Agenda 05/24/2011 Item #16J35/24/2011 Item 16.J.3.
EXECUTIVE SUMMARY
Recommendation that the Collier County Board of County Commissioners approve
a budget amendment in the amount of $9,912.46 recognizing Federal HHS Vote
Program Grant Award 2006 Funds for Voting Accessibility for Individuals with
Disabilities.
OBJECTIVE: To obtain the Board of Commissioner's approval to recognize Federal
HHS Vote Program Grant Award 2006 Funds for Voting Accessibility for Individuals
with Disabilities.
CONSIDERATIONS: The Florida Department of State has been awarded the 2006 U.S.
Department of Health and Human Services (HHS) VOTE Program grant funds in the
amount of $567,355 to assist with making polling places accessible to the disability
community. Supervisor of Elections are eligible to receive a specified amount of this
grant for their respective county based on a formula for distribution. The Florida
Division of Elections shall award the Collier County Supervisor of Elections a total of
$9,912.46, (see Exhibit 1, Attachment A).
FISCAL IMPACT: The Collier County Supervisor of Elections will receive $9,912.46
from the Florida Division of Elections to be appropriated in the Supervisor of Elections
budget with definitive project tracking.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney's
Office, does not present a legal issue and only requires a majority vote for Board
approval —SRT.
GROWTH MANAGEMENT IMPACT: None
RECOMMENDATION: That the Collier County Board of County Commissioners
authorizes the Chairman to approve the budget amendment recognizing $9,912.46 in
Supervisor of Elections grant fund 33281.1.
Submitted by: Jennifer J. Edwards, Supervisor of Elections
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5/24/2011 Item 16.J.3.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.J.3.
Item Summary: Recommendation that the Board of County Commissioners approve a
budget amendment in the amount of $9,912.46 recognizing Federal HHS Vote Program Grant
Award 2006 Funds for Voting Accessibility for Individuals with Disabilities.
Meeting Date: 5/24/2011
Prepared By
Name: BrockMaryJo
Title: Executive Secretary to County Manager, CMO
5/12/2011 12:42:27 PM
Submitted by
Title: Executive Secretary to County Manager, CMO
Name: BrockMaryJo
5/12/2011 12:42:29 PM
Approved By
Name: TeachScott
Title: Deputy County Attomey,County Attorney
Date: 5/12/2011 1:06:56 PM
Name: GreenwaldRandy
Title: Management/Budget Analyst,Office of Management & B
Date: 5/12/2011 1:51:10 PM
Name: SheffieldMichael
Title: Manager- Business Operations, CMO
Date: 5/18/2011 8:03:46 AM
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CHART E CRIS j`
Governor
MEMORANDUM
To: Supervisors of Elections
From: Donald L. Palmer, Director, Division of Election
Date: August 10, 2010
Subject: 2006 HHS VOTE Program Grant
5/24/2011 Item 16.J.3.
DAWN R. ROBERM
Interim Secretary of State
AUG 13 2010 Pm 12:18
The Department of State has been awarded the 2006 U.S. Department of Health and Human
Services (HHS) VOTE Program grant funds in the amount of $567,355 to assist with making
polling places accessible to the disability community. Supervisors of Elections are eligible to
receive a specified amount of this grant for their respective county based on a formula for
distribution that includes the number of polling places that were used on Election Day,
November 4, 2008. This information was obtained from data provided by the Supervisors of
Elections for the U.S. Election Assistance Commission (EAC) 2008 Election Administration and
Voting Survey. These funds are available until September 30, 2011.
The- Supervisors of Elections may determine which categories to use based on their county's
specific needs. If a county needs to use funds from a category that is normally used for other
purposes, simply write a justification explaining your county's needs regarding polling place
accessibility and why you are using a category that normally would be used for other purposes.
To request a reimbursement from the HHS grant funds for purchases already made, please use
the attached Certificate for Reimbursement Request for Use of HHS VOTE Program Grant
Funds. Please submit one of the documents listed below for each of the items referenced on the
Certificate:
• an invoice showing a zero balance; or
• an invoice with the check number and date written on it; or
• an invoice with a copy of a cancelled check.
A Certificate must be submitted with each request that identifies the purpose and amount of
funding being requested by category. There is no limit on the number of requests that a
supervisor may submit up to the maximum allocated amount for the respective county.
