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					       Request for Application

Newborn Home Visiting Initiative

 3 Year Funding: FY 06-07 to FY 08-09



     Applications must be received by:
                  5:00pm
       Thursday February 23rd, 2005


                First 5 Santa Barbara County

1 East Anapamu, Suite 200      218 Carmen Lane, Suite 111
 Santa Barbara, CA 93101         Santa Maria, CA 93458
   (805) 884-8085                    (805) 739-8740
     ABLE OF CONTENTS

Part 1: Background
A.      What is First 5 Santa Barbara County?
B.      Vision and Mission
C.      Strategic Plan Focus Areas and Goals
D.      Funding Strategy

Part 2: Initiative Description
A.      Vision of the Initiative
B.      Eligible Strategies for Investment
C.      Initiative Program Model
D.      Expected Initiative Outcomes
E.      Types of Eligible Applications
F.      Available Funding

Part 3: Eligibility and Requirements
A.      Eligibility
B.      Requirements

Part 4: Application Narrative
A.      Abstract
B.      Agency and Staff Qualifications
C.      Proposed Program Implementation
D.      Supervision and Accountability
E.      Description of Collaborative Planning Process
F.      Evaluation and Program Improvement
G.      Fiscal Management and Controls
H.      Budget and Cost Effectiveness
I.      Sustainability
J.      Required Attachments

Part 5: Timeline and Submission Guidelines
A.      Timeline
B.      Submission Guidelines

Part 6: Award Process
Part 7: Grant Conditions
Part 8: Attachments




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Part 1: Background
A. What is First 5 Santa Barbara County
Research shows that a child’s brain develops more during the first 5 years of life than at
any other time of their lives. What parents and caregivers do during these first years of a
child’s life can make a profound difference on their brain development and can impact
the rest of their life. Based on this research, California voters passed Proposition 10, the
California Children and Families Act, in 1998. Proposition 10 added a 50 cent tax on all
tobacco products to fund early childhood development, health care, parent education
and programs that improve services for children five and under and their families.

Funds from Proposition 10 are distributed to local counties based on the number of
babies born in the county. Santa Barbara County receives approximately $5 million per
year. Funds are distributed by local county commissions. First 5 Santa Barbara County is
responsible for developing a strategic plan to guide local funding decisions that are
consistent with the intent of the California Children and Families Act.

First 5 Santa Barbara County is led by a Commission appointed by the County Board of
Supervisors. An Advisory Board with community representatives is actively involved in First
5 programs and projects including strategic planning, the funding process and
evaluation.

B.     Vision
       First 5 Santa Barbara County envisions a future where all children in Santa Barbara
       County will live and thrive in safe, supportive, nurturing, and loving environments;
       enter school as healthy, active learners; develop resilience; and achieve their
       potential.

       Mission
       First 5 Santa Barbara County is committed to working with families, partners, and
       communities to improve the lives of children through the support of countywide,
       integrated, culturally relevant and sustainable systems of services that promotes
       optimal child development.

C. Strategic Plan Focus Areas and Goals
First 5 Santa Barbara County is focused on making progress in four focus areas with four
overarching results that they would like to see for children birth through age five and their
families in Santa Barbara County.

Child Health: Healthy Children
Early Development & Education: From Birth to Kindergarten, Children Learning & Ready
for School
Family Strengthening: Strong Families
Systems Improvement: Accessible Community-Based Services and Support for Children
and Their Families




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Goals
First 5 believes that in order to accomplish our mission for children and families we must
commit to a set of goals and outcomes that will be the foundation for First 5’s investment
and work over the next 6 years. For each of the four focus areas a set of corresponding
goals and outcomes has been developed. These are based on input from the
community on priority needs, community-wide data, research and First 5’s experience
over the past 6 years of investing in local programs and initiatives.

Goal 1: Child Health
Improve children’s health by increasing access and utilization of comprehensive,
preventative and primary health care

Goal 2: Early Development & Education
Support each child’s innate ability to grow and develop cognitively, emotionally, socially
and physically by increasing and enhancing early learning opportunities

Goal 3: Family Strengthening
Increase support for families so that they are able to provide safe, stable and nurturing
environments for their children

Goal 4: Systems Improvement
Improve the systems of programs and services for children and families so that they are
easily accessible for all families

D.       Funding Strategy
First 5 Santa Barbara County funds programs based on structured initiatives with a
prescribed menu of research based strategies. This application process will provide 3-
year funding (FY 06-07 – FY 08-09) for 1 of the following 5 initiatives:
      Early Childhood Oral Health: A countywide partnership to provide oral health
         education, screenings and treatment for children 0-5 and their families.
      Early Care and Education: A partnership to increase the availability of high quality
         early care and education services in the county and to raise awareness of the
         importance of early care and education.
      Family Support: A network of community-based family support programs that will
         provide services and links to services for families. (i.e. parent education, family
         support, counseling, eligibility assistance)
      Early Childhood Mental Health and Other Special Needs: A partnership of
         organizations to provide services for children and families that focus on early
         identification, assessment and comprehensive services.
      Newborn Home Visiting: Home visiting services for all infants in Santa Barbara
         County from birth through nine months. Services to include information, support,
         health and developmental screenings and referrals for infants and their families.

Each initiative has a separate application process. Please make sure that you are using
the correct initiative application for your program.




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Part 2: Newborn Home Visiting Initiative Description
A.     VISION:
Every family in Santa Barbara County creates a nurturing and healthy environment in
which their babies will thrive. This includes continuing to visit families of all newborns in
Santa Barbara County that consent to visits.

B.     NEWBORN HOME VISITING INITIATIVE STRATEGIES FOR INVESTMENT:
ONLY THE STRATEGIES LISTED BELOW ARE ELIGIBLE FOR FUNDING. PLEASE DO NOT REQUEST FUNDING FOR
STRATEGIES NOT LISTED.

Newborn Home Visiting: Postpartum assessments, developmental screenings, RN and
child development specialist visits, linkages to community health resources and follow-up
for newborns and their parents.

Parental Support For Children’s Early Learning: Programs and services that help parents,
as their child’s first teacher, to foster their child’s early learning and support their
emotional and social development from birth onwards.

Information & Referral: Support for outreach to connect families to available services
through information and referral, family resource centers, home visiting, community-
based programs and community and media outreach.

Coordinated Service Delivery: Require cross-agency coordination in all funded initiatives
and cross-initiative communication and coordination. Encourage co-location of services,
coordinated case management and integrated data collection systems where
appropriate. Support the development of integrated services within communities that
provide a continuum of services from birth through Kindergarten entry.

C.     INITIATIVE PROGRAM MODEL:

First 5 Santa Barbara County will select only one Application to fund in this initiative.
Therefore, only Lead Agency Applications may be submitted. All potential linked
services, such as transportation or nursing must be included as subcontracts under the
lead agency.

Program Components:
A successful application will:
     a. Offer professional-level (RN/BA) newborn home visitation services to all families
        residing in Santa Barbara County with a baby aged birth through 9 months
     b. Base all service delivery on a research based newborn home visitation model
        that has shown to be effective when used universally (non-targeted population)
     c. Provide or link to other agencies to provide additional family supports as needed
     d. Coordinate services with hospitals and birthing centers
     e. Demonstrate effective communication with OBGYN’s and Pediatricians




                                                5
     f. Establish/strengthen relationships with Family Resource Centers throughout the
        county to provide parent and family support, especially after home visitation
        program services have ended
     g. Coordinate the distribution of the Kits for New Parents
     h. Educate families about the multitude of services for families with young children
        by serving as a platform to distribute information for First 5 Santa Barbara County
        and its funded agencies

D.        WHAT ARE THE EXPECTED OUTCOMES FOR THE NEWBORN HOME VISITING INITIATIVE:

ALL APPLICANTS MUST DEMONSTRATE HOW THEY WILL POSITIVELY IMPACT THE OUTCOMES LISTED BELOW. IN
ADDITION, APPLICANTS MUST LIST AND DESCRIBE EACH OF THE INDICATORS THAT WILL TRACK THE PROGRAM
PROGRESS.

1.   Parents understand their children’s development and participate in their children’s
     care and early learning beginning at birth
2.   Children’s health and developmental needs are identified and addressed early
3.   Children live in safe, stable and nurturing family environments

Newborn Home Visiting Indicators:
 Children 0-5 who received a well child check-up in the past year
 Children 0-5 who receive regular well-child visits according to the schedule
  recommended by the American Academy of Pediatrics
 Children 0-5 with a comprehensive developmental screening in the past year
 Children who received services addressing needs identified in the developmental
  screening
 Children 0-5 exposed to tobacco smoke
 Age of referral for health and other special needs intervention and/or treatment
  services
 Children who are receiving breast milk until they are 6 months old
 Mothers screened for and referred for treatment, if necessary, for post-partum
  depression or other mental health problems
 Parents have confidence in their ability to parent
 Parents identified and referred for treatment for substance abuse problems
 Parents provide, safe, stable, nurturing homes for their children
 Parents have formed secure attachments to their children in the first 5 years of their
  children’s lives

Systems Improvement Indicators:
 Programs are leveraging funding
 Programs provide transportation services
 Programs have expanded service hours or make scheduling flexible
 Providers have the training, knowledge and capacity to work with children with
    disabilities and other special needs
 Programs are providing services to traditionally underserved and underrepresented
    populations
 Services are culturally and linguistically reflective of the children and family members
    served


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    Parents are involved in joint planning at the service level
    Programs that participate in coordination and collaboration across agencies
     including client consultation/case management and data integration


E.      TYPES OF ELIGIBLE APPLICATIONS: One type of Application may be submitted:

 Lead Agency Application Description: An application in which one applicant agency
agrees to act as Lead Agency/Fiscal Agent for the project. The lead agency must
submit one set of attachments with the project totals (Lead Agency and all
subcontractors combined) and separate attachments A-3, A-4, A-5, A-6, A-7, and A-8 for
each contributing agency, including subcontractors. Each subcontracting agency must
sign the application cover sheet (A-1). First 5 Santa Barbara County reserves the right to
contract directly with each Partner or Subcontracting Agency or to exclude funding one
or more of the partners within the application.

