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Backup Documents 09/23/2014 Item #16D 1 (DLC) ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 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 Count e�fi� 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 document is already complete 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. Jennifer A. Belpedio,ACA County Attorney Office (AAA 91.14/ 142- 2. BCC Office Board of County Commissioners �/ 91.z.\\4 3. Minutes and Records Clerk of Court's Office f tO l PRIMA Y CONTACT INFORMATION Normally the primary contact is the person who created/p pared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or ssing information. Name of Primary Staff Rosa Munoz,HHVS Phone Number 252-5713 Contact/ Department Agenda Date Item was September 23,2014 Agenda Item Number 16D 1 Approved by the BCC Type of Document DLC 2014 Subrecipient Agreement Number of Original 3 Attached Documents Attached PO number or account �^ / number if document is 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? RM 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A —" provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be RM signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A 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 RM 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 RM ...- signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip RM 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 9/23/14 and all changes made during RM \off the meeting have been incorporated in the attached document. The County � i\ :�,; Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for e Chairman's signature. 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 1613i MEMORANDUM Date: September 29, 2014 To: Rosa Munoz, Grants Mgmt. Coordinator Housing, Human & Veteran Services From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Subrecipient Agreement with the David Lawrence Mental Health Center for the Community Access Administrative Services Program Grant #B-14-UC-12-0016 Attached please find two original agreements for the item referenced above (Agenda Item #16D1), approved by the Board of County Commissioners on Tuesday, September 23, 2014. The Minutes & Records Department will hold the third original as part of the Board's Official Records. If you have any questions, please feel free to contact me at 252-8411. Thank you. 16131 Grant#-B-14-UC-12-0016 CFDA/CSFA#- 14.218 Subrecipient—David Lawrence Mental Health Center, Inc. Agreement#CD14-07PS DUNS #-096580782 IDIS#486 FEID#- 59-2206025 Fiscal Year End: 06/30 Monitor End: 09/2015 AGREEMENT BETWEEN COLLIER COUNTY AND DAVID LAWRENCE MENTAL HEALTH CENTER,INC. THIS AGREEMENT is made and entered into thisZliay of 2014, by and between Collier County, a political subdivision of the State of Florida, ("COUNTY" or "Grantee") having its principal address as 3339 E. Tamiami Trail, Naples FL 34112, and the "David Lawrence Mental Health Center, Inc.", a private not-for-profit corporation existing under the laws of the State of Florida("Subrecipient"), having its principal office at 6075 Bathey Lane, Naples,FL 34116. WHEREAS, the County has entered into an agreement with the United States Department of Housing and Urban Development (HUD) for a grant for the execution and implementation of a Community Development Block Grant Program in certain areas of Collier County, pursuant to Title I of the Housing and Community Development Act of 1974 (as amended); and WHEREAS, the Board of County Commissioners of Collier County approved the Collier County Consolidated Plan —One Year Action Plan for Federal Fiscal Year 2014-2015 for the CDBG Program with Resolution 2014-129 on June 24, 2014—Agenda Item 16D8; and WHEREAS, the Subrecipient has submitted a proposal for participation in the Collier County CDBG program; and WHEREAS, the County and Subrecipient wish to set forth the responsibilities and obligations of each in undertaking the CDBG COMMUNITY ACCESS ADMINISTRATIVE SERVICES PROGRAM; and NOW, THEREFORE, in consideration of the mutual benefits contained herein, it is agreed by the Parties as follows: DLC CDBG CD14-07PS Community Access Administrative Services Program Page 1 of 41 OVa 1602. PART I SCOPE OF WORK The Subrecipient shall, in a satisfactory and proper manner and consistent with any standards required as a condition of providing CDBG assistance, as determined by Collier County Housing, Human and Veteran Services (HHVS), to perform the tasks necessary to conduct the program as follows: SCOPE OF SERVICES FY2014-2015 Action Plan identified and approved the Public Services Project to David Lawrence as follows: Project Component One: Salaries Funding costs will include but not limited to the following expenses: Fund 2 Full Time (FT) Benefits Managers, partial salary for Quality Improvement and Program Support Director Project Component Two: Supplies Funding costs will include but not limited to the following expenses: Fund purchase and set up of computer kiosks at various David Lawrence Center locations. Project Component Three: Postage/Freight/Shipping Funding costs will include but not limited to the following expenses: All costs associated with postage, freight and shipping. Items identified for funding are outlined in the PROJECT DETAILS in Section1.2. 1.1 SPECIAL GRANT CONDITIONS A. Within thirty (30) calendar days of the execution of this agreement, the Subrecipient must deliver to HHVS for approval a detailed project schedule for the completion of the project. B. The following resolutions and policies must be adopted by the Subrecipient's governing body within thirty(30) days of conveyance: 1. Affirmative Fair Housing Policy-N/A 2. Affirmative Action/Equal Opportunity Policy 3. Conflict of Interest Policy 4. Fraud Policy 5. Equal Opportunity Policy DLC CDBG CD14-07PS Community Access Administrative Services Program Page 2 of 41 6. Procurement Policy 16D 1 7. Residential Anti-displacement and Relocation Policy-N/A 8. Sexual Harassment Policy 9. Procedures for meeting the requirements set forth in Section 3 of the Housing and Urban Development Act of 1968, as amended (12 U.S.C. 794 1 u)-N/A 10. Procedures for meeting the requirements set forth in Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794) 1.2 PROJECT DETAILS A. Project Description/Budget Public Services Federal Funds Project Component One:Salaries $64,590 Funding costs will include but not limited to the following expenses: Fund 2 Full Time (FT) Benefits Managers, partial salary for Quality Improvement and Program Support Director; purchase and set up of computer kiosks at various David Lawrence Center locations. Project Component Two:Supplies $22,500 Funding costs will include but not limited to the following expenses: purchase and set up of computer kiosks at various David Lawrence Center locations. Project Component Three:Postage/Freiiht/Shippin2 $2,712 Funding costs will include but not limited to the following expenses: All costs associated with postage, freight and shipping. Total: $89,802 The Subrecipient will accomplish the following project tasks: Project Tasks 1. Maintain and provide to the County resident income certification or presumed eligibility documentation (Exhibit E) or documentation of Census Track 2. Provide quarterly reports on progress and procurement thresholds (Exhibits C & D) 3. Required attendance by Executive Management at quarterly partnership meetings, as requested B. National Objective DLC CDBG CD14-07PS Community Access Administrative Services Program Page 3 of 41 1601 The CDBG program funds awarded to Collier County must benefit low-moderate income persons (LMI). As such the Subrecipient shall be responsible for ensuring that all activities and beneficiaries meet the definition of Low Mod Clientele (LMC) or presumed Low Mod Clientele. C. Project Outcome The Subrecipient will provide Community Access Administrative Services and purchase and set up of computer kiosks to serve a minimum of three hundred (300) persons. D. Performance Deliverables The Following Table Details the Project Deliverables Program Deliverable Deliverable Supporting Submission Schedule Documentation Special Grant Condition Policies Policies as stated in this Within thirty (30) days of (Section 1.1) agreement Agreement Execution Creation and maintenance of income Exhibit E Deliverable: Ongoing and to eligibility files on clients served be reviewed during monitoring This funding will benefit a minimum of Exhibit C and D Deliverable: Ongoing and 300 individuals or presumed clientele evidenced by quarterly report and monitoring Quarterly Progress Reports Exhibit C&D Quarterly through 9/2015 Financial and Compliance Audit Exhibit F Annually one hundred eighty (180)days after FY end Proof of Insurance Insurance Certificate Annually within 30 days of renewal Program Income Re-Use Plan-If Program Income Plan Annually through 09/2015 Applicable Document Inventory(if applicable)-If Applicable Log Annually until 2020 Continued Use Certification Continued Use Affidavit Annually until 2020 E. Payment Deliverables The Following Table Details the Payment Deliverables PAYMENT DELIVERABLES Payment Deliverable Payment—Supporting Submission Schedule Documents DLC CDBG CD14-07PS Community Access Administrative Services Program Page 4 of 41 16131 Project Component One:Salaries Submission of supporting monthly Funding costs will include but not documents must be provided as limited to the following expenses: Fund back up as evidenced by i.e. time 2 Full Time (FT) Benefits Managers, sheets, payroll registers, banking partial salary for Quality Improvement documents, and any additional and Program Support Director. documents as needed—Exhibit B Final 10%($6,459.00)released upon documentation of a minimum of 300 persons served Project Component Two:Supplies Submission of supporting monthly Funding costs will include but not documents must be provided as limited to the following expenses: back up as evidenced by invoices, purchase and set up of computer kiosks procurement documents, banking at various David Lawrence Center documentation and any additional locations. documents as needed-Exhibit B Final 10%($2,250.00)released upon documentation of equipment purchase, installation and beneficiaries served Project Component Three: Submission of supporting monthly Postage/Frei2ht/Shippinj documents must be provided as Funding costs will include but not back up as evidenced by invoices, limited to the following expenses: All procurement documents, banking costs associated with postage, freight documentationand any additional and shipping. documents as needed-Exhibit B Final 10%($271.20)released upon documentation of equipment purchase , installation and beneficiaries served 1.3 TIME OF PERFORMANCE Services of the Subrecipient shall start upon execution of the agreement and shall end on September 30, 2015. 