HomeMy WebLinkAbout2006-05-16-6:00PM-REGULARBRAZOSCOUNTY
BRYAN, TEXAS
NOTICE OF MEETING
AND AGENDA
BRAZOS COUNTY COMMISSIONERS COURT
THE COMMISSIONERS COURT OF BRAZOS COUNTY WILL MEET IN REGULAR
SESSION ON 16 MAY 2006 AT 6:00 P.M. IN ROOM 102 OF THE BRAZOS CENTER,
3232 BRIARCREST DRIVE, BRYAN, TEXAS.
1.--Invocation and Pledge of Allegiance - Commissioner Mallard
2. Call for citizen's input and/or concerns.
Consider and take action on agenda items 3 - 21:
3. Budget Amendment 05/06-32.1 thru 05/06-32.5.
4. Permission to move the following positions in the Juvenile Services Department as
follows, with
approval from the Brazos County Juvenile Board and no change in salary:
a. from:
Division 31050000 (Title IV-E), Class 1827, Group 14, Step 4, Prevention
Specialist, Position 1;
to:
Division 316100 (Community Corrections), Group 14, Step 4, Prevention
Specialist.
b. from:
Division 31050000 (Title IV-E), Class 1827, Group 14, Step 3, Prevention
Specialist, Position 2;
to:
Division 316100 (Community Corrections), Class 1827, Group 14, Step 3,
and renamed Juvenile Detention Officer.
c. from:
Division 316100 (Community Corrections), Class 1879, Group 14, Step 7,
Surveillance Officer, Position 1;
to:
Division 31050000 (Title IV-E), Class 1879, Group 14, Step 7,
Surveillance Officer.
d. from:
Division 316100 (Community Corrections, Class 1879, Group 14, Step 9,
Surveillance Officer, Position 1;
to:
Division 31050000 (Title IV-E), Class 1879, Group 14, Step 9,
Surveillance Officer.
Office of the County Judge . 300 East 26' St. • Suite 114 • Bryan, Texas 77803 . Fax: (979) 361-4503
10L_36 PAGE 5D
Commissione. ^nrt Agenda
to ,,.-2006
.".I
5. Personnel Change of tatus.
6. Payment of Claims.
Contract with the Texas Health and Human Servu,cs Commission for the Brazos County
Detention Center's participation in the National School Lunch Program for the 2006-
2007 academic year. Contract term is 1 July 2006 through 30 June 2007.
8. Contract with Service-Now.com, Inc. for incident tracking and asset management
software. Contract term is 1 June 2006 through 31 May 2008.
9. Service Agreement renewal with Appriss, Inc., provider of the Texas Automated Victim
Notification Service (VINE). This renewal extends services through 31 August 2006.
10. Sole Source status for Insight Public Sector, Inc. for the purchase of five digital in-car
video systems by the Sheriffs Office, and installation.
11. Authorization for the use of LLEBG funds and JAG funds for the purchase of five digital
in-car video systems by the Sheriffs Office, and installation. Estimated cost of five
digital units with software, licenses and installation is $31,098.25.
12. Permission to accept the following items donated by The Bun Company to the Brazos
County Jail:
a. 3,000 chicken sandwich buns.
13. Tax Refund Applications for the following:
a. Chris Camper (2) e. Southwest Petroleum Co.
b. Dorothy T. Hilliard f. Tyler N. & James W. Hayes
c. Matthew Thomas & Terry Moore g. Paul Timmons & Diana George
d. Madolyn Smith
14. Renewal of Bid #2005-029R, Office Supplies, with Wilton's Office Works for an
additional year at the same cost or less for the term of 30 June 2006 through 29 June
2007. The new bid number will be 2006-030R.
15. Approval of the following Committee for the selection of RFP 2006-027, Delinquent Ad
Valorum Tax Collection Service:
Kathy Davidson, City of Bryan
Buddy Winn / alternate Kristi Roe, Brazos County Tax office
Jeff Kersten, City of College Station
Mike Ball / alternate Paul Jackson, College Station Independent School District
Commissioner Carey Cauley, Brazos County
Commissioner Lloyd Wassermann, Brazos County
16. Requisition 00009039 to Insight Public Sector, Inc. in the amount of $31,098.25 for the
purchase of Arbitrator Digital In-Car Video Systems and related costs.
'VOL 90 PAGE 5/
Commissioners Caurt Agenda
16 May 2006
Page 3
17. Co._ ?ssioners Court minutes for the following 2006 dates:
a. 7 March ci; ,6
b. 8 March 2006
c. 14 March 2006
Regular Meeting
`.'i O-kshop Session
Regular i:`•^eting
d. 21 March 2006
e. 21 March 2006
f. 28 March 2006
Regular Meeting
Workshop Session
Regular Meeting
18. Treasurer's Reports for the Month of March 2006, and the Quarter ending 03/31/2006.
19. Request from Wickson Special Utility District to construct five (5) road bores and 3,600
ft. of 12 inch PVC water line in the right of way of Rock Prairie Road and I&GN Road.
Site is located in Precinct 1.
20. Amending plat of Deer Park Subdivision, lots 17-R and 18A-R, block 1, 19.438 acres,
Sterrett D. Smith survey, A-210, Brazos County, Texas. Site is located in Precinct 1.
21. Payment authorization in the amount of $1,049.62 to US Food Service for the purchase of
miscellaneous food items for the Jail. The invoice exceeded the purchase order amount.
22. Announcement of interest items and possible future agenda topics.
23. Call for citizen input and/or concerns.
24. Agency / Board / Committee reports by Court members.
25. 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.
!0L 90 PAGE 5a
COMMISSIONERS' COURT
REGULAR MEETING
MAY 16, 2006
A regular meeting of the Commissioners' Court of Brazos
County, Texas was held in the Brazos Center 3232 Briarcrest
Drive, in Bryan, Brazos County, Texas, beginning at 6:00 p.m.
on Tuesday, may 16, 2006 with the following members of the
Court present:
Randy Sims, County Judge, Presiding;
Lloyd Wassermann, Commissioner of Precinct 1;
Duane Peters, Commissioner of Precinct 2;
Kenny Mallard, Commissioner of Precinct 3;
Carey Cauley, Jr., Commissioner of Precinct 4;
Karen McQueen, County Clerk.
The attached sheet contains the names of the citizens and
officials that were in attendance.
Commissioner Mallard gave the invocation and led the
pledge of allegiance.
There was no citizen input/and or concerns.
The Court next considered Budget Amendment #05/06-32.1
through 32.5, which would reallocate funds for the 85th
District Court, District Clerk Collections, and Information
Technology Department; increase the budget of the Law
Enforcement block Grant; and swap two positions between two
divisions in Juvenile Services. On motion by Commissioner
Cauley, seconded by Commissioner Peters, the Court voted
Vol 96 Page 03
Commissioners Court meeting May 16, 2006
2
unanimously to approve the budget amendment as submitted, a
copy of which is attached.
The next matter before the Court was a request from the
Director of the Juvenile Services Department to reclassify
four (4) positions in the department. The Brazos County
Juvenile Board has approved the reclassifications and will
result in no increases to the budget. On motion by
Commissioner Peters, seconded by Commissioner Cauley, the
Court voted unanimously to approve the reclassifications. A
copy of the request is attached.
The Court proceeded to consider the change of status of
employees as submitted on the attached Personnel Action
Requests. On motion by Commissioner Cauley, seconded by
Commissioner Mallard, the Court voted unanimously to approve
the change of status as submitted.
The Court next considered the following Claims as
submitted by the County Treasurer for payment:
7019226 through 7019516
On motion by Commissioner Peters, seconded by Commissioner
Wassermann, the Court voted unanimously to approve the Claims
as submitted.
The next matter before the Court was consideration of a
contract with the Texas Health and Human Services Commission
Vol 90 Page 5q
Commissioners Court meeting May 16, 2006 3
for the Brazos County Detention Center's participation in the
National School Lunch Program for the 2006-2007 academic year.
On motion by Commissioner Wassermann, seconded by Commissioner
Cauley, the Court voted unanimously to approve the contract
and authorized the County Judge to execute the document. A
copy is attached.
The next matter before the Court was approval of a
Contractual Agreement between Brazos County and Service-Now,
Inc. for Incident Tracking and Asset Management Software. The
cost to Brazos County will be $15,960.00. The term of the
contract is for twenty-four (24) months commencing on June 1,
2006 and terminating May 31, 2008. On motion by Commissioner
Cauley, seconded by Commissioner Peters, the Court voted
unanimously to enter into contractual agreement with the
Service-Now, Inc. A copy of the contractual agreement is
attached.
The Court next considered a Service Agreement renewal
with Appriss, Inc., provider of the Texas Automated Victim
Notification Service (VINE). The renewal extends through
August 31, 2006. The cost to Brazos County will be $25,880.00.
On motion by Commissioner Cauley, seconded by Commissioner
Peters, the Court voted unanimously to approve the renewal. A
copy is attached.
Vol qo Page $S
Commissioners Court meeting May 16, 2006 4
The Court next considered a request from the Sheriff's
department to designate Insight Public Sector's Arbitrator as
a sole source vendor for digital in-car video systems that
will enable administrators and prosecutors to view original
digital images captured by the in car video cameras. The
system appears to be the only product that has that capacity
and has compatibility with the Panasonic mobile data computers
that are installed in the Sheriff's Office patrol vehicles.
On motion by Commissioner Cauley, seconded by Commissioner
Mallard, the Court voted unanimously to approve the request
and recognize Insight Public Sector as a sole source vendor.
The Court next considered a request from the Sheriff's
department for approval to use LLEBG funds and JAG funds for
the purchase of five (5) digital in-car video systems plus
installation. The Systems will enable administrators and
prosecutors to view original digital images captured by the in
car video cameras. Insight Public Sector's Arbitrator System
appears to be the only product that will provide that
capability and have compatibility with the Panasonic mobile
data computers that are installed in the Sheriff's Office
patrol vehicles. On motion by Commissioner Peters, seconded
by Commissioner Wassermann, the Court voted unanimously to
approve the request to purchase the systems and have them
Vol 90 Page 54~
Commissioners Court meeting May 16, 2006
installed.
