Backup Documents 07/08/2014 Item #16D15 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIT, 6 015
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the docum- t is already comp ete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Lisa Can HHVS 7/02/2014
2. Jennifer B. Belpedio, ACA Office located in HHVS Q ,UU[2 i `1 p 1
1
County Attorney Office Department oz �
3. BCC Office Board of County
Commissioners y-\[,/ ,\ VzA
4. Minutes and Records Clerk of Court's Office
14\A-)
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Lisa Carr Phone Number 252-2339
Contact/ De.artment
Agenda Date Item w s 7/8/2014 Agenda Item Number 16.D.15
Approved by the BCC
Type of Document Master Contract with Area Agency on Number of Original 3 originals
Attached Aging for Southwest Florida,Inc. Documents Attached
PO number or account
number if document is 'C\/0.
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? LNC
2. Does the document need to be sent to another agency for additional signatures? If yes, LNC 'v'�'^'e''"`�
provide the Contact Information(Name; Agency;Address; Phone)on an attached sheet. o‘c\o,,c1,ex3c
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman,with the exception of most letters,must be reviewed and signed LNC •••'
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's LNC
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the LNC -
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's LNC
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip LNC e
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 7/8/2014 Tenter date)and all changes LNC i
made during the meeting have been incorporated in the attached document. The
County Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the -- NC
BCC,all changes directed by the BCC have been made,and the document is ready for the IP
Chairman's signature.
ca"
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
16015
INSTRUCTIONS & CHECKLIST #2
Please send the original Chairman signed documents to additional agency for signature:
Kathy Gronberg, Fiscal Specialist III
Area Agency on Aging of Southwest Florida, Inc.
15201 N Cleveland Ave Ste 1100
North Fort Myers, FL 33903
239-652-6900 Ext. 251
1:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
16015
} aunty of Collier
CLERK OF THE CIRCUIT COURT
COLLIER COUNTY COURTHJSE Clerk of Courts
Dwight E. Brock 3315 TAMIAMI TRAIL,EAST STE 102 Accountant
Clerk of Courts P.O. BOX 41 044 Auditor
NAPLES, FLORIDA 34,01-3044 Custodian of County Funds
July 15, 2014
Area Agency on Aging for Southwest Florida, Inc.
Attn: Kathy Gronberg, Financial Specialist III
15201 N. Cleveland Ave.
Suite 1100
North Fort Myers, Florida 33903
Re: Master Contract for Federal and State Programs
Transmitted herewith are three (3) originals of the above referenced documents, as
adopted by the Collier County Board of County Commissioners of Collier County,
Florida on Tuesday, July 8, 2014, during Regular Session.
Very truly yours,
DWIGHT E. BROCK, CLERK
Martha Vergara, Deputy Clerk
Enclosure
.___. __ Phone - (239) 252-2646 Fax- (239) 252-2755
Website-www.collierclerk.com Email - collierclerk @collierclerk.com
4 16 015
. July 2014 Contract#HM203.14
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
MASTER CONTRACT FOR
FEDERAL AND STATE PROGRAMS
THIS MASTER CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency)
and Collier County Board of County Commissioners (Contractor), and collectively referred to as the "Parties". The term
Contractor for this purpose may designate a Vendor, Subgrantee or Subrecipient, the status to be further identified in
ATTACHMENT II,Exhibit-1 as necessary.
1. Purpose of Contract:
The purpose of this Master Contract is to establish the Agency's standard terms and conditions for services
provided in any contract or agreement incorporating this Master Contract by reference including all attachments,
forms and exhibits,which constitute the contract document.
The Contractor agrees to provide the services specified in each contract or agreement incorporating this Master
Contract during the period this contract is in effect.
The Contractor agrees that this Master Contract covers all services provided by the Contractor under contracts or
agreements with the Agency which incorporate this Master Contract by reference.
Agency Mission Statement:
To lead and cultivate relationships with our community partners to better serve the dynamic aging and disability
networks through education, advocacy,program development and resources.
2. Incorporation of Documents within the Contract or Agreement:
All contracts or agreements including attachments, proposal(s), solicitation(s), state plan(s), grant agreements,
relevant Department handbooks, manuals or desk books executed between the Contractor and the Agency
shall incorporate this Master Contract by reference and be subject to the conditions set forth in this Master
Contract for the duration of the contract period(s). Any and all contracts or agreements executed between the
Contractor and the Agency during the effective period of this Master Contract will incorporate this Master
Contract by reference and shall be governed in accordance with the applicable laws, statutes, and other conditions
set for in this Master Contract.
Incorporation of Reference Memoranda:
In accordance with Chapter 287 F.S., amended, and Department of Financial Services' Chief Financial Officer
Memoranda,the following memoranda are hereby incorporated by reference:
(1) CFO Memo No. 02: Release date,October 3,2012;
(2) CFO Memo No. 06: Release date,June 27,2012;
(3) CFO Memo No. 01: Release date,July 26,2012; and
(4) CFO Memo No. 04: Release date,June 30,2006
3. Term of Master Contract:
This Master Contract will become binding at twelve (12:00) A.M., Eastern Standard Time on July 1. 2014 or on
the date the Master Contract has been signed by the last Party required to sign it,whichever is later.It shall end at
eleven fifty-nine(11:59)P.M.,Eastern Standard Time June 30.2017.
4. Compliance with Federal Law:
4.1 If any contract and agreement contains federal funds this section shall apply.
1
16015
July 2014 Contract#HM203.14
4.1.1 The Contractor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable
regulations.
4.1.2 If the contract and agreement contains federal funds and is over $100,000.00, the Contractor shall
comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as
amended(42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended(33
U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental
Protection Agency regulations 40 CFR 30. The Contractor shall report any violations of the above to
the Agency.
4.1.3 The Contractor, or agent acting for the Contractor, may not use any federal funds received in
connection with any contract and agreement to influence legislation or appropriations pending before
the Congress or any State Legislature. If any contract or agreement contains federal funding in excess
of$100,000.00, the Contractor must, prior to contract execution, complete the Certification Regarding
Lobbying form, ATTACHMENT I. All disclosure forms as required by the Certification Regarding
Lobbying form must be completed and returned to the Contract Manager prior to payment under any
contract or agreement.
4.1.4 In accordance with Appendix A to 2 CFR 215, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92,if applicable.
4.1.5 A contract or agreement award with an amount expected to equal or exceed $25,000.00 and certain
other contract or agreement awards will not be made to parties listed on the government-wide
Excluded Parties List System, in accordance with the OMB guidelines at 2 CFR 180 that implement
Executive Orders 12549 and 12689, "Debarment and Suspension." The Excluded Parties List System
contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as
parties declared ineligible under statutory or regulatory authority other than Executive Order 12549.
The Contractor shall comply with these provisions before doing business or entering into subcontracts
receiving federal funds pursuant to any contract or agreement. The Contractor shall complete and sign
ATTACHMENT IV prior to the execution of this Master Contract.
4.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act(8 U.S.C. 1324a)and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violations will be cause for unilateral cancellation of
this Master Contract and any/all contracts or agreements by the Agency.
4.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt
organization reporting requirements (filing a Form 990 or Form 990-N)and has its tax exempt status revoked
for failing to comply with the filing requirements of the Pension Protection Act of 2006 or for any other
reason, the Contractor must notify the Agency in writing within thirty (30) days of receiving the IRS
notice of revocation.
4.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
4.5 Unless exempt under 2 CFR Part 170.110(b), the Contractor shall comply with the reporting requirements of
the Transparency Act as expressed in 2 CFR 170.
4.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116,
the Contractor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the
employment of all new employees hired by Contractor during the contract or agreement term. The Contractor
shall include in related subcontracts a requirement that Subcontractors performing work or providing services
2
16015
July 2014 Contract#HM203.14
pursuant to the state contract utilize the E-verify system to verify employment of all new employees hired by
the Subcontractor during any contract or agreement term. Contractors meeting the terms and conditions of the
E-Verify System are deemed to be in compliance with this provision. The Contractor shall complete and sign
ATTACHMENT J prior to the execution of this Master Contract.
5. Compliance with State Law:
5.1 This Master Contract and all contracts or agreements incorporating this Master Contract by reference is
executed and entered into in the State of Florida, and shall be construed, performed and enforced in all
respects in accordance with the Florida law, including Florida provisions for conflict of laws.
5.2 The Contractor shall comply with requirements of s.287.058,F.S.as amended.
5.2.1 The Contractor shall provide units of deliverables, including various client services, and in some
instances may include reports, findings, and drafts, as specified in this Master Contract and all
contracts or agreement incorporating this Master Contract, which the Contract Manager must receive
and accept in writing prior to payment in accordance with s.215.971,F.S.(1)and(2).
5.2.2 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient
detail for a proper pre-audit and post-audit.
5.2.3 If itemized payment for travel expenses is permitted in any contract or agreement incorporating this
Master Agreement by reference, the Contractor shall submit bills for any travel expenses in
accordance with s. 112.061, F.S., or at such lower rates as may be provided in this Master Contract
and any contract or agreement incorporating this Master Contract by reference.
5.2.4 The Contractor shall allow public access to all documents, papers, letters, or other public records as
defined in subsection 119.011(12), F.S., made or received by the Contractor in conjunction with any
contract or agreement incorporating this Master Contract, except for those records which are made
confidential or exempt by law. The Contractor's refusal to comply with this provision will constitute
an immediate breach of contract or agreement for which the Agency may unilaterally terminate the
Master Contract and any contract or agreement incorporating the Master Contract.
5.3 If clients are to be transported under any contract or agreement incorporating this Master Contract by
reference, the Contractor shall comply with the provisions of Chapter 427, F.S., and Rule Chapter 41-2, F.
