Loading...
Backup Documents 07/24/2012 Item #16D15co ICY county 16015 Public Services Division Housing, Human & Veteran Services Memo To: Clerk's Office Minutes and Records From: Louise Pelletier, CMS Services for Seniors, Collier County Re: Contract Amendments CCE, ADI, HCE, NSIP Date: 8/28/12 Item Number: 16.D.15. Item Summary: Recommendation to approve after - the -fact Community Care for the Elderly, Home Care for the Elderly; and Alzheimer's Disease Initiative 2 year contract with Senior Choices f /k /a Area Agency on Aging for SWFL and approve budget amendments reflecting the difference between estimated and actual funding for FY12 -13 State General Revenue Seniors Programs (First Year Fiscal Net Impact: $3,916). Meeting Date: 7/24/2012 Housing, Human and Veteran Serx,ices of Collier County 3339 Tamiami Trail East, Suite 211 • Naples, FL 34112 -5361 239 - 252 -CARE (2273) • 239 252 -HOME (4663) • 239 -252 -CAFE (2233) • 239 - 252 -RSVP (7787) • 239 - 252 -VETS (8387) • www .colliergov.net/humanservices July 2012 — June 2014 CCE 203.12 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. dba SENIOR CHOICES OF SOUTHWEST FLORIDA 16015 STANDARD CONTRACT COMMUNITY CARE FOR THE ELDERLY PROGRAM THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida ( "Agency ") and Collier County Board of County Commissioners, ( "Recipient "), and collectively referred to as the "Parties." The term Recipient 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 Recipient has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent Recipient 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 STATEMENT Mission: To help aging adults, 60 and older, achieve greater independence through awareness of resources and access to qualified service providers. Vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. Values: The Agency believes the 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; ➢ Personal and professional accountability from all stakeholders. Lead agencies and local service providers as partners and stakeholders in Florida's aging services network are expected to support the agency's mission, vision, and priorities. 2. Incorporation of Documents within the Contract The contract will incorporate attachments, proposal(s), area plan(s), grant agreements, relevant Department handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other general materials not specific to this contract document and identified attachments. 3. Term of Contract This is a two -year contract shall begin on July 1, 2012 or on the date on which the contract has been signed by the last party required to sign it, whichever is later. It shall end at midnight, local time in North Fort Myers, Florida, on June 30, 2014. 4. Contract Amount The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $661,357.00 for year one, 2012 - 2013, 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. July 2012 — June 2014 16015 CCE 203.12 5. Renewals By mutual agreement of the Parties, in accordance with s. 287.058(1)(f), F.S., the Agency may renew the contract every two years within the six year bid term , 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 six year 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 the following shall apply: 6.1.1 The Recipient shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 6.1.2 If this contract contains federal funds and is over $100,000.00, the Recipient 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 Recipient shall report any violations of the above to the Agency. 6.1.3 The Recipient, or agent acting for the Recipient, 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 Recipient 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 Recipient 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 If this contract contains federal funds and provides services to children up to age 18, the Recipient shall comply with the Pro - Children Act of 1994 (20 U. S.C. 6081). 6.1.6 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 Recipient shall comply with these provisions before doing business or entering into subcontracts receiving federal funds pursuant to this contract. The Recipient shall complete and sign ATTACHMENT V prior to the execution of this contract. 6.2 The Recipient 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 Recipient 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 Recipient must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation. 6.4 The Recipient shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 6.5 Unless exempt under 2 CFR Part 170.110(b), the Recipient shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 2 July 2012 - June 2014 6.6 I 0� n �E 203.12 To comply with Presidential Executive Order 12989 and State of Florida Execu e rc r 11 -116, Recipient agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the employment of all new employees hired by Contractor during the contract term. Recipient 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. Recipients 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 Recipient shall comply with requirements of s. 287.058, F.S. as amended. 7.2.1 The Recipient 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 Recipient 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 Recipient 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 Recipient 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 Recipient in conjunction with this contract except for those records which are made confidential or exempt by law. The Recipient's refusal to comply with this provision will constitute an immediate breach of contract for which the Agency may unilaterally terminate the contract. 7.3 If clients are to be transported under this contract, the Recipient 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 Recipient 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 Department for goods or services of $1 million or more. Pursuant to s. 287.135 F.S., the Department may terminate this contract if the Contractor is found to have submitted a false certification of its status on the Lists or has been placed on the Lists. 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 the Certification Regarding Scrutinized Companies Lists, prior to the execution of this contract 8. Background ScreeninScreenin The Recipient 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 exempted from the Department's level 2 background screening pursuant to s. 430.0402(2) -(3), F.S. The Recipient 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. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 3 July 2012 — June 2014 CCE 203.12 9. Grievance and Compliant Procedures 16015 9.1 Grievance Procedures The Recipient shall comply with and ensure subcontractor compliance with the Minimum Guidelines for Recipient Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handbook, to address complaints regarding the termination, suspension or reduction of services, as required for receipt of funds. 9.2 Complaint Procedures The Recipient shall develop and implement complaint procedures and ensure that subcontractors develop and implement complaint procedures to process and resolve client dissatisfaction with services. Complaint procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or any other complaints not related to termination, suspension or reduction in services which require the grievance process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook. The complaint procedures shall include notification to all clients of the complaint procedures and include tracking the date, nature of complaint and the determination of each complaint. 10. Audits, Inspections, Investigations, Public Records and Retention 10.1 The Recipient 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. Recipient 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 Recipient 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 Recipient shall facilitate the duplication and transfer of any records or documents during the required retention period in Paragraph 10.2. 10.4 The Recipient shall assure that the records described in Paragraph 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 Recipient's contracts and related records and documents pertinent to this specific contract, regardless of the form in which kept. 10.6 The Recipient 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 Recipient shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S. 11. Nondiscrimination -Civil Rights Compliance 11.1 The Recipient 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 Recipient 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. 0 July 2012 — June 2014 I 16 0 lc5203.12 11.2 During the term of this contract, the Recipient shall complete and retain on file a timely, complete and accurate Civil Rights Compliance Checklist 11.3 The Recipient 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 Recipient, its successors, transferees, and assignees for the period during which such assistance is provided. The Recipient 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 Recipient 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. Provision of Services The Recipient shall provide services in the manner described in ATTACHMENT I. 13. Monitoring by the AEency The Recipient shall permit persons duly authorized by the Agency to inspect and copy any records, papers, documents, facilities, goods and services of the Recipient which are relevant to this contract, and to interview any clients, employees and subcontractor employees of the Recipient 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 Recipient, and where appropriate, the Recipient shall develop a corrective action plan. The Recipient hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Contract Manager. 14. Coordinated Monitoring with Other Agencies If the Recipient receives funding from one or more of the State of Florida other human service agencies, in addition to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human service agencies shall include the Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead administrative coordinator, the Recipient shall comply and cooperate with all monitors, inspectors, and/or investigators. 15. Indemnification The Recipient 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 Recipient is not required to indemnify the Agency for claims, demands, actions or causes of action arising solely out of the Agency's negligence. 15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contracts executed between the Department and state agencies or subdivisions defined in s. 768.28(2), F.S. 16. Insurance and Bondin 16.1 The Recipient 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 Recipient accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the Recipient and the clients to be served under this contract. The limits of coverage under each policy maintained by the Recipient do not limit the Recipient's liability and obligations under this contract. The Recipient shall ensure that the Agency has the most current written verification of insurance coverage throughout the term of this July 2012 — June 2014 16015E 203.12 contract. Such coverage may be provided by a self - insurance program established and 7perating under the laws of the State of Florida. The Agency reserves the right to require additional insurance as specified in this contract. 16.2 Throughout the term of this agreement, the Recipient shall maintain an insurance bond from a responsible commercial insurance company covering all officers, directors, employees and agents of the Recipient authorized to handle funds received or disbursed under all agreements and /or contracts incorporating this contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by the insurance company and consistent with good business practices. 17. Confidentiality of Information The Recipient shall not use or disclose any information concerning a recipient of services under this contract for any purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized to give that consent or when authorized by law. 18. Health Insurance Portability and Accountability Act Where applicable, the Recipient shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 19. Incident Reporting 19.1 The Recipient shall notify the Agency immediately, but no later than forty-eight (48) hours from, the Recipient's awareness or discovery of conditions that may materially affect the Recipient or subcontractor's ability to perform the services required to be performed under this contract. Such notice shall be made orally to the Contract Manager (by telephone) with an email to immediately follow. 19.2 The Recipient 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 Recipient and its employees. 20. New Contract(s) Reporting The Recipient 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 Recipient shall complete and provide the information to the Agency's Contract Manager. 21. Bankruptcy Notification During the term of this contract, the Recipient shall immediately notify the Agency if the Recipient, its assignees, subcontractors or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Recipient 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. 22. Sponsorship and Publicity 22.1 As required by s. 286.25, F.S., if the Recipient 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 Hope Hospice and Community Services, the State Agency of Elder Affairs, and the Area Agency on Aging for Southwest Florida, Inc." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs and the Area Agency on Aging for Southwest Florida, Inc." shall appear in at least the same size letters or type as the name of the organization. C July 2012 — June 2014 16 D 1 P-)cCE 203.12 22.2 The Recipient shall not use the words "The State of Florida Department of Elder Affairs or the Area Agency on Aging for Southwest Florida, Inc." to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by the State and Agency prior to use. 23. AssiEnments 23.1 The Recipient shall not assign the rights and responsibilities under this contract without the prior written approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring without prior written approval of the Agency will constitute a material breach of the contract. 23.2 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the Recipient. In the event the State of Florida approves transfer of the Recipient's obligations, the Recipient remains responsible for all work performed and all expenses incurred in connection with the contract. 23.3 This contract shall remain binding upon the successors in interest of either the Recipient or the Agency. 24. Subcontracts 24.1 The Recipient is responsible for all work performed and for all commodities produced pursuant to this contract, whether actually furnished by the Recipient or its subcontractors. Any subcontracts shall be evidenced by a written document and subject to any conditions of approval the Agency deems necessary. The Recipient further agrees that the Agency will not be liable to the subcontractor in any way or for any reason. The Recipient, at its expense, shall defend the Agency against any such claims. 24.2 The Recipient 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 Recipient and subcontractor, will result in a penalty as provided by statute. 25. Independent Capacity of Recipient It is the intent and understanding of the Parties that the Recipient, 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 Recipient and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the Recipient or its subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the Recipient are the sole responsibility of the Recipient. 26. Payment Payments shall be made to the Recipient pursuant to s. 215.422, F.S., as services are rendered and invoiced by the Recipient. The Contract Manager will have final approval of the invoice for payment, and will approve the invoice for payment only if the Recipient 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. 27. Return of Funds The Recipient 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 Recipient by the Agency. In the event that the Recipient or its independent auditor discovers that an overpayment has been made, the Recipient 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 7 July 2012 — June 2014 16 D 15CE 203.12 Manager will notify the Recipient in writing of such findings. Should repayment not be made forthwith, the Recipient will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after Agency notification or Recipient discovery. 28. Data Integrity and Safeguarding Information The Recipient shall ensure an appropriate level of data security for the information the Recipient is collecting or using in the performance of this contract. An appropriate level of security includes approving and tracking all Recipient employees that request system or information access and ensuring that user access has been removed from all terminated employees. The Recipient, 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 Recipient shall ensure all subcontractors maintain written procedures for computer system backup and recovery. The Recipient shall complete and sign ATTACHMENT IV prior to the execution of this contract. 29. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses the Department's computer resource systems must comply with the Department's policy regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. 30. Conflict of Interest The Recipient 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 Recipient 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 Recipient or subcontractor's officers, employees or agents will neither solicit nor accept gratuities, favors or anything of monetary value from contractors, potential contractors, or parties to subcontracts. The Recipient'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 Recipient's employees and subcontractors must make the same disclosures described above to the Recipient's board of directors. Compliance with this provision will be monitored. 31. 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 Recipient, 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. 32. Purchasing 32.1 The Recipient 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 Recipient 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 July 2012 — June 2014 16 U[ 17 LCE 203.12 products /services available from PRIDE may be obtained by contacting PRIDE, (800) 643 -8459. 32.2 The Recipient may procure any recycled products or materials, which are the subject of or are required to carry out this contract, in accordance with the provisions of s. 403.7065, F.S. 32.3 The Recipient 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 Recipient 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. 33. 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 Recipient shall refer the discovery, invention or material to the Agency to be referred to the Department of State and 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. 33.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an unencumbered right to use such property, notwithstanding any agreement made pursuant to Paragraph 33. 33.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 34. Emergency Preparedness and Continuity of Operations 34.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the Recipient 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 Recipient shall notify the Agency of emergency provisions. 34.2 In the event a situation results in a cessation of services by a subcontractor, the Recipient shall retain responsibility for performance under this contract and must follow procedures to ensure continuity of operations without interruption. 35. EQUIPMENT If the contract tasks to be performed require the purchase of equipment with state or federal funds, the following paragraphs apply: 35.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for the financial statement purposes, or $5,000.00 [for federal funds]; or (b) nonexpendable, tangible personal property of a nonconsumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at least one year; and hardback bound books not circulated to students or the general public, with a value or cost of $250.00 or more [for state funds]. 35.2 Recipients and subcontractors 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 E July 2012 — June 2014 1 b !�_ CCE 203.12 once every two years, (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must be maintained on file and shall be provided to the Agency upon request. The Recipient shall promptly investigate, fully document and notify the Contract Manager of any loss, damage, or theft of equipment. The Recipient shall provide the results of the investigation to the Contract Manager. 35.3 The Recipient'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 Recipient or the Federal Goveament; (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 Recipient compensates the Federal awarding agency for its share. 35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by the Department is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will vest in the Agency, 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 subcontractors (not included in a cost methodology), is subject to the conditions of section 273, F. S. and 60A- 1.0017, F. A. C. or Title 45 CFR Part 74. 35.5 The Recipient 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 Recipient 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 Recipient's proposed disposition (i.e., transfer or donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc). 35.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120 days of the written request for disposition, the Recipient is authorized to proceed as directed in 2 CFR Part 215 Administrative Requirements (formerly OMB Circular A -110). 35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but excludes movable machinery and equipment. Real property may not be purchased with state or federal funds through agreements covered under this contract without the prior approval of the Agency. Real property purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III, Part A., Sec. 3030b United States Code (USC). Real property purchases from state funds can only be made through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of section 216.348, F. S. 35.8 Any permanent storage devices (e.g., hard drives, removable storage media) must be reformatted and tested prior to disposal to ensure no confidential information remains. 10 July 2012 — June 2014 16q*D"*f5CCE 203.12 35.9 The Recipient 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 Recipient has the responsibility to require any subcontractors to comply with the Agency's ITR procedures. 36. PUR 1000 Form The PUR 1000 Form is hereby incorporated by reference. In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract the terms or conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form shall take precedence. 37. Use of State Funds to Purchase or Improve Real Property Any state funds provided for the purchase of or improvements to real property are contingent upon the Recipient or political subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by law. 38. Dispute Resolution Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the decision to writing and serve a copy on the Recipient. 39. Financial Consequences of Non - Performance If the Recipient fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the Agency must apply financial consequences commensurate with the deficiency. Financial consequences may include, but are not limited to, contract suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and /or cancellation of contract and reacquiring services from an alternate source. 39.1 The Recipient will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the Agency. 40. No Waiver of Sovereign Immunity Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which sovereign immunity may be applicable. 41. Venue If any dispute arises out of this contract, the venue of such legal recourse will be Lee County, Florida. 42. Entire Contract This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the Agency or the Recipient unless expressly contained herein or by a written amendment to this contract signed by both Parties. 43. Force Maieure The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control, provided the party experiencing the force majeure condition provides immediate written notification to the other party and takes all reasonable efforts to cure the condition. 44. Severability Clause The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable the other provisions are severable to that void provision and shall remain in full force and effect. 45. Condition Precedent to Contract: Appropriations The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an 11 July 2012 — June 2014 annual appropriation by the Legislature. 16015 CCE 203.12 46. 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. 47. Waiver The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any such right preclude any other or further exercise thereof or the exercise of any other right. 48. Compliance The Recipient 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 Recipient to abide by these laws shall be deemed an event of default of the Recipient, and subject the contract to immediate, unilateral cancellation of the contract at the discretion of the Agency. 49. Final Invoice The Recipient shall submit the final invoice for payment to the Agency as specified in Paragraph 3.3.5. (date for final request for payment) of ATTACHMENT I. If the Recipient 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 Recipient and necessary adjustments thereto have been approved by the Agency. 50. 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. 51. Termination 51.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the Contract Manager or the representative of the Recipient responsible for administration of the contract. 51.2 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 Recipient. 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 Recipient 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 Recipient will be compensated for any work satisfactorily completed prior to the date of termination. 51.3 This contract may be terminated for cause upon no less than twenty -four (24) hours notice in writing to the Recipient. 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 Recipient's rights to remedies at law or in equity. 51.4 Failure to have performed any contractual obligations with the Agency in a manner satisfactory to the Agency will be a sufficient cause for termination. To be terminated as a Recipient under this provision, the Recipient 12 July 2012 — June 2014 16 a r5 CCE 203.12 must have (1) previously failed to satisfactorily perform in a contract with the Agency, been notified by the Agency of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction of the Agency; or (2) had a contract terminated by the Agency for cause. 