (the `Agreement').
The term of the Agreement shall commence on the effective date and shall continue until termination in
accordance with the terms thereof. This exhibit sets forth the current annual maintenance fee for the software
applications and software modules listed below. Upon payment of the amount set forth below, this Exhibit A
shall be attached to and become part of the Agreement. Except as provided below, annual maintenance fees
are payable in advance of each anniversary of the effective date of the Agreement. Tiburon reserves the right to
increase the annual maintenance fee on an annual basis upon ninety (90) days prior written notice to the
• CLIENT, which adjustments shall become effective on the anniversary of the effective date of the Agreement.
The annual maintenance fee will be adjusted as necessary to reflect changes in the software applications and
software modules listed below or changes in the level of support provided under the Agreement. Such
adjustments will be charged or credited as incurred on a pro rata basis and will be reflected in a new Exhibit A,
which, upon delivery to the CLIENT, shall be attached to, and become part of, the Agreement.
Payments for all technical services outside the scope of Basic Services and Options included in the CLIENTs
annual maintenance fee shall be invoiced to the CLIENT as incurred. All such invoices shall be due and payable
within thirty (30) days of CLIENTs receipt thereof.
Tiburon reserves the right to charge an administrative fee of 10% of the annual maintenance fees for semi-
annual or quarterly invoices.
Software Model Months CPU Make Start End Total Fees
MAKO 12 5/1/02 4/30/03 $ 1,138.00
•
Total $ 1,138.00
Failure to pay when due the annual maintenance fee, any adjustment thereto, any invoice or any other amounts
owing under the Agreement shall constitute a default under the Agreement and could result in the termination of
support services under the Agreement, additional administrative charges for reinstating lapsed support services,
as well as collection fees (including reasonable attorneys' fees and expenses).
Brazos County Ex A 2002 Page 1 of 1
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EXHIBIT B
TO THE AGREEMENT FOR EXTENDED SERVICE
SCHEDULE OF SERVICES AND CHARGES
Support and Maintenance provided to the CLIENT listed in Exhibit A shall be pursuant to the terms and
conditions of the TIBURON Agreement for Extended Service dated May 1, 2002 (the "Agreement").
Upon CLIENTS payment of the amount set forth on Exhibit A to the Agreement, this Exhibit B shall be
attached to, and become part of the Agreement. Any changes to the services options selected in this
Exhibit B shall be reflected in a new Exhibit B which, upon payment of any additional amounts due, shall
be attached to, and become part of, the Agreement.
BASIC SERVICES
TIBURON will provide basic services as defined in the Statement of Work contained In Section 2 of the
Extended Service Agreement for the software systems as defined in Exhibit A.
Support for Computer Aided Dispatch, Message Switch and Corrections Management Systems is 24 hours
per day, 7 days per week. Support for other products is from 8:00 a.m. to 5:30 p.m. Central Time, excluding
weekends and normal TIBURON holidays, unless the "2417" Service Option is selected. In all cases, call-out
charges will apply as described below.
Tiburon personnel will visit CLIENT site periodically and meet with management, operations and other user
personnel to conduct an operations review of the systems and an analysis of the CLIENTs automation
requirements. A report will be produced to include observations and recommendations regarding the
CLIENTS use of the system. Working with the CLIENT, this review will be further documented in the form of
a multi-year automation plan for the CLIENT. There will be no charge for this service if total annual
maintenance exceeds $20,000.
The following is paraphrased from the recently adopted Bylaws.
Voting membership in the Tiburon User Group, as set forth herein, is included in the Basic
Service. The quantity of voting members is based on the number of Tiburon products installed,
with the appropriate software licenses, at the CLIENT. For purposes of establishing voting
memberships, a product is defined as Phoenix - Computer Aided Dispatch, Police Records
Management, Fire Management Information System, Jail Management Information System, and
Communication & Interfaces. The Tiburon User Group Conference is held annually at a location
to be determined.
