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HomeMy WebLinkAbout04-16-2020 Senior Center CommissionCeneter Senior Center Commission Agenda Thursday, April 16, 2020 Electronic Meeting - 4 PM ZOOM MEETING PLATFORM Electronic Meeting (Pursuant to Iowa Code section 21.8) �r I CITY OF IOWA CITY UNESCO CITY OF LITERATURE An electronic meeting is being held because a meeting in person is impossible or impractical due to concerns for the health and safety of Commission members, staff and the public presented by COVID-19. You can participate in the meeting and can comment on an agenda item by joining the Zoom meeting via the internet by going to https://zoom.us/a/270659984. If you are asked for a meeting ID, enter Meeting ID: 270 659 984 to enter a 'Waiting Room' for the meeting. If you have no computer or smartphone, or a computer without a microphone, you can call in by phone by dialing (312) 626-6799 and entering the meeting ID when prompted. Providing comment in person is not an option. 1. Introductions/Welcome—S. Finlayson 2. Minutes (February 20, 2020) 3. Public Discussion for items not on the agenda 4. Commission Assignments— S. Finlayson Board of Supervisors City Council If you will need disability related accommodations to participate in this program or event, please contact LaTasha DeLoach at latasha-deloachgiowa-citv.org or 319-356-5225. Early requests are strongly encouraged to allow sufficient time to meet your access needs. 5. Operational Overview —Staff ❖ Covid-19 Update RFP Update Senior Center Policies Room Rental Document - Deposit amount change - Collection of funds rental rates 6. Commission Discussion— S. Finlayson Current and Potential Community Partners North Liberty Transportation —A. McConville Future Agenda Items 7. Adjourn **Next meeting is Thursday, May 21 at 4 PM ** Meeting Packet Contents: 1. Agenda: Thursday, April 16, 2020 2. Minutes: Senior Center Commission, Thursday, February 20, 2020 3. Policies: Community Use of Center Space; Displays, Bulletin Boards, Materials Distribution; Pantry Exchange 4. Room Rental Document 5. North Liberty Transit Report If you will need disability related accommodations to participate in this program or event, please contact LaTasha DeLoach at latasha-deloach(cDiowa-citv.org or 319-356-5225. Early requests are strongly encouraged to allow sufficient time to meet your access needs. Preliminary Minutes February 20, 2020 MINUTES SENIOR CENTER COMMISSION February 20, 2020 ROOM 205, IOWA CITY/JOHNSON COUNTY SENIOR CENTER Members Present: Lorraine Dorfman, Scott Finlayson, Zach Goldsmith, Angela McConville, George Nelson, Linda Vogel, Paula Vaughan Members Absent: None Staff Present: LaTasha DeLoach, Kristin Kromray, Ashley Monroe Others Present: Allie O'Connell CALL TO ORDER: The meeting was called to order by Dorfman at 4:00 PM. RECOMMENDATIONS TO COUNCIL: 0rem APPROVAL OF MINUTES FROM THE January 16, 2020 MEETING: Motion: To accept the minutes from the January 16, 2020. Motion carried on a vote of 7/0. Goldsmith[Vogel PUBLIC DISCUSSION: Assistant City Manager, Ashley Monroe is on the Census 2020 Complete Count Committee, whose goal is to spread awareness for the upcoming census. She explained the importance of the census and how federal money is allocated based on the information gathered. The census begins April 1 It. Citizens will be able to do the census online and then reminders will be sent before a paper copy is sent. COMMISSION ASSIGNMENTS: Vogel will attend an upcoming City council meeting. Nelson noted there is a City Council listening post on 2/27/2020 at the Senior Center and it might be nice to have commissioners attend. OPERATIONAL OVERVIEW: Preliminary Minutes February 20, 2020 DeLoach reported the request for proposal for the building assessment will be coming before City Council in the next month. The Senior Center survey is off to a good start. The cut of date is March 1St. The Senior Center mailed 5000 surveys as well as having the opportunity to do the survey digitally as well. Once the results are tabulated a public meeting may be held to discuss results. DeLoach has an idea about a senior center in a box. She is formulating this idea and will have additional information later. COMMISSION DISCUSSION: The commission discussed the demographics in the packet and whether they would like to see them on a more frequent basis. Motion: To receive demographic information on an annual basis. Motion carried on a vote of 7/0. Goldsmith/Dorfman Emily Edrington submitted a pantry report. Amazon gifted the Senior Center all items on our wish list in December. Pantry is available to anyone in the community and has been in place for over a year now. Approximately 100 pounds of food are received every week. Nelson would like to see fresh fruits and vegetables through table to table be utilized. DeLoach noted that she had been in contact with Table to Table. She stated we need to be a little careful with perishable items due to the limitations we have. But she agrees it will be nice to have some fresh options there as well. The Senior Center did partner with Horizons last summer and received vegetables and fruit that they could not use. Vaughan mentioned that the community gardens might be a good partnership. Intern, Allie O'Connell, is working on an op ed for the newspaper regarding the first year of the pantry. Finlayson will bring a survey to the next commission meeting. He is hoping to see what other community organizations commissions are involved with in the hope of networking to spread information about the Senior Center. He is working on making name tags for the commissioners. McConville, reported the partnership with the Senior Center and North Liberty is going well with people attending the classes in North Liberty and routinely noting the information in the program guide. Vogel noted that Artisan's gallery may be interested a in a partnership with the Senior Center. Preliminary Minutes February 20, 2020 Future agenda items: - Discuss ways the Commission might get more involved. Add vision discussion to all commission agendas - Discuss 3 years of demographic data from fiscal years 2017-2019 Motion: To Adjourn. Motion carried on a vote of 7/0. GoldsmithNaughan Preliminary Minutes February 20, 2020 Senim, Center Commission Attendance Record Name Tenn Ex ires 3/21/19 4/25/19 5/16/19 6/20/19 7/18/19 8/14/19 9/19/19 10/17/19 11/21/19 12/19/19 1/16/21) 2/20/20 Kenn Bowen 12r1/19 NM X X NM X X NM NM NM X — — Chcryll Clamon 12/31/19 NM X X NM X X -- -- -- -- -- -- Lorraine Dorfman 12/31/21 NM O/E X NM O/E X NM NM NM X X X Robert(Scott) Finlayson 12/31/20 NM X O/E NM O/E X NM NM NM X X X Zach Goldsmith 12/31/21 NM X X NM X X NM NM NM X X X Angela McConville 12/31/21 -- X X NM X X NM NM NM X X X Gcorge Nelson 12/31/22 -- -- -- -- -- -- -- -- -- -- X X Paula Vaughan 12/31/22 -- -- -- -- -- -- -- -- -- -- O/E X Linda Vogcl 12/31/20 -- -- -- -- -- -- -- -- -- -- X X Hirain(Rick) W gibber 12/31/19 NM X X NM X O/E NM NM NM O/E — — Key: X= Present 0= Absent O/F,= Abscnt/Frcuscd NM— No meeting -- = Not a member Title: Community Use of Center Space Date of Current Version: April 2020 Replaces Version: April 2012 Background The Center supports the needs of the community by providing opportunities for community members and organizations to use the facility to disseminate information, offer programs, hold meetings, or host events. Rentals of the facility provide the opportunity to generate revenue that supports operational expenses. Community Use of Center Space General Guidelines 1. When planning programs and activities, Center space needs have priority overall other requests. 2. Requests to schedule space can be made by: a. Individuals (for their personal, not business, use) b. Community groups c. 501c3 Non-profit organizations d. For -profit organizations and businesses e. Candidates for Political Office and Political Parties f. Government entities 3. The location of scheduled space maybe changed due to unforeseen circumstances involving the operation of the facility. 