52. Electronic Records and Siinature The Agency authorizes, but does not require, the Recipient to create and retain electronic records and to use electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A Recipient 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, Fla. Stat. All electronic records must be fully auditable; are subject to Florida's Public Records Law, ch. 119, Fla. Stat.; must comply with section 28, Data Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and maintained by the Recipient to the same extent as non - electronic records are retained and maintained as required by this Agreement. 52.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the Recipient and the Agency. The Recipient is authorized to conduct electronic transactions with the Agency only upon further written consent by the Agency. 52.2 Upon request by the Agency, the Recipient 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. 53. Official Payee and Representatives (Names, Addresses, and Telephone Numbers): 13 The Recipient name, as shown on page 1 of this contract, Collier County Board of County Commissioners a. and mailing address of the official payee to whom the ng and Human Services Departments Housing payment shall be made is: Trail E Bldg H, Rm 211 Naples, FL 34112 Kimberly Grant, Interim Director The name of the contact person and street address where Collier County Board of County Commissioners b. financial and administrative records are maintained is: Housing and Human Services Departments 3339 Tamiami Trail E Bldg H, Rm 211 Naples, FL 34112 Kimberly Grant, Interim Director Collier County Board of County Commissioners C. The name, address, and telephone number of the Housing and Human Services Departments representative of the Recipient responsible for 3339 Tamiami Trail E Bldg H, Rm 211 administration of the program under this contract is: Naples, FL 34112 (239) 252 -2273 Area Agency on Aging for Southwest Florida, Inc. d The section and location within the Agency where dba Senior Choices of Southwest Florida Requests for Payment and Receipt and Expenditure forms 15201 N. Cleveland Ave, Suite 1100 are to be mailed is: North Fort Myers, Florida 33903 Leigh Wade, Executive Director Area Agency on Aging for Southwest Florida, Inc. C. The name, address, and telephone number of the Contract dba Senior Choices of Southwest Florida Manager for this contract is: 15201 N. Cleveland Ave, Suite 1100 North Fort Myers, Florida 33903 (239) 652 -6900 Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 13 July 2012 — June 2014 CCE 203.12 16D15 54. All Terms and Conditions Included This contract and its Attachments, I — X and any exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. By signing this contract, the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF, the Parties hereto have caused this 39 page contract, to be executed by their undersigned officials as duly authorized. Recipient: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS SIGNED BY: q, CW NAME: 1M TITLE: VLbte C CMGz1 �1 x`(11 G DATE: C, (2.A 11-7 Federal Tax ID: 59- 6000588 Fiscal Year Ending Date: 09/30 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. DBA SENIOR CHOICES OF SOUTHWEST FLORIDA SIGNED BY: NAME: LEIGH ANNA NOWAK TITLE: BOARD PRESIDENT DATE: � VI 14 July 2012 — June 2014 INDEX TO CONTRACT ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION ATTACHMENT I STATEMENT OF WORK ATTACHMENT II CERTIFICATION REGARDING LOBBYING CCE 203.12 16D15 ATTACHMENT III FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT ATTACHMENT W CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS /SUBCONTRACTS ATTACHMENT VI ASSURANCES— NON - CONSTRUCTION PROGRAMS ATTACHMENT VII COMMUNITY CARE FOR THE ELDERLY INVOICE REPORT SCHEDULE ATTACHMENT VIII COMMUNITY CARE FOR THE ELDERLY BUDGET SUMMARY ATTACHMENT IX REQUEST FOR PAYMENT DOEA FORM 106C ATTACHMENT X RECEIPTS AND EXPENDITURES REPORT, DOEA FORM 105C 15 PAGE 17 -25 26 27 -31 32 091 34 -35 36 37 38 39 July 2012 — June 2014 16D15 CCE 203.12 ATTACHMENT I AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Activities of Daily Living (ADL) Adult Protective Services (APS) Assessed Priority Consumer List (APCL) Comprehensive Assessment and Review for Long -Term Care Services (CARES) Community Care for the Disabled Adult (CCDA) Community Care for the Elderly (CCE) Client Information and Registration Tracking System (CIRTS) Department of Children and Families (DCF) Department of Elder Affairs (DOEA) Home Care for Disabled Adults (HCDA) Instrumental Activities of Daily Living (IADL) Planning and Service Area (PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families (DCF) Services, Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to the Department's community -based services. Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the Agency enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the Agency or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community -based services to assist elders to reside in the least restrictive environment suitable to their needs. 16 July 2012 — June 2014 1.2.3 Authority The relevant authority governing CCE program are: (1) Rule 58C -1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 16D15CCE 203.12 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20, 2010; (2) CFO Memo No. 03: Release date, June 29, 2010; and (3) CFO Memo No. 06: Release date, June 30, 2010. 1.2.4 Scope of Service The Recipient is responsible for the programmatic, fiscal, and operational management of CCE. The program services shall be provided in a manner consistent with and described in the current Recipient's Request for Proposal, RFP, and the Agency's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in -home and community services as needed under the direction of a lead agency and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this contract, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high -risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long -term care program. 1.3.2.1 Targeted Groups Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. SECTION II: MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS To achieve the goals of the CCE program, the Recipient shall ensure the following tasks are performed: (1) Client Eligibility Determination; (2) Assessment and Prioritization of Service Delivery for New Clients; (3) Delivery of Services to Eligible Clients; and (4) Monitoring the performance of subcontractors. 17 July 2012 — June 2014 16D15CE 203.12 2.1.1 Client Eligibility Determination The Recipient shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this ATTACHMENT I, Section 1.3. 2.1.1.1 APS High -Risk Referrals APS high -risk referrals who are enrolled in a Medicaid long -term care program at the time of referral may receive crisis - resolving CCE- funded services only under the following circumstances: (1) The long -term care program provider is contacted regarding the referral as soon as it is received; (2) The CCE lead agency receives notification from the long -term care program provider that the long -term care program in which the consumer is enrolled will address the consumer's needs; and (3) The CCE lead agency may only provide services until the crisis is resolved. 2.1.1.2 APS Intermediate and Low Risk Referrals The Recipient shall ensure that APS low and medium referrals who are enrolled in a Medicaid capitated long- term care program at the time of referral will be referred to the long -term care provider. 2.1.2 Assessment and Prioritization of Service Delivery for New Clients The Recipient shall ensure that the following criteria are used to prioritize new clients for service delivery. It is not the intent of the Agency to remove existing clients from services in order to serve new clients being assessed and prioritized for service delivery. 2.1.2.1 Abuse, Neglect and Exploitation The Recipient will ensure that pursuant to Section 430.205(5), Florida Statutes, those elderly persons who are determined by APS to be victims of abuse, neglect, or exploitation who are in need of immediate services to prevent further harm and are referred by APS, will be given primary consideration for receiving CCE services. As used in this subsection, "primary consideration" means that an assessment and services must commence within 72 hours after referral to the Agency or as established in accordance with Agency contracts by local protocols developed between the Agency and Department service contractors and APS. 2.1.2.2 Priority Criteria for Individuals in Nursing Homes in Receivership: The Recipient will ensure that pursuant to Section 400.126 (12), Florida Statutes, those elderly persons determined, through a CARES assessment, to be a resident who could be cared for in a less restrictive setting or who do not meet the criteria for skilled or intermediate care in a nursing home, will be referred for such care, as appropriate for the resident. Residents referred pursuant to this subsection shall be given primary consideration for receiving services under the CCE program in a manner as persons classified to receive such services pursuant to Section 430.205, Florida Statutes. 2.1.2.3 Priority Criteria for Service Delivery: (1) Individuals in nursing homes under Medicaid who could be transferred to the community; (2) Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the community; (3) Individuals in nursing homes that are closing and can be discharged to the community; or (4) Individuals whose mental or physical health condition has deteriorated to the degree self care is not possible, there is no capable caregiver, and institutional placement will occur within 72 hours; (5) For the purpose of transitioning individuals receiving CCDA and HCDA services through the DCF Adult Services to community -based services provided through the Agency, when services are not currently available, area agency on aging staff and lead agency case managers shall ensure that "Aging Out" individuals are prioritized for services only after APS High Risk and Imminent Risk individuals. 2.1.2.4 Priority Criteria for Service Delivery for Other Assessed Individuals: The assessment and provision of services should always consider the most cost effective means of service delivery. Service priority for individuals not included in groups one, two or three above, regardless of referral source, will be determined through the Department's client assessment form administered to each applicant, to the extent funding is available. The Recipient shall ensure that first priority will be given to applicants at the higher levels of frailty and risk of nursing home placement. For individuals assessed at the same priority and 18 July 2012 — June 2014 16B15CCE 203.12 risk of nursing home placement, priority will be given to applicants with the lesser ability to pay for services. 2.1.2.5 Referrals for Medicaid Waiver Services: (1) The Recipient must require subcontractors, through the client assessment, to identify potential Medicaid eligible CCE clients and to refer these individuals for application for Medicaid Waiver services. (2) Individuals who have been identified as being potentially Medicaid Waiver eligible are required to apply for Medicaid Waiver services in order to receive CCE services and can only receive CCE services while the Medicaid Waiver eligibility determination is pending. If the client is found ineligible for Medicaid Waiver services for any reason other than failure to provide required documentation, then the individual may continue to receive CCE services. (3) Individuals who have been identified as being potentially Medicaid Waiver eligible must be advised of the responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services while the eligibility determination is being processed. 2.1.3 Delivery of Service to Eligible Clients The Recipient shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The Recipient shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. 2.1.3.1 Core Services for Programmatic Operation The Recipient shall ensure that core services include a variety of home - delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services, to be provided at the unit rate identified in this contract, include the following: (1) Adult Day Care; (2) Chore Services; (3) Enhanced Chore; (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; (7) Housing Improvement; (8) Respite Services; and (9) Transportation 2.1.3.2 Health Maintenance Services The Recipient shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non - medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this contract, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment, Services and Supplies ILI July 2012 — June 2014 16 D 15 CE 203.12 2.1.3.3 Other Support Services Support Services expand the continuum of care options to assist functionally impaired elders and their caregivers. Support services include the following: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Material Aid; and (5) Other. 2.1.4 Use of Subcontractors If this contract involves the use of a subcontractor or third party, then the Recipient 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 Recipient shall notify the Contract Manager and the Agency's Director of Finance in writing of such delay. 2.4.4.1 The Recipient shall not permit a subcontractor to perform services related to this agreement without having a binding subcontractor agreement executed. In accordance with Section 24.1 of the Standard Contract, the Agency will not be responsible or liable for any obligations or claims resulting from such action. 2.1.4.1 Monitoring the Performance of Subcontractors The Recipient will monitor at least once per year each of its subcontractors, subrecipients, vendors and /or consultants paid from funds provided under this contract. The Recipient will 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 Recipient will monitor to ensure that time schedules are met, the budget and scope of work are accomplished within the specified time periods and other performance goals stated in this contract are achieved. 2.2 SERVICE TIMES 2.2.1 Service Times The Recipient shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The Recipient shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day 20 July 2012 - June 2014 i t n 1 ;; CCE 203.12 Material Aid now d6 'of Specialized Medical Equipment, Services and Supplies Episode Escort Shopping Assistance One -Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The Recipient 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 Recipient shall establish due dates for any subcontractors that permits the Recipient to meet the Agency's reporting requirements. 2.4.1 Client Information and Registration Tracking System ( CIRTS The Recipient shall input CCE specific data into CIRTS to ensure CIRTS data accuracy. The Recipient shall use CIRTS generated reports, which include the following: (1) Client Reports; (2) Monitoring Reports; (3) Services Reports; (4) Miscellaneous Reports; (5) Fiscal Reports; (6) Aging Resource Center Reports; and (7) Outcome Measurement Reports. 2.4.2 Service Costs Reports The Recipient shall require subcontractors to submit to the Recipient semi - annual service cost reports, February 15 and August 15 of each year which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.3 Surplus/Deficit Report The Recipient will submit a consolidated surplus /deficit report in a format provided by the Agency to the Contract Manager by the 18th of each month. This report is for all agreements and /or contracts between the Recipient and the Agency. The report will include the following: (1) The Recipient's detailed plan on how the surplus or deficit spending exceeding the threshold specified by the Agency will be resolved; and (2) Recommendations to transfer funds to resolve surplus /deficit spending; 2.5 RECORDS AND DOCUMENTATION The Recipient will ensure the collection and maintenance of client and service information on a monthly basis 2.5.1 from the Client Information and Registration Tracking System ( CIRTS) or any such system designated by the Agency and the State of Florida Department of Elder Affairs. Maintenance includes valid exports and backups of all data and systems according to Department and /or Agency standards. 2.5.2 Each Recipient 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 Recipient 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 Recipient shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and /or agreements with subcontractors. These policies and procedures will be made available to the Agency upon request. 21 July 2012 — June 2014 CE 203.12 2.6 PERFORMANCE SPECIFICATIONS fmi k 2.6.1 Outcomes (1) The Recipient shall ensure services provided under this contract are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The Recipient shall timely submit to the Agency all information described in ATTACHMENT I, SECTION 2.4 REPORTS; and (3) The Recipient shall timely submit to the Agency all information described in ATTACHMENT I, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.6.2 The Recipient 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) Average monthly savings per consumer for home and community -based care versus nursing home care for comparable client groups; (3) Percent of elders assessed with high or moderate risk environments who improved their environment score; (4) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved; (5) Percent of new service recipients whose ADL assessment score has been maintained or improved; (6) Percent of new service recipients whose IADL assessment score has been maintained or improved; (7) Percent of family and family- assisted caregivers who self -report they are likely to provide care; (8) Percent of caregivers whose ability to provide care is maintained or improved after one year of service intervention (as determined by the caregiver and the assessor); (9) Percent of customers who are at imminent risk of nursing home placement who are served with community -based services; (10) Average time in the CCE Program for Medicaid Waiver probable customers; and (11) Percent of customers who are at imminent risk of nursing home placement who are served with the community -based services. The Recipient's performance of these measures will be documented in the Agency's annual monitoring reports. 2.7. RECIPIENT'S FINANCIAL OBLIGATIONS 2.7.1 Matching, Level of Effort, and Earmarking Requirement The Recipient will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in -kind resources. At the end of the contract period, all CCE funds expended must be properly matched. State funds cannot be used to match another state - funded program. 2.7.2 Cost Sharing and Co- payments The Recipient shall establish annual co- payment goals. The Agency has the option to withhold a portion of the Recipient's request for payment if goals are not met according to the Agency and the Department of Elder Affairs' co- payment guidelines. Co- payments include only the amounts assessed consumers or the amounts consumers opt to contribute in lieu of an assessed co- payment. The contribution must be equal to or greater than the assessed co- payment. Co- payments collected in the CCE program can be used as part of the local match. 2.7.3 Use of Service Dollars and Assessed Priority Consumer List Management The Recipient is expected to spend all federal, state and other funds provided by the Agency, for the purpose specified in each contract. The Recipient 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 22 July 2012 — June 2014 16015CE 203.12 Agency. If the Agency determines that the Recipient is not spending service funds accordingly, the Agency may transfer funds to other planning and service areas during the contract period and/ or adjust subsequent funding allocations accordingly, as allowable under state and federal law. 2.8 AGENCY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The Agency will provide to the Recipient guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Recipient. 2.8.2 Contract Monitoring The Agency will review and evaluate the performance of the Recipient under the terms of this contract. Monitoring shall be conducted through direct contact with the Recipient through telephone, in writing, or an on -site visit. The Agency's determination of acceptable performance shall be conclusive. The Recipient 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. k1XI I Ila-11M31 001 XQ 2 7V/0 1 WWI Y 3.1 General Statement of Method of Payment The method of payment for this contract includes advances, cost reimbursement for administration costs, and fixed rate for services. The Recipient 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 Recipient shall consolidate all requests for payment from subcontractors and expenditure reports that support requests for payment and shall submit to the Agency on forms 106C (ATTACHMENT IX) and 105C (ATTACHMENT X). 3.1.1 The Recipient agrees to distribute funds as detailed in the area plan update and the Budget Summary, ATTACHMENT VIII to this contract. Any changes in the total amounts of funds identified on the Budget Summary form require a contract amendment. 3.2 Advance Payments 3.2.1 The Recipient may request up to two months of advances at the start of the contract period to cover program administrative and service costs. The schedule for submission of advance requests, if available, is shown on ATTACHMENT VII to this contract. The payment of an advance will be contingent upon the sufficiency and amount of funds released to the Agency and the State of Florida Department of Elder Affairs ( "budget release "). The Recipient shall provide the Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. 3.2.2 The Recipient's requests for an advance require the approval of the Contract Manager. If sufficient budget is 23 July 2012 - June 2014 16 D 15cCE 203.12 available, the Agency will issue approved advance payments after July 1, 2012. 3.2.3 All advance payments made to the Recipient 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. 3.2.4 The Recipient may temporarily place advanced funds in a FDIC insured interest bearing account. All interest earned on contract fund advances must be returned to the Agency within thirty (30) days of the end of each quarter of the contract period. 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 106C (ATTACHMENT IX) and 105C (ATTACHMENT X). 3.3.1 Remedies - Nonconforming Services The Recipient shall ensure that all goods and /or services provided under this contract for CCE funded programs 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 Recipient 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 Recipient's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Recipient shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The Agency and or Department require 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 Recipient shall ensure the provision of services to the projected number of clients in accordance with the Area Plan as updated and within the contract amount. The Recipient shall ensure expenditure of 100% of the contract amount budgeted for services to clients at the unit rates established in the Area Plan. In the event the Recipient has a surplus of 1% or more at the end of the first year of the contract term, the Agency will reallocate 1% of the budget for the second year of the contract term to other area agencies found to be serving clients to the fullest extent of their allocated budgets. If, or to the extent, there is any conflict between this paragraph and paragraphs 39 and 39.1 of the standard contract, this paragraph shall have precedence. 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 VII to this contract. 3.3.4 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in ATTACHMENT VIII, Budget Summary. 3.3.5 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 Recipient and any adjustments thereto, including any disallowance not resolved as outlined in Section 26 of this contract. 3.3.6 Date for Final Request for Payment The final request for payment for contract year one expenditures will be due to the Agency no later than August 1, 2013. The final request for payment for contract year two expenditures will be no later than August 1, 2014. 3.4 Documentation for Payment The Recipient shall maintain documentation to support payment requests that shall be available to the Agency or authorized individuals, such as the Department of Financial Services, upon request. 3.4.1 The Recipient must enter all required data per the Department's CIRTS Policy Guidelines for clients and 24 July 2012 — June 2014 16015 CCE 203.12 services in the CIRTS database. The data must be entered into the CIRTS before the Recipient submits their request for payment and expenditure reports to the Agency. The Agency shall establish time frames to assure compliance with due dates for the requests for payment and expenditure reports to the Agency and the Department. 3.4.2 The Recipient must run monthly CIRTS reports and verify that the client and service data in the 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 Recipient's request for payment and expenditure reports can be approved by the Agency. 25 July 2012 — June 2014 CCE 203.12 6 1D L5rACHMENT II CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub - awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans and cooperative agreements) and that all subcontractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. .9 - ca C@na Signature Sieve, Cckrnc[ � Name of Authorized Individual Collier County Board of Commissioners Name 3299 Tamiami Trail E Naples, FL 34112 (9 1Zg1,�� Date Gcg 203. 12 Application or Agreement Number 26 r..