Revised 09/18/2015
CONTRACT AND SERVICE AGREEMENT BETWEEN
Provider: ___________________________________
Name of Contact: ____________________________
TIN: __________________________ UBI: _________________________
District: Kennewick School District
Contact: Annabell Gonzalez
RE: Provision of supplemental services for Name of Student, student of the district. See
attached list.
This Agreement is made as of September 2015 between Name of Provider, hereafter
referred to as “Provider” with offices located at:
Address:
Phone number:
And Kennewick School District, hereafter referred to as “District” located at 1000 W. 4th
Ave. Kennewick, WA, Benton county 99336.
Recitals
A. Provider has developed, in collaboration with the Kennewick School District, certain
unique educational subject matter, systems, designs, organization models, curricula,
materials, guidelines, tests, and/or programs.
B. Provider has applied to and been approved by the Office of Superintendent of Public
Instruction (OSPI) and is authorized to use above referenced subject matter to provide
instruction and/or services to students to supplement instruction provided in the district.
C. District wishes to engage Provider to provide said instruction and services to students
listed above whose parents have requested such supplemental educational services.
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Agreement
NOW, THEREFORE, in consideration of the premises, the covenants, and agreements set
out below, Provider and District agree as follows:
1. ENGAGEMENT. District hereby engages and retains Provider, who agrees to serve as
consultant and service provider in connection with instructional design and delivery of
supplemental instruction for the student(s) listed above.
2. TERM. The term of the Agreement shall be from the date of execution of the Agreement
until the objectives set forth in the individual student plan(s) have been achieved or the
amount available for such services is expended. In no case shall the term of tutoring go past
or exceed February 29, 2016, for the amount up to: $1198.00
3. PROVIDER OBLIGATIONS will include:
A. For each student to whom Provider gives services under this Agreement, Provider
must have an official, District-issued, signed and dated registration form on file at
the district office prior to services beginning. All registration forms must include a
release for directory and academic information for each student. Provider shall, on
at least a monthly basis and no fewer than four, send District and the student’s
parent a written report describing the student’s progress, including benchmark data.
SEE SCOPE OF SERVICES ADDENDUM. If requested by District or parent,
Provider shall give these reports in the language choice of the parent. Determine
with the assistance of Park Middle School, Amistad, Eastgate, Edison,
Hawthorne and Westgate Elementary in specific areas of instruction and
organization of instruction and materials.
B. All providers will be trained free of charge, in the use of EZSES software and will
use this software to develop student learning plans, invoice, create student lists,
create and submit progress reports, report pre and post test results and all other
activities that the Kennewick School Districts requires in the EZSES software
program.
C. All student records shall be kept in a secure location preventing access by
unauthorized individuals. Provider will maintain an access log delineating date,
time, agency and identity of any individual accessing student records that is not in
the direct employ of the Provider. Provider shall not forward to any person other
than the parent or District any student records, including, but not limited to, the
student’s identity, without the written consent of the parent and District. Upon
termination of this agreement, at the district’s request, provider shall turn over to
District all student records of District’s eligible students to whom Provider has
provided services under this agreement. Provider must comply with the provisions of
the Family Educational Rights and Privacy Act (“FERPA”) (20 USC 123g: 34 CFR
Part 99) as it applies to Student Personally Identifiable Information (“education
data”) provided to Provider in accordance with this agreement. Those provisions
include, but are not limited to: Provider may use the education data provided only
for the purposes intended by this contract, unless otherwise authorized by law;
where conducting work on behalf of the Kennewick School District, Provider must
conduct its work in a manner that does not permit dissemination of personally
identifiable information of parents or students by individuals other than
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D.
E.
F.
G.
H.
representatives of Provider who have a legitimate educational interest in viewing or
manipulating said educational data. Provider must destroy in a secure manner or
return any education data containing personally identifiable information to the
Kennewick School District when no longer needed for the purposes intended in this
agreement. Provider shall ensure that each of its employees responsible for carrying
out the terms of this contract is aware of the confidentiality requirements of federal
law. The Provider is responsible for the actions of the employees and must take all
precautions necessary to ensure that no dissemination of any personally identifiable
information of students or parents occurs. Any decision on whether to destroy said
educational data or return it to Kennewick School District shall be at the sole
discretion of Kennewick School District. Provider shall not re-disclose personally
identifiable information to any person or entity unless authorized by law or this
agreement. Provider is notified that if the U.S. Department of Education finds that
Provider has violated applicable provisions of FERPA, the Kennewick School
District may not allow access to education data for at least five years.
Provider must comply with SES Guidance pertaining to Supplemental
Educational Services and 2015-2016 Supplemental Educational Provisions
and Assurances provided by the Office of Superintendent of Public Instruction’s
(OSPI).
