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Agenda 11/18/2008 Item #16D 5 Agenda Item No. 16D5 November 18, 2008 Page 1 of 17 EXECUTIVE SUMMARY Recommendation that the Board of County Commissioners approve and authorize the Chairman to sign a subrecipient agreement providing for a $6,336 State of Florida, Department of Children and Families, Challenge Grant to The National Alliance on Mental Illness (NAMI) for homeless assistance. OBJECTIVE: To provide Challenge Grant funds to The National Alliance on Mental Illness for assistance such as, emergency rental assistance, psychiatric evaluations, medications, eye glasses, dental work, and for activities at the Sarah Ann Drop-In Center to benefit the homeless population. CONSIDERATIONS: The Collier County Housing & Human Services Department proposes to provide $6,336 from Challenge Grant funds for a grant to The National Alliance on Mental Illness. This project will provide opportunities for homeless individuals to participate in group activities, receive financial support, and other assistance in the form of psychiatric evaluations, medications, eye glasses, and dental work. On June 24, 2008 the BCC provided approval for a 2008 Challenge Grant application. The total amount of this award is $96,000 and will be passed through to four Collier County social service .~ agencies including: St. Matthew's House, The Shelter for Abused Women and Children, National Alliance on Mental Illness, and the Collier County Hunger and Homeless Coalition. NAMI's allocation of this grant is $6,336. FISCAL IMPACT: Approval of this agreement will provide a grant in the amount of $6,336 to The National Alliance on Mental Illness. No general funds are being utilized. GROWTH MANAGEMENT IMPACT: This project is consistent with the Growth Management Plan. LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney's Office. It is legally sufficient for Board action. - CMG RECOMMENDATION: That the Board of County Commissioners approve and authorize the Chairman to sign a subrecipient agreement providing for a $6,336 grant to The National Alliance on Mental Illness using the State of Florida, Department of Children and Families Challenge Grant funds. Prepared by: Shawn Tan, Grants Coordinator Housing and Human Services Department .- Page 1 of 1 Agenda Item No. 16D5 November 18. 2008 Page 2 of 17 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS Item Number: Item Summary: 1605 Meeting Date: Recommendation that the Board of County Commissioners approve and authorize the Chairman to sign a sub recipient agreement providing for a $6,336 State of Florida, Department of Children and Families, Challenge Grant to The National Alliance on Mental Illness (NAMI) for homeless assistance. 11/18/20089:0000 AM Approved By Marlene J. Foard Grants Coordinator Date Administrative Services Administrative Services Admin. 10/24/20086:02 PM Approved By Marla Ramsey Public Services Administrator Date Public Services Public Services Admin. 10/29/2008 3:47 PM Approved By OMS Coordinator Applications Analyst Date Administrative Services Information Technology 11/3/20088:37 AM Approved By Colleen Greene Assistant County Attorner Date County Attorney County Attorney Office 11/5/2008 6:02 PM Approved By Sherry Pryor Management & Budget Analyst Date County Manager's Office Office of Management & Budget 11/6/20088:25 AM Approved By James V. Mudd County Manager Date Board of County Commissioners County Manager's Office 11/6/200812:39 PM file://C:\AgendaTest\Export\116-November%20 18,%202008\ 16.%20CONSENT%20AGE... 11/12/2008 Agenda Item No. 16D5 November 18, 2008 Page 3 of 17 AGREEMENT BETWEEN COLLIER COUNTY AND NATIONAL ALLIANCE ON MENTAL ILLNESS State of Florida Homeless Assistance Challenge Grant# HFZ93 THIS AGREEMENT, is entered into this day of ,2008, by and between Collier County and the National Alliance on Mental Illness, a private not-for- profit corporation existing under the laws of the State of Florida, having its principal office at 5020 Tamiami North, Naples, FL 34103, and its Federal Tax Identification number as 65- 0047747, hereinafter referred to as "Subrecipient." WHEREAS, Collier County has entered into a Challenge Grant Agreement with the State of Florida Department of Children and Families hereinafter referred to as the "Challenge Agreement," in which Collier County was awarded the sum of $96,000 to provide homeless assistance as described in Collier County's application dated July 8, 2008; and WHEREAS, Collier County believes it to be in the public interest to provide certain activities required by the Challenge Grant Agreement to Collier County