Backup Documents 03/26/2019 Item #16J 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 J 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 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 routinLlines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office JAB 3/26/19
4. BCC Office Board of County V4 Ck
Commissioners AVT5 e)
•fl
5. Minutes and Records Clerk of Court's Office
IVU)
V
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Staff Jennifer J.Edwards,Supervisor of Phone Number 252-8827
Contact/Department Elections
Agenda Date Item was 3/26/19 Agenda Item Number 16-J-1
Approved by the BCC
Type of Document Agreement-Supervisor of Elections Number of Original One
Attached Documents Attached
PO number or account n/a
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) A plicable)
1. Does the document require the chairman's original signature JAB
2. Does the document need to be sent to another agency for additional signatures? If yes,
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAB
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's JAB
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the JAB
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JAB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this JAB
routing slip should be provided to the County Attorney Office at the time the item is
input into MinuteTraq. Some documents are time sensitive and require forwarding
to Tallahassee within a certain time frame or the BCC's actions are nullified. Be
aware of your deadlines!
8. The document was approved by the BCC on 3/26/19 and all changes made during the JAB N/A is not
meeting have been incorporated in the attached document. The County Attorney's an option for
Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the ,, �j N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the �„w an option for
Chairman's signature. this line.
[04-COA-01081/1344830/111:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;
Revised 11/30/12
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MEMORANDUM
Date: April 2, 2019
To: Jennifer J. Edwards, Supervisor of Elections
Division of Elections Office
From: Martha Vergara, Senior Deputy Clerk
Minutes & Records Department
Re: Memorandum of Agreement "Federal Election
Administration Activities"
MOA #2018-2019-0003-
Attached for your records is a scanned copy of the document as referenced above,
(Item #16J1) adopted by the Board of County Commissioners on Tuesday,
March 26, 2019.
The original is being held in the Minutes & Records Department as part of the
Official Records.
If you have any questions, please feel free to contact me at 252-7240.
Thank you.
Attachment
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MEMORANDUM OF AGREEMENT
FOR FEDERAL ELECTION ADMINISTRATION ACTIVITIES
This agreement is between the State of Florida, Department of State,Division of Elections
("Department"),an agency of the State of Florida,and Jennifer J.Edwards
Supervisor of Elections for Collier County, ("Sub-recipient").This agreement
governs the receipt and use of federal funds as specified herein.
I. Governing Law
Grant funds are made available pursuant to Specific Appropriation 3081,Chapter 2018-9, Laws of Florida
to provide funds to the 67 county supervisor of elections offices in the ongoing effort to improve the
administration of federal elections. See Attachment A for appropriation proviso.
The Department of State is authorized to distribute to all 67 county Supervisors of Elections a sum total
of two million dollars ($2,000,000) in non-recurring funds for fiscal year 2018-2019 from the Federal
Grants Trust Fund, pursuant to section 251 of the Help America Vote Act of 2002 (NAVA) and the Catalog
of Federal Domestic Assistance(CFDA)90.401("Help America Vote Act Requirements Payments"). )
1 II. Scope of Work, Deliverables, Restrictions
A. Scope of Work.
Funds provided under this agreement shall be used for advance payment for allowable expenses to
improve the administration of federal elections. Those allowable expenses and the timeline by when i
requests must be submitted are detailed in Table 1 in subsection B. For additional guidance on allowable Po
and non-allowable expenses, see DE Guide 0018 - Allowable and Non-Allowable Expenses for NAVA
Expenditures—Federal Election Activities Grant. €
a
B. Deliverables,Minimum Levels of Service,and Financial Consequences
Table 1
f
Deliverables Level of Service Financial Consequences
(1,2,3,and/or 4) i
1. Federal Election Sub-recipient has until June 1,2019 to If an initial application for funds
Administration submit an application for these funds using is not submitted by June 1,
Activities-Voter the DOS Online Grants program. 2019,funds shall revert to the
Education. Federal Grants Trust Fund.
At the time of grant application,Sub-
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Examples include: recipient shall provide a detailed description Any funds remaining after
Mailing and of the services and/or products to be December 31,2020,or not
publishing of sample provided,received and/or used by otherwise encumbered for r
ballots December 31, 2020.Once submitted and services and/or products
Mailing or publishing approved by the Department, a plan may be received or provided on or
voter information amended once and no later than June 1, before December 31,2020),
cards 2020. including any interest earned, k
Publishing of voter must be returned to the
guides No later than December 31, 2020,Sub- Department no later than f
Voting system recipient shall have expended (and/or January 31, 2021. An amended
Demonstrations encumbered for services and/or products to Final Expenditure Report must )
be used or implemented no later than be submitted with the returned
December 31,2020)the grant funds funds.
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allocated under this agreement,including
any interest earned and county match. Any funds determined not to
be expended in accordance
Sub-recipient shall submit Annual with this agreement shall be
Expenditure Reports due no later than July returned to the Department,
31, 2019 and July 31,2020 that includes within 30 days after the date of
documentation evidencing the services written notice.An amended
and/or products purchased, used and/or Final Expenditure Report must
Implemented. be submitted with the returned
funds.
Sub-recipient shall submit a Final -
Expenditure Report due no later than
December 31, 2020,that includes All funds returned shall revert
documentation evidencing the services to the Federal Grants Trust
and/or products purchased, used and/or Fund.
implemented.
2. Federal Election Sub-recipient has until June 1,2019 to If an initial application for funds
Administration submit an application for these funds using is not submitted by June 1,
Activities—Poll the DOS Online Grants program. 2019,funds shall revert to the
Worker Training Federal Grants Trust Fund.
At the time of grant application,Sub-
Examples include: recipient shall provide a detailed description Any funds remaining after
Poll worker training of the services and/or products to be December 31,2020(or not
stipends provided,received and/or used by otherwise encumbered for
Poll worker training December 31,2020. Once submitted and services and/or products
materials approved by the Department, a plan may be received or provided on or
amended once and no later than June 1, before December 31,2020),
2020. including any interest earned,
must be returned to the
No later than December 31, 2020,Sub- Department no later than
recipient shall have expended (and/or January 31, 2021. An amended
encumbered for services and/or products to Final Expenditure Report must
be used or implemented no later than be submitted with the returned
December 31, 2020)the grant funds funds.
allocated under this agreement, including
any interest earned and county match.
