RFQ‐01‐2012 ExCEL After School Program Request for … · 2012-10-15 · summer programs, the ExCEL After School Program office may determine the school sites available to operate

RFQ‐01‐2012 Page 1 of 20

RFQ‐01‐2012

ExCEL After School Program

Request for Qualifications

San Francisco Unified School District

Student, Family, & Community Support Department

Date issued: October 15, 2012

Question Submittal: October 29, 2012 – 5:00pm

APPLICATION due: 12:00 p.m., November 30, 2012

Qualification Notification: January 19, 2013

Appeal Deadline: January 26, 2013

Final Notification: February 9, 2013

RFQ‐01‐2012 Page 2 of 20

Request for Qualifications (RFQ) – 01 ‐ 2012

TABLE OF CONTENTS

I INTRODUCTION AND OVERVIEW ………………………………………………………….……..………3

A. Introduction

B. Term of the List of Qualified Agencies; Annual Contracts with Selected Qualified Agencies

C. Overview

II SCHEDULE ………………………………………………………………………………………..….………………..5

III LEAD AGENCY OVERVIEW……………………………………………………….……….….………………….5

IV DEPARTMENT OF CHILDREN YOUTH & FAMILIES (DCYF)

MATCH FUNDING ………………………………………………………………………..…………..……..9

V SERVICES CATEGORIES ……………………………………………………………………….….…….………..9

VI LEAD AGENCY QUALIFICATIONS ………………………………………………………….….…….……….10

VII SUBMISSION DETAILS …………………………………………………………………..…………….….………10

VIII APPLICATION SUBMISSION CONTENTS …………………………………………………..….………....11

IX EVALUATION AND SELECTION ……………………………………………………………...…..……..……11

X TERMS AND CONDITIONS FOR RECEIPT OF APPLICATIONS ………………………....…………11

XI STANDARD CONTRACT PROVISIONS ………………………………………………………...…………. 12

XII APPEAL PROCEDURES ……………………………………………………………………………………….…. 13

XIII EVALUATION CONSIDERATIONS………………………………………………...…………….…………. .14

APPENDIX I – RFQ APPLICATION ……………………………………………………………………….……………….16

APPENDIX II ‐ CONTRACT BOILERPLATE CHECKLIST ……………………………….…………..………..… 18

APPENDIX III – CONTRACT SAMPLE ‐ Afterschool Program & Services Agreement ………......20

RFQ‐01‐2012 Page 3 of 20

I. INTRODUCTION AND OVERVIEW

A. Introduction

SFUSD has engaged all of its school communities in a series of opportunities to assess the level of support and

alignment that exists in school programs to the District’s Strategic Plan, “Beyond the Talk: Taking Action to

Educate Every Child Now.” The major goals that serve as the foundation for all District efforts are:

1. Access & Equity: Making Social Justice a Reality

2. Achievement: Engage high achieving and joyful learners

3. Accountability: Keeping our Promises to Students & Families.

In order to achieve these goals, the success of the District’s ExCEL Afterschool Programs is critical.

The San Francisco Unified School District (SFUSD or the District) ExCEL Afterschool Programs Office invites

interested community-based organizations (CBO) to respond with their qualifications to serve as a Lead Agency

in designing, planning, coordinating and operating an effective and high-quality afterschool program that

supports and aligns with the District’s goal of eliminating the achievement gap. With this Request for

Qualifications, the District will provide to principals and individual school site stakeholders a list of pre-qualified

CBOs from which principals and stakeholders may evaluate and choose as a Lead Agency. Those agencies

selected as Lead Agencies will be committed to the goals of SFUSD’s Strategic Plan and a commitment to

supporting school communities in providing an Afterschool Program that is focused on the ExCEL Afterschool

program components of Academic Support, Recreation and Enrichment while directly adding value to the overall

school program and assisting the school to achieve its own unique goals as specified in their Balanced Scorecard.

B. Term of the List of Qualified Agencies; Annual Contracts with Selected Qualified Agencies

This Request for Qualifications (RFQ) for ExCEL After School Program Lead Agency will result in a list of qualified

agencies from which school site Administrators may select an ExCEL After School Program contractor. The term

of the Qualified Lead Agency list shall be a minimum of three years and a maximum of five beginning July 1,

2013.

The selection of the after school program Lead Agency is at the discretion of the school site administrator.

School site administrators will select a Lead Agency from the list of qualified agencies by assessing the quality of

the current after school program, identifying future program goals, and considering any other factors relevant to

the school site. The ExCEL After School Program office does not identify Lead Agencies for any of the ExCEL After

School Programs. School site administrators will submit their Lead Agency selection for the fiscal year July

2013-June 2014 by March 1, 2013. Contracts are entered into on an annual basis with qualified agencies that

are selected by school site administrators to serve as a school site’s Lead Agency.

The school site administrator may choose a new Lead Agency, or may choose to continue to contract with the

same Lead Agency, on an annual basis subject to the District’s annual availability of funds and annual

satisfactory contractor performance with respect to meeting targeted attendance goals, the contractor’s ability

RFQ‐01‐2012

to provide a quality program that supports school and district objectives

the school site.

Failure to adhere to ExCEL After School Program guidelines and policies as described in Section III, Lead Agency

Overview, and Section XI, Standard Contract Provision

qualified list of Lead Agencies.

C. Overview

The ExCEL After School Programs mission

students and community members can access expanded learning opportunities and integrated education,

health, social service, and cultural programs in the out

the theory of action developed in 2011 based on research into what works in youth development, and

specifically what works in youth development programs in afterschool time. The ExCEL theory of action i

regular participation in high

quality program has direct

benefits for youth and

contributes to other positive

outcomes.

The ExCEL After School

Program operates in over 90

elementary schools, K-8

schools, middle schools, and

high schools. School site

administrators partner with

ExCEL partners with local

agencies to deliver quality

after school programs to our

school sites.

The ExCEL After School Program

Central Office provides overall

program design and

administration of the after school program providing guidance

requirements and supporting the alignment

The ExCEL After School Program is funded

school districts that collaborate with community partners to provide safe and educationally enriching

alternatives for children and youths during non school hours. The funds are awarded to specific school sites as

part of a competitive process. The base grants are for school year program

sources:

• After School Education & Safety (ASES) and/or

After School Safety and Enrichment for Teens (

• ASES grants are 3 year renewable funding sources

Page 4 of 20

to provide a quality program that supports school and district objectives, and/or any other

to ExCEL After School Program guidelines and policies as described in Section III, Lead Agency

, and Section XI, Standard Contract Provisions, may result in an agency being removed from the

mission is to create and sustain "safe havens" at public schools where


health, social service, and cultural programs in the out-of-school hours. Program design and evaluation is based


specifically what works in youth development programs in afterschool time. The ExCEL theory of action i

administration of the after school program providing guidance related to grant compliance, funding

ment of the after school program with the school day initiatives.

fter School Program is funded by the California Department of Education. CDE provide



ase grants are for school year programs and are funded through two

After School Education & Safety (ASES) and/or 21st Century for Elementary, Middle, K-8,

After School Safety and Enrichment for Teens (ASSETS) grants for High Schools

ASES grants are 3 year renewable funding sources

other factors relevant to

to ExCEL After School Program guidelines and policies as described in Section III, Lead Agency

being removed from the

is to create and sustain "safe havens" at public schools where


Program design and evaluation is based


specifically what works in youth development programs in afterschool time. The ExCEL theory of action is that

to grant compliance, funding

with the school day initiatives.

provides funds to



and are funded through two grant

8, and 21st Century

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• 21st Century and ASSETS grants are 5 year grants which sunset (end). Sites whose funding has ended must be

re-applied for through an RFA process administered by the California Department of Education (CDE).

This RFQ seeks qualified contractors to partner with the SFUSD to administer after Out of School Time programs.

II. SCHEDULE

The anticipated schedule for creating a list of Qualified Candidates is:

1. RFQ Issue Date: October 15, 2012

2. RFQ Question Submittal Date: October 29, 2012 – 5:00pm – submit questions to: SFUSD ExCEL

Department at [email protected]. Answers will be posted by November 5,2012

3. APPLICATION due: 12:00 p.m., November 30, 2012

4. Qualification Notification: January 19, 2013

5. Appeal Deadline: January 26, 2013

6. Final Notification: February 10, 2013

7. List of Qualified Lead Agencies distributed to Principals: February 10, 2013

8. Selection of Lead Agency by school site Principal: March31, 2013

9. Service Start Date July 1, 2013 or August 21, 2013 depending on grant funding allocation.

III. LEAD AGENCY OVERVIEW

Applicants may respond to the one or more of the following Lead Agency categories:

1. Lead Agency: Elementary School

2. Lead Agency: Middle School (including K-8)

3. Lead Agency: High School

A Lead Agency may be selected to administer school year programs, summer programs or both. For

summer programs, the ExCEL After School Program office may determine the school sites available to

operate summer programs.

After School Program Requirements

• ExCEL elementary and middle school BASE grants can ONLY be used to provide after school programming

daily (176 days) immediately after the school day.

• ExCEL High School ASSETS base grants can be used to operate programs before school, after school, and

weekends and during summer/intersession in accordance with grant guidelines.

• Some sites may also receive 21st Century related grants including Equitable Access (to be used to support full

inclusion of targeted student groups including EL, learning support, mental health staffing) and Family

Literacy (to be used to provide literacy and career support for the adult family members of ExCEL program

participants)

The intention of the after school funding is to provide a comprehensive After School Program which consists of a

balance of academic and enrichment activities, including physical activity components. The funds cannot be

used to supplant school day activities.

After school program must include the following:

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• ASES Funding: 1) educational and literacy component to provide tutoring and/or homework assistance;

2) educational enrichment component and 3) physical activity/recreation component. In addition the

program must provide a nutritious snack each day.

• 21st CCCLC E/M: 1) educational and literacy component to provide tutoring and/or homework

assistance; 2) educational enrichment component and 3) physical activity/recreation component; 4)

family literacy component. In addition the program must provide a nutritious snack each day.

• ASSETs: 1) educational and literacy component to provide tutoring and/or homework assistance; 2)

educational enrichment component and 3) physical activity/recreation component; 4) family literacy

component. In addition the program must provide a nutritious snack each day.

Educational and Literacy Component includes:

ASES and 21st CCLC E/M: tutoring or homework assistance in one or more of the following areas: 1) Language

arts, 2) Mathematics, 3) History & Social Science; 4) Computer training; 5) Science.

ASSETs: The program shall include, but not be limited to: High school exit exam preparation; 2 )Tutoring; 3)

Homework; 4) College Preparation; 5) Career technical education.

Educational Enrichment component may include the following for all grants: 1) visual & performing arts, 2)

career technical education; 3) recreation; 4) physical fitness; 5) prevention activities.

Family Literacy: 21st CCLC E/M and ASSETS must include a family literacy component (this is in addition to the

dedicated funding that a school site may received for family literacy services) that assess the need for family

literacy services among adult family members of students in the program and provide services based on those

needs.

The goal of the after school program is to support student success in school through academic support and

educational enrichment. The school site Principal is an integral part of developing the after school program

components most appropriate to support his/her school site goals articulated in the Balanced Score Card/Single

Plan of Student Achievement. All Lead Agencies selected by Principals will collaborate on the development and

implementation of the school site’s after school program in compliance with State and Federal guidelines.

• Academic Component

All ExCEL sites are required to identify a SFUSD certificated teacher as the Lead Teacher to support

academic alignment with the school day. The Lead Teachers provide important guidance and expertise

to strengthen the academic program in afterschool including the homework help system, curriculum

development, and/or direct tutoring intervention for targeted students. At the High School Level, the

Lead Teacher may coordinate credit recovery program implementation.

• Enrichment Component

Sites offer diverse enrichment activities according to the interests of students and the available

expertise of staff.

• Physical Activity

All ExCEL programs shall provide opportunities for 30 minutes of physical activity each day. Additionally

programs can intentionally build in activity breaks so that students do not sit for more than 60 minutes

at a time.

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Required Program Hours

Elementary & Middle School programs must operate 5 days/week, commence immediately at the end of the

regular school day, run until at least 6 p.m. and for at least 15 hours/week, whichever is longer. The after school

program must operate every regular school day during the school year.

Elementary students are expected to be enrolled and participate 5 days/week. Middle school students are

expected to attend a minimum of 3 days/week and 9 hours/week, but the program must operate all 5 days.

High School programs must operate a minimum of 15 hours per week.

Late Arrival and Early Release policies: ExCEL has an established early release policy and waiver that must be

implemented at each after school program.

Each High School ASSETs program has the option of operating under either of the following modes: (1) after

school only, or (2) after school and during any combination of before school, weekends, summer, intersession,

and vacation. Special arrangements for facility use must be made in advance of weekends, summer, intersession

and/or vacation timeframes are proposed.

Staffing

All staff supervising students in the after school program must meet District TB/Fingerprinting requirements as

well as all minimum requirements for SFUSD Instructional Aide positions. In addition if the program will include

any physical activities related to bicycle riding, at least one staff member must be a League Certified Instructor

(LCIs) from the League of American Bicyclists. LCI information can be found at the following website -

http://www.bikeleague.org/programs/education/seminars.php. Additionally, each school site is required to

have a Site Coordinator. Education Code provides that” selection of the program site[coordinator] shall be

subject to the approval of the school site principal”.