5
The Court next considered authorizing acceptance of
donated property from the New Southwest Baking Company. The
Sheriff's Office has been offered 3,000 chicken sandwich buns
with an estimated value of $360.00. On motion by Commissioner
Cauley, seconded by Commissioner Peters, the Court voted
unanimously to accept the donated property.
The next matter for consideration was approval of tax
refund applications from the following individuals and/or
companies:
a) Chris camper (2), Over Payment $50.43 & $25.00
b) Dorothy T. Hilliard, Over Payment $147.30
c) Matthew Thomas & Terry Moore, Over Payment $60.62
d) Madolyn Smith, Over Payment $15.05
e) Southwest Petroleum Co., Over Payment $34.42
f) Tyler N. & James W. Hayes, Over Payment $62.04
g) Paul Timmins & Diana George, Over Payment $242.64
On motion by Commissioner Peters, seconded by Commissioner
Cauley, the Court voted unanimously to approve the tax refund
applications.
The Court next considered the renewal of Bid #2005-029R,
Office Supplies, with Wilton's Office Works for an additional
year from June 30, 2006 through June 29, 2007 and at the same
cost or less. On motion by Commissioner Cauley, seconded by
Commissioner Peters, the Court voted unanimously to renew the
bid with the new bid number of 2006-030R.
Vol 8o Page 57
Commissioners Court meeting May 16, 2006
6
The next matter before the Court was the selection of
individuals to serve on the committee for the selection of RFP
#2006-027, Delinquent Ad Valorum Tax Collection Service. On
motion by Commissioner Peters, seconded by Commissioner
Cauley, the Court voted unanimously to appoint the following
individuals to serve on the committee:
Kathy Davidson, City of Bryan
Buddy Winn/Kristi Roe (Alternate), Brazos County Tax
Office
Jeff Kersten, City of College Station
Mike Ball/Paul Jackson (Alternate) College Station
Independent School District
Commissioner Carey Cauley, Jr., Brazos County
Commissioner Lloyd Wassermann, Brazos County
The Court next considered approval of a requisition to
Insight Public Sector, Inc. in the amount of $31,098.25 for
the purchase of Arbitrator Digital in Car Video Systems. On
motion by Commissioner Peters, seconded by Commissioner
Wassermann, the Court voted unanimously to approve the
requisition.
The Court next considered approval of the minutes of the
Commissioners' Court meetings held in March 2006 on the
following dates:
Regular Meetings - 7th, 14th , 21st, 28th
Workshop Meeting - 8th, 21st
On motion by Commissioner Cauley, seconded by Commissioner
Peters, the Court voted unanimously to approve the minutes as
Vol ~ Page 58
Commissioners Court meeting May 16, 2006 7
submitted.
On motion by Commissioner Peters, seconded by
Commissioner Wassermann, the Court voted unanimously to
receive, approve and order filed as submitted the Treasurer's
report for March 2006. A copy is attached to and made a part
of these minutes.
The Court next considered the request from Wickson Creek
Special Utility District to construct five (5) road bores and
3,600 feet of 12 inch PVC water line in the right-of-way of
Rock Prairie Road and I&GN Road. The site is located in
Precinct 1. The County Engineer stated that all appeared to be
in order and recommended approval. On motion by Commissioner
Wassermann, seconded by Commissioner Cauley, the Court voted
unanimously to approve the request from Wickson Creek Special
Utility District and authorized the installation. A copy of
the request is attached hereto.
The Court next considered approval of the Amending Plat
of Deer Park Subdivision, Lots 17-R and 18A-R, Block 1, 19.438
Acres in Precinct 1. Richard Vance, County Engineer, stated
that he had reviewed the plat and found it to be in order. On
motion by Commissioner Wassermann, seconded by Commissioner
Peters, the Court voted unanimously to approve the Amending
Plat of Deer Park Subdivision, Lots 17-R and 18A-R, Block 1,
Vol 90 Page S.7
Commissioners Court meeting May 16, 2006
19.438 Acres as submitted.
8
The next matter before the Court was consideration of a
payment authorization in the amount of $1,049.62 to the US
Food Service for the purchase of miscellaneous food items for
the jail. The invoice exceeded the purchase order amount. On
motion by Commissioner Peters, seconded by the County Judge,
the Court voted unanimously to approve the payment
authorization.
Under announcement of interest items and possible future
agenda topics the following spoke:
Commissioner Cauley
a) Introduced his soon to be son-in-law to the
Court.
Under citizen input and/or concerns, the following
spoke:
Constable Precinct 2, Donald Lampo
a) Announced that the Kurten Community Center is
having a Kids Fair on Saturday from 9:00 a.m. to
5:00 P.M.
Under Agency/Board/Committee reports by Court members,
the following spoke:
Commissioner Mallard
a) Yesterday the Intergovernmental Committee (IGC)
met. Brazos Beautiful addressed the group about
litter on the roadways.
b) They discussed the EOC and they are attempting
to finalize all the legalities.
Vol 8D Page (00
Commissioners Court meeting May 16, 2006 9
c) There will be a ceremony for Law Enforcement
tomorrow at noon in College Station.
There being no further business to come before the
Court, the meeting was adjourned.
Vol 8a page (Ql
The foregoing minutes of the Commissioners Court meeting held
May 16, 2006 have been examined and are approved in open Court
this the day of ( 2006, in Bryan, Brazos
County, Texas.
Randy
County
IOU - C L
Duane Peters
Commissioner, Precinct 2
rey C ule , Jr.
Commiss oner, Preci ct 4
Attest•
a n McQueen
County Clerk
Q„z LtJCL[Ll.~ /ti(k sw~
Lloyd ssermann
Commissioner, Precinct 1
Kenny Malla
Commissioner, Precinct 3
Vol 86 Page 6a
BRAZOSCOUNTY
COMMISSIONERS COURT
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VOL 0 PAGE 63
BRAZOS COUNTY
COMMISSIONERS COURT
/&_~L_ DAY OF ,
20" AT 41 M
Name
Organization
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VOL X-0 PAGE Gq
piC OF
BRAZOS COUNTYJUVENILE SERVICES DEPARTMENT
Holmgreen Brazos Coun0 Juvenile Justice Center
1904 :6-rs'.M 21, Bryan, TX 77803 /
"ry o r epa Phone: (979),;-'? 3544, Fax: (979) 8234211
Doug Va Q ~V
Collin A.
MEMO
TO: Brazos County Commissionerr's Court
FROM: Doug Vance, Director D V
DATE: May 11, 2006
RE: Reclassification of Positions
I respectfully request to move the Prevention Specialist position (Class 1827, Position
1) from Division 31050000-Title IV-E to Division 316100-Community Corrections. There
j will be no change in salary and the position will continue to be funded at a Group
14, Step 4.
respectfully request to move the Prevention Specialist position (Class 1827, Position
2) from Division 31050000-Title IV-E to Division 316100-Community Corrections, and
rename the position Juvenile Detention Officer. There will be no change in salary
and the position will continue to be funded at a Group 14, Step 3.
I respectfully request to move the Surveillance Officer position (Class 1879, Position
1) from Division 316100-Community Corrections to Division 31050000-Title IV-E. There
C will be no change in salary and the position will continue to be funded at a Group
14, Step 7.
I respectfully request to move the Surveillance Officer position (Class 1879, Position
1) from Division 316100-Community Corrections to Division 31050000-Title IV-E. There
will be no change in salary and the position will continue to be funded at a Group
14, Step 9.
These reclassifications were approved by the Brazos County Juvenile Board during a
regular meeting on May 8, 2006. The Juvenile Detention Center is understaffed.
These changes will enable the department to better meet the staffing needs of the
Juvenile Detention Center, however, since two of these employees are paid from
Title IV-E funding, they cannot work in the detention center unless the funding
source for their salary is changed. As compared to 2005, the detention center's
average daily population has increased from 34 residents to 36 residents, and the
average length of stay has increased from 12 days to 13 days. This would also help
alleviate comp hours being accrued by detention staff which is approximately 500
hours since the beginning of the fiscal year.
xc: Brazos County Auditor
11GL 8o PAGE 65
BRAZOS COUNTY, TEXAS
BUDGFT AMENDMENT(S) FOR THE 2005-2006 BUDGET YEAR
NO. 05/06-32.1 thru 05/06-32.5
On this the 16'h day of May 2006 at a regular meeting of the Commissioners' Court, the following
members were present:
Randy Sims, County Judge, Presiding
Lloyd Wassermann, Commissioner, Precinct 1
E. Duane Peters, Commissioner, Precinct 2
G. Kenny Mallard, Commissioner, Precinct 3
Carey Cauley, Jr., Commissioner, Precinct 4
Karen McQueen, County Clerk
The following proceedings were held:
THAT WHEREAS, on 16 May 2006 the Court heard and approved a budget amendment for the
2005-2006 budget year for Brazos County, Texas; and
WHEREAS, an expenditure is necessary due to the necessity to meet unusual and unforeseen
conditions which could not be reasonably included in the original budget adopted 20 September 2005, the
following amendment(s) to the original budget are hereby authorized, as described on the attached page(s).
ADOPTED AND APPROVED this the 16'h day of May 2006.
THE COMMISSIONERS COURT OF BRAZOS COUNTY, TEXAS.
By
Original: County Clerk's Office and
attached to the original budget
Copies: County Auditor
County Treasurer
Commissioners' Court Minutes
VILL O~ i'9t(a€
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 05/06 - 32.1
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
0100
22000100
61931000
CR
Visitin Jud es
1,000.00
0100
22000100
52500000
DR
Contract Services
1 _o0o w
85th District Court:
To reallocate funds to contract services line item so that a temporary art-time bailiff
can substitute as needed.
VOL 90 FAGL V
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 05/06 32.2
5/16/2006
"jot ~0 PAGE_ V
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 05i05 - 32.3
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
10100
1 1
48047300
CR
Law Enforcement Block Grant
500.00
0100
285000
80890000
DR
Vehicle
500.00
Enforcement
To increase the budget of both revenue and expenditure line items for the grant based on the
estimated funds available for spendine conducted recently.
