Backup Documents 01/12/2010 Item #16D 4
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLJl 6 D J.
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO .,.
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #1 through #4 as appropriate tor additional signatures, dates, and/or information needed. If the document is already complete with the
exceotion of the Chairman's signature, draw a line through routin~ lines #1 throu~h #4, cormlete the checklist, and forward to Sue Filson line #5).
Route to Addressee(s) Office Initial~ 17 Date
(List in routinll order)
I. Terri Daniels Housing and Human Services /ljIv 1/15/10
2. /
3.
4. Ian Mitchell, Manager Board of County Commissioners .{~ 'Iw!ro
5. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending Bee approval. NonnatIy the primary contact is the person who created/prepared the executive
summary. Primary contact infonnation 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 Bee Chairman's signature are to be delivered to the Bee office only aller the Bee has acted to approve the
item.)
Name of Primary Staff Terri Daniels Phone Number 252-2689
Contact
Agenda Date Item was January 12,2010 Agenda Item Number 16D4
Approved by the BCC
Type of Document Nutrition Services Incentive Program Number of Original 3
Attached (NS!P) Agreements 203.10 Documents Attached
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is
a fO nate.
I. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed I
by the Office of the County Attorney. This includes signature pages from ordinances, i
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 ossibl State Officials.)
2. All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other arties exce t the BCC Chairman and the Clerk to the Board
3. The Chairman's signature line date has been entered as the date ofBCC approval ofthe
document or the final ne otiated contract date whichever is a licable.
4. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
si ture and initials are re uired.
5. In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Sue Filson in the BCC office within 24 hours ofBCC 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 our deadlines!
6. The document was approved by the BCe on (enter date) and all changes
made dnring the meeting have been incorporated in the attached document. The
Count Attorne 's Office has reviewed the chan es if a licable.
I: Forms! eounty Fonns/ Bee Forms! Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
MEMORANDUM
1604
Date:
January 20,2010
To:
Terri Daniels, Grants Supervisor
Human Services Department
From:
Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re:
Nutrition Services Incentive Program (NSIP)
Agreements 203.10
Attached are your three (3) original amendment documents,
referenced above (Agenda Item #16D4), approved by the Board of
County Commissioners on Tuesday, January 12, 2010..
After further processing we request that an original be returned to our
office for the Board's Official Records.
If you should have any questions, please call 252-8411.
Thank you.
Attachments (3)
October 2009
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
STANDARD CONTRACT
16D4""
NSIP 203.10
NUTRITION SERVICES INCENTIVE PROGRAM
THIS CONTRACT is entered into between the Area Agency on Aging for SW FL., Inc., hereinafter
referred to as the "Agency," and Collier County Housing and Human Services, hcreinafter referred to as the
"Contractor", and collectively referred to as the "Parties." The term contractor for this purpose may
designate a vendor, subgrantee or subrecipient, the status to be further identified in A TT ACHMENT III,
Exhibit-2 as necessary.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in nced of certain services as described herein; and
WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully
perform such services as an independent contractor ofthe 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.
2. Incorporation of Documents within the Contract
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant
Agency 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 thc event of conflict in languagc among any of
the documents referenced above, the spccific provisions and rcquirements of the contract
document(s) shall prevail ovcr inconsistent provisions in the Proposal(s), or othcr general materials
not specific to this contract document and identified attachments.
3. Term of Contract
This contract shall begin on October I, 2009 or on the date on which the contract has been signcd by
the last party required to sign it, whichevcr is later. It shall end at midnight, local time in Tallahassee,
Florida, on September 30, 2010.
4. Contract Amount
The Agency agrees to pay for contracted services according to the tcrms and conditions of this
contract in an amount not to excecd $43,504.00, or the rate schcdule, 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 eontract.
5. Renewals
By mutual agreement of the parties, in accordance with s. 287.058(1)(f), F.S., the Agency may renew
the contract for a period not to exceed three years, or the tcrm of the original contract, whichcver is
longer. The renewal price, or method for dctermining a renewal pricc, is set forth in the bid,
proposal, or reply. No other costs for the renewal may be charged. No rcncwal is subject to the same
terms and conditions as the original contract and contingent upon satisfactory pcrformance
evaluations by the Agency and thc availability of funds.
I
October 2009
16D4-
NSIP 203.10
6. Compliance with Federal Law
6.1. If this contract contains federal funds the following shall apply:
6.1.1 The provider shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable
regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the contractor shall comply with all
applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42
D.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 D.S.C. 1251,
et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection
Agency regulations 40 CFR 30. The contractor shall report any violations of the above to the
Agency.
6.1.3 The contractor, or agent acting for the contractor, may not use any federal funds received in
connection with this contract to influence legislation or appropriations pending before he Congress or
any State legislature. If this contract contains federal funding in excess of $100,000.00, the
contractor must, prior to contract execution, complete the Certification Regarding Lobbying form,
ATTACHMENT II. All disclosure forms as required by the Certification Regarding Lobbying form
must be completed and returned to the Contract Manager, prior to payment under this contract.
6.1.4 That if this contract contains $10,000.00 or more of federal funds, the contractor shall comply with
Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and
others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if
applicable.
6.1.5 That if this contract contains federal fimds and provides services to children up to age 18, the
contractor shall comply with the Pro-Children Act of 1994 (20 U.S.C. 6081).
6.1.6 That a contract award with an amount expected to equal or exceed $25,000.00 and certain other
contract awards shall not be made to parties listed on the government-wide Excluded Parties List
System, in accordance with the OMS guidelines at 2 CFR 180 that implement Executive Orders
12549 and 12689, "Department and Suspension." The Excluded Parties List System contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549. The contractor
will comply with these provisions before doing business or entering into subcontracts receiving
federal funds pursuant to this contract. The contractor shall complete and sign ATTACHMENT V
prior to the execution of this contract.
6.2 The contractor shall not employ an unauthorized alien. The Agency shall consider the employment
of unauthorized aliens a violation of the Immigration and Nationality Act (8 u.s.c. ] 324 a) and the
Immigration Reform and Control Act of 1986 (8 U.S.c. 110]). Such violation shall be cause for
unilateral cancellation of this contract by the Agency.
2
October 2009
7. Compliance with State Law
~S~ 2Q.~
7.1 That 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 Requirements of s. 287.058. F.S.
7.2.1 The contractor will provide units of deliverables, including reports, findings, and drafts, as specified
in this contract, which the Contract Manager must receive and accept in writing prior to payment.
7.2.2 The contractor will submit bills for fees or other compensation for services or expenses in sufficient
detail for a proper pre-audit and post-audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract, the contractor will submit bills
for any travel expenses in accordance with s. 112.061. F.S., or at such lower rates as may be provided
in this contract.
7.2.4 The contractor will allow public access to all documents, papers, letters, or other public records as
defined in subsection 119.011(12), F.S., made or received by the contractor in conjunction with this
contract except for those records which are made confidential or exempt by law. The contractor's
refusal to comply with this provision shall constitute an immediate breach of contract for which the
Agency may unilaterally terminate the contract.
7.3 If clients are to be transported under this contract, the contractor shall comply with the provisions of
Chapter 417, F.S., and Rule 41-2, F.A.C.
7.4 Subcontractors who are on the discriminatory vendor list may not transact business with any public
entity, in accordance with the provisions of s. 287.134, F.S.
7.5 The contractor will comply with the provisions ofs. 11.062. F.S., and s. 2]6.347, F.S., which prohibit
the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state
agency.
8. Grievance Procedures
The contractor shall develop and implement, and ensure that its subcontractors have established
grievance procedures to process and resolve client dissatisfaction with or denial of service(s), and
address complaints regarding the termination, suspension or reduction of scrvices, as requircd for
receipt of funds. These procedures, at a minimum, should provide for notice or thc grievance
procedure and an opportunity for review of the subcontractor's determination(s).
