HomeMy WebLinkAbout1985-09-23 85-332 ORDER\ 65-332
Introduced by Councilor Brown, September 23, 1985
CITY OF BANGOR
QITLEJ (Mer, Authorizing Execution of Agreevent with State of Maine
4pactmant of -Health and aslfare - Perobscot-Piscataquis WIC Program
BY the OU9 Caudad of the Dtty of Banner.
ORDERED,
THAT
'MUT the Director of Haelth and welfare i6 hereby authorized aM
directed. on behalf of the City of Bangor So execute an agreement, a copy of
which is on file in the Office of the City Clerk, with the State of Mains
Department of Health and! Welfare providing for the continued operation of
the Penobscot-Piscataquis DIC Program as defined liberals for the period of
October 1, 1985 through September 30, 1986;
AND BE IT FHIII91CQ �, THAT the Director of Health and w3lfare
is hereby authorized xN directed w submit requests for payments pursuant
W the teems of said agrearent on behalf of the City of Bangor.
..IN CITY COUNCIL
September p, 1985
Passed by the following yes and
no votes. joancilows voting
yes: Drown, Frankelo McCarthy,
Tilley and M ler.Conncilote
Swung no: Sao is and
Willey.
'+w,
85-332
O ROIR
Title,
Autharising Execution of Agreement
......................................
with State of Maine Department of
... .. ..... ..............
Health and welfare - Penobscot/Piscatagnie
WIC program.
Introduced and filed by
eilman
Replaces K B:WIC-02-85A
STATE OF MAINE
DCPARTPENf OF WMN SERVICES
BUREAU OF HEALTH
WIC PROCRAM
Contract CDVer Sheet
Name of Operating Agency: passrrmmt of Health and welfare
Address: _103 Toeas Avenue - Bamepr. Maine 04401
Telephone: 945-3743
WIC. Program ontact�ert so'^ . Diana Rook
Contract Dates: From October 1 1985 To September 30, 1986
Type of Proposal: New I ] Renewal [IJ fwen Ment I I
Liability:, Insurance Co. N tfora Ineurmee Company
Policy p 04CBP1@2200 Amount of Coverage; 8300.000
Boadiag: Insurance Co. Nek Hampshire Inmrame Group
Policy B 417329. ;: Amount of Coverage;
Administrative Use Approval
% B WIC -02.86
WIC State Agency epresmtat ve
Amendment B
N mtlm nt B
Date
Amendment p
AmeWaent tl copy p
(BHWIC-001) R 3/85
STATE OF MAINE
DEPARTMENT OF HUMAN SERVICES
BUREAU OF HEALTH
WIC PROGRAM
Articles of Agreement
In rather to effectuate the purpose of Section 17 of the Child Nutrition Act of 1966, as amended (a2
USG. 17W), theSlate of Maims Department of Human Services, hereinafter referred to as the "Depart.
mens" and the
of Nea11h & Wcllane / of Meine
hereinafter placed to as the "I.ocal Agency" enter Into this Agreement.
Witnesseth: That for and inconsideration of the payments and agreements hereinafter mentioned,
the Department and the mast Agency agree to comply with all terms and conditions set forth in this
Agreement.
.. In Witness whereof, the Department and the tccal Agency by their duly allthoriz d representatives
execute this Agreement.
Department of -.Health: and Welfare Department of Human Services
Name of local Agency
By:
Tine
Date:
Winstead:
Approved as to legal Pond
By:
Title
Date:
Witnessed:
Date.
Assistant Attorney General
(81-VWIC-002 page 1) R 416
The following are fire terms of the Agreement:
1. The reemenl
This Agreement consists of the Articles of Agreement Rider A —Specification of Work to be Per-
formed, an Rider B —The Budget Section. This Agreement contains the entire Agreement of the
parties and neither party shall be bound by any statement or representation not contained herein
except as provided for to Article N.
The padres agree to comply with all applicable Federal statutes and regulations, and with applic.
able State policies contained in the State Beholds and Procedures Manual.
2. "orizetion
The Local Agency represents that It possesses legal authority to enter into an Agreement with the
Department; that a resolution, motion or similar action has been duly adopted or passed as an o(1F--
old) act of the local Agencyb governing body, authortzing execution of the Agreement and direct
ing and autllmizing the person identified as the official representative of the Weal Agency Coact
In Connection with the Agreement and to provide such additional Information as may be required.