residents through the Subrecipient according to this Agreement, and all other terms and conditions as specified; and WHEREAS, Collier County, in accordance with the State Challenge Grant (SCG) terms, and Subrecipient desire to provide the activities specified in the SCG application; and WHEREAS, Collier County further agrees that it will use due diligence in supervising the Subrecipient to assure that funds are expended for the purposes intended and that a full accounting for these grant funds are made. NOW, THEREFORE, in consideration of the mutual covenants and obligations herein contained, including the attachments, and subject to the terms and conditions hereinafter stated, the Parties hereto understand and agree as follows: National Alliance on Mental Illness 2008 Challenge Grant Page I of 15 Agenda Item No. 16D5 November 18, 2008 Page 4 of 17 ARTICLE ONE: DEFINITION DEFINITIONS (I) "CCHHS" means Collier County Housing and Human Services Department and where applicable, its authorized representative(s). (2) "CCHHS Approval" means the written approval of the CCHHS Division Director or designee. (3) "COUNTY" means Collier County, and where applicable, it's authorized representative(s). (4) "DCF" means the State of Florida Depmtment of Children and Families as the agent for the State Office on Homelessness. (5) "SCG"means the State Challenge Grant as authorized in Section 420.622(4), Fla. Stat. (6) "SUBRECIPIENT" means National Alliance on Mental Illness. (7) "Homeless" as defined by Section 420.62 I, Fla. Stat. (8) "Program Beneficiaries" means homeless persons or those at risk of becoming homeless. (9) "Project" means the work contemplated to be performed as set forth in Exhibit "A." ARTICLE TWO: SCOPE OF SERVICES The Subrecipient, in a manner satisfactory to County, shall carry out or cause to be carried out all services described or referred to in Exhibit n A, n and shall submit each request for reimbursement using the cover sheet in Exhibit "B," which are attached hereto and made a part hereof. One hundred percent (100%) of the beneficiaries of a project funded under this Agreement must be persons who are homeless or at-risk of homelessness. ARTICLE THREE: TIME OF PERFORMANCE The effective date of this Agreement and all rights and duties designated hereunder are contingent upon the timely release of funds for this project by the State under the SCG. The effective date shall be the latest date of execution of this Agreement, and the services of the Subrecipient shall be undertaken and completed in light of the purposes of this Agreement. In any event, all services required hereunder shall be completed by the Subrecipient by June 30, 2009. No exceptions or extensions shall be granted. Any funds not obligated by the expiration date of this Agreement shall automatically revert to the County. National Alliance on Mental Illness 2008 Challenge Grant Page 2 of 15 Agenda Item No. 16D5 November 18, 2008 Page 5 of 17 ARTICLE FOUR: CONSIDERATION AND LIMITATION OF COSTS Subrecipient shall be reimbursed by the County using SCG funds for allowable costs determined by the County, in an amount not to exceed $6,336 (SIX THOUSAND THREE HUNDRED THIRTY SIX DOLLARS) for the services described in Exhibit "A." In the event the project costs exceed the stated amount, Subrecipient shall be responsible for the excess. The County reserves the right to inspect records and project sites to determine that reimbursement and compensation requests are reasonable. The County also reserves the right to hold payment until adequate docwnentation has been provided and reviewed, but such payments shall not be arbitrarily nor unreasonably withheld if adequate documentation as defined by DCF regulations is provided. Subrecipient may submit a final invoice upon completion with a letter requesting closeout of the project. Final payment shall be made after the County has determined that all services have been rendered, files and docwnentation delivered, and units have been placed in service in full compliance with DCF regulations, including submission of a completion report and documentation of eligible occupancy, property standards and applicable restrictions. Said determination shall be made within reasonable time, but no later than forty-five (45) days after Subrecipient has submitted its final invoice. The County shall have the right to review and audit all records of the Subrecipient pertaining to any payment by the County. Said records shall be maintained for a period of six years after completion. 