Backup Documents 11/14/2017 Item #16D19 1 60 1 9
COMMUNITY AND HUMAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Martha Verg a, Board Minutes and Records
FROM: Jody Pale rants Coordinator, CHS
DATE: November 9, 2017
RE: Amendments between Area Agency on Aging for Southwest Florida, Inc and
Collier County (2016 & 2017 HCE, CCE & ADI & 2017 OAA)
Please find attached a fully executed documents that were approved by the BCC on the day listed
below for recording in Minutes and Records. Feel free to contact me if you have any questions.
BCC Approved on November 14, 2017 Item 16019
Thank you for your assistance.
16Oi91
July 2017—June 2018 ADI 203.17.001
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM STANDARD CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners, ("Contractor"),amends agreement ADI 203.17.
The purpose of this amendment is to change contract language; increase the allocation for Collier County by$74,294; and
amend 4. Contract Amount.
1. Disregard the following(21. New Contract(s)Reporting) contract language of Standard Contract:
21. New Contract(gl Re on rting:
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 and the applicable office or program issuing the contract; (2) contract name and number; (3) contract start and
end dates; (4) contract amount; (5) contract description and commodity or service; (6) Contract Manager name and
contact information. In complying with this provision, and pursuant to Section 287.0575, F.S., as amended, the
Contractor shall complete the Provider's State Contracts List,ask Area Agency for a copy of this form.
2. Attachment III-Exhibit 2,Funding Summary,is hereby replaced
3. Attachment VIII Annual Budget Summary,is hereby replaced.
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 $386,957.00, or the rate schedule, 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.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to
conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract.
This Amendment and all its attachments are hereby made part of the contract.
1
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July 2017. June 2018 ADI 203.17.001 1 6019
N WITNESS THEREOF, the Parties hereto have caused this 4 page amendment,to be executed by their undersigned officials
as duly authorized; and agree to abide by the terms, conditions and provisions of this contract as amended. This amendment
is effective on the last date the amendment has been signed by both Parties.
Contractor: COLLIER COUNTY AREA AGENCY ON AGING FOR
BOARD OF COUNTY SOUTHWEST FLORIDA,INC.
COMMISSIONERS
.-->/ ' i ,,ii ,
/f
SIGNED BY: 7'`` : 11 4 6 ` SIGNED BY: ,taao..)c, 4Z.J. .
NAME: Steve Y. Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: ( (i f zq 1 / 7 DATE: /0/36017
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30
DUNS: 076997790
Approved as to form and legality
Assistant County Ate ncy �7 `�
S)-cY vA
\Q\
I
2
Ju1y,2017—June 2018 ADI 203.17.001
1 6 0 1 9
ATTACHMENT III
EXHIBIT 2
FINANCIAL AND COMPLIANCE AUDIT
ATTACHMENT EXHIBIT 2-FUNDING SUMMARY
Note: Title 2 CFR § 200.331, As Revised, and Section 215.97(5), Florida Statutes, Require That Information About Federal
Programs and State Projects Be Provided to the Recipient and Are Stated in the Financial and Compliance Audit Attachment
and Exhibit 1.Financial and Compliance Audit Attachment, Exhibit 2-Funding Summary Provides Information Regarding the
Funding Sources Applicable to This Contract,Contained Herein,Is A Prediction of Funding Sources and Related Amounts Based on
the Contract Budget.
• FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
CONTRACT CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): N/A FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200—Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133,As amended—Audits of States,Local Governments,and Non-Profit Organizations
• STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec.215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Alzheimer's Disease Initiative General Revenue-Collier 65004 $ 386,957.00
TOTAL AWARD $ 386,957.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO
THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE:
Section 215.97, F.S., Chapter 69I-5, FL Admin Code, Reference Guide for State Expenditures, Other fiscal requirements set forth
in program laws,rules and regulations.
3
1 6 0 1 9
July 2017—June 2018 ADI 203.17.001
• ATTACHMENT VIII
ANNUAL BUDGET SUMMARY
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
For
Collier County Board of County Commissioners
Collier
ALLOCATION TOTAL $ 386,957.00
4
1 601 9
Revised August 2007
Attestation Statement
Agreement/Contract Number ADI 203.17
Amendment Number 001
I, Steve 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 and
Collier County Board of County Commissioners
(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.
in
14 I (0 2
Signature of Re ipient/Con'!"tactor representative Date
Approved as to form and legality
Assistant Coun torney C,
N..
