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VOCA GRANT SOLICITOR'S OFFICE
Before a Depai linent /agency may apply for the grant/award on behalf of Augusta Richmond County, they must first obtain approval signature from the Administrator and the Finance Director. The Administrator will obtain information on the grant program and requirements from the funding agency and review these for feasibility to determine if this grant /award will benefit Augusta Richmond County. The Finance Director will review the funding requirement to determine if the grant will fit within our budget structure and financial goals. Date of Grant Request: if- Q - /3 Department Requesting Grant: \S 0. c. Grant Description: V 0 C A Grant Amount: $ O (Matching Funding Required N/Yes ❑ No Fiscal Year Department/Elected Official Sign att I.) I have reviewed the grant application and enclosed materials and: cam Find the grant /award to be feasible to the needs of Augusta Richmond County o Deny the Request: /7c/win /7A (AJ, - Cfc Finance Director Date 2.) I have revie d the grant application and enclosed materials and: Approve, the Depailuient /Agency to move forward with the application o Deny the Request: Administrator Augusta Richmond County, Georgia New Grant Proposal/Application i -iv - ,<3 / /wo1L3 Date Form A C14 SOD• vD 10 K e 4c - p /3 c9 a 0 / This form will also be used to provide the external auditors with information on all grants for compliance and certification requirements as required by the State and Federal Government. TRANS CD REFERENCE ORDER EFF DATE TYPE PAY DATE INVOICE CONTRACT # 102 13xxx 1 10/01/12 9 ** 012 -8 -006 OVERRIDE ORGAN CLASS PROJECT VENDOR CODE 2 46 4 13yy2 ITEM CODE DESCRIPTION 25 CHARACTERS EXPENSE ACCT AMOUNT 1 2012 Continuation Grant 624.41 $ 30,000 SUBGRANTEE: Richmond County IMPLEMENTING AGENCY: Augusta /Richmond County FUNDING CATEGORY: Solicitor VWAP SUBGRANT NUMBER: C12 - - 006 Award is hereby made in the amount and for the period shown above for a grant under the Victims of Crime Act of 1984, Title II, of Public Law 98 -473. The award is made in accordance with the plan set forth in the application of the subgrantee and subject to any attached special conditions. The subgrantee has agreed through the previously executed copy of certified assurances to be subject to all applicable rules, regulations, and conditions of the Victims of Crime Act. This subgrant shall become effective on the beginning date of the grant period, provided that within forty -five (45) days of the award execution date (below) the properly executed original of this "Subgrant Award" is returned to the Criminal Justice Coordinating Council. ENCY APPROVAL Braxton T. Cotton, Director Criminal Justice Coordinating Council Date Executed: 10/01/12 OFFICE OF THE GOVERNOR CRIMINAL JUSTICE COORDINATING COUNCIL t SUBGRANT AWARD 58- 2204274 -004 REFERENCE NO.: 13xxx FEDERAL FUNDS: $ 30,000 MATCHING FUNDS: $ 7,500 TOTAL FUNDS: $ 37,500 GRANT PERIOD: 10/01/12- 09/30/13 SUBGRANTEE APPROVAL Signature of Authorized Official Date Du t 8 . -a a f_ n I a U (I) a 166 Typed Name & Title of Authorized Officofrial Employer Tax Identification Number (EIN) ******************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** INTERNAL USE ONLY CRIMINAL JUSTICE COORDINATING COUNCIL SPECIAL CONDITIONS SUBGRANTEE: Richmond County FUNDING CATEGORY: Solicitor VWAP SUBGRANT NUMBER: C12 -8 -006 SUBGRANT AWARD: $30,000 1. The subgrantee understands and agrees that it cannot use any federal funds, either directly or indirectly, in support of any contract or subaward to either the Association of Community Organizations for Reform Now (ACORN) or its subsidiaries, without the express prior written approval of the Criminal Justice Coordinating Council and OJP. Initials 2. The subgrantee agrees to register for and maintain an active registration with the Central Contractor Registration (CCR) (available at www.bpn.gov /ccr) and to notify the CJCC in writing of its registration if not already reported. Initials ,..../e/5 3. The subgrantee agrees to take reasonable steps to provide meaningful access to their programs and activities for persons with limited English proficiency (LEP). For more information on the civil rights responsibilities that recipients have in providing language services to LEP individuals, please see the website at http: / /www.lep.gov. In addition, subgrantees that provide hotline services will provide documentation of a contract for 24 -hour language interpretation services for callers who do not speak English. Subgrantees that provide hotline services will ensure that its TTY machine is operable at all times and that all staff, volunteers and interns who answer the hotline receive training and ongoing review of TTY answering procedures. �,.., Initials i- 4. The subgrantee agrees to comply with the Equal Treatment Regulation (28 C.F.R. part 38) which prohibits recipients from using federal grant funding for inherently religious activities. While faith -based organizations can engage in non - funded inherently religious activities, the activities must be held separately from the grant- funded program, and customers or beneficiaries cannot be compelled to participate in them. The Equal Treatment Regulation makes clear that organizations receiving federal grant funding are not permitted to discriminate when providing services on the basis of a beneficiary's religion. SUBGRANT NUMBER: C12 -8 -006 Init;;_als SPECIAL CONDITIONS (Page 2) 5. In accordance with Federal regulations, your organization must comply with the following Equal Employment Opportunity Plan reporting requirements: If your organization has received an award for $500,000 or more and has 50 or more employees (counting both full- and part -time employees but excluding political appointees), then it has to prepare an EEOP and submit it to the Office of Civil Rights (OCR), Office of Justice Programs, U.S. Department of Justice for review within 60 days from the date of this award. For assistance in developing an EEOP, please consult OCR's website at http: // www.ojp.usdoj.gov /ocr /eeop.htm. You may also request technical assistance from an EEOP specialist at OCR by dialing (202) 616 -3208. If your organization received an award between $25,000 and $500,000 and has 50 or more employees, your organization must prepare an EEOP, but it does not have to submit the EEOP to OCR for review. Instead, your organization has to maintain the EEOP on file