Contract and Payments

Programs may not begin program operations at a school site unless the District is in receipt of a contract that

has been properly completed (including all required attachments) and fully executed by the Lead Agency.

Invoices are on a cost reimbursement basis.

Matching Funds

Awarded contractors are required to provide no less than thirty three percent (33%) match funding or a

mix of funding and in-kind services to enhance program services at the named school site program. Lead

Agencies that have fee structure that meets the CDE/SFUSD guidelines may count program fees

generated towards 33% match funding requirement.

Guidelines for Charging Fees

The intent of the ASES or 21st CCLC programs is to establish local programs that offer academic assistance and

enrichment to students in need of such services regardless of their ability to pay. The SFUSD is committed to

providing services to all SFUSD students regardless of their ability to pay. Both CDE and SFUSD discourages

charging fees as it could exclude students in need from attending and taking advantage of the after school

program. ASES or 21st Century grants do not prohibit charging fees for after school programs; therefore should

a program choose to charge fees, the following guidelines must be followed:

• Programs that opt to charge fees* may not prohibit any family from participating due to its financial

situation. All program materials related to outreach and enrollment must state clearly that no child will

be denied services due to inability to pay.

• Programs that opt to charge fees must offer a sliding scale of fees and/or scholarships for those who

cannot afford the program.

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• Income collected from fees must be used to fund program activities specified in the grant application.

Funds generated from fees are subject to audit and program monitoring; therefore programs must

maintain documentation for a period of five (5) years.

*Fees include any fees charged to families. This includes, but is not limited to: tuition, enrollment fees,

application fees, snack fee, supplies fees etc.

Core Competencies

Core competencies are the abilities of staff to apply specific knowledge and skills to their professional practice.

In other words, the core competencies are the key ingredients necessary to make a successful afterschool staff.

Afterschool programs whose staff exhibit the core competencies will be best equipped to transform the next

generation of youth in San Francisco.

The San Francisco Afterschool for All Advisory Council has adopted two sets of competencies: one for

afterschool line staff and one for afterschool supervisors. These core competencies were aligned to the

California After School Program Quality Self-Assessment Tool. Qualified Lead Agencies are required to be

familiar with and have experience in implementing core competencies in after school programs.

Quality Programming

Qualified Lead Agencies will work with the ExCEL After School Program Central Office and school site

administrators to annually assess the quality of the current program and identify future school site program

goals. The ExCEL After School Program Central Office will provide guidelines for this process.

Grant Funding Calculated by Attendance

ASES/21st Century grants are attendance based grants. Elementary/Middle School Grants are based on $7.50

per child per day for all days of the school year. High School grants are based on $10/student/day for all days of

the school year.

Sites that fail to meet calculated attendance will trigger California Department of Education intervention and

funding levels may be reduced. Sites must earn 85% of attendance to be in good standing for full funding.

Failure to achieve attendance targets may result in a Lead Agency being removed from the qualified list of Lead

Agencies.

Attendance and Evaluation Documentation

All ExCEL After Program attendance guidelines and policies are required to be followed. All attendance and

evaluation data must be collected in ExCEL required formats, closely monitored, and managed for accuracy by

the Site Coordinator. All required evaluation activities must be completed.

Enrollment Policy:

Qualified Lead Agencies will work with the school site administrator to develop a written enrollment policy. The

enrollment policy should include, but not be limited to, enrollment priorities, application process, acceptance

notification, wait list procedures, behavior guidelines, parent expectation, student expectation, process for

students being removed from the after school program, etc. Qualified Lead Agencies are required to provide

the written enrollment policy to all families who apply for the program.

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IV. DEPARTMENT OF CHILDREN YOUTH & FAMILIES (DCYF) MATCH FUNDING

The San Francisco City and County’s Department of Children, Youth and Their Families has allocated funds to

providing matching grants to support SFUSD’s ExCEL afterschool programs for FY 2013-14 through FY 2015-16.

Lead Agencies who have been selected by the SFUSD school site administrator to operate afterschool programs

for K-8 students during the school year and Lead Agencies who have been selected by SFUSD to operate summer

programs for K-8 students at assigned sites will be eligible to compete for matching funds from DCYF. To

compete for the funds, Lead Agencies will need to complete the DCYF ExCEL Match Application, and if awarded,

comply with all of DCYF’s contracting requirements.

The DCYF ExCEL Match Application will be available for eligible Lead Agencies to complete starting by January

28, 2013 and all responses must be submitted by March 15, 2013. Only lead agencies who have been selected by

a school site administrator may complete the application.. DCYF grant awards for both afterschool programming

and summer programming will be determined based on: responses to the DCYF ExCEL Match Application, the

number of youth to be served, the proposed number of youth on the wait list to be served, number of days of

programming offered during non-school days, and the level of need of the students to be served. Level of need

will be determined using SFUSD and DCYF data.

DCYF ExCEL Matching Funds for afterschool programs may be used to help meet SFUSD’s 33% matching fund

requirement, and may be used in the following ways:

• To serve students projected to be on the program’s wait list

• To offer programming during non-school days

• To cover operating expenses for the afterschool program

DCYF ExCEL Matching Funds for afterschool programs may NOT be used to support staff to work with youth

during the instructional day except for the Site Coordinator.

DCYF ExCEL Matching Funds for summer programs may be used to help meet SFUSD’s 33% matching fund

requirement, and may be used in the following ways:

• To serve students projected to be on the program’s wait list

• To cover operating expenses for the summer program

Only one Lead Agency will be awarded a DCYF matching grant for afterschool per school site. Once awarded,

DCYF ExCEL Matching Funds for afterschool programs will remain in use at the original school site awarded

through FY 2015-16 even if the school site administrator changes the Lead Agency at any point in time, subject

to continued compliance with the terms of the DCYF matching grant.

V. Service Categories

1. Lead Agency for Elementary School

2. Lead Agency for K‐8 or Middle School

3. Lead Agency for High School

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VI. LEAD AGENCY QUALIFICATIONS

All agencies submitting applications must meet the Minimum Qualifications listed below. Any applications failing

to demonstrate how the proposing agency meets these minimum requirements as outlined below will be

considered non-responsive and will not be eligible for review for placement on the qualified candidates list.

Agencies applying as Lead Agencies for any of the three service categories listed in Section V above, must

demonstrate a least two (2) years of experience in the following:

1. Documented experience in providing program services to the students in the service category (ies) being

applied for. Specifically, evidence of a positive track record of the capacity to effectively coordinate the

entirety of a school’s afterschool and/or extended-year program as well as successful collaboration with

the school site administrator, faculty and staff.

2. Documented experience of agency administrative capacity to comply with compliance and fiscal policies

of the SFUSD and CDE, including: agency administration manual; fiscal and personnel policies; cost

allocation plans, etc.

3. Documented experience in the hiring, retention, and provision of professional development of

appropriately qualified staff to provide services to SFUSD students in a culturally and linguistically

competent and age appropriate manner with a focus on youth development strategies.

4. Documented experience of the capacity to effectively engage a large number of diverse students on an

ongoing basis who demonstrate the desire and enthusiasm to participate in the program at a very high

and consistent rate. Additionally, the agency can illustrate specific examples and strategies it has

developed that actively engage parents and family members throughout the school year.

5. Documented knowledge of and application of youth development strategies and Core Competencies for

After School Program Line Staff and Supervisors.

VII. SUBMISSION DETAILS

A. TIME AND PLACE OF SUBMISSION

Applications must be received by 12:00 p.m., November 16, 2012 at the ExCEL Office at 20 Cook Street, Room

2.

Postmarks will not be considered in judging the timeliness of submissions. Applications may be delivered in

person or mailed to:

Mele Lau-Smith


ExCEL After School Program

20 Cook Street, Room 2

San Francisco, CA 94118

** Applications submitted by facsimile, telephone or electronic mail will not be accepted.

Applicants shall submit one (1) original and three (3) copies of the application, clearly marked “RFQ-01-2012 –

SFUSD – After School Program Lead Agency and the service category applying for. The original copy of the

application must be clearly marked as “Original”.

RFQ‐01‐2012 Page 11 of 20

B. FORMAT

All submissions must be typewritten on standard recycled paper with an easy to read 12-point font such as Arial

or Times New Roman and one inch margins. All submissions must be 1.5 to double-spaced.

Please print copies double sided to the maximum extent possible and bind with binder clip or single staple.

Please do not bind your application with a spiral binding, glued binding or anything similar. No Binders.

VIII. APPLICATION SUBMISSION CONTENTS

Failure to provide any of the following information or forms may result in an application

being disqualified.

A. MINIMUM AGENCY REQUIREMENTS (ONE COPY per proposing agency)

1. Letter of Introduction (no more than one (1) page): A one-page letter signed by the person authorized

to obligate the proposing agency to perform the commitments contained in the application. The letter

should state that the proposing agency is willing and able to perform the commitments contained in the

application.

2. Agency Minimum Qualifications: Completion of the application in Appendix I.

3. Boilerplate Checklist: “Afterschool Program and Services Agreement” - Submission of the Signed

Boilerplate Checklist (Appendix II) will constitute a representation by your firm that it has read all of the

clauses contained in the SFUSD “Afterschool Program and Services Agreement,” the sample contract for

the services detailed in this RFQ (ATTACHED as Appendix III, version for Fiscal Year 2012-2013), and that

your firm is willing to comply with SFUSD contracting requirements.

Any application that does not demonstrate that the proposer meets these minimum requirements by the

deadline for submittal of applications will be considered non-qualified and will not be eligible to be placed on

the list of qualified Lead Agencies from which school site principals select the after school program provider.

IX. EVALUATION AND SELECTION

For all applications, the Minimum Agency Requirements will be reviewed first; applications that do not submit

complete documentation meeting the minimum requirements will not have the project application reviewed.

Project applications meeting minimum agency qualification requirements will be evaluated and scored by a

selection committee made up of individuals with expertise in the project for which the application is submitted

The SFUSD intends to evaluate the applications generally in accordance with the criteria itemized below. Only

applications scoring 70 or more points on the evaluation/scoring criteria will be entered on an eligible list

(“Qualified After School Program Lead Agencies”) for funding. Proposers must agree to abide by all SFUSD policy

requirements as outlined in Appenix III. The eligible list will be utilized by school site Principals for a period of

three (3) to five (5) years pending funding availability to select a Lead Agency to administer the after school

program on his/her school site. No Lead Agency shall have any legal or equitable right or obligation to enter into

a contract or to perform services as a result of such Lead Agency being identified on the list as a Qualified After

School Program Lead Agencies.

X. TERMS & CONDITIONS FOR RECEIPT OF APPLICATIONS

A. Errors and Omissions in RFQ

Proposers are responsible for reviewing all portions of this RFQ. Proposers are to promptly notify the District, in

writing, if the proposer discovers any ambiguity, discrepancy, omission, or other error in the RFQ. Any such

RFQ‐01‐2012 Page 12 of 20

notification should be directed to the District promptly after discovery, but in no event later than five working

days prior to the date for receipt of applications. Modifications and clarifications will be made by addenda as

provided below.

B. Change Notices

The District may modify the RFQ, prior to the application due date, by issuing Change Notices, which will be

posted on the website. The proposer shall be responsible for ensuring that its application reflects any and all

Change Notices issued by the District prior to the application due date regardless of when the application is

submitted. Therefore, the District recommends that the proposer consult the website frequently, including

shortly before the application due date, to determine if the proposer has downloaded all Change Notices.

C. Term of Application

Submission of an application signifies that the proposed services and prices are valid for 120 calendar days from

the application due date and that the quoted prices are genuine and not the result of collusion or any other

anti-competitive activity.

D. Errors and Omissions in Application

Failure by the District to object to an error, omission, or deviation in the application will in no way modify the

RFQ or excuse the vendor from full compliance with the specifications of the RFQ or any contract awarded

pursuant to the RFQ.

E. Financial Responsibility

The District accepts no financial responsibility for any costs incurred by a firm in responding to this RFQ.

Submissions of the RFQ will become the property of the District and may be used by the District in any way

deemed appropriate.

F. Proposer’s Obligations under the Conflict of Interest laws and board policies

A proposer must be aware that if the proposer will enter into a contract with the District, proposer/contractor

shall be responsible to comply with conflict of interest laws and Board policies, which are briefly summarized in

Section 15 (“Conflict of Interest”) of the attached Appendix III (“Afterschool Program and Services Agreement”

sample contract). It is the responsibility of a contractor to comply with the law and SFUSD Board policies.