Division of Elections
R. A. Gray Building, Room 316 • 500 South Bronough Street • Tallahassee, Florida 32399 -0250
Telephone: (850) 245 -6200 • Facsimile: (850) 245 -6217
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5/24/2011 Item 16.13.
Supervisors of Elections
2006 HHS VOTE Program Grant
August 10, 2010
Page Two
Please sign and date the enclosed Memorandum of Agreement and the Debarment and
Suspension form and mail them to the Division of Elections. You will be provided with a copy of
the agreement .upon execution by the Division. When your county is ready to apply for
reimbursement, please submit the Certificate for Reimbursement as described above.
If you have any questions or would like additional information, please contact Althera Johnson at
(850) 245 -6211 or Joyce Durbin at (850) 245 -6206.
DLP /jd/ma
Enclosures
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,y
5/24/2011 Item 16.J.3.
fly' la cv iv I -
ATTACHMENT A to MOA# 2010 -2011 -0002
FEDERAL RESOURCES AWARDED TO THE RECIPIENT UNDER THIS AGREEMENT CONSIST OF THE FOLLOWING:
Federal Program: U.S. Department of Health & Human Services -
CFDA 93.617, Voting Access for Individuals with Disabilities — (i.e. VOTE Program) for the
amount specified in Exhibit 1 to Attachment A.
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED UNDER THIS AGREEMENT
ARE As FOLLOWS:
1. Funds received pursuant to this Agreement must be expended in at least one of the four
major categories of accessibility as follows:
• Category 1: Making polling places accessible to individuals with disabilities (this includes
the path of travel, entrances, exits, and voting areas of each polling facility)
• Category 2: Providing access and participation to individuals with disabilities (this
means providing the same opportunities for access and participation, privacy and
independence provided to all other voters)
• Category 3: Training election officials, poll workers, and election volunteers on how best
to promote the access and participation of individuals with disabilities in elections for
Federal office; and
• Category 4: Providing individuals with disabilities with information on accessibility of
polling places.
Recipients may determine which categories to use based on their county's specific needs. The
Recipient must write a justification explaining their county's needs and why they are using a
category that normally would be used for other purposes.
2. Prior to receipt of funds, the Recipient must complete and submit to the Department the
following two forms:
a. Certificate for Request of HHS Program Grant Funds (attached as Exhibit -2). The
Certificate must include :
➢ The amount of funds requested for reimbursement
➢ A statement that the Recipient agrees to utilize the funds herein in accordance with
the requirements of the HHS VOTE Program grant award;
➢ A statement that such funds shall not be used to support state or federal lobbying
activities.
➢ Supporting documents of expenditures. Examples of acceptable documentation
include copies of invoices or proof of payment (e.g., copy of cancelled check or
check number and date paid written on the invoice or receipt paid by a bank card
and a copy of the bankcard statement on the bank's letterhead.
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5/24/2011 Item 16.J.3.
➢ If the Recipient chooses to use funds from a category for an item that is normally
covered by another category, a written justification explaining the Recipient's
specific needs as they pertain to a particular category must be provided.
b. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion
Lower Tier Covered Transactions (ED Form 'GCAS -009 (6 /88)(attached as Exhibit -3).
Executive Order 12549, Debarment and Suspension, 45 CFR 1183.35, prohibits the
disbursement of federal funds to the intended recipient of such funds or to any sub -
recipient thereunder unless such recipient and each sub - recipient, if any, certify that they
are not excluded or disqualified from receiving federal funds by any federal department or
agency.
STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING:
N/A
MATCHING RESOURCES FOR FEDERAL PROGRAMS: N/A
SUBJECT TO SECTION 215.97, FLORIDA STATUTES: N/A
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT AR
AS FOLLOWS; N/A
Page 2 of 2
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CHARLIE CRIST
Governor
August 18, 2010
The Honorable Jennifer J. Edwards
Supervisor of Elections – Collier County
3301 East Tamiami Trail E, Rev. Dr. Martin Luther King, Jr. Building
Naples, Florida 34112 -4907
Dear Ms. Edwards:
5/24/2011 Item 16.J.3.
