Backup Documents 12/14/2010 Item #16D 7ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16D
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 #I through 44 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
exception of the Chairman's signature, draw a line through routine lines #1 through #4, comnlete the checklist_ and forward to Sue Filson (line #5).
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
1. Jennifer B. White, Assistant
County Attorney
CAO
(�
�L
Applicable)
2.
December 14, 2010
Agenda Item Number
16D7
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4.
Agreement
Number of Original
2
5. Ian Mitchell, BCC Office
Supervisor
Board of County Commissioners
I Documents Attached
f1(
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who created/prepared the executive
summary. Primary contact information is needed in the event one of the addressees above, including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff
Sandra Marrero, Grants Coordinator
Phone Number
252 -2399
Contact
avoromiate.
(Initial)
Applicable)
Agenda Date Item was
December 14, 2010
Agenda Item Number
16D7
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
Agreement
Number of Original
2
Attached I
resolutions, etc. signed by the County Attorney's Office and signature pages from
I Documents Attached
INSTRUCTIONS & CHECKLIST
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 9.18.09
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
avoromiate.
(Initial)
Applicable)
1.
Original document has been signed/initialed for legal sufficiency. (All documents to be
SM
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.)
2.
All handwritten strike - through and revisions have been initialed by the County Attorney's
N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
SM
document or the final negotiated contract date whichever is applicable.
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
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si nature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
SM
should be provided to Ian Mitchell in the BCC office within 24 hours of BCC approval.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
6.
The document was approved by the BCC on 12 -14 -10 (enter date) and all
SM
changes made during the meeting have been incorporated in the attached document.
The County Attorney's Office has reviewed the changes, if applicable.
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 9.18.09
167
MEMORANDUM
Date: December 28, 2010
To: Sandra Marrero, Grants Coordinator
Human Services Department
From: Teresa Polaski, Deputy Clerk
Minutes and Records Department
Re: Agreement w/David Lawrence Center, Inc.
HUD Grant #B- 10 -UC -12 -0016
Attached is an original agreement, referenced above (Agenda Item #16D7)
approved by the Board of County Commissioners on December 14, 2010.
The Minutes and Records Department has kept an original as part of
the Board's Official Records.
If you should have any questions, you may contact me at 252 -8411.
Thank you.
Attachment (1)
AGREEMENT BETWEEN COLLIER COUNTY �+ t
AND
David Lawrence Center, Inc.
Infrastructure
Catalog of Federal Domestic Assistance # 14.218
HUD Grant # B- 10 -UC -12 -0016
THIS AGREEMENT is made and entered into by and between Collier County, a political
subdivision of the State of Florida, ( "COUNTY'), and "David Lawrence Center, Inc.," a private not -for-
profit corporation existing under the laws of the State of Florida, having its principal office at 6075
Bathey Lane Naples, FL 34116, and its Federal Tax Identification number as 59- 2206025 &
#096580782, ( "SUBRECIPIENT ").
WHEREAS, the COUNTY has entered into an agreement with the United States Department of
Housing and Urban Development (HUD) for a grant for the execution and implementation of a
Community Development Block Grant Program in certain areas of Collier County, pursuant to Title I of
the Housing and Community Development Act of 1974 (as amended); and
WHEREAS, pursuant to the aforesaid agreement, COUNTY is undertaking certain activities to
primarily benefit low and moderate income persons and neighborhoods and to alternatively use
Community Development Block Grant (CDBG) funds for: slum or blight treatment or for an urgent
community need; to improve the quality of life in Collier County by providing infrastructure
improvements, public facilities, and other activities which are related to neighborhood/community
improvements; to improve the condition of life for persons who require physical access or other services
that meet their individual needs; and to provide for long range community improvements by assessing
current conditions and planning long range improvement programs as described in the Consolidated Plan
submission; and
WHEREAS, the Board of County Commissioners of Collier County approved the Collier County
Consolidated Plan - One -Year Action Plan for Federal Fiscal Year 2010 -2011 for the CDBG Program
with Resolution 2010 -85 on April 27, 2010; and
WHEREAS, Resolution 08 -121 was developed following the Collier County Consolidated Plan —
Citizen Participation Plan, adopted on January 9, 2001 with Resolution 01 -02; and
WHEREAS, HUD has approved the County's Consolidated Plan One -Year Action Plan for
Federal Fiscal Year 2010 -2011 for the CDBG Program and the use of the CDBG funds for the activities
identified in the Plan; and
WHEREAS, the COUNTY and the SUBRECIPIENT desire to provide the activities specified in
Exhibit A of this Agreement, in accord with the approved Consolidated Plan; and
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WHEREAS, the COUNTY desires to engage the SUBRECIPIENT to implement such
undertakings of the CDBG Program as a valid and worthwhile County purpose.
NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, it
is agreed by the Parties as follows:
I. DEFINITIONS
(A) "COUNTY" means Collier County, and where applicable, it's authorized representative(s).
(B) "CDBG" means the Community Development Block Grant Program.
(C) "HHVS" means Housing, Human & Veteran Services.
(D) "HHVS's Approval" means the written approval of the Department of Housing and
Human Services or designee.
(E) " SUBRECIPIENT" means David Lawrence Center, Inc.
(F) "HUD" means the U.S. Department of Housing and Urban Development or a person
authorized to act on its behalf.
(G) "Low and moderate income persons" means the definition set by HUD.
(H) "Project" means the work to be performed as set forth in Exhibit "A."
II. SCOPE OF SERVICES
The SUBRECIPIENT shall, in a satisfactory and proper manner, as determined by HHVS,
perform the tasks necessary to conduct the program outlined in Exhibit "A."
III. TIME OF PERFORMANCE
The effective date of the Agreement between HUD and Collier County shall be July 1, 2010. The
services of the SUBRECIPIENT shall be undertaken and completed in light of the purposes of this
Agreement. Subrecipients are authorized to incur eligible expenses after that date and prior to execution
of this Agreement subject to HHVS prior written approval. In any event, all services required hereunder
shall be completed by the SUBRECIPIENT prior to August 31, 2011. Any funds not obligated by the
expiration date of this Agreement shall automatically revert to the COUNTY.
