HomeMy WebLinkAboutPR 12046:TOBACCO PREVENTION MEMORANDUM
CITY OF PORT ARTHUR
TO: Steve Fitzgibbons, City Manag~"~
FROM: Ernestine Wade, RN, Director
SUBJECT: Proposed Resolution No. 12046
Approval of Contracts between the City of
Port Arthur and Two Subcontractors to
Perform Prevention and Control Activities
DATE:
FILE:
December 30, 2002
COMMENTS
FOR
ADMINISTRATION
USE
ONLY
* REQUESTED BY: Ernestine Wade, RN, Director
* PURPOSE EXPRESSED BY REQUESTOR:
* Approval of contracts between the City of Port Arthur and
* two subcontractors to perform tobacco control and
* prevention activities
* LOCATION: NIA
RECOMMENDATION
It is recommended that the City Council adopt Proposed Resolution No. 12046 authorizing the
City Manager to execute a contract between the City of Port Arthur and The Friends of Dr. Martin
Luther King, Jr. Support Group of Southeast Texas and the Willie Carter Community Outreach
Center to provide tobacco prevention and control activities.
BACKGROUND
The contract between the City of Port Arthur and Texas Department of Health to provide tobacco
prevention and control activities requires that we subcontract with local community groups and
organizations to perform these activities. To meet this objective, the Health Department
advertised for interested community groups, organizations and coalitions to apply for $7,000
grants. Two applicants, one of which was a subcontractor last FY, have applied for those funds.
The applicants are the Willie Carter Community Outreach Center and The Friends of Dr. Martin
Luther King, Jr. Support Group of Southeast Texas.
BUDGETARY/FISCAL EFFECT:
A total of $28,000 has been budgeted for four $7,000 grants to local community groups,
organizations and coalitions; however, we only received two applications. Subcontractors ara
reimbursed as requests are submitted with a Request for Reimbursement form and the
appropriate receipts.
STAFFING/EMPLOYEE EFFECT:
None.
Port Arthur Health Department
MEMORANDUM
CITY OF PORT ARTHUR
Stephen Fitzgibbons, City Manager
December 30, 2002
Page 2
SUMMARY:
It is recommended that the City Council adopt P.R. No. 12046, authorizing the City Manager to
accept and execute a contract between the City of Port Arthur and The Friends of Dr. Martin
Luther King Support Group of Southeast Texas and the Willie Carter Community Outreach Center
to provide tobacco prevention and control activities to the citizens of Port Arthur.
Port Arthur Health Department
P.R. NO. 12046
12/30/02-YDA
RESOLUTION NO.
A RESOLUTION APPROVING THE ACCEPTANCE AND EXECUTION
OF TWO SUBCONTRACTS TO PERFORM TOBACCO PREVENTION
AND CONTROL ACTIVITIES FOR A TOTAL AMOUNT OF $13,900
WHEREAS, a contract between the City of Port Arthur and Texas Department of
Health was approved on August 20, 2002, Resolution No. 02-248 to provide for tobacco
prevention and control activities; and,
WHEREAS, of the $128,314 total grant award for FY 2003, the Port Arthur City
Health Department must use $28,000 to collaborate with local community groups,
organizations and coalitions to provide tobacco prevention and control activities;
WHEREAS, the Health Department advertised for interested community groups,
organizations and coalitions to apply for $7,000 grants to perform these activities;
WHEREAS, the Health Department has received applications from the following two
(2) organizations:
Name Grant Request
The Friends of Dr. Martin Luther King, Jr.
Support Group of Southeast Texas $6,900
The Willie Carter Community Outreach Center $7,000
WHEREAS, the City of Port Arthur Health Department wishes to enter into contract
with these two organizations for the period January 21,2003 through August 31,2003; now
therefore,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PORT ARTHUR:
P.R. No. 12046
12~30~02
THAT the Contracts, a copy of which are attached hereto and made a part hereof
as Exhibits "A"and "B" are hereby approved; and,
THAT said Contracts are an exact duplicate of a City Standard Form Contract
except for the changes described in the Certificate of Standard Form Contract, a copy of
which is attached hereto as Exhibit "C" and is hereby incorporated by reference, and said
changes are hereby approved; and,
THAT the City Manager of the City of Port Arthur and Ernestine Wade, RN, Director
of the City's Health Department are hereby authorized and directed to execute said
Contract on behalf of the City of Port Arthur; and,
THAT a copy of this Resolution be spread upon the Minutes of the City Council.