G. Reservations of Rights by the District

The issuance of this RFQ does not constitute an agreement by the District that any contract will actually be

entered into by the District. The District expressly reserves the right at any time to:

1. Waive or correct any defect or informality in any response, application, or application procedure;

2. Reject any or all applications;

3. Reissue a Request for Applications;

4. Prior to submission deadline for applications, modify all or any portion of the selection procedures,

including deadlines for accepting responses, the specifications or requirements for any materials,

equipment or services to be provided under this RFQ, or the requirements for contents or format of the

applications;

5. Procure any materials, equipment or services specified in this RFQ by any other means;

6. Determine that no project will be pursued.

H. No Waiver

No waiver by the District of any provision of this RFQ shall be implied from any failure by the District to

recognize or take action on account of any failure by a proposer to observe any provision of this RFQ.

RFQ‐01‐2012 Page 13 of 20

XI. STANDARD CONTRACT PROVISIONS

Any agency selected from the After School Program Lead Agency Qualified List by a school site Principal, and

which chooses to enter into contract with the District, will enter into a contract substantially in the form of the

After School Program Services Agreement, attached hereto as Appendix III. Failure to timely execute the

contract, or to furnish any and all insurance certificates and policy endorsement, surety bonds or other materials

required in the contract, shall be deemed an abandonment of a contract offer. The District, in its sole discretion,

may select another qualified agency and may proceed against the original selectee for damages.

XII. APPEAL PROCEDURES

A. Protest of Non‐Responsiveness Determination

Any agency that has submitted an application and believes that the District has incorrectly determined that its

application is not qualified may submit a written notice of appeal to the District. Such notice of appeal must be

received by the District on or before January 26, 2013 or the fifth (5th) working day following the District’s

issuance of After School Program Lead Agency Qualified List. The notice of appeal must include a written

statement specifying in detail each and every one of the grounds asserted for the appeal. The appeal must be

signed by an individual authorized to represent the proposer, and must cite RFQ provision on which the appeal

is based. In addition, the appealer must specify facts and evidence sufficient for the District to determine the

validity of the protest. Appeals that are based on a disagreement with the professional judgment of the reviewer

will not be considered.

B. Delivery of Appeal

All appeals must be received by the due date. If a appeal is mailed, the appealer bears the risk of non-delivery

within the deadlines specified herein. Appeals should be transmitted by a means that will objectively establish

the date the City received the protest. Appeals or notice of appeals made orally (e.g., by telephone) will not be

considered. Appeals must be delivered to:

Kevin Truitt

Associate Superintendent

Student, Family & Community Support Department

555 Franklin Street, 3rd Floor

San Francisco, CA 94102

RFQ‐01‐2012 Page 14 of 20

Evaluation Rubric:

a) ORGANIZATIONAL CAPACITY– up to 50 points

1. Extent to which the organization’s goals are in alignment with the district’s goals and ExCEL’s goals.

Total of up to 10 points

2. Degree to which the organization has experience in the hiring, retention, and provision of professional

development to appropriately qualified staff to provide services to SFUSD students in a culturally and

linguistically competent and age appropriate manner with a focus on youth development strategies.


3. Extent to which the organization’s systems, policies, and/or requirements will ensure that staff provide

culturally competent services to the community they serve. Cultural competency is defined as

behaviors, attitudes, and policies that enable effective work in a cross cultural situation.


4. Degree to which the organization will provide administrative support and the processes in place that the

organization will utilize to assure that the contract requirements and activities are met in a timely

manner.


5. Describe the Degree to which the organization has administrative systems in place to provide the

necessary infrastructure to ensure that project staff comply with compliance and fiscal policies of the

SFUSD and CDE, including: agency administration manual; fiscal and personnel policies; cost allocation

plans, enrollment policies, family handbook program policies, etc).


b) STATEMENT OF EXPERIENCE AND PAST PERFORMANCE – up to 50 points

1. Extent to which the organization’s experience in administering an afterschool program in the particular

service area(s) for which it is applying. If you are applying for both school year and summer program,

please describe your organization’s experience in BOTH areas. Discuss your enrollment policies, program

policies, etc and how your organization works with a school site administrator to tailor to the school site.

(Total of up to 20 points)

2. Describe your organization’s knowledge of and application of youth development strategies as well as

Core Competencies for After School Line staff and Core Competencies for After School Supervisors (see

the San Francisco After School Alliance website for more information:

http://sfafterschoolforall.blogspot.com/p/what-are-core-competencies.html). (Up to 15 points)

3. Describe your organization’s process in which you work with a school site administer to develop the

after school program plan.(Up to 15 points)

RFQ‐01‐2012 Page 15 of 20

c) SUPPORTING DOCUMENTATION

To support and verify the qualifications cited in your Organizational Capacity and Statement of Experience and

Past Performance, the following documentation is required:

• Provide one (1) sample After School Program Summary and budget related to the program summary.

• Copies of Monitoring Reports and/or other evaluations (maximum of 2)

• Copies of current administrative, personnel and fiscal manuals

• Job description for Site Coordinator and Program Leader

• Letters of Reference (maximum of 2)

• Most recent audited financial statements. If no audited financial statements are available, then financial

statements certified by the Executive Director or Board of Directors of the agency as a true

representation of the Agency’s financial condition may be submitted. Submitted financial statements

must be marked as confidential and will be returned to the Agency upon completion of the RFQ process.

RFQ‐01‐2012 Page 16 of 20

Appendix I – RFQ Application

Agency Name

Service Category

� Elementary �School Year � Summer Program

� K-8 and/or Middle �School Year � Summer Program

� High School

NOTE: An application MUST be completed for each service category checked.

a) ORGANIZATIONAL CAPACITY (no more than 4 pages) – up to 50 points

Candidate will provide a comprehensive description of the organization’s capacity relevant to the service

category for which the application is being submitted, including:

1. Briefly describe your organization and its overall goal(s). Describe how your organization’s goals are in

alignment with the district’s goals and ExCEL’s goals. (up to 10 points)

2. Describe your organization’s experience in the hiring and retention of appropriately qualified staff to

provide services to SFUSD students in a culturally and linguistically competent and age appropriate

manner with a focus on youth development strategies. (up to 10 points)

3. Describe the systems, policies, and/or requirements your organization has in place to ensure that staff

provide culturally competent services to the community they serve. Cultural competency is defined as

behaviors, attitudes, and policies that enable effective work in a cross cultural situation. (10 points)

4. Describe the administrative support and process your organization would utilize to assure that the

contract requirements and activities are met in a timely manner. (up to 10 points)

5. Describe administrative systems in place to provide the necessary infrastructure to ensure that project

staff comply with compliance and fiscal policies of the SFUSD and CDE, including: agency administration

manual; fiscal and personnel policies; cost allocation plans, etc). (up to 10 points)

b) STATEMENT OF EXPERIENCE AND PAST PERFORMANCE (no more than 4 pages) – up to 50 points

Candidate will provide a comprehensive description of the organization’s past performance relevant to the

service category for which the application is being submitted. The following areas will be considered in the

review and evaluation process:

1. Describe your organization’s experience in administering an afterschool program in the particular

service area(s) for which you are applying. If you are applying for both school year and summer

program, please describe your organization’s experience in BOTH areas. Discuss your enrollment

policies, program policies, etc and how your organization works with a school site administrator to tailor

to the school site. (Up to 20 points)

2. Describe your organization’s knowledge of and application of youth development strategies as well as

Core Competencies for After School Line staff and Core Competencies for After School Supervisors (see

RFQ‐01‐2012 Page 17 of 20

the San Francisco After School Alliance website for more information:

http://sfafterschoolforall.blogspot.com/p/what-are-core-competencies.html). (Up to 15 points)

3. Describe your organization’s process in which you work with a school site administer to develop the

after school program plan.(Up to 15 points)

c) SUPPORTING DOCUMENTATION

To support and verify the qualifications cited in your Organizational Capacity and Statement of Experience and

Past Performance, list the projects presented as qualifying experience with dates and managing organization.

• Provide one (1) sample After School Program Summary and budget related to the program summary.

• Copies of Monitoring Reports and/or other evaluations (maximum of 2)

• Copies of current administrative, personnel and fiscal manuals

• Job description for Site Coordinator and Program Leader

• Letters of Reference (maximum of 2)

RFQ‐01‐2012 Page 18 of 20

Appendix II

CONTRACT BOILERPLATE CHECKLIST

Recitals

A. Term of the Agreement/Effective Date of Agreement

B. B. Services Contractor Agrees to Perform

C. Compensation

1. Availability of Funds; Budget and Fiscal Provisions: Termination in the Event of Non-

Appropriation – subsections a-3

2. Agreemetn Evaluation Fee; District Retention – subsections a-c

3. Disallowance – subsections a-b

4. Sumitting False Claims; Monetary Penalites – subsections a-h

5. Payment Does Not Imply Acceptance of Work

6. Qualified Personnel

7. Responsibility for Complinace with District Facilitie Use Permit Process

8. Taxex

9. Independent Contractor – subsections a-b

10. Insurance – subsections a(1)-a(3), b(1)-b(2); c-i

11. Indeminification – subsections a-e

12. District Limitation of Liability to Amount of Agreement

13. Defaulut: Remedies – subsections a(1)-a(2); b-c

14. Termination for Convenience –subsections a-e

15. Conflict of Interest – subsections a(1)-a(7); b-h; i(1)-I(5)

16. Proprietary or Confidential Information of District; Student Information – subsections a-d

17. Ownership of Results

18. Audit and Inspection of Records

19. Subcontracting

20. Assignment

21. Non-Discrimination

22. Criminal Backgroun Checks, Subsequent Arrest Notification – subsections a(1)-a(3); b(1)-b(4)

23. Tuberculosis Testing – subsections a-d

24. Nonwaiver of Rights

25. Modification of Agreement

26. Administrative Remedy for Agreement Interpretation

27. Compliance with Americans with Disabilities Act

28. Compliance with Law and Regulation; Changes Thereto – subsections a-c

29. Governing Law; Venue

30. Section Headings

31. Entire Agreement

32. Execution of the Agreement, Execution in Counterparts – subsections a-b

33. Severability

34. Notice to Parties

Appendix A

I. Scope of Services – subsections a-g

II. After School Program Requirements

a. Lead Agency Requirements – - subsections 1-2

RFQ‐01‐2012 Page 19 of 20

b. Program Components for Elementary and Middle School Program Sites – subsections 1-7

c. Program Components for High School Program Sites – sub sections 1-6

d. Academic Alignment –subsections 1-2

e. Other Programmatic Requirements – subsections 1-4

f. Working with School Site and District – subsections 1-4

g. Staffing – subsections 1-4

h. Documentation, Evaluation and Monitoring – subsections 1 -9 – including 3i-ix

III. USE OF CONTRACT FUNDS CHECKLIST

a. Payment

b. Attendance Review and Consequences of Low Attendance – subsections 1-5

c. Direct Services to Students

d. Administrative Expenses

e. Payment Only for Compliant Costs

f. Accounting Records

g. Use of Subcontract – subsections 1-4

IV. Invoice Format and Process

a. Documentation of Attendance

b. Certification of Compliance

c. Monthly Submission of Invoices – subsections 1-11

d. Attachments to Invoice – subsections 1-3

e. Final Deadline for Invoices

f. Modification of Invoicing Requirements

g. Timeline for Payment

Submission of this Signed Boilerplate Checklist will constitute a representation by your firm that it has read all

the clauses listed in the After School Program and Services Agreement (Appendix III) contract sample, and is

willing to comply with SFUSD contracting requirements.

_____________________________________________ _______________

Signature Date

_____________________________________________

Name and Title of Signatory

_____________________________________________

Name of Organization

SFUSD – Afterschool Program and Services Agreement – FY 2012-2013

Appendix III to RFQ‐‐‐‐01-2012 Page 1 of 28 SAMPLE AGREEMENT for purposes of RFQ

APPENDIX III TO RFQ‐‐‐‐01-2012

AFTERSCHOOL PROGRAM AND SERVICES AGREEMENT — SAMPLE FOR FISCAL YEAR 2012-2013

This Afterschool Program and Services Agreement for Fiscal Year 2012-2013 (“Agreement”) is dated for convenience Insert today's date and is entered into between insert legal/official name of Contractor (hereinafter “Contractor”) and the San Francisco Unified School District (hereinafter “District” or “SFUSD”).

RECITALS

Whereas, the District desires Contractor to serve, for a consideration, as the lead agency to provide after-school educational programs and ensure provision of compliant quality program services for students at insert name of site under the federal, state, and/or local grant funding indicated in Appendix A:

Whereas, Contractor represents itself able and, for a consideration, willing to provide afterschool programming and services at insert name of site. Contractor further represents that it is not acting solely as a fiscal agent, and is not acting as a fiscal agent for another organization, entity, incorporated or unincorporated association related to the delivery of afterschool programming and services described in this Agreement. The personal performance by Contractor of the provision of afterschool programming and services described in this Agreement is a material part of the consideration. Therefore, the Parties hereby enter into this Agreement for Contractor to provide, for a consideration, afterschool programming and services pursuant to the terms of this Agreement. This Agreement attaches and incorporates by reference as though fully set forth herein the following documents: Board Resolution; General Terms and Conditions; Appendix A – Scope of Services; Attachment 1 – School Site After School Program Summary; Attachment 2 – Weekly Program Schedule; Appendix B – Afterschool Program Budget; Attachment 3 – Program Budget Detail; completed W-9 Form; and completed Criminal Background Clearance/Tuberculosis Clearance Written Certification Form (collectively referred to as the “Agreement”). The following documents shall also be attached to this Agreement: Copy of required Insurance Certificates and Endorsements (See Section 10 for Insurance Certificate and Endorsement requirements). A. TERM OF THE AGREEMENT/ EFFECTIVE DATE OF AGREEMENT

Subject to Section 1 of the attached General Terms and Conditions, the term of this Agreement shall be the term of the fiscal year (July 1 to June 30) in which this Agreement is executed for services to be provided by Contractor under this Agreement. Notwithstanding the foregoing, this Agreement shall become effective only upon approval in writing by the District’s Board of Education, proper execution by the parties, and certification by the District’s Chief Financial Officer as to the availability of funds.