All applications, including subcontractors, must show how they will support the overall
vision of the initiative and work in active cross-agency collaboration to meet and sustain
the outcomes outlined in the evaluation plan. Please read the following materials which
were adopted by the First 5 Santa Barbara County Commission in 2005 and can be
downloaded from the First 5 website: Newborn Home Visiting Sustainability Plan,
Newborn Home Visiting Evaluation Plan, 2006-2011 First 5 Strategic Plan.

F.    AVAILABLE FUNDING:
The maximum amount of funding that will be awarded to the successful Lead Agency
per year is $1,018,000 per year for a 3-year maximum of $3,054,000. First 5 Santa Barbara
County may reserve a portion of the dollars allocated for this initiative to solicit additional
applications for areas not met in this application process.




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Part 3: Eligibility and Requirements for all Applicants

A. ELIGIBILITY
Through this competitive process, the Commission will award grants to applicants that
have the expertise and qualifications to successfully facilitate and manage the
described program model for children aged 0-5 and their families.
An organization is eligible to apply if they:

•      Are a nonprofit organization that is tax-exempt of the Internal Revenue Code,
       including faith-based organizations (please request Faith-Based policy if
       clarification is needed) or a Public Agency
•      Have at least three (3) years of demonstrated expertise in serving the under 5 age
       year population
•      Have a demonstrated track record, or capacity to provide services, to families
       within the geographic region that they are proposing to serve;
•      Have the capacity to facilitate and manage the delivery of services as an active
       member of a community based collaborative;
•      Have adequate financial resources and accounting standards;
•      Have no record of unsatisfactory performance or poor business practices; and
•      Have the capacity to conform to all requirements set forth in this RFA

B. REQUIREMENTS
Fingerprinting and Criminal Clearances
Grantees must guarantee that all employees, volunteers and contractors who will
provide direct services to children have a criminal clearance that states that they do not
have a criminal history which would compromise the safety of children.

Child Abuse Prevention and Adherence to Mandatory Reporting Requirements
Grantees and all collaborative partners must ensure that all known or suspected
instances of child abuse or neglect are reported to the either a local law
enforcement agency or Child Welfare Services. Thus, each employee, volunteer or
contractor who have direct contact with children when providing First 5 funded
services must receive annual training and sign a statement that he or she knows of the
child abuse reporting laws and will comply with all requirements.

Technical Assistance and Training
Grantee will be required to participate in all mandatory orientation and training
sessions offered by First 5 Santa Barbara and its approved contractors. All grantees will
be required to participate in a contractors’ orientation.

Bi-monthly Initiative Meetings
Grantees (lead and subcontractors) must attend 6 initiative meetings per year in
order to enhance collaboration, program planning, service quality, sustainability and
evaluation.




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First 5 Initiative Collaboration
To maximize resources and provide a wider array of services and supports to
families, it is imperative that organizations work together. To facilitate joint efforts
at the community level, First 5 Santa Barbara County expects that programs
providing services within an initiative will collaborate with providers from other
First 5 initiatives.

Principles on Equity and Diversity
First 5 Santa Barbara County, in fulfilling its mission, will “take proactive steps to
ensure that children and their families from diverse populations, including
children with disabilities and other special needs, are an integral part of the
planning and implementation of Proposition 10.” 1 The Principles on Equity
developed by the State Committee on Equity will serve as a guide throughout
the work of the Commission:

       1. Inclusive Governance and Participation: to obtain meaningful
          participation and input of the families and other caregivers of children
          from diverse backgrounds with diverse abilities
       2. Access to Services: to assure that children from diverse backgrounds, with
          diverse abilities and that have been traditionally underserved, have
          access to high quality early care and education/development
          opportunities
       3. Legislative and Regulatory Mandates: to ensure that funded programs
          adhere to all legislative, regulatory and accreditation mandates pertinent
          to the provision of services to children from diverse backgrounds and with
          diverse abilities
       4. Results-Based Accountability: to ensure that First 5 programs have
          meaningful outcomes that benefit children from diverse backgrounds and
          with diverse abilities

Record-Keeping and Reports
Grantees, including subcontractors, must institute sound programmatic and
fiscal record-keeping practices. Grantees must keep written and/or electronic
records of all services and activities that are/were provided to families by the
lead agency and subcontractors (if applicable) for which payment will be
rendered under the Initiative for 4 years from the date of delivery.

In-Kind and Matching Funds
Grantees and collaborative partners are strongly encouraged to allocate a
portion of their existing revenue and resources to support the activities in this RFA.
In-kind and matching contributions may include staffing, facilities, supplies and
services. Cash-match contributions may include new or restricted funds to
support the Initiative program requirements and model.

Tri-Annual Reporting Requirements
Grantees will be required to submit a status report three times per year. Any

1   Adapted from the Advisory Committee on Diversity, California Children and Families Commission


                                                      9
reports that are submitted late may be subject to a fiscal penalty.

First 5 Policies
Several commission policies provide information about grantee expectations.
Some of these include: tobacco policy, funding faith-based organizations,
confidentiality, logo and attribution standards, leveraging, supplantation, and
service age.

Insurance Requirements
Successful applicants must maintain and submit annually proof of insurance with
an endorsement naming First 5 Santa Barbara County Children and Families
Commission as additional insured. Please see section 7 in this application for
details.

Lead Agency Responsibilities When Monitoring a Subcontract
The Lead Agency must supervise and monitor all work performed by any and all
sub-contractors including units of service performed, insurance coverage, invoice
amounts and fiscal records. Lead Agency is responsible for reporting units of
service for the subcontractor in each tri-annual report.

Fiscal Reporting
Grantees will be required to submit monthly or tri-annual contractor’s payment
applications in order to be reimbursed for actual expenses.

Leveraging Public Dollars with First 5 Santa Barbara award:
If, during the term of this Agreement, Contractor obtains funding or other income
from a source other than the Commission and such funding or other income is in
excess of that shown as part of the Project Budget and such funding or other
income relates directly to the program or activity funded pursuant to this
Agreement, then Contractor shall so notify the Commission in writing at the next
request for reimbursement. Please note that the Commission strictly prohibits
supplantation of funds (see below.) In addition, it is the expectation that all state
or federal dollars (Title IVE, MAA, TCM, etc.) that are leveraged from commission
dollars are reinvested in services for children aged 0-5 and their families within
two years of receipt.

Supplanting
First 5 Santa Barbara County funds may not be used to replace other federal,
state, private, or local funds that currently, or within the last 12 months, have
been committed for program activities. Grantees that receive State or Federal
funds should only request funds for activities or components not currently
supported by other sources. Funds that are requested by the applicant must be
used exclusively for the operation and administration of the proposed activities
outlined in the applicant’s performance scope of work.

Participation in First 5 Santa Barbara County-sponsored Initiative Evaluation




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In addition to their own evaluation efforts, Grantees will be required to actively
participate in the initiative evaluation activities sponsored and funded by First 5
Santa Barbara County. The Commission has partnered with researchers at the
Center for School-Based Youth Development (C4YBSD) in the Givertz Graduate
School of Education at the University of California, Santa Barbara (UCSB) to
provide evaluation consultation and support to help the Commission and its
funded partners document outcomes for children and families.
Grantees participation in the initiative evaluation includes (but may not be
limited to) the collection of data on project implementation, participant
characteristics, and participant outcomes to inform the Commission’s Initiative
Evaluation and promote program learning and improvement. As described in
the data collection section below, data will be entered and reported using the
GEMS database. All grantees will be required to use this data system.

Data Collection
Grantees will be required to collect client-level data on family members and
providers receiving services through First 5 Santa Barbara County funded
programs. Required data collection may include the following: attendance
and case management logs, family demographic information; outcomes and
performance measures; etc. The Commission will provide training on the use of
any data collection instruments as well as the GEMS data collection reporting
and management system. Grantees are expected to have a dedicated staff
person who is responsible for data collection and management (Data Clerk). This
staff person is required to attend all training sessions on usage of the evaluation
and data reporting systems.




                                         11
Technology
To facilitate use of the data reporting system, the grantee (including
subcontractors) must already have, or include in their budget, a computer
system or upgrades with the following specifications:
                            GEMS System Requirements

      Area                    Minimum                         STRONGLY Preferred

                  PC with Intel Pentium/Celeron,
Processor Type    AMD K6/Athlon/Duron family, or      PC with Intel Pentium 4 or above
                  compatible processor.

