Proposal for RFP #8517-0-2016-MO

Community Development Division

2016 City of Madison Youth Employment Expansion

Application Form

Submit application to

Deadline: 12:00 pm (noon) on Tuesday,March29, 2016

PROPOSALS RECEIVED AFTER 12:00 NOON WILL NOT BE ACCEPTED.

Please limit your proposal and responses to the form provided. Any materials submitted in addition to this application form will not be considered in the evaluation of the proposal. Do not attempt to unlock or alter this form.

Applicant Organization:
Contact Person:
Address:
E-Mail:
Website: / Telephone:
Federal EIN
Legal Status: / Corporation Limited Liability Company General Partnership
Sole Proprietor Unincorporated Association Other:.
501 (c) 3

1.Experience and Qualifications:

a.Please describe in detail your organization’s experience and abilities in successfully providing paid employment or internship opportunities with youth facing barriers to employment due to economic and racial inequity, and youth involved in the juvenile justice system or restorative justice programs. Include how providing these services to this population relates to your organization’s mission or goals.

b.Please describe thestaff with direct responsibilities with this program including required qualifications, experience and training:

c.Please describe your past or current program partners and their experience providing paid employment or internship opportunities, and/or supplemental educational or group building activities with youth facing barriers to employment.

d.Please describe your organizations relationship with employers (if applicable):

2. Program Plan

Please describeeach of the following program components in detail. For each component include a summary of the role of partner organizations, how it is culturally relevant, and how it utilizes a positive youth development strategy.

a. The target population and outreach plan:

b. The pre-employment/internship training forprogram participants:

c. How youth skills and interests will be assessed and utilized in matching youth to a specific employment or internship opportunity:

d.What model(s) of youth employment or internship opportunities will be used (please relate to the continuum included in the RFP guidelines). Include examples of the types of duties or tasks entailed in the jobs or internships:

e. How the youth will be supported throughout the duration of the program:

f. How your organization will prepare and support the supervisors (if applicable):

g. The supplemental educational activities that build on the internship experience and provide other life skills that support positive youth development:

h.How academic requirements and future career or educational planning relate to your program plan, specifically discuss your programs relationship with the Madison Metropolitan School Districtor other key stakeholders. Also include information on opportunities to earn a credential or certificate:

3.Collaboration

If this proposal is submitted in collaboration with a proposal from anotheryouth employment organization, please provide a description of the collaboration (shared intake, joint training etc.).

4.Timeline

Please indicate if your program will occur during the: 1) 2016 summer, 2) 2016-2017 school year, or 3) summer 2016 through the 2016-2017 school-year. Provide a detailed timeline of key activities.

5.Evaluation

How will your organization evaluate the success of the 2016 City of Madison Youth Employment Expansion program(s)? Please include specific service and outcome goals. If your organization has held a youth employment contract with the City of Madison for this program in the past, please include specific measurements and results.

6. Disclosures

A. Disclosure of Conflict of Interest. Disclose any potential conflict of interest due to any other clients, contracts, or property interests, e.g. direct connections to other funders or City funded or potentially funded organizations, or with the City of Madison.

B.Disclosure of Contract Failures, Litigations. Disclose any alleged significant prior or ongoing contract failures, contract breaches, any civil or criminal litigation or investigation pending within the last three (3) yearswhich involves your firm. List any contracts in which your firm and any subcontractor has been found guilty or liable, or which may affect the performance of service to be rendered.

7.Budget: Summarize the budget for this project budget by estimated costs.

BUDGET EXPENDITURES / TOTAL PROJECT COSTS / AMOUNT OF CITY $ REQUESTED / AMOUNT OF NON-CITY REVENUE / SOURCE OF NON CITY FUNDED PORTION
A.Personnel Costs– Applicant staff (Complete Personnel chart below)
1.Salaries/Wages (show detail below)
2.Fringe Benefits and Payroll Taxes
B.Program Costs
1.Program supplies and equipment
2.Office Supplies
3.Transportation
4. Youth wages/stipends or scholarships
(provide detail below)
5.Other (explain *)
C. Space Costs
5.Rent/Utilities/Telephone
6.Other (explain):
D.TOTAL (A + B + C)

Explanation of:

Youth wages, stipends or scholarships -

“Other” expenses -

8. Personnel Chart:

Identify and describe the role of key staff positions who will be directly responsible for the various aspects of the contract, if awarded. For each position, indicate if duties associated with this program will be provided by a current staff position (no additional FTE), a new position, or expanded hours for a current staff position (additional FTE)

Title of Staff Position / Current Position, Expanded Hours or New Position / FTE Expected Allocated to this Program / Proposed Hourly Wage* / Role With This Project
$
$
$
$
$
TOTAL

*Note: All employees involved in programs receiving City of Madison funds must be paid the established Living Wage as required under City of Madison Ordinance 4.20. Effective January 1, 2016 – December 31, 2016, the Living Wage is$12.83per hour.

-SIGNATURE PAGE-

1. Affirmative Action:

If funded, applicant hereby agrees to comply with City of Madison Ordinance 39.02 and file either an exemption or an Affirmative Action Plan with the Department of Civil Rights. A model Affirmative Action Plan and instructions are available at

2. Living Wage Ordinance:

All employees involved in programs supported by City of Madison funds must be paid the established Living Wage as required under City of Madison Ordinance 4.20 Effective January 1, 2016 through December 31, 2016, the Living Wage will be $12.83 per hour. For more information on Living Wage requirements, go to

3. City of Madison Contracts:

If funded, applicant agrees to comply with all applicable local, State and Federal provisions. A sample contract that includes standard provisions is attached to the RFP Guidelines document. If funded, the City of Madison reserves the right to negotiate the final terms of a contract with the selected agency.

4. Acknowledgement

By entering signature below the applicant acknowledges receipt of City of Madison Community Development Division # 8517-0-2016-MO RFP Guidelines and Requirements document.

5. Signature:- Any applications submitted without a signature will be considered incomplete and will not be considered.

Enter Name:
By entering your initials in the box, / You are electronically signing your name and agreeing to the terms above.
Date:
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