AL %0 PAGE V
BRAZOS.COUNTY, TEXAS
BUDGET AMENDMENTS
No. 05/06 - 32.4
5/16/2006
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
3000
316100
51610000
31610600
CR
Hourly - Staff
2,443.00
3000
316100
53100000
31610600
CR
Social Security
103.00
3000
316100
53101000
31610600
CR
Flex Fee
2.00
3000
316100
53200000
31610600
CR
Retirement
268.00
3000
316100
53300000
31610600
CR
Employee Health Insurance
210.00
3000
316100
53320000
31610600
CR
Employee Dental Insurance
3.00
3000
316100
53800000
31610600
CR
Worker's Compensation
9.00
0100
3105000
51610000
DR
Hourly - Staff
2,443.00
0100
3105000
53100000
DR
Social Security
103.00
0100
3105000
53101000
DR
Flex Fee
2.00
0100
31050000
53200000
DR
Retirement
268.00
0100
3105000
53300000
DR
Employee Health Insurance
210.00
0100
3105000
53320000
DR
Employee Dental Insurance
3.00
0100
31050000
53800000
DR
Worker's Compensation
9.00
0100
49029000
CR
Transfer from Grant Fund
3,038.00
3000
91300000
DR
Transfer to General Fund
3,038.00
Juvenile Services:
To move the budget between two divisions funds for swapping two budgeted positions
between two divisions.
7' PAGE7D
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 05/06 - 32.5
5/16/2006
FD
DIV
ACCT
PROD
DR/CR
ACCOUNT NAME
Increase
Decrease
0100
1400010
80211000
CR
Computer Software
3,351.00
0100
14000100
67203000
DR
Minor Computer Hardware
3.351.00
I ITo reallocate funds for the purchase of a new server. I I I
0L S0 PAGE]]
PERSONNEL
CHANGE OF STATUS REQUESTS
Commissioner Court Date: May 16, 2006
Department Submitting Information: Human Resources
Pumose of Submissions: Consider and Take Action on Change Requests
Department Submitting Employee Request Action Requested
Request(s) Applies To
County Clerk Rincon, Cynthia Transfer within Dept.
Elliott, Victoria Transfer within Dept.
CCL #1
Rodriguez, Antoinette
Resignation
District Attorney - Crime Fund
Hunter, Ginger
New Hire
District Clerk - Collections
Zavala, Margarita
Norton, Christy
Transfer to Another
Dept.
New Hire
SO/Jail
Holmes, Allen
Flores, Gabriel
Transfer within Dept.
New Hire
Tax Office
McBride, Lillian
Resignation
Approved in Commissioners' Court: May 16, 2
County Judge's or Commissioner's Signature:
(This Copy to be attached to minutes)
JOL CIA PAGE 7a
Texas Hearth and Human
Services Commission National School Lunch Program and School Breakfast Program
Application for Participation and Policy Statement
School Program Year: July 1, 2006 through June 30, 2007
B, Grade Levels Taught (schools only)
Part 1- Application
Texas ID No.
Contract No.
Program No.
17460004330000
75 61001
TX 021 - 2001
Name of School Food Aut city
Contact Person
Brazos County, Texas
Patrick Munoz
Address (Street or P.O. Box, City, State, ZIP)
1904 SH 21 West Bryan, Tx. 77803
Telephone Number
Fax Number
Email Address
( 979 ) 82&3544
( 979 ) 8234211
pmuraz@co.brazos.lx.us
Name of School/Facility (t more than one site, complete HHSC Form H16D9 for each site.)
Brazos County Juvenile Detention Center
School Address (if ddiereM from School Food Authorhy add ass)
Telephone Number
Type of SchooUFacility, (check all that apply)
Child
School ®
❑ Day School ❑ Boarding School ❑ bl
Sd
❑ Day Schod and
Care Institution
dhoo
ing S
and Boardd
Residential Child Care Institution
❑ Special Education School ❑ Aftersc col Care Snack Site ❑ Other (spealy):
School/Residential child care Institution (RCCI) is:
® Pudic ❑ Private c~, If'Pdvate is the school/RCCI nonprofit and tax exempt ❑ Yes
❑ No r> 9'Yes; atadh copy of
under the Internal Revenue Code of 1954?
letter from the IRS.
Total Enrollmhentfor AN SdhoolslRCCls b
44
TrialNumberdAlISchodsRCCls
b of
Administered by Food Autnortty:
Administered School Food
1. Is the above sc hraresrdeirUchid care institution licensed? (t yes, attach copy of license.) ❑ Yes ® No
2. Program(s) that you are applying for.
® National School Lunch Program
❑ Afterschool Care Snack program (must be participating In National School Lunch Program)
® School Breakfast Program
® Severe Need School Breakfast Program Rates' ' A"llabie to eclhooblrasidwits chid cake Ihatllutlorhs meeting the blbwi g e iptdlity aileda:
1. 40% or mom total troches served In aeoahd preceding yaarwere free or redhroad price,
2. Brmldastaaaexarariftregularmi burtemerdralesavai"wilertheSdadBrealdestftgram.
❑ Seamless Summer Program - Specify Program Year. May 1, through September 1,
Note: Form H1612 must to completed fo each Seamless Summer Site.
NwWdMmft ftimigDalsoloperatiorh Ending Date of opararon
3. Number of months the school will be operating a food service program: 12 07/0112006 0VjVW
4. Number d children enrolled at sdhoolhssidential child care Institution: 44
A. Age Range of Children Enrolled
Fmm• 10
5.
To: 16 From:
To:
Average Daily Participation of Children in Program
T'mhes of Food Service
Food Service:
Free
Reduced Price
Paid
Bunning
Endirhg
Breakfast
44
7 A.M.
8 A.M.
Lunch
44
12 P.M.
1 P.M.
Area Eligible Afterschool Care Snack
Not Area Eligible Aftersdho l Care Snack
6. Attendance (for residential child care Institutions only)
A. Are ail of the children at the institution all day?
t no, do all or some of the children attend public school?
If only some attend public school, how many?
N some or all attend public school, which meals do these student eat at the institution? ❑ Breakfast
B. Chedk if the children attend the institutor on holidays and/or wee/kends
® Yes ❑ No
❑ Al ❑ Some
❑ Lunch ❑ Afterschool Snack
® Holidays ® Weekends
'r 0A
.UL 6- PAGE J,3'
7. Type of Meal Service
A. Meal Preparation
® On-Site IOtchen ❑ Central Kitchen ❑ Food Service Management Company
(submit copy of contract and checklist)
❑ Other (explain):
Form N1610
Page 2(03-2006
❑ Vended Meals
(submit copy of agreement)
B. Meal Planning System
❑ Enhanced Food Based ® Traditional Food Based ❑ Nutrient Standard Menu ❑ Assisted Nutrient Standard Menu Planning
Planning (NSMP or NuMenus) (ANSMP or Assisted NuMenus)
(See instructions for documents to submit.)
❑ Other(explain):
Note: Snacks served in the Aftenichod Care Snack program mustfolow the food based supplement pattern regardless of your menu plarmiii malhod forWealdast and/or lunch.
8. Ty
9.
❑ Separate Charges ® No Separate Charge; Cost of Meals is Included
Made for Meals in Required Payment PIanlFee
❑ Co Ana Separate Charges and
Charges
Daily Price Charged for Each Meal
CHILDREN
ADULTS
(for programs that vnll charge separately only):
Reduced Price
Pad
Breakfast
Lunch
Not Area Eligible Aftersdad C-are-Snack
Note: Area Eligible Afterschool Care Snack program sites must VWde sracks frce of charge 10 al students pa*ipalkV in the afor school care program
10. A. If applying for tike National School Lunch Program, indicate whether Offer versus Serve will be implemented:
High Schaal (mardaory) Junior High (optional) &Wrenary (options) Preschool (aptiahal) Residential Child Care Institution (0**
❑ Yes ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ® No
B. 0 applying for the School Breakfast Program, indicate whether afar versus Serve will be implemented:
High School (optional) Jun10r High I ctionaQ Elementary (optiorhaq Preschool (options) Residential Child Care Institution (ophona~
❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes 0 No
11. Describe your training in food service program requirements for personnel (use an attachment ff necessary):
Kitchen staff is tasked annually with the NSLP and USDA Civil Rights cunicWum. They are also provided food h andIM training through the 10081 health
danartmant. Thane is also soedtic trainina completed in areas of safely, equipment maintenance as well any NSLP updates. Staff are all trained In areas of meal
nattems. portion sites and meal count Drodudion documentation, record keeping, and other areas deemed necessary.
12. Will supplemental (a 10 carte or snack bar) food service be available in addition to the school lunch? ❑ Yes ® No
Questions 13 through 18 apply only to the Afterschool Care Snack program.
13. How will the school food authority operate the after schod care program? ft nonsdhocl parsonrhs, what organ zsion's rasp msible fa day today aphaetiahs?
❑ Will Use School Personnel ❑ Will Use Imo-school Personnel:
14. Total number of shes administered by SdW Food Authority offering the Afterschool Care Snack program
15. Is atendance in after school core program limited to students enrolled in your schooVRCCI?
N no: In which individual pudic schodattendance area (not district) is the site located? _
Note: You must attach an Information stalemart from the ISO (see instructions).
16. Indicate your schooVRCCI or the pudic 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
16. Licensing (for schools only)
A. Is a Texas Child Care License required for your after school care program? ❑ Yes ❑ No
If yes, attach copy of license. H no, attach written confirmation from TDFPS that your facility is not subject to /censure.
B. If after school care she is not on a school campus and is exempt iron Iicensure, are all state and local health and safety
standards met? (Attach copy of most recent inspections.) ❑ Yes ❑ No
❑ Yes ❑ No
4L Se PAGEl_.
Form H1610
Page 3103-2006
Part II - Policy Statemantfor Free and Reduced-Price Meals
If the school food authority operates a program that requires separate charges for meals, it must comply with Sections A and B.
If the school food authority operates a program that does not require separate charges for meals, it must comply with Sections B and C.
If the school food authority operates a program that requires both a separate charge and no separate charge for meals, it must comply with Sections A,
B, and C.
