RFCR—Attachment 1
RFCR Document Checklist
Completion Status / GuidelinesAttachment 1
RFCR Document Checklist / Completed: / Please include completed checklist with RFCR submission
Attachment 2
WorkSource Center General Information / Completed:
Organization Chart
(See Section VII.A) / Completed: / Should include all positions you cost allocate against WIA funds
Attachment 3
Collaboration Network / Completed:
Attachment 4
LA Bridges and Family
Development Network (FDN) Contractors
Attachment 5
Performance Offer Sheet
(E-mailed to your organization as separate Excel file) / Accept:
Do not accept: / Indicate if you accept performance standards in Attachment 5. If you do not accept the performance standards offered, please indicate 1) the area(s) of concern, 2) your proposed performance standard(s), and 3) a justification for any changes – 3-pages maximum.
Attachment 6
Funding Allocation
(Separate PDF file)
Letter of Representation
(See section VII.C) / Completed: / Include a letter of representation on Contractor letterhead signed by authorized signatories
Attachment 7
Code of Conduct Contract Language / In effect:
To be submitted prior to contract execution: / If in effect, please attach copy of Board approved Code of Conduct
Attachment 8
Training and Supportive Service Provided by Non-WIA Funds / Completed:
Attachment 9
WorkSource Center Linkage to Educational Institutions / Completed:
Attachment 10
WorkSource Center—Service Plan / Completed:
WorkSource Center policy on LEP
(See Section VIII.C) / Completed: / Response should address how your Center will sustain the provision of services to LEP customers how you will monitor the frequency of contact between your program and customers
Attachment 11
Limited English Proficiency (LEP) Survey / Completed:
Attachment 12
Funding Sources / Completed:
Attachment 13
Resource Sharing Agreements / Executed RSA with:
(List agencies)
Agency:______
Agency:______
Agency:______
Agency:______
Agency:______
Agency:______/ Indicate each agency you have a completed RSA with and check the box to indicate a copy is attached to the RFCR
Corporate Documents
(See Section XI.C) / No Change:
Revised and attached:
City Business License Number
IRS Taxpayer Identification Number
Articles of Incorporation
Corporate Bylaws / If there have been any changes to your City Business License Number, IRS Taxpayer Identification Number, Articles of Incorporation, or Corporate Bylaws submit the revised documents with this RFCR.
Attachment 14
Certification of Authorities / Attached:
No Change: / Please include original Certification of Authorities with wet signatures, if applicable
Attachment 15
Sample: Board Resolution / Attached:
N/A: / Please include Board Resolution, if applicable
Attachment 16
Sample: Certification of Board Resolution / Attached:
N/A: / Please include Certification of Board Resolution, if applicable
Attachment 17
Sample: Board of Directors / Attached:
No Change: / Please include revised list of Board of Directors, if applicable
Attachment 18
Contractor Responsibility Ordinance (CRO)
Submission Guidelines / Completed: / Please attach copy of completed CRO questionnaire
Attachment 19
Living Wage Ordinance (LWO)
Submission Guidelines / Completed: / Please attach completed copy of appropriate LWO forms
Attachment 20
Inventory Guidelines
Attachment 21
WIA Inventory Form
(Separate Excel file) / Completed: / Follow guidelines in Section XIII and Attachment 20 of the RFCR
Attachment 22
Budget Forms
(Separate Excel file) / Completed: / Include budget narrative with completed budget forms
Attachment 23
Map of Service Delivery Areas
(Separate PDF file)
Attachment 24
Business Service Performance Measure
(Separate PDF file)
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RFCR—Attachment 2
PY 2004-05
WorkSource Center General Information
Contractor:WorkSource Center’s days of operation:
WorkSource Center’s hours of operation:
To update our records, please identify your contact people for the following areas:
Coordination of: / Contact Name / Phone / E-mail addressAdministrative issues
Business Service
Contracts
EmployAbility Network
Equal Employment Opportunity
Limited English Proficient
Marketing and outreach efforts
Site visits (for twice monthly visits)
is interested in a WorkSource center contract with the City for PY 04-05.