3. Term of Agreement
This Agreement is effective commencing 10/01/115 and ening 9/10186 .unless
terminated earlier as provided herein.
<. reemenl Amount
he Department agrees to make funds available to the Weal Agency for administration and
operation of the Special Supplemental Food Program for Women, Infanta, and Children (WIC Pre
gram). During the period of this Agreement the West Agency shall obligatelspend no more.than
$ 764.01 for food in the performance Of the terms of this Agreement; further the Weal
Agency shall spend no more than IS 333,9 for administration in the performance of the
terms of this Agreement. The local Agency is responsible for any forms expended Orobligated that
exceed the Agreement amount.
5. Pa mentsmanm
The Dapadment will make payment (administrative) In advance to the local agency in monthly in
stallments; however, the Department reserves the right to withhold payment if required reports are
not submitted according to schedule or if there is unerexpenditure of bud0eted funds(administra
five) amounting to twenty (20)percent or more of the monthly administrative budget for three cora
secutive months.
6. Terminallan
Either party hereto mag by giving at least thirty (30) days written notice, lenrunate this Agreement.
This Agreement will automatically terml upon notification to the Ictal Agency that the US
Department of Agriculture has cancelled, terminated or suspended its agreement wghIDe Depart
Stand. Upon termination or expiration of this Agreement, as prwidn herein, the Weal Agency shall
Incur no further costs. The Weal Agency agrees So liquidate all approved costs incurred during the
period of this Agreement within fire months Of the termination or xpiratlon date. Any such termini
alien shall not affect any obtigetioos or liabilities incurred by either party prior to such termination.
nt
T. Alga ile=Orenf
Upon termination or expiration of this Agreement, all WIC Program revenues received by the
Weal Agency, that are In excess of the expenses reported, shall be returned to the Department
B. Audit
Afiscal audit may be performed Who Department andlor the Federal Government during the
Seem Of this Agreement or within three (3)"am from Its terminalion or expiration. Audits will
be performed In accordance with GAO generally accepted auditing standards and applicable
program guidelines and regulations.
G Disposition of Capital Equipment
capda equlmment poet 25a—se3w,derthetemis of this Agreement shall become the property
Of the Department upon purchase and remain so upon lamination of the Agreement. Upon
termination of the Agreement, the Department shall dispose of the equipment in such'aman-
(BIIWIC-002 page 2) R 4105
net as to continue the lemmas provided under the firms of this Agreement wherandpossible
and warranted.
When assets acquired with Program funds are (a) sold, (b) no longer useable or (b) used for
purposes not authorized by the Department, the Department's equity in the asset will be is
funded in the "me proportion as its participation in Its best In the event any assets are traded
on new itemo only the net cost of the newly acquired assets is allowable.
& Ownasble
All nolebooko steno wonting papain, audio and visual materials, an work or other work produced
mike pedarmance of this Agreement are the property of the Department and upon request shall
right ortdovetlgks byi orlmehaf of twankalagens,hallnotbee local toapplicationlorsplay
right of thelocal
or the results
f the local agency publish, display
of of theStat iribuleanyof the work product Or the results of ills work without written permis;
sten of the State WIC Director.
g. Agmoment MUUliloatlons
gsson, tmo ca Mrs. must berequested nvintingat feast six(5)weeks prlortothe lermina.
tion of the contract. Any modification of AnlChs 1 through 20of the Articles of Agreement will re.
culls a formal, written amendment approved by all necessary parties Depending on the nature of
the change any modification of Riders A or B may W accomplished either by a formal, written
amendment or a letter of approval from the Department
10. Records
A. Flmmclal Reefords
The Weal Agency agrees W Mountain independent records, banks, payrolls, documents and
other evidence and accounting procedures and practices which sufficiently and accurately
document all direct and Indirect costs attributed to the operation of the WIC Program,
A Promo Records
e In1T ce 0 agreeammaintan necOMs neceasary to document all services provided to
clients and all certifications of client eligibility, food delivery systems, food instrument isuw
ares and redemption, nutrition education, civil rights and hearing requests.