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 state requirements. Subrecipient shall enter into contract for improvements with the lowest responsive and responsible bidder. Contract administration shall be handled by Subrecipient and monitored by the County, which shall have access to all records and documents related to the project. ARTICLE FIVE: PAYMENTS A. Invoices that have been approved by the Subrecipient may be paid directly by CCHHS, or CCHHS shall reimburse the Subrecipient. In both cases, payment will be limited to items in Exhibit A. B. Subrecipient shall submit payment requests to CCHHS using the cover sheet in Exhibit "8," which is attached hereto and made a part hereof. These requests will only be approved if: 1. The contractor's/vendor's requests for payment has been reviewed and approved by the Subrecipient as stated on the Request for Payment and the attached original invoice. In no event shall CCHHS provide advance funding to the Subrecipient or any other subcontractors /vendors hereunder. 2. For purposes of this section, originals of invoices, receipts, or other evidence of National Alliance on Mental Illness 2008 Challenge Grant Page 3 of 15 Agenda Item No. 16D5 November 18. 2008 Page 6 of 17 indebtedness shall be considered proper documentation. When original documents cannot be presented, the Subrecipient must adequately justify their absence, in writing, and furnish copies. 3. Upon receipt of the above enumerated documentation, and approval by Subrecipient, payment shall be made by the CCHHS. C. All disbursements by the Subrecipient must be fully documented to CCHHS so as to be available, on request, for inspection or audit in accordance with the provisions of Article Nine herein. D. The County shall pay the Subrecipient for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by CCHHS pursuant to the submittal of monthly progress reports as identified in Exhibit "C." E. Payment shall be made to the Subrecipient when requested as work progresses but not more frequently than once per month. F. Adherence to the work schedule, when appropriate, will be required unless modified in writing by the parties. G. Payment will be made upon receipt of a proper invoice and upon approval by the CCHHS, or its designee, and in compliance with Section 218.70, Fla. Stat., otherwise known as the "Local Government Prompt Payment Act". H. Subrecipient shall render a final and complete statement to CCHHS of all costs and charges for services not previously invoiced. The CCHHS shall not be responsible for payments of any charges, claims or demands of the Subrecipient received after June 30, 2009. ARTICLE SIX: COMPLIANCE WITH LOCAL AND STATE RULES, REGULATIONS AND LAWS During the performance of this Agreement, the Subrecipient agrees to comply with any applicable laws, rules, regulations and orders that may be applicable to SCG activities as defined in Section 420.621, Fla. Stat. through 420.626, Fla. Stat. No funds provided by this grant may be expended for the purpose of lobbying the legislature, the judicial branch or a state agency. Subrecipient shall permit DCF or CCHHS personnel or representatives to monitor the services, which are the subject of this SCG. The Subrecipient is required to participate in the local homeless management information system for the continuum of care in conformance with state and federal law. National Alliance on Mental Illness 2008 Challenge Grant Page 4 of 15 Agenda Item No. 16D5 November 18, 2008 Page 7 of 17 ARTICLE SEVEN: PROJECT PUBLICITY Any news release or other type of publicity pertaining to the project as stated herein must recognize the County as the recipient funded by the State of Florida Office on Homelessness through the Department of Children and Families as the entity that provided funds for the project. ARTICLE EIGHT: MANAGEMENT ASSISTANCE CCHHS will be available to the Subrecipient to provide guidance on SCG requirements. ARTICLE NINE: MAINTENANCE OF RECORDS Subrecipient shall maintain the following records. A. Subrecipient shall maintain such records, accounts, property records, and personnel records, as are deemed necessary by the CCHHS to assure proper accounting of project funds and compliance with the provisions of this Agreement. The SUB RECIPIENT shall maintain all necessary tinancial records as required by DCF Regulations and shall maintain the following financial records: I. An invoice and a copy of a warranty for all items purchased and paid for under standard Subrecipient procedures. 