1.4 AGREEMENT AMOUNT The COUNTY agrees to make available EIGHTY NINE THOUSAND EIGHT HUNDRED TWO DOLLARS AND NO CENTS ($89,802.00) for the use by the SUBRECIPIENT during the Term of the Agreement (hereinafter, the aforestated amount including, without limitation, any additional amounts included thereto as a result of a subsequent amendment(s)to the Agreement, shall be referred to as the "Funds"). DLC CDBG CD14-07PS Community Access Administrative Services Program Page 5 of 41 /1:7._ 1601 Modifications to the "Budget and Scope" may only be made if approved in advance. Budgeted fund shifts between line items and project components shall not be more than 10% and does not signify a change in scope. Fund shifts that exceed 10% of a line item and a project component shall only be made with board approval. All improvements specified in Section I. Scope of Work shall be performed by SUBRECIPIENT employees, or shall be put out to competitive bidding under a procedure acceptable to the COUNTY and Federal requirements. The SUBRECIPIENT shall enter into contract for improvements with the lowest, responsive and qualified bidder. Contract administration shall be handled by the SUBRECIPIENT and monitored by HHVS, which shall have access to all records and documents related to the project. The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS. SUBRECIPIENT may not request disbursement of CDBG funds until funds are needed for eligible costs, and all disbursements requests must be limited to the amount needed at the time of the request. Invoices for work performed are required every month. SUBRECIPIENT may expend funds only for allowable costs resulting from obligations incurred during the term of this agreement. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a $0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Reimbursement will not occur if Subrecipient fails to perform the minimum level of service required by this agreement. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written authorization from the Grant Coordinator will not be reimbursed. The County Manager or designee may extend the term of this Agreement for a period of up to 180 days. The extension must be authorized prior to the expiration of the agreement. The extension must be authorized in writing by formal letter to the Subrecipient. No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 1.5 COST PRINCIPLES Payments to the Grantee are governed by the Federal grants management rule for cost allowability found at 24 CFR 85.22 (24 CFR 84.27 for nonprofit recipients). Accordingly, payments will be made on a cost reimbursement basis. Each request for reimbursement shall identify the associated project and approved project task(s) listed under this Scope of Work. The Grantee can only incur direct costs that may be attributed specifically to the projects referenced above. The Grantee must provide adequate documentation for validating costs incurred. Payments to Grantee's contractors and vendors are conditioned upon compliance with the procurement requirements provided for in 24 CFR 85.36 or 84.40-48, as applicable. Allowable costs incurred by the Grantee shall be in compliance with OMB Circular A-87 Cost Principles for State, Local, and Indian Tribal Governments. Allowable costs incurred by nonprofit DLC CDBG CD14-07PS Community Access Administrative Services Program Page 6 of 41 16131 recipients shall be in compliance with OMB Circular A-122 Cost Principles for Non-Profit Organizations. Allowable costs incurred by procured private contractors shall be in compliance with 48 CFR Part 31 Contract Cost Principles and Procedures. A SUBRECIPIENT is not subject to 24 CFR Part 84 and 24 CFR Part 85, however the County is Subject to 24 CFR Part 85 and may impose requirements upon the SUBRECIPIENT in order for the County to remain compliant with its obligation to follow 24 CFR Part 85. The SUBRECIPIENT will use adequate internal controls, and maintain necessary source documentation for all costs incurred and adhere to any other accounting requirements included in this Agreement or the Admin Plan. 1.6 NOTICES Notices required by this Agreement shall be in writing and delivered via mail (postage prepaid), commercial courier, personal delivery, or sent by facsimile or other electronic means. Any notice delivered or sent as aforesaid shall be effective on the date of delivery or sending. All notices and other written communications under this Agreement shall be addressed to the individuals in the capacities indicated below, unless otherwise modified by subsequent written notice. COLLIER COUNTY ATTENTION: Rosa Munoz, Grant Coordinator 3339 E Tamiami Trail, Suite 211 Naples, Florida 34112 mailto:RosaMunoz(a Colliergov.net 239-252-5713 SUBRECIPIENT ATTENTION: Scott Geltmeyer, Chief Financial Officer David Lawrence Center 6025 Bathey Lane Naples, FL 34116 SCOTT @dlcmhc.com 239-354-1420 PART II GRANT CONTROL REQUIREMENTS 2.1 AUDITS At any time during normal business hours and as often as the COUNTY (and/or its representatives) may deem necessary, the SUBRECIPIENT shall make available all records, documentation and any other data relating to all matters covered by the Agreement for review, inspection or audit. DLC CDBG CD14-07PS Community Access Administrative Services Program Page 7 of 41. 1601 Any deficiencies noted in audit reports must be fully cleared by the Grantee, Developer, or Subrecipient within 30 days after receipt by the organization. Failure of the organization to comply with the above audit requirements will constitute a violation of this contract and may result in the withholding of future payments. The Subrecipient hereby agrees to have an annual agency audit conducted in accordance with current Grantee policy concerning Subrecipient audits and OMB Circular A-133. 2.2 RECORDS AND DOCUMENTATION The Subrecipient shall maintain sufficient records in accordance with 24 CFR 570.502 and 570.506 to determine compliance with the requirements of this Agreement, the CDBG Program and all other applicable laws and regulations. This documentation shall include, but not be limited to, the following: A. All records required by CDBG regulations. B. SUBRECIPIENT shall keep and maintain public records that ordinarily and necessarily would be required by COUNTY in order to perform the service. C. All reports, plans, surveys, information, documents, maps, books, records and other data procedures developed, prepared, assembled, or completed by the Subrecipient for the purpose of this Agreement shall be made available to the COUNTY by the SUBRECIPIENT at any time upon request by the COUNTY or HHVS. Materials identified in the previous sentence shall be in accordance with generally accepted accounting principles (GAAP), procedures and practices, which sufficiently and properly reflect all revenues and expenditures of funds provided directly or indirectly by this Agreement, including matching funds and Program Income. These records shall be maintained to the extent of such detail as will properly reflect all net costs, direct and indirect labor, materials, equipment, supplies and services, and other costs and expenses of whatever nature for which reimbursement is claimed under the provisions of this Agreement. D. Upon completion of all work contemplated under this Agreement copies of all documents and records relating to this Agreement shall be surrendered to HHVS if requested. In any event the SUBRECIPIENT shall keep all documents and records in an orderly fashion in a readily accessible, permanent and secured location for three (3) years after the date of submission of the annual performance and evaluation report, as prescribed in 24 CFR 91.520 with the following exception: if any litigation, claim or audit is started before the expiration date of the three (3) year period, the records will be maintained until all litigation, claim or audit findings involving these records are resolved. The COUNTY shall be informed in writing if an agency ceases to exist after closeout of this Agreement of the address where the records are to be kept as outlined in 24 CFR 85.42. Meet all requirements for retaining public records and transfer, at no cost, to COUNTY all public records in possession of the SUBRECIPIENT upon termination of the DLC CDBG CD14-07PS Community Access Administrative Services Program Page 8 of 41 1601 contract 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 COUNTY in a format that is compatible with the information technology systems of the public agency. E. The SUBRECIPIENT shall maintain records showing compliance with the Davis- Bacon Law, including files containing contractor payrolls, employee interviews, Davis-Bacon wage rates, and administrative cross-referencing. SUBRECIPIENT shall maintain records showing contractor compliance with the Contract Work Hours and Work Safety Law. Similarly, the SUBRECIPIENT shall maintain records showing compliance with federal purchasing requirements and with other federal requirements for grant implementation. F. The SUBRECIPIENT will be responsible for the creation and maintenance of income eligible files on clients served and documentation that all households are eligible under HUD Income Guidelines. The SUBRECIPIENT agrees that HHVS shall be the final arbiter on the SUBRECIPIENT's compliance. G. The SUBRECIPIENT shall document how the National Objective(s) as defined in 24CFR 570.208 and the eligibility requirement(s) under which funding has been received, have been met. These also include special requirements such as necessary and appropriate determinations as defined in 24 CFR 570.208, income certification, and written Agreements with beneficiaries, where applicable. H. SUBRECIPIENT shall provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. SUBRECIPIENT shall ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. 