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HomeMy WebLinkAbout2003-04-22-9:00AM-RegularBRAZOS COUNTY BRYAN. TEXAS LdjF;!1~ P?:01 CLERK NOTICE OF MEETING AND AGENDA BRAZOS COUNTY COMMISSIONERS COURT THE COMMISSIONERS COURT WILL MEET IN REGULAR SESSION ON TUESDAY, APRIL 22, 2003 AT 9:00 A.M. IN THE COMMISSIONERS COURTROOM OF THE BRAZOS COUNTY COURTHOUSE, 300 EAST 26TH STREET, SUITE 115, BRYAN, TEXAS. Invocation and Pledge of Allegiance - Commissioner Jones. 2. Call for citizen input and/or concerns. Consider and take action on agenda items 3 - 14: 3. Budget Amendment 02/03-23. 4. Payment of Claims. 5. Personnel Changes of Status. 6. Authorizing the Information Technology Department to acquire the consulting services of Sungard/Pentamation regarding the upgrade of the County's financial/human resources software. 7. Appointing two members to the Brazos County Housing Finance Corporation Board of Directors. 8. Application for Renewal for the National School Lunch Program/School Breakfast Program with the Texas Department of Human Services for Juvenile Services. 9. Blanket Purchase Order in the amount of $3,000.00 to Dealers Electric for the Maintenance Department. POO Commissioners Court Meeting Agenda April 22, 2003 Page Two 10. Approving Bid #2003-026 - Asphalt Oil and Emulsion for the Road & Bridge Department. 11. Consulting Agreement with Ben Sanford & Associates, Inc. to negotiate rates for Long Distance Service for the County. 12. Tax Refund Applications for the following: a. Kyle & Susan Bennett b. Cavalier Management Corporation C. Julian Cedillo (Washington Mutual) d. Joyce E. & James S. Chalmers e. Crab & Crawfish Inc., dba The Fishman (Krises Wholesale Seafood, Inc.) f. Des & Angela Daugherty g. Bobby R. & Tara Edwards It. Benito E. & Kathryn Flores i. Kimberley Walker Gonzalez j. William W. Harper k. Ladona Hudson (El Camino Real Estates Development, LP) 1. Shirley J. Jones in. Shirley J. Jones Life Estate n. Liberty Classic Motor Sports o. Miner & Kelli Marchbanks, III. p. Delano & Luke & Ginny McKay q. Pamela J. Parker r. Stephanie Powell (Lereta Corp.) S. Larry G. Roe t. Delia Sauseda (Monica Carera) U. Michael J. & Laura Schultze V. Carl D. & Leslie J. Shirk W. Gloria Mae Smith X. Spacenet,Inc. (3) y. Jarod Alan Staude & Joy Lynn Stoffer (P.Y.S., Inc.) Z. Weingarten Realty Investors (Equitax Property Consultant) (2) 13. Request from Verizon to construct a road bore and 2,248 feet of parallel cable installation in the right-of-way of Luza Lane. Site is located in Precinct 4. 14. Request from Patterson Petroleum LP to construct a road bore to install a produced water gathering pipeline in the right-of-way of Oak Lake Road. Site is located in Precinct 2. 4 3'' - Commissioners Court Meeting Agenda April 22, 2003 Page Three 15. Announcement of interest items and possible future agenda topics. 16. Agency/Board/Committee reports by Court members. 17. Call for citizen input and/or concerns. 18. Adjourn. The Brazos Center 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 APRIL 22, 2003 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, April 22, 2003 with the following members of the Court present: Randy Sims, County Judge, Presiding; Tony Jones, Commissioner of Precinct 1; Duane Peters, Commissioner of Precinct 2; Kenny Mallard, Commissioner of Precinct 3; Carey Cauley, Jr., Commissioner of Precinct 4, Via Telephone; Karen McQueen, County Clerk. The attached sheet contains the names of the citizens and officials that were in attendance. The Commissioner Jones gave the invocation and led the pledge of allegiance. There was no citizen input/and or concerns The Court first considered Budget Amendment #02/03-23.1 through 23.7, which would reallocate funds for the Constable, Precinct 1, Sheriff, Juvenile Services TJPC-State Aide Grant, Juvenile Services TJPC-Juvenile Accountability Block Grant, and Juvenile Services TJPC-Community Corrections and remove two TJPC grants that were never released. On motion by VOL 43 PAGE 5z- Commissioners Court meeting April 22, 2003 2 Commissioner Peters, seconded by the County Judge, the Court voted unanimously to approve the budget amendment as submitted, a copy of which is attached. The Court next considered the following Claims as submitted by the County Treasurer for payment: 20041358 through 20041563 On. motion by Commissioner Jones, seconded by Commissioner Mallard, 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 Jones, seconded by Commissioner Peters, the Court voted unanimously to approve the changes as submitted. The next matter before the Court was authorizing the Information Technology Department to acquire the consulting services of Sungard/Pentamation concerning the upgrade of the County's financial/human resources software. On motion by Commissioner Jones, seconded by Commissioner Peters, the Court voted unanimously to authorize the Information Technology Department to acquire the consulting services. The total estimated cost will be $5,950.00. VOL 4 ~ PAGE ~3 Commissioners Court meeting April 22, 2003 3 The Court next considered appointing two members to the Brazos County Housing Finance Corporation Board of Directors. On motion by Commissioner Mallard, seconded by Commissioner Peters, the Court voted unanimously to appoint Burleson County Judge, Mike Sutherland and Leon County Judge, Byron Rider to the board. The Court proceeded to consider approval for renewal for the National School Lunch Program/School Breakfast Program with the Teas Department of Human Services for Juvenile Services. On motion by the County Judge, seconded by Commissioner Peters, the Court voted unanimously to authorize the County Judge to execute the application for renewal of the National School Lunch Program/School Breakfast Program. . The Court proceeded to consider the following blanket Purchase Order: Dealers Electric Building Maint. $3,000 On motion by Commissioner Jones, seconded by Commissioner Peters, the Court voted unanimously to approve the Blanket Purchase Orders as submitted. The Court next considered approving Bid 42003-026 r Asphalt, Oil and Emulsion and the requisition for materials. On motion by Commissioner Peters, seconded by Commiss'_cner Jones, the Court voted unanimously to approve the bid and the VOL 'q3 PAGE V Commissioners' Court meeting April 22, 2003 4 requisition for materials in the amount of $190,000 for AEP and $175,000 for HFRS2. The next matter for consideration was the approval of a Consulting Agreement with Ben Sanford & Associates, Inc. to negotiate rates for Long Distance Service for the County. On motion by Commissioner Jones, seconded by Commissioner Peters, the Court voted unanimously to approve the agreement. Estimated cost of service is $900.00. A copy of the agreement is attached. The next matter for consideration was approval of tax refund applications from the following individuals and/or companies: a. Kyle & Susan Bennett b. Cavalier management Corporation c. Julian Cedillo (Washington Mutual) d. Joyce E. & James S. Chalmers e. Crab & Crawfish Inc. dba The Fishman (Krises Wholesale Seafood, Inc.) f. Des & Angela Daughtery g. Bobby R. & Tara Edwards h. Benito E. & Kathryn Flores i. Kimberley Walker Gonzalez j. William W. Harper k. Ladona Hudson (El Camino Real Estate Development, LP) 1. Shirley J. Jones m. Shirley J. Jones Life Estate n. Liberty Classic Motor Sports o. Miner & Kelli Marchbanks, III p. Delano & Luke & Ginny McKay q. Pamela J. Parker r. Stephanie Powell (Lereta Corp.) s. Larry G. Roe t. Delia Sauseda (Monica Carera) u. Michael J. & Laura Schultze VOL U PAGE 6-~ Commissioners' Court meeting April 22, 2003 5 v. Carl D. & Leslie J. Shirk W. Gloria Mae Smith