READ, ADOPTED AN D APPROVED THIS DAY OF ,
A.D., 2003 at a Meeting of the City Council of the City of Port
Arthur, Texas, by the following vote: Mayor: .,
Councilmembers:
NOES:
ATTEST:
Evangeline Green, City Secretary
Mayor
P.R. No. 12046
12/30/02
APPROVED AS TO FORM:
Mark $okolow, City Attorney
APPROVED FOR ADMINISTRATION:
Stephen Fitzgibbons, City Manager
EXHIBIT "A"
Contractual A[~reement
THIS AGREEMENT, made this day of ,2003 between
the City of Port Arthur, herein referenced to as the "CITY" AND The Friends of Dr.
Martin Luther Kin.q, Jr. Support Group of Southeast Texas hereinafter referenced to as
"CONTRACTOR."
IN WITNESS WHEREOF, that for and in consideration of payments, terms, and
conditions set forth herein, the City and the Contractor agree on the following:
1. The term of this contract shall be from January 2'1, 2003 to Auqust 3'1,2003,
unless sooner terminated under Paragrah 8 hereof.
2. The Contractor agrees to perform tobacco prevention and control activities as
outlined in the Contractor's attached grant application for a total award amount of
$6,900.00.
3. The Contractor agrees to use funds awarded specifically for tobacco prevention
and elimination events and projects within the City of Port Arthur. Funds may not be used
for any other project.
4. The Contractor agrees to submit original receipts or invoices of purchases to the
City of Port Arthur Health Department along with a Request for Reimbursement form
before any expenses will be reimbursed. Health Department personnel will submit the
requests for reimbursement to the City's Accounting Division so that expenditures can be
properly documented and reimbursed.
5. The Contractor agrees to submit the required reports in a timely manner in
accordance with the specified format and requirements.
6. The Contractor agrees to indemnify the City and hold harmless the City of Port
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Arthur and its officers, agents, employees or assigns from any and all liability, including
claims, causes of action, or damages to property arising out of or in connection with the
work done by the Contractor under the terms of this contr, act.
7. It is expressly understood that, except for the grant reimbursement compensation
delineated in Paragraph 2, the Contractor waives any and all claims against the City of Port
Arthur, its agents, employees, and assigns for any charges to the Contractor, or damages
caused by the Contractor or to any party arising out of this contract.
8. This Contract may be terminated with thirty (30) days written notice by either
party.
THE CITY:
CITY OF PORT ARTHUR, TEXAS
Steve Fitzgibbons
ITS: City Manager
CONTRACTOR:
The Friends of Dr. Martin Luther King,
Jr. Support Group of Southeast Texas.
BY:
Its:
City of Port Arthur Health Department
and
Texas Department of Health
Office of Tobacco Preventions and Control
Community Tobacco Prevention Activities Grant Application
FY 2002-03
[ I. CoverPage ]
Name of Organization: The Friends of Dr. Martin Luther King, Jr. Support Group of Southeast, Texas
Inc
Tax Exempt Number: Federal EIN: 760286069
Name of Contact Person: Terry Gail Savoy
Street Address: 3801 Turtle Creek Dr.
City/State/Zip Code: Port Arthur, Texas 77642
Mailing Address (if different from above): (same)
City/State/Zip Code: (same)
Telephone: 409-7225314 or 985-9298
FAX:
E-mail Address: tsavo¥(~aol.com
Project Name: Dr. Martin Luther King, Jr. Children & Parent: Making Our City Tobacco-Free
Amount of Funding Requested: $6,900
Type of Entity: (enter appropriate letter in space): C
A. City
B. County
C. Nonprofit Organization
D. For Profit Organization
E. School
F. Other (specify)
The facts affirmed in this proposal are truthful and I understand that the facts affirmed herein and the
continuing compliance with these requirements are conditions precedent to the award and continuation of
a contract. This document has been duly authorized by the governing body of the applicant and I (the
?erson signing below) am authorized to represent the applicant.
Typed Name & Title of Authorized Representative Telephone Number
Hargie Faye Savoy- President DR. M. L .King Support Group 409-722-5314
Community Tobacco Prevention Activities Grant Application FY 2003
In this section, please provide no more than a three (3) page narrative on the following:
1) organization's mission, history/background and capacity to conduct the project
activities; 2) detailed description of the proposed project; 3) the population targeted by
the project; 4) project goals and objectives; 5) proposed activities; and, 6) anticipated
project outcomes.