4. The specific areas of the facility available for rent (i.e., for a fee) or use (i.e., for no fee) are determined by the coordinator or designee. 5. Space is reserved on a first come, first served basis. 6. Janitorial services are not provided. Room set-up and return to its original configuration is the responsibility of the individual or group. 7. Publicity for all events is the responsibility of the sponsoring individual or group. It must not be intrusive to participants or disruptive to Center programs and operations. 8. The Center neither approves nor disapproves content, ideas or subject matter presented in the space and does not accept responsibility for ensuring accuracy or that all points of view are represented. 9. Coordinator or designee approval is required to serve or prepare food and non-alcoholic beverages in permitted areas of The Center. 10. All activities held at the Senior Center must comply with Senior Center policies and City of Iowa City resolutions and ordinances. Users and renters of space must follow all applicable City of Iowa City codes and The Center code of conduct. If found in violation of any city code, the person or group will be asked to stop the activity or vacate the premises. If the person or group refuses or are repeat offenders, police will be summoned. 11. Propping open an exterior door of the facility for any reason is prohibited. 12. Scheduling repeating uses or rentals is permitted in four -month intervals: January -April; May - August; and September -December. Rooms are not intended for multiple day exhibitions or displays unless approved by the coordinator or designee. 13. Rental agreements for one-time events can be made up to 12 months in advance, except for rental requests for the Assembly Room which may be made up to 24 months in advance. Space Use and Rental During Business Hours 1. The operations assistant or designee coordinates all community space usage. 2. During business hours individuals, 501c3 non-profit organizations, community groups, and government entities may use the space free of charge. 3. For -profit businesses, political candidates and political parties must rent space during business hours. 4. The individual or group shall identify a contact person and provide contact information at the time of reserving space. 5. Atable to disseminate information maybe reserved by individuals, 501c3 non-profit organizations, community groups, and government entities at no cost if space is available and such use does not interfere with Center programs or operations. The following conditions apply: a. Tables or displays must be confined to the designated space. b. Tables or displays must not be intrusive to Center visitors. Table staffers shall not approach or overtly solicit the involvement of participants or visitors. Space Rental During Non -Business Hours 1. The operations assistant facilitates all rentals of the facility. Coordinator or designee approval is required. 2. A Room Use and Rental Application/Letter of Agreement must be submitted to the operations assistant no later than five (5) business days prior to the requested time of use. Rental fees and deposit money are required to officially reserve the rental space. 3. A City Council approved schedule of rental fees and security deposits is applied. Each are reviewed periodically by Center staff and the Senior Center Commission. Recommended changes are submitted to the City Council for approval. If programming aligns with the Senior Centers mission and is open to Senior Center members, rental fees may be waived at the discretion of the Senior Center coordinator. 4. All deposits shall be returned, in part or full, depending upon the condition of the area and equipment utilized, within 30 days following the scheduled use of space. 5. Additional charges maybe required for damage to the facility or equipment, or rental of space extending beyond the initially agreed upon time limit. 6. Renters must agree to all items on the Room Use and Rental Application/Letter of Agreement. 7. Individuals and community groups: a. Rental fees are only for weekend and evening use of the facility. b. Standard rental fees and security deposits are assessed. 8. 501c3 Non-profit organizations: a. Rental fees are paid only for weekend and evening use of the facility. b. Receive a 50%discount on rental fees. c. Security deposits are paid at the standard rate. 9. For -profit organizations and businesses: a. Rental fees are paid each time the facility is used. b. Standard rental fees and security deposits are assessed. 10. Political candidates and political parties: a. Rental fees are paid each time the facility is used. b. Standard rental fees and security deposits are assessed. c. The Center shall not sponsor any activities that have the purpose or effect of endorsing a political party, candidate, or point -of -view. d. When requested by recognized political parties for space to hold a caucus, meeting space is provided without charge. For all other room use purposes, political candidates and political parties pay rental fees each time the facility is used. e. Candidates, political campaign staff and volunteers, and political party staff shall not disturb visitors or participants in any other program or service offered at The Center. Interaction with candidates, political campaign staff and volunteers, and political party staff must be initiated by the visitor or participants. 11. Government Entities: a. Rental fees are paid only for weekend and evening use of the facility. b. Standard rental fees and security deposits are assessed. Sales and Participation Fees 1. No fundraising, charging of admission, and/or sale of items or services are allowed without Senior Center coordinator approval. Additional rental fees may apply. 2. Charges solely to recoup program and material costs are acceptable on a case by case basis as authorized in advance by the coordinator or designee. 3. 501c3 non-profit organizations collaborating with The Center to offer evening and weekend programs of interest to the 50+ population may assess participation fees for specific events or programs. 4. Requests to use the building for fund-raising efforts sponsored by in-house agencies (e.g., Senior Nutrition Program, VNA, TRAIL), other departments within the City of Iowa City, or Johnson County will be considered on a case by case basis by the coordinator or designee. Administration The Center coordinator or designee administers space and use policies. Decisions to deviate from the policy will be made by the coordinator or designee on a case by case basis. Approved by the Senior Center Commission on: Title: Displays, Bulletin Boards, Resource Materials Distribution Date of Current Version: February 2020 Replaces Version: Background The Senior Center has various bulletin boards, display spaces, and areas for material distribution that are used to promote Senior Center programs and services, and to share community information and resource materials with participants and visitors. Senior Center Bulletin Boards and Digital Signs 1. The purpose of these spaces is to provide information regarding Senior Center sponsored activities. 2. Requests to post items on these spaces by partner organizations can be made to the Coordinator or designee. 3. Materials that have not been approved will be removed. Non -Profit Bulletin Board 1. Non-profit organizations can display information/promotional flyers in designated areas. 2. Preference will be given to organizations dealing with aging or providing services relevant to the 50+ population. 3. Flyers are given to staff to post. 4. Flyers larger than 8.5x11 inches in size will be displayed only if space is available. Public Bulletin Board 1. Community information, volunteer or job opportunities, and IRB approved research flyers maybe displayed on the public bulletin board. 2. Staff may review flyers at regular intervals and remove excess or outdated materials. 3. All flyers must meet existing State and Federal laws on obscenity, libel, defamation of character or invasion of privacy. 