Agenda 12/11/2012 Item #16D1710011
12/11/2012 Item 16.D.17.
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 and approve a subsequent budget amendment in the amount of $35,146 for FY 2013
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 to the frail elderly who are not able to leave their home
through this grant program.
The contract period for this grant is October 1, 2012 through December 15, 2013. This grant program will
reimburse the County $0.68 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 $35,146.
The current grant contact awarded to Collier County as the Lead Agency commenced on October 1, 2011
and ended on September 30, 2012. This item is being presented as an after -the -fact because Collier
County received the grant agreement on October 1, 2012 and we did not learn that immediate execution
was required until after the agenda deadline for the November 13, 2012 Board meeting had past.
Consequently, pursuant to CMA 5330 and Resolution No. 2010 -122, the County Manager authorized
Steve Carnell, 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
$35,146 for FY 2013 in NSIP Grant Fund (707), Project 33245.
LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for Board
action. — JBW
RECOMMENDATION: To provide after -the fact approval for the NSIP contact with Area Agency on
Aging for Southwest Florida, Inc. d/b /a Senior Choices of Southwest Florida and authorize the necessary
budget amendments to recognize grant funding received from the NSIP in the amount of $35,146 into
Grant Fund 707, Project 33182.
Prepared by: Lisa N. Carr, Grants Coordinator, Housing Human and Veteran Services
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.17.
12/11/2012 Item 16.D.17.
Item Summary: Recommendation to approve an after - the -fact Nutrition Services
Incentive Program (NSIP) contract with Senior Choices f /k /a Area Agency on Aging for
Southwest Florida, Inc., d /b /a and approve a subsequent budget amendment in the amount of
$35,146 for FY 2013
Meeting Date: 12/11/2012
Prepared By
Name: CarrLisa
Title: SHIP Program Coordinator
11/16/2012 3:04:16 PM
Submitted by
Title: SHIP Program Coordinator
Name: CarrLisa
11/16/2012 3:04:19 PM
Approved By
Name: SonntagKristi
Date: 11/19/2012 11:37:51 AM
Name: DeSearJacquelyn
Title: Accountant,Housing, Human & Veteran Services
Date: 11/20/2012 2:38:46 PM
Name: AlonsoHailey
Title: Operations Analyst, Public Service Division
Date: 11/28/2012 9:19:22 AM
Name: Ackerman-Maria
Title: Senior Accountant, Grants
Date: 11/28/2012 9:49:58 AM
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Name: CarnellSteve
Title: Director - Purchasing/General Services,Purchasing
Date: 11/28/2012 11:49:31 AM
Name: WhiteJennifer
Title: Assistant County Attorney,County Attorney
Date: 11/30/2012 11:41:57 AM
Name: KlatzkowJeff
Title: County Attorney
Date: 11/30/2012 1:45:59 PM
Name: FinnEd
Title: Senior Budget Analyst, OMB
Date: 11/30/2012 4:55:38 PM
Name: StanleyTherese
Title: Management/Budget Analyst, Senior,Office of Manage
Date: 12/3/2012 10:28:25 AM
Name: OchsLeo
Title: County Manager
Date: 12/3/2012 3:53:33 PM
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12/11/2012 Item 16.D.17.
October 2013 12/11/2012 Item 16.D.17.
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. Pnrnose of Contract
The purposO 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 Agency 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 Iive with
independence and dignity.
2. Incorporation of nocumentc 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, 2012 or on the date on which the contract has been signed by the last party
required to sign it, whichever is later. It shall end at midnight, local time in North Fort Myers, Florida, on
December 15, 2013.
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 $35,146.00, 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.
5. Renewals
By mutual agreement of the Parties, in accordance with s. 287.058(1) (g), F.S., the Agency may renew the contract for
a 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.
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12/11/2012 Item 16.D.17.
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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.
6.13 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 H. 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 oll-111
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.
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
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October 2013 12/11/2012 Item 16.D.17.
during the contract term. Contractors meeting the terms and conditions of the &Verify System are deemed to
be in compliance with this provision (ATTACHMENT.)).
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 bylaw. 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 $1
million 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 $1 million or more, the Contractor shall complete and
sign ATTACHMENT K Certification Regarding Scrutinized Companies Lists, prior to the execution of this
contract.
8. Background 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 of Elder Affairs and the Agency for Health Care
Administration regarding implementation of s. 430.0402 and ch. 435, F.S.
