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Backup Documents 10/25/2011 Item #16C2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING S 4P6 C 2 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper Attaeh to orieinai doeument (hiuinal document, hand the Beard( t`ee he completed routing slip and original document,arc to he Ibnvarded to the Board Office onh after the Board has taken aetu n on the item.) ROUTING SLIP Complete routing lines#1 through#4 as appropriate for additional signatures,dates,and/or information needed.If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#4,complete the checklist,and forward to Sar(line#5). Route to Addressee(s) Office Initials ate (List in routing order) 2. • • 3. 4. 5. Ian Mitchell, BCC Office Board of County Commissioners l 0 Supervisor I '2 ' 6. Minutes and Records Clerk of Court's Office PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending BCC approval.Normally the primary contact is the person who created/prepared the executive summary.Primary contact information is needed in the event one of the addressees above,including Sue Filson,need to contact staff for additional or missing information.All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the item.) Name of Primary Staff 11'1c*C-e t Phone Number �a-5-6 37 Contact Agenda Date Item was OC+06x_ ZS 2 t 1 Agenda Item Number I e . Approved by the BCC l� Type of Document StPric- 'Ffo r d� "FO EP G'eu-4- Number of Original Attached Documents Attached INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Original document has been signed/initialed for legal sufficiency.(All documents to be signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney.This includes signature pages from ordinances, resolutions,etc. signed by the County Attorney's Office and signature pages from contracts,agreements,etc.that have been fully executed by all parties except the BCC Chairman and Clerk to the Board and possibly State Officials.) 2. All handwritten strike-through and revisions have been initialed by the County Attorney's Office and all other parties except the BCC Chairman and the Clerk to the Board 3. The Chairman's signature line date has been entered as the date of BCC approval of the A34/ document or the final negotiated contract date whichever is applicable. 4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's frij signature and initials are required. 5. In most cases(some contracts are an exception),the original document and this routing slip should be provided to Ian Mithchell in the BCC office within 24 hours of BCC approval. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified.Be aware of your deadlines! 6. The document was approved by the BCC on !0/L6/20/i (enter date)and all changes made during the meeting have been incorporated in the attached document.The County Attorney's Office has reviewed the changes,if applicable. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05,Revised 9.18.09 16C2 MEMORANDUM Date: October 27, 2011 To: Linda Jackson Best, Compliance Manager Solid Waste Department From: Ann Jennejohn, Deputy Clerk Minutes & Records Department Re: Grant Agreement No. S0557, with Florida's Department of Environmental Protection to Fund Hazardous Waste Community Cleanup Events Attached for further processing are four (4) original copies of the agreement referenced above (Item #16C2) approved by the Board of County Commissioners October 25, 2011. Upon return of signed originals from FDEP, we request one fully executed original agreement is returned to our office for the Board's Official Record. If you have any questions, please contact me at 252-8406. Thank you. Attachments (4) 16C2 Ann P. Jennejohn From: BestLinda <LindaBest @colliergov.net> Sent: Tuesday, November 08, 2011 2:57 PM To: Ann P.Jennejohn; Foord, Marlene Cc: Jacobs, Susan;Thomas,Joshua;Jaye, David Subject: Fully Executed Copy of the FDEP Grant for Solid Waste Management Importance: High Good afternoon, Attached for your files is a scanned copy of the above mentioned grant approved by the BCC on October 25, 2011, Agenda item 16.C.2. FDEP Agreement S0557 .p df Regards, Linda L.Jackson Best, MBA Waste Reduction and Recycling Manager Solid Waste Management Department Collier County Board of County Commissioners 3339 Tamiami Trail East, Suite 302 Naples, FL 34112 Direct 239-252-5037 Under Horida Law,e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request,do not send electronic mail to this entity.instead,contact this office by telephone or in writing. 1 16C2 AGREEMENT NO.S0557 STATE OF FLORIDA GRANT AGREEMENT PURSUANT TO LINE ITEM 1703E OF THE FY2011-2012 GENERAL APPROPRIATIONS ACT THIS AGREEMENT is entered into between the STATE OF FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION, whose address is 3900 Commonwealth Boulevard, Tallahassee, Florida 32399-3000 (hereinafter referred to as the "Department") and the COLLIER COUNTY BOARD OF COUNTY • COMMISSIONERS, whose address is 3339 Tamiami Trail East, Suite 302, Naples, Florida 34112 (hereinafter referred to as "Grantee" or "Recipient"), a local governmental entity, to provide financial assistance for Adding Household Hazardous Waste and Conditional Exempt Small Quantity Generator Services to Cleanup Events in Neighborhoods with Immigrant Populations. In consideration of the mutual benefits to be derived herefrom, the Department and the Grantee do hereby agree as follows: 1. The Grantee does hereby agree to perform in accordance with the terms and conditions set forth in this Agreement, Attachment A, Grant Work Plan, and all attachments and exhibits named herein which are attached hereto and incorporated by reference. For purposes of this Agreement,the terms "Contract" and "Agreement"and the terms"Grantee","Recipient"and"Contractor",are used interchangeably. 2. This Agreement shall begin upon execution by both parties and end no later than June 30,2012,inclusive. The Grantee shall be eligible for reimbursement for work performed on or after the date of execution and until the expiration of this Agreement. This Agreement may be amended to provide for additional services if additional funding is made available by the Legislature. 