Staff Report\ I
DATE:
TO:
FROM:
SUBJECT:
MEETING DATE: 12/15/15
ITEM NO: I I
COUNCIL AGENDA REPORT
DECEMBER 10, 2015
MAYOR AND TOWN COUNCIL
LAUREL PREVETTI, TOWN MANAGER
COMMUNITY GRANTS PROGRAM UPDATE
A. RECEIVE THE COMMUNITY GRANTS PROGRAM UPDATE
B. PROVIDE DIRECTION ON POTENTIAL MODIFICATIONS TO THE
COMMUNITY GRANT PROCESS, FUNDING CATEGORIES, EVALUATION
CRITERIA, BUDGET ALLOCATION, OR OTHER ELEMENTS
RECOMMENDATION:
1. Receive the Community Grants Program Update;
2. Provide direction on potential modifications to the Community Grant process, funding
categories, evaluation criteria, budget allocation, or other elements.
BACKGROUND:
During the June 2, 2015 budget hearing, the Town Council expressed an interest in receiving a report on
the Community Grant process that included background information, an overview of the grant process,
and a summary of past funding allocations. Additionally, Council directed staff to bring requests for
one -time Community Grant funding for the Council's review and consideration during the fiscal year
(FY) 2015/16 mid -year budget review.
DISCUSSION:
For the last two decades, the Town of Los Gatos has granted approximately $100,000 in General Fund
monies annually to approximately forty local nonprofit organizations offering a variety of programs and
services to Los Gatos residents that maintain or improve their quality of life.
Until FY 2011/12, community grants were administered by the Community Services Department (CSD).
This department also administered approximately $36,000 of federal Community Development Block
Grant (CDBG) funding to local non - profit agencies each year. In FY 2011 /12, the CSD was dissolved
and the administration of the community grant program transitioned to the Town Manager's Office,
PREPARED BY: CHRISTINA GILMORE
Assistant to the Town Mana r
Reviewed by: rVAssistant Town Manager Town Attorney
Council Reports\December 15 \Community Grants \Community Grants 12.15.15.doc
PAGE
MAYOR AND TOWN COUNCIL
SUBJECT: COMMUNITY GRANTS PROGRAM UPDATE
DECEMBER 10, 2015
DISCUSSION (cont'd):
and CDGB funds administered by the Town were diverted to the County of Santa Clara's Housing and
Community Development Advisory Committee for distribution.
Community Grant Funding Criteria
Community Grants are administered on a one -year cycle with applicants for both the human services,
and art, cultural, and educational grants applying for funds that meet one of four funding categories:
1. Seed Program funding to fund the start-up of new programs designed to meet a significant
community need or problem;
2. Project funding to fund one -time projects designed to address a significant community need or
problem;
3. Emergency funding to fund operational programs in the community which meet an existing
need; and
4. Community programs funding to fund programs and services to address identified community
needs or problems as stated in the Town's General Plan, action plans, or other policies.
To be eligible for Community Grant funding, agencies must:
1. Demonstrate the benefits of program and project services to Los Gatos citizens;
2. Be incorporated as a tax - exempt nonprofit corporation and/or exist as another governmental
entity;
3. Demonstrate the managerial and financial capability to receive and expend grant funds;
4. Assure compliance with all applicable local, state, and federal laws; and
5. Demonstrate good faith efforts to secure funding for programs and services from other sources.
Attachments 1 and 2 contain the draft Community Grant General Instructions and Grant Application for
FY 2016/17, which outlines in detail the evaluation criteria, grant process, and a proposed timeline.
Community Grant Evaluation Process
Community Grants are allocated through a competitive process. Applications are made available at the
beginning of the calendar year. Funding availability for Community Grants is based on the amount of
funds allocated by the Town Council in the prior budget year. Attachment 3 contains historical data for
the last ten budget years of Community Grant allocations.
The Community and Senior Service Commission (CSSC) and the Arts and Culture Commission (ACC)
each appoints a Commission member to a Grant Evaluation Committee to review applications to
evaluate eligibility, review past performance, examine the quality and quantity of services to be
provided, ensure that the proposed program or project services will be of benefit to Los Gatos residents,
and make preliminary funding recommendations to the Commissions in their respective area. CSSC
considers human services applications and ACC considers art, cultural and educational applications.