and make it available for review on request. In addition, your organization has to complete Section B of the Certification Form and return it to OCR within 60 days from the date of this award. The Certification Form can be found at http: / /www.ojp.usdoj.gov /about /ocr /eeop.htm . If your organization received an award for less than $25,000; or if your organization has less than 50 employees, regardless of the amount of the award; or if your organization is a medical institution, educational institution, nonprofit organization or Indian tribe, then your organization is exempt from the EEOP requirement. However, your organization must complete Section A of the Certification Form and return it to OCR within 60 days from the date of this award. The Certification Form can be found at http: / /www.ojp.usdoj.gov /about /ocr /eeop.htm. The subgrantee acknowledges that failure to submit an acceptable EEOP (if the subgrantee is required to submit one pursuant to 28 C.F.R. Section 42.302), that is approved by the Office for Civil Rights, is a violation of its Certified Assurances and may result in suspension or termination of funding, until such time as the subgrantee is in compliance. The subgrantee must maintain proof of compliance with the above requirements and be able to provide such proof to the Criminal Justice Coordinating Council upon request. Initials `46 6. In the event a federal or state court or federal or state administrative agency makes an adverse finding of discrimination against your organization after a due process hearing, on the ground of race, color, national origin, or sex, your organization must submit a copy of the finding to the Office of Civil Rights and the Criminal Justice Coordinating Council. Initials 7. The subgrantee agrees to comply with all applicable laws, regulations, policies, and guidance governing the use of federal funds for expenses SUBGRANT NUMBER: C12 -8 -006 SPECIAL CONDITIONS (Page 3) r related to conferences, meeting, training, and events, including the provision of food and /or beverages at such events and costs of attendance at such events. Information on pertinent laws, regulations, policies, and guidance is available at www.ojp.gov /funding/ confcost.htm. 8. The subgrantee agrees to comply with all the requirements of 28 CFR Part 22, the Department of Justice's Regulations on the Confidentiality of Identifiable Research and Statistical Information. The subgrantee agrees that any information identifiable to a private person that is collected as part of this grant will be used for research and statistical purposes only and acknowledges that 42 U.S. C. Section 3789 (g) provides that these data are immune from legal process. The subgrantee agrees to follow all the requirements for subject notification (28 CFR Section 22.27), information transfer agreements (28 CFR Sections 22.24 and 22.26), and final disposition of data (28 CFR Section 22.25). Initials L- 9. The subgrantee agrees that consultant /contractor fees in excess of $450.00 per eight hour day ($56.25 per hour) must have prior approval from the Office of Justice Programs and the Criminal Justice Coordinating Council. Initials 10. The subgrantee agrees that information on race, sex, national origin, age, • and disability of recipients of assistance will be collected and maintained, where such information is voluntarily furnished by those receiving assistance. Initials 11. The subgrantee agrees to obtain and maintain a Data Universal Numbering System (DUNS) number (available at www.dnb.com) and to notify CJCC in writing as soon as this number is obtained if not already reported. Initials 12. The subgrantee agrees that if it currently has an open award of federal funds or if it receives an award of federal funds other than this OJP award , and those award funds have been, are Oeing, or are to be used, in whole or in part, for one or more of the identical cost items for which funds are being provided under this OJP award, the subgrantee will promptly notify, in writing, the grant manger for this CJCC award, and, if so requested by CJCC, seek a budget - modification or change -of- project -scope gran adjustment notice to eliminate any inappropriate duplication of funding. 13. Pursuant to Executive Order 13513, "Federal Leadership an Reducing Text Messaging While Driving," 74 Reg. 51225 (October 1, 2009y -; the Department of Justice and the Criminal Justice Coordinating Council encourages grantees and subgrantees. to adopt and enforce policies banning employees from text SUBGRANT NUMBER: C12 -8 -006 messaging while driving any vehicle during the course of performing work funded by this grant, and to establish workplace safety policies and conduct education, awareness, and other outreach to decrease crashes caused by distracted drivers. Initials 14. The subgrantee certifies that federal funds will not be used to supplant funds that would otherwise be made available for grant- funded initiatives. Federal funds must be used to supplement existing funds for program activities and not replace funds appropriated for the same purpose. Potential supplanting will be the subject of application review, as well as pre -award review, post -award monitoring, and audit. If there is a potential presence of supplanting, the subgrantee will be required to document that the reduction in non - federal resources occurred for reasons other than the receipt or anticipated receipt of federal funds. Initials 15. The subgrantee certifies that all matching funds required to pay the non - federal portion of the project awarded subgrant funds will be in addition to fn1s otherwise made available for project activities. Initials Initials ;66 SPECIAL CONDITIONS (Page 4) 16. The subgrantee certifies that 1) title to all equipment and /or supplies purchased with funds under this subgrant shall vest in the agency that purchased the property; 2) equipment and /or supplies will be maintained in accordance with established local or state procedures as long as the equipment and /or supplies are used for program- related purposes; and 3) once the project concludes and /or equipment is no longer utilized for its grant - funded purpose, the Criminal Justice Coordinating Council will be informed of the available equipment and determine its future use to assure it is utilized in furtherance of the goals and objectives of the grant program and the State of Georgia. 