C Coppet Eoulpment
ii��ceerri6ncy agrees to maintain an inventory of all capital equipment Purchased under
this Agreement
R Retention of Racerds
All records described in this section shall be retained far for" years following the date of sub.
mission of the final expenditure mood for the Federal Fiscal Year to which the union pertains
The Local Agency will make available to the Department, the U.S. Department of Agriculture,
the Comptroller General of the United States, through any authorized representative, all its
records, books, papers, or documents related to the WIC Pmgram upon request.
If. no oris
This cel Agency shall submit to the Department reports Including, but not limited to, those
described in the Financial Manual, Chapter It.
12. Suebc bacling
cTM1 1 cgagency will not issue any subcontracts for work meshed by the Program unless approved
In the contract or otherwise approved In writing by the Department.
13. Indemnll antl Insurance
e label envy will at all times during the farm of MIS Agreement. as specified in Article 3, So.
damnify and hold harmless the Department against any and all liability, loss, damage, cost w ex.
Panditures which the Department may sustain, pourer be required to pay: 1) by reason of any Mail.
find recipient suffering personal injury, death, pmpeny leas Or damage either while participating
In or receiving from the local agency the care and services to be furnished by the local agency
under this Agreement or while being Irenspormal to or from agency premises In any vehicle owned,
operated, leased, or chartered or Otherwise contracted for by the local agency or any officer. agent
or employee thereof or 2) by reason of any qualified moipient causing injury to or damage to the
WHWIC-0 2 page 3) R ApS5
14. Sol
I agency will obtain arm maintain at all limes during the term of this Agreement a Fidelity
Bond covering the activities of all employees handling funds under this Agreement in an amount
sufficient W corer the maximum amount of funds Mantled at any one time under the terms of this
Agreement.
15. Evaluation
he�epadment either directly or through a contract agent may conduct evaluation studies on the
effectiveness, efgciencg quality and/or outcome of services delivered by the local agency. The
Department agrees to notify the local agency in advance of the Initiation of such an evaluation.
The local agency shall grovitle access to staff, program records and administrative information as
requested M evaluation staff in accordance with the Department confidentiality policies.
18. PrombitlonAgalnaf PrNaln GelIt
Tri Tota agency all Seta ITsn saleguaNs to proM1Inif local agency employees from using 1M1elr
positions for a purpose that is or gives the appearance of being motivated by a desire for private
gain forthemselves, or others, particularly grand with whom they have family, business or other
flea
17. Inds andent Capacity
Far purposes of this Agreement, any agents, employees or representatives of the local agency
shall act in an independent capacity and not On officers or employees or agents of the Stale. The
local agency shell ba responsible for compfiance with all applicable Federal and State laws related
to the employment of Individuals providing services pursuant M this Agreement.
18, Stale EM I* a participation
A. Bfele Employees Not In Benefit
1..The local agency shall not play In the performance of this Agreement on fall4ime,part-
time or other basis during the period of this Agreement airy professional or technical per-
sonnel who are or have been at any time during the period of this Agreement in the employ
of the Department except regularly retired employees, without the written usual of the
Department. Further, the local agency shall not employ on this project on a full-time, pad.
time an other basis during the period of this Agreement any retired employee of the Depart-
ment who has not been retired for of least one year, without the written consent of the
Department Contractual Review Committee.
2 No Individual employed by the Slate at anytime during the Agreement period shall the ad-
mitted toamishareor partof this Agreement narshallsuch individual obtain or beentilled
to any benefit that may arise therefrom, either at the time this Agreement is executed or
at any time during the term of this Agreement, directly or Indirectly due to his employment
by or financial interest in the local agency W any affiliate of the local agency. The limits
tion of this provision shall not extend to situations where the financial interest of the
employed individual is as a shareholder in a corporation, the stack of which Is publicly
hem gyR. is held by am hundred or more shareholders).
B. Cenmd of Interest
No employees of the Department and no other public official of the governing body of the
(BH WIC -0D2 page 4) R 4185
State or locality in which this Agreement Is being canted out, who exercises am functions or
responsibilities In the review or approval of the undertaking or carrying out of this Agreement
shall a.) participate In am decision relating to this Agreement, which affects his or her Far
stinal Interest or the Interest Of any corporation, partnership, or association In Which She Or
he is directly or InWrectly Interested; or of have any interest, direct or Indirect, In this Agree
mentorthe proceedshereo ; oro)serve assn ofgcerof the Soi of Direilorsof any corpora
tion, partnership or association related to this Agreement.