PAGE
MAYOR AND TOWN COUNCIL
SUBJECT: COMMUNITY GRANTS PROGRAM UPDATE
DECEMBER 10, 2015
DISCUSSION (cont'd):
After listening to the agencies explain their proposals and conducting public hearings in their respective
grant area, each Commission makes recommendations to the Council. The Town Council makes the
final determination on all funding recommendations through the adoption of the Town's General
Operating
Budget, and has the discretion to accept, modify or decline the recommendations for the allocation of
Community Grant funds.
Community Grant Process Improvements
Even though the Town no longer administers CDBG funding, the Town uses a federal framework to
administer the community grants program, which is time consuming and resource intensive given the
small grant amounts.
Staff proposes to work with each Commission and to request comments from community agencies to
identify potential process improvements for the Community Grant programs, such as: revising the grant
application; revising the grant funding cycle from fiscal year to a calendar year; revising the quarterly
reporting to include more meaningful performance metrics; revising the agreement for services to assist
in expedition of contracts; and digitizing the application to an eSignature platform such as
SeamlessDocs. Proposed process improvements will be returned for Town Council consideration and
would be implemented in FY 2017/18 pending Council approval.
Staff also intends to conduct broader outreach to local agencies and organizations who may meet the
eligibility criteria to encourage a diverse pool of applicants for Community Grants through the Town's
website and social media channels.
Community Grant Questions
The Community Grants program has not been revised since FY 2011/12. As Council expressed an
interest in reviewing the grant process, staff seeks direction on the following questions:
1. What changes, if any, are needed to the existing funding categories, evaluation criteria, and
budget allocation to meet the Council's priorities and objectives for the Community Grants
program? Staff recommends a Community Grant funding allocation for FY 2016/17 based on
the prior year allocation estimated at $109,800.
2. What other input or direction would the Council like to offer regarding the Community Grants
process?
PAGE 4
MAYOR AND TOWN COUNCIL
SUBJECT: COMMUNITY GRANTS PROGRAM UPDATE
DECEMBER 10, 2015
CONCLUSION:
Based on the information contained in this report on the Community Grants Programs, staff
recommends that the Council:
1. Receive the Community Grants Program Update, and
2. Provide direction on potential modifications to the Community Grant process, funding
categories, evaluation criteria, budget allocation or other elements.
ALTERNATIVES:
The Council may choose to receive the report and not provide specific direction at this time. Options for
process improvements will come before Council after community outreach is completed, as described in
this report.
COORDINATION:
This report was coordinated between the Town Manager's Office, Town Attorney, and the Finance
Department. This report will be made available to the CSSC, ACC and past grant applicants.
FISCAL IMPACT:
If the recommendations are approved, the Council can provide direction for the budget allocation of
Community Grant Funds for FY 2016/17.
ENVIRONMENTAL ASSESSMENT:
This is not a project defined under CEQA, and no further action is required.
Attachments:
1. Draft FY 2016/17 Community Grant General Instructions
2. Draft FY 2016/17 Community Grant application
3. Historical data on Community Grant allocations from FY 2005 /06 through FY 2015/16
DRAFT
TOWN OF LOS GATOS * FY 2016/17
APPLICATION FOR COMMUNITY GRANT FUNDING
GENERAL INSTRUCTIONS
Complete this application in full to be considered for FY 2016/17 Community Grant funding. Please
provide current information most crucial to the evaluation process, including: Agency and Project
Information, Budget Data, and Certification. As in prior years, funding is contingent upon the Town
Council's General Fund allocation to the program and the applicant's previous program performance.