                  600 megahertz (MHz) or above
Processor Speed   (300-MHz minimum required;          2 gigahertz (GHz) or above
                  may limit performance)

                  256 megabytes (MB) or higher
Ram               (128 MB minimum supported;          512 MB or higher
                  may limit performance)


                  350 megabyte (MB) of available      350 megabyte (MB) of available free
Disk Space
                  free hard disk space                hard disk space


Operating
                  Windows 98/ME/2000/NT/XP            Windows XP
System

                  128 Kbps (Kilobits Per Second) or
                  higher-speed modem, or a
                                                      1 Mbps (Megabits Per Second) or
                  network connection (56 Kbps
Internet Speed                                        higher-speed Cable, DSL or T1
                  minimum supported; may limit
                                                      equivalent network
                  utility of data transfer to and
                  from the server)




                                          12
Part 4: Application Narrative
Use exact headings and subheadings in the narrative. The narrative must not
exceed fifteen (15) pages total, not including appendices and required
documents. In completing the narrative, applicant must pay special attention to
the Initiative Description and applicant eligibility and requirements section. It is
the responsibility of the applicant to address all issues listed in the Initiative
Description and eligibility and requirements section.

A. Project Abstract – ½ page maximum
       Provide a brief, concise abstract of the proposal that is no longer than ½
       page. This summary should highlight clearly what you hope to
       accomplish, and the proposed plan of action to undertake the activities
       described in the RFA. Please note that the Abstract will be used in the
       Executive Summary of each application.

B. Agency and Staff Qualifications - 1 page maximum (5 points)
     1. Please provide a brief description of your agency/organization,
        including any subcontractors.
     2. State your agency’s mission and overall philosophy.
     3. Highlight all relevant experience in providing early childhood services.
     4. List the qualifications, relevant experience, education, and training of
        each person that will work in the program. Include subcontractors
        and administrators who will have significant involvement in the project.
     5. Specifically describe the ethnic, cultural and linguistic composition of
        direct service staff for this project.

C. Proposed Program Implementation – 7 pages maximum (50 points)
       6. Utilizing the Program Components outlined in “Part 2 – Section C –
          Initiative Program Model,” detail how each Program Component is
          fulfilled in this application. Please reference each Program
          Component by number and letter. Under each Program Component
          identify what strategies the applicant will use to fulfill that component,
          and how the strategies utilize best practices. Please include expertise
          the applicant has in the provision of these services.
       7. How will services from various entities such as Santa Barbara County
          Public Health Department, Public Health Teenage Parenting Program,
          Cottage and Marian Hospitals, and others be triaged with proposed
          services in this application so that newborn home visiting services are
          not duplicated anywhere in the county? Please explain any regional
          differences in program services.
       8. Describe how families who are utilizing the newborn visitation program
          will be connected with family support and other programs offered in
          the community. In particular, how will families who have completed
          the program be connected with other support services in the
          community? Please list which community programs, including family




                                         13
           resource centers, for which you already have established referral
           protocols and/or MOU’s.
       9. What process will be used to connect with families who are difficult to
           reach in order to insure that client cases are not closed prematurely?
       10. In the proposed program, what will be the formal process for clients to
           offer feedback and program suggestions?
       11. In the proposed program, what will be the formal process for nurses,
           physicians, and key partners to offer feedback and program
           suggestions?
       12. What role will the applicant take in advocating for regional unmet
           needs which are identified during the home visits?
       13. Describe your familiarity with serving parents of newborns. Include
           your expertise in working with culturally, linguistically, geographic and
           socio-economically diverse groups.
       14. Describe how you will build on your agency strengths and resources
           and those of other community or collaborative partners to implement
           the model in this application.
       15. Discuss how plans for implementation will ensure that services are
           sensitive and relevant to diverse populations.
       16. Discuss the specific role that collaborative partners and key staff will
           play in implementation and day-to-day activities.
       17. If this application includes a subcontractor/s, please explain how you
           will monitor the completion of subcontractor duties including:
           program, fiscal, and evaluation. Specify which staff person will be
           responsible monitoring subcontractors.

D. Supervision and Accountability – ½ page maximum (5 points)
      18. Please describe how project services and activities will be supervised.
      19. Describe the protocols that you will follow to verify that clients receive
          needed/requested services and monitor participant outcomes.
      20. Explain how collaborative governance will occur amongst
          participating organizations, groups and families.

E. Description of Collaborative Planning Process – ½ page maximum (5 points)
      21. Please describe the process utilized to develop this application
          including the involvement and collaboration of agencies and
          partners.

F. Evaluation – 2 pages maximum (15 points)
      22. Utilizing the First 5 Initiative Evaluation Plan, provide an overview of how
          you will assess and evaluate the effectiveness of the program and your
          efforts. Please explain how the proposed program meets some/all of
          the priority outcomes listed in Part 2 Section D of this application.
      23. Please list all tools that will track and evaluate program services. This
          should match tools listed in Attachment 6. Explain the rationale for
          choosing each tool selected.
      24. How will program participants be included in program evaluation?
      25. Explain how you will ensure the security of client related data. How is


                                         14
           data collected and where is it stored?

G. Fiscal Management and Controls – 1 page maximum (5 points)
       26. Describe the fiscal management experience of your agency and
           discuss the fiscal controls that will be used for this project.
       27. Provide a brief description of agency accounting systems including
           payroll and ledger systems for receivables, payables, expenses and
           disbursements.
       28. If this application includes a subcontractor/s, please explain how you
           will monitor expenditures and verify subcontractor invoices.

H. Budget and Cost Effectiveness – 1 page maximum, not including attachments
   (5 points)
       29. Provide the most recent Independent Audit for the Lead Agency.
           Label as Attachment 12. If the lead agency does not have an
           independent audit, please explain why and provide your most recent
           agency fiscal report.
       30. Complete a detailed budget for each year that you are requesting
           funds in this application using Attachment # 7. If this application
           includes a subcontract, complete attachment # 7 for each
           subcontracting agency.
       31. Provide an explanation of how your agency and any subcontracting
           agencies determine indirect cost rate and describe what costs are
           specifically included in this rate using Attachment #8 . Please note
           that indirect cost cannot exceed 15% of total grant amount awarded
           excluding equipment and capital expenditures.
       32. Provide a narrative for your proposed budget. The information
           included in this section should correspond to the figures in Attachment
           7. If the budget includes consultant costs, describe scope and
           purpose of consultant.

I.   Sustainability Plan – 1 ½ pages maximum (10 points)
       33. If this application is awarded, specifically describe how you plan to
           sustain the proposed program and program results beyond this 3-year
           term.
       34. Describe your experience in sustaining grant-funded programs for
           children in the last 5 years. Please include: how many grant-funded
           programs your agency has sustained and to what extent the original
           program services still exist.
       35. What strategies will the applicant agency utilize in maximizing
           opportunities for federal, state and private forms of leveraging dollars
           for long-term sustainability and program enhancement?
       36. If applicable, please list all staff positions in this application whose work
           will qualify to leverage additional resources such as Medi-Cal
           Administrative Activities (MAA), Targeted Case Management, etc.
           Please explain how these dollars, once secured, will be utilized to
           expand or enhance project services.



                                           15
J.   Required Attachments – Attachments must be clearly labeled.
       1.     Application Cover Sheet (Attachment 1)
       2.     Application Checklist (Attachment 2)
       3.     Geographic Location of Clients Served (Attachment 3)
       4.     Units of Service (Attachment 4)
       5.     Client Type Details (Attachment 5)
       6.     Evaluation Tool Matrix (Attachment 6)
       7.     Program Budget (Attachment 7)
       8.     Indirect Cost Rate Description (Attachment 8)
       9.     Agency Involvement in Litigation (Attachment 9)
       10.    Agency Organizational Chart (Label as Attachment 10)
       11.    Proof of nonprofit status, if applicable (Label as Attachment 11a)
       12.    Clinic/Agency license, if applicable (Label as Attachment 11b)
       13.    Independent Audit (Label as Attachment 12)
              If your agency has not had a recent independent audit, please
              explain.




                                        16
Part 5: Timeline and Submission Guidelines
A. Timeline

           Date                                          Activity
     January 9, 2006        RFA Release Date

    January 13, 2006        Bidders Conference
                            Applicant Workshop and Informational Meeting 9am-12pm at
                            Royal Scandinavian, Solvang
    January 27, 2006        In-person technical assistance regarding forms and requirements
     9:30am-1:30pm          in the Santa Maria and Santa Barbara First 5 Office. Questions
                            regarding content will not be answered.
   February 23rd, 2006      Applications are due received by 5:00 p.m. at either First 5 Santa
                            Barbara County office (Santa Barbara or Santa Maria)
                            Applications are Reviewed by Funding Panels
 March 27 – April 6, 2006
                            Funding recommendations posted to the First 5 Santa Barbara
      April 12, 2006
                            County website
      April 17, 2006        Recommendations are heard by the Commissioners

   April 17 – 21st , 2006   Protest Period

     April 27th, 2006       Protest Hearing

                            Funding Approved by Commission
      May 15, 2006




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B. Submission Guidelines
Applicant must submit the original (signed in blue ink), ten (10) photocopies that
are 3-hole punched of the application, and a CD that includes a copy of the
application and all required attachments (not including agency audit). These
materials must be addressed to:


    Pat Wheatley, Executive Director             Pat Wheatley, Executive Director
      First 5 Santa Barbara County                 First 5 Santa Barbara County
                                         OR
       1 East Anapamu, Suite 200                   218 Carmen Lane, Suite 111
        Santa Barbara, CA 93101                        Santa Maria, CA 93458

Applications can also be delivered by the U.S. Postal Service or Private Mail
Courier but must be received (not post-marked) by 5:00 p.m. on February 23rd,
2006.