� tJ Cj • �JtiJ �'T� July 2012 — June 2014 FINANCIAL AND COMPLIANCE AUDIT 1 6 0 J5cmcHcEE2NoT3- 12 III The administration of resources awarded by the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs to the provider may be subject to audits and /or monitoring by the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs 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 provider agrees to comply and cooperate with any monitoring procedures /processes deemed appropriate by the Area Agency on Aging for Southwest Florida, Inc. In the event the Area Agency on Aging for Southwest Florida, Inc. determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Area Agency on Aging for Southwest Florida, Inc. to the provider regarding such audit. The provider 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 provider 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 provider expends $500,000 or more in federal awards during its fiscal year, the provider must have a single or program - specific audit conducted in accordance with the provisions of OMB Circular A -133, as revised. EXHIBIT 1 to this agreement indicates federal resources awarded through the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs by this agreement. In determining the federal awards expended in its fiscal year, the provider shall consider all sources of federal awards, including federal resources received from the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 provider 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 1, paragraph 1, the provider shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised. If the provider expends less than $500,000 in federal awards in its fiscal year, an audit conducted in accordance with the provisions of OMB Circular A -133, as revised, is not required. In the event that the provider expends less than $500,000 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 provider resources obtained from other than federal entities.) An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. and /or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs shall be fully disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc. and /or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 provider's fiscal year end. 27 July 2012 — June 2014 PART II: STATE FUNDED 16015 E 203.12 This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes. In the event that the provider expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider 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 Area Agency on Aging for Southwest Florida, Inc. and /or the Department of Elder Affairs by this agreement. In determining the state financial assistance expended in its fiscal year, the provider shall consider all sources of state financial assistance, including state financial assistance received from the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of Southwest Florida and /or 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 provider 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 provider expends less than $500,000 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 provider expends less than $500,000 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 provider resources obtained from other than State entities). An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs shall be fully disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc. and /or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 provider'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 provider's fiscal year end. Notwithstanding the applicability of this portion, the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 provider 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 28 July 2012 16D15cCE 2 03. 12 June 2014 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 provider 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 provider 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 the Area Agency on Aging for Southwest Florida, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A -133, Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations), Rules of the Auditor General, as applicable. Providers, when submitting financial reporting packages to the Area Agency on Aging for Southwest Florida, Inc. 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 provider in correspondence accompanying the reporting package. PART IV: RECORD RETENTION The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued, and shall allow the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and or the Department of Elder Affairs or its designee, the CFO or Auditor General access to such records upon request. The provider shall ensure that audit working papers are made available to the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs, or its designee, CFO, or Auditor General upon request for a period of six years from the date the audit report is issued, unless extended in writing by the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs. 29 July 2012 — June 2014 16015CCE 203.12 ATTACHMENT III EXHIBIT —1 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT TOTAL FEDERAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT TOTAL STATE AWARD STATE FINANCIAL ASSISTANCE SUBJECT TO See. 215.97. F.S. PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT Community Care for the Elderl Program General Revenue 65010 $661,357.00 TOTAL AWARD $661,357.00 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 30 July 2012 — June 2014 16015 CCE 203.12 ATTACHMENT III EXHIBIT -2 PART I: AUDIT RELATIONSHIP DETERMINATION Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A -133, as revised, and /or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A- 133, as revised, and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, providers who have been determined to be recipients or subrecipients of Federal awards and /or state financial assistance, must comply with applicable programmatic and fiscal compliance requirements. In accordance with Sec. 210 of OMB Circular A -133 and/or Rule 691 - 5.006, FAC, provider has been determined to be: Vendor or exempt entity and not subject to OMB Circular A -133 and/or Section 215.97, F.S. X_ Recipient/subrecipient subject to OMB Circular A -133 and /or Section 215.97, F.S. NOTE: If a provider is determined to be a recipient /subrecipient of federal and or state financial assistance and has been approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I- .006(2), FAC [state financial assistance] and Section — .400 OMB Circular A -133 [federal awards]. PART H: FISCAL COMPLIANCE REQUIREMENTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal awards or state matching funds on Federal awards and who are determined to be a subrecipient, must comply with the following fiscal laws, rules and regulations: STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW: 2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)* OMB Circular A -102 — Administrative Requirements OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations NON - PROFIT ORGANIZATIONS MUST FOLLOW: 2 CFR Part 230 Cost Principles for Non - Profit Organizations (Formerly OMB Circular A -122 — Cost Principles)* 2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements) Requirements) OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW: 2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A -21 — Cost Principles)* 2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements) OMB Circular A -133 —Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations *Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular A -133 Compliance Supplement, Appendix 1. STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a recipient /subrecipient, must comply with the following fiscal laws, rules and regulations: Section 215.97, Fla. Stat. Chapter 69I -5, Fla. Admin. Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations 31 July 2012 — June 2014 16015 CCE 203.12 ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the Recipient named in the contract or agreement to which this form is an attachment, hereby certifies that: (1) The Recipient and any subcontractors of services under this contract have financial management systems capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant- funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly. (2) Management Information Systems used by the Recipient, subcontractor(s), or any outside entity on which the Recipient 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, Recipient(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 Recipient (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 Recipient 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 Recipient and any subcontractor(s) of services under this contract warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The Recipient shall require that the language of this certification be included in all subagreements, subgrants, and other agreements and that all subcontractors shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A -102 and 2 CFR Part 215 (formerly OMB Circular A -110). Name and Address o ecipient + TVt J• �lyl(�Z Signature itle Date C'feve. Cane, U Name of Authorized Signer Collier County Board of Commissioners 3299 Tamiami Trail E Naples, FL 34112 32 July 2012 —June 2014 16D15 CCE 203.12 ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective Recipient certifies, by signing this certification, neither it nor its principals is 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 Recipient is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this certification. -� - 0 coo 6 - Zq Signature Date �a 66( �(VLQ( WM1 l C-0�ui tr, E0 cc Title Agency /Organization (Certification signature should be same as Contract signature.) 77Y 21" 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 Recipient knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the Department or Agency may pursue available remedies, including suspension and /or debarment. 3. The Recipient will provide immediate written notice to the Contract Manager if at any time the Recipient learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The Recipient 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 Recipient 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 Recipient 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 Recipient 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 or Agency may pursue available remedies, including suspension, and /or debarment. 7. The Recipient 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. 01 July 2012 —June 2014 161115rTACHMENT CCE 203.12 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., 4728 -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., 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C.. 6101 - 6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g). 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C., 290 dd -3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C., 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C.. 1501 -1508 and 7324 - 7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C., 276a to 276a -7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C., 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C., 327 -333), regarding labor standards for federally assisted construction subagreements. 34 July 2012 — June 2014 16 15 CCE 203.12 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 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C., 1451 et seq.); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C., 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93 -523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93 -205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C., 1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C..470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C..469a -1 et seq.). 14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C..2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C., 4801 et seq.), which prohibits the use of lead- based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non - Profit Organizations. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED cz _r 600 � G (-,7q I rz ✓��i— \F�E 35 July 2012 —June 2014 16DIA5rACHMENT CCE 203.12 VII COMMUNITY CARE FOR THE ELDERLY INVOICE REPORT SCHEDULE Report Submit to Agency Number Based On On This Date 1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 15 4 August Expenditure Report September 15 5 September Expenditure Report October 15 6 October Expenditure Report November 15 7 November Expenditure Report December 15 8 December Expenditure Report January 15 9 January Expenditure Report February 15 10 February Expenditure Report March 15 11 March Expenditure Report April 15 12 April Expenditure Report May 15 13 May Expenditure Report June 15 14 June Expenditure Report July 15 15 Final Request for Payment July 25 16 Closeout Report August 1 Legend: * Advance based on projected cash need. Note # 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida prior to July 1 or until the contract with the Agency has been executed and a copy sent to Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida. Actual submission of the vouchers to DFS is dependent on the accuracy of the expenditure report. Note # 2: All advance payments made to the Recipient 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. The adjustment shall be recorded in Part C, 1 of the report (Attachment X). 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. 36 July 2012 — June 2014 16D15 CCE 203.12 ATTACHMENT VIII COMMUNITY CARE FOR THE ELDERLY PROGRAM BUDGET SUMMARY for Collier County Board of Commissioners Collier County 1. CCE Spending Authority $5899107.00 2. Case Management and 729250.00 Case Aide Total $661,357.00 RATE SUMMARY for Collier County Board of Commissioners Collier County Collier County Total Unit Cost Reimbursement Rate- 90% Case Management $55.50 $50.00 Case Aide $30.00 $27.00 Adult Day Care $12.22 $11.00 Chore $22.22 $20.00 Enhanced Chore $28.89 $26.00 Companion $22.22 $20.00 Skilled Nursing $40.00 $36.00 EARS $ 1.24 $ 1.12 Homemaking $21.11 $19.00 Personal Care $24.44 $22.00 Respite -in Home $24.44 $22.00 Home Improvement $ Cost Reimbursement $90% Cost Reimbursement Material Aid $ Cost Reimbursement $90% Cost Reimbursement Specialized Medical Equipment, Service & Supplies $ Cost Reimbursement $90% Cost Reimbursement Transportation $ Cost Reimbursement $90% Cost Reimbursement 37 July 2012 - June 2014 REQUEST FOR PAYMENT COMMUNITY CARE FOR THE ELDERLY CCE 203.12 16 D 15rTACHMENT IX REC#rIENT NAME. ADDRESS, PNONEf snd FE0P TYPE OF PAYMENT: Reeutar Advance This Request P%*W: From: To: Contract Period Contract E Report* PSA t CERTIFICATION: 1 hereby cedifyte the best of my knowtedee ttsN Sk request is complete and correct and conforms wtlh the terms and the purposes of fhe above contract. Prepared by: Date: Approved by: Date: PARTA; BUDGETSUMMARY 1. Approved Contract Am inn 2. Prevkws Ftatbs ReC*od for Coact Period 3. Contract Balance, (line 1 w*ws line 2) 4. Previous Funds Requa ed and Hot Received for Contract Period 5. CONTRACT BALANCE (One 3 minus One 4) CCEAdmin. $ 0.00 COEservicin i 0. TOTAL ; 0.00 0.00 f i S 0.00 $ 0.00 ; 0.00 $ 0.00 ; 0.00 ; 0.00 $ 0.D0 f 0. f 0400 PART d' CONTRACT FUNDS REQUEST 1. Anticipated Cash Need (1st - 29d months) 2. Mel Expendkres For Month (DOER Form 105C, Pert t, We 4) 3. TOTAL f 0.00 $ 0.00 ; 0.00 S 0.00, 0100 f S 0. f f PART C: NET FUNDS REQUESTED 1. Less Advance Appied 2. TOTAL FUNDS REQUESTED (Part 8 Line 3, minus Part C Line 1) S 0.00 f 0.00 ; 0.01 S 0.00 f List of Services f Units / Rates provided - See attached report. DOER FORM 100C 38 July 2012 - June 2014 CCE 203.12 16 D 15kTTACHMENTX RECEIPT AND EXPENDITURE REPORT COMMUNITY CARE FOR THE ELDERLY PROVIDER NAME, ADDRESS, PHONE re and FEIDst Program Funding : THIS REPORT PERIOD: From To CCE Admin. CONTRACT PERIOD: CCE Services CONTRACT K REPORT 7i PSAIW CERTIFICATION: I certify to the best of my knowledge and belief that the report is complete and correct and all outlays herein are for purposes set forth in the contract. Prepared by: Date:_ App.-.d by: oat. PART A: BUDGETED INCOME / RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of utl et For This Report Year to Date Approved Budoot $0.00 $0.00 $0.00 *DIV /01 1. State Funds 2. Program income $0.00 $0.00 $0.00 ARDIV /OI 3. Local Cash Match $0.00 $0.00 $0.00 WDIV /01 4. SUBTOTAL: CASH RECEIPTS 5. Local In -Kind Match e. TOTAL RECEIPTS $0.00 $0.00 $0.00 MDIV /OI PART 8: EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budoot For This Report Year to t ApprovoCI Dudoot $0.00 $0.00 $0.00 OODIV /01 1. Administrative Services 2. Service Subcontractor(*) $0.00 $OAO $0.00 SODIV /01 3. Adult Protective Services $0.00 $0.00 $0.00 #DIV /01 4. TOTAL EXPENDITURES $0.00 $0.00 $0.00 *DIV /01 PART C: OTHER REVENUE AND EXPENDITURES II. interest: Ili. Advance Recouped 1. Program Income (PI) 1_ Earned on GR Advance $ $ 1. CCE: PI Collected YTD $ 2. Return of GR Advance $ (Includes foe* collected) 3. Other Earned $ PART D: CO- PAYIViENTS CURRENT MONTH YEAR -TO -DATE 1. Total of Co- payments assessed $ $ 2. Total of Co- payments collected $ $ (For Tracking Purposes only) 0 *A FORM 10SO R01"00 11=12010 39 16D15 Attestation Statement Agreement/Contract Number CCE 203.12 Amendment Number I, Steve Carnell , attest that no changes or revisions have been made to the (Recipient/Contractor representative) content of the above referenced agreement /contract or amendment between the Area Agency on Aging for Southwest Florida dba as Senior Choices of Southwest Florida and Collier County Board of Commissioners (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting, due to the differences in electronic data processing media, which has no affect on the agreement /contract content. Steve CarMll, Interim Administrator Collier County Public Services Division Date 7j 7 ri- v.l n--) , 'FE- a— Q . . -T r, 16015 Verification of Employment Status Certification As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida, Collier County Board of County Commissioners, hereby referred to as Recipient, certifies the use of the U.S. Department of Homeland Security's E- verify system to verify the employment eligibility of all new employees hired by Recipient during the contract term to perform employment duties pursuant to this Agreement and that any subcontracts include an express requirement that subcontractors performing work or providing services pursuant to this Agreement utilize the E- verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term. �, q, 6,;� - Signat e (Same as contract signature) Steve Carnell, Interim Administrator Collier County Public Services Division Title Collier County Board of Commissioner. Company 6 (zq (rL Date 16D15 VERIFICATION OF EMERGENCY PREPAREDNESS PLAN Contract # CCE 203.12 I, Steve Carrell ,certify that Collier County Board of 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 available to the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida, upon request. �' t�' CPA4 Signature of authorized contractor representative Interim Administrator, Collier County Public Services Division Title � c2� ►Z Date Collier County Board of Commissioners Company October 2008 6�' a i v 16015 CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is an attachment, hereby certifies that: (1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a proposal for, or enter into or renew a contract with the Agency and or Department of Elder Affairs Department) for goods or services of $1 million or more. (2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false certification to the Department is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. (3) The Contractor understands that the contract to which this form is an attachment may be terminated by the Agency and /or Department if the Contractor submits a false certification or has been placed on the Lists. This certification, required by Florida law, is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction. -� -6� - C�W Signature (Same as contract signature) Steve Camell, Interim Administrator Collier County Public Services Division Title Collier County Board of Commissioners Company Name G lzq b -1 Date July 2012 — June 2014 ADI 203.12 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. 16015 dba SENIOR CHOICES OF SOUTHWEST FLORIDA STANDARD CONTRACT ALZHEIMER'S DISEASE INITIATIVE PROGRAM THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida ( "Agency ") and Collier County Board of County Commissioners, ( "Recipient "), and collectively referred to as the "Parties." The term Recipient 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 Recipient has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent Recipient 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 STATEMENT Mission: To help aging adults, 60 and older, achieve greater independence through awareness of resources and access to qualified service providers. Vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. Values: The Agency believes the 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; ➢ Personal and professional accountability from all stakeholders. Lead agencies and local service providers as partners and stakeholders in Florida's aging services network are expected to support the agency's mission, vision, and priorities. 2. Incorporation of Documents within the Contract The contract will incorporate attachments, proposal(s), area plan(s), grant agreements, relevant Department handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other general materials not specific to this contract document and identified attachments. 3. Term of Contract This is a two -year contract shall begin on July 1, 2012 or on the date on which the contract has been signed by the last party required to sign it, whichever is later. It shall end at midnight, local time in North Fort Myers, Florida, on June 30, 2014. 4. Contract Amount The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $94,719.00 for year one, 2012 - 2013, 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. July 2012 — June 2014 5. Renewals 01� D I 203.12 16 By mutual agreement of the Parties, in accordance with s. 287.058(1)(f), F.S., the Agency may renew the contract every two years within the six year bid term , 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 six year 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 the following shall apply: 6.1.1 The Recipient shall comply with the provisions of 45 CFR 74 and /or 45 CFR 92, and other applicable regulations. 6.1.2 If this contract contains federal funds and is over $100,000.00, the Recipient 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 Recipient shall report any violations of the above to the Agency. 6.1.3 The Recipient, or agent acting for the Recipient, 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 Recipient 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 Recipient 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 If this contract contains federal funds and provides services to children up to age 18, the Recipient shall comply with the Pro - Children Act of 1994 (20 U.S.C. 6081). 6.1.6 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 Recipient shall comply with these provisions before doing business or entering into subcontracts receiving federal funds pursuant to this contract. The Recipient shall complete and sign ATTACHMENT V prior to the execution of this contract. 6.2 The Recipient 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 Recipient 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 Recipient must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation. 6.4 The Recipient shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 6.5 Unless exempt under 2 CFR Part 170.110(b), the Recipient shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 2 July 2012- June 2014 Transparency Act as expressed in 2 CFR 170. 16D15ADI 203.12 6.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11 -116, Recipient agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the employment of all new employees hired by Contractor during the contract term. Recipient 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. Recipients 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 Recipient shall comply with requirements of s. 287.058, F.S. as amended. 7.2.1 The Recipient 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 Recipient 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 Recipient 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 Recipient 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 Recipient in conjunction with this contract except for those records which are made confidential or exempt by law. The Recipient's refusal to comply with this provision will constitute an immediate breach of contract for which the Agency may unilaterally terminate the contract. 7.3 If clients are to be transported under this contract, the Recipient 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 Recipient 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 Department for goods or services of $1 million or more. Pursuant to s. 287.135 F.S., the Department may terminate this contract if the Contractor is found to have submitted a false certification of its status on the Lists or has been placed on the Lists. 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 the Certification Regarding Scrutinized Companies Lists, prior to the execution of this contract 8. Background Screening The Recipient 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 exempted from the Department's level 2 background screening pursuant to s. 430.0402(2) -(3), F.S. The Recipient 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. 3 July 2012- June 2014 Further information concerning the procedures for http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 9. Grievance and Compliant Procedures 16 D 15. 203.12 background screening are found at 9.1 Grievance Procedures The Recipient shall comply with and ensure subcontractor compliance with the Minimum Guidelines for Recipient Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handbook, to address complaints regarding the termination, suspension or reduction of services, as required for receipt of funds. 9.2 Complaint Procedures The Recipient shall develop and implement complaint procedures and ensure that subcontractors develop and implement complaint procedures to process and resolve client dissatisfaction with services. Complaint procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or any other complaints not related to termination, suspension or reduction in services which require the grievance process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook. The complaint procedures shall include notification to all clients of the complaint procedures and include tracking the date, nature of complaint and the determination of each complaint. 10. Audits, Inspections, Investigations, Public Records and Retention 10.1 The Recipient 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. Recipient 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 Recipient 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 Recipient shall facilitate the duplication and transfer of any records or documents during the required retention period in Paragraph 10.2. 