9. Audits. Inspectl!ions. Invstil!ations. Public Records and Retention
9.1 To establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all income and expenditures of funds provided by thc Agcncy under this contract.
9.2 To retain all client records, financial records, supporting documents, statistical records, and any other
documents (including electronic storage mcdia) pcrtinent 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
3
October 2009 NSIP 203.10
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 ofthe Agency.
16D4
9.3 Upon demand, at no additional cost to the Agency, the contractor will facilitate the duplication and
transfer of any records or documcnts during the required retention period in Paragraph 9.2.
9.4 To assure that the records described in Paragraph 9 shall be subject at all reasonable times to
inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the
Agency.
9.5 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)(l0), shall be allowed full access to and the right to
examine any of the contractor's contracts and related records an documents pertinent to this specific
contract, regardless of the form in which kept.
9.6 To provide a financial and compliance audit to the Agency as specified in this contract and In
A TT ACHMENT III and to ensure that all related party transactions are disclosed to the auditor.
9.7 To 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.
10. Nondiscrimination-Civil Ril!hts Compliance
10.1 The contractor will 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 scx in compliance with state and
federal law and regulations. The contractor further assures that all contractors, subcontractors,
subgrantees, or others with whom it arranges to provide services or benefits in connection with any of
its programs and activities are not discriminating against clients or cmployees because of age, race,
religion, color, disability, national origin, marital status or sex.
10.2 The contractor will retain, on file, during the term of this agreement a timely, complete and accurate
Civil Rights Compliance Checklist (ATTACHMENT B).
10.3 The contractor agrees to establish procedures pursuant to federal law to handle complaints of
discrimination involving services or benefits through this contract. These procedures shall ineludc
notifying clients, employees, and participants of the right to file a complaint with the appropriate
federal or state entity.
10.4 If this contract contains federal funds, these assurances are a condition of continued rcceipt of or
benefit from federal financial assistance, and are binding upon the contractor, its successors,
transferees, and assignees for the period during which such assistance is provided. The contractor
further assures that all subcontractors, vendors, or others with whom it arranges to provide serviccs or
benefits to participants or employees in connection with any of its programs and activities are not
discriminating against those participants or employees in violation of the above statutes, regulations,
guidelines and standards. In the event of failure to comply, the contractor understands that the
Agency may, at its discretion, seek a court order requiring compliance with thc terms of this
4
16D4
October 2009
assurance or seek other appropriate judicial or administrative relief~
termination of and denial of further assistance.
NSIP 203.10
including but not limited to,
11. Provision of Services
The contractor will provide scrvices in the manner described in A TT ACHMENT I.
12. Monitorinl! bv the Al!encv
The contractor will permit persons duly authorized by the Agency to inspect and copy any records,
papers, documents, facilities goods and services of the contractor which are relevant to this contract,
and to interview any clients, employees and subcontractor employees of the contractor to assure the
Agency of the satisfactory performance of the terms and conditions of this contract. Following such
review the Agency will deliver to the contractor a written report of its findings and request for
development, by the contractor, of a corrective action plan where appropriate. Thc contractor hereby
agrees to timely correct all dcficiencies identified in the corrective action plan.
13. Indemnification
13.1 The contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and
employees from any and all claims, demands, actions, causes of action of whatever nature or
character, arising out of or by reason of the execution of this agreement or performance of the
services provided for herein. It is understood and agreed that the provider is not required to
indemnify the Agency for claims, demands, actions or causes of action arising solely out of the
Ageney's negligence.
13.2 Except to the extent permitted by s. 768.28, F.S., or other Florida law, paragraph 13.1 is not
applicable to contracts executed between the Agency and state agencies or subdivisions defined in
s.768.28(2), F.S.
14. Insurance and Bondinl!
14.1 To provide continuous adequate liability insurance coverage during the existence of this contract and
any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by subsection 768.28(2), F.S., the contractor accepts full responsibility for
identifying and determining the type(s) and extent of liability insurance necessary to provide
reasonable financial protections for the contractor and the clients to be served under this contract.
The limits of coverage under each policy maintained by the contractor do not limit the contractor's
liability and obligations under this contract. The contractor shall ensure that the Agency has the most
current written verification of insurancc coverage throughout the tcrm of this contract. Such
coverage may be provided by a self~insurance program established and operating undcr the laws of
the State of Florida. The Agcncy reserves the right to require additional insurance as specified in this
contract.
14.2 Throughout the term of this agreement, the contractor agrces to maintain an insurance bond from a
responsible commercial insurance company covcring all officcrs, dircctors, employces and agents of
the contractor authorized to handle funds received or disbursed undcr all agreements and/or contracts
incorporating this contract by reference in an amount commcnsurate with thc funds handled, the
degree of risk as determined by the insurance company and consistent with good business practices.
5
October 2009
15. Confidentiality oflnformation
The contractor shall not use or disclose any information concerning a recipient of services under this
contract for any purpose prohibited by state or federal law or regulations except with the written
consent of a person legally authorized to give that consent or when authorized by law.
1~sq2i.10
16. Health Insurance Portability and Accountability Act
Where applicable, the contractor will 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).
17. Incident Report
17.1 The contractor shall notify the Agency immediately, but no later than forty-eight (48) hours from, the
contractor's awareness or discovery of conditions that may materially affect the contractor or
subcontractor's ability to perform the services required to b performed under this contract.
17.2 To 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 (I-800-96ABDSE). As required by Chaptcrs 29 and 415, F.S., this provision is binding upon
both the contractor and its employees.
18. Sponsorship and Publicity
18.1 As required by s. 286.25, F.S., if the contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract,
it shall, in publicizing, advertising, or describing the sponsorship of he program, state: "Sponsored
by (contractor's name), Area Agency on Aging for SW FL. Inc., and the State of Florida, Department
of Elder Affairs." If the sponsorship reference is in written material, the words "Area Agency on
Aging for SW FL., Inc." and "State of Florida, Departmcnt of Elder Affairs" shall appear in at least
the same size letters or type as the name of the Organization.
18.2 The contractor shall not use thc words "Area Agency on Aging for SW FL. Inc.," or 'The State of
Florida, Department of Eldcr Affairs" to indicate sponsorship of a program otherwise financed,
unless, specific authorization has been obtained by the Agency prior to use.
19. Assil!nments
19.1 The contractor shall not assign thc rights and responsibilities undcr this Contract without the prior
written approval of the Agency, which shall not be unreasonably withheld. Any sublicensc,
assignment, or transfer otherwise occurring without prior writtcn approval of the Agency will
constitute a material breach of thc contract.
19.2 The Area Agency on Aging for Southwest Florida shall at all times be entitled to assign or transfer, in
whole or part, its rights, duties, or obligations undcr this contract to another governmental agency in
the State of Florida, upon giving prior writtcn notice to the contractor. In the evcnt the Area Agcncy
on Aging approvcs transfer of thc contractor's obligations, the contactor remains responsible for all
work performed and all expenses incurred in connection with the contract.
6
October 2009 NSIP 203.10
19.3 This contract shall remain binding upon the successors in interest of either the contractor or the
Agency.
16D4
20. Subcontracts
20.1 The contractor is responsible for all work pcrformed and for all commodities produced pursuant to
this contract, whether actually furnished by the contractor or its subcontractors. Any subcontracts
shall be evidenced by a written document and subject to any conditions of approval the Agency
deems necessary. The contractor fUrther agrees that the Agency shall not be liable to the
subcontractor in any way or for any reason. The contractor, at its expense, will defend the Agency
against any such claims.
20.2 The contractor shall promptly pay any subcontractors upon receipt of payment from the Agency or
other state agency. Failure to make payments to any subcontractor in accordance with s. 287.0585,
F.S., unless otherwise stated in the contract bctween the contractor and subcontractor, will result in a
penalty as provided by statute.