x. Spacenet, Inc. (3) y. Jarod Alan Staude & Joy Lynn Stoffer (P.YS., Inc.) z. Weingarten Realty Investors (Equitax Property Consultant) (2) On motion by the County Judge, seconded by Commissioner Jones, the Court voted unanimously to approve the previously noted Tax Refund applications. The Court next considered the request from Verizon to construct a road bore and 2,248 feet of parallel cable installation in the right-of-way of Luza Lane. The site is located in Precinct 4. The County Engineer stated that all appeared to be in order and recommended approval. On motion by Commissioner Jones, seconded by Commissioner Peters, the Court voted unanimously to approve the request by Verizon and authorized the installation. A copy of the request is attached hereto. The Court next considered the request from Patterson Petroleum LP to construct a road bore to install a produced water-gathering pipeline in the right-of-way of Oak Lake Road approximately 6,705 feet from FM 2038. The site is located in Precinct 2. Included with the request is company check #1420 in the amount of $500.00. The County Engineer stated that all appeared to be in order and re commended approval. On motion by Commissioner VOL 4 3 PAGE Commissioners' Court meeting April 22, 2003 Peters, seconded by the County Judge, the Court voted unanimously to approve the request from Patterson Petroleum LP and authorized the installation. A copy of the request is attached hereto. Under announcement of interest items and possible future agenda topics the following spoke: County Judge a) Said that he would be in Austin the rest of the week due to the Legislature to discuss serious bills that would have an impact on Brazos County. Commissioner Jones a) He attended an Intergovernmental meeting yesterday with the two cities. There will be a joint workshop discussion on a healthcare plan on May 19th beginning at 6:30 p.m. at the Brazos Center. The Agency/Board/Committee reports by Court members were discussed with the announcements. Under citizen input and/or concerns, the following spoke: a) Clyde Garland asked for an explanation of item 12 which was the approval of Tax Refund Applications. The County Judge explained that most of the refunds were for overpayments and that the Court was approving the recommendation of the Tax Assessor/Collector. VOL 4 3 PAGE 'D 6 Commissioners' Court meeting April 22, 2003 There being no further business to come before the Court, the meeting was adjourned. 7 VOL y3 PAGE 5 8 The foregoing minutes of the Commissioners Court meeting held ril 22, 2003 have been examined and are approved in open Court this the day of , 2003, in Bryan, d~_ ~ Tony Jones Commissioner, Precinct 1 i Duane Peters Kenny Mallar Commissioner, Precinct 2 Commissioner, Precinct e, C rey a ley, Jr. Commis oner, Precin t 4 i " Karen McQueen County Clerk VOL 43 PAGE 0 Brazos County, Texas. BRAZOS COUN Y COMMISSIONERS C URT MEETING ON 2003 AT .'00)* NAME _ (1R(; A NTT7 A TTr)NT/T)Ul) A n'r X, ,XTr ( j1 . C1 J e L. Gurla)I ~ SFi~ (e x C ✓>9J i b~ &c~Nl3 mod( ~L V I2c.l ~ k ~.61 C BRAZOS COUNTY, -:LAS BUDGET AMENDMENT(S) FOR THE 2002-2003 BUDGET YEAR NO. 02/03-23.1 to 23.7 On this the 22nd day of April 2003 at a regular meeting of th^ Commissioners' Court, the following members were present: Randy Sims, County Judge, Presiding Tony Jones, 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 April 22, 2003 the Court heard and approved a budget amendment for the 2002-2003 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 August 23, 2002 the following amendment(s) to the original are hereby authorized, as described on the attached page (s) . ADOPTED AND APPROVED this the 22nd day of April, 2003. THE COMMISSIONERS' COURT OF BRAZOS COUNTY, TEXAS. iI _ - By: , Randy Sims, County Judge Original: County Clerk's Office and attached to the original budget Copies: County Auditor County Treasurer Commissioners' Court Minutes LRAZOS COUNTY, TEXAS BUDGETAMENDMENTS No. 02/03 113.1 4/22/2003 FD 01 0i DIV 301011 301011 ACCT 5l 6200 516100 PROJ DR/CR Dr. Cr. ACCOUNT NAME Overtime Hourly - Staff Increase . $ 4,870.00 Decrease $ 4 870.00 Constable Precinct 1 To reallocate sal ary bud overti theCommissioner Court 3/11/03. U M ~y i'~4 1 "Y 55.,.. t~ryy 3~, Ids JryiiL yi p6y +OY B } X15 t i5 R ~2t ",Alli" j ^ ~ dz i`5 ~ ! 63{I° { ~.N ~iR L t'u W~tl"j~.~ P} R r H-11 vN:P BRAZOS COUNT Y- TEXAS BUDGET AMENDMENTS No. 02/03-23.2 a/77MMa FD 30 30 DIV 3181 ACCT 480463 710400 PROD DR/CR Dr. Cr. ACCOUNT NAME TJPC-PS Level 5 Plcmt Contract Placement Increa>e Decrease 14,175.00 $ 14,175.00 TJPC-PS Level 5 Placement 30 30 3182 480464 710400 Dr. Cr. TJPC-SA/Wea ons Plcmt Contract Placement 14,504.00 14,504.00 TJPC-SA/Wea ons Placement To remove the budget for two rants from Texas Juvenile Probation Commission which were never released. AD Mig 1a~. 10 di~ p1~Y t t r v 1 t j t ~ r 4 4"$ BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 02/03-23.3 4/22/2003 FD DIV ACCT PROJ DR/Cu ACCOUNT NAME Increase Decrease 01 280001 670100 Dr. Donatedr".overt$ 15,575.00 01 460230 Cr. Donated Property 15.575.00 Sheriff Administration To reco ize the value of property b the Brazos County Sheriffs Citizen Academv Alumni. BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 02/03-23.4 4/22/2003 FD DIV ACCT ^ROJ DR/CR ACCOUNT NAME Increase Decrease 30 3121 614500 312103 Dr. Miscellaneous $ 2,150.00 30 3121 715200 312103 Dr.. Rental Vehicle 650.00 30 3121 721570 312103 Cr. Counseling Services 2,800.00 Juvenile Services Department TJPC - State Aide Grant To reclassif budget for department needs. ~-1/G1o 3 1 '0. "1 R N ~n~*~ h 7, i s~'riu. d1M pia tam t, 1, N14 PAT 43 ~ nj, shy C BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 02/03-23.5 4/22/2003 FD DIV ACCT PROJ DR/CR ACCOUNT NAME Increase Decrease 30 3171 6'3420 317103 Dr. Furniture $ 15.00 30 3171 606000 1 317103 Dr. Office Supplies $ 15.001 Juvenile Services Department TJPC - Juvenile Accountability Block Grant To reclassify budget for department needs. ERAMS COUNTY, TEXAS BUDGE f AMENDMENTS No. 02/03- 73.6 4/22/2003 FD DIV ACCT PROJ DR/CR ACCOUNT NAME Increase Decrease 30 3121 710400 312103 Dr. Contract Placement $ 5,144.00 30 3121 512000 312103 Cr. Salary Dept. Head $ 1,792.00 30 3121 531000 312103 Cr. Social Security 137.00 30 3121 532000 312103 Cr. Retirement 3,205.00 30 3121 538000 312103 Cr. Work.Com . 8.00 30 3121 539000 312103 Cr. Unemployment 2.00 Juvenile Services Administration TJPC - State Aide Grant To correct the budget as approved for the FYE 8/31/2003. W, 44 j,U w a ~Y BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 02/03-23.7 aiz7/7nn'A FD DIV ACCT r; nJ DR/CR ACCOUNT NAME Increase Decrease 30 3161 710400 316103 Dr. Contract Placement $ 10,071.00 30 3161 516100 316103 Cr. Hourly - Staff $ 3,507.00 30 3161 531000 316103 Cr. Social Security 268.00 30 3161 532000 316103 Cr. Retirement 6,271.00 30 3161 538000 316103 Cr. Work.Com . 17.00 30 3161 539000 316103 Cr. Unemployment 8.00 Juvenile Services Administration TJPC - Community Corrections Grant To correct the budget- as approved for the FYE 8/31/2003. i 4 I Y 1 ~p ~,3 PERSONNEL CHANGE OF STATUS page 1 of 1 COURT DATE: April 22, 2003 DEPARTMENT: Personnel PURPOSE: A.p .