First 5 Santa Barbara County takes no responsibility for the handling of any
application that is mailed and not delivered in person. Applications received
after 5:00 p.m. on February 23rd, 2006, or sent via fax or via email to the First 5
Santa Barbara County office will not be accepted. NOTE: First 5 Santa Barbara
County is not responsible for delays due to traffic, parking, or other issues that
may prevent the timely submission of the application. Any application that does
not meet these submission guidelines will not be reviewed. Please allow for
additional time to account for unexpected delays.

Applications must adhere to the following guidelines to be considered:
  • Use only 8 ½” by 11”, white paper
  • Times New Roman font, no less than 12-point
  • Single sided only
  • No less than 1-inch margins
  • 1.0 line spacing
  • Clip all copies of the application-no bound copies accepted
  • Provide page numbers
  • The narrative must not exceed 15 pages total, not including attachments
      and required documents

A complete proposal package will consist of a complete narrative and all
required attachments.

Submission Order:
   1. Application Cover Sheet (Attachment 1)
   2. Application Checklist (Attachment 2)
   3. Application Narrative
   4. Geographic Location of Clients Served (Attachment 3)
   5. Units of Service (Attachment 4)
   6. Client Type Details (Attachment 5)
   7. Evaluation Tool Matrix (Attachment 6)



                                        18
   8. Program Budget (Attachment 7)
   9. Indirect Cost Rate Description (Attachment 8)
   10. Agency Involvement in Litigation (Attachment 9)
   11. Agency Organizational Chart (Label as Attachment 10)
   12. Proof of nonprofit status or applicable business license, if applicable
       (Label as Attachment 11a)
   13. Clinic/Agency license, if applicable (Label as Attachment 11b)
   14. Independent Audit (Label as Attachment 12)
       If your agency has not had a recent independent audit, please explain.

Withdrawal of Application by Applicant
An application may be withdrawn in its entirety by submission of a written
request signed by a representative of the organization. Submit and label a
withdrawal request as follows:

WITHDRAWAL OF RFA 06-09
First 5 Santa Barbara County
1 East Anapamu Street, Suite 200
Santa Barbara, CA 93101




                                      19
Part 6: Award Process
First 5 Santa Barbara County will award grants to applicants that have the
expertise and qualifications to successfully provide high quality programming
matching the prescribed strategies listed in part 2: Initiative Description .

Review of Applications will occur in two phases:

Phase I
Applications must first pass the “Application Requirements Checklist” review
(Attachment 2) in order to be eligible for further review. This is a pass/fail
evaluation. To pass the Checklist, the applicant must have responded “yes” to
each of the questions. If “N/A” is checked a documented reason must be given
for this response. Applications that do not pass the Checklist review will be
considered unresponsive and will not be eligible for further consideration.

Phase II
A panel will be assembled to review proposals. Applications and all required
documentation will be reviewed and scored according to the applicant’s
experience and demonstrated capacity to implement and manage the
requirements of the initiative and program model as listed in this Request for
Application.

A one-hour question and answer session will be scheduled on the day that
initiative applications will be reviewed in order to clarify any items for which
panel members would like additional information from applicants. This session
will be done in a group format, by initiative. Agencies will receive two weeks
advance notice regarding the date, time and location that this question and
answer session will be held.

Scoring Guidelines
Agency and Staff Qualifications                        5 points
Proposed Program Implementation                        50 points
Supervision and Accountability                         5 points
Description of Collaborative Planning Process          5 points
Evaluation and Program Improvement                     15 points
Fiscal Management and Controls                         5 points
Budget and Cost Effectiveness                          5 points
Sustainability                                         10 points

Based on these reviews, qualified applicants will be recommended by the
funding review panel for funding to the First 5 Santa Barbara County Commission.
An applicant must receive a minimum of 75 points in order to be considered for
funding.

Notification of Intent to Award




                                        20
On April 17th, 2006, written notification of the Commission’s recommendations will
be e-mailed to all applicants and posted to the First 5 Santa Barbara County
website. A public hearing will be held by the Commission on final funding
recommendations on May 15, 2006. Written notification of the Commission’s final
recommendations for funding will be e-mailed, and a hard copy mailed, to all
applicants notifying them of the identity of the selected applicants and the
contract amounts.

Contract Award Protest Process
1.    An applicant that has submitted a application may file a Protest Letter
      within five (5) working days after the “Notice of Intent to Award” has been
      posted on April 17th, 2006. Protests will only be considered if received in
      the Commission office by 5:00 p.m. on April 21st 2006.

2.    Protest Letters must state the reasons, law, rule, regulation or practice on
      which the protest is based.

3.    Protest Letters are to be labeled and addressed as follows:


                             PROTEST TO RFA 06-09
                             First 5 Santa Barbara County
                             1 East Anapamu Street, Suite 200
                             Santa Barbara, CA 93101

4. The Commission shall conduct a public hearing on April 27th, 2006 in Solvang
   to resolve all timely protests. The Commission’s decision on each protest will
   be final and cannot be appealed. The Commission will give written notice to
   each protester, setting forth the final outcome of their protest.




                                        21
Part 7: Grant Conditions
Specific grant conditions, including but not limited to the following, apply to
proposal submission and implementation and to any agreements that result from
the submission and implementation of the application. This is not an exhaustive
list of conditions.

A. Rights of the Commission
The Commission may, at its sole discretion, reject any or all applications
submitted in response to this document. The Commission also reserves the right
to cancel this offer at its sole discretion at any time before execution of a Grant
Agreement. The Commission shall not be liable for any costs incurred in
connection with the preparation of any application submitted in response to this
document. Any applications, including attached materials, submitted in
response to this document shall become property of the Commission.

B. Disclaimer
The Commission is not responsible for the representations made by any of its
officers or employees before the execution of a Grant Agreement by the
Commission unless such understanding or representation is included in this
document and/or in subsequent addenda. The Commission is responsible only
for that which is expressly stated in this solicitation document and any authorized
addenda thereto.

C. Applicant’s Financial Status
The Commission reserves the right to request additional financial status
information at any time to verify an applicant’s past and/or current financial
status.

D. Disclosures of Contents of Proposals
All applications, statements of qualification, corporate or organizational
documents, financial statements and/or any other information submitted in
response to this RFA shall be become the excusive property of First 5 Santa
Barbara County. To the extent required by applicable law, all applications shall
be regarded as public records, with the exception of those parts of each
proposal defined by the Applicant as business or trade secrets and plainly
marked as “TRADE SECRET,” “CONFIDENTIAL,” or “PROPRIETARY.” Such
information should not appear on the same page as non-proprietary or non-
confidential information. All determinations regarding the confidentiality of any
information shall be made in the sole and absolute discretion of the Commission
in consultation with legal counsel.
The Commission shall not in any way be liable or responsible for the disclosure of
any such records or any part therefore, if disclosure is required or permitted
under the California Public Records Act or other applicable law or order of a
court.

E. Contact with First 5 Santa Barbara County Employees, Commissioners, and/or


                                        22
Advisory Board Members
As of the issue date of this Funding Request and continuing through the public
notification of the award, all First 5 Santa Barbara County personnel and
Commissioners (except for the below designated First 5 Santa Barbara County
personnel) are specifically directed not to hold meetings, conferences, or
technical discussions regarding this Funding Request with prospective grantees.
“Off the record” contacts can potentially taint the Commission’s decision-
making process. Please do not attempt to initiate this type of communication.


   Any questions or comments regarding this Funding Request must be addressed in
   writing to:

        Sara Soto, Administrative Secretary First 5 Santa Barbara County
         Via fax (805) 564-8586 or email ssoto@co.santa-barbara.ca.us

   In addition to your specific question, indicate which Initiative RFA you are inquiring
   about and your contact information (in case we do not understand your question.)

   All questions received by January 17th at 5pm will be compiled and answered in a
   comprehensive document on our website by 5pm on January 20th. Questions
   received between January 18th and February 1st will be answered as above by
   5pm February 3rd. ALL QUESTIONS RECEIVED AFTER 5PM FEBRUARY 1ST WILL NOT BE ANSWERED.

F. Conflict of Interest Condition
It is the applicants’ sole responsibility to be aware or and comply with all
applicable laws and regulations including, without limitation, California’s strict
conflict of interest laws. FIRST 5 SANTA BARBARA COUNTY RESERVES THE RIGHT TO
REJECT ANY PROPOSAL THAT DOES NOT COMPLY WITH THIS REQUIREMENT.
Applicants who have any question about this or any other restriction are advised
to consult with the designated First 5 Santa Barbara staff member BEFORE
expending time and/or money on developing an application.

G. Conflict of Interest (Grant Agreement Term)
It shall be the responsibility of the Grantee to abide by applicable conflict of
interest laws and regulations pursuant to California law. During the term of this
Agreement, Grantee shall not recruit, hire, employ or compensate any current
Commission employee or consultant for services in connection with this or any
other Commission – funded project without the advance written consent of
Commission.