21. Independent Capacity of Contractor
It is the intent and understanding of the parties that the contractor, or any of its subcontractors, are
independent contractors and are not employees of the Agency and shall not hold themselves out as
employees or agents of the Agency without specific authorization from the Agency. It is the further
intent and understanding of the partics that the Agency does not control the employment practices of
the contractor and shall not be liable for any wage and hour, cmploymcnt discrimination, or other
labor and employment claims against the contractor or its subcontractors. All deductions for social
security, withholding taxes, income taxes, contributions to unemployment compensation funds and
all necessary insurance for the contractor shall bc the sole rcsponsibility of the contractor.
22. Payment
Payments will be made to the contractor pursuant to s. 215.422, F.S., as services are rendered and
invoiced by the contractor. The Agency's Contract Manager will have final approval of the invoice
for payment, and will approve the invoice for payment only if the contractor has met all terms and
conditions of the contract, unless the bid specifications, purchase order, or this contract specify
otherwise. The approved invoice will be submitted to the Agency's finance section for budgetary
approval and processing. Disputes arising over invoicing and payments will be resolved in
accordance with the provisions of s. 215,422 F.S. A Vendor Ombudsman has been established within
the Department of Finance Services and may be contacted at (850) 413-5665.
23. Return for Funds
The contractor will rcturn to the Agency any overpayments due to unearncd funds or funds
disallowed and any intercst attributable to such funds pursuant to the terms and conditions of this
contract that were disbursed to the contractor by the Agency. In the event that thc contractor or its
independent auditor discovcrs that an overpayment has been madc, the contractor shall repay said
overpayment immediately without prior notification from the Agency. In the event that the Agcncy
first discovers an overpayment has been made, the Contract Manager, on behalf of thc i\gency, will
notify the contractor by letter of such findings. Should repayment not bc made forthwith, the
contractor will be chargcd at the lawful rate of interest on the outstanding balance pursuant to s.
55.03, F.S., aftcr Agency notification or contractor discovery.
7
October 2009
24. Data Intel!rity and Safel!uardinl! Information
The contractor shall insure an appropriate level of data security for the information the contractor is
collecting or using in the performance of this contract. An appropriate level of security includes
approving and tracking all contractor employees that request system or information access and
ensuring that user access has been removed from all terminated employecs. The contractor, among
other requirement, must anticipate and prepare for the loss of information processing capabilities. All
data and software must be routinely backed up to insure recovery from losses or outages of the
computer system. The security over the backed-up data is to be as stringent as the protection required
of the primary systems. The contractor shall insure all subcontractors maintain written procedures for
computer system back up and recovery. The contractor shall complete and sign A TT ACHMENT IV
prior to the execution of this contract.
16 EI~03.10
25. Conflict of Interest
The contractor will 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 pcrsonal gain. No employee, officer or agent of the
contractor or subcontractor shall participate in selection, or in the award of an agreement supported
by State or Federal funds if a conflict of interest, real or apparent, would be involved. Such a conflict
would arise when: (a) the employee, officer or agent; (b) any member of his/her immediate family;
(c) his or her partner, or; (d) an organization which employs, or is about to employ, any of the above,
has a financial or other interest in the firm selected for award. The contractor or subcontractor's
officers, employees or agents will neither solicit nor accept gratuities favors or anything of monetary
value from contractors, potcntial contractors, or parties to subcontracts. The contractor's board
members and management must disclose to the Agency any relationship which may bc, or may be
perceived to be, a conflict of intercst within thirty (30) calendar days of an individual's original
appointment or placement in that position, or if the individual is serving as an incumbent, within
thirty (30) calendar days of the commencement of this contract. The contractor's employees and
subcontractors must make the same disclosures described above to the contractor's board of directors.
Compliance with this provision will be monitored.
26. Public Entity Crime
Pursuant to s. 287.133, F.S., the following restrictions are placed on the ability of persons convicted
of public entity crimes to transact business with the Agency. 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 rcpair of a
public building or public work; may not submit bids, proposals, or replies on Icases of real property
to a public entity; may not be awardcd or perform work a a contractor, supplier, subcontractor, or
consultant under a contract with any public entity; and may not transact business with any public
entity in excess of the threshold amount provided in s. 287,017, F.S., for CATEGORY TWO for a
pcriod of 36 months following the date of being placed on the convicted vendor list.
27. Purchasinl!
27.1 To 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 undcr the procedures set forth in subsections 946.515(2) and (4), F.S.
For purposes of this contract, the contractor shall be deemed to be substituted for the Agcncy insofar
as dealings with PRIDE. This clause is not applicable to subcontractors unless otherwise required by
8
October 2009 NSIP 203.10
law. An abbreviated list of products/services available from PRIDE may be obtained by contacting
PRIDE, (800) 642-8459.
16D4
27.2 To procure any recycled product or materials, which are the subject of or are required to carry out this
contract, in accordance with the provisions of s. 403.7065 and 287.045, F.S.
28. Patents. Copvril!hts. Rovalties
If any discovery, invention or copyrightable material is developed or produccd in the course of or as a
result of work or services perfornled under this contract, the contractor shall refer the discovery,
invention or material to the Agency to be referred to the Department of State. Any and all patent
rights or copyrights accruing under this contact are hcreby reserved to the State of Florida in
accordance with Chapter 286, F.S.
29. Emerl!encv Preparedness and Continuity of Operations
29.1 If the tasks to be performed pursuant to this contract, include the physical care and control of clients,
or the administration and coordination of services necessary for client health, safety or welfare, the
contractor shall within thirty (30) calendar days of the execution of this contract, submit to the
Contract Manager verification of an emergency preparedness plan. In the event of an emergency, the
contractor shall notify the Agency of emergency provisions.
29.2 In the event, a situation results in a cessation of services by a subcontractor, the contractor will retain
responsibility for performance under this contract and must follow procedures to ensure continuity of
operations without interruption.
30. 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.
31. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon
the contractor or political subdivision granting to the state a security interest in the property at least to
the amount of state funds provided for at least 5 years from the date of purchase or the completion of
the improvements or as further requircd by law.
32. Dispute Resolution
Any dispute concerning performance of the contract shall be dccided by the Contract Managcr, who
shall reduce the decision to writing and servc a copy on the contractor.
33. No Waiver of Sovereil!n 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.
34. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Lee County, Florida.
9
16D4
October 2009 NSIP 203.10
35. Entire Contract
This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or
representations shall be valid or binding upon the Agency or the contractor unless expressly
contained herein or by a written amendment to this contract signed by both partics.
36. Force Maieure
Neither party shall be liable for any delays or failures in performance due to circumstanccs beyond its
control, provided the party cxperiencing the force majeure condition provides immediate written
notification to the other party and takes all reasonable efforts to cure the condition.
37. Severability Clause
The parties agree that if a court of competent jurisdiction deems any tcrm or condition herein void or
unenforceable, the other provisions are severable to that void provision and shall rcmain in full force
and effect.
38. 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.
39. 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's best interest and reduced to a written amendment
signed by both parties. The parties shall negotiate compensation for any additional services added.
40. Waiver
The delay or failure by the Agency to exercise or enforce any of its rights under this contract shall not
constitute or be deemed a waivcr of the Agency's right thereafter to enforce those rights, nor shall any
single or partial exercise of any such right preclude any other or further exercise thercof or the
exercise of any other right.
41. Compliance
The contractor agrees to abide by all applicable current federal statutes, laws, rules and regulations as
well as applicable current State statutes, laws, rules and regulations. The parties agree that failure of
the contractor to abide by these laws shall be deemed an event of default of the contractor, and
subject the contract to immediate, unilateral canccllation of the contract at the discretion of the
Agency.
