Agenda 10/22/2013 Item #16D14 10/22/2013 16.D.14.
EXECUTIVE SUMMARY
Recommendation to approve an after-the-fact Nutrition Services Incentive Program (NSIP)
contract with Area Agency on Aging for Southwest Florida, Inc. d/b/a Senior Choices of Southwest
Florida Senior and approve a subsequent budget amendment in the amount of$38,171 for FY 2014
OBJECTIVE: To provide continued Nutrition services to the seniors in Collier County.
CONSIDERATIONS: The Services for Seniors program managed within the Housing, Human, and
Veteran Services (HHVS) Department has been providing support services to Collier County's frail and
elderly citizen for over 32 years. In January of 2008, Services for Seniors began administering the Senior
Nutrition program in Collier County. This program consists of four congregate meals sites, located in the
East Naples Community Center, Goodlette Arms Apartments, the Golden Gate Community Center and
the Roberts Center in Immokalee. These social settings provide companionship and meals to the County's
elderly. Home delivered meals are also provided through this grant program to the frail elderly who are
not able to leave their home.
The contract period for this grant is October 1, 2013 through September 30, 2014. This grant program
will reimburse the County $0.72 for each meal served in the Senior Nutrition program, which is used to
provide additional support to the Senior Nutrition program. The anticipated grant funding from this
program is $38,171.
The current grant contact awarded to Collier County as the Lead Agency commenced on October 1, 2012
and ended on September 30, 2013. In order to avoid a lapse in services it was necessary for the
amendment to be signed expeditiously. This item is being presented as an after-the-fact because Collier
County received the grant agreement on September 30, 2013 from the grantor agency. Pursuant to CMA
5330 and Resolution No. 2010-122, the County Manager authorized Steve Y. Carrell, Interim
Administrator, to sign the contract. Collier County, as the Lead Agency, is responsible to respond to
seniors needs and to manage the spending authority for the NSIP program services.
GROWTH MANAGEMENT: There is no growth management impact from this recommendation.
FISCAL IMPACT: A budget amendment is required to recognize grant funding in the amount of
$38,171 for FY 2014 in the Human Services Grant Fund (707),Project 33302.
LEGAL CONSIDERATIONS: This item is legally approved for form and legality and requires a
majority vote for Board approval.—JAB
RECOMMENDATION: To provide after-the fact approval for the NSIP contract with Area Agency on
Aging for Southwest Florida, Inc. d/b/a Senior Choices of Southwest Florida and authorize the
corresponding budget amendment.
Prepared by: Ashley Royer, Grants Coordinator,Housing Human and Veteran Services
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.D.16.D.14.
Item Summary: Recommendation to approve an after-the-fact Nutrition Services
Incentive Program (NSIP) contract with Area Agency on Aging for Southwest Florida, Inc. d/b/a
Senior Choices of Southwest Florida Senior and approve a subsequent budget amendment in
the amount of$38,171 for FY 2014
Meeting Date: 10/22/2013
Prepared By
Name: RoyerAshley
Title: VALUE MISSING
10/8/2013 10:06:24 AM
Submitted by
Title: VALUE MISSING
Name: RoyerAshley
10/8/2013 10:06:27 AM
Approved By
Name: DeSearJacquelyn
Title: Accountant,Housing, Human&Veteran Services
Date: 10/9/2013 11:52:30 AM
Name: SonntagKristi
Date: 10/9/2013 12:27:25 PM
Name: Bendisa Marku
Title: Operations Analyst,Wastewater
Date: 10/9/2013 12:33:51 PM
Name: MagonGeoffrey
Title: Grants Coordinator
Date: 10/9/2013 1:05:23 PM
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10/22/2013 16.D.14.
Name: AlonsoHailey
Title: Operations Analyst,Public Service Division
Date: 10/9/2013 2:42:04 PM
Name: GrantKimberley
Title: Interim Director
Date: 10/10/2013 1:02:40 PM
Name: BelpedioJennifer
Title:Assistant County Attorney,County Attorney
Date: 10/10/2013 3:00:13 PM
Name: CarnellSteve
Title: Purchasing/Genera] Services Director
Date: 10/10/2013 4:42:48 PM
Name: RobinsonErica
Date: 10/11/2013 9:34:34 AM
Name: K]atzkowJeff
Title: County Attorney
Date: 10/11/2013 10:16:58 AM
Name: FinnEd
Title: Senior Budget Analyst, O1v1B
Date: 10/11/2013 12:45:04 PM
Name: IsacksonMark
Title: Director-Corp Financial and Mgmt Svs,CMO
Date: 10/14/2013 11:16:52 AM
Name: OchsLeo
Title: County Manager
Date: 10/14/2013 2:18:23 PM
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AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC
dba SENIOR CHOICES OF SOUTHWEST FLORIDA
STANDARD CONTRACT
NUTRITION SERVICES INCENTIVE PROGRAM
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of
Southwest Florida, (Agency), and Collier County Board of County Commissioners, (Contractor), and collectively referred to
as the "Parties." The term contractor for this purpose may designate a vendor, subgrantee or subrecipient, the status to be
further identified in ATTACHMENT III,Exhibit-2 as necessary.
WITNESSETH THAT:
WHEREAS,the Agency has determined that it is in need of certain services as described herein; and
WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such
services as an independent contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions hereinafter set forth,the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments,forms and exhibits,which constitute the contract document.
1.2. Aaencv Mission Statement
Mission: To help aging adults,60 and older, achieve greater independence through awareness of
resources and access to qualified service providers.
Vision: To be the recognized leader in supporting older adults and their families with access to
trustworthy resources and services in their communities while empowering them to live with
independence and dignity.
2. incorporation of Documents within the Contract
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department
handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly
provides to the contrary. In the event of conflict in language among any of the documents referenced above, the
specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the
proposal(s)or other general materials not specific to this contract document and identified attachments.
3. Term of Contract
This contract shall begin on October 1, 2013 or on the date the contract has been signed by the last party required to
sign it, whichever is later. It shall end at midnight, Eastern Standard Time September 30,2014.
4. Contract Amount
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an
amount not to exceed $38,171.00, subject to the availability of funds. Any costs or services paid for under any other
contract or from any other source are not eligible for payment under this contract.
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5. Renewals
By mutual agreement of the Parties, in accordance with s. 287.058(1xg), F.S., the Agency may renew the contract for
period not to exceed three years, or the term of the original contract, whichever is longer. The renewal price, or method
for determining a renewal price, is set forth in the bid,proposal, or reply. No other costs for the renewal may
be charged. Any renewal is subject to the same terms and conditions as the original contract and contingent upon
satisfactory performance evaluations by the Agency and the availability of funds.
6. Compliance with Federal Law
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable
regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42
U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et
seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency
regulations 40 CFR 30. The Contractor shall report any violations of the above to the Agency.
6.1.3 The Contractor, or agent acting for the Contractor, may not use any federal funds received in connection
with this contract to influence legislation or appropriations pending before the Congress or any state
legislature. If this contract contains federal funding in excess of$100,000.00, the Contractor must, prior to
contract execution, complete the Certification Regarding Lobbying form, ATTACHMENT II. All
disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned
to the Contract Manager prior to payment under this contract.
6.1.4 In accordance with Appendix A to 2 CFR 215, the Contractor shall comply with Executive Order 11246,
Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in
Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract
awards will not be made to parties listed on the government-wide Excluded Parties List System, in
accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689,
"Debarment and Suspension." The Excluded Parties List System contains the names of parties debarred,
suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or
regulatory authority other than Executive Order 12549. The Contractor shall comply with these
provisions before doing business or entering into subcontracts receiving federal funds pursuant to this
contract. The Contractor shall complete and sign ATTACHMENT V prior to the execution of this
contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of
this contract by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt
organization reporting requirements (filing a Form 990 or Form 990-N) and has its tax exempt status revoked
for failing to comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason,
the Contractor must notify the Agency in writing within thirty (30) days of receiving the IRS notice of
revocation.
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6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR Part 170.110(b),the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR 170.
6.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116,
Contractor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in
related subcontracts a requirement that subcontractors performing work or providing services pursuant to the state
contract utilize the E-verify system to verify employment of all new employees hired by the subcontractor during
the contract term. Contractors meeting the terms and conditions of the E-Verify System are deemed to be in
compliance with this provision.
7. Compliance with State Law
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and
enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 The Contractor shall comply with requirements of s.287.058,F.S.as amended.
7.2.1 The Contractor shall provide units of deliverables, including various client services, and in some instances
may include reports, findings, and drafts, as specified in this contract, which the Contract Manager must
receive and accept in writing prior to payment in accordance with s. 215.971, F.S.(1)and(2).
7.2.2 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient
detail for a proper pre-audit and post-audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit bills for
any travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this
contract.
7.2.4 The Contractor shall allow public access to all documents, papers, letters, or other public records as
defined in subsection 119.011(12), F.S.,made or received by the Contractor in conjunction with this contract
except for those records which are made confidential or exempt by law. The Contractor's refusal to comply
with this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate the contract.
7.3 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427,F.S.,and Rule 41-2, F.A. C.
7.4 Subcontractors who are on the discriminatory vendor list may not transact business with any public entity, in
accordance with the provisions of s. 287.134, F.S.
7.5 The Contractor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the
expenditure of contract funds for the purpose of lobbying the legislature,judicial branch or a state agency.
7.6 In accordance with s. 287.135 F.S., any contractor on the Scrutinized Companies with Activities in Sudan List or
the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant to s.
215.473 F.S., is ineligible to enter into or renew a contract with the Agency for goods or services of
$750,000.00 or more. Pursuant to s. 287.135 F.S.,the Agency may terminate this contract if the Contractor is
found to have submitted a false certification of its status on the Lists or has been placed on the Lists. Further,
the Contractor is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to
the finding of false certification. If this contract contains $750,000.00 or more, the Contractor shall complete
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and sign ATTACHMENT H, Certification Regarding Scrutinized Companies Lists, prior to the execution of
this contract.