P ose: The purpose of this application is to:
1. Substantiate demographically the assessed need for the project;
2. Gather required data in order to determine eligibility under the Community Grant Program;
3. Document the quality and quantity of services to be provided; and
4. Demonstrate benefit of program /project services to Los Gatos citizens.
Eligibility: To be eligible for Community Grant funding, agencies must:
1. Submit a separate, completed application form for each project;
2. Be incorporated as a tax- exempt nonprofit corporation (IRS 501 -C.3.) and /or exist as another
governmental entity;
3. Demonstrate the managerial and financial capability to receive and expend grant funds;
4. Assure compliance with all applicable local, state, and federal laws including the non-
discrimination requirement; and
5. Demonstrate good faith efforts to secure funding for programs and services from other sources.
Funding Categories: Programs for which funding is requested must qualify under one of the categories
below. Proposals not fitting into one of these categories will not be considered for funding. Applicant
services must directly benefit residents within the incorporated limits of the Town of Los Gatos.
I. Seed Program: Funding for start -up of new programs designed to meet a significant community
need or problem. Proposers must demonstrate a high probability that funding can be sustained
beyond the commitment of Town funds.
2. Project: Funding for one -time projects designed to address a significant community need or
problem. Town funding shall be limited to a specific time - frame, usually not more than one year.
3. Emergency: Funding for operational programs in the community which meet an existing need.
Applicants must demonstrate that: 1) current programs meet stated goals and objectives; 2)
financial constraints will significantly curtail services to Town residents; and 3) future funding to
continue the program can be obtained from other sources. Funding for programs shall be limited
to one year.
4. Community Programs: Funding for programs and services to address identified community needs
or problems (as stated in the Town's General Plan, action plans, or other policies).
N:\MGR \CSD \GRANTS\FY 2016- 17\Community Great FY 2016 -17 General InswctionsAocx
ATTACHMENTI
DRAFT
Evaluation Criteria:
Human Service Programs: Evaluation criteria for agencies providing human services include, but are not
limited to, the following:
• Community need for the program
• Uniqueness of program, lack of duplications in service
• Qualifications and experience of the agency and its staff
• Past performance in providing established services and meeting Town requirements
• Effectiveness in serving an identified audience
• Community involvement in program, including volunteers
• Number of Los Gatos clients served vs. total clients served (unduplicated clients)
• Cost per Los Gatos resident vs. cost per non -Los Gatos resident
• Number of low and very low income clients served
• Percent of total program budget requested from Town
• Reasonable cost
• Clarity, completeness, and accuracy of grant proposal
Arts, Cultural, Educational Programs: Evaluation criteria for arts /cultural/educational programs include,
but are not limited to, the following:
• Community need for the program
• Uniqueness of program, lack of duplications in service
• Qualifications and experience of the agency and its staff
• Past performance in providing established services and meeting Town requirements
• Number of Los Gatos clients served vs. total clients served (unduplicated clients)
• Cost per Los Gatos resident vs. cost per non -Los Gatos resident
• Target audience for program (e.g., youth, seniors, students)
• Percent of total program budget requested from Town
• Reasonable cost
• Clarity, completeness, and accuracy of grant proposal
Process
To assure that all applications receive due consideration and that the Council is provided with all
information necessary to make appropriate funding decisions, all grant applications are first reviewed by
an Evaluation Committee, consisting of either members of the Community and Senior Services
Commission (which reviews Human Service program applications) or members of the Arts and Culture
Commission (which reviews Arts, Cultural, Educational program applications).
The Evaluation Committees determine proposal eligibility based on the Eligibility Guidelines listed in
this application, and make funding recommendations to the Community and Senior Services Commission
or Arts and Culture Commission based on the Evaluation Criteria listed above. The Commissions, in
turn, make funding recommendations to Town Council. Applicants will be invited to attend Commission
meetings to present their applications and answer Commission member questions. Attendance at these
meetings is not mandatory, but is recommended. Ineligible proposals will be rejected.
The Town Council makes the final determination on all funding allocations through the adoption of the
2
NA MGR\AdminWorkFi1cs\2015 Council Reports\Decemba 15 \Community Grants\Comrounity Grant FY 2016 -17 General Instructions
Attachment l.pdfdocx
DRAFT
Town's Operating Budget.
Schedule: The schedule for the funding process is as follows:
Human Services Timeline*
F
Task
r 18, 2015
Applications available
January 22, 2016
Applications due by 4:00 p.m.
January 25 -27, 2016
Staff review applications and prepare summary documents, then
distribute to CSSC members.
