Appendix B.1 - Sample Memorandum of Understanding

Appendix B.1 - Sample Memorandum of Understanding

Appendix B.1 – Sample Memorandum of Understanding

Memorandumof Understanding

ABCCountyRSVP

This MemorandumofUnderstanding(this“MOU”)contains basic provisions,whichwill guidethe workingrelationship between both parties.Itisentered into byand betweenABCCountyRSVP, sponsored byABCSPONSORAGENCYandthefollowing agencyand/orentity(the“Station”):

StationName:EIN:

StationSiteAddress: ______City:______State:______Zip:______(Station MailingAddress):______City:______State:______Zip:______

TheABC CountyandtheStationmaybereferredtoherein asthe“Parties.”

This MOU iseffective fromthrough. This MOUmay be amended inwritingatanytimewiththeconcurrenceof both parties andmustberenegotiated atleast everythree(3) years.

BasicProvisions

TheABCCounty’sResponsibilities

1.Recruit,enroll,and interviewRSVPvolunteers.

2.ReferRSVPvolunteers totheStation

3.Reviewacceptabilityofvolunteer assignments.

4.InstructRSVPvolunteers inproper useofvolunteer timesheets,reimbursementguidance, andtheRSVP procedures.

5.ProvidetheRSVPorientationtotheStationstaff priortoplacementof volunteers and atothertimesas needed.

6.Initiatepublicity regardingRSVP.

7.Furnish accident, personal liability, andexcess automobile insurancecoverageforenrolledvolunteers required by theRSVPpolicies. Theinsuranceprovidedbythesponsor issecondarycoverageand is notprimaryinsurance.

8.Periodically monitorvolunteer activities attheStationtoassessand/or discuss needs of volunteers andtheStation.

9.Staff an AdvisoryCouncil toRSVP. Alongwiththeadvisorycouncil,arrangefor appeals procedureto address problems arising betweenthevolunteer, theStationand/or RSVP.

10.ArrangeforappropriateRSVPrecognition.

11.Coordinatewithother volunteer and aging programs inthearea tofoster effectivecommunication andavoid duplication.

12.ReimburseRSVPvolunteers fortransportationcosts between their homeandvolunteer stationin accordancewith

RSVPpoliciesand availabilityof funds (ifapplicable).

13.ArrangewiththeStationfor meals and/or snacks,wheneverpossible, for volunteerson assignment.

14.Providephotoidentification forvolunteersif notprovided bythestation.

The Station’sResponsibilities

1.Interviewandmakefinal decisionsonassignmentsofRSVPvolunteers.

2.Perform, if required for a particular assignment,backgroundorother screenings.

3.Implementorientation, in-serviceinstruction,and/orspecial trainingofvolunteers.

4.Furnishvolunteerswithmaterials required forassignment.Thesematerialsmayincludestation uniformandphoto

I.D.

5.Providesupervisionofvolunteerson assignments. (Supervisor nameandcontactinformationon nextpage.)

6.Provide volunteerassignmentdescriptions foreachvolunteeropportunity attheStation.

7.Providefor adequatesafety of volunteers andsubmitan annual assuranceuponrequesttoABC CountyRSVP.

8.Investigateand reportany accidents and injuries involvingRSVP volunteers immediatelyto ABC County.All reports shall besubmitted inwriting.

9.Specify,either bywritten informationorverbally, thatRSVPvolunteers areparticipants intheStation’s programming in publicityfeaturingsuchvolunteers.DisplayanRSVP placardwhereitmaybeviewedbythepublic.

10.Reports:TheStationRepresentativeshall:

•Timesheets:Report volunteer hoursonamonthlybasis onor before 10thof thefollowingmonth(Insurance coverageisonlyeffectivewithverifiedrecordsof hours served.)

•Progress Reports:Stationsarerequestedtocompletea shortbi-annual surveyprovidedbyRSVPdocumenting theimpactsof servicesprovided byvolunteers.

•In-KindDocumentation:Providedocumentationofin-kindcontribution(s)(meals, uniforms,mileage reimbursement, trainingexpenses) andverificationto helpRSVPmeetits localmatchof 30%.