2.3 MONITORING During the term, SUBRECIPIENT shall submit an annual audit report and monitoring report (Exhibit F) to the COUNTY no later than one hundred eighty (180) days after the SUBRECIPIENT's fiscal year end. The COUNTY will conduct an annual financial and programmatic review. The SUBRECIPIENT agrees that HHVS will carry out no less than one (1) annual on-site monitoring visit and evaluation activities as determined necessary. At the COUNTY's discretion, a desk top review of the activities may be conducted in lieu of an on-site visit. The continuation of this Agreement is dependent upon satisfactory evaluations. The SUBRECIPIENT shall, upon the request of HHVS, submit information and status reports required by HHVS or HUD to enable HHVS to evaluate said progress and to allow for completion of reports required. The SUBRECIPIENT shall allow HHVS or HUD to monitor the SUBRECIPIENT on site. Such site visits may be scheduled or unscheduled as determined by HHVS or HUD. DLC CDBG CD14-07PS Community Access Administrative Services Program Page 9 of 41 16131 The COUNTY will monitor the performance of the SUBRECIPIENT based on goals and performance standards as stated with all other applicable federal, state and local laws, regulations, and policies governing the funds provided under this contract. Substandard performance as determined by the COUNTY will constitute noncompliance with this Agreement. If corrective action is not taken by the SUBRECIPIENT within a reasonable period of time after being notified by the COUNTY, contract suspension or termination procedures will be initiated. SUBRECIPIENT agrees to provide HUD, the HUD Office of Inspector General, the General Accounting Office, the COUNTY, or the COUNTY's internal auditor(s) access to all records related to performance of activities in this agreement. 2.4 CORRECTIVE ACTION Corrective action plans may be required for noncompliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. In order to effectively enforce Resolution No. 2013-228, Housing Human and Veteran Services (HHVS) has adopted an escalation policy to ensure continued compliance by Subrecipients, Developers, or any entity receiving grant funds from HHVS. HHVS's policy for escalation for non-compliance is as follows: 1. Initial non-compliance may result in Findings or Concerns being issued to the entity and will require a corrective action plan be submitted to the Department within 15 days following the monitoring visit. o Any pay requests that have been submitted to the Department for payment will be held until the corrective action plan has been submitted. o HHVS will be available to provide Technical Assistance (TA) to the entity as needed in order to correct the non-compliance issue. 2. If in the case an Entity fails to submit the corrective action plan in a timely manner to the Department, the Department may require a portion of the awarded grant amount be returned to the Department. o The County may require upwards of five percent (5%) of the acquisition amount be returned to the Department, at the discretion of the Board of County Commissioners. o The entity may be considered in violation of Resolution No. 2013-228 3. If in the case an Entity continues to fail to correct the outstanding issue or repeats an issue that was previously corrected, and has been informed by the Department of their substantial non-compliance by certified mail; the Department may require a portion DLC CDBG CD14-07PS Community Access Administrative Services Program Page 10 of 41 16D1 of the awarded grant amount or the amount of the CDBG investment for acquisition of the properties conveyed, be returned to the Department. o The Department may require upwards of ten percent (10%) of the acquisition amount be returned to the Department, at the discretion of the Board of County Commissioners. o The entity will be considered in violation of Resolution No. 2013-228 4. If in the case after repeated notification the Entity continues to be substantially non- compliant, the Department may recommend the contract or award be terminated. o The Department will make a recommendation to the Board of County Commissioners to immediately terminate the agreement or contract. The Entity will be required to repay all funds disbursed by the County for project that was terminated. This includes the amount invested by the County for the initial acquisition of the properties. o The entity will be considered in violation of Resolution No. 2013-228 If in the case the Entity has multiple agreements with the Department and is found to be non- compliant, the above sanctions may be imposed across all awards at discretion of the Board of County Commissioners. 2.5 REPORTS Reimbursement may be contingent on the timely receipt of complete and accurate reports required by this Agreement, and on the resolution of monitoring findings identified pursuant to this Agreement as deemed necessary by the County Manager or designee. During the term, SUBRECIPIENT shall submit quarterly progress reports to the COUNTY on the IOl day of January, April, July and October respectively for the prior quarter period end. As part of the report submitted in October, the SUBRECIPIENT also agrees to include, a comprehensive final report covering the agreed-upon Program objectives, activities and expenditures and including, but not limited to, performance data on client feedback with respect to the goals and objectives set forth in Exhibits "C and D". Exhibits "C and D" contain an example reporting form to be used in fulfillment of this requirement. Other reporting requirements may be required by the County Manager or their designee in the event of Program changes; the need for additional information or documentation arises; and/or legislative amendments are enacted. Reports and/or requested documentation not received by the due date shall be considered delinquent and may be cause for default and termination of this Agreement. PART III DLC CDBG CD14-07PS Community Access Administrative Services Program Page 11 of 41 16131 TERMS AND CONDITIONS 3.1 SUBCONTRACTS No part of this Agreement may be assigned or subcontracted without the written consent of the COUNTY, which consent, if given at all, shall be at the COUNTY's sole discretion and judgment. 3.2 GENERAL COMPLIANCE The SUBRECIPIENT agrees to comply with the requirements of Title 24 of the Code of Federal Regulations, Part 570 (the U.S. Housing and Urban Development regulations concerning Community Development Block Grants (CDBG)) including subpart K of these regulations, except that (1) the SUBRECIPIENT does not assume the recipient's environmental responsibilities described in 24 CFR 570.604 and (2) the SUBRECIPIENT does not assume the recipient's responsibility for initiating the review process under the provisions of 24 CFR Part 52 and (3) SUBRECIPIENT is not required to follow federal procurement and (4) for SUBRECIP1ENT's revenue generated is not considered program income. The CDBG program was funded through the Housing and Community Development Act of 1974. The SUBRECIPIENT also agrees to comply with all other applicable Federal, state and local laws, regulations, and policies governing the funds provided under this contract. The SUBRECIPIENT further agrees to utilize funds available under this Agreement to supplement rather than supplant funds otherwise available. 3.3 INDEPENDENT CONTRACTOR Nothing contained in this Agreement is intended to, or shall be construed in any manner, as creating or establishing the relationship of employer/employee between the parties. The SUBRECIPIENT shall at all times remain an "independent contractor" with respect to the services to be performed under this Agreement. The Grantee shall be exempt from payment of all Unemployment Compensation, FICA, retirement, life and/or medical insurance and Workers' Compensation Insurance, as the SUBRECIPIENT is an independent contractor. 3.4 AMENDMENTS The COUNTY or SUBRECIPIENT may amend this Agreement at any time provided that such amendments make specific reference to this Agreement, and are executed in writing, signed by a duly authorized representative of each organization, and approved by the Grantee's governing body. Such amendments shall not invalidate this Agreement, nor relieve or release the Grantee or SUBRECIPIENT from its obligations under this Agreement. The COUNTY may, in its discretion, amend this Agreement to conform with Federal, state or local governmental guidelines, policies and available funding amounts, or for other reasons. If such amendments result in a change in the funding, the scope of services, or schedule DLC CDBG CD14-07PS Community Access Administrative Services Program Page 12 of 41 Ji 1601 of the activities to be undertaken as part of this Agreement, such modifications will be incorporated only by written amendment signed by both Grantee and SUBRECIPIENT. 3.5 AVAILABILITY OF FUNDS The parties acknowledge that the Funds originate from CDBG grant funds from HUD and must be implemented in full compliance with all of HUD's rules and regulations and any agreement between COUNTY and HUD governing CDBG funds pertaining to this Agreement. In the event of curtailment or non-production of said federal funds, the financial sources necessary to continue to pay the SUBRECIPIENT all or any portions of the funds will not be available. In that event, the COUNTY may terminate this Agreement, which termination shall be effective as of the date that it is determined by the County Manager or designee, in his-her sole discretion and judgment, that the funds are no longer available. In the event of such termination, the SUBRECIPIENT agrees that it will not look to, nor seek to hold the COUNTY, nor any individual member of the County Commissioners and /or County Administration, personally liable for the performance of this Agreement, and the COUNTY shall be released from any further liability to SUBRECIPIENT under the terms of this Agreement. There are no funds being granted in association with this Agreement. 3.6 INDEMNIFICATION To the maximum extent permitted by Florida law, the SUBRECIPIENT shall indemnify and hold harmless Collier County, its officers, agents and employees from any and all claims, liabilities, damages, losses, costs, and causes of action which may arise out of an act, omission, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the SUBRECIPIENT or any of its agents, officers, servants, employees, contractors, patrons, guests, clients, licensees, invitees, or any persons acting under the direction, control, or supervision of the SUBRECIPIENT in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. The SUBRECIPIENT shall pay all claims and losses of any nature whatsoever in connection therewith and shall defend all suits in the name of the COUNTY and shall pay all costs (including attorney's fees) and judgments which may issue thereon. This Indemnification shall survive the termination and/or expiration of this Agreement. This section does not pertain to any incident arising from the sole negligence of Collier County. The foregoing indemnification shall not constitute a waiver of sovereign immunity beyond the limits set forth in Section 768.28, Florida Statutes. This Section shall survive the expiration of termination of this agreement. 