Revised August 2007
�J
16019
COMMUNITY AND HUMAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Martha Verg a, Board Minutes and Records
FROM: Jody Pale rants Coordinator, CHS
DATE: November 9, 2017
RE: Amendments between Area Agency on Aging for Southwest Florida, Inc and
Collier County (2016 & 2017 HCE, CCE & ADI & 2017 OAA)
Please find attached a fully executed documents that were approved by the BCC on the day listed
below for recording in Minutes and Records. Feel free to contact me if you have any questions.
BCC Approved on November 14,2017 Item 16Dj
Thank you for your assistance.
9 July 20 i 7—June 2018 CCE 203.17.001 1 6 0 1
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
COMMUNITY CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners, ("Contractor"), amends agreement CCE 203.17.
The purpose of this amendment is to amend contractual language, replace attachments, and amend 4. Contract Amount,
and increase the allocation for Collier by$84,321.
1. Disregard the following(21. New Contract(s)Reporting) contract language of Standard Contract:
21. New Contracts)Renortinn:
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 and the applicable office or program issuing the contract; (2) contract name and number; (3) contract start and
end dates; (4) contract amount; (5) contract description and commodity or service; (6) Contract Manager name and
contact information. In complying with this provision, and pursuant to Section 287.0575, F.S., as amended, the
Contractor shall complete the Provider's State Contracts List, ask Area Agency for a copy of this form.
2. Section 7.7 of Standard Contract is hereby replaced.
•
7.7 In accordance with Section 287.135, F.S., any Contractor on the Scrutinized Companies with Activities in Sudan
List, the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or the Scrutinized
Companies that Boycott Israel List (Lists), created pursuant to Section 215.473, F.S. and 215.4725, F.S., or is
engaged in a boycott of Israel, or is engaged in business operations in Cuba or Syria, is ineligible to enter into or
renew a contract with the Agency and/or Department for goods or services of $1,000,000 or more.
Pursuant to Section 287.135, F.S., the Agency and/or Department 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 or is
engaged in a boycott of Israel or has been engaged in business operations in Cuba or Syria. 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. The Contractor shall complete and sign the Certifications and Assurances Attachment
prior to the execution of this contract.
3. Section ll.C.6. of Attachment I,Clients Served,is hereby replaced.
II.C.6. Clients Served
The Contractor shall not directly provide core services to clients.
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July.2017—June 2018 CCE 203.17.001 1 6 0 1 9
4. Section H.H.1.of Attachment I,Agency Obligations,is hereby replaced.
1. Agency Obligations
The Agency may provide technical support and/or assistance to the Contractor within the resources of the
Agency to assist the Contractor in meeting the requirements of this contract. The support, or lack thereof, shall
not relieve the Contractor from full performance of contract requirements.
5. Attachment II-Exhibit 2,Funding Summary, is hereby replaced.
6. Attachment III,Certifications and Assurances, is hereby replaced.
7. Attachment VIII Annual Budget Summary, is hereby replaced.
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 $878,656.00, or the rate schedule, 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.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to
conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract.
This Amendment and all its attachments are hereby made part of the contract.
IN WITNESS THEREOF, the Parties hereto have caused this 9 page amendment,to be executed by their undersigned officials
as duly authorized; and agree to abide by the terms, conditions and provisions of this CCE contract as amended. This
Amendment is effective on the last date the Amendment has been signed by both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMISSIONERS SOUTHWEST FLORIDA,INC.