H. Grantee’s Project Requirements
The Grantee shall be responsible for providing competent, qualified staff to fulfill
the Grant Agreement. The Grantee will provide sufficient personnel to perform all
work in accordance with the specifications set in the Grant Agreement’s Scope
of Work.
The Grantee shall fully comply with Federal statutes and regulations regarding
employment of aliens and certify to the Commission that the Grantee and its


                                        23
employees assigned to the resultant agreement fully meet the standards
imposed by Federal statutes and regulations. The Grantee will indemnify, defend
and hold the Commission harmless from any sanctions that may be assessed
against the Grantee for violation of Federal statutes and regulations pertaining
to employment of undocumented workers. The Grantee shall provide a “Project
Director” who shall be responsible for the performance of the work under this
Grant Agreement. The name and telephone number of this person and an
alternate who can act for the Grantee when the director is absent shall be
designated in writing to the Commission.

I. Licenses, Permits, Registrations, Accreditations, and Certificates
The Commission reserves the right to request at any time, any or all appropriate
licenses, permits, registrations, accreditations, and/or certificates required by
Federal, State, and local laws, regulations, guidelines, and/or directives for the
operation of applicant’s facility(ies) and for the provision of services hereunder
as well as its officers, employees, and/or agents performing the services
hereunder.

J. Responsibility for Employee Wages and Benefits
The Grantee shall be solely responsible for providing to its employees all legally
required employee benefits. The Commission shall not be called upon to assume
any liability for the direct payment of any salaries, wages, or other compensation
to any employees of the contractor or its collaborative partners.

K. Public Statement/Materials
Grantee shall indicate in any and all press release(s), statement to the public, or
printed materials (including brochures, newsletters, reports, etc.) related to the
program that it is “Funded by First 5 Santa Barbara County” and include the First
5 logo as possible. Please see the Logo and Attribution Policy for details.

L. Confidentiality
The Grantee shall maintain the confidentiality of all records, including but not
limited to Grantee records and client records in accordance with all applicable
federal, state and local laws, regulations, ordinances and directives regarding
confidentiality to the extent permitted by law. Grantee shall inform all of its
employees and agents providing services hereunder of the confidentiality
provisions of the Grant Agreement. Grantee shall employ reasonable
procedures to assure that the details of the advertising campaigns adhere to
laws on confidentiality.

M. Program and Evaluation Review
The selected Grantee shall be required to submit status reports three times per
year (“Tri-annual Reports”) that outline the progress on the activities defined in
the application and relevant attachments. First 5 Santa Barbara County will
conduct programmatic and fiscal compliance visits during the grant term.

N. Tangible Property and Capital Expenditures



                                         24
Any Items purchased and capital improvements made with First 5 funds must be
used for their intended purposes as set forth in the grant. If a grant recipient
ceases operation of their business or the program for which the expenditure was
made is discontinued, then at the discretion of the Commission, assets
purchased must be returned to the Commission and expenditures made on
capital improvements must be reimbursed to the Commission.

O. Scope of Work Revisions
In order to make applications within and across initiatives consist and to address
funding panel recommendations, items within an application may need revisions
in order to be funded. Revisions to the scope of work, budget, or evaluation
plan, must be finalized and approved by commission staff no later than June 2,
2006. Any change in this date will be made in writing by the Commission staff.

P. Contract Signing Deadline
The selected Grantee will be required to sign the Contract no later than June 9th
2006. If the Contract is not signed and returned to the commission by this date,
the Commission may withdraw or decrease the grant award. Any change in that
date must be submitted in a written document that is signed and approved by
both parties.

Q. Required Documentation
The following documents will be required before the Contract can be executed:
         •    Insurance Coverage (see below section)

   Grantee shall provide and maintain in effect throughout the duration of this
   contract at least the following policies of insurance, issued by insurers
   admitted to do business in the State of California with a current A.M. Best’s
   Guide Rating of A: VII or better.

   Each such policy of insurance shall apply on a primary and non-contributing
   basis as to Commission and be endorsed to include as additional insured, First
   5 Santa Barbara County Children and Families Commission AND Santa
   Barbara County, its officials, employees and agents, using standard ISO
   endorsement No. CG 2010 with an edition prior to 1992. Grantee shall
   provide certificates and endorsements evidencing such insurance to
   Commission by June 9, 2006. Each such certificate shall state explicitly that
   the policy of insurance shall not be cancelled, withdrawn or allowed to lapse
   for any reason unless the insurer has first given thirty (30) days written notice to
   the Commission. Failure to maintain such insurance and/or to provide the
   required certificates shall constitute a material breach of this Contract.

   Grantee and subcontractors shall provide policies of liability insurance of at
   least the following coverage and limits:

            Commercial General Liability Insurance
      Such insurance shall be written on an ISO commercial general liability
      form with minimum limits of not less than one million dollars ($1,000,000)


                                          25
       per occurrence and two million dollars ($2,000,000) in the aggregate for
       any personal injury, death, loss or damage.

             Workers’ Compensation Insurance Such insurance shall be in an
       amount and form to meet all applicable requirements of the Labor Code
       of the State of California, including Employer’s Liability with limits not less
       than one million dollars ($1,000,000) per accident or disease, covering all
       persons who provide services for Grantee.

              Professional Liability Insurance Such insurance shall cover liability
       arising from any error, omission, or negligent or wrongful act of Grantee or
       its employees, with a limit of liability of not less than one million dollars
       ($1,000,000) per medical incident for medical malpractice liability, or of
       not less than one million dollars ($1,000,000) per occurrence for all other
       types of professional liability.

             Business Auto Liability Primary coverage shall be provided on ISO
       Business Auto Coverage forms for all owned, non-owned, and hired
       vehicles with a combined single limit of not less than $1,000,000 per
       accident and $2,000,000 aggregate.

             Evidence of Self Insurance Legally adequate evidence of self-
       insurance meeting the approval of the Commission’s Legal Counsel may
       be substituted for any coverage required above. Grantee must submit a
       copy of the self-insured certificate issued by the State of California.

R. Submission of Annual Audit
Grantee shall submit an annual independently audited financial statement to
First 5 within 120 days of fiscal year-end unless an annual waiver of this
requirement is received and approved by the County of Santa Barbara Auditor-
Controller’s office prior to the end of the fiscal year in question.

S. Indemnification (Grant Agreement Term)
To the maximum extent permitted by law, GRANTEE shall defend, indemnify and
hold harmless COMMISSION, its officers, officials, employees, agents and
volunteers, from any losses, injuries, damages, claims, lawsuits, actions, arbitration
proceedings, administrative proceedings, regulatory proceedings, losses,
expenses or costs of any kind, actual attorneys fees, court costs, interest, defense
costs including expert witness fees and any other costs or expenses of any kind
whatsoever incurred in relation to, as a consequence of, or arising out of or in
any way attributable in whole or in part to GRANTEE’S performance of this
Agreement including, without limitation, matters of active or passive negligence
on the part of COMMISSION.

Without affecting the rights of COMMISSION under any provision of this
Agreement or this Section, GRANTEE shall not be required to indemnify or hold
harmless COMMISSION for liability attributable to the sole fault of COMMISSION,
provided such sole fault is determined by agreement between the Parties or the


                                          26
findings of a court of competent jurisdiction. This exception shall apply only in
those instances where COMMISSION is shown to have been solely at fault and
not in instances where GRANTEE is solely or partially at fault or in instances where
COMMISSION’S fault accounts for only a percentage of the total liability. In such
cases, the obligation of GRANTEE to indemnify and defend shall be all-inclusive.
GRANTEE SPECIFICALLY ACKNOWLEDGES THAT ITS OBLIGATION TO INDEMNIFY
AND DEFEND EXTENDS TO LIABILITY ATTRIBUTABLE TO COMMISSION, IF THAT
LIABILITY IS LESS THAN THE SOLE FAULT OF COMMISSION.




                                         27
Part 8: Attachments
Directions:    All of the required attachments to be included in your application
are listed below with specific instructions. Please DO NOT print and use this
application copy as you must complete attachments 1-9 on the template
provided on the First 5 Santa Barbara County website
www.First5SantaBarbaraCounty.org .


15.   Application Cover Sheet (Attachment 1)
       When this attachment is downloaded from the website, notice that there
       are two fields needing to be completed through a dropdown menu that
       will 1) identify the initiative for which you are applying and 2) indicate if
       the application is from a Single Agency or from a Lead Agency with
       subcontractors. Because this is a generic cover sheet across all 5 Initiative
       applications, please make sure that you check Part 2E of your particular
       initiative application to see which types of Applications (Lead or Single
       Agency) are acceptable. Once you have completed all of the text and
       numeric fields via computer, print the attachment, and have the agency
       director, board president, and any subcontractors sign the form in blue
       ink.

16.   Application Checklist (Attachment 2)
       Download the attachment from the website and utilize the checkmark
       option to the right of each question to complete the form. Please type
       the Applicant Agency name in the text field located at the top of the
       form. Once the above steps are competed, print the attachment and
       sign the second page in blue ink.

17.   Geographic Location of Clients Served (Attachment 3)
       This form is required for each agency included in the application,
       including subcontractors. If the application contains subcontractors,
       complete one form that comprises the project total (Lead Agency + all
       Subcontractors) and one form for EACH contributing agency (Lead
       Agency + all Subcontractors). Complete all columns and rows of the
       attachment, which correspond with the each fiscal year of the grant 06-
       07, 07-08, 08-09.

       Download the attachment from the website and utilize the checkmark
       and numeric fields to compete the tables. Please type the Applicant
       Agency name and the Subcontractor Name (if applicable) located at
       the top of the form.

       There are two tables included in this attachment, one to indicate the
       number of individual/unduplicated clients projected to be served by this
       project and another table that indicates how many group/duplicated
       clients projected to be served by this project. Please complete the table


                                         28
       that best matches your project. Depending on your project, you may
       complete one table or both.