IV. CONSIDERATION AND LIMITATION OF COSTS
The SUBRECIPIENT shall be reimbursed by the COUNTY using HUD funding for allowable
costs, determined by COUNTY, in an amount not to exceed Two Hundred Twenty One Thousand Dollars
and 00/100($221,000.00) for the services described in Exhibit "A."
All improvements specified in Exhibit "A" shall be performed by SUBRECIPIENT employees, or
shall be put out to competitive bidding under a procedure acceptable to the COUNTY and Federal
requirements. The SUBRECIPIENT shall enter into contract for improvements with the lowest
responsive and qualified bidder. Contract administration shall be handled by the SUBRECIPIENT and
monitored by HHVS, which shall have access to all records and documents related to the project.
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The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion
or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of
monthly progress reports. Payments shall be made to the SUBRECIPIENT when requested as work
progresses but not more frequently than once per month. Payment will be made upon receipt of a proper
invoice and in compliance with § 218.70, Fla. Stat., otherwise known as the "Local Government Prompt
Payment Act." No payment will be made until approved by HHVS.
V. NOTICES
All notices required to be given under this Agreement shall be sufficient when delivered to HHVS
at its office, presently located at 3301 E. Tamiami Trail, Building H, Suite 211, Naples, Florida 34112,
and to the SUBRECIPIENT when delivered to its office at the address listed on page one (1) of this
Agreement.
VI. GENERAL CONDITIONS
A. IMPLEMENTATION OF PROJECT
The SUBRECIPIENT shall implement this Agreement in accordance with applicable Federal,
State, and County laws, ordinances and codes and with the procedures outlined in HHVS' Policies and
Procedures memoranda.
Should a project receive additional funding after the commencement of this Agreement, the
SUBRECIPIENT shall notify HHVS in writing within thirty (30) days of receiving notification from the
funding source and submit a cost allocation plan for approval by HHVS or its designee within forty -five
(45) days of said official notification.
B. DEBARMENT
The SUBRECIPIENT certifies that neither it, nor its principals, is presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction
by any Federal Department or agency; and, that the SUBRECIPIENT shall not knowingly enter into any
lower tier contract, or other covered transaction, with a person who is similarly debarred or suspended
from participating in this covered transaction.
C. LOCAL AND FEDERAL RULES REGULATIONS AND LAWS
The SUBRECIPIENT agrees to comply with any applicable laws, ordinances, regulations and
orders of the State, local and Federal governments, including, but not limited to:
1. 24 CFR 570, as amended - The regulations governing the expenditure of Community
Development Block Grant (CDBG) funds.
2. 24 CFR 58 - The regulations prescribing the Environmental Review procedure.
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3. Title VI of the 1984 Civil Rights Act, 42 USC § 2000d, et. seq. 1607
4. 24 CFR 107 - The regulations issued pursuant to Executive Order 11063 which prohibits
discrimination and promotes equal opportunity in housing.
5. Executive Order 11246 ( "Equal Employment Opportunity "), as amended by Executive
Orders 11375 and 12086 - which establishes hiring goals for minorities and women on
projects assisted with federal funds.
6. Title VII of the 1968 Civil Rights Act as amended by the Equal Employment Opportunity
Act of 1972, 42 USC § 2000e, et. seq.
7. 24 CFR 135 — Regulations outlining requirements of Section 3 of the Housing and Urban
Development Act of 1968, as amended.
8. Age Discrimination Act of 1975.
9. Contract Work Hours and Safety Standards Act, 40 USC 327 -332.
10. Section 504 of the Rehabilitation Act of 1973, 29 USC 776(b)(5).
11. Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, as
amended.
12. 29 CFR Parts 3 and 5 - Regulations which prescribe the payment of prevailing wages and
the use of apprentices and trainees on federally assisted projects as mandated by the Davis -
Bacon Act. HUD Form 4010 must be included in all construction contracts funded by
CDBG. (See 42 USC 276a and 24 CFR 135.1l(c)).
13. Executive Order 11914 - Prohibits discrimination with respect to the handicapped in
federally assisted projects.
14. Executive Order 11625 and U.S. Department of Housing and Urban Development Circular
Letter 79 -45 - which prescribes goal percentages for participation of minority businesses in
Community Development Block Grant Contracts.
15. Public Law 100 -430 - the Fair Housing Amendments Act of 1988.
16. OMB Circular A -133 - concerning annual audits.
17. OMB Circular A -122 - which identifies cost principles.
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18. 24 CFR 84 - Uniform Administrative Requirements for Grants and Agreements with
Institutions of Higher Education, Hospitals and Other Non - Profit Organizations.
19. 24 CFR 85- Uniform Administrative Requirements for Grants and Agreements to State and
Local Governments.
20. Immigration Reform and Control Act of 1986 as located at 8 USC 1324, et seq. and
regulations relating thereto. Failure by the SUBRECIPIENT to comply with the laws
referenced herein shall constitute a breach of this agreement, and the County shall have the
discretion to unilaterally terminate this agreement immediately.
21. Chapter 112, Florida Statutes.
22. Prohibition Of Gifts To County Employees - No organization or individual shall offer or
give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to
any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier
County Ethics Ordinance No. 2004 -05, as amended, and County Administrative Procedure
5311.
23. Order of Precedence - In the event of any conflict between or among the terms of any of
the Contract Documents, the terms of the Agreement shall take precedence over the terms
of all other Contract Documents, except the terms of any Supplemental Conditions shall
take precedence over the Agreement. To the extent any conflict in the terms of the Contract
Documents cannot be resolved by application of the Supplemental Conditions, if any, or
the Agreement, the conflict shall be resolved by imposing the more strict or costly
obligation under the Contract Documents upon the Contractor at Owner's discretion.
24. Venue - Any suit or action brought by either party to this Agreement against the other
party relating to or arising out of this Agreement must be brought in the appropriate federal
or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction
on all such matters.