A.C.
5.4 Subcontractors who are on the discriminatory vendor list may not transact business with any public entity,
in accordance with the provisions of s.287.134,F.S.
5.5 The Contractor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the
expenditure of contract funds for the purpose of lobbying the legislature,judicial branch or a state agency.
5.6 In accordance with s. 287.135 F.S., any Contractor on the Scrutinized Companies with Activities in Sudan
List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List(Lists), created
pursuant to s. 215.473 F.S., is ineligible to enter into or renew a contract or agreement with the Agency for
goods or services of$1 million or more. Pursuant to s. 287.135 F.S., the Agency may terminate this Master
Contract and any contract or agreement incorporating this Master Contract by reference if the
Contractor is found to have submitted a false certification of its status on the Lists or has been placed on the
Lists. Further, the Contractor is subject to civil penalties, attorney's fees and costs and any costs for
investigations that led to the finding of false certification. If any contract or agreement incorporating this
Master Contract contains $1 million or more, the Contractor shall complete and sign ATTACHMENT H,
Certification Regarding Scrutinized Companies Lists,prior to the execution of this Master Contract.
3
16 015
July 2014 Contract#HM203.14
6. Background Screening:
6.1 The Contractor shall ensure that the requirements of s.430.0402 and Chapter 435, F.S., as amended,are met
regarding background screening for all persons who meet the definition of a direct service provider and who
are not exempt from the Department's level 2 background screening pursuant to s.430.0402(2)-(3),F.S. The
Contractor must also comply with any applicable rules promulgated by the Department and the Agency for
Health Care Administration regarding implementation of s.430.0402 and Chapter 435,F.S.
6.2 Further information concerning the procedures for background screening is found at
http://elderaffairs.state.fl.us/doea/backgroundscreening.php.
6.3 Background Screening Affidavit of Compliance - To demonstrate compliance with section 6 of this
Master Contract, the Contractor shall submit ATTACHMENT G, Background Screening Affidavit of
Compliance annually,by January 15th.
7. Grievance and Complaint Procedures:
7.1 Grievance Procedures:
The Contractor shall comply with and ensure subcontractor compliance with the Minimum Guideline for
Recipient Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services
Handbook,to address complaints regarding the termination, suspension or reduction of services, as required
for receipt of funds.
7.2 Complaint Procedures:
The Contractor shall develop and implement complaint procedures and ensure that Subcontractors develop
and implement complaint procedures to process and resolve client dissatisfaction with services. Complaint
procedures shall address the quality and timeliness of services, provider and direct service worker
complaints, or any other advice related to complaints other than termination, suspension or reduction in
services that require the grievance process as described in Appendix D, Department of Elder Affairs
Programs and Services Handbook. The complaint procedures shall include notification to all clients of the
complaint procedure and include tracking the date, nature of the complaint and the determination of the
complaint.
8. Public Records and Retention:
8.1 If, under any contract or agreement incorporating this Master Contract by reference, the Contractor is
providing services and is acting on behalf of the Agency as provided under section 119.011(2),
Florida Statutes, the Contractor, subject to the terms of section 287.058(1)(c), Florida Statutes, and any
other applicable legal and equitable remedies,shall:
a) Keep and maintain public records that ordinarily and necessarily would be required by the public
agency in order to perform the services.
b) Provide the public with access to public records on the same terms and conditions that the Agency
would provide the records and at a cost that does not exceed the cost provided in Chapter 119, Florida
Statutes,or as otherwise provided by law.
c) Ensure that public records that are exempt or confidential and exempt from public records disclosure
requirements are not disclosed except as authorized by law.
d) Meet all requirements for retaining public records and transfer, at no cost, to the Agency all
public records in possession of the Contractor upon termination or expiration of any contract or
agreement incorporating this Master Contract by reference and destroy any duplicate public records
that are exempt or confidential and exempt from public records disclosure requirements. All records
stored electronically must be provided to the Agency in a format that is compatible with the
information technology systems of the Agency.
4
1r)�
16015
July 2014 Contract#HM203.14
8.2 The Agency may unilaterally cancel this Master Contract, and any contract or agreement
incorporating this Master Contract by reference, notwithstanding any other provisions of this Master
Contract, for refusal by the Contractor to comply with Section 8 of this Master Contract by not allowing
public access to all documents, papers, letters, or other material made or received by the Contractor in
conjunction with the contract or agreement incorporating this Master Contract by reference, unless the
records are exempt from Section 24(a) of Article I of the State Constitution and Section 119.07(1),
Florida Statutes.
9. Audits.Inspections.Investigations:
9.1 The Contractor shall establish and maintain books, records and documents (including electronic storage
media) sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures
of funds provided by the Agency under any contract or agreement incorporating this Master Contract by
reference. Contractor(s) shall adequately safeguard all such assets and assure they are used solely for
the purposes authorized under any contract or agreement which incorporates this Master Contract by
reference. Whenever appropriate, financial information should be related to performance and unit cost
data.
9.2 The Contractor shall retain and maintain all client records, financial records, supporting documents,
statistical records, and any other documents (including electronic storage media) pertinent to any contract
or agreement which incorporates this Master Contract by reference for a period of six (6) years after
completion of the contract or agreement incorporating this Master Contract by reference or longer when
required by law. In the event an audit is required for any contract or agreement incorporating this Master
Contract by reference, records shall be retained for a minimum period of six(6)years after the audit report
is issued or until resolution of any audit findings or litigation based on the terms of any contract or
agreement incorporating this Master Contract by reference,at no additional cost to the Agency.
9.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and
transfer of any records or documents during the required retention period.
9.4 The Contractor shall assure that the records described in this section will be subject at all reasonable times
to inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the
Agency.
9.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Department
and/or Agency and Federal Auditors, pursuant to 45 CFR 92.36(i)(10), will be allowed full access to
and the right to examine any of the Contractor's contracts or agreements, related records and documents
pertinent to any contract or agreement,regardless of the form in which it is kept.
9.6 The Contractor shall provide a financial and compliance audit to the Agency as specified in this Master
Contract and in ATTACHMENT II and ensure that all related third-party transactions are disclosed to the
auditor.
9.7 The Contractor shall comply and cooperate immediately with any inspections, reviews, investigations, or
audits deemed necessary by the office of the Inspector General pursuant to s.20.055,F.S.
10. Nondiscrimination-Civil ights Compliance:
10.1 The Contractor shall execute assurances in ATTACHMENT V that it will not discriminate against any
person in the provision of services or benefits under any contract or agreement incorporating this Master
Contract by reference or in employment because of age, race, religion, color, disability, national origin,
marital status or sex in compliance with state and federal law and regulations. The Contractor further
assures that all Contractors, Subcontractors, Subgrantees, or others with whom it arranges to provide
services or benefits in connection with any of its programs and activities are not discriminating against
5
0)
July 2014
ColaZ'f#1111. 4
clients or employees because of age, race, religion, color, disability, national origin, marital status or sex.
The Contractor shall complete and sign ATTACHMENT V prior to the execution of the Master Contract.
10.2 During the term of any contract or agreement incorporating this Master Contract by reference, the
Contractor shall complete and retain on file a timely, complete and accurate Civil Rights Compliance
Checklist(ATTACHMENT B).
10.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination
involving services or benefits through any contract or agreement incorporating this Master Contract by
reference. These procedures will include notifying clients, employees, and participants of the right to file a
complaint with the appropriate federal or state entity.
10.4 If any contract or agreement incorporating this Master Contract by reference, contains federal funds, these
assurances are a condition of continued receipt of or benefit from federal financial assistance, and are
binding upon the Contractor, its successors, transferees, and assignees for the period during which such
assistance is provided. The Contractor further assures that all Subcontractors,Vendors, or others with whom
it arranges to provide services or benefits to participants or employees in connection with any of its
programs and activities are not discriminating against those participants or employees in violation of the
above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency may, at its discretion, seek a court order requiring compliance with the
terms of this assurance or seek other appropriate judicial or administrative relief, including but not limited
to,termination of and denial of further assistance.
11. Monitoring by the Agency:
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods and services of the Contractor which are relevant to any contract or agreement which
incorporate this Master Contract by reference, and to interview any clients, employees and Subcontractor
employees of the Contractor to assure the Agency of the satisfactory performance of the terms and conditions of
any contract or agreement which incorporate this Master Contract by reference. Following such review, the
Agency will provide a written report of its findings to the Contractor, and where appropriate, the Contractor
shall develop a Corrective Action Plan (CAP). The Contractor hereby agrees to correct all deficiencies identified
in the CAP in a timely manner as determined by the Contract Manager.
12. Provision of Services:
The Contractor shall provide services in the manner to be described in subsequent contracts or agreements
incorporating this Master Contract by reference.
13. Coordinated Monitoring with Other Agencies:
If the Contractor receives funding from one or more of the State of Florida other human service agencies, in
addition to the Department of Elder Affairs and/or the Area Agency on Aging for Southwest Florida, Inc., then a
joint monitoring visit including such other agencies may be scheduled. For the purposes of any contract or
agreement incorporating this Master Contract by reference, and pursuant to s. 287.0575, F.S. as amended,
Florida's human service agencies shall include the Department of Children and Families, the Department of
Health, the Agency for Persons with Disabilities, the Department of Veterans Affairs, and the Department of
Elder Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead
administrative coordinator, the Contractor shall comply and cooperate with all monitors, inspectors, or
investigators.
14. Indemnification:
14.1 The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and
employees from any and all claims, demands, actions, causes of action of whatever nature or character,
arising out of or by reason of the execution of this Master Contract and any contract or agreement
6
16015
July 2014 Contract#HM203.14
incorporating this Master Contract by reference, or performance of the services provided for herein. It is
understood and agreed that the Contractor is not required to indemnify the Agency for claims,
demands,actions or causes of action arising solely out of the Agency's negligence.