3. A. As consideration for the services rendered by the Grantee under the terms of this Agreement,the Department shall pay the Grantee on a cost reimbursement basis in an amount not to exceed $49,976.00. The parties hereto understand and agree that this Agreement does not require a cost sharing or match on the part of the Grantee. B. Prior written approval from the Department's Grant Manager shall be required for changes within approved deliverable budget categories of up to 10%of the total deliverable budget amount. The DEP Grant Manager will transmit a copy of the written approval and revised budget to the DEP Procurement Office and the DEP Contracts Disbursements Office for inclusion in the Agreement file. Changes greater than 10% of the total approved deliverable budget will require a formal change order to the Agreement. Changes that transfer funds from one deliverable to another or that increase or decrease the total funding amount will require a formal amendment to the Agreement. C. The Grantee shall be reimbursed on a cost reimbursement basis for all eligible project costs,upon the completion,submittal and approval of deliverables identified in Attachment A, in accordance with the schedule therein. Reimbursement shall be requested utilizing Attachment B, Payment Request Summary Form. A final payment request must be submitted to the Department no later than June 15, 2012, to assure the availability of funds for payment. In addition to the summary form, the Grantee must provide from its accounting system, a listing of expenditures charged against this Agreement. The listing shall include, at a minimum, a description of the goods or services purchased, date of the transaction, voucher number, amount paid, and vendor name. All requests for reimbursement of travel expenses shall be in accordance with Section 112.061,Florida Statutes. DEP Agreement No. S0557,Page 1 of 6 • 16C2 D. In addition to the invoicing requirements contained in paragraph 3.B. above, the Department will periodically request proof of a transaction (invoice, payroll register, etc.) to evaluate the appropriateness of costs to the Agreement pursuant to State and Federal guidelines(including cost allocation guidelines), as appropriate. This information,when requested, must be provided within thirty (30) calendar days of such request. The Grantee may also be required to submit a cost allocation plan to the Department in support of its multipliers (overhead, indirect, general administrative costs,and fringe benefits). All bills for amounts due under this Agreement shall be submitted in detail sufficient for a proper pre-audit and post-audit thereof. State guidelines for allowable costs can be found in the Department of Financial Services' Reference Guide for State Expenditures at http://www.fldfs.com/aadir/reference%SFguide. E. 1. The accounting systems for all Grantees must ensure that these funds are not commingled with funds from other agencies. Funds from each agency must be accounted for separately. Grantees are prohibited from commingling funds on either a program-by- program or a project-by-project basis. Funds specifically budgeted and/or received for one project may not be used to support another project. Where a Grantee's, or subrecipient's, accounting system cannot comply with this requirement, the Grantee, or subrecipient, shall establish a system to provide adequate fund accountability for each project it has been awarded. 2. If the Department finds that these funds have been commingled, the Department shall have the right to demand a refund,either in whole or in part,of the funds provided to the Grantee under this Agreement for non-compliance with the material terms of this Agreement. The Grantee, upon such written notification from the Department shall refund,and shall forthwith pay to the Department,the amount of money demanded by the Department. Interest on any refund shall be calculated based on the prevailing rate used by the State Board of Administration. Interest shall be calculated from the date(s) the original payment(s) are received from the Department by the Grantee to the date repayment is made by the Grantee to the Department. 3. In the event that the Grantee recovers costs, incurred under this Agreement and reimbursed by the Department, from another source(s), the Grantee shall reimburse the Department for all recovered funds originally provided under this Agreement. Interest on any refund shall be calculated based on the prevailing rate used by the State Board of Administration. Interest shall be calculated from the date(s)the payment(s)are recovered by the Grantee to the date repayment is made to the Department by the Grantee. 4. The State of Florida's performance and obligation to pay under this Agreement is contingent upon an annual appropriation by the Legislature. The parties hereto understand that this Agreement is not a commitment of future appropriations. 5. The Grantee shall utilize Attachment C, Progress Report Form, to describe the work performed, problems encountered, problem resolution, schedule updates and proposed work for the next reporting period. Quarterly reports shall be submitted to the Department's Grant Manager no later than twenty(20) days following the completion of the quarterly reporting period. It is hereby understood and agreed by the parties that the term"quarterly"shall reflect the calendar quarters ending March 31,June 30, September 30 and December 31. The Department's Grant Manager shall have ten (10) calendar days to review the required reports and deliverables submitted by the Grantee. 6. Each party hereto agrees that it shall be solely responsible for the negligent or wrongful acts of its employees and agents. However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity or the provisions of Section 768.28,Florida Statutes. 7. A. The Department may terminate this Agreement at any time in the event of the failure of the Grantee to fulfill any of its obligations under this Agreement. Prior to termination,the Department DEP Agreement No.S0557,Page 2 of 6 16C2 shall provide thirty(30)calendar days written notice of its intent to terminate and shall provide the Grantee an opportunity to consult with the Department regarding the reason(s)for termination, B. The Department may terminate this Agreement for convenience by providing the Grantee with thirty(30)calendar days written notice. 