19, Civil Rights
eT�al agency shall COMP)) lth iherequlremenis Of Title V1 of the Civil Rights Actof 191
IX of the Education Amendments of 1972, Section W of the Rehabilitation Act of19y3, the Age
Discrimination Act of 1975, Department of Agriculture regulations an nondiscrimination (7 CFR
Pads 15, 15aand 15b), and FNSinstmcuons to ensurethat no person shall, on thegmundsof race,
calor, national origin, age, sex or handicap be excluded from prtlichation in, be denied benefits
of, or be otherwise subjected to discrimination under the Program.
This assurance is given in consideration of and for the purpose of obtaining any and all Federal
financial assistance, grants and loans of Federal funds, reimbursable expenditures, grant or done
tion of Federal property or the humming of services without consideration or at a nominal can.
sidereUon, or at a consideration which is reduced for the purpose of assisting the recipient, or in
ecogoition Of the Public interest to be served by such sal% lease, or turnismng of services to the
recipient, or any improvements made with Federal financial assistance extended to the Program
applicant by the Department of Agriculture This includes any Federal agreement, arrangement,
or other contract which has as one of its purposes the provision of assistance such as food, and
cash assistance for punctuator rental of food service equipment or any other financial assistance
extended in reliance on the representations and agreements made in this assurance.
By accepting this assurance, the local agency agrees to compile data, maintain records and sub
mit reports as required to permit animism enforcement of Title VI and to permit authorized USDA
personnel during normal working hours to review such records, books and accounts as needed to
ascertain compliance with Title VI. If there art any violations of this assurance, the Department
of Agreculturs, Food and Nutrition Service shall have the right to seek judicial enforcement of this
assurance. This assurance Is binding on the Pmgralll applicant, its successors, transferees. and
_ assignees as long as it receives assistance or retains possession of any assistance from the
Department of Agriculture. The person or parsons whose signatures appear above am author ad
to sign this assurance on the behalf of the local agency
0.. Facilities and Services
The local agenm agrees to provide staff and the facilities and equipment necessary to perform
codification procedures es inquired by the Department. The local agency agrees to implement a
food beavers system prescribed by the Department and approved by the US. Department of Agri
culture. The local agency agrees to make appropfiate health services available to WIC Program
recipients
21. Fair Hearin a
tic agency will advise applicants for, or recipients of, services or an individual acting on
behalf of an applicant or recipient, of their fight to appeal denial or termination of aservice provided
under this Agreement.
M Congdenliallt
nn con with Federal and State statutes add regulations, the local agency as well as the
Department will restrict the use mon disclosure of information of a confidential nature regarding
all persons served under the terms of this Agreement to persons connected with the adminlsVa-
tion or enforcement of the Program. The local agency as well as the Department will guarantee
the proper care, custody. use and preservation of records paper% files, and communications of
the local agency and soon other Items as may weal the recipient status Of such persons as are
served through this Agreement.
23. Affirmative Action
ne oca7—T Iagenry will not discriminate against any employeeor applicant foremploymerd relating
to this Agreement because of race, color, religion, sex, national origin, ape, or handicap, unless
related to a Oona fide occupational qualification. local agencleswith 15or more employees must
(BHWIC-002 Page 5) R 4/85
'haw a mitten plan far affirmative: action signed by the chief executive officer of theagenrywhich
contains the following:
a. Agenmal statement of commitment to equal employment opportunity withan affirmation
that the agencywlll not discriminale in hiring,promotion, training, levelfs, termination or
any other pmsonnel action or policy. This statement must be distributed to employees and
recruitment sources and a record kept of the documentation.
D. Thedeslgnatlon of the official who is responsible for the affirmative action plan and EEO
policy.
The local agency will, in all solicitation or advertising for employees placed by or on behalf of the
local agency relating to the Agreement, state that all qualified applicants will receive Considerate
tion for employment without regard to race, color, sex, religion, national origin, ag% at handicap.