"2417" SERVICE OPTION $7,000 per year/per system
(initial)
Products not normally covered by 24-hour support may optionally be supported with 24-hour coverage
(including TIBURON holidays). Applicable call-out charges continue to apply. If this option is not in force,
technical support requests outside of covered hours are charged at technical service rates as defined below.
NEW PRODUCTS
Additional TIBURON software systems, subsystems and TIBURON provided third-party products, such as
hardware, and networking software may be acquired under this Agreement. TIBURON installation, special
tailoring, license fees and third-party peripherals required shall be charged at the then current Technical
Services Rate or as quoted by TIBURON or the third party.
Brazos County Ex B 2002 Page 1 of 2
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GOLD CARD SERVICE OPTION
Quote available on request
A total support program is tailored for CLIENT and includes a schedule of on-site visits by TIBURON
personnel for data base management, working with end users to identify and resolve problems and to apply
agreed upon software changes, installation of new software products obtained through this Agreement, and a
comprehensive training program. (if selected by CLIENT the terms of this option are defined in the Gold Card
Service Schedule and will be attached as Exhibit C and incorporated herein by reference.)
TECHNICAL SERVICE RATES
1. Technical Service Rates
Technical Services Rates shall be invoiced to CLIENT as incurred at the rates then in effect.
A minimum of four (4) hours per occurrence will be charged for work conducted at TIBURON
facilities and a minimum of eight (8) hours at CLIENT site for Technical Services not covered
under Bask Services or "2417" Service Option as described previously.
2. Materials, Travel and Per Diem Exoenses
When applicable, all special materials, plus travel and per diem expenses shall be charged to
CLIENT at cost.
3. Call-Out Charges
Systems not covered under 2417 support, call-outs will be billed at $250 per call. After the first
hour, the rate is $250 per hour with a two-hour minimum.
If CLIENT's systems are covered under the 24/7 support, the off-hour call-out fee is $50.
4. Remote Access
Al charges in this Agreement are predicated on CLIENT providing the required hardware,
software, and operating environment for dial-in service. If CLIENT does not provide this support
for dial-in service, the following additional charge will apply:
$500 per month per system supported
In addition, travel and per diem expenses for on-site support required due to lack of remote
access will be charged as defined in Exhibit B, page 2, item 2.
Brazos County Ex 6 2002 Page 2 of 2
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41111ANTSO
COMMUNICA NONS
SWITCHED/DEDICATED SERVICE ENROLLMENT FORM AND AGREEMENT
The undersigned Customer hereby enrolls in the NTS Communications, Inc., Switched/Dedicated Service Term
Plan subject to the terms of this Enrollment Form and Agreement.
Name: Brazos County Service Term Commitment
Term Start (Tum-Up Date):
Address: 300 E. 26 h Street, Suite 117 ❑ Month-to-Month 0 Z
X 12 Months
City. Bryan, TX 77803 ❑ 24 Months
•
Contact Name: Pat Howard Dedicated
Rate:
Switched
Telephone 979-361-4290 Rate.: .0794 Inter/lntra
TERMS AND CONDITIONS
A. Early Termination. In the event Customer terminates service prior to the expiration of the Service Term
Commitment, Customer agrees to pay an early termination fee equal to 35% of Customers average monthly long-
distance changes until the termination date multiplied by the number of whole and partial months remaining in the
unexpired Service Term Commitment.
B. Notification Requirements. All Customer requests to terminate this Enrollment Form and Agreement must be
made in writing to NTS Communications, Inc., no later than the 20th day of the month preceding the month in which
the desired action is to take effect.
C. Service Considerations. Customer shall not be entitled to receive any other discount or promotion from NTS
Communications, Inc., in connection with the charges for long distance service. The switched/dedicated rates
specified herein do not apply to calls made utilizing the NTS Travel Card Service.
D. Complete Agreement. This Enrollment Form and Agreement is subject to, and governed by, the terms and
conditions set forth in the Generally Available Terms and Conditions of NTS Communications, Inc. which is on file
and available for inspection at the offices of the company. This Form and the Generally Available Terms and
Conditions supersede any prior or contemporaneous proposals, discussions or agreements, written or oral,
concerning the services referenced herein.