Provider shall allow access to its facilities for periodic monitoring of each student’s
instructional program by District and shall be invited to participate in any review of
each student’s progress by District. District representatives shall have access to
observe each student at work, observe the instructional setting, interview Provider,
and review each student’s progress. Before or with the submission of the first
invoice, Provider will submit to the District via EZSES, a schedule that lists the
days, times, location and address for all tutoring sessions. The district will be
notified immediately if time, day, or location changes. Failure to do so may result in
revocation of contract.
Provider shall complete and submit, to the district, an acceptable Student Learning
Plan via EZSES for each student which includes student name, ID#, school, address,
provider local contact information, location of services to be provided, the specific
start and end date for the services, the days of the week and times of the tutoring
sessions, the maximum number of hours of tutoring the student will receive, specific,
measurable goals for the student that reference the Washington Common Core State
Standards. The standards are listed in the EZSES software. Each learning plan
will include the name of the pre/post-test, the pre-test score, and the goal score for
the post-test. No payment will be made for students without an approved learning
plan. OSPI, and not the district, approve providers and determines annually if a
provider has demonstrated adequate student academic progress. SEE SCOPE OF
SERVICES ADDENDUM.
Providers must not sign up students without earlier notification from the district.
Only the district can determine the eligibility of students for SES and communicate
with parents about the eligibility for SES services. Providers may not render
services until the district confirms the eligibility of students for SES services. The
enrollment window is from October 2nd -16th, 2015. Any enrollment applications
prior to this window will not be considered, and only official KSD registration forms
may be used.
Providers will ensure that programs align with the state’s academic standards and,
in the case of a student with disabilities, are consistent with the student’s
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I.
J.
K.
L.
M.
individualized education program (IEP) under the Individuals with Disabilities
Education Act. Providers will ensure that programs build on the academic
program a student experiences in the regular school day and are aligned with the
district’s curriculum. Providers will use high quality, research-based instructional
practices designed specifically to increase students’ academic achievement or
language proficiency. Applicant/providers must provide remediation/instruction that
addresses the individual skill gaps revealed during the assessment process and base
remediation/instruction on an individual learning plan.
For students with disabilities, provider will complete and submit, via EZSES, to the
district, a timetable for improving achievement consistent with the student’s
individualized education program (IEP) under section 614 (d) of the Individuals
with Disabilities Education Act.
All students on a provider’s approved list will have an acceptable learning plan
submitted to the district within 30 days of the contract start date, or the students
can be assigned to a different provider. Services will begin within 45 days of the
contract start date or the student can be assigned to a different provider. Tutoring
will end on or before February 29, 2016.
SES tutoring sessions will be scheduled after the last bell of the school day or on the
weekends. Providers that use district facilities/buildings will have an approved
building use agreement on file prior to beginning services. KSD buildings will not be
accessible during weekends, holidays, or over winter break. KSD buildings will only
be available during a regularly scheduled school date. Tutoring can begin on
November 2, 2015 or sooner and must be completed by February 29, 2016.
Provider will provide each parent a copy of their student’s learning plan. Provider
will confer with parents about, and obtain a parent signature for, each learning
plan. If the parent is not available to sign the plan, provider will record the date and
time of the phone call when the learning plan was discussed. If no contact is
possible, in lieu of a parent signature, provider will record the date and time of three
or more phone calls or contact attempts to the parent to discuss the learning plan.
Provider will submit the original signature page of each learning plan to the
District.
Providers will provide parents/guardians of children receiving SES under P.L. 107110, Section 116(e) and the applicable school district information related to the
academic progress of their children in a format and in languages
parent(s)/guardians(s) can understand.
1. State the specific achievement goals for the student.
2. Describe how the applicant/provider will measure the student’s progress.
3. For students with disabilities, provide a timetable for improving achievement
consistent with the student’s individualized education program (IEP) under
section 614 (d) of the Individuals with Disabilities Education Act.
4. Describe how the student’s parent(s)/guardian(s) and the student’s teacher(s)
will be informed regularly, at least four times during the delivery, of the
student’s progress.
5. Provide for the termination of such agreement if the applicant/provider is
unable to meet the goals and timetables.
6. Cover provisions with respect to making payments to the applicant/provider
by the school district.
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N. Provider shall submit to District accurate monthly invoices through EZSES.
Providers will be trained in using EZSES. Providers will not be compensated for
EZSES training. Invoices will not include amounts or hours that exceed the per
student allocation. Invoice will not exceed state requirements for maximum hours
per day. An acceptable learning plan and tutoring log/progress reports must be
submitted before payment can be made. These forms need to be submitted to the
District with one original monthly tutoring log for each student, in the order that
students are listed on the invoice. The tutoring log form can be submitted as a group
as long as an individual student-signed log is also submitted that lists the student’s
name and school, times/hours of tutoring with student or parent signature. Such
invoices shall be submitted within thirty (30) days of the rendering of the services.