4. The Senior Center does not accept responsibility for ensuring that information is accurate or that all points of view are represented. Resource Materials Distribution 1. Businesses and organizations that provide services relevant to the 50+ population can supply up to ten (10) copies of informational materials to be placed in designated areas of the facility. 2. Materials found in non -designated areas of the facility will be discarded. 3. Materials are periodically reviewed by staff, excess or outdated materials will be discarded. 4. Approaching participants or visitors to distribute information is prohibited. Displays 1. Outside organizations may request display space at the Senior Center. 2. The coordinator or designee reserves the right to refuse display space to exhibits which, in their opinion, does not further the Senior Center's mission. 3. The Senior Center assumes no responsibility for theft, loss, damage or destruction of items left for display. 4. All displays must meet existing State and Federal laws on obscenity, libel, defamation of character or invasion of privacy. 5. The Senior Center does not accept responsibility for ensuring that information is accurate or that all points of view are represented. Granting of permission to display materials does not imply Senior Center endorsement of content. 6. Priority is given for displays that are pertinent to the 50+ population and/or groups and individuals within Johnson County. 7. Name and contact information for the group or individual preparing the display must be part of the display. 8. Displays will be confined to the space approved by the coordinator or designee. 9. Senior Center staff may remove displays remaining past the scheduled display end date. Administration The Center coordinator or designee is responsible for oversight of this policy. Approved by the Senior Center Commission on: Title: Pantry Exchange Date of Current Version: February 2020 Replaces Version: Background The Iowa City Senior Center Food Pantry was established to help all members of the communityfacing food insecurity. Pantry Guidelines 1. All members of the community are welcome to donate or take items from the pantry. There are no eligibility requirements for utilizing the pantry. 2. Donations of non-perishable food items, personal hygiene supplies, and pet food are accepted. 3. Shelf -stable food items beyond their expiration date maybe accepted at the discretion of staff or pantry volunteers. 4. Staff and pantry volunteers may discard foods that are exceptionally expired, cans that are badly dented or rusted, perishable foods, opened or home-made foods. Administration The pantry is administered by the Community Outreach Specialist or designee. Approved by the Senior Center Commission on: Senior Center Rental Information and Application The Iowa City Senior Center is located at 28 S Linn St in downtown Iowa City. Built in 1904 and expanded in 1932, the Senior Center was originally the Iowa City Post Office. The City of Iowa City purchased the building in 1979 and renovated it to be the Senior Center, which opened in 1981. The lobby and grand staircase were placed on the National Register of Historic Places in 1979 and on the local Historic Register in 2019. The Senior Center has a number of meeting and event spaces available for rent. The Senior Center is attached via a skywalk to the Tower Place Parking Ramp for convenient parking. Assemblv Room The Assembly Room has a maximum capacity of 225 people. Amenities include 4 (36") round tables, 6 (2.5'x6') tables rectangular tables, and 80 chairs. Audio visual equipment includes: mounted digital video projector and large permanent screen, HDMI and VGA inputs for laptops, auxiliary audio port, wireless lavalier microphones, a wireless hand-held microphone, and Blu-ray player. Additional tables and chairs are available on request. Room 202 Room 202 has a maximum capacity of 50 people. Amenities include 8 (3'x3') square tables, 10 (2'x5') rectangular tables, and 50 chairs. Audio visual equipment includes: mounted digital video projector and large permanent screen, HDMI and VGA inputs for laptops, auxiliary audio port, a wireless lavalier microphone, a wireless hand-held microphone, and Blu-ray player. Room 208 Room 208 has a maximum capacity of 25 people. Amenities include 5 (3'x3') square tables, 8 (2'x5') rectangular tables, and 25 chairs. Audio visual equipment includes: mounted digital video projector and large permanent screen, HDMI and VGA inputs for laptops, auxiliary audio port, a wireless lavalier microphone, a wireless hand-held microphone, and Blu-ray player. Rooms 205 and 209 Rooms 205 and 209 each have a maximum capacity of 15 people. Amenities include 6 (2'x5') rectangular tables and 15 chairs. Rooms 103 and G13 Rooms 103 and G13 have hard wood floors ideal for fitness or dance practice. G13 has two mirrored walls; 103 does not have mirrors. There are no food or drinks allowed in these rooms. Rental Fees Room Rental Cost Deposit Rooms 202, 205, $40/hour $125 208, and 209 Rooms G13 and $60/hour $125 103 Assembly Room Monday —Thursday: 8:00 a.m. to 12:00 a.m. $300; if serving Friday: 8:00 a.m. to 5:00 p.m. alcohol $500 $60/hour; rentals >5 hours will be charged $375 Friday: 5:00 p.m. to 12:00 a.m. Saturday and Sunday 8:00 a.m. to 12:00 a.m. $120/hour; rentals >5 hours will be charged $750 Individuals and non-profit organizations (who are not requesting to sell items) are not charged a room rental fee during business hours (8:00 a.m. to 5:00 p.m. Monday -Friday). Non-profit organizations receive a 50% discount for evening and weekend rentals. Rental Terms and Conditions 1. Rental Time: Renters will be responsible for paying the rental fee listed from the "start time' to the "end time" on the Rental Application. Set-up and clean-up time should be factored in when completing the application. The full hourly rate is charged regardless of the of actual time the facility is used (i.e. hours are not prorated). Rentals are available Monday through Sunday from 8:00 a.m. to midnight. 2. Rental Space: Use of space outside of the rented area or use of equipment not approved is prohibited. 3. Responsible Person: Each rental will have a named Responsible Person who will be present during the rental. The Responsible Person agrees to the Actions Required of the Responsible Person and Rental Terms and Conditions. The Responsible Person must be 18 years or older. Proof of age may be required. 4. Rental Scheduling: Rental space is scheduled on a first come first served basis. Reservations can be made up to 12 months in advance, with the exception of rental requests for the Assembly Room, which may be made up to 24 months in advance. Room Use and Rental Applications must be submitted at least 5 business days before the requested rental date. 5. Reservation Confirmation: The facility is not considered reserved until the Senior Center has received: a. A complete Room Use and Rental Application/Letter of Agreement that has been signed by the responsible person and the Senior Center Coordinator b. The full damage deposit c. A signed Administrative Rules for the Use of Alcohol d. Evidence of insurance for events with alcohol e. Rental Fee Due: Rental fees must be paid no less than 60 days prior to the rental or immediately if rental is occurring in less than 60 days. 6. All activities held at the Senior Center must comply with Senior Center policies and City of Iowa City Resolutions and ordinances. 7. Alcohol: Wine and beer maybe served only in accordance with the Administrative Regulations for the Use of Alcohol attached. 8. Refreshments: Arrangements can be made to serve refreshments in all rental spaces except rooms 103 and G13. 9. Special Equipment: No special equipment maybe used without Senior Center approval. 10. Property Damage: The rental permit holder is responsible to pay for all property damage to the facility resulting directly or indirectly from the conduct of any group member or invitees, including catering staff. Children must be supervised at all times. 