10.4 The Recipient shall assure that the records described in Paragraph 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 Recipient's contracts and related records and documents pertinent to this specific contract, regardless of the form in which kept. 10.6 The Recipient 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 Recipient shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S. 11. Nondiscrimination -Civil Rights Compliance 11.1 The Recipient 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 rd July 2012- June 2014 16015DI 203.12 Recipient 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 Recipient shall complete and retain on file a timely, complete and accurate Civil Rights Compliance Checklist 11.3 The Recipient 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 Recipient, its successors, transferees, and assignees for the period during which such assistance is provided. The Recipient 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 Recipient 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. Provision of Services The Recipient shall provide services in the manner described in ATTACHMENT I. 13. Monitoring by the Agency The Recipient shall permit persons duly authorized by the Agency to inspect and copy any records, papers, documents, facilities, goods and services of the Recipient which are relevant to this contract, and to interview any clients, employees and subcontractor employees of the Recipient 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 Recipient, and where appropriate, the Recipient shall develop a corrective action plan. The Recipient hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Contract Manager. 14. Coordinated Monitoring with Other Agencies If the Recipient receives funding from one or more of the State of Florida other human service agencies, in addition to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human service agencies shall include the Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead administrative coordinator, the Recipient shall comply and cooperate with all monitors, inspectors, and/or investigators. 15. Indemnification The Recipient 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 Recipient is not required to indemnify the Agency for claims, demands, actions or causes of action arising solely out of the Agency's negligence. 15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contracts executed between the Department and state agencies or subdivisions defined in s. 768.28(2), F.S. 16. Insurance and Bonding 16.1 The Recipient 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 5 July 2012- June 2014 16015DI 203.12 as defined by subsection 768.28(2), F.S., the Recipient accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the Recipient and the clients to be served under this contract. The limits of coverage under each policy maintained by the Recipient do not limit the Recipient's liability and obligations under this contract. The Recipient shall ensure that the Agency has the most current written verification of insurance coverage throughout the term of this contract. Such coverage may be provided by a self - insurance program established and operating under the laws of the State of Florida. The Agency reserves the right to require additional insurance as specified in this contract. 16.2 Throughout the term of this agreement, the Recipient shall maintain an insurance bond from a responsible commercial insurance company covering all officers, directors, employees and agents of the Recipient authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by the insurance company and consistent with good business practices. 17. Confidentiality of Information The Recipient shall not use or disclose any information concerning a recipient of services under this contract for any purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized to give that consent or when authorized by law. 18. Health Insurance Portability and Accountability Act Where applicable, the Recipient shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 19. Incident Reporting 19.1 The Recipient shall notify the Agency immediately, but no later than forty -eight (48) hours from, the Recipient's awareness or discovery of conditions that may materially affect the Recipient or subcontractor's ability to perform the services required to be performed under this contract. Such notice shall be made orally to the Contract Manager (by telephone) with an email to immediately follow. 19.2 The Recipient 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 Recipient and its employees. 20. New Contract(s) Reporting The Recipient 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 Recipient shall complete and provide the information to the Agency's Contract Manager. 21. Bankruptcy Notification During the term of this contract, the Recipient shall immediately notify the Agency if the Recipient, its assignees, subcontractors or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Recipient 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. 22. Sponsorship and Publicity 22.1 As required by s. 286.25, F.S., if the Recipient is a non - governmental organization which sponsors a program on July 2012- June 2014 16D15ADI 203.12 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 Hope Hospice and Community Services, the State Agency of Elder Affairs, and the Area Agency on Aging for Southwest Florida, Inc." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs and the Area Agency on Aging for Southwest Florida, Inc." shall appear in at least the same size letters or type as the name of the organization. 22.2 The Recipient shall not use the words "The State of Florida Department of Elder Affairs or the Area Agency on Aging for Southwest Florida, Inc." to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by the State and Agency prior to use. 23. Assignments 23.1 The Recipient shall not assign the rights and responsibilities under this contract without the prior written approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring without prior written approval of the Agency will constitute a material breach of the contract. 23.2 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the Recipient. In the event the State of Florida approves transfer of the Recipient's obligations, the Recipient remains responsible for all work performed and all expenses incurred in connection with the contract. 23.3 This contract shall remain binding upon the successors in interest of either the Recipient or the Agency. 24. Subcontracts 24.1 The Recipient is responsible for all work performed and for all commodities produced pursuant to this contract, whether actually furnished by the Recipient or its subcontractors. Any subcontracts shall be evidenced by a written document and subject to any conditions of approval the Agency deems necessary. The Recipient further agrees that the Agency will not be liable to the subcontractor in any way or for any reason. The Recipient, at its expense, shall defend the Agency against any such claims. 24.2 The Recipient 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 Recipient and subcontractor, will result in a penalty as provided by statute. 25. Independent Capacity of Recipient It is the intent and understanding of the Parties that the Recipient, 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 Recipient and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the Recipient or its subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the Recipient are the sole responsibility of the Recipient. 26. Payment Payments shall be made to the Recipient pursuant to s. 215.422, F.S., as services are rendered and invoiced by the Recipient. The Contract Manager will have final approval of the invoice for payment, and will approve the invoice for payment only if the Recipient 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. 7 July 2012- June 2014 16015 1203.12 27. Return of Funds The Recipient 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 Recipient by the Agency. In the event that the Recipient or its independent auditor discovers that an overpayment has been made, the Recipient 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 Recipient in writing of such findings. Should repayment not be made forthwith, the Recipient will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after Agency notification or Recipient discovery. 28. Data Integrity and Safeguarding Information The Recipient shall ensure an appropriate level of data security for the information the Recipient is collecting or using in the performance of this contract. An appropriate level of security includes approving and tracking all Recipient employees that request system or information access and ensuring that user access has been removed from all terminated employees. The Recipient, 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 Recipient shall ensure all subcontractors maintain written procedures for computer system backup and recovery. The Recipient shall complete and sign ATTACHMENT IV prior to the execution of this contract. 29. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses the Department's computer resource systems must comply with the Department's policy regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. 30. Conflict of Interest The Recipient 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 Recipient 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 Recipient or subcontractor's officers, employees or agents will neither solicit nor accept gratuities, favors or anything of monetary value from contractors, potential contractors, or parties to subcontracts. The Recipient'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 Recipient's employees and subcontractors must make the same disclosures described above to the Recipient's board of directors. Compliance with this provision will be monitored. 31. 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 Recipient, 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. 8 July 2012- June 2014 32. Purchasing 16D15ADl 203.12 32.1 The Recipient 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 Recipient shall be deemed to be substituted for the Agency insofar as dealings with PRIDE. This clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of products /services available from PRIDE may be obtained by contacting PRIDE, (800) 643 -8459. 32.2 The Recipient may procure any recycled products or materials, which are the subject of or are required to carry out this contract, in accordance with the provisions of s. 403.7065, F.S. 32.3 The Recipient 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 Recipient 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. 33. 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 Recipient shall refer the discovery, invention or material to the Agency to be referred to the Department of State and 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. 33.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an unencumbered right to use such property, notwithstanding any agreement made pursuant to Paragraph 33. 33.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 34. Emergency Preparedness and Continuity of Operations 34.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the Recipient 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 Recipient shall notify the Agency of emergency provisions. 34.2 In the event a situation results in a cessation of services by a subcontractor, the Recipient shall retain responsibility for performance under this contract and must follow procedures to ensure continuity of operations without interruption. 35. EQUIPMENT If the contract tasks to be performed require the purchase of equipment with state or federal funds, the following paragraphs apply: 35.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the 9 July 2012- June 2014 16015 ADI 203.12 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]. 35.2 Recipients and subcontractors 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, (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must be maintained on file and shall be provided to the Agency upon request. The Recipient shall promptly investigate, fully document and notify the Contract Manager of any loss, damage, or theft of equipment. The Recipient shall provide the results of the investigation to the Contract Manager. 35.3 The Recipient'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 Recipient 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 Recipient compensates the Federal awarding agency for its share. 35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by the Department is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will vest in the Agency, 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 subcontractors (not included in a cost methodology), is subject to the conditions of section 273, F. S. and 60A- 1.0017, F. A. C. or Title 45 CFR Part 74. 35.5 The Recipient 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 Recipient 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 Recipient's proposed disposition (i.e., transfer or donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc). 35.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120 days of the written request for disposition, the Recipient is authorized to proceed as directed in 2 CFR Part 215 10 July 2012- June 2014 Administrative Requirements (formerly OMB Circular A -110). 16015ADI 203.12 35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but excludes movable machinery and equipment. Real property may not be purchased with state or federal funds through agreements covered under this contract without the prior approval of the Agency. Real property purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III, Part A., Sec. 3030b United States Code (USC). Real property purchases from state funds can only be made through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of section 216.348, F. S. 35.8 Any permanent storage devices (e.g., hard drives, removable storage media) must be reformatted and tested prior to disposal to ensure no confidential information remains. 35.9 The Recipient 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 Recipient has the responsibility to require any subcontractors to comply with the Agency's ITR procedures. 36. PUR 1000 Form The PUR 1000 Form is hereby incorporated by reference. In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract the terms or conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form shall take precedence. 37. Use of State Funds to Purchase or Improve Real Property Any state funds provided for the purchase of or improvements to real property are contingent upon the Recipient or political subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by law. 38. Dispute Resolution Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the decision to writing and serve a copy on the Recipient. 39. Financial Consequences of Non - Performance If the Recipient fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the Agency must apply financial consequences commensurate with the deficiency. Financial consequences may include, but are not limited to, contract suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of contract and reacquiring services from an alternate source. 39.1 The Recipient will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the Agency. 40. No Waiver of Sovereign Immunity Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which sovereign immunity may be applicable. 41. Venue If any dispute arises out of this contract, the venue of such legal recourse will be Lee County, Florida. 42. Entire Contract This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the Agency or the Recipient unless expressly contained herein or by a written amendment to this contract signed by both Parties. 11 July 2012- June 2014 16015kDI203.12 43. 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. 44. Severability Clause The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable the other provisions are severable to that void provision and shall remain in full force and effect. 45. Condition Precedent to Contract: 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. 46. 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. 47. Waiver The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any such right preclude any other or further exercise thereof or the exercise of any other right. 48. Compliance The Recipient 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 Recipient to abide by these laws shall be deemed an event of default of the Recipient, and subject the contract to immediate, unilateral cancellation of the contract at the discretion of the Agency. 49. Final Invoice The Recipient shall submit the final invoice for payment to the Agency as specified in Paragraph 3.3.5. (date for final request for payment) of ATTACHMENT I. If the Recipient 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 Recipient and necessary adjustments thereto have been approved by the Agency. 50. 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. 51. Termination 51.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the Contract Manager or the representative of the Recipient responsible for administration of the contract. 51.2 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 Recipient. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by 12 July 2012- June 2014 16D15ADI 203.12 hand delivery to the Contract Manager or the representative of the Recipient 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 Recipient will be compensated for any work satisfactorily completed prior to the date of termination. 51.3 This contract may be terminated for cause upon no less than twenty -four (24) hours notice in writing to the Recipient. 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 Recipient's rights to remedies at law or in equity. 51.4 Failure to have performed any contractual obligations with the Agency in a manner satisfactory to the Agency will be a sufficient cause for termination. To be terminated as a Recipient under this provision, the Recipient must have (1) previously failed to satisfactorily perform in a contract with the Agency, been notified by the Agency of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction of the Agency; or (2) had a contract terminated by the Agency for cause. 52. Electronic Records and Signature The Agency authorizes, but does not require, the Recipient to create and retain electronic records and to use electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A Recipient 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, Fla. Stat. All electronic records must be fully auditable; are subject to Florida's Public Records Law, ch. 119, Fla. Stat.; must comply with section 28, Data Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and maintained by the Recipient to the same extent as non - electronic records are retained and maintained as required by this Agreement. 52.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the Recipient and the Agency. The Recipient is authorized to conduct electronic transactions with the Agency only upon further written consent by the Agency. 52.2 Upon request by the Agency, the Recipient 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. 53. Official Payee and Representatives (Names, Addresses, and Telephone Numbers): a. The Recipient name, as shown on page 1 of this contract, and mailing address of the official payee to whom the payment shall be made is: Collier County Board of County Commissioners Housing and Human Services Departments 3339 Tamiami Trail E Bldg H, Rm 211 Naples, FL 34112 Kimberly Grant, Interim Director The name of the contact person and street address where Collier County Board of County Commissioners b financial and administrative records are maintained is: Housing and Human Services Departments 3339 Tamiami Trail E Bldg H, Rm 211 Naples, FL 34112 Kimberly Grant, Interim Director Collier County Board of County Commissioners C. The name, address, and telephone number of the Housing and Human Services Departments representative of the Recipient responsible for 3339 Tamiami Trail E Bldg H, Rm 211 administration of the program under this contract is: Naples, FL 34112 (239) 252 -2273 13 July 2012- June 2014 16D15 ADI 203.12 54. All Terms and Conditions Included This contract and its Attachments, I — X and any exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. By signing this contract, the Parties agree that they have read and agree to the entire contract IN WITNESS THEREOF, the Parties hereto have caused this 38 page contract, to be executed by their undersigned officials as duly authorized. Recipient: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS SIGNED BY: AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. DBA SENIOR CHOICES OF SOUTHWEST FLORIDA SIGNED BY: NAME:,-d �. G rn NAME TITLE:��- pry4v47I,L�V� iVl j <lioU� DATE:���Z� Federal Tax ID: 59- 6000588 Fiscal Year Ending Date: 09/30 14 LEIGH ANNA NOWAK TITLE: BOARD PRESIDENT DATE: 11 e , � d. J C), ( D-. Area Agency on Aging for Southwest Florida, Inc. d The section and location within the Agency where dba Senior Choices of Southwest Florida Requests for Payment and Receipt and Expenditure forms 15201 N. Cleveland Ave, Suite 1100 are to be mailed is: North Fort Myers, Florida 33903 Leigh Wade, Executive Director Area Agency on Aging for Southwest Florida, Inc. e• The name, address, and telephone number of the Contract dba Senior Choices of Southwest Florida Manager for this contract is: 15201 N. Cleveland Ave, Suite 1100 North Fort Myers, Florida 33903 (239) 652 -6900 Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 54. All Terms and Conditions Included This contract and its Attachments, I — X and any exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. By signing this contract, the Parties agree that they have read and agree to the entire contract IN WITNESS THEREOF, the Parties hereto have caused this 38 page contract, to be executed by their undersigned officials as duly authorized. Recipient: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS SIGNED BY: AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. DBA SENIOR CHOICES OF SOUTHWEST FLORIDA SIGNED BY: NAME:,-d �. G rn NAME TITLE:��- pry4v47I,L�V� iVl j <lioU� DATE:���Z� Federal Tax ID: 59- 6000588 Fiscal Year Ending Date: 09/30 14 LEIGH ANNA NOWAK TITLE: BOARD PRESIDENT DATE: 11 e , � d. J C), ( D-. July 2012- June 2014 INDEX TO CONTRACT ATTACHMENTS 16D15 ADI 203.12 ATTACHMENT ATTACHMENT DESCRIPTION PAGE ATTACHMENT I STATEMENT OF WORK 16 -24 ATTACHMENT II CERTIFICATION REGARDING LOBBYING 25 ATTACHMENT III FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT 26 -30 ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE 31 ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, 32 INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS /SUBCONTRACTS ATTACHMENT VI ASSURANCES— NON - CONSTRUCTION PROGRAMS 33 -34 ATTACHMENT VII ALZHEIMER'S DISEASE INITIATIVE INVOICE REPORT SCHEDULE 35 ATTACHMENT VIII ALZHEIMER'S DISEASE INITIATIVE PROGRAM BUDGET SUMMARY 36 ATTACHMENT IX REQUEST FOR PAYMENT DOEA FORM 106Z 37 ATTACHMENT X RECEIPTS AND EXPENDITURES REPORT, DOEA FORM 105Z 38 15 July 2012- June 2014 16015 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease (AD) Alzheimer's Disease Initiative (ADI) Activities of Daily Living (ADL) Assessed Priority Consumer List (APCL) Adult Protective Services (APS) Client Information and Registration Tracking System (CIRTS) Community Care for Disabled Adults (CCDA) Department of Elder Affairs (DOEA) Home Care For Disabled Adults (HCDA) Instrumental Activities of Daily Living (IADL) Memory Disorder Clinic (MDC) Planning and Service Area (PSA) 1.1.2 PROGRAM SPECIFIC TERMS ADI 203.12 ATTACHMENT I Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to the Department's community -based services. Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the Agency enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan as instructed by the Department. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. Memory Disorder Clinic: Research oriented programs created pursuant to Sections 430.502(1) and (2), F.S., to provide diagnostic and referral services, conduct basic and service- related multidisciplinary research, and develop training materials and educational opportunities for lay and professional caregivers of individuals with AD. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 16 July 2012- June 2014 16015 ADI 203.12 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD, their families and caregivers. 1.2.1.1 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder- friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.2 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D -1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.2.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20,2010; (2) CFO Memo No. 03: Release date, June 29,2010; and (3) CFO Memo No. 06: Release date, June 30, 2010. 1.2.3 Scope of Service The Recipient is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Recipient's Request for Proposal, RFP, and the Agency's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.4 Major Program Goal The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be suspected of having AD or a related disorder; and (2) Not be enrolled in a Medicaid capitated long -term care program. 1.3.3 Targeted Groups Priority for services under this contract will be given to those eligible persons assessed to be at risk of placement in an institution. 17 July 2012- June 2014 1(D 10 1 -5 ADI 203.12 SECTION H: MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the ADI program, the Recipient shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of subcontractors. 2.1.1 Client Eligibility Determination The Recipient shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this ATTACHMENT I, SECTION 1.3. 2.1.2 Assessment and Prioritization of Service Delivery for New Clients The Recipient shall ensure the following criteria are used to prioritize new clients for service delivery. It is not the intent of the Agency to remove existing clients from any services in order to serve new clients being assessed and prioritized for service delivery. 2.1.2.1 Priority Criteria for Service Delivery (1) Individuals in nursing homes under Medicaid who could be transferred to the community; (2) Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the community; (3) Individuals in nursing homes that are closing and can be discharged to the community; (4) Individuals whose mental or physical health condition has deteriorated to the degree self care is not possible, there is no capable caregiver, and institutional placement will occur within 72 hours; and (5) For the purpose of transitioning individuals receiving CCDA and HCDA services through the Department of Children and Families' Adult Services to community -based services provided through DOEA when services are not currently available, area agency on aging staff and lead agency case managers will ensure that "Aging Out" individuals are prioritized for services only after APS High Risk and Imminent Risk individuals. 2.1.2.2 Priority Criteria for Service Delivery for Other Assessed Individuals The assessment and provision of services should always consider the most cost effective means of service delivery. Functional impairment will be determined through the Agency and or Department's functional assessment form administered to each applicant. The most frail individuals not prioritized as described in this attachment, Paragraph 2.1.2.1 will receive services to the extent funding is available. 