February 1 -12, 2016
CSSC Evaluation Committee reviews applications and summary
documents, and contacts applicants as needed. Committee meets
to consider allocation recommendations.
February 16, 2016
CSSC will submit draft funding allocation recommendations for
Town Council consideration during the FY 2015 -16 Mid -Year
Budget Session.
March 1, 2016
11, 2016
CSSC meeting packet mailed to Commissioners and applicants.
Packet will include draft funding allocation recommendations.
March 22, 2016
Ti
CSSC Meeting: brief presentations (3 minutes each) by
CSSC Public Hearng
applicants and questions of applicants by Commissioners. After
conclusion of presentations and questions, the Commission will
develop its final allocation recommendations to Council.
May 2016
Town Council meeting: Public Hearing to consider FY 2016/17
Preliminary Operating Budget.
June 2016
Town Council meeting: adoption of FY 2016/17 Operating
Budget.
*All dates are tentative and subject to change.
3
N:\MGR \AdminworkFi1es\2015 Council Reports\December 15\Community Grants \Community Grant FY 2016 -17 General Instructions
Attachment l.pdfdocx
DRAFT
Arts, Cultural, Educational Timeline*
Date
Task
December 18, 2015
Applications available
January 22, 2016
Applications due by 4:00 p.m.
January 25 -27, 2016
Staff review applications and prepare summary documents, then
distribute to ACC members.
Arts and Culture Commission Evaluation Committee reviews
February 1 -12, 2016
applications and summary documents, and contacts applicants as
needed. Committee meets to consider allocation
recommendations.
February 16, 2016
CSSC will submit draft funding allocation recommendations for
Town Council consideration during the FY 2015 -16 Mid -Year
Budget Session.
March 1, 2016
FY 2015 -16 Mid -Year Budget Session
March 7, 2016
ACC meeting packet mailed to Commissioners and applicants.
Packet will include draft funding allocation recommendation.
Applicants invited to attend meeting, for brief presentation and
question/answer eriod.
ACC meeting: brief (3 minutes each) presentation by applicants,
March 16, 2016
questions of applicants by Commissioners. After conclusion of
ACC Public Hearing
presentations and questions, the Commission will develop its
final allocation recommendations to Council.
May 2016
Town Council meeting: Public Hearing to consider FY 2016/17
Preliminary Operating Budget.
June 2016
Town Council meeting: adoption of FY 2016 /17 Operating
Budget.
*All dates are tentative and subject to change.
4
NAMGR\AdminWorkFiles\2015 Council Reports\December MCommunity Grants \Community Grant FY 2016 -17 General Instructions
Attachment I.pdfdocx
DRAFT
Tyne of Contract:
This application does not commit the Town to award a contract, pay any costs incurred in preparing the
application, or procure or contract for services or supplies. The Town reserves the right to accept or reject
any or all applications received, to negotiate with all qualified applicants, or to cancel in part or in its
entirety the application if it is in the best interest of the Town. The Town may also negotiate with
qualified agencies to meet community needs.
Copies of the standard contract are available for review at the Town of Los Gatos Town Manager's
Office. Please be advised that the Town's designee and auditors have the right to access the contracted
agency's records. Proof of client participation is required and must be made available for review by the
Town's designee during the course of the contract period (see sample Participation Agreement,
Attachment 2). If funding is awarded, the Town will also require verification of worker's compensation
and appropriate insurance documents.
Funding Availability: Community Grant funds amounting to $109,800 were allocated in FY 2015/16 as
follows: $90,000 to Human Service programs; and $19,800 to Arts, Cultural, and Educational programs.
Application Requirements:
1. Completed applications are due by 4:00 p.m., January 22, 2016, at the Town of Los Gatos Town
Manager's Office, 110 East Main Street, Los Gatos. Applications will not be accepted after the
deadline.
2. One (1) copy of the documents listed on the Applicant Agency/Program Documents Checklist
and three (3) copies of the completed application form must be submitted. Electronic copies will
not be accepted.
3. Please do not include literature or attachments beyond those required or necessary to present a
complete and effective application. Failure to submit a concise, complete application shall be
evidence of the proposer's inability to undertake program objectives.