11. Publicity and Content: Publicity for all events is the responsibility of the renter and must not be intrusive to participants or disrupt Senior Center programming or operations. The Senior Center neither approves nor disapproves the content, ideas, or subject matter presented during a rental. The Senior Center does not accept responsibility for ensuring accuracy or that all points of view are represented. 12. Collection of funds: Fundraising, charging of admission, and/or sale of items or services are not allowed without Senior Center coordinator approval. Additional fees may apply: a. Individuals, community groups, and for -profit organizations and businesses collecting funds will pay two times the established rental rate. b. 501c3 non-profit organizations collecting funds will pay two times the non-profit rental rate. c. Political candidates and political parties conducting for -profit activities will pay the established rental rate. d. Government Entities wanting to collect funds will work with the Senior Center on a case by case basis. 13. Access to rental space: Access to the rental space is provided by a computerized door locking system that is set to automatically open and close specific areas of the building in accordance with the needs identified in the rental request. 14. Set- up, Decorations: No set-up is allowed prior to the "start time' listed on the Rental Application/Letter of Agreement. Only freestanding decorations are permitted, although tape and suction cups may be used on windows. Use of the following items are prohibited: candles, Chinese lanterns, tacks, nails, staples, rice, birdseed, glitter, silly string, and real rose petals. Evidence that any of these items have been used may result in deduction from the rental deposit. All decorations must be removed from the facility upon completion of the event. 15. Rental Checklist: A rental checklist is attached. The checklist includes the following: a. Emergency contact phone numbers b. Electronic door locking information c. List of additional items that the Senior Center will provide beyond standard equipment. (e.g. Additional chairs or large trash barrel) d. Rental Completion Checklist 16. Rental Deposit: Use and Refund a. A damage deposit is required for each rental in the amount set forth above. The renter shall be responsible for any and all damages, including those damages not covered by the damage deposit, caused by the renter or any guests or agents, all in accordance with these Rental Terms and Conditions. b. Where the renter has timely left the premises in a damage -free, clean condition, the City shall return the full deposit to the renter within 30 days of the rental. c. Where the renter fails to complete the Cleaning and Building Walk Through checklist, the City reserves the right to retain all or a portion of the deposit to cover its costs in cleaning the facility to its satisfaction. The City shall refund any remaining deposit to the renter within 30 days after the events, along with an accounting of the amounts deducted from the deposit. d. Where the cost to repair, replace, or clean the facility, equipment or other property lost or damaged during the events is greater than the deposit, the renter shall be responsible for paying the excess costs, as determined solely by the City, which will be charged to the renter's credit card. The City shall notify the renter of such expense prior to charging the credit card. e. If the renter fails to clean and exit the facility prior to the end time listed on the Rental Terms and Conditions, the renter will be charged for the additional time at the full hourly rate, which shall be deducted from the rental deposit. 17. Cancellation Policy: Cancellations should be made at the earliest possible date. The deposit will be forfeited if a rental is cancelled within 5 business days of the rental date. The deposit and rental fees will be forfeited if a rental is cancelled within 2 business days of the event date. To cancel a rental the responsible person must speak directly with a Senior Center staff member. In the event of unforeseen circumstances beyond the City's control, the City reserves the right to reschedule and/or cancel the building reservations. All deposits and payment made will be refunded in full to the renter. 18. Maximum Attendance: Each rental space in the Senior Center has a maximum capacity. The Responsible Person is responsible for all guests on the premises and shall assist the Senior Center in enforcing this limitation. In the event that the Senior Center believes that the maximum capacities (listed below) have been exceeded, guests will be asked to leave or may be refused entrance. The maximum capacity for the rental spaces in the building are as follows: - Assembly Room: 225; Room 202: 50; Room 205: 15; Room 208: 25; Room 209: 15; Room 103: 15; Room G13: 15 Rental Application Applicant Name: Is this a 501c3 non-profit organization? Yes No Address: Phone Number: Email Address: Information for Responsible Person who will be present: Name: Address: Primary Phone Number: Email Address: Event Name: Date of Use: Secondary Phone Number: Birthdate: Rental Start Time: AM/PM Rental End Time: AM/PM Total Hours Requested: Room Requested: Estimated Attendance: Will food and/or non-alcoholic drinks be served? Yes No Would you like permission to serve alcohol during the rental? (Restrictions apply. See Administrative Regulations for the Use of Alcohol attached) Yes No Will you be hiring a caterer for the event? Yes No Catering Company: In the event that you receive permission to serve alcohol, will the caterer be providing the alcohol? Yes No (If yes, please provide a copy of the caterer's liquor license) Is Audio/Visual equipment needed? Yes No If yes, please list equipment needs: Would you like permission to fundraise, charge admission, and/or sell items or services during your event? Yes No Explain Will you be renting special equipment from a third -party vendor? Yes No Actions Required of Responsible Person This Letter of Agreement designates the responsible person(s) who accept(s) the following responsibilities. The responsible person: 1. Must be 18 years of age or older or 21 years of age or older if alcohol is being served; 2. Reads and agrees to the Terms and Conditions for Rentals (included below); 3. Oversees security and safety in the approved area(s) of the building for the duration of the rental; 4. Takes a leadership role in any emergency occurring while the space is being used and reports emergencies to staff, 5. Participates in required room use training; 6. Monitors and secures the facility after the program ends; 7. Operates audiovisual equipment; 8. Manages the set-up and clean-up of the rented space; 9. Reports cancelations. Agreement and Indemnification Signatures 1. (Only applicable if the applicant is not an individual.) I acknowledge that I have the authority to act on behalf of the group making the application. 2. Applicant agrees that the responsible person identified above has received and will abide by the rules, policies, and conditions for use of the room, which are included in this application. 