Applicant
Name: The Friends of Dr. Martin Luther King Support Group of
Southeash Texas (please enter your organization's name on the header of each page
of this proposal)
Proiect Name: Dr. Martin Luther King, Jr. Children and Parents
Making of City Tobacco-Free
II. Project Narrative ]
Organization's Mission History/Background
The Friends of the Dr. Martin Luther King, Jr. Center of Southeast, Texas have served
Southeast, Texas for the past 17 years. This organization has been extremely active in
the community making sure that the "beloved community" that Dr. King talked about is
well informed on current issues and aware that we are our brother's keeper.
The mission of this organization is to educate the community about making our lives
sate and productive and to share the dreams and philosophies of Dr. Martin Luther King,
Jr. We are interested in making sure that violence is approached through conflict
resolutions and that peace is possible in our time. Also, to continue to work with our
youth and their parents in seeing that their future is bright and their dreams can become
reality.
Description of Proiect
The propose project will address intervention programs for our students, prevention
programs for our older students, parental involvement programs and youth rally for
community awareness. This project will provide students and parents and opportunity to
prevent their children for using tobacco and learning about the dangerous effect from
using tobacco. This program will also help older youth to internalize the negative effects
that tobacco has on the body. Also, to get parents actively involved in making sure that
their family is protected from the negative effects of tobacco. Finally, to allow our youth
to actively and aggressively make the community aware of how they feel about tobacco
usage through rallies, letter writing campaigns, flyers, and phone calls to family and
friends.
Population
The targeted populations are:
°:° Students- Ages 4-12
· :° Parents- parents of the students ( ages 4-12 )
Community Tobacco Prevention Activities Grant Application FY 2003
Applicant
Name: The Friends of Dr. Martin Luther King~ Jr. Support Group of
Southeast, Texas Inc.
Population Contiuned
· :. Students in the community- West Side of Port Arthur to Savannah Avenue
Savannah Avenue- Foley Avenue
19th- Lakeshore
Goals and Ob.iective
These are the following goals:
~ To educate 100% of the students at Tekoa Academy about the negative effects of
tobacco
To involve 75% of the parents at Tekoa Academy to attend workshop
concerning tobacco usage
To involve 100% of all parents through letters, phone calls, e-mail and
To educate the targeted community through flyers, rallies and a book fair.
To monthly evaluate the program to make sure that it is roaching and larger body
of people each month
Proposed Activities
These are the proposed activities that will heighten the awareness of the negative effect
of the usage of tobacco:
~' Train all consultants (Jan.)
Establish bi-monthly workshop for parents and students ( survey parents to see
which date is best)
To pass out flyers to inform the targeted areas about the negative effects of
tobacco ( door-to-door campaign )Jan. June & Aug.
Present the "The Dream Team" Living a Tobacco Free Life at the annual Dr.
Martin Luther King, Jr. National Holiday Celebration Brunch ( Jan. 20th & 21st )
Juneteenth Celebration Workshop-" Remember the Past while Protecting Your
Future: Keeping Our Bodies Healthy for A Brighter Future" (June 19th )
Back to school rally in August- "Don't Smoke Your Dreams-Get llooked On
Knowledge Not Tobacco" ( Aug. 6 )
Communi~ Tobacco Prevention Activities Grant Application FY 2003
Applicant
Name: The Friends of Dr. Martin Luther King, Jr. Support Group of
Southeast~ Texas Inc.
Outcomes
The Friends of Dr. Martin Luther King, Jr. expect the following outcomes:
[] Educate all stakeholders about the need to rid the use of tobacco from our
community
Informed youth about the negative effect of tobacco
Provide parents with the necessmy tools needed to share thoughts with their
children
o To increase the awareness of
Community Tobacco Prevention Activities Grant Application FY 2003
Applicant
Name: The Friends of Dr. Martin Luther King~ Jr. Support Group of
Southeast~ Texas Inc.
IV. Project Budget
Cost Categories Amount of Funding Requested
Personnel $ 4, 500
Fringe Benefits $
Travel $ 400
Equipment $ -0-
Supplies $ 1,000
Other $ 1,000
Total $ 6,900
Budget Narrative
Please give a detailed description of the cost categories listed above in which funding is
being requested ( use additional sheets if necessary).