4. All applications must be submitted on the forms provided and in a manner consistent with the
instructions. Applications must be word processed or typed.
5. All supplemental materials shall be returned to agencies not selected for funding upon request
only.
For additional information, please contact:
Via Phone: Shelley Neis, Clerk Administrator
(408) 354 -6834
Via Email: sneis @losgatosca.gov
In Person: Town of Los Gatos
Town Manager's Office
110 East Main Street
Los Gatos, CA 95030
5
NAN4GR\AdminWorkFi1es\2015 Comcil Reports\December 15 \Community Grants \Commmity Grant FY 2016 -17 General Instructions
Attachment I.pdfdoex
II ; . 1
Town of Los Gatos
FY 2016/17 Community Grant Program
Application Summary
Project: Project/Program:
Program Manager:
Agency: Name of Agency
Site Address:
Name of Executive Director
Project Description: Provide brief description of agency, agency goals, and agency services.
List direct services and quantity below.
Direct Services
Service FY 2016/17 FY 2015/16
(proposed) (actual)
Program Funding: Provide prior year fiscal year actual budget amounts and proposed amounts
for new fiscal year.
Program Funding:
FY 2016/17
FY 2015/16
Clients:
FY 2016/17
FY 2015/16
(requested)
(adopted)
(proposed)
(actual)
Town annual funding
Unduplicated
amount
annual Los
Gatos clients
Total annual program
Total
budget
unduplicated
annual clients
Town $ as % of annual
Los Gatos
total
clients as %
of annual
total
Annual
services per
Los Gatos
client
N:NGR \CSD \GRANTS\FY 2016 -17 \One Year Grant Application.2016 -17 rev.2.docx
ATTACHMENT
DRAFT
TOWN OF LOS GATOS °e FY 2016/17
APPLICATION FOR COMMUNITY GRANT FUNDING
APPLICANT AGENCY /PROGRAM DOCUMENTS CHECKLIST
Please submit one copy of each of the documents listed below with your completed application. This
page should serve as the cover sheet for that section of your submittal.
I. PROGRAM/PROJECT INFORMATION
❑ Fee Schedule, Membership, or other fees
II. AGENCY INFORMATION
❑ Current Board of Directors
❑ Articles of Incorporation
❑ Bylaws
❑ Organizational Chart
❑ Brochures, Flyers, Promotional Materials
III. FISCAL INFORMATION
❑ Audit or Financial Statement plus Letter of Auditability
❑ Organizational Budget
❑ Internal Revenue Service Ruling Letter (Section 501 c.3)
❑ California Revenue Code (Section 23701 d)
2
N:\MGR \CSD \GRANTS\FY 2016- 17\One Year Grant Application.2016 -17 rev.2.docx
DRAFT
TOWN OF LOS GATOS %% FY 2016/17
APPLICATION FOR COMMUNITY GRANT FUNDING
GRANT APPLICATION
I. PROGRAM/PROJECT INFORMATION
A. Contact Information
B. Community Need Statement
Describe briefly the demonstrated need in the Los Gatos community for the program. Cite data sources as
appropriate.
C. Program Statement
Describe your program briefly, including the following: who benefits from your program; what direct
services will be provided through the program; how, when, and where services are to be delivered; and
why these services should be provided in Los Gatos.
NAMGR\CSD\GRANTSTY 2016 -1T0ne Year Gmt Applicati 0 3
on.216- 17 rev.2.dox
DRAFT
D. Direct Services
For Human Services and Arts, Culture and Education grant requests, list, describe, and quantify each
direct service to be provided annually from July 1, 2016 through June 30, 2017. A Direct Service is a
service for which there is an identifiable client. A Participation Agreement (Attachment 2) must be
completed by each client receiving the direct services described below.
FY 2016/17 FY 2016/17
Description of Service Number of Number of
Services Provided Unduplicated Los Gatos
Annually Residents served Annuall
1.
2.
3.
4.
5.
Average number of direct services received by each unduplicated client: _
Average number of direct services received by each unduplicated Los Gatos client: _
E. Indirect Services
List, describe, and quantify each indirect service to be provided annually from July 1, 2016, through June
30, 2017. An Indirect Service is a service for which there is no identifiable client; for example,
information and referral that is given over the phone.