District shall process payments for accurate invoices to Provider within forty-five
(45) days of submission of such invoices. Inaccurate or improperly compiled invoices
or improper tutoring logs will be rejected by the district and returned to the
provider.
O. No later than March 11, 2016 of the school year, provider will submit to the district
a summary of services that includes data on each student’s progress towards the
agreed upon goals in the student learning plan. This summary will include a list of
all students served to date, the pretest score for each student, the post test score for
each student, the name of the assessment used, the number of students who met
their goal, the number of students who made progress and the average growth of all
students being tutored, broken out by grade level in math and reading. All
assessments must be approved by the District prior.
P. The provider will inform the district in writing within five business days if a student
on the provider’s approved list moves, withdraws, or declines SES services. Another
student will not be selected to replace the student that has moved, refuses services,
or cannot be contacted.
Q. The Provider will ensure instruction provided and content used are of high quality,
research-based, specifically designed to increase each student’s academic
achievement, and consistent with that of the district and with the state of
Washington’s Common Core State Standards (CCSS). All curriculum used by
Provider must be approved in advance by the District and must align with current
adopted District curriculum. All supplementary services given by Provider under
this agreement shall be secular, neutral, and non-ideological in instruction and
content.
R. Meet all applicable Federal, State, and local health, safety, and civil rights laws.
S. Providers shall distribute, free of charge, adequate information to
parent(s)/guardians(s) related to the school district’s complaint procedures, and
OSPI’s written complaint procedures for violation(s) of a Federal statute or
regulation that applies to Title I, Part A programs). [Chapter 392-168 WAC Special
Services Programs-Citizen Complaint Procedures for Certain Categorical Federal
Programs.] Provider must disclose and SES complaint to the KSD first. Complaint
procedures can be found under the “Documents” section at
http://www.ksd.org/District/Departments/Federal-and-State-Programs.
T. All tutors with unsupervised access to students must pay for and submit
fingerprints for a background check. The FBI fingerprint clearance date must be on
file with Federal Programs prior to the tutor beginning unsupervised tutoring
services. A copy of the fingerprinting receipt must be on file in the Federal
Programs Office of the District prior to tutoring.
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U. Applicant/providers are able to hire district and school personnel for instructional
purposes only. District or school personnel hired as instructors, for example
teachers, must not recruit students to a provider’s program, engage in marketing
activities on behalf of a provider, distribute or collect enrollment forms, or in any
way promote or encourage students to enroll in a provider’s program.
V. Providers will ensure supervision of students before, during, and after tutoring
sessions. Providers will ensure supervision of students starting at the end of the
school day, and as long as students are on school grounds. Elementary age students
must be supervised until released to parents/guardians. Providers hold full
responsibility for the safety of students in their program. Students must not be left
unattended during tutoring hours. Provide a healthy, safe, and clean environment in
which to tutor students. When the provider or any of its employees has reasonable
cause to believe that a child has suffered abuse or neglect, the provider must report
to, or make sure a report is filed with, the proper law enforcement agency, or to the
Department of Social and Health Services, as directed by RCW 26.55.050.
Abuse or neglect means sexual abuse, sexual exploitation, or injury of a child by any
person under circumstances, which cause harm to the child’s health, welfare, or
safety, excluding conduct permitted under RCE 9A.15.100, or the negligent
treatment or maltreatment of a child by a person responsible for, or providing care
to, the child.
W. Breaks will not exceed a total of 10 minutes for any session over 90 minutes. Breaks
are not considered necessary for tutoring sessions of 90 minutes or less. Tutoring
shall not exceed 90 minutes before/after school on school days, 120 minutes on
Saturday, 120 minutes on Sunday. Cumulative tutoring sessions may not exceed six
hours per week (one week is defined as Sunday through Saturday). Travel to and
from a tutoring site shall not be included in the billable tutoring time. Only
instructional time can be billed.
X. Providers will submit to the Federal Programs Office completed W-9 tax and
debarment forms, and fingerprint records of every employee before any tutoring can
begin. All persons with regularly scheduled unsupervised access to children, who are
working via a Personal Services Contract with the District are required to be
fingerprinted per RCW 28A.400.303 and RCW 28A.410.010. Fingerprint records
must be submitted for every tutor who will work unsupervised with students.
Contractors need to be fingerprinted PRIOR to beginning work for the District. All
provider employees must wear picture identification that is visible at all times.
Failure of provider employees to wear visible identification at all times will result in
termination of this agreement.