8. Dackground Screening
The Contractor shall ensure that the requirements of s. 430.0402 and ch. 435, F.S., as amended, are met regarding
background screening for all persons who meet the definition of a direct service provider and who are not excepted from
the Department's level 2 background screening pursuant to s. 430.0402(2)-(3), F.S. The Contractor must also comply
with any applicable rules promulgated by the Department and the Agency for Health Care Administration regarding
implementation of s. 430.0402 and ch.435,F.S.
8.1 Further information concerning the procedures for background screening are found at
http://elderaffairs.state.fl.us/doea/backgroundscreeni ng.php
9. Grievance Procedures
The Contractor shall develop, implement, and ensure that its subcontractors have established grievance procedures to
process and resolve client dissatisfaction with or denial of service(s), and address complaints regarding the
termination, suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum,
will provide for notice of the grievance procedure and an opportunity for review of the subcontractor's determination(s).
10. Public Records and Retention
10.1 If under this contract, the Contractor is providing services and is acting on behalf of the Agency as provided
under section 119.011(2), Florida Statutes, the Contractor, subject to the terms of section
287.058(1)(c),Florida Statutes,and any other applicable legal and equitable remedies, shall:
a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency
in order to perform the services.
b) Provide the public with access to public records on the same terms and conditions that the
Agency would provide the records and at a cost that does not exceed the cost provided in Chapter
119,Florida Statutes, or as otherwise provided by law.
c) Ensure that public records that are exempt or confidential and exempt from public records disclosure
requirements are not disclosed except as authorized by law.
d) Meet all requirements for retaining public records and transfer, at no cost, to the Agency all public
records in possession of the Contractor upon termination or expiration of the 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 Agency in a
format that is compatible with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for refusal
by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,
papers, letters, or other material made or received by the Contractor in conjunction with the contract,
unless the records are exempt from Section 24(a) of Article I of the State Constitution and Section
119.07(1), Florida Statutes.
11. Audits.Inspections.Investigations
11.1 The Contractor shall establish and maintain books, records and documents (including electronic storage
media) sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of
funds provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and
assure they are used solely for the purposes authorized under this contract. Whenever appropriate, financial
information should be related to performance and unit cost data.
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11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six(6)years after completion of the contract or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six(6)years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to
the Agency.
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and
transfer of any records or documents during the required retention period.
11.4 The Contractor shall assure that the records described in this section will be subject at all reasonable times to
inspection,review, copying, or audit by federal, state,or other personnel duly authorized by the Agency.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Department of
Elder Affairs, the Area Agency on Aging for Southwest Florida, and federal auditors, pursuant to 45 CFR
92.36(i)(10), will be allowed full access to and the right to examine any of the Contractor's contracts and
related records and documents pertinent to this specific contract, regardless of the form in which kept.
11.6 The Contractor shall provide a financial and compliance audit to the Agency as specified in this contract and in
ATTACHMENT III and ensure that all related third-party transactions are disclosed to the auditor.
11.7 The Contractor shall comply and cooperate immediately with any inspections, reviews, investigations, or
audits deemed necessary by the office of the Inspector General pursuant to s.20.055,F.S.
12. Nondiscrimination-Civil Rights Compliance
12.1 The Contractor shall execute assurances in ATTACHMENT VI that it will not discriminate against any
person in the provision of services or benefits under this contract or in employment because of age, race,
religion, color, disability, national origin, marital status or sex in compliance with state and federal law and
regulations. The Contractor further assures that all contractors, subcontractors, subgrantees, or others with
whom it arranges to provide services or benefits in connection with any of its programs and activities are not
discriminating against clients or employees because of age, race, religion, color, disability, national origin,
marital status or sex.
12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete and
accurate Civil Rights Compliance Checklist(ATTACHMENT B).
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination
involving services or benefits through this contract. These procedures will include notifying clients, employees,
and participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for
the period during which such assistance is provided. The Contractor further assures that all subcontractors,
vendors, or others with whom it arranges to provide services or benefits to participants or employees in
connection with any of its programs and activities are not discriminating against those participants or employees
in violation of the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the
Contractor understands that the Agency may, at its discretion, seek a court order requiring compliance with the
terms of this assurance or seek other appropriate judicial or administrative relief, including but not limited
to, termination of and denial of further assistance.
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13. Monitoring by the Agency
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers, documents,
facilities, goods and services of the' Contractor which are relevant to this contract, and to interview any clients
employees and subcontractor employees of the Contractor to assure the Department of the satisfactory performance c
the terms and conditions of this contract. Following such review, the Agency will provide a
written report of its findings to the Contractor, and where appropriate, the Contractor shall develop a corrective action
plan. The Contractor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely
manner as determined by the Contract Manager.
14. Provision of Services
The Contractor shall provide services in the manner described in ATTACHMENT I.
15. Coordinated Monitoring with Other Agencies
If the Contractor receives funding from one or more of the State of Florida other human service agencies, in addition to
the Area Agency on Aging for Southwest Florida, Inc., then a joint monitoring visit including such other agencies may
be scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human service
agencies shall include the Department of Children and Families, the Department of Health,the Agency for Persons with
Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the
subsequent scheduling of such a visit by the designated agency's lead administrative coordinator, the Contractor shall
comply and cooperate with all monitors, inspectors, and/or investigators.
16. jpdemnificatiou
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from any and
all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the
execution of this agreement or performance of the services provided for herein. It is understood and agreed that th
Contractor is not required to indemnify the Agency for claims, demands, actions or causes of action arising solely out c
the Agency's negligence.
16.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, this section 15 is not applicable to
contracts executed between the Department and/or Agency and state agencies or subdivisions defined in s.
768.28(2), F.S.
17. Insurance and Bonding
17.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this contract
and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by subsection 768.28(2), F.S., the Contractor accepts full responsibility for identifying
and determining the type(s) and extent of liability insurance necessary to provide reasonable financial
protections for the Contractor and the clients to be served under this contract. The limits of coverage under each
policy maintained by the Contractor do not limit the Contractor's liability and obligations under this
contract. The Contractor shall ensure that the Agency has the most current written verification of
insurance coverage throughout the term of this contract. Such coverage may be provided by a self-insurance
program established and operating under the laws of the State of Florida. The Agency reserves the right to
require additional insurance as specified in this contract.
17.2 Throughout the term of this agreement, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company and consistent with good business practices.
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18. Confidentiality of Information
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized to
give that consent or when authorized by law.
19. Health Insurance Portability and Accountability Act
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act(42 USC
1320d.),as well as all regulations promulgated thereunder(45 CFR 160, 162,and 164).
20. Incident Reportin'
20.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contractor or subcontractor's
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Contract Manager(by telephone)with an email to immediately follow.
20.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S.,this provision is binding upon both the Contractor
and its employees.
21. New Contract(s)Renortinu
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the remaining
four (4) state human service agencies. The notification shall include the following information: (1) contracting state
agency; (2) contract name and number; (3) contract start and end dates; (4) contract amount; (5)contract description
and commodity or service; and(6) Contract Manager name and number. In complying with this provision,and pursuant
to s. 287.0575, F.S. as amended,the Contractor shall complete and provide the information in ATTACHMENT D.
22. Dankruptcv Notification
During the term of this contract, the Contractor shall immediately notify the Area Agency on Aging for Southwest
Florida if the Contractor, its assignees, subcontractors or affiliates file a claim for bankruptcy. Within ten (10) days
after notification, the Contractor must also provide the following information to the Agency: (1)the date of filing of the
bankruptcy petition; (2) the case number; (3) the court name and the division in which the petition was filed (e.g.,
Florida Middle District, Lee County, Fort Myers, Florida); and (4) the name, address, and telephone number of the
bankruptcy attorney.
23. Sponsorship and Publicity
23.1 As required by s. 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in
publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by(Contractor's name)
the Area Agency on Aging for Southwest Florida and the State of Florida, Department of Elder Affairs." If
the sponsorship reference is in written material, the words "Area Agency on Aging for Southwest Florida, and
the State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or type as the
name of the organization.
23.2 The Contractor shall not use the words "The Area Agency on Aging for Southwest Florida and/or The State
of Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless
specific authorization has been obtained by the Agency prior to use.
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24. Assignments
24.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior writte
approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, c
transfer otherwise occurring without prior written approval of the Agency will constitute a materiak''
breach of the contract.
24.2 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or
obligations under this contract to another governmental agency in the State of Florida, upon giving prior written
notice to the Contractor. In the event the State of Florida approves transfer of the Contractor's obligations, the
Contractor remains responsible for all work performed and all expenses incurred in connection with the
contract.
24.3 This contract shall remain binding upon the successors in interest of either the Contractor or the Agency.
25. Subcontracts
25.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this
contract, whether actually furnished by the Contractor or its subcontractors. Any subcontracts shall be
evidenced by a written document and subject to any conditions of approval the Agency deems necessary. The
Contractor further agrees that the Agency will not be liable to the subcontractor in any way or for any reason.
The Contractor, at its expense, shall defend the Agency against any such claims.
25.2 The Contractor shall promptly pay any subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any subcontractor in accordance with s. 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and subcontractor,will result in a penalty as provided by
statute.
26. Independent Capacity of Contractor
It is the intent and understanding of the Parties that the Contractor, or any of its subcontractors, are independent
contractors and are not employees of the Agency and shall not hold themselves out as employees or agents of the
Agency without specific authorization from the Agency. It is the further intent and understanding of the Parties
that the Agency does not control the employment practices of the Contractor and will not be liable for any wage and
hour, employment discrimination, or other labor and employment claims against the Contractor or its subcontractors.
All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation
funds and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
27. Payment
Payments shall be made to the Contractor pursuant to s. 215.472, F.S., as services are rendered and invoiced by the
Contractor. The Contract Manager will have final approval of the invoice for payment, and will approve the invoice for
payment only if the Contractor has met all terms and conditions of the contract. unless the bid specifications, purchase
order, or this contract specify otherwise. The approved invoice will be submitted to the Agency's finance section
for budgetary approval and processing. Disputes arising over invoicing and payments will be resolved in accordance
with the provisions of s. 215.422 F.S. A Vendor Ombudsman has been established within the Department of Financial
Services and may be contacted at(850)413-5665.