N:\MGR\CSD \GRANTS\FY 2016 -17 \One Year Grant A PP licati 4
on.2016- 17 rev.2.docx
DRAFT
F. Demographic Information
Provide demographic breakdown of unduplicated Los Gatos residents to receive direct services.
G. Client Participation Requirements
Attach appropriate fee schedules, membership requirements, or other fee listings.
II. AGENCY INFORMATION
A. General Information
Legal Name of Organization
Address of Organization
Name of Executive Director
Date of Incorporation
Insurance/Tax Information
Federal Employer Tax Number
State Employer Tax Number
WorkWs Compensation Carrier/
Policy Number
N:\MGR \CSD \GRANTS\FY 2016 -17 \One Year Gant Application.2016 -17 rev.2.docx
DRAFT
Insurance Carrier
Amount of Liability Coverage
Property Damage (combined with
liability)
Combined Single Limit
Policy Period
B. Staffing Profile
Please complete the chart below for your organization as it will be staffed during FY 2016/17. Identify
the hours to be devoted to the program for which you are requesting funding, for both employees and
volunteers.
Position Title Number in Approximate Hours Worked Percent of Time
Classification Hourly Rate per w k to Program
Employees
Volunteers
C. Agency Experience -- Describe the experience of your Agency in providing program services.
D. Staff Experience -- Describe the experience of key staff assigned to the program.
E. Staffing Plan -- Describe any anticipated staffing changes to occur during FY 2016/17.
N:\MGR \CSD \GRANTS\FY 2016 -17 \One Year Grant Application.2016 -17 rev.2.docx
DRAFT
III. FISCAL INFORMATION
A. Program Budget
Please complete the following summary tables to reflect the FY 2015/16 budget for your organization and
program. All amounts should be rounded to the nearest dollar. Alternatively, please attach single page
revenue /expense summary sheets for the program for which funds are requested and a separate summary
for the organization.
Budget Data FY 2016/17 FY 2015/17
Los Gatos grant funding Requested: Received:
Total Program budget $ $
Los Gatos grant as percentage of %
total Program budget
Total Organization budget $ $
Cost per year per unduplicated $ $
Los Gatos client
N:\MGR \CSD \GRANTS\FY 2016 -17 \One Year Grant Application.2016 -17 rev.2.docx
FY 2016/17
Organizational
FY 2016/17
Program
FY 2015/16
Organizational
FY 2015/16
Program
Revenue Source
Budget
Budget
Budget
Budget
Los Gatos grant
g
$
$
Other municipal funding
$
$
$
$
(please specify: )
$
County funding
$
$
$
(please specify:)
$
State funding
$
$
$
(please specify:)
$
Federal funding
$
$
$
(please specify:)
$
Other jurisdiction funding
$
$
(please specify:)
$
$
Fees for services
$
$
$
Donations
$
$
$
$
Reserve contingency fund
$
$
All other sources
$
$
$
$
(please specify:)
$
$
Total
$
$
$
$
N:\MGR \CSD \GRANTS\FY 2016 -17 \One Year Grant Application.2016 -17 rev.2.docx
DRAFT
B. Organization Contracts - -Has your organization ever had funds withdrawn or a contract
terminated for cause, unsatisfactory performance, or questionable costs on any financial statements or
audit. If so, please describe.
C. Organization Investigations - -Is your organization currently on probation or under investigation
by any agency which is or was a funding source within the past two years? If so, please describe.
D. Budget Alternatives- -What alternatives will your organization consider if the requested
Community Grant funding is not provided, or provided at a reduced level? Describe how a reduction will
affect the achievement of stated goals.
E. Funding Sources -- Describe your organization's efforts in pursuing other funding sources.
F. Supplies Disclosure - -If any non - expendable supplies with a unit cost of $100 or more are to be
Purchased with Community Grant funds, please describe.
G. Travel Expense Disclosure - -If Community Grant funds are to be used for staff travel expenses,
please describe.