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October 2013 12/11/2012 Item 16.D.17.
8.1 Further information concerning the procedures for background screening are found at
http: / /elderaffairs. state. fl. us /doea/backgroundscreening.php.
9. Grievance and Complaint Procedures
9.1 Grievance Procedures
The Contractor shall comply with and ensure subcontractor compliance with the Minimum Guidelines for
Recipient Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handbook,
to address complaints regarding the termination, suspension or reduction of services, as required for receipt of
funds
9.2 Complaint Procedures
The Contractor shall develop and implement complaint procedures and ensure that subcontractors develop and
implement complaint procedures to process and resolve client dissatisfaction with services. Complaint
procedures shall address the quality and timeliness of services, provider and direct service worker complaints,
or any other complaints not related to termination, suspension or reduction in services which require the
grievance process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook.
The complaint procedures shall include notification to all clients of the complaint procedures and include
tracking the date, nature of complaint, and the determination of each complaint.
10. Audits. Inspections. Investigations. Public Records and Retention
10.1 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.
10.2 The Contractor shall retain 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.
10.3 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 in this section 10.2.
10.4 The Contractor shall assure that the records described in this section 10 will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
10.5 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, Inc., 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.
10.6 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.
10.7 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.
11. Nondiscrimination -Civil Rights omilliance
11.1 The Contractor shall execute assurances in ATTACHMENT B 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.
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im.nr cv.j.ia
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.
11.2 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).
11.3 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.
11.4 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.
12. Monitoring by the Agency
The Contractor shall provide services in the manner described in ATTACHMENT I.
13. Provision of Services
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 Agency of the satisfactory
performance of 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. 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.
15. Indemnification
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
the Contractor is not required to indemnify the Agency for claims, demands, actions or causes of action arising
solely out of the Agency's negligence.
n 15.1 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 Agency and state agencies or subdivisions defined in s. 768.28(2), F.S.
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12/11/2012 Item 16.D.17.
I.- _V __
16. Insnrance and Bonding
16.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of thin"-
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.
16.2 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.
17. 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.
18. 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).
19. Incident Reporting
19.1 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.
19.2 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.
20. New Contract(sl 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: (l )
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.
21. Bankruptcy Notification
During the term of this contract, the Contractor shall immediately notify the Agency 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.
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22. Slfonsorshin and Publicity
22.1 As required by s. 286.25, F.S., if the Contractor is a non - governmental organization which sponsors a program
n 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, Inc. 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.
22.2 The Contractor shall not use the words "The Area Agency on Aging for Southwest Florida, Inc. 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.
23. Assignments
23.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer
otherwise occurring without prior written approval of the Agency will constitute a material breach of the
contract.
23.2 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.
23.3 This contract shall remain binding upon the successors in interest of either the Contractor or the Agency.
^24. Subcontracts
24.1 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.
24.2 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.
25. 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.
26. PayMen
Payments shall be made to the Contractor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the
Contractor. The Contract Manager will have final approval of the invoice for payment, and will approve the invoice
for payment only if the Contractor has met all terms and conditions of the contract, 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
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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.
s-�
27. Return of Funds
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of 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, the Contractor shall repay said overpayment immediately without prior notification from the Agency.
In the event that the Agency first discovers an overpayment has been made, the Contract
Manager will notify the Contractor in writing of such findings. Should repayment not be made forthwith, the
Contractor shall be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55,03, F.S., after
Agency notification or Contractor discovery.
28. Data Integrily 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.
29. Computer Use and Social Media Policy
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy,
which applies to all employees, contracted employees, consultants,- OPS and volunteers, including all personnel
affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses theme
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.
30. Conflict of Interest
The Contractor shall establish safeguards to prohibit employees, board members, management and subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer or agent of the Contractor or subcontractor shall participate
in selection, or in the award of an agreement supported by state or federal funds if a conflict of interest, real or
apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of
his/her immediate family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of
the above, has a financial or other interest in the firm selected for award. The Contractor or subcontractor's officers,
employees or agents will neither solicit nor accept gratuities, favors or anything of monetary value from contractors,
potential contractors, or parties to subcontracts. The 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.
31. Public Enemy 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
Packet Page - 3505 -
October 2013 12/11/2012 Item 16.D.17.
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.
32. Purchasing
32.1 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 of
this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with
PRIDE. This clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of
products /services available from PRIDE may be obtained by contacting PRIDE, (800) 643 -8459.