14.2 Except to the extent permitted by s. 768.28, F.S., or other Florida law, this section 14 is not applicable to
contracts or agreements executed between the Agency and state agencies or subdivisions defined in s.
768.28(2),F.S.
15. Insurance and Bonding:
15.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of any
contract or agreement incorporating this Master Contract by reference and any renewal(s) and
extension(s) of it. By execution of this Master Contract and any contract or agreement incorporating the
Master Contract by reference, unless it is a state agency or subdivision as defined by subsection
768.28(2), F.S., the Contractor accepts full responsibility for identifying and determining the type(s) and
extent of liability insurance necessary to provide reasonable financial protections for the Contractor and
the clients to be served under this any contract or agreement incorporating this Master Contract by
reference. The limits of coverage under each policy maintained by the Contractor do not limit the
Contractor's liability and obligations under this any contract or agreement incorporating this Master
Contract by reference. The Contractor shall ensure that the Agency has the most current written
verification of insurance coverage throughout the term of any contract or agreement incorporating this
Master Contract by reference. Such coverage may be provided by a self-insurance program established
and operating under the laws of the State of Florida. The Agency reserves the right to require
additional insurance as specified in any contract or agreement incorporating this Master Contract by
reference.
15.2 Throughout the term of any contract or agreement incorporating this Master Contract by reference, the
Contractor shall maintain an insurance bond from a responsible commercial insurance company covering
all officers, directors, employees and agents of the Contractor authorized to handle funds received or
disbursed under all contracts or agreements incorporating this Master Contract by reference in an amount
commensurate with the funds handled, the degree of risk as determined by the insurance company and
consistent with good business practices.
16. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under any contract or
agreement for any purpose prohibited by state or federal law or regulations except with the written consent of a
person legally authorized to give that consent or when authorized by law.
17. Health Insurance Portability and Accountability Act:
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42
USC 1320d.),as well as all regulations promulgated thereunder(45 CFR 160, 162,and 164).
18. Incident Reporting:
18.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contractor o r
Subcontractor's ability to perform the services required to be performed under any contract or agreement
which incorporate this Master Contract by reference. Such notice shall be made orally to the Contract
Manager(by telephone)with an email to immediately follow.
18.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or
exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-
free telephone number (1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is
binding upon the Contractor, Subcontractors,and their employees.
7
16015
•
July 2014 Contract#HM203.14
19. New Contract(s)Reporting:
The Contractor shall notify the Agency within ten(10)days of entering into a new contract or agreement with any
of the remaining four(4) state human service agencies. The notification shall include the following
Information: (1) contracting state agency; (2) contract name and number; (3) contract or agreement start and end
dates; (4) contract or agreement amount; (5) contract or agreement description and commodity or service; and (6)
Contract Manager name and number. In complying with this provision, and pursuant to s. 287.0575, F.S. as
amended,the Contractor shall complete and provide the information in ATTACHMENT D.
20. Bankruata Notification:
During the term of any contract or agreement incorporating this Master Contract by reference,the Contractor shall
immediately notify the Area Agency on Aging for Southwest Florida, Inc. if the Contractor, its Assignees,
Subcontractor's or Affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Contractor
must also provide the following information to the Area Agency on Aging for Southwest Florida, Inc.: (1) the
date of filing of the bankruptcy petition; (2) the case number; (3) the court name and the division in which
the petition was filed (e.g., Middle District of Florida,Fort Myers,FL); and(4)the name,address,and telephone
number of the bankruptcy attorney.
21. Sponsorship and Publicity:
21.1 As required by s. 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through any contract or
agreement incorporating this Master Contract by reference, it shall, in publicizing, advertising, or
describing the sponsorship of the program, state: "Sponsored by (Contractor's name) and the Area
Agency on Aging for Southwest Florida, Inc., and the State of Florida, Department of Elder Affairs." If
the sponsorship reference is in written material, the words the "Area Agency on Aging for Southwest
Florida, Inc. and the State of Florida, Department of Elder Affairs" shall appear in at least the same size
letters or type as the name of the organization.
21.2 The Contractor shall not use the words the "Area Agency on Aging for Southwest Florida, Inc., and the
State of Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise
financed, unless specific authorization has been obtained by the Agency prior to use.
22. Assignments:
22.1 The Contractor shall not assign the rights and responsibilities under any contract or agreement
incorporating this Master Contract by reference without the prior written approval of the Agency,
which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring
without prior written approval of the Agency will constitute a material breach of the contract or
agreement.
22.2 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or
obligations under any contract or agreement to another governmental agency in the State of Florida, upon
giving prior written notice to the Contractor. In the event the State of Florida approves transfer of the
Contractor's obligations, the Contractor remains responsible for all work performed and all expenses
incurred in connection with the contract or agreement.
22.3 All contracts or agreements incorporating this Master Contract by reference shall remain binding upon the
successors in interest of either the Contractor or the Agency.
23. Subcontracts:
23.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to any
contract or agreement incorporating this Master Contract by reference, whether actually furnished by the
Contractor or its Subcontractors. Any subcontracts shall be evidenced by a written document and subject
to any conditions of approval the Agency deems necessary. The Contractor further agrees that the
Agency will not be liable to the Subcontractor in any way or for any reason. The Contractor, at its
expense,shall defend the Agency against any such claims.
8
io,
�
16 015
July 2014 Contract#HM203.14
23.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or
other state agency. Failure to make payments to any Subcontractor in accordance with s. 287.0585, F.S.,
unless otherwise stated in the contract or agreement incorporating this Master Contract by reference
between the Contractor and Subcontractor,will result in a penalty as provided by statute.
23.3 Service Cost Reports—The Contractor shall require Subcontractors to annually submit to the Contractor
service cost reports,which reflect actual costs of providing each service by program. This report provides
information for planning and negotiating unit rates.
24. Funding Obligations:
24.1 The Agency acknowledges its obligation to pay the Contractor for the performance of the
Contractor's duties and responsibilities set forth in any contract or agreement incorporating this Master
Contract by reference.
24.2 The Agency shall not be liable to the Contractor for costs incurred or performance rendered unless
such costs and performances are in accordance with the terms and conditions of any contract or agreement
executed between the parties, which incorporates this Master Contract by reference, including but not
limited to terms, governing the Contractor's promised performance and unit rates and/or reimbursement
capitations specified.
24.3 The Agency shall not be liable to the Contractor for any expenditures which are not allowable costs as
defined in the C.F.R., Title 45, Parts 74 and 92, as amended, or which expenditures have not been made in
accordance with all applicable state and federal rules.
24.4 The Agency shall not be liable to the Contractor for expenditures made in violation of regulations
promulgated under the Older Americans Act, as amended, or in violation of applicable state and federal
laws,rules,or provisions of any contract or agreement incorporating this Master Contract by reference.
25. jndependent Capacity of Contractor:
It is the intent and understanding of the Parties that the Contractor, or any of its Subcontractors, are independent
Contractor's and are not employees of the Agency and shall not hold themselves out as employees or agents of
the Agency without specific authorization from the Agency. It is the further intent and understanding of the Parties
that the Agency does not control the employment practices of the Contractor and will not be liable for any wage
and hour, employment discrimination, or other labor and employment claims against the Contractor or its
Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to
unemployment compensation funds and all necessary insurance for the Contractor are the sole responsibility of
the Contractor.
26. Payment;
26.1 Payments shall be made to the Contractor pursuant to s. 215.422, F.S., as services are rendered and
invoiced by the Contractor. The Contract Manager will have final approval of the invoice for payment,
and will approve the invoice for payment only if the Contractor has met all terms and conditions of the
contract or agreement incorporating this Master Contract by reference, unless the bid specifications,
purchase order, or the contract or agreement specify otherwise. The approved invoice will be submitted to
the Agency's finance section for budgetary approval and processing. Disputes arising over invoicing and
payments will be resolved in accordance with the provisions of s. 215.422 F.S. A Vendor
Ombudsman has been established within the Department of Financial Services and may be contacted at
850-413-5665.
26.2 The Contractor agrees to submit bills for fees or other compensation for services or expenses in sufficient
detail for a proper pre audit and post audit thereof. The contractor shall comply with the particular
requirements under the following laws and guidelines that are applicable to the contracts or agreements
9
16015
July 2014 Contract#HM203.14
incorporating this Master Contract by reference: (a)paragraph(16)(b)of section 216.181, F.S.,regarding
advances; (b)Rule 691-40.103 F.A.C. pertaining to Restriction of Expenditures from state funds; and, (c)
the Invoice Requirements of the Reference Guide for State Expenditures from the Department of
Financial Services at:
(http://www.myfloridacfo.com/aadir/reference_guide/Reference Guide For_State Expenditures.pdf).
The Contractor will certify that detailed documentation is available to support each item on the itemized
invoice or payment request for cost reimbursed expenses, fixed rate or deliverables contracts or
agreements incorporating this Master Contract by reference, including paid Subcontractor invoices, and
will be produced upon request by the Agency. The Contractor will further certify that reimbursement
requests are only for allowable expenses as defined in the laws and guiding circulars cited in Sections 4
and 5 of this Master Contract, in the Reference Guide for State Expenditures, and any other laws or
regulations, as applicable, and that administrative expenses do not exceed amounts budgeted in the
Contractor's approved area plan as developed in accordance with and pursuant to section 306(a) of the
Older Americans Act of 1965,as amended.