25. Dispute Resolution - Prior to the initiation of any action or proceeding permitted by this
Agreement to resolve disputes between the parties, the parties shall make a good faith
effort to resolve any such disputes by negotiation. The negotiation shall be attended by
representatives of SUBRECIPIENT with full decision - making authority and by
COUNTY'S staff person who would make the presentation of any settlement reached
during negotiations to COUNTY for approval. Failing resolution, and prior to the
commencement of depositions in any litigation between the parties arising out of this
Agreement, the parties shall attempt to resolve the dispute through Mediation before an
agreed -upon Circuit Court Mediator certified by the State of Florida. The mediation shall
be attended by representatives of SUBRECIPIENT with full decision - making authority
and by COUNTY'S staff person who would make the presentation of any settlement
reached at mediation to COUNTY'S board for approval. Should either party fail to submit
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to mediation as required hereunder, the other party may obtain a court order requiring
mediation under § 44.102, Fla. Stat.
D. SUBCONTRACTS
Any work or services subcontracted by the SUBRECIPIENT shall be specifically by written
contract or agreement, and such subcontracts shall be subject to each provision of this Agreement and
applicable County, State, and Federal guidelines and regulations. Prior to execution by the
SUBRECIPIENT of any subcontract hereunder, such subcontracts must be submitted by the
SUBRECIPIENT to HHVS for its review and approval, which will specifically include a determination of
compliance with the terms of the attached Scope of Services set forth in Exhibit "A."
This review also includes ensuring that all consultant contracts and fee schedules meet the
minimum standards as established by the Collier County Purchasing Department, Florida Statutes and
HUD. Reimbursements for such services will be made at SUBRECIPIENT cost. None of the work or
services covered by this Agreement, including but not limited to consultant work or services, shall be
subcontracted by the SUBRECIPIENT or reimbursed by the COUNTY without prior written approval of
the HHVS or its designee.
E. AMENDMENTS
This Agreement, and any exhibit or attachment, may be amended only by written agreement
executed by the governing boards of both parties, except that County representative(s) may approve
adjustments between line item amounts, scope clarifications, or an extension of time and schedule that do
not change the project, or exceed the amount funded by the County, as stated herein. Any modifications
to this contract shall be in compliance with the County Purchasing Policy and Administrative Procedures
in effect at the time such modifications are authorized.
F. INDEMNIFICATION
To the maximum extent permitted by Florida law, the SUBRECIPIENT shall indemnify and hold
harmless Collier County, its officers and employees from any and all liabilities, damages, losses and
costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by
the negligence, recklessness, or intentionally wrongful conduct of the SUBRECIPIENT or anyone
employed or utilized by the SUBRECIPIENT in the performance of this Agreement. This
indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies
which otherwise may be available to an indemnified party or person described in this paragraph. This
section does not pertain to any incident arising from the sole negligence of Collier County. The foregoing
indemnification shall not constitute a waiver of sovereign immunity beyond the limits set forth in Section
768.28, Florida Statutes.
G. GRANTEE RECOGNITION
All facilities purchased or constructed pursuant to this Agreement shall be clearly identified as to
funding source. The SUBRECIPIENT will include a reference to the financial support herein provided by
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HHVS in all publications and publicity. In addition the SUBRECIPIENT will make a oolfa3fh�foYt to
P P Y � g
recognize HHVS' support for all activities made possible with funds made available under this
Agreement. The SUBRECIPIENT will mount a temporary construction sign for projects funded by
HHVS. This design concept is intended to disseminate key information regarding the development team
as well as Equal Housing Opportunity to the general public. The construction sign shall comply with
applicable County codes.
H. TERMINATION
In event of termination for any of the reasons identified in sub - sections 1 -3 as follows, all finished
or unfinished documents, data studies, surveys, drawings, maps, models, photographs, reports prepared,
and capital equipment secured by the SUBRECIPIENT with funds under this Agreement shall be returned
to HHVS or the COUNTY. In the event of termination, the SUBRECIPIENT shall not be relieved of
liability to the COUNTY for damages sustained by the COUNTY by virtue of any breach of the Contract
by the SUBRECIPIENT, and the COUNTY may withhold any payment to the SUBRECIPIENT for set-
off purposes until such time as the exact amount of damages due to the COUNTY from the
SUBRECIPIENT is determined.
1. TERMINATION FOR CAUSE
If through any cause either party shall fail to fulfill in timely and proper manner its obligations
under this Agreement, or if either party shall violate any of the covenants, agreements, or stipulations of
this Agreement, either party shall thereupon have the right to terminate this Agreement in whole or part
by giving written notice of such termination to the other party and specifying therein the effective date of
termination. (See 24 CFR 85.43.)
2. TERMINATION FOR CONVENIENCE
At any time during the term of this Agreement, either party may, at its option and for any reason,
terminate this Agreement upon ten (10) working days written notice to the other party. Upon termination,
the COUNTY shall pay the SUBRECIPIENT for services rendered pursuant to this Agreement through
and including the date of termination. (See 24 CFR 85.44.)
3. TERMINATION DUE TO CESSATION
In the event the grant to the COUNTY under Title I of the Housing and Community Development
Act of 1974 (as amended) is suspended or terminated, this Agreement shall be suspended or terminated
effective on the date that HUD specifies.
I. INSURANCE
SUBRECIPIENT shall obtain and carry, at all times during its performance under the Contract
Documents, insurance of the types and in the amounts described herein and further set forth in Exhibit
"B" to this Agreement.
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J. SUBRECIPIENT LIABILITY OBLIGATION 1607
Compliance with the insurance requirements in Exhibit B shall not relieve the SUBRECIPIENT of
its liability and obligation under this subsection or under any subsection of this contract. The contract is
contingent upon receipt of the insurance documents within fifteen (15) calendar days after the Board of
County Commissioners' approval. If the Insurance certificate is received within the specified period, but
not in the manner prescribed in these requirements, the SUBRECIPIENT shall be verbally notified of the
deficiency and shall have an additional five (5) calendar days to submit a corrected Certificate to the
County.