18.   Units of Service (Attachment 4)
       This form is required for each agency included in the application,
       including subcontractors. If the application contains subcontractors,
       complete one form that comprises the project total (Lead Agency + all
       Subcontractors) and one form for EACH contributing agency. Complete
       all columns and rows of the attachment, which correspond with the each
       fiscal year of the grant 06-07, 07-08, 08-09.

       Download the attachment from the website and utilize the dropdown,
       text, and numeric fields to compete the tables. Please type the Applicant
       Agency name, Subcontractor Name (if applicable), and the Program
       Name located at the top of the form.

       If the applicant has more than 6 units of service, please complete
       additional pages of the template as needed.

       There are 6 types of dropdown menus located on this form: Service
       Code, Client Type, Client Type Details, Focus Area, Service Modality, and
       Measurement Type. Each is described below. Based on what best
       matches the descriptions below with proposed applicant activities, select
       options from the dropdown menus provided.

       Service Codes are designated names for program strategies. For each
       unit of service, select the service code that best matches your program
       strategy. Each of the available service codes and their descriptions are
       located in Table A of these instructions. Please note that there are two
       dropdown menus that provide available codes based on alpha
       sequence A-He and Hf-Z. Select ONLY 1 code per unit of service.

       Client Types include 3 main categories under which all First 5 clients are
       tracked for evaluation purposes. The types are: Family Member, Provider
       (for example child care provider or health care provider), and Group.

       Client Type Details provide further information about who programs are
       serving. Details by the 3 client types are below.
              Family member: Child 0-5, Biological parent, Foster Parent,
                                Adopted Parent, Expecting Parent, Grandparent,
                                Other Relatives, Domestic Partner, Sibling 6-18

             Provider:         Center based ECE, Education Community, Family
                               Support Providers, Family Based ECE, Health Care
                               Providers, Informal Care Providers, Internal
                               Program Staff, Kindergarten Teachers, Other

             Group:            Business Community, Center Based ECE, Children


                                        29
                                 0-5, Community At Large, Education Community,
                                 Expectant Parents, Family Support Providers,
                                 Family Based ECE Providers, Health Care Providers,
                                 Infant Care Providers, Internal Program Staff,
                                 Kindergarten Providers, Parents/Guardians, Siblings
                                 6-18

         The Focus Area dropdown menu links the applicant proposed services to
         the First 5 Strategic Plan. As described in the application, the 4 Strategic
         Plan focus areas are: Child Health, Family Strengthening, Systems
         Improvement, and Early Development and Education. While the
         proposed strategy may fit under more than one category, choose the
         one category that BEST describes it.

         Service Modality describes how the applicant will be providing the
         service. The available modalities for selection in the drop down menu are:
         case management, class/workshop, home visit, in-person consultation,
         mailing/distribution of materials, mobile service, phone consultation,
         public community event, and support group session.

         Measurement Type is how the applicant and First 5 Santa Barbara County
         staff will measure the applicants’ progress in achieving the proposed units
         of service under the column “Units Funded By First 5.” For example, 1 unit
         = 1 hour of service.

         Units Funded By First 5 is where the applicant will type the number of
         measurable units the project will complete per fiscal year with the award.

         Total Units for Project (including leveraged dollars) is where the applicant
         will type the number of measurable units that will be completed by the
         applicant for the project as a whole (First 5 award + additional matched
         and leveraged dollars). If your proposed program will be funded 100% by
         the request in this application, then the numbers in this column would be
         the same as “Units Funded by First 5.”

      EXAMPLE: Program Healthy Teeth is applying to treat 100 children aged 1-5
      who have severe dental problems. Service Code = dental treatment; Client
      Type = Family Member; Client Type Details = Child 0-5; Focus Area = Child
      Health; Service Modality = In-person consultation; Units of Measurement =
      Client Contacts; Units Funded by First 5 = 200 (assumption is that each of the
      100 children needed to have 2 contacts/visits to the dentist to complete
      treatment.)

19.    Client Type Details (Attachment 5)
        This form is required for each agency included in the application,
        including subcontractors. If the application contains subcontractors,
        complete one form that comprises the project total (Lead Agency + all



                                           30
Subcontractors) and one form for EACH contributing agency. Complete
all columns and rows of the attachment, which correspond with the each
fiscal year of the grant 06-07, 07-08, 08-09.

Download the attachment from the website and utilize the numeric fields
to compete the tables. Please type the Applicant Agency name and
Subcontractor Name (if applicable) at the top of the form.

This attachment is comprised of three tables that the applicant will
complete in order to illustrate how many clients the proposed program will
serve over the duration of the grant with First 5 funds and as a whole
(including leveraged funds.) If your proposed program will be funded
100% by the request in this application, then the numbers in the column
“Clients Funded by First 5” would be the same as “Total Clients in the
Project.” Depending on what type of program the applicant is
proposing, there may be projected client counts in one, two, or all three
of the tables. Please enter “0” in each field where there are no clients
projected to be served.

The three tables are: projected unduplicated family members, projected
unduplicated providers, and projected duplicated/group clients and are
described below. Each table is mutually exclusive. In other words, family
member numbers included in table 1 should not count that be included in
table 3.

Table 1: Projected individual/unduplicated family members to be served
Based on the Family Member Type Details that are listed on the left side of
the table and which correspond to the description in Attachment 4,
project how many individual/unduplicated family members will be served
for each fiscal year of the program. An individual and unduplicated
count means that regardless of how many times a program serves a
family member “Anna” she is still counted as 1 person.

Table 2: Projected individual/unduplicated providers to be served
Based on the Provider Type Details that are listed on the left side of the
table and that correspond to the description in Attachment 4, project
how many individual/unduplicated providers will be served for each fiscal
year of the program. An individual and unduplicated count means that
regardless of how many times a program serves a provider named
“Maria” she is still counted as 1 person.

Table 3: Projected group/duplicated clients to be served
Based on the Group Type Details that are listed on the left side of the
table and which correspond to the description in Attachment 4, project
how many clients served in these categories for each fiscal year of the
program. These counts may contain duplicated counts. This table should
be used to estimate counts of group types for programs that are, as part
of the funded application scope of work, serving audiences in a format


                                 31
       where it would not be feasible to obtain specific and individual client
       information (for example, hosting a conference or large workshops.)

20.   Evaluation Tool Matrix (Attachment 6)
        This form is required for each agency included in the application,
        including subcontractors. Use the text fields at the top of the form to type
        the applicant name, subcontractor name (if applicable) and the
        program name.

       In the “Name of Tool” column, please type the name of each tool
       (assessment, screening or other measurement instrument) that the
       applicant is proposing to use in order to evaluate program success and
       client progress. In the narrative section, applicants must explain why they
       have chosen each of the tools listed in this attachment.

       In the second column, please select one of the predesignated client
       types from the drop down menu (family member, provider/professional, or
       group) to indicate the audience for which this tool will be administered.

       In the third column, briefly describe how often the tool will be
       administered to the client. For example: 2 times per year, every 8 weeks,
       etc.

       In the forth column, indicate how many individual clients will be assessed
       with the tool within each fiscal year. If the client type for the tool is a
       group, indicate how many different groups will be assessed within each
       fiscal year.

       In the last column, type each of the indicators in part 2 of this application
       that the selected tool will measure. Please use the exact language in the
       application. If it will measure more than one indicator, please number
       each indicator starting with “1” for each tool.

21.   Program Budget (Attachment 7)
        This form is required for each agency included in the application,
        including subcontractors. If the application contains subcontractors,
        complete one form that comprises the project total (Lead Agency + all
        Subcontractors) and one form for EACH contributing agency. For Lead
        Agencies and Subcontractors, complete one attachment for each of the
        fiscal years corresponding to the application (06-07, 07-08, 08-09.)

       Please make sure that the budget adds correctly and corresponds to the
       application request on Attachment 1- Cover Sheet.

       The maximum allowable indirect cost rate is 15% of the program total
       minus the cost of any equipment and/or capital expenses.

22.   Indirect Cost Rate Description (Attachment 8)


                                         32
       This form is required for each agency included in the application,
       including subcontractors. Complete each of the two questions in the text
       fields provided. Items that listed as part of the indirect cost may not also
       be included as line items in the budget (Attachment 7).

23.   Agency Involvement in Litigation (Attachment 9)
       Complete one form per application utilizing the text fields and the check-
       mark enabled boxes to the right of each question.

24.   Agency Organizational Chart (Label as Attachment 10)
       Submit the Lead Agency organizational chart and label as Attachment 10
       centered at the top of the page.

25.   Proof of nonprofit status, if applicable (Label as Attachment 11a)
        Submit the Lead Agency nonprofit status and label as Attachment 11a
        centered at the top of the page.

26.   Clinic/Agency license, if applicable (Label as Attachment 11b)
       Submit the Lead Agency License and label as Attachment 11b centered
       at the top of the page.

27.   Independent Audit (Label as Attachment 12)
        Submit the Lead Agency Audit and label as Attachment 12 centered at
        the top of the page. If your agency has not had a recent independent
        audit, please explain.