3.7 GRANTEE RECOGNITION/SPONSORSHIPS The SUBRECIPIENT agrees that all notices, informational pamphlets, press releases, advertisements, descriptions of the sponsorships of the Program, research reports and similar public notices prepared and released by the SUBRECIPIENT for, on behalf of, and/or about the Program shall include the statement: DLC CDBG CD14-07PS Community Access Administrative Services Program Page 13 of 41 1601 "FINANCED BY U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) AND COLLIER COUNTY HOUSING, HUMAN AND VETERAN SERVICES DEPARTMENT" and shall appear in the same size letters or type as the name of the SUBRECIPIENT. This design concept is intended to disseminate key information regarding the development team as well as Equal Housing Opportunity to the general public. Construction signs shall comply with applicable COUNTY codes. 3.8 DEFAULTS, REMEDIES AND TERMINATION In accordance with 24 CFR 85.43, this Agreement may also be terminated for convenience by either the Grantee or the SUBRECIPIENT, in whole or in part, by setting forth the reasons for such termination, the effective date, and, in the case of partial terminations, the portion to be terminated. However, if in the case of a partial termination, the Grantee determined that the remaining portion of the award will not accomplish the purpose for which the award was made, the Grantee may terminate the award in its entirety. The following actions or inactions by SUBRECIPIENT shall constitute a Default under this Agreement: A. Failure to comply with any of the rules, regulations or provisions referred to herein, or such statutes, regulations, executive orders, and HUD guidelines, policies or directives as may become applicable at any time; B. Failure, for any reason, of the SUBRECIPIENT to fulfill in a timely and proper manner its obligations under this Agreement; C. Ineffective or improper use of funds provided under this Agreement; or D. Submission by the SUBRECIPIENT to the Grantee reports that are incorrect or incomplete in any material respect. E. Submission by the SUBRECIPIENT of any false certification; F. Failure to materially comply with any terms of this Agreement; and G. Failure to materially comply with the terms of any other agreement between the County and the SUBRECIPIENT relating to the project. In the event of any default by SUBRECIPIENT under this Agreement, the County may seek any combination of one or more of the following remedies: A. Require specific performance of the Agreement, in whole or in part; DLC CDBG CD14-07PS Community Access Administrative Services Program Page 14 of 41 1601 B. Require the use of or change in professional property management; C. Require immediate repayment by SUBRECIPIENT to the County of all CDBG funds SUBRECIPIENT has received under this Agreement; D. Apply sanctions set forth in 24 CFR 92, if determined by the County to be applicable; E. Stop all payments until identified deficiencies are corrected; F. Terminate this Agreement by giving written notice to SUBRECIPIENT of such termination and specifying the effective date of such termination. If the Agreement is terminated by the County as provided herein, SUBRECIPIENT shall have no claim of payment or claim of benefit for any incomplete project activities undertaken under this Agreement. 3.9 REVERSION OF ASSETS In the event of a termination of this Agreement and in addition to any and all other remedies available to the COUNTY (whether under this Agreement or at law or in equity) the SUBRECIPIENT shall immediately transfer to the COUNTY any property on hand at the time of termination (or expiration) and any accounts receivable attributable to the use of CDBG funds per 24 CFR 570.503(b)(7). The COUNTY's receipt of any funds on hand at the time of termination shall not waive the COUNTY's right (nor excuse SUBRECIPIENT's obligation) to recoup all or any portion of the funds or property, as the COUNTY may deem necessary. 3.10 INSURANCE SUBRECIPIENT shall not commence any work and/or services pursuant to this Agreement until all insurance required as outlined in Exhibit "A" has been obtained, and carried, at all times during its performance. 3.11 ADMINISTRATIVE REQUIREMENTS The SUBRECIPIENT agrees to perform the Scope of Work in compliance with the Grant Budget and the Scope of Work(Part I), the Uniform Administrative Requirements for Grants and Cooperative Agreements to State, Local and Federally Recognized Indian Tribal Governments (24 CFR Part 85), and the federal regulations for the Community Development Block Grants (24 CFR 570 et seq.). 3.12 PURCHASING SUBRECIPIENT's are required to follow Federal Procurement regulations and Collier County's purchasing thresholds. DLC CDBG CD14-07PS Community Access Administrative Services Program Page 15 of 41 1 16131 All purchasing for services and goods, including capital equipment, shall be made by purchase order or by a written contract and in conformity with the thresholds of Collier County Purchasing Policy. Purchasing Threshold Policy Dollar Range (5) Quotes Under$3K 1 Written Quote $3K to $50K 3 Written Quotes Request for Proposal (RFP) Above $50K Invitation for Bid (IFB) 3.13 PROGRAM-GENERATED INCOME Any "Program Income" (as such term is defined under applicable Federal regulations) gained from any activity of the SUBRECIPIENT funded by CDBG funds shall be reported to the COUNTY through an annual program income re-use plan, utilized by the SUBRECIPIENT and shall be in compliance with 24 CFR 570.503(c) in the operation of the Program. 3.14 GRANT CLOSEOUT PROCEDURES SUBRECIPIENT's obligation to the COUNTY shall not end until all closeout requirements are completed. The County may close out the project with the SUBRECIPIENT after the five (5) year period has been met. Activities during this closeout period shall include, but not be limited to: making final payments, disposing of program assets (including the return of all unused materials, equipment, program income balances, and receivable accounts to the COUNTY), and determining the custodianship of records. In addition to the records retention outlined in Section IX.B.4, the SUBRECIPIENT shall comply with Section 119.021 Florida Statutes regarding records maintenance, preservation and retention. A conflict between state and federal law records retention requirements will result in the more stringent law being applied such that the record must be held for the longer duration. Any balance of unobligated funds which have been advanced or paid must be returned to the COUNTY. Any funds paid in excess of the amount to which the SUBRECIPIENT is entitled under the terms and conditions of this Agreement must be refunded to the COUNTY. SUBRECIPIENT shall also produce records and information that complies with Section 215.97, Florida Single Audit Act. 3.15 OPPORTUNITIES FOR RESIDENTS AND CIVIL RIGHTS COMPLIANCE The SUBRECIPIENT agrees that no person shall be excluded from the benefits of, or be subjected to, discrimination under any activity carried out by the performance of this Agreement on the basis of race, color, disability, national origin, religion, age, familial status, or sex. Upon receipt of evidence of such discrimination, the COUNTY shall have the right to terminate this Agreement. DLC CDBG CD14-07PS Community Access Administrative Services Program Page 16 of 41 ■ 16131 To the greatest extent feasible, lower-income residents of the project areas shall be given opportunities for training and employment; and to the greatest feasible extent eligible business concerns located in or owned in substantial part by persons residing in the project areas shall be awarded contracts in connection with the project. The SUBRECIPIENT shall comply with Section 3 of the Housing and Community Development Act of 1968. 3.16 OPPORTUNITIES FOR SMALL AND MINORITY/WOMEN-OWNED BUSINESS ENTERPRISES The SUBRECIPIENT will use its best efforts to afford small businesses, minority business enterprises, and women's business enterprises the maximum practicable opportunity to participate in the performance of this contract. As used in this contract, the terms "small business" means a business that meets the criteria set forth in section 3(a) of the Small Business Act, as amended (15 U.S.C. 632), and "minority and women's business enterprise" means a business at least fifty-one (51) percent owned and controlled by minority group members or women. For the purpose of this definition, "minority group members" are Afro-Americans, Spanish-speaking, Spanish surnamed or Spanish-heritage Americans, Asian-Americans, and American Indians. The SUBRECIPIENT may rely on written representations by businesses regarding their status as minority and female business enterprises in lieu of an independent investigation. 3.17 PROGRAM BENEFICIARIES At least fifty-one percent (51%) of the beneficiaries of a project funded through this Agreement must be low- and moderate- income persons. If the project is located in an entitlement city, as defined by HUD, or serves beneficiaries countywide, more than thirty percent (30%) of the beneficiaries directly assisted under this Agreement must reside in unincorporated Collier County or in municipalities participating in the County's Urban County Qualification Program. The project shall assist beneficiaries as defined above for the time period designated in Exhibits "C and D" of this Agreement. 3.18 AFFIRMATIVE ACTION The SUBRECIPIENT agrees that it shall be committed to carry out pursuant to the COUNTY's specifications an Affirmative Action Program in keeping with the principles as provided in President's Executive Order 11246 of September 24, 1966. The COUNTY shall provide Affirmative Action guidelines to the SUBRECIPIENT to assist in the formulation of such program. The SUBRECIPIENT shall submit a plan for an Affirmative Action Program for approval prior to the award of funds. The Affirmative Action will need to be updated throughout the five year period and submitted to County within 30 days of update/modification. 