Any funds determined not to
Sub-recipient shall submit Annual be expended in accordance
Expenditure Reports due no later than July with this agreement shall be
31,2019 and July 31, 2020 that includes returned to the Department,
documentation evidencing the services within 30 days after the date of k,
and/or products purchased,used and/or written notice. An amended
implemented. Final Expenditure Report must
be submitted with the returned
Sub-recipient shall submit a Final funds.
Expenditure Report due no later than
December 31, 2020,that includes All funds returned shall revert
documentation evidencing the services to the Federal Grants Trust
Fund.
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and/or products purchased, used and/or
implemented.
3. Federal Election Sub-recipient has until June 1, 2019 to If an initial application for funds
Administration submit an application for these funds using is not submitted by June 1,
Activities— the DOS Online Grants program. 2019,funds shall revert to the
Standardizing Election Federal Grants Trust Fund.
Results Reporting At the time of grant application,Sub-
recipient shall provide a detailed description Any funds remaining after
Examples include: of the services and/or products to be December 31,2020 (or not
Software or hardware provided, received and/or used by otherwise encumbered for
technology that December 31, 2020. Once submitted and services and/or products
enhances or facilitates approved by the Department, a plan may be received or provided on or
the reporting of amended once and no later than June 1, before December 31,2020),
election results 2020. including any interest earned,
must be returned to the
No later than December 31, 2020,Sub- Department no later than r
recipient shall have expended (and/or January 31, 2021. An amended
encumbered for services and/or products to Final Expenditure Report must
be used or implemented no later than be submitted with the returned
December 31, 2020)the grant funds funds.
allocated under this agreement, including
any interest earned and county match.
Any funds determined not to
Sub-recipient shall submit Annual be expended in accordance
Expenditure reports due no later than July with this agreement shall be
31,2019 and July 31,2020 that includes returned to the Department,
documentation evidencing the services within 30 days after the date of I
and/or products purchased, used and/or written notice.An amended
implemented. Final Expenditure Report must
be submitted with the returned
Sub-recipient shall submit a Final funds.
Expenditure Report due no later than
r
December 31,2020,that includes
documentation evidencing the services All funds returned shall revert
and/or products purchased, used and/or to the Federal Grants Trust
s'
implemented. Fund. 1
4. Federal Election Sub-recipient has until June 1, 2019 to If an initial application for funds
Administration submit an application for these funds using is not submitted by June 1,
Activities-Other the DOS Online Grants program. 2019,funds shall revert to the t
Federal Grants Trust Fund.
Federal Election G
Administration At the time of grant application,Sub-
Activities, as recipient shall provide a detailed description Any funds remaining after
approved in advance of the services and/or products to be December 31,2020(or not
by the Department of provided, received and/or used by otherwise encumbered for
State. December 31, 2020. Once submitted and services and/or products
approved by the Department, a plan may be received or provided on or
Examples include: amended once and no later than June 1, before December 31,2020),
2020. including any interest earned,
must be returned to the
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MOVE Act No later than December 31, 2020,Sub- Department no later than
implementation and recipient shall have expended (and/or January 31, 2021. An amended
maintenance; encumbered for services and/or products to Final Expenditure Report must
Software or hardware be used or implemented no later than be submitted with the returned
technology that December 31,2020)the grant funds funds.
enhances or facilitates allocated under this agreement,including
the delivery of vote- any interest earned and county match.
by-mail ballots, Any funds determined not to
casting and counting Sub-recipient shall submit annual be expended in accordance
of valid votes,voting expenditure reports due no later than July with this agreement shall be
systems audits or 31,2019 and July 31, 2020 that includes returned to the Department,
recounts, or the documentation evidencing the services within 30 days after the date of
certification of and/or products purchased,used and/or written notice.An amended
accurate and implemented. Final Expenditure Report must
complete election be submitted with the returned
results. Sub-recipient shall submit a final funds.
expenditure report due no later than
December 31,2020,that includes
documentation evidencing the services All funds returned shall revert
and/or products purchased, used and/or to the Federal Grants Trust
implemented. Fund.
C. Request and Disbursement Process
The Department shall distribute to each eligible Sub-recipient upon request and submission of a
completed grant application a minimum payment amount of five thousand dollars ($5,000) plus a
proportional amount based on the voting age population in the Sub-recipient's county. See Attachment
B. The amount per county is based on the aggregated remaining amount of the total grant for the 67
Sub-recipients divided by the total number of voting age population for the State in the most recent
decennial census and then multiplied by the respective county's voting age population.
To receive funds,the Sub-recipient shall submit a complete grant application no later than June 1, 2019,
using the Department of State's Online Grants Program at https://www.dosgrants.com. The application
must contain a description of the plan to be implemented. If a county has remaining funds from one or
more prior federal election activities grant distributions,as part of their application for 2018-2019 funds,
the sub-recipient shall provide an explanation as to why those funds have yet to be expended.
Additionally, before the Sub-recipient may receive funds,the Sub-recipient must submit the following:
1. A completed ED Form GCAS-009(6/88),entitled"Certification Regarding Debarment,Suspension,
Ineligibility, and Voluntary Exclusion Lower Tier Covered Transactions", and attached hereto as
Attachment C. [Executive Order 12549, Debarment and Suspension, 45 CFR 1183.35, prohibits
the disbursement of federal funds to the intended recipient of such funds or to any sub-recipient
thereunder unless such recipient and each sub-recipient,if any,certify that they are not excluded
or disqualified from receiving federal funds by any federal department or agency.]
2. A completed "Certificate of Equipment for Casting and Counting Ballots" (DS-DE 135, Effective
8/16),attached hereto as Attachment D.This is required if the request, in part or in full, is to use
NAVA funds for the purpose of purchasing emerging or enhancing software and hardware
technology.
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3. A completed "Matching Funds Certification" (DS-DE 127),attached hereto as Attachment E.The
form certifies that the county governing body shall provide addition matching funds in an amount
equal to fifteen percent (15%) of the amount to be received from the state. If the county
governing body fails to appropriate the matching funds, the Supervisor must return to the
Department all funds received under this agreement.