(Insert Contractor name above)
(Original) Signature of Individual Authorized to Sign Contracts
Typed name of above individual Title
Date
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RFCR—Attachment 3
PY 2004-05
Collaboration Network
Contractor:
Youth Opportunity System
With which YOS contractor will you collaborate?
Are you currently working with this contractor? Yes No
If yes, how are you already collaborating with this contractor?
What percentage of your registrants do you plan to be referred to you by a YOS contractor?
Will you colocate with a YOS contractor? Yes No
Have you executed an Agreement with a YOS contractor? Yes No
If yes, attach a copy of the Agreement to your RFCR.
LA Bridges
With which LA Bridges contractor will you collaborate?
Are you currently working with this contractor? Yes No
If yes, how are you already collaborating with this contractor?
What percentage of your registrants do you plan to be referred to you by an LA Bridges contractor?
Will you colocate with a Bridges contractor? Yes No
Have you executed an Agreement with an LA Bridges contractor? Yes No
If yes, attach a copy of the Agreement to your RFCR.
Family Development Network (FDN)
With which FDN contractor will you collaborate?
Are you currently working with this contractor? Yes No
If yes, how are you already collaborating with this contractor?
What percentage of your registrants do you plan to be referred to you by an FDN contractor?
Will you colocate with an FDN contractor? Yes No
Have you executed an Agreement with a Bridges contractor? Yes No
If yes, attach a copy of the Agreement to your RFCR.
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RFCR—Attachment 4
PY 2004-05
LA Bridges and Family Development Network (FDN) Contractors
LA Bridges Contractors
CONTRACTOR
NAME / CONTACTNAME(S) / ADDRESS,
PHONE, & FAX /
1. Barrio Action Youth & Family Center
L.A. Bridges I (Gang Prevention) / Tammy E. Membreño
Marta Escobar / 4927 Huntington Dr. No., LA 90032
P (323) 221-0779; F (323) 223-8417
2. Hathaway Children & Family Services
L.A. Bridges I (Gang Prevention) / Sylvia Esqueda
Tessa Charnofsky / 840 No. Avenue 66, L.A. 90042
P (323) 257-9600; F (323) 257-8118
3. Hollenbeck Police Business Council
L.A. Bridges I (Gang Prevention) / Daniel Hernandez
Jose “Nati” Correa / 2015 E. 1st Street, L.A. 90033
P (323) 881-6568; F (323) 881-6573
4. Chinatown Service Center
L.A. Bridges I (Gang Prevention) / Lawrence Lue
Gloria Arredondo / 767 No. Hill St., #400, L.A. 90012
P (213) 808-1700 & (323) 224-8280
F (213) 680-0787 & (323) 224-8242
5. Plaza Community Center
L.A. Bridges I (Gang Prevention) / Gloria Ornelas / 4018 City Terrace Dr., L.A. 90063
P (323) 268-1041; F (323) 268-2578
6. All Peoples Christian Center
L.A. Bridges I (Gang Prevention) / Saundra Bryant
Larry Gonzales / 822 E. 20th St., L.A. 90011
P (213) 747-6357; F (213) 747-0541
7. El Centro Del Pueblo
L.A. Bridges I (Gang Prevention) / Elba Salmeron / 1157 Lemoyne St., L.A. 90026
P (213) 386-7332; F (213) 386-7234
8. Woodcraft Rangers
L.A. Bridges I (Gang Prevention) / Cathie Mostovoy
Jerry Garcia / 2111 Park Grove Ave., L.A. 90007
P (213) 749-3031 & (323) 232-2366
F (213) 741-2532 & (323) 232-0263
9. People Coordinated Services
L.A. Bridges I (Gang Prevention) / Donna Watson
Keith Parker / 1221 So. Western Ave., L.A. 90006
P (323) 735-1231; (323) 232-7820 & (323) 234-3137
F (323) 735-7059; (323) 231-0136; & (323 234-3665
10. African American Unity Center
L.A. Bridges I (Gang Prevention) / Linda Collins / 5300 So. Vermont Ave., L.A. 90037