17. The subgrantee agrees to abide by all administrative and financial guidelines as stipulated in the current edition of the Office of Justice Program's Financial Guide for Grants available at http: / /www.ojp.usdoj.gov /financialguide /. All services paid by federal and /or matching funds must have a valid contract that has been pre- approved by the Criminal Justice Coordinating Council to ensure compliance with federal and state guidelines and statutes. Initials 18. The subgrantee must submit Subgrant Adjustment Request #1 with the completed award package. The adjustment request must be accompanied by a detailed project budget that itemizes all projected expenditures. The project budget and summary will not be established, or officially approved, until the subgrantee receives a written approval notice from the Criminal Justice Coordinating Council. All project costs and project activities must coincide with the approved budget, summary, and implementation plan unless subsequent revisions are approved by the Criminal Justice Coordinating Council. SUBGRANT NUMBER: C12-8-006 SPECIAL CONDITIONS (Page 5) r Initials ` ;62 19. The subgrantee must submit subsequent requests to revise the budget, project summary, and implementation plan prior to any substantial changes, but no later than 60 days prior to the end of the subgrant period. Initials �.Z -i 20. All project costs not exclusively related to this approved project must be prorated, and only the costs of project - related activities will be reimbursable under the subgrant award. Initials 21 The subgrantee agrees to submit requests for reimbursement on either a monthly or quarterly basis, as selected by the subgrantee at the time of award. Subgrant Expenditure Reports are due 15 days after the end of the month (if reporting monthly) or 30 days after the end of the quarter (if reporting quarterly). Initials, 22. If any changes occur in the subgrantee's lobbying status or activities, a revised Disclosure of Lobbying Activities Form must be submitted. The subgrantee further understands and agrees that it cannot use any federal funds, either directly or indirectly, in support of the enactment, repeal, modification, or adoption of any law, regulation or policy, at any level of government, without the express prior Written approval of the Office of Justice Program Initials 23. If any changes occur in the subgrantee's eligibility status regarding debarment, a revised Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion form must be submitted to the Criminal Justice Coordinating Council. Initials , 16 . _/ . 3 7 24. Repeatedly late submission of any reports will result in a recommendation to the Criminal Justice Coordinating Council for a reduction to your award. These reports include, but are not limited to, Subgrant Expenditure Reports, Progress Reports, Outcome Performance Measures and Annual Local Victim Assistance Al -On Fund Reports. Initials 25. Pursuant to O.C.G.A. §36 -60 -6, as amended, all private employer subgrantees with greater than 500 employees shall register with the federal work authorization system, E- Verify, and provide CJCC with its eligibility verification system user number by January 1, 2012. Private employer subgrantees with greater than 100 but fewer than 500 employees shall also register with the federal work authorization system and submit to CJCC its eligibility verification system user number by July 1, 2012. Private employer subgrantees with more than ten employees but fewer than 100 employees shall register with the federal work authorization system and submit to CJCC its eligibility verification system user number by July 1, 2013. SUBGRANT NUMBER: C12 -8 -006 Initials 26. Pursuant to U.S. Attorney General Order No. 2353 -2001, and O.C.G.A. §50- 36 -1(d), public or private nonprofit service providers that deliver in -kind (non -cash) services necessary to protect life or safety and do not charge for said services based on the recipients' income, may neither require clients seeking their organization's services to verify their immigration status nor deny services based on the clients' legal status. (Department of Justice (2001), Final Specification of Community Programs Necessary for Protection of Life or Safety Under Welfare Reform Legislation, (A.G. Order No. 2353 -2001) 66 FR 3613.) Agencies providing said services shall establish a policy ensuring all victims have access to services regardless of immigrant status, and shall promulgate same with staff and clients seeki5g services. Initials 27. Any law enforcement or prosecution subgrantee that provides in -kind (non -cash) services necessary to protect life or safety and does not charge for said services based on the recipients' income shall not deny these services to any crime victim who seeks their protection based on the victim's immigration or legal status, nor shall the agency require any victim who contacts them in good faith to verify their immigration status prior to delivering services. (Department of Justice (2001), Final Specification of Community Programs Necessary for Protection of Life or Safety Under Welfare Reform Legislation, (A.G. Order No. 2353 -2001) 66 FR 3613.; O.C.A 5- 100(f)). Initials 28. All nonprofit organizations shall comply fully with the requirements set forth in the Official Code of Georgia Annotated, Chapter 50 -20, and submit, prior to the drawdown of any funds, completed financial statements (including balance sheet, income statement and statement of cash flows) and salary information for all personnel whether grant funded or not. Initials --, /t- 29. NEEDS TO BE FILLED IN 30. Subgrantees who provide emergency shelter agree that, if their agency cannot house a domestic violence victim, they will identify available resources and assist the victim in developing and implementing a feasible plan to access other emergency shelter. Initials 31. Subgrantees who provide emergency shelter will conduct appropriate screening so as not to discriminate against individuals based on physical or mental disability, including mental health concerns and substance abuse issues, or deny shelter solely upon the presence of these factors, and ensure that reasonable accommodations are documented and made available to those victims. Initials SPECIAL CONDITIONS (Page 6) SUBGRANT NUMBER: C12 -8 -006 32 The subgrantee agrees to comply with the CJCC Subgrantee' Progtammatic and Fiscal Compliance Policy finalized in October 2011. Initials 33. The subgrantee understand and agrees that any training or training