D. Reporting
The Sub-recipient must submit an annual expenditure report that includes supporting documentation
evidencing allowable expenses no later than July 31, 2019 and again on July 31, 2020.The Sub-recipient
must provide a final expenditure report including submitting supporting documentation evidencing
allowable expenses no later than December 31, 2020 and written confirmation that all remaining
previously distributed grant funds remaining were expended first.Supporting documentation shall include
invoices,canceled checks,purchase orders,vendor contracts,sample publications,and other records that
detail the services or products provided and the costs of such services and/or products. Documentation
must account for all expenditures made from grant funds awarded under this agreement.Documentation
must also provide details regarding matching funds and any interest earned. Failure to submit the report
may result In immediate notice to return all funds, including any interest accrued.Any funds determined
not to be expended in accordance with this agreement shall be returned, including any interest earned,
to the Department within 30 days of written notice. All funds returned shall revert to the Federal Grants
Trust Fund.
Using the Form DS-DE 129,the Sub-recipient shall report annually to the Department any unspent funds
remaining on June 30 of each fiscal year. The Sub-recipient shall submit the annual report no later than
July 31 of every year until funds are fully expended,or returned,whichever is earlier.
E. Restrictions
Sub-recipient shall not use any funds received hereunder to support lobbying activities to influence
proposed or pending federal or state legislation or appropriations,but this does not affect the right of
the Sub-recipient, or that of any other organization to petition Congress,or any other level of
Government,through the use of other resources.
If the Sub-recipient expends any funds on expenses that are not allowable,the Sub-recipient must
reimburse immediately the Department the funds, not otherwise expended for allowable costs,
rl•
including any interest earned during the term of this agreement.
The Sub-recipient must establish and maintain the grant funds in an interest bearing account in a
"qualified public depository"as defined by section 280.02(26), Florida Statutes.The Sub-recipient must
segregate the funds in a separate account established to hold only such funds. Sub-recipient must
comply with the applicable requirements of chapter 280, including but not limited to:
• The execution and retention in your official records of a Public Deposit Identification and
Acknowledgement Form.
• The submission each year by November 30th of a Public Depositor Annual Report to the Chief
Financial Officer(DFS-J1-1009)
For more information refer to the Department of Financial Services Collateral Management for
Governmental Units webpage or contact the Program Administrator at 850-413-3167.
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III. Payments
The Sub-recipient is encouraged to use electronic funds transfer(EFT)to receive payment as an alternative
to receipt of payment by warrant. All Sub-recipients wishing to receive funds through electronic funds
transfer must submit a Direct Deposit Authorization form to the Florida Department of Financial Services.
If EFT has already been set up for your organization, you do not need to submit another authorization
form unless you have changed bank accounts.
IV. Monitoring, Audits, and Audit Reporting
The administration of resources awarded to the Sub-recipient,as indicated on Attachment F, may be
subject to monitoring,audits and reporting requirements herein.
A. Monitoring 1
In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised,and
Section 215.97, F.S., (see Part B"Audits") monitoring procedures may include, but not be limited to,on-
site visits by Department staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or
other procedures. By entering into this agreement,the Sub-recipient agrees to comply and cooperate
with any monitoring procedures/processes the Department deems appropriate.
B. Audits
1. Federally Funded Audits(OMB Circular A-133,as revised in supplemental 2017.)
In the event that the Sub-recipient expends$750,000 or more in Federal awards in its fiscal year,the
Sub-recipient is required to have a single or program-specific audit conducted in accordance with the
provisions of OMB Circular A-133,as revised. In determining the Federal awards expended in its fiscal
year,the Sub-recipient shall consider all sources of Federal awards, including Federal resources received
from the Department.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 conducted by
the Auditor General must satisfy the requirements of Subpart E of OMB Circular A-133,as revised. In
connection with the audit requirements the Sub-recipient shall fulfill the responsibilities of an auditee as
provided in Subpart C of OMB Circular A-133,as revised.
If the Sub-recipient expends less than$750,000 in Federal awards in its fiscal year, an audit is not
required.The Sub-recipient, however, must make records available for review or audit upon request by
appropriate officials of U.S. Election Assistance Commission,the Department, and the General
Accounting Office (GAO). If the Sub-recipient elects to have an audit conducted in accordance with the
provisions of OMB Circular A-133, as revised,the cost of the audit must be paid from non-federal
resources (i.e., resources obtained from other than Federal entities).
2. Other audits
The Department may conduct a limited scope audit of federal funds as defined by OMB Circular A-133
(as revised)or other financial analysis or review of federal funds as permitted by federal law. In the
event the Department determines that a limited scope audit or other type of audit of the Sub-recipient
is appropriate,the Sub-recipient agrees to comply with any additional instructions provided by
Department staff to the Sub-recipient regarding such audit. If the Department determines that federal E'
funds received under this Agreement were used for any unauthorized purpose or that the Sub-recipient
did not comply with this agreement or state or federal requirements for receipt,expenditure,or
accounting,the Sub-recipient must return or repay these federal funds in an amount sufficient to ensure
or obtain compliance, including expenses for any corrective or remedial action.
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The Sub-recipient further agrees to comply and cooperate with any inspections, reviews, investigations,
or audits deemed necessary by the Department of State,Chief Financial Officer(CFO)or Auditor
General.
Additional guidance to state and federal monitoring and auditing requirements may be found at
http://www.eac.gov.
C. Audit Reporting
Copies of financial reporting packages as described in Subpart C-Auditees, section .320(c), OMB A-
133 (as revised)for audits conducted by or on behalf of the Sub-recipient pursuant to Section IV.B.1 of
this agreement,shall be submitted as required by sections.320(d)of such circular to:
Department of State Department of State Auditor General's Office Federal Audit Clearinghouse
Division of Elections Office of Inspector General Claude Pepper Bldg. Bureau of the Census
R.A. Gray Bldg.,Ste 316 R.A. Gray Bldg.,Rm.406 111 West Madison St. 1201 East 106 St.
500 S.Bronough St. 500 S. Bronough Street Tallahassee,FL Jeffersonville,IN
Tallahassee,FL Tallahassee, FL 32399-1450 47130
32399-0250 32399-0250
Any reports,management letter,or other information required to be submitted to the Department
pursuant to this agreement shall be submitted timely and in accordance with OMB Circular A-133,the
Florida Statutes, and/or Chapter 10,550(local governmental entities)of the Rules of the Auditor
General,whichever is applicable.The correspondence accompanying the financial reporting package
forwarded to the Department must include the date the Sub-recipient received the reporting package.