2.1.3 Delivery of Services to Eligible Clients The Recipient shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Recipient shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training /Support; (2) Case Aid; (3) Case Management; (4) Counseling (Gerontological); (5) Counseling (Mental Health/Screening); (6) Education/Training; July 2012- June 2014 16D15 ADI 203.12 (7) Model Day Care; ( 8) Respite (Facility- Based); ( 9) Respite (In- Home); and (10) Specialized Medical Equipment, Services, and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.1.4 Use of Subcontractors If this contract involves the use of a subcontractor or third party, then the Recipient 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 Recipient shall notify the Contract Manager and the Agency's Director of Finance in writing of such delay. 2.1.4.1 The Recipient shall not permit a subcontractor to perform services related to this agreement without having a binding subcontractor agreement executed. In accordance with Section 24.1 of the Standard Contract, the Agency will not be responsible or liable for any obligations or claims resulting from such action. 2.1.4.2 Monitoring the Performance of Subcontractors The Recipient will monitor at least once per year each of its subcontractors, subrecipients, vendors and/or consultants paid from funds provided under this contract. The Recipient will 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 Recipient will monitor to ensure that time schedules are met, the budget and scope of work are accomplished within the specified time periods and other performance goals stated in this contract are achieved. 2.2 SERVICE TIMES 2.2.1 Service Times The Recipient shall ensure the services listed in this contract are available at times appropriate to meet client service needs, at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The Recipient shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling (Gerontological); Hour Counseling (Mental Health/Screening); Hour Respite (Facility- Based); Hour Respite (In- Home); Hour Education/Training; Episode Specialized Medical Equipment, Services, and Episode Supplies. 19 July 2012- June 2014 16015ADI 203.12 2.4 REPORTS The Recipient 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 Recipient shall establish due dates for any subcontractors that permits the Recipient to meet the Agency's reporting requirements. 2.4.1 Client Information and Registration Tracking System ( CIRTS) The Recipient shall input ADI specific data into CIRTS database system to ensure CIRTS data accuracy. The Recipient shall use CIRTS generated reports which include the following: (1) Client Reports; (2) Monitoring Reports; (3) Services Reports; (4) Miscellaneous Reports; (5) Fiscal Reports; (6) Aging and Disability Resource Center Reports; and (7) Outcome Measurement Reports. 2.4.2 Service Costs Reports The Recipient shall require its subcontractors to submit to it the Recipient semi - annual service cost reports, February 15 and August 15 of each year, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.3 Surplus/Deficit Report The Recipient shall submit a consolidated surplus /deficit report in a format provided by the Agency to the Contract Manager by the 18th of each month. This report is for all agreements and/or contracts between the Recipient and the Agency. This report will include the following: (1) The Recipient's detailed plan on how the surplus or deficit spending exceeding the threshold specified by the Agency will be resolved; and (2) Recommendations to transfer funds to resolve surplus /deficit spending; 2.5 RECORDS AND DOCUMENTATION 2.5.1 The Recipient shall ensure the collection and maintenance of client and service information on a monthly basis from the CIRTS or any such system designated by the Agency and the State of Florida Department of Elder Affairs. Maintenance includes valid exports and backups of all data and systems according to Department and/or Agency standards. 2.5.2 Each Recipient 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 Recipient 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 Recipient 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 20 July 2012- June 2014 16015ADI 203.12 (1) The Recipient shall ensure services provided under this contract are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The Recipient shall timely submit to the Agency all reports described in ATTACHMENT I, SECTION 2.4 REPORTS; and (3) The Recipient shall timely submit to the Agency all information described in ATTACHMENT I, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.6.2 The Recipient shall develop and document strategies in the Request for Proposal (RFP) 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) Average monthly savings per consumer for home and community -based care versus nursing home care for comparable client groups; (3) Percent of elders assessed with high or moderate risk environments who improved their environment score; (4) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved; (5) Percent of new service recipients whose ADL assessment score has been maintained or improved; (6) Percent of new service recipients whose IADL assessment score has been maintained or improved; (7) Percent of family and family- assisted caregivers who self -report they are very likely to provide care; (8) Percent of caregivers whose ability to provide care is maintained or improved after one year of service intervention (as determined by the caregiver and the assessor); and (9) Percent of customers who are at imminent risk of nursing home placement who are served with community -based services. The Recipient's performance of these measures will be documented in the Agency's annual monitoring reports. 2.7 RECIPIENT'S FINANCIAL OBLIGATIONS 2.7.1 Cost Sharing and Co- payments The Recipient shall establish annual co- payment goals. The Agency has the option to withhold a portion of the Recipient's request for payment if goals are not met according to the Agency and the Department of Elder Affairs' co- payment guidelines. 2.7.1.1 Co- payments include only the amounts assessed consumers or the amounts consumers opt to contribute in lieu of an assessed co- payment. The contribution must be equal to or greater than the assessed co- payment. 2.7.2 Use of Service Dollars and Assessed Priority Consumer List Management The Recipient is expected to spend all federal, state and other funds provided by the Agency for the purpose specified in each contract. The Recipient must manage service funds 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 Agency. If the Agency determines that the Recipient is not spending service funds accordingly, the Agency may transfer funds to other planning and service areas during the contract period and/or adjust subsequent funding allocations accordingly, as allowable under state and federal law. 2.8 AGENCY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance 21 16D15 July 2012- June 2014 ADI 203.12 The Agency will provide the Recipient with guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Recipient. 2.8.2 Contract Monitoring The Agency will review and evaluate the performance of the Recipient under the terms of this contract. Monitoring shall be conducted through direct contact with the Recipient through telephone, in writing, or an on- site visit. The Agency's determination of acceptable performance shall be conclusive. The Recipient 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. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this contract includes advances, cost reimbursement for administration costs, and fixed rate for services. The Recipient 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 Recipient shall consolidate all requests for payment from subcontractors and expenditure reports that support requests for payment and shall submit to the Agency on forms 106Z (ATTACHMENT IX) and 105Z (ATTACHMENT X). 3.1.1 The Recipient agrees to distribute funds as detailed in the area plan update and the Budget Summary, ATTACHMENT VIII to this contract. Any changes in the total amounts of funds identified on the Budget Summary form require a contract amendment. 3.2 Advance Payments 3.2.1 The Recipient may request up to two months of advances at the start of the contract period to cover program administrative and service costs. The schedule for submission of advance requests, if available, is shown on ATTACHMENT VII to this contract. The payment of an advance will be contingent upon the sufficiency and amount of funds released to the Agency and the State of Florida Department of Elder Affairs ( "budget release "). The Recipient shall provide the Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. 3.2.2 The Recipient's requests for advance require the approval of the Contract Manager. If sufficient budget is available, the Agency will issue approved advance payments after July 1, 2011. 3.2.3 All advance payments made to the Recipient 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 VII to this contract. 3.2.4 The Recipient may temporarily place advanced funds in a FDIC insured interest bearing account. All interest 22 July 2012- June 2014 ADI 203.12 earned on contract fund advances must be returned to the Agency within thirty (30) days of the end of each quarter of the contract period. 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 106Z (ATTACHMENT X) and 105Z (ATTACHMENT XI). 3.3.1 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. 3.2 Advance Payments 3.2.1 The Recipient may request up to two months of advances at the start of the contract period 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 Department by the State of Florida ( "budget release "). The Recipient shall provide the Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. 3.2.2 The Recipient's requests for advance require the approval of the Contract Manager. If sufficient budget is available, the Agency will issue approved advance payments after July 1, 2012. 3.2.3 All advance payments made to the Recipient 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 VII to this contract. 3.2.4 The Recipient may temporarily place advanced funds in a FDIC insured interest bearing account. All interest earned on contract fund advances must be returned to the Agency within thirty (30) days of the end of each quarter of the contract period. 3.3 Invoice Submittal and Requests for Payment All requests for payment documentation and expenditure reports submitted to support requests for payment shall be on DOEA forms 106Z (ATTACHMENT IX) and 105Z (ATTACHMENT X). 3.3.1 Remedies - Nonconforming Services The Recipient 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 Recipient 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 Recipient's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Recipient shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The Agency and or Department require 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 Recipient shall ensure the provision of services to the projected number of clients in accordance with the Area Plan as updated and within the contract amount. The Recipient shall ensure expenditure of 100% of the contract amount budgeted for services to clients at the unit rates established in the Area Plan. In the event the Recipient has a surplus of 1% or more at the end of the first year of the contract term, the Agency will 23 July 2012- June 2014 16D15 ADI 203.12 reallocate I% of the budget for the second year of the contract term to other area agencies found to be serving clients to the fullest extent of their allocated budgets. If, or to the extent, there is any conflict between this paragraph and paragraphs 39 and 39.1 of the standard contract, this paragraph shall have precedence. 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 VII to this contract. 3.3.4 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in ATTACHMENT VIII, Budget Summary. 3.3.5 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 Recipient and any adjustments thereto, including any disallowance not resolved as outlined in Section 26 of this contract. 3.3.6 Date for Final Request for Payment The final request for payment for contract year one's expenditures will be due to the Agency no later than August 1, 2013. The final request for payment for contract year two expenditures will be no later than August 1, 2014. 3.4 Documentation for Payment The Recipient shall maintain documentation to support payment requests that shall be available to the Agency or authorized individuals, such as the Department of Financial Services, upon request. 3.4.1 The Recipient must enter all required data per the Department's CIRTS Policy Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS before the Recipient submits their request for payment and expenditure reports to the Agency. The Agency shall establish time frames to assure compliance with due dates for the requests for payment and expenditure reports to the Agency and the Department. 3.4.2 The Recipient must run monthly CIRTS reports and verify that the client and service data in the 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 Recipient's request for payment and expenditure reports can be approved by the Agency. 24 July 2012- June 2014 16015 ADI 203.12 ATTACHMENT II CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub - awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans and cooperative agreements) and that all subcontractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature sue, Cak Uri Name of Authorized Individual Collier County Board of Commissioners 3299 Tamiami Trail E Naples, FL 34112 6(Wa Date kb 1 2 03. l2. Application or Agreement Number 25 July 2012- June 2014 Ith a 15 ADI 203.12 ATTACHMENT III FINANCIAL AND COMPLIANCE AUDIT The administration of resources awarded by the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs to the provider may be subject to audits and/or monitoring by the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs 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 provider agrees to comply and cooperate with any monitoring procedures /processes deemed appropriate by the Area Agency on Aging for Southwest Florida, Inc. In the event the Area Agency on Aging for Southwest Florida, Inc. determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Area Agency on Aging for Southwest Florida, Inc. to the provider regarding such audit. The provider 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 provider 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 provider expends $500,000 or more in federal awards during its fiscal year, the provider must have a single or program- specific audit conducted in accordance with the provisions of OMB Circular A -133, as revised. EXHIBIT 1 to this agreement indicates federal resources awarded through the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs by this agreement. In determining the federal awards expended in its fiscal year, the provider shall consider all sources of federal awards, including federal resources received from the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or 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 provider 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 1, paragraph 1, the provider shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised. If the provider expends less than $500,000 in federal awards in its fiscal year, an audit conducted in accordance with the provisions of OMB Circular A -133, as revised, is not required. In the event that the provider expends less than $500,000 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 provider resources obtained from other than federal entities.) An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. and/or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs shall be fully disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc. and/or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or 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 provider's fiscal year end. 26 July 2012- June 2014 PART II: STATE FUNDED 16015 ADI 203.12 This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes. In the event that the provider expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider 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 Area Agency on Aging for Southwest Florida, Inc. and/or the Department of Elder Affairs by this agreement. In determining the state financial assistance expended in its fiscal year, the provider shall consider all sources of state financial assistance, including state financial assistance received from the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of Southwest Florida and /or 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 provider 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 provider expends less than $500,000 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 provider expends less than $500,000 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 provider resources obtained from other than State entities). An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs shall be fully disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc. and/or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or 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 provider'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 provider's fiscal year end. Notwithstanding the applicability of this portion, the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or 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 provider 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 27 16D15 July 2012- June 2014 ADI 203.12 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 101h 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 provider 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 provider 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 the Area Agency on Aging for Southwest Florida, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A -133, Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations), Rules of the Auditor General, as applicable. Providers, when submitting financial reporting packages to the Area Agency on Aging for Southwest Florida, Inc. 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 provider in correspondence accompanying the reporting package. PART IV: RECORD RETENTION The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued, and shall allow the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and or the Department of Elder Affairs or its designee, the CFO or Auditor General access to such records upon request. The provider shall ensure that audit working papers are made available to the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs, or its designee, CFO, or Auditor General upon request for a period of six years from the date the audit report is issued, unless extended in writing by the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs. July 2012- June 2014 16015ADI 203.12 ATTACHMENT III EXHIBIT — 1 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT TOTAL FEDERAL AWARD COMPLIANCE REQUHtEMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT TOTAL STATE AWARD STATE FINANCIAL ASSISTANCE SUBJECT TO See. 215.97. F_S_ PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT Alzheimer's Disease Initiative General Revenue 65004 $94,719.00 TOTAL AWARD $94,719.00 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 29 July 2012- June 2014 16015 ADI 203.12 ATTACHMENT III EXHIBIT -2 PART I: AUDIT RELATIONSHIP DETERMINATION Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A -133, as revised, and/or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A- 133, as revised, and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, providers who have been determined to be recipients or subrecipients of Federal awards and/or state financial assistance, must comply with applicable programmatic and fiscal compliance requirements. In accordance with Sec. 210 of OMB Circular A -133 and/or Rule 691 - 5.006, FAC, provider has been determined to be: Vendor or exempt entity and not subject to OMB Circular A -133 and/or Section 215.97, F.S. X Recipient /subrecipient subject to OMB Circular A -133 and /or Section 215.97, F.S. NOTE: If a provider is determined to be a recipient /subrecipient of federal and or state financial assistance and has been approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 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. Providers who receive Federal awards or state matching funds on Federal awards and who are determined to be a subrecipient, must comply with the following fiscal laws, rules and regulations: STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW: 2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)* OMB Circular A -102 — Administrative Requirements OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations NON - PROFIT ORGANIZATIONS MUST FOLLOW: 2 CFR Part 230 Cost Principles for Non -Profit Organizations (Formerly OMB Circular A -122 — Cost Principles)* 2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements) Requirements) OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW: 2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A -21 — Cost Principles)* 2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements) OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations *Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular A -133 Compliance Supplement, Appendix 1. STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a recipient/subrecipient, must comply with the following fiscal laws, rules and regulations: Section 215.97, Fla. Stat. Chapter 69I -5, Fla. Admin. Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations kro July 2012- June 2014 CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS 161115 ADI 203.12 ATTACHMENT IV The undersigned, an authorized representative of the Recipient named in the contract or agreement to which this form is an attachment, hereby certifies that: (1) The Recipient and any subcontractors of services under this contract have financial management systems capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant- funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly. (2) Management Information Systems used by the Recipient, subcontractor(s), or any outside entity on which the Recipient 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, Recipient(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 Recipient (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 Recipient 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 Recipient and any subcontractor(s) of services under this contract warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The Recipient shall require that the language of this certification be included in all subagreements, subgrants, and other agreements and that all subcontractors shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A -102 and 2 CFR Part 215 (formerly OMB Circular A -110). L'ct(ievL�cte�i � � t>,t C��>'ril�sli -r��r5 Name and Address of Recipient s Signature Title Date Name of Authorized Signer Collier County Board of Commissioners 3299 Tamiami Trail E Naples, FL 34112 31 .��v,,� N 0X Q_ C.N. wr" X-r Y_ July 2012- June 2014 16DI; ADI 203.12 ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective Recipient certifies, by signing this certification, neither it nor its principals is 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 Recipient is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this certification. 2-1 k2 il2 Signature Date Title Agency /Organization (Certification signature should be same as Contract signature.) Instructions for Certification `L.. tj - 1. The terms covered transaction, debarred, suspended, ineligible, lower tier coveredt transaction," " erson " , "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 Recipient knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the Department or Agency may pursue available remedies, including suspension and/or debarment. 3. The Recipient will provide immediate written notice to the Contract Manager if at any time the Recipient learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The Recipient 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 Recipient 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 Recipient 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 Recipient 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 or Agency may pursue available remedies, including suspension, and/or debarment. 7. The Recipient 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. 32 July 2012- June 2014 16015ADI 203.12 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.. 4728 -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.. 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C., 6101 - 6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to nondiscrimination on the basis of drug abuse; (0 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 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C., 1501 -1508 and 7324 - 7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C., 276a to 276a -7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C.. 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C., 327 -333), regarding labor standards for federally assisted construction subagreements. 33 July 2012- June 2014 16015ADI 203.12 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 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C.. 1451 et seq.); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C., 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93 -523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93 -205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C., 1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C..470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C..469a -1 et seq.). 14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C._ 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C..4801 et seq.), which prohibits the use of lead- based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non -Profit Organizations. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED GkP)Tj 7BC)CC, 6(Z1 V'-> 34 July 2012- June 2014 ALZHEIMER'S DISEASE INITIATIVE (ADI) INVOICE SCHEDULE 16D15 ADI 203.12 ATTACHMENT VII Report Submit to Agency Number Based On On This Date 1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 15 4 August Expenditure Report September 15 5 September Expenditure Report October 15 6 October Expenditure Report November 15 7 November Expenditure Report December 15 8 December Expenditure Report January 15 9 January Expenditure Report February 15 10 February Expenditure Report March 15 11 March Expenditure Report April 15 12 April Expenditure Report May 15 13 May Expenditure Report June 15 14 June Expenditure Report July 15 15 Final Request for Payment July 25 16 Closeout Report August 1 Legend: * Advance based on projected cash need. Note # 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida prior to July 1 or until the contract with the Agency has been executed and a copy sent to Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida. Actual submission of the vouchers to DFS is dependent on the accuracy of the expenditure report. Note # 2: All advance payments made to the Recipient 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. The adjustment shall be recorded in Part C, 1 of the report (Attachment X). 