Section A - Programs that Charge Separate ONLY
1. The school food authority accepts responsibility for providing free and reduced-price meals to eligible children.
2. The school food authority assures HHSC that it will uniformly implement the following policy to determine children's eligibility for free and
reduced-price meals in the National School Lunch Program and School Breakfast Program. In fulfilling its responsibilities, the school authority
agrees to:
a. Serve free meals to children from households whose income is equal to or less than the income eligibility standard far free meals on Form
H4504, Income Standards for Determining Free and Reduced-Price Eligibility, applicable to the contract period, or to children from
food stamp households or TANF assistance units that provide a case number.
b. Serve reduced-finc.'e 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 ice meals on Form H4504, Income Standards for Determining Free and Reduced-Price
Eligibility, applicable to the contract period.
c. Provide these benefits to children from families submitting completed applications whose incorthes meet the criteria on Form H4504, and to
foster children and children from families whose incomes meet the criteria on Forth H4504 because of strikes, layoffs, or unemployment
d• Designate to review applications and determine
Name roe
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 has etiglohlitp 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 tides 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 sdwol'sIRCCI's decisions on applications and for officials of
sdhooIWRCCla who dispute Information in an application or the eligibility of children for free or reduced-price meals. During the appeals and
hearing, the duld must continue to receive free or reduced-prioe meals. Records must be kept according to raced retention requirements
in the National School Luridg cool Brasldaat Program Handbook and agreement
Before beginning the hearing procedure, the parent or kcal schoogRCCI official may request a conference. The conference should provide
an opportunity for the parent and schooURCCI 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 Nair 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 oonfront 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 tD
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 prowled 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. Q c-7
Form H1610
Page 4103-2006
(11) Record retention of the hearing forthree years and 90 days after the end of the fiscal year to which ftgertains. 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 include:
(1) A sample of the letter to the parents (Form H4524).
(2) Form H4504.
The information for public release was or will be provided to the organizations on the dates that follow (attach a sheet If more space is
needed):
Public News Media Data
Organization
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,
reduosd.price, and full-price meals served. The procedurQ deribed in this stern must be used so that children will not be aware ofA ho is
receiving free and reduced-price meals.
Check the collection procedure the school food authority uses.
❑ Collecton 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 reducedgxice 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 end sent to the cafeteria. A cashier famifiar with the children checks 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
schooVRCCI 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 tree 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
dolly 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 meats. In the
classrooms, the secretary distributes Identical tickets labeled only with the clAdren's names. Since the parents may pay, even the
children may not know whether their meals are free, full-pdoed, or reduced-price.
❑ Collection Procedure 6 - Parents are billed monthly for full-priced or reduced-price meals their children are served. All payments
are mailed in. All participating children receive a coded ticket each month, which is punched at each meat 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 'd necessary.)
1UL ga ma I~
Form H1610
Page 032006
i. Describe how the daily numbers of free, reduced-price, and full-price meals are identified and counted, and the numbers recorded. (Use an
attachment if necessary.)
J. 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 If necessary.)
Section B - Programs that Charge Separately AND Programs that DO NOT Charge Separately
In fulfilling Its responsibilities, the school food authority agrees:
1. In accordance with federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race,
color, national origin, sex, age or disability.
To file a complaint of decximinalim, write USDA, Director, Office of Civil Rights, 1400 hx4wdence Avenue, SW, Washirgfon, D.C. 20250-9410
or call 000.795.3272 or 202-720.6382 (TTY). USDA Is an equal opportunity provider and emplW.
2. (Applicable only O 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 flee or reduced-price meals. These must be distributed at the beginning of each year and when
efigibifity aitaft charge. _
a. The school food authority must complete (1) or (2) as applicable:
(1) Form H4524 is a sample of the letter to parents whose chidren are in a program that charges separately for
meals. Is the school food authority usin the attached sample? [Yes ® No
(2) Form H4524 is a sample of the letter to parents whose children are in a program that does not charge
separately for meals. Is the school food authority using the attached sample? ❑ Yes ® No
If the answer to either (1) or (2) is 'No; the school food authority must submit to HHSC, with this application form, a copy of the letter they
send to parents. HHSC must approve this letter before the school food authority sends it to parents. On approval, the school food authority
must attach Form M625-A to the letter and send bath documents to parents.
b. Form H4524 is a sample of the application for free and reduced-price meals. Is the school food authority using the
attached sample? ❑ Yes ® No
The school food authority must ask parents to complete the application and retum it to the determining official named in Section A of this form.
Applications and documentation of action taken are kept for three yearn and 90 days after the end of the fiscal year to which they pertain. If audit
findings are not resolved, the records are kept until the issues are resolved.
Applications may be filed at any time during the year. The school food authority must supply an application to parents enrolling a child in a
sdhooMCCI for the first time (at any time during the year). If a child transfers from one schooVRCCI to another under the jurisdiction of the same
school food authority, his w eligibility for a free or reduced-price meal is also transferred.
Note - Programs that Charge Separately ONLY:
All children from the same family must receive the same benefits. Within 10 workdays of receiving applications, parents or guardians
must be notified knsiridually of the decision on their applications. Children are served meals as soon as they are determined eligible.
Form H1623 is a sample of the notification letter to the parents about the application for free and reduced-
price meals. Is the school food authority using the attached sample? - ❑ Yes ❑ No
If 'No,' the school food authority must attach a copy of the letter being sent to parents.
When an application O denied, parents or guardians are informed in writing of the reason for denial and the hearing procedure.
The designated hearing official is
Name
Title
This person must be someone not involved in the original eligibility determination. it is suggested that the hearing official hold a
higher position than the determining official. The hearing official and the determining Official cannot be the same person.
3. Submit to HHSC any proposed changes to this policy statement before it is implemented. Changes are effective only when they are approved by
HHSC.
.lot 80 rAGF :77.
Form H1610
Page 03-2006
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
schooWRCCis. This period can be reduced If 80% of the children in attendance are eligible for free and/or reduced-price meals based on
data from March of the previous year. Applications must still be sent annually to students who pay full-priced or reduced-price or who are
newly enrolled.
For claiming purposes, school staff must continue to keep a daily record of the number of paid, free, and reduced-price meals served to
children.
We choose NOT to participate in Provision 1.
❑ We will participate In Provision 1, and certify that the following schools had 80% or above free and/or reduced-price
recipients participating:
Our first year under Provision 1 will be school year
b. Provision 2 - School food authorities may choose to serve all children at no charge. Any sdooVRCCI that chooses to serve al children
meals at no charge may reduce the frequency of certification for children eligible for flee andor reduced-price meals to am every four
years.
School food authorities must submit socioeconomic data from an approved source with their base year (first year) application do implement
Provision 2, and socioeconomic data from the same source with their application for extension at the end of the four-year cycle. The base
year, or first year, that a school is on Provision 2 is part of the four-year cycle. If HHSC determines at the end of the four-year cycle that
there has been negligible improvement (five percent or less improvement after adjusting for inflation) in the socioeconomic status of that
school food authority's population, the Provision 2 period may be extended another four years.
School food authorities choosing Provision 2 must use local sources Ow than federal mainbursement to absorb tie cost of (1) meals
served to children rat 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 schoolslRCCls using Provision 2 are required to send letters and applications to parents only at the beginning of
the four-year period.
School food authorities must maintain all approved applications and eligibility documentation from the designated base year at least three
years and 90 days after the final Claim for Reimbursement of the final school year that employed base year data, or longer If required for
audit resolution.
SchoolslRCCls are required to determine daily during the first year of the four-year period the actual number of meals served to all
attending children by type (free, reduced-price, and paid). In the second, third, and fourth years, monthly claims for meals served by type
(free, reduced-price, and paid) are based on a percentage of the total number of meals served by type in the corresponding month of the
first year.
® We choose NOT to participate in Provision 2.
❑ The following schoolslRCCis 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 yeas
and
The school year that we will be reconsidered for an extension for Provision 2 is in the fourth year or school year
JOL -U PAGE -79
Form H1610
Page 7103-2006
We will use and submit the following approved source of socioeconomic data with our application for our base year and when being
considered for an extension (check source being used):
❑ local data collected by the city or county zoning and economic planning office.
❑ Unemployment data.
❑ Local Food Stamp Program certification data.
❑ Temporary Assistance for Needy Families (TANF) data (provided that eligibility standards were the same or more
restrictive in the base year as current year with allowance for Inflation).
Form H4524 is a sample of the letter to parents whose children are in programs with no separate charges for meals. It can be sent to
parents for Provision 2 participants. If participating in Provision 2, you must answer the following question:
Is the school food authority using the attached sample Form H4524? ❑ Yes ❑ No
If 'No,' the school food authority must attach a copy of the letter being sent to parents.
c. Provision 3 - School food authorities may choose to serve all children meals at no charge. Any sd=MCCl which chooses to serve all
children meals at no charge will conduct certificolion of children eligible for tree andlor reducedirice meals during a designated base year
and will not conduct eligibility certification during the successive four-year period following the base year. The school food authority must
submit socioeconomic data from an approved source with their base year application, and from the same source with their application for
extension at the end of the four-year cycle. If HHSC determines after the initial four-year period of Provision 3 that Ihere has been negligible
change (five percent or less mprovertment altar a*mbng 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.
Sduool food authorities loosing Provision 3 must use local sources other than federal 10 absorb the cost of (1) Meals
served to children rat eligible for free or reduced rice meals; and (2) the dmfleremce between the cost of time meal and the federal
reimbursement received for each free or reduced-ow meat served to children eligible for meals.
School food authorities of sdaoWCCts 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 meats 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 emollment data from the designated base
year at least three years and 90 days after the final Claim for Reimbursement of the final school year that employed base year data, or
longer If required for audit resolution.
School food authorities must determine any increase or decrease in enrollment each year of Provision 3 based upon the schools
enrollment on October 1 annually.
SchooWRCCls 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 (fro, 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, reducedgice, and paid) based on the total male claimed for the corresponding
month of the designated base year and reflecting the percent Increase or decrease of the sdW'& RCCI's enrollment on October 1 of the
current school year, and must take total meal counts of reimbursable meals served to participating children at the point of service.
® We choose NOT to participate In Provision 3.
❑ The following schooMCCis will participate in Provision 3:
Our first year under Provision 3 wilt be school year
Our designated blase 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
11 40L 8D
)'rt~vC ` 1
Form 141610
Page 6/03-2006
We will use and submit the following approved source'of socioeoonomicdata with our application for our base year and when being
considered for an extension (check source being used):
❑ Local data collected by the city or county zoning and economic planning office.
❑ Unemployment data.
❑ Local Food Stamp Program certification data.
❑ Temporary Assistance for Needy Families (TANF) data (provided that eligibility standards were the same or more
restrictive in the base year as current year with allowance for inflation).