32.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to
carry out this contract, in accordance with the provisions of s. 403.7065, F.S.
32.3 The Contractor may purchase articles that are the subject of, or required to carry out, 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.respectofllorida.org. This clause is not applicable to
subcontractors unless otherwise required by law.
33. Patents. Copyrights. Ro al i
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.
33.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this section 33.
33.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36.
34. Emergency Pr naredness and Continuity of nnerations
34.1 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.
34.2 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.
35. Equinment
35.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than
one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the
organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable,
tangible personal property of a 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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October 2013
12/11/2012 Item 16.D.17.
35.2 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 n
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.
353 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.
35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by
the Agency is part of the cost of carrying out the activities and functions of the grant awards and Title
(ownership) will vest in the Contractor, subject to the conditions of 2 CFR Part 215 Administrativf�
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.
35.5 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.).
35.6 The Contract Manager will issue disposition instructions. If disposition instructions are not.ro®eived within 120
days of the written request for disposition, the Contractor is authorized to proceed as directed in 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A -110).
35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under 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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12/11/2012 Item 16.D.17.
October 2013
.1- ----
35.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested
prior to disposal to ensure no confidential information remains.
35.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information Technology
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is
required for any computer related item costing $1,000.00 or more, including data processing hardware,
software, services, supplies, maintenance, training, personnel and facilities. The completed ITR worksheet
shall be maintained in the LAN administrator's file and must be provided to the Agency upon request. The
Contractor has the responsibility to require any subcontractors to comply with the Agency's ITR procedures.
36. 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.
37. Use of State Funds to Purchase or Improve Real PMWM
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by
law.
38. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the
decision to writing and serve a copy on the Contractor.
39. Financial Consequences of Non- Performance
n 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.
39.1 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.
40. No Waiver of Sovereign Immunity
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.
41. Venne
If any dispute arises out of this contract, the venue of such legal recourse will be Leon County, Florida.
42. 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.
43. Force Maieure
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
11
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October 2013
and takes all reasonable efforts to cure the condition.
12/11/2012 Item 16.D.17.
NSIP 203.13
44. Severability Clause
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable
the other provisions are severable to that void provision and shall remain in full force and effect.
45. Condition Precedent to Contract: Aggronriations
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature.
46. AddRion/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.
47. 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.
48. .om Ip iance
The Contractor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable^
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these
laws shall be deemed an event of default of the Contractor, and subject the contract to immediate, unilateral
cancellation of the contract at the discretion of the Agency.
49. 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.
50. 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.
51. Termination
51.1 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 by
hand delivery to the Contract Manager or the representative of the Contractor responsible for administration of
the contract.
51.2 In the event funds for payment pursuant to this contract become unavailable, the Agency may terminate thi^
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 nr the renresentative of the Contractor responsible for administration of
the contract. The Agency will be thf Packet Page -3509- the availability and adequacy of funds. In the
ac,Pnt of termination of this contract, the Contractor will be compensated for any work satisfactorily completed
October 2013
12/11/2012 Item 16.D.17.
NSIP 203.13
51.3 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.
51.4 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. Feectronic Records and Sipunture
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.
52.1 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.
n 52.2 Upon request by the Agency, the Contractor shall provide the Agency with non - electronic (p a per ) 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.
a.
The Contractor name, as shown on page 1 of this
contract, and mailing address of the official payee to
whom the payment shall be made is:
Collier County Housing, Human and Veteran Services
3339 E Tamiami Trail, Building H
Naples, FL 34112
The name of the contact person and street address where
Kimberly Grant, Director
b'
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.
representative of the Contractor responsible for
Collier County Housing, Human and Veteran Services
administration of the program under this contract is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
(239) 252 -2273
13
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October 2013
12/11/2012 Item 16.D.17.
1 \JII LV J.iJ
54. All Terms and Conditions Included
This contract and its Attachments, I — VII A, H, and J and any exhibits referenced in said attachments, together
with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties.
There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall
supersede all previous communications, representations or agreements, either written or verbal between the
Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, the Parties hereto have caused this 39 page contract, to be executed by their undersigned
officials as duly authorized.