8. This Agreement may be unilaterally canceled by the Department for refusal by the Grantee to allow public access to all documents, papers, letters, or other material made or received by the Grantee in conjunction with this Agreement,unless the records are exempt from Section 24(a)of Article I of the State Constitution and Section 119.07(1)(a),Florida Statutes. 9. The Grantee shall maintain books, records and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. The Department, the State, or their authorized representatives shall have access to such records for audit purposes during the term of this Agreement and for five(5)years following Agreement completion. In the event any work is subcontracted, the Grantee shall similarly require each subcontractor to maintain and allow access to such records for audit purposes. 10. A. In addition to the requirements of the preceding paragraph, the Grantee shall comply with the applicable provisions contained in Attachment D,Special Audit Requirements, attached hereto and made a part hereof. Exhibit 1 to Attachment D summarizes the funding sources supporting the Agreement for purposes of assisting the Grantee in complying with the requirements of Attachment D. A revised copy of Exhibit 1 must be provided to the Grantee for each amendment which authorizes a funding increase or decrease. If the Grantee fails to receive a revised copy of Exhibit 1,the Grantee shall notify the Department's Grants Development and Review Manager at 850/245-2361 to request a copy of the updated information. B. The Grantee is hereby advised that the Federal and/or Florida Single Audit Act Requirements may further apply to lower tier transactions that may be a result of this Agreement. The Grantee shall consider the type of financial assistance(federal and/or state)identified in Attachment D,Exhibit 1 when making its determination. For federal financial assistance, the Grantee shall utilize the guidance provided under OMB Circular A-133, Subpart B, Section .210 for determining whether the relationship represents that of a subrecipient or vendor. For state financial assistance, the Grantee shall utilize the form entitled "Checklist for Nonstate Organizations Recipient/Subrecipient vs. Vendor Determination" (form number DFS-A2-NS)that can be found under the"Links/Forms"section appearing at the following website: https://apps.fldfs.com/fsaa The Grantee should confer with its chief financial officer,audit director or contact the Department for assistance with questions pertaining to the applicability of these requirements. C. In addition, the Grantee agrees to complete and submit the Certification of Applicability to Single Audit Act Reporting,Attachment E, attached hereto and made a part hereof,within four (4)months following the end of the Grantee's fiscal year. Attachment B should be submitted to the Department's Grants Development and Review Manager at 3900 Commonwealth Boulevard, Mail Station 93, Tallahassee, Florida 32399-3000. The Grants Development and Review Manager is available to answer any questions at(850)245-2361. 11. A. The Grantee may subcontract work under this Agreement without the prior written consent of the Department's Grant Manager. The payment terms of subcontracts(other than construction and the purchase of commodities)shall comply with the terms of this Agreement(for example, if payment under this Agreement is being made on a cost reimbursement basis, then the subcontract should also be cost reimbursement). The Grantee shall submit a copy of the executed subcontract to the Department within ten (10) days after execution. The Grantee agrees to be responsible for the DEP Agreement No.S0557,Page 3 of 6 16C2 fulfillment of all work elements included in any subcontract and agrees to be responsible for the payment of all monies due under any subcontract. It is understood and agreed by the Grantee that the Department shall not be liable to any subcontractor for any expenses or liabilities incurred under the subcontract and that the Grantee shall be solely liable to the subcontractor for all expenses and liabilities incurred under the subcontract. B. The Department of Environmental Protection supports diversity in its procurement program and requests that all subcontracting opportunities afforded by this Agreement embrace diversity enthusiastically. The award of subcontracts should reflect the full diversity of the citizens of the State of Florida. A list of minority owned finns that could be offered subcontracting opportunities may be obtained by contacting the Office of Supplier Diversity at(850)487-0915. 12. In accordance with Section 216.347, Florida Statutes, the Grantee is hereby prohibited from using funds provided by this Agreement for the purpose of lobbying the Legislature, the judicial branch or a state agency. 13. The Grantee shall comply with all applicable federal, state and local rules and regulations in providing services to the Department under this Agreement. The Grantee acknowledges that this requirement includes compliance with all applicable federal,state and local health and safety rules and regulations. The Grantee further agrees to include this provision in all subcontracts issued as a result of this Agreement. 14. Any notices between the parties shall be considered delivered when posted by Certified Mail,return receipt requested, or overnight courier service, or delivered in person to the Grant Managers at the addresses below. 