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.
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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:
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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
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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
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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
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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").
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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
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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.
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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
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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.
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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
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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
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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
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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:
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"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;
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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.
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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.
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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
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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,
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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
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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
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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.
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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
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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
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• 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.
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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
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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/
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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
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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)
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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
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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)
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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.
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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)
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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?
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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
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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.
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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 -
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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
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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)
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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
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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.
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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