Form H4524 is a sample of the letter to parents whose children are in programs with no separate charges for meals. It can be sent to
parents for Provision 3 participants. If participating in Provision 3, you must answer the following question:
Is the school food authority using the attached sample Form H4524?
❑ Yes ❑ No
If 'No; the school food authority must attach a copy of the letter being sent to parents and describe how it will notify households that
meals will be available free of charge to all enrolled students.
Section C - Programs that DO NOT Charge Separately ONLY
1. The scrod food authority is responsible for providing program benefits to eligible children.
2. The school food authority assures HHSC that although no identifiable charge is established for meals, it will uniformly implement the following
policy. In fuNlling its responsibilities, the school food authority agrees to:
a. Claim as free meals only those meals served to children from farni ies whose Income is equal to or less than the income eligibility standard
for free meals on Form H4504, Standards forDefermining Fss and Reduced price Ellig bift, applicable to the contract period, or to
children from food stamp households or TANF assistance units that provide a case number.
b. Claim as redukedoaed meals only those meals served b children from famNes whosei nceme is above the Income eligibility standard for
free meals but equal lo or less than the standard for reduced-price meals on Form H4504, Standard for Determining Fee 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 ID 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 reduca"rice
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 fine; (4) enter the lunchroom through a
separate entrance; (5) ant meals at a Merent time; or (6) eat a di larent mad.
e. Designate Patrick Munoz Assistant Superintendent to determine eligibility for free and
Name We
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 reduoed-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; and (5) eligibility determination and data (Initialed by official making
determination).
Note: Children at RCCIs are considered a family of one. Exceptions to this are children of house parents living at the Institution. These
children must have an application on file as described in Section B, number 2.
g. Describe how daily point-of-service counts are taken. The point-of-servioe 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 cetlected at the beginning,
explain how you assure that a reimbursable meal was taken (attach a sheet If needed).
Residents are only served meals OW are reirfmsable by our kitchen staff. A final count is made by the child care staff memberwhen residents exit the
serving line and are seated.
Q'n 42n
Form HIli70
Page W3-2006
SECTION D - The following attachments are a pant of the policy statement for free and reduced-price meals:
Form H1623, Notification Letter to Parents (regarding application for free and reduced-price meals)
Form H1625A, Standards for Determining Free and Reduced-Price Eligibility, b be provided lo parents (will be forwarded as soon as USDA
publishes)
Form H4524, Application for Free and Reduced-Price Meals and Letter to Parents
Form H4504, Standards for Determining Free and Reduced-Pdoe EgUity (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 bwwWge. I understand that detlberate misrepresentation
or withholding of information may result In prosecution under applicable state and federal statutes.
N our school food authority has applied and is approved to participate in one of the Provisions, l certify that our school food authority will
follow all rules and regulations for the Provision for which we have been approved.
_ Title-olflcial
-7. County Judge
Signature - HHSC Representative
Title - HHSC Representative
Date
8'0+ itt4i $
Forth N1610
Page 10/03-2006
Sample
Public Release for Free and Reduced-Price Meals
(Make appropriate charges 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
(Dale)
These groups must be advised of program availability, new programs, or changes in edsfing programs.
today announced its policy for
(Name of local school food authority)
free and reducedom meals served under the
(Inert National School Lmch Program ardor School Breakfast Program.)
Each school and the office of the
which anyone may review.
The following household size and income criteria will be used to determine eligibility:
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 tams 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 priori a office. The information provxkd 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 applicetion: all household members' names; total household income by source and the Social Security number
or the adult household member signing the application, or an indication that the household member does not possess a Social Seoudty, number, OR the household's
food stamp or TANF case number, If appropriate; and the signature of an adult household members r8fying that the information is aired.
Applications may be submitted any fime during the year
According to the free and reduced-price policy, will review applications and
(Name of Determining Official)
determine eligibility. Pan* or guardians dissatisfied with the ndng of the official may discuss the decision with the determining official. Parents may request a formal
appeal either orally or in vatting to.,
(Nance, Address, and Telephone Number of the Nearing Official)
dbuselholdg approved for free or redumd-price meals are not required to report changes In income status, household size, or when the household is no longer eligible
for food stamps or TANF. This provision does not apply to a household provided with %mpmW approval for meal benefits.
Some foster children are also eligible for free or reduced-price meals. A household with foster children should-contact the school for more information.
The information that households provide is confidential and will be used only to determine eligibility and for vedfying data.
In aom dance with federal law and U.S. Department of Agriuxhn policy, this institution is prohibited from discriminating on the basis of race, cola, national origin, sex,
age or disability.
To file a complaint of discrimination, write USDA, Director, Office of Coil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call 800-795-3272
or 202-7W5382 (1TY). USDA Is an equal opportunity provider and employer.
i g~ PAGE_ 6
Texds Health and Human National School Lunch Program and School Breakfast Program
Services Commission Individual Site Information
Form M1609
April 2002
Name of SchooURCCI/Afterschool Care Feeding Site
Telephone Number
Brazos County Juvenile Detention Center
( 979 ) 823-3544
Address (Street or P.O. Box, City, State, Zip)
1904 SH 21 West Bryan, Tx. 77803
Name of Person in Charge of Food Service Program
Name of School Food Authority
Patrick Munoz
Brazos County Juvenile Detention Center
Type of Feeding Site (check all that apply)
❑ Day Schad ❑ Boarding School
❑ Combination Day School ® Residential Chill ❑ Combination Day School and
and Boarding School Care Instikft Residential Child Care Institution
❑ Special Education School ❑ Afterschool Cue Snack Site ❑ Other (specfy):
1. Is the above school/residential child care institution licensed? (If yes, attach copy of license.) ❑ Yes ® No
2. Program(s) that you are applying for.
National Scrod Lunch Program
❑ Afterschod Care Snack program (SFA must be participating in National School Lunch Program)
® School Breakfast Program
® Severe Need School Breakfast Program Rates' 'Available to sdaoldresidenhal child care knsilluli s meeting the following esgibilky aiede:
1. 40% of more trial kmdm served In seooM geoading yearware free or refixed price; and
2. Breakfast owls o eadpremgwarreYn6usanentmissamisblewidertosdrodBreeldiStPngmm.
NumberofMomhs Beginnkg0ateotopmation Ending Dab ofWation
3. Number of months the school will be operating a food service program: 12 07f01rM 06/JOM7
4. Number of children enrolled at schod/residengal child care Institution: ........................................................................Ad
A. Age Range of4bikNen Enrolled
5.
From: 10 To:
B. Grade Levels Taught (schools only)
Fran:
TO.,
Food Service:
AVERAGE DAILY PARTICIPATION OF CHILDREN IN PROGRAM
TIMES OF FOOD SERVICE
Free
Reduced Price
Paid
Beginning
Ending
Breakfast
44
7 A.M.
8 A.M.
Lunch
44
12 P.M.
1 P.M.
Area Eligible Aftersdnool Care Snack
Not Area Eligible Afterschool Care Snack
6. Attendance (for residential child are Institutions only)
A. Are all of the children at the institution all day? ® Yes ❑ No
N no, do all or some of the children attend public school? ❑ All ❑ Some
It only some attend public school, how many?
0 some or all attend public school, which meals do these student eat at the institupon? ❑ Breakfast ❑ Lunch
B. Check If the children attend the Institution on holidays and/or weekends ® Holidays ® Weekends
7.
I ype w mum aerwae
A. Meal Preparation
® On-Site ICdchen ❑ Central Kkhen ❑ Food Service Management Company ❑ Vended Meals
(submit copy of contract and checklist) (submit copy of agreement)
❑ Other (e)plain:
0. Meal Planning System
❑ Enhanced Food Based ® Traditional Food Based ❑ Nutrient Standard Menu ❑ Assisted Nutrient Standard Menu Planning
Planning (NSMP or NuMenus) (ANSMP or Assisted NuMenus)
(See instructions for documents to submit)
❑ Other (explain:
NOTE: Snacks served In the ARsrsdneol Care Snack program must Mow the food based supplement pattern regandless of your menu plaming mehod for leek a d andfor lurxh.
8.
Type of Program
❑ Separate Charges ® No Separate Charge; Cost of Meals is Included ❑ Combination of
Separate Charges and
Made for Meals in Required Payment Plan/Fee No Separate Charges
VGL 9D PAGE 83,
For mN1609
Page 2104-2002
9.
Daily No Charged for Each Meal (for programs that will charge separately
CHILDREN
only):
Reduced Price
Paid
ADULTS
Breakfast
Lunch
Not Area FJigible Afterschod Care Snack
NOTE: Area Ergble Aaersdnoc Care Snack program sites must provide weeks free of charge b all students participating in the aftersChcol care program.
10. A. If applying for the National School Lurch Program, indicate whether Offer versus Serve will be implemented:
High Sdnool (mandatory)
Junior High (optional)
Elementary(optional)
Preschool (optional)
Residential Child Care Institution (opt onal)
El Yes
I
El Yes 11 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
B. If applying for the School Breakfast Program, indicate whether Offer versus Serve will be implemented:
High School (optional)
Junior High (optional
Elementary (optional)
PMdXd (optional)
Residential Child Care Institution (Optional
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
11. Will supplemental (a la carte or snack bar) food service be avail" in addition to the school lunch? El Yes ® No
Questions 12 through 15 apply only to the Afterschool Care Snack program.
12. Is attendarm in afterschoc care program limited to students enrolled in your schooVRCCI? ❑ Yes ❑ No
If no: In which individual public stool attendance area (not district) is the site located?
NOTE: You must attach an information statement from the ISO (see instructions).
13. Indicate your schooVRCCI or the pudic school freeorreduced price enrollment percentage Free or Reduced Prise: %
14. Which required activities are included in your after school program? ❑ Educational Activities ❑ Enrichment Activities
15. Ixensing (for schools only)
A. Is a Texas Child Care License required for your after schod care program? ❑ Yes ❑ No
If yes, attach copy of license. If no, attach written confirmation from TDPRS that your facility is not subject to licensure.
B. If alter school care site is not on a school campus and is exempt from licensure, are all state and local health and safety
standards matt (Attach copy of most recent inspections.) ❑ Yes ❑ No
I CERTIFY that the Information on this form is true and correct to the best of my knowledge. I understand that deliberate misrepresentation
or7 =under applicable state and federal statutes.
