PACIFIC LIBRARY PARTNERSHIP CLAIM FORM
California Library Services Act (CLSA) Distribution of Funds for FY 2024-25
Library: _________________________________
Amount of Approved Allocation: ____________
Please indicate the amount of funds to be spent by category. Should you plan to allocate funds to more than one category, please indicate that by entering the dollar amount for each item.
SECTION 1 – CLAIM INFORMATION
Shared Digital Content
$ _______________ OverDrive (only for the 20 libraries which are in a shared environment) $ _______________ Palace eBooks-for-All Project (materials that will be shared) $ _______________ OCLC Consortia CloudLibrary
For Shared Digital Content, please indicate the estimated number of titles to be purchased and estimated circulation
____________ # of Titles ____________Circulation
Link + Software and Associated Courier
$ _______________ Link+ Software and Associated Courier
For Link+, please provide:
Number of items loaned: ________________
Number of items borrowed: _______________
Telecommunication Costs
$ _______________ Broadband hardware routers and switches (this should not be claimed multiple years in a row) List items to be purchased ________________________________________________________________________
$ _______________ CENIC telecommunication costs, costs for covering warranties in data center (only by rural libraries)
List ways funds will be used: ______________________________________________________________ Other Collaborative Projects (Please discuss with PLP before claiming) Answer:
Docusign Envelope ID: 3635955F-02CF-4969-A9EC-E797E411A0AE 3174
4,443
Richmond Public Library
3,957
$3,174
SECTION 2: COMMUNITY SERVED BY CLSA FUNDING
Completion of the following questions is required for CLSA distribution to the library.
Please answer to the best of your ability with regard to how your library allocates CLSA funds.
Please provide a written answer for each question.
1. Describe how, for the activities you chose to use your CLSA allocation, the funds help your library to serve underserved groups in your jurisdiction. Please include the underserved groups you are serving, as well as the activities. ( Examples of underserved groups may include geographically isolated populations; persons with disabilities; adults with limited literacy skills; immigrant populations, etc. Examples of activities may include purchasing shared eMaterials in multiple languages or in response to a community need; replacing an older router to improve network speed for access to computers in the library.)
2. Describe how you promote services funded with CLSA funds to the underserved groups in your jurisdiction. If you have not specifically promoted to the underserved, how would you promote going forward? Examples might include allocating some CLSA funds to buy OverDrive items in languages other than English and then developing promotional materials or providing training on how to use Libby; partnering with a community organization to provide training on a service funded by CLSA f unds, developing and delivering training on CLSA-funded services.
Docusign Envelope ID: 3635955F-02CF-4969-A9EC-E797E411A0AE Richmond is a diverse city with a number of challenges. Of our population of about 114,000,
34.4% are born outside of the United States., and 37% of Richmond children are living below 200% of the federal poverty line. Of active cardholders, 8719 (43%) live in zip codes where 90% percent of residents are members of a Covered Population as defined by the NTIA – groups such as seniors, non-English speakers, and people with disabilities who are most impacted by the digital divide and therefore less likely to access the resources they need online or through digital library collections. CSLA funds help us provide Link+ lending services to these populations so that they can access the materials they need even without the resources to find information online or travel to neighboring library systems.
We have not, to date, promoted Link+ lending specifically to underserved groups. Going forward, an obvious first step would be to create a brochure regarding Link+ lending at Richmond Public Library and translate it into at least Spanish, and potentially other languages. Greater user of Link+ by speakers of languages other than English would help to augment our offerings to this community and increase satisfaction with the library.
3. Describe how you will, in the next 12 months, measure the impact of the services on the underserved groups in your jurisdiction. (Outcomes versus Outputs) PLEASE NOTE:
Next year you will be asked for the data to support how you are measuring the impact of the services. Examples might include developing a survey for those underserved groups to ensure your library understands their needs (such as what genres to select in for underserved communities)
Certification
The filled out and signed CLSA Claim Form should be submitted by February 28, 2025
I hereby certify that the library named above shall use these funds for CLSA approved purposes as indicated above that facilitate resourcing sharing among the PLP Members in FY 2024 -25. I understand that the use of CLSA funds is defined by law, and that m y library’s allocation may only be used in the way indicated.
______________________________________ ______________________________________ Library Director PLP CEO
_______________________________
Date Date
Docusign Envelope ID: 3635955F-02CF-4969-A9EC-E797E411A0AE The library can slip a customer satisfaction survey into Link+ checkouts asking patrons to anonymously provide demographic information and describe the impact of Link+ loans on their personal, educational and economic life. These surveys will enable us to better understand the impact of Link+ loans for the community and how service can be improved to better target underserved groups.
2/6/2025
2/6/2025
Certificate Of Completion
Envelope Id: 3635955F-02CF-4969-A9EC-E797E411A0AE
Status: Completed
Subject: Complete with Docusign: FY24-25 PLP CLSA Claim Form Source Envelope:
Document Pages: 3
Signatures: 2
Envelope Originator:
Certificate Pages: 5
Initials: 0
Gina Forrester
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
32W. 25th Ave, Suite 201
San Mateo, CA 94403
[email protected]
IP Address: 207.62.246.152
Record Tracking
Status: Original
1/15/2025 10:49:30 AM
Holder: Gina Forrester
[email protected]
Location: DocuSign
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Kate Eppler
[email protected]
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(None)
Signature Adoption: Pre-selected Style
Using IP Address: 205.154.244.10
Sent: 1/15/2025 10:49:31 AM
Viewed: 1/16/2025 3:33:11 PM
Signed: 2/6/2025 9:59:21 AM
Electronic Record and Signature Disclosure:
Accepted: 1/16/2025 3:33:11 PM
ID: 0f586f35-b02f-4d4c-9a0e-0a82b24f3736
Carol Frost
[email protected]
CEO
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 207.62.246.152
Sent: 2/6/2025 9:59:22 AM
Viewed: 2/6/2025 10:26:00 AM
Signed: 2/6/2025 10:26:36 AM
Electronic Record and Signature Disclosure:
Accepted: 11/7/2024 1:04:59 PM
ID: fb931e17-3b61-4508-8632-c64582860c61
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[email protected]
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Sent: 2/6/2025 10:26:37 AM
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Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Peninsula Library System (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us.
All notices and disclosures will be sent to you electronically Electronic Record and Signature Disclosure created on: 8/16/2019 3:29:25 PM Parties agreed to: Kate Eppler, Carol Frost
Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.
How to contact Peninsula Library System:
You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:
To contact us by email send messages to: [email protected]
To advise Peninsula Library System of your new email address To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at [email protected] and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your account preferences.
To request paper copies from Peninsula Library System
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with Peninsula Library System
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The current system requirements are found here: https://support.docusign.com/guides/signer-guide- signing-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.
By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:
You can access and read this Electronic Record and Signature Disclosure; and You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and Disclosure to a location where you can print it, for future reference and access; and
Until or unless you notify Peninsula Library System as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by Peninsula Library System during the course of your relationship with Peninsula Library System.