DAWN K. ROBERTS
Interim Secretary of State
AUG 20 2010 PIt12:26
Enclosed is an executed copy of your county's Memorandum of Agreement — Federal HHS Vote
Program Grant Award 2006 Funds for Voting Accessibility for Individuals with Disabilities.
If you have any questions, or need anything further, please do not hesitate to contact us.
Sincerely,
Donald L. Palmer, sq.
Director, Division of Elections
DLP /jad/aj
Enclosure
Division of Elections
R. A. Gray Building, Room 316 • 500 South Bronough Street • Tallahassee, Florida 32399 -0250
Telephone: (850) 245 -6200 • Facsimile: (850) 245 -6217
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W
5/24/2011 Item 16.13.
AUG 13 2010 Pµ12:1$
MEMORANDUM OF AGREEMENT
FOR FEDERAL HHS VOTE PROGRAM GRANT
This agreement, effective as of the date fully executed by the State of Florida,
Department of State, Division of Elections ( "Department "), an agency of the State of Florida, the
address of which is the R.A. Gray Building, 500 South Bronough Street, Room 316, Tallahassee,
FL 32399 -0250 and Collier County Supervisor of Elections, The Honorable Jennifer J. Edwards
( "Recipient "), the address of which is 3301 Tamiami Trail East, Reverend Dr. MLK, Jr. Building,
Naples, Florida 34112 -4907 is for the purpose of governing the receipt and use of federal funds
as specified herein.
I. Governing Law
Grant funds are made available pursuant to Title II, Subtitle D, Part II, section 261 of the
Help America Vote Act of 2002 (HAVA) (42 USC 15421) to satisfy the accessibility requirements
for individuals with disabilities. The Voting Access for Individuals with Disabilities (VOTE)
Program within the Department of Health and Human Services (HHS) administers these grants
to the States for this purpose.
II. Disbursement
Through the Grants and Donations Trust Fund, the Department of State is authorized to
distribute to all 67 county Supervisors of Elections a sum total of five hundred sixty -seven
thousand three hundred fifty -five dollars ($567,355) in federal HHS Vote Program Funds. The
amount allocated for each respective county is set forth in Exhibit 1 to Attachment A.
III. Scope of Use /Restrictions
The funds shall be used solely to reimburse expenses made to establish, expand, and
improve access to and participation in the election process by individuals with disabilities in the
four categories of accessibility specified in Attachment A, incorporated by reference.
No Recipient shall receive funds pursuant to this Agreement until the Recipient submits
to the Department the two certificates specified in Attachment A. No Recipient shall use any
funds received hereunder to support lobbying activities to influence proposed or pending
federal or state legislation or appropriations but this does not affect the right of the Recipient,
or that of any other organization to petition Congress, or any other level of Government,
through the use of other resources.
IV. Monitoring, Audits, and Reporting
MOA #2010 - 2011 -0002
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5/24/2011 Item 16.J.3.
A. Monitoring
In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised,
and Section 215.97, F.S., (see Part B "Audits ") monitoring procedures may include, but not be
limited to, on -site visits by Department staff, limited scope audits as defined by OMB Circular A-
133, as revised, and /or other procedures. By entering into this agreement, the Recipient agrees
to comply and cooperate with any monitoring procedures /processes the Department deems
appropriate.
B. Audits
1. Federally Funded Audits (OMB Circular A -133, as revised.)
In the event that the Recipient expends $500,000 or more in Federal awards in its fiscal
year, the recipient is required to have a single or program- specific audit conducted in
accordance with the provisions of OMB Circular A -133, as revised. Attachment A and
Exhibit -1 indicate Federal resources awarded through the Department by this
Agreement. In determining the Federal awards expended in its fiscal year, the Recipient
shall consider all sources of Federal awards, including Federal resources received from
the Department. 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 conducted by the Auditor General must satisfy the requirements of Subpart E of
OMB Circular A -133, as revised.
In connection with the audit requirements the Recipient shall fulfill the responsibilities
of an auditee as provided in Subpart C of OMB Circular A -133, as revised.
If the Recipient expends less than $500,000 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. The Recipient, however, must make records available for review or audit upon
request by appropriate officials of HHS, the Department, and the General Accounting
Office (GAO). If the Recipient 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., resources obtained from other than Federal entities).