15. The Department's Grant Manager for this Agreement is identified below. Jack Price Florida Department of Environmental Protection Solid and Hazardous Waste 2600 Blair Stone Road Tallahassee,Florida 32399-2400 Telephone No.: (850)245-8751 Fax No.: (850)245-8811 E-mail Address: John.l.price a,dep.state.fl.us 16. The Grantee's Grant Manager for this Agreement is identified below. David Jaye Collier County Board of County Commissioners Solid Waste Management Department 3339 Tamiami Trail East,Suite 302 Naples,Florida 34112 Telephone No.: (239)252-7620 Fax No.: (239)774-9222 E-mail Address: DavidJaye @colliergov.net 17. To the extent required by law, the Grantee will be self-insured against, or will secure and maintain during the life of this Agreement, Workers' Compensation Insurance for all of its employees connected with the work of this project and, in case any work is subcontracted, the Grantee shall require the subcontractor similarly to provide Workers' Compensation Insurance for all of the latter's employees unless such employees are covered by the protection afforded by the Grantee. Such self-insurance program or insurance coverage shall comply fully with the Florida Workers'Compensation law. In case any class of employees engaged in hazardous work under this Agreement is not protected under Workers' Compensation statutes, DEP Agreement No. S0557,Page 4 of 6 16C2 '1 0 the Grantee shall provide, and cause each subcontractor to provide, adequate insurance satisfactory to the Department,for the protection of his employees not otherwise protected. 18. The Grantee,as an independent contractor and not an agent,representative,or employee of the Department, agrees to carry adequate liability and other appropriate forms of insurance. The Department shall have no liability except as specifically provided in this Agreement. 19. The Grantee covenants that it presently has no interest and shall not acquire any interest which would conflict in any manner or degree with the performance of services required. 20. Reimbursement for equipment purchases costing $1,000 or more is not authorized under the terms and conditions of this Project Agreement. 21. The Department may at any time,by written order designated to be a change order, make any change in the Grant Manager information or task timelines within the current authorized Agreement period. All change orders are subject to the mutual agreement of both parties as evidenced in writing. Any change, which causes an increase or decrease in the Grantee's cost or time, shall require formal amendment to this Agreement. 22. A. No person, on the grounds of race, creed, color, national origin, age, sex, or disability, shall be excluded from participation in;be denied the proceeds or benefits of;or be otherwise subjected to discrimination in performance of this Agreement. B. An entity or affiliate who has been placed on the discriminatory vendor list may not submit a bid on a contract to provide goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not award or perform work as a contractor, supplier, subcontractor, or consultant under contract with any public entity, and may not transact business with any public entity. The Florida Department of Management Services is responsible for maintaining the discriminatory vendor list and intends to post the list on its website. Questions regarding the discriminatory vendor list may be directed to the Florida Department of Management Services,Office of Supplier Diversity,at 850/487-0915. 23. Land acquisition is not authorized under the terms of this Agreement. 24. If a court deems any provision of this Agreement void or unenforceable, that provision shall be enforced only to the extent that it is not in violation of law or is not otherwise unenforceable and all other provisions shall remain in full force and effect. 25. This Agreement represents the entire agreement of the parties. Any alterations, variations, changes, modifications or waivers of provisions of this Agreement shall only be valid when they have been reduced to writing,duly signed by each of the parties hereto,and attached to the original of this Agreement,unless otherwise provided herein. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK DEP Agreement No.S0557,Page 5 of 6 1 16C2 IN WITNESS WHEREOF,the parties have caused this Agreement to be duly executed,the day and year last written below. COLLIER COUNTY BOARD STATE OFF, LORIDA DEPARTMENT OF OF COUNTY COMMISSIONERS ENVIRONMENTAL PROTECTION ‘..,), - Lck LAJ. Co-i.y)s ,...Z,Z. ,le-cpe„ By: By: Title: *Fred W.Coyle,Chairman Secretary or designee Date: (,.=C -1 5 ?()/( Date: ref/�v! P 4,t``f(tE l=. ,, .)m J lad rice,DEP Grant Manager . I HT CK, Ck rk y i,z ' _. iy} 6r f Attut i .� DEP Contracts Administrator num Approved at .' o.t , +- ' b.fficiency: Approved as to form and legality: . \‘'.\tak,‘,...‘t 'te \1/4kr—N\-- By: i *D 572_,,.,v , ' L a....- '3 . +...)s,--a. N„r 1.„.. DEP ttorney FEID No.:59-6000558 *For Agreements with governmental boards/commissions: If someone other than the Chairman signs this Agreement,a resolution,statement or other document authorizing that person to sign the Agreement on behalf of the Grantee must accompany the Agreement. List of attachments/exhibits included as part of this Agreement: Specify Letter/ Type Number Description(include number of pages) Attachment A Grant Work Plan(3 Pages) Attachment B Payment Request Summary Form(2 Pages) Attachment C Progress Report Form(2 Pages) Attachment D Single Audit Requirements(5 Pages) Attachment E Certification of Applicability to Single Audit Act Reporting(3 Pages) DEP Agreement No.S0557,Page 6 of 6 16C2 ATTACHMENT A GRANT WORK PLAN Project Title: Adding Household and Small Business Hazardous Waste Services to Cleanup Events in Neighborhoods with Immigrant Populations ' S c t rWig gaon N ONTr w z r a ;nl i r S pgf = .,a itoggi[ag,stt MMI u ak j"> ltoo sz t - l var v ?3.i 3�, 3 mJS . . ,a, Project Location: C,kyo llier County akaSemr - " ' ro_z v A ' }U t ma id =v " 3�..s"opt_ Yo: +� ,{ g,g.4H ; "ggo .Gx� ,*. ., &glm 1�r ;. Project Background: This project will assist in adding education and outreach to Conditionally Exempt Small Quantity Generators (CESQG) about the new Landfill Household Hazardous Waste (HHW) facility and HHW collections to five neighborhood cleanup events by June 15, 2012. All 5 communities have significant immigrant populations. HHW and CESQG collection services have not been promoted or provided during these community cleanup events in the past. • Before each neighborhood cleanup, County staff and community volunteers will deliver HHW educational material to homes