42. Final Invoice
The contractor shall submit the final invoice for payment to the Agency as specificd in Paragraph
3.2.1. (date for final request for payment) of ATTACHMENT I. If thc contractor tails to submit
final request for payment by thc deadline, then all rights to payment may bc forfeited and thc Agency
may not honor any requests submitted after the aforesaid time period. Any payment due under thc
terms of this contract may be withheld until all reports due from the contractor and necessary
adjustments thereto have been approved by the Agency.
43. Renel!otiations 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 thc total dollar amount may be
adjusted retroactively to reflect price level increases and changes in the rate of payment when these
10
October 2009 1 6 D ltrSIP 203.10
have been established through the appropriations process and subsequently identified in the Agency's
operating budget.
44. Termination
44.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar
days notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said
notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides
verification of delivery or by hand delivery to the Contract Manager or the representative of the
contractor responsible for administration of the contract.
44.2 In the event funds for payment pursuant to this contract become unavailable, the Agency may
terminate this contract upon no less than twenty-four (24) hours notice in writing to the contractor.
Said notice shall be delivered by U.S. Postage Service or any expedited delivery service that provides
verification of delivery or by hand delivery to the Contract Manager or the representative of the
contractor responsible for administration of the contract. The Agency shall be the final authority as
to the availability and adequacy of funds. In the event of termination of this contract, the contractor
will be compensated for any work satisfactorily completed prior to the date oftermination.
44.3 This contract may be terminated for cause upon no less than twenty-four (24) hours notice in writing
to the contractor. If applicable, the Agency may employ the default provisions in Rule 60A-I.006(3),
F.A.C. Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any
other breach and shall not be construed to be a modification of the terms and conditions of this
contract. The provisions herein do not limit the Agency's or the contractor's rights to remedies at law
or in equity.
44.4 Failure to have performed any contractual obligations with the Agency in a manner satisfactory to the
Agency will be a sufficient cause for termination. To be terminated as a contractor under this
provision, the contractor must have (I) 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; and (2) had a contract terminated by the
Agency for cause.
45. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
Collier County Housing and Human
The contractor name, as shown on page I of this Services Department
a. contract. and mailing address of the official 3050 N. Horseshoe Drive, Suite 110
payee to whom the payment shall be made is: Naples, Florida 34104
239-252-2273
Marcy Krumbine, Director
The name of the contact person and street Collier County Housing and Human
b. address where financial and administrative Services Department
records are maintained is: 3301 Tamiami Trail E. H/211
Naples, FL 34112
239-252-2273
11
Marcy Krumbine, Director
The name, address, and telephone number of the Collier County Housing and Human
I c. representative of the contractor responsible for Services Department
administration of the program under this 3301 Tamiami Trail East H/211
contract is: Naples, FL 34112
I 239-252-2273
j The section and location within the agency Area Agency on Aging for Southwest
I d. where Requests for Payment and Receipt and Florida, Inc.
Expenditure forms are to be mailed is: 15201 N. Cleveland Avenue, Ste. 1100
Fort Myers, Florida 33909
Leigh W. Schield, Executive Director I
The name, address, and telephone number of the I Area Agency on Aging for Southwest
Florida, Inc.
e. Contract Manager for the agency for this 15201 N. Cleveland Avenue, Ste. 1100
contract is:
I Fort Myers, Florida 33909
(239) 332-4233
Upon change ofreprcsentatives (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.
16 D 4 NSIP 203.10
October 2009
46. All Terms and Conditions Included
This contract and its Attachments, I - VII, A and B, 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 havc read and agree to the entire contract.
IN WITNESS THEREOF, the parties hereto have caused this 35 page contract, to be executed by their
under~ignt;d'Qfficials as duly authorized.
,
ATTEST:
DWIGHT E. S,RQ. Q~~
~ f)-L
~fi ~rbl4' I'1LSII .
,'_tUft', 0/1..
Approved as to fonn and
legal sufficiency
~~~
Assistant County Attorney
BOARD OFm'O NTY COMMISSIONERS
COLLIER C TY, FLORIDA !
'f/ .. /!
g6NNA F;~,::~;~~~~MA~~/:I.:...
Date: January 12,2010
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA
. . . . . . . . .
...... ....
. . . . . . . . .
. . . . . . . . . .
. . . . . . . . .
::~i:i:!:i:i::
By:
JOAN MARSH. BOARD TREASURER
. , .. , .. . "
. .. . . . . . .
. , .. . . . . "
. . . . .. . ..
. . . . .. . . ..
DA TE: September 30, 2009
FEDERAL ID NUMBER: 59-6000558
FISCAL YEAR-END DATE: 9130
12
October 2009
ATTACHMENT
A TT ACHMENT I
A TT ACHMENT II
ATTACHMENT III
ATTACHMENT IV
ATTACHMENT V
ATTACHMENT VI
ATTACHMENT VII
ATTACHMENT A
ATTACHMENT B
16 D 4 NSIP 203.10
INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT DESCRIPTION
STATEMENT OF WORK
CERTIFICATION REGARDING LOBBYING
FINANCIAL COMPLIANCE AUDIT ATTACHMENT
CERTlFICA TION REGARDING DATA INTEGRITY COMPLIANCE
CERTIFICA TlON REGARDING DEBARMENT, SUSPENSION,
INELlGIILITY AND VOLUNTARY EXCLUSION
CONTRACTS/SU BCONTRACTS
ASSURANCES - NON-CONSTRUCTION PROGRAMS
REQUEST FOR REIMBURSEMENT
DEPARTMENT OF ELDER AFFAIRS PROGRAMS AND SERVICES
HANDBOOK (ON CD)
DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE
CHECKLIST AND INSTRUCTIONS
13
PAGE
14-22
23
24-29
30
31
32-33
34
35
36-39
16D4
October 2009
NSIP 203.10
ATTACHMENT I
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
STATEMENT OF WORK
NUTRITION SERVICES INCENTIVE PROGRAM
SECTION I: SERVICES TO BE PROVIDED
1.1 DEFINITIONS OF TERMS AND ACRONYMS
1.1.1. CONTRACT ACRONYMS
American Recovery and Reinvestment Act of2009 (ARRA)
Area Agency on Aging (AAA)
Client Information and Registration Tracking System (CIRTS)
Dietary Reference Intake (D RI)
Nutrition Services Incentive Program (NSIP)
Older Americans Act (OM)
Planning and Service Area (PSA)
Web-based Database System (WebDB)
United States Department of Agriculture (USDA)
1.1.2. PROGRAM SPECIFIC TERMS
American Recovery and Reinvestment Act of 2009: ARRA is an economic stimulus package
enacted by the Unitcd States Congress and signed into law by the President on February 17, 2009.
The act is intended to provide a stimulus to the U.S. economy and specifically provides assistance to
those individuals affected by the recession. Assistance provided includes, but is not limited to: job
creation, food program subsidies and the expansion of existing social service programs.
Service Provider Application: A service provider application plan developed by the contractor
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 (OAA) and agency
instructions.
Service Provider Application Update: A revision to the service provider application wherein the
area agency on aging enters OAA program specific data in the web-based database system (WebDB).
An update may also include other revisions to the service provider application as instructed by the
agency.
1.2 AGENCY'S 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:
14
.
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.
16D4
NSIP 203.10
October 2009
.
.
.
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.
1.2.1. Nutrition Services Incentive Program Mission Statement
The Nutrition Services Incentive Program (NSIP) is intended to provide incentives for the effective
delivery of nutritious meals to older individuals. NSIP allows programs to increase thc number
and/or the quality of meals served.
1.3. GENERAL DESCRIPTION
1.3.1. General Statement
The NSIP is intended to provide incentives for the effective delivcry of nutritious meals to older
individuals. NSIP is a cash allotment or commodity program that supplements funding or food used
in meals served under the Older Americans Act and ARRA. Florida has opted for cash payments in
lieu of donated foods.