                                        33
                                                                                  Table A




              Service Code                                                                              Service Definition
                                              Educational and consulting activities to help providers obtain and maintain state-regulated licenses and accreditation for operating child
Accreditation Facilitation                    care and preschool facilities
Administrative/collaborative coordination     Activities to help agencies deliver high-quality services/activities for children and families
                                              Includes assessing needs, coordinating the delivery of needed services, creating a service plan with family goals, ensuring that services
Case Management                               are obtained in accordance with the case plan, and/or following up and monitoring progress to ensure that services are having an impact
Dental Screening                              Providing brief dental screenings to identify need to additional treatment
Dental Treatment                              Providing check-ups, cleanings, and treatment for identified problems
Developmental Services                        Providing behavioral and developmental services not covered by more specific codes in this table; please provide specifics in Attach # 4
Developmental assessments                     Assessment used to determine if a client has a developmental delay
Developmental Screening                       Screening to determine if a client appears to have typical development or will need further assessment to identify a developmental delay
                                              Classes (not for training or education) that give providers a chance to assemble, discuss common issues, and develop a professional
ECE Classes                                   network
ECE outreach & information                    Outreach to the Early Childhood Provider Community
                                              Providing educational activities and experiences for children 0-5 that are intended to foster social, emotional, and intellectual growth and
ECE provided during other service provision   prepare them for further formal learning at the same time their parent or caregivers are receiving other services (ex. Parent workshop)
ECE provider grants                           Mini-grants to improve quality of care
ECE provider site visits                      Site visits to early childhood providers
ECE provider technical assistance             Workshops, classes, or consulting with providers to build their knowledge and skills for working with children and families
Family assessments/ screening                 Tracks when a family member or client has received an assessment or screening (for example mental health screening)
Family literacy services                      Providing classes, workshops or other supports that focus on the importance of literacy of the family as a whole
Family school readiness services              Providing classes, workshops or home visits with parents together with their children to promote school readiness
Family support services/linkages              Linking families with support programs such as counseling or food assistance and following up to see if the client accessed services
Family Support/Advocacy                       Working with families to access needed supports and services
Father support services                       Programming designed to specifically support and engage fathers in the health and development of their 0-5 aged child
Health advocacy services                      Working with families to connect them with health related services or insurance programs
Health Screening                              Brief screenings to identify if further assessment is needed to treat health related problems such as vision, hearing, asthma, etc.
Health Treatment                              Provision of health services previously identified during screenings
Health/Safety Presentation                    Providing education regarding health and safety of families with young children
Home play kits                                Giving or lending educational materials to families to use with children 0-5
Home Visit - Developmental Screening          Screening a client in his/her home to identify if they appear to have typical development or indicate they should have further assessment
Home Visit - Health and Safety Focus          Serving a client in his/her home with a focus on client and family health and safety
                                                                                    Table A


Home Visit - Parent Education Focus             Providing individualized parent education in his or her home
Home Visit - Birth/Infant Focus                 Providing home visits in a client’s home with a focus on the health, development and well being of his/her infant
                                                Providing individual and family counseling of children or adults (and their families), including play therapy, parent-child interaction
Individual/Family Counseling                    therapy, and family therapy
                                                Providing referrals or service information about various community resources, such as medical facilities, counseling programs, family
Information & referral                          resource centers, and other supports for families. This is intended to capture quick I&R - NOT related to ongoing case management

Kindergarten Preparatory Education              Providing classes, home visits, camps, tours, or other activities designed to help children transition smoothly into kindergarten
                                                Providing activities that promote adult literacy skills, such as reading, writing, speaking, listening, and learning English as a second
Language/Literacy Education                     language.
Mental Health Assessment                        A formal assessment to identify if a client has mental illness and/or to create a mental health treatment plan
Mentoring                                       Mentoring of Early Care Providers
                                                Offering classes, groups, or other educational opportunities for parents or expectant parents to increase knowledge and skills related to
Parenting Education                             parenting young children
Service provider training/TA                    Workshops, classes, mentoring, or consulting with providers to build their knowledge and skills for working with children and families
Site Visit - ECE Licensing                      Site Visits with a focus on licensing
                                                Salary augmentation, honorariums, or tuition scholarships to encourage early care and education providers to participate in further
Staff/Provider Stipends                         training and remain in the field
                                                Offering classes and other educational opportunities for providers to increase knowledge and skills related to children 0-5 and their
Staff/Provider Training                         families
Transportation                                  Providing free or low cost transportation for individuals whose points of origin and destination are within the county
W.E.B. 1. Hospital liaison visits               Hospital visit to explain and offer the Welcome Every Baby program to new parents
W.E.B. 2. Postpartum home visits                Home visit completed to new parents with newborns under 2 weeks old
W.E.B. 3. Postpartum follow-up telephone call   Phone call completed to new parents with newborns under 2 weeks old
W.E.B. 4. 4-month home visit                    Home visit completed to new parents with babies who are approximately 4 months old
W.E.B. 5. 6-month follow-up telephone call      Phone call to parents with babies who are approximately 6 months old
W.E.B. 6. 9-month home visit                    Home visit completed to new parents with babies who are approximately 9 months old
W.E.B. 7. 9-month follow-up telephone call      Phone call to parents with babies who are approximately 9 months old
                                                   Attachment 1
                               First 5 Santa Barbara County Application Cover Sheet

 What Initiative:     Select

Type of Application            Select

Name of Applicant Agency/Organization:

Program Contact/Title                                                       Telephone #

Email address:
Agency Address:
                                                                            FAX #
(Street/City/Zip)
                                                           FY 06-07       FY 07-08        FY 08-09       Total
Amount of Grant Application Request
                                                       $              $               $              $

Name of Agency Director

Signature of Agency Director

Name of the President of the Board of Directors

Signature of President of the Board of Directors

Tax-exempt Status:
   Granted          170 Status with State of CA    Applied for Tax Exempt              Qualified with 509 exemption
   Other                                                Tax ID Number:


                                        Subcontractor Signatures
All subcontractors included in the requested budget must sign below. By signing, the subcontractor is
assuring First 5 Santa Barbara County that they have seen and approved the corresponding
subcontractor budget, scope of work, and related attachments submitted by the applicant on their
behalf. For reference, these attachments are: 3, 4, 5, 6, 7 and 8.
           NAME OF AGENCY                    NAME OF AGENCY DIRECTOR                 DIRECTOR SIGNATURE
                                           Attachment 2
                                Application Requirements Checklist

Agency Name:
                                                                                  Yes   No   N/A

1. My organization is a non profit organization or a public agency

2. My organization has the relevant experience and capability to
   perform the work described in this proposal, and certifies that
   adequate internal controls are in place to manage and meet
   all terms and conditions of the contract

3. My organization has submitted proof of its financial solvency
   as evidenced by the most recent CPA audit (unless exempt), or
   year end financial statement and fully explained any exceptions

4. My organization agrees to comply with all requirements and grant conditions
   .conditions set forth in this Request for Application

5. My organization has completed and included the following items
   in this proposal package:


   a) Proposal Content:
      i)     Abstract
      ii)    Agency and Staff Qualifications
      iii)   Proposed Program Implementation
             Supervision and Accountability
             Description of Collaborative Planning Process
      iv)    Evaluation and Program Improvement
      v)     Fiscal Management and Controls
      vi)    Budget and Cost Effectiveness
      vii)   Sustainability


   b) Required Attachments:
      i)     Application Cover Sheet (Attachment 1)
      ii)    Application Checklist (Attachment 2)
      i)     Geographic Location of Clients Served (Attachment 3)
      ii)    Units of Service (Attachment 4)
      iii)   Client Type Details (Attachment 5)
      iv)    Evaluation Tool Matrix (Attachment 6)
      v)     Program Budget (Attachment 7)
      vi)    Indirect Cost Rate Description (Attachment 8)
      vii)   Agency Involvement in Litigation (Attachment 9)
      viii) Agency Organizational Chart (Label as Attachment 10)
      ix)    Proof of nonprofit status, if applicable (Label as Attachment 11a)
      x)     Clinic/Agency license, if applicable (Label as Attachment 11b)
                                           Attachment 2
                                Application Requirements Checklist



        xi)    Independent Audit (Label as Attachment 12)
               If your agency has not had a recent independent audit, please explain.

6.   Each subcontractor included in this application has:
       i)     Signed the Application Cover Sheet
       ii)    A separate attachment 3, 4, 5, 6, 7, and 8 included in this
              Application

7.   Lead Agency Applications include one set of Attachments 3, 4, 5, 6, 7, 8
     that comprise a complete project total (all subcontractors + lead agency)

8. Applicant Agency and subcontractors have not had any contact with
   First 5 Commissioners and First 5 Commission Staff regarding the content
   of this Application starting January 9th 2006 and will continue not to have
   contact regarding these matters until May 16th, 2006

9. Applicant has signed the original application in blue ink and made 10 copies
   of the application on 3-hole punched paper. Applicant will submit a CD copy
   of the application narrative and all attachments (excluding agency audit).