N:WGRICSD \GRANTS\FY 2016 -17 \One Year Grant Application.2016 -17 mv.2.docx
FY 2016/17
Organizational
FY 2016117
FY 2015/16
FY 2015/16
Expense Category
Budget
Program
Budget
Organizational
Program
Personnel
Budget
Budget
$
$
$
Facility
$
$
$
Overhead
f $
$
Materials /Supplies
$
$
$
Professional Services
$
$
$
Fundraising
$
$
$
Capital Projects
$
$
$
Other
$
$
$
$
(please specify)
$
$
Total
$
$
$
$
B. Organization Contracts - -Has your organization ever had funds withdrawn or a contract
terminated for cause, unsatisfactory performance, or questionable costs on any financial statements or
audit. If so, please describe.
C. Organization Investigations - -Is your organization currently on probation or under investigation
by any agency which is or was a funding source within the past two years? If so, please describe.
D. Budget Alternatives- -What alternatives will your organization consider if the requested
Community Grant funding is not provided, or provided at a reduced level? Describe how a reduction will
affect the achievement of stated goals.
E. Funding Sources -- Describe your organization's efforts in pursuing other funding sources.
F. Supplies Disclosure - -If any non - expendable supplies with a unit cost of $100 or more are to be
Purchased with Community Grant funds, please describe.
G. Travel Expense Disclosure - -If Community Grant funds are to be used for staff travel expenses,
please describe.
N:WGRICSD \GRANTS\FY 2016 -17 \One Year Grant Application.2016 -17 mv.2.docx
DRAFT
CERTIFICATION
The applicant hereby proposes to provide the services as listed in this proposal. If this proposal is
approved and funded, it is agreed that relevant federal, state, and local regulations, including non-
discrimination laws and other assurances as required by the Town of Los Gatos, will be adhered to.
Furthermore, as the duly authorized representative of the applicant organization, I certify that the
applicant is fully capable of fulfilling its obligation under this proposal as stated herein.
This application and the information contained herein are true and correct and complete, to the best of my
knowledge.
Date: 2016
Organization Name
Executive Director
(Print Name)
N:NGR \CSD \GRANTS\Fy 2016- 17\One Year Gant Application.2016 -17 rev.2.doc9
DRAFT
ATTACHMENT
SAMPLE PARTICIPATION AGREEMENT
Over the course of the contract period, a grantee may be required submit Participation Agreements similar
to this sample. Do not submit this Sample Participation Agreement with your completed application.
a nonprofit corporation and families in Santa Clara County. Partial funding (subsidy) forth se services is provided under duals
contract by the Town of Los Gatos to this Agency.
This information is reviewed for quality control and/or auditing purposes only. Therefore it is held in
confidence by the Agency, the Town, and the Federal representatives and not considered "Public
Information."
The purpose of this Participation Agreement is as follows:
1. To have the client acknowledge the request and receipt of needed services and provide the client
with an opportunity to evaluate such services.
2. To have the client authorize the release of demographic information to the Agency /the Town.
3• To assure the client that information about them is held in confidence and not considered public
information and that only statistical information about all clients served is reported.
4. To have the client hold harmless and release from liability the Agency, the Town, and their
respective employees, officers, and agents in the event of any suit, claim, loss, damage, or
obligation arising out of/or attributed to any of the Agency's programs.
Please complete the following:
Name
Address: Age:
Phone:
Sex (check one): ❑ Male ❑ Female
Disability Status (check one): ❑ Disabled ❑ Not Disabled
Female Head of Household (check one): ❑ Yes ❑ No
Income Level (check one):
❑ 30% of median and below
❑ 31 % -50 %of median
❑ 51 % -80 %of median
❑ 81 % - 100% of median
❑ Above 100% of median
I understand that this agreement is an affidavit and certify that the information provided above is true and
complete.
