Backup Documents 01/22/2013 Item #16D5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING siito D
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper.Attach to original document.Original documents should be hand delivered to the Board Office.The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines#1 through#4 as appropriate for additional signatures,dates,and/or information needed.If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#4,complete the checklist,and forward to Sue Filson(line#5).
Route to Addressee(s) Office Initials Date
(List in routing order)
1. Lisa N. Can,Grants Coordinator Housing,Human,Veterans Services LNC 1/23/13
Department
2. Jennifer B. White,ACA Office located within Housing,Human,
Veterans Services Department *()•-()) 1 '23 113
3. County Attorney's Office County Attorney's Office
4. BCC Office Board of County Commissioners / _
!(2 ,3
5. Minutes and Records Clerk of Court's Office
`fin 1(2: (r(3
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval.Normally the primary contact is the person who created/prepared the executive
summary.Primary contact information is needed in the event one of the addressees above,including Sue Filson,need to contact staff for additional or missing
information.All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff Lisa N.C Grants Coordinator Phone Number 239-252-2339
Contact
Agenda Date Item was 1/22/13 Agenda Item Number 44:13:fr l(o D S
Approved by the BCC
Type of Document Contract between Area Agency on Aging for Number of Original 3 total originals
Attached SW FL,Inc d/b/a Senior Choices of SWFL- Documents Attached
Older American Act Program Title III
Contact#OAA203.13
INSTRUCTIONS&CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is appropriate. Yes N/A(Not
(Initial) Applicable)
I. Original document has been signed/initialed for legal sufficiency.(All documents to be signed by the
Chairman,with the exception of most letters,must be reviewed and signed by the Office of the
County Attorney.This includes signature pages from ordinances,resolutions,etc.signed by the LNC
County Attorney's Office and signature pages from contracts,agreements,etc.that have been fully
executed by all parties except the BCC Chairman and Clerk to the Board and possibly State
Officials.)
2. All handwritten strike-through and revisions have been initialed by the County Attorney's Office and n/a
all other parties except the BCC Chairman and the Clerk to the Board
3. The Chairman's signature line date has been entered as the date of BCC approval of the document or LNC
the final negotiated contract date whichever is applicable.
4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and LNC
initials are required.
5. In most cases(some contracts are an exception),the original document and this routing slip should be LNC
provided to Kristi Bartlett in the BCC office within 24 ho rs of BCC approval. Some documents are
time sensitive and require forwarding to Tallahassee withi a certain time frame or the BCC's actions
are nullified.Be aware of your deadlines!
6. The document was approved by the BCC on 1-22-13 nd all changes made during the meeting LNC a
have been incorporated in the attached document.The County Attorney's Office has reviewed _.
the changes,if applicable.
61)‘ij
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05
«matter numben>h<document number»
1605
MEMORANDUM
Date: January 29, 2013
To: Lisa Carr, Grants Coordinator
Housing, Human & Veteran Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Contract #OAA 203.13 between the Area Agency
on Aging of SWFL and Collier County for the
Older Americans Act Program Title III
Attached for further processing are three (3) original copies of the document
referenced above (Item #16D5) approved by the Board of County Commissioners
on Tuesday, January 22, 2013.
After you've acquired all necessary signature(s) on the contract documents please
return one of the fully executed original copies to the Board's Minutes and
Record's Department for the Board's Official Record.
If you have any questions, please call me at 252-8406.
Thank you.
Attachment (3)
1605
January 2013 Contract#0AA 203.13
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. dba
Senior Choices of Southwest Florida
STANDARD CONTRACT
OLDER AMERICANS ACT PROGRAM TITLE HI
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc., dba Senior Choices of
Southwest Florida(Agency)and Collier County Board of County Commissioners(Contractor)and collectively referred to as
the"Parties." The term contractor for this purpose may designate a vendor, subgrantee or subrecipient,the status to be further
identified in ATTACHMENT III,Exhibit-2 as necessary.
WITNESSETH THAT:
WHEREAS,the Agency has determined that it is in need of certain services as described herein; and
WHEREAS,the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services
as an independent contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made,together with the mutual
covenants and conditions hereinafter set forth,the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
1.1 Agency Mission, Vision and Values Statement
The agency's mission: To help aging adults achieve greater independence through awareness of resources and access
to qualified service providers.The agency's vision: To be the recognized leader in supporting older adults and their
families with access to trustworthy resources and services in their communities while empowering them to live with
independence and dignity. The agency's values: We believe residents of Southwest Florida are entitled to:
Comprehensive information about their choices of care; Timely access to resources and services; High standards of
quality and performance; and Personal and professional accountability from all stakeholders.
2. Incorporation of Documents within the Contract
The contract will incorporate attachments, proposal(s),area plan(s), grant agreements,relevant Agency and or
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 January 1,2013 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
31, 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 $706,053.00,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.
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.
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January 2013 1' ' C tract#OAA 203.13
6.1.2 If this contract contains federal funds and is over$100,000.00, the Contractor shall 46 y 1 applicable
standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended(42 U.S.C. 7401,et seq.), s. 508
of the Federal Water Pollution Control Act as amended(33 U.S.C. 1251,et seq.), Executive Order 11738,as
amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The Contractor shall
report any violations of the above to the Agency.
6.1.3 The Contractor, or agent acting for the Contractor, may not use any federal funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any state legislature. If this
contract contains federal funding in excess of$100,000.00,the Contractor must, prior to contract execution,complete
the Certification Regarding Lobbying form,ATTACHMENT II. All disclosure forms as required by the
Certification Regarding Lobbying form must be completed and returned to the Contract Manager prior to payment
under this contract.
6.1.4 In accordance with Appendix A to 2 CFR 215,the Contractor shall comply with Executive Order 11246, Equal
Employment Opportunity, as amended by Executive Order 11375 and others,and as supplemented in Department of
Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed$25,000.00 and certain other contract awards will not
be made to parties listed on the government-wide Excluded Parties List System, in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." The
Excluded Parties List System contains the names of parties debarred, suspended,or otherwise excluded by agencies,
as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. The
Contractor shall comply with these provisions before doing business or entering into subcontracts receiving federal
funds pursuant to this contract. The Contractor shall complete and sign ATTACHMENT V prior to the execution
of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of unauthorized
aliens a violation of the Immigration and Nationality Act(8 U.S.C. 1324a)and the Immigration Reform and Control
Act of 1986(8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this contract by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service(IRS)tax exempt organization
reporting requirements(filing a Form 990 or Form 990-N)and has its tax exempt status revoked for failing to comply
with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor must notify
the Agency in writing within thirty(30)days of receiving the IRS notice of revocation.
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. Agency of Homeland Security's E-verify system to verify the employment of all
new employees hired by Contractor during the contract term. Contractor shall include in related subcontracts a
requirement that subcontractors performing work or providing services pursuant to the state contract utilize the E-
verify system to verify employment of all new employees hired by the subcontractor during the contract term.
Contractors meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this
provision.
7. Compliance with State Law
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in
all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 The Contractor shall comply with requirements of s. 287.058, F.S. as amended.
7.2.1 The Contractor shall provide units of deliverables, including various client services, and in some instances may
include reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and accept
in writing prior to payment in accordance with s.215.971, F.S. (1)and(2).
7.2.2 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre-audit and post-audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit bills for any travel
expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract.
7.2.4 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined in
subsection 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except for those
records which are made confidential or exempt by law. The Contractor's refusal to comply with this provision will
constitute an immediate breach of contract for which the Agency may unilaterally terminate the contract.
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January 2013 1 6 0 5Contract#0AA203.13
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 H,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 and the Agency for Health Care Administration
regarding implementation of s. 430.0402 and ch. 435,F.S.
8.1 Further information concerning the procedures for background screening are found at
http://elderaffairs.state/fl.us/doea/backgroundscreening.php.
8.2 For purposes of this section, the term"direct service provider"means a person 18 years of age or older who, pursuant
to a program to provide services to the elderly, has direct, face-to-face contact with a client while providing services
to the client or has access to the client's living areas or to the client's funds or personal property. This term includes
coordinators, managers, and supervisors of residential facilities and volunteers.
9. Grievance Procedures
The Contractor shall develop, implement, and ensure that its subcontractors have established grievance procedures to
process and resolve client dissatisfaction with or denial of service(s), and address complaints regarding the
termination, suspension or reduction of services,as required for receipt of funds. These procedures,at a minimum,
will provide for notice of the grievance procedure and an opportunity for review of the subcontractor's
determination(s).
10. 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 Agency 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.
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January 2013 16 5ntract#OAA 203.13
11. Nondiscrimination-Civil Rights Compliance t
11.1 The Contractor shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in the
provision of services or benefits under this contract or in employment because of age, race, religion,color, disability,
national origin, marital status or sex in compliance with state and federal law and regulations. The Contractor further
assures that all contractors, subcontractors, subgrantees, or others with whom it arranges to provide services or
benefits in connection with any of its programs and activities are not discriminating against clients or employees
because of age, race, religion, color, disability, national origin, marital status or sex.
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 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 fmdings 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.
13. Provision of Services
The Contractor shall provide services in the manner described in ATTACHMENT I.
14. 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.
14.1 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.
15. Insurance and Bonding
15.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this contract
and any renewal(s)and extension(s)of it. By execution of this contract, unless it is a state agency or subdivision as
defined by subsection 768.28(2), F.S., the Contractor accepts full responsibility for identifying and determining the
type(s)and extent of liability insurance necessary to provide reasonable financial protections for the Contractor and
the clients to be served under this contract. The limits of coverage under each policy maintained by the Contractor do
not limit the Contractor's liability and obligations under this contract. The Contractor shall ensure that the Agency
has the most current written verification of insurance coverage throughout the term of this contract. Such coverage
may be provided by a self-insurance program established and operating under the laws of the State of Florida. The
Agency reserves the right to require additional insurance as specified in this contract.
15.2 Throughout the term of this agreement, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Contractor authorized to
handle funds received or disbursed under all agreements and/or contracts incorporating this contract by reference in an
amount commensurate with the funds handled, the degree of risk as determined by the insurance company and
consistent with good business practices.
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January 2013 1 6 fl #OAA 203.13
16. 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.
17. 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).
18. Incident Reporting
18.1 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.
18.2 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.
19. New Contract(s)Reporting
The Contractor shall notify the Agency within ten(10)days of entering into a new contract with any of the remaining
four(4)state human service agencies. The notification shall include the following information: (1)contracting state
agency; (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.
20. 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 Area Agency on Aging for Southwest Florida, Inc.: (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., United States Bankruptcy Court Middle District of Florida, Fort Myers, FL); and (4) the name, address, and
telephone number of the bankruptcy attorney.
21. Sponsorship and Publicity
21.1 As required by s. 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a program
financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in publicizing,
advertising, or describing the sponsorship of the program, state: "Sponsored by Senior Choices of Southwest Florida
and the State of Florida, Department of Elder Affairs." If the sponsorship reference is in written material, the words
"Senior Choices of Southwest Florida and State of Florida, Department of Elder Affairs" shall appear in at least the
same size letters or type as the name of the organization.
21.2 The Contractor shall not use the words"Senior Choices of Southwest Florida and/or the State of Florida, Department
of Elder Affairs"to indicate sponsorship of a program otherwise financed, unless specific authorization has been
obtained by the Agency prior to use.
22. Assignments
22.1 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.
22.2 Senior Choices of Southwest Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or
obligations under this contract to another agency in the State of Florida, upon giving prior written notice to the
Contractor. In the event the Agency approves transfer of the Contractor's obligations, the Contractor remains
responsible for all work performed and all expenses incurred in connection with the contract.
22.3 This contract shall remain binding upon the successors in interest of either the Contractor or the Agency.
23. Subcontracts
23.1 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.
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23.2 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.
24. 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.
25. Payment
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 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.
26. 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.
27. Data Integrity and Safeguarding Information
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or
using in the performance of this contract. An appropriate level of security includes approving and tracking all
Contractor employees that request system or information access and ensuring that user access has been removed from
all terminated employees. The Contractor, among other requirements, must anticipate and prepare for the loss of
information processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses
or outages of the computer system. The security over the backed-up data is to be as stringent as the protection
required of the primary systems. The Contractor shall ensure all subcontractors maintain written procedures for
computer system backup and recovery. The Contractor shall complete and sign ATTACHMENT IV prior to the
execution of this contract.
28. Computer Use and Social Media Policy
The Agency of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy,
which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel
affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses the
Agency's computer resource systems must comply with the Agency's policy regarding social media. Social Media
includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks
like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This policy is
available on the Department's website. (ATTACHMENT E).
29. 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,
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January 2013 16 D 5 C,ntract#OAA 203.13
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.
30. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real
property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant
under a contract with any public entity; and may not transact business with any public entity in excess of the threshold
amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being
placed on the convicted vendor list.
31. Purchasing
31.1 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.
31.2 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.
31.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a nonprofit
agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S., in the same
manner and under the same procedures set forth in s. 413.036(1) and (2), F.S. For purposes of this contract, the
Contractor shall be deemed to be substituted for the Agency insofar as dealings with such qualified nonprofit agency
are concerned. Additional information about the designated nonprofit agency and the products it offers is available at
http://www.respectofflorida.org. This clause is not applicable to subcontractors unless otherwise required by law.
32. Patents, Copyrights,Royalties
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed,
produced or for which ownership was purchased in the course of or as a result of work or services performed under
this contract, the Contractor shall refer the discovery, invention or material to the Agency to be referred to the
Department of Elder Affairs. 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.
32.1 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.
32.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36.
33. Emergency Preparedness and Continuity of Operations
33.1 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.
33.2 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.
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34. Equipment
34.1 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].
34.2 Contractors and sub-contractors who are Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 215 Administrative
Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the elements identified in the
circular; and, (b) a procedure for conducting a physical inventory of equipment at least once every two years. The
property records must be maintained on file and shall be provided to the Agency upon request.
34.3 The Contractor's property management standards for equipment acquired with federal funds and federally-owned
equipment shall include accurately maintained equipment records with the following information:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number, federal stock number, national stock number, or other identification
number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the Contractor or the federal government;
(5) Acquisition date(or date received, if the equipment was furnished by the federal government)and cost;
(6) Information from which one can calculate the percentage of federal participation in the cost of the equipment(not
applicable to equipment furnished by the federal government);
(7) Location and condition of the equipment and the date the information was reported;
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine current fair
market value where a Contractor compensates the federal awarding agency for its share.
34.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with state
funds with an acquisition cost over$1,000.00 that is specifically identified in the area plan approved by the Agency is
part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will vest in the
Contractor, subject to the conditions of 2 CFR Part 215 Administrative Requirements (formerly OMB Circular A-
110), Subpart C, paragraph 34. Equipment purchased under these thresholds is considered supplies and is not subject
to property standards. Equipment purchased with funds identified in the budget attachments to agreements covered by
this contract, or identified in the sub-agreements with sub-contractors(not included in a cost methodology), is subject
to the conditions of section 273, F. S. and 60A-1.0017, F. A. C. or Title 45 CFR Part 74.
34.5 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.).
34.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120 days
of the written request for disposition, the Contractor is authorized to proceed as directed in 2 CFR Part 215
Administrative Requirements(formerly OMB Circular A-110).
34.7 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
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January 2013 16 D 5 Contract#OAA 203.13
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.
34.8 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.
34.9 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.
35. 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.
36. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by
law.
37. 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.
38. Financial Consequences of Non-Performance
If the Contractor fails to meet the minimum level of service or performance identified in this agreement, or that is
customary for the industry, then the Agency must apply financial consequences commensurate with the deficiency.
Financial consequences may include, but are not limited to, contract suspension, refusing payment, withholding
payments until deficiency is cured, tendering only partial payments, and/or cancellation of contract and reacquiring
services from an alternate source.
38.1 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.
39. 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.
40. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Lee County, Florida.
41. 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.
42. Force Majeure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
43. 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.
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44. Condition Precedent to Contract: Appropriations
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature.
45. Addition/Deletion
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this contract
when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both Parties.
The Parties shall negotiate compensation for any additional services added.
46. 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.
47. Compliance
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.
48. Final Invoice
The Contractor shall submit the final invoice for payment to the Agency as specified in section 3.3.7. (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.
49. Renegotiations or 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.
50. Termination
50.1 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.
50.2 In the event funds for payment pursuant to this contract become unavailable, the Agency may terminate this contract
upon no less than twenty-four (24) hours notice in writing to the Contractor. Said notice shall be delivered by U.S.
Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the
Contract Manager or the representative of the Contractor responsible for administration of the contract. The Agency
will be the final authority as to the availability and adequacy of funds. hi the event of termination of this contract, the
Contractor will be compensated for any work satisfactorily completed prior to the date of termination.
50.3 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.
50.4 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.
51. Electronic Records and Signature
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A contractor that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with the
requirements contained in the Uniform Electronic Transaction Act, s. 668.50, F.S. All electronic records must be
fully auditable; are subject to Florida's Public Records Law, ch. 119, F.S.; must comply with section 28, Data
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January 2013 16 0 5 Contract#OAA 203.13
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.
51.1 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.
51.2 Upon request by the Agency, the Contractor shall provide the Agency with non-electronic (paper) copies of
records. Non-electronic(paper)copies provided to the Agency of any document that was originally in electronic form
with an electronic signature must indicate the person and the person's capacity who electronically signed the
document on any non-electronic copy of the document.
52. Official Payee and Representatives(Names,Addresses,and Telephone Numbers):
Collier County Housing, Human and Veteran Services
The contractor name,as shown on page 1 of
3339 E Tamiami Trail,Building H
a. this contract, and mailing address of the official Naples, FL 34112
payee to whom the payment shall be made is:
Kimberly Grant, Director
The name of the contact person and street Collier County Housing, Human and Veteran Services
b. address where financial and administrative 3339 E Tamiami Trail, Building H
records are maintained is: Naples,FL 34112
The name,address,and telephone number of Kimberly Grant, Interim Director
Collier County Housing, Human and Veteran Services
the representative of the contractor responsible
c. for administration of the program under this 3339 E Tamiami Trail, Building H
Naples, FL 34112
contract is: (239)252-2273
Area Agency on Aging for Southwest Florida, Inc. dba
The section and location within the agency Senior Choices of Southwest Florida
d. where Requests for Payment and Receipt and 15201 N Cleveland Avenue, Suite 1100
Expenditure forms are to be mailed is: North Fort Myers,FL 33903
Leigh Wade, Executive Director
The name,address,and telephone number of Area Agency on Aging for Southwest Florida, Inc. dba
e. the Executive Director for the agency for this Senior Choices of Southwest Florida
contract is: 15201 N.Cleveland Avenue, Suite. 1100
North Fort Myers, FL 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.
All Terms and Conditions Included
This contract and its ATTACHMENTS: I—XI,A,B,D,E,G,H and J and any exhibits referenced in said
53. 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.
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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 52 page contract,to be executed by their undersigned officials
as duly authorized.