26.3 The Contractor and Subcontractors shall provide units of deliverables, including reports, findings, and
drafts as specified in the contracts or agreements and attachments which incorporate this Master Contract
by reference, and the area plans developed by the Contractor (pursuant to section 306(a) of the Older
Americans Act),to be received and accepted by the Contract Manager prior to payment.
27. Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of any contract or agreement
incorporating this Master Contract by reference that were disbursed to the Contractor by the Agency. In the
event that the Contractor or its independent auditor discovers that an overpayment has been made,the Contractor
shall repay said overpayment immediately without prior notification from the Agency. In the event that the
Agency first discovers an overpayment has been made, the Contract Manager will notify the Contractor in
writing of such findings. Should repayment not be made forthwith, the Contractor shall be charged at the lawful
rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after Agency notification or Contractor
discovery.
28. pata Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or
using in the performance of any contract or agreement incorporating this Master Contract by reference. An
appropriate level of security includes approving and tracking all Contractor employees that request system or
information access and ensuring that user access has been removed from all terminated employees. The
Contractor, among other requirements, must anticipate and prepare for the loss of information processing
capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages of the
computer system. The security over the backed-up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign ATTACHMENT III prior to the execution of the
Master Contract.
29. Computer Use and Social Media Policy:
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use
Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all
personnel affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any
entity that uses the Department's computer resource systems must comply with the Department's policy regarding
social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds,
video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as
flickr and YouTube.This policy is available on the Department's website at:
http://elderaffairs.state.fl.us/doea/financial.php
10 o'�
16D15
July 2014 Contract#HM203.14
30. Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management and Subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer or agent of the Contractor or Subcontractor shall
participate in selection, or in the award of an agreement supported by state or federal funds if a conflict of interest,
real or apparent, would be involved. Such a conflict would arise when: (a)the employee, officer or agent; (b)any
member of his/her immediate family; (c) his or her partner; or (d) an organization which employs, or is about to
employ, any of the above, has a financial or other interest in the firm selected for award. The Contractor or
Subcontractors officers, employees or agents will neither solicit nor accept gratuities, favors or anything of
monetary value from Contractors, potential Contractors, or parties to subcontracts. The Contractors board
members and management must disclose to the Agency any relationship which may be, or may be perceived to
be, a conflict of interest within thirty (30) calendar days of an individual's original appointment or placement in
that position, or if the individual is serving as an incumbent, within thirty (30) calendar days of the
commencement of any contract or agreement incorporating this Master Contract by reference. The Contractors
employees and Subcontractors must make the same disclosures described above to the Contractors Board of
Directors.Compliance with this provision will be monitored.
31. Public Entity Crime:
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid,proposal,or reply on a contract or agreement to provide
any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract or agreement with
a public entity for the construction or repair of a public building or public work; may not submit bids, proposals,
or replies on leases of real property to a public entity; may not be awarded or perform work as a Contractor,
Supplier, Subcontractor, or Consultant under a contract or agreement with any public entity; and may not transact
business with any public entity in excess of the threshold amount provided in s. 287.017(2), F.S., for Category
Two for a period of 36 months following the date of being placed on the convicted vendor list.
32. Purchasing:
32.1 The Contractor may purchase articles which are the subject of or are required to carry out any contract or
agreement from Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified
under Chapter 946,F.S., in the same manner and under the procedures set forth in subsections 946.515(2)
and (4), F.S. For purposes of any contract or agreement incorporating this Master Contract by reference,
the Contractor shall be deemed to be substituted for the Agency insofar as dealings with PRIDE. This
clause is not applicable to Subcontractors unless otherwise required by law. An abbreviated list of
products/services available from PRIDE may be obtained by contacting PRIDE, 800-643-8459.
32.2 The Contractor may procure any recycled products or materials, which are the subject of or are required
to carry any contract or agreement incorporating this Master Contract by reference, in accordance with the
provisions of s.403.7065,F.S.
32.3 The Contractor may purchase articles that are the subject of, or required to carry out, any contract or
agreement from a nonprofit agency for the Blind or for the Severely Handicapped that is qualified
pursuant to Chapter 413, F.S., in the same manner and under the same procedures set forth in s.
413.036(1) and (2), F.S. For purposes of any contract or agreement incorporating this Master Contract by
reference, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with
such qualified nonprofit agency are concerned. Additional information about the designated nonprofit
agency and the products it offers is available at http://www.respectofflorida.org/. This clause is not
applicable to Subcontractors unless otherwise required by law.
33. Patents.Copyrights.Royalties:
33.1 If any contract or agreement incorporating this Master Contract by reference is awarded state funding and
if any discovery, invention or copyrightable material is developed,produced or for which ownership was
purchased in the course of or as a result of work or services performed under any contract or agreement
11
16 015
July 2014 Contract#HM203.14
incorporating this Master Contract by reference, the Contractor shall refer the discovery, invention or
material to the Agency to be referred to the Department of State. Any and all patent rights or
copyrights accruing under any contract or agreement incorporating this Master Contract by reference are
hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5)
(k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and
reasonably valued in any contract or agreement incorporating this Master Contract by reference.
33.2 If the primary purpose of any contract or agreement incorporating this Master Contract by reference is the
creation of intellectual property, the State of Florida shall retain an unencumbered right to use such
property,notwithstanding any agreement made pursuant to this section 33.
33.3 If any contract or agreement incorporating this Master Contract by reference is awarded solely federal
funding,the terms and conditions are governed by 2 CFR 215.36.
34. Jmergency Preparedness and Continuity of Operations:
34.1 If the tasks to be performed pursuant to any contract or agreement incorporating this Master Contract by
reference include the physical care and control of clients, or the administration and coordination of
services necessary for client health, safety or welfare, the Contractor shall, within thirty (30) calendar
days of the execution of any contract or agreement, submit to the Contract Manager verification of an
emergency preparedness plan. In the event of an emergency,the Contractor shall notify the Agency of
emergency provisions.
34.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall retain
responsibility for performance under any contract or agreement incorporating this Master Contract by
reference and must follow procedures to ensure continuity of operations without interruption.
35. JEquipment;
35.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more
than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level
established by the organization for the financial statement purposes,or$5,000.00 [for federal funds],or(b);
nonexpendable, tangible personal property of a non-consumable nature with an acquisition cost of
$1,000.00 or more per unit, and expected useful life of at least one year; and hardback bound books not
circulated to students or the general public,with a value or cost of$250.00 or more [for state funds].
35.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; and, (b)a procedure for conducting a physical inventory of equipment at
least once every two years. (c) a control system to insure adequate safeguards to prevent loss, damage, or
theft of the equipment; and (d) maintenance procedures to keep the equipment in good condition. The
property records must be maintained on file and shall be provided to the Agency upon request. The
Contractor shall promptly investigate, fully document and notify the Contract Manager of any loss,
damage, or theft of equipment. The Contractor shall provide the results of the investigation to the Contract
Manager.
35.3 The Contractor's property management standards for equipment acquired with Federal funds and federally-
owned equipment shall include accurately maintained equipment records with the following information:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
(3) Source of the equipment,including the award number;
(4) Whether title vests in the Contractor or the federal government;
(5) Acquisition date (or date received, if the equipment was furnished by the federal government) and
cost;
12
July 2014 16015#HM203.14
(6) Information from which one can calculate the percentage of federal participation in the cost of the
equipment(not applicable to equipment furnished by the federal government);
(7) Location and condition of the equipment and the date the information was reported;
(8) Unit acquisition cost;and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased
with state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan
approved by the Agency is part of the cost of carrying out the activities and functions of the grant
awards and Title (ownership) will vest in the Contractor, subject to the conditions of 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A-110), Subpart C, paragraph 34. Equipment
purchased under these thresholds is considered supplies and is not subject to property standards. Equipment
purchased with funds identified in the budget attachments to agreements covered by any contract or
agreement incorporating this Master Contract by reference, or identified in the sub-agreements with
Subcontractors (not included in a cost methodology), is subject to the conditions of section 273, F. S. and
60A-1.0017,F.A.C. or Title 45 CFR Part 74.
35.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or purchased with
funds provided through any contract or agreement incorporating this Master Contract without first
obtaining the approval of the Contract Manager. When disposing of property or equipment the Contractor
must submit a written request for disposition instructions to the respective Contract Manager. The request
should include a brief description of the property, purchase price, funding source, percentage of state or
federal participation, acquisition date and condition of the property. The request should also indicate the
Contractors proposed disposition (i.e., transfer or donation to another agency that administers federal
programs,offer the items for sale,destroy the items,etc.).
35.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within
120 days of the written request for disposition,the Contractor is authorized to proceed as directed in 2 CFR
Part 215 Administrative Requirements(formerly OMB Circular A-110).
35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto,
but excludes movable machinery and equipment. Real property may not be purchased with state or federal
funds through agreements covered under any contract or agreement incorporating this Master Contract
without the prior approval of the Agency. Real property purchases from Older Americans Act funds are
subject to the provisions of Title 42, Chapter 35, Subchapter III, Part A., Sec. 3030b United States Code
(USC). Real property purchases from state funds can only be made through fixed capital outlay grants and
aids appropriations and therefore are subject to the provisions of section 216.348,F.S.
35.8 Any permanent storage devices (e.g.: hard drives, removable storage media)must be reformatted and tested
prior to disposal to ensure no confidential information remains.
35.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any contract or agreement incorporating this Master Contract by
reference. An ITR worksheet is required for any computer related item costing$1,000.00 or more, including
data processing hardware, software, services, supplies, maintenance, training, personnel and facilities. The
completed ITR worksheet shall be maintained in the LAN administrator's file and must be provided to the
Agency upon request. The Contractor has the responsibility to require any Subcontractors to comply with
the Agency's ITR procedures.