If the SUBRECIPIENT fails to submit the required insurance documents in the manner prescribed
in these requirements within twenty (20) calendar days after the Board of County Commissioners'
approval, the SUBRECIPIENT shall be in default of the terms and conditions of the contract.
K. INDEPENDENT AGENT AND EMPLOYEES
The SUBRECIPIENT agrees that it will be acting as an independent agent and that its employees
are not Collier County employees and are not subject to the County provisions of law applicable to
County employees relative to employments, hours of work, rates of compensation, leave, unemployment
and employee benefits.
VII. ADMINISTRATIVE REQUIREMENTS
A. FINANCIAL MANAGEMENT
The SUBRECIPIENT agrees to comply with OMB Circular A —110 (Uniform Administrative
Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and other Non -
Profit Organizations) and agrees to adhere to the accounting principles and procedures required therein,
utilize adequate internal controls, and maintain necessary source documentation for all costs incurred.
B. DOCUMENTATION AND RECORDKEEPING
The SUBRECIPIENT shall maintain all records required by CDBG.
2. All reports, plans, surveys, information, documents, maps, and other data procedures
developed, prepared, assembled, or completed by the SUBRECIPIENT for the purpose of
this Agreement shall be made available to the COUNTY by the SUBRECIPIENT at any
time upon request by the COUNTY or HHVS. Upon completion of all work contemplated
under this Agreement copies of all documents and records relating to this Agreement shall
be surrendered to HHVS if requested. In any event the SUBRECIPIENT shall keep all
documents and records for three (3) years after expiration of this Agreement.
3. The SUBRECIPIENT shall submit reports as required to assist the COUNTY in the
preparation of HUD Labor Relations, WBE/MBE, Equal Opportunity Employment, and
HUD Section 3 reports, pursuant to 24 CFR 570.502, 507, and 92 (3)(vi).
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4. The SUBRECIPIENT shall submit detailed monthly progress reports to HHVS outlining
the status of specific activities under the project. Each report must account for the total
activity for which the SUBRECIPIENT is paid with CDBG funds, in part or in whole, and
which is required in fulfillment of their obligations regarding the Project. The progress
reports shall be submitted on the form Exhibit "D," Schedule "D -2."
5. The SUBRECIPIENT shall maintain records showing compliance with the Davis -Bacon
Law, including files containing contractor payrolls, employee interviews, Davis -Bacon
wage rates, and administrative cross - referencing. SUBRECIPIENT shall maintain records
showing contractor compliance with the Contract Work Hours and Work Safety Law.
Similarly, the SUBRECIPIENT shall maintain records showing compliance with federal
purchasing requirements and with other federal requirements for grant implementation.
6. If indirect costs are charged, the SUBRECIPIENT will develop an indirect cost allocation
plan for determining the appropriate SUBRECIPIENT'S share of administrative costs and
shall submit such plan to the COUNTY for approval, in a form specified by the COUNTY.
7. Failure to adequately maintain any former CDBG funded project may result in the delay of
processing reimbursement requests for ongoing activities or in the forfeiture of future
CDBG funds.
8. The SUBRECIPIENT will be responsible for the creation and maintenance of income
eligible files on clients served and documentation that all households are eligible under
HUD Income Guidelines.
9. The SUBRECIPIENT further agrees that HHVS shall be the final arbiter on the
SUBRECIPIENT's compliance with the above.
C. REPORTS, AUDITS, AND EVALUATIONS
Reimbursement will be contingent on the timely receipt of complete and accurate reports required
by this Agreement, and on the resolution of monitoring or audit findings identified pursuant to this
Agreement.
The SUBRECIPIENT agrees that HHVS will carry out periodic monitoring and evaluation
activities as determined necessary. The continuation of this Agreement is dependent upon satisfactory
evaluations. The SUBRECIPIENT shall, upon the request of HHVS, submit information and status
reports required by HHVS or HUD to enable HHVS to evaluate said progress and to allow for completion
of reports required. The SUBRECIPIENT shall allow HHVS or HUD to monitor the SUBRECIPIENT
on site. Such site visits may be scheduled or unscheduled as determined by HHVS or HUD.
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D. ADDITIONAL HOUSING & HUMAN SERVICES, COUNTY AND HUD
REQUIREMENTS
The SUBRECIPIENT agrees to utilize funds available under this Agreement to supplement rather
than supplant funds otherwise available for specified activities.
E. WRITTEN APPROVALS
(1) All subcontracts and agreements proposed to be entered into by the
SUBRECIPIENT pursuant to this Agreement;
(2) All capital equipment expenditures of $1,000 or more;
(3) All out -of -town travel (travel shall be reimbursed in accordance with Chapter 112,
Fla. Stat. unless otherwise required by CDBG);
(4) All change orders;
(5) All requests to utilize uncommitted funds after the expiration of this agreement for
programs described in Exhibit "A "; and
(6) All rates of pay and pay increases paid out of CDBG funds, whether for merit or
cost of living.
F. PURCHASING
All purchasing for services and goods, including capital equipment, shall be made by purchase
order or by a written contract and in conformity with the procedures prescribed by the Federal
Management Circulars A -110, A -122, 24 CFR Part 84, and 24 CFR Part 85.
G. AUDITS AND INSPECTIONS
Non - profit organizations that expend $500,000 or more annually in federal awards
shall have a single or program- specific audit conducted for that year in accordance
with OMB A -133. Non - profit organizations expending federal awards of $500,000
or more under only one federal program may elect to have a program - specific audit
performed in accordance with OMB A -133.
2. Non - profit organizations that expend less than $500,000 annually in federal awards
shall be exempt from an audit conducted in accordance with OMB A -133, although
their records must be available for review (e.g., inspections, evaluations). These
agencies are required by HHVS to submit "Reduced Scope" audits (e.g., financial
audit, performance audits). They may choose, instead of a Reduced Scope Audit,
to have a program audit conducted for each federal award in accordance with
federal laws and regulations governing the program in which they participate.
3. When the requirements of OMB A -133 apply, or when the SUBRECIPIENT elects
to comply with OMB A -133, an audit shall be conducted for each fiscal year for
which federal awards attributable to this contract have been received by the
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SUBRECIPIENT. A copy of the audit report must be received by HHVS no later
than six months following the end of the SUBRECIPIENT's fiscal year.