28. Return of Funds
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed and any interest
attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the Contractor by
the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment has been made,
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the Contractor shall repay said overpayment immediately without prior notification from the Agency. In the event
that the Agency first discovers an overpayment has been made, the Contract Manager will notify the Contractor in
writing of such findings. Should repayment not be made forthwith,the Contractor shall be charged at the lawful rate of
interest on the outstanding balance pursuant to s. 55.03,F.S., after Agency notification or Contractor discovery.
49. Data Integrity and Safeguarding Information
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages of
the computer system. The security over the backed-up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign ATTACHMENT IV prior to the execution of this
contract.
30. Computer Use and Social Media Policy
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy,
which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated
with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses the
Department's computer resource systems must comply with the Department's policy regarding social media. Social
Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social
networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This
policy is available on the Department's website.
31. Conflict of Interest
The Contractor shall establish safeguards to prohibit employees, board members, management and subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict
of interest or personal gain. No employee, officer or agent of the Contractor or subcontractor shall participate in
selection, or in the award of an agreement supported by state or federal funds if a conflict of interest, real or apparent,
would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her
immediate family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the
above, has a financial or other interest in the firm selected for award. The Contractor or subcontractor's officers,
employees or agents will neither soiicit nor accept gratuities, favors or anything of monetary value from contractors,
potential contractors, or parties to subcontracts. The Contractor's board members and management must disclose to
the Agency any relationship which may be. or may be perceived to be, a conflict of interest within thirty (30)
calendar days of an individual's original appointment or placement in that position, or if the individual is serving as an
incumbent, within thirty (30) calendar days of the commencement of this contract. The Contractor's employees and
subcontractors must make the same disclosures described above to the Contractor's board of directors. Compliance
with this provision will be monitored.
32. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid,proposal, or reply on a contract with a public entity for the construction
or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a
public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the
convicted vendor list.
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33. Purchasing
33.1 The Contractor may purchase articles which are the subject of or are required to carry out this contract from
Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946,F.S.,
in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes o
this contract, the Contractor shall be deemed to be substituted for the Department insofar as dealings with
PRIDE. This clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of
products/services available from PRIDE may be obtained by contacting PRIDE, (800)643-8459.
33.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to
carry out this contract, in accordance with the provisions of s. 403.7065,F.S.
33.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a
nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413,F.S., in
the same manner and under the same procedures set forth in s. 413.036(1) and (2), F.S. For purposes of this
contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with such
qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and the
products it offers is available at http://www.respectofflorida.org. This clause is not applicable to subcontractors
unless otherwise required by law.
34. Patents.Copyrights.Royalties
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed,produced
or for which ownership was purchased in the course of or as a result of work or services performed under this
contract, the Contractor shall refer the discovery, invention or material to the Agency to be referred to the Department of
State. Any and all patent rights or copyrights accruing under this contract are hereby reserved to the State of Florida
in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this
provision shall be those that are clearly expressed and reasonably valued in the contract.
34.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain ai
unencumbered right to use such property, notwithstanding any agreement made pursuant to this section 33.
34.2 If this contract is awarded solely federal funding,the terms and conditions are governed by 2 CFR 215.36.
35. Emergency Preparedness and Continuity of Operations
35.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of
an emergency preparedness plan. In the event of an emergency, the Contractor shall notify the Agency of
emergency provisions.
35.2 In the event a situation results in a cessation of services by a subcontractor, the Contractor shall retain
responsibility for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
36. Equipment
36.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more
than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by
the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable,
tangible personal property of a nonconsumable nature with an acquisition cost of$1,000.00 or more per unit,
and expected useful life of at least one year; and hardback bound books not circulated to students or the general
public, with a value or cost of $250.00 or more [for state funds].
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36.2 Contractors and sub-contractors who are Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; and, (b) a procedure for conducting a physical inventory of equipment at least
once every two years. The property records must be maintained on file and shall be provided to the Agency upon
request.
36.3 The Contractor's property management standards for equipment acquired with Federal funds and federally-
owned equipment shall include accurately maintained equipment records with the following information:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the Contractor or the federal government;
(5) Acquisition date(or date received,if the equipment was furnished by the federal government)and cost;
(6) Information from which one can calculate the percentage of federal participation in the cost of the
equipment(not applicable to equipment furnished by the federal government);
(7) Location and condition of the equipment and the date the information was reported;
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
36.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased
with state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan
approved by the Agency is part of the cost of carrying out the activities and functions of the grant awards and
Title (ownership) will vest in the Contractor, subject to the conditions of 2 CFR Part 215 Administrative
Requirements (formerly OMB Circular A-110), Subpart C, paragraph 34. Equipment purchased under these
thresholds is considered supplies and is not subject to property standards. Equipment purchased with funds
identified in the budget attachments to agreements covered by this contract, or identified in the sub-agreements
with sub-contractors (not included in a cost methodology), is subject to the conditions of section
273, F. S.and 60A-1.0017,F.A. C. or Title 45 CFR Part 74.
36.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or purchased with
funds provided through this contract without first obtaining the approval of the Contract Manager. When
disposing of property or equipment the Contractor must submit a written request for disposition instructions to
the respective Contract Manager. The request should include a brief description of the property, purchase price,
funding source, percentage of state or federal participation, acquisition date and condition of the property. The
request should also indicate the Contractor's proposed disposition (i.e., transfer or donation to another agency
that administers federal programs,offer the items for sale, destroy the items, etc.).
36.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within
120 days of the written request for disposition, the Contractor is authorized to proceed as directed in 2 CFR
Part 215 Administrative Requirements(formerly OMB Circular A-110).
36.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Sec. 3030b United States Code (USC). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of section
216.348, F. S.
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36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested
prior to disposal to ensure no confidential information remains.
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Informatio
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITI
worksheet is required for any computer related item costing $1,000.00 or more, including data processing
hardware, software, services, supplies, maintenance, training, personnel and facilities. The completed ITR
worksheet shall be maintained in the LAN administrator's file and must be provided to the Agency upon request.
The Contractor has the responsibility to require any subcontractors to comply with the Agency's ITR procedures.
37. PUR 1000 Form
The PUR 1000 Form is hereby incorporated by reference. In the event of any conflict between the PUR 1000 Form and
any terms or conditions of this contract the terms or conditions of this contract shall take precedence over the PUR
1000 Form. However, if the conflicting terms or conditions in the PUR 1000 Form are required by any section of the
Florida Statutes,the terms or conditions contained in the PUR 1000 Form shall take precedence.
38. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least 5 years from the date of purchase or the completion of the improvements or as further required by law.
39. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the
decision to writing and serve a copy on the Contractor.
40. financial Consequences of Non-Performance
If the Contractor fails to meet the minimum level of service or performance identified in this agreement, or that is
customary for the industry, then the Agency must apply financial consequences commensurate with the
deficiency. Financial consequences may include, but are not limited to, contract suspension, refusing payment,
withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of contract and
reacquiring services from an alternate source.
40.1 The Contractor will not be charged with financial consequences, when a failure to perform arises out of
causes that were the responsibility of the Agency.
41. No Waiver of Sovereign jmuuuda
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
42. Venue
If any dispute arises out of this contract,the venue of such legal recourse will be Leon County,Florida.
43. Entire Contract
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
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44. Force Majeure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
45. Severabi ity Clause
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable
the other provisions are severable to that void provision and shall remain in full force and effect.
46. Condition Precedent to Contract: Appropriations
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature.
47. Addition/Deletion
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this contract
when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both Parties.
The Parties shall negotiate compensation for any additional services added.
48. Waiver
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
). Compliance
The Contractor shall abide by all applicable current federal statutes, laws, rates and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these
laws shall be deemed an event of default of the Contractor, and subject the contract to immediate, unilateral cancellation
of the contract at the discretion of the Agency.
50. Final invoice
The Contractor shall submit the final invoice for payment to the Agency as specified in section 3.2.1. (date for final
request for payment) of ATTACHMENT I. If the Contractor fails to submit final request for payment by the
deadline, then all rights to payment may be forfeited and the Agency may not honor any requests submitted after the
aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from
the Contractor and necessary adjustments thereto have been approved by the Agency.
51. Renegotiations of Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations
process and subsequently identified in the Agency's operating budget.
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52. Termination
52.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days
notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall
be delivered by U.S.Postal Service or any expedited delivery service that provides verification of delivery or
hand delivery to the Contract Manager or the representative of the Contractor responsible for
administration of the contract.
52.2 In the event funds for payment pursuant to this contract become unavailable, the Agency may terminate this
contract upon no less than twenty-four (24) hours notice in writing to the Contractor. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manager or the representative of the Contractor responsible for administration of
the contract. The Agency will be the final authority as to the availability and adequacy of funds. In the event of
termination of this contract, the Contractor will be compensated for any work satisfactorily completed
prior to the date of termination.
52.3 This contract may be terminated for cause upon no less than twenty-four (24) hours notice in writing to the
Contractor. If applicable, the Agency may employ the default provisions in Rule 60A-1.006(3), F.A.C.
Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and
shall not be construed to be a modification of the terms and conditions of this contract. The provisions herein
do not limit the Agency's or the Contractor's rights to remedies at law or in equity.
52.4 Failure to have performed any contractual obligations with the Agency in a manner satisfactory to the
Agency will be a sufficient cause for termination. To be terminated as a contractor under this provision, the
contractor must have (1) previously failed to satisfactorily perform in a contract with the Agency, been
notified by the Agency of the unsatisfactory performance and failed to correct the unsatisfactory
performance to the satisfaction of the Agency; or (2) had a contract terminated by the Agency for cause.
52.5 Upon expiration or termination of the contract the Contractor(s) and Subcontractor(s) shall transfer all public
records in its possession to the Agency and destroy any duplicate public records that are exempt or confidential
and exempt from public records, disclosure requirements at no cost to the Agency. All electronically stored
records shall be provided to the Agency in a format that is compatible with the Agency's information technolog;
system(s).