materials developed or delivered with funding provided under this award must adhere to the OJP Training Guiding Principles for Grantees and Subgrantees, available at http: // www. ojp. usdojtrainingguidingprincples .htm. 34. The subgrantee agress that all fully or partially grant- funded staff and his /her supervisor must attend a victim's compensation training hosted through the Criminal Justice Coordinating Council during the grant year. Training hours may be used to satisfy part of the 8 -hour victim services training requirement specified elsewhere in these special conditions. Any new employee - whether they are grant- funded or not - must attend a Criminal Justice Coordinating Council victim's compensation training within six (6) months of beginning employment with the grant- funded agency. Initials The subgrantee must maintain its certification to receive Local Victim Assistance Add -On Funds (5% Funds). In addition, the subgrantee must submit an annual report to the Criminal Justice Coordinating Council regarding the receipt and expenditure of these funds by January 30 each year per O.C.G.A. § 15 -21 -132. Initials `-/ 36. The subgrantee authorizes the Office for Victims of Crime, the Office of the Chief Financial Officer (OCFO), the Criminal Justice Coordinating Council and its representatives, access to and the right to examine all records, books, paper, or documents related to the VOCA grant. Initials 37. The subgrantee agrees that each project employee (new or existing) will attend and sucessfully complete at least eight (8) hours of training in victim assistance. A training request will be submitted to the Criminal Justice Coordinating Council for approval at least 15 days prior to the proposed training date. Initials "i7 SPECIAL CONDITIONS (Page 7) Initials 38. The subgrantee agrees to abide by the provisions of the "Crime Victims' Bill of Rights" as stipulated under Georgia law (O.C.G.A. Chapter 17). 39. The subgrantee agrees to adhere to the Program Guidelines for the Victims of Crime Act Victim Assistance Grant Program available at http: // www. ojp. usdoj.gov /ovc /voca /vaguide.htm. Initials _ SUBGRANT NUMBER: C12 -8 -006 40., The ; subgrantee agrees to comply with the organizational 'audit requirements of the Single Audit Act as detailed in OMB Circular A -133, Audits of States, Local Governments, and Non - Profit Organizations, and further understands and agrees that funds may be withheld, or other requirements may be imposed, if outstanding audit issues (if any) from OMB Circular A -133 audits (and any other audits of OJP grant funds) are not satisfactory and promptly addressed, as further described in the current edition of the OJP Financial Guide, Chapter 19. The CFDA number for this grant program is 16.575. Initials Initials Initials The subgrantee agrees to abide by Georgia law regarding the utilization of professional counselors, social workers, and marriage and family therapists. (O.C.G.A. § 43- 10A -1, et. seq). SPECIAL CONDITIONS (Page 8) 42. The subgrantee agrees to abide by Georgia law regarding the utilization of psychologists. (O.C.G.A. § 43 -39 -1, et. seq). Initials 43. The subgrantee agrees to utilize project volunteers that provide direct services as defined under the Victims of Crime Act. In order to comply with this requirement, the subgrantee shall furnish a listing of all project volunteers that provide direct services, a copy of the contract between each volunteer and the subgrantee identifying responsibilities for both parties, and a written job description indicating what types of direct services the volunteer will provide. 44. The subgrantee agrees to satisfy 25% of the required match (20%) through the in -kind donation of volunteer hours. The standard rate for the provision of direct services by a volunteer is $12.00 per hour. Higher rates must be pre - approved by the Criminal Justice Coordinating Council. Any deviation from this requirement must be submitted in writing to the Criminal Justice Coordinating Council utilizing the volunteer requirement waiver request form. Initials 45. The subgrantee agrees to advise victims of their eligibility for benefits under the Georgia Crime Victims Compensation Program, and assist them with application forms and procedures, obtaining necessary documentation, and /or checking on their claim status. Initials 46. Statistical data describing project performance from programs providing direct victim services must be submitted to the Criminal Justice Coordinating Council using the Victim Services Statistical Report (VSSR) provided to the subgrantee. VSSRs describing program outputs (total services SUBGRANT NUMBER: C12 -8 -006 deli total clients served, etc.) are due quarterly on January 30, April 30, July 30, and October 30. The fourth quarter report, due to CJCC October 30, requires subgrantees to complete the narrative section included with that quarter's statistical report. Performance Reports describing program outcomes (changes in clients as a result of services delivered) must be based on surveys administered to individual clients. Each program should include the appropriate performance measures for their respective type of program on their client surveys. Programs are required to follow the CJCC Data Collection Guidelines and report on the on -line reporting system. Subgrantees are encouraged, but not required, to use the Excel -based spreadsheets to enter and tally their individual client outcome data. Totals reported for outputs may not match totals reported for outcomes since outcomes are collected from clients only at the substantial completion of services. The performance reports are due semi - annually, April 30th and October 30th. Initials 47. The subgrantee agrees to fully cooperate with any monitoring or evaluation activities, and any related training activities, initiated and /or conducted by the Criminal Justice Coordinating Council during and subsequent to the award period. Initials 48. The subgrantee agrees to promptly refer to the U.S. Department of Justice (DOJ) Office of Inspector General (OIG) any credible evidence that a principal, employee, agent, contractor, subcontractor, or other person has either 1) submitted a false claim for grant funds under the False Claims Act; or 2) committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct involving grant funds. Potential fraud, waste, abuse, or misconduct should be reported to the OIG by mail: Office of the Inspector