SIGNED BY: j */1
( (1,2 SIGNED BY: /fi t.,Ze_ 0,440)17 ° —
NAME: Steve Y. Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
" li
DATE: �� � � DATE: 0/3 oh2
Federal Tax ID: 59-6000588 Approved as to form and legality
Fiscal Year Ending Date: 09/30
DUNS: 076997790
.•sistant Co ttorney 057 \O
1
\O
2
ti.t
Julys 2017—June 2018 CCE 203.17.001
1 6 0 1 9
ATTACHMENT III
EXHIBIT 2
FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT
EXHIBIT 2-FUNDING SUMMARY
Note: Title 2 CFR§200.331,As Revised, and Section 215.97(5),Florida Statutes,Require That Information About Federal Programs
and State Projects Be Provided to the Recipient and Are Stated in the Financial and Compliance Audit Attachment and Exhibit 1.
Financial and Compliance Audit Attachment, Exhibit 2-Funding Summary Provides Information Regarding the Funding Sources
Applicable to This Contract,Contained Herein,Is A Prediction of Funding Sources and Related Amounts Based on the Contract Budget.
• FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
CONTRACT CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): N/A FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200—Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133,As amended—Audits of States,Local Governments, and Non-Profit Organizations
• STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST
OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec.215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Community Care for the Elderly General Revenue-Collier 65010 $ 878,656.00
TOTAL AWARD $ 878,656.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE:
Section 215.97, F.S., Chapter 69I-5, FL Admin Code, Reference Guide for State Expenditures, Other fiscal requirements set forth in
program laws,rules and regulations.
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July 2017 —June 2018 CCE 203.17.001 6 0 1 9
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
DOEA will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 75)
B. Certification Regarding Lobbying(29 CFR Part 93 and 45 CFR Part 93)
C. Nondiscrimination &Equal Opportunity Assurance(29 CFR Part 37 and 45 CFR Part 80)
D. Certification Regarding Public Entity Crimes,section 287.133,F.S.
E. Association of Community Organizations for Reform Now (ACORN)Funding Restrictions Assurance(Pub.
L. 111-117)
F. Certification Regarding Scrutinized Companies Lists,section 287.135,F.S.
G. Certification Regarding Data Integrity Compliance For Contracts, Agreements, Grants, Loans And
Cooperative Agreements
H. Verification of Employment Status Certification
I. Records and Documentation
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS—PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies to the best of its knowledge and belief,that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from covered transactions by a Federal department or agency;
2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment
rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal,
State or local)with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public
transactions (Federal, State, or local)terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at
all tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements)and that all
sub recipients and contractors shall provide this certification accordingly.
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July 2017 —June 2018 CCE 203.17.001 I 1 9
B. CERTIFICATION REGARDING LOBBYING — CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS,AND COOPERATIVE AGREEMENTS.
The undersigned Contractor certifies,to the best of its knowledge and belief,that:
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 Congress, or an employee of a Member of Congress
in connection with the awarding of any Federal contract,the making of any Federal grant, the making of any Federal
loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or
modification of any Federal contract, grant, loan or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying,"in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at
all tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements)and that all
sub-recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this Contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31
U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than$100,000 for each such failure.
C. NON DISCRINIINATION&EQUAL OPPORTUNITY ASSURANCE(29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and
equal opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color,religion, sex national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully
admitted immigrant authorized to work in the United States or participation in any WIA Title I-financially
assisted program or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 80),to the end that, in
accordance with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of
race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise
subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Department and/or Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112) as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84),to the end that, in
accordance with Section 504 of that Act, and the Regulation, no otherwise qualified handicapped individual in
the United States shall, solely by reason of his handicap,be excluded from participation in,be denied the benefits
of, or be subjected to discrimination under any program or activity for which the Applicant receives Federal
financial assistance from the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in
accordance with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied
the benefits of, be excluded from participation in, or be subjected to discrimination under any program or activity
for which the Applicant receives Federal financial assistance from the Agency.
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July 2017—June 2018 CCE 203.17.001 16 D 1 9
5. Title 1X of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall,on the basis of sex,be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices, including, job application procedures, hiring, firing, advancement, compensation, training, and other
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave,
fringe benefits,and all other employment-related activities.
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed
above. This assurance applies to Contractor's operation of the WIA Title I—financially assisted program or activity,
and to all contracts, Contractor makes to carry out the WIA Title I — financially assisted program or activity.