3.19 CONFLICT OF INTEREST The SUBRECIPIENT covenants that no person under its employ who presently exercises any functions or responsibilities in connection with the Project, has any personal financial DLC CDBG CD14-07PS Community Access Administrative Services Program Page 17 of 41 16 n interest, direct or indirect, in the Project areas or any parcels therein, which would conflict in any manner or degree with the performance of this Agreement and that no person having any conflict of interest shall be employed by or subcontracted by the SUBRECIPIENT. The SUBRECIPIENT covenants that it will comply with all provisions of 24 CFR 570.611 "Conflict of Interest", and the State and County statutes, regulations, ordinance or resolutions governing conflicts of interest. Any possible conflict of interest on the part of the SUBRECIPIENT or its employees shall be disclosed in writing to HHVS provided, however, that this paragraph shall be interpreted in such a manner so as not to unreasonably impede the statutory requirement that maximum opportunity be provided for employment of and participation of low and moderate- income residents of the project target area. The SUBRECIPIENT will notify the COUNTY in writing and seek COUNTY approval prior to entering into any contract with an entity owned in whole or in part by a covered person or an entity owned or controlled in whole or in part by the SUBRECIPIENT. The COUNTY may review the proposed contract to ensure that the contractor is qualified and that the costs are reasonable. Approval of an identity of interest contract will be in the COUNTY's sole discretion. This provision is not intended to limit SUBRECIPIENT's ability to self-manage the projects using its own employees. Any possible conflict of interest on the part of the SUBRECIPIENT or its employees shall be disclosed in writing to HHVS provided, however, that this paragraph shall be interpreted in such a manner so an not to unreasonably impede the statutory requirement that maximum opportunity be provided for employment of and participation of low and moderate income residents of the project target area. 3.20 RELIGIOUS ORGANIZATIONS CDBG funds may be used by religious organizations or on property owned by religious organizations only in accordance with requirements set in Section 24 CFR 570.200(j). The SUBRECIPIENT shall comply with First Amendment Church/State principles as follows: a. It will not discriminate against any employee or applicant for employment on the basis of religion. and will not limit employment or give preference in employment to persons on the basis of religion b. It will not discriminate against any person applying for public services on the basis of religion and will not limit such services or give preference to persons on the basis of religion. c. It will retain its independence from Federal, State and local governments and may continue to carry out its mission, including the definition, practice and expression of its religious beliefs, provided that it does not use direct CDBG funds to support any inherently religious activities, such as worship, religious instruction or proselytizing. d. The funds shall not be used for the acquisition, construction or rehabilitation of structures to the extent that those structures are used for inherently religious activities. Where a structure is used for both eligible and inherently religious activities, CDBG funds may not exceed the cost of those portions of the acquisition, construction or rehabilitation that are attributable to eligible activities in accordance with the cost accounting requirements applicable to CDBG funds in this part. Sanctuaries, chapels, DLC CDBG CD14-07PS Community Access Administrative Services Program Page 18 of 41 `ti� 16131 or other rooms that a CDBG funded religious congregation uses as its principal place of worship, however, are ineligible for CDBG funded improvements. 3.21 SEVERABILITY Should any provision of the Agreement be determined to be unenforceable or invalid, such a determination shall not affect the validity or enforceability of any other section or part thereof. Remainder of Page Intentionally Left Blank DLC CDBG CD14-07PS Community Access Administrative Services Program Page 19 of 41 1601 PART IV GENERAL PROVISIONS 4.1 24 CFR 570 as amended- All the regulations regarding the CDBG program http://www.law.cornel I.edu/cfr/text/24/part-570 4.2 24 CFR 58 - The regulations prescribing the Environmental Review procedure. Link: http://www.ecfr.gov/cgi-bin/text- idx?c=ecfr&tpl=/ec frbrowse/T i tle24/24c fr5 8_mai n_02.tp l 4.3 Section 104(b) and Section 109 of Title I of the Housing and Community Development Act of 1974 as amended http://portal.hud.gov/hudportal/HUD?src=/program offices/fair housing equal opp/FH Laws/109 4.4 The Fair Housing Act (42 U.S.C. 3601-20) Reasonable Accommodations Under the Fair Housing Act. http://www.hud.gov/offices/fheo/library/huddojstatement.pdf E.O. 11063 —Equal Opportunity in Housing http://portal.hud.zov/hudportal/HUD?src=/program offices/fair housing equal opp/l2I-1 Laws/EXO11063 E.O. 11259 - Leadership & Coordination of Fair Housing in Federal Programs http://www.archives.gov/federal-register/codification/executive-order/12259.htm1 24 CFR Part 107 -Non Discrimination and Equal Opportunity in Housing under E.O. http://www.law.cornell.edu/cfr/text/24/part-107 4.5 Title VI of the Civil Rights Act of 1964 as amended, Title VIII of the Civil Rights Act of 1968 as amended http://portal.hud.gov/hudportal/HUD?src=/program offices/fair housing equal opp/prog desc/title8 4.6 24 CFR 570.601 Subpart K - The regulations issued pursuant to Executive Order 11063 which prohibits discrimination and promotes equal opportunity in housing. http://www.gpo.gov/fdsys/pkg/CFR-2007-title24-vo13/pdf/CFR-2007-title24-vo13- sec570-602.pdf 4.7 Executive Order 11246 ("Equal Employment Opportunity"), as amended by Executive Orders 11375 and 12086 - which establishes hiring goals for minorities and women on projects assisted with federal funds and as supplemented in Department of Labor regulations. EO 11246: http://www.eeoc.gov/eeoc/history/35th/thelaw/eo-11246.html EO 11375 and 12086: see item #8 below 4.8 Title VII of the 1968 Civil Rights Act as amended by the Equal Employment Opportunity Act of 1972, 42 USC § 2000e, et. seq. The SUBRECIPIENT will, in all solicitations or DLC CDBG CD14-07PS Community Access Administrative Services Program Page 20 of 41 1613 1 advertisements for employees placed by or on behalf of the SUBRECIPIENT, state that it is an Equal Opportunity or Affirmative Action employer. http://www.eeoc.gov/Laws/statutes/titlevii.cfm 4.9 24 CFR 135 —Regulations outlining requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended. Compliance with the provisions of Section 3 of the HUD Act of 1968, as amended, and as implemented by the regulations set forth in 24 CFR 135, and all applicable rules and orders issued hereunder prior to the execution of this contract, shall be a condition of the Federal financial assistance provided under this contract and binding upon the COUNTY, the SUBRECIPIENT and any of the SUBRECIPIENT's Sub-recipients and subcontractors. Failure to fulfill these requirements shall subject the COUNTY, the SUBRECIPIENT and any of the SUBRECIPIENT's Sub-recipients and subcontractors, their successors and assigns, to those sanctions specified by the Agreement through which Federal assistance is provided. The SUBRECIPIENT certifies and agrees that no contractual or other disability exists that would prevent compliance with these requirements. The SUBRECIPIENT further agrees to comply with these "Section 3" requirements and to include the following language in all subcontracts executed under this Agreement: "The work to be performed under this Agreement is a project assisted under a program providing direct Federal financial assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended (12 U.S.C. 1701). Section 3 requires that to the greatest extent feasible opportunities for training and employment be given to low- and very low-income residents of the project area, and that contracts for work in connection with the project be awarded to business concerns that provide economic opportunities for low- and very low-income persons residing in the metropolitan area in which the project is located." The SUBRECIPIENT further agrees to ensure that opportunities for training and employment arising in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to low- and very low-income persons residing within the metropolitan area in which the CDBG-funded project is located; where feasible, priority should be given to low- and very low-income persons within the service area of the project or the neighborhood in which the project is located, and to low- and very low- income participants in other HUD programs; and award contracts for work undertaken in connection with a housing rehabilitation (including reduction and abatement of lead- based paint hazards), housing construction, or other public construction project to business concerns that provide economic opportunities for low- and very low-income persons residing within the metropolitan area in which the CDBG-funded project is located; where feasible, priority should be given to business concerns that provide economic opportunities to low- and very low-income residents within the service area or the neighborhood in which the project is located, and to low- and very low-income participants in other HUD programs. DLC CDBG CD14-07PS Community Access Administrative Services Program Page 21 of 41 1613 1 The SUBRECIPIENT certifies and agrees that no contractual or other legal incapacity exists that would prevent compliance with these requirements. http://www.ecfr.gov/cgi- bin/text-idx?c=ecfr&tp1=/ecfrbrowse/Title24/24cfrl35 main 02.tpl 4.10 Age Discrimination Act of 1975, Executive Order 11063, and Executive Order 11246 as amended by Executive Orders 11375, 11478, 12107 and 12086. Age Discrimination Act of 1975 - http://wwwedocgov/oasam/regs/statutes/age act.htm 11063:http://portal.hud.aov/hudportal/HUD?src=/program_offices/fair_housin equal_o pp/FHLaws/EXO 1 1063 11246: http://www.eeoc.gov/eeoc/history/35th/thelaw/eo-11.246.html 11375: Amended by EO 11478 11478: http://www.archives.gov/federal-register/codification/executive-order/1 1478.html 12107: http://www.archives.gov/federal-register/codification/executive-order/121.07.html 12086: http://www.archives.gov/federal-register/codification/executive-order/12086.html 4.11 Contract Work Hours and Safety Standards Act, 40 USC 327-332. http://usaceengineerin..pamplets2.tpub.com/EP-1 180-1-1/EP-1 180-1-l0012.htm 4.12 Section 504 of the Rehabilitation Act of 1973, 29 USC 776(b) (5), 24 CFR 570.614 Subpart K. Section 504: http://www.epa.gov/civilrights/sec504.htm 29 USC 776: http://law.onecle.com/uscode/29/776.htrnl 24 CFR 570.614: http://www.law.cornell.edulcfr/text/24/570.614 4.13 The Americans with Disabilities Act of 1990 http://www.thwa.dot.gov/realestate/ua/index.htm 4.14 Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, as amended. http://www.fhwa.dotwv/realestate/ua/index.htm 4.15 29 CFR Parts 3 and 5 - Regulations which prescribe the payment of prevailing wages and the use of apprentices and trainees on federally assisted projects as mandated by the Davis-Bacon Act. HUD Form 4010 must be included in all construction contracts funded by CDBG. (See 42 USC 276a and 24 CFR 135.11(c). 