B. SERVICES CONTRACTOR AGREES TO PERFORM

Contractor agrees to perform the services provided for in the attached Appendix A (“Scope of Services”). Contractor agrees that its services and compensation will be subject to the evaluation and monitoring procedure in the attached Appendix A and as provided elsewhere in this Agreement.

C. COMPENSATION

Compensation to Contractor shall not exceed insert contract dollar amount in WORDS dollars, ($insert contract dollar amount in numbers). Contractor must comply with all payment conditions, and any other conditions imposed by the District to receive payment for services. Payments shall be made upon satisfaction of all conditions, and approval by the District’s Site, Department Head or Director of the Student Support Services



Department, in the District’s sole discretion, that the services, set forth in Appendix A (“Scope of Services”) of this Agreement, have been rendered satisfactorily, and in a professional and timely manner in accordance with this Agreement. If the District and Contractor mutually agree that the scope of work in Appendix A must be amended or modified, the Compensation may also be amended or modified provided that there is a prior written modification to the Agreement in accordance with Section 25 (“Modification of Agreement”) of the General Conditions and a Board Resolution authorizing said increase(s). It shall be the responsibility of the Contractor to ensure that the total approved amount of the Agreement is not exceeded. Any work performed in excess of said amount shall not be compensated. In no event shall the District be liable for interest or late charges for late payments. Total Payment. District shall pay only for the services rendered by Contractor pursuant to this Agreement. District shall not pay any additional sum for any expense or cost whatsoever incurred by Contractor in rendering services pursuant to this Agreement. District shall make no payment for any extra, further, or additional service beyond what is specifically authorized this Agreement. In no event shall Contractor submit any invoice for an amount in excess of the not-to-exceed amount of compensation provided for pursuant to this Agreement, unless this Agreement is modified by a properly executed and approved amendment to this Agreement pursuant to Section 25 (“Modification of Agreement”). Payment of Taxes. Contractor is solely responsible for the payment of employment taxes incurred under this Agreement, and any similar federal or state taxes.



GENERAL TERMS AND CONDITIONS

TO THE AFTERSCHOOL PROGRAM AND SERVICES AGREEMENT 1. AVAILABILITY OF FUNDS; BUDGET AND FISCAL PROVISION; TERMINATION IN THE EVENT OF NON-

APPROPRIATION a. This Agreement is subject to the budget and fiscal policies, regulations and practices of the District, and

approval and appropriation of funds for this Agreement. Charges will accrue only after prior written authorization is provided by the District’s Board of Education, proper execution of this Agreement by the parties, and certification by the Chief Financial Officer as to the availability of funds.

b. The amount of the District’s obligation hereunder shall not at any time exceed the amount herein stated or established by any amendment or District review.

c. The District has no obligation to renew this Agreement after expiration of its term. If funds are appropriated for a portion of a fiscal year, this Agreement will terminate, without penalty, at the end of the term for which funds are appropriated. In the event there are additional funds remaining, Contractor shall promptly return such funds to District. Contractor shall not carryover funds from fiscal year to fiscal year. Any excess payments, funds, transfers, unearned or excessive disbursements, reimbursements or expenditures of any kind received by or on behalf of Contractor from or on behalf of District shall be promptly returned to District, at no cost to District within sixty (60) days of receipt of said funds or within sixty (60) days of conclusion of the fiscal year in which said funds were received, whichever is earlier.

d. Contractor’s assumption of risk of possible non-appropriation is part of the consideration for this Agreement.

e. This Section controls against any and all other provisions of this Agreement.

2. AGREEMENT EVALUATION FEE; DISTRICT RETENTION a. Where the services to be provided by Contractor under this Agreement have been designated as

Evaluation Level IV on a Board Resolution, Contractor understands and agrees that a contract evaluation fee of up to five percent (5%) of the total Agreement amount (including, but not limited to, payments for services and expenses) may be assessed by the District on this Agreement. The monies collected through this fee will be used to monitor and evaluate similar agreements to guarantee that the promised services are provided in a timely and effective manner.

b. This evaluation fee shall apply only to those Agreements in excess of two thousand five hundred dollars ($2,500.00). The fee may be deducted from the District funds encumbered to pay Contractor at any time during or following the term of the Agreement and this Section shall survive the termination or expiration of this Agreement. If the parties later amend this Agreement to increase payments to Contractor, those increases will also be subject to the 5% assessment.

c. Contractor further agrees that District, at its option, may retain up to 5% of the total Agreement amount from Contractor. Such funds shall be kept by District exclusive of any administrative fee that District is legally allowed to charge pursuant to any federal law, state law, or any grant agreement.

3. DISALLOWANCE

a. If Contractor claims or receives payment from the District for a service, reimbursement for which is later disallowed by the State of California or United States Government, Contractor shall promptly refund the disallowed amount to the District upon the District’s request. At its option, the District may offset the amount disallowed from any payment due or to become due to Contractor under this Agreement or any other Agreement.

b. By executing this Agreement, Contractor certifies that Contractor is not suspended, debarred or otherwise excluded from participation in federal or state programs. Contractor acknowledges that this certification of eligibility to receive state or federal funds is a material term of this Agreement.

4. SUBMITTING FALSE CLAIMS; MONETARY PENALTIES

Pursuant to Government Code §12650 et. seq., any person, including a contractor, subcontractor or a consultant, who submits a false claim, invoice, or request for reimbursement (“false claim”), shall be liable to the District for three times the amount of damages that the District sustains because of the false claim. A person who commits a



false claim act violation shall also be liable to the District for the costs of a civil action brought to recover any of those penalties or damages, and may be liable to the District for a civil penalty of up to ten thousand dollars ($10,000) for each false claim. A person will be deemed to have submitted a false claim to the District if the person: a. knowingly presents or causes to be presented to an officer or employee of the District, a false claim for

payment or approval; b. knowingly makes, uses, or causes to be made or used a false record or statement to get a false claim

paid or approved by the District; c. conspires to defraud the District by getting a false claim allowed or paid by the District; d. has possession, custody, or control of public property or money used or to be used by the District and

knowingly delivers or causes to be delivered less property than the amount for which the person receives a certificate or receipt;

e. is authorized to make or deliver a document certifying receipt of property used or to be used by the District and knowingly makes or delivers a receipt that falsely represents the property used or to be used;

f. knowingly buys, or receives as a pledge of an obligation or debt, public property from any person who lawfully may not sell or pledge the property;

g. knowingly makes, uses, or causes to be made or used a false record or statement to conceal, avoid, or decrease an obligation to pay or transmit money or property to the District; or

h. is a beneficiary of an inadvertent submission of a false claim to the District, subsequently discovers the falsity of the claim, and fails to disclose the false claim to the District within a reasonable time after discovery of the false claim.

5. PAYMENT DOES NOT IMPLY ACCEPTANCE OF WORK

No payment shall in any way lessen the liability of Contractor to remedy or replace unsatisfactory work, service, equipment, or materials, if the unsatisfactory character of such work, service, equipment or materials was not detected at the time of payment. Service, materials, equipment, components, or workmanship that do not conform to the requirements of this Agreement may be rejected by the District and in such case must be remedied or replaced by Contractor without delay at no additional cost to the District.

6. QUALIFIED PERSONNEL

Work under this Agreement shall be performed only by competent personnel under the supervision of and in the employment of Contractor. Contractor will comply with the District’s reasonable requests regarding assignment of personnel, but all personnel, including those assigned at the District’s request, must be supervised by Contractor. Contractor shall commit adequate resources to complete this Agreement’s scope of work.

7. RESPONSIBILITY FOR COMPLIANCE WITH DISTRICT FACILITIES USE PERMIT PROCESS

A Contractor seeking to use a District facility must obtain an approved Facilities Use Permit from the Real Estate Office of the District’s Facilities Department prior to any such use. Contractor shall be responsible for complying with District’s Facilities Use Permit requirements in the performance of this Agreement, and shall comply with all District processes and procedures for obtaining approval to utilize District sites or property, including applying for and obtaining an approved Facilities Use Permit from the Real Estate Office of the District’s Facilities Department.

8. TAXES

Contractor shall pay all taxes levied in connection with this Agreement, or the services delivered pursuant hereto.

9. INDEPENDENT CONTRACTOR a. Contractor or any agent or employee of Contractor shall be deemed at all times to be an independent

contractor and not an employee of the District. Contractor shall be wholly responsible for the manner in which it performs the services required of it under this Agreement. Nothing contained in this Agreement shall be construed as creating an employment or agency relationship between the District and Contractor or its agents and employees. If any governmental authority should, nevertheless, determine that Contractor is an employee, then the District’s payment obligations hereunder shall be reduced so that the aggregate amount of payments directly to Contractor and to the applicable governmental authority does



not exceed the maximum amount specified in this Agreement. Contractor shall refund any amounts necessary to effect such reduction.

b. Contractor shall complete and file with the District the attached W-9 form.

10. INSURANCE a. Without in any way limiting Contractor’s liability pursuant to the “Indemnification” Section of this

Agreement, Contractor shall procure and maintain during the full term of this Agreement the following insurance amounts and coverage: (1) Commercial General Liability Insurance with limits not less than $2,000,000 (two million dollars)

each occurrence Combined Single Limit for Bodily Injury and Property Damage (including coverage for claims of sexual abuse and molestation).

(2) Commercial Automobile Liability Insurance with limits not less than $1,000,000 (one million dollars) each occurrence Combined Single Limit for Bodily Injury and Property Damage, including Owned, Non-Owned and Hired auto coverage, as applicable.

(3) Workers’ Compensation Insurance, with Employer’s Liability limits not less than $1,000,000 (one million dollars) each accident.

b. Commercial General Liability policy must provide the following: (1) Name as Additional Insured the San Francisco Unified School District, its Board, officers and

employees. (2) That such policy is primary insurance to any other insurance available to the Additional Insured,

with respect to any claims arising out of this Agreement and that such policies apply separately to each insured against who claim is made or suit is brought.

c. All policies shall provide thirty (30) days advance written notice to the District of cancellation, non-renewal or reduction in coverage to the following office:

SFUSD Contracts Office 135 Van Ness Street, Room 102 San Francisco, CA 94102 d. If any policies are written on a claims-made form, Contractor agrees to maintain such coverage

continuously throughout the term of this Agreement and, without lapse, for a period of three years beyond the expiration of this Agreement, such that should occurrences during the Agreement term give rise to claims made after expiration of the Agreement, such claims shall be covered.

e. Should any of the required insurance be provided under a form of coverage that includes a general annual aggregate limit or provides that claims investigation or legal defense costs are included in such general annual aggregate limit, such annual aggregate limit shall be double the occurrence or claims limits specified above.

f. Should any required insurance lapse during the term of this Agreement, requests for payments originating after such lapse shall not be processed until the District receives satisfactory evidence of reinstated coverage as required by this Agreement, effective as of the lapse date. If insurance is not reinstated, the District may, at its sole option, terminate this Agreement effective on the date of such lapse of insurance.

g. Before commencing any operations under this Agreement, Contractor must provide the District with the certificates of insurance, and additional insured policy endorsement and with insurers satisfactory to the District, evidencing all coverages set forth above, and shall furnish complete copies of policies promptly upon the District's request. Contractor also understands and agrees that the District may withhold payment for services performed for any violations of the insurance provisions of this Agreement.

h. Contractor shall include its subcontractors as insureds under its policies, or shall furnish separate certificates and endorsements for each subcontractor to SFUSD for review and approval. All coverages for subcontractors shall comply with all requirements of this Section 10 (“Insurance”).

i. Approval of the insurance by the District shall not relieve or decrease the liability of Contractor hereunder.