COLLIER COUNTY BOARD OF COUNTY AREA AGENCY ON AGING FOR SOUTHWEST
Contractor: CO 1 SSIONERS FLORIDA, INC. DBA SENIOR CHOICES OF
SOUTHWEST FLORIDA
SIGNED BY: SIGNED BY:
NAME: Georgia A. Hiller,Esq. NAME: RONALD LUCCHINO,PhD
TITLE: Chairwoman TITLE: BOARD PRESIDENT
DATE: January 22, 2013 DATE:
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 9/30
Allproliod as to form & legal Suticiancy
3T:
.� Clerk
:.z•; • 90) . A2ara"#ant County Attorrtey
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INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT ATTACHMENT DESCRIPTION PAGE
ATTACHMENT I STATEMENT OF WORK 14
ATTACHMENT II CERTIFICATION REGARDING LOBBYING 27
ATTACHMENT III FINANCIAL COMPLIANCE AUDIT 28-30
Exhibit 1 County Award Allocations 31
Exhibit 2 Part I: Audit Relationship Determination and Part II: Fiscal Compliance 32
Requirements.
ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE 33
ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, 34
INELIGIBILITY AND VOLUNTARY EXCLUSION
ATTACHMENT VI ASSURANCES—NON-CONSTRUCTION PROGRAMS 35-36
ATTACHMENT VII BUDGET and RATE SUMMARY 37-38
ATTACHMENT VIII INVOICE SCHEDULE 39
ATTACHMENT IX REQUEST FOR PAYMENT, DOEA FORM 106A 40
ATTACHMENT X RECEIPTS/EXPENDITURES,TITLE IIIB, IIIC1 & IIIC2, DOEA FORM 105as 41
ATTACHMENT XI RECEIPTS AND EXPENDITURES, TITLE IIIE, DOEA FORM 105AE 42
ATTACHMENT A DEPARTMENT OF ELDER AFFAIRS' PROGRAMS & SERVICES 43
HANDBOOK(ON CD)
ATTACHMENT B DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE 44-47
CHECKLIST AND INSTRUCTIONS
ATTACHMENT D PROVIDER'S STATE CONTRACTS LIST 48
ATTACHMENT E DEPARTMENT OF ELDER AFFAIRS' COMPUTER USE AND SOCIAL 49
MEDIA POLICY
ATTACHMENT G BACKGROUND SCREENING AFFIDAVIT OF COMPLIANCE 50
ATTACHMENT H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS 51
ATTACHMENT J VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION 52
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ATTACHMENT I
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.dba
Senior Choices of Southwest Florida
STATEMENT OF WORK
OLDER AMERICANS ACT PROGRAM TITLE III
SECTION I: SERVICES TO BE PROVIDED
1.1 DEFINITIONS OF TERMS AND ACRONYMS
1.1.1 CONTRACT ACRONYMS
Area Agency on Aging(AAA)
Activities of Daily Living(ADL)
Alliance of Information&Referral Systems(AIRS)
Assessed Priority Consumer List(APCL)
Adult Protective Services(APS)
Client Information and Registration Tracking System(CIRTS)
Information and Referral(I& R)
Instrumental Activities of Daily Living(IADL)
Older Americans Act(OAA)
Planning and Service Area(PSA)
1.1.2 PROGRAM SPECIFIC TERMS
Area Plan: A plan developed by the AAA outlining a comprehensive and coordinated service delivery system
in its PSA in accordance with the Section 306(42 U.S.C. 3026)of the OAA and Department instructions.
Request for Proposal: A proposed plan developed by the Contractor outlining a comprehensive and coordinated
service delivery system approved by the Agency's Board of Directors.
Child: An individual who is not more than 18 years of age or an individual with disability.
Family Caregiver: An adult family member,or another individual, who is an informal provider of in-home
and community care to an older individual.
Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance,
including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment,
requires substantial supervision because the individual behaves in a manner that poses a serious health or safety
hazard to the individual or to another individual.
Grandparent: A grandparent or step-grandparent of a child,or a relative of a child by blood,marriage or
adoption and who lives with the child; is the primary caregiver of the child because the biological or adoptive
parents are unable or unwilling to serve as the primary caregiver of the child;and has a legal relationship to the
child, such as legal custody or guardianship,or is raising the child informally.
1.2 Agency Mission,Vision and Values Statement
The agency's mission: To help aging adults achieve greater independence through awareness of resources and
access to qualified service providers. The agency's vision: To be the recognized leader in supporting older
adults and their families with access to trustworthy resources and services in their communities while
empowering them to live with independence and dignity. The agency's values: We believe residents of
Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to
resources and services; High standards of quality and performance; and Personal and professional
accountability from all stakeholders.
1.2.1 Older Americans Act Program Mission Statement
The Older Americans Act (OAA) Program is a federal program initiative that provides assistance to older
persons and caregivers and is the only federal supportive services program directed solely toward improving
the lives of older people. The program provides a framework for a partnership among the different levels of
government and the public and private sectors with a common objective, improving the quality of life for all
older individuals by helping them to remain independent and productive.
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1.3 GENERAL DESCRIPTION
1.3.1 General Statement
The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is
the only federal supportive services program directed solely toward improving the lives of older people. The
program provides a framework for a partnership among the different levels of government and the public and
private sectors with a common objective, improving the quality of life for all older individuals by helping them
to remain independent and productive. The primary purpose of the OAA program is to foster the development
and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program
uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a
home environment and allows for the capability of self-care with appropriate supportive services.
1.3.2 Authority
The relevant references authority governing the OAA program are:
1. Older Americans Act of 2006,as amended;
2. Rule 58A-1, Florida Administrative Code; and
3. Section 430.101, Florida Statutes.
1.3.2.1 Incorporation of Reference Memoranda
In accordance with Ch. 287 F.S., as amended,and Agency of Financial Services' Chief Financial Officer
Memoranda,the following memoranda are provided for informational purposes and 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.
1.3.3 Scope of Service
The Contractor is responsible for the programmatic, fiscal, and operational management of the Title IIIB, Title
IIIC 1, Title IIIC2 and Title IIIE programs of the OAA within its designated PSA. The scope of service
includes planning, coordinating and assessing the needs of older persons, and assuring the availability and
quality of services. The services shall be provided in a manner consistent with and described in the current
Contractor's Request for Proposal, and the Agency's Area Plan Update, and the current Department of Elder
Affairs Programs and Services Handbook(ATTACHMENT A).
1.3.4 Major Program Goals
The major goals of the OAA program are to improve the quality of life for older individuals, preserve their
independence and prevent or delay more costly institutional care. These goals are achieved through the
implementation of a comprehensive and coordinated service system that provides a continuum of service
alternatives that meet the diverse needs of elders and their caregivers.
1.4 INDIVIDUALS TO BE SERVED
1.4.1 Eligibility(Title III Programs)
1.4.1.1 OAA Title III, General
Consumers shall not be dually enrolled in an OAA program and a Medicaid capitated long-term care program.
1.4.1.2 OAA Title MB,Supportive Services
Eligibility for OAA Title IIIB, Supportive Services, are as follows:
1. Individuals must be age 60 or older;and
2. Information and Referral/Assistance services are provided to individuals regardless of age.
1.4.1.3 OAA Titles IIIC1 and C2,Nutrition Services,General
General factors that should be considered in establishing priority for Nutrition Services, both Cl and C2,
include those older persons who meet the following:
1. Cannot afford to eat adequately;
2. Lack the skills or knowledge to select and prepare nourishing and well-balanced meals;
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Have limited mobility which may impair their capacity to shop and cook for themselves; or
Have a disabling illness or physical condition requiring nutritional support or have been screened at a high
nutritional risk.
1.4.1.3.1 OAA Title IIIC1,Congregate Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I,
Paragraph 1.4.1.3, individuals must be mobile, not homebound and physically, mentally and medically able to
attend a congregate nutrition program. Individuals eligible to receive congregate meals include the following:
1. Individuals age 60 or older;and
2. Any spouse(regardless of age)who attends the dining center with his/her eligible spouse;
3. Persons with a disability, regardless of age, who reside in a housing facility occupied primarily by older
individuals where congregate nutrition services are provided;
4. Disabled persons who reside at home with and accompany an eligible person to the dining center; and
5. Volunteers, regardless of age, who provide essential services on a regular basis during meal hours.
1.4.1.3.2 OAA Title IIIC2,Home Delivered Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I,
Paragraph 1.4.1.3, individuals must be homebound and physically, mentally or medically unable to attend a
congregate nutrition program. Individuals eligible to receive home delivered meals include the following:
1. Individuals age 60 or older who are homebound by reason of illness,disability or isolation;
2. The spouse of a homebound eligible individual, regardless of age, if the provision of the collateral meal
supports maintaining the person at home;
3. Individuals with disabilities, regardless of age, who reside at home with eligible individuals and are
dependent on them for care; and
4. Persons at nutritional risk who have physical, emotional or behavioral conditions, which would make their
presence at the congregate site inappropriate; and persons at nutritional risk who are socially or otherwise
isolated and unable to attend a congregate nutrition site.
1.4.1.4 OAA Title IIIE,Caregiver Support Services
Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows:
1. Family caregivers of individuals age 60 or older;
2. Grandparents(age 55 or older)or older individuals(age 55 or older) who are relative caregivers;
3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and
related disorders with neurological and organic brain dysfunction and for grandparents or older individuals
who are relative caregivers who provide care for children with severe disabilities; and
4. For respite and supplemental services, a family caregiver must be providing care for an older individual
who meets the definition of the term"frail"in OAA, Section 102 Paragraph 22.
1.4.2 Targeted Groups
Preference shall be given to those with the greatest economic and social need,with particular attention to low-
income older individuals, including those that are low-income minorities, have limited English proficiency, and
older individuals residing in rural areas.
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January 2013
1 #OAA 203.13
SECTION II—MANNER OF SERVICE PROVISION 6 D 5
2.1 SERVICE TASKS
In order to achieve the goals of the OAA program, the Contractor shall ensure the following tasks are
performed:
1. Client eligibility determination;
2. Targeting and screening of service delivery for new clients;
3. Delivery of services to eligible clients;
4. Use of volunteers to expand the provision of available services;
5. Monitoring the performance of its subcontractors.
6. Grievance and Compliance Procedures
2.1.1 Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in ATTACHMENT I,Paragraph 1.4.
2.1.2 Targeting and Screening of Service Delivery for New Clients
The Contractor shall develop and implement policies and procedures consistent with OAA targeting and
screening criteria.
2.1.3 Delivery of Services to Eligible Clients
The Contractor shall ensure the provision of a continuum of services that meets the diverse needs of elders and
their caregivers. The Contractor shall ensure the performance and report performance of the following services in
accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded
pursuant to this contract are in accordance with the OAA,Title III,sections 321,331,336,and 373 as follows:
1. Section 321, Title IIIB Supportive Services;
2. Section 331, Title IIIC 1 Congregate Nutrition Services;
3. Section 336,Title IIIC2 Home Delivered Nutrition Services;
4. Section 373,Title 111E Caregiver Support Services.
2.1.3.1 Supportive Services
Supportive services include a variety of community-based and home-delivered services that support the quality
of life for older individuals by helping them remain independent and productive. Services include the
following:
(1) Adult Day Care/Adult Day Health Care; (17) Homemaker;
(2) Caregiver Training/Support; (18) Housing Improvement;
(3) Case Aide/Case Management; (19) Information;
(4) Chore Services; (20) Intake;
(5) Companionship; (21) Interpreter/Translating;
(6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance;
(7) Education/Training; (23) Personal Care;
(8) Legal Assistance; (24) Physical Therapy;
(9) Material Aid; (25) Shopping Assistance;
(10) Occupational Therapy; (26) Skilled Nursing;
(11) Outreach; (27) Specialized Medical Equipment, Services,
and Supplies
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January 2013 1 6 D 5 4::43ntract#OAA 203.13
(12) Recreation; (28) Respite Services;
(13) Emergency Alert Response; (29) Screening/Assessment;
(14) Escort; (30) Speech Therapy;
(15) Health Support; (31) Telephone Reassurance; and
(16) Home Health Aide; (32) Transportation
2.1.3.2 Congregate Nutrition Services
Nutrition services are provided in congregate settings and are designed to reduce hunger and food insecurity,
promote socialization and the health and well being of older individuals by assisting them to gain access to
nutrition and other disease prevention and health promotion services. Services include the following:
1. Congregate meals;
2. Congregate meals screening;
3. Nutrition education and nutrition counseling; and
4. Outreach.
2.1.3.3 Home Delivered Nutrition Services
In-home nutrition services are provided to reduce hunger and food insecurity; promote socialization and the
health and well being of older individuals by assisting such individuals to gain access to nutrition and other
disease prevention and health promotion services. Services include the following:
1. Home delivered meals;
2. Nutrition education and counseling; and
3. Outreach.
2.1.3.4 Caregiver Support Services(Title HIE Program)
The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and
financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles
and responsibilities:
1. Adult Day Care/Adult Day Health Care;
2. Caregiver Training/Support;
3. Counseling(Gerontological and Mental Health);
4. Education/Training;
5. Financial Risk Reduction(Assessment and Maintenance);
6. Information;
7. Intake;
8. Outreach;
9. Respite Services;
10. Screening/Assessment; and
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January 2013 ntract#OAA 203.13
1 11. 6 D 5
Transportation.
2.1.3.5 Caregiver Support Supplemental Services (Title DIES Program): The following services are provided to
complement the care provided by caregivers:
1. Chore Services;
2. Housing Improvement;
3. Legal Assistance;
4. Material Aid; and
5. Specialized Medical Equipment, Services and Supplies.
2.1.3.6 Caregiver Support Grandparent Services (Title IIIEG Program): Services for grandparents or older
individuals who are relative caregivers designed to help meet their caregiving obligations include the following:
1. Caregiver Training/Support; 6. Legal Assistance;
2. Child Day Care; 7. Outreach;
3. Counseling(Gerontological and Mental Health); 8. Screening/Assessment;
4. Education/Training; 9. Sitter; and
5. Information; 10. Transportation
2.1.4 Use of Volunteers to Expand the Provision of Available Services
2.1.4.1 The Contractor shall ensure the use of trained volunteers in providing direct services delivered to older
individuals and individuals with disabilities needing such services. If possible, the Contractor shall work in
coordination with organizations that have experience in providing training, placement, and stipends for
volunteers or participants (such as organizations carrying out federal service programs administered by the
Corporation for National and Community Service), in community service settings.
2.1.4.2 The Contractor shall submit a quarterly report of volunteer activities and services electronically on the interne
in a format provided by the Agency. The quarterly report schedule is as follows:
Report Period Report Due Date
January 1 -March 31 April 15, 2013
April 1-June 30 July 15,2013
July 1-September 30 October 15,2013
October 1 - December 31 January 15, 2014
2.1.5 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 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.
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January 2013 16 D 5 Con' t#OAA 203.13
2.1.5.1 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 contracts. 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.
2.1.6 Subcontractor Outreach Reporting Requirements
The Contractor shall document its oversight of subcontractor performance of outreach activities, by establishing a
uniform reporting format that includes the following: number and type of provider events or activities; date and
location; total number of participants at each event or activity; individual service needs identified; and referral
sources or information provided. The Contractor shall require subcontractors to use this format for reporting on
outreach activities at least semi-annually.
2.1.7 Grievance and Complaint Procedures
2.1.7.1 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
2.1.7.2 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
advice related to complaints other than termination, suspension or reduction in services that 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 procedure and include tracking the
date,nature of complaint and the determination of each complaint.
2.2 SERVICE LOCATION
2.2.1 Service Times
The Contractor shall ensure the provision of the services listed in the contract during normal business hours unless
other times are more appropriate to meet the performance requirements of the contract,and it shall monitor its
subcontractors to ensure they are available to provide services during hours responsive to client needs and during
those times which best meet the needs of the relevant service community.
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January 2013 Contract#OAA 203.13
2.3 DELIVERABLES
1605 9
2.3.1 Programmatic Operations/Administration
The Contractor shall ensure the provision of services outlined in Section 2.3.2 in accordance with Department of
Elder Affairs Programs and Services Handbook through its review of reports outlined in Section 2.4 of this
agreement at least as follows: A.)monthly review of contractors' surplus/deficit reports,and CIRTS data accuracy
reports; B.) semi-annual review of service cost reports; and C.) at least annually and as needed to correlate with
applicable contract amendments for OAA service units, recording of manual units of service portions of the OAA
Annual Report.
2.3.2 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 services tasks described in Section 2.1. The
chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the
rate established in the 2010 RFP and approved by the Agency.
Services l'no ofScnicr
Adult Day Care/Adult Day Health Care Interpreter/Translating
Caregiver Training/Support Legal Assistance
Case Aid/Case Management Medication Management
Child Day Care Mental Health Counseling/Screening
Chore Services Nutrition Counseling
Companionship Occupational Therapy
Congregate Meals Screening Personal Care
Counseling Services Physical Therapy Hour
Escort Recreation
Financial Risk Reduction Services Respite Services
Health Support Screening/Assessment
Home Health Aide Sitter
Homemaker Skilled Nursing Services
Housing Improvement Speech Therapy
Intake
Emergency Alert Response Day
Education/Training Episode
Information
Material Aid
Nutrition Education
Outreach
Referral/Assistance
Specialized Medical Equipment, Services and Supplies
Telephone Reassurance
Escort One-Way Trip
Shopping Assistance
Transportation
Congregate and Home Delivered Meals Meal
REPORTS
2.4 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 permit the Contractor to meet the Agency's
reporting requirements.
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2.4.1 Client Information and Registration Tracking System (CIRTS) Reports
The Contractor shall input OAA 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) Outcome Measurement Reports.
2.4.2 Service Costs Reports
The Contractor shall require subcontractors to submit to the Contractor semi-annual service cost reports
(August 15, 2013 and February 15, 2014), which reflect actual costs of providing each service by program. This
report provides information for planning and negotiating unit rates.
2.4.3 Variance(Surplus/Deficit)Report
The Contractor will submit a consolidated variance 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 shall include the following:
1. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
Agency will be resolved;
2. Recommendations to transfer funds to resolve surplus/deficit spending;
3. Number of clients currently on APCL that receive a priority ranking score of 4 or 5; and
4. Number of clients currently on the APCL designated as Imminent Risk.
2.4.4 OAA Annual Report
The completed manual units of service portions of the OAA Annual Report, if applicable, are due to the Contract
Manager on the date established by the Agency. The Agency will obtain the remaining report sections from the
CIRTS.
2.4.5 Background Screening Affidavit of Compliance
To demonstrate compliance with section 8 of the Standard Contract, the Contractor shall submit ATTACHMENT
G, Background Screening Affidavit of Compliance annually, by January 15th.