2. Other audits
The Department may conduct a limited scope audit of federal funds as defined by OMB Circular
A -133 (as revised) or other financial analysis or review of federal funds as permitted by federal
law. In the event the Department determines that a limited scope audit or other type of audit
of the Recipient is appropriate, the Recipient agrees to comply with any additional instructions
provided by Department staff to the Recipient regarding such audit. If the Department
determines that federal funds received under this Agreement were used for any unauthorized
purpose or that the Recipient did not comply with this agreement or state or federal
requirements for receipt, expenditure, or accounting, the Recipient must return or repay these
federal funds in an amount sufficient to ensure or obtain compliance, including expenses for any
corrective or remedial action.
MOA #2010 - 2011 -0002
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5/24/2011 Item 16.J.3.
The Recipient further agrees to comply and cooperate with any inspections, reviews,
investigations, or audits deemed necessary by the Department of State, Chief Financial Officer
(CFO) or Auditor General.
Additional guidance to state and federal monitoring and auditing requirements may be found at
http: / /Www.eac.aov; and htto:// election. dos .state.fl.us /hava/index.shtml
C. Reporting
Copies of financial reporting packages as described in section .320(c), OMB A -133 (as revised)
for audits conducted by or on behalf of the Recipient pursuant to Section IV.13.1 of this
agreement, shall be submitted as required by sections .320(d) of such circular to:
Department of State
Department of State
Auditor General's Office
Federal Audit
Division of Elections
Office of Inspector General
Room 401, Pepper Bldg
Clearinghouse
R.A. Gray Building
Clifton Building, Ste 320
111 West Madison St.
Bureau of the Census
500 S. Bronough St., Ste 316
2661 Executive Cntr Or.
Tallahassee, FL
1201 East 10' St.
Tallahassee, FL
Tallahassee, FL
32399 -1450
Jeffersonville, IN
32399 -0250
32399 -0250
47132
Other Federal agencies and pass- through entities in accordance with Sections .320 (e) and (fJ,
OMB Circular A -133 (as revised).
Any reports, management letter, or other information required to be submitted to the
Department pursuant to this agreement shall be submitted timely and in accordance with OMB
Circular A -133, the Florida Statutes, and Chapter 10.550 (local governmental entities) of the
Rules of the Auditor General, whichever is applicable
( http: / /www.myflorida.com /audgen /pages /locaIgovt.htm). The correspondence accompanying
the financial reporting package forwarded to the Department must include the date the
Recipient received the reporting package.
V. Record Retention
The Recipient shall keep and maintain accurate and detailed records sufficient to
demonstrate its compliance with the terms of this agreement. The Recipient shall retain these
records for five fiscal years in accordance with the guidelines of the Department of Financial
Services and the Office of the Auditor General, or three years after the date an audit report is
issued, whichever is later, and the Recipient shall allow the Department or its designee, CFO, or
Auditor General access to such records, including access to the audit working papers upon
request.
Vt. Entirety of the Agreement
All terms and conditions of this agreement are fully set forth in this
document and its attachments and shall be governed by the laws of the State of Florida
regardless of any conflict of laws provisions. In any proceeding or action brought under this
section, the parties agree that the prevailing party will be entitled to its reasonable attorney's
fees from the other party. The parties agree that proper venue will be in Leon County, Florida.
MOA #2010 - 2011 -0002
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5/24/2011 Item 16.J.3.
IN WITNESS THEREOF, the parties have caused this Agreement to be executed by their
undersigned officials as duly authorized.
County Supervisor of Election Department tate, 'on of Elections/
nnt, Depart M
By:
Je er J. E a
Typed name and title
I A�?&MXA—j
Witness
August 13, 2010
Date
M OA#2010- 2011 -0002
Date
Page 4 of 4
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5/24/2011 Item 16.J.3.