~rove Personnel Change of Status DEPARTMENT NAME EMPLOYEE NAME ACTION REQUESTED DISTRICT ATTORNEY LOWREY. JAMI RESIGNATION SHERIFF'S OFFICE/JAIL BABIC, ROBERT H. MUSHINSKI, MELINDA BURNS, DON CARELOCK, ALVIN FRANKLIN, RUTH PATRANELLA, FRANK ALONZO, PAULINE RESIGNATION BUDGETED INCREASE BUDGETED INCREASE BUDGETED INCREASE BUDGETED INCREASE BUDGETED INCREASE BUDGETED INCREASE TAX OFFICE RICO, JEANETTE TRANSFER WITHIN DEPT. DISTRICT CLERK RILEY, BECKY APPLEGATE, KIMBERLY PROMOTION PROMOTION Approved in Commissioners' Court: April 22• County Judge's or Commissioner's Signature: (This copy to be attached to minutes) BOARD MEMBERS TEXAS Jon M. Bradley Department of Chair, Dallas Human Services Jerry Kane Vice Chair, Corpus Christi COMMISSIONER James R. Hine Abigail Rios Barrera, M.D. San Antonio May 6, 2003 John A. Cuellar Dallas Brazos County, Texas Manson S. Johnson Brazos County Juvenile Detention Center Houston 1904 West SH 21 Terry Durkin Wilkinson Bryan, Texas 77803 Midland Attn: Olivia Body Dear Ms. Body: Your application for the NSLP/SBP has been approved for Program Year 2004 (School Year July 1, 2003 - June 30, 2004). A copy of your approved application is enclosed. We have also enclosed the forms listed in the attachment to this letter. You need these forms for the operation of the program. The program number for your NSLP/SBP contract is 021-2001. The program number identifies your organization as a participant in the NSLP/SBP. The contract number for your NSLP/SBP contract is 7561001. The contract number identifies your organization as a contractor with the Texas Department of Human Services (TDHS), Special Nutrition Programs. Both numbers are unique to your organization and will be required to be entered on forms when filing a claim for reimbursement and when completing the renewal documents each Program year. Please note that you must complete the form titled "Attendance Factor Sheet" and return it to our office by July 31, 2003. Failure to return this form may result in a less realistic representation of your school's attendance information on our payment system. Please note that you must conduct annual verification of household eligibility for free and reduced-price meals by December 15" of each year. Complete the attached document titled "National School Lunch Program Verification of Household Eligibility for Free and reduced-Price Meals," and keep it on file. Special Nutrition Programs will review the completed documents as part of the administrative review. Failure to complete and maintain the verification of eligibility documentation may result in corrective action. For additional information on the verification process refer to the NSLP/SBP handbook. You may be eligible for state surplus property under House Bill (HB) 2840. Included in the approval packet is a notification letter of your eligibility to acquire state surplus equipment and an attachment to the letter titled "Overview of the Acquisition of State of Texas Surplus Property by State Agencies, Political Subdivisions, & Assistance Organizations as Administered by the General Services Commission". If you are interested in receiving surplus equipment submit the notification letter to the General Services Commission. You must retain a copy of all forms and documents as part of your official records for at least three years and 90 days after the termination of the contract or until all audit findings, claims, or litigation have been resolved, whichever period is longer. Please reference the agreement for additional record retention requirements. r~ 0 VIP NSLP Approval Letter May 6, 2003 Page 2 of 2 Please be informed that you have the right to appeal Texas Department of Human Services (TDHS) adverse actions that affect your participation in the NSLP/SBP or your claims for reimbursement. A request for an appeal hearing must be submitted in writing and received by TDHS 15 calendar days from the date you receive a notice of adverse action from TDHS. Requests for hearings must be addressed to: Hearing Department, W-613 Texas Department of Human Services P.O. Box 149030 Austin, Texas 78714-9030 To expedite the appeal hearing process include a copy of the adverse action/finding letter that you receive from TDHS with your request for appeal. Please note also that you must comply with the Single Audit Act of 1984. Failure to submit an audit or comply with audit requirements can result in adverse action against your contract, up to and including contract termination. . You are required to submit an audit by May 31, 2004 for fiscal year 2004. If you have any questions feel free to contact our office at 512-873-6326. Sincerely, ~ Fernando Becerra, Jr Area Program Manager Special Nutrition Programs Austin Field Office FBJ: kmt Enclosure(s) 4 43 11 S~ }h -fi exas Departent of Human Services National School Lunch Program and School Breakfast Program APPLICATION FOR PARTICIPATION AND POLICY STATEMENT School Program Year: July 1, 2003 Through June 30, 2004 10 PART I - APPLICATION Texas ID Number Contract Number Program Number 1 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, Zp) 1904 West SH 21 Bryan, Texas 77803 Telephone Number Fax Number Email Address (979 ) 823-3544 ( 979 ) 823-4211 olivia@co.brazos.tx.us Name of School/Facility (If more than one site, complete a DHS Form 1609 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 )E91 Residential Child ❑ Combination Day School and and Boarding School Care Institution Residential Child Care Institution ❑ Special Education School ❑ Afterschool Care Snack Site ❑ Other (specify): School/Residenfial child pre institution (RCCI) is: EFXPublic ❑ Private b If'Pdvate,' is the schooVRCCI nonprofit and tax exempt ❑ Yes ❑ No b If'Yes ; attach copy of under the Internal Revenue Code of 1954? letter from the IRS. Taal EnmllmentforAll Schods/RCCis b 44 ' Sc of All Schools/RCCls Total = b Administered b Food ' by AdmiSchool Food Authority: O 1 1. Is the above schooViresidenfial child care institution licensed? (If yes, attach copy of license.) ❑ Yes Xa No 2. Program(s) that you are applying for. UK National School Lunch Program ❑ Afterschool Care Snack program (must be participating in National School Lunch Program) XEX School Breakfast Program xMa Severe Need School Breakfast Program Rates' ' Available to sdroolsfresidential 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. Number of hbnths Beginning Date of Operation Ending Date of Operation 3. Number of months the school wilt be operating a food service program: 12 0 1/01/2003 06/30/2004 4. Number of children enrolled at school/residential child rare institufion 44 A. Age Range of Children Enrolled From: 5. To: 16 B. Grade Levels Taught (schools only) From: Form 1610 March 2003 To: Food Service: AVERAGE DAILY PARTICIPATION OF CHILDREN IN PROGRAM TIMES OF FOOD SERVICE Free Reduced Price Paid Beginning Ending Breakfast 44 lam gam Lunch 44 PECIAL NUTRITIO PROGRAMS 12 noon lpm Area Eligible Afterschool Care Snack Not Area Eligible Afterschool Care Snack 6. Attendance (for residential child care Institutions only) 40p MAY - 2 2003 A. Are all of the children at the institution all day? R3®X Yes ❑ No If no,-do all or some of the children attend public school? .t.: ❑ All ❑ Some If only some attend public school, how many? AUSTIN-FIELD OFFICE If some or all attend public school, which meals do these student eat at the institution? ❑ Breakfast ❑ Lunch ❑ Afterschool Snack B. Check 4 the children attend the institution on holidays and///or weekenddss. . XIQHolidays X10meekends .77 eras Department of Human Services National School Lunch Program and School Breakfast Program APPLICATION FOR PARTICIPATION AND POLICY STATEMENT School Program Year: July 1, 2003 Through June 30, 2004 16 PART I -APPLICATION Texas ID Number Contract Number 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 (979 ) 823-3544 ( 979 ) 823-4211 olivia@co.brazos.tx.us Name of SchoollPacility (if more than one site, complete a DHS Forth 1609 for each site.) Brazos County Juvenile Detention Center Scitool 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 3qjK Residential Child ❑ Combination