11. INDEMNIFICATION Contractor shall indemnify and hold harmless the District, its Board, officers, employees and agents from, and if requested, shall defend them against all liabilities, obligations, losses, damages, judgments, costs or expenses (including legal fees and costs of investigation) (collectively “Losses”) arising from, in connection with or caused by:



a. personal injury or property damage caused, directly or indirectly, by any act or omission of Contractor, its subcontractors or either’s agent or employee; or

b. Contractor’s failure to timely and promptly reimburse and/or refund any excess payments, funds, transfers, unearned or excessive disbursements, reimbursements or expenditures of any kind received by or on behalf of Contractor from or on behalf of District; or

c. any infringement of patent, copyright, trademark, trade secret or other proprietary right caused by Contractor, its subcontractors or either’s agent or employee. Notwithstanding the foregoing, Contractor shall have no obligation under this Section with respect to any Loss that is caused solely by the active negligence or willful misconduct of District and is not contributed to by any act or omission (including any failure to perform any duty imposed by law) by Contractor, its subcontractors or either’s agent or employee.

d. Contractor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation and contribution against the District with respect to those Claims as to which District is indemnified, except for such Claims which are the result of District’s sole negligence or willful misconduct.

e. The provisions of this Section shall survive the termination or expiration of this Agreement. 12. DISTRICT LIMITATION OF LIABILITY TO AMOUNT OF AGREEMENT

DISTRICT’S PAYMENT OBLIGATIONS UNDER THIS AGREEMENT SHALL BE LIMITED TO THE PAYMENT PROVIDED FOR IN SECTION C (“COMPENSATION”) OF THIS AGREEMENT. DISTRICT SHALL NOT BE LIABLE FOR ANY SPECIAL, CONSEQUENTIAL, INDIRECT, OR INCIDENTAL DAMAGES, INCLUDING BUT NOT LIMITED TO LOST PROFITS IN CONNECTION WITH THIS AGREEMENT.

13. DEFAULT; REMEDIES a. Each of the following shall constitute an event of default (“Event of Default”) under this Agreement:

(1) Contractor fails or refuses to perform or observe any term, covenant or condition contained in this Agreement.

(2) Contractor (A) is generally not paying its debts as they become due, (B) files, or consents by answer or otherwise to the filing against it of, a petition for relief or reorganization or arrangement or any other petition in bankruptcy or for liquidation or to take advantage or any bankruptcy, insolvency or other debtors’ relief law of any jurisdiction, (C) makes an assignment for the benefit of its creditors, (D) consents to the appointment of a custodian, receiver, trustee or other officer with similar powers of Contractor or of any substantial part of Contractor’s property, (E) takes action for the purpose of any of the foregoing, or (F)is the subject of any order of a court or government authority related to the Federal Bankruptcy Act.

b. On and after any Event of Default, the District shall have the right to exercise its legal and equitable remedies, including, without limitation, the right to terminate this Agreement with ten (10) days’ written notice, or to seek specific performance of all or any part of this Agreement. In addition, District shall have the right (but no obligation) to cure (or cause to be cured) on behalf of Contractor any Event of Default; Contractor shall pay to the District on demand all costs and expenses incurred by the District in effecting such cure, with interest thereon from the date of incurrence at the maximum rate then permitted by law. The District shall have the right to offset from any amounts due to Contractor under this Agreement or any other agreement between District and Contractor all damages, losses, costs, or expenses incurred by the District as a result of such Event of Default due from Contractor pursuant to the terms of this Agreement.

c. All remedies provided for in this Agreement may be exercised individually or in combination with any other remedy available hereunder or under applicable laws, rules, regulations. The exercise of any remedy shall not preclude or in any way be deemed to waive any other remedy.

14. TERMINATION FOR CONVENIENCE

a. The District shall have the option, in its sole discretion, to terminate this Agreement, at any time during the term hereof, for convenience and without cause upon thirty (30) days prior written notice specifying the date on which termination shall become effective.

b. Upon receipt of the notice, Contractor shall commence and perform, with diligence, all actions necessary on the part of Contractor to effect the termination of this Agreement on the date specified by District in a manner which minimizes the liability of Contractor and District to third parties as a result of termination.



All such actions shall be subject to prior approval by District and shall include, without limitation: canceling orders, assigning interests to the District, settling outstanding liabilities and claims, securing and safe-guarding District property, and halting or completing services in the manner specified by the District.

c. Within thirty (30) days after the specified termination date, Contractor shall submit to District an itemized invoice detailing the unpaid costs incurred for the services rendered up to the date of termination.

d. In no event shall District be liable for costs incurred by Contractor or any of its subcontractors after the termination date specified by District, except for those costs specifically approved by the District as necessary to effect the termination in a manner acceptable to the District. Such non-recoverable costs include, but are not limited to, anticipated profits on this Agreement, post-termination employee salaries, post-termination administrative expenses, post-termination overhead or unabsorbed overhead, attorneys’ fees or other costs relating to the prosecution of a claim or lawsuit, prejudgment interest.

e. The District’s payment obligation under this Section shall survive termination of this Agreement.

15. CONFLICT OF INTEREST a. Conflict of Interest Standards. The following is a brief overview of conflict of interest laws and policies.

Contractor is responsible to know, and comply with, the full requirements of the law. (1) Under the California Political Reform Act (CPRA), codified in part as Government Code section

1090 and sequential, and section 87100 and sequential: No public official shall make, participate in making, or in any way attempt to use his or her official position, to influence a contract on behalf of the public agency when he or she knows, or has reason to know, that he or she has a personal financial interest in that contract.

(2) Government Code section 1090 defines “making” a contract broadly to include actions that are preliminary or preparatory to the selection of a contractor such as but not limited to: involvement in the reasoning, planning, and/or drafting of scopes of work, making recommendations, soliciting bids and requests for proposals, and/or participating in preliminary discussions or negotiations. (Cal. Govt. Code § 1090)

(3) SFUSD Board Policy 3850 provides: “That no Board Member or employee of the San Francisco Unified School District, except persons engaged in the performance of contracts as early retirants or consultants under the approved federally assisted programs, may participate in bidding or have any interest, direct or indirect, in any contract made by or on behalf of the School District within two (2) years after the termination of a Board Member’s term in office or the termination of employment with the School District. Except as herein provided, any contract or other transaction entered into for or on behalf of the School District, in violation of the terms herein provided, shall be void and unenforceable against the School District.” (SFUSD Board Policy 3850)

(4) State law limits the amount of gifts that may be received by public officials from a single source during a calendar year. In 2011-2012, the gift limit is $420 per source per calendar year. (See e.g. Cal. Govt Code 89503; 2 CCR 18940.2. See also www.fppc.ca.gov)

(5) State law prohibits, with limited exceptions, certain former local public officials from appearing before their former public agency for the purpose of influencing a governmental decision for 12 months from the date the former employee left that public agency. (Cal. Govt. Code § 87406.3)

(6) State law bars a public agency employee from making governmental decisions regarding an organization which is engaged in employment negotiations with that public agency employee. (Cal. Govt. Code § 87407)

(7) Contractors and their representatives may be required to disclose economic interests that they hold that could foreseeably be affected by the exercise of their public duties. If applicable, Contractors/representatives must submit a disclosure filing called a Statement of Economic Interests or “Form 700.” (Cal. Govt. Code §§ 81000-91015; SFUSD Board Rules and Procedures 9270, “Conflict of Interest Code”)

b. Obligations of Contractor. It is the obligation of the Contractor, as well as any subcontractors, to determine whether or not participation in a contract may constitute a conflict of interest. While the District staff maintains records regarding the award and execution of contracts, it does not have access to specific information concerning which entities, partners, subcontractors or team members perform specific work on these contracts. A conflict of interest or an unfair advantage may exist without any knowledge of the



District. The determination of the potential for a conflict must be made by the Contractor. Contractor is responsible to notify the District immediately if it finds that a potential conflict may exist.

c. Consultation with Counsel. The District strongly advises any Contractor, and any proposing/ bidding firm, to consult with its legal counsel to determine whether a conflict of interest may exist. It is the responsibility of a Contractor, or a proposing/bidding firm, to make that determination.

d. Consequences of a Violation. Any contract made in violation of Section 1090 is void and cannot be enforced. When Section 1090 is violated, a government agency is not obligated to pay the Contractor for any goods or services received under the void contract. The government agency can seek repayment from the Contractor of any amounts already paid, and refer the matter to appropriate authorities for prosecution. Additional consequences may also apply.

e. Disclosure Requirement. Contractor will submit to the District a list of all of Contractor’s employees (including owners) who are also current SFUSD Board members or employees, or former SFUSD Board members or employees in the last two years. Contractor will submit the attached “Contractor’s Disclosure Form Regarding SFUSD Officials.” Contractor will update this form with SFUSD, as needed, during the term of this Agreement. Exception: Public agencies that provide contract services to the District are not subject to this disclosure requirement.

f. Compliance with Gift Limits. Contractor will abide by legal gift limits and use good judgment, discretion and moderation when offering gifts, meals or entertainment or other business courtesies to District officials, and in order not to place District officials in conflict with any specific gift restrictions: (1) No Contractor or representative thereof shall offer, give, or promise to offer or give, directly or indirectly, any money, gift or gratuity to any District contracting or procurement official at any time. (2) No Contractor or representative thereof shall offer or give, directly or indirectly, any gifts in a calendar year to a District official which exceed the allowable gift limit. (See e.g. Cal. Govt Code 89503; 2 CCR 18940.2. See also www.fppc.ca.gov)

g. Employment Negotiations. Prior to engaging in employment negotiations with a District employee (e.g. a job interview or discussion of a job offer), Contractor shall notify that District employee’s supervisor of Contractor’s interest in hiring said employee, so that, if applicable, and if practicable, a full separation may be established between the public employee and any governmental decisions regarding that Contractor.

h. Contractor Certification. In signing this Agreement, Contractor certifies that it will comply with conflict of interest laws and regulations, and SFUSD Board Policies. Contractor acknowledges that it is familiar with these provisions; certifies that it does not know of any facts that constitute a violation of such provisions; and agrees to promptly notify the District if it becomes aware of any such facts during the term of this Agreement.

i. File Statement of Economic Interests (“Form 700”) as Applicable. Contractors and their representatives may be required to disclose any economic interests they hold that could foreseeably be affected by the exercise of their public duties. (Govt. Code §§ 81000-91015; SFUSD Board Rules and Procedures 9270 “Conflict of Interest Code”) This filing, called a Statement of Economic Interests or “Form 700,” aides public officials to ensure they do not make or participate in making any governmental decision in which they have a financial interest. (1) Applicability. Contractors/representatives are considered public officials and must file a Form 700

only if they qualify as “Consultants.” Under SFUSD’s Conflict of Interest Code, “Consultant” means any natural person who provides, under contract, information advice, recommendation or counsel to an agency, department, officer, or commission, provided, however, that a “Consultant” shall not include a person whom: A. Conducts research and arrives at conclusions with respect to his or her rendition of

information, advice, recommendation or counsel independent of the control and direction of the agency or of any agency official, other than normal contract monitoring; and

B. Possesses no authority with respect to any agency decision beyond the rendition of information, advice, recommendation or counsel.

(2) Filing Deadlines. Contractors/representatives required to file a Form 700 shall submit a filing: (a) ten days prior to commencement of work with SFUSD; (b) yearly thereafter by the April 1st annual due date; and (c) upon termination of work with SFUSD.



(3) Interests to Be Disclosed. Contractors/representatives required to file a Form 700 shall disclose only income, investments and business positions in: (a) business entities that manufacture or sell supplies, books, machinery or equipment of the type utilized or purchased by SFUSD and for which the Contractor/representative is a manager or director; and/or in (b) business entities that are contractors or subcontractors engaged in the performance of work services of the type utilized or purchased by SFUSD and for which the Contractor/representative is a manager or director.

(4) Filing Process. Form 700 must be received by SFUSD’s Contracts Office by the timelines provided herein, in order to be considered properly filed.

(5) Disqualification. Consultants/Representatives who must file financial disclosure statements, like other public officials under the CPRA, are subject to disqualification when they encounter decision-making that could affect their financial interests. Contractors and their representatives shall be responsible for ensuring that they take the appropriate actions necessary in order not to violate applicable laws and SFUSD policies.

16. PROPRIETARY OR CONFIDENTIAL INFORMATION OF DISTRICT; STUDENT INFORMATION a. Contractor understands and agrees that, in connection with this Agreement, the Contractor may have

access to proprietary or confidential information which may be owned or controlled by the District and that such information may contain proprietary details, the disclosure of which to third parties will be damaging to the District, its employees or students. Contractor also understands and agrees that the disclosure of such information may violate state and/or federal law and may subject the Contractor to civil liability. Consequently, Contractor agrees that all information disclosed by the District to the Contractor shall be held in strict confidence and used only in performance of the Agreement, unless disclosure is required by law or court order. Contractor shall exercise the same standard of care to protect such information as is used to protect its own proprietary or confidential information.

b. Contractor shall comply at all times with the requirements of the Family Educational Records Privacy Act (“FERPA”) and relevant state law regarding the confidentiality and handling of student records, including but not limited to California Education Code sections 49073 and sequential. Contractor shall only access student information pursuant to prior written parental consent, legitimate educational interest in performing duties on behalf of SFUSD under this Agreement, or other provisions of federal and state law permitting access to confidential student information. Contractor shall not use student data for any purposes other than those provided for in this Agreement. Contractor shall not re-disclose confidential student information unless pursuant to federal and state law.

c. Use of Student Data for Studies. Consistent with state and federal law as detailed in Subsection (b) of this Section, Contractor understands and acknowledges that use of student data by Contractor for purposes other than those authorized under this Agreement, such as for Contractor’s own research studies or program evaluation, requires approval by the District’s Office of Research, Planning, and Accountability (“RPA”). Not every application for the use of student data is approved by RPA due to resource limitations. If Contractor wishes to receive, gather or use student data for purposes other than those authorized under this Agreement, then prior to receiving, gathering or using any student data for such purposes, Contractor will complete and submit a Research Application to RPA and await approval or denial from RPA. If RPA approves Contractor’s Research Application, Contractor must also execute a Data Use and Confidentiality Agreement (“DUA”) with RPA. Only if the Contractor submits a Research Application to RPA that is approved by RPA, and Contractor then fully executes a DUA with RPA, may the Contractor receive, gather or use student data for purposes other than those authorized under this Agreement, such as Contractor’s own research studies or program evaluation.

d. The provisions of this Section shall survive the termination or expiration of this Agreement.