EXHIBIT -1, ATTACHMENT A
to MOA> #2010- 2011 -002
DEPARTMENT OF STATE
DIVISION OF ELECTIONS
POLLING PLACE ACCESSIBILITY - HHS GRANTS
FY 2006 Grant
COUNTY
POLLING
PLACES
ELECTION DAY
NOV. 4, 2008
TOTAL
DISTRIBUTION
PER COUNTY
MAKING POLLING
PLACES
ACCESSIBLE
TO INDIVIDUALS
WITH
DISABILITIES
5%
PROVIDING
ACCESS AND
PARTICIPATION
TO INDIVIDUALS
WITH
DISABILITIES
90%
TRAINING
ELECTION
OFFICIALS,
POLL WORKERS
& ELECTION
VOLUNTEERS
3%
PROVIDING
INFORMATION
ON
POLLING
PLACE
ACCESSIBILITY
2%
Alachua
70
7,460.99
373.05
6,714.89
223.83
149.22
1 Baker
9
959.27
47.96
863.34
28:78
19.19
Bay
54
5,7 5.62
287.78
5,180.06
172.67
115.11
Bradford
16
1705.37
85.27
1534.83
51.16
34.11
Brevard
140
14 921.98
746.10
13 429.78
447.66
298.44
Broward
457
48,709 . 61
2,435.48
43,838.65
1,461.29
974.19
Calhoun
12
1279.03
63.95
1151.12
38.37
25.58
Charlotte
36
3,837.08
191.85
3,453.37
115.11
76.74
Citrus
41
4,37 .01
218.50
3,933.01
131.10
87.40
Clay
60
6,395.13
319.76
5,755.62
191.85
127.90
Collier
93
9,912.46
495.62
8,921.21
297.37
198.25
Columbia
23
2,451.47
122.57
2,206.32
73.54
49.03
Desoto
13
1385.61
69.28
1247.05
41.57
27.71
Dixie
10
1065.86
53.29
959.27
31.98
21.32
Duval
263
28 032.01
1,401.60
25.228.80
840.96
560.64
Escambia
85
9,059.77
452.99
8153.80
27119
181.20
Fla ler
38
4,050.25
202.51
3,645.23
121.51
81.01
Franklin
8
852.68
42.63
767.42
25.58
17.05
Gadsden
25
2664.64
133.23
2,398.18
79.94
53.29
Gilchrist
10
1065.86
53.29
959.27
31.98
21.32
Glades
16
1,065.86
53.29
959.27
31.98
21.32
Gulf
8
852.68
42.63
767.42
25.58
17.05
Hamilton
8
852.68
42.63
767.42
25.58
17.05
Hardee
12
1,279.03
63.95
1151.12
38.37
25.58
Hendry
22
2,3 .88
117.24
2,110.39
70.35
46.90
Hernando
46
4,902.94
245.15
4,412.64
147.09
98.06
Highlands
25
2,664.64
133.23
2,398.18
79.94
53.29
Hillsborough
296
31 549.33
1,577.47
28 394.40
946.48
630.99
Holmes
7
746.10
37.30
671.49
22.38
14.92
Indian River
48
5,116.11
255.81
4,604.50
153.48
102.32
(Jackson
25
2,664.64
133.23
2,398.18
79.94
53.29
Jefferson
15
1598.78
79.94
1438.91
47.96
31.98
Lafayette
5
532.93
26.65
479.64
15.99
10.66
Lake
103
10 978.31
548.92
9,880.413
329.35
219.57
Lee
169
18 012.96
900.65
16 211.67
540.39
360.26
Leon
102
10 871.73
543.59
9,784.56
326.15
217.43
Levy
14
1492.20
74.61
1342.98
44.77
29.84
Liberty
8
852.68
42.63
767.42
25.58
17.05
Madison
11
1,172.44
58.62
1055.20
35.17
23.45
Manatee
136
14,495.64
724.78
13,046.07
434.87
289.91
Marion
122
13,003.44
650.17
11703.10
390.10
260.07
Martin
52
5,542.45
277.12
4,988.20
166.27
110.85
Miami -Dade
529
56,383.77
2,819.19
50,745.39
1,691.51
1,127.68
Monroe
31
31304.15
165.21
2,973.74
99.12
66.08
Nassau
20
2131.71
106.59
1,918.54
63.95
42.63
Okaloosa
52
5,542.45
277.12
4,988.20
166.27
110.85
Okeechobee
15
1,598.78
79.94
1,438.91
47.96
31.98
Orange
229
24 408.10
1,220.40
21,967.29
732.24
488.16
Osceola
72
7,674.16
383.71
6,906.75
230.22
153.48
Palm Beach
454
48,389.85
2,419.49
1 43,550-86
1,451.70
967.80
Exhibit 1 to Attach A - -HHS Distribution 2006 Funds Final- 07 -29 -10
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5/24/2011 Item 16.J.3.