13
i'
bb 1
July 2014
CI(Oct MZ'0�.14
36. pUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http://www.myflorida.com/apps/vbs/adoc/F7740_PUR1000.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of any contract or
agreement terms or conditions the contract shall take precedence over the PUR 1000 Form. However, if the
conflicting terms or conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the
terms or conditions contained in the PUR 1000 Form shall take precedence.
37. Use of State Funds to Purchase or Improve Real Property:
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor
or political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the date of purchase or the completion of the improvements or as further
required by law.
38. )Dispute Resolution:
Any dispute concerning performance of any contract or agreement incorporating this Master Contract by
reference shall be decided by the Contract Manager, who shall reduce the decision to writing and serve a copy on
the Contractor.
39. Financial Consequences of Non-Performance:
39.1 If the Contractor fails to meet the minimum level of service or performance identified in any contract or
agreement incorporating this Master Contract by reference, or that is customary for the industry, then the
Agency must apply financial consequences commensurate with the deficiency. Financial consequences
may include, but are not limited to, contract or agreement suspension, refusing payment,
withholding payments until the deficiency is cured, tendering only partial payments, and/or cancellation
of any contract or agreement and reacquiring services from an alternate source.
39.2 The Contractor wilt not-be charged with financial consequences, when a-failure to perform rises•out,of°•
causes that were the responsibility of the Agency.
40. No Waiver of Sovereign Immunity:
Nothing contained in any contract or agreement incorporating this Master Contract by reference is intended to
serve as a waiver of sovereign immunity by any entity to which sovereign immunity may be applicable.
41. Venue;
If any dispute arises out of any contract or agreement incorporating this Master Contract by reference, the venue
of such legal recourse will be Lee County,Florida.
42. Entire Contract:
This Master Contract and/or any contract or agreement incorporating this Master Contract by reference, contains
all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or
binding upon the Agency or the Contractor unless expressly contained herein or by a written subsequent
contract,agreement and/or amendment to this Master Contract signed by both Parties.
43. Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other
party and takes all reasonable efforts to cure the condition.
44. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or
unenforceable the other provisions are severable to that void provision and shall remain in full force and effect.
14
16
015
July 2014 Contract#HM203.14
45. Condition Precedent to Contract Appropriations:
The Parties agree that the Agency's performance and obligation to pay under any contract or agreement
incorporating this Master Contract by reference is contingent upon an annual appropriation by the Legislature.
46. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under any
contract or agreement incorporating this Master Contract by reference when deemed to be in the State of Florida's
best interest and reduced to a written amendment signed by both Parties. The Parties shall negotiate compensation
for any additional services added.
47. Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this Master Contract and any
contract or agreement incorporating this Master Contract by reference will not constitute or be deemed a waiver
of the Agency's right thereafter to enforce those rights,nor will any single or partial exercise of any such right
preclude any other or further exercise thereof or the exercise of any other right.
48. Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules and regulations as well as
applicable current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to
abide by these laws shall be deemed an event of default of the Contractor, and subject any contract or agreement
incorporating this Master Contract by reference, to immediate, unilateral cancellation at the discretion of the
Agency.
49. Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency as specified in any contract or
agreement incorporating this Master Contract by reference. If the Contractor fails to submit final request for
payment as specified in any contract or agreement,then all rights to payment may be forfeited and the Agency may
not honor any requests submitted. Any payment due under the terms of any contract or agreement incorporating
this Master Contract by reference may be withheld until all reports due from the Contractor and necessary
adjustments thereto have been approved by the Agency.
50. Renegotiation or Modification;
Modifications of the provisions of any contract, agreement, and this Master Contract shall be valid only when
they have been reduced to writing and duly signed by both parties. The rate of payment and the total dollar
amount may be adjusted retroactively for any contract or agreement incorporating this Master Contract by
reference to reflect price level increases and changes in the rate of payment when these have been established
through the appropriations process and subsequently identified in the Agency's operating budget.
51. Nuspension of Work:
The Agency may in its sole discretion suspend any or all activities under this Master Contract and any
Contract or agreement incorporating this Master Contract by reference, at any time, when in the best interests of
the State to do so. The Agency shall provide the Contractor written notice outlining the particulars of
suspension. Examples of the reason for suspension include, but are not limited to, budgetary constraints,
declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor shall
comply with the notice and shall not accept any purchase orders. Within ninety days, or any longer period agreed
to by the Contractor, the Agency shall either (1) issue a notice authorizing resumption of work, at which time
activity shall resume, or (2) terminate the Contract or purchase order. Suspension of work shall not entitle the
Contractor to any additional compensation.
52. Termination:
52.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate the
Master Contract and any contract or agreement incorporating this Master Contract by reference in whole or
in part when the Agency determines in its sole discretion that it is in the State's interest to do so.The
l5
16015
•
July 2014 Contract#HM203.14
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of the contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
52.2 Termination for Cause. The Agency may terminate the Master Contract and any contract or agreement
incorporating this Master Contract if the Contractor fails to (1) deliver the product within the time specified
in the contract or any extension, (2) maintain adequate progress, thus endangering performance of the
contract, (3)honor any term of the Master Contract and any contract or agreement incorporating this Master
Contract by reference, or (4) abide by any statutory, regulatory, or licensing requirement. Rule 60A-
1.006(3), F.A.C., governs the procedure and consequences of default. The contractor shall continue work on
any work not terminated. Except for defaults of Subcontractors at any tier,the Contractor shall not be liable
for any excess costs if the failure to perform the Contract arises from events completely beyond the control,
and without the fault or negligence, of the Contractor. If the failure to perform is caused by the default of a
Subcontractor at any tier, and if the cause of the default is completely beyond the control of both the
Contractor and the Subcontractor, and without the fault or negligence of either, the Contractor shall not be
liable for any excess costs for failure to perform, unless the subcontracted products were obtainable from
other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the
rights and obligations of the Parties shall be the same as if the termination had been issued for the
convenience of the Agency. The rights and remedies of the Agency in this clause are in addition to any
other rights and remedies provided by law or under the Contract.
52.3 Upon expiration or termination of this Master Contract and any contract or agreement incorporating this
Master Contract by reference the Contractor and Subcontractors shall transfer all public records in its
possession to the Agency and destroy any duplicate public records that are exempt or confidential and
exempt from public records, disclosure requirements at no cost to the Agency. All electronically stored
records shall be provided to the Agency in a format that is compatible with the Agency's information
technology system(s).
53. Electronic Records and Signature:
53.1 The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to
use electronic signatures to conduct transactions necessary to carry out the terms of this Master Contract
and any contract(s) or agreement(s)which incorporate this Master Contract by reference. A Contractor that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply
with the requirements contained in the Uniform Electronic Transaction Act, s. 668.50, F.S. All electronic
records must be fully auditable; are subject to Florida's Public Records Law, chapter 119, F.S.; must
comply with section 28, Data Integrity and Safeguarding Information; must maintain all confidentiality, as
applicable; and must be retained and maintained by the Contractor to the same extent as non-electronic
records are retained and maintained as required by any contract or agreement incorporating this Master
Contract by reference.
53.2 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the
Agency only upon further written consent by the Agency.
53.3 Upon request by the Agency, the Contractor shall provide the Agency with non-electronic (paper) copies
of records. Non-electronic (paper) copies provided to the Agency of any document that was originally
in electronic form with an electronic signature must indicate the person and the person's capacity
who electronically signed the document on any non-electronic copy of the document.
54. Special Provisions:
The Contractor agrees to the following provisions:
16
16015
July 2014 Contract#HM203.14
54.1 Investigation of Criminal Allegations:
Any report that implies criminal intent on the part of the Contractor or any Subcontractors and referred to
a governmental or investigatory agency must be sent to the Agency and/or Department. If the Contractor
has reason to believe that the allegations will be referred to the State Attorney, a law enforcement
agency, the United States Attorney's office, or other governmental agency, the Contractor shall notify
the Agency and the Inspector General at the Department immediately. A copy of all documents, reports,
notes or other written material concerning the investigation, whether in the possession of the Contractor
or Subcontractors, must be sent to the Agency and the Department's Inspector General with a summary of
the investigation and allegations.
54.2 Volunteers:
The Contractor shall ensure the use of trained volunteers in providing direct services delivered to older
individuals and individuals with disabilities needing such services. If possible, the Contractor shall work
in coordination with organizations that have experience in providing training,placement,and stipends for
volunteers or participants (such as organizations carrying out federal service programs administered by
the Corporation for National and Community Service),in community service settings.
54.3 Enforcement:
54.3.1 In accordance with Section 430.04, F.S., the Agency may, without taking any intermediate
measures available to it against the Contractor, rescind the Contractors designation as a lead
agency, if the Agency finds that:
54.3.2 An intentional or negligent act of the Contractor has materially affected the health, welfare, or
safety of clients served pursuant to any contract or agreement incorporating this Master Contract
by reference, or substantially and negatively affected the operation of services covered under any
contract or agreement;
54.3.3 The Contractor lacks financial stability sufficient to meet contractual obligations or that
contractual funds have been misappropriated;
54.3.4 The Contractor has committed multiple or repeated violations of legal and regulatory standards,
regardless of whether such laws or regulations are enforced by the Agency, or the Contractor has
committed or repeated violations of Agency standards;
54.3.5 The Contractor has failed to continue the provision or expansion of services after the declaration
of a state of emergency; and/or
54.3.6 The Contractor has failed to adhere to the terms of any contract or agreement incorporating this
Master Contract by reference.
54.3.7 In the alternative, the Agency may, at its sole discretion, in accordance with section 430.04,
F.S., take immediate measures against the Contractor, including: corrective action, unannounced
special monitoring, temporary assumption of the operation of one or more contractual services,
placement of the Contractor on probationary status, imposing a moratorium on Contractor action,
imposing financial penalties for nonperformance, or other administrative action pursuant to
Chapter 120,F.S.