in the cleanup areas in addition to the recycling and curbside collection information currently provided during the door to door canvassing; provide HHW brochures and other educational materials in 3 languages; and offer and provide upon request, plastic bags for homeowners' containment and transport of HHW to the neighborhood cleanup collection site. • Prior to each cleanup event county staff and volunteers will visit the businesses checking for compliance and promoting the Cleanup event; educate CESQG businesses in the cleanup areas about the new HHW facility, which these businesses can use, at the County Landfill scheduled to open in May 2012; and provide CESQG businesses disposal forms, brochures and a HHW video. • We will develop a HHW presentation for Adult English Language Learners including brochures, Power Point, information/educational materials and a HHW video in three languages. We will offer to make HHW presentations to area Adult English Classes, Habitat Homeowners, Home Owner Organizations, Churches and other groups within the communities. The County currently makes presentations to these classes about recycling. • Conduct 5 community cleanup events including HHW and CESQG hazardous waste services,one each in East Naples,Immokalee, Golden Gate City, Golden Gate Estates, and North Naples. • Project Report and present results at annual HHW/Small Quantity Generator(SQG) workshop. +z"rs'.cfr `4- w t"*'. 44 - ^^t a �a� °l€„s v`"t s4 y ,3^f f�;.,Jte dt�' i+' ,s--r`it as k"„ -+.c+l'JY ' �'w- :.Y }�, Xn 33+�i h''�r ?E :'. -,v-..2o h%p'* z^�lkSC:."'k -w Cr'�t"a o 4 n + o *'`-.t. . 'S r 'fig ,a�i'+3 5�., i "„ -A imi 4 .,:,1� �. T ' -5+. �� .�.>:''`.:,x'�..s,.f'xmn.,,....:s+' �,Y L.t�...,�'r�._7.,3�.�,c_`�".r"�°'.,,...e.<...�,`�',?��.::siv.�.�..:n'?�''..r. �a.�d 'F`.�,'.�- "r.�':''�`� t,�'>�.r3`.x�,_��„ .,..�,.;F""'�.^�,.,n_�s�,;: Project Description: 1.Task: Develop and procure all written public educational materials. Cost: =$7,425 la.Deliverable:7,500 CESQG Brochures in Spanish, Creole and English- $900 Performance Standards: Samples of brochures Completion Date: December 31, 2011 DEP Agreement S0557,Attachment A,Page 1 of 3 • 16C2 Budget Information: Contractual: Printing $900 lb.Deliverable:HHW Brochures in Spanish and Creole,2,000 in each language -$2,520 Performance Standards: Samples of translated brochures Completion Date:December 31,2011 Budget Information: Contractual: Translation, art work and printing$2,520 Ic.Deliverable: 4,500 Public Information Refrigerator Magnets -$4,005 Performance Standards: Samples of refrigerator magnets Completion Date:December 31, 2011 Budget Information: Contractual: Refrigerator Magnets $4,005 2.Task: Develop script and film HHW video in 3 languages Cost: $8,000 2a.Deliverable: HHW video in English, Spanish and Creole Performance Standards: Copy of videos Completion Date:February 29, 2012 Budget Information: Contractual: Script and produce video $8,000 3.Task: Conduct 5 community cleanup events. Cost: =$34,145 3a.Deliverable: Modify existing trailer for HHW collections Performance Standards: Liner, spill kits,racks,containers Completion Date:April 30,2012 Budget Information: • Contractual: Install Liner, spill kits,racks,containers $3,500 • 3b.Deliverable: 100 plastic bags for HHW packing and transport Performance Standards: 24"x 24"6 mil plastic bags with zip lock Completion Date:April 30, 2012 Budget Information Supplies/Other Expenses: Plastic bags for 1-11-1W packing and transport- $125 3c.Deliverable: Event advertising Performance Standards: Samples of door hanger and quantity(2,000) Completion Date:April 30,2012 • Budget Information: • Contractual: Design and produce advertising door hangers$520 3d.Deliverable: Conduct 5 events Performance Standards: Number of homes and number of CESQG businesses provided HHW DEP Agreement 50557,Attachment A,Page 2 of 3 • 16C2 • information; number of event participants; HHW amounts collected Completion Date:April 30,2012 Budget Information: • Contractual: Collection and disposal of HHW-$30,000 4.Task : Prepare Project Report and present results at workshop Cost: $406 Ia.Deliverable: Project Report and presentation at annual HHW/Small Quantity Generator (SQG)workshop May 20-25, 2011 Performance Standards: Project report (hard copy and electronic format) to include, at minimum, a description of all project activities; data collected (number of homes and number of CESQG businesses provided HHW information; number of event participants; HHW amounts collected, etc.); description and listing of grant expenditures; copies of brochures, videos, advertising, presentations; and other information as requested by DEP Grant Manager. Copy of presentation. Completion Date: May 25,2012 Budget Information: Travel: Per diem for Workshop 6 days at$51/day $306 Supplies/Other Expenses: Workshop Registration$100 REMAINDER OF PAGE INTENTIONALLY LEFT BLANK DEP Agreement S0557,Attachment A,Page 3 of 3 16C2 ATTACHMENT B • PAYMENT REQUEST SUMMARY FORM • Grantee: Grantee's Grant Manager: Mailing Address: Payment Request No.: • DEP Agreement No.: S0557 Date Of Request: Performance Period: Task/Deliverable Amount Task/Deliverable Requested:$ No.: GRANT EXPENDITURES SUMMARY SECTION [Effective Date of Grant through End-of-Grant Period] AMOUNT OF TOTAL MATCHING TOTAL CATEGORY OF EXPENDITURE THIS REQUEST CUMULATIVE FUNDS CUMULATIVE PAYMENTS MATCHING FUNDS • Salaries $N/A $N/A $N/A $N/A Fringe Benefits $N/A $N/A $N/A $N/A • Travel(if authorized) $ $ $N/A SN/A Subcontracting: $N/A $N/A Hazardous Waste Disposal Events $ $ $N/A $N/A Videos $ $ $N/A $N/A Brochures $ $ $N/A $N/A Equipment Purchases $N/A $N/A $N/A ' $N/A Supplies/Other Expenses $ $ $N/A $N/A Land $N/A $N/A $N/A SN/A Indirect $N/A $N/A $N/A $N/A TOTAL AMOUNT $ $ $N/A $N/A TOTAL TASK BUDGET AMOUNT $ $N/A Less Total Cumulative Payments of $ $N/A TOTAL REMAINING IN TASK $ $N/A GRANTEE CERTIFICATION The undersigned certifies that the amount being requested for reimbursement above was for items that were charged to and utilized only for the above cited grant activities. Grantee's Grant Manager's Signature Grantee's Fiscal Agent Print Name Print Name Telephone Number Telephone