3. Applicant waives, releases, and discharges the City and its officers, agents, and employees from any and all claims for damages for personal injury, death, property damage, any claim in tort, or any other claim, regardless of legal theory, that may accrue as a result of the use of the room. This waiver includes but is not limited to any negligent acts or omission of the City. In no event shall the City or its officers, employees or agents, be responsible or liable for any direct, indirect, special, incidental, or consequential damages; lost profits; or any other economic or physical loss or damage to any individual regardless of legal theory resulting from participation in the use of the room. Applicant agrees to indemnify and defend, at Applicant's own cost, the City of Iowa City and its directors, officers, employees and agents from any claims, demands, damages, rights of action or causes of action present or future whether the same be known or unknown, anticipated or unanticipated, brought against any or all such persons or entities based on the Applicant's use of the room. By approving this application, Applicant acknowledges and agrees that the City of Iowa City is not waiving any immunity. Signature of Applicant Date Iowa Citv Senior Center Rental Check List Senior Center Address: 28 S Linn St, Iowa City, IA 52240 Applicate Name/Event Senior Center Emergency Phone Numbers: Room being Exterior Doors Washington St (ground floor) door Linn St (1" floor) door North Ramp (1n floor) door SkywaIk (2n1 floor) door Propping open doors is prohibited under any circumstances due to fire code. Interior Spac( Ground Floor 1" Floor 2nd Floor List of items that will be made available for the rental: Rental Completion Checklist Place all garbage in trash can, tie garbage bag, leave in the rental space Place tables and chairs in original positions Wipe off tables with provided towels and spray bottle Remove all decorations, special equipment, or other items brought on -site Check restrooms and hallways to confirm they are empty, turn off lights Turn off lights and audiovisual equipment in rental space Confirm all exterior doors are locked and latched at the end of the rental period Report any emergencies that occurred to staff IMPORTANT: The doors are on a scheduled electronic door system. Do not leave the facility before all exterior doors are locked. You must confirm all people who attended your program have exited the building after the doors have locked. You must confirm all of the exterior doors have latched. II:I6`lILI Its] :7LTA I_\IM0MF_lINWIR.IMI01:1011LTAIwIa01F-\Iawloll]IIIIIY--l0SUC0MIlr_\IMOWa01:100`]II IIll 0pill" IPL61 CC Number: Exp. Date: Authorization code: FOR ADMINISTRATIVE USE ONLY Application Reviewed and Approved: Coordinator Signature Date Special Requests: The following special requests shown on the Application are hereby granted: Use of alcohol Fundraise, charge admission, and/or sell items, or services Use of special equipment Additional: Room Rental Fee: Received by: Deposit Amount: Received by: Returned to renter by: Amount returned: $ Deductions from Deposit, if any: Date: Date: Signed Administrative Regulations for the Use of Alcohol (required for events with alcohol): Received by: Date: Caterer liquor license (required for alcohol events where caterer is providing the alcohol) Received by: NORTH LIBERTY TRANSPORTATION ASSISTANCE PROGRAM (NLTAP) REPORT FEBRUARY2020 W W W.NORTHLIBERTYIOWA.ORG/TRANSIT Items included in this report: • User Guide Pamphlet • Application Form • Code of Conduct • Frequently Asked Questions • Template Doctor Note • Authorization for Release of Information rcmir.q pane iceav a ov ld nla N Ih Lil IV Cirr I N,koL (17) aa�tilc .krkl� Nlaxwv�116) Nx�h Lilrer�y.IR Sl311 �1•igi In P. or emmgmcy,c nt t: Ben Greene 319 :Mc IDDOO 1 o book a rlde, cat Yelkrn Cab of Iowa City al CJM 3414939_ FRONT Unique Identifier: used by both Yellow Cab and City Expiration Date: one year from date application process was completed or - for temporary cards - date doctor says patient can resume driving Home Address: cab driver uses this to confirm the residential pick up or drop off is their verified home address Date of Birth: to help confirm identity Full Name Both Yellow Cab and North Liberty logos BACK "If found please return to": helps the finder return the card to the correct location "In case of emergency": for the cab driver to have a contact person, considering a lot of our transportation is for medical purposes "Approved dependents": only these children under 18 can ride with cardholder; ages included to help confirm identity 'To book a ride": includes our dedicated NLTAP phone number as a reminder Magnetic stripe has no information stored in it at this time Who is using the North Liberty Transportation Assistance Program? YEARAPPLIED MONTH APPLIED # NEW CARDHOLDERS 2019 November 51 December 21 2020 January 23 February 1 TOTAL 96 16 incomplete applications = emails or phone calls have been sent to all, no show appointments, program does not fulfill needs, or has not completed process. Category A: No Vehicle 47 49% Category B: Low Income 40 42% Category C: Permanent Disability 4 4% Category D: Temporary Disability 5 5% Registration Drive Results: DATE LOCATION # NEW CARDHOLDERS 11/18/2019 Library 4 IV19/2019 Pantry 6 11/21/2019 Living Center 22 11/22/2019 Jefferson Point 12 11/25/2019 Library 3 11/26/2019 Pantry 4 12/12/2019 Open Drop In 6 12/18/2019 Open Drop In 1 12/30/2019 Living Center 11 1/2/2020 Jefferson Point 5 1/6/2020 Keystone 11 TOTAL FROM DRIVES 85 INDIVIDUAL APPOINTMENTS 11 When are people using the program? Most popular weekdays to ride are Wednesday and Thursday. With midday rides being the most common (-1:00 PM). What does NLTAP cost? In December 2019, out of the 72 with cards, only 21 individual cardholders (30%) used the program on a total of 182 rides. Invoiced $2,506.76. Program cost $119.37 per December user, at an average of $13.77 per ride ($9.38 ride median). Cheapest ride was $2.00 from Westwood Apartments to Fareway. Most expensive rise was $49.00 from a residential neighborhood near Cafe Muse to an appointment near the Iowa City Village Inn. In January 2020, out of the 95 with cards, only 24 individual cardholders (25%) used the program on a total of 193 rides. Invoiced $2,868.00. Program cost $119.50 per January user, at an average of $14.86 per ride ($11.50 ride median). Cheapest ride was $4.25 from Jefferson Point housing to the Community Center. Most expensive ride was $41.25 from Holiday Mobile Home Court to at appointment at the Johnson County Health and Human Services Building. MONTH EXPENSE INCURRED - INVOICE -SUPPLIES FY20 $ REMAINING 2019 OCTOBER $ 50,000.00 100% 2019 NOVEMBER $ 270.00 $ 49,730.00 99.50/0 2019 DECEMBER $ 2,506.76 $ 0.00 $ 47,223.24 94.5% 2020 JANUARY $ 2,868.00 $ 66.12 $ 44,289.12 88.5% 2020 FEBRUARY TBD $ 0.00 TBD TBD 200 180 160 140 120 100 80 60 40 20 I01175I 1111l0I 1111 AVERAGE COST/RIDE $20.00 $10.00 $5.00 $0.00 2019 DECEMBER 2020 JANUARY 2019 DECEMBER 2020 JANUARY Where are cardholders going? For all rides taken in December 2019 and January 2020 (not going to cardholder residence): • 28%were to grocery stores (Fareway, Crosspark HyVee, or Aldis) • 23%were to medical appointments • 13%were to pharmacies • 12%were to the North Liberty Community Center • 10%were to the North Liberty Community Pantry • 6%were to government buildings • 6% were to connecting bus stops • 2%were to banks and credit unions 17 trips in December 2019 and 25 trips in January 2020, were taken from one approved destination to another non -home approved destination, which means some cardholders are doing multiple purposes in one trip before going back home. For example, going from the doctor's office to the pharmacy before booking a ride home. This is called trip -chaining and helps us get the most out of our money. Where are our cardholders located? . . . . . . . . . . . . . . . Off . . . . . . . . . . . . . . . . . How are we getting feedback? Cardholders are informed that they can call NLTAP Program Administrator Angela McConville or Yellow Cab directly to give feedback or report concerns, via phone or email. Existing cardholders and applicants who have started but not completed the entire process have been sent a feedback survey in the mail with an addressed, stamped envelope to return the form. We anticipate having feedback before the end of March. Media coverage: November 12, 2019 City News https://northlibertyiowa.org/2019/11/12/north-liberty-to-launch- transpo rtation-assista nce-program/ November 13, 2019 KW WL Travis Breese https�//kwwl.com/2019/11/13/city-sponsoring-cab- rides-for-low-income-or-d isabled-residents-without-a-car/ November 26, 2019 CBS2 Emily Chavez https�//cbs2iowa.com/news/local/north-liberty launches- new -transportation -assistance- program December 2, 2019 Gazette https:l/www.theaazette.com/subject/news/aovernment/north- liberty-introduces-transportation-assistance-prog ram-to-help-those-i