54.3.8 In making any determination under this provision the Agency may rely upon the findings of
another state or federal agency, or other regulatory body. Any claims for damages for breach of
any contract or agreement incorporating this Master Contract by reference are exempt from
administrative proceedings and shall be brought before the appropriate entity in the venue of
Lee County. In the event the Agency initiates action to rescind an area agency on aging's
designation,the Agency shall follow the procedures set forth in 42 U.S.C. § 3025(b).
17
16015
• July 2014 Contract#HM203.14
54.4 Use of Service Dollars/Wait List Management:
The Contractor will spend all federal, state, and other funds provided by the Agency, for the purpose
specified in each contract or agreement incorporating this Master Contract by reference.The Contractor must
manage the service dollars to ensure that the Assessed Prioritized Consumer List (APCL) contains no
individuals who have been assigned a ranking of four(4)or five(5)when service dollars are available.
If the Agency determines that the Contractor is not spending funds accordingly, the Agency may transfer
funds to other PSAs during the contract period and/or adjust subsequent funding allocations accordingly, as
allowable under state and federal law.
54.5 The Contractor agrees to distribute funds as detailed in the area plan update and the Budget Summary,
included in each contract or agreement incorporating this Master Contract by reference. Any changes in the
amounts of federal or general revenue funds identified on the Budget Summary form require a contract
amendment.
54.6 Surplus/Deficit Report:
The Contractor will submit a consolidated surplus/deficit report in a format provided by the Agency to
the Agency's Contract Manager by the 15th of each month, "Lead Agency Spending Report."This report is
for all contracts or agreements incorporating this Master Contract by reference between the Contractor and
the Agency. The report will include the following
54.6.1 The Contractor's detailed plan on how the surplus or deficit spending exceeding the threshold
of+/-2%; and
54.6.2 Recommendations to transfer funds to resolve surplus/deficit spending.
55. All Terms and Conditions Included:
This Master Contract and its Attachments, I — V, A, B, D, G, H and J and any exhibits referenced in said
attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed
upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein,
and this Master Contract shall supersede all previous communications, representations or agreements, either
written or verbal between the Parties,
By signing this contract,the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, the Parties hereto have caused this Master Contract to be executed by their
undersigned officials as duly authorized.
Contractor: COLL R COI QTY BOARD OF AREA AGENC f N GING FOR
COU,'t' C i ISSIONERS SOUTHW. J O' 1 • NC.
SIGNED ' : SIGNED B
NAME: Tom Hennin• I NAME: RONALD LUCCHINO, PhD
TITLE: Chairman TITLE: BOARD PRESIDENT
DATE: July 8, 2014 DATE: T J fi
Approved as to form and legality
Federal Tax ID: 59-6000558 i
Fiscal Year Ending Date: 9/30 t(A
Ass stant Coun orney
Attest aslo Chairman s
signature only.
18 \ie
16 015
' July 2014 Contract#HM203.14
ATTACHMENTI
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS,GRANTS,LOANS AND AGREEMENTS
The undersigned certifies,to the best of his or her knowledge and belief,that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an
officer or employee of congress, an employee of a member of congress, or an officer or employee of the state
legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of
any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan,or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of
congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying,"
in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all sub-
awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements)
and that all Subcontractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil
penalty of nlo ess than ', 0,000.00 and not more than$100,000.00 for each such failure.
ii July 8, 2014
Si_nature / Date
Tom Henning, Chairman HM203.14
Name of Authorized Individual Application or Agreement Number
Collier County Board of County Commissioners
Approved as to form and legality
tar As istant Coun orney �(
Attest as to Chairman's V
signature only.
DOEA Form 103
(Revised Nov 2002)
19
16 015
July 2014 Contract#HM203.14
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Area Agency on Aging for Southwest Florida, Inc. to the Contractor
may be subject to audits and/or monitoring by the Area Agency on Aging for Southwest Florida, Inc., as described in this
section.
Monitoring
In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 215.97, F.S.,
(see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the Agency staff,
limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this
agreement, the Contractor agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate
by the Area Agency on Aging for Southwest Florida, Inc. In the event the Area Agency on Aging for Southwest Florida,
Inc. determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any
additional instructions provided by the Area Agency on Aging for Southwest Florida, Inc. to the Contractor regarding
such audit. The Contractor further agrees to comply and cooperate with any inspections, reviews, investigations, or
audits deemed necessary by the Chief Financial Officer(CFO)or Auditor General.
AUDITS
PART I:FEDERALLY FUNDED
This part is applicable if the Contractor is a state or local government or a non-profit organization as defined in OMB
Circular A-133,as revised.
In the event that the Contractor expends $500,000.00 or more in federal awards during its fiscal year,the Contractor must
have a single or program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised.
EXHIBIT 1 to this agreement indicates federal resources awarded through the Department of Elder Affairs by this
agreement. In determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of
federal awards, including federal resources received from the Department of Elder Affairs. The determination of amounts
of federal awards expended should be in accordance with the guidelines established by OMB Circular A-133, as revised.
An audit of the Contractor conducted by the Auditor General in accordance with the provisions of OMB Circular A-133,
as revised,will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133,as revised.
If the Contractor expends less than $500,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of OMB Circular A-133, as revised, is not required. In the event that the Contractor expends less than
$500,000.00 in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of
OMB Circular A-133, as revised, the cost of the audit must be paid from non-federal resources (i.e.,the cost of such audit
must be paid from Contractor resources obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Department of Elder Affairs shall be based on the agreement's
requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall
disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and
liabilities due to the Department of Elder Affairs shall be fully disclosed in the audit report with reference to the
Department of Elder Affairs agreement involved. If not otherwise disclosed as required by Section .310(b)(2) of OMB
Circular A-133, as revised, the schedule of expenditures of federal awards shall identify expenditures by agreement
number for each agreement with the Department of Elder Affairs in effect during the audit period. Financial reporting
packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9
months after the end of the Contractors fiscal year end.
20
J
iôui5
July 2014 Contract#HM203.14
PART II: STATE FUNDED
This part is applicable if the Contractor is a non-state entity as defined by Section 215.97(2),Florida Statutes.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of$500,000.00 in
any fiscal year of such Contractor (for fiscal years ending September 30, 2004 or thereafter), the Contractor must have a
State single or project-specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable
rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and
for-profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance
awarded through the Department of Elder Affairs by this agreement. In determining the state financial assistance
expended in its fiscal year, the Contractor shall consider all sources of state financial assistance, including state financial
assistance received from the Department of Elder Affairs, other state agencies, and other non-state entities. State financial
assistance does not include federal direct or pass-through awards and resources received by a non-state entity for federal
program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting
package as defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for-profit organizations),Rules of the Auditor General.
If the Contractor expends less than $500,000.00 in state financial assistance in its fiscal year (for fiscal years ending
September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida
Statutes, is not required. In the event that the Contractor expends less than $500,000.00 in state financial assistance in its
fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, the
cost of the audit must be paid from the non-state entity's resources (i.e., the cost of such an audit must be paid from the
Contractor resources obtained from other than state entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Department of Elder Affairs shall be based on the agreement's
requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or
not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the
Department of Elder Affairs shall be fully disclosed in the audit report with reference to the Department of Elder Affairs
agreement involved. If not otherwise disclosed as required by Rule 691-5.003, Fla. Admin. Code, the schedule of
expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the
Department of Elder Affairs in effect during the audit period. Financial reporting packages required under this part must
be submitted within 45 days after delivery of the audit report,but no later than 12 months after the Contractors fiscal year
end for local governmental entities. Non-profit or for-profit organizations are required to be submitted within 45 days
after delivery of the audit report, but no later than 9 months after the Contractors fiscal year end. Notwithstanding the
applicability of this portion, the Department of Elder Affairs retains all right and obligation to monitor and oversee the
performance of this agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by
PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or
on behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Marianne G. Lorini, President/CEO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
21
16015
July 2014 Contract#HM203.14
The Federal Audit Clearinghouse designated in OMB Circular A-133,as revised(the number of copies required by
Sections.320(d)(1)and(2),OMB Circular A-133,as revised, should be submitted to the Federal Audit Clearinghouse),at
the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville,IN 47132
Other federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as
revised.
Pursuant to Sections .320(f), OMB Circular A-133, as revised,the Contractor shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the
Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Marianne G. Lorini, President/CEO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on
behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida,Inc.
Attn: Marianne G. Lorini,President/CEO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building,Room 574
111 West Madison Street
Tallahassee,Florida 32399-1450
Any reports, management letter, or other information required to be submitted to the Area Agency on Aging for Southwest
Florida, Inc pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-133, Florida
Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of
the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Area Agency on Aging for Southwest Florida, Inc. for
audits done in accordance with OMB Circular A-133 or Chapters 10.550(local governmental entities)or 10.650(nonprofit
and for-profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was
delivered to the Contractor in correspondence accompanying the reporting package.
PART IV:RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period
of six years from the date the audit report is issued, and shall allow the Department of Elder Affairs and/or the
Area Agency on Aging for Southwest Florida, Inc. or its designee, the CFO or Auditor General access to such records
upon request. The Contractor shall ensure that audit working papers are made available to the Area Agency on Aging for
Southwest Florida, Inc., or its designee, CFO, or Auditor General upon request for a period of six years from the date the
audit report is issued,unless extended in writing by the Area Agency on Aging for Southwest Florida, Inc.