_______________________________________________________________________________
Name of agency/organization


                                      _____          _____________________________________
Name of authorized agency official                   Title


                                                     _____________________________________
Authorized signature                                 Date
                                          Attachment 3
                                    Location of Clients Served
                                                                           Required for Lead Agency
                                                                           & all Subcontractors.
Lead Agency Name:
Subcontractor Name:


         Directions: Please identify how many clients will be served with First 5 funding

       Table 1: Geographic Location of Clients to be Served Individually
    Check      Community Area              2006-2007       2007-2008        2008-2009
    all that                                Projected       Projected        Projected
    apply
               Santa Barbara
               Carpinteria
               Cuyama/New Cuyama
               Los Alamos
               Santa Maria
               Lompoc Valley
               Goleta
               Guadalupe
               Orcutt
               Isla Vista
               Santa Ynez Valley
               Other in SB County



       Table 2: Geographic Location of Clients to be Served in Groups
    Check      Community Area              2006-2007       2007-2008        2008-2009
    all that                                Projected       Projected        Projected
    apply
               Santa Barbara
               Carpinteria
               Cuyama/New Cuyama
               Los Alamos
               Santa Maria
               Lompoc Valley
               Goleta
               Guadalupe
               Orcutt
               Isla Vista
               Santa Ynez Valley
               Other in SB County
                                                                                                                        Required for Lead Agency
                                                                         Attachment 4                                   & all Subcontractors.
                                                                   Projected Units of Service

Agency Name:                                                                 Program Name:
Subcontractor:
                                                                                      Units Funded by First 5              Total Units for Project
                                                                                                                         including leveraged dollars
     Units of Service                                                              FY: 06-07    FY: 07-08   FY: 08-09   FY: 06-07   FY: 07-08   FY: 08-09

     Service Code: (A - He)     OR     (Hf - Z)

     Client Type: Select             Client Type Details: Select

1.   Focus Area: Select
     Service Modality: Select        Measurement Type: Select
     Additional details:


     Service Code: (A - He)     OR     (Hf - Z)

     Client Type: Select             Client Type Details: Select

2.   Focus Area: Select
     Service Modality: Select        Measurement Type: Select
     Additional details:



     Service Code: (A - He)     OR     (Hf - Z)

     Client Type: Select             Client Type Details: Select

3.   Focus Area: Select
     Service Modality: Select        Measurement Type: Select
     Additional details:
                                                                                                                        Required for Lead Agency
                                                                         Attachment 4                                   & all Subcontractors.
                                                                   Projected Units of Service

Agency Name:                                                                 Program Name:
Subcontractor:
                                                                                      Units Funded by First 5              Total Units for Project
                                                                                                                         including leveraged dollars
     Units of Service                                                              FY: 06-07    FY: 07-08   FY: 08-09   FY: 06-07   FY: 07-08   FY: 08-09

     Service Code: (A - He)     OR     (Hf - Z)

     Client Type: Select             Client Type Details: Select

4.   Focus Area: Select
     Service Modality: Select        Measurement Type: Select
     Additional details:


     Service Code: (A - He)     OR     (Hf - Z)

     Client Type: Select             Client Type Details: Select

5.   Focus Area: Select
     Service Modality: Select        Measurement Type: Select
     Additional details:



     Service Code: (A - He)     OR     (Hf - Z)

     Client Type: Select             Client Type Details: Select

6.   Focus Area: Select
     Service Modality: Select        Measurement Type: Select
     Additional details:
                                               Attachment 5
                                            Client Type Details
                                                                                                     Required for Lead Agency
                                                                                                     & all Subcontractors.
Lead Agency Name:
Subcontractor Name:



Table 1: Enter total # individual/unduplicated family members expected to be served by this program.
(Enter “0” if none)
 Number of Family Member Type            Total           Clients        Total           Clients        Total           Clients
                                        Clients         Funded by     Clients in      Funded by       Clients        Funded by
                                       in Project         First 5      Project          First 5      in Project        First 5
                                       FY: 06-07       FY: 06-07     FY: 07-08       FY: 07-08      FY: 08-09       FY: 08-09

 Child 0-5
 Biological Parent
 Foster Parent
 Adopted Parent
 Expecting Parent
 Grandparent
 Other Relatives
 Domestic Partner
 Sibling 6-18



Table 2: Enter total # individual/unduplicated providers expected to be served by this program. (Enter “0”
if none)
         Number of Provider Type       Total Clients      Clients         Total          Clients         Total       Clients Funded
                                        in Project       Funded by      Clients in      Funded by       Clients         by First 5
                                        FY: 06-07          First 5       Project          First 5      in Project      FY: 08-09
                                                         FY: 06-07      FY: 07-08       FY: 07-08     FY: 08-09
 Center based ECE
 Education Community
 Family Support Providers
 Family Based ECE
 Health Care Providers
 Informal Care Providers
 Internal Program Staff
 Kindergarten Teachers
 Other
                                                Attachment 5
                                             Client Type Details

Lead Agency Name:
Subcontractor Name:



Table 3: Enter total # clients expected to be served by this program in groups-duplicated counts. (Enter “0”
if none)
 Number of Group Client Type         Total Clients   Clients Funded   Total Clients     Clients     Total Clients     Clients
                                      in Project        by First 5     in Project      Funded by     in Project      Funded by
                                      FY: 06-07      FY: 06-07        FY: 07-08          First 5   FY: 08-09           First 5
                                                                                      FY: 07-08                     FY: 08-09

 Business Community
 Center Based ECE
 Children 0-5
 Community at Large
 Education Community
 Expectant Parents
 Family Support Providers
 Family Based ECE Providers
 Health Care Providers
 Infant Care Providers
 Internal Program Staff
 Kindergarten Teachers
 Parents/Guardians
 Siblings 6-18
                                                                   Attachment 6
                                                               Evaluation Tool Matrix



Lead Agency Name:                                                                  Program Name:

Subcontractor Name:

   Name of Tool       To whom will this tool      How often will it be       How many           List the indicator(s) this tool will measure (RFA Section 2)
                        be administered?                                     clients will be
                                               administered to the client?
                           (client type)                                     screened/
                                                                             assessed by this
                                                                             tool per year?
                      Select
                      Select
                      Select
                      Select
                      Select
                      Select
                                             Attachment 7
                                            Program Budget
                                                                                   Required for Lead Agency
                                                                                   & all Subcontractors for
                                                                                   each fiscal year

Complete this form for the entire project. If there are subcontractors budgets involved, please
submit an additional form for each. Identify the subcontractor, and the line items involved in each
subcontract.


Agency Name:                                             (Please check the appropriate box)
                                                              Prime Contractor’s budget
                                                              Subcontractor’s budget

                                                              (Subcontractor’s Name)


Program Name:




Budget Period (Please check the appropriate box)

      July 1, 2006 – June 30, 2007
      July 1, 2007 – June 30, 2008
      July 1, 2008 – June 30, 2009

I.    PERSONNEL                                       Amount           Matching                 Total
                                       Salary         Requested        Amount          **       Project
      Position Title                   Range    FTE   from First 5     Available       Source
                                                                                                Budget
                                                                                       Code
A.
 B.
 C.
D.
 E.
 F.

      Benefits@         %
      Benefits@ various %
      Sub Total-Personnel


II.   OPERATING EXPENSES
 A.   Rent and Utilities
 B.    Office Supplies and Materials
 C.   Telephone/Communications
D.    Postage/Mailing
E.    Reproduction/Copying
F.    Printing
G.    Equipment Lease/Equipment
H.    Travel
 I.   Insurance
 J.   Audit
K.    Training Conferences
L.    Evaluation
M.    Subcontractors
N.    Other




         Subtotal –Operating Expenses


         Capital Expenditures over $5,000 (if required for this project)
         (Itemize and identify items requested.) Competitive bids may be requested by the Commission prior to
         contract.

                  Total Capital Expenditures



      *INDIRECT COSTS


                                     Total Program Costs


**Using the code list below, indicate the            In-Kind: Please identify any in-kind support that is
source of the marching amount available to           available to this project (i.e.: Volunteer hours,
support this program.                                identify role(s) of volunteers, donated office space
                                                     or equipment, etc.)

      Source Code               Description
              1         Agency General Fund
              2         Foundation Grant
              3         Government Grant
              4         Other
              5         State/Federal Leveraging




                          And
                                              Attachment 8
                                     Indirect Cost Rate Description
                                                                      Required for Lead Agency
Lead Agency Name:                                                     & all Subcontractors.

Subcontractor Name:

1. How is the rate for which indirect costs are charged calculated?




2. List all items that are included in your indirect costs:




Please note that indirect cost cannot exceed 15% of total grant amount awarded, excluding
equipment and/or capital expenses.
                                                 Attachment 9

                Agency Involvement in Litigation Form and/or Compliance Difficulties


Agency Name:

Program Name:

Check YES or NO on the following questions. If a YES answer is checked, please explain fully the
circumstances and include discussion of the potential impact on the program, if funded. As part of
the grant agreement process, the COMMISSION, as its own discretion, may implement procedures
to validate the responses made below. The COMMISSION reserves the right to reject all or part of
the grant agreement if false or incorrect information is submitted by the grantee.

                                                                                         YES   NO
 1. Is the organization (or a collaborative partner) currently, or within the past two
 (2) years, involved in litigation?
 2. Is the lead agency director currently, or within the past two (2) years, involved
 in litigation related to the administration and operation of a program or
 organization?
 3. Have there been unfavorable rulings by a funding source against the agency (or
 collaborative partners) for improper management or contract compliance
 deficiencies?
 4. Has the agency or agency director (for the lead agency or subcontractors) ever
 had public or foundation funds withheld?
 5. Has the agency (or subcontractors) ever had its non-profit status revoked or
 withheld?
 6. Has the agency or agency director (for the lead agency or subcontractors)
 refused to participate in any fiscal audit requested by a government agency or
 funding source?

Explanation (Use additional pages, if necessary):




Signature: ___________________________________________ Date: _________________
            (Must be signed by authorized sign signatory).

				
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