2. The current, prevailing Agreement, all project contracts, and corresponding billings. B. Subrecipient shall maintain project records and financial information so that the State could conduct an audit of SCG activities and funds. All audits covering the use ofSCG funds shall be provided to CCHHS. C. All records and contracts of whatever nature required by this Agreement shall be available for audit, inspection or copying at any time during normal business hours and as often as the CCHHS or DCF, may deem necessary, CCHHS shall have the right to obtain and inspect any audit pertaining to the performance of this Agreement made by any local, state or federal agency. Subrecipient shall retain all of its records and supporting documentation applicable to the Agreement for a period of not less than six (6) years after the starting date of this SCG Agreement or, if audit findings have not been resolved at the end of the six (6) year period, the records shall be retained until resolution of the audit findings. State auditors and any person duly authorized by DCF or CCHHS shall have the right to examine any of the said materials at any time during regular business hours. National Alliance on Mentallllness 2008 Challenge Grant Page 5 of 15 Agenda Item No. 16D5 November 18, 2008 Page 8 of 17 D. Subrecipient shall allow public access to all documents, papers, letters or other materials subject to the provisions of Chapter 119, Fla Stat., and made or received by the Subrecipient in conjunction with this SCG. ARTICLE TEN: MONTHLY REPORTS AND EV ALUA TION Subrecipient agrees to provide the CCHHS with monthly status repOlts no later than the 10'h of every month as shown in Exhibit C beginning the month of contract execution. A final report summarizing progress, timetables, and financial information for monitoring and evaluating all aspects of project activities must be provided prior to grant closeout. ARTICLE ELEVEN: INDEPENDENT AGENT AND EMPLOYEES Subrecipient agrees that, in all matters relating to this Agreement, 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 the law applicable to County employees relative to employment, hours of work, rates of compensation, leave, unemployment compensation and employee benefits. ARTICLE TWELVE: CONTRACTS All contracts made by the Subrecipient to carry out the activities described in Exhibit "A" shall be made in accordance with all applicable laws, rules and regulations stipulated in this Agreement. Any work or services contracted hereunder shall Qe specified by written contract or Agreement and shall be subject to each Article set forth in this Agreement and written approval ofCCHHS. ARTICLE THIRTEEN: CONFLICT OF INTEREST No employee, agent, consultant, officer or elected official or appointed official of the Subrecipient who exercises or have exercised any function or responsibility with respect to SCG activities assisted under or who are in the position to participate in a decision making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a SCG assisted activity, or have a financial interest in any contract, subcontract or agreement with respect to an SCG assisted activity or with respect to the proceeds of the SCG assisted activity, either for themselves or those with whom they have family or business ties, during their tenure or for one year thereafter. ARTICLE FOURTEEN: 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 National Alliance on Mental Illness 2008 Challenge Grant Page 6 of 15 Agenda Item No. 16D5 November 18, 2008 Page 9 of 17 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. ARTICLE FIFTEEN: INSURANCE Subrecipient agrees this coverage shall be provided on a primary basis. Unless expressly waived in writing by the County, Subrecipient shall provide the following: 1. COMMERCIAL GENERAL LIABILITY The SUBRECIPIENT shall fumish to the Housing and Human Services Department, Certificate(s) of Insurance evidencing insurance coverage that meets the requirements as outlined below: (a.) Workers' Compensation as required by Chapter 440, Florida Statutes. (b.) 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. (c) 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, ARTICLE SIXTEEN: WAIVER Subrecipient will not waive any of the duties and obligations under the contract without the express written consent of Collier County. ARTICLE SEVENTEEN: SALES TAX INDEMNIFICATION The State of Florida requires payment of sales tax on the transfer of tangible personal property. CCHHS will provide a resale certificate to be completed by the Subrecipient whereby Subrecipient represents and warrants that it has filed for and received an exemption from Florida Department of State for sales taxes. Subrecipient further agrees to indemnify and hold harmless Collier County from any and all taxes, penalties, interest and professional fees associated