Personnel
Grant Manager- $100 a month for 8 month. The grant manager will manager the grant
and give monthly report the organization and the City of Port Arthur
Consultants - Each consultants will be paid 200 per workshop. There will be 2 (two)
workshops held each month.
Travel
This will cover the cost for Grant Manager for the period of the grant and for any
consultant from the organization acting as the grant manager. We estimate an average of
$50.00 a month.
Supplies
Tobacco-Free T-Shirts- $400
Printing-Flyers- $400
Books- $200
Other-
Dr. M.L.King National Holiday Celebration
Sponsorship 6 Tables ~ 80 = $ 480
Food for Rally, Juneteenth and Back to School Rally $ 620
Equipment Purchases
N/A
EXHIBIT "B"
Contractual A~reement
THIS AGREEMENT, made this day of ,2003 between
the City of Port Arthur, herein referenced to as the "CITY" AND The Willie Carter
Community Outreach Center, Inc. hereinafter referenced to as "CONTRACTOR."
IN WITNESS WHEREOF, that for and in consideration of payments, terms, and
conditions set forth herein, the City and the Contractor agree on the following:
1. The term of this contract shall be from January 21, 2003 to Au.qust 31,2003,
unless sooner terminated under Paragrah 8 hereof.
2. The Contractor agrees to perform tobacco prevention and control activities as
outlined in the Contractor's attached grant application for a total award amount of
$7,000.00.
3. The Contractor agrees to use funds awarded specifically for tobacco prevention
and elimination events and projects within the City of Port Arthur. Funds may not be used
for any other project.
4. The Contractor agrees to submit original receipts or invoices of purchases to the
City of Port Arthur Health Department along with a Request for Reimbursement form
before any expenses will be reimbursed. Health Department personnel will submit the
requests for reimbursement to the City's Accounting Division so that expenditures can be
properly documented and reimbursed.
5. The Contractor agrees to submit the required reports in a timely manner in
accordance with the specified format and requirements.
6. The Contractor agrees to indemnify the City and hold harmless the City of Port
Page 2 of 2
Arthur and its officers, agents, employees or assigns from any and all liability, including
claims, causes of action, or damages to property arising out of or in connection with the
work done by the Contractor under the terms of this contract.
7. It is expressly understood that, except for the grant reimbursement compensation
delineated in Paragraph 2, the Contractor waives any and all claims against the City of Port
Arthur, its agents, employees, and assigns for any charges to the Contractor, or damages
caused by the Contractor or to any party arising out of this contract.
8. This Contract may be terminated with thirty (30) days written notice by either
party. .,
THE CITY:
CITY OF PORT ARTHUR, TEXAS
Steve Fitzgibbons
ITS: City Manager
CONTRACTOR:
The Willie Carter Community Outreach
Center, Inc.
BY:
Its:
City of Port Arthur Health Department
and
Texas Department of Health
Office of Tobacco Prevention and Control
Community Tobacco Prevention Activities Grant Application
FY 2002-03
I I. Cover Page /
II
Name of Organization: Willie Carter Conmmunity Outreach Center, Inc.
Tax Exempt Number / Federal EIN: 740612392
Name of Contact Person: dohnny Hulin
Street Address:s40 W 11TH Street
City/State/Zip Code: Port Arthur, TX 77642
Mailing Address (if different from above):
City/State/Zip Code:
Telephone: 409-982-1387 I Fax Number: 409-982-1387
E-mail Address:
Johnnvhulh(~aol.com
Project Name: 2003 Tobacco Prevention and Cessation
Amount of Funding Requested: $7,000
Type of Entity: (enter appropriate letter in space): C
A. City
B. County
C. Nonprofit Organization
D. For Profit Organization
E. School
F. Other (specify).
The facts affirmed in this proposal are a'uthful and I understand that the facts affirmed herein and the continuing
compliance with these requirements are conditions precedent to the award and continuation ofa conlxact. This
document has been duly authorized by the governing body of the applicant and I (the person signing below) am
authorized to represent the applicant.
Typed Name & Title of Authorized Representative Telephone Number
Johnny Hulin 409-982-2109
Sign ~ture ~3f Authorized Repre_sentafive Date
Community Tobacco Prevention Activities Grant Application FY 2003
In this section, please provide no more than a three (3) page nanative on the following: 1) organizationts mission,
history/background and capacity to conduct the project activities; 2) detailed description of the proposed project; 3)
the population targeted by the project; 4) project goals and objectives; 4) proposed activities; and, 5) anticipated
project Otltconles.