1.3.2. Authority
(1) Older Americans Act of 2006, as amended, Section 311;
(2) 42 U.S.c. 303a, 42 U.S.c. 604,42 U.S.c. 3057;
(3) Section 430.101, Florida Statutes; and
(4) American Recovcry and Reinvestment Act of2009, P.L. 111-5.
1.3.3. Scope of Service
The contractor is responsible for the programmatic, fiscal, and operational management of NSIP.
The scope of services associated with this contract shall include cnsuring that the following program
service tasks are addressed: (I) program eligibility requirements are met; (2) meals served are
compliant with prcscribed nutritional requirements; and (3) meals served comply with U.S. origin
food requirements.
The contractor is also responsible for overseeing the nutrition service operations of the provider to
ensure that the expected results are achieved. Services shall be provided in a manner consistent with
and described in the current service provider's application update and the current Departmcnt of
Elder Affairs Programs and Summary Handbook.
The contractor shall use the NSIP funding under this contract to supplement funding for food uscd in
meals served under the OAA and ARRA.
1.3.4. Term of Provision of Services
The term of this contract for the delivery of services shall be as referenced in Scction 3. of the
Standard Contract. However, for the purpose of settling upon the appropriate meal reimbursement
rate, as provided by USDA, the contract shall remain open until December 3 I, 20 I O.
Notwithstanding this three (3) month reconciliation period, this contract makes no provisions for the
payment of any services provided beyond September 30,2010.
15
October 2009
16D4
NSIP 203.10
1.3.5. Major Program Goals
The major goals of the Nutrition Services Incentive Program (NSIP) program are to:
(I) Supplement funding for food used in meals served by older Americans Act Nutrition Program
Providers; and
(2) Provide incentives for the effective delivery of nutritious meals to older individuals.
1.4 INDIVIDUALS TO BE SERVED
1.4.1. Individual Eligibility
Congregate Meals:
(1) Individuals age 60 or older;
(2) Any spouse (regardless ofagc) who attends the dining center with his/her eligible spouse;
(3) Persons with a disability, regardless of age, who reside in a housing facility occupied
primarily by older individuals where congregate nutrition services are provided;
(4) Disabled persons who reside at home with and accompany an eligible person to the dining
center: and
(5) Volunteers, regardless of age, who provide essential services on a regular basis during meal
hours.
Home Delivered Meals:
(1) Individuals age 60 or older who are also frail and homebound by reason of illness, disability
or isolation;
(2) The recipient's spouse of a homebound eligible individual. regardlcss of age if the provision
of the collateral meal supports maintaining the person at home.
(3) Individuals with disabilities, regardless of age, who reside at home with eligible individuals
and are dependent on them for care; and
(4) Persons at nutritional risk who have physical, cmotional or behavioral conditions, which
would make their presence at the congregate site inappropriate; and persons at nutritional risk
who are socially or otherwise isolate and unable to attend a congregate nutrition site.
SECTION 11: MANNER OF SERVICE PROVISION
2.1. SERVICE TASKS
2.1.1. Task List
In order to achieve the goals of the NSIP, the contractor shall ensure the following tasks are
performed:
2.1.1.1.IndividuaI (Recipient) Eligibility
Client eligibility determination as listed in A TT ACHMENT I, Paragraph 1.4.
2.1.1.2. Program Eligibility Requirements
The program must meet the following criteria:
(I) An agency that has receivcd a grant under the OAA Titlc III must service the meal (Ref. OAA
section 311 (42 U.S.C.3030a); and
16
October 2009
(2)
16D4
NSIP 203.10
A nutrition service provider who is under the jurisdiction, control, management and audit
authority of the Area Agency on Aging and the Department of Elder Affairs must serve the
meal.
2.1.1.3.Prescribed Nutritional Requirements
Each meal provided must meet the following criteria:
(1) Comply with the current Dietary Guidelines for Americans, published by the secretaries of the
Department of Health and Human Services and the Department of Agriculture; and
(2) Provide a minimum of 33 1/3 percent of the dietary reference intakes/adequatc intakes for an
age 70+ female as established by the Food and Nutrition Board of the National i\cademy of
Sciences.
2.1.1.4.Food Origin and Commodities Requirements
Consistent with existing requirements of this program, the contractor and/or its service providers may
use NSIP cash to purchase foods of U.S. origin for their nutrition projects under Title III of the OAA.
NSIP funds must be used to expand meal services to older adults.
2.1.1.5.0versight of Provider's Nutrition Service Operations
The AAA must oversee the nutrition service operations of the provider to ensure that the
requirements of Attachment I, Paragraphs 2.1.1.1, and 2.1.1.2. are met as well as any other applicable
regulations and policies prescribed by the Department of Health and Human Services, USDA, state
and local health departments or an other agency designated to inspect meal quality for the State.
2.1.1.6.Remedies-Nonconforminl! Meals and Services
The contractor shall ensure that all meals served and reimbursed under this agreement are complaint
with the prescribed nutritional requirements referenced in Paragraphs 2.1.1.3, and 2.1.1.4.
Any nonconforming meals not meeting such nutritional and food origin requirements shall not be
eligible for reimbursement under this program. The costs associated with preparing or providing
nonconforming meals shall be borne solely by the contractor. The Agency requires immediate notice
of any significant and/or systemic infractions that compromise the quality, safety or nutritional valuc
of meals served to clients.
2.1.2. Task Limits
Meals served to an elderly individual under the Medicaid Waiver, Community Care for the Elderly
funded meals or other means tested program may not be included in the NSIP count.
2.2. Monitoring the Performance of Subcontractors
The contractor shall conduct at least one monitoring per contract year of each subcontractor. The
contractor shall perform fiscal, administrative and programmatic monitoring of each subcontractor to
ensure contractual compliancc, fiscal accountability, programmatic pcrformance, and compliance
with applicable state and federal laws and regulations.
2.3 SERVICE LOCATION AND EQUIPMENT
2.3.1. Service Times
The contractor shall ensure the provision of the services listed in this contract are available at times
appropriate to meet client service nceds 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.
17
October 2009
16D4
NSIP 203.10
2.3.2. Equipment
2.3.2.1.Equipment means: (a) an article of nonexpendable, tangible personal property having a uscfullife of
more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization
level established by thc organization for the financial statement purposes, or $5,000.00 [for fcderal
funds], or (b) nonexpendable, tangible personal property of a non-consumablc nature with an
acquisition cost of $1,000.00 or more per unit, and cxpected useful life of at lcast one year; and
hardback bound books non circulated to studcnts or the general public, with a value or cost of
$250.00 or more [for state funds].
2.3.2.2.Contractors and sub-contractors who are Institutions of Higher Education, Hospitals, and Other Non-
Profit Organizations shall have written property management standards in compliance with 2 CFR
Part 215 Administrative Requircments (formerly OMB Circular A-IIO) that include; (a) a property
list with all the elements identified in the circular; and, (b) a procedure for conducting a physical
inventory of equipment at least once every two years. The property records must be maintained on
file and shall be provided to the Agency upon request.
2.3.2.3.The contractor's property management standards for equipment acquired with Federal funds and
federally owned cquipment shall include accurately maintained equipment records with the following
information:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number, Fcderal stock number, national stock number,
or other identification number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the contractor or the Federal Government;
(5) Acquisition date (or date received, if the equipment was furnished by the Federal
Government) and cost;
(6) Information from which one can calculate the percentage of Fcderal participation in the cost
of the equipment (not applicable to equipment furnished by the Federal Governmcnt.
(7) Location and condition of the equipment and the date the information was reported;
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to
determine current fair market value where a contractor compensates the Federal awarding
agency for its share.