General U.S. Department of Justice Investigations Division 950 Pennsylvania Avenue, N.W. Room 4706 Washington, DC 20530 e -mail: oig.hotline @usdoj.gov hotline: (contact information in English and Spanish): (800) 869 -4499 or hotline fax: (202) 616 -9881 Additional information is available from the DOJ OIG website at www.usdoj.gov /oig. Initials SPECIAL CONDITIONS (Page 9) SUBGRANT NUMBER: C12 -8 -006 SPECIAL CONDITIONS (Page 10) 49,. The,subgrantee agrees to comply with any additional requirements that may be imposed during the grant performance period if the Criminal Justice Coordinating Council determines that the recipient is a high -risk subgrantee. Cf.28 C.F.R. parts 66, 70. Initials /7 50. All subgrantees must have written policies and procedures which govern the fiscal management of grant funds. Initials 51. The subgrantee agrees to comply with the National Environmental Policy Act (NEPA) and other related federal environmental impact analysis requirements if the subgrantee engages in one or more of the following activities and the activity needs to be undertaken in order to use grant funds, whether or not the activities specifically are funded with federal funds: new construction; minor renovation or remodeling of a property either a) listed on or eligible for listing on the National Register of Historic Places or b) located within a 100 -year flood plain; a renovation, lease, or any other proposed use of a building or facility that either will a) result in a change in its basic prior use or b) significantly change its size; and, implementation of a new program involving the use of chemicals other than those a) purchased as an incidental component of a funded activity and b) traditionally used, for example, in office, household, recreational, or educational environments. Initials Please be advised that failure to comply with any of the Special Conditions will result in material noncompliance with the Subgrant Agreement, thus subjecting the Subgrant Agreement to possible termination by the Criminal Justice Coordinating Council. Typed name of t d Authorized Official t r'1 I l a U L' 1' Title : nTh C3L , j a e.- Signature • Date : PRINT DATE: 09/28/12 GMIS DOCUMENT 3A SUBGRANTEE: Richmond County FUNDING CATEGORY: Solicitor VWAP NATURE OF ADJUSTMENT: Mark all that apply. Adjustments of each type shown should be entered in the section indicated. MUST BE JUSTIFIED AND EXPLAINED THOROUGHLY IN SECTION IV. SECTION I. REQUEST FOR BUDGET CHANGE - JUSTIFY IN SECTION IV. CURRENT APPROVED REVISIONS +/- $ 37,500 SECTION III PERSONNEL EQUIPMENT SUPPLIES TRAVEL PRINTING OTHER TOTAL $ Federal $ Match $ SECTION II. REQUEST FOR CHANGE CURRENT GRANT PERIOD Start Date: 10/01/12 End Date: 09/30/13 NOTE: The maximum extension request CRIMINAL JUSTICE COORDINATING COUNCIL SUBGRANT ADJUSTMENT REQUEST FEDERAL GRANT # 2012 -VA -GX -0035 REQUEST DATE: REVISED BUDGET PROJECT PERIOD AND /OR EXTENSION PROJECT OFFICIALS /ADDRESSES. . PROJECT PERSONNEL GOALS AND OBJECTIVES OTHER 0 0 0 0 0 37,500 30,000 7,500 cannot exceed 12 months. CONTINUED ON NEXT PAGE REQUESTED GRANT PERIOD Start Date: End Date: SUBGRANT #: C12 -8 -006 Go To Go To Go To Go To Go To Go To IN PROJECT PERIOD - JUSTIFY IN SECTION IV. ADJ REQUEST #: 1 • • • • • • REVISED BUDGET PAGE 1 OF 2 • SECTION I • SECTION II . SECTION III • SECTION III • SECTION III . SECTION III FOR EXTENSION, # OF MONTHS: REQUESTS FOR REVISIONS TO PROJECT OFFICIALS /ADDRESSES, PROJECT PERSONNEL, GOALS AND OBJECTIVES, AND /OR OTHER NON - BUDGET, NON- PERIOD CHANGES (JUSTIFY IN SECTION IV.) SUBMITTED BY: C' PRINT DATE: 09/28/12 GMIS DOCUMENT 3A SUBGRANTEE: Richmond County FUNDING CATEGORY: Solicitor VWAP CRIMINAL JUSTICE COORDINATING COUNCIL SUBGRANT ADJUSTMENT REQUEST FEDERAL GRANT # 2012 -VA -GX -0035 REQUEST DATE: ADJ REQUEST #: 1 SUBGRANT #: C12 -8 -006 SECTION IV. JUSTIFICATION OF ALL REQUESTED ADJUSTMENTS, REVISIONS, AND /OR CHANGES All requested adjustments in Sections I, II & III (page 1) must be justified in detail in this Section. Include item costs, descriptions, equipment lists, detailed explanations, and any other information that would further clarify and support your request for adjustment. Attach additional pages as needed. S. ject Director Titl Approval Disapproval Reviewer Signature PAGE 2 of 2 Date SUBGRANT NUMBER: C12 -8 -006 BANK NAME: CRIMINAL JUSTICE COORDINATING COUNCIL REIMBURSEMENT SELECTION FORM AGENCY NAME: AUGUSTA /RICHMOND COUNTY SOLICITOR 1. SELECT A SCHEDULE FOR SUBMITTING REIMBURSEMENTS (CHECK ONE BOX) ❑ MONTHLY (Requests for reimbursement are due 15 days after the end of the month) X QUARTERLY (Requests for reimbursement are due 30 days after the end of the quarter) 2. SELECT A PROCESS FOR RECEIVING REIMBURSEMENT PAYMENTS (CHECK ONE BOX) ❑ ELECTRONIC FUNDS TRANSFER (Reimbursements will be deposited into the bank account listed below. A voided check must be attached to ensure proper routing of funds.) BANK ROUTING NUMBER: BANK ACCOUNT NUMBER: AGENCY CONTACT NAME: AGENCY CONTACT TELEPHONE NUMBER: AGENCY AUTHORIZED OFFICIAL NAME AND TITLE: AGENCY AUTHORIZED OFFICIAL SIGNATURE: XCHECK (Reimbursements will be mailed in the form of a check to the address listed below) MAILING ADDRESS: 735 JAMES BROWN BLVD SUITE 2500 CITY, STATE & ZIP: AUGUSTA, GA 30901 ATTENTION: KELLIE K. MCINTYRE AGENCY AUTHORIZED OFFICIAL SIGNATURE: For CJCC Use ONLY CJCC Auditor: Phone Number: Grant Award Number: GBI Entry Initial /Date: (1) Civil Rights Contact Person: JACQUELINE HUMPHRIES (4) Number of persons employed by the organizational unit (agency) responsible for administering the subgrant: 6 CIVIL RIGHTS CONTACT (2) Title /Address: DIRECTOR AUGUSTA/RICHMOND CO HR DEOT 501 GREEN ST SUITE 314 AUGUSTA, GA 30901 (3) Telephone Number: 706- 826 -4789 Questions regarding the EEOP compliance requirements in connection with funding under this program should be addressed directly to the Office of Civil Rights Compliance, Office of Justice Programs, 633 Indiana Avenue, NW, Washington, D.C. 20531. That Office may be reached at (202) 724 -7861. AUDIT REQUIREMENTS State and local governments are governed by the Single Audit Act of 1984 and OMB Circular A- 133, as amended, which is effective regarding audits beginning July 1, 1996 and thereafter. The type of audit required under the Circular is dependent upon the amount of total Federal funds expended in the subrecipient's fiscal year. State or local governments and non - profit organizations that expend $500,000 or more