53. Electronic Records and Signature
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A contractor that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with the
requirements contained in the Uniform Electronic Transaction Act, s. 668.50, F.S. All electronic records must be
fully auditable; are subject to Florida's Public Records Law, ch. 119, F.S.; must comply with section 28, Data
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and
maintained by the Contractor to the same extent as non-electronic records are retained and maintained as required by this
Agreement.
53.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the Agency
only upon further written consent by the Agency.
53.2 Upon request by the Agency, the Contractor shall provide the Agency with non-electronic (paper) copies of
records. Non-electronic (paper) copies provided to the Agency of any document that was originally in
electronic form with an electronic signature must indicate the person and the person's capacity who
electronically signed the document on any non-electronic copy of the document.
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54. Official Payee and Representatives(Names. Addresses,and Telephone Numbers);
The Contractor name, as shown on page 1 of this Collier County Housing,Human and Veteran Services
a. contract,and mailing address of the official payee to 3339 E Tamiami Trail,Building H
whom the payment shall be made is: Naples,FL 34112
b. The name of the contact person and street address where Kimberly Grant,Director
financial and administrative records are maintained is: Collier County Housing,Human and Veteran Services
3339 E Tamiami Trail,Building H
Naples,FL 34112
The name, address,and telephone number of the Kimberly Grant,Director
C. Collier County Housing,Human and Veteran Services
representative of the Contractor responsible for �' g
administration of the program under this contract is: 3339 E Tamiami Trail,Building H
Naples,FL 34112
(239)252-2273
The section and location within the Agency where Delores Kadlec-Roussey, Chief Financial Officer
d. Area Agency on Aging for Southwest Florida,Inc.
Requests for Payment and Receipt and Expenditure
dba Senior Choices of Southwest Florida
forms are to be mailed is: 15201 N. Cleveland Ave., Suite 1100
North Fort Myers, Florida 33903
(239)652-6900
Marianne G.Lorini,President/CEO
e. The name,address,and telephone number of the 15201 N. Cleveland Ave.
Contract Manager for this contract is: Area Agency on Aging for Southwest Florida,Inc.
dba Senior Choices of Southwest Florida
15201 N. Cleveland Ave., Suite 1100
North Fort Myers, Florida 33903
(239)652-6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be
provided in writing to the other party and the notification attached to the originals of this contract.
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55. All Terms and Conditions_Included
This contract and its Attachments, I — VII, A, B, D, E, G, H, J and any exhibits referenced in said attachments,
together with any documents incorporated by reference, contain all the terms and conditions agreed upon by thr
Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contrac..
shall supersede all previous communications, representations or agreements, either written or verbal between the
Parties.
By signing this contract,the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, the Parties hereto have caused this contract to be executed by their undersigned officials as
duly authorized.
Contractor: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.,DBA SENIOR CHOICES OF
SOUTHWEST FLORIDA
SIGNED BY: % SIGNED BY:
NAME: Stephen Y. Carnell NAME: RONALD LUCCHINO,PhD
TITLE: Interim Public Services Administrator TITLE: BOARD PRESIDENT
DATE: October 1, 2013 DATE:
Federal Tax ID: 59-600055 8
Fiscal Year Ending Date: 9/30
Approved as to form and legality
Aa nt �,�
t Coun omey
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INDEX OF ATTACHMENTS
A'17ACHMENT I
Statement of Work 18-26
A7 7ACHMENT II
Certification Regarding Lobbying, Certification for Contracts, Grants, Loans and Agreements . . . 27
ATTACHMENT HI
Financial and Compliance Audit 28-33
EXHIBIT 1 32
EXHIBIT 2 33
ATTACHMENT IV
Certification Regarding Data Integrity Compliance for Agreements, Grants, Loans and Cooperative
Agreements 34
ATTACHMENT V
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Lower
Tier Covered Transactions 35
ATTACHMENT VI
Assurances—Non-Construction Programs 36-37
ATTACHMENT VII
Request for Reimbursement 38
ATTACHMENT A
Department of Elder Affairs Programs & Services Handbook_ 39
AJ7ACHMENT B
State of Florida Department of Elder Affairs Civil Rights Compliance Checklist and Instructions 40-43
ATTACHMENT D
Provider's State Contracts List 44
ATTACHMENT E
Department's Computer Use policy and its Social Media Policy 45
ATTACHMENT G
Background Screening Affidavit of Compliance–Employer 46
ATTACHMENT H
Certification Regarding Scrutinized Companies Lists 47
AI 7ACHMENT J
Certification of Employment Status Certification 48
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ATTACHMENT I
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC
STATEMENT OF WORK
NUTRITION SERVICES INCENTIVE PROGRAM
SECTION I: SERVICES TO BE PROVIDED
1.1 DEFINITIONS OF TERMS AND ACRONYMS
1.1.1 DEFINITIONS OF ACRONYMS
Area Agency on Aging(AAA)
Client Information and Registration Tracking System(CIRTS)Dietary
Reference Intake(DRI)
Nutrition Services Incentive Program(NSIP)Older
Americans Act(OAA)
Planning and Service Area(PSA)
United States Department of Agriculture(USDA) State of
Florida(State)
Department(Florida,Department of Elder Affairs)DOEA
(Department of Elder Affairs)
1.1.2 PROGRAM SPECIFIC TERMS
Area Plan: A plan developed by the area agency on aging outlining a comprehensive and coordinated service
delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the OAA
and Agency instructions.
Area Plan Update: A revision to the area plan wherein the area agency on aging enters OAA program specific
data in the CIRTS. An update may also include other revisions to the area plan as instructed by the Agency.
1.2 GENERAL DESCRIPTION
1.2.1 General Statement
The NSIP is intended to provide incentives for the effective delivery of nutritious meals to older individuals.
NSIP allows programs to increase the number and/or the quality of meals served. NSIP is a cash allotment or
commodity program that supplements funding or food used in meals served under the OAA. Florida has opted for
cash payments in lieu of donated foods.
1.2.2 Authority
The relevant authority governing NSIP are:
(1) Older Americans Act of 2006, as amended, Section 311;
(2) 42 U.S.C. 303a,42 U.S.C. 604,42 U.S.C.3057; and
(3) Section 430.101,Florida Statutes.
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1.2.2.1 Incorporation of Reference Memoranda
In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial
Officer Memoranda, the following memoranda are provided for informational purposes and are hereby
incorporated by reference:
(1) CFO Memo No. 02: Release date,August 20,2010;
(2) CFO Memo No. 03: Release date,June 29,2010; and
(3) CFO Memo No. 06: Release date,June 30,2010.
1.2.3 Scope of Service
The Contractor is responsible for the programmatic, fiscal and operational management of the NSIP,
involving oversight of the nutrition service operations of its subcontracted providers. The program
services provided under this contract shall be provided in a manner consistent with and described in the
Contractor's current area plan update, which is incorporated by reference, and the current DOEA Program
and Services Handbook,which is also incorporated by reference.
1.2.3.1 In fulfilling the terms of this agreement, the Contractor's scope of services shall consist of completion of
the following service tasks: (1) Client Eligibility Determination; (2) Program Eligibility Compliance; (3)
Program Coordination and Oversight; (4) Ensuring Compliance with Prescribed Nutrition Requirements;
(5) Ensuring Compliance with Prescribed Food Origin Requirements; (6) Compliance with Program
Reporting and Records Management Requirements; and (7) Monitoring the Performance of
Subcontractors.
1.2.3.2 The Contractor shall use the NSIP funding under this contract to supplement funding for food used in
meals served under the OAA.
1.2.4 Term of Provision of Services
The term of this contract for the delivery of services shall be as referenced in Section 3. of the Standard
Contract. However, for the purpose of settling upon the appropriate meal reimbursement rate, as provided
by USDA, the contract shall remain open until December 31, 2014. Notwithstanding this three (3)month
reconciliation period, this contract makes no provisions for the payment of any services provided beyond
September 30, 2014.
1.2.5 Major Program Goals
The major goals of the NSIP program are as follows:
(1) To supplement funding for food used in meals served by OAA Nutrition Program Providers;and
(2) Provide incentives for the effective delivery of nutritious meals to older individuals.
1.3 INDIVIDUALS TO BE SERVED
1.3.1 Congregate Meals
Client eligibility for congregate meals is as follows:
(1) Individuals age 60 or older;
(2) Spouses(regardless of age)attending the dining center with their eligible spouse;
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(3) Persons with a disability, regardless of age, residing in a housing facility occupied primarily by older
individuals where congregate nutrition services are provided;
(4) Persons with disabilities residing at home with and accompanying an eligible person to the dining center; and
(5) Volunteers,regardless of age, providing essential services on a regular basis during meal hours.
1.3.2 Home Delivered Meals
Client eligibility for congregate meals is as follows:
(1) Individuals age 60 or older who are homebound by reason of illness, disability or isolation;
(2) The spouse of a homebound eligible individual, regardless of age if the provision of the collateral
meal supports maintaining the homebound eligible individual at home;
(3) Individuals with a disability, regardless of age, residing at home with eligible individuals and are
dependent on them for care;
(4) Persons at nutritional risk having physical, emotional or behavioral conditions, which would make
their presence at the congregate site inappropriate; and
(5) Persons at nutritional risk who are socially or otherwise isolated and unable to attend a congregate
nutrition site.
1.3.3 Restrictions
Meals served to an elderly individual funded in whole or in part under the Medicaid Waiver, Home Care
for the Elderly or Community Care for the Elderly Programs or other means tested programs may not be
included in the NSIP count.
SECTION II: MANNER OF SERVICE PROVISION
2.1 SERVICE TASKS
2.1.1 Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client
is based on meeting the requirements described in this ATTACHMENT I,Section 1.3.