In addition to having a written statement and designated affirmative action officer the local agency
must:
a. Examine Its personnel policies and prourcures and correct any which may appear to dis
criminate men if there is not Intent to do SO.
'b Review its work force to evaluate the effectiveness of the agency§ affirmative action pro
gram and to identify instances where there may have been failures to carry out affirmative
action: When instances Of discrimination are discovered they must be corrected and the
-
Correctlon documented.
The local agency will cause the foregoing provisions to be Inserted In any subcontracts for any
Work covered by lhiaAgreemenu so that such prmislons shall be binding upon each subcontractor,
provided that the foregoing provisions shall not apply to Contracts or subcontracts for standard
commercial supplies of raw materials. '
The local agency of any subcontractor bottling a contract directly under the local agency, shall
when suitable employment openings are anticipated or occur. forward to the Regional Manager
of the Division ofiWilfam Employment a Completed "Notice of Employment Opening:' The
Regional Manager will in turn nobly regional offices of the Bureau of Rehabilitation and Bureau
of Malnels Elderly of the employment opening In order that qualified handicapped; elderly and
AFDO.recipients may be referred on a first source basis for consideration for hire. Such referrals,
or notice that there will be referrals, will be made within 5 days of receipt by the contact person
local agency will interview the candidate or Candidates that it detennlneS t0 be most qualified
Ong those referred by the Contact person. This provision shall not apply to employment opn-
ings which the local agency, or any subcontractor bolding a contract under the local agency, pro -
powers to fill from within its own organization.
24. Publli�ic�")
nrnypublicity release or other pubkk reference Including media releases, information pamphlets,
etc, relating to the services provided under this contract it will be clearly stated (hat the project
Is, In part, funded by the United States Department of Agriculture and the Department and shall
contain the appropriate nondiscrimination statement. Further, where a product such as a report,
study, Chad, map, or slide movie Of video tape or other visual presentation is prepared, the title
block In
l bear a
d with the
pr ml of or Deparrtment, which shall visual
indicatematerials
that the wiork product was fiinancaly assisted y
the United States Department of Agriculture and the Department.
25. Reporting Sex acted AbuselNeglwel
he Iota ageuy agrees that wlren any staff in Its employ under this contract has reasonable
cause, pursuant to 22 MRSA 4011, and 22 MRSA Sin and 3479, to suspect that a child or adult
has been or is likely to be abused or neglected, the local agency will cause a repod to be made
to the Department, unless the factual basis for knowing or suapecting abuse or neglect comes
from instrumental apsourn responsible forthechlldor adult, the treatmentwea sought bythatpen
son fora problem otabuseor neglect and there is little threat of Serious harm to the child Oradell.
(BHWIOL 2page 6)R 4185
CONIAACT # W1 2-86
Aides A - Fiscal Y 1986
A. Tbe Bangor City Depar6rent of Health and Welfare WIC I agmen distributes
food instrnmiants Wafts) to clients on a hmthly basis. We enonurage clients to pick up
their drafts on cr about the save day earn ucnth. OYus-practice is also in effect
at os eleven na mach sites. To reintorm this requir ent we write the date of Hie
next schedules appointment an the inside of all WIC M folde . As requires by feH al
regulations, we issue fifteen day aatanss to clients failing to participate. Mailing
drafts to clients is dao only vs an extenwtiny ciramstances Dawn. Addi.tioually,
we maintain a daily log a all wtgov nail. Postage is affirm to all mail at the
Treasurer's Office, City Hall. .
-A waiting list is available for persons applying to WSC vie fends are not
available to serve the total needs. This agency has adopt a screening process
(pf Wlimtim papers), him nay be filled out in this office w nailed to lerapec-
tive clients.
B: .Y locations of the Pembsmt-Pismtquis WAC Program facilities are as
follows:
1. Bangor DeSn w of health amp Welfare
2. Eastern H ins M1 iml Cent¢ .
3.
Bre Nati ium
4.
Dexter Mwnicipal m.:ldi
Oen2er
S:Dover-Foxcroft
Municipal Building
ewer
6.
unita'i Metbolist Church
E. Corinth
7.
United Methodist Ctnurch
Guilford
8.
Penqufs CAP
I. Oln,
9.