P (323) 789-7326 & (323) 971-7344
F (323) 789-7327
11. The Martin L. King Legacy Assoc.
L.A. Bridges I (Gang Prevention) / Lawrence Foy
Reverend Johnson
Hekima Jaliwa / 4182 So. Western Ave., L.A. 90062
P (323) 290-4116 & (323) 737-6304
F (323) 296-4742; (323) 735-9629; & (323) 733-2120
12. YWCA
L.A. Bridges I (Gang Prevention) / D’Shaun Booker / 3345 Wilshire Blvd., #300, LA 90010
P (213) 365-2991 & (323) 753-4994
F (213) 365-9887 & (323) 753-5191
13. T.H.E. Clinic
L.A. Bridges I (Gang Prevention) / Torre Reese / 3860 W. M.L.King Blvd., L.A. 90008
P (323) 295-6571 x3020
F (323) 295-6577
14 Community Build, Inc.
L.A. Bridges I (Gang Prevention) / Beatrice Lee
Maria De Jesus Gomez / 4305 Degnan, Ste. #105, L.A. 90008
P (323) 789-4736 & (323) 789-996
F (323) 759-2412
15. Toberman Settlement House
L.A. Bridges I (Gang Prevention)
L.A. Bridges II (Gang Intervention) / Howard Uller / 131 No. Grand Ave., San Pedro 90731
P (310) 832-1145 & (310) 833-5105
F (310) 832-7861
16. Los Angeles Conservation Corps
L.A. Bridges I (Gang Prevention) / Kevin Lasley
Bruce Saito / 234 E. 112th St., L.A., 90061
P (323) 779-8279 & (213) 233-1483
F (323) 779-8279 & (323) 418-0778
17. WLCAC
L.A. Bridges I (Gang Prevention) / Ralph Flores / 10950 So. Central Ave., L.A. 90059
P (323) 357-6274; F (323) 357-6275
18. Children’s Hospital of L.A.
L.A. Bridges I (Gang Prevention) / Saul Gonzalez
Susan Rabinovitz / 4650 Sunset Blvd., L.A. 90027
P (213) 639-7567; F (323) 962-4619
19. Children’s Institute International
L.A. Bridges I (Gang Prevention) / Lillian Payan / 711 So. New Hampshire, L.A. 90005
P (213) 381-1146 & (213) 385-5100
F (213) 381-8585 X105
20. Venice Community Housing Corp.
L.A. Bridges I (Gang Prevention) / Susan Nakaoka x115
Kelley Richards x102 / 720 Rose Ave., Venice 90291
P (310) 399-4100; F (310) 399-1130
21. Asian Amer. Drug Abuse Program
L.A. Bridges I (Gang Prevention) / Jose Esqueda
Sergio Gueller / 5318 So. Crenshaw Blvd., LA 90043
P (323) 766-5541; F (323) 766-5546
22. Child & Family Guidance Clinic
L.A. Bridges I (Gang Prevention) / Christine Kwok
Lorena Garcia / 9650 Zelzah Ave., Northridge 91135
P (818) 830-3270 & (818) 772-1425
F (818) 830-8550 & (818) 772-1484
23. New Directions For Youth
L.A. Bridges I (Gang Prevention) / Luann Rollens / 7400 Van Nuys Blvd., #203, Van Nuys 91405
P (818) 375-1000; F (818) 787-4389
24. Communities in Schools
L.A. Bridges I (Gang Prevention)
L.A. Bridges II (Gang Intervention) / Blinky Rodriguez
Bobbie Arias / 8743 Burnett Ave., North Hills 91343
P (818) 891-9399; F (818) 891-2510
25. El Centro de Amistad
L.A. Bridges I (Gang Prevention) / Michael Lerma / 566 So. Brand Blvd., San Fernando 91340
P (818) 898-0223 & (818) 837-9001
F (818) 361-5384 & (818) 782-0827
26. Public Health Foundation
L.A. Bridges I (Gang Prevention)
L.A. Bridges II (Gang Intervention) / Enrique Hurtado / 3516 N. Broadway Street #70 Los Angeles, CA. 90031
P (323) 842-8970
F (323) 526-3032
Family Development Contractors
CONTRACTOR
NAME / CONTACTNAME(S) / ADDRESS,
PHONE, & FAX /
1. 1736 Family Crisis Center / Carol A. Adelkoff,
Executive Director / 2116 Arlington Avenue, Suite 200
Los Angeles, Ca 90018
P (323) 737-3900; F (323) 737-3993
2. Career Planning Center Inc. / Eleanor Hoskins,
Chief Executive Director / 1623 S. La Cienega Blvd.