29 CFR Part 3 - Contractors and Subcontractors on public building or Public Work Financed in whole or in part by Loans or Grants from the United States- http://www.law.cornell.edu/c fr/text/29/part-3 29 CFR Part 5 - Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction (Also Labor Standards Provision Applicable ...Subject to the Contract Work Hours and Safety Standards Act) http://www.law.cornell.edu/cfr/text/29/part-5 DLC CDBG CD14-07PS Community Access Administrative Services Program Page 22 of 41 t r ( F Executive Order 11914 - Prohibits discrimination with respect to the handicapped in federally assisted projects. http://www.presidencv.ucsb.edu/ws/index.php?pid=23675 4.16 Executive Order 11625 and U.S. Department of Housing and Urban Development Circular Letter 79-45 -which prescribes goal percentages for participation of minority businesses in Community Development Block Grant Contracts. E.O. 11625 Prescribing additional arrangements for developing and coordinating a national program for minority business enterprise http://w\kw.mbda.gov/node/333 HUD Circular Letter 79-45:No reference found 4.17 The SUBRECIPIENT agrees to comply with the non-discrimination in employment and contracting opportunities laws, regulations, and executive orders referenced in 24 CFR 570.607, as revised by Executive Order 13279. The applicable non-discrimination provisions in Section 109 of the HCDA are still applicable. 24 CFR 570.607: http://www.gpo.gov/fdsys/pkg/CFR-2010-title24-vol3/pdf/CFR-2010- title24-vol3-sec570-608.pdf E.O. 13279: http://fedgovcontracts.com/pe02-I 92.htm 4.18 Public Law 100-430 -the Fair Housing Amendments Act of 1988. http://www.ncbi.nlm.nih.aov/pubmed/12289709 4.19 24 CFR 84 - Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and Other Non-Profit Organizations and specified by the following subsections: http://www.law.cornell.edu/cfr/text/24/part-84 • Subpart A—General; • Subpart B — Pre-Award Requirements, except for 84.12, Forms for Applying for Federal Assistance; • Subpart C—Post-Award Requirements, except for: o Section 84.22, Payment Requirements- Grantees shall follow the standards of 85.20(b)(7) and 85.21 in making payments to SUBRECIPIENT's; o Section 84.23, Cost Sharing and Matching; o Section 84.24, Program Income — in lieu of 84.24 CDBG SUBRECIPIENT's shall follow 570.504; o Section 84.25, Revision of Budget and Program Plans; o Section 84.32, Real Property — In lieu of 84.32, CDBG SUBRECIPIENT's shall follow 570.505; o Section 84.34(g), Equipment—In lieu of the disposition provisions of 84.34(g) the following applies: • In all cases in which equipment is sold, the proceeds shall be program income (pro-rated to reflect the extent to which CDBG funds were used to acquire the equipment); and DLC CDBG CD14-07PS Community Access Administrative Services Program Page 23 of 41 , J 16 .01 • Equipment not needed by the SUBRECIPIENT for CDBG activities shall be transferred to the recipient for the CDBG program or shall be retained after compensating the recipient; o Section 84.51(b), (c), (d), (e), (f) and (h), Monitoring and Reporting Program Performance; o Section 84.52, Financial Reporting; o Section 84.53(b), Retention and Access Requirements for Records. Section 84.53(b) applies with the following exceptions: • The retention period referenced in 84.53(b) pertaining to individual CDBG activities shall be three years; and • The retention period starts from the date of submission of the annual performance and evaluation report, as prescribed in 24 CFR 91.520, in which the specific activity is reported on for the final time rather than from the date of submission of the final expenditure report for the award; o Section 84.61, Termination - In lieu of the provisions of 84.61, CDBG SUBRECIPIENT's shall comply with 570.503(b)(7); and • Subpart D—After-the-Award Requirements—except for 84.71, Closeout Procedures 4.20 24 CFR 85 - Administrative Requirements for Grants and Agreements to State and Local Governments shall be followed for sub recipients that are governmental entities. http://www.ecfr.gov/cgi-bin/text- idx?c=e.cfr&tpl=/ecf:rbrowse/Tit1e24/24cfr85 main 02.tpl 4.21 Immigration Reform and Control Act of 1986 http://www.eeoc.gov/eeoc/history/35th/thelaw/irca.html 4.22 Prohibition Of Gifts To County Employees -No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311. Florida Statutes - http://www.lawserver.com/law/state/florida/statutes/florida statutes chapter 112 part iii Collier County- http://bccspO 1/SiteDirectory/ASD/HR/labor/CMAs/Shared%20Documents/CMA%20531 1.1%20Standards%20o1%20Conduct.pdf 4.23 Order of Precedence - In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the Agreement shall take precedence over the terms of all other Contract Documents, except the terms of any Supplemental Conditions shall take precedence over the Agreement. To the extent any conflict in the terms of the Contract Documents cannot be resolved by application of the Supplemental Conditions, if any, or the Agreement, the conflict shall be resolved by imposing the more strict or costly obligation under the Contract Documents upon the Contractor at Owner's discretion. DLC CDBG CDI4-07PS Community Access Administrative Services Program Page 24 of 41 16131 4.24 Venue-Any suit of action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, FL which courts have sole jurisdiction on all such matters. (No reference required for this item). 4.25 Dispute Resolution - Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. Any situations when negotiations, litigation and/or mediation shall be attended by representatives of SUBRECIPIENT with full decision-making authority and by COUNTY'S staff person who would make the presentation of any settlement reached during negotiations to COUNTY for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under § 44.102, Florida Statutes. The litigation arising out of this Agreement shall be Collier County, Florida, if in state court and the US District Court, 20th Judicial Court of Florida, if in federal court. BY ENTERING INTO THIS AGREEMENT, COLLIER COUNTY AND THE SUBRECIPIENT EXPRESSLY WAIVE ANY RIGHTS EITHER PARTY MAY HAVE TO A TRIAL BY JURY OF ANY CIVIL LITIGATION RELATED TO, OR ARISING OUT OF, THIS AGREEMENT. http://www.flsenate.gov/Laws/Statutes/20 I 0/44.102 4.26 The SUBRECIPIENT agrees to comply with the following requirements: a. Clean Air Act, 41 USC 7401, et seq. http://www.law.cornell.edu/uscode/text/42/7401 b. Federal Water Pollution Control Act, 33 USC 1251, et seq., as amended. http://www.law.cornell.edu/uscode/text/33/chapter-26 4.27 In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42 USC 4002 and 24 CFR 570.605 Subpart K),the SUBRECIPIENT shall assure that for activities located in an area identified by FEMA as having special flood hazards, flood insurance under the National Flood Insurance Program is obtained and maintained. If appropriate, a letter of map amendment(LOMA) may be obtained from FEMA, which would satisfy this requirement and/or reduce the cost of said flood insurance. http://www.ecfr.gov/cgi-bin/text- idx?c=ecfr&SlD=eba40bdb52822d80827a48bced5b0b56&rgn=div8&view=text&Wade=2 4:3.1.1.3.4.11.1.6&idno=24 4.28 The SUBRECIPIENT agrees that any construction or rehabilitation of residential structures with assistance provided under this contract shall be subject to HUD Lead- Based Paint Poisoning Prevention Act found at 24 CFR 570.608, Subpart K. http://www.ec1 .gov/cgi-binitext- idx?c=ecfr&S ID=eba40bd b52822d80827a48bced 5 b0h56&rgn=div8&view=text&node=2 4:3.1.1.3.4.1 1.1.9&idno=24 DLC CDBG CD14-07PS Community Access Administrative Services Program Page 25 of 41 1601 4.29 The SUBRECIPIENT agrees to comply with the Historic Preservation requirements set forth in the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470) and the procedures set forth in 36 CFR Part 800, Advisory Council on Historic Preservation Procedures for Protection of Historic Properties, insofar as they apply to the performance of this agreement. http://www.nps.gov/history/local-law/nhpaI 966.htm http://www.ecfr.gov/cgi-bin/text- idx?c=ecfr&tp1=/ecfrbrowse/Title36/36cfr800 main_02.tpl In general, this requires concurrence from the State Historic Preservation Officer for all rehabilitation and demolition of historic properties that are fifty years old or older or that are included on a federal, state or local historic property list. http://www.nps.gov/hi story/local-law/nhpa 1966.htm 4.30 The SUBRECIPIENT must certify that it will provide drug-free workplaces in accordance with the Drug-Free Workplace Act of 1988 (41 USC 701). http://us-code.vlex.com/vid/drug-free-workplace-requirements-contractors-19242870 4.31 The SUBRECIPIENT certifies that neither it, nor its principals, is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal Department or agency; and, that the SUBRECIPIENT shall not knowingly enter into any lower tier contract, or other covered transaction, with a person who is similarly debarred or suspended from participating in this covered transaction as outlined in 24 CFR 570.609, Subpart K. http://www.ecfr.gov/cgi-bin/text- idx?c=ecfr&SID=eba40bdb52822d80827a48bced5 b0b56&ran=div 8&view=text&node=2 4:3.1.1.3.4.1 1.1.10&i d no=24 4.32 The SUBRECIPIENT agrees to comply with the following OMB Circulars whichever is applicable, and agrees to adhere to the accounting principles and procedures required therein, utilize adequate internal controls, and maintain necessary source documentation for all costs incurred. States, local governments, and Indian Tribes follow: • A-87 for Cost Principles • A-102 for Administrative Requirements Educational Institutions (even if part of a State or local government) follow: • A-21 for Cost Principles • A-110 for Administrative Requirements Non-Profit Organizations follow: • A-122 for Cost Principles • A-110 for Administrative Requirements OMB Circular A87: http://www.whitehouse. ov/omb/circulars a087 2004/ OMB Circular A102:http://www.w hitehouse.gov/omb/circulars a 1.02/ OMB Circular A21:http://www.whitehouse.gov/omb/circulars a02 1 2004/ OMB Circular A110:http://www.whitehouse.gov/omb/circulars a110/ DLC CDBG CD14-07PS Community Access Administrative Services Program Page 26 of 41 1613 1 OMB Circular A122: http://www.whitehouse.gov/omb/circulars a 122 2004/ 4.33 Audits shall be conducted annually and shall be submitted to the COUNTY one hundred eighty (180) days after the end of the SUBRECIPIENT's fiscal year. The SUBRECIPIENT shall comply with the requirements and standards of OMB A-133, Audits of States, Local Governments, and Non-Profit Organizations. If this Agreement is closed out prior to the receipt of an audit report, the COUNTY reserves the right to recover any disallowed costs identified in an audit after such closeout. http://www.whitehouse.gov/omb/circulars/a133 _compliance_ supplement_2011 Clarification of Eligible Audit Costs The Amendment to 92.206(d)(3) clarifies that eligible costs of a