Contractor understands that the Agency and/or DOEA and the United States have the right to seek judicial
enforcement of the assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all
sub recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133,F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public
Entity Crime as defined in section 287.133,F.S.,nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform Agency and/or DOEA immediately upon any change
of circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub.L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511
(Pub. L. 111-117). The Continuing Appropriations Act,2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub.L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all
sub recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS CERTIFICATION,SECTION 287.135,F.S.
If this Contract is in the amount of$1 million or more, in accordance with the requirements of Section 287.135,
F.S., Contractor hereby certifies that it is not participating in a boycott of Israel, is not listed on either the Scrutinized
Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy
Sector List, and that it does not have business operations in Cuba or Syria. Both lists are created pursuant to Section
215.473,F.S.
Contractor understands that pursuant to Section 287.135, F.S., the submission of a false certification may subject
Contractor to civil penalties, attorney's fees,and/or costs.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this Contract.
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July 2017—June 2018 CCE 203.17.001 I 6 0 1 9
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS,
AGREEMENTS, GRANTS,LOANS AND COOPERATIVE AGREEMENTS
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 contract supported activities; and (3) the comparison of outlays with budgeted
amounts for each award. The inability to process information in accordance with these requirements could result
in a return of grant funds that have not been accounted for properly.
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported,transmitted or calculated, have been assessed and verified
to be capable of processing data accurately, including year-date dependent data. For those systems identified to
be non-compliant, Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology,
the undersigned warrants that these products are capable of processing year-date dependent data accurately. All
versions of these products offered by the Contractor(represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer. _
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc., 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 contract and
that any subcontracts include an express requirement that Subcontractors performing work or providing services
pursuant to this Contract utilize the E-verify system to verify the employment eligibility of all new employees hired
by the Subcontractor during the entire contract term.
The Contractor shall require that the language of this certification be included in all sub-agreements, sub-grants, and
other agreements/contracts 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 Circulars A-102 and 2 CFR Part 200, and 215 (formerly OMB Circular A-110).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contract related records and documentation.The Contractor shall ensure the collection and maintenance of all program
related information and documentation on any such system designated by the Agency.Maintenance includes valid
exports and backups of all data and systems according to Agency standards.
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July 2017—June 2018 CCE 203.17.001 6 D 19
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of sections, 10.1, 10.2 of the Standard Contract, and 119.0701(3) and (4) F.S., and
any other applicable law, if a civil action is commenced as contemplated by Section 119.0701(4), F.S., and the
Agency is named in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs
incurred by the Agency, and any attorneys' fees assessed or awarded against the Agency from a Public Records
Request made pursuant to Chapter 119,F.S., concerning this contract or services performed thereunder.
a.Notwithstanding Section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Department and state agencies or subdivisions defined in Section 768.28(2),F.S.
2. Section 119.01(3), F.S. states if public funds are expended by an agency in payment of dues or membership
contributions for any person, corporation, foundation, trust, association, group, or other organization, all the
financial, business, and membership records of such an entity which pertain to the public agency (Area Agency
on Aging for Southwest Florida, Inc.) are public records. Section 119.07, F.S., states every person who has
custody of such a public record shall permit the record to be inspected and copied by any person desiring to do so,
under reasonable circumstances.
Additionally,I certify this organization does does not provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection as stated above.
By execution of this contract, Contractor must include these provisions in all related subcontract agreements (if
applicable).
By execution of this contract, Contractor must include these provisions (A-J) in all related subcontract agreements (if
applicable).
By signing below,Contractor certifies the representations outlined in parts A through J above, are true and correct.
r
� �.VI "4 all SEM* _ 3339 E. Tamiami Trail, Suite 211
Signature Ad Title of Authorized Represen ative Street Address
Collier County Board of County
Commissioners Naples,FL 34112
Contractor Date City,State,Zip code
Approved as to form and legality
Att>iistarit County ncy
tdI
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July 2017 —June 2018 CCE 203.17.001 16 019
ATTACHMENT VIII
COMMUNITY CARE FOR THE ELDERLY PROGRAM
ANNUAL BUDGET SUMMARY
for
Collier County Board of County Commissioners
Collier
CCE Services Allocations $ 878,656.00
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Revised August 2007
Attestation Statement
Agreement/Contract Number CCE 203.17
Amendment Number: 001
I, Steve 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 and
Collier County Board of County Commissioners
(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.
e
1O( /7
Signature f Recipideht/Contractor representative Date
Approved as to form and legality
ssistant C'p itorneyoty?
e.