V. Record Retention
The Sub-recipient shall keep and maintain accurate and detailed records sufficient to demonstrate its
compliance with the terms of this agreement. The Sub-recipient shall retain these records for five fiscal
years in accordance with the guidelines of the Department of Financial Services and the Office of the
Auditor General, or three years after the date an audit report is issued,whichever is later.The Sub-
recipient shall allow the Department or its designee,CFO,or Auditor General access to such records,
including access to the audit working papers upon request.
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VI. Entirety of the Agreement
All terms and conditions of this agreement are fully set forth in this document and its attachments and
shall be governed by the laws of the State of Florida regardless of any conflict of laws provisions. In any
proceeding or action brought under this section,the parties agree that the prevailing party will be
entitled to its reasonable attorney's fees from the other party. The parties agree that proper venue will
be in Leon County, Florida.This agreement is effective as of the date it is fully executed.
IN WITNESS THEREOF,the parties have caused this Agreement to be executed by their undersigned
officials as duly authorized.
By County Supervisor of Elections Su,b1recipient By Department of State, Division of Elections
t
Signature: cY -fit ' Signature:
� �!2-a,u
Name and Titi Jennifer J.E wa d.i Name and Title:
Collier County Supervisor of Elections
Address: 3750 Enterprise Ave Address: R.A.Gray Building
Naples,FL 34104 500 S. Bronough Street,Ste. 316
Tallahassee, Florida 32399
County F I o.59-256279 r
Witness: W%► • Witness:
Date: l ( Date:
C
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ATTACHMENT A to MOA#2018-2019-0003
3081 SPECIAL CATEGORIES
GRANTS AND AIDS - FEDERAL ELECTION ACTIVITIES (HELP AMERICA VOTE ACT)
FROM FEDERAL GRANTS TRUST FUND . . . $2,000,000
Funds in Specific Appropriation 3081 shall be distributed to county supervisors of elections to
be used for election administration activities such as voter education; pollworker training;
standardizing elections results reporting; or other federal election administrative activities as
approved by the Department of State.
County supervisors of elections will receive funds only after providing the Department of State
a detailed description of the programs that will be implemented. Funds distributed to county
supervisors of elections require a certification from the county that matching funds will be
provided in an amount equal to fifteen percent of the amount to be received from the state.
Also, before a county supervisor of elections receives funds for any software or hardware
technology, including, but not limited to, any emerging technology that enhances or facilitates
the delivery of absentee ballots, the casting and counting of valid votes, voting system audits or
recount processes, and the certification of accurate and complete official election results, the
software or technology must first be certified or approved, whichever is applicable, by the
Department of State. Additionally, before the supervisor can receive funds for emerging or
enhancing technology, the county supervisor of elections and the chairperson of the county
governing body must certify that the county has purchased and made available sufficient
equipment for casting and counting ballots to meet the needs of the county electors including
reducing the wait time at the polls during the early voting period and on election day for the
next regularly scheduled general election.
To be eligible, a county must segregate federal funds and required county matching dollars in a
separate account established to hold only such funds. Funds in this account must be used only
for the activities for which the funds were received. Funds shall remain in the account to be
used for the same purposes for subsequent years or until such funds are expended. Supervisors
of elections shall report to the Department of State any unspent funds remaining on June 30 of
each fiscal year.
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ATTACHMENT B to MOA 2018-2019-0003
FLORIDA DEPARTMENT OF STATE-DIVISION OF ELECTIONS
County Allocation of Help America Vote Act Funds-Federal Election Administration Activities-FY 2018-2019
Voting Age Amount- Amount- Amount- Amount-
Population Federal Election Federal Election Federal Election 15%
(2010 Census) Activities Funds Activities Funds Activities Funds Match By County
County Minimum Payment Voting Age Population Minimum+Per population Funds
Alachua 203,051 $ 5,000.00 $ 22,844.44 $ 27,844.44 $ 4,176.67