Applicant
Name: Willie Carter Community Outreach Center, Inc.
(Please enter your organization's name on the header of each page ofthls proposal)
Project Name:_2003 Tobacco Prevention and Cessation Program
Project Narrative:
Who We Are
The Willie Carter Community Outreach Center, lnc is a nonprofit organization comprised of substance
abuse professionals, recovering men, women, and community leaders. These concerned citizens crone
together as a consequence of the lack of services available to the indigent population of South Jefferson
County struggling to overcome their addiction to alcohol, tobacco and other drugs. The WCCOC's
fundamental purpose is to provide substance abuse education, prevention and referral services. It's goal is
to assist in eliminating addiction, crime and poverty by helping individuals during transitional periods in
their lives to achieve and maintain a drug free lifestyle and a greater level of emotional, mental and
spiritual health, promote independence and self respect, thus incorporating them back into the community
productive members of society.
The Problem
Tobacco use remains the leading preventable cause of death in the United States, causing more than 400,000
deaths each year and resulting in an annual cost of more than $50 billion in direct medical costs.
Each year, smoking kills more people than AIDS, alcohol, drag abuse, car crashes, murders, suicides, and
fires - combined!
Nationally, smoking results in more than 5 million years of potential life lost each year.
Approximately 80% of adult smokers started smoking before the age of 18. Every day, nearly 3,000 young
people trader the age of 18 become regular smokers.
More than 5 million children living today will die prematurely because of a decision they will make as
adolescents - the decision to smoke cigarettes.
Our Mission
The WCCOC's mission is to coordinate, sponsor, develop and/or implement programming to increase
awareness and educate the community on key tobacco issues including second hand smoke, tobacco use,
cessation, state and local tobacco laws and ordinances
Community Tobacco Prevention Activities Grant Application
Applicant
Name: Willie Carter Community Outreach Center, Inc.__
FY 2003
II. Project Narrative continued.
(duplicate this page as needed)
Capacity
wccoc has addressed the challenges of tobacco prevention for three years with active participation in thc
Texas tobacco prevention pilot progran~, last year our tobacco prevention activities included reaching over
3000 youth and adults, plamfing/and cmTying out several city-wide conmaunity events. WCCOC is committed
to comnmnity-wide collaboration to draw on organizational financial and human resources to enhance public
awareness ofprogranas and services to our target population.
Program Overview
Tbe anti-smoking anti-tobacco program at the Willie Carter Community Outreach Center will help towards the
elimination of disparities among the diverse and special populations of our community including, minorities by
providing anti-smoking anti-tobacco and cessation activities focusing on awareness and prevention of tobacco
use, awareness and protection of the community to environmental tobacco smoke and the hazards of second-hand
smoke.
The curriculum provides information about the consequences of tobacco use; The anti-smoking anti-tobacco
program's main emphasis, is to change the normal beliefs and perceptions of prevalence of use, and on teaching
decision-lnaking, effective communication and refusal assertion skills to increase self-efficacy too not to begin
the use of tobacco products. In the anti smoking anti-tobacco program the participant will learn:
· Active listening skills
· The course of tobacco related addiction and disease
· Correct tobacco use prevalence estimates
· Ways to build self-esteem
· Tobacco-use-specific cognitive coping skills
· Effective communication skills
· General assertiveness
· Assertive refusal practice
· Ways to counteract media portrayals of tobacco use
· Social activism letter writing
2
E
Community Tobacco Prevention Activities Grant Application
Applicant Name: Willie Carter Community Outreach Center~ Inc.
FY 2003
IV. Project Budget
Cost Categories Amount of Funding
Requested
Personnel $ 3600
Fringe Benefits $ 0
Travel $ 0
Equipment $ 600
Supplies $ 800
Other $ 2000
Total $ 7000
Budget Narrative
Please give a de~ailcd descriplion of thc cost categories listed above in which funding is being requested (use additional sheets if
necessary).
· Stipends for Case Managers $3600 for 10 months
· Office Equipment $600
· Supplies/Educational material $800
· Incentives and rewards for Youth$2000
EQUIPMENT PURCHASES
?or all equipment purchases, be sure to give detailed specifications to included: a description o£ each item, the cost per unit, the
number of units to be purchased, the total amount of the purchase, the purpose for the item (s), why the equipment is necessary for the
project, and how thc applicant determined or will determine that the cost is reasonable.