Milliwcl:et Baptist Chnuch
Millinocket
10.
Milo lbws Office
Milo
11.
High St. Cmgregatienal Cnurch -
Newport
12.
Old Tawn Cnmunuty Health Center
Old lbws
13.
Capehart Camunity Cent
Bangor
C. Poing the 1986 mntract year this program anticipates the £.Mewing amthly
caseload:
By cat Pzy:
Wrnan
Iitants
Ctildren
'ental
370
690
7240
2,300
D. Me Dire t of Health ani Nelfare for U City of Banque is Me Addnistra-
tw of the wlC Pr(gran.
The Program Dira;tor is res{misible for the daily ope[atioas of all apsects of Ne
P og am.
7 e x ition Cmaultart is eRpiwe3 to oversee all alucation and _inm ftion abrcati
dispersed by the nutrition staff. Tne`ConsUl t is also raspaaaZle fre certification
Proarkses perfornai by the Nutrition Aidan.
The Nutrition Aides are responsible for the eligibility c ificet:,.,. of the clients,
as Wali as Perfomnvig secondary and high risk onntacfs, arc( group nutrition education.
The Office Manages oversees clerical duties.
The lnG Clerk is reponsible for �t ^re ical, m�m¢udcatiore, and public relations
of the program.
T Ch k Clerks- issue drafts as well as per£onni g semdery oantacis on each WC
client. on a monthly basis.. Thsy are also responsible for veheor navtruing, and
GalO Payment syst business.
The uksk/Study Stodart will be responsible for group nutrition educatim, and sere
oleri®1 activities.
H. The Penobscot-Pia2taquis WIC Program will provide nutrition �cation serv-
iras to all participants. Dishy the certification process each recipient will he
designated as in need of a high rysk or secmdaiy cartact by the Nutrition Aide.
secwdary contacts will be made on a mu y b sis at the time of draft
issuance. A brief dicussion, bomber, and,/or dananstration of a particular subjsct
selected by the Nutrition Consult will ce Provided to all recipients; (parents,
guardiare, or caretakers) both at the nein office and at ontreacb sites. Ali nutrition
ceucation services Will be rewm l ort a sP ifiel sheet placed in tie front of each
folder, as wall as on the Gelc tuvarand.
Nigh risk o nselirg will be cede as often as duan( necessary by the Nutri-
tion Aide. a klitimal mmaeling may be p=ida3 by other health servim. agencies
by referral. Consistency fn nutritional information will be insured by philosophies
agreed upon by area health service providers.
F. During the 1986 contract year ontreacb efforts will be made throulb the neaia
(television arc( radio public service annonne ), poaters (providedto us by the
State) Which Will w distributed i ughout Penobscot arc( Piseataquis cmntie, is
our clinic oxnm pities, a l through referrals. Agencies with eAmp xe plan to continue
close contact are Barges Public health Nurses, State Public Health Noises, Family
Practice, FM4C Praatal Clinic, Family Planing, State/lm=r immunisation program,
Southern Pan're County Pre stlml Project, Depof Huen Services, a' obstet-
2 a 3
ficians and pediatricians.
G. one of our cw_ck clerks is responsible for vender Mooring activities.
Vendor mttract renewals are staggered, therefore sus is sdieduled to visit a certain
section of our two -county area each month to moritor and ren ea contracts. The Direc-
tor oversees registration and aottnrization of new vendors, and handles any client/ -
vendor anPlaiM .
- A. As rentio d above, this pmgran enjoys the unique privilege of work n
Coarct goals established by stte/laal Public Health Hknses, Fasters Maitre [zaiicsl
Center Freed Clinics, Racal Pediatrics Progran Of 1 , statc/loeal itmwuzation
.. pi89ia(sr
and vaziws bmlth-relatai educationsl frograms..
1. Sob Descriptions - same as in Rider A of PY 1985 contract.
2. Affimetiux Action Plan - save as in Rider A of FY 1985 contract.
3.: Agency By-laws - The P cot-Pisestagois 4 C Pr gram has no By-laws.
This cores -under the City Quarter. Tie governing body is the City council.