Number DEP 55-223(07/10) DEP Agreement No.S0557,Attachment B,Pagc 1 of 2 16C2 INSTRUCTIONS FOR COMPLETING PAYMENT REQUEST SUMMARY FORM GRANTEE: Enter the name of the grantee's agency. MAILING ADDRESS: Enter the address that you want the state warrant sent. DEP AGREEMENT NO.: This is the number on your grant agreement. DATE OF REQUEST: This is the date you are submitting the request. TASK AMOUNT REQUESTED: This should match the amount on the"TOTAL TASK BUDGET AMOUNT"line for the "AMOUNT OF THIS REQUEST'column. GRANTEE'S GRANT MANAGER: This should be the person identified as grant manager in the grant Agreement. PAYMENT REQUEST NO.: This is the number of your payment request,not the quarter number. PERFORMANCE PERIOD: This is the beginning and ending date of the invoice period. TASK NO.: Enter the number of the task that you are requesting payment for. GRANT EXPENDITURES SUMMARY SECTION: "AMOUNT OF THIS REQUEST" COLUMN: Enter the amount that was paid out for this task/deliverable during the invoice period for which you are requesting reimbursement. This must agree with the budget category as in the currently approved budget in the current Grant Work Plan of your grant Agreement. Do not claim expenses in a budget category that does not have an approved budget. Do not claim items that are not specifically identified in the current Budget Narrative section of the current Grant Work Plan. Enter the column total on the"TOTAL AMOUNT' line. Enter the amount of the task on the"TOTAL TASK BUDGET AMOUNT' line. Enter the total cumulative amount of this request and all previous payments on the "LESS TOTAL CUMULATIVE PAYMENTS OF' line. Deduct the "LESS TOTAL CUMULATIVE PAYMENTS OF' from the "TOTAL TASK BUDGET AMOUNT' for the amount to enter on the"TOTAL REMAINING IN TASK"line. "TOTAL CUMULATIVE PAYMENTS"COLUMN: Enter the cumulative amounts that have been claimed to date for reimbursement by budget category. The final report should show the total of all payments; first through the final payment (this amount cannot exceed the approved budget amount for that budget category for the task you are reporting on). Enter the column total on the"TOTALS"line. Do not enter anything in the shaded areas. "MATCHING FUNDS"COLUMN: Enter the amount to be claimed as match for the invoice period for the task you are reporting on. This needs to be shown under specific budget categories according to the currently approved Grant Work Plan. Enter the total on the "TOTAL AMOUNT' line for this column. Enter the match budget amount on the "TOTAL TASK BUDGET AMOUNT' line for this column. Enter the total cumulative amount of this and any previous match claimed on the "LESS TOTAL CUMULATIVE PAYMENTS OF' line for this column. Deduct the "LESS TOTAL CUMULATIVE PAYMENTS OF' from the "TOTAL TASK BUDGET AMOUNT' for the amount to enter on the "TOTAL REMAINING IN TASK'line. "TOTAL CUMULATIVE MATCHING FUNDS" COLUMN: Enter the cumulative amount you have claimed to date for match by budget category for the task. Put the total of all on the line titled"TOTALS." The final report should show the total of all claims,first claim through the final claim,etc. Do not enter anything in the shaded areas. GRANTEE CERTIFICATION: Must be signed by both the Grantee's Grant Manager as identified in the grant agreement and the Grantee's Fiscal Agent. NOTE: If claiming reimbursement for travel, you must include copies of receipts and a copy of the travel reimbursement form approved by the Department of Financial Services,Chief Financial Officer. DEP 55-223(07/10) DEP Agreement No.S0557,Attachment B,Page 2 of 2 16C2, ATTACHMENT C PROGRESS REPORT FORM DEP Agreement No.: S0557 Grantee Name: Grantee Address: Grantee's Grant Manager: I Telephone No.: Quarterly Reporting Period: Project Number and Title: _ Provide a summary of project accomplishments to date. (Include a comparison of actual accomplishments to the objectives established for the period. If goals were not met, provide reasons why.) Provide an update on the estimated time for completion of the project and an explanation for any anticipated delays. Provide any additional pertinent information including,when appropriate, analysis and explanation of cost overruns or high unit costs. DEP Agreement No. 50557,Attachment C,Page 1 of 2 16C2 (continued from page 1) Identify below,and attach copies of, any relevant work products being submitted for the project for this reporting period (e.g.,report data sets,links to on-line photographs,etc.) Provide a project budget update,comparing the project budget to actual costs to date. Expenditures Prior to this Expenditures Budget Total Project Reporting this Reporting Project Funding Category Budget Period Period Balance This report is submitted in accordance with the reporting requirements of DEP Agreement No. S0557 and accurately reflects the activities and costs associated with the subject project. Signature of Grantee's Grant Manager Date DEP Agreement No. S0557,Attachment C,Page 2 of 2 1602 ATTACHMENT D SPECIAL AUDIT REQUIREMENTS The administration of resources awarded by the Department of Environmental Protection (which may be referred to as the "Department", "DEP", "FDEP" or "Grantor", or other name in the contract/agreement) to the recipient (which may be referred to as the "Contractor", Grantee"or other name in the contract/agreement) may be subject to audits and/or monitoring by the Department of Environmental Protection,as described in this attachment. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A-133 and Section 215.97, F.S., as revised (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by Department staff,limited scope audits as defined by OMB Circular A-133,as revised, and/or other procedures. By entering into this Agreement, the recipient agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Department of Environmental Protection. In the event the Department of Environmental Protection determines that a limited scope audit of the recipient is appropriate, the recipient agrees to comply with any additional instructions provided by the Department to the recipient regarding such audit. The recipient further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial Officer or Auditor General. AUDITS PART I:FEDERALLY FUNDED This part is applicable if the recipient is a State or local government or a non-profit organization as defined in OMB Circular A-133,as revised. 