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. 35 July 2012- June 2014 16D15 ADI 203.12 ATTACHMENT VIII ALZHEIMER'S DISEASE INITIATIVE PROGRAM BUDGET SUMMARY for Collier County Board of County Commissioners 1. Respite $93,969.00 2. Case Management and Case Aide Allocation 750.00 3. Total $94,719.00 RATE SUMMARY for Collier County Board of County Commissioners SERVICES Case Management Case Aide In -Home Respite Respite Facility Specialized Medical Equipment, Services and Supplies 36 UNIT RATE $55.50 $30.00 $24.44 $12.22 100% Reimbursement July 2012- June 2014 16015 REQUEST FOR PAYMENT ALZHEIMERS DISEASE INITIATIVE PROGRAM ADI 203.12 ATTACHMENT IX RECIPIENTNAId `,ADDRES3,PiiONEkand rEIDJO TYPE OF REPORT: This RequestPedod PSA fi A. PAYMLN I KLWLS I: Report A Regular_....._._ Supplemental Contract S. METHOD OF PAYAIi:NT: Contract Period Advance Reimburceracnt CERTIFICATICN: I hereby cartiy to the bes: of my knowledge that this request Is ooinp:ele and correct and conforms with the terms and the purposes of the above contrW. Prepared by: bete: Approved by. Data (1) (2) PARTA: 6UDGETSUMMARY ResloM Model Day Care TOTAL 1. Approved Contract Amount $0,00 $0,00 $0.00 2. Previous Funds Received for Conliaut Period $0.00 50.00 $lt.()n 3. Contract Batarce (line 1 minus ine 2) $0.00 $0.00 "'Co 4. Previous Furds Requested and Not Received fur Cont^tc: Pedud $0.0 50.00 $n nn N. t:oritract Halarm (line. 3 minus line 4) $0.00 $0,00 $0.00 YARr R, CONTRACT FUNDS REQUEST 1. Arill6pated Cash Needs (1st • 2nd month, Attach Justifice:ior) $0.00 $0.00 10,00 2, Net Expendit.rtes For Month 50.00 V.DO ;000 (DOCA rcrm 1052 Pa..t B, UnD 3) 3. TOTAL $0.00 $0.00 $0.00 PART U NET FUNDS REQUESTED 1. Less Advance Aapliod $0.00 $0.00 $$0.00 2. Contract Funds are Hereby Requosted for ;Part B, Llne 3 50.00 $0,00 SO 00 minus Part C, Lina 1) List of Seavicesl Urts I Rates provided - See attached report. DOEA FORM 1662 nevi; ed 51V 12 37 July 2012- June 2014 RECEIPT AND EXPENDITURE REPORT ALZHEIMERS DISEASE INITIATIVE PROGRAM 161115 ADI 203.12 ATTACHMENT X PART [3: EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For Thls Report. Year to Date Approved Bud 1. Administrative Services $0.00 $0.00 $0.00 #DIVlOt 2. Service Subcontractor(s) $0.00 $0.00 $0.00 #DIV/0t 3. TOTAL EXPENDITURES 50.00 $0.00 $0.00 #DIV /01 PART C : OTHER REVENUE AND EXPENDITURES 11, Interest: Ill. Advance Recouped 1. Program Income (PI) 1. Earned on GR Advance $ $ 1. ADI: PI Colloctod YTO S 2. Return of GR Advance $ (Includes co- payments collected) 3. Other Earned $_ PART D: (:U- f'AYMLN'rS 1. Total of Co- payments assessed 2. Total or Co- payments collected (For Tracking Purposes only) DOER FORM 1052 R"..d 6262010 CURRENT MONTH YEAR-TO-DATE $ $ $ S • Respite Model Day Care From ------ _ To CONTRACT PERIOD: CONTRACT # REPORT # PS A# CERTIFICATION: I ccrtity to the best of my knowledge and belief that the report is complete and correct and all outlays herein are for purposes set forth in the contract. Prepared by : Date: Approved by: PART A: BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budg©t For This Report Year to Date Anomyod,13udge t 1. State Funds $0.00 $0.00 $0.00 #DIV/01 2. Program Income $$0.00 $0.00 $0.00 MDIV /Ol 3. Local Cash Match $0.00 $0.00 $0.00 #DIV /Of 4. SUBTOTAL: CASH RECEIPTS 5. Local In -Kind Match 0. TOTAL RECEIPTS $0.00 $0.00 SO.00 #DIW01 PART [3: EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For Thls Report. Year to Date Approved Bud 1. Administrative Services $0.00 $0.00 $0.00 #DIVlOt 2. Service Subcontractor(s) $0.00 $0.00 $0.00 #DIV/0t 3. TOTAL EXPENDITURES 50.00 $0.00 $0.00 #DIV /01 PART C : OTHER REVENUE AND EXPENDITURES 11, Interest: Ill. Advance Recouped 1. Program Income (PI) 1. Earned on GR Advance $ $ 1. ADI: PI Colloctod YTO S 2. Return of GR Advance $ (Includes co- payments collected) 3. Other Earned $_ PART D: (:U- f'AYMLN'rS 1. Total of Co- payments assessed 2. Total or Co- payments collected (For Tracking Purposes only) DOER FORM 1052 R"..d 6262010 CURRENT MONTH YEAR-TO-DATE $ $ $ S • 16D15 Attestation Statement Agreement/Contract Number ADI 203.12 Amendment Number I, Steve Carnell , attest that no changes or revisions have been made to the (Recipient/Contractor representative) content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida dba as Senior Choices of Southwest Florida and Collier County Board of Commissioners (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting, due to the differences in electronic data processing media, which has no affect on the agreement/contract content. Steve Carnell, Interim Administrator Collier County Public Services Division i t-z' Date 16015 Verification of Employment Status Certification As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida, Collier County Board of County Commissioners, hereby referred to as Recipient, certifies the use of the U.S. Department of Homeland Security's E- verify system to verify the employment eligibility of all new employees hired by Recipient during the contract term to perform employment duties pursuant to this Agreement and that any subcontracts include an express requirement that subcontractors performing work or providing services pursuant to this Agreement utilize the E- verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term. ,2 - M � (fl� gignatYre (Same as contract signature) Steve Carrell, Interim Administrator Collier County Public Services Division Title Collier Cou= Board of Commissioners Company V 2 " Date 16D15 VERIFICATION OF EMERGENCY PREPAREDNESS PLAN Contract # ADI 203.12 I, Steve Carnell ,certify that Collier County Board of 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 available to the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida, upon request. --�' U� , GjdV14 SignatulY of authorized contractor representative Interim Administrator Collier County Public Services Division Title Date Collier County Board of Commissioners Company October 2008 16D15 CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is an attachment, hereby certifies that: (1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a proposal for, or enter into or renew a contract with the Agency and or Department of Elder Affairs Department) for goods or services of $1 million or more. (2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false certification to the Department is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. (3) The Contractor understands that the contract to which this form is an attachment may be terminated by the Agency and /or Department if the Contractor submits a false certification or has been placed on the Lists. This certification, required by Florida law, is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction. -�, , (A Signatu (Same as contract signature) Steve Carnell, Interim Administrator Collier County Public Services Division Title Collier County Board of Commissioners Company Name Date July 2012 — June 2014 HCE 203.12 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. dba SENIOR CHOICES OF SOUTHWEST FLORIDA STANDARD CONTRACT 16015 HOME CARE FOR THE ELDERLY PROGRAM THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida ( "Agency ") and Collier County Board of County Commissioners, ( "Recipient "), and collectively referred to as the "Parties." The term Recipient 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 Recipient has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent Recipient 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 STATEMENT Mission: To help aging adults, 60 and older, achieve greater independence through awareness of resources and access to qualified service providers. Vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. Values: The Agency believes the 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; ➢ Personal and professional accountability from all stakeholders. Lead agencies and local service providers as partners and stakeholders in Florida's aging services network are expected to support the agency's mission, vision, and priorities. 2. Incorporation of Documents within the Contract The contract will incorporate attachments, proposal(s), area plan(s), grant agreements, relevant Department handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other general materials not specific to this contract document and identified attachments. 3. Term of Contract This is a two -year contract shall begin on July 1, 2012 or on the date on which the contract has been signed by the last party required to sign it, whichever is later. It shall end at midnight, local time in North Fort Myers, Florida, on June 30, 2014. 4. Contract Amount The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $61,709.00 for year one, 2012 - 2013, 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. July 2012 — June 2014 1601 HCE 203.12 5. Renewals By mutual agreement of the Parties, in accordance with s. 287.058(1)(f), F.S., the Agency may renew the contract every two years within the six year bid term , 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 six year 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 the following shall apply: 6.1.1 The Recipient shall comply with the provisions of 45 CFR 74 and /or 45 CFR 92, and other applicable regulations. 6.1.2 If this contract contains federal funds and is over $100,000.00, the Recipient 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 Recipient shall report any violations of the above to the Agency. 6.1.3 The Recipient, or agent acting for the Recipient, 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 Recipient 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 Recipient 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 If this contract contains federal funds and provides services to children up to age 18, the Recipient shall comply with the Pro - Children Act of 1994 (20 U.S.C. 6081). 6.1.6 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 Recipient shall comply with these provisions before doing business or entering into subcontracts receiving federal funds pursuant to this contract. The Recipient shall complete and sign ATTACHMENT V prior to the execution of this contract. 6.2 The Recipient 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 Recipient 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 Recipient must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation. 6.4 The Recipient shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 6.5 Unless exempt under 2 CFR Part 170.110(b), the Recipient 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, Recipient agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the 2 July 2012 — June 2014 16 Lf 15 HCE 203.12 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11 -116, Recipient agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the employment of all new employees hired by Contractor during the contract term. Recipient 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. Recipients 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 Recipient shall comply with requirements of s. 287.058, F.S. as amended. 7.2.1 The Recipient 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 Recipient 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 Recipient 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 Recipient 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 Recipient in conjunction with this contract except for those records which are made confidential or exempt by law. The Recipient's refusal to comply with this provision will constitute an immediate breach of contract for which the Agency may unilaterally terminate the contract. 7.3 If clients are to be transported under this contract, the Recipient 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 Recipient 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 Department for goods or services of $1 million or more. Pursuant to s. 287.135 F.S., the Department may terminate this contract if the Contractor is found to have submitted a false certification of its status on the Lists or has been placed on the Lists. 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 the Certification Regarding Scrutinized Companies Lists, prior to the execution of this contract 8. BackEround Screening The Recipient 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 exempted from the Department's level 2 background screening pursuant to s. 430.0402(2) -(3), F.S. The Recipient 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. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. July 2012 — June 2014 9. Grievance and Compliant Procedures 16D15 HCE 203.12 9.1 Grievances Procedures The Recipient shall comply with and ensure subcontractor compliance with the Minimum Guidelines for Recipient Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handbook, to address complaints regarding the termination, suspension or reduction of services, as required for receipt of funds. 9.2 Complaint Procedures The Recipient shall develop and implement complaint procedures and ensure that subcontractors develop and implement complaint procedures to process and resolve client dissatisfaction with services. Complaint procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or any other complaints not related to termination, suspension or reduction in services, which require the grievance process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook. The complaint procedures shall include notification to all clients of the complaint procedures and include tracking the date, nature of complaint and the determination of each complaint. 10. Audits, Inspections, Investigations, Public Records and Retention 10.1 The Recipient 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. Recipient 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 Recipient 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 Recipient shall facilitate the duplication and transfer of any records or documents during the required retention period in Paragraph 10.2. 10.4 The Recipient shall assure that the records described in Paragraph 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 Recipient's contracts and related records and documents pertinent to this specific contract, regardless of the form in which kept. 10.6 The Recipient 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 Recipient shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S. 11. Nondiscrimination -Civil Rights Compliance 11.1 The Recipient 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 Recipient 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 Recipient shall complete and retain on file a timely, complete and accurate 4 July 2012 — June 2014 16015 CE 203.12 Civil Rights Compliance Checklist 11.3 The Recipient 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 Recipient, its successors, transferees, and assignees for the period during which such assistance is provided. The Recipient 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 Recipient 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. Provision of Services The Recipient shall provide services in the manner described in ATTACHMENT I. 13. Monitoring by the Agency The Recipient shall permit persons duly authorized by the Agency to inspect and copy any records, papers, documents, facilities, goods and services of the Recipient which are relevant to this contract, and to interview any clients, employees and subcontractor employees of the Recipient 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 Recipient, and where appropriate, the Recipient shall develop a corrective action plan. The Recipient hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Contract Manager. 14. Coordinated Monitoring with Other Agencies If the Recipient receives funding from one or more of the State of Florida other human service agencies, in addition to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human service agencies shall include the Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead administrative coordinator, the Recipient shall comply and cooperate with all monitors, inspectors, and /or investigators. 15. Indemnification The Recipient 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 Recipient is not required to indemnify the Agency for claims, demands, actions or causes of action arising solely out of the Agency's negligence. 15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contracts executed between the Department and state agencies or subdivisions defined in s. 768.28(2), F.S. 16. Insurance and Bonding 16.1 The Recipient 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 Recipient accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the Recipient and the clients to be served under this contract. The limits of coverage under each policy maintained by the Recipient do not limit the Recipient's liability and obligations under this contract. The Recipient 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 5 July 2012 — June 2014 16015 HCE 203.12 of the State of Florida. The Agency reserves the right to require additional insurance as specified in this contract. 16.2 Throughout the term of this agreement, the Recipient shall maintain an insurance bond from a responsible commercial insurance company covering all officers, directors, employees and agents of the Recipient authorized to handle funds received or disbursed under all agreements and /or contracts incorporating this contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by the insurance company and consistent with good business practices. 17. Confidentiality of Information The Recipient shall not use or disclose any information concerning a recipient of services under this contract for any purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized to give that consent or when authorized by law. 18. Health Insurance Portability and Accountability Act Where applicable, the Recipient shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 19. Incident Reporting 19.1 The Recipient shall notify the Agency immediately, but no later than forty-eight (48) hours from, the Recipient's awareness or discovery of conditions that may materially affect the Recipient or subcontractor's ability to perform the services required to be performed under this contract. Such notice shall be made orally to the Contract Manager (by telephone) with an email to immediately follow. 19.2 The Recipient 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 Recipient and its employees. 20. New Contract(s) Reporting The Recipient 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 Recipient shall complete and provide the information to the Agency's Contract Manager. 21. Bankruptcy Notification During the term of this contract, the Recipient shall immediately notify the Agency if the Recipient, its assignees, subcontractors or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Recipient 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. 22. Sponsorship and Publicity 22.1 As required by s. 286.25, F.S., if the Recipient 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 Hope Hospice and Community Services, the State Agency of Elder Affairs, and the Area Agency on Aging for Southwest Florida, Inc." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs and the Area Agency on Aging for Southwest Florida, Inc." shall appear in at least the same size letters or type as the name of the organization. 0 July 2012 — June 2014 16 D 1-1 , HCE 203.12 11 22.2 The Recipient shall not use the words "The State of Florida Department of Elder Affairs or the Area Agency on Aging for Southwest Florida, Inc." to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by the State and Agency prior to use. 23. Assignments 23.1 The Recipient shall not assign the rights and responsibilities under this contract without the prior written approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring without prior written approval of the Agency will constitute a material breach of the contract. 23.2 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the Recipient. In the event the State of Florida approves transfer of the Recipient's obligations, the Recipient remains responsible for all work performed and all expenses incurred in connection with the contract. 23.3 This contract shall remain binding upon the successors in interest of either the Recipient or the Agency. 24. Subcontracts 24.1 The Recipient is responsible for all work performed and for all commodities produced pursuant to this contract, whether actually furnished by the Recipient or its subcontractors. Any subcontracts shall be evidenced by a written document and subject to any conditions of approval the Agency deems necessary. The Recipient further agrees that the Agency will not be liable to the subcontractor in any way or for any reason. The Recipient, at its expense, shall defend the Agency against any such claims. 24.2 The Recipient 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 Recipient and subcontractor, will result in a penalty as provided by statute. 25. Independent Capacity of Recipient It is the intent and understanding of the Parties that the Recipient, 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 Recipient and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the Recipient or its subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the Recipient are the sole responsibility of the Recipient. 26. Payment Payments shall be made to the Recipient pursuant to s. 215.422, F.S., as services are rendered and invoiced by the Recipient. The Contract Manager will have final approval of the invoice for payment, and will approve the invoice for payment only if the Recipient 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. 27. Return of Funds The Recipient 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 Recipient by the Agency. In the event that the Recipient or its independent auditor discovers that an overpayment has been made, the Recipient 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 VA July 2012 — June 2014 iroyD 5 HCE 203.12 1 Manager will notify the Recipient in writing of such findings. Shou ment no e made forthwith, the Recipient will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after Agency notification or Recipient discovery. 28. Data Integrity and Safeguarding Information The Recipient shall ensure an appropriate level of data security for the information the Recipient is collecting or using in the performance of this contract. An appropriate level of security includes approving and tracking all Recipient employees that request system or information access and ensuring that user access has been removed from all terminated employees. The Recipient, 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 Recipient shall ensure all subcontractors maintain written procedures for computer system backup and recovery. The Recipient shall complete and sign ATTACHMENT IV prior to the execution of this contract. 29. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses the Department's computer resource systems must comply with the Department's policy regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. 30. Conflict of Interest The Recipient 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 Recipient 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 Recipient or subcontractor's officers, employees or agents will neither solicit nor accept gratuities, favors or anything of monetary value from contractors, potential contractors, or parties to subcontracts. The Recipient'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 Recipient's employees and subcontractors must make the same disclosures described above to the Recipient's board of directors. Compliance with this provision will be monitored. 31. 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 Recipient, 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. 32. Purchasing 32.1 The Recipient 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 Recipient 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 July 2012 — June 2014 16D15HCE 203.12 products /services available from PRIDE may be obtained by contacting PRIDE, (800) 643 -8459. 32.2 The Recipient may procure any recycled products or materials, which are the subject of or are required to carry out this contract, in accordance with the provisions of s. 403.7065, F.S. 32.3 The Recipient 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 Recipient 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. 33. 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 Recipient shall refer the discovery, invention or material to the Agency to be referred to the Department of State and 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. 33.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an unencumbered right to use such property, notwithstanding any agreement made pursuant to Paragraph 33. 33.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 34. Emergency Preparedness and Continuity of Operations 34.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the Recipient 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 Recipient shall notify the Agency of emergency provisions. 34.2 In the event a situation results in a cessation of services by a subcontractor, the Recipient shall retain responsibility for performance under this contract and must follow procedures to ensure continuity of operations without interruption. 35. EQUIPMENT If the contract tasks to be performed require the purchase of equipment with state or federal funds, the following paragraphs apply: 35.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for the financial statement purposes, or $5,000.00 [for federal funds]; or (b) nonexpendable, tangible personal property of a nonconsumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at least one year; and hardback bound books not circulated to students or the general public, with a value or cost of $250.00 or more [for state funds]. 35.2 Recipients and subcontractors 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 0 July 2012 — June 2014 16 15 HCE 203.12 once every two years, (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must be maintained on file and shall be provided to the Agency upon request. The Recipient shall promptly investigate, fully document and notify the Contract Manager of any loss, damage, or theft of equipment. The Recipient shall provide the results of the investigation to the Contract Manager. 