Contractor: COLLIER COUNTY BOARD OF
COUNTY CONMUSSIONERS
SIGNED BY:
NAME: Stephen Y. Carnell
AREA AGENCY ON AGING FOR SOUTHWEST
FLORIDA, INC. DBA SENIOR CHOICES OF
SOUTHWEST FLORIDA
SIGNED BY:
NAME: LEIGH ANNA NOWAK
TITLE: Interim Public Services Administrator TITLE: BOARD PRESIDENT
DATE: I � (0 � ��L DATE:
Federal Tax ID: 59- 6000558
Fiscal Year Ending Date: 9/30
Approved as to form & 1e9al SUMillCyt
s
aistant County Attorney
14
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The section and location within the Agency where
Delores Kadlec- Roussey, Fiscal Officer
15201 N. Cleveland Ave.
d
Requests for Payment and Receipt and Expenditure
North Fort Myers, Florida 33903
forms are to be mailed is:
(239) 652 -6900
Leigh Wade, Executive Director
e.
The name, address, and telephone number of the
15201 N. Cleveland Ave.
Executive Director for this contract is:
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.
54. All Terms and Conditions Included
This contract and its Attachments, I — VII A, H, and J and any exhibits referenced in said attachments, together
with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties.
There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall
supersede all previous communications, representations or agreements, either written or verbal between the
Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, the Parties hereto have caused this 39 page contract, to be executed by their undersigned
officials as duly authorized.
Contractor: COLLIER COUNTY BOARD OF
COUNTY CONMUSSIONERS
SIGNED BY:
NAME: Stephen Y. Carnell
AREA AGENCY ON AGING FOR SOUTHWEST
FLORIDA, INC. DBA SENIOR CHOICES OF
SOUTHWEST FLORIDA
SIGNED BY:
NAME: LEIGH ANNA NOWAK
TITLE: Interim Public Services Administrator TITLE: BOARD PRESIDENT
DATE: I � (0 � ��L DATE:
Federal Tax ID: 59- 6000558
Fiscal Year Ending Date: 9/30
Approved as to form & 1e9al SUMillCyt
s
aistant County Attorney
14
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October 2013
INDEX OF ATTACHMENTS
12/11/2012 Item 16.D.17.
ATTACHMENT I
STATEMENTOF WORK .................................................................................................................... .............................16
ATTACHMENT H
CERTIFICATIONREGARDINGLOBBYINGCERTIFICATIONFORCONTRACTS GRANTS, LOANSAND
AGREEMENTS.................................................................................................................................. ...............................
25
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT ...................................................................................... ............................... 26
=BIT 1 ......................................................................................................................................... ...............................
30
=IBIT 2 ......................................................................................................................................... ...............................
31
ATTACHMENT IV
CERTIFICATIONREGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS GRANTS, LOANS AND
COOPERATIVEAGREEMENTS ...................................................................................................... ...............................
32
ATTACHMENT V
CERTIFICATIONREGARDINGDEBARMENT, SUSPENSION, INELIGIBILITYAND VOLUNTARYEXCLUSION
OR LOWER TIER COVERED TRANSACTIONS ................................................................................. .............................33
ATTACHMENT VI
ASSURANCES NON - CONSTRUCTION PROGRAMS ..................................................................... .............................34
ATTACHMENT VII
REQUESTFOR REIMBURSEMENT ................................................................................................ ...............................
36
ATTACHMENT A
DEPARTMENT OF ELDER AFFAIRS PROGRAMS & SERVICES HANDBOOK .......................... ...............................
37
ATTACHMENT H
CER TIFICA TIONREGARDING SCR UTINIZED COMPANIES LISTS ........................................... ...............................
38
ATTACHMENT J
VERIFICATION OFEMPLOYMENTSTATUSCERTIFICATION .................................................... .............................39
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October 2013 12/11/2012 Item 16.D.17.
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)
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. The NSIP is intended to provide
incentives for the effective delivery of nutritious meals to older individuals. 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.
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
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12/11/2012 Item 16.D.17.
October 2013
IvJII GVJ.iJ ..
The Contractor is responsible for the pratic, 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.
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; and (6) Compliance with Program Reporting and
Records Management Requirements.
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, 2013. Notwithstanding this three (3) month reconciliation period,
this contract makes no provisions for the payment of any services provided beyond September 30, 2013.
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
13.1. 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;
(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.
13.2 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 recipient's spouse of a homebound eligible individual, regardless of age if the provision of the collateral
meal supports maintaining the person 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.
133 Restrictions
Meals served to an elderly individual funded in whole or in part under the Medicaid Waiver, Home Care for the
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12/11 /2012 Item 16.D.17.