2.1.2 Program Eligibility Requirements
Entities considered to be eligible for program participation must meet the following criteria:
(1) Be an agency that has received a grant under the OAA Title III must serve the meal (Ref. OAA section
311(42 U.S.C.3030a)); and
(2) Be a nutrition service provider who serves meals and is under the jurisdiction, control, management and audit
authority of the Area Agency on Aging for Southwest Florida and the Department of Elder Affairs must serve
the meal.
2.1.3 Oversight of Provider's Nutrition Service Operations
The Contractor shall oversee the nutrition service operations of the provider to ensure that the requirements of
ATTACHMENT I, Sections 1.2.3.1 and 2.1 are met as well as any other applicable regulations and policies
prescribed by the Department of Health and Human Services, USDA, state and local health departments or any
other agency designated to inspect meal quality for the State,
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2.1.4 Prescribed Nutritional Requirements
The Contractor shall ensure that each meal provided under this NSIP contract meet the following criteria:
(1) Comply with the current Dietary Guidelines for Americans, published by the secretaries of the Department of
Health and Human Services and the Department of Agriculture; and
(2) Provide a minimum of 33 1/3 percent of the dietary reference intakes/adequate intakes for an age 70+ female
as established by the Food and Nutrition Board of the National Academy of Sciences.
2.1.5 Food Origin and Commodities Requirements
Consistent with existing requirements of the Nutrition Services Incentive program, the Contractor and its service
providers may use NSIP cash to purchase foods of U.S. origin for their nutrition projects under Title III of the
OAA. NSIP funds must be used to expand meal services to older adults.
2.1.6 Compliance with Program Reporting and Records Management Requirements
(1) The Contractor shall ensure that all program reporting requirements evidencing service delivery are timely
met. The Contractor must establish interim report submittal due dates for its providers or subcontractors to
permit the Contractor to meet the Agency reporting deadlines.
(2) In addition to any special reports that may be requested by the Agency, the Contractor shall comply with the
reporting and records management requirements as referenced in this ATTACHMENT I, sections 2.4
through 2.5.1.
2.1.7 Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the subcontractor. If any circumstances occur that may result in a delay for
a period of 60 days or more of the initiation of the subcontract or in the performance of the subcontractor, the
Contractor shall notify the Contract Manager and the Agency's Chief Financial Officer in writing of such
delay.
The Contractor shall not permit a subcontractor to perform services related to this agreement without having a
binding subcontractor agreement executed. In accordance with Section 25.1 of the Standard Contract,the Agency
will not be responsible or liable for any obligations or claims resulting from such action.
2.1.8 Monitoring the Performance of Subcontractors
The Contractor shall monitor at least once per year each of its subcontractors, subrecipients, vendors and/or
consultants paid from funds provided under this contract. The Contractor shall perform fiscal, administrative and
programmatic monitoring to ensure contractual compliance, fiscal accountability, programmatic performance and
compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that
time schedules are met, the budget and scope of work are accomplished within the specified time periods and
other performance goals stated in this contract are achieved.
2.2 SERVICE TIMES
2.2.1 Service Times
The Contractor shall ensure the services listed in this contract are available at times appropriate to meet client
service needs, at a minimum, during normal business hours. Normal business hours are defined as Monday
through Friday, 8:00am to 5:00pm.
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2.3 DELIVERABLES
2.3.1 Service Unit
The Contractor shall ensure the provision of the services described in the contract in accordance with the current
Department of Elder Affairs Programs and Services Handbook and the service tasks described in
ATTACHMENT I Section 2.1. The chart below lists the type of services allowed and the unit of measurement:
service Congregate Unit of Service
Meals Home Delivered Meal
Meals Meal
2.4 REPORTS
The Contractor shall respond to additional routine and/or special requests for information and reports required by
the Agency in a timely manner as determined by the Contract Manager. The Contractor shall establish due
dates for any subcontractors that permits the Contractor to meet the Agency's reporting requirements.
2.4.1 Area Plan Update and All Revisions Thereto
The Contractor is required to submit an area plan update wherein the Contractor enters OAA specific data in the
Client Information and Registration Tracking System (CIRTS).
2.4.2 Client Information and Registration Tracking System (CIRTS)Reports
The Contractor shall input NSIP specific data into CIRTS to ensure CIRTS data accuracy. The Contractor shall
use CIRTS generated reports which include the following:
(1) Client Reports;
(2) Monitoring Reports;
(3) Services Reports;
(4) Miscellaneous Reports;
(5) Fiscal Reports;
(6) Aging and Disability Resource Center Reports;and
(7) Outcome Measurement Reports.
2.4.3 Service Costs Reports
The Contractor shall require subcontractors to submit to the Contractor bi-annual service cost reports (every 6
months) which reflect actual costs of providing each service by program. This report provides information for
planning and negotiating unit rates.
2.4.4 Surplus/Deficit Report
The Contractor shall submit a consolidated surplus/deficit report in a format provided by the Agency to the
Contract Manager by the 18th of each month. This report is for all agreements and/or contracts between the
Contractor and the Department. The report will include the following:
(1) A list of all subcontractors and their current status regarding surplus/deficit;
(2) The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
Agency will be resolved;
(3) Recommendations to transfer funds to resolve surplus/deficit spending;
(4) Input from the Contractor's Board of Directors on resolution of spending issues,if applicable;
(5) The number of clients currently on the Assessed Priority Consumer List (APCL) that receive a priority
ranking score of 4 or 5; and
(6) The number of clients currently on the APCL designated as Imminent Risk.
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2.5 RECORDS AND DOCUMENTATION
The Contractor shall ensure the collection and maintenance of client and service information on a monthly basis
from the CIRTS or any such system designated by the Agency. Maintenance includes valid exports and backups
of all data and systems according to Agency standards.
2.5.1 Each contractor and subcontractor, among other requirements, must anticipate and prepare for the loss of
information processing capabilities. The routine backing up of all data and software is required to
recover from losses or outages of the computer system. Data and software essential to the continued
operation of contractor functions must be backed up. The security controls over the backup resources
shall be as stringent as the protection required of the primary resources. It is recommended that a copy of
the backed up data be stored in a secure, offsite location. The Contractor shall maintain written policies
and procedures for computer system backup and recovery and shall have the same requirement in its
contracts and/or agreements with subcontractors. These policies and procedures will be made available
to the Agency upon request. To demonstrate compliance with section 8 of the Standard Contract, the
contractor shall submit a Background Screening Affidavit of Compliance annually.
2.6 PERFORMANCE SPECIFICATIONS
2.6.1 Outcomes
The Contractor shall ensure services provided under this contract are in accordance with the current
DOEA Programs and Services Handbook.
The Contractor shall timely submit to the Agency all reports described in ATTACHMENT I,
SECTION 2.4 REPORTS;
The Contractor shall timely submit to the Agency all information described in ATTACHMENT I,
SECTION 2.5 RECORDS AND DOCUMENTATION.
2.7 CONTRACTOR'S FINANCIAL OBLIGATIONS
2.7.1 Use of Service Dollars and Assessed Priority Consumer List Management
The Contractor is expected to spend all federal, state and other funds provided by the Agency, for the purpose
specified in this contract. The Contractor must manage the service dollars in such a manner so as to avoid having
a wait list and a surplus of funds at the end of the contract period, for each program managed by the Contractor.
If the Agency determines that the Contractor is not spending service funds accordingly, the Agency may transfer
funds to other planning and service areas during the contract period and/or adjust subsequent funding
allocations accordingly, as allowable under state and federal law.
2.7.1.1 The Contractor agrees to distribute funds as detailed in this contract and the area plan update. Any
changes in the total amounts of the funds identified in this contract, number of meals served or meal rate
require a contract amendment.
2.8 AGENCY RESPONSIBILITIES
2.8.1 Program Guidance and Technical Assistance
The Agency will provide the Contractor with guidance and technical assistance as needed to ensure the
successful fulfillment of the contract by the Contractor.
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2.8.2 Contract Monitoring
The Agency will review and evaluate the performance of the Contractor under the terms of this contras
Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, or an 01
site visit. The Agency's determination of acceptable performance shall be conclusive. The Contractor agrees to-
cooperate r>
with the Agency in monitoring the progress of completion of the service tasks and deliverables. The
Agency may use, but is not limited to, one or more of the following methods for monitoring:
(1) Desk reviews and analytical reviews;
(2) Scheduled,unscheduled and follow-up on-site visits;
(3) Client visits;
(4) Review of independent auditor's reports;
(5) Review of third-party documents and/or evaluation;
(6) Review of progress reports;
(7) Review of customer satisfaction surveys;
(8) Agreed-upon procedures review by an external auditor or consultant;
(9) Limited-scope reviews; and
(10) Other procedures as deemed necessary.
SECTION HI: METHOD OF PAYMENT
3.1 GENERAL STATEMENT OF METHOD OF PAYMENT
This is a fixed rate contract. The Agency shall make payment to the Contractor for provision of services up to a
maximum number of units of service and at the prospective rate stated below: dook
Service to be Provided I Unit of Service Unit Rate
Eligible Congregate and 1 unit= 1 meal $.72
Home Delivered Meals
The prospective rate is based on the estimated OAA grant award.
COLLIER
Service to be Provided Unit of Unit Rate Maximum Allocation
Service U n its
Eligible Congregate and
Home Delivered Meals 1 unit= $0.72 53,015 $ 38,171
(Under OAA and ARRA) 1 meal
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3.2 REQUESTS FOR PAYMENT
3.2.1 Date for Final Request for Payment
(1) The final request for payment is due to the Agency no later than December 15.2014. This contract is for
services provided during the 2014 Federal Fiscal Year beginning October 1. 2013 through September 30,
Mjl 4; however, the contract is in effect through December 31. 2014. The additional three months
(October 1. 2014 through December 31. 2014) are to allow rates to be adjusted for the service period.
This contract shall automatically terminate after the final rate for the federal fiscal year has been established
and the release of final payments are authorized by the Agency.
(2) In the event that the final reimbursement rate is greater or less than the rate in ATTACHMENT I, Section
3.1,then this contract shall be appropriately adjusted upon notice from the Contract Manager.
(3) In the event of a conflict between this paragraph and any other provision in the contract, this section shall
supersede.
