City of New Haven Community Services Administration Youth Services Department 165 Church Street New Haven, CT 06510 Office: 203-946-7665 OR 203-946-8593 www.cityofnewhaven.com

SUMMER BUSING APPLICATION 2015

APPLICATION DUE DATE: FRIDAY, FEBRUARY 27, 2015 4:00 P.M. ATTN: EARLE LOBO [email protected] NO FAXES WILL BE ACCEPTED COMPLETE ALL INFORMATION REQUESTED ORGANIZATION NAME:

SITE ADDRESS: (Include city, state and zip) @

EMAIL ADDRESS:

.com

MAILING ADDRESS: (If different from above)

OFFICE TELEPHONE:

/ (DAY)

(FAX)

EXECUTIVE DIRECTOR: CONTACT PERSON AND CELL PHONE #: (Trip supervisor and/or person(s) responsible for scheduling trips) FOR OFFICE USE ONLY

APPLICATION #: ________ Completed Application Award Amount:

Yes YSB

No

$_____________

Date Reviewed: ______________ CNH

$_____________

COVER SHEET (MUST BE ATTACHED TO FRONT OF APPLICATION) 1

ANSWERS SHOULD BE TYPED ON AGENCY LETTERHEAD & SIGNED BY AN AGENCY OFFICIAL

PROGRAM OPERATIONS 1.

Briefly summarize your program.

Include beginning and ending dates, days of

operations, hours of operation, location of program, and outline the major components of the program. What is the purpose of the program and main goal? BE SPECIFIC. Include number of youth to be served; age group; geographic area to be served and client profile.

2.

Your organization should designate one staff person to be in charge of all reporting and logistics for summer busing. This person should also be the main contact person for the Board of Education Transportation Department. Who will that staff member be? This person should also be listed on the first page of this application as the CONTACT PERSON.

3.

Explain your agency’s procedure for supervising children on field trips. At what point(s) and how often will head counts be taken? What is the ratio of counselors/chaperones to children on field trips?

4.

Attached to this application are the Special Conditions for the Summer Busing Transportation Program. (Please sign your name to the Special Conditions (page 5) to confirm you have read and fully understood these rules and regulations and attach to application, making sure to keep a copy for yourself)

PLEASE ATTACH A COPY OF THE AGENCY’S ENROLLMENT APPLICATION AND FIELD TRIP PERMISSION FORM TO THE APPLICATION.

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ANSWERS SHOULD BE TYPED ON AGENCY LETTERHEAD & SIGNED BY AN AGENCY OFFICIAL

FINANCES 1.

What is the “per week” and/or “per session” fee for your program/camp? If there are separate registration or activities fees (i.e. field trips), please describe them in detail, including any sliding scale or scholarship provisions.

2.

Have you applied for or does your Grant include a line item for Transportation/Busing or any other funds such as: CDBG, DSS, Police Department, Community Foundation, United Way, or other?

3.

Please indicate all preliminary trips planned for the summer, including: destination and number of buses needed. (bus capacity 55)

NOTE: ALL QUESTIONS SHOULD BE ANSWERED FULLY. APPLICATIONS THAT ARE INCOMPLETE WILL NOT BE ACCEPTED OR PROCESSED. ANY FALSE INFORMATION SUBMITTED ON THIS APPLICATION WILL CAUSE YOUR APPLICATION TO BE NULL AND VOID. SPECIAL CONDITIONS FOR SUMMER BUSING PROGRAMS A)

The Contractor agrees to the following Summer Busing Program terms and conditions and funding restrictions, as enforced by the Department and the Connecticut Department of Environmental Protection (“DEP”), Office of Parks and Recreation:

i.

The Contractor agrees that Program funding, as provided under this contract, is exclusive to the provision of transportation services to State Parks or Recreation Areas, for youth enrolled or participating in ‘summer recreation’ programs as the program identified in this Part III Section 1(B)(a) of this contract.

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ANSWERS SHOULD BE TYPED ON AGENCY LETTERHEAD & SIGNED BY AN AGENCY OFFICIAL ii.

The Contractor will require and certifies that the ‘sponsoring organization’ provide ‘written reservations’ to be completed on DEP Bus Permit Application forms. Such ‘written reservations’ must be received by the DEP-Office of Parks and Recreation at least fourteen (14) days prior to the scheduled trip or visit date.

a.

If a scheduled trip-date is changed, a new DEP Bus Permit Application must be processed and will require the same fourteen (14) day notice or receipt to DEP-Office of Parks and Recreation. Under no circumstances will last minute changes to scheduled trips be accepted by DEP. This will insure that the State Parks have adequate notice of all bus arrivals.

iii.

The Contractor will require and certifies that the ‘sponsoring organization assign a ‘group leader’ for each trip or visit to the State Park or Recreation Area. The ‘group leader’ will serve as the designated contact person for the group and must be present during the entire trip or visit as well as maintain a ‘roster’ of the clients in attendance.

a.

The ‘group leader’ will require and certify that the State Park or Recreation Area’s Manager or Patrolman is contacted upon arrival to the site as to provide the ‘group leader’ with any special information, directions, or other necessary assistance.

iv.

The Contractor will require and certifies that the ‘sponsoring organization’ assigns at least one ‘adult counselor’, eighteen (18) years of age or older, for every group of ten (10) clients in the Program. The ‘adult counselor(s)’ must accompany each group of ten (10) clients under the age of eighteen (18) years. The ‘adult counselor(s)’ shall remain with their assigned group of clients during the entire trip or visit.

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ANSWERS SHOULD BE TYPED ON AGENCY LETTERHEAD & SIGNED BY AN AGENCY OFFICIAL v.

The Contractor will require and certifies that at least one (1) of the ‘adult counselor(s)’ in attendance for each trip or visit, is trained or certified in Cardio-Pulmonary Resuscitation (“CPR”), and/or First-Aid. The ‘adult counselor’ will have in their possession an ‘emergency kit’ (as provided by the ‘sponsoring organization’ or the Contractor) for each trip or visit to facilitate such circumstances.

vi.

The Contractor will require and certifies that the ‘sponsoring organization’ staff person(s) leading or instructing “learn-to-swim” classes or other waterfront activities will be suitable trained and certified in “life-saving” techniques.

vii.

The Contractor will require and certifies that all of the transportation vehicles and drivers assigned for each trip or visit shall remain at the State Park or Recreation area and not leave the site during the entire time period or duration of such trip or visit.

B)

The Contractor agrees to the Program reporting requirements as set forth in Part III Section 8 and Section 9 of this contract. Failure to submit such reports in a timely manner will result in disallowing expenditures or payments to the Contractor and may jeopardize future Program funding to the Contractor, at the discretion of the Department.

C)

No fees will be imposed on clients for the provision of Program services.

D)

The Contractor agrees that the Program services funded under this contract are limited to rental or operating costs for the buses or vehicles used to transport clients to and from state Parks and Recreation areas, during the contract period. Such operating costs include actual bus or vehicle rentals and insurance costs, driver or operator fees, and related gas and toll charges.

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ANSWERS SHOULD BE TYPED ON AGENCY LETTERHEAD & SIGNED BY AN AGENCY OFFICIAL

You must read this section very carefully, as the State will monitor any agency/program or organization that uses the services of the City Summer Busing Program. (Please sign your name to these Special Conditions to confirm you have read and fully understood these rules and regulations and attach to application, making sure to keep a copy for yourselves.) _______________________________ Executive Director

_____________________ Date

_______________________________ Contact Person and/or Program Director

_____________________ Date

*Include with your completed application a current copy of the organization’s transportation insurance issued by the City of New Haven. Contact us with any questions.

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