2.3.2.4.Equipment purchascd with federal funds with an acquisition cost over $5,000.00 and equipmcnt
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 thc activities and functions of
the grant awards and Title (ownership) with vest in the contractor, subject to the conditions of2 CFR
Part 215 Administrative Requirements (formcrly OMS Circular A-IIO), Subpart C, Paragraph 34.
Equipment purchased under these thresholds is considered supplies and is not subject to property
standards. Equipment purchased with funds identificd in the budget attachments to agreements
covered by this contract, or identified in the sub-agreements with sub-contractors (not included in a
cost methodology), is subject to the conditions of section 273, F.S. and 60A-1.0017, F.A.C. or Title
45 CFR Part 74.
18
16f14 I
October 2009 NSIP 203.10
2.3.2.5. The contractor shall not dispose of any equipment or materials provided by the Agency, or purchased
with funds provided through this contract without first obtaining the approval of the Agency's
Contract Manager. When disposing of property or equipment the contractor must submit a written
request for disposition instructions to the respective Contract Manager. The request should include a
brief description of the property, purchase price, funding source, percentage of state or federal
participation, acquisition date and condition of the property. The request should also indicate the
contractor's proposed disposition (i.c., transfer or donation to another agency that administers federal
programs, offer the items for sale, destroy the items, etc.).
2.3.2.6.The Agency's Contract Manager will issue disposition instructions. If disposition instructions are not
received within 120 days of the written request for disposition, the contractor is authorized to proceed
as directed in 2 CFR Part 215 Administrative Requirements (formerly OMB Circular A-IIO).
2.3.2.7.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 fund can only be made through a fixed capital outlay grants and aids
appropriation and therefore are subject to the provisions of s.216.348, F.S.
2.3.2.8.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.
2.3.2.9.The contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An
ITR worksheet is required for any computer related item costing $1,000.00 or more, including data
processing hardware, software, services, supplies, maintenance, training personnel and facilities. The
completed ITR worksheet shall be maintained in the LAN administrator's file and must be provided
to the Agency upon request. The contractor has the responsibility to require any subcontractors to
comply with the department's ITR procedures.
2.4. DELIVERABLES
2.4.1. Service Unit
The contractor shall provide the services described in the contract in accordance with the current
Department of Elder Affairs Programs and Services Handbook. The chart bclow lists the services
that can be performed and the unit ofmeasuremcnt:
Service
Congregate Meals (under OAA and ARRA)
Home Delivered Meals (under OAA and
ARRA)
Unit ofServicc
I Unit ~ I Meal
I Unit = I Meal
2.4.2. Reports
The contractor is responsible for responding in a timcly fashion to additional routine and/or special
requests for information and reports required by the Agency. The contractor must establish due dates
for any subcontractors that permit the contractor to meet the Agency's reporting requirements:
19
16D4
October 2009
NSIP 203.10
Client Information and Registration Tracking System (CIRTS) Reports
The contractor is required to use CIRTS reports in the web-based CIRTS database system to ensure
CIRTS data accuracy. The report categories include:
(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.
Surplus/Deficit Report
The contractor will submit a consolidated surplus/deficit report in a format provided by the Agency to
the Agency's Contract Manager by the 18th of each month. This rcport is for all agreements and/or
contracts between the contractor and the Agency. The report will include the following:
(1) A list of all subcontractors and their current status regarding surplus or deficit;
(2) The contractor's detailed plan on how the surplus or deficit spending exceeding the threshold
specified by the Agency will be resolved;
(3) Recommendations to transfer funds to resolve surplus/deficit spending;
(4) Input from the contractor's Board of Directors on resolution of spending issues, if applicable;
(5) Number of clients currently on Assesssed Priority Consumer List (APCL) that receive a
priority ranking score of 4 or 5; and
(6) Number of clients currently on the APCL designated as Imminent Risk.
2.4.3. Records and Documentation
The contractor will ensure the collection and maintenance of client and service information on a
monthly basis from the Client Information and Registration Tracking System (CIRTS) or any such
system designated by the Agency. Maintenance includes valid exports and backups of all data and
systems according to Agency standards.
2.5. PERFORMANCE SPECIFICATIONS
2.5.1. Outcomes and Outputs
(I) The contractor shall submit timely to the Agency all reports describe in Attachment I,
Paragraph 2.4.2. Reports;
(2) The contractor shall submit timely to the Agency all information described in Attachment I,
Paragraph 2.4.3. Records and Documcntation;
(3) The contractor shall ensure serviccs in this contract are in accordance with thc current
Department of Elder Affairs Programs and Services Handbook.
2.5.2. Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the contractor under the terms of this
contract. Monitoring shall be conducted through direct contact with the contractor through telephone,
in writing, or an on-site visit. The Agency's determination of acceptable performance shall bc
conclusive. The contractor agrees to cooperate with the Agcncy in monitoring the progress of
completion of the service tasks and deliverables.
20
October 2009
16D4
NSIP 203.10
2.6. CONTRACTOR'S FINANCIAL OBLIGATIONS
2.6.1. Use of Service DoIIars and Assessed Priority Consumer List Management
The contractor is expected to spend all federal, state and other funds provided by the Agency, for the
purpose specified in each contract. The contractor must manage the service dollars in such a manner
so as to avoid having a wait list and a surplus of funds at the end of the contract pcriod for each
program managed by the contractor. If thc Agency determines that thc contractor is not spending
service funds accordingly, the Agency may transfer funds to other planning and service areas during
the contract period and/or adjust subsequent funding allocations accordingly as allowable under state
and federal law.
The contractor agrees to distribute funds as detailed in this contract and the service providr's
application update. Any changes in the total amounts of the funds identified in this contract, number
of meal served or meal rate require a contract amendment.
2.7. AGENCY RESPONSIBILITIES
2.7.1. Agency Obligations
2.7.1.1.Program Guidance and Technical Assistance
The Agency will provide to the contractor guidance and technical assistance as needed to ensure the
successful fulfillment of the contract by the contractor.
2.7.1.2.Program/Contract Monitoring
The Agency shall, at its own discretion, conduct monitoring concerning any aspect of the contractor's
performance of this contract.
SECTION III: METHOD OF PAYMENT
3.1. STATEMENT OF METHOD OF PAYMENT
This is a fixed rate contract. The Agency shall make payment to the contractor for provision of
services up to a maximum number of units of service and at the prospective rate stated below:
Service to be Provided Unit of Service Unit Rate Allocation
Eligible Congregate and I unit ~ I meal $0.60 $43.504.00
Home Delivered Meals I
(Under OAA and I
' ARRA) I
COLLIER
The prospective rate is based on the estimated OAA grant award.
3.2. REQUEST FOR PAYMENT
21
16D4
October 2009 NSIP 203.10
3.2.1. Date for Final Request for Payment
(1) The final request for payment will be due to the Agency no later than December 10, 2010.
This contract is for services provided during the 2009 Federal Fiscal Year beginning October
1, 2009 through September 30. 2010, however, the contract is in em~ct through December
10,2010. The additional three months (October 1,2010 through December 10. 2010) are to
allow rates to be adjusted for the service period. This contract shall automatically terminate
after the tinal rate for the federal fiscal year has been established and the release of final
payments are authorized by the agency.
(2) In the event that thc final reimbursement rate is greater or less than the rate in Attachment I,
Paragraph 3.1, then this contract shall be appropriately adjusted upon noticc from the agency's
Contract Manager.