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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 Task List
In order to achieve the goals of the NSIP, the Contractor shall ensure the following tasks are performed:
(1) Client Eligibility Determination;
(2) Program Eligibility Requirements;
(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
() Monitoring the Performance of Subcontractors.
2.1.1.1 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 13.
2.1.1.2 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
31 l (42 U. S.C.3030a)); and
(2) Be a nutrition service provider who is under the jurisdiction, control, management and audit authority of the
Area Agency on Aging for Southwest Florida, Inc. and the Department of Elder Affairs must serve the meal.
2.1.1.3 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 2.1.1.1 and 2.1.1.2 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.
2.1.1.4 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.
2.1.1.5 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.
2.1.1.6 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
18
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12/11/2012 Item 16.D.17.
October 2013 11.F11 �.,�.
permit the Contractor to meet the Agency reporting deadlines.
101-N (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 —
2.5.1.
2.1.1.7 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 24.1 of the Standard Contract, the
Agency will not be responsible or liable for any obligations or claims resulting from such action.
2.1.1.7.1 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.
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 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
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12/11/2012 Item 16.D.17.
October 2013
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
CIRTS.
2.4.2 Client Information and Registration Tracldng 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 semi - annual service cost reports, 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 Agency. The report will include the following:
(1) A list of all subcontractors and their current status regarding surplus or deficit;
(2) The Contractor's detailed plan on how the surplus or 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) Number of clients currently on Assessed Priority Consumer List (APCL) that receive a priority ranking score
of 4 or 5; and
(6) Number of clients currently on the APCL designated as Imminent Risk.
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.
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October 2013 12/11/2012 Item 16.D.17.
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
n 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
(1) The Contractor shall ensure services provided under this contract are in accordance with the current
DOEA Programs and Services Handbook.
(2) The Contractor shall timely submit to the Agency all reports described in ATTACHMENT I,
SECTION 2.4 REPORTS;
(3) 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 each contract. The Contractor must. manage the service dollars in such a manner so as to avoid
n 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.
2.8.2 Contract Monitoring
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, or an on-
site visit. The Agency's determination of acceptable performance shall be conclusive. The Contractor agrees to
cooperate 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;
21
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October 2013
(4)
(5)
(6)
(7)
(g)
(9)
(10)
Review of independent auditor's reports;
Review of third -party documents and/or evaluation;
Review of progress reports;
Review of customer satisfaction surveys;
Agreed -upon procedures review by an external auditor or consultant;
Limited -scope reviews; and
Other procedures as deemed necessary.
12/11/2012 Item 16.D.17.
SECTION III: 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:
Service to be Provided
Unit of Service
Unit Rate
Eligible Congregate and
Home Delivered Meals
1 unit = 1 meal
$.68
The prospective rate is based on the estimated OAA grant award.
COLLIER
Service to be Provided
Unit of
Service
Unit Rate
Maximum
Units
Allocation
Eligible Congregate and
Home Delivered Meals
1 unit=
$0.68
51,686
$ 35,146
(Under OAA and ARRA)
1 meal
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12/11/2012 Item 16.D.17.
October 2013
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. 2013. This contract is for
services provided during the2012 Federal Fiscal Year beginning Octoher 1. 2012 through Selltember 30.
=; however, the contract is in effect through December 15, 2013. The additional three months
(October 1. 2013 through December 15. 2013) 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.
3.21 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
I I7nsip;
(3) The due date for the request for reimbursement and report(s) is no later than the 15th day of the month
following the month being reported, except for the final request for reimbursement (December 2013) which is
no later than December 15, 2013.
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 26 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.
3.23 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
n
delivered to eligible program participants.
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October 2013
12/11/2012 Item 16.D.17.
w.air cva.io
If the Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed
under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services nc�
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 and acknowledgement that the Contractor shall
solely bear the costs associated with preparing or providing 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 Financial Consequences
The Contractor shall ensure expenditure of 100% of the contract amount budgeted for services to clients at the
unit rate established in the contract. In the event the Contractor has a surplus at the end of the contract term, the
Agency will reallocate of the budget to other area agencies found to be serving clients to the fullest extent of their
allocated budgets. If, or to the extent, there is any conflict between this paragraph and paragraphs 39 and
39.1 of the standard contract, this paragraph shall have precedence.
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October 2013 12/11/2012 Item 16.D.17.