Titre
(fto County Judge
Signature-uncial Date
'fit 30 PAGE 9q
Texas Health and Human Special Nutrition Programs
Services Commission Single Audit Identification Data
For Program Year 2007
(SNP Use Only)
Pan I
Form H1569
April 2005
Contractor Name Contact Person
Brazos County Texas Patrick Munoz
Address (Street or P.O. Box, City, State, ZIP Code)
1904 W SH 21 Bryan, TX. 77803
Area Code and Telephone No. Texas ID No.
Contract No.
( 979 ) 823 - 3544 17460004330000
75-
Contractor Fiscal Year End (mm/dd/yyyy) Type of Contract
61001
09/30/06 ❑ For Profit ❑ Nonprofit
❑ State Agency ®Other
Fad u
Check the appropriate box(es) to indicate the type(s) of program(s) In which you currently participate or for which vn,r am n.. t.e
Commodity Assistance Programs
Program Nos.
-
Cash Reimbursement Programs
^rrv•••a•
Program Nos.
❑ A - National School Lunch
021187A
❑ AD - Adult Day Care
TX _
❑ B - Charitable Institutions
❑ BL- National School Lunch/Breakfast
TX - 021-2001
❑ C - Area Agency on Aging
❑ CC - CACFP Center
❑ G - Summer Camps
❑ DH - CACFP Day Home
TX-
❑ H - Summer Food Service
❑ SF - S
F
TX -
ummer
ood
TX -
❑ J - Jails
❑ SM - Special Milk
❑ I - TEXCAP
❑ TE -TEXCAP
TX -
TX -
❑ CS - Commodity Supplemental Food Prog.
❑ CS - Commodity Supplemental Food Prog.
TX -
Part III
A. Does your agency expend federal funds from programs other than those listed above? M Yes ❑ No
If yes, complete Part III, B.
B. Give the source and amount of any federal funds that your agency expended In your most recent com 1-4 d r.
P
Source
e scal yvar.
Amount
Brazos County Juvenile Service Annual Budget 2005-2006 Expenditures
3,021,234384
Part IV
Single Audit Exemption - I certify that I am not required to submit an audit under the Single Audit Act for the following reason.
Check only one choice.
❑ I am a for-profit organization.
❑ I am a military base.
❑ 1 am a nonprofit organization and expend less than $500,000 annually in totalfederal funding.
❑ 1 am an Indian Reservation.
I understand that if I meet the requirements of the Single Audit Act, now or in the future, I must submit an audit as a condition of
eligibility to participate in the Special Nutrition Programs, and that failure to do so as required could result in adverse action, including
the withholding of my claim for reimbursement payments and termination of my contract. I also understand that if I am a private non-
profit organization subject to the requirements of the Single Audit Act and have a financial audit performed annually, I must also obtain
a single audit on an annual basis. l(
N v'4AWL 0510512006
Signature-Au o ized Representative Date
Name (please type or print) Title
Patrick Munoz Assistant Superintendent
lti° Ra (-A~iit. 85
Texas Health and Human - Form H450r6
Services Commission Special Nutrition Program July 2005
Certification of Authority
This is to certify that the following person(s):
Name of Authorized Representative (please type or print)
Title
Patrick Munoz
Assistant Superintendent
X y
S' net -Authorized ReDiesentative
Name of Authorized Representative (please type or pint)
Title
Collin Coker
Deputy Director
X
S' nature -Authorized Representative
Is are designated as an Authorized Representative of
Name of Contracting Organization
Brazos County, Texas
Address (Sireat, City, State, ZIP)
1904 SH 21 West Bryan, TX. 77803
The representative(s) designated above, and myself, sclmowledge that each is individually authorized on behalf of the
contracting organization to make written agreements with the Texas Health and Human Services Commission (HHSC) to
operate a food program, to sign documents or reports about the agreement and to present claims for reimbursement, when
appropriate, to the 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, HHSC, areMil be true and correct in all respects, that they
amWII be completed according to the terms and conditions of existing agreements, including amendments
that records
,
art twill be available to support any and all claims and that we will not submit claims (excluding amendedladjusted clakns) for
goods or services for which we have
l
d
iv
d
a
rea
y rece
e
payment We recognize that we are fully responsible for arty 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 pint)
Title
Rand Sims
Coun Jud
o
S' nature - Official of Contralti 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 deleting an authorized representative, list the
name(s) of the individual(s) to be removed as authorized representative(s) below:
Name of Deleted Representative
Name of Deleted Representative
Name of Deleted Representative
For HHSC Use Only
Coact No. Received By Date Received
757
VOL g0 PAOE 9&
SPECIAL NUTRITION PROGRAMS
CHARITABLE CHOICE DATA FORM
The information in this form is being requested to help the Texas Health and Human Services
Commission (HHSC) determine the approximate number of contracts it has with charitable and religious
organizations. This information will assist HHSC in implementing Section 104 of the Personal
Responsibility and Work Opportunity Reconciliation Act of 199, 42 U.S.C. § 604a, and in providing more
accurate information to the Govemor'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 HHSC.
Name of Organization
Brazos County, Texas
Address
ber
1904 W SH 21 Bryan, 1% 77803
t9797-823---354:47
1. How did your organization find out about this contract?
❑ Texas Register ❑ Newspaper
❑ Magazine
Name of Magazine
❑ Publication
Name of Newspaper
Name of Pubucation
❑ Other Contractor LJ Other Area Program Manager for yearly
Name of Offrer Contractor renewal
2. Is your organization a charitable or religious organization? Check the box(es) that apply.
❑ Charitable ❑ Religious
You are not required to provide the information requested on this form. Electing not to provide the
information requested on this forth will not affect your contract with HHSC.
RETURN THE COMPLETED FORM TO YOUR SPECIAL NUTRITON PROGRAMS AREA
PROGRAM OFFICE.
.fOL96 PAGE 97
State of Texas
Health & Human Services Commission
Nondisclosure Statement
Acknowledgment
As a contractor to the Texas Health & Human Services Commission, I have been provided access to
information, systems, operations, or procedures that are security sensitive or have been identified as confidential
by the Health & Human Services Commission, the State of Texas, or the United States Goverment. As such, I
acknowledge the following:
• that my access to this information is provided solely in my capacity as a contractor to the Texas Health &
Human Services Commission;
• that access to this information is solely for the purpose of discharging my duties or the duties of my
employer under Texas Health & Human Services Commission contract number HHSC
-
_
_ _
• that premature or unauthorized disclosure of this information will irreparably harts the interests of the State
of Texas and the Texas Health & Human Services Commission and may constitute a violation of Section
39.02 of the Texas Penal Code, the antitrust laws of the United States and the State of Texas, and the
Texas Public Information Act [chapter 552, Texas Goverment Code];
• that the information may present confidential or proprietary information, the release of which may
restricted or prohibited b law.
Agreement
In view of the foregoing, I agree that I shall use any information that I receive in my capacity as a contractor to
the Texas Health & Human Services Commission - whether written or oral, formal or informal - for the following
purposes only:
• to provide the services and/or deliverables required or requested under contract number HHSC-
• to provide advice, opinion or recommendation requested by the Texas Health & Human Services
Commission in the course of fulfilling the duties prescribed under the contract;
• to assist the Texas Health & Human Services Commission in developing any documents, reports, working
papers, evaluations, schedules, or instruments necessary to fulfill the requirements of the contract
I further agree that I shall regard any such information as confidential and that I shall not disclose, reveal,
communicate, impart or divulge the information or any summary or synopsis of the information in any manner or
any form whatsoever, except under the following circumstances:
• when authorized in writing by the Project Manager employed by the Texas Health & Human Services
Commission;
• when required by court order, subpoena, or ruling of the Attorney General of Texas;
• when advised by legal counsel that disclosure is required by law or legal process;
• when the information has previously been released to the general public by the Project Manager, the Texas
Health & Human Services Commission;
• when required to brief or inform a superior, provided the superior is informed of and has also executed a
non-disclosure statement.
In the event I receive a request for information relating to contract number HHSC-==-, either during or
after the performance of this contract, I-agree to do the following: _
• notify the Project Manager or the Texas Health & Human Services Commission as soon as practical
following receipt of the request;
• seek advice from appropriate I al counsel regarding m abil' to disclose the information.
By signing this statement, I acknowledge that I understand and agree to adhere to the limitations
on disclosure dp riri ~Sd ab
o e.
1/u l~ oG
S s
t~ra
gipna
Yatr ek Munoz Date
Printed Name -
Ser ice-nowxom
IT Service Management On Demand
May 23, 2006
Debbie L. Lockledge
Office of the County Judge
300 E. 26'" Street, Suite 114
Bryan, TX 77803
Dear Debbie:
I am pleased to enclose a copy of your signed Software Subscription License Agreement with
Service-now.com.
I have listed below, for your convenience, a directory of staff members to contact should you have
any questions relating to the implementation of the software, IT support or billing.
Andy Chedrick/Carla Goldsberry
Accounting
858-356-0999 Ext 103
Carla.goldsberry@service-now.com
Paul Morrison
Help Desk
858-356-0999 Ext101
help@service-now.com
However, if at any time you have any questions or concerns, please do not hesitate to contact me
directly at (858) 356-0999 Ext 235 or by e-mail at chris.jurges@service-now.com
Thank you again for the opportunity to be of service to you.
Sincerelly,,j,,A
44 -
V
Chris Jurges
Account Executive
12680 High Bluff Drive, Suite 101, San Diego, CA 92130
858-356-0999 - Fax 858-356-0378
ga~=.
MIN
Seailce-nowxom
IT Service Management On Demand
SERVICE-NOW.COM
ON DEMAND SOFTWARE SUBSCRIPTION LICENSE AGREEMENT
Brazos County Texas
This On Demand Software Subscription Services Agreement ("Agreement") is entered into and effective as of
June 1, 2006 ("Effective Date") by and between Service-now.com, Inc., a California corporation, having its principal
place of business at 12680 High Bluff Drive, Suite 200, San Diego, CA 92130 ("Service-now.com") and Brazos County
Texas, having its principal place of business 202 E. 27th Street, Suite 102, Bryan, TX 77803("Customer").