(City el Peri Arthur)
(Law Dapmtmenl)
(Required Form)
(7/8/08)
(t 0/5/89)
(3/15/90)
{0-8.04)
(p.2 Revised 9/10/90)
CERTIFICATE OF STANDARD FORM CONTRACT FOR LAW
DEPARTMENT REVIEW AND CITY COUNCIL AGENDA
I certi[v that the conlract (hereinafter called 'said con0act*) affixed Io the altached proposed City Council Resolution
No. ].?04(~ is an exact duplicate of e,n applicable standard form conlract ([he title or which is shown below}
previously approved by Ihe Law department and adopled es a slandard Iorm by Cily Council Resolulion, excepl for tho
blanks gini have been lilled in with all necessary inlormalion and except Ior the changes described below.
lille of tho applicable standard form conlracl is:
[ ] Fedornlly Funded Construction Contract, Revised 1/5/08, 7/09, 0/09; 4/20/94
[ J Non-Federally Funded Construclion Contracl. Revised 1/5/88.7/89, 8/80; 4/20/04
[ ] Federal - Professional Services - Engineering Contracl, Revised t/5/88, 5/89 (§10) 7/80/(§0); 10/09; 2/et (~O)
Non-Federal - Prolessional Services - Engineering Conlract. Revised 1/5/88. 5/89(§10). 7/09(~8). tO/Se; 2/9t (~])
[ J CDBG - Prolessionol Services - Engineering Con[racl, Revised 115/88, 5/09 {§10}, 7/89(,~0). 10/09; 2/01
[ ] Federal - Professional Services -
Non-Engineedng (Consultanl) Contract, Revised 1/5/88, 5/89 {§10), 7/89 {{8); 10/09; 2/01
[ ] Non-Federal - P~ofesslonal Services *
Non-Engineering (Consultanl) Conlracl. Revised 1/5/88, 5/09 (§tO). 7/89 (~8); 10/09; 2/91 (§8)
[ ] CDBG - Prolessiorlal services -
Non-Engineering (Consultanl) Contract, Revised 1/5/88, 5/09 (§10), 7/09 (~); 10/09; 2/91 (~,~)
~(] Other Slandard Form Conlract, described as ~ollows: FY 200].-02 CONTRACT BETt~EEN TEXAS
DEPARTMENT OF HEALTH AND CITY OF PORT ARTHUR, RESOLUTION NO.
02-09 DATED ]./8/02,
The changes are as follows: (Pul an 'X' In Ihe appropriate [ J)
[j None.
J J The following described provisions ~t Ihe Jndicaled page, seclion, etc. el Ihe standard [ornl have been deJeled
DELETIONS
Page Number Section or Paragraph No. Subsection or
Where and Caption Subparagraph No.
Deleled Provision Which and Caplion
Found On Slandard Form Deleted From Form Deleted From Form Provision Deleted
Page 1 of 2
(p.2 Revised 9/18/90)
(Certificate al Standard Form Conlract, page 2)
[ ] The following described provisions al Ihe indicated page, section, etc. al Ihe standard form have been ~ltered,
modified, ~eplaced or othe~vise changed;
A£TERATtONS, MODIFICATIONS, HEPL~CEMENTS, ETC.
Page § & caption
sub § & caption, etc.
Sub § or Sub 1] No, al said conlraot
Page No. § or 1~ No. & Caption & Caption Description which conlains
Where al o! al alleled, etc.
Provision Found Standard'Form Standard Form Piovision provision; &
on which which in Description of
Standard Form Contains Provision Conlains Provision Slandard Form Alteration elc.
The following provisions have been added Io Said Conlrnct:
Page, Section and Caption
Subsection and Caption, etc. of Said Contract Which
Contains the Added Provision and Descriplion Thereof
I further cerlify Ihal said atlached proposed City Council Resolulion conlalns the Iollowlng provision:
'That said conlrncl is an oxacl duplicnle al a Cily Slnndard Form Contr~c[ oxcepl for the changes described
Certificale at Standard Form Contract,, s copy of which is at[ached herelo ss Exhibil "B" and is hereby incorporaled by
reference, and said changes are heroDy approved."
I undms[ond that Ibis certificate will be relied on ~y Iho Law Deparlr~eld in reviewing and apploving (or rejecting)
as to form end by Ihe Cily Council in reviewing and adopting (or rejec[ing) said Resolution and ConlracL
Depadmenl Head or
Assistant City Manger
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