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.
six"
Signature
Stephen Y. Carnell, Interim Public Services Administrator
Name of Authorized Individual
Collier County Government
3299 Tamiami Trail E. Suite 303
_Naples. FL 34112 -5746
Contractor Name and Address
n,
Date
NSIP 203.13
Application or Agreement Number
AppmvW as to farm & legal SufltClenCy
I a���- Ass County Attorney
25
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October 2013
FINANCIAL AND COMPLIANCE AUDIT
12/11/2012 Item 16.D.17.
NSIP 203.13
ATTACHMENT III
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 Director of Finance 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 Area Agency on Aging for Southwes,
Florida, Inc. by this agreement. In determining the federal awards expended in its fiscal year, the Contractor shall
consider all sources of federal awards, including federal resources received from the Area Agency on Aging for Southwest
Florida, Inc.. The determination of amounts of federal awards expended should be in accordance with the guidelines
established by OMB Circular A -133, as revised. An audit of the Contractor conducted by the Auditor General in
accordance with the provisions of OMB Circular A -133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised.
If the Contractor expends less than $500,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of OMB Circular A -133, as revised, is not required. In the event that the Contractor expends less than
$500,000.00 in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of
OMB Circular A -133, as revised, the cost of the audit must be paid from non- federal resources (i.e., the cost of such audit
must be paid from Contractor resources obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the 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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October 2013
12/11/2012 Item 16.D.17.
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. EXIMIT 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 69I- 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 III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A -133, as revised, and required by
PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A -133, as revised, by or
on behalf of the Contractor directiv 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: Leigh Wade, Executive Director
15201 N. Cleveland Avenue, Ste 1100
North Fort Myers, Florida 33903
Phone: (239) 652 -6900
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October 2013
12/11 /2012 Item 16.D.17.
The Federal Audit Clearinghouse designated in OMB Circular A -133, as revised (the number of copies required by
Sections .320 (dxl) 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 10' 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: Leigh Wade, Executive Director
15201 N. Cleveland Avenue, Ste 1100
North Fort Myers, Florida 33903
Phone: (239) 652 -6900
Additionally, copies of financial reporting packages required by Part H 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: Leigh Wade, Executive Director
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 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
12/11/2012 Item 16.D.17.
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..
29
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October 2013
12/11/2012 Item 16.D.17.
ATTACHMENT III
EDIT 1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Nutrition Services Incentive Program
Older Americans Act
93.053
$ 35,146.00
TOTAL FEDERAL AWARD
$ 35,146.00
TOTAL FEDERAL AWARD
$ 35,146.00
COLLIER
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Nutrition Services Incentive Program
Older Americans Act
93.053
$ 35,146.00
TOTAL FEDERAL AWARD
$ 35,146.00
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October 2013
AUDIT RELATIONSHIP DETERMINATION
12/11/2012 Item 16.D.17.
NSIP 203.13
ATTACHMENT III
EXHIBIT 2
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 69I- .006(2), FAC [state financial assistance) and
Section _ .400 OMB Circular A -133 [federal awards].
PART 11: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive federal awards or
state matching funds on federal awards and who are determined to be a subrecipient, must comply with the following fiscal laws, rules
and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)*
OMB Circular A -102 — Administrative Requirements
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON - PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non -Profit Organizations (Formerly OMB Circular A -122 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
Requirements)
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST
FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A -21 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
*Some federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular
A -133 Compliance Supplement, Appendix 1.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient/subrecipient, must comply with the following fiscal laws, rules and regulations:
Section 215.97, Fla. Stat.
Chapter 69I -5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
31
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October 2013
12/11/2012 Item 16.D.17.
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 products are capable of processing year -date dependent data accurately. All versions
of these products offered by the Contractor (represented by the undersigned) and purchased by the state will be
verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that ,---,
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted herein,
at no charge to the state, and without interruption to the ongoing business of the state, time being of the essence.
(4) The Contractor and any 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).
Signature
Stephen Y. Carrell
Name of Authorized Signer
Collier County Government
3299 Tamiami Trail E. Suite 303
Naples, FL 34112 -5746
Name and Address
(Revised June 2008)
Interim Public Services Administrator
Title
32
Date
Approved as to farm & legal SuMoWney
Packet Page -3529-
Assistant County Attorney
October 2013 12/11/2012 Item 16.D.17.
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.
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.
110� 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)
33
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12/11/2012 Item 16.D.17.