Baker 20,068 $ 5,000.00 $ 2,257.77 $ 7,257.77 $ 1,088.67
Bay 131,776 $ 5,000.00 $ 14,825.58 $ 19,825.58 $ 2,973.84
Bradford 22,885 $ 5,000.00 $ 2,574.70 $ 7,574.70 $ 1,136.20
Brevard 435,690 $ 5,000.00 $ 49,017.71 $ 54,017.71 $ 8,102.66
Broward 1,356,717 $ 5,000.00 $ 152,638.72 $ 157,638.72 $ 23,645.81
Calhoun 11,493 $ 5,000.00 $ 1,293.03 $ 6,293.03 $ 943.95
Charlotte 137,100 $ 5,000.00 $ 15,424.56 $ 20,424.56 $ 3,063.68
Citrus 118,842 $ 5,000.00 $ 13,370.43 $ 18,370.43 $ 2,755.56
Clay 140,695 $ 5,000.00 $ 15,829.02 $ 20,829.02 $ 3,124.35
Collier 258,873 $ 5,000.00 $ 29,124.75 $ 34,124.75 $ 5,118.71
Columbia 52,338 $ 5,000.00 $ 5,888.34 $ 10,888.34 $ 1,633.25
DeSoto 27,027 $ 5,000.00 $ 3,040.70 $ 8,040.70 $ 1,206.10
Dixie 13,278 $ 5,000.00 $ 1,493.85 $ 6,493.85 $ 974.08
Duval 660,749 $ 5,000.00 $ 74,338.19 $ 79,338.19 $ 11,900.73
Escambia 233,465 $ 5,000.00 $ 26,266.20 $ 31,266.20 $ 4,689.93
Flagler 76,660 $ 5,000.00 $ 8,624.71 $ 13,624.71 $ 2,043.71
Franklin 9,579 $ 5,000.00 $ 1,077.69 $ 6,077.69 $ 911.65
Gadsden 35,184 $ 5,000.00 $ 3,958.41 $ 8,958.41 $ 1,343.76
Gilchrist 13,308 $ 5,000.00 $ 1,497.23 $ 6,497.23 $ 974.58
Glades 10,467 $ 5,000.00 $ 1,177.60 $ 6,177.60 $ 926.64
Gulf 13,289 $ 5,000.00 $ 1,495.09 $ 6,495.09 $ 974.26
Hamilton 11,886 $ 5,000.00 $ 1,337.25 $ 6,337.25 $ 950.59
Hardee 20,056 $ 5,000.00 $ 2,256.42 $ 7,256.42 $ 1,088.46
Hendry 28,254 $ 5,000.00 $ 3,178.74 $ 8,178.74 $ 1,226.81
Hernando 138,620 $ 5,000.00 $ 15,595.57 $ 20,595.57 $ 3,089.34
Highlands 80,814 $ 5,000.00 $ 9,092.05 $ 14,092.05 $ 2,113.81
Hillsborough 935,018 $ 5,000.00 $ 105,195.08 $ 110,195.08 $ 16,529.26
Holmes 15,645 $ 5,000.00 $ 1,760.16 $ 6,760.16 $ 1,014.02
Indian River 112,076 $ 5,000.00 $ 12,609.22 $ 17,609.22 $ 2,641.38
Jackson 39,839 $ 5,000.00 $ 4,482.12 $ 9,482.12 $ 1,422.32
Jefferson 12,013 $ 5,000.00 $ 1,351.53 $ 6,351.53 $ 952.73
Lafayette 7,085 $ 5,000.00 $ 797.10 $ 5,797.10 $ 869.57
Lake 235,311 $ 5,000.00 $ 26,473.88 $ 31,473.88 $ 4,721.08
Lee 497,885 $ 5,000.00 $ 56,015.02 $ 61,015.02 $ 9,152.25
Leon 221,514 $ 5,000.00 $ 24,921.64 $ 29,921.64 $ 4,488.25
Levy 32,172 $ 5,000.00 $ 3,619.54 $ 8,619.54 $ 1,292.93
Liberty 6,588 $ 5,000.00 $ 741.19 $ 5,741.19 $ 861.18
Madison 15,037 $ 5,000.00 $ 1,691.75 $ 6,691.75 $ 1,003.76
Manatee 256,550 $ 5,000.00 $ 28,863.40 $ 33,863.40 $ 5,079.51
Marion 267,117 $ 5,000.00 $ 30,052.25 $ 35,052.25 $ 5,257.84
Martin 120,572 $ 5,000.00 $ 13,565.07 $ 18,565.07 $ 2,784.76
Miami-Dade 1,950,707 $ 5,000.00 $ 219,466.12 $ 224,466.12 $ 33,669.92
Monroe 62,089 $ 5,000.00 $ 6,985.38 $ 11,985.38 $ 1,797.81
Nassau 57,395 $ 5,000.00 $ 6,457.28 $ 11,457.28 $ 1,718.59
Okaloosa 140,434 $ 5,000.00 $ 15,799.66 $ 20,799.66 $ 3,119.95
16 J I.
ATTACHMENT B to MOA 2018-2019-0003
FLORIDA DEPARTMENT OF STATE-DIVISION OF ELECTIONS
County Allocation of Help America Vote Act Funds-Federal Election Administration Activities-FY 2018-2019
Voting Age Amount- Amount- Amount- Amount-
Population Federal Election Federal Election Federal Election 15%
(2010 Census) Activities Funds Activities Funds Activities Funds Match By County
County Minimum Payment Voting Age Population Minimum+Per population Funds
Okeechobee 30,412 $ 5,000.00 $ 3,421.53 $ 8,421.53 $ 1,263.23
Orange 875,809 $ 5,000.00 $ 98,533.71 $ 103,533.71 $ 15,530.06
Osceola 198,269 $ 5,000.00 $ 22,306.44 $ 27,306.44 $ 4,095.97
Palm Beach 1,051,250 $ 5,000.00 $ 118,271.87 $ 123,271.87 $ 18,490.78
Pasco 366,124 $ 5,000.00 $ 41,191.12 $ 46,191.12 $ 6,928.67
Pinellas 753,654 $ 5,000.00 $ 84,790.55 $ 89,790.55 $ 13,468.58
Polk 460,359 $ 5,000.00 $ 51,793.12 $ 56,793.12 $ 8,518.97
Putnam 57,579 $ 5,000.00 $ 6,477.98 $ 11,477.98 $ 1,721.70
St.Johns 146,188 $ 5,000.00 $ 16,447.02 $ 21,447.02 $ 3,217.05
St. Lucie 215,781 $ 5,000.00 $ 24,276.64 $ 29,276.64 $ 4,391.50
Santa Rosa 115,163 $ 5,000.00 $ 12,956.52 $ 17,956.52 $ 2,693.48
Sarasota 319,713 $ 5,000.00 $ 35,969.61 $ 40,969.61 $ 6,145.44
Seminole 325,537 $ 5,000.00 $ 36,624.85 $ 41,624.85 $ 6,243.73
Sumter 84,908 $ 5,000.00 $ 9,552.65 $ 14,552.65 $ 2,182.90
Suwannee 32,102 $ 5,000.00 $ 3,611.67 $ 8,611.67 $ 1,291.75
Taylor 18,125 $ 5,000.00 $ 2,039.17 $ 7,039.17 $ 1,055.88
Union 12,525 $ 5,000.00 $ 1,409.14 $ 6,409.14 $ 961.37
Volusia 401,320 $ 5,000.00 $ 45,150.88 $ 50,150.88 $ 7,522.63
Wakulla 23,851 $ 5,000.00 $ 2,683.38 $ 7,683.38 $ 1,152.51
Walton 43,713 $ 5,000.00 $ 4,917.97 $ 9,917.97 $ 1,487.70
Washington 19,626 $ 5,000.00 $ 2,208.04 $ 7,208.04 $ 1,081.21
TOTAL 14,799,219 $335,000.00 $ 1,665,000.00 $ 2,000,000.00 $ 300,000.00
Formula for Allocation: Each county starts with a minimum payment($5,000). Remaining funds are allocated by voting age
population(2010 Census) in each county.