4. If an audit is required by Section G of this contract, but the requirements of OMB
A -133 do not apply or are not elected, the SUBRECIPIENT may choose to have an
audit performed either on the basis of the SUBRECIPIENT's fiscal year or on the
basis of the period during which HHVS - federal assistance has been received. In
either case, each audit shall cover a time period of not more than twelve months
and an audit shall be submitted covering each assisted period until all the assistance
received from this contract has been reported. Each audit shall adhere to all other
audit standards of OMB A -133, as these may be limited to cover only those
services undertaken pursuant to the terms of this contract. A copy of the audit
report must be received by HHVS no later than six months following each audit
period.
5. The SUBRECIPIENT shall maintain all contract records in accordance with
generally accepted accounting principles, procedures, and practices which shall
sufficiently and properly reflect all revenues and expenditures of funds provided
directly or indirectly by the County pursuant to the terms of this Agreement.
6. The SUBRECIPIENT shall include in all HHVS approved subcontracts each of the
record - keeping and audit requirements detailed in this contract.
H. PROGRAM - GENERATED INCOME
All income earned by the SUBRECIPIENT from activities financed in whole or in part by funds
provided hereunder must be reported to HHVS. Such income would include, but not be limited to,
income from service fees, sale of commodities, and rental or usage fees. The SUBRECIPIENT shall
report its plan to utilize such income to HHVS, and said plan shall require the prior written approval of
HHVS or its designee. Accounting and disbursement of such income shall comply with OMB Circular A-
110 (Uniform Administrative Requirement for Federal Grants) and other applicable regulations
incorporated herein by reference.
Program Income, as defined by 24 CFR 570.500(a), may be retained by the COUNTY. Program
Income shall be utilized to undertake activities specified in "Exhibit A" of this Agreement, and all
provisions of this Agreement shall apply to stated activities. Any Program Income received by the
SUBRECIPIENT or its sub - contractors shall be returned to the COUNTY unless the SUBRECIPIENT
requests and is authorized by HHVS to utilize uncommitted funds.
L GRANT CLOSEOUT PROCEDURES
SUBRECIPIENT's obligation to the COUNTY shall not end until all closeout requirements are
completed. Activities during this closeout period shall include, but not be limited to: making final
payments, disposing of program assets (including the return of all unused materials, equipment, unspent
cash advances, program income balances, and receivable accounts to the COUNTY), and determining the
custodianship of records.
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD 10 -01
Page 11 of 28
16D7
VIII. OTHER PROGRAM REQUIREMENTS
A. OPPORTUNITIES FOR RESIDENTS AND CIVIL RIGHTS COMPLIANCE
The SUBRECIPIENT agrees that no person shall be excluded from the benefits of, or be subjected
to, discrimination under any activity carried out by the performance of this Agreement on the basis of
race, color, disability, national origin, religion, age, familial status, or sex. Upon receipt of evidence of
such discrimination, the COUNTY shall have the right to terminate this Agreement.
To the greatest extent feasible, lower- income residents of the project areas shall be given
opportunities for training and employment; and to the greatest feasible extent eligible business concerns
located in or owned in substantial part by persons residing in the project areas shall be awarded contracts
in connection with the project. The SUBRECIPIENT shall comply with Section 3 of the Housing and
Community Development Act of 1968.
B. OPPORTUNITIES FOR SMALL AND MINORITY /WOMEN -OWNED BUSINESS
ENTERPRISES
In the procurement of supplies, equipment, construction, or services, the SU 3RECIPIENT shall
make a positive effort to utilize small business and minority /women -owned business enterprises of
supplies and services, and provide these sources the maximum feasible opportunity to compete for
contracts to be performed pursuant to this Agreement. To the maximum extent feasible, these small
business and minority /women -owned business enterprises shall be located in or owned by residents of the
CDBG areas designated by Collier County in the Annual Consolidated Plan approved by HUD.
C. PROGRAM BENEFICIARIES
At least fifty -one percent (51 %) of the beneficiaries of a project funded through this Agreement
must be low- and moderate- income persons. If the project is located in an entitlement city, as defined by
HUD, or serves beneficiaries countywide, more than thirty percent (30 %) of the beneficiaries directly
assisted under this Agreement must reside in unincorporated Collier County or in municipalities
participating in the County's Urban County Qualification Program. The project shall assist beneficiaries
as defined above for the time period designated in Exhibit "A" of this Agreement.
D. CONFLICT OF INTEREST
The SUBRECIPIENT covenants that no person who presently exercises any functions or
responsibilities in connection with the Project, has any personal financial interest, direct or indirect, in the
target areas or any parcels therein, which would conflict in any manner or degree with the performance of
this Agreement and that no person having any conflict of interest shall be employed by or subcontracted
by the SUBRECIPIENT. Any possible conflict of interest on the part of the SUBRECIPIENT or its
employees shall be disclosed in writing to HHVS provided, however, that this paragraph shall be
interpreted in such a manner so as not to unreasonably impede the statutory requirement that maximum
opportunity be provided for employment of and participation of low and moderate - income residents of the
project target area.
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD 10 -01
Page 12 of 28
E. PUBLIC ENTITY CRIMES
1607
As provided in § 287.133, Fla. Stat. by entering into this Agreement or performing any work in
furtherance hereof, the SUBRECIPIENT certifies that it, its affiliates, suppliers, subcontractors and
consultants who will perform hereunder, have not been placed on the convicted vendor list maintained by
the State of Florida Department of Management Services within the 36 months immediately preceding the
date hereof. This notice is required by § 287.133 (3)(a), Fla. Stat.
F. DRUG -FREE WORKPLACE REQUIREMENTS
The SUBRECIPIENT must certify that it will provide drug -free workplaces in accordance with
the Drug -Free Workplace Act of 1988 (41 USC 701).
G. CERTIFICATION REGARDING LOBBYING
The undersigned certifies, to the best of his or her knowledge and belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of
the undersigned, to any person for influencing or attempting to influence an officer
or employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with the
awarding of any Federal contract, the making 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, contracts under grants, loans, and cooperative agreements) and that all
SUBRECIPIENTS shall certify and disclose accordingly.
H. REAL PROPERTY
Any real property acquired by the SUBRECIPIENT for the purpose of carrying on the projects
stated herein, and approved by the COUNTY in accordance with the Uniform Relocation Assistance and
Real Property Acquisition Policies Act of 1970 and 49 CFR 24.101, shall be subject to the provisions of
CDBG including, but not limited to, the provisions on use and disposition of property. Any real property
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
Page 13 of 28
1607
within the SUBRECIPIENT control, which is acquired or improved in whole or part with CDBG funds in
excess of $25,000, must adhere to the CDBG Regulations at 24 CFR 570.505.
IX. ENVIRONMENTAL CONDITIONS
A. AIR AND WATER
The SUBRECIPIENT agrees to comply with the following requirements:
1. Clean Air Act, 41 USC 7401, et seq.
2. Federal Water Pollution Control Act, 33 USC 1251, et seq., as amended.
B. FLOOD DISASTER PROTECTION
In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42 USC 4002),
the SUBRECIPIENT shall assure that for activities located in an area identified by FEMA as having
special flood hazards, flood insurance under the National Flood Insurance Program is obtained and
maintained. If appropriate, a letter of map amendment (LOMA) may be obtained from FEMA, which
would satisfy this requirement and/or reduce the cost of said flood insurance.
C. LEAD -BASED PAINT
The SUBRECIPIENT agrees that any construction or rehabilitation of residential structures with
assistance provided under this contract shall be subject to HUD Lead -Based Paint Poisoning Prevention
Act found at 24 CFR 570.608.
D. HISTORIC PRESERVATION
The SUBRECIPIENT agrees to comply with the Historic Preservation requirements set forth in
the National Historic Preservation Act of 1966, as amended (16 USC 470) and the procedures set forth in
36 CFR 800, Advisory Council on Historic Preservation Procedures for Protection of Historical
Properties.
X. CONDITIONS FOR RELIGIOUS ORGANIZATIONS
CDBG funds may not be used for religious activities or provided to primarily religious
organizations. Section 24 CFR 570.2000) specifies the limitations on CDBG funds.
XI. REVERSION OF ASSETS
Upon expiration of the Agreement, the SUBRECIPIENT shall transfer to the COUNTY any
CDBG funds on hand at the time of expiration, any accounts receivable attributable to the use of CDBG
funds, and any non - expendable personal property that was purchased with CDBG funds. Any real
property under SUBRECIPIENT control will be covered by the regulations 24 CFR 570.503(B)(8).
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
Page 14 of 28
XII. SEVERABILITY 1607
Should any provision of the Agreement be determined to be unenforceable or invalid, such a
determination shall not affect the validity or enforceability of any other section or part thereof.
XIII. COUNTERPARTS OF THE AGREEMENT
This Agreement, consisting of twenty -eight (28) enumerated pages, which include the exhibits
referenced herein, shall be executed in two (2) counterparts, each of which shall be deemed to be an
original, and such counterparts will constitute one and the same instrument.
XIV. ENTIRE UNDERSTANDING
This Agreement and its provisions merge any prior agreements, if any, between the parties and
constitutes the entire understanding. The parties hereby acknowledge that there have been and are no
representations, warranties, covenants, or undertakings other than those expressly set forth herein.
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
Page 15 of 28
16D7
IN WITNESS WHEREOF, the Subrecipient and the County, have each, respectively, by an authorized
person or agent, hereunder set their hands and seals on this I + day of D FG.gng dam- , 20 t O
ATTEST:
4DWT E. BROC CLERK st as to CN Inum I
�,.
(SEAL)
s"
7..
Fi> st Vtness
Type /print witness name
BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA
By: 4� W
FRED W. COYLE, CHA
David Lawrence Mental Health Center Inc.
By: i
Subrecipient Signature
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
Dave Schimmel, CEO
Type /print Subrecipient name and title
Approved as to form and legal sufficiency:
Jennifer . White
Assistant County Attorney
Page 16 of 28
EXHIBIT "A"
SCOPE OF SERVICES
DAVID LAWRENCE CENTER INFRASTRUCTURE
A. PROJECT SCOPE
1607
On April 27th, 2010, the Board of County Commissioners approved the HUD Action Plan allocating
funding for this initiative. Community Development Block Grant (CDBG) funding will be used for
the infrastructure portion of construction of a Crisis Stabilization Unit at David Lawrence Center
(DLC).
The Action Plan indicates: Provide funding for the DLC for construction of a crisis stabilization unit.
Upon completion, the unit will add 16 transitional beds to the county's Continuum of Care (COC)
inventory. The additional beds will be used for patients who are incarcerated under the Baker Act due
to mental health issues. This grant is paying for a portion of costs associated with the infrastructure
of a Construction Stabilization Unit, to be located at David Lawrence Center. This will increase the
number of beds within the unit from 20 to 36. The grant funds are to be expended toward all
infrastructure costs which will include site irrigation and landscaping for the infrastructure installed
with CDBG funds, until fully expended, even though there are other funding sources for this unit. In
order to assure the 16 beds are achieved, the final 10% of the grant amount will be withheld until it
has been demonstrated that the goals have been accomplished.
The detailed project scope will be contained in the bid specifications of the vendor awarded the
project's construction contract. The project construction contract will include details sufficient to
document the number, amount, and costs associated with all activities.
The project activities will meet the U.S. Department of Housing and Urban Development's national
objective to benefit a low and moderate income area.
B. BUDGET
Collier County Housing, Human and Veteran Services is providing Two Hundred Twenty One
Thousand Dollars and 00 /100 ($221,000.00) in CDBG funding for the project scope described above.
Line Item Description CDBG Funds
Infrastructure including site
irrigation and landscaping for
infrastructure installed with CDBG
funds $ 221,000.00
TOTAL $221,000.00
Any modifications to this contract shall be in compliance with the County Purchasing Policy and
Administrative Procedures in effect at the time such modifications are authorized.