17. OWNERSHIP OF RESULTS Any studies, reports, memoranda, computation sheets, data, computer data files and media or other documents prepared by Contractor in connection with services to be performed under this Agreement, shall be the property of and be promptly transmitted to the District. However, Contractor may retain and use copies for reference and as documentation of its experience and capabilities, but only to the extent that such retention and use complies with



Section 16 of this Agreement (“Proprietary or Confidential Information of District; Student Information”). The provisions of this Section shall survive the termination or expiration of this Agreement.

18. AUDIT AND INSPECTION OF RECORDS

Contractor agrees to maintain and make available to the District accurate books and accounting records relative to its activities under this Agreement. Contractor will permit the District to audit, examine and make excerpts and transcripts from such books and records, and to make audits of all invoices, materials, payrolls, records or personnel records and other data related to all other matters covered by this Agreement, whether funded in whole or in part under this Agreement. The Contractor shall maintain such data and records in an accessible location and condition for a period of not less than five years after a final payment under this Agreement or until after final audit has been completed, whichever is later.

19. SUBCONTRACTING

Contractor is prohibited from subcontracting this Agreement or any services provided pursuant to this Agreement without the prior written consent of the District, pursuant to Section III(g) (“Use of Subcontractor”) of Appendix A of this Agreement.

20. ASSIGNMENT It is understood and agreed that the services to be performed by the Contractor are personal in character and neither this Agreement, nor any duties or obligations hereunder, shall be assigned or delegated by the Contractor without the prior written consent of the District.

21. NON-DISCRIMINATION

Contractor agrees that it shall not discriminate on the basis of sex, race, religious creed, national origin, age, marital status, sexual orientation, gender, AIDS/ARC/HIV status, or disability, in its performance under this Agreement.

22. CRIMINAL BACKGROUND CHECKS; SUBSEQUENT ARREST NOTIFICATION

a. Criminal Background Checks (1) Contractor is required to fulfill the provisions of California Education Code section 45125.1,

whereby CONTRACTOR will conduct a criminal background check with the California Department of Justice for all of CONTRACTOR’s employees, agents and volunteers assigned to the District, and CONTRACTOR will certify in writing that no employee, agent or volunteer assigned to the District who will have contact with students pursuant to this Agreement has been convicted of a serious or violent felony as described in EC 45125 .1 (citing 45122.1), a sexual offense as defined by EC 44010, or a controlled substance offense as described in EC 44011. This prohibition does not apply to an employee, agent or volunteer who has obtained a certificate of rehabilitation and pardon pursuant to California Penal Code section 4852.01 et seq. for the offense or offenses at issue.

(2) CONTRACTOR will be responsible for any and all costs of the criminal background check fingerprinting process.

(3) As written certification of its compliance with these provisions, Contractor will complete and sign the Service Provider/Independent Contractor Agreement Criminal Background Clearance/ Tuberculosis Clearance Written Certification Form (attached). Contractor will submit an updated form whenever there are staffing changes.

b. Subsequent Arrest Notification (1) In addition to the initial criminal background check, CONTRACTOR will also request from the

California DOJ subsequent arrest notifications for every CONTRACTOR employee, agent and volunteer who will have contact with students under this Agreement.

(2) CONTRACTOR will be responsible for any and all costs of these subsequent arrest notifications. (3) Upon receipt of notice by Contractor that any of Contractor’s employees, agents or volunteers

providing services to student pursuant to this Agreement has been subsequently arrested or convicted of a serious or violent felony as described in EC 45125 .1 (citing 45122.1), a sexual



offense as defined by EC 44010, or a controlled substance offense as described in EC 44011, CONTRACTOR will immediately notify SFUSD and prohibit such employee, agent or volunteer from having any contact with students pursuant to this Agreement.

(4) Failure to comply with these provisions may result in, at the District’s sole discretion, termination of this Agreement.

23. TUBERCULOSIS TESTING

a. Contractor agrees that all employees, agents or volunteers whose functions require frequent or prolonged contact with students will complete tuberculosis testing the same as the testing that is described in California Education Code section 49406. The examination shall consist of an approved intradermal tuberculin test, which, if positive, shall be followed by an x-ray of the lungs. Thereafter, the Contractor shall ensure that its employees, agents or volunteers who are skin test negative have undergone the foregoing examination at least once every four years if the Contractor is still rendering services to SFUSD pursuant to this contract and shall be listed by name on Service Provider/Independent Contractor Criminal Background Clearance/ Tuberculosis Clearance Written Certification Form.

b. The Contractor shall be responsible for the costs of the examination. c. The District’s Cabinet level Administrator has the responsibility to make a reasonable determination of

whether Contractor, their employees, agents or volunteers will have frequent or prolonged contact with students prior to confirmation that the Consultant has passed the TB test.

d. Contractor shall certify in writing on the attached Service Provider/Independent Contractor Criminal Background Clearance/ Tuberculosis Clearance Written Certification Form that all employees, agents or volunteers who have not submitted to a TB test will not have frequent or prolonged contact with students.

24. NONWAIVER OF RIGHTS

Either party’s failure at any time to enforce any default or right reserved to it, or to require performance of any of the Agreement’s terms, covenants, or provisions by the other party at the time designated, shall not be a waiver of any such default or right to which the party is entitled, nor shall it in any way affect the right of the party to enforce such provisions thereafter.

25. MODIFICATION OF AGREEMENT Except as otherwise provided in Section V(c) of Appendix A (“Modification of Attachments 1 and 2”) of this Agreement and Section II(c) of Appendix B (“Modification of Attachment 3”) of this Agreement, the Parties may only amend this Agreement in writing by mutual consent, and changes, including any increase or decrease in the amount of the Contractor’s compensation, shall only be effective upon proper approval of the Board of Education, certification of funds by the District’s Chief Financial Officer, and execution of a written amendment to this Agreement by the duly authorized representatives of the Parties.

26. ADMINISTRATIVE REMEDY FOR AGREEMENT INTERPRETATION Should any question arise as to the meaning and intent of the Agreement, the matter shall, prior to any action or resort to any other legal remedy, be referred to the District’s Superintendent or his designee who shall decide the true meaning and intent of the Agreement.

27. COMPLIANCE WITH AMERICANS WITH DISABILITIES ACT Contractor acknowledges that, pursuant to the Americans Disabilities Act (ADA), programs, services and other activities provided by a public entity to the public, whether directly or through a contractor, must be accessible to the disabled public. Contractor shall provide the services specified in this Agreement in a manner that complies with the ADA and any and all other applicable federal, state and local disability rights legislation. Contractor agrees not to discriminate against disabled persons in the provision of services, benefits or activities provided under this Agreement and further agree that any violation of this prohibition on the part of Contractor, its employees, agents or assigns will constitute a material breach of this Agreement.

28. COMPLIANCE WITH LAWS AND REGULATIONS; CHANGES THERETO



a. Contractor shall keep itself fully informed of all applicable state and federal laws and regulations affecting the performance of this Agreement, and as they may be amended from time to time, and shall at all times comply with such laws and regulations.

b. Contractor understands that changes in state or federal laws and regulations, or District policies, may impact contract funding levels, grant requirements, and responsibilities for Contractor during an academic year. This Agreement may be amended during its term, pursuant to Section 25 (“Modification of Agreement”) to reflect any necessary revisions resulting from any such changes.

c. Any citation to state and federal laws and regulations in this Agreement is for convenience of reference only, and shall not be relied upon by Contractor as an accurate or complete reflection of the current status of state and federal laws and regulations.

29. GOVERNING LAW; VENUE

This Agreement shall be governed by the laws of the State of California. The venue for all litigation relative to this Agreement shall be the City and County of San Francisco.

30. SECTION HEADINGS

The section headings contained herein are for convenience in reference and are not intended to define the scope of any provision of this Agreement.

31. ENTIRE AGREEMENT

This Agreement contains the entire agreement between the parties and supersedes all other oral or written provisions.

32. EXECUTION OF THE AGREEMENT, EXECUTION IN COUNTERPARTS a. Original copies of this Agreement shall be executed by the respective party’s authorized signatory(ies). b. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original

agreement, but all of which shall be considered one instrument and shall become a binding agreement when one or more counterparts have been signed by each of the parties and delivered to the other.

33. SEVERABILITY

If any term or provision of this Agreement shall be found illegal or unenforceable, this Agreement shall remain in full force and effect and such term or provision shall be deemed stricken.

34. NOTICE TO PARTIES All notices to be given by the parties hereto shall be in writing and served by depositing the same in the United States Post Office as follows:

NOTICE TO THE DISTRICT:

SITE/DEPARTMENT

HEAD OF SITE/DEPARTMENT

CONTACT PERSON

STREET ADDRESS

CITY, STATE, ZIP

TELEPHONE/FAX (TEL) (FAX) EMAIL ADDRESS



NOTICE TO THE DISTRICT CONTRACT OFFICE: San Francisco Unified School District Contracts Office 135 Van Ness Street, Room 102 San Francisco, CA 94102 415-355-6963 (TEL) 415-522-6711 (FAX) contract@sfusd,edu

NOTICE TO THE CONTRACTOR:

CONTRACTOR

CONTACT NAME

STREET ADDRESS

CITY, STATE, ZIP

TELEPHONE/FAX (TEL) (FAX) EMAIL ADDRESS



IN WITNESS WHEREOF the parties hereto have executed this Agreement the year and date first above

written per Board Resolution #: insert approved resolution number - if not known, leave blank approved on the following date insert date Board approved resolution - if not known, leave blank. [See attached ‘Approved K-Resolution’.] For insert name of Contractor APPROVED: By:_________________________________ Authorized Signature ____________________________________ Print Name and Title of Signatory

For SAN FRANCISCO UNIFIED SCHOOL DISTRICT APPROVED: ____________________________________________ Joseph C. Grazioli Chief Financial Officer APPROVED AS TO FORM: ____________________________________________ Cassie Coleman, Sr. Deputy Gen. Counsel (N/A if <= $25,000) REVIEWED: ____________________________________________ Contracts Office RECOMMENDED: _____________________________________________ Insert Name & Title of Site Principal/ Asst. Supt./ Designee ____________________________________________ Mele Lau-Smith Program Director, ExCEL After School ____________________________________________ Kevin Truitt, Associate Superintendent Student, Family & Community Support Department



Appendix A

Scope of Services

I. SCOPE OF SERVICES FOR 2012-2013 AFTERSCHOOL PROGRAM

a. The District is the grantee of the California Department of Education (CDE), awarded grant funding by CDE to provide afterschool programming to District students.

b. Pursuant to this Agreement, District is contracting with Contractor to serve as the Lead Agency responsible for administering all aspects of the grant-funded afterschool program described in this Appendix A and in the incorporated attachments, and Contractor shall be responsible for the provision of quality, grant-compliant afterschool educational programs and services to serve a sufficient number of students as targeted by the grant, for the full one hundred and seventy six (176) instructional school days in SFUSD’s 2012-2013 school year. High school program sites may, in addition, opt to operate beyond the 176-instructional-day minimum, pursuant to Section II(c)(5) of Appendix A of this Agreement.

c. The After School Program that Contractor will provide will operate under the following grant:

Check All That Apply:

After School Education and Safety (ASES) Base Grant

21st Century Community Learning Center (21st CCLC) Base Grant

21st Century High School After School Safety and Enrichment for Teens (ASSETs)

d. School site where Contractor will provide After School Program under this Agreement:

School Site Location of Afterschool Program:

e. Grade level range of students to be served by Contractor under this Agreement: [Grade level range should be listed from lowest grade level to highest grade level to be served, as applicable—e.g. Grades K-5; Grades 6-8; Grades 9-12, etc.]:

Grade level range of students to be served:

f. ExCEL Office-approved Minimum Daily Attendance Target for After School Program:

Approved minimum number of students to be served daily:

g. ExCEL Office-approved Total Annual Student Attendance Days for After School Program:

Approved Total Number of Student Attendance Days to be provided:



II. AFTERSCHOOL PROGRAM REQUIREMENTS

Contractor will provide the services described in this Agreement, including in but not limited to Attachment 1 – School Site After School Program Summary and Attachment 2 – Weekly Program Schedule, in accordance with the following: applicable grant requirements (21st Century, ASSETS, and/or ASES grant); relevant California Education Code sections including but not limited to 8482 – 8484.6; 8484.7 – 8484.9; 8420 – 8428; and SFUSD ExCEL program and policy guidelines including but not limited to the requirements listed below. All of the following SFUSD ExCEL program and policy guidelines apply to all afterschool programs, except where expressly noted as applying only to certain grade levels or grants.

a. Lead Agency

1. Contractor will serve as the Lead Agency at the stated school site providing such duties as programmatic oversight, hiring and supervision of program staff, fiscal management, payroll services, and direct instruction for students. Contractor will provide tutoring, arts, recreation, leadership activities and program coordination for the site’s comprehensive after school program.