2.5 RECORDS AND DOCUMENTATION
Each Contractor and subcontractor,among other requirements, must anticipate and prepare for the loss of
information processing capabilities. The routine backing up of all data and software is required to recover from
losses or outages of the computer system. Data and software essential to the continued operation of contractor
functions must be backed up. The security controls over the backup resources shall be as stringent as the protection
required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure,
offsite location.
The Contractor shall maintain written policies and procedures for computer system backup and recovery and shall
have the same requirement in its contracts and/or agreements with subcontractors. These policies and procedures
shall be made available to the Agency upon request.
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,ATTACHMENT A.
2. The Contractor shall timely submit to the Agency all reports described in ATTACHMENT I, Paragraph 2.4
REPORTS.
3. The Contractor shall timely submit to the Agency all information described in ATTACHMENT I,
Paragraph 2.5 RECORDS AND DOCUMENTATION.
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January 2013 D 5 Contract#OAA 203.13
2.6.2 The Contractor shall develop and document strategies in the Area Plan to support performance achievement of the
following:
1. Percent of most frail elders who remain at home or in the community instead of going into a nursing home;
2. Percent of APS referrals who are in need of immediate services to prevent further harm who are served within
72 hours;
3. Average monthly savings per consumer for home and community-based care versus nursing home care for
comparable client groups;
4. Percent of elders assessed with high or moderate risk environments who improved their environment score;
5. Percent of new service recipients with high-risk nutrition scores whose nutritional status improved;
6. Percent of new service recipients whose ADL assessment score has been maintained or improved;
7. Percent of new service recipients whose IADL assessment score has been maintained or improved;
8. Percent of family and family-assisted caregivers who self-report they are very likely to provide care;
9. Percent of caregivers whose ability to continue to provide care is maintained or improved after one year of
service intervention(as determined by the caregiver and the assessor); and
10. Percent of customers who are at imminent risk of nursing home placement who are served with community
based services.
The Contractor's performance of these measures will be reviewed and documented in the Agency's annual
monitoring reports.
2.7 CONTRACTOR'S FINANCIAL OBLIGATIONS
2.7.1 Matching,Level of Effort,and Earmarking Requirements
The Contractor shall provide match of at least 10 percent of the federal funds received. The Contractor's match
will be made in the form of cash and/or in-kind resources. The Contractor will assure, through a provision in
subcontracts, a match requirement of at least 10 percent of the cost for all services funded through this contract.
The subcontractor's match will be made in the form of cash and/or in-kind resources. The Contractor shall report
match by title each month. At the end of the contract period,the Contractor must properly match all OAA funds.
2.7.2 Consumer Contributions
Consumer contributions are to be used under the following terms:
1. The Contractor assures compliance with Section 315 of the OAA as amended in 2006, in regard to consumer
contributions;
2. Voluntary contributions are not to be used for cost sharing or matching;
3. Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; and
4. Voluntary contributions are to be used only to expand services.
2.7.3 Use of Service Dollars
The Contractor is expected to spend all federal, state and other funds provided by the Agency for the purpose
specified in the contract. The Contractor must manage the service dollars in such a manner so as to avoid having a
wait list and a surplus of funds at the end of the contract period, for each program managed by the Contractor. If
the Agency determines that the Contractor is not spending service funds accordingly, the Agency may transfer
funds to other Contractors during the contract period and/or adjust subsequent funding allocations accordingly, as
allowable under state and federal law.
2.7.4 The Contractor agrees to distribute funds as detailed in the Budget Summary, ATTACHMENT VII to this
contract. Any changes in the amounts of federal funds identified on the Budget Summary form require a contract
amendment.
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January 2013 Con.,act#OAA 203.13
2.7.5 Title III Funds
The Contractor assures compliance with Section 306 of the OAA, as amended in 2006, that funds received under
Title III will not be used to pay any part of a cost incurred by the Contractor to maintain a contractual or
commercial relationship that is not carried out to implement Title III.
2.8 AGENCY RESPONSIBILITIES
2.8.1 Program Guidance and Technical Assistance
The Agency will provide to the Contractor guidance and technical assistance as needed to ensure the successful
fulfillment of the contract by the Contractor.
2.8.2 Program/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;
4. Review of independent auditor's reports;
5. Review of third-party documents and/or evaluation;
6. Review of progress reports;
7. Review of customer satisfaction surveys;
8. Agreed-upon procedures review by an external auditor or consultant;
9. Limited-scope reviews; and
10. Other procedures as deemed necessary.
2.8.3 Contract Monitoring
The Agency shall, at its own discretion,conduct monitoring concerning any aspect of the contractor's performance
of this contract.
SECTION HI: METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The method of payment for this contract includes advances and fixed rate for services. The Contractor shall ensure
fixed rates for services include only those costs that are in accordance with all applicable state and federal statutes
and regulations and are based on audited historical costs in instances where an independent audit is required. The
Contractor shall consolidate all requests for payment from subcontractors and expenditure reports that support
requests for payment and shall submit to the Agency on forms 106A(ATTACHMENT IX), 105AA
(ATTACHMENT X,EXHIBIT 1), 105AS(ATTACHMENT X,EXHIBIT 2),and 105AE(ATTACHMENT
X,EXHIBIT 3).
3.1.1 The Contractor agrees to distribute funds as detailed in ATTACHMENT VII, Budget Summary. Any changes
in the total amounts of the funds identified on the Budget Summary form require a contract amendment.
3.2 Advance Payments
The Contractor may request up to two months of advances at the start of the contract period, if available, to cover
program administrative and service costs. The payment of an advance will be contingent upon the sufficiency and
amount of funds released to the Agency by the State of Florida ("budget release"). The Contractor shall provide
24
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January 2013 C ontract#OAA 203.13
the Contract Manager documentation justifying the need for an advance and describing how the funds will be
distributed.
3.2.1 The Contractor's requests for advance require the approval of the Contract Manager. If sufficient budget is
available,the Agency will issue approved advance payments after January 1, 2013.
3.2.2 All advance payments made to the Contractor shall be returned to the Agency as follows: one — twelfth of the
advance payment received shall be reported as an advance recoupment on each request for payment, starting with
report number three, in accordance with the Invoice Schedule,ATTACHMENT VIII to this contract.
3.2.3 Interest earned on advances must be identified separately by source of funds, state or federal. Contractors shall
maintain advances of federal funds in FDIC interest bearing accounts unless otherwise exception is made in
accordance with 45 CFR 74.22(k). Earned interest must be returned to the Agency at the end of each quarter.
3.3 Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA
forms 106A(ATTACHMENT IX), 105AS (ATTACHMENT X), and 105AE(ATTACHMENT XI. The
Contractor shall include with its request for payment documentation of services provided, the units of service
provided,and the rates for the services provided in conformance with the requirements as described in the
deliverables and service tasks beginning with the first month of the contract. The schedule for submission of
advance requests(when available)and invoices is ATTACHMENT VIII to this contract.
3.3.1 Remedies for Nonconforming Services
The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,
completely and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
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 not
meeting such standards will not be reimbursed under this contract. The Contractor's signature on the request for
payment form certifies maintenance of supporting documentation 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.
33.2 Financial Consequences
Contractor shall ensure the provision of services to the projected number of clients in accordance with the 2010
RFP and within the contract amount. The Contractor shall ensure expenditure of 100% of the contract amount
budgeted for services to clients at the unit rates established in the RFP.
3.3.3 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the
first month of the contract. The schedule for submission of advance requests(when available)and invoices is
ATTACHMENT VIII to this contract.
33.4 Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments
thereto, including any disallowance not resolved as outlined in Section 25 of this contract.
3.3.5 Final requests for budget revisions has to be submitted no later than December 1, 2013
3.3.6 The Agency will authorize payment only for allowable expenditures, which are in accordance with the limits
specified in ATTACHMENT VII, Budget Summary. Any changes in the amounts of federal or general revenue
funds identified on the Budget Summary form require a contract amendment.
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January 2013 16 D 5 Contract#OAA 203.13
3.3.7 Date for Final Request for Payment
The Contractor shall submit the final request for payment to the Agency no later than February 1, 2014.
3.4 Documentation for Payment
The Contractor shall maintain documentation to support payment requests, and the Contractor shall make such
documentation available to the Agency or authorized individuals upon request.
3.4.1 The Contractor shall ensure all required data per the Department of Elder Affair's CIRTS Policy Guidelines for
clients and services is entered into the CIRTS database. The data must be entered into 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.
3.4.2 The Contractor must run monthly CIRTS reports and verify client and service data in CIRTS is accurate. This
report must be submitted to the Agency with the monthly request for payment and expenditure report and must be
reviewed by the Agency before the Contractor's request for payment and expenditure reports can be approved.
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January 2013 ontract#OAA 203.13
1 6 D5
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 sub-contractors 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$1 ,000.00 and not more than$100,000.00 for each such failure.
()I /
J
January 22,2013
Signature Date
Georgia A. Hiller,Esq.—Chairwoman OAA 203.13
Name of Authorized Individual Application or Agreement Number
Collier County Board of County Commissioners: 3299 Tamiami Trail East,Suite 303,Naples,FL 34112
Name and Address of Organization
AS to form & legal SU1`ticlsnsy
DOEA Form 103 =;WICilil; 84d
(Revised Nov 2002) l -Cl r
�:_„ _ .�sitaln± County
.attrrrey
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January 2013 1 6 5 .ntract#OAA 203.13
• TTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
•
The administration of resources awarded by Senior Choices of Southwest Florida to the Contractor may be subject to
audits and/or monitoring by the Agency, 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 Senior Choices of Southwest Florida. hi the event the Agency determines that a limited scope audit of the Contractor
is appropriate, the Contractor agrees to comply with any additional instructions provided by the Agency to the
Contractor regarding such audit. The Contractor further agrees to comply and cooperate with any inspections, reviews,
investigations, or audits deemed necessary by the Chief Financial Officer(CFO)or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in
OMB Circular A-133,as revised.
In the event that the Contractor expends $500,000.00 or more in federal awards during its fiscal year, the Contractor
must have a single or program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as
revised. EXHIBIT 1 to this agreement indicates federal resources awarded through the Department of Elder Affairs by this
agreement. In determining the federal awards expended in its fiscal year, the Contractor shall consider all sources
of federal awards, including federal resources received from the Department of Elder Affairs. 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 Department of Elder Affairs 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 Department of Elder Affairs shall be fully disclosed in the audit report with reference to the
Department of Elder Affairs 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 Department of Elder Affairs 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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January 2013 Contract#OAA 203.13
PART II: STATE FUNDED
This part is applicable if the Contractor is a nonstate entity as defined by Section 215.97(2), Florida
Statutes.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of$500,000.00
in any fiscal year of such Contractor (for fiscal years ending September 30, 2004 or thereafter), the Contractor must have a
State single or project-specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable
rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit
and for- profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial
assistance awarded through the Department of Elder Affairs by this agreement. In determining the state financial
assistance expended in its fiscal year, the Contractor shall consider all sources of state financial assistance, including
state financial assistance received from the Department of Elder Affairs, 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 Department of Elder Affairs 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
Department of Elder Affairs shall be fully disclosed in the audit report with reference to the Department of Elder Affairs
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
Department of Elder Affairs 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 Department of Elder Affairs 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 directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida 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 Ave.,Suite 1100
North Fort Myers,FL 33903
29
16135 r
January 2013 Contract#OAA 203.13
The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections
.320 (d)(1) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at the
following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10`h 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. dba Senior Choices of Southwest Florida 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 Ave.,Suite 1100
North Fort Myers,FL 33903
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on
behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida 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 Ave.,Suite 1100
North Fort Myers,FL 33903
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 Senior Choices of Southwest Florida
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 Senior Choices of Southwest Florida 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.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of
six years from the date the audit report is issued, and shall allow Senior Choices of Southwest Florida 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 Senior Choices of Southwest Florida, 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 Senior Choices of Southwest
Florida.
30
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January 2013 Contract#OAA 203.13
ATTACHMENT III
EXHIBIT 1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
COLLIER COUNTY
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Older Americans Act Title IIIB—
CA/CM/SCAS/INSC $ 11,500.00
Transportation U.S. Health and Human Services 93.044 $ 65,000.00
Support Services $ 76,500.00
TotalIIIB $ 296,567.00*
OAA Title IIIC 1 —Congregate Meals $ 272,751.00
Meals
Screening $ 6,692.00
Nutrition Education U.S. Health and Human Services 93.045 $ 1,975.00
Outreach $ 432.00
Total HIC1 $ 281,850.00
OAA Title III C2—Home Delivered Meals
Meals $ 229,521.80
Screening $ 19,125.00
Nutrition Education U.S. Health and Human Services 93.045 $ 2,430.00
Outreach $ 43.20
TotalIIIC2 $ 251,120.00
Older Americans Act Title III E
CAICM/Intake(Title III E) $ 4,500.00
Services(Title III E) U.S. Health and Human Services 93.052 $ 61,868.00
Supplement Services(Title III ES) $ 20,280.00
Grandparent Services(Title III EG) $ 9,935.00
Total HIE
$ 96,583.00
TOTAL FEDERAL AWARD $ 706,053.00
*In Home Services$296,567.00
In Home Services are funds to serve Collier County Clients. The Vendors are paid directly by the Area Agency on
Aging for Southwest Florida,Inc.dba Senior Choices of Southwest Florida
31
January 2013 Contract#OAA 203.13
mox
16 p 5 A tACHMENT III
EXHIBIT 2
PART I:AUDIT RELATIONSHIP DETERMINATION
Contractors 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. Contractors 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. Contractors 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, Contractors 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, Contractor 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 Contractor is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by
the Department 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 [I: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors 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. Contractors 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
32
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January 2013 Contract#OAA 203.13
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 sub-contractors 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, sub-contractor(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 sub-contractor(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 sub-contractors 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).
Collier Co‘;A B .1.If Co ' ty Commissioners: 3299 Tamiami Trail East, Suite 303, Naples,FL 34112
Name anqI Ad r s es Contractor
Chairwoman January 22,2013
Signature 1 Title Date
V'
Georgia A.Hiller,Esq.
Name of Authorized igrr�l"J),„(Revised June 2008) .` 'r° la to form d, �q )
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January 2013 ntract#OAA 203.13
j -
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT,SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1) The prospective 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 prospective contractor is unable to certify to any of the statements in this certification, such prospective
participant . .11 attach an explanation to this certification.
January 22,2013
Signature Date
Chairwoman Collier County Board of County Commissioners
Title Agency/Organization
Certification signature should be same as Contract signature.)
jpstructions for Certification
1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person,"
"primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the sections of
rules implementing Executive Order 12549. (2 CFR 180.5-180.1020, as supplemented by 2 CFR 376.10-
376.995). You may contact the Contract Manager for assistance in obtaining a copy of those regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this
transaction. If it is later determined that the contractor knowingly rendered an erroneous certification, in addition
to other remedies available to the federal government, the Department 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 Department may pursue available remedies, including suspension,and/or debarment.
7. The contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not
debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the
certification is erroneous.(Revised June 2008)
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Ja nuary 2013 16fl
n ract#OAA 203.13
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. 004728-4763)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. 001681-1683, 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. 0794),which prohibits discrimination on the basis of
handicaps; (d) the Age Discrimination Act of 1975, as amended(42 U.S.C. 6101-6107), which prohibits discrimination on the basis
of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis
of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L.
91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient
records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to nondiscrimination in the
sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for
federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the
application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of federal participation in purchases.
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328), which limit the political
activities of employees whose principal employment activities are funded in whole or in part with federal funds.
9. Will comply,as applicable, with the provisions of the Davis-Bacon Act(40 U.S. C. 276a-7), the Copeland Act(40 U.S.C.
35
16
#
ry
Janua 2013 Contr AA 203.13
276c and 18 U.S.C. ❑❑874)and the Contract Work Hours and Safety Standards Act(40 U.S.C. 327-333),regarding labor standards
for federally assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a)of the Flood Disaster Protection Act
of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase
flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental
quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514;
(b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. ❑❑1451 et seq.); (f) conformity of
federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42
U.S.C. ❑07401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974,
as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended,
(P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. ❑❑1721 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C. 0470), 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. ❑02131 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 AUT1) RIZED CERTIFYIN OFFICIAL TITLE
(1,
Chairwoman
APPLICANT ORGANIZATION DATE SUBMITTED
Collier County Board of County Commissioners January 22, 2013
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January 2013 Contract#OAA 203.13
ATTACHMENT VII
Budget Summary
OLDER AMERICANS ACT BUDGET SUMMARY
CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
1. Title III B Support Services $ 76,500.00*
2. Title III Cl Congregate Meals $ 281,850.00
3. Title III C2 Home Delivered Meals $ 251,120.00
4. Title III E Services $ 96,583.00
TOTAL $ 706,053.00
*In Home Services$296,567.00
In Home Services are funds to serve Collier County Clients. The Vendors are paid directly by the Area Agency on
Aging for Southwest Florida,Inc.dba Senior Choices of Southwest Florida
37
J 1
an ont ct AA 203.13
uary 2013
ATTACHMENT VII
Rate Summary
OLDER AMERICANS ACT
RATE SUMMARY
CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
IIIB & IIIE
Services Total Cost Reimbursement Rate
IIIB
Case Aide $27.78 $25.00
Case Management $50.00 $45.00
*Intake-EHEAP Only $27.78 $25.00
Screening/Assessment $50.00 $45.00
Transportation 100%Cost 90%of Cost
*Intake Units only used for EHEAP
Services Total Cost Reimbursement Rate
IIIE
Respite-Day Care $11.12 $10.00
Direct Pay Respite Must include match Up to$21.00
Direct Pay Facility Respite Must include match 24 hours--$125.00
Day Care Sitter $13.34 $12.00
IIIEG-Child Day Care $16.67 $15.00
Screening/Assessment $50.00 $45.00
Specialized Medical Equipment, 100%Cost 90%of Cost
Service& Supplies
C-1 & C-2
COLLIER COUNTY
Services Total Cost Reimbursement Rate
C1
Congregate Meals $ 9.84 $ 8.86
Nutrition Counseling $58.89 $53.00
Nutrition Education $ 1.80 $ 1.62
Nutrition Screening $31.11 $28.00
Outreach $4.80 per person $4.32 per person
C2
Home Delivered Meals $ 9.77 $ 8.79
Nutrition Counseling $58.89 $53.00
Nutrition Education $ 1.80 $ 1.62
Nutrition Screening $50.00 $45.00
Outreach $4.80 per person $4.32 per person
38
16115 11
January 2013 Contract#OAA 203.13
ATTACHMENT VIII
INVOICE SCHEDULE
ADVANCE BASIS CONTRACT
Submit to State
Report Number Based On On This Date
1 January Advance* January 1
2 February Advance* January 1
3 January Expenditure Report February 9 *See Note#4*
4 February Expenditure Report March 9
5 March Expenditure Report April 9
6 April Expenditure Report May 9
7 May Expenditure Report June 9
8 June Expenditure Report July 9
9 July Expenditure Report August 9
10 August Expenditure Report September 9
11 September Expenditure Report October 9
12 October Expenditure Report November 9
13 Report Advance Refund/Recoupment November 9
14 November Expenditure Report December 9
15 December Expenditure Report January 9
16 Final Expenditure and Request for Payment February 1
17 Closeout Report February 15
Legend: * Advance based on projected cash need.