C. PROJECT WORK PLAN
The following Project Work Plan is in effect for program monitoring requirements only and, as such,
is not intended to be used as a payment schedule.
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
Page 17 of 28
16D7
Date
Start
Date
End
Work Plan
10/2010
12/2010
Complete design package
01/2011
06/2011
Contract Begins, Permitting, Construction activities
07/2011
08/2011
Complete final inspections and project close -out
D. PAYMENT SCHEDULE
The following table details the project deliverables and payment schedule.
Deliverable
Payment Schedule
Infrastructure including site
Monthly invoices per contractor's Schedule of
irrigation and landscaping for
Values
infrastructure installed with
CDBG funds
16 beds available
Final 10% ($22,100.00) released upon Certificate
of occupancy for completed building indicating
that 16 beds are available
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
Page 18 of 28
EXHIBIT "A -1"
CHANGE BY LETTER
COLLIER COUNTY GOVERNMENT
Housin , Human & Veteran Services User Name
Public Services Division Address
NAPLES, FLORIDA Zip code
PHONE: (239) Phone #
Date FAX (239) Fax #
Contact Name
Name of Firm
Address
RE: Zero Dollar Contract Change Notification
Re: Contract # and Title of Contract
Project #
Purchase Order #
Dear Contact Name:
16D7
By copy of this letter, the above referenced contract is being issued a zero dollar ($0.00) change as indicated below:
r The above referenced contract time is hereby extended by Number of days calendar days. The new completion date shall
be on or before month and date, Year.
By extending this contract, the County is not relieving your firm of its obligations to perform work in a timely and satisfactory
manner or any consequences resulting from failing to do so. Collier County hereby reserves all legal rights, including, but not
limited to, rights to terminate, suspend or elect any other appropriate course(s) of action should circumstances warrant with
regard to the referenced contract.
Additional Staffing Categories Professional Position(s) Hourly Rate(s)
Draw against Allowance (specify allowance item and identify specific items and quantities)
Other: Scope Clarifications as indentified in Schedule B -1, "Clarifications in Scope ", (attached).
Sincerely,
Your name
Title
cc: Contract Specialist Name Contract Specialist, Purchasing Department
Suzanne Boothby, Clerk's Grants Department
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CDIO -01
Page 19 of 28
EXHIBIT "B" 1607 1
INSURANCE REQUIREMENTS
The SUBRECIPIENT shall furnish to Collier County, c/o Housing, Human & Veteran Services,
3301 E Tamiami Trail Bldg H Suite 211, Naples, Florida 34112, Certificate(s) of Insurance evidencing
insurance coverage that meets the requirements as outlined below:
1. Workers' Compensation as required by Chapter 440, Florida Statutes.
2. Public Liability Insurance on a comprehensive basis in an amount no less than $300,000
per occurrence for combined Bodily Injury and Property Damage. Collier County must be shown as an
additional insured with respect to this coverage.
3. Automobile Liability Insurance covering all owned, non -owned and hired vehicles used in
connection with this contract in an amount not less than $300,000 per occurrence for combined Bodily
Injury and Property Damage.
DESIGN STAGE (IF APPLICABLE)
In addition to the insurance required in 1 — 3 above, a Certificate of Insurance must be provided as
follows:
4. Professional Liability Insurance in the name of the SUBRECIPIENT or the licensed design
professional employed by the SUBRECIPIENT in an amount not less than $300,000 per occurrence
providing for all sums which the SUBRECIPIENT and /or the design professional shall become legally
obligated to pay as damages for claims arising out of the services performed by the SUBRECIPIENT or
any person employed by the SUBRECIPIENT in connection with this contract. This insurance shall be
maintained for a period of two (2) years after the certificate of Occupancy is issued.
CONSTRUCTION PHASE (IF APPLICABLE)
In addition to the insurance required in 1 — 4 above, the SUBRECIPEINT shall provide or cause
its Subcontractors to provide original policies indicating the following types of insurance coverage prior
to any construction:
5. Completed Value Builder's Risk Insurance on an "All Risk" basis in an amount not less
than one hundred (100 %) percent of the insurable value of the building(s) or structure(s). The policy shall
be in the name of Collier County and the SUBRECIPIENT.
6. Flood Insurance shall be provided for those properties found to be within a flood hazard
zone, in an amount not less than the full replace values of the completed structure(s) or the maximum
amount of coverage available through the National Flood Insurance Program (NFIP), whichever is
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD 10 -01
Page 20 of 28
1607
greater. The policy will show Collier County as a Loss Payee A.T.I.M.A. This policy will be provided as
such time that he buildings' walls and roof exist.
OPERATION /MANAGEMENT PHASE (IF APPLICABLE)
After the Construction Phase is completed and occupancy begins, the following insurance must be
kept in force throughout the duration of the loan and/or Contract:
7. Public Liability coverage in an amount not less than $1,000,000 per occurrence for
combined Bodily Injury and Property damage. Collier County must be shown as an additional insured
with respect to this coverage.
8. Property Insurance coverage on an "All Risk" basis in an amount not less than one hundred
(100 %) of the replacement cost of the property. Collier County must be shown as a Loss payee with
respect to this coverage A.T.I.M.A.
9. Flood Insurance coverage for those properties found to be within a flood hazard zone for
the full replacement values of the structure(s) or the maximum amount of coverage available through the
National Flood Insurance Program (NFIP). The policy must show Collier County as a Loss Payee
A.T.I.M.A.
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD 10 -01
Page 21 of 28
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
EXHIBIT "C"
ADDITIONAL CDBG GRANT REQUIREMENTS 16D7
There are no additional grant requirements
Page 22 of 28
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
EXHIBIT "D"
REQUIRED SUBMITTALS
D -1 Request for Payment
D -la Release and Affidavit Form
D -2 CDBG Monthly Progress Report
Page 23 of 28
16D7
SCHEDULE "D -1"
COLLIER COUNTY HOUSING AND HUMAN SERVICES 160?