2. Contractor will meet and maintain enforcement of all requirements for a Lead Agency as outlined in the most recent RFQ approval process, including but not limited to the provision of thirty three percent (33%) match funding or a mix of funding and in-kind services to enhance program services at the named school site program.

b. Program Components for Elementary and Middle School Program Sites:

1. The program will include an educational and literacy element, which must provide tutoring and/or homework assistance designed to help students meet state standards in one or more of the following core academic subjects: reading/language arts, mathematics, history and social studies. (EC 8482.3(c)(1))

2. The program will include an educational enrichment element, which may include but is not limited to positive youth development strategies, recreation and prevention activities. Such activities might involve the visual and performing arts, music, physical activity, health/nutrition promotion, and general recreation; career awareness and work preparation activities; community service-learning; and other youth development activities based on student needs and interests. Enrichment activities may be designed to enhance the core curriculum. (EC 8482.3(c) (2))

3. The program must include a physical activity element.

4. 21st CCLC programs must provide family literacy services. (20 U.S.C. 7171(a)(1)-(3).)

5. Commence immediately upon the conclusion of the regular instructional school day; operate a minimum of fifteen (15) hours per week; and operate until at least six in the evening (6:00 p.m.) on every regular instructional school day. (EC 8483.)

6. Elementary school students are expected to attend five (5) days per week. Middle School/Junior High students are expected to attend a minimum of nine (9) hours per week and three (3) days per week. (EC 8483(a)(1)-(2).)

7. Adhere to SFUSD ExCEL Early Release Policy, and implement all required documentation. (EC 8483(a)(1).)

c. Program Components for High School Program Sites:



1. The program will include an academic assistance element, which shall include but need not be limited to at least one of the following: preparation for the high school exit examination, tutoring, homework assistance, and college preparation. The academic assistance shall be aligned with the regular academic programs of the pupils. (EC 8421(a)(1).)

2. The program will include an enrichment element, which may include but need not be limited to: community service, career and technical education, job readiness, opportunities for mentoring and tutoring younger pupils, service learning, arts, computer and technology training, physical fitness, and recreation activities. (EC 8421(b)(1)-(2).)

3. The program must include a physical activity element. (EC 8423(c)(3).)

4. The program must operate for a minimum of fifteen (15) hours per week. (EC 8421(c).)

5. The program may also opt to operate before school, weekends, summer, intersession, and/or vacation, or any combination thereof. (EC 8422(d)(1),(2).)

6. ASSETS programs must provide family literacy services. (20 U.S.C. 7171(a)(1)-(3).)

d. Academic Alignment

1. Utilize a certificated faculty member from the school site to serve in the role of Lead Teacher to assist with academic alignment and related communication between the school day and after school program, as well as provide curriculum support.

2. Adhere to and implement ExCEL Office academic program directives.

e. Other Programmatic Requirements

1. Enroll students at the school site listed in this Agreement, and in the grade levels specified in this Agreement to participate in the after school program.

2. Provide the afterschool program to students for all of the one hundred and seventy six (176) instructional school days in the 2012-2013 school year.

3. Serve a nutritious snack that conforms to the nutrition standards in Article 2.5 of Chapter 9 of Part 27. (EC 8482.3(d).) Complete all required SFUSD Student Nutrition Services paperwork in an accurate and timely manner.

4. Make information regarding Contractor’s afterschool program available in a form and language that is easily understandable to all parents. (EC 48985; 20 U.S.C. 6318(e)(5).)

f. Working with School Site and District

1. Carry out the program with active collaboration with the schools that the students attend, and integrated with the regular school day and other extended learning opportunities. (EC 8483.3(c)(5).)

2. Ensure that the program aligns with District and school site goals and objectives to support the success of students as articulated in the school site’s Single Plan for Student Achievement (SPSA).

3. Maintain clean, safe, and secure program environments for staff and students in conjunction with SFUSD and following SFUSD guidelines. Contractor will, as it deems necessary, initiate and establish additional cleanliness, safety, and security policies and protocols within its program that are sufficient to ensure staff, student and family member safety.



4. Maintain regular and effective communication with the school site principal and the ExCEL Office.

g. Staffing

1. Contractor must ensure that all staff members who directly supervise pupils meet the minimum qualifications for an instructional aide, pursuant to the policies of the District. (EC 8483.4.)

2. The student-to-staff ratio must not exceed twenty-to-one (20:1). (EC 8483.4.)

3. Contractor and any subcontractor must comply with the Child Abuse and Neglect Reporting Act (CANRA) guidelines as Mandated Reporters to report suspicions of possible child abuse to the appropriate reporting agency as stated in California Penal Code sections 11164 – 11174.

4. Contractor will participate in technical assistance, training, orientation, monthly meetings, and other support and resource development activities provided by the District and collaborative partners in conducting program planning, implementation, and evaluation. These include required regular meetings with the school principal or principal’s designee to ensure collaboration with the school’s programs. Contractor understands and agrees to participate in all meetings facilitated by the District to address program success, areas of concern, contractual issues, and general troubleshooting. (EC 8483.3(c)(4).)

h. Documentation, Evaluation and Monitoring

1. Attendance Reports. Contractor will provide District with attendance reports using the ExCEL Office’s attendance systems, and will maintain required attendance reports, including completion of mandatory monthly reports.

2. Accuracy. Contractor must ensure accuracy of all attendance data submitted. The Contractor may be held liable for any attendance errors and/or discrepancies that result in monies returned or paid back to the District and/or the California Department of Education.

3. Accountability Documents. Provide SFUSD with requested program accountability documents and reports, to include, but not limited to:

i. Financial reports

ii. Activity reports

iii. Outcomes reports: behavioral and academic

iv. Attendance reports using designated ExCEL Attendance Systems and protocols

v. Written certification of current Tuberculosis testing for each employee, agent, or volunteer working with students pursuant to Section 23 (“Tuberculosis Testing”) of this Agreement.

vi. Written certification of current criminal background check clearance for each employee, agent, or volunteer working with students pursuant to Section 22 (“Criminal Background Checks; Subsequent Arrest Notification”) of this Agreement.

vii. Documentary evidence that any staff who will directly supervise pupils meet the instructional aide qualifications pursuant to Section II(g)(1) of Appendix A of this Agreement.



viii. Additional reports and documentation as needed upon request for monitoring purposes.

ix. All records, including attendance hard copies, payroll, and financial documents, must be maintained by contractor and made available for District review for five (5) years.

4. Other Documentation. Provide required documentation to District upon request as needed for evaluation, audit, program monitoring, Categorical Program Monitoring (CPM) or other review processes.

5. Data Collection and Analysis. Work with ExCEL to collect and analyze data on student enrollment, student attendance, student academic performance, student satisfaction, and parent satisfaction. Contractor will conduct such data collection and analysis activities in conformity with Section 16 (“Proprietary or Confidential Information of District; Student Information”) of this Agreement.

6. Evaluation. Contractor must participate in all federal, state, county, and district evaluation procedures. Contractor will participate in such evaluation procedures in conformity with Section 16 (“Proprietary or Confidential Information of District; Student Information”) of this Agreement.

7. Student Outcomes. Contractor shall achieve the student outcomes as described within the Evaluation Plan, Program Plan, and grant narrative documents from the ExCEL Office. Contractor agrees to develop school-specific outcomes, as defined after consultation with the school site principal. Contractor will design instructional strategies to support achievement of the school site’s academic objectives as articulated in the school site plan.

8. Use of Form Templates. As directed by the ExCEL Office, Contractor will use the ExCEL Office’s form templates, cut and pasted onto Contractor’s letterhead, for After School Program Parent Permission forms, and Student Information enrollment packet forms, including early release waiver forms (for elementary/middle school sites) and attendance tracking forms, for all after school participants.

9. Technical Assistance Action Plan. Contractor will work with the ExCEL Office to develop and sign a Site Response/Technical Assistance Action Plan Agreement to address any identified compliance or safety concerns at the school site within seven (7) days of notification to Contractor by the ExCEL Office of such findings.

III. USE OF CONTRACT FUNDS

In addition to and not exclusive of any other terms relating to the use of contract funds contained elsewhere in this Agreement, Contractor shall comply with the following requirements regarding use of contract funds:

a. Payment. Contractor will receive payment for services rendered, up to the maximum contract amount, based upon Contractor’s submission of detailed monthly invoices documenting expenditures that reflect use of funds that is compliant with the grant and with this Agreement, and which are accepted as compliant by the District.

b. Attendance Review and Consequences of Low Attendance.

1. Funding for afterschool program under this Agreement is based upon positive student attendance. It is the intention of the District to fully utilize its grant funds on behalf of



effective, quality after school programs for students. Therefore, the District reserves the right to modify the maximum contract funding allocation made pursuant to this Agreement based on Contractor’s reported attendance during the 2012-2013 contract period, as follows.

2. Contractor must submit documentation of attendance to the ExCEL Office according to required monthly deadlines and in the required format.

3. Afterschool Program Attendance Data Review Intervals will be November 2012 and February 2012. The ExCEL Office will review Contractor’s attendance data at these intervals, and reserves the right to review attendance data at other times in addition to these intervals.

4. If Contractor’s afterschool program does not attain at least seventy five percent (75%) of its year-to-date approved attendance target at either of the Data Review Intervals, the District will: (1) Notify Contractor in writing that Contractor did not attain at least 75% of its approved attendance target for that Data Review Interval; and (2) Provide Contractor with technical assistance designed to aid Contractor in attaining its approved attendance target. If, after the above steps have been taken, Contractor’s attendance numbers are still below seventy five percent (75%) of the approved attendance target, the District reserves the right to reduce the total contract amount, and/or reassign some or all of the contract funds to other contractors, or to the District, for program implementation.

5. For an afterschool program that does not attain at least fifty percent (50%) of its year-to-date approved attendance target at either of the Data Review Intervals, the District will immediately notify Contractor in writing that the Contractor did not attain at least 50% of its approved attendance target. The Contractor must then provide a written response to the District within ten (10) business days detailing a proposed corrective action plan to increase attendance above 75% of the attendance target. Upon receipt of the proposed corrective action plan, the District will review the plan and determine whether the District will: (1) provide technical assistance to Contractor to implement the proposed plan with any recommended revisions, or (2) reduce the total contract amount, and/or reassign some or all of the contract funds to other contractors, or to the District, for program implementation. The District will notify the Contractor in writing of its determination.

c. Direct Services to Students. Contractor shall use contract funds for direct services for students. Costs incurred by Contractor for Direct Services provided pursuant to this Agreement shall be reimbursed by the District pursuant to the terms of this Agreement. Direct Services include but are not limited to expenditures such as: instructional materials; supplies to be used directly with/by students; salaries and benefits paid to those who provide direct services to students; and/or costs of enrichment services that directly benefit students. Contractor shall submit for reimbursement for Direct Services expenditures via monthly invoices as provided in this Agreement. All Direct Services expenditures submitted on monthly invoices will be reviewed for compliance with grant guidelines and with this Agreement. The District will notify Contractor of any submissions of expenses for Direct Services that the District deems inappropriate for payment under the grant or this Agreement. The District will not pay Contractor for submissions of expenses for Direct Services that the District deems inappropriate for payment under the grant or this Agreement.

d. Administrative Expenses. Contractor understands and agrees that it may not utilize more than a maximum of seven and one half percent (7.5%) of its documented and accepted expenses for Direct Services and administrative expenses combined, and that the total of its Direct Services expenses plus allowable administrative expenses is included in, and not in addition to, the not-to-



exceed amount of the Agreement. Examples of acceptable administrative expenses include but are not limited to: office supplies and salary costs directly related to grant oversight fiscal activities. Contractor shall submit for reimbursement of any administrative expenses via monthly invoices pursuant to the terms of this Agreement. All administrative expenses submitted on monthly invoices will be reviewed for compliance with grant guidelines and with this Agreement. The District will notify Contractor of any submissions of administrative expenses the District deems inappropriate for payment under the grant or this Agreement. The District will not pay Contractor for submissions of administrative expenses that the District deems inappropriate for payment under the grant or this Agreement.

e. Payment Only for Compliant Costs. The District will not be liable to Contractor for payment of any costs or expenses paid or incurred by Contractor that are not compliant with the terms of the grant and/or the terms of this Agreement.

f. Accounting Records. Contractor will maintain its accounting records based upon the principles of fund accounting and Generally Accepted Accounting Principles.

g. Use of Subcontractor.