Note# 1: Report#1 for Advance Basis Agreements cannot be submitted to the Agency prior to January 1 or
until the agreement with the Agency has been executed.
Note#2: Report numbers 3 through 14 shall reflect an adjustment of one-twelfth of the total advance amount,
on each of the reports, repaying advances issued the first two months of the agreement. The
adjustment shall be recorded in Part C, 1 of the report(ATTACHMENT IX).
Note#3: Submission of expenditure reports may or may not generate a payment request. If final expenditure
report reflects funds due back to the Agency, payment is to accompany the report.
Note#4: ALL Expenditure Reports are due by 12:00 p.m. on the 9th of each month. IF the 9th falls on a
Saturday, then the report will be due by the 8th by 12:00 p.m. AND IF the 9th falls on a Sunday, the
report will be due by the 10th by 12:00 p.m. Actual submission of the vouchers to Dept. of Elder
Affairs is dependent on the accuracy of the expenditure report which is verified and paid by CIRTS
data only.
39
1605 ..
..,
January 2013 Contract#OAA 203.13
ATTACHMENT IX
REQUEST FOR PAYMENT
OLDER AMERICANS ACT
CONTRACTOR NAMF ADDRFSS PHONF AND FFD ID NIIMRFR 3YPF OF RFPORT• _HIS RFQIIFST PFRIOn•
Adtance Report#
Reimbursement Agreement d:
Agreement Period:
PSA:
CFRTIFICATION• I hereby certify to the hest of my knowledge:that this regnest cosforms with the terms aid the purposes set forth in t re Rhine agreement
Prepared By: Date: Approved By: Date:
PART A• a (1. (2) (3) (4) (7) (6)
BUDGET SUMMARY III B DIC1 IIIC2 Title ITE TOTAL
I.Approved
Agreement Amount. 0.00 0.00 0.00 0.00 0.00 , 0.00
2.Previous Funds
RECEIVED fir
Agreement period. 0.00 0.00 0.00 0.00 0.00 r 0.00
3.Agreement Balance 0.00 0.00 0.00 0.00 0.00 0.00
4.Previous Funds
REQUESTED and
Not Received. 0.00 0.00 0.00 0.00 0.00 0.00
5.Agreement Balance 0.00 0.00 0.00 0.00 0,00 0.00
PART R.
FUNDS REQUESTED
1. 1st-2nd Months
Request Only 0.00 0.00 0.00 0.00 0.00 , 0.00
2.Net Expenditures
For Month 0.00 0.00 0.00 0.00 0.00 r 0.00
3.Additional
Cash Needs(Attach Doc.) 0.00 0.00 0.00 0.00 0.00 r 0.00
4.Total 0.00 0.00 0.00 0.00 0.00 0.00
PART C: .
NET FUNDS REQUESTED:
I.Less:Over-Advance 0.00 0.00 0.00 0.00 0.00 r 0.00
2.Agreement Funds are
Hereby Requested For 0.00 0.00 0.00 0.00 0.00 0.00
DOFA FORM 106A revised 5/10
40
16n5 ..
January 2013 Contract#OAA 203.13
RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT ATTACHMENT X
RECEIPTS AND EXPENDITURE REPORT OLDER
AMERICAN ACT
CONTRACTOR NAME,ADDRESS, PHONE#AND FEID# Program Funding Source: THIS REPORT PERIOD
FROM: TO:
IIIB II1C 1
CONTRACT
IIIC2 PERIOD:
CONTRACT#
REPORT#
PS A#
CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the
contract.
Prepared by: Date: Approved by: Date:
PART A:BUDGETED INCOME/RECEIPTS 1.Approved 2.Actual Receipts 3.Total Receipts 4.Percent of
Budget For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00
2. State Funds $0.00 $0.00 $0.00
3.Program Income $0.00 $0.00 $0.00 %
4.Local Cash Match(CCE,HCE and Other) $0.00 $0.00 p $0.00 %
5.SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 %
6.Local In-Kind Match $0.00 $0.00 $0.00 %
7.TOTAL RECEIPTS $0.00 $0.00 $0.00
PART B:EXPENDITURES 1.Approved 2.Expenditures 3.Expenditures 4.Percent of
Budget For This Report Year to Date Approved Budget
1.Meals/Meal Agreements $0.00 $0.00 $0.00
2.Service Subcontractor $0.00 $0.00 $0.00 %
3.Other $0.00 $0.00 $0.00 %
4.Indirect Cost $0.00 $0.00 $0.00
5.TOTAL EXPENDITURES $0.00 $0.00 $0.00 %
PART C:OTHER EXPENDITURES(For
Tracking Purposes only)
1-Match
a Other and In-Kind $0.00 $0.00 $0.00 %
b.Local Match $0.00 $0.00 $0.00 %
2.USDA Cash Received $0.00 $0.00 $0.00
3.TOTAL OTHER $0.00 $0.00 $0.00
PART D:OTHER REVENUE AND EXPENDITURES 2.Addition Cost Alternative Program Income 3.Interest
1. Program Income(PI) a.Approved Budget$ a.Earned on GR Advances$
a.OAA Unbudgeted PI Receipts YTD
b. Received YTD $ b.Return of GR Advance $
$
c.Expenditures $ c.Other Earned $
41
January 2013 16 ® 'r 203.1
ATTACHMENT XI
RECEIPTS AND EXPENDITURE REPORT
OLDER AMERICAN ACT
CONTRACTOR NAME,ADDRESS,PHONE#AND FEID# Program Funding Source: THIS REPORT PERIOD
FROM: TO:
CONTRACT
Title II E PERIOD:
CONTRACT#
REPORT#
PSA#
CERTIFICATION : !certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the
contract.
Prepared by: Date: Approved by: Date:
PART A:BUDGETED INCOME/RECEIPTS I.Approved 2.Actual Receipts 3.Total Receipts 4.Percent of
Budget For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00
2.State Funds $0.00 $0.00 $0.00
3.Program Income $0.00 $0.00 $0.00
4.Local Cash Match $0.00 5000 $000 %s
5.SUBTOTAL: CASH RECEIPTS $0.00 50.00 50.00
6.Local In-Kind Match $0.00 $0.00 $0,00 %
7.TOTAL RECEIPTS $0.00 $0.00 $0.00
PART B:EXPENDITURES 1.Approved 2.Expenditures 3.Expenditures 4.Percent of
Budget For This Report Year to Date Approved Budget
A:Direct Services
1.Personnel $0.00 $0.00 $0.00
2.Travel $0.00 $0.00 $0.00
3.Building Space $0.00 $0.00 $0.00 %
4.Communication/Utilities $0.00 $000 $0.00
5.Printing/Supplies $0.00 50.00 $0.00 %s
6.Equipment $0.00 $0.00 $0.00
7.Other $0.00 $0.00 $0.00
B:Agreement Services
8.Services Subcontracted $0.00 $0 00 $000 %
9.TOTAL EXPENDITURES $0.00 $0.00 $0.00
10.DEDUCTIONS
a.Total Local Match $0.00 $0.00 $0.00 %b.Program
Income Used $0.00 50.30 $0.00 %e.TOTAL DEDUCTIONS
$0.00 $0.00 $0.00
It NET EXPENDITURES $0.00 $0.00 $0.00
PART C:EXPENDITURES ANALYSIS
2.Units of Services Year to Date 3 Number of People Served Year to Date
A.Expenditures by Services Year to Date
I.Information... .. 50.0
.... 0 �0 QQ 4.44
2.Assistance 5010 50.00 ....___..,,. 0,00
3 Counseling.._.. . __ ..... S0.00 50.00 4.44
4.Respite 50.00 50.00 IN
5.Supplemental Services 50.00 £244 •__.....__...__.._LW
6.TOTAL. $0.00
Part B Line I I,column 3 should be equal to this total.
PART D:GRANDPARENT SERVICES(reported by Federal Fiscal Year)
FFY S FFY $ FFY S
Match$ Match S Match S
DOEA FORM 105AE revised 12/08
42
January 2013 1 tract#OAA 203.13
6Da
ATTACHMENT A
Department of Elder Affairs Programs& Services Handbook, provided on CD.
Also, available at the Agency's Intranet site under,"Publications".
43
16D5ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS
CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name: County: AAA/Contractor
Collier County Government Collier
Address: Completed By:
3299 Tamiami Trail East,Suite 303 Lisa N.Carr,Grants Coordinator
City,State,Zip Code: Date: Telephone:
Naples,FL 34112 January 2,2013 (239)252-2339
PART I:READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE THIS
FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided: Collier County is situated
over a 2,300 square mile area. CCSSS provides in-home care case management and nutritional services to frail, elderly residents
of Collier County.
Total# % % % % % % %
.wing: White Black Hispanic Other Female Disabled Over 40
Source of data:2011 Censu!329,89 90.20% 6.90% 25.90% 1.70% 50.60%
Effective date: 1/1/13 11 36% 18% 36% 91%
Effective date: 1/1/13 467 100%
Effective date: 1/1/13 5 100% 40%
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE.
6. Is an Assurance of Compliance on file with DOEA? If N/A or NO,explain. N/A YES NO
❑ ® ❑
7. Compare the staff composition to the population. Is staff representative of the population?
If N/A or NO,explain. N/A YES NO
❑ ® ❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race,color,
national origin,sex,age,religion or disability? If N/A or NO,explain. N/A YES NO
❑ ® ❑
9. Are all benefits,services and facilities available to applicants and participants in an equally effective
manner regardless of race, sex,color, age,national origin,religion or disability? If N/A or NO,explain. N/A YES NO
❑ ® ❑
10. For in-patient services,are room assignments made without regard to race,color,national origin
or disability? If N/A or NO,explain. N/A YES NO
❑ ❑
1 I. Is the program/facility accessible to non-English speaking clients? If N/A or NO,explain. N/A YES NO
❑ ® ❑
12. Are employees, applicants and participants informed of their protection against discrimination? If YES,
how? Verbal❑ Written® Poster® If N/A or NO,explain. N/A YES NO
❑ ® ❑
44
16135
13. Give the number and current status of any discrimination complaints regarding services or employment filed
against the program/facility. N/A NUMBER
14. Is the program/facility physically accessible to mobility, hearing, and sight-impaired individuals? If N/A or
NO,explain. N/A YES NO
❑ ® ❑
PART HI:THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES.
15. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make
any necessary modifications? If NO,explain. YES NO
❑ ❑
16. Is there an established grievance procedure that incorporates due process in the resolution of complaints? If
NO,explain. YES NO
❑ ❑
17. Has a person been designated to coordinate Section 504 compliance activities? If NO,explain. YES NO
❑ ❑
18. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination
on the basis of disability? If NO,explain. YES NO
❑ ❑
19. Are auxiliary aids available to assure accessibility of services to hearing and sight-impaired individuals? If
NO, explain. YES NO
❑ ❑
PART IV:FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF$50,000.00 OR MORE.
20. Do you have a written affirmative action plan? If NO,explain. YES NO
❑ ❑
DOEA USE ONLY
Reviewed By In Compliance: YES ❑ NO* ❑
Program Office *Notice of Corrective Action Sent
/ /
Date Telephone Response Due /_/_
On-Site ❑ Desk Review ❑ Response Received / /
Revised August 2010,Page 2 of 2
45
16D5 5
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves a
specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population statistics
can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing
Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific
Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA recipients and their sub-grantees,45 CFR 80.4(a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff'?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons,45 CFR 80.3 (b)(6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment,45 CFR 80.3 (a)and
45 CFR 80.1 (b)(2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin,
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting
rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b).
11. For in-patient services, residents must be assigned to rooms, wards,etc., without regard to race,color, national origin
or disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a
different race,color, national origin,or disability,45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist in
the provision of services, 45 CFR 80.3 (a).
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested parties. This should include information on their right to file a
46
complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. De as m�fit d1'H1 . The
p
information may be supplied verbally or in writing to every individual, or may be supplied through the use of an
equal opportunity policy poster displayed in a public area of the facility,45 CFR 80.6(d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement,
termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address
of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled,
no reasonable cause found,failure to conciliate, failure to cooperate, under review, etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated
parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone,
restroom facilities,water fountains, information and admissions offices should be accessible. Door widths and traffic
areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed
for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls
for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility
impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not
comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have
been followed.),45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Section 504.45 CFR 84.7(b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7(a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads,
and other appropriate written communication, 45 CFR 84.8(a).
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters
for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide
equally effective services,45 CFR 84.52 (d).
21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246,41 CFR 60 and
Title VI of the Civil Rights Act of 1964,as amended.
DOEA Form 101-B,Revised August 2010
47
1605
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16 Unct#Oj2O3.l:January 2013
ATTACHMENT E
Department of Elder Affair's Computer Use Policy and its Social Media Policy,provided on CD
49
January 2013 Contract003.13
DEPARTMENT OF
BACKGROUND SCREENING
ELDER
AFFAIRS Affidavit of Compliance - Employer
STATE OF FLORIDA
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
➢ The term "employer" means any person or entity required by law to conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long-Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §§
435.02,430.0402, Fla.Stat.
> A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has access to the client's living area,funds, personal property, or personal identification information
as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities;and volunteers." §430.0402(1)(b),Fla.Stat.
ATTESTATION:
As the duly authorized representative of Collier County Housing,Human and Veteran Services
Employer Name
located at 3339 Tamiami Trail East, Suite 211 Naples FL 34112 ,
Street Address City State ZIP code
I, Kimberley Grant,Interim Director do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402 . lorida al., -s r; ding level 2 background screening.
Ng, January 22, 2013
Signature of Representative Date
STATE OF FLORIDA,COUNTY OF Collier
Sworn to (or affirmed) and subscribed before me this l day of JQfl , 20 L3, by
Kimberley Grant (Name of Re resentative)who is personally known
tO r g91.,Praii
SC oORIA as proof of identification.
0`°P;1•f,; Comm#DD0891636
Print r :� .Cormrri4 �ieaName o Notglry Public Notary Public
'`' coQ Florida Notary Assn.,Inc
: r���h!!!il:\\� YMll.11
DOEA Form 235,Affidavit of Compliance-Employer,Effective April 2012 Section 435.05(3),F.S.
Form available at:http://elderaffairs.state.fl.us/english/backgroundscreenine.php
50
1605 1
January 2013 Contract#OAA 203.13
ATTACHMENT H
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is
an attachment, hereby certifies that:
(1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a
proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized Companies with Activities in
Sudan List"or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List(collectively, "the Lists")
Southwest Florida, Inc. dba Senior Choices of Southwest Florida 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 (Agency) 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 enter," into. Submission of this certification is a prerequisite for making or entering into this
transaction.
r January 22, 2013
Signature: V.'gia A. Hiller, Esq. Date
(Same as c• tract signature)
Chairwoman
Title
Collier County Board of County Commissioners
Company Name
t,14`1 �!'•�
ci ,1'-'Ij7' ;-gark
adtk "44
alte# „Sr�at" i,t a n tI;)it` f+ .
Attest as
51
16D5
January 2013 Contract#OAA 203.13
As a condition of contracting with the Area Agency Aging for Southwest Florida, Inc. dba Senior Choices of Southwest
Florida,hereby referred to as agency, Collier County Board of County Commissioners, hereby referred to as the
contractor, certifies the use of the U.S. Agency 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(b)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 h' =4 by the subcontractor during the contract term.
January 22, 2013
Signature G-. gia • . Hiller,Esq. Date
(Same as contract signature)
Chairwoman
Title
Collier County Board of County Commissioners
1as o form is legal S6c teltCY
r . 3AOCK, Clerk
�A.� t; nt �o��nt d
osr
® y . ttorney
52
1605 9
VERIFICATION OF EMERGENCY PREPAREDNESS PLAN
Contract # HA 113
1, Antoinette Ruggieri certify that Area Agency on Acing for Southwest Florida,Inc.dba
(Name of authorized contractor representative) (Name of contractor) Senior Choices of Southwest Florida
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made available to the Area Agency on Aging for Southwest Florida, Inc. dba
Senior Choices of Southwest Florida, upon request.
Signature of authorized contractor representative
Board Vice President
Title
December 19,2012
Date
Area Agency on Aging for Southwest Florida Inc. dba Senior Choices of Southwest Florida
Company
DOEA Contract Managers Review
October 2008
1605 5 I
Attestation Statement
Agreement/Contract Number OAA 203.13
Amendment Number n/a
1, Georgia A.Hiller.Esq-Chairwoman ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida dba as Senior Choices of Southwest Florida and
Collier County Board of County Commissioners
(Signature of Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media which has no affect on the agreement/contract content.c
U January 22,2013
Signature Recipient/Contractor representative Date
1
cliptit
j�� � . �f cif '$ "...r4nr,, ,.____(_, ,
3y; ,.... :„_' - 4.4 . . ,_ ___ , --B-).. ,,..,-
... , 4 a
160 5 1 :
OFFICE OF THE COUNTY ATTORNEY
INTEROFFICE MEMORANDUM
TO: Board Minutes and Records
FROM: Lisa N. Carr, Grant Coordinator, HHVS
DATE: January 11, 2013
RE: January 22, 2013 Agenda Item 16. D.5. and 16.D. 3.
Please find attached three (2) separated documents that are fully executed and were approved by
the BCC on Dec for recording in Minutes and Records. Feel free to contact me if you have any
questions.
Thank you for your assistance.
gyp`' 1fl` "
January 2013
Contract#0AA .13
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.dba
Senior Choices of Southwest Florida
STANDARD CONTRACT
OLDER AMERICANS ACT PROGRAM TITLE HI
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida,Inc.,dba Senior Choices of
Southwest Florida(Agency)and Collier County Board of County Commissioners(Contractor)and collectively referred to as
the"Parties." The term contractor for this purpose may designate a vendor, subgrantee or subrecipient,the status to be further
identified in ATTACHMENT'III,Exhibit-2 as necessary.
WITNESSETH THAT:
WHEREAS,the Agency has determined that it is in need of certain services as described herein;and
WHEREAS,the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services
as an independent contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made,together with the mutual
covenants and conditions hereinafter set forth,the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits,which constitute the contract document.
1.1 Agency Mission,Vision and Values Statement
The agency's mission: To help aging adults achieve greater independence through awareness of resources and access
to qualified service providers.The agency's vision: To be the recognized leader in supporting older adults and their
families with access to trustworthy resources and services in their communities while empowering them to live with
independence and dignity. The agency's values: We believe residents of Southwest Florida are entitled to:
Comprehensive information about their choices of care;Timely access to resources and services;High standards of
quality and performance; and Personal and professional accountability from all stakeholders.