n-need-20191202 January 19, 2020 Press Citizen Dick Hakes "Taxi Assistance for Local Trips" January 23, 2020 KWWL Travis Breese https�//kwwl.com/2020/01/23/low-income-and- d isabl ed-riders-say-city program- liberates -them / Outreach: November 6, 2019 2:00 PM Mobility Coordinator Team Meeting November 11, 201910:00 AM Social Hour at the North Liberty Library (residents) December 19, 2019 4:00 PM Iowa City/Johnson County Senior Center Commission December 27, 2019 2:00 PM Yellow Cab Touch -base (Rod Blair & Kaila Rome) January 13, 20201:00 PM Johnson County Task Force on Aging (forum participant) January 29, 2020 2:30 PM NL Pantry & Mobility Coordinator (Kaila Rome & Kelly Schneider) February 4, 2020 9:30 AM Solon Senior Advocates leadership (Sandy Hanson) February 24, 20201:00 PM Horizons (Mike Barnhart & Kelzye Bedwell) February 24, 2020 3:00 PM Coralville Transit (Vicky Robrock) February 26, 202010:30 AM Improving Transportation for Cancer Patients Workgroup $1fare HOW TO BOOK A RIDE Call Yellow Cab of Iowa City at (319) 341-7939 no less than 30 minutes prior to requested ride When selecting a time, keep in mind that Yellow Cab driver will not wait more than five minutes for passengers to arrive_ Tell the scheduling operator you would like to book a ride under the North Liberty Transportation Assistance Program, the total number of passengers, whether you require an accessible vehicle, and the intended eligible destination (i e. name of medical office, pharmacy, etc)_ At the start of each ride, the Yellow Cab driver will collect the $1 fare per ride and use your card to verify eligibility and fill out a ride report To ride, card holder must have weight appropriate, unexpired car seats for all children Syears old and under Cardholders who do not have their card will be denied a ride. QUESTIONS? If you lose your card or have a question about your card and cannot find the answer in this brochure or online, then call or email the City of North Liberty Please leave a message with your name, a phone number to reach you and a description of your concern Allow up to three business days to receive a response. (319) 626-3722 transit@northlibertyiowa org North Liberty City Hall 3 Quail Creek Circle North Liberty, IA 52317 north bertyiowazrg/transit If you have a question about vehicles & accessibility, then please call Yellow Cab of Iowa City (315) 338-9777 General Line (319) 341-7939 NLTAP Line yellowcabic ccm ,o1k North ` Liberty TRANSIT Transportation Assistance Program (NLTAP) USER GUIDE YELLOW CAB (319)338-9777 GENERAL LINE (319) 341-7939 NLTAP LINE version_ 2019.12 HOW CAN AN NLTAP CARD BE USED? Please exhaust any available alternative modes of transportation before using NLTAP. Rides must be scheduled to take place: Monday through Friday 7 a.m. to 10 p.m. Saturday 7 a no to 7 p m_ Rides will be given to: Cardholder plus dependents (names must be listed on back of card) Cardholder plus one friend or family member Cardholder plus one personal care attendant and one friend or family member Dependents not allowed to ride without cardholder. All riders must have same origin and destination. WHAT IS NLTAP? The purpose of the North Liberty Transportation Assistance Program, or NLTAP, is to assist residents who may — for various reasons — be unable to travel to important destinations in and near North Liberty for essential quality -of -life services For eligibility details and necessary documentation, refer to the program application online at northlibertyiowa org/transit or in print at North Liberty City Hall, 3 Quail Creek Circle, North Liberty, IA 52317. Cardholder Is responsible for paying $1 fare per ride Payment must be made to the driver at time of pickupqwAIW Rides must originate from or arrive at one of the following locations: North Liberty Community Pantry - North Liberty Community Center Grocery Stores: North Liberty Fareway, Coralville Aldi or Crosspark Road Hy-Vee only Medical Offices located within North Liberty, Coralville, Iowa City or Tiffin, for verifiable appointments Pharmacies and Durable Medical Equipment Suppliers: must be located within North Liberty, Coralville, Iowa City or Tiffin Banks and Credit Unions: must be located within North Liberty Government Offices, including North Liberty City Hall, North Liberty Police Department, North Liberty Fire Department, North Liberty Post Office, Social Security Administration (local office), Iowa Drivers License Station (local office), Johnson County Administration Building or Johnson County Health and Human Services Building only Bus Stops: CAMBUS Research Park stops, Coralville Bus Heartland stop or Coralville Bus Coral Ridge Mall stop only Other Medical Transport Stops. intermediate connection to third party medical transports Cardholder address as printed on front of card USAGE RESTRICTIONS Ways the North Liberty Transportation Assistance Program cannot be used: - NLTAP card cannot be used in place of an official federal or state ID (i.e, to obtain a passport, board an airplane, prove employment eligibility, vote or verify age for alcohol or cigarette purchases)_ - Travel cannot be provided to unapproved locations. - Aswork crschccl transportation - For rideswith lessthan a 30-minute notice_ In the event of a medical emergency, you must call 911. What happens if I try to use the program incorrectly or produce an invalid card? Driver will retain the card being used and refuse your ride. You should call the City of North Liberty (contact information on other side of brochure) if you feel that your card has been retained in error, If an emergency medical situation is suspected, the driverwill call 911 and the person listed as the emergency contact on the card. The City of North Liberty will review individual transportation use records on a monthly basis. Staff will contact cardholder in the event that unapproved use is suspected. �`hTRANSIT North Liberty Pass Application Form Administration (319)626-5722 Email transit@northllbertyiowa org TRANSPORTATION ASSISTANCE PROGRAM Website northlibertyiowa org/transt PURPOSE The focus of the City of North Liberty Transportation Assistance Program (NLTAP) is to assist eligible residents who may - for various reasons - be unable to travel to important destinations in and near North Liberty for essential quality -of -life services. APPLICANT IDENTIFICATION INFORMATION Must provide one of the following proof of identification photo documents (current and not expired): U.S. Driver's License US Non -Driver's ID card US or foreign Passport U.S. Permanent Resident card Johnson County Iowa Community ID Consular ID Must provide one of the following proof of residency documents with applicant name and home address: Utility bill (dated within last 30 days), Insurance bill (dated within last 30 days); Bank statement (dated within last 30 days); Employment pay stub (dated within last 30 days); Local property tax statement (dated for present year), Mortgage payment receipt (dated within last 30 days), Voter registration card (current); Jury summons or court order issued by a state or federal court (dated within last 30 days); Rental agreement (dated for present year); Mobile home lot payment receipt (dated within last 30 days), or Vehicle registration (dated for present year). NAME HOME ADDRESS NORTH LIBERTY, IA 52317 BIRTH DATE PHONE # E-MAIL optional If applicant required the assistance of a preparer to fill out application, complete the information below. PREPARERS NAME F RELATIONSHIP TO APPLICANT E-MAIL optional �`hTRANSIT North Liberty Pass Application Form TRANSPORTATION ASSISTANCE PROGRAM EMERGENCY CONTACT INFORMATION NAME PHONE # RELATIONSHIP TO APPLICANT TRANSPORTATION NEEDS ASSESSMENT DOES APPLICANT RECEIVE OTHER Y ❑ N ❑ TRANSPORTATION ASSISTANCE? IF YES, LIST ASSISTANCE SERVICES. APPLICANT'S PREFERRED PRONOUNS SHE/HER/HERS1-1 HE/HIM/HIS THEY/THEM/THEIRS OTHER IF APPLICANT HAS LEGAL DEPENDENTS under 18 years old Must be legal dependent(s) of applicant and provide documentation of dependent status (for example, a birth certificate). Dependents must ride