22
J./1
16015
July 2014 Contract#HM203.14
ATTACHMENT II
EXHIBIT 1
PART I:AUDIT RELATIONSHIP DETERMINATION
Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A-133,as
revised,and/or Section 215.97,Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards or state
financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of
Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A-
133,as revised,and/or Section 215.97,Fla. Stat. Regardless of whether the audit requirements are met,providers who have been
determined to be recipients or subrecipients of Federal awards and/or state financial assistance,must comply with applicable
programmatic and fiscal compliance requirements.
In accordance with Sec.210 of OMB Circular A-133 and/or Rule 691-5.006,FAC,provider has been determined to be:
Vendor or exempt entity and not subject to OMB Circular A-133 and/or Section 215.97,F.S.
X Recipient/subrecipient subject to OMB Circular A-133 and/or Section 215.97,F.S.
NOTE: If a provider is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by
the Department to subcontract,they must comply with Section 215.97(7),F.S.,and Rule 69I-.006(2),FAC [state financial assistance]
and Section 400 OMB Circular A-133 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive federal awards or
state matching funds on federal awards and who are determined to be a subrecipient,must comply with the following fiscal laws,rules
and regulations:
STATES,LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State,Local and Indian Tribal Governments(Formerly OMB Circular A-87)*
OMB Circular A-102—Administrative Requirements
OMB Circular A-133—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non-Profit Organizations(Formerly OMB Circular A-122—Cost Principles)*
2 CFR Part 215 Administrative Requirements(Formerly OMB Circular A-110—Administrative Requirements)
Requirements)
OMB Circular A-133—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
EDUCATIONAL INSTITUTIONS(EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)MUST
FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB(Formerly Circular A-21 —Cost Principles)*
2 CFR Part 215 Administrative Requirements(Formerly OMB Circular A-110—Administrative Requirements)
OMB Circular A-133—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
*Some federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular
A-133 Compliance Supplement,Appendix 1.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient/subrecipient,must comply with the following fiscal laws,rules and regulations:
Section 215.97,Fla. Stat.
Chapter 691-5,Fla.Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
23
` ^1
. 16015
•
July 2014 Contract#HM203.14
ATTACHMENT III
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,GRANTS,
LOANS AND COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is
an attachment,hereby certifies that:
(1) The Contractor and any Subcontractors of services under this contract have financial management systems capable of
providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each
grant-funded project or program in accordance with the prescribed reporting requirements; (2) the source and
application of funds for all agreement supported activities; and(3) the comparison of outlays with budgeted amounts
for each award. The inability to process information in accordance with these requirements could result in a return of
grant funds that have not been accounted for properly.
(2) Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported,transmitted or calculated, have been assessed and verified to be
capable of processing data accurately, including year-date dependent data. For those systems identified to be non-
compliant,Contractors will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year-date dependent data accurately. All versions
of these products offered by the Contractor (represented by the undersigned) and purchased by the state will be
verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted herein,
at no charge to the state,and without interruption to the ongoing business of the state,time being of the essence.
(4) The Contractor and any Subcontractors of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from
data integrity compliance issues.
The Contractor shall require that the language of this certification be included in all subagreements,subgrants,and other
agreements and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
OMB Circulars A-102 and 2 FR Part 215 (formerly OMB Circular A-110).
Chairman July 8, 2014
Signature Title Date
Tom Henning r►:
Name of Authorized Signer
Attest as to Chairman Approved as to form and legality
Collier County Board of County Commissioners signature only.
(Revised June 2008) VAS4
Assistant County ey > ho.
9 S\
24 ti
• 16015
•
July 2014 Contract#HM203.14
ATTACHMENT IV
CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY
EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1) The Contractor certifies, by signing this certification, neither it nor its principals are presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this
transaction by any federal department or agency.
(2) Where the Contractor is unable to certify to any of the statements in this certification, such prospective
participant shall attach explanation to this certification.
¢�� July 8,2014
S na e: oT m Henning Date
Chairman Collier County Board of County Commissioners
Title Agency/Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification
1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction,"
"person," "primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out
in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020, as supplemented by 2
CFR 376.10-376.995). You may contact the Contract Manager for assistance in obtaining a copy of those
regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered
into this transaction. If it is later determined that the Contractor knowingly rendered an erroneous certification,
in addition to other remedies available to the federal government, the Department may pursue available
remedies,including suspension and/or debarment.
3. The Contractor will provide immediate written notice to the Contract Manager if at any time the Contractor
learns that its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances. The Contractor may decide the method and frequency by which it determines the eligibility of
its principals. Each participant to a lower tier covered transaction may, but is not required to, check the
Excluded Parties List System(EPLS).
4. The Contractor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations
for lower tier covered transactions.
5. The Contractor agrees that it shall not knowingly enter into any lower tier covered transaction with a person
who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise
authorized by the federal government.
6. If the Contractor knowingly enters into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies
available to the federal government, the Department may pursue available remedies, including suspension,
and/or debarment.
7. The Contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that
it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows
that the certification is erroneous. Approved as to form and legality
(Revised June 2008) Attest as to Chairma Assistant County y
signature only. v -
16015
•
•
July 2014 Contract#HM203.14
ATTACHMENT V
ASSURANCES—NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the
collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project(0348-0043),
Washington,DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the
awarding agency. Further, certain federal awarding agencies may require applicants to certify to additional assurances.
If such is the case,you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability (including funds
sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and completion of the project
described in this application.
2. Will give the awarding agency,the Comptroller General of the United States, and if appropriate, the state,through any authorized
representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest,or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728-4763)relating to prescribed standards for merit
systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit
System of Personnel Administration(5 C.F.R. 900,Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil
Rights Act of 1964 (P.L. 88-352)which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended(20 U.S.C. 1681-1683, and 1685-1686), which prohibits discrimination on the basis
of sex; (c)Section 504 of the Rehabilitation Act of 1973,as amended(29 U.S.C. 794),which prohibits discrimination on the basis
of handicaps; (d)the Age Discrimination Act of 1975, as amended(42 U.S.C. 6101-6107), which prohibits discrimination on the
basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on
the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970(P.L. 91-616), as amended,relating to nondiscrimination on the basis of alcohol abuse or alcoholism;(g) 523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug
abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s)
under which application for federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s)
which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of federal participation in purchases.
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328), which limit the political
activities of employees whose principal employment activities are funded in whole or in part with federal funds.
9. Will comply, as applicable,with the provisions of the Davis-Bacon Act(40 U.S.C. 276a to 276a-7),the Copeland Act(40 U.S.C.
276c and 18 U.S.C. 874)and the Contract Work Hours and Safety Standards Act(40 U.S.C. 327-333),regarding labor standards
for federally assisted construction subagreements.
26 ' �1
16
015
July 2014 Contract#HM203.14
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a)of the Flood Disaster Protection Act of
1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood
insurance if the total cost of insurable construction and acquisition is $10,000.00 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental
quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order(EO) 11514;
(b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of
federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended(42
U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as
amended,(P.L. 93-523); and (h)protection of endangered species under the Endangered Species Act of 1973,as amended,(P.L.
93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1721 et seq.)related to protecting components or potential
components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic
Preservation Act of 1974(16 U.S.C.469a-I et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.)pertaining to the
care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of
assistance.
16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. 4801 et seq.),which prohibits the use of lead-based
paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of
1996 and OMB Circular No.A-133,Audits of States,Local Governments,and Non-Profit Organizations.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies governing this
program.
SIGNATURE OF AUTHORIZE RTIF ,/ OFFICIAL TITLE
Tom Henn' Q°`� Chairman
APPLICANT ORGANIZATION DATE SUBMITTED
July 8,2014
Collier County Board of Commissio ers
Approved as to form and legality
+:. ... ■
Assisnt County y
Attest as to Chaiman
signature only, tea'
-7
27 ,; �
16015
July 2014 Contract#HM203.14
ATTACHMENT A
DEPARTMENT OF ELDER AFFAIRS PROGRAMS&SERVICES HANDBOOK
Department of Elder Affairs Programs&Services Handbook available at:
http://elderaffairs.state.fl.us/doea/nois.php (scroll to*July 2013 -Notices)
28
16015
July 2014 Contract#HM203.14
ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL County AAA/Contractor
RIGHTS COMPLIANCE CHECKLIST Program/Facility Name Collier
Address Completed By
3339 Tamiami Trail E, Suite 211 Lisa N. Carr, Grants Coordinator
City,State,Zip Code Date Telephone
Naples, FL 34112 06/23/2014 239-252-2339
PART I:READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
Collier County is situated over a 2,300 square mile area.Collier County Services for Seniors provides in-home care,care management and nutritional services
Total# % % % % %
For questions 2-5 please indicate the following: White Black Hispani Other Female Disabled Over 40
2.Population of area served Source of data:2012 Census 19,320,749 78.3% 16.6% 23.2% 1.9% 51.1%
3.Staff currently employed Effective date:6/24/14 8 50% 25% 25% 91%
4.Clients currently enrolled/registered Effective date:6/24/14 361 100%
5.Advisory/Governing Board if applicable 5 100% 40%
PART IL: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA? N/A YES NO
❑ • ❑
7. Compare the staff composition to the population. Is staff representative of the population? N/A YES NO
❑ • ❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race,color,national N/A YES NO
origin,sex,age,religion or disability? ❑ • ❑
9. Are all benefits, services and facilities available to applicants and participants in an equally effective manner N/A YES NO
regardless of race,sex,color,age,national origin,religion or disability? ❑ • ❑
10. For in-patient services,are room assignments made without regard to race,color,national origin or disability? N/A YES NO
• ❑ ❑
11. For in-patient services,are room assignments made without regard to race,color,national origin or disability? N/A YES NO
• ❑ ❑
12. Is the program/facility accessible to non-English speaking clients? N/A YES NO
❑ • ❑
Revised August 2010,Page 1 of 2
29
,Ji
16Q- 15
July 2014 Contract#HM203.14
13. Are employees,applicants and participants informed of their protection against discrimination? If YES,how? N/A YES NO
Verbal ❑ Written❑Poster❑ ❑ • ❑
14.Give the number and current status of any discrimination complaints regarding services or employment filed N/A NUMBER
against the program/facility.