2. Incorporation of Documents within the Contract
The contract will incorporate attachments,proposal(s),area plan(s), grant agreements,relevant Agency and or
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 January 1,2013 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
31,2013.
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$706,053.00,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.
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.
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6.1.2 If this contract contains federal funds and is over$100,000.00,the Contractor shall comply with all applicable
standards,orders, or regulations issued under s. 306 of the Clean Air Act as amended(42 U.S.C. 7401, et seq.), s. 508
of the Federal Water Pollution Control Act as amended(33 U.S.C. 1251, et seq.), Executive Order 11738,as
amended,and where applicable Environmental Protection Agency regulations 40 CFR 30. The Contractor shall
report any violations of the above to the Agency.
6.1.3 The Contractor,or agent acting for the Contractor,may not use any federal funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any state legislature. If this
contract contains federal funding in excess of$100,000.00,the Contractor must,prior to contract execution,complete
the Certification Regarding Lobbying form,ATTACHMENT 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 or regulatory authority other than Executive Order 12549. The
Contractor shall comply with these provisions before doing business or entering into subcontracts receiving federal
funds pursuant to this contract. The Contractor shall complete and sign ATTACHMENT V prior to the execution
of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of unauthorized
aliens a violation of the Immigration and Nationality Act(8 U.S.C. 1324a)and the Immigration Reform and Control
Act of 1986(8 U.S.C. 1 101). 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.Agency of Homeland Security's E-verify system to verify the employment of all
new employees hired by Contractor during the contract term. Contractor shall include in related subcontracts a
requirement that subcontractors performing work or providing services pursuant to the state contract utilize the E-
verify system to verify employment of all new employees hired by the subcontractor during the contract term.
Contractors meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this
provision.
7. Compliance with State Law
7.1 This contract is executed and entered into in the State of Florida,and shall be construed,performed and enforced in
all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 The Contractor shall comply with requirements of s. 287.058,F.S. as amended.
7.2.1 The Contractor shall provide units of deliverables, including various client services,and in some instances may
include reports, findings,and drafts,as specified in this contract,which the Contract Manager must receive and accept
in writing prior to payment in accordance with s.215.971, F.S. (1)and(2).
7.2.2 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre-audit and post-audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract,the Contractor shall submit bills for any travel
expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract.
7.2.4 The Contractor shall allow public access to all documents, papers, letters,or other public records as defined in
subsection 119.011(12),F.S.,made or received by the Contractor in conjunction with this contract except for those
records which are made confidential or exempt by law. The Contractor's refusal to comply with this provision will
constitute an immediate breach of contract for which the Agency may unilaterally terminate the contract.
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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 H,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 and the Agency for Health Care Administration
regarding implementation of s.430.0402 and ch.435,F.S.
8.1 Further information concerning the procedures for background screening are found at
http://elderaffairs.state/fl.us/doea/backgroundscreening.php.
8.2 For purposes of this section,the term"direct service provider"means a person 18 years of age or older who,pursuant
to a program to provide services to the elderly,has direct,face-to-face contact with a client while providing services
to the client or has access to the client's living areas or to the client's funds or personal property. This term includes
coordinators,managers, and supervisors of residential facilities and volunteers.
9. Grievance Procedures
The Contractor shall develop, implement, and ensure that its subcontractors have established grievance procedures to
process and resolve client dissatisfaction with or denial of service(s), and address complaints regarding the
termination, suspension or reduction of services,as required for receipt of funds. These procedures,at a minimum,
will provide for notice of the grievance procedure and an opportunity for review of the subcontractor's
determination(s).
10. 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,fmancial 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 Agency 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.
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11. Nondiscrimination-Civil Rights Compliance
11.1 The Contractor shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in the
provision of services or benefits under this contract or in employment because of age,race,religion,color, disability,
national origin,marital status or sex in compliance with state and federal law and regulations. The Contractor further
assures that all contractors, subcontractors, subgrantees,or others with whom it arranges to provide services or
benefits in connection with any of its programs and activities are not discriminating against clients or employees
because of age,race,religion, color,disability,national origin,marital status or sex.
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 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.
13. Provision of Services
The Contractor shall provide services in the manner described in ATTACHMENT I.
14. 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.
14.1 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.
15. Insurance and Bonding
15.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this contract
and any renewal(s)and extension(s)of it. By execution of this contract,unless it is a state agency or subdivision as
defined by subsection 768.28(2), F.S.,the Contractor accepts full responsibility for identifying and determining the
type(s)and extent of liability insurance necessary to provide reasonable financial protections for the Contractor and
the clients to be served under this contract. The limits of coverage under each policy maintained by the Contractor do
not limit the Contractor's liability and obligations under this contract. The Contractor shall ensure that the Agency
has the most current written verification of insurance coverage throughout the term of this contract. Such coverage
may be provided by a self-insurance program established and operating under the laws of the State of Florida. The
Agency reserves the right to require additional insurance as specified in this contract.
15.2 Throughout the term of this agreement,the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers,directors, employees and agents of the Contractor authorized to
handle funds received or disbursed under all agreements and/or contracts incorporating this contract by reference in an
amount commensurate with the funds handled,the degree of risk as determined by the insurance company and
consistent with good business practices.
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16. 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.
17. 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).
18. Incident Reporting
18.1 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.
18.2 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.
19. New Contract(s)Reporting
The Contractor shall notify the Agency within ten(10)days of entering into a new contract with any of the remaining
four(4)state human service agencies. The notification shall include the following information: (1)contracting state
agency; (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.
20. 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 Area Agency on Aging for Southwest Florida, Inc.: (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., United States Bankruptcy Court Middle District of Florida, Fort Myers, FL); and (4) the name, address, and
telephone number of the bankruptcy attorney.
21. Sponsorship and Publicity
21.1 As required by s. 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a program
financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in publicizing,
advertising, or describing the sponsorship of the program, state: "Sponsored by Senior Choices of Southwest Florida
and the State of Florida, Department of Elder Affairs." If the sponsorship reference is in written material, the words
"Senior Choices of Southwest Florida and State of Florida, Department of Elder Affairs" shall appear in at least the
same size letters or type as the name of the organization.
21.2 The Contractor shall not use the words"Senior Choices of Southwest Florida and/or the State of Florida, Department
of Elder Affairs"to indicate sponsorship of a program otherwise financed,unless specific authorization has been
obtained by the Agency prior to use.
22. Assignments
22.1 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.
22.2 Senior Choices of Southwest Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or
obligations under this contract to another agency in the State of Florida, upon giving prior written notice to the
Contractor. In the event the Agency approves transfer of the Contractor's obligations, the Contractor remains
responsible for all work performed and all expenses incurred in connection with the contract.
22.3 This contract shall remain binding upon the successors in interest of either the Contractor or the Agency.
23. Subcontracts
23.1 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.
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23.2 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.
24. 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.
25. Payment
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 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.
26. 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.
27. Data Integrity and Safeguarding Information
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or
using in the performance of this contract. An appropriate level of security includes approving and tracking all
Contractor employees that request system or information access and ensuring that user access has been removed from
all terminated employees. The Contractor, among other requirements, must anticipate and prepare for the loss of
information processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses
or outages of the computer system. The security over the backed-up data is to be as stringent as the protection
required of the primary systems. The Contractor shall ensure all subcontractors maintain written procedures for
computer system backup and recovery. The Contractor shall complete and sign ATTACHMENT IV prior to the
execution of this contract.
28. Computer Use and Social Media Policy
The Agency of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy,
which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel
affiliated with third parties, such as, but not limited to,Area Agencies on Aging and vendors. Any entity that uses the
Agency's computer resource systems must comply with the Agency's policy regarding social media. Social Media
includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks
like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This policy is
available on the Department's website.(ATTACHMENT E).
29. 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 fmancial 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,
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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.
30. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real
property to a public entity;may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant
under a contract with any public entity; and may not transact business with any public entity in excess of the threshold
amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being
placed on the convicted vendor list.
31. Purchasing
31.1 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.
31.2 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.
31.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a nonprofit
agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S., in the same
manner and under the same procedures set forth in s. 413.036(1) and (2), F.S. For purposes of this contract, the
Contractor shall be deemed to be substituted for the Agency insofar as dealings with such qualified nonprofit agency
are concerned. Additional information about the designated nonprofit agency and the products it offers is available at
http://www.respectofflorida.org. This clause is not applicable to subcontractors unless otherwise required by law.
32. Patents,Copyrights,Royalties
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed,
produced or for which ownership was purchased in the course of or as a result of work or services performed under
this contract, the Contractor shall refer the discovery, invention or material to the Agency to be referred to the
Department of Elder Affairs. 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.
32.1 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.
32.2 If this contract is awarded solely federal funding,the terms and conditions are governed by 2 CFR 215.36.
33. Emergency Preparedness and Continuity of Operations
33.1 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.
33.2 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.
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34. Equipment
34.1 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].
34.2 Contractors and sub-contractors who are Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 215 Administrative
Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the elements identified in the
circular; and, (b) a procedure for conducting a physical inventory of equipment at least once every two years. The
property records must be maintained on file and shall be provided to the Agency upon request.
343 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.
34.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with state
funds with an acquisition cost over$1,000.00 that is specifically identified in the area plan approved by the Agency is
part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will vest in the
Contractor, subject to the conditions of 2 CFR Part 215 Administrative Requirements (formerly OMB Circular A-
110), Subpart C, paragraph 34. Equipment purchased under these thresholds is considered supplies and is not subject
to property standards. Equipment purchased with funds identified in the budget attachments to agreements covered by
this contract, or identified in the sub-agreements with sub-contractors(not included in a cost methodology), is subject
to the conditions of section 273,F. S. and 60A-1.0017, F.A. C. or Title 45 CFR Part 74.
34.5 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.).
34.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120 days
of the written request for disposition, the Contractor is authorized to proceed as directed in 2 CFR Part 215
Administrative Requirements(formerly OMB Circular A-110).
34.7 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
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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.
34.8 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.
34.9 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.
35. 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.
36. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by
law.
37. 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.
38. Financial Consequences of Non-Performance
If the Contractor fails to meet the minimum level of service or performance identified in this agreement, or that is
customary for the industry, then the Agency must apply financial consequences commensurate with the deficiency.
Financial consequences may include, but are not limited to, contract suspension, refusing payment, withholding
payments until deficiency is cured, tendering only partial payments, and/or cancellation of contract and reacquiring
services from an alternate source.
38.1 The Contractor will not be charged with fmancial consequences,when a failure to perform arises out of causes that
were the responsibility of the Agency.
39. 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.
40. Venue
If any dispute arises out of this contract,the venue of such legal recourse will be Lee County,Florida.
41. 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.
42. Force Majeure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
43. 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.
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44. Condition Precedent to Contract: Appropriations
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature.
45. Addition/Deletion
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this contract
when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both Parties.
The Parties shall negotiate compensation for any additional services added.
46. 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.
47. Compliance
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.
48. Final Invoice
The Contractor shall submit the final invoice for payment to the Agency as specified in section 3.3.7. (date for final
request for payment) of ATTACHMENT I. If the Contractor fails to submit fmal 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.
49. Renegotiations or 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.
50. Termination
50.1 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.
50.2 In the event funds for payment pursuant to this contract become unavailable,the Agency may terminate this contract
upon no less than twenty-four (24) hours notice in writing to the Contractor. Said notice shall be delivered by U.S.
Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the
Contract Manager or the representative of the Contractor responsible for administration of the contract. The Agency
will be the final authority as to the availability and adequacy of funds. In the event of termination of this contract,the
Contractor will be compensated for any work satisfactorily completed prior to the date of termination.
50.3 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.
50.4 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.
51. Electronic Records and Signature
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A contractor that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with the
requirements contained in the Uniform Electronic Transaction Act, s. 668.50, F.S. All electronic records must be
fully auditable; are subject to Florida's Public Records Law, ch. 119, F.S.; must comply with section 28, Data
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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.
51.1 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.
51.2 Upon request by the Agency, the Contractor shall provide the Agency with non-electronic (paper) copies of
records. Non-electronic(paper)copies provided to the Agency of any document that was originally in electronic form
with an electronic signature must indicate the person and the person's capacity who electronically signed the
document on any non-electronic copy of the document.
52. Official Payee and Representatives(Names,Addresses,and Telephone Numbers):
The contractor name,as shown on page 1 of Collier County Housing,Human and Veteran Services
3339 E Tamiami Trail,Building H
a. this contract,and mailing address of the official Naples,FL 34112
payee to whom the payment shall be made is:
Kimberly Grant,Director
The name of the contact person and street Collier County Housing,Human and Veteran Services
b. address where financial and administrative 3339 E Tamiami Trail,Building H
records are maintained is: Naples,FL 34112
The name,address,and telephone number of Kimberly Grant,Interim Director
the representative of the contractor responsible Collier County Housing,Human and Veteran Services
3339 E Tamiami Trail,Building H
c. for administration of the program under this Naples,FL 34112
contract is: (239)252-2273
Area Agency on Aging for Southwest Florida,Inc.dba
The section and location within the agency Senior Choices of Southwest Florida
d. where Requests for Payment and Receipt and 15201 N Cleveland Avenue, Suite 1100
Expenditure forms are to be mailed is: North Fort Myers,FL 33903
Leigh Wade,Executive Director
The name,address,and telephone number of Area Agency on Aging for Southwest Florida,Inc. dba
e. the Executive Director for the agency for this Senior Choices of Southwest Florida
contract is: 15201 N. Cleveland Avenue, Suite. 1100
North Fort Myers,FL 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.
All Terms and Conditions Included
This contract and its ATTACHMENTS: I—XI,A,B,D,E,G,H and J and any exhibits referenced in said
53. 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.
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January 2013 Contract#OAA 20 .13
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 52 page contract,to be executed by their undersigned officials
as duly authorized.
AREA AGENCY ON AGING FOR SOUTHWEST
COLLIER CO ► Y BOARD OF COUNTY FLORIDA, INC.DBA SENIOR CHOICES OF
Contractor: CO -I i 1 SIO RS
SOUTHWEST FLORIDA
SIGNED BY: I_J SIGNED BY: 444-- ��`& ,s1.411-•
NAME: Georgia A.Hiller,Esq. NAME: RONALD LUCCHINO,PhD
TITLE: Chairwoman TITLE: BOARD PRESIDENT
DATE: January 22,2013
DATE: 5 /3
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 9/30
. 0
AWTLST: = Nipe0Vad as to form & legal Sufficiency
DW IGHf BR K.Mark
-C
Ass stant County Attorney
&Meta MM. 01
s si!.
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January 2013
CdTT1 t
INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT ATTACHMENT DESCRIPTION PAGE
ATTACHMENT I STATEMENT OF WORK 14
ATTACHMENT II CERTIFICATION REGARDING LOBBYING 27
ATTACHMENT III FINANCIAL COMPLIANCE AUDIT 28-30
Exhibit 1 County Award Allocations 31
Exhibit 2 Part I: Audit Relationship Determination and Part II: Fiscal Compliance 32
Requirements.
ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE 33
ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, 34
INELIGIBILITY AND VOLUNTARY EXCLUSION
ATTACHMENT VI ASSURANCES—NON-CONSTRUCTION PROGRAMS 35-36
ATTACHMENT VII BUDGET and RATE SUMMARY 37-38
ATTACHMENT VIII INVOICE SCHEDULE 39
ATTACHMENT IX REQUEST FOR PAYMENT,DOEA FORM 106A 40
ATTACHMENT X RECEIPTS/EXPENDITURES,TITLE IIIB, IIIC1 &IIIC2,DOEA FORM 105as 41
ATTACHMENT XI RECEIPTS AND EXPENDITURES,TITLE ME,DOEA FORM 105AE 42
ATTACHMENT A DEPARTMENT OF ELDER AFFAIRS' PROGRAMS & SERVICES 43
HANDBOOK(ON CD)
ATTACHMENT B DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE 44-47
CHECKLIST AND INSTRUCTIONS
ATTACHMENT D PROVIDER'S STATE CONTRACTS LIST 48
ATTACHMENT E DEPARTMENT OF ELDER AFFAIRS' COMPUTER USE AND SOCIAL 49
MEDIA POLICY
ATTACHMENT G BACKGROUND SCREENING AFFIDAVIT OF COMPLIANCE 50
ATTACHMENT H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS 51
ATTACHMENT J VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION 52
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ATTACHMENT I
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.dba
Senior Choices of Southwest Florida
STATEMENT OF WORK
OLDER AMERICANS ACT PROGRAM TITLE III
SECTION I: SERVICES TO BE PROVIDED
1.1 DEFINITIONS OF TERMS AND ACRONYMS
1.1.1 CONTRACT ACRONYMS
Area Agency on Aging(AAA)
Activities of Daily Living(ADL)
Alliance of Information&Referral Systems(AIRS)
Assessed Priority Consumer List(APCL)
Adult Protective Services(APS)
Client Information and Registration Tracking System(CIRTS)
Information and Referral(I&R)
Instrumental Activities of Daily Living(IADL)
Older Americans Act(OAA)
Planning and Service Area(PSA)
1.1.2 PROGRAM SPECIFIC TERMS
Area Plan: A plan developed by the AAA outlining a comprehensive and coordinated service delivery system
in its PSA in accordance with the Section 306(42 U.S.C.3026)of the OAA and Department instructions.
Request for Proposal:A proposed plan developed by the Contractor outlining a comprehensive and coordinated
service delivery system approved by the Agency's Board of Directors.
Child: An individual who is not more than 18 years of age or an individual with disability.
Family Caregiver: An adult family member,or another individual,who is an informal provider of in-home
and community care to an older individual.
Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance,
including verbal reminding,physical cueing or supervision; or due to cognitive or other mental impairment,
requires substantial supervision because the individual behaves in a manner that poses a serious health or safety
hazard to the individual or to another individual.
Grandparent: A grandparent or step-grandparent of a child, or a relative of a child by blood,marriage or
adoption and who lives with the child; is the primary caregiver of the child because the biological or adoptive
parents are unable or unwilling to serve as the primary caregiver of the child;and has a legal relationship to the
child, such as legal custody or guardianship,or is raising the child informally.
1.2 Agency Mission,Vision and Values Statement
The agency's mission: To help aging adults achieve greater independence through awareness of resources and
access to qualified service providers. The agency's vision: To be the recognized leader in supporting older
adults and their families with access to trustworthy resources and services in their communities while
empowering them to live with independence and dignity. The agency's values: We believe residents of
Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to
resources and services; High standards of quality and performance; and Personal and professional
accountability from all stakeholders.
1.2.1 Older Americans Act Program Mission Statement
The Older Americans Act (OAA) Program is a federal program initiative that provides assistance to older
persons and caregivers and is the only federal supportive services program directed solely toward improving
the lives of older people. The program provides a framework for a partnership among the different levels of
government and the public and private sectors with a common objective, improving the quality of life for all
older individuals by helping them to remain independent and productive.