Revised August 2007
16019
COMMUNITY AND HUMAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Martha Verg a, Board Minutes and Records
FROM: Jody Pale rants Coordinator, CHS
DATE: November 9, 2017
RE: Amendments between Area Agency on Aging for Southwest Florida, Inc and
Collier County (2016 & 2017 HCE, CCE & ADI & 2017 OAA)
Please find attached a fully executed documents that were approved by the BCC on the day listed
below for recording in Minutes and Records. Feel free to contact me if you have any questions.
FICC Approved on November 14, 2017 Item 16D/q
Thank you for your assistance.
July 2017—June 2018 HCE 203.17.001ri
°
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
HOME CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"), amends agreement HCE 203.17.
The purpose of this amendment is to amend contractual language, and replace attachments.
1. Disregard the following(21. New Contract(s)Reporting) contract language of Standard Contract:
21. New Contract(s)Reporting:
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 and the applicable office or program issuing the contract; (2) contract name and number; (3) contract start and
end dates; (4) contract amount; (5) contract description and commodity or service; (6) Contract Manager name and
contact information. In complying with this provision, and pursuant to Section 287.0575, F.S., as amended, the
Contractor shall complete the Provider's State Contracts List, ask Area Agency for a copy of this form.
2. Section 7.7 of Standard Contract is hereby replaced.
7.7 In accordance with Section 287.135, F.S., any Contractor on the Scrutinized Companies with Activities in Sudan
List, the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or the Scrutinized
Companies that Boycott Israel List (Lists), created pursuant to Section 215.473, F.S. and 215.4725, F.S., or is
engaged in a boycott of Israel, or is engaged in business operations in Cuba or Syria, is ineligible to enter into or
renew a contract with the Agency and/o r Department for goods or services of $1,000,000 or more.
Pursuant to Section 287.135, F.S., the Agency and/or Department 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 or is
engaged in a boycott of Israel or has been engaged in business operations in Cuba or Syria. 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. The Contractor shall complete and sign the Certifications and Assurances Attachment
prior to the execution of this contract.
3. Section H.C.1.c.15. of Attachment I, Outreach,is hereby removed as a listed service.
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1 July 2017-June 2018 HCE 203.17.001 lip6 0
4. Section II.H.1. of Attachment I,Agency Obligations,is hereby replaced.
1. Agency Obligations
The Agency may provide technical support and/or assistance to the Contractor within the resources of the
Agency to assist the Contractor in meeting the requirements of this contract. The support, or lack thereof, shall
not relieve the Contractor from full performance of contract requirements.
5. Section II.Special Provisions B. of Attachment I,use of Service Dollars and Management of the Assessed Priority
Consumer List is hereby removed.
6. Section III.F. of Attachment I,Enforcement is hereby replaced.
F. Enforcement
1. In accordance with Section 430.04,F.S.,the Agency shall rescind designation of a contractor or take intermediate
measures against the Contractor, including corrective action,unannounced special monitoring,temporary assumption
of operation of one or more programs by the Agency,placement on probationary status, imposing a moratorium on
Contractor action, imposing financial penalties for nonperformance, or other administrative action pursuant to Chapter
120,F.S.,if the Agency finds that any of the following have occurred:
a. An intentional or negligent act of the Contractor has materially affected the health,welfare,or safety of clients,
or substantially and negatively affected the operation of an aging services program.-
b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds have
been misappropriated.
c. The Contractor has committed multiple or repeated violations of legal and regulatory requirements or Agency
standards.
d. The Contractor has failed to continue provision or expansion of services after the declaration of a state of
emergency.
e. The Contractor has exceeded its authority or otherwise failed to adhere to the terms of this contract with the
Agency or has exceeded its authority or otherwise failed to adhere to the provisions specifically provided by
statute or rule adopted by the Agency.
f. The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets.
g. The Contractor has failed to implement and maintain an Agency-approved client grievance resolution
procedure.