Signature
Date
NAMGR \CSD \GRANTSWY 2016 -17 \One Year Cn t Applica[ion.2016- 17 rev.2.do10
COMMUNITY GRANTS SUMMARY
N:WGR\AdminWorkFiles\2015 Council Reports \December 15 \Community Grants\Attachment 3 Commuity Grants Summary FY 2005 -2016
ATTACHMENT
Source
2005/06
Actuals
2006/07
Actuals
2007/08
Actuals
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
2014/15
2015/16
Human Services
Actuals
Actuals
Actuals
Actuals
Actuals
Actuals
Estimated
Budgeted
Catholic Charities/LTC Ombudsman
CDBG
7,680
7,680
7,680
7,680
7,370
7,370
7,370
Live Oak Adult Day Services
CDBG
12,988
12,988
12,988
12,980
12,470
12,470
13,094
7,370
12,988
Second Harvest Food Bank
CDBG
3,802
3,802
3,802
3,800
4,800
4,800
SJSU Foundation/The Health Place
CDBG
12,211
12,211
11,094
8,260
2,410
Emergency Housing Consortium
Town
1,574
1,574
1,574
Live Oak Adult Day Services
Town
-
_
-
Live Oak Sr. Nutrition and Service
Town
27,456
27,456
27,456
27,456
_
26,360
-
26,360
26,360
-
26,360
13,094
13,000
13,000
Next Door Solutions Dom. Violence
Town
12,000
12,000
8,903
12,000
11,520
11,520
26,360
26,500
26,500
LGS Recreation Department Case Management
Town
-
_
11,520
11,520
15,000
15,000
15,000
Helping
Parents Hel rn Parents
Town
1,920
1,920
_
1,920
1,920
1,840
1,840
1,840
1,000
1,840
2,000
7,000
A Place for Teens
Town
10,840
13,340
13,340
14,975
10,950
10,950
8,213
2,000
2,000
Support Network
SJSU Foundation/The Health Place
Town
Town
4,800
4,681
4,800
4,681
4,800
4,800
4,600
4,600
4,600
4,600
6,000
6,000
6,000
Teen and Family Counseling Center
Town
27,044
27,044
5,798
27,044
8,630
27,050
13,810
9,975
16,220
16,220
16,220
_
United Way - 211 Funding
Town
1,890
Teen Force
Town
-
_
-
_
-
2,500
2,400
2,400
2,400
2,400
00
2,4,5,500
200
2
Santa Clara Family Health Foundation
Town
-
-
-
-
-
5,000
5,000
_
Counseling and Support Services for Youth
Town
-
-
-
-
-
1,100
1,100
_
West Valley Community Services
Town
-
-
_
_
10,000
10,000
15,000
16,800
15,000
Total Human Services Grants
12_ 6
129,496
126,399
132,051
108,505
100,420
107,717
106,398
3,146
10,000
10,000
83,000
98,800
90,000
Art, Cultural, Educational
Art Docents of Los Gatos
Festival Theatre Ensemble
Town
Town
4,500
4,500
4,500
4,500
4,260
4,260
4,000
4,000
4,000
4,000
3,000
Los Gatos Community Concert
Town
1,000
870
1,000
870
1,000
1,000
900
900
1,000
1,000
1,400
1,400
1,400
Photographic Guild of Los Gatos
Town
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
St. Luke's /Sunset Concert Series
Town
-
500
-
500
1,000
1,000
1,000
1,000
1,000
1,000
1,000
1,000
_
Forbes Mill
Town
_
_
1,000
1,000
1,000
1,000
1,000
1,000
-
Cat Walk
Town
_
-
2,236
4,200
3,000
Arts Comission
Town
_
_
8,000
4,200
4,400
Cinecats
Town
-
500
-
-
2,000
Total Art, Cultural, Educational Grants
6,870
7 370
-
8,500
8,500
8,160
8,160
8,000
8,000
17,636
15,800
14,800
Community Contributions
Los Gatos Museum Association
Total Community Contributions
Town
12,430
12,430
12,430
12,430
12,430
12,430
12,430
12,430
4.000
5,000
12,430
12,430
12,430
12,430
12,430
12,430
12,430
>
12 430
+
-
4,000
5,000
CDBG Total
CDBG
36,681
36,681
35,564
32,720
27,050
24,640
20,464
20,358
-
_
Town's General Fund Total
Town
109,615
112,615
111,765
120,261
102,045
96,370
107,683
106,470
100,636
118,600
109,800
N:WGR\AdminWorkFiles\2015 Council Reports \December 15 \Community Grants\Attachment 3 Commuity Grants Summary FY 2005 -2016
ATTACHMENT