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lnfictclAA
1.3 GENERAL DESCRIPTION
1.3.1 General Statement
The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is
the only federal supportive services program directed solely toward improving the lives of older people. The
program provides a framework for a partnership among the different levels of government and the public and
private sectors with a common objective, improving the quality of life for all older individuals by helping them
to remain independent and productive. The primary purpose of the OAA program is to foster the development
and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program
uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a
home environment and allows for the capability of self-care with appropriate supportive services.
1.3.2 Authority
The relevant references authority governing the OAA program are:
1. Older Americans Act of 2006, as amended;
2. Rule 58A-1,Florida Administrative Code; and
3. Section 430.101,Florida Statutes.
13.2.1 Incorporation of Reference Memoranda
In accordance with Ch.287 F.S., as amended,and Agency of Financial Services' Chief Financial Officer
Memoranda,the following memoranda are provided for informational purposes and 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.
13.3 Scope of Service
The Contractor is responsible for the programmatic, fiscal, and operational management of the Title IIIB, Title
IIIC1, Title IIIC2 and Title THE programs of the OAA within its designated PSA. The scope of service
includes planning, coordinating and assessing the needs of older persons, and assuring the availability and
quality of services. The services shall be provided in a manner consistent with and described in the current
Contractor's Request for Proposal, and the Agency's Area Plan Update, and the current Department of Elder
Affairs Programs and Services Handbook(ATTACHMENT A).
1.3.4 Major Program Goals
The major goals of the OAA program are to improve the quality of life for older individuals, p reserve their
independence and prevent or delay more costly institutional care. These goals are achieved through the
implementation of a comprehensive and coordinated service system that provides a continuum of service
alternatives that meet the diverse needs of elders and their caregivers.
1.4 INDIVIDUALS TO BE SERVED
1.4.1 Eligibility(Title III Programs)
1.4.1.1 OAA Title III,General
Consumers shall not be dually enrolled in an OAA program and a Medicaid capitated long-term care program.
1.4.1.2 OAA Title IIIB,Supportive Services
Eligibility for OAA Title IIIB, Supportive Services,are as follows:
1. Individuals must be age 60 or older;and
2. Information and Referral/Assistance services are provided to individuals regardless of age.
1.4.13 OAA Titles IIIC1 and C2,Nutrition Services,General
General factors that should be considered in establishing priority for Nutrition Services,both Cl and C2,
include those older persons who meet the following:
1. Cannot afford to eat adequately;
2. Lack the skills or knowledge to select and prepare nourishing and well-balanced meals;
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Have limited mobility which may impair their capacity to shop and cook for themselves; or
Have a disabling illness or physical condition requiring nutritional support or have been screened at a high
nutritional risk.
1.4.13.1 OAA Title HIC1,Congregate Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I,
Paragraph 1.4.13, individuals must be mobile,not homebound and physically,mentally and medically able to
attend a congregate nutrition program. Individuals eligible to receive congregate meals include the following:
1. Individuals age 60 or older;and
2. Any spouse(regardless of age)who attends the dining center with his/her eligible spouse;
3. Persons with a disability, regardless of age, who reside in a housing facility occupied primarily by older
individuals where congregate nutrition services are provided;
4. Disabled persons who reside at home with and accompany an eligible person to the dining center; and
5. Volunteers,regardless of age,who provide essential services on a regular basis during meal hours.
1.4.13.2 OAA Title IIIC2,Home Delivered Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I,
Paragraph 1.4.1.3, individuals must be homebound and physically,mentally or medically unable to attend a
congregate nutrition program. Individuals eligible to receive home delivered meals include the following:
1. Individuals age 60 or older who are homebound by reason of illness,disability or isolation;
2. The spouse of a homebound eligible individual, regardless of age, if the provision of the collateral meal
supports maintaining the person at home;
3. Individuals with disabilities, regardless of age, who reside at home with eligible individuals and are
dependent on them for care;and
4. Persons at nutritional risk who have physical, emotional or behavioral conditions, which would make their
presence at the congregate site inappropriate; and persons at nutritional risk who are socially or otherwise
isolated and unable to attend a congregate nutrition site.
1.4.1.4 OAA Title HIE,Caregiver Support Services
Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows:
1. Family caregivers of individuals age 60 or older;
2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers;
3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and
related disorders with neurological and organic brain dysfunction and for grandparents or older individuals
who are relative caregivers who provide care for children with severe disabilities; and
4. For respite and supplemental services, a family caregiver must be providing care for an older individual
who meets the definition of the term"frail"in OAA, Section 102 Paragraph 22.
1.4.2 Targeted Groups
Preference shall be given to those with the greatest economic and social need,with particular attention to low-
income older individuals, including those that are low-income minorities,have limited English proficiency, and
older individuals residing in rural areas.
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SECTION II—MANNER OF SERVICE PROVISION
2.1 SERVICE TASKS
In order to achieve the goals of the OAA program,the Contractor shall ensure the following tasks are
performed:
1. Client eligibility determination;
2. Targeting and screening of service delivery for new clients;
3. Delivery of services to eligible clients;
4. Use of volunteers to expand the provision of available services;
5. Monitoring the performance of its subcontractors.
6. Grievance and Compliance Procedures
2.1.1 Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in ATTACHMENT I,Paragraph 1.4.
2.1.2 Targeting and Screening of Service Delivery for New Clients
The Contractor shall develop and implement policies and procedures consistent with OAA targeting and
screening criteria.
2.1.3 Delivery of Services to Eligible Clients
The Contractor shall ensure the provision of a continuum of services that meets the diverse needs of elders and
their caregivers. The Contractor shall ensure the performance and report performance of the following services in
accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded
pursuant to this contract are in accordance with the OAA,Title III,sections 321,331,336,and 373 as follows:
1. Section 321,Title IIIB Supportive Services;
2. Section 331,Title IIIC1 Congregate Nutrition Services;
3. Section 336,Title IIIC2 Home Delivered Nutrition Services;
4. Section 373,Title DIE Caregiver Support Services.
2.1.3.1 Supportive Services
Supportive services include a variety of community-based and home-delivered services that support the quality
of life for older individuals by helping them remain independent and productive. Services include the
following:
(1) Adult Day Care/Adult Day Health Care; (17) Homemaker;
(2) Caregiver Training/Support; (18) Housing Improvement;
(3) Case Aide/Case Management; (19) Information;
(4) Chore Services; (20) Intake;
(5) Companionship; (21) Interpreter/Translating;
(6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance;
(7) Education/Training; (23) Personal Care;
(8) Legal Assistance; (24) Physical Therapy;
(9) Material Aid; (25) Shopping Assistance;
(10) Occupational Therapy; (26) Skilled Nursing;
(11) Outreach; (27) Specialized Medical Equipment, Services,
and Supplies
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(12) Recreation; (28) Respite Services;
(13) Emergency Alert Response; (29) Screening/Assessment;
(14) Escort; (30) Speech Therapy;
(15) Health Support; (31) Telephone Reassurance; and
(16) Home Health Aide; (32) Transportation
2.1.3.2 Congregate Nutrition Services
Nutrition services are provided in congregate settings and are designed to reduce hunger and food insecurity,
promote socialization and the health and well being of older individuals by assisting them to gain access to
nutrition and other disease prevention and health promotion services. Services include the following:
1. Congregate meals;
2. Congregate meals screening;
3. Nutrition education and nutrition counseling; and
4. Outreach.
2.13.3 Home Delivered Nutrition Services
In-home nutrition services are provided to reduce hunger and food insecurity;promote socialization and the
health and well being of older individuals by assisting such individuals to gain access to nutrition and other
disease prevention and health promotion services. Services include the following:
1. Home delivered meals;
2. Nutrition education and counseling; and
3. Outreach.
2.1.3.4 Caregiver Support Services(Title HIE Program)
The following services are intended to provide direct help to caregivers,assist in the areas of health,nutrition and
financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles
and responsibilities:
1. Adult Day Care/Adult Day Health Care;
2. Caregiver Training/Support;
3. Counseling(Gerontological and Mental Health);
4. Education/Training;
5. Financial Risk Reduction(Assessment and Maintenance);
6. Information;
7. Intake;
8. Outreach;
9. Respite Services;
10. Screening/Assessment; and
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January 2013 Contract#OAA 203.13
11. Transportation.
2.1.3.5 Caregiver Support Supplemental Services (Title IDES Program): The following services are provided to
complement the care provided by caregivers:
1. Chore Services;
2. Housing Improvement;
3. Legal Assistance;
4. Material Aid; and
5. Specialized Medical Equipment, Services and Supplies.
2.1.3.6 Caregiver Support Grandparent Services (Title MEG Program): Services for grandparents or older
individuals who are relative caregivers designed to help meet their caregiving obligations include the following:
1. Caregiver Training/Support; 6. Legal Assistance;
2. Child Day Care; 7. Outreach;
3. Counseling(Gerontological and Mental Health); 8. Screening/Assessment;
4. Education/Training; 9. Sitter; and
5. Information; 10. Transportation
2.1.4 Use of Volunteers to Expand the Provision of Available Services
2.1.4.1 The Contractor shall ensure the use of trained volunteers in providing direct services delivered to older
individuals and individuals with disabilities needing such services. If possible, the Contractor shall work in
coordination with organizations that have experience in providing training, placement, and stipends for
volunteers or participants (such as organizations carrying out federal service programs administered by the
Corporation for National and Community Service), in community service settings.
2.1.4.2 The Contractor shall submit a quarterly report of volunteer activities and services electronically on the internet
in a format provided by the Agency. The quarterly report schedule is as follows:
Report Period Report Due Date
January 1 -March 31 April 15, 2013
April 1-June 30 July 15,2013
July 1-September 30 October 15,2013
October 1 -December 31 January 15,2014
2.1.5 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 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.
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2.1.5.1 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 contracts. 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.
2.1.6 Subcontractor Outreach Reporting Requirements
The Contractor shall document its oversight of subcontractor performance of outreach activities, by establishing a
uniform reporting format that includes the following: number and type of provider events or activities; date and
location; total number of participants at each event or activity; individual service needs identified; and referral
sources or information provided. The Contractor shall require subcontractors to use this format for reporting on
outreach activities at least semi-annually.
2.1.7 Grievance and Complaint Procedures
2.1.7.1 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
2.1.7.2 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
advice related to complaints other than termination, suspension or reduction in services that 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 procedure and include tracking the
date,nature of complaint and the determination of each complaint.
2.2 SERVICE LOCATION
2.2.1 Service Times
The Contractor shall ensure the provision of the services listed in the contract during normal business hours unless
other times are more appropriate to meet the performance requirements of the contract,and it shall monitor its
subcontractors to ensure they are available to provide services during hours responsive to client needs and during
those times which best meet the needs of the relevant service community.
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2.3 DELIVERABLES
2.3.1 Programmatic Operations/Administration
The Contractor shall ensure the provision of services outlined in Section 2.3.2 in accordance with Department of
Elder Affairs Programs and Services Handbook through its review of reports outlined in Section 2.4 of this
agreement at least as follows: A.)monthly review of contractors' surplus/deficit reports, and CIRTS data accuracy
reports; B.) semi-annual review of service cost reports; and C.) at least annually and as needed to correlate with
applicable contract amendments for OAA service units, recording of manual units of service portions of the OAA
Annual Report.
2.3.2 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 services tasks described in Section 2.1. The
chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the
rate established in the 2010 RFP and approved by the Agency.
Seim ices Unit of Service
Adult Day Care/Adult Day Health Care Interpreter/Translating
Caregiver Training/Support Legal Assistance
Case Aid/Case Management Medication Management
Child Day Care Mental Health Counseling/Screening
Chore Services Nutrition Counseling
Companionship Occupational Therapy
Congregate Meals Screening Personal Care
Counseling Services Physical Therapy Hour
Escort Recreation
Financial Risk Reduction Services Respite Services
Health Support Screening/Assessment
Home Health Aide Sitter
Homemaker Skilled Nursing Services
Housing Improvement Speech Therapy
Intake
Emergency Alert Response Day
Education/Training Episode
Information
Material Aid
Nutrition Education
Outreach
Referral/Assistance
Specialized Medical Equipment, Services and Supplies
Telephone Reassurance
Escort One-Way Trip
Shopping Assistance
Transportation
Congregate and Home Delivered Meals Meal
REPORTS
2.4 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 permit the Contractor to meet the Agency's
reporting requirements.
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January 2013 on ract D#OAA fe3.13
2.4.1 Client Information and Registration Tracking System (CIRTS)Reports
The Contractor shall input OAA 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) Outcome Measurement Reports.
2.4.2 Service Costs Reports
The Contractor shall require subcontractors to submit to the Contractor semi-annual service cost reports
(August 15, 2013 and February 15, 2014), which reflect actual costs of providing each service by program. This
report provides information for planning and negotiating unit rates.
2.4.3 Variance(Surplus/Deficit)Report
The Contractor will submit a consolidated variance 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 shall include the following:
1. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
Agency will be resolved;
2. Recommendations to transfer funds to resolve surplus/deficit spending;
3. Number of clients currently on APCL that receive a priority ranking score of 4 or 5; and
4. Number of clients currently on the APCL designated as Imminent Risk.
2.4.4 OAA Annual Report
The completed manual units of service portions of the OAA Annual Report,if applicable, are due to the Contract
Manager on the date established by the Agency. The Agency will obtain the remaining report sections from the
CIRTS.
2.4.5 Background Screening Affidavit of Compliance
To demonstrate compliance with section 8 of the Standard Contract,the Contractor shall submit ATTACHMENT
G,Background Screening Affidavit of Compliance annually,by January 15th.
2.5 RECORDS AND DOCUMENTATION
Each Contractor and subcontractor, among other requirements,must anticipate and prepare for the loss of
information processing capabilities.The routine backing up of all data and software is required to recover from
losses or outages of the computer system.Data and software essential to the continued operation of contractor
functions must be backed up.The security controls over the backup resources shall be as stringent as the protection
required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure,
offsite location.
The Contractor shall maintain written policies and procedures for computer system backup and recovery and shall
have the same requirement in its contracts and/or agreements with subcontractors. These policies and procedures
shall be made available to the Agency upon request.
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,ATTACHMENT A.
2. The Contractor shall timely submit to the Agency all reports described in ATTACHMENT I, Paragraph 2.4
REPORTS.
3. The Contractor shall timely submit to the Agency all information described in ATTACHMENT I,
Paragraph 2.5 RECORDS AND DOCUMENTATION.
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2.6.2 The Contractor shall develop and document strategies in the Area Plan to support performance achievement of the
following:
1. Percent of most frail elders who remain at home or in the community instead of going into a nursing home;
2. Percent of APS referrals who are in need of immediate services to prevent further harm who are served within
72 hours;
3. Average monthly savings per consumer for home and community-based care versus nursing home care for
comparable client groups;
4. Percent of elders assessed with high or moderate risk environments who improved their environment score;
5. Percent of new service recipients with high-risk nutrition scores whose nutritional status improved;
6. Percent of new service recipients whose ADL assessment score has been maintained or improved;
7. Percent of new service recipients whose IADL assessment score has been maintained or improved;
8. Percent of family and family-assisted caregivers who self-report they are very likely to provide care;
9. Percent of caregivers whose ability to continue to provide care is maintained or improved after one year of
service intervention(as determined by the caregiver and the assessor); and
10. Percent of customers who are at imminent risk of nursing home placement who are served with community
based services.
The Contractor's performance of these measures will be reviewed and documented in the Agency's annual
monitoring reports.
2.7 CONTRACTOR'S FINANCIAL OBLIGATIONS
2.7.1 Matching,Level of Effort,and Earmarking Requirements
The Contractor shall provide match of at least 10 percent of the federal funds received. The Contractor's match
will be made in the form of cash and/or in-kind resources. The Contractor will assure, through a provision in
subcontracts, a match requirement of at least 10 percent of the cost for all services funded through this contract.
The subcontractor's match will be made in the form of cash and/or in-kind resources. The Contractor shall report
match by title each month. At the end of the contract period,the Contractor must properly match all OAA funds.
2.7.2 Consumer Contributions
Consumer contributions are to be used under the following terms:
1. The Contractor assures compliance with Section 315 of the OAA as amended in 2006, in regard to consumer
contributions;
2. Voluntary contributions are not to be used for cost sharing or matching;
3. Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; and
4. Voluntary contributions are to be used only to expand services.
2.73 Use of Service Dollars
The Contractor is expected to spend all federal, state and other funds provided by the Agency for the purpose
specified in the contract. The Contractor must manage the service dollars in such a manner so as to avoid having a
wait list and a surplus of funds at the end of the contract period,for each program managed by the Contractor. If
the Agency determines that the Contractor is not spending service funds accordingly,the Agency may transfer
funds to other Contractors during the contract period and/or adjust subsequent funding allocations accordingly, as
allowable under state and federal law.
2.7.4 The Contractor agrees to distribute funds as detailed in the Budget Summary, ATTACHMENT VII to this
contract. Any changes in the amounts of federal funds identified on the Budget Summary form require a contract
amendment.
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January 2013
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2.7.5 Title III Funds
The Contractor assures compliance with Section 306 of the OAA,as amended in 2006,that funds received under
Title III will not be used to pay any part of a cost incurred by the Contractor to maintain a contractual or
commercial relationship that is not carried out to implement Title III.
2.8 AGENCY RESPONSIBILITIES
2.8.1 Program Guidance and Technical Assistance
The Agency will provide to the Contractor guidance and technical assistance as needed to ensure the successful
fulfillment of the contract by the Contractor.
2.8.2 Program/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;
4. Review of independent auditor's reports;
5. Review of third-party documents and/or evaluation;
6. Review of progress reports;
7. Review of customer satisfaction surveys;
8. Agreed-upon procedures review by an external auditor or consultant;
9. Limited-scope reviews; and
10. Other procedures as deemed necessary.
2.8.3 Contract Monitoring
The Agency shall,at its own discretion,conduct monitoring concerning any aspect of the contractor's performance
of this contract.
SECTION III: METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The method of payment for this contract includes advances and fixed rate for services. The Contractor shall ensure
fixed rates for services include only those costs that are in accordance with all applicable state and federal statutes
and regulations and are based on audited historical costs in instances where an independent audit is required. The
Contractor shall consolidate all requests for payment from subcontractors and expenditure reports that support
requests for payment and shall submit to the Agency on forms 106A(ATTACHMENT IX), 105AA
(ATTACHMENT X,EXHIBIT 1), 105AS(ATTACHMENT X,EXHIBIT 2),and 105AE(ATTACHMENT
X,EXHIBIT 3).
3.1.1 The Contractor agrees to distribute funds as detailed in ATTACHMENT VII, Budget Summary. Any changes
in the total amounts of the funds identified on the Budget Summary form require a contract amendment.