35.3 The Recipient'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 Recipient 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 Recipient compensates the Federal awarding agency for its share. 35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by the Department is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will vest in the Agency, 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 subcontractors (not included in a cost methodology), is subject to the conditions of section 273, F. S. and 60A- 1.0017, F. A. C. or Title 45 CFR Part 74. 35.5 The Recipient 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 Recipient 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 Recipient's proposed disposition (i.e., transfer or donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc). 35.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120 days of the written request for disposition, the Recipient is authorized to proceed as directed in 2 CFR Part 215 Administrative Requirements (formerly OMB Circular A -110). 35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but excludes movable machinery and equipment. Real property may not be purchased with state or federal funds through agreements covered under this contract without the prior approval of the Agency. Real property purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III, Part A., Sec. 3030b United States Code (USC). Real property purchases from state funds can only be made through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of section 216.348, F. S. 35.8 Any permanent storage devices (e.g., hard drives, removable storage media) must be reformatted and tested prior to disposal to ensure no confidential information remains.. 10 July 2012 — June 2014 16D15 HCE 203.12 35.9 The Recipient must adhere to the Agency's and standards when urciasin Inormation 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 Recipient has the responsibility to require any subcontractors to comply with the Agency's ITR procedures. 36. PUR 1000 Form The PUR 1000 Form is hereby incorporated by reference. In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract the terms or conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form shall take precedence. 37. Use of State Funds to Purchase or Improve Real Property Any state funds provided for the purchase of or improvements to real property are contingent upon the Recipient or political subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by law. 38. Dispute Resolution Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the decision to writing and serve a copy on the Recipient. 39. Financial Consequences of Non - Performance If the Recipient fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the Agency must apply financial consequences commensurate with the deficiency. Financial consequences may include, but are not limited to, contract suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and /or cancellation of contract and reacquiring services from an alternate source. 39.1 The Recipient will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the Agency. 40. No Waiver of Sovereiin Immunity Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which sovereign immunity may be applicable. 41. Venue If any dispute arises out of this contract, the venue of such legal recourse will be Lee County, Florida. 42. Entire Contract This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the Agency or the Recipient unless expressly contained herein or by a written amendment to this contract signed by both Parties. 43. Force Maieure The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control, provided the party experiencing the force majeure condition provides immediate written notification to the other party and takes all reasonable efforts to cure the condition. 44. Severability Clause The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable the other provisions are severable to that void provision and shall remain in full force and effect. 45. Condition Precedent to Contract: Appropriations The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an 11 July 2012 —June 2014 � L D 15� E 203.12 annual appropriation by the Legislature. V 46. 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. 47. Waiver The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any such right preclude any other or further exercise thereof or the exercise of any other right. 48. Compliance The Recipient 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 Recipient to abide by these laws shall be deemed an event of default of the Recipient, and subject the contract to immediate, unilateral cancellation of the contract at the discretion of the Agency. 49. Final Invoice The Recipient shall submit the final invoice for payment to the Agency as specified in Paragraph 3.3.5. (date for final request for payment) of ATTACHMENT I. If the Recipient 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 Recipient and necessary adjustments thereto have been approved by the Agency. 50. 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. 51. Termination 51.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the Contract Manager or the representative of the Recipient responsible for administration of the contract. 51.2 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 Recipient. 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 Recipient 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 Recipient will be compensated for any work satisfactorily completed prior to the date of termination. 51.3 This contract may be terminated for cause upon no less than twenty -four (24) hours notice in writing to the Recipient. 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 Recipient's rights to remedies at law or in equity. 51.4 Failure to have performed any contractual obligations with the Agency in a manner satisfactory to the Agency will be a sufficient cause for termination. To be terminated as a Recipient under this provision, the Recipient 12 July 2012 — June 2014 1 t 5 HCE 203.12 must have (1) previously failed to satisfactorily perform in a contract with the Agency, been notified by the Agency of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction of the Agency; or (2) had a contract terminated by the Agency for cause. 52. Electronic Records and Signature The Agency authorizes, but does not require, the Recipient to create and retain electronic records and to use electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A Recipient 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, Fla. Stat. All electronic records must be fully auditable; are subject to Florida's Public Records Law, ch. 119, Fla. Stat.; must comply with section 28, Data Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and maintained by the Recipient to the same extent as non - electronic records are retained and maintained as required by this Agreement. 52.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the Recipient and the Agency. The Recipient is authorized to conduct electronic transactions with the Agency only upon further written consent by the Agency. 52.2 Upon request by the Agency, the Recipient 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. 53. Official Payee and Representatives (Names, Addresses, and Telephone Numbers): 54. All Terms and Conditions Included This contract and its Attachments, I — X and any exhibits referenced in said attachments, together with any 13 The Recipient name, as shown on page 1 of this contract, Collier County Board of County Commissioners a. and mailing address of the official payee to whom the Housing and Human Services Departments payment shall be made is: 3339 Tamiami Trail E Bldg H, Rm 211 Naples, FL 34112 Kimberly Grant, Interim Director b. The name of the contact person and street address where Collier County Board of County Commissioners Housing and Human Services Departments financial and administrative records are maintained is: 3339 Tamiami Trail E Bldg H, Rm 211 Naples, FL 34112 Kimberly Grant, Interim Director Collier County Board of County Commissioners C. The name, address, and telephone number of the Housing and Human Services Departments representative of the Recipient responsible for 3339 Tamiami Trail E Bldg H, Rm 211 administration of the program under this contract is: Naples, FL 34112 (239) 252 -2273 Area Agency on Aging for Southwest Florida, Inc. d The section and location within the Agency where dba Senior Choices of Southwest Florida Requests for Payment and Receipt and Expenditure forms 15201 N. Cleveland Ave, Suite 1100 are to be mailed is: North Fort Myers, Florida 33903 Leigh Wade, Executive Director Area Agency on Aging for Southwest Florida, Inc. e. The name, address, and telephone number of the Contract dba Senior Choices of Southwest Florida Manager for this contract is: 15201 N. Cleveland Ave, Suite 1100 North Fort Myers, Florida 33903 (239) 652 -6900 Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 54. All Terms and Conditions Included This contract and its Attachments, I — X and any exhibits referenced in said attachments, together with any 13 July 2012 — June 2014 1 51ICE 203.12 documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. By signing this contract, the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF, the Parties hereto have caused this 38 page contract, to be executed by their undersigned officials as duly authorized. Recipient: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS SIGNED BY: NAME: �4 P—Vt TITLE: 740h ` 'L S(kCeJ P&',Ri*A+Jr DATE: Co �Z Federal Tax ID: 59- 6000588 Fiscal Year Ending Date: 09/30 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. DBA SENIOR CHOICES OF SOUTHWEST FLORIDA SIGNED BY: NAME: LEIGH ANY11 A NOWAK TITLE: BOARD PRESIDENT DATE: --2 } W `k P iagni SU 14 5-, r-� 1� % T - a- � . l.�i" "� _ I July 2012 – June 2014 16015 HCE 203.12 INDEX TO CONTRACT ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE ATTACHMENT I STATEMENT OF WORK 16 -24 ATTACHMENT II CERTIFICATION REGARDING LOBBYING 25 ATTACHMENT III FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT 26 -30 ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE 31 ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, 32 INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS /SUBCONTRACTS ATTACHMENT VI ASSURANCES— NON - CONSTRUCTION PROGRAMS 33 -34 ATTACHMENT VII HOME CARE FOR THE ELDERLY PROGRAM INVOICE REPORT 35 SCHEDULE ATTACHMENT VIII HOME CARE FOR THE ELDERLY PROGRAM BUDGET SUMMARY 36 ATTACHMENT IX REQUEST FOR PAYMENT DOEA FORM 106H 37 ATTACHMENT X RECEIPTS AND EXPENDITURES REPORT, DOEA FORM 105H 38 15 July 2012 — June 2014 16D15 ATTACHMENT I AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services (APS) Activities of Daily Living (ADL) Assessed Priority Consumer List (APCL) Community Care for Disabled Adults (CCDA) Community Care for the Elderly (CCE) Client Information and Registration Tracking System (CIRTS) Department of Children and Families (DCF) Home Care for Disabled Adults (HCDA) Home Care for the Elderly (HCE) Institutional Care Program (ICP) Instrumental Activities of Daily Living (IADL) Planning and Service Area (PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to the Department's community -based services. Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the Agency enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan as instructed by the Department. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701 B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved for up to three HCE clients in their home. 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non - profit basis, as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 16 July 2012 — June 2014 16015 HCE 203.12 1.2.3 Authority 1 The relevant authority governing the HCE program include: (1) Rule Chapter 58H -1, Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date, August 20, 2010; CFO Memo No. 03: Release date, June 29, 2010; and CFO Memo No. 06: Release date, June 30, 2010. 1.2.4 Scope of Service The Recipient is responsible for the programmatic, fiscal and operational management of HCE. The Recipient shall provide services in a manner consistent with and described in the current Agency's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well -being of the client. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this contract must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program (ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long -term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this contract must: (1) Be at least 18 years of age, capable of providing a family -type living environment; (2) Be a relative or a friend who has been accepted by the client as a surrogate family or is a responsible adult with whom the client has made an arrangement to provide home care services; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care recipient; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; 17 July 2012 — June 2014 1601; HCE 203.12 5 Maintain the residential dwelling free of conditions that ose an immediate threat the life safe health () g p � h'� and well -being of the home care client; and (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.3 Targeted Groups Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the HCE program, the Recipient shall ensure the following tasks are performed: (1) Client Eligibility Determination; (2) Assessment and Prioritization of Service Delivery for Eligible Clients; (3) Delivery of Services to Eligible Clients; and (4) Monitor the Performance of Subcontractors. 2.1.1 Client Eligibility Determination The Recipient shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this ATTACHMENT I, SECTION 1.3. 2.1.2 Assessment and Prioritization of Service Delivery for New Clients The Recipient shall ensure the following criteria are used to prioritize new clients for service delivery. It is not the intent of the Agency to remove existing clients from any services in order to serve new clients being assessed and prioritized for service delivery. 2.1.2.1 Priority Criteria for Service Delivery: (1) Individuals in nursing homes under Medicaid who could be transferred to the community; (2) Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the community; (3) Individuals in nursing homes that are closing and can be discharged to the community; (4) Individuals whose mental or physical health condition has deteriorated to the degree self care is not possible; there is no capable caregiver, and institutional placement will occur within 72 hours; and (5) For the purpose of transitioning individuals receiving CCDA and HCDA services through the Department of Children and Families' Adult Services to community -based services provided through DOEA when services are not currently available, area agency on aging staff and lead agency case managers will ensure that "Aging Out" individuals are prioritized for services only after APS High Risk and Imminent Risk individuals. 2.1.2.2 Priority Criteria for Service Delivery for Other Assessed Individuals: The assessment and provision of services should always consider the most cost effective means of service delivery. Functional impairment will be determined through the Agency and or Department's functional assessment form administered to each applicant. The most frail individuals not prioritized as described in this attachment, Paragraph 2.1.2.1 will receive services to the extent funding is available. 2.1.3 Delivery of Services to Eligible Clients The Recipient shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Recipient shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 18 July 2012 —June 2014 16D15 HCE 203.12 2.1.3.1 Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the care recipient, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less, the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.1.3.1.1 Calculating the Basic Subsidy The Basic Subsidy shall be based on the financial status of the client receiving care. In the event that both a husband and wife are clients, their combined financial status shall be used to determine the amount of the Basic Subsidy. 2.1.3.2 Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre- authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well -being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be essential to maintain the well -being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy may be authorized through a vendor agreement. All Special Subsidy services must be performed in accordance with the Department of Elder Affairs Programs and Services Handbook. Special Subsidy services include: (1) Adult Day Care; (8) Other; (2) Chore; (9) Personal Care; (3) Chore (Enhanced); (10) Respite (Facility Based or In- Home); (4) Homemaker; (11) Skilled Nursing Services; (5) Housing Improvement; (12) Specialized Medical Equipment, Services and Supplies; and (6) Vendor Payment; (13) Transportation. (7) Material Aid; 2.1.3.3 ACCESS TO AND COORDINATION OF SERVICES Through intake, case management and case aide services, the HCE client's needs are documented and needed services are planned, arranged and coordinated for the client. 2.1.4 Use of Subcontractors If this contract involves the use of a subcontractor or third party, then the Recipient 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 Recipient shall notify the Contract Manager and the Director of Finance in writing of such delay. 2.1.4.1 The Recipient shall not permit a subcontractor to perform services related to this agreement without having a binding subcontractor agreement executed. In accordance with Paragraph 24.1 of the Standard Agreement, the Agency or Department will not be responsible or liable for any obligations or claims resulting from such action. 2.1.4.2 Monitoring the Performance of Subcontractors The Recipient will monitor at least once per year each of its subcontractors, subrecipients, vendors and /or consultants paid from funds provided under this contract. The Recipient will 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 Recipient will 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. 19 July 2012 — June 2014 HCE 203.12 2.2 SERVICE LOCATION AND EQUIPMENT 16D15 2.2.1 Service Times The Recipient shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The Recipient shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. 2.4 REPORTS The Recipient 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 Recipient shall establish due dates for any subcontractors that permits the Recipient to meet the Agency's reporting requirements. 2.4.1 Client Information and Registration Tracking System (CIRTS) Reports The Recipient shall input HCE specific data into CIRTS database system to ensure CIRTS data accuracy. The Recipient shall use CIRTS generated reports which include the following: (1) Client Reports; (2) Monitoring Reports; (3) Services Reports; (4) Miscellaneous Reports; (5) Fiscal Reports; (6) Aging and Disability Resource Center Reports; and (7) Outcome Measurement Reports. 2.4.2 Service Costs Reports The Recipient shall require its subcontractors to submit to it the Recipient semi - annual service cost reports, February 15 and August 15 of each year, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.3 Surplus/Deficit Report The Recipient shall submit a consolidated surplus /deficit report in a format provided by the Agency to the Contract Manager by the 18th of each month. This report is for all agreements and /or contracts between the Recipient and the Agency. This report will include the following: K1] Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Hour Chore Respite (Facility Based or In -Home) Chore (Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.4 REPORTS The Recipient 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 Recipient shall establish due dates for any subcontractors that permits the Recipient to meet the Agency's reporting requirements. 2.4.1 Client Information and Registration Tracking System (CIRTS) Reports The Recipient shall input HCE specific data into CIRTS database system to ensure CIRTS data accuracy. The Recipient shall use CIRTS generated reports which include the following: (1) Client Reports; (2) Monitoring Reports; (3) Services Reports; (4) Miscellaneous Reports; (5) Fiscal Reports; (6) Aging and Disability Resource Center Reports; and (7) Outcome Measurement Reports. 2.4.2 Service Costs Reports The Recipient shall require its subcontractors to submit to it the Recipient semi - annual service cost reports, February 15 and August 15 of each year, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.3 Surplus/Deficit Report The Recipient shall submit a consolidated surplus /deficit report in a format provided by the Agency to the Contract Manager by the 18th of each month. This report is for all agreements and /or contracts between the Recipient and the Agency. This report will include the following: K1] July 2012 — June 2014 1� HCE 203.12 1 The Recipient detailed plan on how the surplus or deficit s end1 exCee in�thLsthreshold specified b () p P � p g g p Y the Agency will be resolved; and (2) Recommendations to transfer funds to resolve surplus /deficit spending. 2.5 RECORDS AND DOCUMENTATION 2.5.1 The Recipient shall ensure the collection and maintenance of client and service information on a monthly basis from the CIRTS or any such system designated by the Agency and the State of Florida Department of Elder Affairs. Maintenance includes valid exports and backups of all data and systems according to Department and /or Agency standards. 2.5.2 The Recipient must ensure all data for HCE subsidies are entered in the Client Information and Registration Tracking System (CIRTS) by the 15th of each month. HCE subsidy data entered into the CIRTS by the 15th of the month will be for payments incurred between the 16th of the previous month and the 15th of the current month. Case management data entered into the CIRTS by the 15th of the month will be for units of service provided during the previous month from the 16th and up to and including the 15th of the current month or case management units of service may be entered according to the Recipient schedule, in aggregate on the 31 st or daily, weekly or monthly. 2.5.3 The Recipient and each 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 Recipient 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. 2.5.4 The Recipient will ensure data entry for HCE subsidies will cease on the 15th of the month and the CIRTS Monthly Service Utilization Report, by consumer and by worker identification is generated. 2.5.5 The Recipient will ensure the Monthly Utilization Report, by consumer and by worker identification is verified, corrected, certified no later than the 20th of the month in which the report is generated. 2.5.6 The Recipient will ensure copies of receipts for all HCE special subsidies of $150 and over will accompany the Monthly Utilization Report. These receipts should be no older than 90 days. Payment of HCE special subsidies will not be processed until supporting documentation is received by the agency no later than the 20"' of the month in which the report is generated. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1) The Recipient shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook. (2) The Recipient shall timely submit to the Agency all reports described in ATTACHMENT I, SECTION 2.4 REPORTS; and (3) The Recipient shall timely submit to the Agency all information described in ATTACHMENT I, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.6.2 The Recipient shall develop and document strategies in the Request for Proposal (RFP) 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) Average monthly savings per consumer for home and community -based care versus nursing home care for comparable group clients; 21 I July 2012 — June 2014 1 6 o HCE 203.12 (3) Percent of elders assessed with high or moderate risk environments who impro5heir environment score; (4) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved; (5) Percent of new service recipients whose ADL assessment score has been maintained or improved; (6) Percent of new service recipients whose IADL assessment score has been maintained or improved; (7) Percent of family and family- assisted caregivers who self -report they are likely to provide care; (8) Percent of caregivers whose ability to provide care is maintained or improved after one year of service intervention (as determined by the caregiver and the assessor); and (9) Percent of customers who are at imminent risk of nursing home placement who are served with community based services; 2.7 RECIPIENT'S FINANCIAL OBLIGATIONS Special subsidy payments for each client and for the program overall must be maintained within the amount of program funding available. The Recipient will refund the Agency for any subsidy payments made to vendors and/or caregivers for services performed after the death of the client. 2.7.1 Use of Service Dollars /Assessed Priority Consumer List Management The Recipient is expected to spend all federal, state and other funds provided by the Agency for the purpose specified in each contract. The Recipient must manage service funds 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 Agency. If the Agency determines that the Recipient is not spending service funds accordingly, the Agency may transfer funds to other planning and service areas during the contract period and /or adjust subsequent funding allocations accordingly, as allowable under state and federal law. 2.8 AGENCY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The Agency will provide to the Recipient guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Recipient. 2.8.2 Contract Monitoring The Agency will review and evaluate the performance of the Recipient under the terms of this contract. Monitoring shall be conducted through direct contact with the Recipient through telephone, in writing, or an onsite visit. The Agency's determination of acceptable performance shall be conclusive. The Recipient 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. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this contract includes advances, cost reimbursement for administration costs, and fixed rate for services. The Recipient shall ensure fixed rates for services include only those costs that are in 22 1 July 2012 — June 2014 1 p 1 r°"! HCE 203.12 federal statue regulations an0are based on audited historical accordance with all applicable state and statutes and re g costs in instances where an independent audit is required. The Recipient shall consolidate all requests for payment from subcontractors and expenditure reports that support requests for payment and shall submit to the Agency on forms 106H (ATTACHMENT IX) and 105H (ATTACHMENT X). 