Day School and and Boarding School Care Institution Residential Child Care Institution ❑ Special Education School ❑ Afterschool Care Snack Site ❑ Other (specify): School/Residential child care institution (RCCI) is: EPIlPublic; ❑ Private r-> If 'Private,' is the schooVRCCI nonprofit and tax exempt ❑ Yes ❑ No b If 'Yes,' attach copy of under the Internal Revenue Code of 1954? letter from the IRS. Total Enrollment for All Schools/RCCIs b 44 ' Total Number of AN SchoolstRCCIS b O 1 Administered b Food Autho Administered b School Food Author 1. Is the above school/residential child care institution licensed? (If yes, attach copy of license.) ❑ Yes 19k No 2. Program(s) that you are applying for. EFK National School Lunch Program ❑ Afterschooi Can: Snack program (must be participating in National School Lunch Program) Y.EFK School Breakfast Program X55($ Severe Need School Breakfast Program Rates' ' Available to sdtools/residenttal child care instiNtions meeting the following eligibNiy atteria: 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. Number of Months Beginning Date of Operation Ending Date of Operation 3. Number of months the school will be operating a food service program: . 12 07/01/2003 06/30/2004 4. Number of children enrolled at schoollresidential child care institution: 44 A. Age Range of Children Enrolled From: 10 To: 5. F,om: To: Forth 1610 March 2003 F d S i AVERAGE DAILY PARTICIPATION OF CHILDREN IN PROGRAM TIMES OF FOOD SERVICE oo erv ce: Free Reduced Price Paid Beginning Ending Breakfast 44 7am Sam Lunch 44 PECIAL NUTRITIO PROGRAMS 12 noon lpm Area Eligible Afterschool Care Snack Not Area Eligible Afterschool Care Snack 6. Attendance (for residential child pre 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? S. Grade Levels Taught (schools only) a~•" MAY - 2 2003 ';j' X)[NK Yes ❑ No .).lCF.1,..Q.(:..N,JMAfx..utiY.LGkS..... ❑ All ❑ Some AUSTIN FIELD OFFICE If some or all attend public school, which meals do these student eat at the institution? ❑ Breakfast ❑ Lunch ❑ Afterschool Snack B. Check N the children attend the Institution on holidays and/or weekends ............................................................................)U7 g Holidays RI$Jeekends Form 1610 Page 2,03-2003 7. Type of Meal Service A. Meal Preparation XE3X 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 Nu Menus) (See instructions for documents to submit.) ❑ Other (explain: NOTE: Snacks sewed in the Aflorscirool Care Snack follow the food based supplement pattern regardless of your menu plannN method for breakfast and/or lunch. 8. Type of Program 9. ❑ Separate Charges 1U No Separate Charge; Cost of Meals is Included Made for Meals in Required Payment Plan/Fee ❑ Combination of Separate Charges and No Separate Charges Daily Price Charged for Each Meal CHILDREN ADULT (for programs that will charge separately only): Reduced Price Paid S Breakfast Lunch Not Area Eligible Afterschod Care Snack NOTE: Area Eligible Atierscitod Care Snack program sites must provide snacks free of charge to all students participating in the after school care program. 10. A. H applying for the National School Lunch Program, indicate whether Offer versus Serve will be Implemented: Hgh School (mandatory) Junior High (optional) Elementary (optional) Preschool (optional) Residential Child Care Institirtion (optional) ❑ Yes ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes M 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 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes M 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 on USDA Civil rights. They are also pr o specific tr aff are all trained in areas of meal. natterns. portion sizes. meal count procedures, meal production uv~.uwma~a ~y..up - we cr.-- .........J. 12. Will supplemental (a la cane or snack bar) food service be available in addition to the school lunch? ❑ Yes ❑ No ]uestions 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-to-day 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 schooVRCCI? ❑ Yes ❑ No H 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). 16. Indicate your schooVRCCI 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 H 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 1=1 health and safety standards met? (Attach copy of most recent inspections) ❑ Yes ❑ No Form 1610 Page 3, 03-2003 BART II - POLICY STATEMENT FOR FREE AND REDUCED-PRICE MEALS the school food authority operates a program that requires separate charges for meals, it must comply with Sections A and B. ` the school food authority operates a program that does not require separate charges for meals, it must comply with Sections B and C. f 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, 3, 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 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. 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 TITLE 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 overfly 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. f. Establish and use a fair hearing procedure for parents who appeal the school's/RCCI's decisions on applications and for officials of schools/RCCls 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/Breakfast Programs Handbook and agreement Before beginning the hearing procedure, the parent or local schooVRCCI official may request a conference. The c~nferen ~hould~provide an opportunity for the parent and schooVRCCI official to discuss the situation, present inf I ' I I data submitted in the application and decisions made. A conference must not prejudice or diminish r The hearing procedure must provide: "77~ (1) A simple, publicly announced method for making an oral or written request for a hearing. MAY - 2 2003 (2) An opportunity to be assisted or represented by an attorney or other person. TEXAS DEPT. OF HUMAN SERVICES (3) An opportunity to examine, before and during the hearing, the documents and records presefiUTtdlsruj$ia e9l'aEdsion 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. 7L$! Form 1610 Page 4, 03=2003 (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 schooVRCCI. 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 indude: (1) A sample of the letter to the parents (Forth 1625). (2) Form 4504. 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 Organization Organization 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 ful-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 managers 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 children who paid or are eligible for free or reduced-price meals is prepared and sent to the cafeteria. A cashier farmliar 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 schooURCCI 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- or reduced-price. ❑ Collection Procedure 6 - Parents are billed monthly for full- 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.) 