For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties
agree as follows:
1. Definitions.
"Authorized Users" means Customer's employees, consultants, contractors, customers or agents who are
authorized to use the Service for Customer's internal business purposes and have been supplied user identifications and
passwords by Customer (or by Service-now.com at Customer's request). Service-now.com provides for two types of
users; (i) the Process User is a named or fixed license granted broad access to the Service to support the normal course
of their responsibilities. Process Users rights include, but are not limited to, managing Incidents, Problems, Changes,
Releases and Configuration Items within the system, or general maintenance and administration of the system. Service-
now.com bases its pricing structure off of the number of Process Users requiring access to the Service. (ii) The End User
or Employee Self Service User is a user requiring limited access to the Service to submit Incidents and Requests to the IT
and Maintenance departments. Use of the Service by an Employee Self Service user is strictly limited to submitting
Incidents or Requests, viewing the status of their submitted Incidents, browsing Knowledge from the Knowledge Base,
using the Service Catalog and viewing published reports and News. There is no additional charge for the Employee Self
Service user.
"Customer Data" means all information submitted by Customer to the Service.
"Order Form" means the ordering documents representing the initial purchase of the Service as well as any
subsequent purchases agreed to between the parties in writing from time to time, that are executed hereunder and
deemed incorporated into the Subscription License Agreement Order Form from time to time and that specify, among
other things, the number of Subscriptions ordered, the Subscription Term and the applicable fees.
"Subscription" means the right for an Authorized User to access the Service, pursuant to the terms of this
Agreement.
"Subscription Term" shall mean the period of time commencing with the Effective Date of the Agreement and
ending on the anniversary thereof during the term of this Agreement, unless agreed otherwise in an Order Form.
Service. 'Brazos County Texas is hosting all these applications on premise'
1.1 Provision of Service. Service-now.com shall make the Service available to Customer pursuant to the
terms and conditions set forth in this Agreement and any and all Order Forms executed hereunder from time to time.
During the term of this Agreement, the Service shall perform materially in accordance with the following schedule.
Time Period Definition Availabil
Service-now.com, Inc.
On Demand Subscription Software License Agreement
Page 1 of $
~ 80 PhGE_,j.
Business Day
4:00 AM - 7:00 PM Pacific Time
99.9%
Monday - Friday
Non-Business Hours
7:01 PM - 3:59 Pacific Time
99.5%
Monday - Friday
All Day Saturday and Sunday
All Da on Public Holidays
Service Level Agreement: Service-now.com shall provide a response to the Customer for all open Incidents,
Enhancement Requests and inquiries in accordance with the following schedule:
Type
Impact
Time Period
Response Time
Incident
1 - System Outage
An
One Hour
Incident
2 - Moderate Degradation
of Service
Business Day
Two Hours
Incident
2 - Moderate Degradation
of Service
Non Business Day
Before 8:00 AM the
Following Business Da
Incident
3 - Minor Degradation of
Service
Any
Within one Business Day
Enhancement Request
N / vi
An
Within three Business Da
Inquiries
N / A
An
Within three Business Days
A "Business Day" is defined as Monday through Friday 7:00 AM to 7:00 PM Pacific Time
1.2 The Service shall be generally available except for: (i) planned downtime (of which Service-now.com shall
give at least 48 hours notice and which Service-now.com shall schedule to the extent reasonably practicable during off
hours); or (ii) downtime caused by circumstances beyond Service-now.com's reasonable control, including acts of God,
acts of government, flood, fire, earthquakes, civil unrest, acts of terror, war, strikes or other labor problems, computer or
telecommunications failures or delays involving hardware or software not within Service-now.com's possession or
reasonable control, and network intrusions or denial of service attacks, but only to the extent unavailability results
notwithstanding the exercise by Service-now.com of reasonable care and due diligence to avoid or mitigate the same in
anticipation of or in response to such causes.
1.3 Use Limits. Customer shall use the Service solely for its internal business purposes as contemplated by
this Agreement and Customer and its Authorized Users shall not: (i) license, sublicense, sell, resell, rent, lease, transfer,
assign, distribute, time share or otherwise commercially exploit or make the Service available to any third party, other than
as contemplated by this Agreement; (ii) utilize the Service to violate the law or rights of any person or entity, including
sending spam or unlawful or tortious material; (iv) send or store software viruses, worms, Trojan horses or other harmful
computer code, files, scripts, agents or programs; (v) interfere with or disrupt the integrity or performance of the Service or
the data contained therein; or (vi) attempt to gain unauthorized access to the Service or its related systems or networks.
2. Proprietary Rights.
2.1 License Grant. Subject to the terms and conditions of this Agreement, Service-now.com grants
Customer and its Authorized Users a worldwide, non-exclusive, non-transferable (except in connection with a permitted
assignment of this Agreement), non-sublicenseable right to access and use the Service in accordance with the terms of
this Agreement, solely in connection with the operation of the business of Customer and not for the purpose of providing
the Services to others.
2.2 Restrictions. Customer shall not (i) modify, copy or create derivative works based on the Service or
Service-now.com Technology; (ii) create Internet "links" to or reproduce any content forming part of the Service, other
than for its own internal business purposes; or (iii) disassemble, reverse engineer, or decompile the Service or part
thereof, or access it in order to copy any ideas, features, content, functions or graphics of the Service. Customer
bu P- x_91
acknowledges that except for the limited right to use the Service granted herein, no other right title or interest in the
intellectual property rights or technology of Service-now.com is granted and all such licenses and rights are hereby
expressly reserved.
23 Customer Data. As between Service-now.com and Customer, all Customer Data is owned exclusively
by Customer. Customer Data shall be considered Confidential Information subject to the terms of this Agreement.
Service-now.com may access Customer's Authorized User accounts, including Customer Data, solely to respond to
service or technical problems or at Customer's request and for the purposes of hosting such Customer Data in connection
with the provision of the Service to Customer and Customer's Authorized Users.
3. Fees & Payment.
3.1 Authorized User Fees. Customer shall pay all fees specified in all executed Order Forms hereunder.
Except as otherwise provided, all fees are quoted in United States dollars. Except as otherwise provided, fees are non-
refundable, and the number of Authorized User Subscriptions purchased cannot be decreased during the relevant
Subscription Tenn stated on the Order Form.
3.2 Invoicing & Payment. Fees for the Service will be invoiced in advance and otherwise in accordance with
the terns set forth in the relevant Order Form. Unless otherwise stated in the Order Form, charges are due net 30 days
from the invoice date. Unless otherwise stated in the Order Form, all payments made under this Agreement shall be in
United States dollars. Any payment not received from Customer by the due date may accrue (except with respect to
charges then under reasonable and good faith dispute), at Service-now.com's discretion, late charges at the rate of 1.0%
of the outstanding balance per month, or the maximum rate permitted by law, whichever is lower, from the date such
payment was due until the date payment is received by Service-now.com.
3.3 Suspension of Service. If Customer's account is thirty (30) days or more overdue in addition to any of
its other rights or remedies, Service-now.com reserves the right to suspend the Service provided to Customer, without
liability to Customer, until such amounts are paid in full.
4. Warranties & Disclaimers.
4.1 Warranties. Each party represents and warrants to the other that it has the legal power to enter into this
Agreement. Service-now.com further represents and warrants to Customer that it will provide the Service in a manner
consistent with general industry standards reasonably applicable to the provision thereof and that the Service will perform
substantially in accordance with the online Service-now.com help documentation under normal use and circumstances.
4.2 Disclaimer. EXCEPT AS EXPRESSLY PROVIDED HEREIN, SERVICE-NOW.COM MAKES NO
WARRANTY OF ANY KIND, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHERWISE. SERVICE-NOW.COM
HEREBY SPECIFICALLY DISCLAIMS ALL IMPLIED WARRANTIES, INCLUDING ANY WARRANTY OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND NON-INFRINGEMENT TO THE MAXIMUM
EXTENT PERMITTED BY APPLICABLE LAW.
5. Mutual Indemnification.
5.1 Indemnification by Service-now.com. Subject to this Agreement, Service-now.com shall defend and
indemnify Customer for any amounts paid by Customer for any final judgment or settlement approved by Service-
now.com incurred in connection with claims, demands, suits, or proceedings made or brought against Customer by a third
party alleging that the use of the Service as contemplated hereunder infringes the intellectual property rights of a third
party; Provided, that Customer (a) promptly gives written notice of such claim to Service-now.com; (b) gives Service-
now.com sole control of the defense and settlement of the claim; and (c) provides to Service-now.com, at Service-
now.com's cost, all reasonable assistance.
5.2 Indemnification by Customer. Subject to this Agreement, Customer shall defend and indemnify
Service-now.com for any amounts paid by Service-now.com for any final judgment or settlement approved by Customer
incurred in connection with claims, demands, suits, or proceedings made or brought against Service-now.com by a third
party alleging that the Customer Data infringes the intellectual property rights of, or Customer's unauthorized use of the
Service has otherwise harmed, a third party; roo vided, that Service-now.com (a) promptly gives written notice of the Claim
to Customer; (b) gives Customer sole control of the defense and settlement of such claim; and (c) provides to Customer,
at Customer's cost, all reasonable assistance.
VOL 90 PAGE 901
6. Limitation of Liability.
6.1 Limitation of Liability. EXCEPT FOR A PARTY S LIABILITY UNDER SECTION 6, IN NO EVENT
SHALL EITHER PARTY'S AGGREGATE LIABILITY ARISING OUT OF OR RELATED TO THIS AGREEMENT,
WHETHER IN CONTRACT, TORT OR UNDER ANY OTHER THEORY OF LIABILITY, EXCEED THE AMOUNTS
ACTUALLY PAID BY AND DUE FROM CUSTOMER HEREUNDER.
6.2 Exclusion of Consequential and Related Damages. EXCEPT FOR A PARTY'S LIABILITY UNDER
SECTION 7, IN NO EVENT SHALL EITHER PARTY HAVE ANY LIABILITY TO THE OTHER PARTY FOR ANY LOST
PROFITS, LOSS OF USE, COSTS OF PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES, OR FOR ANY
INDIRECT, SPECIAL, INCIDENTAL, PUNITIVE, OR CONSEQUENTIAL DAMAGES HOWEVER CAUSED AND,
WHETHER IN CONTRACT, TORT OR UNDER ANY OTHER THEORY OF LIABILITY, WHETHER OR NOT THE PARTY
HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGE.