Y. Applicant/provider must keep all documentation related to these provisions and
assurances on file at their official business address for 5 years, in the event that a
school district or OSPI requests to review them. Distance learning providers must
keep all documentation related to these provisions and assurances on file at the site
where the provider delivers services.
Z. Providers must not offer or advertise economic incentives or gratuities of any kind to
parents or students, who could be eligible for SES, as a means to solicit their
selection of provider.
1. No recruiting or solicitation shall take place on the school district property
other than the official vendor fairs. Provider shall not solicit parents and
students outside of the school building when parents are dropping off or
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picking up their children in an effort to recruit them to sign up for a specific
program.
4. DISTRICT’S OBLIGATIONS. District will participate and cooperate as follows:
A. District will check for FRL (Free/Reduced Lunch) status of students that have
signed and dated parent permission forms. District will contact provider with an
approved list of students (having the FRL status and a signed and dated parent
permission form on file) in order for provider to know which students are approved.
If more students than slots exist, District will rank-order students by need and serve
them accordingly.
B. Consult with Provider and permit Provider an opportunity to determine impact on
student performance and make recommendations to District in connection with
individual student progress and performance.
C. Provide free training in the use of EZSES software for submitting lesson plans,
invoices, and monthly progress reports.
D. Review and approve student learning plans, curriculum and assessments.
E. Review and approve provider invoices.
F. Budget funds and authorize payment of expenses to Provider.
G. District will not pay for a student that is served by another provider. In such cases
where a student has two registration forms submitted to the District, the Federal
Programs Department will contact the family to determine the parent’s choice of
provider.
H. The district may terminate the contract of any provider who violates any provisions
of this agreement.
I. Provider will provide a copy of their Washington State Business License to the
District. Out of state SES providers that are OSPI approved internet based
(students participate online only, no tutoring is done in Washington) do not need a
WA business license. The SES providers that are out of state but have an office or
person in Washington who is administrative or a tutor will need a business license.
J. All contracts must be approved by the Kennewick Board of Directors.
K. Provider contracts are only for SES instructional services, “Academic Instruction”,
and do not include any reimbursable expenses for administrative costs incurred by
providers as part of the preparation and administration of their program.
5. MUTUAL OBLIGATIONS. Both Provider and District agree to:
A. Confer and agree to the content of any official announcements regarding this
contract, its contents, objectives, and results.
B. Promptly inform the other party of any issues and problems that may arise during
the development and implementation of services.
C. Determine with the assistance of Park Middle School, Amistad, Eastgate,
Edison, Hawthorne and Westgate Elementary in specific areas of instruction
and organization of instruction and materials.
6. SCOPE OF SERVICE ADENDUM See Provider and District Obligations
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7. TERMINATION FOR CONVENIENCE. Except as otherwise provided in this
contract, the district may, by ten (10) days written notice, beginning on the second day after
the mailing, terminate this contract in whole or in part. The notice shall specify the date of
termination and shall be conclusively deemed to have been delivered to and received by the
Provider as of midnight the second day of mailing in the absence of proof of actual delivery
to and receipt by the Provider. If this contract is so terminated, the District shall be liable
only for payment required under the terms of the contract for services rendered or goods
delivered prior to the effective date of termination.
8. WASHINGTON LAW. This agreement shall be construed, enforced and interpreted
pursuant to the laws of the State of Washington. The parties agree that any dispute
arising under this agreement shall be heard in a court of competent jurisdiction in the State
of Washington. The parties hereby consent to the personal and subject matter jurisdiction
of said courts.
Provider Name certifies that all Provider Name employees who will or may have
unsupervised access to children under sixteen years of age or developmentally disabled
persons or vulnerable adults during the course of providing services to Kennewick School
District have had the required criminal records checked through Washington State Patrol
criminal identification system pursuant to RCW 43.43.830 through 43.43.834, 10.97.030
and 10.97.050 and through the Federal Bureau of Investigation. Provider Name certifies
the record check included a fingerprint check using a complete Washington state criminal
identification fingerprint card.
Provider Name certifies that all Provider Name employees providing services to
Kennewick School District have no criminal conviction record which would preclude the
individual from providing services to Kennewick School District, and that Provider
Name has a sworn statement from all employees providing services to Kennewick School
District that the employee has not been found in a civil adjudication to have sexually
assaulted, exploited any minor, or physically abused any minor, or developmentally
disabled person in accordance with RCW 43.43.834.
Provider may request termination after giving ten (10) days written notice to the District.
Prior to termination, Provider will provide a report containing information on the progress
of the child to the District and parents. Upon receipt of said report, District will promptly
make payment and the parties shall have no further obligations under this Agreement.
__________________________
(Superintendent) (Date)
_______________________
(Provider)
(Date)
Approved as to form:
____________________________
(Attorney for district) (Date)
_______________________
(Title I Director) (Date)
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