Pasco
139
EXHIBIT -1, ATTACHMENT A
740.77
13,333.86
to MOA#2010- 2011 -002
296.31
DEPARTMENT OF STATE
254
27 072.74
1,353.64
DIVISION OF ELECTIONS
812.18
541.45
Polk
POLLING PLACE ACCESSIBILITY - HHS GRANTS
15 668.08
783.40
14 101.27
FY 2006 Grant
313.36
Putnam
33
3,517.32
175.87
MAKING POLLING
PROVIDING
TRAINING
PROVIDING
45
POLLING
TOTAL
PLACES
ACCESS AND
ELECTION
INFORMATION
58
PLACES
DISTRIBUTION
ACCESSIBLE
PARTICIPATION
OFFICIALS,
ON
41
ELECTION DAY
PER COUNTY
TO INDIVIDUALS
TO INDIVIDUALS
POLL WORKERS
POLLING
123
NOV. 4, 2006
655.50
WITH
WITH
& ELECTION
PLACE
98
10,445.39
522.27
DISABILITIES
DISABILITIES
VOLUNTEERS
ACCESSIBILITY
COUNTY
31730.50
186.52
5°%
90%
3°%
2%
16
1705.37
85.27
1534.83
51.16
Pasco
139
14 815.39
740.77
13,333.86
444.46
296.31
Pinellas
254
27 072.74
1,353.64
24 365.46
812.18
541.45
Polk
147
15 668.08
783.40
14 101.27
470.04
313.36
Putnam
33
3,517.32
175.87
3,165.59
105.52
70.35
St Johns
45
4 796.35
239.82
4,316.72
143.89
95.93
St. Lucie
58
6,181.96
309.10
5,563.77
185.46
123.64
Santa Rosa
41
4370.01
218.50
3,933.01
131.10
87.40
Sarasota
123
13110.03
655.50
11799.02
393,30
262.20
Seminole
98
10,445.39
522.27
9,400.85
313.36
208.91
Sumter
35
31730.50
186.52
3,357.45
111.91
74.61
Suwannee
16
1705.37
85.27
1534.83
51.16
34.11
Taylor
14
1,492.20
74.61
1,342.98
44.77
29.84
Union
6
639.51
31.98
575.56
19.19
12.79
Volusia
142
15,135.15
756.76
13 621.64
454.05
302.70
Wakulla
12
1279.03
63.95
1151.12
38.37
25.58
Walton
33
3,517.32
175.87
3,165.59
105.52
70.35
Washington
181
1,918.54
95.93
1,726.69
57.56
38.37
TOTAL 5,323 510,619-967 7, 1,
5% - Making polling places accessible to individuals with disabilities (this includes the path of travel, entrances,
exits, and voting areas of each polling facility)
90°% - Providing access and participation to individuals with disabilities (providing the same opportunities
for access and participation, privacy and independence provided to all other voters)
3 % - Training election officials, pollworkers, and election volunteers on how best to promote the access and
participation of Individuals with disabilities in elections for Federal office.
2% - Providing individuals with disabilities with Information on accessibility of polling places
Exhibit 1 to Attach A -HHS Distribution 2006 Funds Final- 07 -29 -10
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July 23, 2010
5/24/2011 Item 16.13.
Exhibit 3 to Attachment A of MOA 2010- 20114002
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
LOWER TIER COVERED TRANSACTIONS
This certification is required by the regulations implementing Executive Order 12549, Debarment
and Suspension, 45 CFR 1183.35, Participants' responsibilities. The regulations were published as
Part VII of the May 26, 1988 Federal Resister (pages 19160- 19211). Copies of the regulations may be
obtained by contacting the person to which this proposal is submitted.
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE)
(1) The prospective lower tier participant certifies, by submission of this proposal, that 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 prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participarrt shall attach an explanation to this proposal.
Jennifer J. Edwards, Collier County Supervisor of Elections
Name and Title of epresentative
ED Forth GCS-M, 6189
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