FY 2018-2019 Appropriation- Federal Election Administration Activities $2,000,000.00
Total funds to be allocated by minimum payment($5,000 x 67) $335,000.00
Total funds to be allocated by voting age population $1,665,000.00
Voting Age Population (2010 Census)-Statewide 14,799,219.00
Per voting age population funding multiplier 0.1125
1 6 J
ATTACHMENT E of MOA 2018-2019-0003
Certificate
County Match to Federal Grant Trust Funds
under the Help America Vote Act
William L. McDaniel Jr. Chairman of the Board of County Commissioners of
Collier County, Florida, do hereby certify that the Board of County Commissioners shall
provide the county Supervisor of Elections a minimum 15% county match* to the total
amount that the county Supervisor of Elections may request and receive from the State
in FY 2018-19. The Board shall appropriate an amount equal to or greater than
$5, 118.71 . 1 understand that if the Board fails to appropriate the matching funds,
all funds received from the State for this grant during the 2018-2019 state fiscal year,
including interest, will be required to be returned to the Department of State and shall
reevert •eral Gran Trus ds. ATI i-. I
' CRY i. \L ic�•,-:•, F k t. LEKK
a
' C' B- ''.
_...•. Air. BY'Thar • / L a. - 00 _.
Cha rman, Board of County Commissioners AttGS as to hairman's
S
signature only.
Z t , Approved as to Corm and legality
Date 1 G
Assistant County A t my
1V5 I
*See Attachment B to Memorandum of Agreement for Calculation
DS-DE 127
Revised 09/2018
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ATTACHMENT F to MOA#2018-2019-0003
Florida Single Audit Act Requirements
The administration of resources awarded by the Department of State to the Supervisor may be subject to
audits and/or monitoring by the Department of State,as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-133 and Section 215.97,
F.S., as revised(see"AUDITS"below), monitoring procedures may include, but not be limited to, on-site
visits by Department of State staff, limited scope audits as defined by OMB Circular A-133, as revised,
and/or other procedures. By entering into this agreement, the Supervisor agrees to comply and cooperate
with any monitoring procedures/processes deemed appropriate by the Department of State." In the event
the Department of State determines that a limited scope audit of the Supervisor is appropriate, the
Supervisor agrees to comply with any additional instructions provided by the Department of State staff to
the Supervisor regarding such audit. The Supervisor further agrees to comply and cooperate with any
inspections, reviews, investigations, or audits deemed necessary by the Chief Financial Officer (CFO) or
Auditor General.
AUDITS
PART I:FEDERALLY FUNDED
This part is applicable if the Supervisor is a State or local government or a non-profit organization as
defined in OMB Circular A-133,as revised.
1. In the event that the Supervisor expends $300,000 ($500,000 for fiscal years ending after
December 31, 2003) or more in Federal awards in its fiscal year,the Supervisor must have a single
or program-specific audit conducted in accordance with the provisions of OMB Circular A-133,as
revised. EXHIBIT 1 to this agreement indicates Federal resources awarded through the
Department of State by this agreement. In determining the Federal awards expended in its fiscal
year, the Supervisor shall consider all sources of Federal awards, including Federal resources
received from the Department of State. 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 Supervisor conducted by the Auditor General in accordance with the
provisions OMB Circular A-133,as revised,will meet the requirements of this part.
2. In connection with the audit requirements addressed in Part I, paragraph 1, the Supervisor shall
fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB
Circular A-133,as revised.
3. If the Supervisor expends less than$300,000($500,000 for fiscal years ending after December 31,
2003) in Federal awards in its fiscal year,an audit conducted in accordance with the provisions of
OMB Circular A-133, as revised, is not required. In the event that the Supervisor expends less
than$300,000($500,000 for fiscal years ending after December 31, 2003)in Federal awards in its
fiscal year and elects to have an audit conducted in accordance with the provisions of OMB
Circular A-133, as revised,the cost of the audit must be paid from non-Federal resources(i.e.,the
cost of such an audit must be paid from Supervisor resources obtained from other than Federal
entities).
PART II: STATE FUNDED
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Rule 69I-5.006,FAC
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ATTACHMENT F to MOA#2018-2019-0003
This part is applicable if the Supervisor is a non-state entity as defined by Section 215.97(2), Florida
Statutes.
1. In the event that the Supervisor expends a total amount of state financial assistance equal to or in
excess of$500,000 in any fiscal year of such Supervisor (for fiscal years ending September 30,
2004 or thereafter),the Supervisor must have a State single or project-specific audit for such fiscal
year in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of
Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and
for-profit organizations), Rules of the Auditor General. EXHIBIT 1 to this agreement indicates
state financial assistance awarded through the Department of State by this agreement. In
determining the state financial assistance expended in its fiscal year,the Supervisor shall consider
all sources of state financial assistance, including state financial assistance received from the
Department of State, other state agencies, and other non-state entities. State financial assistance
does not include Federal direct or pass-through awards and resources received by a non-state
entity for Federal program matching requirements.
2. In connection with the audit requirements addressed in Part II, paragraph 1, the Supervisor 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 Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations),Rules of the Auditor General.
3. If the Supervisor 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 Supervisor
expends less than$500,000 in state financial assistance in its fiscal year and elects to have an audit
conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the
audit must be paid from the non-state entity's resources(i.e.,the cost of such an audit must be paid
from the Supervisor's resources obtained from other than State entities).
The Internet web addresses listed below will assist recipients in locating documents referenced in
the text of this agreement and the interpretation of compliance issues.
State of Florida Department Financial Services(Chief Financial Officer)
www.fldfs.com/
State of Florida Legislature (Statutes, Legislation relating to the Florida Single Audit Act)
www.leg.state.fl.us
PART III: REPORT SUBMISSION
1. Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as
revised, and required by PART I of this agreement shall be submitted, when required by Section
.320(d),OMB Circular A-133,as revised,by or on behalf of the Supervisor directly to each of the
following:
A. The Department of State at each of the following addresses:
Department of State
Division of Elections
R.A.Gray Building,Ste 316
500 S.Bronough St.
Tallahassee,FL 32399-0250
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DFS-A2-CL
July 2005
Rule 69I-5.006,FAC
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ATTACHMENT F to MOA#2018-2019-0003
B. The Federal Audit Clearinghouse designated in OMB Circular A-133,as revised(the number
of copies required by Sections .320(d)(1)and(2),OMB Circular A-133,as revised,should be
submitted to the Federal Audit Clearinghouse),at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville,IN 47132
C. Other Federal agencies and pass-through entities in accordance with Sections .320(e)and(f),
OMB Circular A-133,as revised.