with the collection of any sales tax under the SCG. National Alliance on Mental Illness 2008 Challenge Grant Page 7 of 15 Agenda Item No. 16D5 November 18, 2008 Page 10 of 17 ARTICLE EIGHTEEN: AMENDMENT; NON-ASSIGNABILITY; MERGER AND SEVERABILITY The County may, at its discretion, amend this Agreement to conform to changes required by Federal, State, County, or DCF guidelines, directives, and objectives. Such amendments shall be incorporated by written amendment as a part of this Agreement and shall be subject to approval of the County. Except as otherwise provided herein, no amendment to this Agreement shall be binding on either party unless in writing, approved by the County and signed by each Party's authorized representatives. This Agreement may not be extended beyond JW1e 30, 2009, Subrecipient may not assign this Agreement without the prior written consent of Collier County and DCF. o This Agreement and its provisions merge any prior agreements, if any, between the parties hereto and constitutes the entire understanding. The parties hereby acknowledge that there have been and are no representations, warranties, covenants, or W1dertakings other than those expressly set forth herein, If any provision of this Agreement is held invalid, the remainder of this Agreement shall not be affected thereby if such remainder would then continue to conform to the terms and requirements of applicable law. ARTICLE NINETEEN: TERMINATION 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. 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. 3. TERMINATION DUE TO CESSATION In the event the grant to the County is suspended or terminated, this Agreement shall be suspended or terminated effective on the date that DCF specifies, 4, GRANT CLOSEOUT PROCEDURES Subrecipient's obligation to the COW1ty 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, National Alliance on Mental Illness 2008 Challenge Grant Page 8 of 15 Agenda Item No. 1605 November 18, 2008 Page 11 of 17 equipment, unspent cash advances, program income balances, and receivable accounts to the County), and determining the custodianship of records. ARTICLE TWENTY: HEADINGS All articles and descriptive headings of paragraphs in this Agreement are inserted for convenience only and shall not affect the construction or interpretation hereof. ARTICLE TWENTY ONE: NOTICES All notices required to be given under this Agreement shall be sufficient when delivered to Collier County Housing and Human Services Department at its office, presently located at 3050 North Horseshoe Drive, Suite 110, Naples, Florida 34104, and to Subrecipient when delivered to its office at the address listed on this Agreement. REMAINDER OF PAGE INTENTION ALL Y LEFT BLANK SIGNATURE PAGE TO FOLLOW National Alliance on Mental Illness 2008 Challenge Grant Page 9 of 15 Agenda Item No. 16D5 November 18, 2008 Page 12 of 17 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 November 18, 2008. ATTEST: Dwight E. Brock, Clerk of Courts BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA By: By: Tom Henning, Chairman Dated: (SEAL) - National Alliance on Mental Illness "~ . ~ Vt: t, IIIl td7r Ltf. .'f!1/ Filst WitWSs iI/ /Iv 1/ Y t;. / /iI'~ r Type/print witness name ~:/ Second Witness By: I~ f/u~ Subrecipient Signature k'er.-th(\/I'l ~",t(("/ ~'f.f.c.lAfl~( D\(!cfur Type Print Subrecipient name and title <;h~ IN.., 70" Type/print witness name Approved as to form and legal sufficiency: c@~ m A-rr20k-I? Assistant County Attorney Signature Celli ern IYJ, 6YeenL Type/Print Name National Alliance on Mental Illness 2008 Challenge Grant Page 10 of 15 Agenda Item No. 1605 November 18, 2008 Page 13 of 17 EXHIBIT "A" SCOPE OF SERVICES L THE SUBRECIPIENT AGREES TO; A. PROFESSIONAL SERVICES; The procurement process of the consultant shall also incorporate any sub-consultants, which shall be funded as reimbursable under the consultant's contract for services. Reimbursement for sub- consultants shall be at cost. Such sub-consultants may include surveyors, testing services, or others as deemed necessary for the nature of the project. B. PROJECT SCOPE; The purpose of this project is to provide the homeless population in Collier County with consumer care assistance, such as, emergency rental assistance, psychiatric evaluations, medications, eye glasses, and dental work; and for social activities at the Sarah Ann Drop-In Center. C. BUDGET; Challenge Grant funding for Consumer Care and Sarah Ann Drop-In Center Line Item; SCG Funds Consumer Care (emergency rental assistance/ Psychiatric Evaluations/ Medications/Eye Glasses/ Dental Work $5,336 Sarah Ann Drop-In Center $1,000 