with eligible adult; cannot ride alone. Vehicle size will limit the number of dependents that can safely ride with the applicant for each trip. Vehicles are not equipped with child seats. Applicant must provide a size appropriate, unexpired child restraint system for any rider six years old and under; must be a rear facing child restraint system for any child less than one year old and weighing less than 20 pounds. NAME 1 BIRTH DATE NAME 2 BIRTH DATE NAME 3 BIRTH DATE NAME 4 BIRTH DATE �`hTRANSIT North Liberty Pass Application Form TRANSPORTATION ASSISTANCE PROGRAM ELIGIBILITY INFORMATION complete one box OPTION A O PIERS DOES APPLICANT OWN A VEHICLE, Y REGISTERED IN THEIR NAME? IF YES, WHY IS APPLICANT UNABLE TO USE THIS VEHICLE? OPTION B INCOME STATUS Must provide official documentation for any benefits or income listed below. Date on documentation must be within the past two months. APPLICANT'S HOUSEHOLD RECEIVES THE FOLLOWING. Check all that apply CHILDCARE VOUCHER❑ FIR (FAMILY INVESTMENT PROGRAM)❑ LIHEAP (LOW INCOME ENERGY ASSISTANCE) MEDICAID oR MEDICARE ❑ PUBLIC HOUSING VOUCHER (SECTION 8) SNAP (FOOD ASSISTANCE PROGRAM) TANF (TEMPORARY ASSIST ❑ NEEDY FAMILIES) WIG (WOMEN, INFANTS & CHILDREN) ❑ If applicant does not currently receive OTHER ❑ any of the above assistance, then they Household Site Gross Annual Income could qualify based on annual gross 1 $23,105 income_ Limit is set at 185% of the 2 $31,283 Federal Limit, but not exceeding 85% of 3 $39,460 the North Liberty Median Income from 4 $47,637 the most recent census. 5 $55,814 OPTION C DISABILITY PERMANENT OR D TEMPORARY Must provide note from physician attesting to the following answers. If necessary, new applicants may receive a temporary transportation pass valid for 30 days to allow for the note to be obtained. DOES APPLICANT HAVE A MEDICAL CONDITION (PHYSICAL OR Y ❑ N ❑ MENTAL) WHICH CONSTITUTES A SUBSTANTIAL HANDICAP? DOES APPLICANT HAVE A MOBILITY AID? Y ❑ N ❑ IF YES, DESCRIBE. IS THE NATURE OF THE MEDICAL TEMPORARY ❑ PERMANENT El CONDITION TEMPORARY OR PERMANENT? IF TEMPORARY, DATE CONDITION IS EXPECTED TO RESOLVE. V`� North Liberty TRANSIT Pass Application Form TRANSPORTATION ASSISTANCE PROGRAM CONSENT, ACKNOWLEDGEMENT, AND AUTHORIZATION The undersigned applicant (the "Applicant") authorizes the City of North Liberty, Iowa, to contact any service or benefit providers indicated in this application for the purpose of verifying the documentation provided, and to verify Applicant's eligibility for the North Liberty Transportation Assistance Program ("NLTAP"). Applicant agrees that membership in NLTAP, if approved, is effective only for the period that the applicant qualifies to receive services, and that membership in NLTAP must be renewed on an annual basis or upon termination date of a temporary pass, whichever happens first. Applicant understands and agrees that the City of North Liberty may terminate the Transportation Assistance Program for any reason. In the event the Transportation Assistance Program is terminated, the City of North Liberty will mail a written notice to the address on this application at least 10 days prior to the termination date. Applicant hereby specifically waives any claim or cause for damages resulting from the cancellation or discontinuation of the Transportation Assistance Program. By submitting this application, the Applicant attests that all statements on this application are true and correct, and agrees that intentionally false statements made on this application will be grounds for the City of North Liberty to deny the application or to cancel Applicant's membership in NLTAP Applicant agrees that they have reviewed the NLTAP Program Information, Cardholder User Guide, and Code of Conduct documents, and agrees to abide by the terms contained therein, including all program rules and restrictions as may be modified from time to time. Applicant acknowledges that NLTAP passes are for the exclusive use of NLTAP members, and may not be shared. Applicant agrees that, if applicant's pass is lost or stolen, to the applicant will report that loss immediately. Applicant understands that violation of any of these terms will result in the immediate cancellation of Applicant's membership in NLTAP If this application is signed by a preparer ("Preparer") on behalf of the Applicant, Preparer affirms that Applicant understands and agrees to the terms of membership described in this application, and that the application was prepared at Applicant's direction. PRINT APPLICANT'S NAME APPLICANT'S (OR PREPARERS) SIGNATURE DATE It is the policy of the City of North Liberty, Iowa, not to discriminate on the basis of race, color, national origin, sex, disability, religion, creed, age, marital status, sexual orientation, and gender identity in its programs, activities, and employment practices. If you have questions related to this policy, please contact Human Resources Director Deb Hilton at dhilton@northlibertyiowa.org or (319) 626-5700, OTHER RESOURCES AVAILABLE: Elderly Transportation Assistance RSVP through United Way of Washington &Johnson Counties unitedwaypmcorg or (319) 338-7823 TRAIL of Johnson County trailofjchnsoncounty.org/ or 319-900-9003 Assistance in Buying a Car Charity organizations FreeCharityCars. org or 1-800-CharityCars Local Transit Referrals, Education, Outreach, and Awareness Johnson County Mobility Coordinator johnson-countycom/mobility or 319-3S6-6090 Johnson County SEATS johnson-county com/SEATS or 319-339-6127 Need a Car Seat or Learn How to Properly Install One? Community Partnerships for Protecting Children johnson-countycom/ss/cppc or 319-339-6179 North Liberty Police Department 319-3S6-6800 (non -emergency number) North Liberty IOWA NORTH LIBERTY TRANSPORTATION ASSISTANCE PROGRAM (NLTAP) CODE OF CONDUCT Updated January 28, 2020 Membership and participation in NLTAP is conditioned upon adhering to the Code of Conduct set forth below, as well as any NLTAP Rules established by the City of North Liberty, which are available online. By participating in NLTAP, you agree to abide by this Code of Conduct and the NLTAP Rules.. The purpose of this Code of Conduct is to ensure the safety and comfort of North Liberty Transportation Assistance Program (NLTAP) cardholders, partners, providers, and of the general public. Violent, illegal, disrespectful behavior, demeaning language, yelling, or other seriously disruptive conduct is not permitted in connection with NLTAP membership or ridership. This provision extends to NLTAP cardholders, cardholder dependents, additional riders such as personal care attendants, as well as service animals and pets. NLTAP may deny, suspend, or revoke membership, and Yellow Cab may refuse service, to any persons who engage in such conduct. Notwithstanding the above, neither On -Demand Transit Services nor NLTAP membership will be refused to an individual with disabilities solely because the individual's disability results in an appearance or involuntary behavior (sounds or actions) that may offend, annoy, or inconvenience NLTAP staff, providers, or partners. When a person has engaged in behavior that violates this Code of Conduct, Yellow Cab will inform the NLTAP Coordinator at the City of North Liberty of the circumstances and events surrounding that behavior. City staff will evaluate on a case -by -case basis what corrective action, if any, is warranted. Such action may range from warnings to suspension of NLTAP program privileges, to permanent revocation of the offending person's membership in NLTAP. PO Box77 North Liberty IA 52317 (319) 626-5700 northlibertyiowa.org avwLeded 6.