October 2013 �< �...,•�.,
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.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. D 047284763) relating to
prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in
Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI
of the Civil Rights Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national
origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. DD1681 -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.1 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) 1 523 and 527 of the Public
Health Service Act of 1912 (42 U.S.C. 1290 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. 13601 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 0) 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.
34
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October 2013
12/11/2012 Item 16.D.17.
IIJIr GW.J.1J
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 1501 -1508 and 7324 - 7320, which limit
n 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. 0 0874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. 1
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. 007401 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. 0111721 et seq.) related to protecting
components or potential components of the national wild and scenic rivers system.
3. 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. 13470), 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. 1302131 et
seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other
activities supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. ❑ ❑4801 et seq.), which prohibits the use
of lead-'based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non - Profit
Organizations.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies
governing this program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
L% r Interim Public Services Administrator
%c
APPLICANT ORGANIZATION I DATE SUBMITTED
oilier County Government APPMe ! as to form & legal Sufficl r ney 1 ( ( k 6 k—�,
Xaftietant rl,%., ., s.sorney
Packet Page =3532-
October 2013
REQUEST FOR REIMBURSEMENT
Nutrition Services Incentive Program
12/11/2012 Item 16.D.17
ATTACIIlVIENT VII ,----
PROVIDER NAME, ADDRESS, PHONE# and FEID#
TYPE OF REPORT :
THIS REQUEST PERIOD:
Payment Request:
From To
Regular Final
Report #
Contract Period To
Contract #
PSA #
CERTIFICATION: 1 hereby certify treat to the best of my ItnrnMedge 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
D
0
0
0
2. Line 1 Times $.68 cents per Meal
80.00
50.00
80.00
$0.00
Year To Date Total Meals 0
Current Month Total Meals 0
Year To Dale Total Reimbursed 50.00
Total Reimbursement Requested 50.00
PART B: CONTRACT SUMMARY
1. Approved Contract Amount
80.00
2. Previous Reimbursements Requested
80.00
3. Contract Balance
80.00
4. Amount to be Reimbursed - This Report
80.00
5. Contract Balance
80.00
DOER Form 117reip revised 1112
36
Packet Page -3533-
October 2013 12/11/2012 Item 16.D.17.
I•J /1 LVJ.LJ
i"*N
ATTACHMENT A
DEPARTMENT OF ELDER AFFAIRS PROGRAMS & SERVICES HANDBOOK
Department of Elder Affairs Programs & Services Handbook, provided on CD.
Also, available at the Department's Intranet site under, "Publications ".
37
Packet Page -3534-'
12/11/2012 Item 16.D.17.
October 2013 �..,,•�.,
ATTACHMENT H /1
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.
(Department) for goods or services of $1 million or more.
(2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false
certification to the Agency is subject to civil penalties, attorney's fees and costs and any costs for
investigations that led to the finding of false certification.
(3) The Contractor understands that the contract to which this form is an attachment may be terminated
by the Agency if the Contractor submits a false certification or has been placed on the Lists.
This certification, required by Florida law, is a material representation of fact upon which reliance was
placed when this transaction was made or entered into. Submission of this certification is a prerequisite
for making or entering into this transaction.
Am
Signature Date
(Same as contract signature)
Interim Public Services Administrator
Title
pmved as to form & legal SUffkgirltiry
Collier County Government
3299 Tamiami Trail E Suite 303 Assists County Attorney
Naples, FL, 34112 -5746
Name and Address
38
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12/11/2012 Item 16.D.17.
October 2013 mair LJV.iJ
n ATTACHM ENT J
VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc., Collier
County Board of County Commissioners, 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.
Signature Date
(Same as contract signature)
Interim Public Services Administrator
Title
Collier County Government
3299 Tamiami Trail E Suite 303
Naples, FL, 34112 -5746
Name and Address
rpMV*d as to form & 160al Su1fthMOY
Q
Packet Page -3536-
1�\ -f; —\:�s *-- �.
-sp-iyttsnt County Attorney
12/11/2012 Item 16.D.17.
Attestation Statement
Agreement/Contract Number NSIP 203.13
Amendment Number n/a
Stephen Y. Carnell , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreemeatleontract or amendment between the Area Agency on Aging for
Southwest Florida On as Senior Choices of Southwest Florida and
Collier County Board of Commissioners
(Signature of RecipieuVContractor 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.
Stephen Y. Carnell, Interim Mministrs
Collier County Public Services Division
Packet Page -3537-
Date