a year in Federal funds shall have an audit made in accordance with the Single Audit Act of 1984 and OMB Circular A -133, as amended. This audit report is due in the State Administering Agency =s office not Later than nine (9) months after the end of the subrecipient's fiscal year. State or local governments that expend less than $500,000 in federal funds yearly shall be exempt from compliance with the Single Audit Act and other Federal audit requirements. [NOTE: This does not exempt you from the requirement to maintain, produce, and report financial and other records and documentation relative to the expenditure of these grant funds upon request of the State or Federal Agency administering this program.] Please provide the following information: Period of Fiscal Year: Date of Last Audit: Date of Next Audit: Anticipated Date Next Scheduled Audit Will Be Forwarded to the Council: 01 -01 -2012 - 12 -31 -12 12 -31 -2011 12 -31 -2012 06 -30 -13 [NOTE: If the total amount of your agency's federal funds expenditures (including this grant) does not equal or exceed $500, 000 you may write "Not Applicable" in this space. VOCA AUTHORIZED PURPOSE AREAS Agency Name: Ps"Q S j .A re ON CO Sub -Grant Number: C [ - ? -00 1. Authorized Purpose Areas: ❑ Start up a new victim services project Continue a VOCA funded victim project funded in a previous year Expand or enhance an existing project funded by VOCA in the previous year 2. These VOCA Funds will primarily be used to (check one): D Expand services into a new geographic area ❑ Offer new types of services ❑ Serve additional victim populations A Continue existing services to crime victims ❑ Other (Please explain): 3. For the proposed victim services program indicate: J1 The number of paid staff (full -time equivalents) ❑ The number of volunteer staff (full -time equivalents) Note: Only Volunteers providing direct services to crime victims should be counted. 4. Identify any and or all of the VOCA Subgrant Award that will be used to meet the priority and underserved requirements (please indicate both dollar amount and percentage of FEDERAL VOCA Funds utilized toward each category): a) Child Abuse $ / % b) Domestic Violence $ 361000.5-'1)/ / 0 0 c) Sexual Assault . $ / d) Underserved: • DUI/DWI Crashes $ / • Survivors of Homicide Victims $ / • Assault $ / • Adults Molested as Children $ / • Elder Abuse $ / • Robbery $ / • Other Violent Crime $ / 5. Type of Implementing Agency (check the appropriate boxes): n Criminal Justice — Government o Law Enforcement X Prosecution o Probation o Court o Corrections o Other (Please explain) Non- Criminal Justice — Government o Social Services o Mental Health o Public Housing o Hospital o Other (Please explain) D Non - Profit Non - Governmental o Hospital o Rape Crisis o Religious Organization o Shelter o Mental Health Agency o Other (Please explain) Other (Please Explain) 6. PIease provide the total amount of funding allocated to victim services based on your prior year and current fiscal year budget. Funding Source Prior Year Current Year a) Federal (excluding VOCA) $ $ b) VOCA Funds $ .5 0 OQCf) $-.3_,O O © 0 c) State $ ° $ • o d) Local $ rt i ,SD Q $ 7 c n Q e) Other (Please explain) $ $ - ' - tY� 7. Identify the victims to be served through this VOCA- funded project (VOCA Subgrant plus Match) by checking the type of crime(s): a) ❑ Child Physical Abuse b) ❑ Child Sexual Assault c) rs DUI /DWI Crashes d) lit Domestic Violence e) ❑ Adult Sexual Assault f) ❑ Elder Abuse g) ❑ Adults Molested as Children h) ❑ Survivors of Homicide Victims i) ❑ Robbery j) ❑ Assault k) ❑ Other Violent Crime (Please explain) 1) ❑ Other (Please explain) 8. Check the services provided by this VOCA- funded project (VOCA Subgrant plus Match): a) ❑ Crisis Counseling b) x Follow -up Contact c) ❑ Therapy d) ❑ Group Treatment e) ❑ Crisis Hotline Counseling f) ❑ Shelter /Safe House g) 2( Information & Referral (In- Person) h) k Criminal Justice Support/Advocacy i) ❑ Emergency Financial Assistance j) ❑ Emergency Legal Assistance k) is Assistance in Filing Compensation Claims 1) ❑ Personal Advocacy m) Telephone Contacts (Information & Referral) n) ❑ Other (Please explain) LEGAL NAME OF AGENCY: C12 -8 -006 DESIGNATION OF GRANT OFFICIALS AUGUSTA/RICHMOND CO SOLICITOR GENERAL'S PROJECT TITLE: OFFICE ❑ Mr. ® Ms. REBECCA W BALLIEW PROJECT DIRECTOR NAME (Type or Print) PROGRAM COORDINATOR AUGUSTA/RICHMOND CO VWAP PROGRAM Title and Agency 735 JAMES BROWN BLVD SUITE AUGUSTA 30901 2500 Official Agency Mailing Address City 706 -821 -1220 706 -821 -1183 Daytime Telephone Number Fax Number rballiew@augustaga.gov E -Mail Address ❑ Mr. ® Ms. DONNA WILLIAMS FINANCIAL OFFICER (Type or Print) DIRECTOR AUGUSTA/RICHMOND CO ACCOUNTING OFFICE Title and Agency 530 GREENE ST AUGUSTA Official Agency Mailing Address City 706 -821 -2334 Daytime Telephone Number Fax Number dwilliams@augustaga.gov E -Mail Address El Mr. ❑Ms. DAVID S COPENHAVER AUTHORIZED OFFICIAL (Type or Print) MAYOR AUGUSTA/RICHMOND COUNTY COMMISSION Title and Agency 530 GREENE ST AUGUSTA Official Agency Mailing Address City 706 -821 -1833 706 -821 -1835 Daytime Telephone Number Fax Number mayordeke@augustaga.gov E -Mail Address Zip 30911 Zip 30911 Zip Augusta Richmond County, Georgia New Grant Proposal /Application Form A Before a Department /agency may apply for the grant /award on behalf of Augusta Richmond County, they must first obtain approval signature from the Administrator and the Finance Director. The Administrator will obtain information on the grant program and requirements from the funding agency and review these for feasibility to determine if this grant /award will benefit Augusta Richmond County. The Finance Director will review the funding requirement to determine if the grant will fit within our budget structure and financial goals. Date of Grant Request: 1- 4— /3 Depai tll nent Requesting Grant:'o/r c ,10 r s 01:1 c Grant Description: V 0 C A Grant Amount: $ 3 c ) 00 () (Matching Fiscal Year e rant: 0/,_ - r3 epartment /Elected Official Sign re o Deny the Request: Finance Director Administrator Funding Required IYes ❑ No 7 Soo • v o 1.) I have reviewed the grant application and enclosed materials and: o Find the grant/award to be feasible to the needs of Augusta Richmond County Date 7.2 Date 2.) I have reviewed the grant application and enclosed materials and: o Approve, the Departwent /Agency to move forward with the application o Deny the Request: Date This form will also be