HomeMy WebLinkAboutContract CAG-18-106
Memorandum of Understanding'
An Agreement Between
Solid Ground, King County Retired Et Senior Volunteer Program
Et
Partner Organization: C i fy er
Street Address: i C 5 4,,-�`,� /11-4/
City State, Zip: g42--r1z.-v�4 '�� >7
Contact Person: S c,- 1 `t't
Phone: ( YZ5-) 415e CC' Z Fax: ( ` Z,S) �
Email: Js ft.
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Web Site: rs" 01-0' 1i- i i .5 ei
This Memorandum of Understanding (MOU) is a letter of agreement between
your agency and RSVP which defines the basic provisions that will guide our
working relationship.
AS AN RSVP PARTNER ORGANIZATION, YOU ARE ENTITLED TO:
• Ask RSVP to recruit and refer volunteers with specific skills and experience.
• Expect RSVP volunteers to be punctual, professional and cooperative.
• Discharge an RSVP volunteer from his/her volunteer job if his/her work or
conduct is unsatisfactory. If needed, discussion of individual separations will
occur among RSVP staff, partner organization staff, and the volunteer to
clarify the reasons, resolve conflicts, or take remedial action, including
placement with another partner organization.
RSVP PARTNER ORGANIZATION RESPONSIBILITIES:
• Interview the volunteers referred by RSVP within 10 working days. The
partner organization will make final decisions regarding their placement.
RSVP does not run background checks on volunteers referred to work sites.
• Collect, verify and submit monthly volunteer time reports for the previous
month to the RSVP office no later than the 5th of each month.
• Provide reports of outputs and outcomes related to RSVP volunteer
activities (clients served), due October 5th and April 5th.
Page 1 of 3
• Provide RSVP with information pertaining to volunteer accomplishments and
the impact they have on your agency, clients and community if requested.
• Provide in-kind reports for meals, recognition and other tangible volunteer
support you provided to RSVP members.
• Ensure that volunteers receive adequate supervision and a safe environment
for their volunteer assignment. Reply to an annual email of safety
assurance. Comply with any appropriate WA State and King County health
and safety regulations. Be responsible for determining appropriate
insurance coverage for volunteers in compliance with WA State laws.
• Read and understand the RSVP supplemental volunteer insurance policy
which applies to all of its members. Please note coverage limits. Coverage
details are available at: https://14621-presscdn-0-86-pagety.netdna-sst.com/wp-
content/uploads/2015/12/RSVP-VotlnsuranceBrochure.pdf
• Notify the RSVP office in the event of an accident involving an RSVP
volunteer.
• Provide a job description, supervision, training and recognition for the
volunteers.
• Ensure that volunteers are not engaged in political and religious activities,
labor or anti-labor organizations or related activities.
• Not place volunteers in activities that displace employed workers.
• Not discriminate against RSVP volunteers on the basis on race, color,
national origin (including limited English proficiency), sexual orientation,
age, political affiliation, religion, or on the basis of disability if the
volunteer is a qualified individual with a disability.
• Maintain the programs and activities to which RSVP volunteers are assigned
accessible to persons with disabilities (including mobility, hearing, vision,
mental, and cognitive impairments or addictions and diseases) and/or
limited English language proficiency and provide reasonable accommodation
to allow person with disabilities to participate in programs and activities.
• For in-home placements, provide a "Letter of Agreement" to RSVP
authorizing the volunteer to enter the person's home and perform
designated duties. The Agreement defines arrangements for days and hours
of service and the specific plan for the volunteer's training and supervision.
Supervision includes regularly scheduled reviews and supervisor visits with
the volunteer in-home with the assigned person on a regular basis. The
Agreement must be signed by the person (or person legally responsible for
the person) to be served, the volunteer, the volunteer supervisor and RSVP
of King County staff. RSVP must keep a copy on-file.
Page 2 of 3
RSVP OF KING COUNTY WILL
• Promote the importance of senior volunteering in King County.
• Maintain your current volunteer opportunities on-line and in all of our
listings of current positions.
• Refer interested volunteer applicants for your consideration.
• Inform RSVP volunteers of their responsibilities as a volunteer.
• Update and review your requests for volunteer assistance.
• Annually recognize RSVP volunteers and extraordinary volunteer service.
• Provide supplemental accident, personal liability and auto liability
insurance beyond any other coverage available to the volunteer. RSVP
insurance is secondary coverage and is not primary insurance.
• Provide an orientation to new staff and volunteers at partner organizations
as requested.
• Conduct reviews of volunteer sites and activities as needed or requested.
This MOU will remain in effect for 1 0 3 Er 0 years. It may be amended,
in writing, at any time with concurrence of both parties. It may also be
ended by either party with 30 days notice.
Your agency representative who will serve as liaison with RSVP and who will be
responsible for volunteer orientation, supervision and turning in RSVP hours is:
Name: iCol S(1.--14 Title: r. lT� C4 rk
Phone :( 4/4 ) ) 130 (0 0 7- E-mail: (.1 e f t4 4Liklidall)e-)Z/
*******************************************************************
By signing this MOU, the RSVP Partner Organization Representative verifies
that that your agency is a public or non-profit private organization
(501(c)(3)), or a proprietary health care agency.
Li (:, Cle '4 laZ.Si nat a Et Titl f Partner Or a. zation Re resentative te
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Signature Ft Title of RSVP Program Representative Date
Page 3 of 3
RSVP MONTHLY REPORT OF IN-KIND SERVICE
KING COUNTY RETIRED AND SENIOR VOLUNTEER PROGRAM
Mail or fax this form by the 5th of each month to: RSVP of King County
1501 North 45th St.
Seattle, WA 98103
FAX 206-694-6777
If you have questions please call or e-mail: (206)694-6785, jeng@solid-ground.org
Please fill in Month &Year: Month Year
YOUR ORGANIZATION INFORMATION (please print legibly, sign and date):
Name of your Organization:
Coordinator Name:
Address:
Phone Number:
Fax or E-mail:
Coordinator Signature: Date:
Your signature verifies the information that you provide on this form
MEALS SERVED TO RSVP VOLUNTEERS:
If you provide free meals to RSVP volunteers please fill in this section.
Total value of meals served: $
Total number of meals served:
Value of each meal: $
Number of volunteers served:
Was any portion of this contribution purchased with federal funds? ❑ Yes ❑ No
If yes, how much was purchased with federal funds? $
Please provide the name of the federal agency providing the contribution and the grant or contract number:
OTHER IN-KIND SERVICES PROVIDED BY YOUR AGENCY TO RSVP VOLUNTEERS:
If you provide RSVP volunteers any additional items or services of value,please let us know what it is that you provide and it's monetary
value.This may include coffee,mileage,parking passes,bus fair,van service or other volunteer perks.Please use additional forms if you
provide more than one type of"other In-Kind".
Specify the type of In-Kind Provided(please fill in):
Number of volunteers receiving it:
Total Value: $
Total Value Associated with all In-kind Services : $
Was any portion of this contribution purchased with federal funds? ❑ Yes ❑ No
For internal use only:
Date received Staff signature:
Value recorded: Form revised 5/14/2016