REQUEST FOR PAYMENT
SECTION I: REQUEST FOR PAYMENT
Subrecipient Name: David Lawrence Center, Inc.
Subrecipient Address: 6075 Bathey Lane Naples, FL 34116
Project Name: Construction
Project No: CD10 -01 Payment Request #
Dollar Amount Requested: $
SECTION II: STATUS OF FUNDS
1. Grant Amount Awarded
2. Sum of Past Claims Paid on this Account
3. Total Grant Amount Awarded Less Sum
Of Past Claims Paid on this Account
4. Amount of Previous Unpaid Requests
5. Amount of Today's Request
6. Current Grant Balance (Initial Grant Amount Awarded
Less Sum of all requests)
$ 221,000.00
I certify that this request for payment has been drawn in accordance with the terms and conditions
of the Agreement between the COUNTY and us, as the SUBRECIPIENT. I also certify that the amount
of the Request for Payment is not in excess of current needs.
Signature
Title
Authorizing Grant Coordinator
Date
Supervisor (approval authority under $14,999)
Dept Director
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
(approval required $15,000 and above)
Page 24 of 28
16D7
SCHEDULE 11D -1 a"
RELEASE AND AFFIDAVIT FORM
The SUBRECIPIENT certifies for itself and its subcontractors, material -men, successors and
assigns, that all charges for labor, materials, supplies, lands, licenses and other expenses for which
COUNTY might be sued or for which a lien or a demand against any payment bond might be filed, have
been satisfied and paid.
This Release and Affidavit is given in connection with the SUBRECIPIENT's (monthly /final)
Request for Payment.
SUBRECIPIENT
Witness:
mm
Print name and title
STATE OF
COUNTY OF
ITS: President
DATE:
The foregoing instrument was acknowledged before me this day of , 2010,
by as of
A Choose Not - For - Profit, or Corporation or Municipality on behalf of
Choose Not - For - Profit, Corporation or Municipality . He /She is personally known to me OR has
produced as identification and who did (did not) take an oath.
My Commission Expires:
(Signature)
Name:
(Legibly Printed)
(AFFIX OFFICIAL SEAL) Notary Public, State of:
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
Page 25 of 28
Commission No.:
SCHEDULE "D -2" 1607
CDBG MONTHLY PROGRESS REPORT
Complete form for past month and submit to Housing &Human Service's staff by the 10`" of the
following month.
Status Report for Month of Submittal Date:
Project Name
Infrastructure
Project Number CD 10 -01
Subrecipient: David Lawrence Center, Inc.
Contact Person Scott Geltemeyer, CFO
Telephone: 239 - 354 -01420 Fax:
E -mail: Scottgkdlcmhc.com
Activity Number
1. Activity Status /Milestones (describe any action taken, relating to this project, during the
past month):
2. What events /actions are scheduled for the next two months?
3. Describe any affirmative marketing you have implemented regarding this project.
Please list and attach any recent media coverage of your organization relating to this project.
4. List any additional data relevant to the outcome measures listed on the application
for this project.
5. Identify any potential issues that may cause delay.
New contracts executed this month (if applicable):
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
Page 26 of 28
16D7
Name of Contractor or
Subcontractor, Address & Phone
Number
Amount of
Contract
Contractor
Federal ID
Number
Race
(see definitions
on following
page)
Ethnicity
(see definitions
on following
page)
Total Number of
Extremely
Very
Low Income
Female Head of
Households or
Low Income
Low Income
(51 -80 %)
Household
For projects that serve a particular clientele, please complete the following information by
entering the appropriate number in the blank spaces and in the chart below. Complete the below chart for
NEW clients served this month. DO NOT DUPLICATE clients served in previous months. You may
provide data by either households or persons served. However, if one person received TWO services this
counts as TWO SERVICE UNITS:
TOTAL BENEFICIARIES
This project benefits households or persons. Please circle one category (either "households"
or "persons "). Enter the number of beneficiaries in the blank space and in Box
INCOME
Of the households or persons assisted, are extremely low- income income (0 -30 %) of the
current Median Family Income (MFI). Enter this number in Box "2. "
Of the households or persons assisted, are very low- income (31 -50 %) of the current Median
Family Income (MFI). Enter this number in Box "3. "
Of these households or persons assisted, are low- income (51 -80 %) of the current Median
Family Income (MFI). Enter this number in Box "4. "
NOTE: The total of Boxes 2, 3 and 4 should equal the number in Box 1.
FEMALE HEAD OF HOUSEHOLD
This project assisted Female Head of Households REGARDLESS of income. Enter this
number in box 5 " below.
BOX 1
BOX 2
BOX 3
BOX 4
BOX 5
Total Number of
Extremely
Very
Low Income
Female Head of
Households or
Low Income
Low Income
(51 -80 %)
Household
Persons Assisted
(0 -30 %)
(31 -50 %)
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD10 -01
Page 27 of 28
6Di
Subrecipient's must indicate total beneficiaries for Race AND Ethnicity
Definitions of Race:
White: A person having origins in any of the original peoples of Europe, the Middle East, or North
Africa.
Black or African - American: A person having origins in any of the black racial groups of Africa.
Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the
Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia,
Pakistan, the Philippine Islands, Thailand, and Vietnam.
American Indian or Alaska Native: A person having origins in any of the original peoples of North
and South America (including Central America), and who maintains tribal affiliation or community
attachment.
Native Hawaiian or Other Pacific Islander: A person having origins in any of the original people of
Hawaii, Guam, Samoa, or other Pacific Islands.
Definitions of Ethnicity:
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other
Spanish culture or origin, regardless of race.
Tabulation Table of Race and Ethnicity Beneficiaries
Race
# Total
# Hispanic
White
Black or African American
Asian
American Indian or Alaskan Native
Native Hawaiian or Other Pacific Islander
American Indian/Alaska Native and White
Asian and White
Black/African American and White
American Indian/Alaskan Native and Black/African American
Other Multi- Racial
TOTAL:
David Lawrence Center, Inc.
Infrastructure
2010 CDBG CD 10 -01
Page 28 of 28