project audit include the cost certification of costs performed by a certified public accountant. This has always been an eligible cost; the amendment clarifies and codifies this. http://www.law.cornell.eda/cfr/text/24/92.206 4.34 Any real property acquired by the SUBRECIPIENT for the purpose of carrying on the projects stated herein, and approved by the COUNTY in accordance with the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 and 49 CFR 24.101, shall be subject to the provisions of CDBG including, but not limited to, the provisions on use and disposition of property. Any real property within the SUBRECIPIENT control, which is acquired or improved in whole or part with CDBG funds in excess of$25,000, must adhere to the CDBG Regulations at 24 CFR 570.505. http://lNww.flawa.dot.gov/realestate/ua/index.htm http://www.law.cornell.edu/cfr/text/49/24.101 http://cfr.v lex.com/vid/570-505-use-real-property-19928754 4.35 As provided in § 287.133, Florida Statutes by entering into this Agreement or performing any work in furtherance hereof, the SUBRECIPIENT certifies that it, its affiliates, suppliers, subcontractors and consultants who will perform hereunder, have not been placed on the convicted vendor list maintained by the State of Florida Department of Management Services within the 36 months immediately preceding the date hereof. This notice is required by § 287.133 (3) (a), Florida Statutes. http://www.lawserver.com/law/state/florida/statutes/florida statutes 287-133 4.36 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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making 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. 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 DLC CDBG CD14-07PS Community Access Administrative Services Program Page 27 of 41 1601 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. 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, contracts under grants, loans, and cooperative agreements) and that all SUBRECIPIENT's shall certify and disclose accordingly. 4.37 Travel reimbursement will be based on the U.S. General Services Administration (GSA) per diem rates in effect at the time of travel. 4.38 Any rule or regulation determined to be applicable by HUD. 4.39 Florida Statutes 713.20, Part 1, Construction Liens http://www.le2.state.fl.us/Statutes/index.clm?App mode=Displav_Statute&URL=0700- 0799/0713/0713.html 4.40 Florida Statutes 119.021 Records Retention http://www.lawserver.com/law/state/florida/statutes/Forida statutes 119-021 4.41 Florida Statutes, 119.071, Contracts and Public Records http://www.leg.state.fl.us/Statutes/index.cfin?App mode=Display Statute&URL=0100- 0199/01 19/Sections/0119.07.html (Signature Page to Follow) DLC CDBG CDI4-07PS Community Access Administrative Services Program Page 28 of 41 1 01 IN WITNESS WHEREOF, the SUBRECIPIENT and the County, have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date first written above. ATTEST: ,- BOARD OF P iUNTY 'I MISSIONERS OF DWIGH .BROCK, C RK COLLIE' 14UNTY IS RIDA � ' By: / —� Attest as to ChairdifrPr Clerk TOM HENNING, CHAIRMAN (I!gnaft e only.9 DAVID LAWRENCE MENTAL HEALTH CENTER, Dated: 101-1 I I INC.,d/b/a DAVID L WRENCE CENTER (SEAL) By: 64 t c Scott.:ur•ess,Chief E cu fficer --A ' POte4,6,-... Witness A 6:2L1 Name and Title / )d,--- .4difilL Witness — m ��" - f ' ' Name and Title / / Approved as to form and legality: N. Jennit A.B pedio Assistant County Attorney ausiees Item# l (e.1 Agenda et $3.3)I 1 Date DLC Date d l�(J 1D(I1 CDBG CD14-07PS R. ' Community Access Administrative Services Program Page 29 of 41 IIII■ ViGki II Deputy Clerk C:169) PART V 16D1 EXHIBITS EXHIBIT "A" INSURANCE REQUIREMENTS The SUBRECIPIENT shall furnish to Collier County, c/o Housing, Human and Veteran Services Department, 3339 E. Tamiami Trail, Suite 211, Naples, Florida 34112, Certificate(s) of Insurance evidencing insurance coverage that meets the requirements as outlined below: 1. Workers' Compensation as required by Chapter 440, Florida Statutes. 2. Commercial General Liability including products and completed operations insurance in the amount of$1,000,000 per occurrence and $2,000,000 aggregate. Collier County must be shown as an additional insured with respect to this coverage. 3. Automobile Liability Insurance covering all owned, non-owned and hired vehicles used in connection with this contract in an amount not less than $1,000,000 combined single limit for combined Bodily Injury and Property Damage. Collier County shall be named as an additional insured. DESIGN STAGE(IF APPLICABLE) In addition to the insurance required in 1 — 3 above, a Certificate of Insurance must be provided as follows: 4. Professional Liability Insurance in the name of the SUBRECIPIENT or the licensed design professional employed by the SUBRECIPIENT in an amount not less than $1,000,000 per occurrence/$1,000,000 aggregate providing for all sums which the SUBRECIPIENT and/or the design professional shall become legally obligated to pay as damages for claims arising out of the services performed by the SUBRECIPIENT or any person employed by the SUBRECIPIENT in connection with this contract. This insurance shall be maintained for a period of two (2) years after the certificate of Occupancy is issued. Collier County shall be named as an additional insured. CONSTRUCTION PHASE(IF APPLICABLE) In addition to the insurance required in 1 —4 above,the SUBRECIPIENT shall provide or cause its Subcontractors to provide original certificates indicating the following types of insurance coverage prior to any construction: 5. Completed Value Builder's Risk Insurance on an "All Risk" basis in an amount not less than one hundred (100%) percent of the insurable value of the building(s) DLC CDBG CD14-07PS Community Access Administrative Services Program Page 30 of 41 16D1 or structure(s). The policy shall be in the name of Collier County and the SUBRECIPIENT. 6. In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42 U.S.C. 4001), the SUBRECIPIENT shall assure that for activities located in an area identified by the Federal Emergency Management Agency (FEMA) as having special flood hazards, flood insurance under the National Flood Insurance Program is obtained and maintained as a condition of financial assistance for acquisition or construction purposes (including rehabilitation). OPERATION/MANAGEMENT PHASE(IF APPLICABLE) After the Construction Phase is completed and occupancy begins, the following insurance must be kept in force throughout the duration of the loan and/or contract: 7. Workers' Compensation as required by Chapter 440, Florida Statutes. 8. Commercial General Liability including products and completed operations insurance in the amount of$1,000,000 per occurrence and $2,000,000 aggregate. Collier County must be shown as an additional insured with respect to this coverage. 9. Automobile Liability Insurance covering all owned, non-owned and hired vehicles used in connection with this contract in an amount not less than $1,000,000 combined single limit for combined Bodily Injury and Property Damage. Collier County as an additional insured. 10. Property Insurance coverage on an "All Risk" basis in an amount not less than one hundred (100%) of the replacement cost of the property. Collier County must be shown as a Loss payee with respect to this coverage A.T.I.M.A. 11. Flood Insurance coverage for those properties found to be within a flood hazard zone for the full replacement values of the structure(s) or the maximum amount of coverage available through the National Flood Insurance Program (NFIP). The policy must show Collier County as a Loss Payee A.T.I.M.A. DLC CDBG CDI4-07PS Community Access Administrative Services Program Page 31 of 41 16 ® 1 EXHIBIT "B" COLLIER COUNTY HOUSING, HUMAN AND VETERAN SERVICES REQUEST FOR PAYMENT SECTION I: REQUEST FOR PAYMENT Sub recipient Name: David Lawrence Mental Health Center, Inc., d/b/a David Lawrence Center Sub recipient Mailing Address: 6025 Bathey Lane,Naples, FL 34116 Project Name: Community Access Administrative Services Program Agreement No: CD14-07PS Payment Request# Total Payment Minus Retainage: $ Period of Availability: through Period for which Agency has incurred indebtedness: through SECTION II: STATUS OF FUNDS 1. Grant Amount Awarded $ 2. Sum of Past Claims Paid on this Account $ 3. Total Grant Amount Awarded Less Sum Of Past Claims Paid on this Account $ 4. Amount of Previous Unpaid Requests $ 5. Amount of Today's Request $ 6. 10%Retainage Amount Withheld 7. Current Grant Balance (Initial Grant Amount Awarded Less Sum of all requests) $ I certify that this request for payment has been drawn in accordance with the terms and conditions of the Agreement between the COUNTY and us as the SUBRECIPIENT. To the best of my knowledge and belief, all grant requirements have been followed. Signature Date Title Grant Coordinator Grant Accountant Supervisor (approval required $15,000 and above) Dept Director (approval required $15,000 and above) DLC CDBG CD14-07PS Community Access Administrative Services Program Page 32 of 41 EXHIBIT "C" REPORTING SCHEDULE The SUBRECIPIENT shall submit quarterly reports to Grantee based on the following schedule. Reports shall be submitted according to this schedule as long as this Agreement is in force: Activity Reporting Period Report Due Date October 1st—December 31st January 10th January 31'—March 31st April 10th April 1st—June 30th July 10th July 1st—September 30th October 10th SUBRECIPIENT AGREEMENT COMMUNITY ACCESS ADMINISTRATIVE SERVICES PROGRAM Date Submitted: Activity Reporting Period: Contact Person: Telephone: Email: GENERAL 1. Activity Status or Milestones — describe any significant actions taken or outcomes achieved during this reporting period. 