2. .In making any determination under this provision the Agency may rely upon findings of another state or federal
agency, or other regulatory body. Any claims for damages for breach of contract are exempt from administrative
proceedings and shall be brought before the appropriate entity in the venue of Lee County,Florida. In the event the
Agency initiates action to rescind a Contractor designation,the Agency shall follow the procedures set forth in 42
U.S.C. §3025(b}.
7. Section II.D. of Attachment I,Surplus/Deficit Report,is hereby removed.
8. Attachment III,Certifications and Assurances,is hereby replaced.
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All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to
conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract.
This Amendment and all its attachments are hereby made part of the contract.
IN WITNESS THEREOF, the Parties hereto have caused this 8 page amendment,to be executed by their undersigned officials
as duly authorized; and agree to abide by the tennis, conditions and provisions of this CCE contract as amended. This
Amendment is effective on the last date the Amendment has been signed by both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY c I ISSIONERS SOUTHWEST FLORIDA,INC.
SIGNED BY: IF 11F. Mr ' Y-1,7 1,e''' SIGNED BY:
NAME: Steve Y. Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: t Q (14 /1 DATE: /°/3 0//
Federal Tax ID: 59-60005 88
Fiscal Year Ending Date: 09/30
DUNS: 076997790
Approved as to form and legality
Assistant
County orney C :1
.o
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ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
DOEA will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 75)
B. Certification Regarding Lobbying(29 CFR Part 93 and 45 CFR Part 93)
C. Nondiscrimination & Equal Opportunity Assurance(29 CFR Part 37 and 45 CFR Part 80)
D. Certification Regarding Public Entity Crimes,section 287.133,F.S.
E. Association of Community Organizations for Reform Now (ACORN)Funding Restrictions Assurance(Pub.
L. 111-117)
F. Certification Regarding Scrutinized Companies Lists,section 287.135,F.S.
G. Certification Regarding Data Integrity Compliance For Contracts, Agreements, Grants, Loans And
Cooperative Agreements
H.Verification of Employment Status Certification
I. Records and Documentation
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS—PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies to the best of its knowledge and belief,that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from covered transactions by a Federal depai tient or agency;
2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment
rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal,
State or local)with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public
transactions(Federal, State, or local)terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at
all tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements)and that all
sub recipients and contractors shall provide this certification accordingly.
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July 2017—June 2018 HCE 203.17.001
B. CERTIFICATION REGARDING LOBBYING — CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS,AND COOPERATIVE AGREEMENTS.
The undersigned Contractor certifies,to the best of its knowledge and belief,that:
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 Congress, or an employee of a Member of Congress
in connection with the awarding of any Federal contract,the making of any Federal grant, the making of any Federal
loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or
modification of any Federal contract, grant,loan or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying,"in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at
all tiers(including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements)and that all
sub-recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this Contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31
U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than$100,000 for each such failure.
C. NON DISCRIMINATION&EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and
equal opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully
admitted immigrant authorized to work in the United States or participation in any WIA Title I-financially
assisted program or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 80),to the end that, in
accordance with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of
race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise
subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Department and/or Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112) as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services(45 CFR Part 84),to the end that, in
accordance with Section 504 of that Act, and the Regulation, no otherwise qualified handicapped individual in
the United States shall, solely by reason of his handicap,be excluded from participation in,be denied the benefits
of, or be subjected to discrimination under any program or activity for which the Applicant receives Federal
financial assistance from the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in
accordance with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied
the benefits of, be excluded from participation in, or be subjected to discrimination under any program or activity
for which the Applicant receives Federal financial assistance from the Agency.
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July 2017—June 2018 HCE 203.17.001
5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
• pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation,no person in the United States shall, on the basis of sex,be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices, including, job application procedures, hiring, firing, advancement, compensation, training, and other
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave,
fringe benefits, and all other employment-related activities.
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed
above. This assurance applies to Contractor's operation of the WIA Title I—financially assisted program or activity,
and to all contracts, Contractor makes to carry out the WIA Title I — financially assisted program or activity.