3.2.2. Documentation for Payment
All requests for reimbursement shall be in accordance with policy regarding reimbursable meals and
Client Information and Registration Tracking System (CIRTS) policy regarding data entry for
reimbursable meals. All requests for reimbursement shall include:
(1) The request for reimbursement shall be submitted on DOEA Form I I 7aar 4/09, NSIP Request
for Reimbursement, (Attachment VII);
(2) A CIRTS report must bc submitted with DOEA Form I 17aar 4/09 as supporting
documentation for the total number of meals reportcd. The CIRTS report must match the
number of meals reported on DOEA Form I] 7aar 4/09;
(3) Duplication or replication of the DOEA Form 117aar 4/09 via data processing equipment is
permissible but replication must include all data elements in the same format as included on
the departmental form; and
(4) The due date for the request for reimbursement and report (2) shall be no later than the 10th
day of the month following the month being reported except for the final request for
reimbursement (December 20 10) shall be no later than December 10, 20 I O.
Invoices shall be in sufficient detail for a proper pre-audit and post-audit thereof. The contractor
shall maintain documentation to support payment requcsts that shall be available to the Department
of Financial Services or the Agency upon request.
Any payment due by the Agency under the terms of this contract may be withheld pending the receipt
and approval by the Agency or complete and accurate financial and programmatic reports due from
the contractor and any adjustments thereto, including any disallowance not resolved as outlined in s.
23 of this contract.
22
16D4
October 2009
NSIP 203.10
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:
(I) 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 nOJ!q;s than $10,000 an,d not more than $100,000 for each such failure.
I f I !
! II , ,/--.::}
1'<, y:l-"YYI..( " ,-,,'.(.;> /< 1/12/2010
Signature r Date
DONNA FIALA. CHAIRMAN
Name of Authorized Individual
NSIP 203.10
Application or Agreement Number
Collier County Board of Commissioners, 3301 Tamiami Trail E. Naples. FL 34112
Name and Address of Organization
'.1 ":::rr
Approved as to form & legal sufficiency
~~
Colleen Greene,
Assistant County Attorney
DOEA Fonn 103
(Revised N ov 2002
~~~}L
ft1lA4urf on I ,
23
October 2009
16tr1" I
NJIP 203.10
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Agency of Elder Affairs to the provider may be subject to audits
and/or monitoring by the Area Agency on Aging for Southwest Florida, Inc.(AAA), as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 2 15.97,
F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the agency of
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 AAA. In the event the AAA detennines that a limited scope audit of the provider is appropriate, the
provider agrees to comply with any additional instructions provided by the AAA 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 Agency of Elder Affairs' 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 A133, 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 OMS Circular A-133, as
revised. EXHIBIT 1 to this agreement indicates Federal resources awarded through the Agency of Elder Affairs by
this agreement. In detennining the Federal awards expended in its fiscal year, the provider shall consider all sources of
Federal awards, including Federal resources received from the Agency 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 Gencral in accordance with the provisions ofOMB
Circular A-133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph I, 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 OMS 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 elccts to have an audit conducted in accordancc with thc provisions of
OMS Circular A133, as revised, the cost of the audit must be paid from non-Fcderal rcsourccs (i.eo, 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 thc entire organization for the organization's fiscal ycar.
Compliance findings relatcd to agreements with the Agency of Elder Affairs shall be bascd on thc agrcement's
requirements, including any rulcs, regulations, or statutcs refcrenced in the agreement. The financial statements shall
disclose whether or not the matching rcquircmcnt was met for each applicablc agreement. All questioncd costs and
liabilities due to the Agency of Eldcr Atfairs shall be fully disclosed in the audit report with referencc to the Agency of
Elder Affairs agrcement involved. If not otherwisc discloscd as requircd by Scction .310(b)(2) of OMS Circular A-
133, as revised, the schedule of cxpcnditures of Federal awards shall identify expenditures by agrcement number for
each agreement with thc Agency of Elder Affairs in effect during the audit period. Financial rcporting packages
requircd under this part must be submitted within the earlier of 30 days after receipt of thc audit report or 9 months
24
16D4
October 2009
after the end of the provider's fiscal year end.
NSIP 203.10
PART II: STATE FUNDED
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 thereaftcr), the provider must have a State single
or project-specific audit for such fiscal year in accordance with Section 215.97, Florida Statutcs; applicable rules of the
Agency of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprotit and for-profit
organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded
through the Agency of Elder Affairs by this agreement. In detennining the state tinancial assistance expended in its
fiscal year, the provider shall consider all sources of state financial assistance, including state financial assistance
received from the Agency of Elder Affairs, other state agencies, and other nonstate entities. State financial assistance
does not include Federal direct or pass-through awards and rcsources received by a nonstate entity for Federal program
matching requirements
In connection with the audit requirements addressed in Part II, paragraph I, 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 tinancial 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 trom 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 Agency of Elder Affairs shall be based on the agreement's
requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclosc whether or
not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the
Agency of Elder Affairs shall be fully disclosed in the audit report with reference to the Agency 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 agreemcnt number for each agreement with the
Agency of Elder Affairs in etlect 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 govemmental 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 Agency of Elder Affairs retains all right and obligation to monitor and oversee the
perfonnance of this agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages tor 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 tor Southwest Florida, Inc. at the following address:
Area Agency on Aging for Southwest Florida, Inc.
AUn: Leigh W. Schield, Executive Director
15201 N. Cleveland Avenue, Ste 1100
25
October 2009
160&
N'SIP 203.10
Fort Myers, Florida 33909
Phone: (239) 652-6900
The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by
Sections .320 (d)(I) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Audit
Clearinghouse), at the following address:
Federal Audit Clearinghouse
Bureau ofthe Ceusus
1201 East 10th Street
Jeffersouville, IN 47132
Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (I), OMB Circular A-133, as
revised.
Pursuant to Sections .320(1), 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 AAA at each of the following addresses:
Area Ageucy on Aging for Southwest Florida, Inc.
Attn: Leigh W. Schield, Executive Director
15201 N. Clcveland Avenue, Ste 1100
Fort Myers, Florida 33909
Phone: (239) 332-4233
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. at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Altu: Leigh W. Schield, Executive Director
15201 N. Cleveland Avenue, Ste 1100
Fort Myers, Florida 33909
Phone: (239) 652-6900
The Auditor General's Office at the following address:
State of Florida Auditor Geueral
Room 574, Claude Pepper Building
III West Madison Street
Tallahassee, Florida 32302-1450
Any reports, management letter, or other information required to be submitted to the AAA 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-protit organizations), Rules of the Auditor General, as applicable.
Providers, when submitting financial reporting packages to the AAA 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.
26
16D4
October 2009 NSIP203.10
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 AAA 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 AAA, 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 AAA.
27
October 2009
16D4
NSIP 203.10
ATTACHMENT 1II
EXHIBIT-l
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
AGREEMENT CONSIST OF THE FOLLOWING:
COLLIER
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Nutrition Services Incentive Program Older Americans Act 93.053 $43,504.00
TOT AL FEDERAL AWARD $43,504.00
28
16D4
October 2009
PART I: AUDIT RELATIONSHIP DETERMINATION
NSIP 203.10
ATTACHMENT III
EXHIBIT-2
Providers who receive state or federal resources mayor may not be subject to the audit requirements of OMS 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 I are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMS
Circular A-133, as revised. and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, providers who
have been detennined 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 OMS Circular A-133 and/or Rule 691-5.006. FAC, provider has been determined to be:
_ Vendor or exempt entity and not subject to OMS Circular A-133 and/or Section 215.97, F.S.
~ Recipient/subrecipient subject to OMS 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 691-.006(2). F AC [state financial
assistance] and Section _ .400 OMS 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 OMS
Circular A-87)*
OMS Circular A-I 02 - Administrative Requirements
OMS Circular A-133 Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZA T10NS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non-Profit Organizations (Formerly OMS Circular A-122 - Cost
Principles )*
2 CFR Part 215 Administrative Requirements (Formerly OMS Circular A-110 - Administrative Requirements)
OMS 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 OMS (Formerly Circular A-2l - Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMS Circular A-II 0 - Administrative Requirements)
OMS 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 ITom compliance with the Cost Principles Circulars as noted in the OMS
Circular A- I 33 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 tiscallaws, rules and regulations:
Section 215.97, Fla. Stat.