3of 3
Mn OF MAINE bu or Depertmeat of
DEPARTMEMP OF i SERVICES - AGENCY Bea1N and Velf"s
BDREAO OF iff MNTRACI llA
WPC PRoG C=sr 1985 - Sep6 1986
PROGRAM BOW£(- INCOW
FUNDILG SOORCPS
CUFAFNT YFPR
PROP05m YEAR
1. State/Federal Flmding Sources
a. NIC
$ 898,012
$ 898,012
b.
C.
2. Loral F m Sources
'
b.
C.
3. Private F im S Ces
-
a.
b
C.
4. Pro ram Imme
a. Consultation Services
b.
C.
S. ONer Income
a.
b.
C.
TOTAL A'Cq¢:
898,012
898,032
(B IC -003A) R 7/85
STATE OF M4INE Bangor Department of
DEPART10I7 OF fl W SERVICESAGFIVCY
BURE6U OF HEALTH aA DATES:
MIC PROGRAM October 1985 - September 1986
PERSONNFI. E%PFN
1,. Salaries 8 Wages
TOTAL IXPF1t96
106 641
Z.
Fringe Benefits
- 8,172
3. Total Personnel Fx enses,
$
116,813
EQUI
4. Purfiaus
S.
Rentals
.
6. Total Equipment I! GISeS
$
7.
Occupancy Ex vise
8.
lepreciation
9.
Utilities
10.
Heat
_
11.
Maintenance
12.
Telephone
onn
13.
Materials 8'Supplies
I
goo
16.
Travel
15.
Insurance
,�mn
25D
16.
Postage
17.
General 8 Administrative (Indirect)
$
18.
other
19. Total All Other Expenses
$
17
368
20.
MT AEMINISIRATIVE EIPENSBS
(lines 3, 6 6 19)
$
133.981
21.
Food
$
764,031
22.
TOTAL PROGM WENSES
(liras 20 8 21)
$
898$012
2 of 7 (IEKIC-003B) R 6/85
STATE OF MAINE Bangor Department of
DuaTM4 OF nuM SP vim AGENCY .Health and Welfare
BUREAU OF p¢ALTH CONTRA
MIC PROCRPM October 1905 - September 1906
no" BODGE! - NUTRITION EDUCATION ERPEMES
PERSONNEL ECPFh'S6
1. 'Salaries 4 Wages
TO AL
NU[RtiTION" IHBIG4TION
E%PIIVSFS
$
18,107
2. Fringe Benefits
1 161
3. Totalms
$
19 469
U�I..
d. Purchases
S. Rentals
-6. Total E ipent fl eases
.. 7. ccqupang
_
8. Depreciation
9. Utilities
10,.Heat.
11. Maintenance
12. Telephme
cm
13- Materials 6 Su lies
Cal
14. Travel
500
15. Insurance
42
16. Postage
231
r. General 8 Administrative (Indirect)
18. Other
19. Total All Other Expenses
$
1861
20. TOTAL A INIMNTNE E%PFNSES.
(lines 3, 6 B 19)
7Tu rE i ion Education Expanses as 8 Or aureau aI Meaim - rvil
3 of 7 ("IC -0030) R 6/85
BmBer Deportment of
STATE OF MAIIO: envy: eealtb and Welfare
DEPAUbg4 OF HU6WN BFRVICFS Contract Oates:
BUREAU OF M TH
WIC PROGRAM I I Oetober 1985 . Sa ember 1986
DHIFR3IINATION OF WIC PFACEFG GE OF EXPENSE REPORT
- ncaue B antt
-A. TttA1
Funding Sources
0 Tota
Income Bud et
100
o Tote
Avail. IMme
Aval a e_
Income
898,011
898 012
WIC
WIC Food
164 031
764,031
Total Adjustments
764,031
164 3
C. TOTAL AVAILABLE F COSI SNARING (A. mim B)
133 981
133-981
Funding Sources
0 Tota
Income Bud et
100
o Tote
Avail. IMme
Aval a e_
Income
A OC3t
ease
Balance
WIC
3 8
Totals
300%
333 981
131-981
MIC -023 6/85
4 Of 7
STATE OF MUNE
UFPARTMINf OF IiIQ4gN BEkVlt6 -
BUREAU OF IO'ALTN
WIC PROGRAM
BUOGEf JUSTIFICATION -
PERWMhL F. rhMbS
B for M sstmeat of Bealth 6 Welfare
TE
October 1985 . 8e ember 1986
No. Of
Personnel
Position or Title
Hourly
Rate
Total
Weekly Has.