3.2.2 Documentation for Payment
The Contractor shall submit all requests for reimbursement in accordance with policy regarding reimbursable
meals and CIRTS policy regarding data entry for reimbursable meals. All requests for reimbursement will
include the following:
(1) The Contractor shall submit the request for reimbursement on DOEA Form 117nsip, NSIP Request for
Reimbursement,(ATTACHMENT VII);
(2) The Contractor shall submit a CIRTS report with DOEA Form 117nsip as supporting documentation for the
total number of meals reported. The CIRTS report must match the number of meals reported on DOEA Form
117nsip;
(3) The due date for the request for reimbursement and report(s) is no later than the Lith day of the month
following the month being reported, except for the final request for reimbursement (December 2014)which is
no later than December 15.2014.
3.2.2.1 The Contractor shall maintain documentation to support payment requests that shall be available to the
Agency or authorized individuals, such as Department of Financial Services,upon request.
3.2.2.2 Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of complete and accurate financial and programmatic reports due from the
Contractor and any adjustments thereto, including any disallowance not resolved as outlined in
Section 27 of the Standard Contract.
3.2.2.4 The Contractor must require subcontractors to enter all required data per the Department's CIRTS Policy
Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS
before the subcontractors submit their request for payment and expenditure reports to the Contractor. The
Contractor shall establish time frames to assure compliance with due dates for the requests for payment
and expenditure reports to the Agency.
3.2.2.5 The Contractor must require subcontractors to run monthly CIRTS reports and verify client and service
data in the CIRTS is accurate. This report must be submitted to the Contractor with the monthly request
for payment and expenditure report and must be reviewed by the Contractor before the subcontractor's
request for payment and expenditure reports can be approved by the Contractor.
3.2.3 Remedies for Nonconforming Services
The Contractor shall ensure that all goods and/or services provided under this contract are delivered
timely, completely and commensurate with required standards of quality. Such goods and/or services will
only be delivered to eligible program participants.
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3.23.1 If the Contractor fails to meet the prescribed quality standards for services, such services will not be
reimbursed under this contract. In
addition, any nonconformin g g oods (including home delivered meals)
and/or services not meeting such standards will not be reimbursed under this contract. The Contractor's
signature on the request for payment form certifies maintenance of supporting documentation a -
acknowledgement that the Contractor shall solely bear the costs associated with preparing or providinL
nonconforming goods and/or services. The Agency requires immediate notice of any significant
and/or systemic infractions that compromise the quality, security or continuity of services to clients.
3.2.4 Consequence for Noncompliance
The Contractor shall ensure 100% of the deliverables identified in ATTACHMENT I, Section 1.2.5
are performed pursuant to contract requirements, and as described in ATTACHMENT I, Sections
1.2.3.1; 2.1,and Section 23 are identified as major deliverables in this contract.
3.2.4.1 If at any time the Contractor is notified by the Agency's Contract Manager that it has failed to
correctly, completely, or adequately perform the Major Deliverables, the Contractor will have 10 days
to issue a Corrective Action Plan ("CAP") to the Contract Manager or delegee that addresses the
deficiencies and states how the deficiencies will be remedied within the specified time period. The
Agency shall assess a Financial Consequence of 1% of the monthly value of the contract for Non-
Compliance on the Contractor for each Deficiency identified in the CAP which is not corrected
pursuant to the CAP. The Agency will also assess a Financial Consequence for failure to timely
submit a CAP.
3.2.4.2 In the event the Contractor fails to correct an identified deficiency within the timeline specified
in the CAP, the Agency shall deduct, from the payment for the invoice of the following month, 1% of
the monthly value of the contract for each day the deficiency is not corrected.
3.2.4.3 If the Contractor fails to timely submit a CAP, the Agency shall deduct 1% of the monthly value
of the contract for each day the CAP is overdue, beginning with the 11`h day after notification by
the contract manager of the deficiency. The deduction will be made from the payment for the
invoice of the following month. If or to the extent, there is any conflict between this paragraph and
paragraphs 40 and 40.1 of the standard contract,this paragraph shall have precedence.
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ATTACHMENT II
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS,GRANTS,LOANS AND AGREEMENTS
The undersigned certifies,to the best of his or her knowledge and belief,that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an
officer or employee of congress, an employee of a member of congress, or an officer or employee of the state
legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of
any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan,or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of
congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying,"
in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all sub-
awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements)
and that all subcontractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by section 1352, Title 31,U.S. Code. Any person who fails to file the required certification shall be subject to a civil
penalty of not less than$10,000.00 and not more than$100,000.00 for each such failure.
mr.v October 1 ,2013
Signature Date
Stephen Y.Carnell NSIP 203.14
Name of Authorized Individual Application or Agreement Number
Collier County Government
Agency
DOER Form 103 Approved as to form and legality
(Revised Nov 2002)
Assistant County ey
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ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Area Agency on Aging for Southwest Florida, Inc. to the Contractor may
be subject to audits and/or monitoring by the Area Agency on Aging for Southwest Florida,Inc., as described in this section.
Monitoring
In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 215.97, F.S.,
(see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the Agency staff,
limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this
agreement, the Contractor agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate
by the Area Agency on Aging for Southwest Florida, Inc. In the event the Area Agency on Aging for Southwest Florida,
Inc. determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any
additional instructions provided by the Area Agency on Aging for Southwest Florida, Inc. to the Contractor regarding
such audit. The Contractor further agrees to comply and cooperate with any inspections, reviews, investigations, or
audits deemed necessary by the Chief Financial Officer(CFO) or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a state or local government or a non-profit organization as defined in OMB
Circular A-133,as revised.
In the event that the Contractor expends $500,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised.
EXHIBIT 1 to this agreement indicates federal resources awarded through the Department of Elder Affairs by this
agreement. In determining the federal awards expended in its fiscal year, the Contractor shall consider all sources ofook
federal awards, including federal resources received from the Area Agency on Aging for Southwest Florida, Inc. Thy_
determination of amounts of federal awards expended should be in accordance with the guidelines established by OMB
Circular A-133, as revised. An audit of the Contractor conducted by the Auditor General in accordance with the
provisions of OMB Circular A-133, as revised,will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised.
If the Contractor expends less than $500,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of OMB Circular A-133, as revised, is not required. In the event that the Contractor expends less than
$500,000.00 in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of
OMB Circular A-133, as revised, the cost of the audit must be paid from non-federal resources (i.e., the cost of such audit
must be paid from Contractor resources obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. shall be based on
the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial
statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned
costs and liabilities due to the Area Agency on Aging for Southwest Florida, Inc. shall be fully disclosed in the audit report
with reference to the Area Agency on Aging for Southwest Florida, Inc. agreement involved. If not otherwise disclosed
as required by Section .310(b)(2) of OMB Circular A-133, as revised, the schedule of expenditures of federal awards
shall identify expenditures by agreement number for each agreement with the Area Agency on Aging for Southwest
Florida, Inc. in effect during the audit period. Financial reporting packages required under this part must be submitted
within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's fiscal year
end.
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PART II: STATE FUNDED
This part is applicable if the Contractor is a nonstate entity as defined by Section 215.97(2),Florida Statutes.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of$500,000.00 in
any fiscal year of such Contractor (for fiscal years ending September 30, 2004 or thereafter), the Contractor must have a
State single or project-specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable
rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and
for-profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance
awarded through the Department of Elder Affairs by this agreement. In determining the state financial assistance
expended in its fiscal year, the Contractor shall consider all sources of state financial assistance, including state financial
assistance received from the Area Agency on Aging for Southwest Florida, Inc., other state agencies, and other nonstate
entities. State financial assistance does not include federal direct or pass-through awards and resources received by a
nonstate entity for federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting
package as defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for-profit organizations), Rules of the Auditor General.
If the Contractor expends less than $500,000.00 in state financial assistance in its fiscal year (for fiscal years ending
September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida
Statutes, is not required. In the event that the Contractor expends less than $500,000.00 in state financial assistance in its
fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes,the
cost of the audit must be paid from the nonstate entity's resources (i.e., the cost of such an audit must be paid from the
Contractor resources obtained from other than state entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. shall be based on
the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall
disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and
liabilities due to the Area Agency on Aging for Southwest Florida, Inc. shall be fully disclosed in the audit report with
reference to the Area Agency on Aging for Southwest Florida, Inc. agreement involved. If not otherwise disclosed as
required by Rule 691-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify
expenditures by agreement number for each agreement with the Area Agency on Aging for Southwest Florida,Inc. in effect
during the audit period. Financial reporting packages required under this part must be submitted within 45 days after
delivery of the audit report, but no later than 12 months after the Contractor's fiscal year end for local governmental
entities. Non-profit or for-profit organizations are required to be submitted within 45 days after delivery of the audit
report, but no later than 9 months after the Contractor's fiscal year end. Notwithstanding the applicability of this
portion, the Area Agency on Aging for Southwest Florida, Inc. retains all right and obligation to monitor and oversee the
performance of this agreement as outlined throughout this document and pursuant to law.
PART HI: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by
PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or
on behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida,Inc.at the following address:
Area Agency on Aging for Southwest Florida,Inc.
dba Senior Choices of Southwest Florida
Attn: Marianne G.Lorini,President/CEO
15201 N.Cleveland Avenue,Ste 1100
North Fort Myers,Florida 33903
Phone: (239)652-6900
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The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by
Sections .320 (d)(1)and (2), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at
the following address: ..,
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville,IN 47132
Other federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as
revised.