Contractor understands that the Agency and/or DOEA and the United States have the right to seek judicial
enforcement of the assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all
sub recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133,F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public
Entity Crime as defined in section 287.133, F.S.,nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform Agency and/or DOEA immediately upon any change
of circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub.L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511
(Pub.L. 111-117). The Continuing Appropriations Act,2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all
sub recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS CERTIFICATION,SECTION 287.135,F.S.
If this Contract is in the amount of$1 million or more, in accordance with the requirements of Section 287.135,
F.S., Contractor hereby certifies that it is not participating in a boycott of Israel, is not listed on either the Scrutinized
Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy
Sector List, and that it does not have business operations in Cuba or Syria. Both lists are created pursuant to Section
215.473,F.S.
Contractor understands that pursuant to Section 287.135, F.S., the submission of a false certification may subject
Contractor to civil penalties, attorney's fees, and/or costs.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this Contract.
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HCE 203.17.001
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS,
AGREEMENTS, GRANTS,LOANS AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have fmancial 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 contract supported activities; and (3) the comparison of outlays with budgeted
amounts for each award. The inability to process information in accordance with these requirements could result
in a return of grant funds that have not been accounted for properly.
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported,transmitted or calculated, have been assessed and verified
to be capable of processing data accurately, including year-date dependent data. For those systems identified to
be non-compliant,,Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology,
the undersigned warrants that these products are capable of processing year-date dependent data accurately. All
versions of these products offered by the Contractor(represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Area Agency on Aging for Southwest Florida,Inc., 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 contract and
that any subcontracts include an express requirement that Subcontractors performing work or providing services
pursuant to this Contract utilize the E-verify system to verify the employment eligibility of all new employees hired
by the Subcontractor during the entire contract term.
The Contractor shall require that the language of this certification be included in all sub-agreements, sub-grants, and
other agreements/contracts 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 Circulars A-102 and 2 CFR Part 200, and 215 (formerly OMB Circular A-110).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contract related records and documentation.The Contractor shall ensure the collection and maintenance of all program
related information and documentation on any such system designated by the Agency.Maintenance includes valid
exports and backups of all data and systems according to Agency standards.
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July y 2017—June 2018 HCE 203.17.001 1 61) 19
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of sections, 10.1, 10.2 of the Standard Contract, and 119.0701(3) and (4) F.S., and
any other applicable law, if a civil action is commenced as contemplated by Section 119.0701(4), F.S., and the
Agency is named in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs
incurred by the Agency, and any attorneys' fees assessed or awarded against the Agency from a Public Records
Request made pursuant to Chapter 119,F.S., concerning this contract or services performed thereunder.
a.Notwithstanding Section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Department and state agencies or subdivisions defined in Section 768.28(2),F.S.
2. Section 119.01(3), F.S. states if public funds are expended by an agency in payment of dues or membership
contributions for any person, corporation, foundation, trust, association, group, or other organization, all the
financial, business, and membership records of such an entity which pertain to the public agency (Area Agency
on Aging for Southwest Florida, Inc.) are public records. Section 119.07, F.S., states every person who has
custody of such a public record shall permit the record to be inspected and copied by any person desiring to do so,
under reasonable circumstances.
Additionally,I certify this organization does does not provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection as stated above.
By execution of this contract, Contractor must include these provisions in all related subcontract agreements (if
applicable).
By execution of this contract, Contractor must include these provisions (A-J) in all related subcontract agreements (if
applicable).
By signing below, Contractor certifies the representations outlined in parts A through J above, are true and correct.
a; a ��61 C 3339 E. Tamiami Trail, Suite 211
//, 1)e0-. )--fe
Signature arid Title of Authorized Representati a Street Address
Collier County Board of County J
Commissioners Naples,FL 34112
1
Contractor Date City,State,Zip code
Approved as to form and legality
Assistant County 'Qvncy 0517 \\
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Revised August 2007
Attestation Statement
Agreement/Contract Number HCE 203.17
Amendment Number: 001
I, Steve 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 and
Collier County Board of County Commissioners
(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.
,61/7/1 (0(2(6117
Signature o.Recipietr Contractor representative Date
Approved as to form and legality
Assistant County At 'rney
Revised August 2007