3.1.1 The Recipient agrees to distribute funds as detailed in the area plan update and the Budget Summary, ATTACHMENT VII to this contract. Any changes in the total amounts of the funds identified on the Budget Summary form require a contract amendment. 3.1.2 Effective July 1, 2012, all newly enrolled caregivers will receive payment via direct deposit. The case managers will have until December 31, 2012 to get current clients' caregivers set up for HCE direct deposit. Any client, whose caregiver is not set up for direct deposit, will not be eligible to receive HCE services. 3.2 Advance Payments 3.2.1 The Recipient may request up to two months of advances at the start of the contract period to cover program administrative and service costs. The schedule for submission of advance requests, if available, is shown on ATTACHMENT VII to this contract. The payment of an advance will be contingent upon the sufficiency and amount of funds released to the Agency and the State of Florida Department of Elder Affairs ( "budget release "). The Recipient shall provide the Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. 3.2.2 The Recipient's requests for advance require the approval of the Contract Manager. If sufficient budget is available, the Agency will issue approved advance payments after July 1, 2012. 3.2.3 All advance payments made to the Recipient 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. 3.2.4 The Recipient may temporarily place advanced funds in an FDIC insured interest bearing account. All interest earned on contract fund advances must be returned to the Agency within thirty (30) days of the end of each quarter of the contract period. 3.3 Invoice Submittal and Requests for Payment All requests for payment and expenditure reports submitted to support requests for payment for Case Management /Case Aide shall be on DOEA forms 106H (ATTACHMENT IX) and 105H (ATTACHMENT X). Duplication or replication of both forms via data processing equipment is permissible, provided all data elements are in the same format as included on Agency forms. 3.3.1 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 and invoices is ATTACHMENT VIII to this contract. 3.3.2 Remedies - Nonconforming Services The Recipient shall ensure that all goods and /or services provided under this contract for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and /or services shall only be delivered to eligible program participants. If the Recipient 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 Recipient's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Recipient shall solely bare the costs associated with preparing or providing nonconforming goods and /or services. The Agency and or Department require immediate notice of any significant and /or systemic infractions that 23 July 2012 —June 2014 16D1F CE 203.12 compromise the quality, security or continuity of services to clients. 3.3.3 Financial Consequences Recipient shall ensure the provision of services to the projected number of clients in accordance with the Area Plan as updated and within the contract amount. The Recipient shall ensure expenditure of 100% of the contract amount budgeted for services to clients at the unit rates established in the Area Plan. In the event the Recipient has a surplus of 1% or more at the end of the first year of the contract term, the Agency will reallocate 1% of the budget for the second year of the contract term to other area agencies found to be serving clients to the fullest extent of their allocated budgets. If, or to the extent, there is any conflict between this paragraph and paragraphs 39 and 39.1 of the standard contract, this paragraph shall have precedence. 3.3.4 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 VII to this contract. 3.3.5 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 Recipient and any adjustments thereto, including any disallowance not resolved as outlined in Section 26 of this contract. 3.3.6 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in ATTACHMENT VIII, Budget Summary. 3.3.7 Date For Final Request For Budget Revisions Final requests for budget revisions or adjustments to contract funds based on expenditures for services provided through June 30, 2013, must be submitted to the Contract Manager no later than the contract end date of June 30, 2013. 3.3.8 Date for Final Request for Payment The final request for payment for contract year one's expenditures will be due to the Agency no later than August 1, 2013. The final request for payment for contract year two expenditures will be no later than August 1, 2014. 3.4 Documentation for Payment The Recipient shall maintain documentation to support payment requests that shall be available to the Agency or authorized individuals upon request. Such documentation shall be provided upon request to the Agency or the Department of Financial Services. 3.4.1 The Recipient must ensure all data for HCE subsidies are entered in the Client Information and Registration Tracking System (CIRTS) by the 15th of each month. HCE subsidy data entered into the CIRTS by the 15th of the month will be for payments incurred between the 16th of the previous month and the 15th of the current month. Case management data entered into the CIRTS by the 15th of the month will be for units of service provided during the previous month from the 16th and up to and including the 15th of the current month or case management units of service may be entered according to the Recipient schedule, in aggregate on the 31 st or daily, weekly or monthly. The Recipient will ensure data entry for HCE subsidies will cease on the 15th of the month and the CIRTS Monthly Service Utilization Report, by consumer and by worker identification is generated. The Recipient will ensure the Monthly Utilization Report, by consumer and by worker identification is verified, corrected, certified no later than the 20th of the month in which the report is generated. 3.4.2 The Recipient will be required to enter all required data per the Department's CIRTS Policy Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS before the Recipient submits their request for payment and expenditure reports to the Agency by the twentieth, 201", of the month. See ATTACHMENT VII for all invoice dates. The Agency shall establish time frames to assure compliance with due dates for the requests for payment and expenditure reports to the Agency and the Department. 3.4.3 The Agency will require the Recipient to run monthly CIRTS reports and verify that the client and service data in the 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 Recipient's request for payment and expenditure reports can be approved by the Agency. 24 July 2012 — June 2014 HCE 203.12 16015ATTACHMENT II ATTACHMENT II CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub - awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans and cooperative agreements) and that all subcontractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. i o, caa SignatuYe Sieve. Qoc�I Name of Authorized Individual Collier County Board of Commissioners 3299 Tamiami Trail E Naples, FL 34112 �>(Eq I12 Date L% Application or Agreement Number 25 J E ►�v N l i 2 Q. �'a X-i- July 2012 — June 2014 D 1 5 HCE 203.12 TTACHMENT III FINANCIAL AND COMPLIANCE AUDIT The administration of resources awarded by the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs to the provider may be subject to audits and /or monitoring by the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs 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 provider agrees to comply and cooperate with any monitoring procedures /processes deemed appropriate by the Area Agency on Aging for Southwest Florida, Inc. In the event the Area Agency on Aging for Southwest Florida, Inc. determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Area Agency on Aging for Southwest Florida, Inc. to the provider regarding such audit. The provider 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 provider 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 provider expends $500,000 or more in federal awards during its fiscal year, the provider must have a single or program - specific audit conducted in accordance with the provisions of OMB Circular A -133, as revised. EXHIBIT 1 to this agreement indicates federal resources awarded through the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs by this agreement. In determining the federal awards expended in its fiscal year, the provider shall consider all sources of federal awards, including federal resources received from the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 provider 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 1, paragraph 1, the provider shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised. If the provider expends less than $500,000 in federal awards in its fiscal year, an audit conducted in accordance with the provisions of OMB Circular A -133, as revised, is not required. In the event that the provider expends less than $500,000 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 provider resources obtained from other than federal entities.) An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. and /or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs shall be fully disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc. and /or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 provider's fiscal year end. ll July 2012 — June 2014 PART II: STATE FUNDED 16 D 1 r _ HCE 203.12 This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes. In the event that the provider expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider 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 Area Agency on Aging for Southwest Florida, Inc. and /or the Department of Elder Affairs by this agreement. In determining the state financial assistance expended in its fiscal year, the provider shall consider all sources of state financial assistance, including state financial assistance received from the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of Southwest Florida and /or 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 provider 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 provider expends less than $500,000 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 provider expends less than $500,000 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 provider resources obtained from other than State entities). An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs shall be fully disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc. and /or 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 provider'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 provider's fiscal year end. Notwithstanding the applicability of this portion, the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or 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 provider 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 27 July 2012 — June 2014 D 15HCE 203.12 The Federal Audit Clearinghouse designated in OMB Circular A -133, as rev dohe nu 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 101h 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 provider 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 provider 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 the Area Agency on Aging for Southwest Florida, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A -133, Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations), Rules of the Auditor General, as applicable. Providers, when submitting financial reporting packages to the Area Agency on Aging for Southwest Florida, Inc. 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 provider in correspondence accompanying the reporting package. PART IV: RECORD RETENTION The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued, and shall allow the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and or the Department of Elder Affairs or its designee, the CFO or Auditor General access to such records upon request. The provider shall ensure that audit working papers are made available to the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs, or its designee, CFO, or Auditor General upon request for a period of six years from the date the audit report is issued, unless extended in writing by the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs. 28 July 2012 — June 2014 1 16015 HCE 203.12 ATTACHMENT III EXHIBIT —1 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT TOTAL FEDERAL AWARD 1 $0 1 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT TOTAL STATE AWARD 1 $0 STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97. F.S. PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT Home Care for the Elderly Program General Revenue 65001 $61,709.00 TOTAL AWARD $61,709.00 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 29 July 2012 —June 2014 16015 HCE 203.12 ATTACHMENT III EXHIBIT -2 PART I: AUDIT RELATIONSHIP DETERMINATION Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A -133, as revised, and/or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A- 133, as revised, and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, providers who have been determined to be recipients or subrecipients of federal awards and/or state financial assistance, must comply with applicable programmatic and fiscal compliance requirements. In accordance with Sec. 210 of OMB Circular A -133 and /or Rule 691 - 5.006, FAC, provider has been determined to be: Vendor or exempt entity and not subject to OMB Circular A -133 and /or Section 215.97, F.S. X Recipient /subrecipient subject to OMB Circular A -133 and/or Section 215.97, F.S. NOTE: If a provider is determined to be a recipient /subrecipient of federal and or state financial assistance and has been approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 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. Providers who receive federal awards or state matching funds on federal awards and who are determined to be a subrecipient, must comply with the following fiscal laws, rules and regulations: STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW: 2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)* OMB Circular A -102 — Administrative Requirements OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations NON- PROFIT ORGANIZATIONS MUST FOLLOW: 2 CFR Part 230 Cost Principles for Non - Profit Organizations (Formerly OMB Circular A -122 — Cost Principles)* 2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements) Requirements) OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW: 2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A -21 — Cost Principles)* 2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements) OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations *Some federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular A -133 Compliance Supplement, Appendix 1. STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a recipient/subrecipient, must comply with the following fiscal laws, rules and regulations: Section 215.97, Fla. Stat. Chapter 69I -5, Fla. Admin. Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations 30 July 2012 — June 2014 CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS HCE 203.12 16015ATTACHMENT IV The undersigned, an authorized representative of the Recipient named in the contract or agreement to which this form is an attachment, hereby certifies that: (1) The Recipient and any subcontractors of services under this contract have financial management systems capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant- funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly. (2) Management Information Systems used by the Recipient, subcontractor(s), or any outside entity on which the Recipient 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 Recipient (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 Recipient 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 Recipient and any subcontractor(s) of services under this contract warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The Recipient shall require that the language of this certification be included in all subagreements, subgrants, and other agreements and that all subcontractors shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A -102 and 2 CF/R Part 215 (formerly OMB Circular A -110). Ld),C" Ce,1613ea'4Ao/ &)k4AMASS /'GherS Name and Address o Recipient T11 C.�r I �, � Qk- < �>� 6f� ( Signature Title Date S +ergE) Name of Authorized Signer (Revised June 2008) Collier County Board of Commissioners 3299 Tamiami Trail E Naples, FL 34112 31 - _I...J i�✓ P`��e t� 7 � <<� i t' �i"ef s' r � i �YY7. �C+a�,'l3Ra - � ,N aJ � '1;:'i_ 12 Q. �_ July 2012 — June 2014 1 0 15 HCE 203.12 ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective Recipient certifies, by signing this certification, neither it nor its principals is 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 Recipient is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this certification. I , �fl - C��ed Z41 ?. Signature Date � l� ��� � � wu`n` e ►r- Cpl i 4� 60(^ �Cf 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 Recipient knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the Agency may pursue available remedies, including suspension and /or debarment. 3. The Recipient will provide immediate written notice to the Contract Manager if at any time the Recipient learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The Recipient 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 Recipient 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 Recipient 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 Recipient knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the Agency may pursue available remedies, including suspension, and /or debarment. 7. The Recipient 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) 32 July 2012 – June 2014 16015 HCE 203.12 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..4728 -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.. 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C., 6101 - 6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g). 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C.. 290 dd -3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C., 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Titles 11 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 to 276a -7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C._ 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C.. 327 -333), regarding labor standards for federally assisted construction subagreements. 33 July 2012 — June 2014 160 1 5 HCE 203.12 10. Will comply, if a applicable, with flood insurance purchase requirements of Section 2 a of the Flooa Disaster Protection Act of pp P q 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 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C., 1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C.. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93 -523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93 -205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C.. 1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C..470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C., 469a -1 et seq.). 14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C., 4801 et seq.), which prohibits the use of lead- based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non - Profit Organizations. 18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies governing this program. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE 1 4I;�, APPLICANT ORGANIZATION DATE SUBMITTED C l (1 e r Co� '1 t30 CC, 6 lzq (� Z 34 July 2012 — June 2014 16015TTACHMENT HCE 203.12 VII HOME CARE FOR THE ELDERLY INVOICE SCHEDULE Report Submit to Agency Number Based On On This Date 1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 20 4 August Expenditure Report September 20 5 September Expenditure Report October 20 6 October Expenditure Report November 20 7 November Expenditure Report December 20 8 December Expenditure Report January 20 9 January Expenditure Report February 20 10 February Expenditure Report March 20 11 March Expenditure Report April 20 12 April Expenditure Report May 20 13 May Expenditure Report June 20 14 June Expenditure Report July 20 15 Final Request for Payment August 1 16 Closeout Report August 15 Legend: * Advance based on projected cash need. Note # 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida prior to July 1 or until the contract with the Agency has been executed and a copy sent to Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida. Actual submission of the vouchers to DFS is dependent on the accuracy of the expenditure report. Note # 2: All advance payments made to the Recipient 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. The adjustment shall be recorded in Part C, 1 of the report (Attachment X). 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. 35 July 2012 — June 2014 D �� HCE 203.12 ATTACHMENT VIII HOME CARE FOR THE ELDERLY PROGRAM BUDGET SUMMARY Collier County Board of Commissioners HCE Case Management HCE Basic Subsidies 13 -27 -HCE Clients HCE Special Subsidies Total SERVICES $ 4,601.00 16,428.00 40,680.00 $61,709.00 HOME CARE FOR THE ELDERLY PROGRAM Case Management Case Aide RATE SUMMARY 36 REIMBURSEMENT RATE $55.50 $30.00 July 2012 — June 2014 16015 HCE 203.12 ATTACHMENT IX REQUEST FOR PAYMENT HOME CARE FOR THE ELDERLY PROGRAM REC04ENT WWE, ADDRESS, PWJNF* and FEDrt TYPE OF PAYMENT: This Request Priori Fterw To: Rrpr/r Contract Priod Cord #� Advance RopatK PSA # CERTIFICATION: 1 tae reby artily to the best of my OW fts row" is complete and correct and conforms w4h the Iwms and the pueposes of rile obwo eoMract P""Mdby Daft AppraWby- Deft PART A BUDGET SUMMARY AAA Adtnin. Case Mmoilemem Subsides TOTAL 1. Appmvod Contract Amorist $O,OD $0,00 $000 $000 2. PiwAou s Fwda Received for Contact PN;od $0.00 $0.00 i4A0 SOHO 3. Cartnt Wante (1no 1 minus tine 2) $0.00 SOHO so_00 5000 4. Revue Fserds Ro**W ed and Mat Received for Cartroct Period $0.00 $900 $000 $000 S. CONTRACT BALANCE (tine S minus N ne 4) $0.00 $0,00 50.00 $000 PART It CONTRACT FUNDS REOUIEST 1. Aaticoated Coth Need (W - 2nd nvn trs) $0.00 $0.00 SO.DD $000 2. Net b pardburos Fa Morah $0.00 $000 $0.00 $0,00 (DOEA Form 1091 Part a line 4) 3. TOTAL $0.00 $0.00 5000 $0,00 PART C: NET FUNDS REQUESTED 1. Less Adrance Applied $O.OD $000 $000 $0,00 2. TOTAL FUNDS REQUESTED (Pot It Una 3:, minus Pad C Um 1) $0.00 sDO0 $0.00 $0 -00 List of Smite t Units / Rates provided -See Mod" roper. DOEA FORM 109N 37 July 2012 - June 2014 RECEIPT AND EXPENDITURE REPORT NOME CARE FOR THE ELDERLY PROGRAM PROVIDER NAME, ADDRESS. PHONE N and FEIDO Program Funding: THIS REPORT PERIOD- HCE 203.12 16015ATTACHMENT From To X RECEIPT AND EXPENDITURE REPORT NOME CARE FOR THE ELDERLY PROGRAM PROVIDER NAME, ADDRESS. PHONE N and FEIDO Program Funding: THIS REPORT PERIOD- From To AAA Admin CONTRACT PERIOD° Case Managenett CONTRACT N Subsldiev REPORT N Basic ISpecial PSAN CERTIFICATION: I eedWy to the best of my knowledge and belief that the report Is complete and correct and all oulays herein are for purposes set forlh in the contract- aparad by : DW : Appravad by : Do" PART A: BUDGETED INCOME I RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For TNs Reoort Year to Date Agoroved Budget 1. SlttBe Funds SOHO $0.00 $x0.00 NW101 2. TOTAL RECEIPTS $0.00 $0.00 $O.00 NDIVIDI PART 6: EXPENDITURES 1. Approved 2. Expend1itures 3. Expenditures 4. Percent of Budw For This Report Year to Dote Axxxived Budget $0.00 $0,00 $O,OD 0DIV101 1. AAA Program AtAttinistr0ori 2 Service Sub rs: Case Management $0.00 $0.00 $0.00 NW/01 3. Service Subcontractors: Subsidy $0.00 50,00 $000 NWIOI a. Basic Subsidy WOO $0.00 $0.00 NDIVATI b. Special Subsidy $0.00 $0.00 $0,00 $KW101 4. TOTAL EXPENDITURES $4.00 $0.00 $0.00 110DIVA?1 PART C: OTHER REVENUE AND EXPENDITURES I. Interest: II Advance Recoupmeni 1. Earned on OR Advance S 2. Return of OR Advance 5 1. Advance Recouped $ 3. 00w tamed 5 00FAFORM 1efH Fte.6l 1 V_1!'_010 38 1601E Attestation Statement Agreement/Contract Number HCE 203.12 Amendment Number I, Steve Carvell , 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 Commissioners (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting, due to the differences in electronic data processing media, which has no affect on the agreement/contract content. Steve Carnell, Interim Administrator Collier County Public Services Division Date 16D15 Verification of Employment Status Certification As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida, Collier County Board of County Commissioners, hereby referred to as Recipient, certifies the use of the U.S. Department of Homeland Security's E- verify system to verify the employment eligibility of all new employees hired by Recipient during the contract term to perform employment duties pursuant to this Agreement and that any subcontracts include an express requirement that subcontractors performing work or providing services pursuant to this Agreement utilize the E- verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term. /_ . 6 . 6/0 Signature (Same as contract signature) Steve Carrell, Interim Administrator Collier County Public Services Division Title Collier County Board of Commissioners Company C (zi -Z- Date a - 701�-? Sr, , 2 r3 . -,,� 'C�L 16015 VERIFICATION OF EMERGENCY PREPAREDNESS PLAN Contract # HCE 203.12 I, Steve Carrell ,certify that Collier County Board of 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 available to the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida, upon request. '� - L'I - cj� Signatur of authorized contractor representative Interim Administrator, Collier County Public Services Division Title (0 Date Collier County Board of Commissioners Company October 2008 16D15 CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is an attachment, hereby certifies that: (1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a proposal for, or enter into or renew a contract with the Agency and or Department of Elder Affairs Department) for goods or services of $1 million or more. (2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false certification to the Department is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. (3) The Contractor understands that the contract to which this form is an attachment may be terminated by the Agency and /or Department if the Contractor submits a false certification or has been placed on the Lists. This certification, required by Florida law, is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction. -,� . _`'rl Signature (Same as contract signature) Steve Carnell, Interim Administrator Collier County Public Services Division Title Collier County Board of Commissioners Company Name 6(zq Date Z