Chapter 691-5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
29
16D4
October 2009
NSIP 203.10
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
FOR AGREEMENTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the contractor named in the contract or agreement to which this form is an
attachment, hereby certifies that:
(I) The contractor and any sub-contractors of services under this contract have financial management systems capable of
providing certain information, including: (I) accurate, current, and complete disclosure of the fmancial results of each
grant-funded project or program in accordance with the prescribed reporting requirements; (2) the source and application
of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award.
The inability to process information in accordance with these requirements could result in a return of grant funds that
have not been accounted for properly.
(2) Management Information Systems used by the contractor, sub-contractor(s), or any outside entity on which the contractor
is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be capable of
processing data accurately, including year-date dependent data. For those systems identified to be non-compliant,
contractor(s) will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year-date dependent data accurately. All versions of
these products offered by the contractor (represented by the undersigned) and purchased by the State will be verified for
accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede
the hardware or software programs from operating properly, the contractor agrees to immediately make required
corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge
to the State, and without interruption to the ongoing business of the state, time being of the essence.
(4) The contractor and any sub-contractor( s) of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data
integrity compliance issues.
The contractor shall require that the language of this certification be included in all subagreements, sub grants, and other
agreements and that all sub-contractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered
into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A I 02
and 2 CFR Part 2t5 (formerly OMB Circular A-I to).
Collier County Board of Commissioners
Name and Address of Contractor
."'J
. Ii
/'j
A! c"?-' ",',,,,: /
Signature
-j/ ,
"J
Chairman
Title
1/12/2010
Date
Donna Fiala
Name of Authorized Signer
,
,
. ,"':::3"( .
- ,. "r - . .""",,' "", (
~ '\1:',? '~"r;s;c;g,({'k
~N ClI41,..... .
i fjJHture Of!,.
30
ved as to form & legal sufficiency
Appro ~
('~
Colleen Greene,
Assistant County Attorney
16D4
October 2009
NSIP 203.10
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
FOR LOWER TIER COVERED TRANSACTIONS
(I) The prospective contractor 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
agency or agency.
(2)
Where the prospectiv/:Contractor is unable to certifY to any of the statements in this certification, such
shall attach an eX9rljl\fion to this certification.
/ iJ' jk _-I
1\' J,.
/,J.1-'JI-rr..-<.w' _':~A.t ,::1:. (<~
I
prospective participant
Signature
1/12/2010
Date
Donna Fiala. Chairman
Name Title
Collier Countv Board of Commissioners
Agency/Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification
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 detennined that the contractor knowingly rendered an erroneous certification, in addition to other
remedies available to the federal government, the agency may pursue available remedies, including suspension and/or
debarment.
3 The contractor will provide immediate written notice to the Contract Manager if at any time the contractor learns that its
certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The contractor may
decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier
covered transaction may, but is not required to, check the Excluded Parties List System (EPLS).
4 The contractor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion _ Lower
Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier covered transactions
5 The contractor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred,
suspended, determined ineligible or voluntarily excluded from participation. unless otherwise authorized by the federal
government.
6 If the contractor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible,
or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal
government, the agency may pursue available remedies, including suspension, and/or debarment.
7 The contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not
debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is
erroneous.
(Revised June 2008)
-'-7=:_3,":
~8J~' 'Ec
" '. ~~
~tust 1$ tO~f"-'t
11gR't.".f on..
31
Approved as to form & legal sufficiency
~,~
Colleen reene,
Assistant County Attorney
October 2009
16 D 4 NSIP203.10
ATTACHMENT VI
ASSURANCES-NON-CONSTRUCTION PROGRAMS
Public rcporting 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 ofinfonnation,
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.
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 Vnited 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 aftcr receipt of approval of the awarding agency.
5 Will comply with the Intergovernmental Personnel Act of 1970 (42 V.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 ofOPM's Standards
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 V.S.c.. 1681-1683, and 1685-1686), which prohibits discrimination on the
basis of sex; (c) Section 504 ofthe Rehabilitation Act of 1973. as amended (29 V.S.c.. 794), which prohibits discrimination on the
basis of handicaps; (d) the Age Discrimination Act of 1975. as amended (42 V.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; (I) 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;
(gJ. 523 and 527 of the Public Health Service Act of 1912 (42 V.S.c.. 290 dd-3 and 290 ee 3). as amended, relating to
confidentiality of alcohol anddrug abuse patient records; (h) Title VIll of the Civil Rights Act of 1968 (42 V.S.c.. 360 I et seq.),
as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in
the specific statute(s) under which application for Federal assistance is being made; and (j) the requirements of any other
for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
7. Will comply, or has already complied. with the requirements of Titles II and III of the unifonn 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 V.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 lJ.S.C. 276a to 276a-7), the Copeland Act (40
V.S.C. 276c. and 18 V.S.c.. 874) and the Contract Work Hours and Safety Standards Act (40 lJ .S.c. 327-333), regarding
labor standards for federally assisted construction subagreements.
32
16D4
October 2009 NSIP 203.10
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.
1
II. 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 pursuantto 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.. Federal
actions to State (Clear Air)1451 et seq.); (I) confonnity of Implementation Plans under Section I 76(c) of the Clear Air Act
of 1955, as. amended (42 U.S.c. 740 I 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 V.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 perfonned 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 Aj1ffiORIZED CERTlFl1NG OFFICIAL TITLE
A l:~~ ~.=.<.- ----CLI ,t_?~ Chairman
Donna F,ala I
APPLICANT ORGANIZATION DATE SUBMITTED
Collier County Board of Commissioners 1/12/2010
3301 Tamiami Trail E.. Bldg. F
Naples, FL 34112
~.:.:> . ,
r\.,' '//(p ;.~~E eo 3';;';~j'~'..A~. .~
,~~. c
, . . . - 'XftiSi n, 'to' C~ 1(';"'" f
:.i 1911atlirt ;)1\" .
33
Approved as to form & legal sufficiency
C~~
Colleen Greene,
Assistant County Attorney
October 2009
16D4
NSIP 203.10
A TT ACHMENT VII
REQUEST FOR REIMBURSEMENT
Nutrltton Services Incentive Program
American Recovery and Reinvestment Act
PROVIDER NAME. ADDRESS. PHONE# and FEID# TYPE OF REPORT: THIS REQUEST PERIOD:
Payment Request From To
Regular _ Supplemental Report #
Contract #
PSA#
CERTIFICATION: I hereby certify that to the best of my knowledge the information in this report is aCCUrate and complete
and that all outlays reported herein were for purposes set forth in the contract documents.
Prepared bv: Date: Approved by: Date
PART A: REIMBURSEMENT COMPUTATION YEAR TO DATE CURRENT MONTH
1 . Number of Meals Served
2. Line 1 Times $ per Meal $ $
3. Amount to be Reimbursed $. -- -.."------ I L_. ___..__n_._
PARTB: CONTRACT SUMMARY
4. Approved Contract Amount L -- -
5. Reimbursement Requested through last Report $
6. Contract Balance per Last Report $
7. Amount to be Reimbursed. this report L_ - - --'-
8. Contract Balance ~- -- ------.._--
PART C: ARR (included in above totals) CONGREGATE MEALS HOME DELIVERED MEALS
9. Monthly Expenditures i._ ________ L____ --
10. Year to Date Expenditures L______ I i_____
11. Monthly Meals i
---- ---- -- - - --.- n -
12. Year to Date Meals ---- --- -- - I - --.---
i
DOEAFDrm 117,3rr 4fQB
34
October 2009
16D4
Department of Elder Affairs Programs & Services Handbook, provided on CD.
Also, available at the Department's Intranet site under, "Publications."
35
NSIP 203.10
ATTACHMENT A