OtherProvisions

1.Separation fromVolunteerService:TheStationmayrequesttheremovalofanRSVPvolunteer atanytime.AnRSVP volunteermaywithdrawfromserviceattheStationor fromtheRSVPatanytime. TheRSVPstaff,theStationstaff,and volunteers areencouragedtocommunicate toresolveconcernsorconflicts,ortakeremedial action, including, butnot limitedto, placementwithanotherstation.

2.LettersofAgreement:For in-home assignments, the Volunteer Station will obtain a Letter of Agreement signed by the person or persons legally responsible for the child served, the Volunteer Station liaison, and the RSVP liaison authorizing the assignment of an RSVP volunteer in the child’s home, defining the volunteer’s activities, and specifying supervisory arrangements. When in-home assignments of volunteers are made, a letter of agreement will be signed by the parties involved. The document will authorize volunteer service in the home and identify specific volunteer activities, periods, and conditions of service. A blank copy of the letter of agreement shall be accessible at the RSVP Office.

3.Religious/PoliticalActivities:TheStationwill notrequestor assignRSVPvolunteers toconductorengageinreligious, sectarian,or politicalactivities.

4.Displacement of Employees:TheStationwill notassignRSVP volunteersto any assignmentwhichwould displace employedworkersor impair existingcontracts forservices.

5.Compensation: Neitherthestationnor RSVPwillrequestor receivecompensation fromthebeneficiaries of RSVP volunteers.RSVPvolunteers will notreceivea feeforservicefrombeneficiaries.

6.AccessibilityandReasonableAccommodation:TheStationwillmaintaintheprograms andactivitiestowhichRSVP volunteers areassigned accessibleto persons with disabilities (includingmobility,hearing, vision,mental, andcognitive impairmentsor addictionsand diseases)and/or limitedEnglish languageproficiencyand providereasonable accommodationto allowpersonswith disabilities toparticipateinprograms andactivities.

7.Prohibitionof Discrimination: TheStationwillnotdiscriminateagainstRSVPvolunteersor intheoperationof RSVPon the basis of race; color; national origin; gender; sexual orientation; religion; age; disability; political affiliation; marital or parental status; or military service.

8.Terminationof MOU:ThisMOUmaybeterminatedatanytimebyeitherpartybysendingwrittennoticeof terminationoftheMOUtotheotherparty.ThisMOUshall bereviewedatleasteverythree(3)years bythe Parties.

9.Signatures.BysigningthisMOU,theStation,through its authorized representative,self-certifiesthatitmeets the requirements necessaryto becomea RSVPStation.

10.If mealsareprovided bytheStationtoRSVP volunteers,pleasecompletethisportion:

( ) Contributedmeals areFEDERALLYFUNDED under:

TitleIIIoftheOlder Americans ActOther(federal) fundingsource ( )Contributedmealsarenot provided byFEDERALFUNDS.

Mealswill beprovidedtoRSVPvolunteers ata freeorreduced priceof$______when______hoursof servicehavebeenor willbevolunteered duringthatday. Thevalue ofthe mealprovided is$______each. (RSVPwill utilizethis informationtomeetits local in-kindmatch.)

ForAllStations

VolunteerSupervisor[StationStaff]

Name: / Title:
Phone: / Email:

VolunteerStationPrimaryType:Toqualifyas aRSVP Station, anagency/office/departmentmustself-certifythatit isoneof thefollowing:

Public Non-ProfitPrivateNon-ProfitProprietaryHealth CareAgencyGovernmentalAgency

AuthorizedSignatures

AuthorizedStationRepresentativeDate

RSVP Project Director[orothersponsordesignatedrepresentative]Date

PLEASE RETURNTHISCOMPLETED FORMTO:ABCRSVP,POBox123, OurTown,XX81234

Pleaseinclude avolunteer assignmentdescription foreach volunteeropportunityattheStation.Thank you!

Version 2018.1Pg. 1 of 4

This document is provided as a sample ONLY. Its use is optional and, if used, it should be customized as appropriate.For all appendices, including editable versions of samples and templates, visit .