75 it Form 1610 Page 5, 03-2003 Describe how the daily numbers of free, reduced-price, and full-price meals are identified and counted, and the numbers recorded. (Use an attachment if 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.) >ECTION B - Programs that Charge Separately AND Programs that DO NOT Charge Separately i fulfilling its responsibilities, the school food authority agrees to: 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 Building, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call (202) 720-5960 (voice and TDD). Note: Discrimination complaints based on religion or political beliefs must be referred only to the Director, Civil Rights Division, Texas Department of Human Services. (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 1625 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 X9jK No (2) Form 1626 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 XnX 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 school food authority sends it to parents. On approval, the school food authority must attach Form 1625-A to the letter and send both documents 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 XW 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. SPECIAL NUTRITION PROGRAMS Applications may be filed at any time during the year. The school food authority c a child in an schooVRCCI for the first time, at any time during the year. If a child transfers from o 1 to another un er; diction of the same school food authority, his/her eligibility for a free or reduced price meal is also transf MAY - 2 2003 Note - Programs that Charge Separately ONLY: All children from the same family must receive the same benefits. WithinT k Tof ,eP ~ii9,Ns,rents or guardians must be notified individually of the decision on their applications. Children are serl4WW~9 Huey 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 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 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 beforg it is implemented. Changes are gffective only when they are approved by DHS. Form 1610 Page 6, 03-2003 4. Verify eligibility according to the National School Lunch/School Breakfast Program Handbook and program regulations. 5. 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- 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. JtK 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 schooVRCCI 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 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 DHS determines 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 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 schoois/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 which 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. KOX 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 -7- Four 1610 Page 7, 03-2003 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 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? ❑ Yes ❑ No If '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 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. It DHS 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 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 which 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 31 annually. Sch001s/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 in enrollment based on the school's/RCCI's enrollment on October 31 of the current school year, and must take total meal counts of E0@j;jqaWeTRR jp) eM6&"gdpating children at the point of service. XZ~ We choose NOT to participate in Provision 3. ❑ The following schoolslRCCls will participate In Provision 3: MAY - 2 2003 Our first year under Provision 3 will be school year AIJ-014 ~F16L&- ~ IGjj t 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 o The school year that we will be reconsidered for an extension for Provision 3 is in the fourth year or school year Form 1610 Page 8, 03=2003 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 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? ❑ 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 DHS 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 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. 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 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 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 Olivia M. Body Food Service Manager 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. I. 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 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 8, 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). Residents are only served meals that are reimbursable by kitchen staff A final r r is made by child care staff when residents exit the serving line and are seared NI Form 1610 Page 10, 03-2003 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-price meals served under the Each school and the office of the which anyone may review. The following household size and income criteria will be used to determine eligibility: has a copy of the policy, (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. Application forms and a letter to parents or guardians are being sent to all homes. To apply for free or reduced-price 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, 'd 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 must report increases of over $50 per month or $600 per year in household income, and decreases in household size. If a household member becomes unemployed or if the household size increases, the household should contact the school. These changes may qualify children for reduced-price meals or for free meals if the household's income falls to or below the levels sham above. TANF/Food Stamp households must report termination of 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. People who are eligible to partidpate in the child nutrition programs must not be discriminated against 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 Building, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call (202) 720-5960 (voice and TDD). Note: Discrimination complaints based on religion or political beliefs must be referred only to the Director, Civil Rights, Texas Department of Human Services. (insert National School Lunch Program, and/or School Breakfast Program) Form 1610 Page 9, 03-2003 SECTION D - The following attachments are a part of the policy statement for free and reduced-price meals: Form 1623, Notification Letter to Parents Regarding Application for Free and Reduced-price Meals Form 1625, Letter to Parents (programs that charge separately for meals) Form 1625A, Standards for Determining Free and Reduced-price Eligibility to be provided to parents (will be forwarded as soon as USDA publishes) Form 1626, Letter to Parents (programs that do not charge separately for meals) Form 4524, Application for Free and Reduced-price Meals Form 4504, 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. Tide County Judge ate FOR DH USE ONLY y\' A , Sig ~ture-DHS Re resentative True J , bS D ON -,2flC i P NAR 2 Date SPECIAL NUTP.170N PROGRAMS MAY - 4 2003 TEXAS DEPT. OF HUMAN SERviGtS AbSTIN FlEtD OFFICE TEXAS DEPARTMENT OF HUMAN SERVICES (DHS) CLIENT SERVICES HUB SUBCONTRACTING PLAN APPLICANT STATUS DETERMINATION (C-ASD) DHS Contract Number: Description Goods/Services Purchased: Summer Food Service Program PREAMBLE: The Texas Department of Human Services and other Health and Human Services agencies are committed to promoting full and equal business opportunities for all businesses in state contracting. To better promote these opportunities, it is imperative that we collect information on prime contractors and their subcontractors to determine if an entity meets the General Services Commission (GSC) Historically Underutilized Business (HUB) certification criteria. PURPOSE: The purpose of the Applicant Status Determination form (C-ASD) and the Subcontractor Status Determination form (C-SSD) is to collect HUB-related information about a prime contractor and its subcontractors. PROCEDURE: Please complete this form with information about the prime contractor. Complete Form C-SSD (additional copies may be attached if necessary) with information about subcontractors. Return the signed and completed forms to DHS along with the other forms in your SFSP Contract Application Package. After DHS reviews the information, a representative may contact you to share additional information about HUB certification and reporting. Information on the State of Texas HUB program can be found on the GSC website at http://www.gsc.state.tx.us or by contacting Hope Degollado, DHS HUB Coordinator, at (512) 438-5429 or by email at hooe.degollado cbdhs.state.tx.us. 1. Print Legal Name of Prime Contractor: 2. Print the 14-digit Vendor Identification Number assigned by the State of Texas Comptroller (or enter the Federal Tax ID # (9-digits): 3. Is the owner or company a for-profit entity? If no, ski to number 9. Yes No 4. Is Prime Contractor a GSC certified HUB? (see HUB definition on form C-SSD). Yes No If es, lease provide our GSC Certification No. and continue with number 9. 5. Is the Prime Contractor certified as a minority/women-owned business from an Yes El I No agency other than the GSC? If es, lease provide the name of the certifying a enc . 6. Please indicate which group best describes the individuals who own at least 51% of the assets and interest and/or classes of stock and equitable securities. These individuals must demonstrate an active artici ation in the control, o eration and mane ement of firm's dail business affairs. ae Asian Pacific Americans (AS) Black Americans (BL) SPECIALNUTRITIOP PROGRAMS Hispanic Americans (HI) Native Americans NA) American Women O AY - P None of the above 7. Is our rime lace of business in Texas? S TEXAS DEPT OF HUMAN Yes No 8. , Has the Prime Contractor maintained or exceede#UgfpF;jpL0a QC6r total Yes ❑ No ❑ employment levels four consecutive years in any of the following categories of the U.S. Small Business Administration's size standards? • Financial and Accounting - $17,000,000 • Wholesale Commodities - 100 Full Time Employees • Medical and Other Services - $5,000,000 • Manufactured Commodities - 500 Full Time Employees 9. If Prime Contractor will NOT subcontract any portion of the contract/agreement, please check this box. Complete Form C-SSD if an contractla reement activities will be subcontracted. To the the above information to be true and complete. Date ~3 # l9t- SPECIAL NUTRITION PROGRAMS CHARITABLE CHOICE DATA FORM The information in this form is being requested to help the Texas Department of Human Service (TDHS) determine the approximate number of contracts it has with charitable and religious organizations. This information will assist TDHS in implementing Section 104 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 42 U.S.C. § 604a, and in providing more accurate information to the Governor's Office about the implementation of this section. This information will not be used to help select contractors or to favor or discriminate against any individual organization. You are not required to provide the information requested on this form. Electing not to provide the information requested in this form will not affect your contract with TDHS. Name of Organization Brazos County, Texas Address Phone Number 1904 West SH 21 Brysn, Texas 77803 (979) 823-3544 How did your organization find out about this contract? sent from the Area Program Manager for yearly renewal ❑ Texas Register ❑ Newspaper name of newspaper ❑ Magazine name of magazine ❑ Other contractor name of other contractor ❑ Other publication name of other publication SPECIAL NUTRITION PROGRAMS I a ':fila t ~r ❑ r ? M11Y 2. Is your organization a charitable or reli lous or aniza y- H M SERViuES 9 9 } t ~~pLW6~tLhat apply. ❑ Charitable ❑ Religious You are not required to provide the information requested on this form. Electing not to provide the information requested on this form will not affect your contract with TDHS. RETURN THE COMPLETED FORM TO YOUR SPECIAL NUTRITION PROGRAMS AREA PROGRAM MANAGER. N BRAZOS COUNTYJUVENILE SERVICES DEPARTMENT R. J. Holmgreen Brazos County Juvenile Justice Center 1904 West SH 21, Bryan, 7X 778o3 Phone: (979) 823-3544; Far. (979) 823-4211 Rhonda Gilchrist; Chief Executive April 28, 2003 Fernando Becerra, Jr., Area Program Manager Texas Department of Human Services Special Nutrition Programs, MC 017-3 1601 Rutherford Lane, Bldg. D-1 Austin, Texas 78754 Dear Sir: Enclosed is the completed application packet for participation in the National School Lunch Program/School Breakfast Program for school year July 1, 2003 thru June 30,2004. If there are any questions you may reach me at (979) 823-3544 or email me at oliviaPco.brazos txc us Sni tted, vro~ Olivia M. Body Food Services Manz SPECIAL NUTRITION PROGRAMS MAY 2003 TEXAS DEPT. OF HUMAN SERVICES AUSTIN FI@t6 OFFICE Texas Department of Human Services NONGOVERNMENTAL CONTRACTOR CERTIFICATION Forth 4732 September 1994 The Texas Department of Human Services (OHS) 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 for one 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-govemmental contractors for any type of contract must complete this certification. The contract, if 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 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 Xn No 2. A person who was a former DHS employee or board member whose last day of duty with DHS was within the past two years? ❑ Yes Xn No 3. A person who is related (see Relationship key below) to a current DHS employee or DHS board member? ❑ Yes )CE3 No 4. A person who is related (see Relationship key below) to a former DHS employee or DHS board member Xu is whose last day of service to DHS was within the past two years? ❑ Yes - No Wife Brother Stepdaughter Spouse's Sister RELATIONSHIP Husband Sister Stepson Spouse's Brother KEY Father Son Mother-in-law Mother Daughter Father-in-law IF YOU ANSWERED "YES" TO ANY OF THE ABOVE QUESTIONS FORM 4732-A. MAY _ 21112003 CERTIFICATION F G 1 certify that the information above is complete, true and correct t& ~6e"jnf ilknU +y~ ~n~JAAnd that lack of full, true and complete disclosure may be grounds for withholdingttpp*T*nF&[2I 7106~~services and may cause contract termination. Name of Potential Nongovernmental Contractor Contract No. Social Security No. or VIN Brazos County, Texas 75-61001 1743000430000 Signature- AuthorizVRepkeeentalive Date Print or Type Name Rand Sims Uj Texas Department SPECIAL NUTRITION PROGRAMS of Human Services SINGLE AUDIT IDENTIFICATION DIIATA For Program Year aC~ (SNP Use Only) Form 1569 March 2001 Contractor Name Contact Person Brazos County, Texas Olivia M. Body Address (Street or P.O. Box, City, State, ZIP) 1904 West SH 21 Bryan, Texas 77803 Telephone No. Texas ID No. (Payee ID No.) 0 Contract No. (979 ) 823-3544 174Ti~04330000 / g In 75_ 61001 Contractor Fiscal Year End (mm/dmyyyy) T I ype of tract 09/30/2003 ❑ For Profit ❑ Non-Profit a§ovemmental Check the appropriate box(es) to Indicate the type(s) of program(s) in which you currently participate or for which you are applying: COMMODITY ASSISTANCE PROGRAMS PROGRAM NOS. CASH REIMBURSEMENT PROGRAMS PROGRAM NOS. A - National School Lunch 021187A ❑ AD - Adult Day Care TX - ❑ B - Charitable Institutions BL- National School Lunch/Breakfast TX- 021-200 ❑ C - Area Agency on Aging ❑ CC - CACFP Center TX - ❑ G - Summer Camps ❑ DH - CACFP Day Home TX - ❑ H - Summer Food Service ❑ SF -Summer Food TX - ❑ J - Jails ❑ SM -Special Milk TX - ❑ I - TEXCAP ❑ TE - TEXCAP TX - ❑ CS -Commodity Supplemental Food Prog. I ❑ CS - Commodity Supplemental Food Frog. TX - Give the source and amount of any federal funds that your agency expends other than from those nrnnrnms gdo.i nr\n+ - SOURCE AMOUNT Criminal Justice NUTRITION PROGRAMS 300,000.00 D II W o inn o ILMU UL(1. VI IIVI\I!\I\ , SINGLE AUDIT EXEMPTION - I certify that I am not required to submit an audit underr theefSingle Audit Act for the following reason(s): ❑ 1 am a for-profit organization. ❑ I expend less than $300,000 annually In total federal funding. ® SINGLE AUDIT ASSURANCE - I understand that if I meet 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 adverse action, including the withholding of my Claim for reimbursement payments and termination of my contract. 1 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°dudit on an annual bHc'c ~o Name (please type or print) j Title - Randy Sims County Judge "IVN Texas Department of Human Services SPECIAL NUTRITION PROGRAM CERTIFICATION OF AUTHORITY Form 4508 May 2000 This Is to certify that the following person(s): Name of Authorized Representative (plea a or print) Title Olivia M. Body ood Service Mana er Si nature-Authorized Re res five Name of Authorized Representative (please type or print) Title Rhonda Gilchrist D" ector F X Si nature-Authorized a resentativ is are desi nated 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 department 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, TDHS, arelwill be true and correct in all respects, that they arelwill be completed according to the terms and conditions of existing agreements Including amendments, that records areWil be available to support any and all claims, and that we will not submit claims (excluding amendedladjusted 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 Agency (please type or print) Tdle Randy Sims Z2 Z-7 Co ud e X ature - Official of Contracting Agency 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 replacing or deleting an Authorized Representative, list the names of the individuals to be removed as Authorized Representative(s) below: Name of Deleted Representative Name of Deleted Representative Name of Deleted Representative E. A. Wentrcek, Jr. Alvin W. Jones SPECIAL NUTRITION PROGRAMS R;CXjVFOGRAMS MAY - 2 2003 TEXAS DEPT. OF HUMAN SERViutS FOR DHS USE ONLY AUSTIN FIELD OFFICE Rec ed By Date Re ived Contract No. 11 ©S oS 83 75- o0J >1~ f~~iLfi ht,k3 y 8 7 b CONSULTING AGREEMENT THIS AGREEMENT dated below, by and between Ben Sanford & Associates, Inc., hereinafter referred to as CONSULTANT, and Brazos County, Texas, hereinafter referred to as CLIENT. WITNESSETH WHEREAS, CLIENT is desirous of obtaining advice, counsel and assistance in the definition and solution of certain telecommunication problems it has now, or anticipates in the future, encountering; and WHEREAS, CONSULTANT possesses the experience, expertise, familiarity with the industry and capacity to fulfill said need of CLIENT, and is willing to assist CLIENT as herein described for the fee set forth; NOW THEREFORE, for and in consideration of these premises, the mutual promises and covenants contained, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: CLIENT HEREBY engages CONSULTANT for the period of six (6) months to render the CLIENT such consulting services as are more particularly described in the attached "Exhibit A", which services CONSULTANT agrees to render to CLIENT on the terms and conditions set forth. II CLIENT AGREES to pay CONSULTANT, for said consulting services, a fee as enumerated in "Exhibit B". CLIENT shall authorize CONSULTANT to deal with applicable vendors by written Letter of Agency. III A CREDIT CHARGE of two percent (2%) per month on the unpaid balance shall be charged to CLIENT on all invoices remaining unpaid for more than thirty (30) days, and all costs of collection, including reasonable attorney fees and expenses, shall be home by the CLIENT in the event any invoices are not paid in a timely manner. IV THIS AGREEMENT SHALL constitute the entire agreement of the parties, shall inure to the benefit of the parties hereto, their heirs and assigns forever, and any amendment, modification, or alteration shall be of no force and effect unless embodied in writing and executed by the parties concerned. Signatures below must be dated within sixty days of one another. Offered y: - 'S . X& - - Ben Sanford Ben Sanford & Associates, Inc. Company President 4/110/0-5 Title Date EXHHiIT A SERVICES TO BE PERFORMED HOURS 1. Toll Analysis 7 A. Current Contract Review B. Current Billing Analysis C. Review of Competing Proposal D. Vendor Negotiations E. Financial Analysis F. Report Preparation TOTAL HOURS 7 EXHIBIT B FEE SCHEDULE Fee is $125 per hour, plus expenses. These include travel, lodging, meals, long distance, postage, and other misc. out-of-pocket items. Automobile travel is $35 per mile. No travel is anticipated for this project. Fee for Services shall not exceed $875 (7 hours), plus expenses (estimated at less than $25), for a total of $900. Invoice shall be at completion of report. Any additional hours requested by Client shall be billed at the same hourly rate, plus expenses. CLIENT SHALL PROVIDE LONG DISTANCE BILL COPY AND ELECTRONIC USAGE FILE FOR THE MOST RECENT MONTH WITH STATISTICALLY AVERAGE USAGE. Initials OC2 BSA UZ~ Client / I' O BRAZOS COUNTY COMMISSIONERS' COURT ACTION FORM DEPAR T i:+IENT Road and Bridae NUMBER 560010 DATE OF COURT MEETING: April 22. 2003 ITEM: Request from Verizon to construct a road bore and 2.248 feet of parallel cable installation in the right of way of Luza Lane. Site is located in Precinct 4. SOURCE OF FUNDS: N/A 1) No work will be permitted between front slope and/or back slope. 2) All installation(s) shall be constructed in designated utility easements, if applicable. If no utility easement exists, the installation(s) shall be 1) within 3-5' of and parallel to the right-of-way line and/or 2) in the case of a road bore, perpendicular to the right-of-way line. 3) If clearing of brush, trees and other obstruction is necessary, it shall be the Applicant's responsibility to do so and to remove all cleared brush, trees etc. from county right-of-way. 4) Ditch line shall be compacted to 90% standard density ASTM-Test Method No. D-698; test shall be conducted by an independent geotechnical testing firm; copies of all test results shall be furnished to the office of the Brazos County Engineer. 5) Construction shall be in strict conformance to the latest Texas Manual of Uniform Traffic Control Devices for Streets and Highways, published by the Texas Department of Transportation, and all other State and Federal laws governing utility construction. NOTES/EXCEPTIONS: ACTION REQUESTED OR ALTERNATIVES: SUBMITTED BY: /row Rich F. Vance, P.E. County Engineer 0003-033 APP Precinct 4 Approved IP / 99eni Date: Randy S Carey Cauley Commissioners' Court Judge veriLon Engineering & Planning 301 Industrial Blvd. Bryan, TX 77803 April 11, 2003 Richard Vance Brazos County Engineering Office County Engineer 2617 W. Hwy. 21 Bryan, TX 77803 Dear Mr. Vance: Subject: AGRMNTS 24 BURIED CABLE Enclosed are From ED-135 and a work location sketch showing the location of our proposed communications cable line on county roads in Brazos County at Bryan, Texas. This work is to be completed on Work Order 5413 - 3P002EL which is scheduled for April 23, 2003. If you have any questions concerning this work, please contact Joe Young at our office in Bryan, telephone 979-821-4303 within 15 days so that we may explain of modify our proposal, otherwise, it is understood that this proposal is approved. Sincerely, Jo n Arnold Supervisor - Network Engineer JA:ec Attachment VERIZON COMMUNICATION Notice of Line instal/anon April 11, 2003 To The Commissioner's Court of Brazos County ATTENTION COUNTY JUDGE: Formal notice is hereby given that VERIZON COMMUNICATIONS will construct a communication line within the right-of-way of a County Road in Brazos County, Texas as follows: Verizon will bore under Luza Lane at a minimum depth of 36 inches at pole #18, which is in front of 3116 Luza Lane. We will then place a buried cable 0.79 inches in diameter along the northwest right-of-way for a distance of 2248 feet to L-10722 Pd 11. This cable will be placed 4 feet in the right-of-way at a minimum depth of 30 inches. We will abandon an existing 25 pair buried cable in place along this same route at the completion of this job. The location and description of this line and associated appurtenances is more fully shown by two (2) copies of drawings attached to this notice. The line will be constructed and maintained on the County Road right-of-way in accordance with governing laws. Notwithstanding any other provision contained herein, it is expressly understood that the tender of this notice by the Verizon Southwest Incorporated does not constitute a waiver, surrender, abandonment or impairment of any property rights, franchise, easement, license, authority, permission, privilege or right now granted by law or may be granted in the future and any provision or provisions so construed shall be null and void. Construction of this line will begin on or after April 23, 2003. VE ON COMMUNICATIONS 5413-3P002EL Joh Arnold Supervisor-Network Engineer 301 Industrial Blvd. Bryan, TX 77803 . *E l , Qichardonl t ° s c, (903) 729-5663 FAX (903) 731-4210 800-382-3624 www.chamberbuilders.com email: radvl@eardilink.net 1hs map has been Prepared from the most seliabln infonsutian available from store and local Ml =T. r omissions brought to our allmdon will be appreciated anbe eubseq= editions. Copyright ® 2002 by Richardson Advertising and Publishing. Reproduction without permission of the publisher is a violation of fedeM law. eoa ~,,1•.,y c~ ~2 F SEE WP- 1 g .`v F~ ~ s ~ at F 1 ~i m m aN y~ 6 • 4 m. C i p g D ' w " N O ° p 11 S 1 I n ¢ O ~ F a rF 1 i a 1 , ■5 S q T , z 1 fl a I 4. 3 C , j !j j! 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L H `J S U7 4 II o- a ~ a ` i { 6 Q co z Q N 1Y gF 0 3 b ~t J Q Q J J O g ~ y( d bi Y a ~W > w U a LLJ U M LL, M =8 q y ; J vi Co L I O O g ~3 <g Lf`QLLt Jg $ ab 8 O L x J m ,s x ~ab! NW~~ U$ ~8 ~ ~ £ a . N ( p kY~ JJ 4Q SW ~ W y 0 i <J O y . W cr Q i Op y~ Q Z C G S W.. SY V S 1- ' I O 0IC' H .T p ~br asb* :.0d O Z . .V rn BRAZOS COUNTY COMMISSIONERS' COURT ACTION FORM DEPARTMENT Road and Bridge DATE OF COURT MEETING: April 22. 2003 ITEM: Request from Patterson Petroleum LP to construct a road bore to install a produced water gathering pipeline in the right-of-way of Oak Lake Road approximately 6,705 feet from FM 2038. Company Check No. 1420 in the amount of $500.00 accompanies this reguest. Site is located in Precinct 2. (Deposit to account no. 01-460650) SOURCE OF FUNDS: REQUIREMENTS: A) No work will be permitted between front slope and/or back slope. B) All installations shall be constructed in designated utility easements, if applicable. If no utility easement exists, the installation(s) shall be 1) within 3-5' of, and parallel to the right-of-way line and/or 2) in the case of a road bore, perpendicular to the right-of-way line. C) If clearing of brush, trees and other obstruction is necessary, it shall be the Applicant's responsibility to do so and to remove all cleared brush, trees, etc. from county right-of-way. D) Ditch line shall be compacted to 90% standard density ASTM-Test Method No. D-698; test shall be conducted by an independent geotechnical testing firm; copies of all test results shall be furnished to the office of the Brazos County Engineer. E) Construction shall be in strict conformance to the latest Texas Manual of Uniform Traffic Control Devices for Streets and Highways, published by the Texas Department of Transportation, and all other State and Federal laws governing utility construction. II. ACTION REQUESTED OR ALTERNATIVES: SUBMITTED BY Richard F. Vance, P.E. County Engineer 0003-032 Approved L7 Z/ Denied C b Commissioners Date: <L/o2o7/!!~ APPROVED BY: 0 0- - 45~~ Commissioner Duane Peters Precinct 2 Court Randy Sim3!County Judge REQUEST FOR PROPOSED INSTALLATION IN COUNTY RIGHT-OF-WAY TO THE COMMISSIONERS' COURT OF BRAZOS COUNTY, TEXAS BRAZOS COUNTY COURTHOUSE BRYAN, TEXAS 77803 FROM: REF: Patterson Petrole>nn Lp CrossingZ_ and/or Parallel Installation _ 654 N Sam Houston Pkwy E #330 Road: Oak lake Road Pnncrnn, TPYAC 77nan Precinct Number: 2 Formal notice is hereby given that (applicant) Patterson Petroleum proposes to place a (type) Produced Water Gathering pipeline within the right-of-way of (road)- Oak Lake Road in Brazos County, Texas as fOllow5:6705' fran FM 2038, a 6.5" cased road bore crossing that will contain a 3.5" Poly pipeline. The location or description of the proposed installation is more fully shown by three copies of the drawings attached to this notice. I understand and agree: 1. The County Engineer must be notified prior to the beginning of construction in order that a designated inspector may inspect the actual installation. 2. That all damage to the roadways and right-of-ways will be repaired to their original condition to the satisfaction of the County Engineer. 3. That Brazos County reserves the right to require Applicant to relocate or lower any such line at no cost to Brazos County, should same become necessary due to widening or lowering, or other alteration of the roadway or right-of-way. 4. That Brazos County will in no way be responsible for any damage which may occur to any existing utility lines in the right-of-way. 5. That the line will be constructed and maintained on the County right-of-way in accordance with the Utility Accommodation Policy which was adopted by the Texas Department of Transportation on May 29, 1989. 6. That the line or lines will be constructed no less than forty-eight inches (48") lower than the lowest part of the drainage or bar ditch and the drainage is to be considered at least two feet (2') below the center of the roadway. 7. That all roads shall be bored in accordance with the Utility Accommodation Policy of the Texas Department of Transportation dated 1989. 8. That all sites will be barricaded during the construction period. 9. That the normal charge is $500.00 per crossing and/or $40.00 per rod when paralleling the roadway established by the Commissioners Court on January 28, 1985. 10. Ditch line shall be compacted to 90% standard density ASTM-Test Method No. D-698; test shall be conducted by an independent Geotechnical testing firm; copies of all test results shall be furnished to the office of the Brazos County Engineer. 11. Construction shall be in strict conformance to the latest Texas Manual on Uniform Traffic Control Devices for Streets and Highways, published by the Texas Department of Transportation, and all other State and Federal laws governing utility construction. Construction of this line will begin on or after the 28 day of April 2003 APPROVED BY COMMISSIONERS' APPLICANT: COURT ON: ZZ Patterson Petroletun LP Date Company Name Harrold Smith Engineer o `6~ Honarab Rarndy Sims Company Representativerritle County udge 281-591-1381 Telephone Number Peer 2 04-11-03 e efZor0 jQ~ 44 t 6( lvoreo.4 OAK LAKE ROAD CROSSING R/W I Warning Sign 4'- 0" Min. Warning Sign 4'- 0" Min. / Pipeline - 6 1/2" 0180 Wall API 5LX42 MEASURED WIDTH OF COUNTY ROAD RIGHT OF WAY PROFILE Patterson Petroleum LP f 6y: HD Smith Oak Lake Road Crossing 2003 Brazos County, Texas 65' Oak Lake Road 2'- 0" Min. R/W I 0 D 7 ~i C. _ \h i Pipeline will cross Oak Lake Road approximatly 6705' East of FM 2038. Easement is 30'. Patterson Petroleum LP Prepared By: HD Smith Oak Lake Road Crossing April 10. 2003 Brazos County, Texas 43 U` .5Km 0' '.25Mi Pipeline will cross Oak Lake Road approximatly 6705' East of FM 2038. Easement is 30'. Patterson Petroleum LP Prepared By: HD Smith Oak Lake Road Crossing April 10, 2003 Brazos County, Texas (00 " 1Km 0. '.5011