1. In the event that the recipient expends $500,000 or more in Federal awards in its fiscal year,the recipient 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 Attachment indicates Federal funds awarded through the Department of Environmental Protection by this Agreement. In determining the Federal awards expended in its fiscal year,the recipient shall consider all sources of Federal awards, including Federal resources received from the Department of Environmental Protection. 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 recipient conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised,will meet the requirements of this part. 2. In connection with the audit requirements addressed in Part I, paragraph I, the recipient shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised. 3. If the recipient expends less than $500,000 in Federal awards in its fiscal year, an audit conducted in accordance with the provisions of OMB Circular A-133, as revised, is not required. In the event that the recipient 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 an audit must be paid from recipient resources obtained from other than Federal entities). 4. The recipient may access information regarding the Catalog of Federal Domestic Assistance (CFDA) via the internet at httn://12.46.245.173/cfda/cfda.html. DEP 55-215(03/09) DEP Agreement No. S0557,Attachment D,Page 1 of 5 16C2 PART II:STATE FUNDED This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2)(m),Florida Statutes. 1. In the event that the recipient expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal year of such recipient,the recipient 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 1 to this Attachment indicates state financial assistance awarded through the Department of Environmental Protection by this Agreement. In determining the state financial assistance expended in its fiscal year,the recipient shall consider all sources of state financial assistance, including state financial assistance received from the Department of Environmental Protection, 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. 2. In connection with the audit requirements addressed in Part II,paragraph 1; the recipient shall ensure that the audit complies with the requirements of Section 215.97(7), Florida Statutes. This includes submission of a financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. 3. If the recipient expends less than$500,000 in state financial assistance in its fiscal year,an audit conducted in accordance with the provisions of Section 215.97,Florida Statutes, is not required. In the event that the recipient 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 non-state entity's resources (i.e., the cost of such an audit must be paid from the recipient's resources obtained from other than State entities). 4. For information regarding the Florida Catalog of State Financial Assistance (CSFA), a recipient should access the Florida Single Audit Act website located at https://apps.fldfs.com/fsaa for assistance. In addition to the above websites, the following websites may be accessed for information: Legislature's Website at http://www.leg.state.fl.us/Welcome/index.cfm, State of Florida's website at http://www.myflorida.com/, Department of Financial Services' Website at http://www.fldfs.com/ and the Auditor General's Website at http://www.state.fl.us/audgen. PART III:OTHER AUDIT REQUIREMENTS (NOTE: This part would be used to speck any additional audit requirements imposed by the State awarding entity that are solely a matter of that State awarding entity's policy(i.e., the audit is not required by Federal or State laws and is not in conflict with other Federal or State audit requirements). Pursuant to Section 215.97(8), Florida Statutes,State agencies may conduct or arrange for audits of State financial assistance that are in addition to audits conducted in accordance with Section 215.97, Florida Statutes. In such an event, the State awarding agency must arrange for funding the full cost of such additional audits) PART IV:REPORT SUBMISSION 1. Copies of reporting packages for audits conducted in accordance with OMB Circular A-133,as revised,and required by PART I of this Attachment shall be submitted, when required by Section .320 (d), OMB Circular A-133,as revised,by or on behalf of the recipient directly to each of the following: DEP 55-215(03/09) DEP Agreement No. S0557,Attachment D,Page 2 of 5 16C2 A. The Department of Environmental Protection at the following address: Audit Director Florida Department of Environmental Protection Office of the Inspector General,MS 40 3900 Commonwealth Boulevard Tallahassee,Florida 32399-3000 B. The Federal Audit CIearinghouse 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 Submissions of the Single Audit reporting package for fiscal periods ending on or after January 1, 2008,must be submitted using the Federal CIearinghouse's Internet Data Entry System which can be found at http://harvester.census.gov/fac/ C. Other Federal agencies and pass-through entities in accordance with Sections.320,(e)and(f), OMB Circular A-133,as revised. 