Total Budget $6,336 D. STAFFING; Provide list of staff and time commitments to be allocated to each activity specified in B (Project Scope) and C (Budget) above, if applicable. E. FORMER PROJECTS; Failure to adequately maintain any former State of Florida funded projects may result in the delay of processing reimbursement requests for ongoing activities or in the forfeiture of future State of Florida Challenge Grant funds. F. WORK SCHEDULE; The time frame for comoletion of the outlined activities shall be; Project to be complete no later than June 30, 2009 K. REPORTS; The SUB RECIPIENT shall submit detailed monthly progress reports to the CCHHS coordinator outlining the status of specific activities under the project. Each report must account for the total activity for which the SUBRECIPIENT is reimbursed with State National Alliance on Mental Illness 2008 Challenge Grant Page 11 of 15 Agenda Item No. 1605 November 18, 2008 Page 14 of 17 Challenge Grant funds, in part or in whole, and which is required in fulfillment of their obligations regarding the Project. The progress reports shall be used as an additional basis for CCHHS approval of invoices, etc. for reimbursement. L. COMPENSATION. The County shall pay the SUBRECIPIENTfor the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHS pursuant to the submittal of monthly progress reports as identified in Article Ten. Payments shall be made to the SUBRECIPIENT when requested as work progresses, but not more frequently than once per month. Adherence to the work schedule identified in Exhibit A, Article F, will be required, unless modified in writing by the parties. Payment will Payment will be made upon receipt of a proper invoice and upon approval by the or his designee, and in compliance with Section 2]8.70, Fla. Stat., otherwise known as the "Local Government Prompt Payment Act", National Alliance on Mental Illness 2008 Challenge Grant Page ]2 of15 Agenda Item No. 16D5 November 18, 2008 Page 15 of 17 EXHIBIT "B" National Alliance on Mental Illness ST ATE OF FLORIDA HOMELESS ASSISTANCE CHALLENGE GRANT REQUEST FOR PAYMENT SECTION I: REQUEST FOR PAYMENT Subrecipient Name: National Alliance on Mental Illness Subrecipient Address: 5020 Tamiami Trail North. Naples. FL 34103 Project Name: Challenge Grant Project No: HFZ93 Payment Request# Dollar Amount Requested: $ SECTION II: STATUS OF FUNDS I. Grant Amount A warded $ 6,336 2. Sum of Past Claims Paid on this Account $ o 3. Total Grant Amount Awarded Less Sum Of Past Claims Paid on this Account 4. Amount of Previous Unpaid Requests $ $ o 5. Amount of Today's Request $ 6. Current Grant Balance (Initial Grant Amount Awarded Less Sum of all requests) $ 7. If applicable amount held as retainage to date by the County, ifnot retained by the sub-recipient $ o I certify that this request for payment has been drawn in accordance with the terms and conditions of the Agreement between the County and the Sub-recipient. I also certify that the amount of the Request for Payment is not in excess of current needs. Signature Date Title Authorizing Grant Coordinator Supervisor Dept Director (approval authority under $14,999) (approval required $15,000 and above) National Alliance on Mental Illness 2008 Challenge Grant Page 13 of IS Agenda Item No. 1605 November 18. 2008 Page 16 of 17 EXHIBIT "C" National Alliance on Mental Illness STATE OF FLORIDA HOMELESS ASSISTANCE CHALLENGE GRANT MONTHLY PROGRESS REPORT Complete form for past month and submit to HHS staff by the 1 ri'l of the following month. Status Report for Month of Submittal Date: Project Name Project Number HFZ93 Activity Number Subrecipient: Contact Person Telephone: Fax: E-mail: Performance Measures 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. National Alliance on Mentallllness 2008 Challenge Grant Page 14 of 15 Agenda Item No. 16D5 November 18, 2008 Page 17 of 17 Progress on Completion ofthe Grant Activity(s) For each funded activity, provide a concise written narrative that compares work accomplished to date versus planned timeframes for completion of the activity as outlined in your application, Provide detailed explanations for any delays in carrying out a grant activity, its cause, and steps being taken to assure completion of the activity or use by .June 30, 2009. Should any activity be identified as facing the likelihood of NOT BEING COMPLETED BY JUNE 30, 2009, report on the activity, the cause, and corrective actions (amendment to reduce grant award, return of funds. identification of other uses that could be completed by June 30, 2009 etc,). National Alliance on Mental Illness 2008 Challenge Grant Page 15 of 15