Pursuant to Sections .320(f), OMB Circular A-133, as revised, the Contractor shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the
Area Agency on Aging for Southwest Florida, Inc. at the following address:
Area Agency on Aging for Southwest Florida,Inc.
dba Senior Choices of Southwest Florida
Attn: Marianne G.Lorini,President/CEO
15201 N. Cleveland Avenue,Ste 1100
North Fort Myers,Florida 33903
Phone: (239)652-6900
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on
behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. at the following address:
Area Agency on Aging for Southwest Florida,Inc.
dba Senior Choices of Southwest Florida
Attn: Marianne G.Lorini,President/CEO
15201 N. Cleveland Avenue,Ste 1100
North Fort Myers,Florida 33903
Phone: (239)652-6900
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building,Room 574
111 West Madison Street
Tallahassee,Florida 32399-1450
Any reports, management letter, or other information required to be submitted to the Area Agency on Aging for Southwest
Florida, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-133, Florida
Statutes, and Chapters 10.550 (local governmental entities)or 10.650 (nonprofit and for-profit organizations),Rules of the
Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Area Agency on Aging for Southwest Florida, Inc.
and/or the Department of Elder Affairs for audits done in accordance with OMB Circular A-133 or Chapters 10.550
(local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, should
indicate the date that the reporting package was delivered to the Contractor in correspondence accompanying the reporting
package.
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PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period
of six years from the date the audit report is issued, and shall allow the Area Agency on Aging for Southwest Florida, Inc.
or its designee, the CFO or Auditor General access to such records upon request. The Contractor shall ensure that audit
working papers are made available to the Area Agency on Aging for Southwest Florida, Inc., or its designee, CFO, or
Auditor General upon request for a period of six years from the date the audit report is issued, unless extended in writing
by the Area Agency on Aging for Southwest Florida,Inc.
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ATTACHMENT III
EXHIBIT 1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
CONTRACT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Nutrition Services Incentive Program Older Americans Act 93.053 $38,171.00
TOTAL FEDERAL AWARD $38,171.00
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 230 Cost Principles for Non-Profit Organizations(Formerly OMB Circular A-122—Cost Principles)*
2 CFR Part 215 Administrative Requirements(Formerly OMB Circular A-110—Administrative
Requirements)OMB Circular A-133—Audit Requirements
COLLIER
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Nutrition Services Incentive Program Older Americans Act 93.053 $ 38,171.00
Amok
TOTAL FEDERAL AWARD $ 38,171.00
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ATTACHMENT III
EXHIBIT 2
PART I: AUDIT RELATIONSHIP DETERMINATION
Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A-133,as
revised,and/or Section 215.97,Fla.Stat. Providers who are determined to be recipients or subrecipients of federal awards and/or state
financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of
Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A-
133,as revised,and/or Section 215.97,Fla.Stat. Regardless of whether the audit requirements are met,providers who have been
determined to be recipients or subrecipients of Federal awards and/or state financial assistance,must comply with applicable
programmatic and fiscal compliance requirements.
In accordance with Sec.210 of OMB Circular A-133 and/or Rule 691-5.006,FAC,provider has been determined to be:
Vendor or exempt entity and not subject to OMB Circular A-133 and/or Section 215.97,F.S.
X Recipient/subrecipient subject to OMB Circular A-133 and/or Section 215.97,F.S.
NOTE: If a provider is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by
the Agency to subcontract,they must comply with Section 215.97(7),F.S.,and Rule 691-.006(2),FAC[state financial assistance]and
Section 400 OMB Circular A-133 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive federal awards or
state matching funds on federal awards and who are determined to be a subrecipient,must comply with the following fiscal laws,rules
and regulations:
STATES,LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State,Local and Indian Tribal Governments(Formerly OMB Circular A-87)*
OMB Circular A-102—Administrative Requirements
OMB Circular A-133—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non-Profit Organizations(Formerly OMB Circular A-I22—Cost Principles)*
2 CFR Part 215 Administrative Requirements(Formerly OMB Circular A-110—Administrative Requirements)
Requirements)
OMB Circular A-133—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
EDUCATIONAL INSTITUTIONS(EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)MUST
FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB(Formerly Circular A-21 —Cost Principles)*
2 CFR Part 215 Administrative Requirements(Formerly OMB Circular A-110—Administrative Requirements)
OMB Circular A-133—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
*Some federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular
A-133 Compliance Supplement,Appendix I.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient/subrecipient,must comply with the following fiscal laws,rules and regulations:
Section 215.97,Fla.Stat.
Chapter 691-5,Fla.Admin.Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
33
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ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,GRANTS,
LOANS AND COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is
an attachment, hereby certifies that:
(1) The Contractor and any subcontractors of services under this contract have financial management systems capable of
providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each
grant-funded project or program in accordance with the prescribed reporting requirements; (2) the source and
application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts
for each award. The inability to process information in accordance with these requirements could result in a return of
grant funds that have not been accounted for properly.
(2) Management Information Systems used by the Contractor, subcontractor(s), or any outside entity on which the
Contractor is dependent for data that is to be reported,transmitted or calculated, have been assessed and verified to be
capable of processing data accurately, including year-date dependent data. For those systems identified to be non-
compliant, contractor(s)will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these roducts are capable p pa le of processing year-date dependent data accurately. All versions
of these products offered by the Contractor (represented by the undersigned) and purchased by the state will be
verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted herei-
at no charge to the state, and without interruption to the ongoing business of the state,time being of the essence.
(4) The Contractor and any subcontractor(s) of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from
data integrity compliance issues.
The Contractor shall require that the language of this certification be included in all subagreements, subgrants, and other
agreements and that all subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110).
04'
/4
,? '0, Public Services Administrator October 1,2013
Signa re Title Date
Stephen Y.Carnell
Name of Authorized Signer Approved as to form and legality
Collier County Government
Agency Assistant County
(Revised June 2008)
34
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ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY
EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1) The Contractor certifies, by signing this certification, neither it nor its principals are presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this
transaction by any federal department or agency.
(2) Where the Contractor is unable to certify to any of the statements in this certification, such prospective
participant shall attach an explanation to this certification.
0 r �
0 �7 �� October 1,2013
Signature / Date
Interim Public Services Administrator Collier County Government
Title Agency/Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification
1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction,"
"person," "primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out
in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020, as supplemented by 2
CFR 376.10-376.995). You may contact the Contract Manager for assistance in obtaining a copy of those
regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered
into this transaction. If it is later determined that the Contractor knowingly rendered an erroneous certification,
in addition to other remedies available to the federal government, the Agency may pursue available remedies,
including suspension and/or debarment.
3. The Contractor will provide immediate written notice to the Contract Manager if at any time the Contractor
learns that its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances. The Contractor may decide the method and frequency by which it determines the eligibility of
its principals. Each participant to a lower tier covered transaction may, but is not required to, check the
Excluded Parties List System(EPLS).
4. The Contractor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations
for lower tier covered transactions.
5. The Contractor agrees that it shall not knowingly enter into any lower tier covered transaction with a person
who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise
authorized by the federal government.
6. If the Contractor knowingly enters into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies
available to the federal government, the Agency may pursue available remedies, including suspension, and/or
debarment.
7. The Contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that
it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows
that the certification is erroneous.
(Revised June 2008)
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Lu3.14
ATTACHMENT VI
ASSURANCES—NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project(0348-0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET,SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances.If such is the case,you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through
any authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest,or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C..4728-4763) relating to prescribe_
standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personnel Administration(5 C.F.R.900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not Iimited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C.,1681-1683, and 1685-1686), which prohibits
discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended(29 U.S.C.
794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended(42
U.S.C., 6101-6107),which prohibits discrimination on the basis of age; (e)the Drug Abuse Office and Treatment Act of
1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g). 523 and 527 of the Public Health Service
Act of 1912 (42 U.S.C., 290 dd-3 and 290 ee 3), as amended,relating to confidentiality of alcohol and
drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C., 3601 et seq.), as amended,
relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the
specific statute(s) under which application for federal assistance is being made; and (j) the requirements of any other
nondiscrimination statute(s)which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These
requirements apply to all interests in real property acquired for project purposes regardless of federal participation in
purchases.
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October 2013 MI LU3.14
8. Will comply,as applicable, with the provisions of the Hatch Act(5 U.S.C. 1501-1508 and 7324-7328),which limit
the political activities of employees whose principal employment activities are funded in whole or in part with federal
funds.
9. Will comply, as applicable,with the provisions of the Davis-Bacon Act(40 U.S.C.,276a to 276a-7),the Copeland Act
(40 U.S.C. 276c and 18 U.S.C.,874) and the Contract Work Hours and Safety Standards Act (40 U.S.C., 327-333),
regarding labor standards for federally assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management
Act of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans
under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C.,7401 et seq.); (g) protection of
underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and
(h)protection of endangered species under the Endangered Species Act of 1973,as amended,(P.L.93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C., 1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966,as amended(16 U.S.C.,470),EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974(16 U.S.C.,469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and
related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C.,2131 et seq.)
pertaining to the care, handling, and treatment of warm blooded animals held for research,teaching,or other activities
supported by this award of assistance.
16, Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C.,4801 et seq.), which prohibits the use of
lead-based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and OMB Circular No. A-133, Audits of States, Local Governments, and Non-Profit
Organizations.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies
governing this program.
SIGN TURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
Interim Public Services Administrator
/ r
APPLICA T ORGANIZATION DATE SUBMITTED
Collier County Government October 1, 2013
Approved as to form and legality
37
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tv31.1-
ATTACHMENT VII
REQUEST FOR REIMBURSEMENT
Nutrition Services Incentive Program
PROVIDER NAME,ADDRESS. PHONE#and FEID# TYPE OF REPORT: THIS REQUEST PERIOD:
Payment Request: Front To
Regular Final Report#
Contract Period To
Contract#
PSA#
CERTIFICATION: I hereby certify that to the best of my knowledge the information in this report is accurate and complete and that all outlays reported herein were for purposes
set forth in the contract documents.