7. Term $ Termination.
7.1 Term of Agreement. This Agreement commences on the Effective Date and continues until all
Authorized User Subscriptions granted in accordance with this Agreement have expired or been terminated unless the
Agreement is terminated earlier pursuant to Section 8 below. Authorized User Subscriptions commence on the start date
specified in the Subscription License Agreement Order Form and continue until the end date in the Subscription License
Agreement Order Form.
7.2 Termination for Cause. A party may terminate this Agreement for cause: (1) upon 30 days written notice
of a material breach to the other party if such breach remains uncured at the expiration of such period; or ft if the other -
party becomes the subject of a petition in bankruptcy or any other proceeding relating to insolvency, receivership,
liquidation which is not dismissed within 60 days of its commencement or an assignment for the benefit of creditors.
73 --Effect of Termination. Upon any termination for cause by Customer, Service-now.com shall refund
Customer any prepaid fees for the remainder of the Subscription Tenn after the date of termination. Termination shall not
relieve Customer of the obligation to pay any fees accrued or payable to Service-now.com prior to the effective date of
termination. Upon request by Customer made within 45 days of the effective date of termination, Service-now.com will
make available to Customer for download a file of Customer Data in a mutually agreed upon commercially standard
format. After such 45-day period, Service-now.com shall have no obligation to maintain or provide any Customer Data
and shall thereafter, unless legally prohibited, delete all Customer Data in its systems or otherwise in its possession or
under its control.
7.4 Brazos County Clause. The Customer is a County, operating under the Constitution and laws of the
State of Texas. As such, the Customer's budget appropriation is limited to a term of one (1) year. The Customer will use
its best efforts to appropriate funds to continue this contract through its full contract term. If the Customer is unable to
appropriate funds to continue this contract, after making best efforts to do so, the contract will terminate at the end of the
appropriation period then funded.
8. General Provisions.
8.1 Governing Law. This Agreement shall be governed exclusively by, and construed exclusively in
accordance with, the laws of the State of California, without regard to its conflicts of laws provisions. The state and
federal courts located in California shall have exclusive jurisdiction to adjudicate any dispute arising out of or relating to
this Agreement. Each party hereby consents to the jurisdiction of such courts and waives any right it may otherwise have
to challenge the appropriateness of such forums.-
Service-now.com, Inc.
(Signature of Authorized Officer)
Robert C. Luddv. Jr.
(Printed Name)
Vice President- Sales and Marketing
(Title)
S/rt~/cle 1 sl~~,o6
(Date)
(,0 r( te)
County Judge
(Title)
Service-now.com, Inc,
•
Subscription License Agreement
Serce-now.Com
Order Form
IT Service Management On Demand
Name Brazos County Texas
Address 202 E. 27th Street Suite 102
Name Anita Lee
city
Bryan
Title
Administrative Assistant
State
TX
Phone
979-361-4520
ZIP Code
77803
email
anita co.brazos.tx.us
Phone
979-361-4688
Website
www.co.brazos,b(.us
Term of Service
Bill To
Same as Above
Effective Term J
une 1, 2006
Start Date
Address
Same as Above
Duration of 2
4 Months
Services
Effective Term
May 31, 2008
End Date
• Deman
d
Description Number of Price Per
Number of Annual
Total Fees
Process Month
Months Fees Due
Due
users
-
Service-now.com Custom
15
36.00
24
$6480.00
$12,960.00
Configuration
• Incident Management
• Configuration Management
• Asset Management
• Asset Contracts
• Service Catalog
• Service Level Agreement
• Knowledge Base
• Employee Self Service
• Reporting
3000.00
One Time On Premise Deployment Fee
erm
Total Fees
$15,960.00
T
s
Bill: Annual Ne
Conditions and Notes
t: 30 Da
•
Payments to be made up front
• Maintenance and upgrades included
• Customer has the option to renew in year three with a price increase not to exceed 10%.
• This offers expires June 1 2006
IN WITNESS WHEREOF, the parties hereto have caused their duly authorized representatives to execute a counterpart of this Agreement effective as
of the date indicated above.
Brazos County, Texas
VOL 8D PAGE R
Service-now.com, Inc.
(Signature of Aut orized Offi&r)
Robert C. Luddv. Jr. (Date) S W26
Randy Sims (Date) "WCPIUP
Exhibit R-02 Maintenance Renewal
Automated Victim Notification Services
Brazos County
Category: Pilot -Large
Subject to the terms and conditions included in the Agreement, this Exhibit R-02 Schedule of
Payments shall describe the payments that Customer shall pay to Appriss.
Maintenance Amount. Customer shall pay Appriss a maintenance amount for the Renewal of
Services determined as follows. This Renewal will extend services through August 31, 2006.
Standard Discount #•Months Billed
Through
Amoune Rate3 Discount Amount Total Annual 8/31/06
$32,350 20% $6,470 $25,880 12
Total Phase 1 &
Phase 2 Billing
Through 8/31/06
$25,880
Services After Termination. Subject to the terms and conditions included in the Agreement,
the cost of Services provided by-Appriss to the Customer shall be governed by the following
payment terms. Following either the expiration or termination of this Agreement, then
Customer shall pay Appriss an amount equal to 1/12th the then current Annual Maintenance
Fee, for each month that the Customer elects to receive the Services. Customer may elect to
receive the Services for any increment of months up to the maximum time period stated in the
Agreement.
based on the size category of the county listed in Service Price: L County Standard Pricing Guide of the Yeador Certification
2 based on the size category of the county and the related price listed in Service Price: I. County Standard Pricing Guide of the
Vendor Certification
3 based on the number of counties participating as defined in Service Price: N. Discounts for Annual Service of the Vendor
Certification
CzA
R-02 Service Agreement Renewal Notice
DATE:
CUSTOMER NAME:
LOCATION:
PROJECT TYPE:
ORIGINAL SERVICE AGREEMENT DATE:
SERVICE AGREEMENT RENEWAL DATE:
SERVICE AGREEMENT RENEWAL TERM:
3/29/2006
Brazos County
300 East 26th Street
Bryan, TX 77803
Brazos County VINE Service
3/30/2004
9/1/2005
12 Months
NEXT SERVICE AGREEMENT RENEWAL DATE: -9/1/2006
PROJECT PRICING: $25,880 (12 Month Period)
" Billing-Phase 1: $12,940 (6 Months --Invoice Paid)
Billing Phase 2:
AUTHORIZATION:
APPRISS, I
ignature Date
Thomas R. Seigle
Vice-President of Government Sales -
$12,940 (6 Months - To be bill after OAG Signature)
j L SO 91P.
Title Name
RENEWAL ACCEPTANCE
By signing herewith, I acknowledge and agree to renew Bid 2005-02911-
OFFICE SUPPLIES, in accordance with all terms and conditions
agreed to. The new bid number will be Bid 2006-030R.
I understand this agreement will be for a period of June 30, 2006
through June 29, 2007.
WILTON'S OFFICE WORKS
Y/,- -/a 0
Date
BRAZOSCOUNTY
sAL/n(~
Date
VU-96 YAu-,-9171
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VOI _~O PAGE
The State of Texas, County of BRAZGS
We, the undersigned, as County Commissioners wiwi, and for Brazos County, and the
Honorable Randy Sims, County Judge of Brazos County, constituting the entire
Commissioners' Court of Brazos County, during a regular meeting of said Court have
examined the foregoing report and have caused an order to be entered upon the Minutes
of the Commissioners' Court of Brazos County approving said Report as presented and
submitted as true and correct by Kay Hamilton, Treasurer of Brazos County, as provided
for in the Revised Statutes of the State of Texas. (Texas Local Government Code,
114.026)
Witness my hand this J> day of A.D. 2006
ar n McQueen
County Clerk, County of BRAZOS, State of Texas
Examined and approved in open Commissioners' Court this 109- _ day of
2006.
Duane Peters, Commissioner Precinct #2
Kenny Mallard, jj'ssioner inct #3
Carey Cauley ommissioner P ec' ct #4
Treasurer's Reports for the MONTH of MARCH 2006
AND OTR ENDING 03/31/06
Vol,~b 101
Lloyd Wassermann, Commissioner Precinct #1
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wo 03
BRAZOS COUNTY
COMMISSIONERS' COURT ACTION FORM
DEPARTMENT Road and Bridge NUMBER 560010
DATE OF COURT MEETING: May 16, 2006
ITEM: Request from Wellborn Special Utility District to construct five (5) road bores and
3,600 ft of 12 inch PVC water line in the right of way of Rock Prairie Road and I&GN
Road Site is located in precinct 1
SOURCE OF FUNDS: N/A
REQUIREMENTS:
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:
SUBMIT D BY:
Richard F. Vance, P.E.
County Engineer
0006-035
APPROVED BY:
Commi sioner Lloyd Wassermann
Precinct 1
This Request is Approved 0'/ Denied ❑
Date: O
Randy Si , County Judge
by Commissioners' Court
REQUEST FOR PROPOSED INSTALLATION IN COUNTY RIGHT-OF-WAY
TO THE COMMISSIONERS' COURT OF BRAZOS COUNTY, TEXAS
BRAZOS COUNTY COURTHOUSE
BRYAN, TEXAS 1177'' 803 / 7~
Formal notice is hereby given that (applicant) 4tlp(~b o giyaic Q U~7 ~r-Fy E/iSrIYIUL
propo es to lace a ( at c within V acro s_ the right-of-way of
(road) 1 k At+'i e in Brazos County, Texas as follows:
Z(b N
The location or description of the proposed installation is more fully shown by 3
copies of the drawings attached to this notice.
I understand and agree that:
1. The County Engineer must be notified 72 hours prior to the beginning
of construction in order that he, or his designated inspector, may
inspect the actual installation.
2. All damage to the roadways and rights-of-way will be repaired to their
original condition to the satisfaction of the County Engineer.
3. 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. Brazos County will in no way be responsible forlany damage which
might occur to any existing utility lines in the right-of-way.
5. 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. The line or lines will be constructed no less than twenty-four inches (24")
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. All sites will be barricaded during the construction period.
Construction of this line will begin on or after theJ-aay of]Yt@4 200(0
5 Bores W, We P PC
-4. Pt°
By:
v,4yUs- .
s17 gA Pt f ~
APPROVED BY COMMISSIONERS'
COURT ON:
County Judge
Address: V0. Q&( ~5b
WPE C6lK-1-798(
Phone kaT (idO _Ornq
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