3.2 Advance Payments
The Contractor may request up to two months of advances at the start of the contract period, if available, to cover
program administrative and service costs. The payment of an advance will be contingent upon the sufficiency and
amount of funds released to the Agency by the State of Florida ("budget release"). The Contractor shall provide
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January 2013 Contract#OAA 203.13
the Contract Manager documentation justifying the need for an advance and describing how the funds will be
distributed.
3.2.1 The Contractor's requests for advance require the approval of the Contract Manager. If sufficient budget is
available,the Agency will issue approved advance payments after January 1,2013.
3.2.2 All advance payments made to the Contractor shall be returned to the Agency as follows: one — twelfth of the
advance payment received shall be reported as an advance recoupment on each request for payment, starting with
report number three, in accordance with the Invoice Schedule,ATTACHMENT VIII to this contract.
3.2.3 Interest earned on advances must be identified separately by source of funds, state or federal. Contractors shall
maintain advances of federal funds in FDIC interest bearing accounts unless otherwise exception is made in
accordance with 45 CFR 74.22(k). Earned interest must be returned to the Agency at the end of each quarter.
3.3 Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA
forms 106A(ATTACHMENT IX), 105AS(ATTACHMENT X),and 105AE(ATTACHMENT XI. The
Contractor shall include with its request for payment documentation of services provided,the units of service
provided,and the rates for the services provided in conformance with the requirements as described in the
deliverables and service tasks beginning with the first month of the contract. The schedule for submission of
advance requests(when available)and invoices is ATTACHMENT VIII to this contract.
3.3.1 Remedies for Nonconforming Services
The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,
completely and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
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 not
meeting such standards will not be reimbursed under this contract. The Contractor's signature on the request for
payment form certifies maintenance of supporting documentation 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.
3.3.2 Financial Consequences
Contractor shall ensure the provision of services to the projected number of clients in accordance with the 2010
RFP and within the contract amount. The Contractor shall ensure expenditure of 100% of the contract amount
budgeted for services to clients at the unit rates established in the RFP.
3.33 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the
first month of the contract.The schedule for submission of advance requests(when available)and invoices is
ATTACHMENT VIII to this contract.
Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
3.3.4
approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments
thereto, including any disallowance not resolved as outlined in Section 25 of this contract.
3.3.5 Final requests for budget revisions has to be submitted no later than December 1,2013
3.3.6 The Agency will authorize payment only for allowable expenditures, which are in accordance with the limits
specified in ATTACHMENT VII,Budget Summary. Any changes in the amounts of federal or general revenue
funds identified on the Budget Summary form require a contract amendment.
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January 2013 $'onc1OAA 513
3.3.7 Date for Final Request for Payment
The Contractor shall submit the final request for payment to the Agency no later than February 1,2014.
3.4 Documentation for Payment
The Contractor shall maintain documentation to support payment requests, and the Contractor shall make such
documentation available to the Agency or authorized individuals upon request.
3.4.1 The Contractor shall ensure all required data per the Department of Elder Affair's CIRTS Policy Guidelines for
clients and services is entered into the CIRTS database. The data must be entered into 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.
3.4.2 The Contractor must run monthly CIRTS reports and verify client and service data in CIRTS is accurate. This
report must be submitted to the Agency with the monthly request for payment and expenditure report and must be
reviewed by the Agency before the Contractor's request for payment and expenditure reports can be approved.
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ATTACHMENT H
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 sub-contractors 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 0,000.00 and not more than$100,000.00 for each such failure.
January 22,2013
Signature Date
Georgia A.Hiller,Esq.—Chairwoman OAA 203.13
Name of Authorized Individual Application or Agreement Number
Collier County Board of County Commissioners:3299 Tamiami Trail East,Suite 303,Naples,FL 34112
Name and Address of Organization
ATTEST: t
DOEA Form 103 DWIGHT BRO ! rk , Approved as to form & legal Sufllcis
(Revised Nov 2002) �`�
' 1
By: _ !� _ —� �
gam f
r s As taut County Attorney
Attest
��t4 �Lba�e'lN4M t�
twgnetire ti
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January 2013 160 Contract# A 201.13
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by Senior Choices of Southwest Florida to the Contractor may be subject to
audits and/or monitoring by the Agency,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 Senior Choices of Southwest Florida. In the event the Agency determines that a limited scope audit of the Contractor
is appropriate, the Contractor agrees to comply with any additional instructions provided by the Agency to the
Contractor regarding such audit. The Contractor further agrees to comply and cooperate with any inspections, reviews,
investigations, or audits deemed necessary by the Chief Financial Officer(CFO)or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in
OMB Circular A-133,as revised.
In the event that the Contractor expends $500,000.00 or more in federal awards during its fiscal year, the Contractor
must have a single or program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as
revised.EXHIBIT 1 to this agreement indicates federal resources awarded through the Department of Elder Affairs by this
agreement. In determining the federal awards expended in its fiscal year, the Contractor shall consider all sources
of federal awards, including federal resources received from the Department of Elder Affairs. 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 Department of Elder Affairs 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 Department of Elder Affairs shall be fully disclosed in the audit report with reference to the
Department of Elder Affairs 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 Department of Elder Affairs in effect during the audit period. Financial reporting
packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9
months after the end of the Contractor's fiscal year end.
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PART II: STATE FUNDED
This part is applicable if the Contractor is a nonstate entity as defined by Section 215.97(2), Florida
Statutes.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of$500,000.00
in any fiscal year of such Contractor(for fiscal years ending September 30, 2004 or thereafter), the Contractor must have a
State single or project-specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable
rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit
and for- profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial
assistance awarded through the Department of Elder Affairs by this agreement. In determining the state financial
assistance expended in its fiscal year, the Contractor shall consider all sources of state financial assistance, including
state financial assistance received from the Department of Elder Affairs, 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 Department of Elder Affairs 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
Department of Elder Affairs shall be fully disclosed in the audit report with reference to the Department of Elder Affairs
agreement involved. If not otherwise disclosed as required by Rule 691-5.003, Fla. Admin. Code, the schedule of
expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the
Department of Elder Affairs 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 Department of Elder Affairs 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 directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida 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 Ave.,Suite 1100
North Fort Myers,FL 33903
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January 2013 Contract#OAA 203.13
The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections
.320 (d)(1) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at the
following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville,IN 47132
Other federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as
revised.
Pursuant to Sections .320(f), OMB Circular A-133, as revised, the Contractor shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the Area
Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida 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 Ave.,Suite 1100
North Fort Myers,FL 33903
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on
behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida 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 Ave.,Suite 1100
North Fort Myers,FL 33903
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 Senior Choices of Southwest Florida
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 Senior Choices of Southwest Florida 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.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of
six years from the date the audit report is issued, and shall allow Senior Choices of Southwest Florida 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 Senior Choices of Southwest Florida, 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 Senior Choices of Southwest
Florida.
30
160 51
January 2013 Contract#OAA 203.13
ATTACHMENT III
EXHIBIT 1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
COLLIER COUNTY
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Older Americans Act Title II1B— $ 11,500.00
CA/CM/SCAS/INSC $ 65,000.00
Transportation U.S.Health and Human Services 93.044 $ 76,500.00
Support Services $ 296,567.00*
Total IIIB
OAA Title IIIC1 —Congregate Meals $ 272,751.00
Meals $ 6,692.00
Screening U.S. Health and Human Services 93.045 $ 1,975.00
Nutrition Education $ 432.00
Outreach $ 281,850.00
Total IIIC1
OAA Title III C2—Home Delivered Meals $ 229,521.80
Meals $ 19,125.00
Screening U.S.Health and Human Services 93.045 $ 2,430.00
Nutrition Education $ 43.20
Outreach $ 251,120.00
Total IIIC2
Older Americans Act Title III E
CA/CM/Intake(Title III E) $ 4,500.00
Services(Title III E) $ 61,868.00
Supplement Services(Title III ES)
U.S.Health and Human Services 93.052 $ 20,280.00
Grandparent Services(Title III EG) $ 9,935.00
Total HIE $ 96,583.00
TOTAL FEDERAL AWARD $ 706,053.00
*In Home Services$296,567.00
In Home Services are funds to serve Collier County Clients. The Vendors are paid directly by the Area Agency on
Aging for Southwest Florida,Inc.dba Senior Choices of Southwest Florida
31
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January 2013 Contract#OAA 203.13
ATTACHMENT III
EXHIBIT 2
PART I: AUDIT RELATIONSHIP DETERMINATION
Contractors 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. Contractors 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. Contractors 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, Contractors 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,Contractor 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 Contractor is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by
the Department 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 II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors 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. Contractors 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
32
160 5 4
January 2013 Contract#OAA 203.13
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 sub-contractors 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, sub-contractor(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 sub-contractor(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 sub-contractors 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 C" Part 215 (formerly OMB Circular A-110).
Collier •oun' B'. d of Co ty Commissioners: 3299 Tamiami Trail East, Suite 303,Naples,FL 34112
Name . d • ■dr ss -f C• tractor
Chairwoman 22,2013
Signa = Title
<r
Georgia A.Hiller,Esq. ATTEST
Name of Authorized Signer (Revised June 2008) DWIGHT*. BROCK,CIer k
By: t I V A'• C
Malt q t0 i i Jam,,
stiesure 4.01; Approved as to form & legal Sufficiency
33
As3istant County Attorney
160
5 ,1
January 2013 Contract#OAA 203.13
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1)The prospective 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) Whe t e I ospecti - contractor is unable to certify to any of the statements in this certification, such prospective
pa ici .n h.11 a,r ch an explanation to this certification.
January 22,2013
Signature Date
Chairwoman Collier County Board of County Commissioners
Title Agency/Organization
Certification signature should be same as Contract signature.)
Instructions for Certification
1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person,"
"primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the sections of
rules implementing Executive Order 12549. (2 CFR 180.5-180.1020, as supplemented by 2 CFR 376.10-
376.995). You may contact the Contract Manager for assistance in obtaining a copy of those regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this
transaction. If it is later determined that the contractor knowingly rendered an erroneous certification, in addition
to other remedies available to the federal government, the Department 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 Department 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)
;' Approved as to form & legal Suffidi+ y
ATTES'Y` . ',`;,,
DWI= T Li i Veit
By
li - -R ,� ` d ���, , 34 Assns t County Attorney \�
TAR 0** sow'
160 5
January 2013 Contract#OAA 203.13
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. ❑04728-4763)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. ❑❑1681-1683, and 1685-1686), which prohibits discrimination on the basis
of sex; (c) Section 504 of the Rehabilitation Act of 1973,as amended(29 U.S.C. 0794),which prohibits discrimination on the basis of
handicaps; (d)the Age Discrimination Act of 1975, as amended(42 U.S.C. 6101-6107), which prohibits discrimination on the basis
of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis
of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L.
91-616), as amended,relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient
records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to nondiscrimination in the
sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for
federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the
application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of federal participation in purchases.
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328), which limit the political
activities of employees whose principal employment activities are funded in whole or in part with federal funds.
9. Will comply,as applicable,with the provisions of the Davis-Bacon Act(40 U.S.C.276a-7),the Copeland Act(40 U.S.C.
35
160 5 1
January 2013 Contract#0AA 203.13
276c and 18 U.S.C. ❑0874)and the Contract Work Hours and Safety Standards Act(40 U.S.C. 327-333),regarding labor standards
for federally assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a)of the Flood Disaster Protection Act
of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase
flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental
quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514;
(b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. ❑❑1451 et seq.); (f) conformity of
federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42
U.S.C. D 0740 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974,
as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended,
(P.L.93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. ❑❑1721 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C. 0470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic
Preservation Act of 1974(16 U.S.C. ❑0469a-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. ❑02131 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 .' ORIZED CERTIFY I• OFFICIAL TITLE
Chairwoman
APPLICANT ORGANIZATION DATE SUBMITTED
Collier County Board of County Commissioners January 22, 2013
ATZES— s �d
DWIGHT E. BROCK,Y$lerk Approved as to form & legal Suf loi.RCy
By ` 41 . 36
Attest agrfler
A;;su ant County Attorney
Stillitirt SSW \13
160 51
January 2013 Contract#OAA 203.13
ATTACHMENT VII
Budget Summary
OLDER AMERICANS ACT BUDGET SUMMARY
CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
1. Title III B Support Services $ 76,500.00*
2. Title III Cl Congregate Meals $ 281,850.00
3. Title III C2 Home Delivered Meals $ 251,120.00
4. Title III E Services $ 96,583.00
TOTAL $ 706,053.00
*In Home Services$296,567.00
In Home Services are funds to serve Collier County Clients. The Vendors are paid directly by the Area Agency on
Aging for Southwest Florida,Inc.dba Senior Choices of Southwest Florida
37
160 5 1
January 2013 Contract#0AA 203.13
ATTACHMENT VII
Rate Summary
OLDER AMERICANS ACT
RATE SUMMARY
CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
IIIB & IIIE
Services Total Cost Reimbursement Rate
HIB
Case Aide $27.78 $25.00
Case Management $50.00 $45.00
*Intake-EHEAP Only $27.78 $25.00
Screening/Assessment $50.00 $45.00
Transportation 100%Cost 90%of Cost
*Intake Units only used for EHEAP
Services Total Cost Reimbursement Rate
IIIE
Respite-Day Care $11.12 $10.00
Direct Pay Respite Must include match Up to$21.00
Direct Pay Facility Respite Must include match 24 hours--$125.00
Day Care Sitter $13.34 $12.00
IIIEG-Child Day Care $16.67 $15.00
Screening/Assessment $50.00 $45.00
Specialized Medical Equipment, 100%Cost 90%of Cost
Service& Supplies
C-1 & C-2
COLLIER COUNTY
Services Total Cost Reimbursement Rate
Cl
Congregate Meals $ 9.84 $ 8.86
Nutrition Counseling $58.89 $53.00
Nutrition Education $ 1.80 $ 1.62
Nutrition Screening $31.11 $28.00
Outreach $4.80 per person $4.32 per person
C2
Home Delivered Meals $ 9.77 $ 8.79
Nutrition Counseling $58.89 $53.00
Nutrition Education $ 1.80 $ 1.62
Nutrition Screening $50.00 $45.00
Outreach $4.80 per person $4.32 per person
38
16OIJanuary 2013 Contract#OAA 03.
ATTACHMENT VIII
INVOICE SCHEDULE
ADVANCE BASIS CONTRACT
Report Number Based On On This Date
1 January Advance* January 1
2 February Advance* January 1
3 January Expenditure Report February 9 *See Note#4*
4 February Expenditure Report March 9
5 March Expenditure Report April 9
6 April Expenditure Report May 9
7 May Expenditure Report June 9
8 June Expenditure Report July 9
9 July Expenditure Report August 9
10 August Expenditure Report September 9
11 September Expenditure Report October 9
12 October Expenditure Report November 9
13 Report Advance Refund/Recoupment November 9
14 November Expenditure Report December 9
15 December Expenditure Report January 9
16 Final Expenditure and Request for Payment February 1
17 Closeout Report February 15
Legend: * Advance based on projected cash need.
Note# 1: Report#1 for Advance Basis Agreements cannot be submitted to the Agency prior to January 1 or
until the agreement with the Agency has been executed.
Note#2: Report numbers 3 through 14 shall reflect an adjustment of one-twelfth of the total advance amount,
on each of the reports,repaying advances issued the first two months of the agreement. The
adjustment shall be recorded in Part C, 1 of the report(ATTACHMENT IX).
Note#3: Submission of expenditure reports may or may not generate a payment request. If final expenditure
report reflects funds due back to the Agency,payment is to accompany the report.
Note#4: ALL Expenditure Reports are due by 12:00 p.m. on the 9th of each month. IF the 9th falls on a
Saturday,then the report will be due by the 8th by 12:00 p.m. AND IF the 9th falls on a Sunday,the
report will be due by the 10th by 12:00 p.m. Actual submission of the vouchers to Dept. of Elder
Affairs is dependent on the accuracy of the expenditure report which is verified and paid by CIRTS
data only.
39
160 5
January 2013 Contract#OAA 203.13
ATTACK ENT IX
REQUEST FOR PAYMENT
OLDER AMERICANS ACT
CONTRACTOR NAME.ADDRESS PHONE AND FED ID NTTMRFR JYPF.OF RFPORT THIS RF.QTIFST PERIOD.
Advance Report#. - -. .
Reimbursement Agreement#:
Agreement Period:._ _....
PSA: __ -_
CERTIFICATION. T hereby certify to the hest of my knowledge that this request conforms with the terms and the proposes set forth in tie slime agreement
Prepared By: Date: Approved By: Date:
PART A. (1) (7) ■ (1) , (4) (7) (6)
BUDGET SUMMARY III B IRCI IIIC2 Title IIIE TOTAL
1.Approved
Agreement Amount. 0.00 0.00 0.00 0.00- . _ 0.00 r 0.00
2.Previous Funds
RECEIVED for
Agreement period. 0.00. 0.00 0.00 0.00 ._- 0.00 r 0.00
3.Agreement Balance _ 0.00 0.00 0.00 0.00 0.00 0.00
4.Previous Funds
REQUESTED and
Not Received. 0.00 0,00 0.00 0.00 0.00 r 0.00
5.Agreement Balance 0.00 0.00 - 0.00 0.00 .00 0.00
PART R•
FUNDS REQUESTED
1.Ist-2nd Months
Request Only 0.00 . 0.00 0.00 0.00 0.00 r 0.00
2,Net Expenditures
For Month 0.00 0.00 0.00 0.00 0.00 r 0.00
3.Additional
Cash Needs(Attach Doc.) 0.00 0.00 0.00 0.00 0.00 r 0.00
4.Total 0.00 0.00 0.00 0.00 0.00 0.00
PART C:
NET FUNDS REQUESTED:
1.Less:Over-Advance 0.00 0.00 0.00 0.00 0.00 • 0.00
2.Agreement Funds are
Hereby.Requested For 0.00 0.00 0.00 0.00 0.00 0.00
DOEA FORM 106A revised 5/10
40
1613 5 1
January 2013 Contract#0AA 203.13
RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT ATTACHMENT X
RECEIPTS AND EXPENDITURE REPORT OLDER
AMERICAN ACT
CONTRACTOR NAME,ADDRESS, PHONE#AND FEID# Program Funding Source: THIS REPORT PERIOD
FROM: TO:
rIIB MCI
CONTRACT
IIIC2 PERIOD:
CONTRACT#
REPORT#
PRA#
CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the
contract.