used to provide the external auditors with information on all grants for compliance and certification requirements as required by the State and Federal Government. Tif EI - Partial Order FOR ACCOUNTING USE ONLY Tif ED - Schedule Pay Date DISCOUNT PO /AUTH PAY DATE DEPARTMENT FUND SOURCE PROJECT PROGRAM CLASS ACCOUNT INVOICE AMOUNT 471060600C13yy2 13xxx 10630104 315 707013 C12- 8- 006E01 09/28/12 DOC3H EXPENDITURES FOR THE PERIOD OF THRU SUBGRANTEE:Richmond County 530 Greene Street 806 City /County Building Augusta, GA 30911 CRIMINAL JUSTICE COORDINATING COUNCIL SUBGRANT EXPENDITURE REPORT /REQUEST FOR FUNDS 4 1 FEDERAL GRANT #2012-VA-GX-0035 COMBINED FEDERAL & MATCH EXPENDITURES APPROVED PREVIOUSLY APPROVED EXPENDITURES REMAINING EXPENDED BUDGET N/A THIS RPT N/A THIS RPT BALANCE THIS PERIOD PERSONNEL $ 37,500 $ 0 $ 0 $ 37,500 $ EQUIPMENT 0 0 0 0 SUPPLIES 0 0 0 0 TRAVEL 0 0 0 0 PRINTING OTHER TOTAL FEDERAL MATCH SUBGRANT #: SUBGRANT AWARD: REQUESTED TO DATE: BALANCE: * Substantiated $ 37,500 $ 30,000 7,500 0 0 0 0 0 0 0 0 EARNED PROJECT INCOME FOR THE PERIOD: EARNED PROJECT STATUS INCOME FOR THE PERIOD: FORFEITED $ OTHER $ EXPENDED $ UNEXPENDED $ CERTIFICATION: I certify that the above statements are accurate based on official records, that expenditures shown have been made for the purpose of, and in accordance with, applicable arant terms and conditions, and that appropriate supportive documentation relative to all expenditures is attached. SUBGRANTEE OFFICIAL APPRO PREPARED BY : d 1'E L -EL- 67 i � OFFICIAL' S S I GNATURE C.V.: DATE t t `mil 6 Z... PHONE NUMBER: 9 OLo ' k - { 1 /p 0 TYPED NAME & TITLE 0.U; t . C. n r ha 6: ° 1- FOR CRIMINAL JUSTICE COORDINATING COUNCIL USE ONLY 012 -8 -006 AMOUNT REQUESTED THIS REPORT: $ 30 REVIEWED BY (INITIALS & DATE): Advanced FUNDING CATEGORY: Solicitor VWAP 0 $ 0 $ 37,500 $ 0 0 PROJECT PERIOD: 10/01/12 to 09/30/13 AUTHORIZED BY 0 0 30,000 7,500 SUBGRANT #: C12 - 8 - 006 FINAL RPT? (Y /N) DATE PRINT DATE: 09/28/12 GMIS DOCUMENT 3A SUBGRANTEE: Richmond County FUNDING CATEGORY: Solicitor VWAP CRIMINAL JUSTICE COORDINATING COUNCIL SUBGRANT ADJUSTMENT REQUEST FEDERAL GRANT # 2012 -VA -GX -0035 REQUEST DATE: SECTION IV. JUSTIFICATION OF ALL REQUESTED ADJUSTMENTS, REVISIONS, AND /OR CHANGES All requested adjustments in Sections I, II & III (page 1) must be justified in detail in this Section. Include item costs, descriptions, equipment lists, detailed explanations, and any other information that would further clarify and support your request for adjustment. Attach additional pages as needed. SUBMITTED BY: Signature of Financial Officer or Project Director CJCC ROUTING AND APPROVALS: Reviewed By: Authorized By: PAGE 2 of 2 ADJ REQUEST #: 1 SUBGRANT #: C12 -8 -006 " \. oLL 0 t /f-l- ti 2 Titi Date Approval Disapproval Reviewer Signature SUBGRANT NUMBER: C12 -8 -006 BANK NAME: CRIMINAL JUSTICE COORDINATING COUNCIL REIMBURSEMENT SELECTION FORM AGENCY NAME: AUGUSTA /RICHMOND COUNTY SOLICITOR 1. SELECT A SCHEDULE FOR SUBMITTING REIMBURSEMENTS (CHECK ONE BOX) ❑ MONTHLY (Requests for reimbursement are due 15 days after the end of the month) X QUARTERLY (Requests for reimbursement are due 30 days after the end of the quarter) 2. SELECT A PROCESS FOR RECEIVING REIMBURSEMENT PAYMENTS (CHECK ONE BOX) ❑ ELECTRONIC FUNDS TRANSFER (Reimbursements will be deposited into the bank account listed below. A voided check must be attached to ensure proper routing of funds.) BANK ROUTING NUMBER: BANK ACCOUNT NUMBER: AGENCY CONTACT NAME: AGENCY CONTACT TELEPHONE NUMBER: AGENCY AUTHORIZED OFFICIAL NAME AND TITLE: AGENCY AUTHORIZED OFFICIAL SIGNATURE: XCHECK (Reimbursements will be mailed in the form of a check to the address listed below) MAILING ADDRESS: 735 JAMES BROWN BLVD SUITE 2500 CITY, STATE & ZIP: AUGUSTA, GA 30901 ATTENTION: KELLIE K. MCINTYRE AGENCY AUTHORIZED OFFICIAL SIGNATURE: For CJCC Use ONLY CJCC Auditor: Phone Number: Grant Award Number: GBI Entry Initial /Date: (1) Civil Rights Contact Person: JACQUELINE HUMPHRIES (2) Title /Address: DIRECTOR (3) Telephone Number: 706 - 826 -4789 (4) Number of persons employed by the organizational unit (agency) responsible for administering the subgrant: 6 CIVIL RIGHTS CONTACT AUGUSTA/RICHMOND CO HR DEOT 501 GREEN ST SUITE 314 AUGUSTA, GA 30901 Questions regarding the EEOP compliance requirements in connection with funding under this program should be addressed directly to the Office of Civil Rights Compliance, Office of Justice Programs, 633 Indiana Avenue, NW, Washington, D.C. 20531. That Office may be reached at (202) 724 -7861. State and local governments are governed by the Single Audit Act of 1984 and OMB Circular A- 133, as amended, which is effective regarding audits beginning July 1, 1996 and thereafter. The type of audit required under the Circular is dependent upon the amount of total Federal funds expended in the subrecipient's fiscal year. State or local governments and non - profit organizations that expend $500,000 or more a year in Federal funds shall have an audit made in accordance with the Single Audit Act of 1984 and OMB Circular A -133, as amended. This audit report is due in the State Administering Agency =s office not later than nine (9) months after the end of the subrecipient's fiscal year. State or local governments that expend less than $500,000 in federal funds yearly shall be exempt from compliance with the Single Audit Act and other Federal audit requirements. [NOTE: This does not exempt you from the requirement to maintain, produce, and report financial and other records and documentation relative to the expenditure of these grant funds upon request of the State or Federal Agency administering this program.] Please provide the following information: Period of Fiscal Year: 01 -01 -2012 - 12 -31 -12 Date of Last Audit: 12 -31 -2011 Date of Next Audit: 12 -31 -2012 Anticipated Date Next Scheduled Audit Will Be Forwarded to the Council: AUDIT REQUIREMENTS 06-30-13 [NOTE: If the total amount of your agency's federal funds expenditures (including this grant) does not equal or exceed $500, 000 you may write "Not Applicable" in this space. VOCA AUTHORIZED PURPOSE AREAS Agency Name: PsWILi STA��,L� itrtohl0 CO Sub -Grant Number: CI - g -00 1. Authorized Purpose Areas: o Start up a new victim services project Li Continue a VOCA funded victim project funded in a previous year Expand or enhance an existing project funded by VOCA in the previous year 2. These VOCA Funds will primarily be used to (check one): Expand services into a new geographic area ri Offer new types of services Serve additional victim populations ,.k Continue existing services to crime victims Other (Please explain): 3. For the proposed victim services program indicate: ,e The number of paid staff (full -time equivalents) 0 The number of volunteer staff (full -time equivalents) Note: Only Volunteers providing direct services to crime victims should be counted. 