2. In the event that a copy of the reporting package for an audit required by PART I of this
agreement and conducted in accordance with OMB Circular A-133, as revised, is not required to
be submitted to the Department of State for the reasons pursuant to Section .320 (e)(2), OMB
Circular A-133, as revised, the Supervisor shall submit the required written notification pursuant
to Section .320 (e)(2) and a copy of the Supervisor's audited schedule of expenditures of Federal
awards directly to each of the following:
Department of State
Division of Elections
R.A.Gray Building,Ste 316
500 S.Bronough St.
Tallahassee,FL 32399-0250
3. Copies of financial reporting packages required by PART II of this agreement shall be submitted
by or on behalf of the Supervisor directly to each of the following:
A. The Department of State at each of the following addresses:
Department of State
Division of Elections
R.A.Gray Building,Ste 316
500 S.Bronough St.
Tallahassee,FL 32399-0250
B. The Auditor General's Office at the following address:
Auditor General's Office
Room 401,Pepper Building
111 West Madison Street
Tallahassee,Florida 32399-1450
4. Any reports, management letter, or other information required to be submitted to the Department
of State pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-
133, Florida Statutes, and Chapters 10.550(local governmental entities) or 10.650 (nonprofit and
for-profit organizations),Rules of the Auditor General,as applicable.
5. Supervisors, when submitting financial reporting packages to the Department of State 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 Supervisor in correspondence accompanying
the reporting package.
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Rule 69I-5.006,FAC
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ATTACHMENT F to MOA#2018-2019-0003
PART IV: RECORD RETENTION
1. The Supervisor shall retain sufficient records demonstrating its compliance with the terms of this
agreement for a period of 5 years from the date the audit report is issued, and shall allow the
Department of State, or its designee, CFO, or Auditor General access to such records upon
request. The Supervisor shall ensure that audit working papers are made available to the
Department of State,or its designee,CFO,or Auditor General upon request for a period of 3 years
from the date the audit report is issued, unless extended in writing by the Department of State.
NOTE: Records need to be retained for at least five years to comply with record retention
requirements related to original vouchers prescribed by the Department of State, Division of
Library and Information Services, Bureau of Archives and Records Management.
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Nx
0.
F:P 1.
ATTACHMENT F to MOA#2018-2019-0003
EXHIBIT - 1
FEDERAL RESOURCES AWARDED TO THE SUPERVISOR PURSUANT TO THIS
AGREEMENT CONSIST OF THE FOLLOWING:
NOTE:If the resources awarded to the Supervisor represent more than one Federal program,provide the
same information shown below for each Federal program and show total Federal resources awarded.
Federal Help America Vote Act—Catalog of Federal Domestic Assistance(CFDA) §90.401 Help America
Vote Act Requirements Payments
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS:
CFDA Number 90.401,Help America Vote Act Requirements Payments
Part 1 of Subtitle D of Title II (Sections 251-258) and Title III of Public Law 107-252,the Help America
Vote Act of 2002, Sections 301-305, and Sections 902 and 906. EAC has determined that the following
Office of Management and Budget guidelines apply: Cost Principles for State, Local, and Indian Tribal
Governments, 2 § CFR Part 225; Uniform Administrative Requirements for Grants and Cooperative
Agreements to State and Local Governments,OMB Circular A-110(amended 9/30/99).
State resources awarded to the recipient pursuant to this agreement consist of the following:
Not Applicable.
Matching resources for federal programs:
Not Applicable.
Subject to section 215.97,Florida Statutes:
Not Applicable.
Compliance requirements applicable to state resources awarded pursuant to this agreement are as
follows:
Not Applicable.
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ATTACHMENT F to MOA#2018-2019-0003
Exhibit- 2
December 3, 2014
CHIEF FINANCIAL OFFICER'S MEMORANDUM NO. 03 (2014 -2015)
SUBJECT: COMPLIANCE REQUIREMENTS FOR AGREEMENTS
This memorandum supersedes the Chief Financial Officer's Memorandum No.4 (2005-
2006)minimum requirements and confirms state agencies must follow for proper
accountability over state and federal resources. While the State is accountable to the federal
government, sub-recipients of federal financial assistance must be accountable to the State.
Recipients/sub-recipients of state financial assistance must also be accountable to the State.
FEDERAL FUNDS
This memorandum is applicable to discretionary grants,which the State receives from the
federal government. Applicability to federal entitlement programs or formula based awards
should be determined on a case by case basis pursuant to federal regulations for these
programs.
State agencies must determine whether they are passing on federal awards in the form of
federal financial assistance to sub-recipients or procuring goods and services from a
contractor. This determination is critical for the proper accountability over federal financial
assistance,which is passed on to sub-recipients. State agencies will use the criteria
established in Uniform Administrative Requirements, Cost Principles and Audit
Requirements for Federal Awards, Code of Federal Regulations Title 2, Part 200.330 to make
this determination. Agencies must retain documentation to support this determination.
In 2005 the Office of Federal Financial Management confirmed to the Department of
Financial Services, if the State receives an award of federal financial assistance in the form of
a grant or cooperative agreement, any sub-award for the purpose of the grant is subject to the
rules applicable to the grant, even if the sub-award is on a fixed price basis. Agreements
(sub-awards)with sub-recipients of federal financial assistance must require compliance with
the published requirements entitled Uniform Administrative Requirements, Cost Principles
and Audit Requirements for Federal Awards (also known as the Super Circular), Code of
Federal Regulations Title 2, Part 200(2 CFR, Part 200). This guidance supersedes and
consolidates the requirements from the Office of Management and Budget(OMB)Circulars
A-21,A-87,A-110,A-122,A-89,A-102 and A-133 and is effective for awards or increments
of awards issued on or after December 26, 2014.
The Super Circular also applies to sub-awards made by State and local governments to
an organization covered by the circular and provides that:
a. A grant may be charged only allowable costs resulting from obligations incurred
during the specified funding period.
6
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ATTACHMENT F to MOA#2018-2019-0003
b. Any balance of unobligated cash that has been advanced or paid that is not
authorized to be retained for other projects must be refunded to the federal
government.
c. Any funds paid in excess of the amount to which the recipient is finally determined
to be entitled, under the terms and conditions of the award, constitutes a debt to
the Federal government.