Prepared by: Date: Approwd by: Date:
PART A:BUDGETED INCOME/RECEIPTS 1.Approved 2.Actual Receipts 3.Total Receipts 4.Percent of
Budget For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00
2.State Funds $0.00 $0.00 $0.00 %
3.Program Income $0.00 $0.00 $0.00
4.Local Cash Match(CCE,HCE and Other) $0.00 $0.00 , $0.00
5.SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 %
6.Local In-Kind Match $0.00 $0.00 $0.00
7.TOTAL RECEIPTS $0.00 $0.00 $0.00 %
PART B:EXPENDITURES 1.Approved 2.Expenditures 3.Expenditures 4.Percent of
Budget For This Report Year to Date Approved Budget
1.Meals/Meal Agreements $0.00 $0.00 $0.00 %
2.Service Subcontractor $0.00 $0.00 $0.00
3.Other $0.00 $0.00 $0.00 %
4.Indirect Cost $0.00 $0.00 $0.00 %
5.TOTAL EXPENDITURES $0.00 $0.00 $0.00 %
PART C:OTHER EXPENDITURES(For
Tracking Purposes only)
1.Match
a.Other and In-Kind $0.00 $0.00 $0.00 %
b.Local Match $0.00 $0.00 $0.00 %
2.USDA Cash Received $0.00 $0.00 $0.00 %
3.TOTAL OTHER $0.00 $0.00 $0.00 %
PART D:OTHER REVENUE AND EXPENDITURES 2.Addition Cost Alternative Program Income 3.Interest
1. Program Income(PI) a.Approwd Budget$ a.Earned on GR Advances$
a.OAA Unbudgeted PI Receipts YTD
b.Received YTD $ b.Return of GR Advance $
$
c.Expenditures $ c.Other Earned $
41
160 5 .1
January 2013 Contract#OAA 203.1;
ATTACHMENT XI
RECEIPTS AND EXPENDITURE REPORT
OLDER AMERICAN ACT
CONTRACTOR NAME,ADDRESS,PHONE#AND FEID# Program Funding Source: THIS REPORT PERIOD
FROM: TO:
CONTRACT
Title III E PERIOD:
CONTRACT#
REPORT#
PSA#
CERTIFICATION: I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the
contract.
Prepared by: Date: Approved by: Date:
PART A:BUDGETED INCOME/RECEIPTS 1.Approved 2.Actual Receipts 3.Total Receipts 4.Percent of
Budget For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00
2.State Funds $0.00 $0.00 $0.00
3.Program Income $0.00 $0.00 $0.00
4.Local Cash Match $0.00 $0.00 $0.00
5.SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00
6.Local In-Kind Match $0.00 $0.00 $0.00
7.TOTAL RECEIPTS $0.00 $0.00 $0.00
PART B:EXPENDITURES 1.Approved 2.Expenditures 3.Expenditures 4.Percent of
Budget For This Report Year to Date Approved Budget
A:Direct Services
1.Personnel $0.00 $0.00 $0.00
2 Trawl $0.00 $0.00 $0.00
3.Building Space $0.00 $0.00 $0.00 %
4.Communication/Utilities $0.00 $0.00 $0.00 %
5.Printing/Supplies $0.00 $0.00 $0.00 %
6.Equipment $0.00 $0.00 $0.00 /a
7.Other $0.00 $0.00 $0.00
B:Agreement Services
8.Services Subcontracted $0.00 $0.00 $0.00
9.TOTAL EXPENDITURES $0.00 $0.00 $0.00
10.DEDUCTIONS
a.Total Local Match $0.00 $0.00 $0.00 %b.Program
Income Used 10.00 $0.30 $0.00 %c.TOTAL DEDUCTIONS
$0.00 $0.00 $0.00
11.NET EXPENDITURES $0.00 $0.00 $0.00
PART C:EXPENDITURES ANALYSIS
2.Units of Services Year to Date 3.Number of People Served Year to Date
A.Expenditures by Services Year to Date:
I.Information 50.00 $0.00 0_00
2.Assistance $0.00 . . $0.00 . . 000
3.Counseling..................... 50.00 2212 0_00
4.Respite $0.00 $.0 QO ... . . . . . 000
5.Supplemental Services tom $0.00 0 00
6.TOTAL $0.00
Part B Line 11,column 3 should be equal to this total.
PART D:GRANDPARENT SERVICES(reported by Federal Fiscal Year)
FFY $ FFY $ FFY $
Match$ Match$ Match$
DOEA FORM 105AE revised 12/08
42
160 5 `1
January 2013 Contract#OAA 203.13
ATTACHMENT A
Department of Elder Affairs Programs& Services Handbook,provided on CD.
Also, available at the Agency's Intranet site under,"Publications".
43
160 51
ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS
CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name: County: AAA/Contractor
Collier County Government Collier
Address: Completed By:
3299 Tamiami Trail East,Suite 303 Lisa N.Carr,Grants Coordinator
City,State,Zip Code: Date: Telephone:
Naples,FL 34112 January 2,2013 (239)252-2339
PART I:READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE THIS
FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided: Collier County is situated
over a 2,300 square mile area. CCSSS provides in-home care case management and nutritional services to frail, elderly residents
of Collier County.
Total#
swing: White Black Hispanic Other Female Disabled Over 40
Source of data:2011 Censu;329,89 90.20% 6.90% 25.90% 1.70% 50.60%
Effective date: 1/1/13 11 36% 18% 36% 91%
Effective date: 1/1/13 467 100%
Effective date: 1/1/13 5 100% 40%
PART H: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE.
6. Is an Assurance of Compliance on file with DOEA? If N/A or NO,explain. N/A YES NO
❑ ® ❑
7. Compare the staff composition to the population. Is staff representative of the population?
If N/A or NO,explain. N/A YES NO
❑ ® ❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race,color,
national origin, sex,age,religion or disability? If N/A or NO,explain. N/A YES NO
❑ ® ❑
9. Are all benefits,services and facilities available to applicants and participants in an equally effective
manner regardless of race,sex,color,age,national origin,religion or disability? If N/A or NO,explain. N/A YES NO
❑ ® ❑
10. For in-patient services,are room assignments made without regard to race,color,national origin
or disability? If N/A or NO,explain. N/A YES NO
® ❑ ❑
11. Is the program/facility accessible to non-English speaking clients? If N/A or NO,explain. N/A YES NO
❑ ® ❑
12. Are employees, applicants and participants informed of their protection against discrimination? If YES,
how? Verbal❑ Written® Poster® If N/A or NO,explain. N/A YES NO
❑ ® ❑
44
160
5
13. Give the number and current status of any discrimination complaints regarding services or employment filed
against the program/facility. N/A NUMBER
14. Is the program/facility physically accessible to mobility, hearing, and sight-impaired individuals? If N/A or
NO,explain. N/A YES NO
❑ ® ❑
PART III:THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES.
15. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make
any necessary modifications? If NO,explain. YES NO
❑ ❑
16. Is there an established grievance procedure that incorporates due process in the resolution of complaints? If
NO,explain. YES NO
❑ ❑
17. Has a person been designated to coordinate Section 504 compliance activities? If NO,explain. YES NO
❑ ❑
18. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination
on the basis of disability? If NO,explain. YES NO
❑ ❑
19. Are auxiliary aids available to assure accessibility of services to hearing and sight-impaired individuals? If
NO,explain. YES NO
❑ ❑
PART IV:FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF$50,000.00 OR MORE.
20. Do you have a written affirmative action plan? If NO,explain. YES NO
❑ ❑
DOEA USE ONLY
Reviewed By In Compliance: YES ❑ NO* ❑
Program Office *Notice of Corrective Action Sent
/ /
Date Telephone Response Due / /
On-Site ❑ Desk Review ❑ Response Received / /
Revised August 2010,Page 2 of 2
45
160 5 '
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves a
specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population statistics
can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing
Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific
Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA recipients and their sub-grantees,45 CFR 80.4(a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons,45 CFR 80.3 (b)(6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment,45 CFR 80.3 (a)and
45 CFR 80.1 (b)(2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin,
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting
rooms,reception areas,restrooms and other facilities must also be equally available to all clients,45 CFR 80.3 (b).
11. For in-patient services, residents must be assigned to rooms, wards,etc., without regard to race, color, national origin
or disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a
different race,color,national origin,or disability,45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist in
the provision of services,45 CFR 80.3 (a).
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested parties. This should include information on their right to file a
46
160 51
complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The
information may be supplied verbally or in writing to every individual, or may be supplied through the use of an
equal opportunity policy poster displayed in a public area of the facility,45 CFR 80.6(d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement,
termination,etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address
of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled,
no reasonable cause found,failure to conciliate, failure to cooperate,under review,etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated
parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone,
restroom facilities,water fountains, information and admissions offices should be accessible. Door widths and traffic
areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed
for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls
for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility
impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not
comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have
been followed.),45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Section 504.45 CFR 84.7(b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7(a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads,
and other appropriate written communication,45 CFR 84.8(a).
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters
for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide
equally effective services,45 CFR 84.52(d).
21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246,41 CFR 60 and
Title VI of the Civil Rights Act of 1964, as amended.
DOEA Form 101-B,Revised August 2010
47
160 5
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160 5 411
January 2013 Contract#OAA 203.1
ATTACHMENT E
Department of Elder Affair's Computer Use Policy and its Social Media Policy,provided on CD
l
49
1605 '
January 2013 Contract OAA 203.13
DEPARTMENT OF
BACKGROUND SCREENING
ELDER
AFFAIRS Affidavit of Compliance - Employer
STATE OF FLORIDA
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
➢ The term "employer" means any person or entity required by law to conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long-Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §§
435.02,430.0402, Fla.Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has access to the client's living area, funds, personal property, or personal identification information
as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities;and volunteers." §430.0402(1)(b), Fla.Stat.
ATTESTATION:
As the duly authorized representative of Collier County Housing,Human and Veteran Services
Employer Name
located at 3339 Tamiami Trail East, Suite 211 Naples FL 34112 ,
Street Address City State ZIP code
I, Kimberley Grant, Interim Director do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.040 rida Statutes,regarding level 2 background screening.
January 22, 2013
Signature of Representative Date
STATE OF FLORIDA, COUNTY OF Collier
Sworn to (or affirmed) and subscribed before me this /C}
day of Jan UQ , 20 /3, by
Kimberley Grant (Name of Representative)who is personally known
to rrrarprEsil as proof of identification.
"r"'"'% Comm#DD0891636 ! •
3G .::
_
- = '
.,3,.; Expires 13
Print, p Commissions of Notary Public Notary Public
'" i� Florida Notary Assn.,Inc .
w9F989 ...i "
DOEA Form 235,Affidavit of Compliance-Employer,Effective April 2012 Section 435.05(3),F.S.
Form available at:http://elderaffairs.state.fl.us/english/backgroundscreening.php
50
16051
January 2013 Contract#0AA 203.13
ATTACHMENT H
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is
an attachment, hereby certifies that:
(1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a
proposal for a new contract or renewal of an existing contract,that is on the"Scrutinized Companies with Activities in
Sudan List"or the"Scrutinized Companies with Activities in the Iran Petroleum Sector List(collectively, "the Lists")
Southwest Florida, Inc. dba Senior Choices of Southwest Florida 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 (Agency) 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 fmding 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 ent ed into. Submission of this certification is a prerequisite for making or entering into this
transacts ?L
/AU January 22,2013
Signaa: Georgia A. Hiller,Esq. Date
(Same as contract signature)
Chairwoman
Title
Collier County Board of County Commissioners
Company Name
ATTEST Appi-oved as tottrm legal jai Sus cFancy
By: ;2: ::;�' �,', ' {, C \ G
Ar..s nt County Attorney
Ate 11 � # ; 6
51
1605 '
January 2013 Contract#0AA 203.13
ATTACHMENT J
Verification of Employment Status Certification
As a condition of contracting with the Area Agency Aging for Southwest Florida, Inc. dba Senior Choices of Southwest
Florida,hereby referred to as agency, Collier County Board of County Commissioners, hereby referred to as the
contractor,certifies the use of the U.S. Agency 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(b)that any subcontracts include an express requirement that subcontractors performing work or
providing services pursuan to this Agreement utilize the E-verify system to verify the employment eligibility of all new
emrrk es /red by the 'bcontractor during the contract term.
1,
/ January 22,_2013
Suture: Georgia A. Hiller,Esq. Date
(Same as contract signature)
Chairwoman
Title
Collier County Board of County Commissioners
Approved as to form & legal Sufficiency
ATTEST:
DWIGHT E. BROCK,Clerk --813 ,
,�- . : ' <•�� 4116 Assi ant County Attorney
I' WIFe_12 a WwiTc
Attest es tO
ash ; *a
i.J ,
Ijt� ;,
•
• \J
52
ORIGINAL DOCUMENTS CHECKLIST & ROUTING Qff
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TZ6 05
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
Complete routing lines #1 through #2 as appropriffie for additional signatures, dates, and/or information needed. lftbe document is already complete with the
exception of the Chairman's signature. draw a line through muting linen *I tl.rn . Al ,Y,.....at. ti,.. —A f,..,.e_,.......-
Route to Addressee(s) (List in routing order)
Office
Initials
t u mw VLLI%X.
Date
1. Lisa N. Carr
HHVS
LNC
2/4/2013
2. Jennifer B. White, ACA
County Attorney Office
Office located in HHVS
Department
Agenda Item Number
2 `` \k3
3. BCC Office
Board of County
Commissioners
n/a
4. Minutes and Records
Clerk of Court's Office
Number of Original
21 r� f
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above. may need to contact Staff for additional nr miccino in1hrm.dirm
Name of Primary Staff
Lisa N. Carr, Grants Coordinator _
Phone Number
239 - 252 -2339
Contact / ent
appropriate.
Agenda Date Item was
1/22/2013
Agenda Item Number
ic
16.D.5.
Approved b the BCC
Does the document need to be sent to another agency for additional signatures? If yes,
n/a
Type of Document
Verification of Emergency Preparedness
Number of Original
3
Attached
Plan
Documents Attached
PO number or account
N/A
INC
number if document is
by the Office of the County Attorney.
to be recorded
All handwritten strike - through and revisions have been initialed by the County Attorney's
*00EA"
n/a
INSTRUCTIONS & CHECKLIST
d,
I: Fours/ County Forms/ 13CC Fors/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised evised 11/30/12
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
1.
Does the document require the chairman's original signature?
INC
-Applicable)
2.
Does the document need to be sent to another agency for additional signatures? If yes,
n/a
provide the Contact Information (Name; Agency; Address; Phone on an attached sheet.
3.
Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
INC
by the Office of the County Attorney.
4.
All handwritten strike - through and revisions have been initialed by the County Attorney's
n/a
Office and all other parties except the BCC Chairman and the Clerk to the Board
5.
The Chairman's signature line date has been entered as the date of BCC approval of the
INC
document or the final negotiated contract date whichever is applicable.
6.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
INC
signature and initials are required.
7.
In most cases (some contracts are an exception), the original document and this routing slip
INC
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8.
The document was approved by the BCC on 1/2212013 and all changes made during
INC
the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes, if applicable.
9.
Initials of attorney verifying that the attached document is the version approved by the
BCC, all changes directed by the BCC have been made, and the document is ready for the
X Ia
Chairman's signature.
o°
d,
I: Fours/ County Forms/ 13CC Fors/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised evised 11/30/12
1605
MEMORANDUM
Date: February 19, 2013
To: Lisa Carr, Grants Coordinator
Housing, Human & Veteran Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Correcting previously submitted Seniors Choices of
SWFL Contract #OAA 203.13 to clarify the accurate agency
named on the "Verification of Emergency Preparedness Plan"
Attached are two original copies of the document referenced above, (Item #16D5)
approved by the Board of County Commissioners on January 22, 2013.
The third original copy will be held on file in the Minutes and Record's
Department for the Board's Official Record.
If you have any questions please call me at 252 -8406.
Thank you
Attachment (2)
1605
HO USING HUMAN AND VETERIAN SERI VCES
INTEROFFICE MEMORANDUM
TO: Board Minutes and Records
FROM: Lisa N. Carr, Grants Coordinator, HHVS C-W/
DATE: February 4, 2013
RE: January 22, 2013 Agenda Item 16.1).5
The attached document, Verification of Emergency Preparedness Plan, was sent to us from
Senior Choices and was approved by the Board with the Older American Act Contract (agenda
item above). On February 4, 2013, Senior Choices informed us that the Verification of
Emergency Preparedness Plan that was sent with the contract to Collier County was filled out in
error by Senior Choices with another agency name (see attached email from Senior Choices). G�
Jennifer B. White, Assistant County Attorney has opined that further Board approval is not
required to process the Verification of Emergency Preparedness Plan document. 2�
I am requesting the Chairwoman's and Clerk of Courts signature on three (3) originals of the
corrected Verification of Emergency Preparedness Plan.
Feel free to contact me if you have any questions.
Thank you for your assistance.
Cc: Jennifer B. White, Assistant County Attorney
CarrLisa 1605
From: Kathryn Gronberg [kathryn.gronberg @srchoices.org]
Sent: Monday, February 04, 2013 11:33 AM
To: CarrLisa
Cc: Kathryn Gronberg
Subject: OAA Contract
Attachments: VERIFICATION OF EMERGENCY PREPAREDNESS PLAN - LA- Vendors.doc
Follow Up Flag: Follow up
Flag Status: Flagged
Categories: Appointment
Good morning Lisa,
Thank you for getting the contract back to us. We are missing, though, the
Verification of Emergency Preparedness Plan. (The copy that I had sent with
the contract as an attachment was accidentally filled out in error with another agency.)
I didn't realize this error until recently.
I've attached a copy for you to print off and sign. I only need one original.
Please return to our office as soon as possible.
Thank you,
Kathy
Kathy , JXccalSyecialtst rfr
x
152019V-Clevel d- ve Ste 11oo
✓'lrorth,Tbrt✓31yers, FL339o3
ivivW :srCA0,(Ces orA
239- 652 -6goo Ext. 264
Kathryn. Gronbergksrchoices. org
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1
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VERIFICATION
OF EMERGENCY PREPAREDNESS PLAN 1605
Contract # HA 113
I, Antoinette Ruggieri certify that Area Agency on Aging for Southwest Florida. Inc. dba
(Name of authorized contractor representative) (Name of contractor) Senior Choices of Southwest Florida
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made available to the Area Agency on Aging for Southwest Florida, Inc. dba
Senior Choices of Southwest Florida, upon request.
Signature of authorized contractor representative
Board Vice President
Title
December 19. 2012
Date
Area Agency on Aging for Southwest Florida Inc. dba Senior Choices of Southwest Florida
Company
DOEA Contract Managers Review
October 2008
16 D5
VERIFICATION OF EMERGENCY PREPAREDNESS PLAN
Contract #OAA 203.13
I, Chia A- Hiller, certify that Collier County Board of County Commissioners
(Name of authorized contractor representative) (Name of contractor)
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made avoable to the Area Agency on Aging for Southwest Florida, Inc. dba
Senior Choices of Soutywest Florida, upon request.
Signat"e f authorized contractor representative
Chairwoman
Title
1/22/2013
Date
Collier County Board of County Commissioners
Company
Alt
DWiQ T.,E AR K Clerk
JrW
October 2008
Approved as to form & legal sufflclency
As ant County Attorney
1 �Z2�13
(tern # kal
Agenda
Date •
Date