Weekly
Salary
Number
Weeks
TotalI Time
Salary For Spent On
Contract WIG Program
Period
Total TV
Salary
For
Contract
Period
Dirpstor
9.30-
7.5
368.75
32
18 135IDU
18 J35
1
Wisp MrtL Nutrition Aide
7.23
3
52
4099
14,099
Aa
40.75
52
12519 IN
12519
1
Nutrition A11,895
1
Check Clerk
37.5
�28.75
52
11,895
1
Chack Clark
37.5
@2_
52
11,095
6. IS
q7 -q
231.75
12�051
M Ion
a 601 Paid by U.N.O.
paid to
With
(HMVIC-004) 5/80
5 o 7
-:. y.
Occupancy Expense
923squarefeat
Total Line
Banger
Department of
STATE OF MINE
Item
- Basis
of.
Expenses.
- DEPASTNNf OF MANN SERVICES
ency:
Ueelth
and Nelfare
- BUREAU OF HEALTH
2 days par month
ntract
Dales:
-
- NIC MGSM
300
$5,533 -
11.
-
-- _Cember
1
- September 1986
OIRN DINEK7 EXPENSE MSTIFIaTION
I
-:. y.
Occupancy Expense
923squarefeat
Total Line
- -- Lim
Item No.
- Inscription Of
Item
- Basis
of.
Expenses.
Item Expense
-:. y.
Occupancy Expense
923squarefeat
- -
$5.15 per square feet annually
-
-
(includes utilities)' -- _
34,153
Lincoln Site - $20 per. day
2 days par month
480
Newport site - $25 Per month
300
$5,533 -
11.
Halntmence
$42 Per =nth contracted with
Penobscot Valley Industries
500
12.
Telephone - hued an average monthly bills -
Amarican Telephone I, Telegraph
- 810
New England Telephone
Itin
Express Telecommunications
960
.1:3,000
13.
Materials and Supplies A of total line
Paper and printing n
2,650
Miscellaneous 30
10050
3,500
(pens, pencils, data binders, ledger notebooks,
arbor paper, scotch tape, staplesq clips,
correction fluid, folders, envelopes, etc.)
14.
Travel
Car Rental ( contract path Nnrscar Auto -
leave, inc.) $189 par month
2,268
(BHWIC-006) R 3/8S '
6 of 7
14. Travel (wet.)
Casolane.
15.-lmoramse
Car Insurance
-^16. Poabage -
17. General and Administrative
City computer cbarge based on comber Of
checks issued by City a Bangor ..
Di -RIND gIpENSES
1. Salaries and Wages
-Balance of U.M.O. Work/Study salary.; paid by O.M.O.
7. Otto peney expense at outreach oitan
;9,973 square feet total
$5.50 per square foot
14. Insurance
Liability insurance defrayed by the City
7 o£7
$ 732 $3:000.
250
785
600
-1,217 -
1,521
50
Orn
(BNNIC-006) R 3/85
STATE OF M INE
Bangor Departueet a
- DEPAR'Tb OF HUMPN SERVICES
ency:
1 and Wolf se
"DURFAU OF HUALM
ntract Dateb -
.. NIC FROGRMI -
-
- - - - -
Oembar
1985,- Septenbex 1986
OlIDIt DIRECT E EME JUSTIFICATION
-
Total Line
Lime Item No. - Description of Ilam-- Basis of BTOmes
Item Exyense
14. Travel (wet.)
Casolane.
15.-lmoramse
Car Insurance
-^16. Poabage -
17. General and Administrative
City computer cbarge based on comber Of
checks issued by City a Bangor ..
Di -RIND gIpENSES
1. Salaries and Wages
-Balance of U.M.O. Work/Study salary.; paid by O.M.O.
7. Otto peney expense at outreach oitan
;9,973 square feet total
$5.50 per square foot
14. Insurance
Liability insurance defrayed by the City
7 o£7
$ 732 $3:000.
250
785
600
-1,217 -
1,521
50
Orn
(BNNIC-006) R 3/85