% ?,tha/, /%66PA4 r�`� No TRANSPORTATION ASSISTANCE Frequently Asked Questions NORTH LIBERTY TRANSPORTATION ASSISTANCE PROGRAM (NLTAP) Why do we have our own Yellow Cab phone number? To provide our cardholders with a more responsive service, Yellow Cab reserved anew phone line for our users_ 319-341-7939- Only NLTAP cardholders in good standing can use this line. If the NLTAP line is busy, please understand that one of your fellow North Libertarians is on the phone booking a ride, so be patient & keep trying. You are also welcome to call their general line at 319-338- 9777 When can I pre -schedule a ride? Rides scheduled ahead of time for a particular day & time are called "timed rides" NLTAP cardholders can reserve a timed ride for verifiable medical appointments (i e_ primary care physicians, psychiatrists, chiropractors, physical therapists, optometrists, dentists, and other medical professionals) up to 24 hours prior to the appointment time. Rides for any other purpose must be scheduled at the time of need, giving Yellow Cab a 30-minute window in which to pick you up How early in the day can I contact Yellow Cab dispatch? Phone lines to schedule an NLTAP ride are open from 7.00 AM to 10-00 PM Monday through Friday, and Saturday from 7.00 AM to 7.00 PM_ Will the driver wait for me while I run into my destination? No. You need to book each trip separately. What is the NLTAP Code of Conduct? The NLTAP Code of Conduct is a set of rules for ridership which are intended to promote the safety and welfare of NLTAP members. Use of NLTAP requires abiding by the Code of Conduct_ A copy of this document is provided to every cardholder and can also be found online 24/7 at northlibertyiowa.org/transit. What should I do if I suspect Yellow Cab dispatcher or driver misconduct? Report the issue immediately to the City of North Liberty via email at transit@northlibertyiowa.org or leave a message at 319-626-S722 (only if email is not an option). What if I/my driver makes a mistake and I get dropped off at the wrong location/an unapproved location? Will Yellow Cab pick me back up? No. Yellow Cab dispatchers will not book a ride to pick you up from an unapproved location_ NLTAP cardholders are expected to understand the limitations of the program and will have to arrange for alternate transportation if they end up in the wrong place. Detailed information is available in the NLTAP User Guide, online 24/7 at north libertyiowa.org/transit, and other questions can be addressed to transit@ northlibertyiowa_org at any time It might take me more than five minutes to get from my home to the taxi cab. The cab driver will only wait five minutes_ If you do not show immediately, a Yellow Cab dispatcher will give you a courtesy call_ If dispatch cannot reach you by phone, then they will tell the cab driver to leave. If you live with personal mobility issues, you should communicate that information to the Yellow Cab dispatcher when you book your ride. If you have booked a timed ride, please make sure you are at the front door ready for your scheduled time. Can I use this service to get to work or school? No. Your NLTAP card cannot be used for work or school trips. What if the transportation program or Code of Conduct changes? You will be notified of major changes to the program (approved destination edits, new restrictions, etc) by postal mail and email (for persons who submitted an optional email address)_ Minor changes to the program will be communicated electronically and available for review online 24/7 at northlibertyiowa.org/transit. What if I move outside of North Liberty? NLTAP is a program for North Liberty residents only r�`� No TRANSPORTATION ASSISTANCE Frequently Asked Questions NORTH LIBERTY TRANSPORTATION ASSISTANCE PROGRAM (NI -TAP) What if I move to a new location in North Liberty or to a different apartment in my building? Please notify City staff so your card and contact information can be updated Send an email to transit@northlibertyiowa org or leave a message at 319-626-5722. You will not need to reapply in full or take a new photo, but you will need to reestablish proof of residence by furnishing a piece of official mail, mortgage document, or rental agreement with your new address on it If you lose your card or still have unanswered questions about program details, call or email the City of North Liberty Please leave a message with your name, a phone number to reach you, and a description of your concern_ Allow up to three business days to receive a response. (319)626-5722 transit@northlibertyiowa org North Liberty City Hall, 3 Quail Creek Circle, North Liberty, IA 52317 northlibertyiowa.org/transit If you have a question about vehicles & accessibility, then please call Yellow Cab of Iowa City. (319) 626-9777 General Line (319) 341-7939 NLTAP Line yellowcabiccom Version: 2020_02 b North qVii Ubert3 C`�C>p 7EJ1RaE 11ftaA6ar-! North Liberty IOWA You have applied for a North Liberty Transportation Assistance Program (NLTAP) card under Option C: Permanent Disability or Option D: Temporary Disability. The application you filled out specifies that a note from your physician is required to receive NLTAP service under Option C or Option D. Please have your physician fill out the following verification letter attesting to the presence of a handicap. We do not need details about the condition or any other private medical information. This letter should be returned to the City of North Liberty (C/O Angela McConville, 3 Quail Creek Circle, North Liberty, IA 52317) within 30 days of receiving a NLTAP card or your privileges may be limited or revoked. Patient Information Name: Date of Birth: Address: TO BE FILLED OUT BY PHYSICIAN ONLY Physician Information Name: Clinic: Phone #: Please initial below where applicable: F�II confirm that this patient has a medical condition (physical or mental) which constitutes a substantial handicap (including procedures which will impact their ability to drive). The nature of the medical condition is permanent. OR The nature of the medical condition is temporary. Patient can resume driving on Signature: Date: (date). 14 PO Box 77 North Liberty IA 52317 (319) 626-5700 northlibertyiowa.org e4rwzp� ed 6 WG a'/ / �'1 q ,W North Liberty TR ASS SOTAN EION TRANSIT PROGRAM Authorization for the Release of Information FOR VERIFICATION OF PROGRAM PARTICIPANT STATUS I authorize the City of North Liberty to release to the Johnson County Treasurer's Office, the Johnson County Social Services Department, the Iowa Department of Human Services, my current landlord, and/or the Social Security Administration confidential information pertaining to my eligibility for the specific programs I have indicated on the North Liberty Transportation Assistance Program application and also circled below. I authorize the Johnson County Treasurer's Office, the Johnson County Social Services Department, the Iowa Department of Human Services, my current landlord, and/or the Social Security Administration to release to the City of North Liberty confidential information pertaining to my eligibility for the specific programs I have indicated on the North Liberty Transportation Assistance Program application and also circled below. I also do hereby forever release and discharge the City of North Liberty, the Johnson County Treasurer's Office, the Johnson County Social Services Department, the Iowa Department of Human Services, my current landlord and/ or the Social Security Administration from any liability for divulging such information whether such information is deemed confidential or not A photocopy of this form shall be considered as acceptable as the original_ CIRCLE PROGRAMS NAME TO VERIFY: Childcare (Title XX) HOMEADDRESS FIP LIHEAP NCIRTH I IRFRTV IA 59317 Medicaid/Medicare Section 8 SNAP SSDI SSI TANF WIC PHONE # SOCIAL SECURITY # CURRENTLANDLORD No vehicle registered under name. SIGNATURE Subsidized/income-based housing. (USED TO VERIFY STATUS OF PROGRAMS) (ONLY IF APPLICABLE) DATE F AA1501*111N 4721WA In order to help the City of North Liberty detemine qualification for the North Liberty Transportation Assistance Program, please verify this individual's eligibility for the programs circled above. Thank you for your assistance! PROGRAM NAME AUTHORIZED SIGNER DATE PROGRAM NAME AUTHORIZED SIGNER DATE Please return addressed to the North Liberty Special Projects Coordinator, North Liberty City Hall, 3 Quail Creek Circle, North Liberty, IA 52317 Questions? Email amcconville@northlibertyiowa.org or call 319-626-5722.