2. Future Actions — what significant actions or outcomes are expected during the next reporting period? DLC CDBG CD14-07PS Community Access Administrative Services Program Page 33 of 41 16131 3. Obstacles—describe any potential obstacles, challenges, or issues that may cause delay. ACTIVITY STATUS Complete the following information by entering the appropriate numbers for this reporting period in the tables below. Do not duplicate information from previous reporting periods. Activity This Reporting Period No.Active Projects No. Projects Complete No.Properties Demolished No. Properties Sold TOTAL HOUSEHOLD INFORMATION Complete these tables for those properties sold during this reporting period. Household Data This Reporting Period No. Extremely-Low Income Households(0-30%AMI) No. Very-Low Income Households(31-50%AMI) No. Low-Income Households(51-80%AMI) No.Moderate-Income Households(81-120%AMI) No. Female Head of Households TOTAL RACE AND ETHNICITY BENEFICIARIES Race Total No. Hispanic White Black or African American Asian American Indian or Alaskan Native Native Hawaiian or Other Pacific Islander American Indian/Alaska Native and White Asian and White Black/African American and White American Indian/Alaskan Native and Black/African American Other Multi-Racial TOTAL DLC CDBG CD14-07PS Community Access Administrative Services Program Page 34 of 41 16 /3 1 EXHIBIT "D" QUARTERLY PERFORMANCE REPORT DATA GENERAL Grantee is required to submit to HUD, through the Integrated Disbursement and Information System ("IDIS") Performance Reports. The County reports information on a quarterly basis. To facilitate in the preparation of such reports, Subrecipient shall submit the information contained herein within ten (10) days of the end of each calendar quarter. QUARTERLY PROGRESS REPORT Sub-recipients: Please fill in the following shaded areas of the report Agency Name: David Lawrence Center Date: Project Title: Community Access Administrative Services Program Alternate Program Contact: Sharie Boscaglia,Director Contact: Rob Wilkinson Telephone Number: 239-354-1402 *REPORT FOR QUARTER ENDING:(check one that applies to the corresponding grant period): ❑12/31/14 03/31/15 006/30/15 ❑9/30/15 ❑ Please take note: Each quarterly report needs to include cumulative data beginning from the start of the agreement date. Please list the outcome goal(s)from your approved application&sub-recipient agreement and indicate your progress in meeting 1. those goals since the beginning of the agreement. A.Outcome Goals: list the outcome goal(s)from your approved application&sub-recipient agreement. Outcome 1: Provide community access services, including healthcare enrollment and provide educational materials on insurance options to persons accessing kiosk sites. Outcome 2: Purchase and install free-standing computer benefits kiosks at DLC sites. Outcome 3: Employ personnel to assist person utilizing kiosks. Outcome 4: Serve 300 individuals Outcome 5: B.Goal Progress: Indicate the progress to date in meeting each outcome goal. DLC CDBG CD14-07PS Community Access Administrative Services Program Page 35 of 41 1601 Outcome 1: Outcome 2: Outcome 3 etc: Is this project still in compliance with the original project schedule?If more than 2 months behind schedule,must submit a new 2. timeline for approval. ❑ ❑ Yes No If no,explain: 3. Since effective date of agreement,of the persons assisted,how many.... a. ...now have new access(continuing)to this service or benefit? 0 b. ...now has improved access to this service or benefit? 0 c. ...now receive a service or benefit that is no longer substandard? 0 TOTAL: 0 4. What funding sources are applied for this period/program year? $ $ Section 108 Loan Guarantee - HOPWA - $ $ Other Consolidated Plan Funds - CDBG - $ $ Other Federal Funds - ESG - $ $ State/Local Funds - HOME - Total $ Entitlement $ Total Other Funds - Funds - DLC CDBG CD14-07PS Community Access Administrative Services Program Page 36 of 41 1601 5. 'What is the total number of UNDUPLICATED clients served this quarter,if applicable? a. Total No.of adult females served: 0 Total No.of females served under 18: 0 b. Total No.of adult males served: 0 Total No.of males served under 18: 0 TOTAL: 0 TOTAL: 0 c. Total No.of families served: 0 Total No.of female head of household: 0 6. What is the total number of UNDUPLICATED clients served since October,if applicable? a. Total number of adult females served: 0 Total number of females served under 18: 0 b. Total number of adult males served: 0 Total number of males served under 18: 0 TOTAL: 0 TOTAL: 0 c. Total No.of families served: 0 Total No.of female head of household: 0 Complete EITHER question#7 OR#8.Complete question#7 if your program only serves clients in one or more of the listed HUD Presumed Benefit categories. Complete question#8 if any client in your program does not fall into a Presumed Benefit category. DO NOT COMPLETE BOTH QUESTION 7 AND 8. 7. (PRESUMED BENEFICIARY DATA r 8. 'OTHER BENEFICIARY DATA INCOME RANGE Indicate the total number of UNDUPLICATED Indicate the total number of UNDUPI KCATFrz persons persons served since October 1 who fall into served since October 1 who fall into each income each presumed benefit category (the total category(the total should equal the total in question#6): should equal the total in question#6): Report as: Report as: O Abused Children 0 Extremely low Income(0-30%) O Homeless Person 0 Low Income(31-50%) O Battered Spouses 0 Moderate Income(51-80%) O Persons w/HIV/AIDS 0 Above Moderate Income(>80%) O Elderly Persons O Veterans O Chronically/Mentally ill O Physically Disabled Adults O Other-Youth TOTAL: 0 TOTAL: 0 9. 'Racial&Ethnic Data: I(if applicable) Please indicate how many UNDUPLICATED clients served since October fall into each race category. In addition to each race category, please indicate how many persons in each race category consider themselves Hispanic (Total Race column should equal the total cell). RACE ETHNICITY White ;of whom,how many are Hispanic? Black/African American 0 0 ;of whom,how many are Hispanic? Asian 0 0 of whom,how many are Hispanic? American Indian/Alaska Native 0 0 ;of whom,how many are Hispanic? Native Hawaiian/Other Pacific Islander 0 0 ;of whom,how many are Hispanic? American Indian/Alaskan Native&White 0 0 ;of whom,how many are Hispanic? Black/African American&White 0 0 ;of whom,how many are Hispanic? Am.Indian/Alaska Native&Black/African Am. 0 0 ;of whom,how many are Hispanic? Other Multi-racial 0 0 ;of whom,how many are Hispanic? Other 0 0 ;of whom,how many are Hispanic? TOTAL: 0 0 TOTAL HISPANIC Name: Signature: Your typed name here represents your electronic Title: signature DLC CDBG CD14-07PS Community Access Administrative Services Program Page 37 of 41 161 EXHIBIT "E" INCOME CERTIFICATION INSTRUCTIONS Complete form, and retain appropriate supporting documentation,to document providing CDBG assistance to an eligible beneficiary. Please file in your organization's records and have on hand for future monitoring visits. Effective Date: A. Household Information Member Names—All Household Members Relationship Age 1 2 3 4 5 6 7 8 B. Assets: All Household Members,Including Minors Member Asset Description Cash Value Income from Assets 1 2 3 4 5 6 7 8 Total Cash Value of Assets B(a) Total Income from Assets B(b) If line B(a) is greater than $5,000, multiply that amount by the rate specified by HUD(applicable rate 2.0%)and enter results in B(c), otherwise leave blank. B(c) DLC CDBG CD14-07PS Community Access Administrative Services Program Page 38 of 41 f . 16D1 A C. Anticipated Annual Income: Includes Unearned Income and Support Paid on Behalf of Minors Member Wages/ Benefits/ Public Other Salaries Pensions Assistance Income (include tips, commissions, Asset bonuses,and Income overtime) 1 (Enter the 2 greater of box B(b)or 3 box B(c), 4 above, in 5 box C(e) 6 below) 7 8 Totals (a) (b) (c) (d) (e) Enter total of items C(a)through C(e). This amount is the Annual Anticipated Household Income. D. Recipient Statement: The information on this form is to be used to determine maximum income for eligibility. I/we have provided, for each person set forth in Item A, acceptable verification of current and anticipated annual income. I/we certify that the statements are true and complete to the best of my/our knowledge and belief and are given under penalty of perjury. WARNING: Florida Statutes 817 provides that willful false statements or misrepresentations concerning income and assets or liabilities relating to financial condition is a misdemeanor of the first degree and is punishable by fines and imprisonment provided under S.775.082 and 775.083. Signature of Head of Household Date Signature of Spouse or Co-Head of Household Date Adult Household Member(if applicable) Date Adult Household Member(if applicable) Date DLC CDBG CDI4-07PS Community Access Administrative Services Program Page 39 of 41 16131 E. CDBG Grantee Statement: Based on the representations herein, the family or individual(s) named in Item A of this Income Certification is/are eligible under the provisions of the CDBG Program. The family or individual(s) constitute(s) a: Very-Low Income (VLI) Household means and individual or family whose annual income does not exceed 30 percent of the area median income as determined by the U.S. Department of Housing and Urban Development with adjustments for household size. (Maximum Income Limit$ ). Low-Income (LI) Household means and individual or family whose annual income does not exceed 50 percent of the area median income as determined by the U.S. Department of Housing and Urban Development with adjustments for household size. (Maximum Income Limit $ ). Moderate-Income (MOD) Household means and individual or family whose annual income does not exceed 80 percent of the area median income as determined by the U.S. Department of Housing and Urban Development with adjustments for household size. (Maximum Income Limit$ ). Based upon the (year) income limits for the Naples-Marco Island Metropolitan Statistical Area(MSA) of Collier County, Florida. Signature of the CDBG Administrator or His/Her Designated Representative: Signature Date Printed Name Title F. Household Data Number of Persons By Race/Ethnicity By Age Native American Asian Black Hawaiian or White Oth 0— 26— 41 — 62+ Indian Other Pac. er 25 40 61 Islander Hispanic Non- Hispanic NOTE:Information concerning the rate or ethnicity of the occupants is being gathered for statistical use only. No beneficiary is required to give such information he or she desires to do so, and refusal to give such information will not affect any right he or she has to the CDBG program. DLC CDBG CD14-07PS Community Access Administrative Services Program Page 40 of 41 1601 EXHIBIT "F" ANNUAL AUDIT MONITORING REPORT OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our sub recipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Name Fiscal Year Period Total State Financial Assistance Expended during most recently completed Fiscal Year Total Federal Financial Assistance Expended during most recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ending ❑ as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter is attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ending as ❑ indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. ❑ We are not subject to the requirements of OMB Circular A-133 because we: ❑ Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are exempt for other reasons—explain An audited financial statement is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title This form may be used to monitor Florida Single Audit Act(Statute 215.97) requirements. DLC CDBG CD14-07PS Community Access Administrative Services Program Page 41 of 41