1. Pursuant to Section 19 (“Subcontracting”) of this Agreement, Contractor is prohibited from subcontracting this Agreement or any services provided pursuant to this Agreement without the prior written consent of the District. Any subcontracting by Contractor of the services to be provided under this Agreement must be approved by in writing the District ExCEL Office at least thirty (30) days in advance of the proposed commencement of any such subcontracting.

2. If Contractor uses a subcontractor to perform services under this Agreement Contractor shall be responsible for the subcontractor as Contractor is responsible for its own employees pursuant to the terms of this Agreement, including but not limited to Section 9 (“Independent Contractor”), Section 10 (“Insurance”), Section 11 (“Indemnification”), Section 22 (“Criminal Background Checks; Subsequent Arrest Notification”), and Section 23 (“Tuberculosis Testing”), as well as meeting instructional aide qualifications pursuant to Section II(g)(1) of Appendix A of this Agreement, as applicable. For Section 22 (“Criminal Background Checks; Subsequent Arrest Notification”) requirements as applied to subcontractor, the Contractor shall ensure that the subcontractor follows Section 22 as to subcontractor’s employees, agents, and volunteers, and that the subcontractor provides the Contractor with written certification of compliance, which Contractor will in turn provide to the District.

3. Contractor shall ensure that any services provided by a subcontractor are consistent with the requirements of the grant funding and the terms of this Agreement.

4. Contractor’s use of a subcontractor without the District’s prior written approval as required in this Agreement may result in District’s immediate termination of this Agreement at the sole discretion of the District.

IV. INVOICE FORMAT AND PROCESS

In addition to and not exclusive of any other terms relating to invoice format and process contained elsewhere in this Agreement, Contractor shall comply with the following invoice format and process requirements:

a. Documentation of Attendance. Contractor will submit documentation of attendance to the District’s ExCEL Office in order for payment of invoices to be processed. Monthly Attendance is



due to the ExCEL Office by the fifth (5th) business day of each month, and invoices are due to the EXCEL Office by tenth (10th) business day of each month, for the preceding calendar month.

b. Certification of Compliance. Contractor’s signature certifies that all expenditures, reimbursements, and disbursements requested comply with state and federal laws. Contractor agrees to promptly reimburse in full, and at no cost to District, any unauthorized, unearned or excessive disbursements, reimbursements or expenditures of any kind.

c. Monthly Submission of Invoices. Contractor will submit to the ExCEL Office detailed monthly invoices for services rendered during the preceding calendar month, not to exceed the maximum contract amount, documenting expenditures that reflect use of funds that is compliant with the grant and with this Agreement. Invoices are due to the ExCEL Office on the tenth (10th) business day of each month for services rendered in the preceding calendar month. Contractor shall submit invoices based on the actual cost of services performed, and otherwise consistent with the grant requirements and this Agreement. Invoices must include detailed line item accounting of all expenses. Required documentation must be attached. Back-up documentation and receipts must be provided for all expenses. Staffing expenses shall be listed on invoices by the position title, not by the name of staff person. Invoices shall be submitted in conformity with District required format and contain the following information:

1. Agency letterhead or logo

2. Agency name, address, phone, fax and contact person

3. School Site Location Name

4. District Board of Education “K-Reso” Number, Purchase Order Number

5. Grant funding source name—i.e. After School Education and Safety (ASES) Base Grant; 21st Century (21st CCLC) Community Learning Center Base Grant; 21st Century High School After School Safety and Enrichment for Teens (ASSETs)

6. Invoice billing period by calendar month (ex. 9/1/12 – 9/30/12)

7. Total not-to-exceed contract amount

8. Total Monthly Student Attendance total and total days of program operation

9. Remaining contracted amount

10. Invoice number (assigned by Contractor)

11. Authorized Signature from Contractor

d. Attachments to Invoice. Attachments to the invoice must include:

1. Expense Back-Up Documentation

2. Income Statements, Revenue and Expenses Statements, or Profit and Loss Statement

3. Expense summary sheet (including breakdown of expenses)

e. Final Deadline for Invoices. No invoices will be accepted more than twenty (20) days past the end of the term of this Agreement.

f. Modification of Invoicing Requirements. The District reserves the right to modify invoice format, information, or attachment requirements with thirty (30) days’ prior written notice to Contractor.

g. Timeline for Payment. The District will make reasonable efforts to pay Contractor within sixty (60) days of the District’s receipt of an invoice from Contractor that the District accepts as



compliant with this Agreement and the terms of the grant. If payment is not issued within 60 days, the District will provide to Contractor, upon Contractor’s request, a written explanation of the delay with the estimated timeline for payment.



Appendix A

Scope of Services

(CONTINUED)

V. APPENDIX “A” ATTACHMENTS: SCHOOL SITE AFTER SCHOOL PROGRAM SUMMARY (“ATTACHMENT 1”) AND WEEKLY PROGRAM SCHEDULE (“ATTACHMENT 2”)

a. Required Attachments 1 and 2. Contractor shall attach to Appendix A the following attachments, once each is approved by the ExCEL Office: Attachment 1 – School Site After School Program Summary, and Attachment 2 – Weekly Program Schedule.

b. Incorporation of Attachments 1 and 2. Both Attachment 1 – School Site After School Program Summary, and Attachment 2 – Weekly Program Schedule, are incorporated by reference into Appendix A of this Agreement as though fully set forth herein.

c. Modification of Attachments 1 and 2. Attachment 1 – School Site After School Program Summary, and Attachment 2 – Weekly Program Schedule, may be modified with prior written approval from the ExCEL Office, provided that such modification does not alter the not-to-exceed amount of this Agreement or any other requirements of this Agreement. Any modification that will alter the not-to-exceed amount of this Agreement or any other requirements of this Agreement must be executed as a written modification of this Agreement pursuant to Section 25 (“Modification of Agreement”).

The following affirmation is to be completed by the District ExCEL staff member administering this Agreement:

I have reviewed, and approved, Attachment 1 – School Site After School Program Summary and Attachment 2 – Weekly Program Schedule to this Agreement.

Date

SIGNATURE of District ExCEL Staff Administering this Agreement

PRINT Name & Title of District ExCEL Staff Administering this Agreement



Appendix B

Afterschool Program Budget

I. TOTAL COST OF THE AGREEMENT (NOT-TO-EXCEED AMOUNT)

The Total Cost of this Agreement (Not to Exceed Amount) is: INSERT CONTRACT DOLLAR AMOUNT IN WORDS dollars, ($INSERT CONTRACT DOLLAR AMOUNT IN NUMBERS).

II. APPENDIX B ATTACHMENT: PROGRAM BUDGET DETAIL (“ATTACHMENT 3”)

a. Required Attachment 3. Contractor shall attach to Appendix B the following attachment, once it is approved by the ExCEL Office: Attachment 3 – Program Budget Detail.

b. Incorporation of Attachment 3. Attachment 3 – Program Budget Detail is incorporated by reference into Appendix B of this Agreement as though fully set forth herein.

c. Modification of Attachment 3. Attachment 3 – Program Budget Detail may be modified with prior written approval from the ExCEL Office, provided that such modification does not alter the not-to-exceed amount of this Agreement or any other requirements of this Agreement. Any modification that will alter the not-to-exceed amount of this Agreement or any other requirements of this Agreement must be executed as a written modification of this Agreement pursuant to Section 25 (“Modification of Agreement”).

The following affirmation is to be completed by the District ExCEL staff member administering this Agreement:

I have reviewed, and approved, this Afterschool Program Budget for this Agreement, including Attachment 3 – Program Budget Detail.

Date

SIGNATURE of District ExCEL Staff Administering this Agreement

PRINT Name & Title of District ExCEL Staff Administering this Agreement



Form W-9

(Rev. January 2011)

Department of the Treasury Internal Revenue Service

Request for Taxpayer Identification Number and Certification

Give form to the requester. Do not send to the IRS.

Please print or type

See Specific Instructions on page 2.

Name (As shown on your income tax return)

Business name /disregarded entity name, if different from above

Check appropriate box for federal tax

classification (required): Individual/sole proprietor Corporation S Corporation Partnership Trust/estate

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership �

Other (see instructions) �

Exempt payee

Address (number, street, and apt. or suite no.)

Requester’s name and address (optional)

City, state, and ZIP code

List account number(s) here (optional)

Part I Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter

Social security number

-

-

Employer identification number

-

Part II Certification

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue

Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and

3. I am a U.S. citizen or other U.S. person (defined below). Certification Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the instructions on page 4.

Sign Here

Signature of U.S. person � Date ��

General Instructions

Section references are to the Internal Revenue Code unless otherwise noted.

Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued),

2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S.

exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income.

Note: If a requester gives you a form other than a W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien,

• A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States,

• An estate (other than a foreign estate), or

• A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners’ share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income.

Page 1 of 4 – refer to www.irs.gov/pub/irs-pdf/fw9.pdf for pages 2-4)




Criminal Background Check/Tuberculosis Clearance Written Certification Form

Name of Independent Contractor/Service Provider:

Services to be performed under the Agreement:

Schools/Locations where services are being performed:

Total amount to be paid by the District Under this Agreement not to exceed:

Term of Agreement:

FY 2012-2013

Contractor shall check the applicable boxes and fill in any applicable blanks.

CRIMINAL BACKGROUND CHECK

1. Contractor/Contractor’s employees, agents or volunteers will ONLY HAVE LIMITED OR

NO CONTACT with District students (as defined by the District) during the term of the

Agreement

2.

Contractor/Contractor’s employees, agents or volunteers, listed below, will have MORE THAN LIMITED CONTACT with District students (as defined by the District) during the term of the Agreement. (Attach and sign additional pages, as needed): INSERT OR ATTACH NAMES OF EMPLOYEES AND DATES OF C.B.C. CLEARANCE The employees, agents, volunteers noted above have been fingerprinted under procedures established by the California Department of Justice and the FBI, and the results of those fingerprints reveal that none of these employees have been arrested or convicted of a serious or violent felony, as defined by the California Penal Code and that I have requested a subsequent arrest notification for these employees.

TUBERCULOSIS CLEARANCE

3.

Contractor/Contractor’s employees, agents or volunteers will ONLY HAVE LIMITED OR NO CONTACT with District students (as defined by the District).

4.

Contractor/Contractor’s employees, agents or volunteers, listed below, will have MORE THAN LIMITED OR PROLONGED CONTACT with District students (as defined by the District) during the term of the Agreement and have received a TB Test (attach and sign additional pages, as needed): Attach names and dates of TB Test. INSERT OR ATTACH NAMES OF EMPLOYEES AND DATES OF T.B. CLEARANCE

Certification by Independent Contractor/Service Provider (“Contractor”) “I hereby certify on behalf of Contractor that the information provided herein is true and accurate. I further acknowledge that during the term of this Agreement, if Contractor learns of additional information that differs from the responses provided above, including but not limited to hiring of new personnel and/or notice of a subsequent arrest, Contractor will immediately forward this information to District. If Contractor receives any such subsequent arrest notification, I certify that Contractor will immediately notify District and bar such employee/ agent/ volunteer of Contractor from performing any services under this agreement that involve any contact with students.”

Contractor’s Signature Date

Administrator’s Signature Date Cabinet Member’s Signature Date

Print name of Contractor Print name of Administrator Print name of Cabinet Member



San Francisco Unified School District Contractor’s Disclosure Form Regarding SFUSD Officials

To be completed by Contractor:

Name of Contractor:

Services to be performed under the Agreement:

Schools/Locations where services will be performed:

Total amount to be paid by the District Under this Agreement not to exceed:

Term of Agreement:

FY 2012-13

Are any of Contractor’s employees (or owners) ALSO current SFUSD employees/Board members, or former SFUSD employees/Board members within the last two years? (Check “Yes” or “No” as applicable.)

NO. None of Contractor’s employees (or owners) are ALSO current SFUSD employees/Board members, or former SFUSD employees/Board members within the last two years.

YES. Contractor’s employees (or owners) listed in the table below are ALSO current SFUSD employees/Board members, or former SFUSD employees/Board members within the last two years. (Complete the table below. The list may be continued on an additional page as needed.)

NAME of current SFUSD employee/Board member, or former SFUSD employee/Board member within the last two years, who is ALSO Contractor’s employee (or owner):

JOB TITLE(S) AT SFUSD of current SFUSD employee/Board member, or former SFUSD employee/Board member within the last two years, who is ALSO Contractor’s employee (or owner):

DATE on which individual left SFUSD employment/Board.

Or, if the individual is currently an SFUSD employee/Board member, write “current.”

If individual is a current SFUSD employee/Board member, how is he/she to be paid? (I.e., through SFUSD Human Resources or Contractor plans to pay directly, etc.)

Certification by Contractor:

On behalf of Contractor, I hereby certify that, to Contractor’s knowledge, the information provided in this form is true, accurate, and complete. I agree that during the term of this Agreement, if Contractor learns of information that differs from that provided above, including but not limited to the hiring of new personnel who are current SFUSD employees or Board members, or former SFUSD employees or Board members or within the last two years, Contractor will promptly update this form with the District.

For SFUSD Office Use Only: Received by:

_________________ (SFUSD staff initials) Date received: ________________

Contractor’s Signature DATE

Print Name of Signatory