OW-PY'01-04-03
CLfRK'S ORtGI~AL
SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM
AMENDMENT TO CONTRACT
SOUTH FLORIDA EMPLOYMENT AND TRAINING CONSORTIUM
AND SERVICE PROVIDER
SOUTH FLORIDA EMPLOYMENT AND TRAINING CONSORTIUM (SFETC)
3403 NW 82nd Avenue, Suite 300
Miami, Florida 33122-1029
SERVICE PROVIDER
Monroe County Department of Social Services
1100 Simonton Street
Suite 1-202
Key West, FL 33040
TITLE OF SERVICE PROVIDER'S PROGRAM
"Senior Community Service Employment Program"
CONTRACT AMOUNT
'$84,766
CONTRACT NUMBER
INDEX CODE
OW-PY'01-04-03
511003
ARTICLE III
AMENDED REIMBURSEMENT COSTS
Those exhibits incorporated within this Amendment replace any exhibits, which were incorporated in
Contract Number OW-PY'01-04-01 or in a previous Amendment for the program entitled "Senior
Community Service Employment Program". This Amendment modifies current contract due to
the increase of funds by $16,016 to continue providing services for the period of July 1, 2002
through September 30,2002. Maximum reimbursement shall not exceed $84,766.
SENIOR COMMUNITY SERVICE
EMPLOYMENT PROGRAM
PAGE 1
2001-2002
(These Signatures Shall be the Same As Those Names Which Appear in the List of Authorized Signatures
Provided in the Operational Documents on File with the SOUTH FLORIDA EMPLOYMENT AND
~NING CONSORTIUM~) lb.." jJ fJ ~
o Signature of Authorized Officials 0 v
ACTING CCWNT'l ADMI~STRATOR
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o Full Title of Aothorized Off~ --: '. J '
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Signature of Person Att tmg Signature of Person Attesting
Signature that Appears on Line la Signature that Appears on Line Ib
APPROVED AS TO FORM
ANDLE ALSU~
s ANNEt~7re
PLOYMENT AND'11UI.INING7!v
Date
SIGNATORY FORM
AUTHORIZED SIGNATURES FOR: Monroe County Department of Social Services
PROGRAM ENTITLED: Senior Community Service Employment Program
CONTRACT NUMBER: OW-PY'Ol-04-03
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SENIOR COMMUNITY SERVICE
EMPLOYMENT PROGRAM
PAGE 2
2001-2002
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OLDER WORKER
BUDGET
FINAL NEGOTIATED BUDGET
SERVICE PROVIDER:
TITLE:
INDEX CODE:
DATE:
Monroe County SCSEP
Older Workers
511003
7/1/01-9/30/02
.........................
.........................
.........................
.........................
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. . . . . . . . . . . . . . . .
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$ 62,960
$ 536
$ 3,770
$ 919
$ 463
$ 9,733
$ 141
$ 608
$ 1,323
$ 1,317
$ 707
$ 70
$ 346
$ 17
$ 62
$ 200
$ 143
$ 85
$ 771
$ 381
$ 214
$ 84,766
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002 Part Wages Inc. & Incentive
002 Participant Physicals
003 Participant FICA
003 Participant MICA
004 Participant Workcomp
101 Staff Salaries
200 Staff MICA
201 Staff FICA
202 Staff Workers Compensation
204 Staff Group Insurance
206 Staff Retirement
260 Special Services
301 General Liability
Public Liability
350 Telephone
450 Equipment Rental
501 Postage
507 Memberships
510 Local Travel
511 Out of Town Travel
521 Office Supplies
TOTAL
FINANCIAL SHELL mod 1 July 02 to Sept 30
..................
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$ 62,960
$ 536
$ 3,770
$ 919
$ 463
$ 9,733
$ 141
$ 608
$ 1 ,323
$ 1 ,317
$ 707
$ 70
$ 346
$ 17
$ 62
$ 200
$ 143
$ 85
$ 771
$ 381
$ 214
$ 84,766
OLDER WORKER
BUDGET MODIFICATION
#1
SERVICE PROVIDER:
TITLE:
INDEX NUMBER:
DATE:
Monroe County SCSEP
Older Workers
511003
7/1/01-9/30/02
.. .. ..
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................................
................................ .
002 Part Wages Inc. & Incentive 50,960
002 Participant Physicals $ $ 450
003 Participant FICA $ $ 3,160
003 Participant MICA $ $ 739
004 Participant Workcomp $ $ 373
101 Staff Salaries $ $ 7,761
200 Staff MICA $ $ 113
201 Staff FICA $ $ 481
202 Staff Workers Compensation $ $ 1,073
204 Staff Group Insurance $ $ 1,067
206 Staff Retirement $ $ 567
260 Special Services $ $ 60
301 General Liability $ $ 346
Pubilc Liability $ $ 17
350 Telephone $ 10 $ 52
450 Equipment Rental $ 10 $ 190
501 Postage $ 25 $ 118
507 Memberships $ 15 $ 70
510 Local Travel $ 105 $ 666
511 Out of Town Travel $ 68 $ 313
521 Office Supplies $ 40 $ 174
TOTAL $ 16,016 $ 84,766 $ 68,750
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