15. Is the program/facility physically accessible to mobility,hearing, and sight-impaired individuals? N/A YES NO
❑ • ❑
PART III:THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF NO
EXPLAIN.
16.Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals,and to make any YES NO
necessary modifications? ❑ ❑
17. Is there an established grievance procedure that incorporates due process in the resolution of complaints? YES NO
❑ ❑
18. Has a person been designated to coordinate Section 504 compliance activities? YES NO
❑ ❑
19.Do recruitment and notification materials advise applicants,employees and participants of nondiscrimination on YES NO
the basis of disability? ❑ ❑
20.Are auxiliary aids available to assure accessibility of services to hearing and sight-impaired individuals? YES NO
❑ ❑
PART IV:FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF$50,000.00 OR MORE.
21. Do you have a written affirmative action plan? If NO,explain. YES NO
❑ ❑
DOEA USE ONLY
Reviewed By In Compliance: YES ❑ NO* ❑
Program Office *Notice of Corrective Action Sent / /
Date Telephone Response Due / /
On-Site ❑ Desk Review ❑ Response Received / /
Revised August 2010,Page 2 of 2
30
July 2014 .,untract#H2 .
g)
1
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city or other locality. If the program/facility
serves a specific target population such as adolescents, describe the target population. Also, define the type of
service provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population
statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census
containing Florida population statistics. Include the source of your population statistics. ("Other" races include
Asian/Pacific Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and
list their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA recipients and their sub-grantees,45 CFR 80.4(a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic,is there a comparable percentage of Hispanic staff?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their
availability in the population, the program/facility has the responsibility to determine the reasons for such
variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities
may exist when programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR
80.3 (b)(6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a)
and 45 CFR 80.1 (b)(2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national
origin,religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be
applied uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances,
waiting rooms, reception areas,restrooms and other facilities must also be equally available to all clients, 45 CFR
80.3 (b).
11. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race,color,national origin,or disability,45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons
who may not speak English. In geographic areas where a significant population of non-English speaking people
live,program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a
31
16015
July 2014 Contract#HM203.14
policy or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will
assist in the provision of services,45 CFR 80.3 (a).
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to
their participants, beneficiaries or any other interested parties. This should include information on their right to
file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of
HHS. The information may be supplied verbally or in writing to every individual, or may be supplied through the
use of an equal opportunity policy poster displayed in a public area of the facility,45 CFR 80.6(d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g.,race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment,
placement, termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the
name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the
current status,e.g.,settled,no reasonable cause found,failure to conciliate,failure to cooperate,under review,etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes
designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby,
public telephone, restroom facilities, water fountains, information and admissions offices should be accessible.
Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and
serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or
raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be
installed at an appropriate height for mobility impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a
self-evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
a. With the assistance of a disabled individual/organization,evaluate current practices and policies which do
not comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps
have been followed.),45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate
appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any
action prohibited by Section 504.45 CFR 84.7(b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7(a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper
ads,and other appropriate written communication,45 CFR 84.8(a).
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with
impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to,
interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be
used to provide equally effective services,45 CFR 84.52(d).
21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60
and Title VI of the Civil Rights Act of 1964,as amended.
32 =J
i
16
al5
z
W tD
V ° O N C O.. 1A
CD E V 4A- - - - - - - - � tfr — � -s - - - - - - - op
H W
o. n to
d
O O +O+
a o H # N CO
ILA 'LE C c N`n
H
O
a
M
N
Ct
4..f0 L C M O
N
In
CU H
CV 1-C a) C! 0U
3-1 U0 c c
O U O ci)C) = O IA
Co) 00 o T-fl
00 • t0
E•I Z;
CL
""`
N .2 -la'C� _
U
i C C d U C O N O (n
✓ °
.fl
W a `r
N Y Y fr
E-1 .„ w r- \4:1\. L
CA O — C W t0 \O 0)
° c
E O M ti, es
a w U I v.
W .t V
th▪ j Lm 4a N t 2
0 •— 61
P.
; > fa
z
v ro c
claw 3 i fa
,ct+-, N CU L \„� f - \.
C � Q
U
o -(0 fyW
W -�
� , ea nN
CO z C E 00 @zti a ~
.� Ln L E Z
O U C ° L �: w
Q 00 O cy.,5‘
�
a� 0 U O
cc o M o, GL. 's
L O U 01 "' C..)
.. ....
d.)
-O #
•> W
O E - o o N
� ° w
0. Q U �r
O ,-i N M d- ix) t0 N 00 fs O� ,__, ,N-1 m-ii Cr r_i t�D N
N
ti
16015
Contract#HM203.14
DEPARTMENT OF
BACKGROUND SCREENING
ELDER
Affidavit of Compliance - Employer
AFFAIRS p
STATE OF FLORIDA
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
➢ The term "employer" means any person or entity required by law to conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long-Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §§
435.02,430.0402, Fla.Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has access to the client's living area, funds, personal property, or personal identification information
as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities;and volunteers." §430.0402(1)(b), Fla.Stat.
ATTESTATION:
As the duly authorized representative of Collier County Housing, Human and Veteran Services
Employer Name
located at 3339 Tamiami Trail E. Suite 211 Naples FL 34112 ,
Street Address City State ZIP code
I, Kimberley Grant, Director do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402, Florida Statutes,regarding level 2 background screening.
��a�(�y �` .•
...o.•.Q
=
�
ooh h is '- �s•
Signature of Representative Date ��c ?o, 9•
zr. m.
p•. 1FF 101384 :Qi-
E` • i .•.+0.,:64404 lho o:••Q�
STATE OF FLORIDA, COUNTY OF ' ey' '�i9�A• ..:.:. �•��0`
olc suit Off\\`\`
Sworn to (or affirmed) and subscribed before me this day of �1( Lr�k , 20 1�, by
xr(� y (Name of Representative)who is personally known
to me or produced ''�,(S'UY1(LU.tj knu n AO MI- as proof of identification.
�1r c1� C Mcxxt 1 C . -1'YRc
Print,Type,or Stamp Commissioned Name of Notary Public Not ry Pub • `
DOEA Form 235,Affidavit of Compliance-Employer,Effective April 2012 Section 435.05(3),F.S.
Form available at:http://elderaffairs.state.fl.us/english/backgroundscreening.php
16 015
July 2014 Contract#HM203.14
ATTACHMENT H
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to
which this form is an attachment, hereby certifies that:
(1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or
submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized
Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran
Petroleum Sector List (collectively, "the Lists") is ineligible for, and may not bid on, submit a proposal
for, or enter into or renew a contract with the Area Agency on Aging for Southwest Florida, Inc.
(Agency) for goods or services of$1 million or more.
(2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false
certification to the Agency is subject to civil penalties, attorney's fees and costs and any costs for
investigations that led to the finding of false certification.
(3) The Contractor understands that the contract to which this form is an attachment may be terminated
by the Agency if the Contractor submits a false certification or has been placed on the Lists.
This certification, required by Florida law, is a material representation of fact upon which reliance was
placed when this transaction was made or entered into. Submission of this certification is a prerequisite
for making or entering into this transaction.
July 8, 2014
Signature: Tom Henning Date
(Same as contract sign./'re)
Chairman
Title
Collier County Board of County Commissioners
Approved as to form and legality
Assistant County Att y
0 ,\v
Attest as to,Chairman's c¢
signature
35
..
16015
July 2014 Contract#HM203.14
.
ATTACHMENT J
VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc.,
Collier County Board of County Commissioners—Human Services, hereby referred to as
Contractor, certifies the use of the U.S. Department of Homeland Security's E-verify system to
verify the employment eligibility of all new employees hired by Contractor during the contract
term to perform employment duties pursuant to this Agreement and that any subcontracts
include an express requirement that Subcontractors performing work or providing services
pursuant to this Agree, -nt utilize the E-verify system to verify the employment eligibility of
all new e /oyees .' :d by the Subcontractor during the contract term.
_.a... l& July 8, 2014
C 1• at e: Tom Henning Date
(Same as contract signature) /
Chairman
Title
Collier County Board of County Commissioners
Approved as to form and legality
C-.k-
• Assistant County Att
1 1: ' ' 4
Attest as to Chairman s �' ��
signature only
36
16015
Attestation Statement
Agreement/Contract Number HM203.14
Amendment Number N/A
I, Tom Henning.Chairman ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of Commissioners
(Signature of Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
1i). Ah ad& 7/8/2014
Signature of Recipient/Contracto' • I resentative Date
Approved as to form and legality
Pif
#1. Assistant County Atto
Attest as to Chairman's, c4
signature only. 41 1\�
• 16 015 i
VERIFICATION OF EMERGENCY PREPAREDNESS PLAN
Contract# HM203.14
I, Tom Henning, Chairman certify that Collier County Board of Commissioners
(Name of authorized contractor representative) (Name of contractor)
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made available to the Area Agency on Aging for Southwest Florida, Inc. upon
request.
L Signature of authorized contr pr representative
Chairman
Title
July 8, 2014
Date
Collier County Board of Commissioners
Company
,.- Approved as to form and legality
Attestasto Chairman's 4101 Assistant County Att
cidn3tii•n -e3;' `'
October 2008 5`
`