Agreements with vendors must be procured in a manner that ensures a fair and reasonable
price to the Federal government and compliance with applicable rules and regulations,
including, but not limited to:
a. 2 CFR, Part 200
b. Section 287.057, Florida Statutes(F.S.)
c. Section 215.917, F.S.
d. Section 216.3475, F.S.
(1) Non-competitive procurements and competitive procurements that result in less
than 2 responses must be supported by a detailed cost analysis. Cost must be
reasonable, necessary and allowable in accordance with state and federal laws,
rules and regulations. Agencies must maintain documentation to evidence the
agency's review of individuals cost elements included on the detailed budget
submitted by the person or entity awarded funding.
STATE FUNDS
State agencies must determine whether they are awarding state financial assistance to a
recipient or procuring goods and services from a vendor. State agencies will use the Florida
Single Audit Checklist for Non-state Organizations—Recipient/Sub-recipient vs Vendor
Determination to make this determination. Agencies must retain copy of the checklist.
Agreements with recipients of state financial assistance, even if awarded on a fixed price
basis, must require:
a. Compliance with Section 215.97,F.S.
b. Compliance with Section 215.971, F.S.
c. Expenditures of state financial assistance be in compliance with laws, rules and
regulations applicable to expenditures of State funds, including, but not limited
to,the Reference Guide for State Expenditures
Agreements involving the State University System,the Florida Community College System,
district school board, or charter schools using state funds must be procured in a manner that
ensures a fair and reasonable price to the State and compliance with applicable rules and
regulations, including, but not limited to:
a. Section 216.3475, F.S.
(1)Non-competitive procurements and competitive procurements that result in
less than two(2)responses must be supported by a detailed cost analysis. Cost
must be reasonable, necessary and allowable in accordance with state laws,rules
and regulation. Agencies must maintain documentation to evidence the agency's
review of individual cost elements included on the detailed budget submitted by
the person or entity awarded funding.
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T_'
16 J I
ATTACHMENT F to MOA#2018-2019-0003
b. May be fixed price contract that entitles the provider to receive compensation of
the fixed contract amount upon completion of all deliverables.
c. May be fixed rated per unit contract that entitles the provider to receive
compensation for each deliverable provided.
d. May be a cost reimbursable contract that entitles the provider to receive
compensation for actual allowable costs incurred in performing contract
deliverables.
e. May be a combination of b,c and d.
Agreements with vendors must be procured in a manner that ensures a fair and reasonable
price to the State and compliance with applicable rules and regulations, including,but not
limited to:
a. Section 287.057,F.S.
b. Section 216.3475,F.S.
(1)Non-competitive procurements and competitive procurements that result in
less than two(2)responses must be supported by a detailed cost analysis. Costs
must be reasonable, necessary and allowable in accordance with state laws,rules
and regulations. Agencies must maintain documentation to evidence the agency's
review of individual cost elements included on the detailed budget submitted by
the person or entity awarded funding.
Please contact the Bureau of Auditing at(850)413-5512 if you have any questions.
8
16 J 1
ATTACHMENT C to MOA 2018-2019-0003
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
LOWER TIER COVERED TRANSACTIONS
This certification is required by the regulations implementing Executive Order 12549,Debarment
and Suspension, 45 CFR 1183.35, Participants' responsibilities. The regulations were published as
Part VII of the May 26, 1988 Federal Register(pages 19160-19211). Copies of the regulations may be
obtained by contacting the person to which this proposal is submitted.
(BEFORE COMPLETING CERTIFICATION,READ INSTRUCTIONS ON REVERSE)
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it
nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certification,such prospective participant shall attach an explanation to this proposal.
Jennifer J. Edwards, Collier County Supervisor of Elections
Name and Title of Authorized Representative
Sigtiture E: Date
ED Form GCS-009,6/88
16 J 1
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set
out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed when this
transaction was entered into. If it is later determined that the prospective lower tier participant knowingly
rendered an erroneous certification, in addition to other remedies available to the federal government, the
department or agency with which this transaction originated may pursue available remedies, including
suspension and/or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the person to which this
proposal is submitted if at any time the prospective lower tier participant learns that its certification was
erroneous when submitted or has become erroneous by reason of changed circumstances,
4. The terms "covered transaction," «debarred," «suspended, ineligible," "lower tier covered transaction,"
"participant,""person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as
used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing
Executive Order 12549, You may contact the person to which this proposal is submitted for assistance in
obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered
transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person
who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered
transaction, unless authorized by the department or agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will include the clause
titled "Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion-Lower Tier
Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for
lower tier covered transactions,
YI
7. A participant in a covered transaction 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, A participant may decide the method and
frequency by which it determines the eligibility of its principals. Each participant may, but is not required to,
check the Nonprocurement List(Telephone Number).
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order
to render in good faith the certification required by this clause, The knowledge and information of a
participant is not required to exceed that which is normally possessed by a prudent person in the ordinary
course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered
transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,
ineligible, or voluntary excluded from participation in this transaction, in addition to other remedies available
to the federal government, the department or agency with which this transaction originated may pursue
available remedies, including suspension and/or debarment.
ED Form GCS-009,6/88
rs
3
16J I.
ATTACHMENT D of MOA 2018-2019-0003
Certificate of Equipment for Casting and Counting Ballots
We, Jennifer J. Edwards Supervisor of Elections and
William L. McDaniel Jr. Chairperson of Board of County Commissioners, of
Collier County, Florida, do hereby certify that prior to the receipt and use of fiscal year
2018-2019 NAVA funds for the purchase of State-approved or certified (whichever is applicable)
emerging or enhancing software or hardware technology as allowable per Attachment A, the i
I
county has purchased and made available sufficient equipment for casting and counting ballots
6
to meet the needs of the county electors for the next regularly scheduled general election. If
the Florida Department of State determines that there is insufficient equipment for casting and
counting ballots for the next regularly scheduled general election as herein certified, we shall
return the NAVA funds that were used to purchase other emerging or enhancing software and
hardware technology to the State.
r - Al:i F- �) r f!� .err Let
,
Supervisor of El tions f Cha/man, Board of County Commissioners
I
i
Date Date
Approved as to form and legality
ATTF ,
C '' AL f4 zEta CLERK
i A i t pi .-i.1 AMP
' Assistant County orncY x 1
DS DE 135 Attest as 0 8i ••r y3`�4
Revised 6/18
signature only: tom 1
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