4. Identify any and or all of the VOCA Subgrant Award that will be used to meet the priority and underserved requirements (please indicate both dollar amount and percentage of FEDERAL VOCA Funds utilized toward each category): a) Child Abuse $ / b) Domestic Violence $ 3 ( O Q 0 / / D c) Sexual Assault $ / d) Underserved: • DUI/DWI Crashes $ / • Survivors of Homicide Victims $ / • Assault $ / • Adults Molested as Children $ / • Elder Abuse $ / ov • Robbery $ / • Other Violent Crime $ / 5. Type of Implementing Agency (check the appropriate boxes): o Criminal Justice — Government o Law Enforcement ,bt Prosecution o Probation o Court o Corrections o Other (Please explain) Non- Criminal Justice — Government o Social Services o Mental Health o Public Housing o Hospital o Other (Please explain) Ei Non -Profit Non - Governmental o Hospital o Rape Crisis o Religious Organization o Shelter o Mental Health Agency o Other (Please explain) ❑ Other (Please Explain) 6. Please provide the total amount of funding allocated to victim services based on your prior year and current fiscal year budget. Funding Source Prior Year Current Year a) Federal (excluding VOCA) $ $ b) VOCA Funds $ 3 10 OJ® $ J 000 c) State $ 1 $ f d) Local $ `l I 5 ' O0 $ ? SD e) Other (Please explain) $ $ 7. Identify the victims to be served through this VOCA - funded project (VOCA Subgrant plus Match) by checking the type of crime(s): a) ❑ Child Physical Abuse b) ❑ Child Sexual Assault c) DUI /DWI Crashes d)( Domestic Violence e) ❑ Adult Sexual Assault f) ❑ Elder Abuse g) ❑ Adults Molested as Children h) ❑ Survivors of Homicide Victims i) ❑ Robbery j) ❑ Assault k) ❑ Other Violent Crime (Please explain) 1) ❑ Other (Please explain) S. Check the services provided by this VOCA- funded project (VOCA Subgrant plus Match): a) ❑ Crisis Counseling b) x Follow -up Contact c) ❑ Therapy d) ❑ Group Treatment e) ❑ Crisis Hotline Counseling f) ❑ Shelter /Safe House g) Information & Referral (In- Person) h) . Criminal Justice Support /Advocacy i) ❑ Emergency Financial Assistance j) ❑ Emergency Legal Assistance k) In Assistance in Filing Compensation Claims 1) ❑ Personal Advocacy m) Telephone Contacts (Information & Referral) n) ❑ Other (Please explain) U.S. Department of Justice Office of Justice Programs Office of the Comptroller Federal Certification Regarding Debarment, Suspension, ineligibility and Voluntary Exclusion Lower Tier Covered Transactions (Sub - Recipient) This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 28 CFR Part 67, Section 67.510, Participants' responsibilities. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160- 19211). (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE) (1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. .Da_ 0 C d S. Co yen K.0-0 e. r- (Y\ a or Name and Title of Authorized "epresentative :' 1 /lit /z—.. Signature Date G.- - G l , r c p L c n (7 o r t S 5 b D "J Name f Organization g 3 O , 5 20 rt e n ,54- 1 0 5 5/( Address of Organization LEGAL NAME OF AGENCY: C12 -8 -006 AUGUSTA/RICHMOND CO SOLICITOR GENERAL'S PROJECT TITLE: OFFICE ❑ Mr. ® Ms. REBECCA W BALLIEW PROJECT DIRECTOR NAME (Type or Print) PROGRAM COORDINATOR AUGUSTA/RICHMOND CO VWAP PROGRAM Title and Agency 735 JAMES BROWN BLVD SUITE AUGUSTA 30901 2500 Official Agency Mailing Address 706 - 821 -1220 Daytime Telephone Number rballiew@augustaga.gov E -Mail Address ❑ Mr. ® Ms. Mr. ❑ Ms. DAVID S COPENHAVER AUTHORIZED OFFICIAL (Type or Print) MAYOR AUGUSTA/RICHMOND C Title and Agency 530 GREENE ST Official Agency Mailing Address 706 -821 -1833 Daytime Telephone Number mayordeke@augustaga.gov E -Mail Address DESIGNATION OF GRANT OFFICIALS City 706 -821 -1183 Fax Number DONNA WILLIAMS FINANCIAL OFFICER (Type or Print) DIRECTOR AUGUSTA/RICHMOND CO ACCOUNTING OFFICE Title and Agency 530 GREENE ST Official Agency Mailing Address 706 -821 -2334 Daytime Telephone Number Fax Number dwilliams@augustaga.gov E -Mail Address AUGUSTA City OUNTY COMMISSION AUGUSTA City 706 - 821 -1835 Fax Number Zip 30911 Zip 30911 Zip Budget Detail Worksheet This worksheet should be used to prepare the program budget and budget summary. Any category not applicable to your budget may be left blank. A. (1) Personnel/Salaries (see pg. 11). List each position by title and name of employee, if available. In order to calculate the budget, enter the annual salary and the percentage of time to be devoted to the program. Compensation of employees engaged in program activities must be consistent with that for similar work within the applicant agency. Position Title /Name of Employee �V A-Avocalt VVI*Ar ycc.Adtr Calculation Budget SXIoot olio -7Y TOTAL $3 Ul(o. (2) Personnel/Fringe Benefits. Amounts should be based on actual costs or a formula for personnel listed above, utilizing the percentage of time devoted to the program. Fringe benefits on overtime hours are limited to FICA, Worker's Compensation and State Unemployment Compensation. Costs included within this category are: FICA (employer's portion of Social Security and Medicare taxes), employer's portion of retirement, employer's portion of insurance (health, life, dental, etc.), employer's portion of Worker's Compensation and State Unemployment Compensation. Each benefit for each position should be shown as a separate calculation/estimate. Position Title /Name of Employee Benefit Title Calculation Budget TOTAL $ I 4 • To: CJCC From Solicitor General's office Re: Grant C12 -8 -006 AktVI Re . ecca W. Balliew Richmond County Solicitor General's Victim Assistance Program Director Office of the SOLICITOR GENERAL State Court of Richmond County Victims Assistance Program Augusta- Richmond County Judicial Center & John H. Ruffin, Jr. Courthouse 735 James Brown Boulevard, Suite 2500 Augusta, Georgia 30901 Kellie K. McIntyre Phone: (706) 821 -1220 Solicitor General February 21, 2013 In accordance to your request, I do hereby state that Vivian Alexander does in fact receive a salary of $31,o16.28 annually for her services as our Domestic Violence Advocate. Since Fax: (706) 821 -1183