2. Pursuant to Section .320(f), OMB Circular A-133, as revised, the recipient shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letters issued by the auditor,to the Department of Environmental Protection at the following address: Audit Director Florida Department of Environmental Protection Office of the Inspector General,MS 40 3900 Commonwealth Boulevard Tallahassee,Florida 32399-3000 3. Copies of financial reporting packages required by PART II of this Attachment shall be submitted by or on behalf of the recipient directly to each of the following: A. The Department of Environmental Protection at the following address: Audit Director Florida Department of Environmental Protection Office of the Inspector General,MS 40 3900 Commonwealth Boulevard Tallahassee,Florida 32399-3000 • B. The Auditor General's Office at the following address: State of Florida Auditor General Room 401,Claude Pepper Building 111 West Madison Street Tallahassee,Florida 32399-1450 REMAINDER OF PAGE INTENTIONALLY LEFT BLANK DEP 55-215(03/09) DEP Agreement No.S0557,Attachment D,Page 3 of 5 16C2 4. Copies of reports or management letters required by PART III of this Attachment shall be submitted by or on behalf of the recipient directly to the Department of Environmental Protection at the following address: Audit Director Florida Department of Environmental Protection Office of the Inspector General,MS 40 3900 Commonwealth Boulevard Tallahassee,Florida 32399-3000 5. Any reports, management letters, or other information required to be submitted to the Department of Environmental Protection pursuant to this Agreement shall be submitted timely in accordance with OMB Circular A-133,Florida Statutes, or Chapters 10.550(local governmental entities)or 10.650(nonprofit and for-profit organizations),Rules of the Auditor General,as applicable. 6. Recipients, when submitting financial reporting packages to the Department of Environmental Protection 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 recipient in correspondence accompanying the reporting package. PART V: RECORD RETENTION The recipient shall retain sufficient records demonstrating its compliance with the terms of this Agreement for a period of 5 years from the date the audit report is issued, and shall allow the Department of Environmental Protection, or its designee, Chief Financial Officer, or Auditor General access to such records upon request. The recipient shall ensure that audit working papers are made available to the Department of Environmental Protection, or its designee, Chief Financial Officer, or Auditor General upon request for a period of 3 years from the date the audit report is issued,unless extended in writing by the Department of Environmental Protection. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK DEP 55-215(03/09) DEP Agreement No. S0557,Attachment D,Page 4 of 5 1602 ^ i N 0 O 0 A a.+ UD ) - D V - D. 0 *'' 0 k d a aU PL•U 5,U ° 0 - a a. 0. ca bn g Q i Q Q '4 y U .3 as .4 L U ..+ a)G ti U o a o E O O n � Q Q N Q 0 0.) N 0 aa) op .p op 0 I:0 O. 0. 4) ..o 4 'b G4 'y +•' In w T y C y g Ff> fA ^p O ..D a V d W W W LT vi O ` w ++ 'O •_ 0 0) 0 bA oi aa) O " t, C Y 3 tj O a o in E ms •.a .0 J.. E, .G 0 o 4' '2 Qx W bt � Ad x ". w �° o = Di U� O � `'3 W O a> N P.O v 4 I c F c U e p v a 4 aQ C 0 N�? ° ' a a rA Q Q v " a o N 4, U o o g Cd a in o Z o in W 0 U 0 0 td W a Co) U o k" a W w o rt U 9 5 - rte-. L b[ Z O .5 3 0 Qy �H• ° r.. w r U o H Q ° Q ° a ,•,,.. o O at .a Q .o A �, �V cd 0 •a a> oUz U A yc 0. _ .d 0 miv _ N CAI I 0 rn• R6 4 ,... I. a 0+ a a a an w a ai as .fl a. ,. a 0. Y Q"U> l�x. w 4' t0 -0 . 'c. U .c! N /. 'd 0 al Q 0 Cj 4 '�O .� O 5 w w r icy W n 3 0 ln 3 O L w DAN O U y N Q a r V d ,8 a 4 N Q v a>-0 .o > 5 � a Q aai O a a> 0 O a> O I,^ 11.3 .n Q) . +16 z a ZOO ? 16C2 ATTACHMENT E CERTIFICATION OF APPLICABILITY TO SINGLE AUDIT ACT REPORTING Grantee's Name: Grantee Fiscal Year Period: FROM: TO: Total State Financial Assistance Expended during Grantee's most recently completed Fiscal Year: • Total Federal Financial Assistance Expended during Grantee's most recently completed Fiscal Year: CERTIFICATION STATEMENT: I hereby certify that the above information is correct. Signature Date Print Name and Position Title DEP Agreement No.S0557,Attachment E,Page 1 of 3 16 C { INSTRUCTIONS FOR COMPLETING THE ATTACHMENT Grantee Fiscal Year Period: FROM: Month/Year TO: Month/Year 'i. NOTE: THIS SHOULD BE THE GRANTEE'S FISCAL YEAR FROM (MONTH/YEAR) TO (MONTH/YEAR). Total State Financial Assistance Expended during Grantee's most recently completed Fiscal Year: NOTE: THIS AMOUNT SHOULD BE THE TOTAL STATE FINANCIAL ASSISTANCE EXPENDED FROM ALL STATE AGENCIES,NOT JUST DEP. Total Federal Financial Assistance Expended during Grantee's most recently completed Fiscal Year: NOTE: THIS AMOUNT SHOULD BE THE TOTAL FEDERAL FINANCIAL ASSISTANCE EXPENDED FROM ALL FEDERAL AGENCIES,NOT JUST THROUGH DEP. The Certification should be signed by your Chief Financial Officer. Please print the name and include the title and date of the signature. DEP Agreement No. S0557,Attachment E,Page 2 of 3 16C2 CERTIFICATION OF APPLICABILITY TO SINGLE AUDIT ACT REPORTING FREQUENTLY ASKED QUESTIONS 1. Question: Do I complete and return this form when I return my signed Agreement/Amendment? Answer: No, this form is to be completed and signed by your Chief Financial Officer and returned 4 months after the end of your fiscal year. 2. Question: Can I fax the form to you? Answer: Yes,you can fax the Certification form,the fax number is 850/245-2411. 3. Question: How can I submit the form if our audit is not completed by the due date of this letter? Answer: You should be able to complete the form from the information in your accounting system. This is just to let our Office of the Inspector General know which entities they should be getting an audit from. If you are under the threshold you do not have to submit a copy of your audit, only the Certification form. 4. Question: Do you only want what we received from DEP? Answer: No, the Single Audit is the TOTAL AMOUNT of funds that you expended towards all state or federal grants that you receive. You should list those that are specific to DEP on the form. 5. Question: Do I have to submit the completed form and a copy of my audit? Answer: No, you do not have to submit your audit unless you are over the threshold of $500,000. If you would prefer to submit your audit (CAFR) instead of the form, that is fine. 6. Question: Our CAFR will not be ready before your due date and we don't have the information necessary to complete the certification. Can we get an extension? Answer: Yes, just send us an Email letting us know when you will have your CAFR completed and we will place the Email with your letter in our file so that you don't get a 2nd notice. 7. Question: Can I submit my Certification Form or CAFR electronically? Answer: Yes,you can submit them by Email to Debbie.skeltotadep.state.fl.us DEP Agreement No.50557,Attachment E,Page 3 of 3