AUTHORIZATION
Your signature acknowledges that you understand the terms and conditions under which the Switched Service will
• be provided and that you are duly authorized to make the commitment set forth herein.
Customer.
NTS Communications, Inc. Brazos County
By. By:
%
Printed Name: BARBARA ANDREWS Printed Name: Alvin Jones
Title: PRESIDENT Title: County Judge
Date: Date: • - o Z -
OFFICE USE ONLY
Sales Initials: GBJ Sales Office: Dallas
s.dj 73
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DESCRIPTION
INC.
UNIFORMS
ANDEQUIPMENT
SUPPLY INC.
EMBLEM, INC.
QTY
PRICE EA EXTENDED
PRICE EA EXTENDED
I
PRICE EA EXTENDED
PRICE EA EXTENDED
PRICE EA EXTENDED
PRICE EA EXTENDED
a
short sleeve blurts
75% dampolyester.25%
210
$ 41.38 $ 8.6898D
$ 3895 $ 8,17950
$ 54.27 S 11,39670
NIB
NIB
worstedwool Inchding
epaulets
A terdMe Merit
$ 41.38
$ 3895
$ 33.10
S 5427
Made-to-measuro
$ 6789
S 3895
$ 33.10
$ 65 DO
b
g Sleeve Shirts
75X, dacirm poyester,25%
45
$ 4628 $ 2,08260
$ 43.50 S 1,957.50
$ 60 78 Z735,10
NI8
NIB
worsted wool including
epaulets
Allamble Item
$ 4628
$ 43.50
S 36.45
$ 60.78
Madado-measwe
$ 6494
S 43.50
S 36.45
S 7080
Ails
Short e SWrts
10D%cmfttrelpolyester
210
$ 29.70 $ 6.237.00
$ 28.25 $ 5,90260
2650 i S9
S 31 DO $ 6.51000
MB
IVB
Including epaulets
Alterabe Item.
S 29.70
$ 28.25
$ 26.50
S 3150
Madedoanessuro
$ 41.07
$ 2825
S 2650
$ 3565
b
Long eeve s
100%combbelPolyester
45
$ 32.56 $ 1,465.20
S 29.76 $ 1,338.75
S 35.00 $ 1,57500
NIB
NJB
Inclu ft epaulets
Alterabe Kem
$ 3256
$ 29.75
S 29 75
$ 35.00
Marla tofneasure
$ 4519
$ 2975
S 29,75
$ 40.25
TYLER UNIFORM
DIRECTACTION
S 1F RM
TROOPER
MILLER NIFORMAND
ACM 8 PPLY
DESCRIPTION
INC.
UNIFORMS
AND EQUIPMENT
SUPPLY INC.
EMBLEM, INC.
QTY
PRICE EA EXTENDED
PRICE EA EXTENDED
PRICE EA EXTENDED
PRICE EA EXTENDED
PRICE EA EXTENDED
PRICE EA EXTENDED
. a
arils- orlon
2
5%wonted wool Ind. Lag piping
AfteraW Item.
$ 7100
Inaaa~
S 71100
a
Pants-Visafabric
Including leg plptsg
Alterable Item
$ 41.71
$ 33.65
$ 2775
S 3547
Made,40-measure
$ 6793
S 33.65
$ 27.75
$ 35.47
C.1
ac
Alterable Item
$ 107.68
$ 85.50
$ 9275
S 11295
Madedo-measure
$ 143.58
$ 8550
$ 92.75
S 12000
C.II
Windbrealar
Alterable Item
$ 19.37
$ 2000
$ 3100
$ 26.95
Meds4wn sure
$ 25.83
S 20.00
$ 31.00
$ 29.OD
D
21, per s hirt
Seim on each shoulder
534
NIC N!C
NIC Im
N/C NIC
NIC IUC
N1B
NB
Delver 3045 days Delivery 30 days Delivery 15 days Stock Berns 7.14 days
RECOMMENDATION: PRIMARY VENDOR: SKAGGS UNIFORM & EQUIPMENT
AWARD DATE: 7-May-02
fJ1e.
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