Prepared by Date Approved by:
Date
PART A: REIMBURSEMENT COMPUTATION YEAR TO DATE
CURRENT MONTH
CONGREGATE HOME DELIVERED CONGREGATE HOME DELIVERED
1.Number of Meals Served 0 0
0 0
2.Line 1 Times$.68 cents per Meal $0.00 $0.00
$0.00 $000
Year To Data Total Meals 0 Current Month Total Meals 0
Year To Date Total Reimbursed s0.00 Total Reimbursement Requested $0.00
PART B: CONTRACT SUMMARY
1. Approved Contract Amount
s0.00
2. Previous Reimbursements Requested
$0.00
3. Contract Balance
$0.00
4. Amount to be Reimbursed -This Report $0.00
5. Contract Balance
$0.00
DOEA Form f 17nsip revised 1/12
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October 2013 — September 2014 1tl J11 1.1
ATTACHMENT A
DEPARTMENT OF ELDER AFFAIRS PROGRAMS& SERVICES HANDBOOK
Department of Elder Affairs Programs& Services Handbook available at:
http://elderaffairs.state.fl.us/doea/publications.php
39
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iv.-7u c,v✓.i•r
ATTACHMENT B
STATE OF FLORIDA DEPARMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name County AAA/Contractor
Collier County Housing Human Veteran Services County Senior Choices of Southwest FL
Address Completed By
339 Tamiami Trail East Suite 211 Ashley Royer
City, State,Zip Code Date Telephone
Naples,FL 34112 October 1,2013 239-252-2273
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
Total # % % %
For questions 2-5 please indicate the following: White Black Hispanic Other Female Disabled Over 40
2. Population of area served Source of data: 10/1/2013 332,427 90% 7.1% 26.2% 1.7% 50.8%
3. Staff currently employed Effective date: 10/1/2013 11 36% 18% 36% 91%
4. Clients currently enrolled/registered Effective date: 10/1/2013 400 100%
5. Advisory/Governing Board if applicable Effective date: 10/1/2013 5 100% 40%
. . ........__..............
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA? N/A YES NO
gl
7. Compare the staff composition to the population. Is staff representative of the population? N/A YES NO
❑ ® ❑
S. Are eligibility requirements for services applied to clients and applicants without regard to race, color,national N/A YES NO
origin,sex,age,religion or disability? ❑ E ❑
9. Are all benefits,services and facilities available to applicants and participants in an equally effective manner N/A YES NO
regardless of race,sex,color,age,national origin,religion or disability?
❑ ® ❑
10. For in-patient services,are room assignments made without regard to race,color,national origin or disability? N/A YES NO
❑ ® ❑
11. For in-patient services,are room assignments made without regard to race,color,national origin or disability? N/A YES NO
❑ ❑ ❑
N/A YES NO
❑ ❑ ❑
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October 2013 — September 2014 '"'"' `Y
13. Are employees,applicants and participants informed of their protection against discrimination? If YES,how? N/A YES NO
Verbal iN Written ®Poster i ❑ ® ❑
14. Give the number and current status of any discrimination complaints regarding services or employment filed N/A NUMBER
against the program/facility.
15. Is the program/facility physically accessible to mobility,hearing,and sight-impaired individuals? N/A YES NO
❑ ® ❑
PART HI:THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF NO
EXPLAIN.
16. Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals,and to make any YES NO
necessary modifications? ❑ ❑
17. Is there an established grievance procedure that incorporates due process in the resolution of complaints? YES NO
❑ ❑
18. Has a person been designated to coordinate Section 504 compliance activities? YES NO
❑ ❑
19. Do recruitment and notification materials advise applicants,employees and participants of nondiscrimination on YES NO
the basis of disability? ❑ ❑
20.Are auxiliary aids available to assure accessibility of services to hearing and sight-impaired individuals? YES NO
❑ ❑
PART IV:FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF 550,000.00 OR MORE.
21. Do you have a written affirmative action plan? If NO,explain. YES NO
❑ ❑
DOE USE ONLY
Reviewed By In Compliance: YES ❑ NO* El
Program Office *Notice of Corrective Action Sent _/ /�
Date Telephone Response Due _/ /�
On-Site El Desk Review ❑ Response Received /./__
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111.311 LJJ.1
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city or other locality. If the program/facilit
serves a specific target population such as adolescents, describe the target population. Also, define the type or
service provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population
statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census
containing Florida population statistics. Include the source of your population statistics. ("Other" races include
Asian/Pacific Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and
list their percent by race,sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA recipients and their sub-grantees,45 CFR 80.4(a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their_
availability in the population, the program/facility has the responsibility to determine the reasons for such
variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities
may exist when programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR
80.3 (b)(6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a)
and 45 CFR 80.1 (b)(2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national
origin, religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be
applied uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances,
waiting rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR
80.3 (b).
11. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race,color, national origin, or disability, 45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons
who may not speak English. In geographic areas where a significant population of non-English speaking people
live, program accessibility may include the employment of bilingual staff In other areas, it is sufficient to have a
42
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policy or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will
assist in the provision of services, 45 CFR 80.3 (a).
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to
their participants, beneficiaries or any other interested parties. This should include information on their right to
file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of
HHS. The information may be supplied verbally or in writing to every individual, or may be supplied through the
use of an equal opportunity policy poster displayed in a public area of the facility,45 CFR 80.6(d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment,
placement, termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the
name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the
current status,e.g., settled,no reasonable cause found, failure to conciliate, failure to cooperate, under review,etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes
designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby,
public telephone, restroom facilities, water fountains, information and admissions offices should be accessible.
Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and
serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or
raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be
installed at an appropriate height for mobility impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a
self-evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do
not comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps
have been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate
appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any
action prohibited by Section 504.45 CFR 84.7 (b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper
ads, and other appropriate written communication, 45 CFR 84.8 (a).
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with
impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to,
interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be
used to provide equally effective services, 45 CFR 84.52(d).
21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60
and Title VI of the Civil Rights Act of 1964, as amended.
43
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A
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10/22/2013 16.D.14.
October 2013 — September 2014
ATTACHMENT E
Department's Computer Use Policy and its Social Media Policy available at:
http://204.156.2 55.8/os/pp/420.1 OMISPolicies02 I 207.pdf
and
http://204.15 6.25 5.8/os/pp/Social%20Media%20PolicY%20August 132010.pdf
45
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October 2013 —September 2014 nvwr Lt.?. .14
ATTACHMENT G
DEPARTMENT OF
BACKGROUND SCREENING
!ELDER
AFFAIRS Affidavit of Compliance - Employer
STATE Or FLORIDA
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05{3),Florida Statutes.
. The term 'employer' means any person or entity required by law to conduct background screening,
including but not Limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers,Lead Agencies,Long-Term Care Ombudsman Program,Serving Health Insurance Needs
of Elders Program, Service Providers,Diversion Providers, and any other person or entity which hies
employees or has volunteers in service who meet the definition of a direct service provider. See f§
435.02,430.0402,Fla.Stat.
i A direct service provider is 'a person 18 years of age or older who,pursuant to a program to provide
services to the elderly,has drect,face-to-face contact with a client while providing services to the client
and has access to the clients living area,funds,personal property,or personal identification information
as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities;and volunteers' §430.0402(1)(b),Fla_Stat
ATTESTATION:
As the duly authorized representative of ad ii i.@-l' Can rtj itaSi t1 q I ,Ica an an a YL ua n Sf fY! e S
Employer Name
located at 33q Int7;iarni Tr al I eQSi 50)t-t 9.11 tr p_S FL 3140 r)'
Street Address City Stare VP code*
I, Ki m hcn� Cn ran+-, Dv C i Ct do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402;f10-' a Statutes,regarding level 2 background screening.
L
`- ,' tip' ' Oettbel I, Sul
Signature of Representative Date
STATE OF FLORIDA,COUNTY OF L 01 I I L 1
Sworn to(or affirmed)and subscrbed before me this I day of l:6-;b•e-✓ . 20 13. by
(Name of Representative)who is personally known
to me or produced /. as proof of identification.
, r'il :; MY COMMI i EE 876607 —
Prim.T M
f8; r• loo a��r, ry PUb(K
DDEA form 235,Affidavit of Cempdu -Employer.Effective Aprit 2012 Section A35.05(3),FS. ;ry,,
Fern available at hr.F! Id to fair..t-ta l nSr'-"r...yth31'auzur1d°•"^:nz,.a;
46
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October 2013 — September 2014
ATTACHMENT H
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to which
this form is an attachment,hereby certifies that:
(1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or
submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized
Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran
Petroleum Sector List (collectively, "the Lists") is ineligible for, and may not bid on, submit a proposal for,
or enter into or renew a contract with the Area Agency on Aging for Southwest Florida, Inc. dba Senior
Choices of Southwest Florida (Agency) for goods or services of$750,000.00 or more.
(2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false certification
to the Department is subject to civil penalties, attorney's fees and costs and any costs for investigations that
led to the finding of false certification.
(3) The Contractor understands that the contract to which this form is an attachment may be terminated by the
Department if the Contractor submits a false certification or has been placed on the Lists.
This certification, required by Florida law, is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction.
1 �,? October I,2013
Signature `f Date
(Same as contract signature)
Interim Public Services Administrator
Title
Approved as to form and legality
Collier County Government
Agency
Assistant County rney
47
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October 2013 — September 2014 10/22/2013 16.D.14.
ATTACHMENT J
VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc., dba Senior
Choices of Southwest Florida, Collier County Board of County Commissioners, hereby referred to as
Contractor, certifies the use of the U.S. Department of Homeland Security's E-verify system to verify the
employment eligibility of all new employees hired by Contractor during the contract term to perform
employment duties pursuant to this Agreement and that any subcontracts include an express requirement
that subcontractors performing work or providing services pursuant to this Agreement utilize the E-
verify system to verify the employment eligibility of all new employees hired by the subcontractor
during the contract term.
✓
0/WV October 1,2013
Signatute Date
(Same as contract signature)
Interim Public Services Administrator
Title
Collier County Government
Agency
Approved as to form and legality
riLA
Ass nt County A , ev
48
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Attestation Statement
Agreement/Contract Number: NSIP 203
Amendment Number:Q
I,Stephen Y.Carnell,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida dba as Senior Choices of Southwest Florida and
Interim Public Services Administrator
(Signature of Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
��
0/-27,
:fro
October 3,2013
Signature .f Recipien ontractor representative Date
Approved as to form and legality
Assistant County orney
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