Los Angeles, Ca 90035
P (310) 273-6633 ; F (310) 273-2363
3. Children’s Bureau of Southern California / Alex Morales,
Executive Director / 3910 Oakwood Avenue
Los Angeles, Ca 90004
P (323) 953-7356; F (323) 661-7306
4. El Centro de Ayuda / Raul Estrada
Executive Director / 2130 E. First Street, Suite 205
Los Angeles, Ca 90033
P (323) 265-9228; F (323) 265-7166
5. El Centro Del Pueblo / Sandra Figueroa-Villa
Executive Director / 1157 Lemoyne Street
Los Angeles, Ca 90026
P (213) 483-6335; F (213) 483-9876
6. Los Angeles Community College District / LA Mission College / Angelica Toledo / 436 N Maclay Ave
San Fernando, Ca 91340
P (818) 837-2236 ext. 222 ;
F (818) 365-5751
7. Neighborhood Legal Services of Los Angeles County / Neal S. Dudovitz
Executive Director / 13327 Van Nuys Blvd
Pacoima, Ca 91331
P (818) 896-5211; F (818) 834-7540
8. New Economics for Women / Maggie Cervantes
Executive Director / 303 S. Loma Drive
Los Angeles, Ca 90017
P (213) 483-2060; F (213) 483-7848
9. The Children’s Collective Inc. / Jackie Kimbrough
Director
Francine Bailard
Project Coordinator / 3817 S. San Pedro Street
Los Angeles, Ca 90011
P (323) 231-1367; F (323) 231-6242
3655 S. Grand Ave, 2nd floor
Los Angeles, Ca 90007
P (213) 747-4046; F (213) 747-4604
10. Toberman Settlement House Inc. / Howard Uller
Executive Director / 131 N. Grand Avenue
San Pedro, Ca 90731
P (310) 832-1145; F (310) 832-7861
11. Watts Labor Community Action Committee / Timothy Watkins
President, CEO / 10950 S. Central Avenue
Los Angeles, Ca 90059
P (323) 563-5600; F (323) 563-7307
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RFCR—Attachment 7
PY 2004-05
Code of Conduct Contract Language
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REQUIREMENT FOR ADOPTING A CODE OF CONDUCT
WorkSource Center contracts require contractors to adhere to a Code of Conduct subject to City approval. Contractors submitting an RFCR must therefore adopt by duly authorized motion of their Board of Directors a Code of Conduct:
1. The Code of Conduct set forth below; or
2. Contractor’s own Code of Conduct subject to City approval
Contractors shall submit a copy of the Resolution of their Board of Directors adopting either the City’s Code of Conduct as their Code of Conduct, or such other Code of Conduct which contains all requirements, to the City for approval.
LANGUAGE FOR USE IN BOARD RESOLUTION:
REQUIREMENT TO NOTIFY CONTRACTOR’S EMPLOYEES
WIA Contractors shall notify all employees of the Code of Conduct adopted by the Board of Directors and approved by the City. Contractors shall include in each employee’s personnel file proof that each employee has received a copy of the Code of Conduct and has agreed to comply with its requirements. Employee personnel files shall be made available for review at the City’s request.
CODE OF CONDUCT
A. The following Code of Conduct will remain in effect unless amended through a future board resolution.
B. Contractor covenants that none of its directors, officers, employees, or agents shall participate in selecting, or administering any subcontract supported (in whole or in part) by Federal funds where such person is a director, officer, employee or agent of the subcontractor; or where such person knows or should have known that: