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Agenda 04/28/2020 Item #16D 4 (Contract #19-7596 - Services for Seniors)04/28/2020 EXECUTIVE SUMMARY Recommendation to approve and award Contract #19-7596 Services for Seniors Respite Facility & Adult Day Care to Arden Courts -Lely Palms of Naples FL, LLC d/b/a Arden Courts of Lely Palms and Shifting Sands Adult Day Center, LLC and authorize the Chairman to sign the associated agreements. OBJECTIVE: To provide facility respite and daycare services to the elderly in Collier County. CONSIDERATION: The Older Americans Act (OAA) Programs are federal program initiatives that assist older persons and caregivers and are the only federally funded support service programs directed solely toward improving the lives of older people. These funds are received by Collier County through the Area Agency on Aging of Southwest Florida, Inc. (Agency). Program funds are administered by the Collier County Community and Human Services for Seniors Program (CCSS), which has been providing support services to Collier County's frail and elderly citizens for over thirty (30) years. Collier County as the Lead Agency is required to enter into their own agreements with area service providers to administer Respite Facility and Adult Day Care. Annually, services provided to program participants cost approximately $150,000. The County is reimbursed the cost of service through agreements between Collier County and the Agency. The Procurement Services Division released Request for Proposal (RFP) #19-7596 on three (3) separate instances (July 15, 2019, August 23, 2019, and October 1, 2019). On July 15th, 2019, the Procurement Services Division released the RFP to Eleven Thousand Eighty - Nine (11,089) vendors for the "Services for Seniors Program -Respite Care & Adult Day Care" project. Fifty (50) bid packages were downloaded, and two (2) submittals were received by the August 21, 2019 deadline. Procurement Services staff reviewed the bid responses and documents. Shifting Sands Adult Day Center was found to be responsive/responsible, while Arden Courts -Lely Palms of Naples, FL, LLC d/b/a Arden Courts of Lely Palms was non-responsive due to an incomplete Proposal. Community and Human Services (CHS) staff requested the RFP be resolicited to obtain respite services. On August 23, 2019, the Procurement Services Division released the proposal for the second time to Eleven Thousand Two Hundred Sixty -Four (11,264) vendors for the "Services for Seniors Program - Respite Care & Adult Day Care" project. Thirty -Six (36) bid packages were downloaded, and Two (2) submittals were received by the September 23, 2019 deadline. Procurement Services staff reviewed the bid responses and bidder's documents. Shifting Sands Adult Day Center was found to be responsive/responsible, while Arden Courts -Lely Palms of Naples, FL, LLC d/b/a Arden Courts of Lely Palms was non-responsive due to not submitting their complete proposal by the required Bid close. CHS staff requested the RFP be cancelled and resolicited to obtain needed respite services. On October 1, 2019, the Procurement Services Division released the proposal to Eleven Thousand Two Hundred and One (11,201) vendors for the "Services for Seniors Program -Respite Care & Adult Day Care" project. Thirty -Three (33) bid packages were downloaded and One (1) submittal was received by the October 21, 2019 deadline. Arden Courts -Lely Palms of Naples, FL, LLC d/b/a Arden Courts of Lely Palms was the only submitter and was deemed non-responsive due to an incomplete bid package. Collier County Procurement Ordinance No. 2017-08, Section 12, subsection 1: "Collier County reserves the right in any solicitation to accept or reject any or all bids, proposals or offers; to waive minor irregularities and technicalities; or to request 16.D.4 Packet Pg. 2089 04/28/2020 resubmission, .... Notwithstanding any other provisions of the Article, if none or only one responsive and responsible bid or proposal is received following any solicitation, the County Manager, or designee, reserves the right to reject all bids, proposals or offers and to negotiate with any responsible provider(s) to secure the best terms and conditions in the sole interest of the County unless otherwise provided by law." Based upon the three (3) separate attempts to reach out to a large number of qualified vendors, the Procurement Staff determined that it is in the best interest of the County to waive minor irregularities and technicalities and give Arden Courts -Lely Palms of Naples, FL, LLC d/b/a Arden Courts of Lely Palms the opportunity to complete its application Therefore, staff recommends that the Board of County Commissioners (Board) accept contracts with Arden Courts -Lely Palms of Naples, FL LLC d/b/a Arden Courts of Lely Palms and Shifting Sands Adult Day Center. During the RFP process, Arden Courts -Lely Palms of Naples, FL LLC d/b/a Arden Courts of Lely Palms who has been a provider of this service for over ten (10) years, had a change in their Director which attributed to the delay and inability to submit a complete proposal in the required time frame in the RFP process. The new Director of Arden Court is fully prepared to continue to provide the Respite Facility service in accordance with the contract requirements providing much-needed respite to caregivers. Shifting Sands provides a required service of Adult Day Care and has strong partnerships with other agencies who provide services to the elderly in our community providing activities to keep the clients active and engaged and was considered to be a responsive/responsible bidder in the July and August RFP solicitations. The agreements are for a three (3) year contract period, with the option of two (2) additional one (1) year renewal periods, consistent with the period of the grant funds awarded. Due to the sensitive and specialized nature of the services procured under this RFP, should the current awardee be unable to fulfill all the contract services, a supplemental RFP for services needed may be required. FISCAL IMPACT: Funds for vendor services and supplies are available in Human Services Grant Fund (707), projects 33657 and 33660 through funding received from OAA grant programs. New project numbers will be assigned as future agreements are received from the grantor, Area Agency on Aging. GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this Executive Summary. LEGAL CONSIDERATIONS: This Item is approved for form and legality and requires a majority vote for Board action. -JAB RECOMMENDATION: To approve award Contract #19-7596 Services for Seniors Respite Facility & Adult Day Care to Arden Courts -Lely Palms of Naples FL, LLC d/b/a Arden Courts of Lely Palms and Shifting Sands Adult Day Center LLC and authorize the Chairman to execute associated agreements. Prepared By: Wendy Klopf, Grant Coordinator, Community & Human Services Division ATTACHMENT(S) 1. 19-7596 ArdenCourts-LelyPalmsOfNaplesFL_Contract VendorSigned- (PDF) 2. 19-7596 Shifting Sands—Contract VendorSigned (PDF) 16.D.4 Packet Pg. 2090 3.19-7596 NORA (PDF) 4. 19-7596 Solicitation (PDF) 5. (Linked) 19-7596 Arden—Court—Proposal (PDF) 6. 19-7596 Shifting Sands—Proposal (PDF) 7. 19-7596 Arden CourtInsurance_3-3-20 (PDF) 8. 19-7596 Shifting Sands_COI_1-15-20 (PDF) 16.D.4 04/28/2020 Packet Pg. 2091 16. D.4 04/28/2020 COLLIER COUNTY Board of County Commissioners Item Number: 16.D.4 Doe ID: 11893 Item Summary: Recommendation to approve and award Contract #19-7596 Services for Seniors Respite Facility & Adult Day Care to Arden Courts -Lely Palms of Naples FL, LLC d/b/a Arden Courts of Lely Palms and Shifting Sands Adult Day Center, LLC and authorize the Chairman to sign the associated agreements. Meeting Date: 04/28/2020 Prepared by: Title: Operations Coordinator — Community & Human Services Name: Wendy Klopf 03/06/2020 3:35 PM Submitted by: Title: Manager - Federal/State Grants Operation — Community & Human Services Name: Kristi Sonntag 03/06/2020 3:35 PM Approved By: Review: Procurement Services Sandra Herrera Level 1 Purchasing Gatekeeper Procurement Services Sandra Herrera Additional Reviewer Community & Human Services Maggie Lopez Additional Reviewer Community & Human Services Kristi Sonntag CHS Review Operations & Veteran Services Kimberley Grant Level 1 Reviewer Public Services Department Todd Henry Level 1 Division Reviewer Grants Erica Robinson Level 2 Grants Review County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Public Services Department Steve Carnell Level 2 Division Administrator Review Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Budget and Management Office Ed Finn Additional Reviewer Grants Therese Stanley Additional Reviewer County Manager's Office Nick Casalanguida Level 4 County Manager Review Board of County Commissioners MaryJo Brock Meeting Pending Completed 03/09/2020 3:31 PM Completed 03/10/2020 5:55 PM Completed 03/13/2020 11:35 AM Completed 03/20/2020 5:55 PM Completed 03/23/2020 12:04 PM Completed 03/24/2020 1:12 PM Completed 03/25/2020 3:52 PM Completed 04/06/2020 10:04 AM Completed 04/07/2020 2:08 PM Completed 04/07/2020 2:43 PM Completed 04/07/2020 4:07 PM Completed 04/07/2020 7:01 PM Completed 04/14/2020 3:42 PM Completed 04/18/2020 11:09 AM 04/28/2020 9:00 AM Packet Pg. 2092 GENERAL SERVICE AGREEMENT (NON -SOLICITATION) # 19-7596 for Services for Seniors Program- Additional Services -Respite Facility & Adult Day Care THIS AGREEMENT, made and entered into on this day of 20_, by and between Arden Courts -Lely Palms of Naples FL, LLC d/b/a Arden Courts of Lely Palms , authorized to do business in the State of Florida, whose business address is 6125 Rattlesnake Hammock Rd, Naples, Florida 34113 (the "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: AGREEMENT TERM. The Agreement shall be for a three (3 ) year period, commencing ❑■ upon the date of Board approval or D en and terminating on three() year(s) from that date or until all outstanding Purchase Order(s) issued prior to the expiration of the Agreement period have been completed or terminated. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all of the terms and conditions contained in this Agreement for two (2 ) additional one (1 ) year(s) periods. The County shall give the Contractor written notice of the County's intention to renew the Agreement term prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term prior to the end of the Agreement term then in effect. 2. COMMENCEMENT OF SERVICES. The Contractor shall commence the work upon issuance of a 0 Purchase Order ❑ . 3. STATEMENT OF WORK. The Contractor shall provide services/products in accordance with the terms and conditions of this Agreement, ❑■ Exhibit A — Scope of Services, attached to this Agreement ❑N Exhibit B — Fee Schedule, attached to this Agreement and made an integral part of this Agreement. Services/products acquired through this Agreement have been authorized through the approval of a ❑ Single SeuFGe VVaiYeF, ❑ Sale SeuFGe VVaiveF, ❑ Exemption ftem the G.,mpetitiye PFE)Gess, Al Other: Collier County Procurement Ordinance No. 2017-08, Section 12, Subsection 1: Reserved Riqhts Page 1 of 17 General Service Agreement Non -Solicitation #2017-004 (Ver.2) 16. D.4.a W rn LO ti o) T11 Packet Pg. 2093 2 3.1 This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Parties, in compliance with the County's Procurement Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. 3.2 The execution of this Agreement shall not be a commitment to the Contractor to order any minimum or maximum amount. The County shall order items/services as required but makes no guarantee as to the quantity, number, type or distribution of items/services that will be ordered or required by this Agreement. THE AGREEMENT SUM. 0■ The County shall pay the Contractor for the performance of this Agreement based on Exhibit B- Fee Schedule, attached hereto and the price methodology as defined in Section 4.1. Payment will be made upon receipt of a proper invoice and upon approval by the County's Contract Administrative Agent/Project Manager, and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act". MENT ..- __ . ._ _. w _ w_. _ w__I'llI IN 0■ The County shall pay the Contractor for the performance of this Agreement based on Exhibit B- Fee Schedule, attached hereto and the price methodology as defined in Section 4.1. Payment will be made upon receipt of a proper invoice and upon approval by the County's Contract Administrative Agent/Project Manager, and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act". MENT ..- __ . ._ _. w _ w_. _ w__I'llI 4.1 Price Methodology (as selected below): A-1 Time and Materials: The County agrees to pay the contractor for the amount of labor time spent by the contractor's employees and subcontractors to perform the work (number of hours times hourly rate), and for materials and equipment used in the project (cost of Page 2 of 17 General Service Agreement Non -Solicitation 42017-004 (Ver.2) 16. D.4.a Packet Pg. 2094 16. D.4.a materials plus the contractor's markup). This methodology is generally used in projects in which it is not possible to accurately estimate the size of the project, or when it is expected that the project requirements would most likely change. As a general business practice, these contracts include back-up documentation of costs; invoices would include number of hours worked and billing rate by position (and not company (or subcontractor) timekeeping or payroll records), material or equipment invoices, and other reimbursable documentation for the project. 4.2 Any County agency may obtain services under this Agreement, provided sufficient funds are included in their budget(s). 4.3 Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of the Agreement. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this Agreement. Reimbursable iterns E)th-, el expense be LO c E Page 3 of 17 General Service Agreement Non -Solicitation #2017-004 (Ver.2) Q Packet Pg. 2095 16.D.4.a 5. SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. Collier County, Florida as a political subdivision of the State of Florida, is exempt from the payment of Florida sales tax to its vendors under Chapter 212, Florida Statutes, Certificate of Exemption # 85-8015966531 C. 6. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed or emailed to the Contractor at the following: Company Name: Arden Courts of Lely Palms Address: 6125 Rattlesnake Hammock Road Naples, Florida 34113 Authorized Agent: Renee Smith, Executive Director Attention Name & Title: Telephone: (239) 417-8511 E-Mall(s): 511mktg a@hcr-manorcare.com/ 449mktg@hcrmanorcare.com All Notices from the Contractor to the County shall be deemed duly served if mailed or emailed to the County to: Board of County Commissioners for Collier County, Florida Division Director: Kristi Sonntag Division Name: Community and Human Services Division Address: 3339 Tamiami Trail East Naples, Florida 34112 Administrative Agent/PM: Louise Pelletier Telephone: (239) 252-2696 E-Mail(s): Louise. Pelletier@colliercountyfl.gov The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 7. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 8. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits M necessary for the prosecution of the Work shall be obtained by the Contractor. The County r7 will not be obligated to pay for any permits obtained by Subcontractors. T" c as E M Page 4 of 17 U General Service Agreement Non -Solicitation #2017-004 (Ver.2) Q Packet Pg. 2096 16. D.4.a Payment for all such permits issued by the County shall be processed internally by the County. All non -County permits necessary for the prosecution of the Work shall be procured and paid for by the Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition, the Contractor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 9. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance. rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the Agreement of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 10. TERMINATION. Should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said Agreement for cause-, further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be the sole judge of non-performance. In the event that the County terminates this Agreement, Contractor's recovery against the County shall be limited to that portion of the Agreement Amount earned through the date of termination. The Contractor shall not be entitled to any other or further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. 11. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 12. INSURANCE. The Contractor shall provide insurance as follows: A. ■0 Commercial General Liability: Coverage shall have minimum limits of a $1,000,000 Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations-, Independent Contractors-, Products and Completed Operations and Contractual Liability. °; r` & ❑ Business Auto L,abtllt Coverage shall have minimum limits of $..._ . Pef._Occurrence-;_.Combined-- Sing le -..Limit for Bodily--injury--Liability-and E Page 5 of 17 ca General Smice Agreemcnt Non -Solicitation #2017-004 (Vcr 2) 4 Packet Pg. 2097 16.D.4.a P r-t-y-Dame-ge_Liab4i+r�---ha# ;c1tadL-�--Gwrled-Vehic4es; .Hired and -Non -Owned Veh fete --a nd-Efnplayee--Non-OwReFsbi p C. ■❑ Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $1,000,000 for each accident. D. ■* Professional Liability/Abuse Liability: Shall be maintained by the Contractor to ensure its legal liability for claims arising out of the performance of professional services under this Agreement. Contractor waives its right of recovery against County as to any claims under this insurance. Such insurance shall have limits of not less than $ 1,000,000 _each claim and aggregate. E- 0 -- Coverage--shall-haver ire rn-una l mjts of- aim. F. FMI M Coverage -shall have-m-iRimUm limits -of - - - per claire: Special Requirements: Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR, Collier County Government shall be listed as the Certificate Holder and included as an "Additional Insured" on the insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Contractor's policy shall be endorsed accordingly, Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. The Contractor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County thirty (30) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of- thirty (30) days prior written notice, or in accordance with policy provisions. Contractor shall also notify County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non -renewal or material change in coverage or limits received by Contractor from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Contractor shall ensure that all subcontractors comply with the same insurance requirements that the Contractor is required to meet. 13. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor shall defend, 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, whether resulting from any claimed breach of this Agreement by Contractor, any statutory or regulatory violations, or from personal injury, E M Page 6 of 17 R General Scrvicc Aptcement Nnn-S(1] 1crtaLinn -42017-0,) 4 { Vcr._) � a Packet Pg. 2098 16. D.4.a property damage, direct or consequential damages, or economic loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor or anyone employed or utilized by the Contractor 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. 13.1 The duty to defend under this Article 13 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Contractor, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Contractor. Contractor's obligation to indemnify and defend under this Article 13 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. 14. AGREEMENT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Community and Human Services Division 15, CONFLICT OF INTEREST. Contractor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Contractor further represents that no persons having any such interest shall be employed to perform those services. 16. COMPONENT PARTS OF THIS AGREEMENT. This Agreement consists of the following component parts, all of which are as fully a part of the Agreement as if herein set out verbatim: ❑ ■❑ Insurance Certificate(s), ❑■ Exhibit A Scope of Services, ❑■ Exhibit B Fee Schedule, ❑ subsequent quotes, a� ■❑ Other Exhibit/Attachment: Federal Contract Provisions, Grant Assurances and Certifications . 17. APPLICABILITY. Sections corresponding to any checked box expressly apply to the terms of this Agreement. 18. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this Agreement is subject to appropriation by the Board of County Commissioners. 19. 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 a 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. Violation of this provision may result in one or more of C6 the following consequences: a. Prohibition by the individual, firm, and/or any employee of r the firm from contact with County staff for a specified period of time; b. Prohibition by theCD E Page 7 of 17 General Service Agreement Non -Solicitation 42017-004 (Ver.2) Q Packet Pg. 2099 16. D.4.a individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any Agreement held by the individual and/or firm for cause. 20. COMPLIANCE WITH LAWS. By executing and entering into this Agreement, the Contractor is formally acknowledging without exception or stipulation that it agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to this Agreement, including but not limited to those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended; taxation, workers' compensation, equal employment and safety including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes, and the Florida Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(a) -(b) as stated as follows: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East, Suite 102 Naples, FL 34112-5746 Telephone. (239) 252-8383 The Contractor must specifically comply with the Florida Public Records Law to: 1. Keep and maintain public records required by the public agency to perform the service. a 2. Upon request from the public agency's custodian of public records, provide the z public agency with a copy of the requested records or allow the records to be o inspected or copied within a reasonable time at a cost that does not exceed the E cost provided in this chapter or as otherwise provided by law. a 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law y for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. o 4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public -� records required by the public agency to perform the service. If the Contractor a transfers all public records to the public agency upon completion of the contract, a the Contractor shall destroy any duplicate public records that are exempt or ti confidential and exempt from public records disclosure requirements. If the r Contractor keeps and maintains public records upon completion of the contract, CDE Page 8 of 17 0 General Service Agreement Non -Solicitation #2017-004 (Ver.2) Q Packet Pg. 2100 16. D.4.a the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. If Contractor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Contractor 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. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful Contractor extending the pricing, terms and conditions of this solicitation or resultant Agreement to other governmental entities at the discretion of the successful Contractor. 22, PAYMENTS WITHHELD. The County may decline to approve any Application for Payment, or portions thereof, because of defective or incomplete work, subsequently discovered evidence or subsequent inspections. The County may nullify the whole or any part of any approval for payment previously issued and the County may withhold any payments otherwise due to Contractor under this Agreement or any other Agreement between the County and Contractor, to such extent as may be necessary in the County's opinion to protect it from loss because of: (a) defective Work not remedied; (b) third party claims failed or reasonable evidence indicating probable fling of such claims; (c) failure of Contractor to make payment properly to subcontractors or for labor, materials or equipment; (d) reasonable doubt that the Work can be completed for the unpaid balance of the Contract Amount; (e) reasonable indication that the Work will not be completed within the Contract Time; (f) unsatisfactory prosecution of the Work by the Contractor; or (g) any other material breach of the Contract Documents. If any conditions described above are not remedied or removed, the County may, after three (3) days written notice, rectify the same at Contractor's expense. The County also may offset against any sums due Contractor the amount of any liquidated or unliquidated obligations of Contractor to the County, whether relating to or arising out of this Agreement or any other Agreement between Contractor and the County. 24. STANDARDS OF CONDUCT: PROJECT MANAGER SUPERVISOR EMPLOYEES. a The Contractor shall employ people to work on County projects who are neat, clean, well-groomed and courteous. Subject to the American with Disabilities Act, Contractor M shall supply competent employees who are physically capable of performing their r employment duties. The County may require the Contractor to remove an employee it CD E Page 9 of ] 7 General Service Agreement Nan -Solicitation #2017-004 (Ver.2) Q Packet Pg. 2101 MMM I. ■ _HE 24. STANDARDS OF CONDUCT: PROJECT MANAGER SUPERVISOR EMPLOYEES. a The Contractor shall employ people to work on County projects who are neat, clean, well-groomed and courteous. Subject to the American with Disabilities Act, Contractor M shall supply competent employees who are physically capable of performing their r employment duties. The County may require the Contractor to remove an employee it CD E Page 9 of ] 7 General Service Agreement Nan -Solicitation #2017-004 (Ver.2) Q Packet Pg. 2101 16. D.4.a Q deems careless, incompetent, insubordinate or otherwise objectionable and whose M continued employment on Collier County projects is not in the best interest of the County. 0 25. ❑ WARRANTY. GeRtFaGtoF eXpFeSS! warrants -that the go al s andIeF a - -- +�+ M r __.-r-.-.--_.___ ._.:ice a`_ n,....s�...,.i t�,....�,....,..•,+., r'.,�,+r..n+i.r nhnll nnrron4..._.i4 —+ -4— nf4or TMV!t O. f KJ#1 L Q i- ON W Z 36 WIM A - _ - . rim L M r __.-r-.-.--_.___ ._.:ice a`_ n,....s�...,.i t�,....�,....,..•,+., r'.,�,+r..n+i.r nhnll nnrron4..._.i4 —+ -4— nf4or TMV!t O. f KJ#1 L Q i- ON W Z 36 .....�...._...+.r.ar-�a��a���:ii - �r�rir i�!ii���i•...:rrrai:. LW C f� shall y t Page 10 of 17 General Service Agreement Non -Solicitation #2017-004 (Ver.2) Q Packet Pg. 2102 16. D.4.a 28. SUBMITTALS AND SUBSTITUTIONS. Any substitution of products/materials form specifications shall be approved in writing by the County in advance. 29. CHANGES IN THE WORK. The County shall have the right at any time during the progress of the Work to increase or decrease the Work. Promptly after being notified of a change, Contractor shall submit an estimate of any cost or time increases or savings it foresees as a result of the change. Except in an emergency endangering life or property, or as expressly set forth herein, no addition or changes to the Work shall be made except upon modification of the Purchase Order by the County, and the County shall not be liable to the Contractor for any increased compensation without such modification. No officer, employee or agent of the County is authorized to direct any extra or changed work orally. Any modifications to this Agreement shall be in compliance with the County Procurement Ordinance and Procedures in effect at the time such modifications are authorized. 30. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 31. ADDITIONAL ITEMSISERVICES. Additional items and/or services may be added to this Agreement in compliance with the Procurement Ordinance, as amended, and Procurement Procedures. 32. 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 Contractor 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 Contractor 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 to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 33. 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. a o� 34. ❑ v6 a. r r-. C E L Page 11 of 17 General Service Agreement Non -Solicitation #2017-004 (Ver.2) Q Packet Pg. 2103 16. D.4.a 0 AGREEMENT STAFFING. The Contractor's personnel and management to be utilized for this Agreement shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent persons will be utilized in the performance of the Agreement. The Contractor shall assign as many people as necessary to complete required services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet required services. 0 R. �- - - - -H ___ N-1.1 ■❑ ORDER OF PRECEDENCE (Grant Funded). In the event of any conflict between or among the terms of any of the Contract Documents and/or the County's Board approved Executive Summary, 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 County's discretion. 36. ASSIGNMENT. Contractor shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the obligations and responsibilities that Contractor has assumed toward the County. 37. SECURITY. The Contractor is required to comply with County Ordinance 2004-52, as 5 amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the -� costs of providing background checks by the Collier County Facilities Managementto a Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence r and employment verifications and other related records. Contractor shall be required to E Page 12 of 17 General Service Agreement Nan -Solicitation 42017-004 (Ver.2) Q Packet Pg. 2104 maintain records on each employee and make them available to the County for at least four (4) years. All of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor ID badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL-FMOPS@colliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of $500 per incident. (Intentionally left blank -signature page to follow) 16. D.4.a LO c E Page 13 of 17 General Service Agreement Non -Solicitation UM -004 (Ver.2) Q Packet Pg. 2105 . i -. IN (Intentionally left blank -signature page to follow) 16. D.4.a LO c E Page 13 of 17 General Service Agreement Non -Solicitation UM -004 (Ver.2) Q Packet Pg. 2105 IN WITNESS WHEREOF, the parties hereto, by an authorized person or agent, have executed this Agreement on the date and year first written above. ATTEST: crystal Kinzel, Clerk of Courts & Comptroller By: Dated: (SEAL) Contractor's Witnesses: Contractor's nrs�Witn ss �- TTypelprint witness namefi *antr_adc_t0fs �Seco�ndWit�ness TType/print witness name's Approved as to Form and Legality: '= County Attorne e_ L feito Print Name BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA By: Chairman Arden Courts -Lely Palms of Naples FL, LLC d/b/a Arden Courts of Lely Palms Contractor By)�Signature ftTypelprint signature an title's 16. D.4.a rn LO ti a) c a� Pale 1.4 of 17 E Geu"j Service A8reemcait Npti SolicitatfoF+#12017.004 (4cr.2) � U fC Packet Pg. 2106 Exhibit A Scope of Services ■❑ following this page (pages 1 through 2 ) ❑ this exhibit is not applicable 16. D.4.a W M LO ti o� r C E L Pagc 15 of 17 General Service Agreement Nan -Solicitation #2017-004 (Ver,2) Q Packet Pg. 2107 16.D.4.a EXHIBIT A SCOPE OF SERVICES 19-7596. "Respite Facillity & Adult Day Care" Collier County and CHS shall be used interchangeably. Contractor, Provider, and Vendor Agency shall be used interchangeably. The purpose of this award is for the provision of facility respite services and for the provision of adult day care to be delivered to Collier County persons sixty years and older under CCE, OAA and to qualified persons eighteen years or older under ADI. Unless otherwise stated, minimum hours of availability for adult day care are 8:00 am to 5:00 p.m. Monday through Friday, except for federal and state holidays. The hours for Respite Facility services and emergency respite would be available 24 hours/day, 365 days/year. Definitions, standards, and requirements of these services are included in the Department of Elder Affairs' Handbook (DOEA Handbook). The Contractor shall adhere to all requirements of Request for Proposal (RFP) #19-7529, in addition to maintaining adherence with the guidelines referenced in the current DOEA Handbook. Lack of knowledge of all requirements of a service listed in the proposal SHALL NOT relieve the Contractor of liability and obligations ander the agreement. Collier County Community & Human Services (CHS) division shall lead all service authorization and coordination. To comply with the requirements of the ADI, CCE, and OAA Programs, clients entering the service system will be assessed and prioritized by CHS. Upon determination of the service level to be provided, the CHS will offer the client a listing of service vendors for the specific service(s) outlined within their care plan. Upon the determination of the service, the service levels, and the selected Contractor, CHS will contact the vendor agency, and authorize the service, number of hours, and frequency. In keeping with the state policy of client choice of service providers, Collier County does not guarantee a minimum or maximum number of clients that will be referred, nor a minimum or maximum number of service hours that will be requested during the contract period. CHS shall send the agreed-upon Service Authorization to the chosen provider. These "service authorizations" or "service orders" must contain necessary client information, such as street address, telephone number, and services or items needed, as well as the name and telephone number of the CHS case manager authorizing the service. The County may do so through a competitive and publicly announced selection process, which shall be coordinated through the County's Procurement Division. Services shall be provided in the mariner described in the then current DOEA manual and outlined herein. Services covered by this agreement include, but are not limited to (should funding for additional Senior Services be identified, the County reserves the right to add to the resultant agreements the services, descriptions, rates, etc. by way of a contract addendum): I. Adult Day Care: A day program of therapeutic social and health activities and day services provided to adults who have functional impairments, in a Florida state licensed, protective environment that provides activities as a non -institutional environment as possible. Provides a safe environment for seniors who need daily supervision and a can engage with other seniors. Monday -Friday, Sam -Spm 2. Facility Respite Services: a nursing facility that provides 24-hour care/365 days and is licensed as a State of rn u� !9 Florida Licensed Nursing home. The facility will provide 24/7 nursing care and supervision for days authorized by r CHS to assist the senior's caregiver with respite services. m E 3. Establish protocols for contacting CHS Case Managers in emergency or unusual circumstances and include the documentation requirements (oral and written) in the Service Provider Application. a Page 1 of 2 Packet Pg. 2108 16.D.4.a 4. Provide disaster response protocols, plans and services: In the event of a natural disaster (hurricane, tropical storm, tornado, flood, heat wave, etc.), the provider will have staff available to serve those clients in critical need of services, as designated by the CHS Case Managers, 5. Establish a client grievance process: Each service provider agency must have a policy addressing client grievances and/or complaints. 6. Establish and provide staff training: All services provided with funding from DOEA require service delivery personnel to have general pre -service orientation and training specific to the service being provided. CHS is responsible for provision of the pre -service training on program and billing requirements to the vendors who are awarded the Proposal. Pre -service orientation also must include: • An overview of the aging process • An overview of the aging network • Communication techniques with the elderly • Observation of abuse, neglect, exploitation and incident reporting • Client confidentiality. NOTE: All "hands-on" service personnel must receive training emphasizing the necessity of Universal Precautions. Aides must have documentation of successful completion of 40 hours required training, and CNAs must have on file a copy of their State of Florida certification. In-service training hours and topics are to be provided at the discretion of the service provider agency and shall meet state requirements. 7. Compile and report program service delivery statistics and other data as identified by CHS. These are reported to the Area Agency on Aging and Department of Elder Affairs in accordance with the reporting requirements developed by the Department. CHS is responsible for entry of data in the Client Information and Registration Tracking System (CIRTS), which generates payment to the service provider agency. 8. Maintain complete and accurate records: Service delivery logs, at a minimum, must be legible and contain the name of client, type/s of services and date/s and hour/s of delivery. The client/caregiver must sign the log at the time of each service visit. The service worker must sign and date the log upon completion and submit it to the service provider agency. 9. Provide complete, clear and accurate invoices: Invoices must be submitted monthly by the following the week once the services have been provided and shall include the services provided. The service week is defined as Monday through Sunday. Monthly invoices will include: • Vendor name • Vendor address y • Vendor telephone number c • Client name v • Services authorized and the service dates • Number of service hours, cost per hour and total cost a • Person preparing the report and the date it was prepared CnP 10. Prepare for annual on-site compliance audits by CHS Monitoring Unit team as directed by the CHS Division C6 and/or grant requirements. r c m E Page 2 of 2 Q Packet Pg. 2109 Exhibit B Fee Schedule n following this page (pages 1 through 1 ) ❑ this exhibit is not applicable 16. D.4.a C 0 E L V Page 16 of 17 2 General Service Agreement Nan -Solicitation #2017-004 (Ver.2) Q Packet Pg. 2110 16. D.4.a EXHIBIT B -FEE SCHEDULE #19-7596 "Services for Seniors Program -Additional Services -Respite Facility Services & Adult Day Care ARDEN COURTS- LELY PALMS OF NAPLES FL, LLC Item Services Grant Service Cost Per Service. In -Kind 10% Reimbursement Rate Unit Unit (Cost your Service Unit (Cost. Per Unit (Amount company charges .. your. company the. County wilt.. . for the service) charges for the reimburse your service) company for a given service) 1 Respite CCE Per Hour $10.417 $1.04 $5.38 (Facility Based) ADI* OAA *The ADI program does not require an in-kind match contribution • Prices shall remain firm for the initial term of this contract. • Adult Day Care and Skilled Nursing services will not be provided under this Agreement, co as u� ti rn CD E U ca Q Packet Pg. 2111 Description: Other Exhibit/Attachment Federal Contract Provisions, Grant Assurances and Certifications FMI following this page (pages 1 through 24 ) ❑ this exhibit is not applicable 16. D.4.a to M LO ti r C W E L V Page 17 of 17 0 General Service Agreement Non -Solicitation 02017-004 (Ver.2) Q Packet Pg. 2112 16.D.4.a CollierCouniy Solicitation 19-7598 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (ADMINISTRATION ON AGING) AND FLORIDA. DFP kRTl17ENT OF ELDER AFFAIRS CFDA 93.OXX (CSFA 65.010) The supplemental coAditioas contained in this sectioa are itaterlded to cooperate with,, to supplement, and to modify the general conditions and other specifications. In cases of disagreement with any other section of this contract, the Supplemental Conditions shall govern. Gontr,,actgr 1Ctaeal7.s art Britity that receives a_co>Jtract. The services performed by the awarded Contractor shall be in compliance with the provisions of Title 45 CFR Part 75; and/or, 2 CFR Pati 200; and/or Title 45 Chapter XIII Part 1321 and/or other applicable regulations. It shall be the awarded Contractor's responsibility to acquh)e and utilize the necessary manuals and guidelines that apply to the work required to complete this protect. Ila general, 1) The Contractor (including all subcontractors) must insert these contract provisions in each lower tier contracts (e.g. subcontract or sub -agreement), 2) The contractor (or subcontractor) must incorporate the applicable regtritements of these contract provisions by reference for work done under any purchase orders, rental agreements and other agreements for supplies or services; 3) The piritne contractor is responsible for compliance with these contract provisions by any subcontractor, tower -tier subcontractor or sezviCe provider. FEDERAL STATUTORY AUTHORITY Older Americans ,A.ct of 1965 (OAA), as amended (42 U.S•C § 3001 et seq., as amended by Public Law 114-1.44; 106-501; Section20.41) OLDER AMERICANS ACT PROGRAM FUNDS OAA, Title Ill, Section 307(a)(10) OAA, Title III E - Supportive Services; Title 45 Public Welfare (45 CFR 1321) Chapter XIII Office of Human .Development Services, Department of Health and Human Services Part 1321.65 Grants to State and Co>txXtnunity Programs on Aging; Paa•t 1321.67 Service Contributions FLORIDA STATUTORY AUTHORITY J TITLE XXX (Social Welfare), Chapter 430 (Elder Affairs) u� t= 3 CONTRACT COMPLL4,NCE OVERVIEW ° Under the Florida Department of Elder Affair's Older Americans Act, the contractor must comply with the contract documentation, conforun to state arad AAA. policies, and oomply with federal and state statutory -a aad regulatozy requizements. (Ref, - .Department of Elder Affairs Programs and Services Handbook, Q Chapter 4 Page 22; July 2016: Alder Americans Act.). The contractor will comply with the intent of Title III to provide for formula grants to State agencies on aging to stimulate the development or enbancemeat of ti comprohepsive and comdiaatod corrLTtlunity-based systerns resulting, in a continuum of services to older persons r tivith special ernpbasis on older individuals with the greatest economic or social need, with particular attention }; to low-income minority individuals. (Ref. - Title SFS CFR 1321) � a� E ca (lief.; Flor{cfaDept.vfElderAjlair;r'Homeand FCP-I/KOvised01.-14-19 Q 10/112018 8.03 AM P Packet Pg. 2113 EXHIBIT LA 16.D.4.a Collier CPUnty 5oiinitation 19-76H FEDERAL CONTRACT PROVISIONS U.S. DEPARTMENT OF RE LTH AND HUMAN SERVICES FEDERAL CONTRACT PROVISIONS >$100A00 Administrative, Contractual, or Legal Remedies (Ref. 41 U.S.G. 1908,2 CFR § 200 Appendix II (A) Unless otherwise provided in this contract, all claims, countez-clam, disputes attd other matters is qu"tioo berween the local government and the contractor, arising out of or relating to this contract, or the breach of it, will be decided by arbitration, if the parties mutually agree, or in a Florida cornu of competent jurisdiction. Access to Records and Reports (Reference; 2 CFR § 200,333, 2 CFR § 200.336) The contractor/vendor agXees to maintain all boobs, records, accounts and reports required under this contract for a period of not less than three years after the date of termination or expiration of this contract, except in the event of litigation or settlement of claims arising from the performance of this contract, in which case the Contractor agrees to nxaititain same until the Purchaser, the Grantor Administrator, the Comptroller General, or any of their duly authorized representatives, have disposed of all such litigation, appeals, claims or exceptions related thereto. Furthermore, the County shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement of its Coatractors. Byrd Anti-Lonying,Amet dineat (31 U.S.C. X3.52) (Reference 2 CFR § 200 Appendix 11(J) Vendors must certify it will not and has not used Federal appzopriated funds have been paid or will be paid, by or to any person or organization for influencing or attempting to influence aii officer or employee of act agency, a Member of Congress, all officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contx act, the malting 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. The certification includes any lobbyiag with non -Federal funds that takes place in connection with obtaining any Federal award. Civil Rights The contractor or a subcontractor who is the recipient of Federal funds (or assumes others with whom it arranges to provide services or benefits 6 connection with any of its programs and activities or assures others with whom it arralages to provide services or benefits to participants or Pmploye.es) must comply with Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color, or national origin (45 CFR 80), and Statutes and Regulations erxforced by tb,e Office of Civil Rights, U.S. Department of Health and Iluman Services, as follow; Section 504 of the Rehabilitation Act of 1973, as amended (29 USC § 794), prohibits discrimblation against otherwise qualified individuals on the basis of disability in progratns and activities receiving financial assistance from HNS 45 CFR 84 and/or programs or activities conducted by ffj�S 45 CFR 85 in the provision of benefits and under the iQ As that does riot'. a. 8xclude a person with a disability from a program or activity; b_ Deny a person with a disability the benefits of a program or activity; c. Afford a person with a disability an opportunity to participate in or benefit from a benefit or service that is not equal to what is afforded others; d. Provide a benefit or service to a person with a disability that is not as effective as what is provided others; e. Provide different or separate benefits or services to a person with a disability unless necessary to provide benefits or services that are as effective as what is provided others; or, f; Apply eligibility criteria that tend to screen out pexsorxs with disabilities unless necessary for the provision of the service, program or activity. (iR&f,: FforidaDepr.nfElder-Affab-s'HomfcardCwhnnuniVRasodSemlicesHandbook) FCP-VReviscdUI-r4-JY co as W ti CD r s= CD E U ca Q 40/1/2045 8:08 AM P- 20 Packet Pg. 2114 16.D.4.a Collier county Solicitation 19-7596 EXHIBIT I.A FEDERAL CaNTRA.CT PROVISIONS Section 548 of the RehabWtation Act of X973, as amended, (29 USC § 794(d)) prohibits dlscrinz motion on the basis of disability in electronic and information technology as they relate to programs and activities conducted by HHS. The Age Discrimination Act of 1975, as amended (42 USC § 51.01) probibits discrimination on the basis of age in programs or activities receiving Federal financial assistance 45 CFR 90; and/or programs or services receiving HHS financial assistance 45 CFI, 91; Title 11 of the Americans with Dlsabilitles Act (28 CFR Part 35), relating to Nondiscrimination on the Basis of Disability in State and Local Govennnent Services 2010 ADA Standards for Accessible Design; The drug Abuso Office and Treatment ,Act of 1972 (P.L 92-255), as arneuded, relating to nondiscrimination on the basis of drug abuse; Tire Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L, 91-616), as amended, relating to nondiscdrnivation on the basis of alcohol abuse or alcoholism; (g) §523 and 527 of the Public Health Service Act of 191.2 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended, as relating to confidentiality of'aleobol and drug abuse patient records; Section 1908 of the Public Reaitb Service Act (42 USC § 300w-7) prohibits discritWnation oa the basis of age, race, color, national origin, disability, sex (gender), or religion in programs, services, and activities funded by Preveatative Health and Health Services Flock Grants. Federal Health Cane Conscience Pirotection Statutes (42 USC § 300a-7; 42 USC § 300a-7; 42 USC § 23 Su and the Weldon Amendment (Continuing Appropriations Resolutiou, Pub. L. No, 113-164, Sec. 101(a) (Sept. 19, 2015); regulation for the Enforcement of Federal Health Care Provider Cotascience Protection Laws, which prohibit recipients of certain Federal funds .&ora diserirnivating against certain health care providers who refuse to participate in certain health care services on religious or moral grounds. Section 1557 of the Affordable Care Act prohibits diseritztination oti the basis of disability by entities that operate a health program or activity. 45 CFR $Q. The contractor roust have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. Clean Air Act and Federal Water Pollution Control Act (Applicable to contracts containing federal funds arta over $100,000.) The Contractor shall comply with all applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42 United States Code (U.S.C.) 7401, et sect.), Section 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seg.), Executive Order 11738, as amended, and where applicable Ettviroturtental Protection Agency regulations, 2 Cl~R part 1500. The Contractor shall report at'ay violations of the above to tkre Agency. Computer Use and Social Media Policy The Florida Department of Elder ,Affairs bas ixrtpl McAted a Social Media Policy, in addition to its Computer Use Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all persowlel affiliated with third parties, such as, but riot limited to, contractor's and subcontractors. Any entity that uses the Department's computer resource systems must comply with the Department's policy regarding social media_ Social Media includes, but is trot lirziited to blogs, podeasts, discussion fonvns, Wlk is, RSS feeds, video sharing, social networks like MySpace, Faceboolc and Twitter, as well as content sbarizag Networks such as flickr and YouTube. This policy is available on the Department's website at; h :llc dela' a . tatc. .0 /doca/f anc'al. h to Debarment and Suspension (Reference 2 CFR § 200 Appendix 11 (1) M Contract awards that exceed the small purchase threshold and certain other contract awards shall not be made to ti parties listed on the government wide Exchided Parties List System in the System for Award Management °' (SAM), in, accozdsnce wi(b the QMB guidelines at 2 CFR 180 that iwplemerat fteoutive Orders 12549 (3 CFR Part 1986 Comp., p. 189) and 12689 (3 CFR Part 1989 Comp., p. 235), "Debarment and Suspension." The ami Excluded parties List System in SAM contains the names of parties debarred, suspended, or otherwise excluded E U 2 (Rcf.' ,Florida 17ept. of ElderAfj-airs'.ffonw acrd Coramaniey-13asmi Services Handbook) FCP-3liitevised R]»14-14 Q 10/1/2015 8:03 AM p' 21 Packet Pg. 2115 Collier County 16.D.4.a nVof€dtation 19-755 ' EXHIBIT 1.A FEDERAL CONTRACT PROVISIONS by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. The successful bidder, by administering each lower tier subcontract that exceeds $25,000 as a "covered transaction", must verify each lower tier participant of a "covered transactioW' under the project is not presently debarred or otherwise disqualified from participation in this federally assisted project. The Contractor shall comply with these provisions before doing business or entering into subcontracts receiving federal fU06 pursuant to this contract. The Contracto t shall complete, and sign. the Certifications and Assurances Attachment prior to the execution of this eomtact, Diversity (Reference 2 CFR § 200.321) The County is dedicated to fostering the continued development and economic growth of small, minority-, women-, and service -disabled veteran business enterprises. All contracting and subcontracting opportuvities afforded by this solicitation/contract are strongly encouraged to contribute as both, Contractors and Sub - Contractors. Firms may be required to submit documentation addressing diver'si'ty and describing the efforts being made to encourage the participation of small, minority-, women-, and service -disabled veteran, business enterprises. Information on Certified Minority Business )Nnterprises (CMBE) and Certified Service -Disabled Veteran Busizuess Enterprises (CSDVBF,) is available from the Office of Supplier Diversity at: htt :!/dms.mvfiorida.eotxt/other xa ramsJoffice of su Tier diversit osd/ Eocrgy Policy and Conservation Act - (Reference 2 CFR § 200 Appendix II (H) The Contractor shall comply with any mandatory standards and policies relating to energy efficiency which are contained in the F l o r i d a state, energy conservation plata issued in compbauce with the Energy Policy and Conservation Act (Pub. L. 94-163, 89 Stat, 871, 42 U.S.0 Section 6201) Equal Entploymeot Opportunity (,(appendix 11, 2 CFR Part 200; F_xecutive Order 11245, Equal Employment Opportunity, a5 amended by Executive Order 1.1375 and others, and Department of Labor 41 CFR Part 60; Dept. of Health and Human Services 45 CFR part 80; 45 CFR Part 92, if applicable). The Contractor shall not discriminate against any employee or applieatrt for employment because of race:, age, creed, color, sex or national origin. The Agency will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, age, creed, color, sex, or national origin. Such action shall include, but not be limited to, the following: Employment upgrading, deination, or transfer; recruitment or recruituacut advertising; layoff or terrrx cation; rates of pay or other forms of compensation; and select ort for training, including apprenticesbip. Contractors must insert a similar provisions in all subcontracts, except subcontracts for statl&rd commercial supplies or raw Materials. E -verily, Presidential Executive Order 1.2989; Florida Executive Order Number 11-116 Vendors/Contractors/Sttbcontracts: 1, Agree to utWze the U.S. Department of Homeland Security's E -verify system to verify the employment of all new employees hired by Contractor dining the contract term; and 2. Contractor shall include in related subcontracts a requirement that Subcontractors perf'orming work or providing services pursuant to the state contract utilize the E -verify system to verify employment eligibility of all new employees buired by the Subcontractor during the contract term. HIPAA Privacy Rules, 4 CFR tart 160 and Supairts A and E of part 164 The Third Party subrecipient wilt comply with 1IIPA,q, requirements to appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. to Immigration and Nationality Act M The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of tun - authorized aliens a violation of the Im-migration and Nationality Act (8 U.S_C. 1324x) and the lmxrtigration r Deform and Coatxol Act of 1986 ($ U.S.C. 1101). Such violation will be cause for unilateral cancellation of this contract by the Agency. ar E U ca (Rif.: Ffoiida Dept. ??fEfder Afj"airs' Hbnia and Senlau Ha"400k) FCP-4/kevised 0)-14-19 a 101112419 5:03 AM 22 Packet Pg. 2116 Collier County 16.D.4.a Sollcltation 19-7596 EXHIBIT I.A. FEDERAL CONTRACT PROVISIONS No Government Obligation to Third Parties - The Federal Government is not a party to this contract and is not subject to any obligations or liabilities to the non -Federal entity, contractor; or any other party pertaining to any matter resulting from the contract." Nondiscrimination The Contractor will. 1. not discriminate against any person in the provision of services or benefits under this contract or in employment because of age, race, religion, color, disability, national origin, marital status or sex ira corntpUaace with state and federal law and regulations. 2. ,A.ssumos others with whom it arranges to provide services or benefits in connection with any of its programs and activities are not disaxirxkiaatirrg against clients or employees because of age, race, religion, color, disability, national origin, marital status or sex. And 3. Assures others with whom it arranges to provide services or benefits to participants or employees in correction with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines, and standards. Pension Protection Qct of 2006 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization reporting requirements (Irfatzg a Form 990 or Form 994-N) and bas its tax exempt status revolted for failing to comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation. Procurement of Recovered Materials (Reference 2 CFR § 200.322) Cv]atractoi and subcontractor agree to comply with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act, and the regulatory ptovisions o£40 CFR Part 247. (1) In the performance of this contraM the Contractor shall make maximum use of products containing recovered materials that are EPA designated items unless tlie, product cannot be acquired (i) Competitively withixt a ftefrazrie providing for compliance with the contract performance schedule; (ii) Meeting contract performance requiremepts; or (iii) At a reasonable price. (2) Information about this requirement is available at EPA's Comprehensive Procurement Guidelines web siteLhttp://www.epa.gov/. The list of EPA -designate items is available at https:/Iw°vw.epa,gov/smm/comprehensive-procurement-guidoline-cpg-program. Program Fraud and False or Fraudulent Statements of )Related Acts The contracwt acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements) applies to the contractor's actions pertaining to this contract. Termination"for Cause and ConvWence See County's Standard Terror and Conditions. Trafficking in Persons The Contractor and subcontractors shall comply with Title 2 CFR Part 175 and 2 CFR §175-15 ,provisions applicable to a private entity, as defined in 2 CFR 175.25. Transparency Act Unless exempt under 2 CFR § 170. 11 O(b), the Contractor shall comply With the reporting requirements of the Transparenr,y Art as expressed in 2 Celt Part 170. (Ref ; fforida Depr, of.Elde+-4fYairs' h(omk and 0'M—Hiry-Ba.eed Sen'ices Handbook) 10/112019 8'03 AM co as u� ti rn T_ C E L V FQF-5Mavised 0444-14 Q p. 23 Packet Pg. 2117 16.D.4.a Collier county Solicitation 15-7586 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS STATE CONTRACT PROVISIONS Administrative Procedures Act, Section 120.57(2), F.S. Additional pr»cedures for porticular cases. In a (natter initiated as a result of agency action proposing to determine the substantial irlterests of a party, the party's timely petition for hearing may challenge the proposed agency action based on a rule that is an invalid exercise of delegated legislative authority or based on an alleged unadopted rule, Data Integrity and Safeguarding Information, Uniform Electronic Transactiotr Act, Section 669.50, F.S.; Public Recoz,ds Law, Chapter 119, Section 29, F.S The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using it the performance of this contract. An appropriate level of security includes approving and tracking all Contractor employees that request system or inforMatiort access and ensuring that user access has been removed from all temAn.ated employees. The Contractor, among other requirements, must anticipate and prepare for the loss ofinforrnation processing capabilities. Ali data and software shall be routinely backed up to ensure recovery from losses or outages of the computer system. The security over the backed -up data is to be as stria.-ent as the protection required of the p6mary systems. The Contractor shall ensure all Subeoatinctors maintain written procedures for computer system backup arad recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract, Discriminatory Vendors List, Section 287.134, F.S. In accordance with Section 287.134, Florida Statutes, ata entity or affiliate who has been placed on the discriminatory vendor list may not scbmit a bid on a contract to provide any goods or Services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a pnblie building or public work, may not submit bids on leases of real property to a public entity, way not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a cortiraot with any public entity, and may not transact business with aoy public entity, Equal Employment Opportunity The Contractor shall not discrinunate against any employee or applicant for employment because of race, age, creed, color, sex or national origin. The Agency will take affirmative action to ensure that applicants are employed, and that employees are treated during employtaegt, without regard to their race, age, creed, color, sex, or national origin. Such action shall include, but not be limited to, the following: Employment upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination,- rates of pay or other forms of compensation,; and selection for training, including apprenticeship. Contractors must insert a similar provision in all subcontracts, except subcontracts for standard conunercial supplies or raw materials. Wspeetions (Meals) The Contractor trust agree to notify the Nutrition Provider within 24 hours of any sanitation inspection and provide a copy of the report. Inspector General Cooperation, Section 20.055(5), F -S. The Parties agree to comply with Section 20.055(5), Florida Statutes, for the inspector general to have access to arry records, data and other information deemed taeeessary to carry out his or her duties and incorporate into all subcontracts the obligation to comply with Section 20.055(5), Florida Statutes_ Interest of Members of Congress No member of or delegate to the CoWess of the United States shall be admittie-d to any share or part of this ca>atract ar to any benefit arising therefrom, (R@f: FfvrfdaDept, ofElderAf}aira'Horrreand CammunityflasedSei,icesHandbook) FCP-6/Revised 0i-[4-19 co as u� ti rn CD E U ca Q 10/1/2019 8:03 AM p' 24 Packet Pg. 2118 16. D.4.a Collier County SoficitatiQn 19.759' EXHIBIT I.A )FEDERAL CONTRACT PROVISIONS Interest of Pub is Officials No mernber, officer, or employee of the public body or of a local public body during his texture or for two years thereafter shall have any interest, direct or indireot, in this contract or the proceeds thereof. For purposes of this provision, public body skaall include municipalities and othor political subdivisions of States; and public corporations, boards, and commissions established wider the laws of any Suite. No member. ok'fjcer, or employee of LbC MPO or of a local public body during his teauxe or for two years thereafter shall have any interest, direct or indirect, in this coutrgct or the proceeds thereof. Lobbying No f=ds received pursuant to this Agreement may be expended for lobbying the Legislature, the judicial branch or a state agency, (Ref,; Florida Depr.ofElderAffrairs'Horneand Conanunir}-BasedSemitesHandbook) 10/112019 8:03 AM w rn u� r` rn T" FCP-WRevised 0t-14-0 Q p. 25 Packet Pg. 2119 FX l .l l [311 1.1.3 l ll-1t.,A..1..K)N,� :1Nl_.} GRANT CERTIFICATIONS AND ASSURANCES THE FOLLOWING DOCUMENTS NEED TO BE RETURNED WITH SOLICITATION DOCUMENTS BY DEADLINE TO BE CONSIDERED RESPONSIVE. Pape Certification and Form GCA 2-6 Attachment III - Certifications and Assurances A- A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 75) B. Certification Regarding Lobbying (29 CFR Part 93 and 45 CFR Part 93) C. Nondiscrimination & Equal Opportunity Assurance (29 CFR Part 37 and 45 CFR Part 80) D. Certification Regarding Public Entity Crimes, section 287.133. F.S. E. Association of Community Organizations for Reform Now (ACORN) Funding Restrictions Assurances (Pub. L. 1 I 1-117) F. Scrutinized Companies Lists and No Boycott of Israel Certification, section 287.135. F.S. G. Certification Regarding Data Integrity Compliance for Contracts, Agreements, Grants, Loans and Cooperative Agreements H. Verification of Employment Status Certification I. Records and Documentation J. Certification Regarding Inspection of Public Records GCA - 7-9 Attachment IV — Assurances Non -Cons traction Programs GCA -10-13 Attachment V —Civil Rights Compliance Checklist GCA - 14 Attachment VII — Background Screening Affidavit of Compliance - Employer GCA - 15 Conflict of Interest Certification GCA - 16 Anticipated DBE, M/WBE or VETERAN Participation Statement GCA - 17 Bid Opportunity List for Commodities and Contractual Services and Professional Consultant Services 16. D.4.a co as u� ti rn CD E U ca Q Packet Pg. 2120 16.D.4.a EXB. 1.13 GRANT ASSURANCES AND CERTIFICATIONS ATTACHMENT III CERTIFICATIONS AND ASSURANCES Agency will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In performance of this contract, Contractor provides the following certifications and assurances: A. 5 and 45 CFR Part B. Cerfification Regardon'! Lobbying,�29 CFR Part 93 a0d 45 CFR Part 93) C. NoU discrimination & Egual Q11Vortunity Assurance (29 CFR Part 37 and 45 CFR Part 80) D. CerIffication Regarding Publicity . Crimes. section 287,133. F E. Associlition of Communily Organizations F. Scrutinized Companies Lists and No Bove Ott of Israel Certification seetion 287.135. F.S. G. Certification Regarding Data Integrily Compliancefor CSIntracts, Agreemenis, (;rauts, Loans, and C'nnnerative Agreements H. Verification of EmLiloyment Statu5 Certification 1. Records and Dociluientation J. Certification Regarding Inst ection of Public Reco_r_tIs A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS — PRIMARY COVERED TRANSACTION. The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by a Federal department or agency; 2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph A.2, of this certification; and/or Q 4. Have not within a three-year period preceding this application/proposal had one or more public transactions rn (Federal, State, or local) terminated for cause of default. ti rn The undersigned shall require that language of this certification be included in the documents for all subcontracts atall r tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients and contractors shall provide this certification accordingly. E s GCA - z a Packet Pg. 2121 I:X41.N0 GRANT ASSURANCES AND CERTIFICATIONS 16.D.4.a B. CERTIFICATION REGARDING LOBBYING --- CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS. The undersigned Contractor certifies, to the best of its knowledge and belief, that, 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 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. 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 employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The undersigned shall require that language of this certification be included in the documents for all subcontracts atall tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients and contractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. C. NON- DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART 80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal opportunity provisions of the following Iaws: 1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination _J against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability, w political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted n immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program z Z or activity. O 2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant 0 to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance M with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or L national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to J discrimination under any program or activity for which the Applicant receives Federal financial assistance from the rn Agency. 3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or v pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in m accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the -a United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, Q or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial Cn assistance from the Agency. r C d GCA - 3 E V r r.+ Q Packet Pg. 2122 16.D.4.a GRANT ASSURANCES AND CERTIFICATIONS 4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of, be excluded from participation in, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. 5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education program or activity for which the Applicant receives Federal financial assistance from the Agency. 6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment practices, including job application procedures, hiring, firing, advancement, compensation, training, and other terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe benefits, and all other employment-related activities. 7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or activity, and to all contracts Contractor makes to carry out the WIA Title I -- financially assisted program or activity. Contractor understands that the Agency and/or DOER and the United States have the right to seek judicial enforcement of the assurance. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients and contractors shall provide this assurance accordingly. D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S. Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list. Contractor understands and agrees that it is required to inform Agency immediately upon any change of circumstances regarding this status. E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING RESTRICTIONS ASSURANCE (Pub. L. 111-117). As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub. L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that appropriations made under Pub. L. 1 I I-117 are available under the conditions provided by Pub. L. 111-117. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub - recipients and contractors shall provide this assurance accordingly. F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION L 2.87.135, F.S. Q In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized Cn Companies that Boycott Israel List and that it is not participating in a boycott of Israel. os r GCA -4 C d E t V r r.+ Q Packet Pg. 2123 16.D.4.a GRANT ASSURANCES AND CERTIFICATIONS If this Contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135, F.S., Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it does not have business operations in Cuba or Syria. Contractor understands that pursuant to section 287.135, 1~.S., the submission of a false certification may result in the Agency terminating this contract and the submission of a false certification may subject Contractor to civil penalties and attorney fees and costs, including any costs for investigations that led to the finding of false certification. GCA -3 If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to this Contract. G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS 1, The Contractor and any Subcontractors of services under this contract have financial management systems capable of providingcertain information, including; (1) accurate, current, and complete disclosure of the financial results of each grant -funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all contract supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly. 2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the Contractor is dependent for data that is to be reported, transmitted, or calculated have been assessed and verified to be capable of processing data accurately, including year -date dependent data. For those systems identified to be non-compliant, Contractors will tape immediate action to assure data integrity. 3. If this contract includes the provision of hardware, software, firmware, microcode, or imbedded chiptechnology, the undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state will be verified for accuracy and integrity of data prior to transfer. a. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the Contractor agrees to immediatelymake required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the essence. 5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies arising from data integrity compliance issues. H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland -a Security's E -verify system to verify the employment eligibility of all new employees hired by Contractor during the Q contract term to perform employment duties pursuant to this contract, and that any subcontracts include an express Cn W requirement that Subcontractors performing work or providing services pursuant to this Contract utilize the E -verify "O ti system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract r term. c m E GCA -5 t V r r.+ Q Packet Pg. 2124 16.D.4.a Collier county Solioltation 15-7596 EX13. 1,13 GRANT ASSURANCES AND CERTIFICATIONS The Contractor shall require that the lajuguage of this certification be included is all sub -agreements, sub -grants, and other agreements/cont-acts and that all Subconmetors shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certification, is a prerequisite for making or entering into this Contract unposed by Circulars A-[ 02 and 2 CFR fart 200 and 215 (formerly OMB Circular A-110). I. RECORDS AND DOCUMENTATION The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all contract related records and documentation. The Contractor strap ensure the collection and maintenance of all program related information and documentation on any such system designated by the Agency. Maintenance includes valid exports and backups of all data and systems according to Agency standards. J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS 1. In addition to the requirements of sections 10.1 and 10.2 of the Standard Contract, sections 119.0701(3) and (4) F.S., and any other applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., arzd tate Agency is named in the civil action, Contractor agrees to iudemuify and hold hE=Wess the Agency for any costs incurred by the Agency and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made pursuant to Chapter 119, F.S., concerning this contract or services performedthereuader. a. Notwithstanding section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed between the Agency and state agencies or subdivisions defined in sectio.0 768.28(2), F.S. 2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions for wiy person, corporation, foundation, trust, association, group, or other organization, all the financial, business, and membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest Florida, Inc.) are public records. Section 119.07, F. S, states that every person wbo has custody of such a public recoxd shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumsta.nms. Additionally, T certify this organization does —does not_.larovide for institutional memberships, Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are available for inspection if applicable, as stated above. By execution of this contract, Contractor must include these provisions (A -J) in all related subcontract agreements (if applicable). By signing below, Contractor certifies that the representations outlined in parts A through J above are true and correct. %�kre ��thoWrizedRepresentative trcet Address Oz) j [( L V S -1 Contractor Date City, State, ip code GCA -4 co as W ti CD r a+ C CD E L V Q 1 0111201 9 8,03 AM P. 31 Packet Pg. 2125 EXHIBIT 1.13 16.D.4.a GRANT CERTIFICATIONS AND ASSURANCES ATTACHMENT IV ASSURANCES--NON-CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing' the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. 1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, throughany authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to; (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; N (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §1681-1683, and 1685-1686), which E prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment J Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, v relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse -a patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §3601 ct seq.), as amended, relating to Q nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific clon LO statute(s) under which application for federal assistance is being made; and 0) the requirements of any other r - nondiscrimination statute(s) which may apply to the application. r' c m CYCA-7 E v Q Packet Pg. 2126 EXHIBIT 1.11 1li.D.4.a GRANT CERTIFICATIONS AND ASSURANCES 7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of federal participation in purchases. 8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §1501-1508 and 7324-7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with federal funds. 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C, §874) and the Contract Work Hours and Safety Standards Act (40 U.S.C, §327-333), regarding labor standards for federally assisted construction sub -contracts. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(x) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or more. H. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Enviromnental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §7401 et seq.), (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §469a -I et seq.). 14. Will comply with P,L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1956 (P.L. 89-544, as amended, 7 U.S.C. §2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §4801 et seq.), which prohibits the use of Q lead- based paint in construction or rehabilitation of residence structures. to rn LO r` rn T" GCA -8 d E t V r Packet Pg. 2127 16.D.4.a Collier County Solicitation 19-759F EXHIBIT LB GRANT CERTIFICATIONS AND ASSURANCES 17. Will cause to be performed the required financial and compliance audits its accordance witli the Single ,Audit Act Amendments of 1996 and 2 CFR kart 2013. IS_ Will comply with all applicable requirements of all other federal laws, executive ordexs, regulations and policies governing this program. NUItIA$laD CEITTIk i'IEIV G OFFICIAL TITL,E� -- APPLICANT ORGANIZATION DATI~ SUBMITTED a GCA -9 10/112019 8:03 AM Q p. 34 Packet Pg. 2128 STATE 01F FLORIDA DEP Pf09Cam/Fa4Uty Name: state, zip Cole: COMOr County _ OF ELDER AI+k,A,IRS CIvm t3y: 16. D.4.a Solicitation 19-75AA COMPLIANCE CHECKLIST Bate: Telephone: PART It REAI] `W A.TTACMD INSTRUCT ONS FOR ILLUSTRATIVE INF011- IATION VMICR WILL HELP YOU COMPUTE THIS FORM. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: rki-na ix: u?.a r1 "to k FAF K JVl(p-NX hlL LANAA'JUi%N 1-,EQUUUNG MOR.L SPACE. 1. Is an Assurance of Compliance on file with DOEA? NIA YI~ NO ❑ ❑ 2. Compare the staff composition to the popftla6on. Is staff representative df the, population? NiA YES NO Fm qui?stio€3s 2-5, please indicate the Followit)g. White Black Hispanic Other Female Disabled Over 2.Population of area served Source oFdata 4. Are all benefits, services and facilities available to applicants and partioipauts in an equally effective manner regardless of race, sex, color, age, national origin, r4giort or disability? NIA ❑ 3,Slaff currently employed Source of data 4,Clients currently enrolled/registered Source of data S. Advisoryidoverroinsg Board if applicable Source of data rki-na ix: u?.a r1 "to k FAF K JVl(p-NX hlL LANAA'JUi%N 1-,EQUUUNG MOR.L SPACE. 1. Is an Assurance of Compliance on file with DOEA? NIA YI~ NO ❑ ❑ 2. Compare the staff composition to the popftla6on. Is staff representative df the, population? NiA YES NO 3, Are eligibility requirements for sErvices applied to clients and applicants without regard to race, color, national origin., sex, age, religion or disability? NIA ❑ Yl K NO ❑ 4. Are all benefits, services and facilities available to applicants and partioipauts in an equally effective manner regardless of race, sex, color, age, national origin, r4giort or disability? NIA ❑ Y S a``'l NO ❑ 5. For in-patient services, are room assi.gmuouts made without regard to rs,oe, color, national origin or disability? NIA XF,NO ❑ ❑ b- Is the prograzx,/facility accessible to uort-English speaking clients? NIA YF,$ NO ❑❑ 7. Are employees, applicants and participants inforraed of their protection against discrimination? If YES, how? Verbal Written J� Poster ❑ NIA Y S NO L]❑ < Q as u� ti S. Give the: number and current status of any discriminatioza complaints regarding services or employment filed against the program/facility. NUMBER E to Q 10/112019 8:03 AM p, 35 Packet Pg. 2129 16. D.4.a Collier County Solicitatiori 19-758" 5. Is the program/fvility physically accessible to mobility, hearing, and sight -impaired individuals? NIA vEQ NO ❑ Of ❑ PAIN IIT: THE FOLLOWING QUI'✓ TIONS APPLY TO PROGRAMSi AND FACILITIES VV'I H 15 OR MORE EMPLOYEES, IF NO EXPLAIN 10. Has a self-evaluation boon conducted to identify any barriers to serving disabled individuals, and to make any necessary modifications? YES NO ❑ 1 I . is there att established grievance pxocedwe that incorporates due process in the resolution of complaints? Yl; NO 91 0 12. Hasa person been designated to coordinate Section 504 compliance activities? 'YES NO 13, Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? Xis NO 14, Are auxiliary aids available to assure accessibility of services to hearing and sight -impaired individuals? YES NO W ❑ PART IV; FOR PROGRAMS OR FACILITIES Wfrlj'50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $30,000AO OR MORE. 15. Ido you have a written affirmative action plan? If NO, explain, 1w NO ❑ Revised AciVst 2010, Page 2 oN GCA . 11 2 co os ti rn C CD E t U Q t 011i2019 6:03 AM P. 3E Packet Pg. 2130 16.D.4.a INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST 1. Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves a specific target population such as adolescents, describe the target population. Also, define the type of service provided. 2. Enter the percent of the population served by race and sex. The population served includes persons in the geographical area for which services are provided such as a city, county or other regional area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific Islanders and American hidian/Alaskan Natives.) 3. Enter the total number of full-time staff and their percent by race, sex and disability, Include the effective date of your summary. 4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list their percent by race, sex and disability. Include the date that enrollment was counted. 5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no advisory or governing board, leave this section blank. 6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the contract language for DOER recipients and their sub -grantees, 45 CFR 80.4 (a). 7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the population is Hispanic, is there a comparable percentage of Hispanic staff? 8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability in the population, the program/facility has the responsibility to determine the reasons for such variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6). 9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a) and 45 CFR 80.1 (b) (2). 10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services, physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin, religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 GFR 80.3 (b). 11. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin or disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a different race, color, national origin, or disability, 45 CFR 80.3 (a). 12. The program/facility and all services must be accessible to participants and applicants, including those persons who � may not speak English. In geographic areas where a significant population of non-English speaking people live, Cn program accessibility may include the employment of bilingual staff, In other areas, it is sufficient to have a policy or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist in r the provision of services, 45 CFR 80.3 (a). m E s GCA - 12 Q Packet Pg. 2131 16.D.4.a 13, Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their participants, beneficiaries or any other interested parties. This should include information on their right to file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The information may be supplied verbally or in writing to every individual, or may be supplied through the use of an equal opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6 (d). 14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color, creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement, termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc. 15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility impaired individuals. 16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self- evaluation to identify any accessibility barriers. Self-evaluation is a four step process: a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not comply with Section 504. b. Modify policies and practices that do not meet Section 504 requirements. c. Take remedial steps to eliminate any discrimination that has been identified. d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been followed.), 45 CFR 84.6. 17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b). 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply with Section 504.45 CFR 84.7 (a). 19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads, and other appropriate written communication, 45 CFR 84.8 (a). 20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide equally effective services, 45 CFR 84.52 (d). 21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60 and Title VI of the Civil Rights Act of 1964, as amended. W rn LO DOEA Form 101-B, Revised August 2010 ti Q1 r C d E t V r GCA - 13 Q 4 Packet Pg. 2132 i7EPA 'mavi. F 16.D.4.a Collier County Solicitation 19-7596 BACKGROUND SCREENING. Affidavit of Compliance - Employer AUTHORITY: This form is required annually of all employers to comply with the attestation requirements set forth in section 435.05(3), Florida Statutes. The term "employer" means any person or entity required by law to conduct background screening, including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability Resource Centers, Lead Agencies, Long -Term Care ombudsman Program, Serving Health Insurance Needs of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires employees or has volunteers In service who meet the definition of a direct service provider. See §§ 435.02, 4N.0402, Fla, Stat. ➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide services to the elderly, has direct, face-to-face contact with a client while providing services to the client and has acress to the client's living area, funds, personal property, or personal Identification information as defined in s, 817.568. The term Includes coordlnators, managers, and supervisors of residential facilities; and volunteers." § 430.0442(1)(b), Fla, Stat, ATTESTATION; As the duly authorized representative of located at Street Address Fmployerilome City I, �flJ�.- L ►�tt�� do hereby affirm under penalty of perjury ame of Representative that the above named employer is in compliance with the provisions of Chapter 435 and section 30.0402, Florida Statutes, regarding level 2 background screening. A Slgnatu Trten five pate STATE OF FLORIDA, COUNTY OF Wft Sworn to (or affirmed) and subscribed before me this El Sy day of 0(�-r , 20J�, by (Name of Representative)who is personally known to me me or produced y as proof of identification. Print, TIf,-1�7 rn "�8 "M ;IRtary EX0454 42W2022 Notary Public DOEA Form 235, Affldwitcf Compliance- Employer, Effective April 2012 Form available at; http:/jelderaffairs,state.fE.ua/englishlbaciceroundscreenine.vhp 101112019 8 08 AM Sectlon 435.05(3), F.S. co as u� ti C6 r C CD E t U Q p. 39 Packet Pg. 2133 I':XIIIBIT 1.13 Collier County Solicitation No, Collier County 16.D.4.a Solicitation 19-75F GRANT -CERTIFICATIONS AND ASSURANCES EM COMT'Y F'>l�:terest:Cextilient�ort' ,' .,. �; . ��+Ior—my �pouso, �eppen(�Ien )hereby certify that to the test of my knowledge, neittreild, general partner, or any organization, for which I aM serving as an officer, director, trustee, general partner ox employee, of any person or orgatftatiorr with whom, I am negotiating or have an arrangement concelxdng prospective etnployrnent has a fman6al interest in this matter. I fuk'ther certify to the best of my knowledge that this matter will not affect the financial interests of any member of my household_ Also, to the best of xray knowledge, no member of my household) no relative with whorn l have a close relationship-, no one with whom my spouse, parent or dependent child has or seeks employment; and no organization with which I, am seeking a business relationship nor which l now serve actively or have served within the last year are parties or represent a party to the matter. I also aelmowledge my responsibility to disclose the acquisition of any financial or personal interest as described above that would be affected by the matter, and to disclose any ixxterest I, or anyone noted above, has in arxy person or organization that docs become involved in, or is affected at a later date by, the 1'U i Position Date PrIvar,:_y Act 5tatement Title I of the ;ethics in Govermnent Act of 1978 (3 U.S.C, App.), Executive Order 12674 and 5 CFR fart . 2634, Subpart I require the reporting of tWs information. The primary use of the information on this form J is for review by officials of The Justice Department to determine compliance with applicable federal u� conflict of interest laws aztd regulations_ ,Additional disclosures of the inufortuation on this report way be 3 made: (1) to a federal, state or local law enforcement agency if the Justice Department becomes aware of �j a violation or potential violation of law or regulations; (2) to a court or party in a court or federal � administrative proceeding if the government is a party or bi order to comply with a judge -issued � subpoena; (3) to a source when necessary to obtain infatmation relevant to a conflict of interest Q investigation or decision; (4) to the National Arcbives and Records Administration or the General M Services Administration in .records management inspections; (5) to the Office of Management and Budget ' ; during legislative coordination on private relief legislation; and (6) in response to a r'eques't for discovery r or ;Fox the appearance of a witrxess in a judicial or administrative proceeding, if the information is relevant to the subject matter. This confidential certification will not be disclosed to any requesting person unless authorized by .law. See also the 0GB/GOVT-2 executive branch -wide Privacy Act system of records. � ca GCA - 15 Q 1011/2019 5:03 AM p. 40 Packet Pg. 2134 EXHIBIT 11i Collier County 16.D.4.a Solicitalion 19-756 GRANTT RTIFICATION5AND ASSURANC8S COWER COUNJY ANTICIPATED UtSADVANTAGE0, 31+1lTWRITY, WOMEN OR VE,TEF" PARWIP'ATIIGN STATEMENT Sot- wilp be vjyfified- vj;VeT aw statuses W41 r*gdim rhe PA7MEto RSL W Proeudq a re%ised strtv_rrien'r w Wi}JldaSy—dacuT"mation that. validatrm a slot. WmE NAW KIMFEW WJM0J.;H CONTRA"DOLLAR AN: UPfr --`l R61 q Y1- � J 6571i�PgN4YEl#it6lPIfi4CEifiifidD!".ADV .pGRt vrrotAN X FSTFiERfii]VIiYOFTi715cR[9TRArT._ MINIDAnY Ott W4D MSN 9UrMfSS RMif ft9 SE? O8F7 'Y i t,~i G7A15Z'AIIfLTiIOr�7 Y (08F4%W-N,t6E) OA KAVE A SAA AU D15ADVAKT96GED EMS &U94N�5SSAC;�1YiNJCAnoNFROMTMES?�iALL6JUItIESS nAex? Y CONSU4Td1tON? Y AUMICANTRA<T1OW A fiTRViCE DISAb;W VFTM"A Wan Y N (YMKR? Y t4 SDa AA? Y _ JS URS$UOMM5 GNA REVIsrom?i V 14 ffVESRWVQHNUMBE a u.. DBE M/WBE WJ COMYRACTORORStl"LIM TYPE'rWWORKOR 06mx StNE♦IStvvLwR P BMcEmorct1ifTpj%cF 9lETEAdH NAME SPEtfaLTT {S�e.S�a�} DOLLdBAUclrrsrT DOLLARS TOTALS: . i a OAW TLtUoFsurrMir WR 47A1LSEJ� Sf]AIH.1'i7'E/R' ,. } 11EMAUL AOf)R,.F55 CW PRIME (,SSll6MUTL` I TIEL"HONI! Hummflt FMINU1i11UR �".��-`"�TO�igf� rs31 in r:�at�iar>�epoRinrrapatedi�enrhlbKpacVScipati�.irtfhdar;4j�.€vrsc#ti�untr®ct�. 7�neantid�aredDSEut A+ eamountisvoltmin tandtellnotbw4mepartof1hatuntsxcttuiltens.This`enr►?rtspL6esti6ntirteartte�eo€re�arasedaa SoWtatann. tfand wiYAn8l vd,:f daCountyQorWwt,the*me,NAlibadsked10updzWihe1rfoffn&ionlbrthigr2mcpmpTrarimfdes. k�SWi11[dfBltliC Flo W- �� , Sukxnnt.A�Anwritan fAA NoII 1h umm idmw a - DfFAffWFNTWA?gE 4nfiiER CDFti�liGT# R/pti�or PO G12kQTT '4lDG"irA7UJ COtiiRAC3' ACCERTED5Y, DA T4 GCA -16 Y XON to rn tti ti CD r C d E t V m r r+ a 10li120lq 8:03 AM4 Packet Pg. 2135 1AI-11.$IT LD Collier County 16.D.4.a Solicitation 19-75g GRANT C'.ERTIFICATI0714S AND ASSURANCES COWER LATitldTi 6Rfixr izF4 R{r4P r��.f oR�y GrpOPPOR MrFYL35TFORCOMMODITIES AND CONR ACrUAt.�jER jcrE, AND PROFES OKAL CC+tt ULTAUT $EWCE3 7 it sf l- laariiry rFRW ORMY d10 Okld—usinasses wta.,,inner3v r afa�s rrs mined an oatFe n� fiadEral raeyr sit sins{CEJ d' nor�lp stzm�s �Tnosi hove ih+r a tv cars ror+a7tt� ymir edergracxSTwsre�e er# assamtnce. �[�nze�arNsector/PfiCnE[�insuttanf� y --, �• � �{� � � —� sddmsta.d PFrasroetwurnbar- c4l Praanr�nemNyn}b�rlridnms.e■aAlaimbeF� � .,� TA&Mt belaw b kgeRded t4, bt i lisx9x; ❑ffgTN that am, o` ■;"-Ttl%Wt poetittiP3tAv n%1W Prq)--O nlrrpbemd a6u.* nie piss mugs indssde #1e ilran hidQfh ar xs ! � a�Acv�J t subs and svPtsCs�s rg3atlag for Pail ip al toN Peirce rsi�gy-a+cnxs attd t4r"ttanu miest ytrrvi& 6nftum3ftM for ttl Vb nrs 1r 2, 3,'Md 4, and, Owift prdNide,a W Wfprmatiaa tt eV five for Nth PArs Sr G. 7� ARtt & 7hfs inftn tttwst be au�rnt1t�13tvtts rha b'cti t��6t 1. fet3eta1T;WD UumGer F � - ' 6 bei 4..l w4al Craw Acwaipts 2. Mtn Name- A17 ] �'.C1r�'YLr"`Uvl {�'{�' �� µe•} ose less ttwn S 1 rn;Wan 5. phone d'iamber_ ��... '.,Y.��_� tietvrecn5�•lgmvif�+ 7-' 1 stdionntraciof 8e WW15:10-25 meA 06 1 "> buy 5t9bCRn34lrtsniIt&tVrare than..$ 94 rYso;w, 5. clear f�Ftp bU17lJsrYed1 7- i 0 Meetwe-n t 6•AS mJion E A. FeCkfalTPA iU Number 2- Fft:t! Narita: .6-El UBE "O"M $. Anmsal Gross Receipts � Ian big" $ 1 mlidtott � 3. Shone Numt�r; ISEb/leRa � 1^S ariJtisan � —..— +'i- ktadrt'fis , ` 5. Ye`i>•P{ryi1 E�rlistted; MLW"n S 5.10 MWOR Y 7_ 5095wardaw J {ietween $ 10-38 Miaripn. O S� [i8>= in #t, AnrYnel GYess Reeee�jts 5trtrCOTr"Si c ni Non -DU mom thin S Sa to"Wi0a U iess OW S 1 miNan 3 3. PhartePttaxt+6er'� J S. YeW FErMEstabtisttdd- LL _ _ rn �at�reen Sxxo ma{faas O d d 1. silbaysttraetiv DUE &. ,Annua14YasSAWefptr Q 2. *M Name• ..�. -- -- NOn-Det' Less than 91 mOnn fa Z A. AhaneNunitfot: - Y'+4ocetlaanS tsmtttbtt Q 9Etween5l-a�F7>kUil `~ HBPtweQn$5-1A"0jw A. addreAs ) T 7- sbmw Meetwe-n t 6•AS mJion E 5UbE*Jh5y.*zVt -Awe than $ 3.5 m&rign M — d 5. Ye`i>•P{ryi1 E�rlistted; d J 1. Fedzral Talc 10 t4umber_ S� [i8>= in #t, AnrYnel GYess Reeee�jts 2_ i'trm name: • • Non -DU iess OW S 1 miNan 3 3. PhartePttaxt+6er'� 8etrv+4n�,i-5�1'sm U a A&*eu �at�reen Sxxo ma{faas O d 7-� silbaysttraetiv t�•rreen 5 aa��s gttitlrxr 'a -- � subootcadratrr Y'+4ocetlaanS tsmtttbtt Q to 5- YKedPFV c t liytred: aj l` C1 T_ C O E L V GCA - 17 t4 Q 1011/2019 8:03 AM P. 42 Packet Pg. 2136 GENERAL SERVICE AGREEMENT (NON-SOLICITAT[O� # 19-7596 for Services for Seniors Program -Additional Services -Respite Facility & Adult Day Care THIS AGREEMENT, made and entered into on this day of 20_, by and between Shifting Sands Adult Day Center LLC I authorized to do business in the State of Florida, whose business address is 28410 Bonita Crossing Blvd, Suite 7, Bonita Springs, FL 34135 (the "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: AGREEMENT TERM. The Agreement shall be for a three (_L_) year period, commencing ■❑ upon the date of Board approval or Ej an and terminating on threq_) year(s) from that date or until all outstanding Purchase Order(s) issued prior to the expiration of the Agreement period have been completed or terminated. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all of the terms and conditions contained in this Agreement for two ( 2 ) additional one (1 ) year(s) periods. The County shall give the Contractor written notice of the County's intention to renew the Agreement term prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term prior to the end of the Agreement term then in effect. 2. COMMENCEMENT OF SERVICES, The Contractor shall commence the work upon issuance of a FRI Purchase Order ❑ 3. STATEMENT OF WORK. The Contractor shall provide services/products in accordance with the terms and conditions of this Agreement, 0 Exhibit A — Scope of Services, attached to this Agreement FEW Exhibit B — Fee Schedule, attached to this Agreement and made an integral part of this Agreement. Services/products acquired through this Agreement have been authorized through the approval of a ❑ , ❑, V I I f the f V ElM ExernptiGR fFGOho ❑■ Other: Collier County Procurement Ordinance No. 2017-08, Section 12, Subsection 1: Reserved Riqhts Page l of 17 General Service Agreement Non -Solicitation #2017-004 (Ver.2) Packet Pg. 2137 3.1 This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Parties, in compliance with the County's Procurement Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. 3.2 The execution of this Agreement shall not be a commitment to the Contractor to order any minimum or maximum amount. The County shall order items/services as required but makes no guarantee as to the quantity, number, type or distribution of items/services that will be ordered or required by this Agreement. 4. THE AGREEMENT SUM, o nr„ n h,o+H„ pie_ by the Gounty's GentraGt . " W The County shall pay the Contractor for the performance of this Agreement based on Exhibit B- Fee Schedule, attached hereto and the price methodology as defined in Section 4.1. Payment will be made upon receipt of a proper invoice and upon approval by the County's Contract Administrative Agent/Project Manager, and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act", yeal, based OR quoted pri 111m; el Q_-#GFI -Rd pw6yant4a A nc'F'TVYITTTfJ�77I—' al by _141'a -et A4wil-16461W u in GomplianGe with Gk-ptel 2-10 Fla. stato,.�,�0 known aG the DFOMP+ Paymon+4 1 GV 4.1 Price Methodology (as selected below): an- ­11 -of the is-autheF9zeE6 01 Time and Materials: The County agrees to pay the contractor for the amount of labor time spent by the contractor's employees and subcontractors to perform the work (number of hours times hourly rate), and for materials and equipment used in the project (cost of Pale 2 of 17 General Service Agreement Non -Solicitation #2017-004 (Ver.2) Packet Pg. 2138 materials plus the contractor's markup). This methodology is generally used in projects in which it is not possible to accurately estimate the size of the project, or when it is expected that the project requirements would most likely change. As a general business practice, these contracts include back-up documentation of costs; invoices would include number of hours worked and billing rate by position (and not company (or subcontractor) timekeeping or payroll records), material or equipment invoices, and other reimbursable documentation for the project. MIN ANN 4.2 Any County agency may obtain services under this Agreement, provided sufficient funds are included in their budget(s). 4.3 Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of the Agreement. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this Agreement. -W.M.1- _ ._ - - _ Page 3 of 17 General Service Agreement Non -Solicitation 112017-004 (Ver,2) Packet Pg. 2139 5. SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. Collier County, Florida as a political subdivision of the State of Florida, is exempt from the payment of Florida sales tax to its vendors under Chapter 212, Florida Statutes, Certificate of Exemption # 85-8015966531C. 6. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed or emailed to the Contractor at the following: Company Name: Shifting Sands Adult Day Center, LLC Address: 28410 Bontia Brossing Blvd, Suite 7 Bonita Springs, Florida 34135 Authorized Agent: Tamatha Wilkinson, Administrator Attention Name & Title: Telephone: 239 405-7009 E-Mail(s): Tammy@shiftingsandsseniorservices.com All Notices from the Contractor to the County shall be deemed duly served if mailed or emailed to the County to: Board of County Commissioners for Collier County, Florida Division Director: Kristi Sonntag Division Name: Community and Human Services Division Address: 3339 Tamiami Trail East Naoles. Florida 34112 Administrative Agent/PM: Louise Pelletier Telephone: (239) 252-2696 E-Mail(s): Louise. Pelletier@colliercountyfl.gov The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 7. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 8. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Contractor. The County will not be obligated to pay for any permits obtained by Subcontractors. Page 4 of 17 General Service Agreement Non -Solicitation 42017-604 (Ver.2) Packet Pg. 2140 Payment for all such permits issued by the County shall be processed internally by the County. All non -County permits necessary for the prosecution of the Work shall be procured and paid for by the Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition, the Contractor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 9. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance. rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the Agreement of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 10. TERMINATION. Should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said Agreement for cause-, further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be the sole judge of non-performance. In the event that the County terminates this Agreement, Contractor's recovery against the County shall be limited to that portion of the Agreement Amount earned through the date of termination. The Contractor shall not be entitled to any other or further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. 11. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 12. INSURANCE. The Contractor shall provide insurance as follows: A. ■0 Commercial General Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations-, Independent Contractors-, Products and Completed Operations and Contractual Liability. ❑ Business Auto L:abtllt Coverage shall have minimum limits of $..._ ........... Pef._Occurrenc.e-;_.Combined-- Sing le -..Limit for Bodily--injury--Liability-and Page 5 of 17 General Smice Agreemcnt Non -Solicitation #2017-004 (Vcr Packet Pg. 2141 Pyr-t-y-Dama-ge_Liab4i+r�-:ha#4nc1tadL-�--Gwrled-Vehic4es;.Hired and-Non-Owned Veh fete--a nd-Efnpleyee--Non-OwReFshi p C. ■❑ Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $1,000,000 for each accident. D. ■* Professional Liability/Abuse Liability: Shall be maintained by the Contractor to ensure its legal liability for claims arising out of the performance of professional services under this Agreement. Contractor waives its right of recovery against County as to any claims under this insurance. Such insurance shall have limits of not less than $ 1,000,000 _each claim and aggregate. E=-. 0 -- Coverage--shall-haver ire rn-una l mjts of- --.__ .�.__._._._._. _..._ ....per claim. F. FMI M Coverage-shall have-m-iRimUm limits-of - - - per claire: Special Requirements: Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR, Collier County Government shall be listed as the Certificate Holder and included as an "Additional Insured" on the insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Contractor's policy shall be endorsed accordingly, Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. The Contractor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County thirty (30) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of- thirty (30) days prior written notice, or in accordance with policy provisions. Contractor shall also notify County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non -renewal or material change in coverage or limits received by Contractor from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Contractor shall ensure that all subcontractors comply with the same insurance requirements that the Contractor is required to meet. 13. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor shall defend, 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, whether resulting from any claimed breach of this Agreement by Contractor, any statutory or regulatory violations, or from personal injury, Page 6 of 17 General Scrvicc Agrcemcnt Nnn-S(1] 10t;uinn -42017-0,) 4 { Vcr._ i Packet Pg. 2142 property damage, direct or consequential damages, or economic loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor or anyone employed or utilized by the Contractor 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. 13.1 The duty to defend under this Article 13 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Contractor, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Contractor. Contractor's obligation to indemnify and defend under this Article 13 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. 14. AGREEMENT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Community and Human Services Division 15. CONFLICT OF INTEREST. Contractor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Contractor further represents that no persons having any such interest shall be employed to perform those services. 16. COMPONENT PARTS OF THIS AGREEMENT. This Agreement consists of the following component parts, all of which are as fully a part of the Agreement as if herein set out verbatim: ❑ , ❑■ Insurance Certificate(s), F Exhibit A Scope of Services, X Exhibit B Fee Schedule, ❑ Fll� Other Exhibit/Attachment: Federal Contract Provisions, Grant Assurances and Certifications 17, APPLICABILITY. Sections corresponding to any checked box (1111) expressly apply to the terms of this Agreement. 18, SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this Agreement is subject to appropriation by the Board of County Commissioners. 19. 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. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the Page 7 of 17 General Service Agreement Non -Sol icitation #2017-004 (Ver.2) Packet Pg. 2143 individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any Agreement held by the individual and/or firm for cause. 20. COMPLIANCE WITH LAWS. By executing and entering into this Agreement, the Contractor is formally acknowledging without exception or stipulation that it agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to this Agreement, including but not limited to those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended; taxation, workers' compensation, equal employment and safety including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes, and the Florida Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(x) -(b) as stated as follows: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East, Suite 102 Naples, FL 34112-6746 Telephone: (239) 262-8383 The Contractor must specifically comply with the Florida Public Records Law to: 1. Keep and maintain public records required by the public agency to perform the service. 2. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. 4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public records required by the public agency to perform the service. If the Contractor transfers all public records to the public agency upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, Page 8 of 17 General Service Agreement Non -Solicitation #2017-004 (Ver.2) Packet Pg. 2144 the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. If Contractor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Contractor 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. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful Contractor extending the pricing, terms and conditions of this solicitation or resultant Agreement to other governmental entities at the discretion of the successful Contractor. 22. PAYMENTS WITHHELD, The County may decline to approve any Application for Payment, or portions thereof, because of defective or incomplete work, subsequently discovered evidence or subsequent inspections. The County may nullify the whole or any part of any approval for payment previously issued and the County may withhold any payments otherwise due to Contractor under this Agreement or any other Agreement between the County and Contractor, to such extent as may be necessary in the County's opinion to protect it from loss because of: (a) defective Work not remedied; (b) third party claims failed or reasonable evidence indicating probable fling of such claims; (c) failure of Contractor to make payment properly to subcontractors or for labor, materials or equipment; (d) reasonable doubt that the Work can be completed for the unpaid balance of the Contract Amount; (e) reasonable indication that the Work will not be completed within the Contract Time; (f) unsatisfactory prosecution of the Work by the Contractor; or (g) any other material breach of the Contract Documents. If any conditions described above are not remedied or removed, the County may, after three (3) days written notice, rectify the same at Contractor's expense. The County also may offset against any sums due Contractor the amount of any liquidated or unliquidated obligations of Contractor to the County, whether relating to or arising out of this Agreement or any other Agreement between Contractor and the County. 24, STANDARDS OF CONDUCT: PROJECT MANAGER SUPERVISOR EMPLOYEES. The Contractor shall employ people to work on County projects who are neat, clean, well-groomed and courteous. Subject to the American with Disabilities Act, Contractor shall supply competent employees who are physically capable of performing their employment duties. The County may require the Contractor to remove an employee it Page 9 of 17 General Service Agreement Non -Solicitation #2017-004 (Ver.2) Packet Pg. 2145 deems careiess, incompetent, insubordinate or otherwise objectionable and whose continued employment on Collier County projects is not in the best interest of the County. ■ r r i i w i �.. �� Page ip of 17 General Service Agreement Non -Solicitation 42017-004 (Ver,2) a� U D 3 Q 06 r .v tts LL (D Q U) m to M LO a LL W M a) 00 T r e Packet Pg. 2146 ......... -!MMMIUMMIM- - FRM -- -- -MZ- ■ r r i i w i �.. �� Page ip of 17 General Service Agreement Non -Solicitation 42017-004 (Ver,2) a� U D 3 Q 06 r .v tts LL (D Q U) m to M LO a LL W M a) 00 T r e Packet Pg. 2146 ......... -!MMMIUMMIM- - FRM ■ r r i i w i �.. �� Page ip of 17 General Service Agreement Non -Solicitation 42017-004 (Ver,2) a� U D 3 Q 06 r .v tts LL (D Q U) m to M LO a LL W M a) 00 T r e Packet Pg. 2146 28. SUBMITTALS AND SUBSTITUTIONS. Any substitution of products/materials form specifications shall be approved in writing by the County in advance. 29. CHANGES IN THE WORK. The County shall have the right at any time during the progress of the Work to increase or decrease the Work. Promptly after being notified of a change, Contractor shall submit an estimate of any cost or time increases or savings it foresees as a result of the change. Except in an emergency endangering life or property, or as expressly set forth herein, no addition or changes to the Work shall be made except upon modification of the Purchase Order by the County, and the County shall not be liable to the Contractor for any increased compensation without such modification. No officer, employee or agent of the County is authorized to direct any extra or changed work orally. Any modifications to this Agreement shall be in compliance with the County Procurement Ordinance and Procedures in effect at the time such modifications are authorized. 30, AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 31. ADDITIONAL ITEMSISERVICES. Additional items and/or services may be added to this Agreement in compliance with the Procurement Ordinance, as amended, and Procurement Procedures. 32, 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 Contractor 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 Contractor 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 to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 33. 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. Page 11 of 17 General Service Agreement Non -Solicitation 92017-004 (Ver.2) Packet Pg. 2147 0 AGREEMENT STAFFING. The Contractor's personnel and management to be utilized for this Agreement shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent persons will be utilized in the performance of the Agreement. The Contractor shall assign as many people as necessary to complete required services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet required services. a. - - ' 'Mid 11 ■- 0 ORDER OF PRECEDENCE Grant Funded . In the event of any conflict between or among the terms of any of the Contract Documents and/or the County's Board approved Executive Summary, 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 County's discretion. 36. ASSIGNMENT. Contractor shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the obligations and responsibilities that Contractor has assumed toward the County. 37. SECURITY. The Contractor is required to comply with County Ordinance 2004-52, as amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the costs of providing background checks by the Collier County Facilities Management Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBi fingerprint check, credit reports, education, residence and employment verifications and other related records. Contractor shall be required to Page 12 of 1'i General Service Agreement Non -Solicitation #2017-004 (Ver.2) Packet Pg. 2148 maintain records on each employee and make them available to the County for at least four(4)years. All of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor ID badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL-FMOPS@colliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of $500 per incident. (Intentionally left blank -signature page to follow) Page 13 of 17 General service Agreement Non -Solicitation 02017-004 (Ver.2) Packet Pg. 2149 -- - - (Intentionally left blank -signature page to follow) Page 13 of 17 General service Agreement Non -Solicitation 02017-004 (Ver.2) Packet Pg. 2149 INVITNESS WHEREOF, the parties hereto, by an authorized person of agent, have executed this Agreement on the date and year first written above, ATTES-T, Cry-stal Kinze.1,01erk of Courts & Comptroller Contractor's Witnesses, contractor' ILirAt Witness ---- 1 17- tness name -17 lec 1 did Witness C witness name'll, Approved as to Form and Legality: 0-A4x Cour"y Afforing-y Print Name 174 Pv" 14 o('17 Owle, -,0 I Packet Pg. 2150 1 BOARD OF COUNTY COMMISS)ONERS COLLIER COUNTY, FLORIDA By: Ca C, hairman >1 .3 M U- Shiffing Sands Adult Care Center, LLC CL Contractor LC) a. sign re U - we I'TypelpMt signature and Title' 0rn 0 Pv" 14 o('17 Owle, -,0 I Packet Pg. 2150 1 Exhibit A Scope of Services ❑■ following this page (pages 1 through 2 ) ❑ this exhibit is not applicable Page 15 of 17 General Service Agreement Non -Solicitation #2017-004 (Ver.2) Packet Pg. 2151 EXHIBIT A SCOPE OF SERVICES 19-7596 "Respite Facility & Adult Day Care" Collier County and CHS shall be used interchangeably. Contractor, Provider, and Vendor Agency shall be used interchangeably. The purpose of this award is for the provision of facility respite services and for the provision of adult day care to be delivered to Collier County persons sixty years and older under CCE, OAA and to qualified persons eighteen years or older under ADI. Unless otherwise stated, minimum hours of availability for adult day care are 5:00 am to 5:00 p.m. Monday through Friday, except for federal and state holidays. The hours for Respite Facility services and emergency respite would be available 24 hours/day, 365 days/year. Definitions, standards, and requirements of these services are included in the Department of Elder Affairs' Handbook (DOEA Handbook). The Contractor shall adhere to all requirements of Request for Proposal (RFP) #19-7524, in addition to maintaining adherence with the guidelines referenced in the current DOER Handbook. Lack of knowledge of all requirements of a service listed in the proposal SHALL NOT relieve the Contractor of liability and obligations under the agreement. Collier County Community & Human Services (CHS) division shall lead all service authorization and coordination. To comply with the requirements of the ADI, CCE, and OAA Programs, clients entering the service system will be assessed and prioritized by CHS. Upon determination of the service level to be provided, the CHS will offer the client a listing of service vendors for the specific service(s) outlined within their care plan. Upon the determination of the service, the service levels, and the selected Contractor, CHS will contact the vendor agency, and authorize the service, number of hours, and frequency. In keeping with the state policy of client choice of service providers, Collier County does not guarantee a minimum or maximum number of clients that will be referred, nor a minimum or maximum number of service hours that will be requested during the contract period. CHS shall send the agreed-upon Service Authorization to the chosen provider. These "service authorizations" or "service orders" must contain necessary client information, such as street address, telephone number, and services or items needed, as well as the name and telephone number of the CHS case manager authorizing the service. The County may do so through a competitive and publicly announced selection process, which shall be coordinated through the County's Procurement Division. Services shall be provided in the manner described in the then current DOEA manual and outlined herein. Services covered by this agreement include, but are not limited to (should funding for additional Senior Services be identified, the County reserves the right to add to the resultant agreements the services, descriptions, rates, etc. by way of a contract addendum): 1. Adult Day Care: A day program of therapeutic social and health activities and day services provided to adults who have functional impairments, in a Florida state licensed, protective environment that provides activities as a non -institutional environment as possible. Provides a safe environment for seniors who need daily supervision and can engage with other seniors. Monday -Friday, 8am-5pm 2. Facility Respite Services: a nursing facility that provides 24-hour care/365 days and is licensed as a State of Florida Licensed Nursing home. The facility will provide 2417 nursing care and supervision for days authorized by CHS to assist the senior's caregiver with respite services. 3. Establish protocols for contacting CHS Case Managers in emergency or unusual circumstances and include the documentation requirements (oral and written) in the Service Provider Application. Page 1 of 2 Packet Pg. 2152 4. Provide disaster response protocols, plans and services: In the event of a natural disaster (hurricane, tropical storm, tornado, flood, heat wave, etc.), the provider will have staff available to serve those clients in critical need of services, as designated by the CHS Case Managers. 5. Establish a client grievance process: Each service provider agency must have a policy addressing client grievances and/or complaints. 6. Establish and provide staff training: All services provided with funding from DOEA require service delivery personnel to have general pre -service orientation and training specific to the service being provided. CHS is responsible for provision of the pre -service training on program and billing requirements to the vendors who are awarded the Proposal. Pre -service orientation also must include; • An overview of the aging process • An overview of the aging network • Communication techniques with the elderly • Observation of abuse, neglect, exploitation and incident reporting • Client confidentiality. NOTE: All "hands-on" service personnel must receive training emphasizing the necessity of Universal Precautions. Aides must have documentation of successful completion of 40 hours required training, and CNAs must have on file a copy of their State of Florida certification, In-service training hours and topics are to be provided at the discretion of the service provider agency and shall meet state requirements. 7. Compile and report program service delivery statistics and other data as identified by CHS. These are reported to the Area Agency on Aging and Department of Elder Affairs in accordance with the reporting requirements developed by the Department. CHS is responsible for entry of data in the Client Information and Registration Tracking System (CIRTS), which generates payment to the service provider agency. 8. Maintain complete and accurate records: Service delivery logs, at a minimum, must be legible and contain the name of client, type/s of services and date/s and hour/s of delivery. The client/caregiver must sign the log at the time of each service visit. The service worker must sign and date the log upon completion and submit it to the service provider agency. 9. Provide complete, clear and accurate invoices: Invoices must be submitted monthly by the following the week once the services have been provided and shall include the services provided. The service week is defined as Monday through Sunday. Monthly invoices will include: • Vendor name • Vendor address • Vendor telephone number • Client name • Services authorized and the service dates • Number of service hours, cost per hour and total cost • Person preparing the report and the date it was prepared 10, Prepare for annual on-site compliance audits by CHS Monitoring Unit team as directed by the CHS Division and/or grant requirements. Page 2 of 2 Packet Pg. 2153 Exhibit B Fee Schedule ■❑ following this page (pages 1 through 1 ) ❑ this exhibit is not applicable Page 16 of 17 General Service Agreement Non -Solicitation 92017-004 (Ver.2) Packet Pg. 2154 EXHIBIT B -FEE SCHEDULE #19-7596 "Services for Seniors Program -Additional Services -Respite Facility Services & Adult Day Care SHIFTING SANDS ADULT DAY CENTER, LLC Item Services Grant Service Cost Per Service In -Kind 10%.. Reimbursement Rate Unit Unit (Cost your Service Unit (Cost. Per Unit (Amount company charges your company the County will for the service) charges for the reimburse your service) company for a given . service) 1 Adult Day Care CCE Per Hour $13.89 $1.39 $12.50 ADI* OAA *The ADI program does not require an in-kind match contribution. • Prices shall remain firm for the initial term of this contract. • Skilled Nursing and Respite Services will not be provided under this Agreement. Packet Pg. 2155 Other ExhibiVA"achment Description: Federal Contract Provisions, Grant Assurances and Certifications F following this page (pages through 2 ' ) ❑ this exhibit is not applicable Page 17 of 17 General Service Agrecment Non -Solicitation 42017-004 (Ver.2) Packet Pg. 2156 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (ADMINISTRATION ON AGING) AND FLORIDA DEPARTMENT OF ELDER AFFAIRS CFDA 93.OXX (CSFA 65.01.0) The supplemental conditions contained in this section are intended to cooperate with, to supplement, and to modify the general conditions and other specifications. In cases of disagreement with any other section of this contract, the Supplemental Conditions shall govern. Contractor means an entity, that receives a contract. The services performed by the awarded Contractor shall be in compliance with the provisions of Title 45 CFR Part 75; and/or, 2 CFR Part 200; and/or Title 45 Chapter XIII Part 1321 and/or other applicable regulations. it shall be the awarded Contractor's responsibility to acquire and utilize the necessary manuals and guidelines that apply to the work required to complete this project. In general, 1) The contractor (including all subcontractors) must insert these contract provisions in each lower tier contracts (e.g. subcontract or sub -agreement); 2) The contractor (or subcontractor) must incorporate the applicable requirements of these contract provisions by reference for work done under any purchase orders, rental agreements and other agreements for supplies or services; 3) The prime contractor is responsible for compliance with these contract provisions by any subcontractor, lower -tier subcontractor or service provider. FEDERAL STATUTORY AUTHORITY Older Americans Act of 1965 (OAA), as amended (42 U.S.0 § 3001 et seq., as amended by Public Law 114-144; 106-501; Section 20.41) OLDER AMERICANS ACT PROGRAM FUNDS OAA, "title III, Section 307(a)(10) OAA, Title III P - Supportive Services; Title 45 Public Welfare (45 CPR 1321) Chapter XIII Office of Human Development Services, Department of Health and Human Services Part 1321.65 Grants to State and Community Programs on Aging; Part 1321.67 Service Contributions FLORIDA STATUTORY AUTHORITY TITLE XXX (Social Welfare); Chapter 430 (Elder Affairs) CONTRACT COMPLIANCE OVERVIEW Under the Florida Department of Elder Affairs Older Americans Act, the contractor must comply with the contract documentation, conform to state and AAA policies, and comply with federal and state statutory and regulatory requirements. (Ref - Department of Elder Affairs Programs and Services Handbook, Chapter 4, Page 22; July 2018: Older Americans Act.). The contractor will comply with the intent of Title III to provide for formula grants to State agencies on aging to stimulate the development or enhancement of comprehensive and coordinated community-based systems resulting in a continuum of services to older persons with special emphasis on older individuals with the greatest economic or social need, with particular attention to low-income minority individuals. (Ref. - Title 45 CFR 1321) (Ref.: Florida Dept. of Elder Affairs' Honne and Counnin ity-Based Services Handbaok) PCP -I (Revised 01-14-19 Packet Pg. 2157 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL CONTRACT PROVISIONS >$100,000 Administrative, Contractual, or Legal Remedies (Ref. 41 U.S.C. 1908,2 CFR § 200 Appendix Il (A) Unless otherwise provided in this contract, all claims, counter -claims, disputes and other matters in question between the local government and the contractor, arising out of or relating to this contract, or the breach of it, will be decided by arbitration, if the parties mutually agree, or in a Florida court of competent jurisdiction. Access to Records and Reports (Reference: 2 CFR § 200.333, 2 CFR § 200.335) The contractor/vendor agrees to maintain all books, records, accounts and reports required under this contract for a period of not less than three years after the date of termination or expiration of this contract, except in the event of litigation or settlement of claims arising from the performance of this contract, in which case the Contractor agrees to maintain same until the Purchaser, the Grantor Administrator, the Comptroller General, or any of their duly authorized representatives, have disposed of all such litigation, appeals, claims or exceptions related thereto, Furthermore, the County shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement of its Contractors. Byrd Anti -Lobbying Amendment (31 U.S.C. 1352) (Reference 2 CFR § 200 Appendix IT (J) Vendors must certify it will not and has not used Federal appropriated funds have been paid or will be paid, by or to any person or organization for influencing or attempting to influence an officer or employee of an 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. The certification includes any lobbying with non -Federal funds that takes place in connection with obtaining any Federal award. Civil Rights The contractor or a subcontractor who is the recipient of Federal funds (or assumes others with whom it arranges to provide services or benefits in connection with any of its programs and activities or assures others with whom it arranges to provide services or benefits to participants or employees) must comply with Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color, or national origin (45 CFR 80), and Statutes and Regulations enforced by the Office of Civil Rights, U.S. Department of Health and Human Services, as follow: Section 504 of the Rehabilitation Act of 1973, as amended (29 USC § 794), prohibits discrimination against otherwise qualified individuals on the basis of disability in programs and activities receiving financial assistance from NHS 45 CFR 84 and/or programs or activities conducted by HHS 45 CFR 85 in the provision of benefits and under the ADA that does not: a. Exclude a person with a disability from a program or activity; b. Deny a person with a disability the benefits of a program or activity; c. Afford a person with a disability an opportunity to participate in or benefit from a benefit or service that is not equal to what is afforded others; d. Provide a benefit or service to a person with a disability that is not as effective as what is provided others, c. Provide different or separate benefits or services to a person with a disability unless necessary to provide benefits or services that are as effective as what is provided others; or, f. Apply eligibility criteria that tend to screen out persons with disabilities unless necessary for the provision of the service, program or activity. (Ref.: Florida Dept- of Elde)-A,fjairs'HomeaitdConimtarity-BasedServicesHandbook) FCP-2/Revised 01-14-19 Packet Pg. 2158 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS Section 508 of the Rehabilitation Act of 1973, as amended, (29 USC § 794(d)) prohibits discrimination on the basis of disability in electronic and information technology as they relate to programs and activities conducted by HHS. The Age Discrimination Act of 1975, as amended (42 USC § 6101) prohibits discrimination on the basis of age in programs or activities receiving Federal financial assistance 45 CFR 90; and/or programs or services receiving HHS financial assistance 45 CFR 91; Title 11 of the Americans with Disabilities Act (28 CFR Part 35), relating to Nondiscrimination on the Basis of Disability in State and Local Government Services 2010 ADA Standards for Accessible Design; The Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §290 dd-3 and 290 ce 3), as amended, as relating to confidentiality of alcohol and drug abuse patient records; Section 1908 of the Public Health Service Act (42 USC § 300w-7) prohibits discrimination on the basis of age, race, color, national origin, disability, sex (gender), or religion in programs, services, and activities funded by Preventative Health and Health Services Block Grants. Federal Health Care Conscience Protection Statutes (42 USC § 300a-7; 42 USC § 300a-7; 42 USC § 238n and the Weldon Amendment (Continuing Appropriations Resolution, Pub, L, No. 113-164, Sec. 101(a) (Sept. 19, 2015); Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws, which prohibit recipients of certain Federal funds from discriminating against certain health care providers who refuse to participate in certain health care services on religious or moral grounds. Section 1557 of the Affordable Care Act prohibits discrimination on the basis of disability by entities that operate a health program or activity. 45 CFR 80. The contractor must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. Clean Air Act and Federal Water Pollution Control Act (Applicable to contracts containing federal funds and over $100, 000.) The Contractor shall comply with all applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42 United States Code (U.S.C.) 7401, et sect.), Section 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency regulations, 2 CFR Part 1500. The Contractor shall report any violations of the above to the Agency. Computer Use and Social Media Policy The Florida Department of Elder Affairs has implemented a Social Media Policy, in addition to its Computer Use Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third parties, such as, but not limited to, contractors and subcontractors, Any entity that uses the Department's computer resource systems must comply with the Department's policy regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This policy is available on the Department's website at: http//eideraffairs.state.flus/doca/financial.pl� a Debarment and Suspension (Reference 2 CFR § 200 Appendix Il (1) Contract awards that exceed the small purchase threshold and certain other contract awards shall not be made to parties listed on the government wide Excluded Parties List System in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1986 Comp., p. 189) and 12689 (3 CFR Part 1989 Comp., p. 235), "Debarment and Suspension." The Excluded Parties List System in SAM contains the names of parties debarred, suspended, or otherwise excluded (Ref.., Florida Dept. of Elder Affairs' Honre and Communify-Based Serwlices Handbook) FCP-3lRevised 01-14.19 Packet Pg. 2159 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. The successful bidder, by administering each lower tier subcontract that exceeds $25,000 as a "covered transaction", must verify each lower tier participant of a "covered transaction" under the project is not presently debarred or otherwise disqualified from participation in this federally assisted project. The Contractor shall comply with these provisions before doing business or entering into subcontracts receiving federal funds pursuant to this contract. The Contractor shall complete and sign the Certifications and Assurances Attachment prior to the execution of this contract. Diversity (Reference 2 CFR § 200.321) The County is dedicated to fostering the continued development and economic growth of small, minority-, women-, and service -disabled veteran business enterprises. All contracting and subcontracting opportunities afforded by this solicitation/contract are strongly encouraged to contribute as both Contractors and Sub - Contractors. Firms may he required to submit documentation addressing diversity and describing the efforts being made to encourage the participation of small, minority-, women-, and service -disabled veteran business enterprises, hnformation on Certified Minority Business Enterprises (CMBE) and Certified Service -Disabled Veteran Business Enterprises (CSDVBE) is available from the Office of Supplier Diversity at- littp://diiis.myflot-ida.com/other programs/office of su lier diversi osd/ Energy Policy and Conservation Act - (Reference 2 CFR § 200 Appendix 11 (H) The contractor shall comply with any mandatory standards and policies relating to energy efficiency which are contained in the F I o r i d a state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub. L. 94-163, 89 Stat. 871, 42 U.S.0 Section 6201) Equal Employment Opportunity (Appendix Il, 2 CFR Part 200; Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and Department of Labor 41 CFR Part 60; Dept. of Health and Human Services 45 CFR Part 80; 45 CFR Part 92, if applicable). The Contractor shall not discriminate against any employee or applicant for employment because of race, age, creed, color, sex or national origin. The Agency will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, age, creed, color, sex, or national origin. Such action shall include, but not be limited to, the following: Employment upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. Contractors must insert a similar provision in all subcontracts, except subcontracts for standard commercial supplies or raw materials. E -verify, Presidential Executive Order 12989; Florida Executive Order Number 11-116 Vendors/Contractors/Subcontracts: 1. Agree to utilize the U.S. Department of Homeland Security's E -verify system to verify the employment of all new employees hired by Contractor during the contract term; and 2. Contractor shall include in related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the state contract utilize the E -verify system to verify employment eligibility of all new employees hired by the Subcontractor during the contract term. HIPAA Privacy Rules, 4 CFR fart 160 and Suparts A and E of part 164 The Third Party subrecipient will comply with HIPAA requirements to appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. Immigration and rationality Act The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of un- authorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this contract by the Agency. (Ref.: Florida Dept. of Elder Affairs' Honie and Community -Based Services Handbook) FCP-4/Revised 01-14-19 Packet Pg. 216071 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS No Government Obligation to Third Parties - The Federal Government is not a party to this contract and is not subject to any obligations or liabilities to the non -Federal entity, contractor, or any other party pertaining to any matter resulting from the contract." Nondiscrimination The Contractor will l . not discriminate against any person in the provision of services or benefits under this contract or in employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance with state and federal law and regulations. 2. Assumes others with whom it arranges to provide services or benefits in connection with any of its programs and activities are not discriminating against clients or employees because of age, race, religion, color, disability, national origin, marital status or sex. And 3. Assures others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines, and standards. Pension Protection Act of 2006 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization reporting requirements (filing a Form 990 or Form 990-N) and has its tax exempt status revoked for failing to comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor must notify the Agency in writing within thirty (30) days of receiving; the IRS notice of revocation. Procurement of Recovered Materials (Reference 2 CFR § 200.322) Contractor and subcontractor agree to comply with Section 6002 of the .Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act, and the regulatory provisions of 40 CFR Part 247. (1) In the performance of this contract, the Contractor shall matte maximum use of products containing recovered materials that are EPA designated items unless the product catmot be acquired (i) Competitively within a timeframe providing for compliance with the contract performance schedule; (ii) Meeting contract performance requirements; or (iii) At a reasonable price. (2) Information about this requirement is available at EPA's Comprehensive Procurement Guidelines web sitc_littp://Nvww.epa.gov/. The list of EPA -designate items is available at littps://www,epa.gov/smm/comprehensive-procurement-guideline-cpg-program. Program Fraud and False or Fraudulent Statements of Related Acts The contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements) applies to the contractor's actions pertaining to this contract. Termination for Cause and Convenience See County's Standard Tennis and Conditions. Trafficking in Persons The Contractor and subcontractors shall comply with Title 2 CFR Part 175 and 2 CFR § 175.15 provisions applicable to a private entity, as defined in 2 CFR 175.25, Transparency Act Unless exempt under 2 CFR § 170.11 O(b), the Contractor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR Part 170. (Ref.: Florida Dept. of Elder Affairs' Home and Comnniniry-Based Services Handbook) FCP-5/Revised 01-14-19 Packet Pg. 216171 EXHIBIT LA FEDERAL CONTRACT PROVISIONS STATE CONTRACT PROVISIONS Administrative Procedures Act, Section 120.57(2), F.S. Additional procerlttres for particular cases. In a matter initiated as a result of agency action proposing to determine the substantial interests of a party, the party's timely petition for hearing may challenge the proposed agency action based on a rule that is an invalid exercise of delegated legislative authority or based on an alleged unadopted rule. Data Integrity and Safeguarding Information, Uniform Electronic Transaction Act, Section 668.50, F.S.; Public Records Law, Chapter 119, Section 29, F.S The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages of the computer system. The security over the backed -up data is to be as stringent as the protection required of the primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract. Discriminatory Vendors List, Section 287.134, F.S. In accordance with Section 287.134, Florida Statutes, an entity or affiliate who has been placed on the discriminatory vendor list may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity. Equal Employment Opportunity The Contractor shall not discriminate against any employee or applicant for employment because of race, age, creed, color, sex or national origin. The Agency will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, age, creed, color, sex, or national origin. Such action shall include, but not be limited to, the following: Employment upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. Contractors must insert a similar provision in all subcontracts, except subcontracts for standard commercial supplies or raw materials. Inspections (Meals) The Contractor must agree to notify the Nutrition Provider within 24 hours of any sanitation inspection and provide a copy of the report. Inspector General Cooperation, Section 20,055(5), F.S. The Parties agree to comply with Section 20.055(5), Florida Statutes, for the inspector general to have access to any records, data and other information deemed necessary to carry out his or her duties and incorporate into all subcontracts the obligation to comply with Section 20.055(5), Florida Statutes. Interest of Members of Congress No member of or delegate to the Congress of the United States shall be admitted to any share or part of this contract or to any benefit arising therefi-om. (Ref.: Florida Dept. of Elder Affairs' Horrre and Corrrmrnrio -Based Services Handbook) FCP-6/Revised 0144-19 Packet Pg. 2162 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS Interest of Public Officials No member, officer, or employee of the public body or of a local public body during his tenure or for two years thereafter shall have any interest, direct or indirect, in this contract or the proceeds thereof. For purposes of this provision, public body shall include municipalities and other political subdivisions of States; and public corporations, boards, and commissions established under the laws of any State. No member, officer, or employee of the MPO or of a local public body during his tenure or for two years thereafter shall have any interest, direct or indirect, in this contract or the proceeds thereof, Lobbying No funds received pursuant to this Agreement maybe expended for lobbying the Legislature, the judicial branch or a state agency. (Ref.: Florida Dept, of Elder Affairs' Horne and Conrrnurub,Hased Services Handbook) FC [14/Revised 01-14-19 Packet Pg. 21 3 tlPANN1 ��l,It11� I�,.� ] IONS A\1)'AS" IPP`\i_t 1,� GRANT CERTIFICATIONS AND ASSURANCES THE FOLLOWING DOCUMENTS NEED TO BE RETURNED WITH SOLICITATION DOCUMENTS BY DEADLINE TO BE CONSIDERED RESPONSIVE. Pale Certification and Form GCA 2-6 Attachment III - Certifications and Assurances A- A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 75) B. Certification Regarding Lobbying (29 CFR Part 93 and 45 CFR Part 93) C. Nondiscrimination & Equal Opportunity Assurance (29 CFR Part 37 and 45 CFR Part 80) D. Certification Regarding Public Entity Crimes, section 287.133. F.S. E. Association of Community Organizations for Reform Now (ACORN) Funding Restrictions Assurances (Pub. L. I I 1-117) F, Scrutinized Companies Lists and No Boycott of Israel Certification, section 287.135. F.S. G. Certification Regarding Data Integrity Compliance for Contracts, Agreements, Grants, Loans and Cooperative Agreements H. Verification of Employment Status Certification 1. Records and Documentation J. Certification Regarding Inspection of Public Records GCA - 7--9 Attachment IV -- Assurances Non -Construction Pro rams GCA - 10-13 Attachment V —Civil Rights Compliance Checklist GCA - 14 Attachment VII — Background Screenin Affidavit of Compliance - Employer GCA - 15 Conflict of Interest Certification GCA - 16 Anticipated DBE M/WBE or VETERAN Participation Statement GCA - 17 Bid O ortuni List for Commodities and Contractual Services and Professional Consultant Services Packet Pg. 2164 WNN@ GRANT ASSURANCES AND CERTIFICATIONS ATTACHMENT III CERTIFICATIONS AND ASSURANCES Agency will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. Tn performance of this contract, Contractor provides the following certifications and assurances: A. B. 5 CFR Part 931 C. NondiscriMilaptign & Egual 0111jortunirance2 FR Part 37 aljd 45 CFR Part D. Certiflgalion Regarding 1' im in2 E. (Pub. L. l 11-117) F. Serutinized Comllanies Lists andIsrael n n2 G. Certification Data Integrity for Conj[agts. Agreements, Grants. Loans. Cooperative AgrggWent H. I. Records and Documentation J. Certification Regarding Inspection of PnbliS Records A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS — PRIMARY COVERED TRANSACTION. The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by a Federal department or agency; 2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, malting false statements, or receiving stolen property; 3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph A.2, of this certification; and/or 4. Have not within a three-year period preceding this applicatior/proposal had one or more public transactions (Federal, State, or local) terminated for cause of default. The undersigned shall require that language of this certification be included in the documents for all subcontracts atall tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients and contractors shall provide this certification accordingly. GCA -2 Packet Pg. 2165 I GRANT ASSURANCES AND CERTIFICATIONS B. CERTIFICATION REGARDING LOBBYING -- CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS. The undersigned Contractor certifies, to the best of its knowledge and belief, that: 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 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. 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 employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The undersigned shall require that language of this certification be included in the documents for all subcontracts atall tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients and contractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. C. NON- DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART 80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal opportunity provisions of the following laws: I. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability, political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program or activity. 2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 GFR Part 80), to the end that, in accordance with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. 3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. GCA -3 Packet Pg. 2166 GRANT ASSURANCES AND CER`T'IFICATIONS 4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of, be excluded from participation in, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. 5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education program or activity for which the Applicant receives Federal financial assistance from the Agency. 6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment practices, including job application procedures, hiring, firing, advancement, compensation, training, and other terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe benefits, and all other employment-related activities. 7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or activity, and to all contracts Contractor makes to carry out the WIA Title I —financially assisted program or activity. Contractor understands that the Agency and/or DOEA and the United States have the right to seek judicial enforcement of the assurance. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients and contractors shall provide this assurance accordingly. D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S. Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list. Contractor understands and agrees that it is required to inform Agency immediately upon any change of circumstances regarding this status. E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING RESTRICTIONS ASSURANCE (Pub. L. 111-117). As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub. L, I I1-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that appropriations made under Pub. L. I I 1-117 are available under the conditions provided by Pub. L. 111-117. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub - recipients and contractors shall provide this assurance accordingly. F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION 287.135, F.S. In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized Companies that Boycott Israel List and that it is not participating in a boycott of Israel. GCA -A Packet Pg. 2167 GRANT ASSURANCES AND CERTIFICATIONS If this Contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135, F.S., Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it does not have business operations in Cuba or Syria. Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may result in the Agency terminating this contract and the submission of a false certification may subject Contractor to civil penalties and attorney fees and costs, including any costs for investigations that led to the finding of false certification. GCA -3 If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to this Contract. G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS 1. The Contractor and any Subcontractors of services under this contract have financial management systems capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant -funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all contract supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly. 2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the Contractor is dependent for data that is to be reported, transmitted, or calculated have been assessed and verified to be capable of processing data accurately, including year -date dependent data. For those systems identified to be non-compliant, Contractors will take immediate action to assure data integrity. 3. If this contract includes the provision of hardware, software, firmware, microcode, or imbedded chiptechnology, the undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state will be verified for accuracy and integrity of data prior to transfer. 4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the Contractor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the essence. 5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies arising from data integrity compliance issues. H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland Security's E -verify system to verify the employment eligibility of all new employees hired by Contractor during the contract terra to perform employment duties pursuant to this contract, and that any subcontracts include an express requirement that Subcontractors performing work or providing services pursuant to this Contract utilize the E -verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract term. GCA -5 Packet Pg. 2168 EXB. 1.11 GRANT ASSURANCES AND CERTIFICATIONS The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and other agreements/contracts and that all Subcontractors shall certify compliance accordingly. This certificatiott,is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by Circulars A-102 and 2 CFR fart 200 and 215 (formerly OMB Circular A-110). I. RECORDS AND DOCUMENTATION The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all contract related records and documentation. The Contractor shall ensure the collection and maintenance of all program related information and documentation on any such system designated by the Agency. Maintenance includes valid exports and backups of all data and systems according to Agency standards. J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS 1. In addition to the requirements of sections 10.1 and 10.2 of the Standard Contract, sections 119.0701(3) and. (4) F.S., and any other applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is narried in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the Agency 'and any attorneys' fees assessed or awarded against the Agency from a' Public Records Request made pursuant to Chapter 119, F.S., concerning this contract or services performed thereunder. a. Notwithstanding section 119.070 1, F.S., or other Florida law, this section is not applicable to contracts executed between the Agency and state agencies or subdivisions defined in section 768.28(2), RS. 2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions for any person, corporation, foundation, trust, association, group, or other organization, all the financial, business, and membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest Florida, Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a public record shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances. Additionally, I certify this organization does does not provide for institutional memberships. 004 Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are available for inspection if applicable, as stated above. By execution of this contract, Contractor must include these provisions (A -J) in all related subcontract agreements (if applicable). By signing below, Contractor certifies that the representations outlined in parts A through J above are true and'correct. _ aafello 160"_4r ►,v� el6l �Title�AuthoMizedRepresentative rgnature Street Address Contra9t _r to City, State, Zip code GCA -6 Packet Pg. 2169 EXHIBIT 1.13 GRANT CERTIFICATIONS AND ASSURANCES ATTACHMENT IV ASSURANCES--NON-CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington, DC 20503. Pi .F A SF DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will he notified. 1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, throughany authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awardingagency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to; (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. § 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. GCA -7 Packet Pg. 217071 EXHIBIT 13 GRANT CERTIFICATIONS AND ASSURANCES 7. Will comply, or has already complied, with the requirements of Titles lI and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of federal participation inpurchases. 8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §1501-1508 and 7324-7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with federal funds. 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C. §874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §327-333), regarding labor standards for federally assisted construction sub -contracts. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or more. 11, Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §4801 et seq.), which prohibits the use of lead- based paint in construction or rehabilitation of residence structures. GCA -8 Packet Pg. 2171 EXHIBIT 1.13 GRANT CERTIFICATIONS AND ASSUkANCES 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and 2 CFR Part 200. i C 18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies = governing this program. SIGN TURF OF AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED GCA -9 U n Packet Pg. 2172 STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST Program/Facility Name: # County: AAAIContractor riven Address: U. Completed By: �W0 D `t% W 7 City State, "Lip Code: V Date: Teleph PARI' I: READ TRE ATT CHE INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE THIS FORM. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: For questions 2-5, please indicate the following: Total # White % Black % Hispanic % Other Female Disabled. Over 40 2.Population of area served Source of data 0 ❑ �Z ❑ S. For in-patient services, are room assignments made without regard to race, color, national origin 3.Staff currently employed Source of data or disability? NI YES NO . 4.Clients currently enrolled/registered Source of data . 6. Is the program/facility accessible to non-English speaking clients? NIA YES NO 5.Advisa y/Governini,l4oard if applicable Source of data 1. 00 ❑ [� o_,C) PART 11: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE, 1. Is an Assurance of Compliance on file with DOEA? NIA YES NO 2. Compare the staff composition to the population. Is staff representative of the population? N/A YES NO ❑ Ez ❑ 3. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, sex, age, religion or disability? N/A YES NO ❑ 0 ❑ 7. Are employees, W icants a part^ictp� s informed of their protection against discrimination? how? Verbal W'Written Poster L/ If YES, N/A YES NO 4. Are all benefits, services and facilities available to applicants and participants in an equally effective manner regardless of race, sex, color, age, national origin, religion or disability? N/AYES ❑ NO 0 ❑ �Z ❑ S. For in-patient services, are room assignments made without regard to race, color, national origin or disability? NI YES NO . . 6. Is the program/facility accessible to non-English speaking clients? NIA YES NO ❑ X ❑ 7. Are employees, W icants a part^ictp� s informed of their protection against discrimination? how? Verbal W'Written Poster L/ If YES, N/A YES NO ❑ � 0 8. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility. N/A NUMBER i Packet Pg. 2173 9. is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals? YES YE,NO *Notice of Corrective Action Sent 1 I 0 ❑ Response Due PARI' III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF NO EXPLAIN 13, Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination i 10. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make on the basis of disability? YES any necessary modifications? YES C NO ❑ ❑ [ - 1 l . Is there an established grievance procedure that incorporates due process in the resolution of complaints? YES i NO ❑ ❑ a 12, Has a person been designated to coordinate Section 504 compliance activities? YES i NO u u *Notice of Corrective Action Sent 1 I ❑ ❑ Response Due On -Site ❑ Desk Review ❑ 'i 13, Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination i on the basis of disability? YES NO c C e 14. Are auxiliary aids available to assure accessibility of services to hearing and sight -impaired individuals? YES NO u r C a PART IV: FOR PROGRAMS 09 FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE. 15. Do you have a written affirmative action plan? If NO, explain, YES I Z NO i ❑ ❑ t u s DOIFA USE ONLY Reviewed By In Compliance: YES NO* Program Office *Notice of Corrective Action Sent 1 I Date Telephone Response Due On -Site ❑ Desk Review ❑ Response Received I I Revised August 2010, Page 2 ut'2 } INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves a specific target population such as adolescents, describe the target population, Also, define the type of service provided. 2. Enter the percent of the population served by race and sex. The population served includes persons in the geographical area for which services are provided such as a city, county or other regional area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing Florida population statistics, Include the source of your population statistics. ("Other" races include Asian/Pacific Islanders and American Indian/Alaskan Natives.) Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of your summary. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list their percent by race, sex and disability. Include the date that enrollment was counted. 5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no advisory or governing board, leave this section blank. 6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the contract language for DOEA recipients and their sub -grantees, 45 CFR 80.4 (a). 7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the population is Hispanic, is there a comparable percentage of Hispanic staff? 8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability in the population, the program/facility has the responsibility to determine the reasons for such variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6). Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a) and 45 CFR 80.1 (b) (2). 10, Participants or clients must be provided services such as medical, nursing and dental care, laboratory services, physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin, religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b). 1 l . For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin or disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a different race, color, national origin, or disability, 45 CFR 811.3 (a). 12. The program/facility and all services must be accessible to participants and applicants, including those persons who may not speak English. In geographic areas where a significant population of non-English speaking people live, program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist in the provision of services, 45 CFR 80.3 (a). GCA - 12 Packet Pg. 2175 13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their participants, beneficiaries or any other interested parties. This should include information on their right to file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The information may be supplied verbally or in writing to every individual, or may be supplied through the use of an equal opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6 (d). 14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color, creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement, termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc. 15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility impaired individuals. 16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self- evaluation to identify any accessibility barriers. Self-evaluation is a four step process: a a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not LL comply with Section 504. b. Modify policies and practices that do not meet Section 504 requirements. M c. Take remedial steps to eliminate any discrimination that has been identified. T- d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been followed.), 45 CFR 84.6. 'D ar IT Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate _ � due process standards and provide for the prompt and equitable resolution of complaints alleging any action o prohibited by Section 504.45 CFR 84.7 (b). CD 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to r1 comply with Section 504.45 CFR 84.7 (a). L 19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of C nondiscrimination on the basis of disability, This includes recruitment material, notices for hearings, newspaper ads, NI and other appropriate written communication, 45 CFR 84.8 (a). c 20. Pra rams/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired ca CO) sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters = for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide equally effective services, 45 CFR 84.52 (d). y 21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and to an ti maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60 and C6 Title VI of the Civil Rights Act of 1964, as amended, T m E DDEA Fonn 101-B, Revised August 2010 t V r� Q GCA - 13 4 I Packet Pg. 2176 BACKGROUND SCREENING Affidavit of'Compliance - Employer AUTHORITY: This form is required annually of all employers to comply with the attestation requirements set forth In section 435.05(3), Florida Statutes. ➢ The term "employer" means any person or entity required by law to conduct background screening, including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Serving Health Insurance Needs of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires employees or has volunteers in service who meet the definition of a direct service provider. See §§ 435.02, 430.0402, Fla. Stat, A A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide services to the elderly, has direct, face-to-face contact with a client while providing services to the client and has access to the client's living area, funds, personal property, or personal identification information as defined In s. 817.568. The term includes coordinators, managers, and supervisors of residential facilities; and volunteers." § 430.0402(1)(b), Fla. $tat. ATTESTATION: As the duly authorized representative of located at��pl?[� Street Address 1,_�/i�J� Name of ReoresentoHve { E ployer Name do hereby affirm under penalty of,perjury i that the above named employer is in compliance with the provisions of Chapter 435 and section 430.0402, Florida Statutes, regarding level 2 background screening. Signature of Representative Date r 4+ STATE OF FLORIDA, COUNTY OF /-rte- rn Sworn to(or affirmed) and subscribed before me this t'day of �Q� 20 by m rn LO ti M - . {Name of Representative) who is personally known r to me or produced _ as proof of identification. " E ex C— U print, Type, at Stamp Commissioned Name of Notary Public Nota ryLLhI1r TRINAWCAR80NNEAU- ODEA Form 235, Affidavit of Compliance- Employer, Effective April 2012 = « Commis5 Pn a GGgsihidn 435 5(3), F,s, ? Formavallableat: htt vlderaffalrs,state.fl.us en lisp back roundscreenin h htyComm.�xpiresluii3,2021 Packet Pg. 2177 EXHIBIT 1.13 /9- �U-f&-0l- Of Collier County Solicitation No. GRANTCERTIFICA-HONS AND ASSURANCES I, ,c} hereby certify that to the best of my knowledge, neither I nor m spouse, dependent child, general partner, or any organization for which I am serving as an officer, director, trustee, general partner or employee, or any person or organization with whom I am negotiating or have an arrangement concerning prospective employment has a financial interest in this matter. I further certify to the best of my knowledge that this matter will not affect the financial interests of any member of my household. Afso, to the best of my knowledge, no member of my household; no relative with whom I have a close relationship; no one with whom my spouse, parent or dependent child has or seeks employment; and no organization with which I am seeking a business relationship nor which I now serve actively or have served within the last year are parties or represent a party to the matter. I also acknowledge my responsibility to disclose the acquisition of any financial or personal interest as described above that would be affected by the matter, and to disclose any interest 1, or anyone noted above, has in any person or organization that does become involved in, or is affected at a later date by, the conduct of this matter. kl Name Position Date Privacy Act Statement Title I of the Ethics in Government Act of 1978 (5 U.S.C. App.), Executive Order 12674 and 5 CFR Part 2634, Subpart I require the reporting of this information. The primary use of the information on this form is for review by officials of The Justice Department to determine compliance with applicable federal conflict of interest laws and regulations. Additional disclosures of the information on this report may be made: (1) to a federal, state or local law enforcement agency if the Justice Department becomes aware of a violation or potential violation of law or regulations; (2) to a court or party in a court or federal administrative proceeding if the government is a party or in order to comply with a judge -issued subpoena; (3) to a source when necessary to obtain information relevant to a conflict of interest investigation or decision; (4) to the National Archives and Records Administration or the General Services Administration in records management inspections; (5) to the Office of Management and Budget during legislative coordination on private relief legislation; and (6) in response to a request for discovery or for the appearance of a witness in a judicial or administrative proceeding, if the information is relevant to the subject matter. This confidential certification will not be disclosed to any requesting person unless authorized by law. See also the OGE/GOVT-2 executive branch -wide Privacy Act system of records. GCA -15 __ Packet Pg. 2178 EXHIBIT LB GRANT CEIMFICATIONS AND ASSURANCES EXHIBIT I.B GRANT CERTIFICATIONS AND ASSURANCES e r a t• a c ••r .=c.. Ci J. 1kw,wtEowwkelmbraW ig-cf VOL ?m a[�ta„ acme#A[[�jttt��tit�lii>71ie'Set ad��te�irrfrE>ie�g�krCac�s�eirass�s�s��aS�Un6ioreitwm rsa�aontraeforfa�� c�einer+tart%�r�F:srlrts. �:s aad9R�'rt�rutA ��r GeiomMes't�rFEttr���� -�d<�: n i+� ws�er�i'iasd.w�i 8ere`�d• : r rat ax G a rimlv~t 9. B olm 14OWMf a,. �fbrnz�tINICOW waihm$3nmwm lx a. utmwwaow sur z rear tT r a OBE a WWA. ea$;IS Homes $..tssS - 6Btwe26�'S*YS Lu-w*t 7fk&mw*bQ ILrFi TZxtv"m*W- Z� 14M if anw- � .iii ri R4DRE.' X- AAfl1811 t M177NL� .O i 9. A�di9AE'�!!RY}JPS: 6'�SaeE�a�33' AC PSS �, 0�1iie@Aj.l:l$7!�/t - .......... Wxt1�PI�Sbeii�aiY . ~rM'FPy Com: 3. Eedtil"Y1Taxiotawthar- Z,- riurntawaMc 6_ :r)ru El floe -ME ,. arxrre ei c. tr":thm im "irn r kme Nwdbe�_ eatween a +t.'�ddkass 7_ r�twces��-� eewkka� IWlbrrll�e��3 �. Y�eor�`ilEtta�: GCA -17 __ Packet Pg. 2180 DocuSign Envelope ID: 3EF8B88C-6D77-49F5-A6FC-3411 EF6D2CF2 � 16.D.4.c Collier Co1.nty Administrative Services Department Procurement Services Division Notice of Recommended Award Solicitation: 19-7596 Title: Services for Seniors Respite Facility & Adult Day Care Due Date and Time: 10/21/2019; 3:00 PM Respondents: Company Name City County State Bid Amount Responsive/Responsible Arden Courts -Lely Naples Collier FI N/A N/A Palms of Naples, LLC d/b/a Arden Courts of Lely Palms Shifting Sands Adult Bonita Springs Lee FL N/A N/A Day Center, LLC Utilized Local Vendor Preference: Yes = No - Recommended Vendors) For Award: The Procurement Services Division released Request for Proposal (RFP) #19-7596 on three (3) separate instances (July 15, 2019, August 23, 2019, and October 1, 2019). On July 15th, 2019, the Procurement Services Division released the Request for Proposal (RFP) to Eleven Thousand Eighty -Nine (11,089) vendors for the "Services for Seniors Program -Respite Care & Adult Day Care" project. Fifty (50) bid packages were downloaded, and two (2) submittals were received by the August 21, 2019 deadline. Procurement services staff reviewed the bid responses and documents. Shifting Sands Adult Day Center was found to be responsive/responsible, while Arden Courts -Lely Palms of Naples, FL, LLC d/b/a Arden Courts of Lely Palms was non-responsive due to an incomplete proposal. Community and Human Services staff requested the RFP be resolicited to obtain respite services. On August 23, 2019, the Procurement Services Division released the proposal for the second time to eleven thousand two hundred sixty-four (11,264) vendors for the "Services for Seniors Program -Respite Care & Adult Day Care" project. Thirty-six (36) bid packages were downloaded, and two (2) submittals were received by the September 23, 2019 deadline. Procurement services staff reviewed the bid responses and bidder's documents. Shifting Sands Adult Day Center was found to be responsive/responsible, while Arden Courts -Lely Palms of Naples, FL, LLC d/b/a Arden Courts of Lely Palms was non-responsive due to not submitting their complete proposal by the required Bid close. Community and Human Services staff requested the RFP be cancelled and resolicited to obtain needed respite services. On October 1, 2019, the Procurement Services Division released the proposal to eleven thousand two hundred and one (11,201) vendors for the "Services for Seniors Program -Respite Care & Adult Day Care" project. Thirty-three (33) bid packages were downloaded and one (1) submittal was received by the October 21, 2019 deadline. Arden Courts -Lely Palms of Naples, FL, LLC d/b/a Arden Courts of Lely Palms was the only submitter and was deemed non-responsive due to an incomplete bid package. Collier County Procurement Ordinance No. 2017-08, Section 12, subsection 1: "Collier County reserves the right in any solicitation to accept or reject any or all bids, proposals or offers; to waive minor irregularities and technicalities; or to request resubmission, .... Notwithstanding any other provisions of the Article, if none or only one responsive and responsible bid or proposal is received following any solicitation, the County Manager, or Packet Pg. 2181 DocuSign Envelope ID: 3EF8B88C-6D77-49F5-A6FC-3411 EF6D2CF2 16.D.4.c designee, reserves the right to reject all bids, proposals or offers and to negotiate with any responsible provider(s) to secure the best terms and conditions in the sole interest of the County unless otherwise provided by law." Based upon the three (3) separate attempts to reach out to a large number of qualified vendors, the Procurement Staff determined that it is in the best interest of the County to exercise the reserved rights and negotiate contracts. Therefore, staff recommends that the Board accept contracts with Arden Courts -Lely Palms of Naples, FL LLC d/b/a Arden Courts of Lely Palms and Shifting Sands Adult Day Center. Required Signatures Project Manager: Louise Pelletier ' A,,,(, p, (1, F;, v J/ 1V/ LVLV Procurement Strategist: Barbara Lance I Ea,� C-�a -t, 3/10/2020 I 14490C19A3D448F_. Procurement Services Director: DOCUSigned by: Sandra He CCC8279B554F5... 3/10/2020 Date Packet Pg. 2182 16. D.4.d 4 6— Collier C01nty Administrative Services Department Procurement Services Division COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS REQUEST FOR PROPOSAL (RFP) Qon SERVICES FOR SENIORS PROGRAM -ADDITIONAL SERVICES -RESPITE FACILITY SERVICES & ADULT DAY CARE SOLICITATION NO: 19-7596 0 Ito BARBARA LANCE, PROCUREMENT STRATEGIST PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 M NAPLES, FLORIDA 34112 a TELEPHONE: (239) 252-8998 Barbara.Lance@colliercountyfl.gov (Email) This solicitation document is prepared in a Microsoft Word format (Rev 8/7/2017). Any alterations to this document made by the Vendor maybe grounds for rejection of proposal, cancellation of any subsequent award, or any other legal remedies available to the Collier County Government. Packet Pg. 2183 16. D.4.d SOLICITATION PUBLIC NOTICE REQUEST FOR PROPOSAL (RFP) NUMBER: 19-7596 PROJECT TITLE: Services for Seniors Program -Additional Services -Respite Facility Services & Adult Day Care LOCATION: PROCUREMENT SERVICES DIVISION, CONFERENCE ROOM A, 3295 TAMIAMI TRAIL EAST, BLDG C-2, NAPLES, FLORIDA 34112 DUE DATE: September 20, 2019 A 3:00 pm PLACE OF RFP OPENING: PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST BLDG C-2 NAPLES, FL 34112 All proposals shall be submitted online via the Collier County Procurement Services Division Online Bidding System: hlWs://www.bidsync.com/bidsync-cas/ INTRODUCTION As requested by the Community & Human Services Division (hereinafter, the "Division or Department"), the Collier County Board of County Commissioners Procurement Services Division (hereinafter, "County") has issued this Request for Proposal (hereinafter, "RFP") with the intent of obtaining proposals from interested and qualified vendors in accordance with the terms, conditions and specifications stated or attached. The vendor, at a minimum, must achieve the requirements of the Specifications or Scope of Work stated. BACKGROUND Collier County requires the provision of services based on no more than 30 minutes of travel time between services and clients' primary residence. Collier County is requesting respite services and adult day care to be delivered to Collier County persons sixty years and older under CCE, OAA and to qualified persons eighteen years or older under ADI. Unless otherwise stated, minimum hours of availability for adult day care are 8:00 am to 5:00 p.m. Monday through Friday, except for federal and state holidays. The hours for Respite Facility services and emergency respite would be available 24 hours/day, 365 days/year. TERM OF CONTRACT The contract term, if an award(s) is/are made is intended to be for three (3) years with two (2) one (1) year renewals. Prices shall remain firm for the initial term of this contract. Surcharges will not be accepted in conjunction with this contract, and such charges should be incorporated into the pricing structure. The County Manager, or designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred eighty (180) days. The County Manager, or designee, shall give the Contractor written notice of the County's intention to extend the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. All goods are FOB destination and must be suitably packed and prepared to secure the lowest transportation rates and to comply with all carrier regulations. Risk of loss of any goods sold hereunder shall transfer to the COUNTY at the time and place of delivery, provided that risk of loss prior to actual receipt of the goods by the COUNTY nonetheless remain with VENDOR. DETAILED SCOPE OF WORK Collier County requires the provision of services based on no more than 30 minutes of travel time between services and the clients' primary residence. The purpose of this solicitation is to secure vendors for the provision of facility respite services and for the provision of adult day care to be delivered to Collier County persons sixty years and older under CCE, OAA and to qualified persons eighteen years or older under ADI. Unless otherwise stated, minimum hours of availability for adult day care are 8:00 am to 5:00 p.m. Monday through Friday, except for federal and state holidays. The hours for Respite Facility services and emergency respite would be available 24 hours/day, 365 days/year. Definitions, standards, and requirements of these services are included in the Department of Elder Affairs' Handbook (DOEA Handbook). c 0 :r 6 co W CD Ln ti os c d E t U M Q Packet Pg. 2184 7. Compile and report program service delivery statistics and other data as identified by CHS. These are reported to the Area Agency on Aging and Department of Elder Affairs in accordance with the reporting requirements developed by the Department. CHS is responsible for entry of data in the Client Information and Registration Tracking System (CIRTS), which generates payment to the service provider agency. 8. Maintain complete and accurate records: Service delivery logs, at a minimum, must be legible and contain the name of client, type/s of services and date/s and hour/s of delivery. The client/caregiver must sign the log at the time of each service visit. The service worker must sign and date the log upon completion and submit it to the service provider agency. Packet Pg. 2185 16. D.4.d Those interested in providing the services detailed below must adhere to all requirements in this RFP, in addition to maintaining adherence with the guidelines referenced in the current DOEA Handbook. Lack of knowledge of all requirements of a service listed in the proposal SHALL NOT relieve the provider of liability and obligations under the agreement. Collier County Community & Human Services (CHS) shall lead all service authorization and coordination. To comply with the requirements of the ADI, CCE, and OAA Programs, clients entering the service system will be assessed and prioritized by CHS. Upon determination of the service level to be provided, the CHS will offer the client a listing of service vendors for the specific service(s) outlined within their care plan. Upon the determination of the service, the service levels, and the selected vendor, CHS will contact the vendor agency, and authorize the service, number of hours, and frequency. In keeping with the state policy of client choice of service providers, Collier County does not guarantee a minimum or maximum number of clients that will be referred, nor a minimum or maximum number of service hours that will be requested during the contract period. CHS shall send the agreed-upon Service Authorization to the chosen provider. These "service authorizations" or "service orders" L must contain necessary client information, such as street address, telephone number, and services or items needed, as well as the V name and telephone number of the CHS case manager authorizing the service. O The County may do so through a competitive and publicly announced selection process, which shall be coordinated through the County's Purchasing Department. Services shall be provided in the manner described in the then current DOEA manual and outlined herein. Services covered by this agreement include, but are not limited to (should funding for additional Senior Services be identified, Q the County reserves the right to add to the resultant agreements the services, descriptions, rates, etc. by way of a contract addendum): 06 k 1. Adult Day Care: A day program of therapeutic social and health activities and day services provided to adults who have functional Z impairments, in a Florida state licensed, protective environment that provides activities as a non -institutional environment as possible. u_ Provides a safe environment for seniors who need daily supervision and can engage with other seniors. Monday -Friday, 8am-5pm °r Q. 2. Facility Respite Services: a nursing facility that provides 24-hour care/365 days and is licensed as a State of Florida Licensed Nursing home. The facility will provide 24/7 nursing care and supervision for days authorized by CHS to assist the senior's caregiver to with respite services. ti 3. Establish protocols for contacting CHS Case Managers in emergency or unusual circumstances and include the a documentation requirements (oral and written) in the Service Provider Application. u_ 4. Provide disaster response protocols, plans and services: In the event of a natural disaster (hurricane, tropical storm, tornado, flood, heat wave, etc.), the provider will have staff available to serve those clients in critical need of services, as designated by the 00 CHS Case Managers. 5. Establish a client grievance process: Each service provider agency must have a policy addressing client grievances and/or c complaints. 6. Establish and provide staff training: All services provided with funding from DOEA require service delivery personnel to have co general pre -service orientation and training specific to the service being provided. CHS is responsible for provision of the pre -service t0 training on program and billing requirements to the vendors who are awarded the Proposal. Pre -service orientation also must include: o6 • An overview of the aging process • An overview of the aging network • Communication techniques with the elderly • Observation of abuse, neglect, exploitation and incident reporting • Client confidentiality. Q NOTE: All "hands-on" service personnel must receive training emphasizing the necessity of Universal Precautions. Aides must have documentation of successful completion of 40 hours required training, and CNAs must have on file a copy of their State of Florida certification. In-service training hours and topics are to be provided at the discretion of the service provider agency and shall meet state requirements. 7. Compile and report program service delivery statistics and other data as identified by CHS. These are reported to the Area Agency on Aging and Department of Elder Affairs in accordance with the reporting requirements developed by the Department. CHS is responsible for entry of data in the Client Information and Registration Tracking System (CIRTS), which generates payment to the service provider agency. 8. Maintain complete and accurate records: Service delivery logs, at a minimum, must be legible and contain the name of client, type/s of services and date/s and hour/s of delivery. The client/caregiver must sign the log at the time of each service visit. The service worker must sign and date the log upon completion and submit it to the service provider agency. Packet Pg. 2185 16.D.4.d 9. Provide complete, clear and accurate invoices: Invoices must be submitted monthly by the following the week once the services have been provided and shall include the services provided. The service week is defined as Monday through Sunday. Monthly invoices will include: • Vendor name • Vendor address • Vendor telephone number • Client name • Services authorized and the service dates • Number of service hours, cost per hour and total cost • Person preparing the report and the date it was prepared 10. Prepare for annual on-site compliance audits by CHS Monitoring Unit team as directed by the CHS Division and/or grant requirements. REQUEST FOR PROPOSAL (RFP) PROCESS 1.1 The Proposers will submit a qualifications proposal which will be scored based on the criteria in Evaluation Criteria for Development of Shortlist, which will be the basis for short -listing firms. The Proposers will need to meet the minimum requirements outlined herein in order for their proposal to be evaluated and scored by the COUNTY. The COUNTY will then score and rank the firms and enter into negotiations with the top ranked firm to establish cost for the services needed. The COUNTY reserves the right to issue an invitation for oral presentations to obtain additional information after scoring and before the final ranking. With successful negotiations, a contract will be developed with the selected vendor(s), based on the negotiated price and scope of services and submitted for approval by the Board of County Commissioners. 1.2 The COUNTY will use a Selection Committee in the Request for Proposal selection process. 1.3 The intent of the scoring of the proposal is for respondents to indicate their interest, relevant experience, financial capability, staffing and organizational structure. 1.4 The intent of the oral presentations, if deemed necessary, is to provide the vendors with a venue where they can conduct discussions with the Selection Committee to clarify questions and concerns before providing a final rank. 1.5 Based upon a review of these proposals, the COUNTY will rank the Proposers based on the discussion and clarifying questions on their approach and related criteria, and then negotiate in good faith an Agreement with the top ranked Proposer. 1.6 If, in the sole judgment of the COUNTY, a contract cannot be successfully negotiated with the top-ranked firm, negotiations with that firm will be formally terminated and negotiations shall begin with the firm ranked second. If a contract cannot be successfully negotiated with the firm ranked second, negotiations with that firm will be formally terminated and negotiations shall begin with the third ranked firm, and so on. The COUNTY reserves the right to negotiate any element of the proposals in the best interest of the COUNTY. RESPONSE FORMAT AND EVALUATION CRITERIA FOR DEVELOPMENT OF SHORTLIST: 1.7 For the development of a shortlist, this evaluation criterion will be utilized by the COUNTY'S Selection Committee to score each proposal. Proposers are encouraged to keep their submittals concise and to include a minimum of marketing materials. Proposals must address the following criteria: Evaluation Criteria Maximum Points 1. Cover Letter / Management Summary 5 Points 2. Certified Minority Business Enterprise 5 Points 3. Business Plan 25 Points 4. Cost of Services to the County 25 Points 5. Experience and Capacity of the Firm 20 Points 6. Specialized Expertise of Team Members 20 Points TOTAL POSSIBLE POINTS 100 Points c 0 0 co W ti as c d E z 0 Q Tie Breaker: In the event of a tie at final ranking, award shall be made to the proposer with the lower volume of work previously awarded. Volume of work shall be calculated based upon total dollars paid to the proposer in the twenty-four (24) months prior to the RFP submittal deadline. Payment information will be retrieved from the County's financial system Packet Pg. 2186 16. D.4.d of record. The tie breaking procedure is only applied in the final ranking step of the selection process and is invoked By Me Procurement Services Division Director or designee. In the event a tie still exists, selection will be determined based on random selection by the Procurement Services Director before at least three (3) witnesses. Each criterion and methodology for scoring is further described below. ***Proposals must be assembled, at minimum, in the order of the Evaluation Criteria listed or your proposal may be deemed non-responsive*** EVALUATION CRITERIA NO. 1: COVER LETTER/MANAGEMENT SUMMARY (5 Total Points Available) Provide a cover letter, signed by an authorized officer of the firm, indicating the underlying philosophy of the firm in providing the services stated herein. Include the name(s), telephone number(s) and email(s) of the authorized contact person(s) concerning proposal. Submission of a signed Proposal is Vendor's certification that the Vendor will accept any awards as a result of this RFP. EVALUATION CRITERIA NO. 2: CERTIFIED MINORITY BUSINESS ENTERPRISE AND/OR VETERAN BUSINESS ENTERPRISE (5 Total Points Available) Submit certification with the Florida Department of Management Service, Office of Supplier Diversity as a Certified Minority Business Enterprise and/or Veteran Business Enterprise. EVALUATION CRITERIA NO. 3: Business Plan (25 Total Points Available) In this tab, include but not limited to: A. Facility Respite: Provide 24 hours per day of care and supervision in a secure facility for seniors, describe intake process and medical screening required. B. Adult Day Care: Provide 8 hours of supervised day care to seniors, describe intake process and medical screening required. 1. Detailed plan of approach (including major tasks and sub -tasks) i. Proposer is licensed from the Agency for Health Care Administration (AHCA) and has the m appropriate license to provide services in Collier or Lee Counties. 00 ii. Proposed by-laws which describes how business is conducted and includes a clear plan for the development/implementation of structured day plan which includes structured activities and daily r schedule. :r 2. Detailed qualifications of staff and staffing plan. Bilingual (i.e. Spanish/English) and culturally competent staff i6 should be identified. Demonstration of plans for training and oversight to provide care to high risk senior W population. ti 3. Include with the Business Plan or as an attachment, the agency's ability, experience and knowledge to administer d6 a Facility Respite program and/or an Adult Day care program. i. Proposer has to provide an Organizational chart indicating lines of authority and staffing c ii. Proposer has supervisory staff on call 24 hours per day/365 days per year. a) E iii. Proposer's Owner/Operator license has never been denied, suspended or revoked by Medicare, Medicaid or any Federal and/or State Agency. M Q EVALUATION CRITERIA NO. 4: COST OF SERVICES TO THE COUNTY (25 Total Points Available) In this tab you will be provided a list of services needed by the County. Those services with rates, In-kind match and Cost Packet Pg. 2187 16. D.4.d already completed are standard rates in which you will be required to accept. Please sign as an acceptance to the rates if you deem these standard rates to be acceptable. I accept the standard contract rates listed below. *The ADI program does not require an in-kind match contribution. Initial pricing is for grading purposes and are subiect to change during negotiations with the selected vendor. EVALUATION CRITERIA NO. 5: EXPERIENCE AND CAPACITY OF THE FIRM (20 Total Points Available) In this tab, include but not limited to: • Provide information that documents your firm's and subcontractors' qualifications to produce the required deliverables, including abilities, capacity, skill, and financial strength, and number of years of experience in providing the required services. • Describe the various team members' successful experience in working with one another on previous projects. The County requires that the vendor submits no fewer than three (3) completed reference forms from clients during the last 5 years whose projects are of a similar nature to this solicitation as a part of their proposal. Provide information on the projects completed by the vendor that best represent projects of similar size, scope and complexity of this project using the Reference Form attached. Vendors may include two (2) additional pages for each project to illustrate aspects of the completed project that provides the information to assess the experience of the Proposer on relevant project work. EVALUATION CRITERIA NO. 6: SPECIALIZED EXPERTISE OF TEAM MEMBERS (20 Total Points Available) In this tab, include but not limited to: • Description of the proposed contract team and the role to be played by each member of the team. • Attach brief resumes of all proposed project team members who will be involved in the management of the total package of services, as well as the delivery of specific services. • Attach resumes of any sub -vendors and attach letters of intent from stated sub -vendors must be included with proposal submission. VENDOR CHECKLIST c 0 2 0 CO W CD LO ti os c d E z U M Q ***Vendor should check off each of the following items as the necessary action is completed (please see, Form 2: Vendor Check Packet Pg. 2188 Cost Per Reimbursement Rate Service Unit In-kind 10% Per Unit (Amount Service (Cost your Match (Amount the County will Item Services Grant Unit company your company will reimburse your company for a given charges for the be contributing) service) service) Skilled CCE, I Nursing DI*, Per Hour $40.00 $4.00 $36.00 Adult CCE, 2 ADI*, Per Hour $13.89 $1.39 $12.50 Day Care OAA, Respite CCE, 3 (Facility ADI*, Per Hour $10.417 $1.04 $9.38 Based) OAA, *The ADI program does not require an in-kind match contribution. Initial pricing is for grading purposes and are subiect to change during negotiations with the selected vendor. EVALUATION CRITERIA NO. 5: EXPERIENCE AND CAPACITY OF THE FIRM (20 Total Points Available) In this tab, include but not limited to: • Provide information that documents your firm's and subcontractors' qualifications to produce the required deliverables, including abilities, capacity, skill, and financial strength, and number of years of experience in providing the required services. • Describe the various team members' successful experience in working with one another on previous projects. The County requires that the vendor submits no fewer than three (3) completed reference forms from clients during the last 5 years whose projects are of a similar nature to this solicitation as a part of their proposal. Provide information on the projects completed by the vendor that best represent projects of similar size, scope and complexity of this project using the Reference Form attached. Vendors may include two (2) additional pages for each project to illustrate aspects of the completed project that provides the information to assess the experience of the Proposer on relevant project work. EVALUATION CRITERIA NO. 6: SPECIALIZED EXPERTISE OF TEAM MEMBERS (20 Total Points Available) In this tab, include but not limited to: • Description of the proposed contract team and the role to be played by each member of the team. • Attach brief resumes of all proposed project team members who will be involved in the management of the total package of services, as well as the delivery of specific services. • Attach resumes of any sub -vendors and attach letters of intent from stated sub -vendors must be included with proposal submission. VENDOR CHECKLIST c 0 2 0 CO W CD LO ti os c d E z U M Q ***Vendor should check off each of the following items as the necessary action is completed (please see, Form 2: Vendor Check Packet Pg. 2188 List): The Solicitation Submittal has been signed. The Solicitation Pricing Document (Bid Schedule/Quote Schedule/Proposal Pricing/etc.) has been completed and attached. All applicable forms have been signed and included, along with licenses to complete the requirements of the project. Any addenda have been signed and included. Affidavit for Claiming Status as a Local Business, if applicable. Division of Corporations - Florida Department of State — http://dos.inyflorida.com/sunbiz/ (If work performed in the State). E-Verify/Immigration Affidavit (Memorandum of Understanding). 16. D.4.d r- 0 :r 0 CO W ti C6 c d E z 0 Q Packet Pg. 2189 C>®y Admn%tave Sw4ms Depanm"A Pr=immnt Smices Dvisim Form 2: Vendor Check List 16. D.4.f IMPORTANT: THIS SHEET MUST BE SIGNED. Please read carefully, sign in the spaces indicated and return with your Proposal. Vendor should check off each of the following items as the necessary action is completed: L�V The Solicitation Submittal has been signed. +� The Solicitation Pricing Document (Bid Schedule/Quote Schedule/etc.) has been completed and attached. [� All applicable forms have been signed and included, along with licenses to complete the requirements of the project. Any addenda have been signed and included. Affidavit for Claiming Status as a Local Business, if applicable. [� Division of Corporations - Florida Department of State — http.//dos.m ryflorida.com/sunbiz/ (If work performed in the State). E-Verify/Immigration Affidavit (Memorandum of Understanding). ALL SUBMITTALS MUST HAVE THE SOLICITATION NUMBER AND TITLE Name of Firm: Address: City, State, Zip: Telephone: Email: Representative Signature: Representative Name: .: • AA ! _ f FA+ ✓ HYYwh I�yl.�vrJ Date _/��/7 IE' • eu d �a U ca Q 06 ca LL ii N d rn LO ti rn a UM M 00 r �a 0 CL 0 a i W a� w s W W rn LO rn d E s r r Q Packet Pg. 2190 Co > C014nty Admjni5b� ;� C7epatTm# Prowra mera Semces CNmm Form 3: Conflict of Interest Affidavit 16.D.4.f The Vendor certifies that, to the best of its knowledge and belief, the past and current work on any Collier County project affiliate( with this solicitation does not pose an organizational conflict as described by one of the three categories below: Biased ground rules — The firm has not set the "ground rules" for affiliated past or current Collier County project identifee above (e.g., writing a procurement's statement of work, specifications, or performing systems engineering and technica direction for the procurement) which appears to skew the competition in favor of my firm. L Impaired objectivity — The firm has not performed work on an affiliated past or current Collier County project identifies above to evaluate proposals / past performance of itself or a competitor, which calls into question the contractor's ability tc 0 render impartial, advice to the government. +, Unequal access to information — The firm has not had access to nonpublic information as part of its performance of ; Q Collier County project identified above which may have provided the contractor (or an affiliate) with an unfair competitivE 6 advantage in current or future solicitations and contracts. In addition to this signed affidavit, the contractor / vendor must provide the following: Li 1. All documents produced as a result of the work completed in the past or currently being worked on for the above-menti.onec project; and, CL 2. Indicate if the information produced was obtained as a matter of public record (in the "sunshine") or through non-public (not it the "sunshine") conversation (s), meeting(s), document(s) and/or other means. rn LO Failure to disclose all material or having an organizational conflict in one or more of the three categories above be identified, mai w result in the disqualification for future solicitations -affiliated with the above referenced project(s). a LL By the signature below, the firm (employees, officers and/or agents) certifies, and hereby discloses, that, to the best of their knowledg( W and .belief, all relevant facts concerning past, present, or currently planned interest or activity (financial, contractual, organizational w or otherwise) which relates to the project identified above has been. fully disclosed.and does not pose an organizational conflict. w Firm:-fllh75- o1CLS LL e Signature and DatCh&, C . aPrint Name: JHl1yrtil�/kl;*{'��r i Title of Signatory:. I%ll�►tfr� _ v7 c t y to rn LO os r c a� E t Q Packet Pg. 2191 coll u y ?rowrerreTi Servims t7ivssw Form 4: Vendor Declaration Statement BOARD OF COUNTY COMMISSIONERS Collier County Government Complex Naples, Florida 34112 Dear Commissioners: 16. D.4.f The undersigned, as Vendor declares that this response is made without connection or arrangement with any other person and thi proposal is in every respect fair and made in good faith, without collusion or fraud. The Vendor agrees, if this solicitation submittal is accepted, to execute a Collier County document for the purpose of establishing formal contractual relationship between the firm and Collier County, for the performance of all requirements to which the solicitatioi pertains, The Vendor states that the submitted is based upon the documents listed by the above referenced Solicitation. Further, thi vendor agrees that if awarded a contract for these.goods and/or services, the vendor will not be eligible to compete, submit; proposal, be awarded, or perform as a sub -vendor for any future associated with work that isja result of this awarded contract IN WITNESS WHEREOF, WE have hereuntgsubscribed our names on this, day of ! 20 Mn the County of in the State of0 • . Firm's Legal Name: Address: 52,FS116 City, State, Zip Code: Florida Certificate of Authority Document Number Federal Tax Identification Number *CCR # or CAGE Code *Only if Grant Funded Telephone: Signature by: (Typed and written) Title: �,-1 jel J4 "7105 7,0o r/7i d L U ca 0 r Q 06 w LL m CL N d rn LO ti a LL M 00 0 CL 0 a. I c� Cn w s U) cc M LO ti C6 r d E t r r Q Packet Pg. 2192 Packet Pg. 2193 Additional Contact Information 16.D.4.f Send payments to: lh � •P.C�S ACka4 bgQu (required if different from Company name ded as payee above) Contact name: Title: Address: City, State, ZIP &"I � � �" d L Telephone: U ca r Email:Q kq C'D.y,'-1 its w Office servicing Collier County to place orders LL (required if different from; above) ii Contact name: ayi Title: L ti Address: rn r a LL City, State, ZIP M Telephone: 00 r Email: 0 0 CL 0 L a i c� a� _ w s U) cc rn LO rn r �i _ d E t V rr Q Packet Pg. 2193 cogP ier coulity Ac:rnirs abve Serviaas Dem cuemert Semmes rDwoon Form 5: Immigration Affidavit Certification 16. D.4.f This Affidavit is required and should be signed, notarized by an authorized principal of the firm and submitted with formal solicitatioi submittals. Further, Vendors are required to enroll in the E -Verify program, and provide acceptable evidence of their enrollment, a the time of the submission of the Vendor's proposal. Acceptable evidence consists of a copy of the properly completed E-Verif: Company Profile page or a copy of the fully executed E -Verify Memorandum of Understanding for the company. Failure to includ, this Affidavit and acceptable evidence of enrollment in the E -Verify program may deem the Vendor's proposal as non responsive. Collier County will not intentionally award County contracts to any Vendor who knowingly employs unauthorized alien workers constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e) Section 274A(e) of the Immigratioi and Nationality Act ("INA"). Collier County may consider the employment by any Vendor of unauthorized aliens a violation of Section 274A (e) of the INA. Sucl Violation by the recipient of the Employment Provisions contained in Section 274A (e) of the INA shall be grounds for unilatera termination of the contract by Collier County. Vendor attests that they are fully compliant with all applicable immigration laws (specifically to the 1986 Immigration Act an subsequent Amendment(s)) and agrees to comply with the provisions of the Memorandum of Understanding with E -Verify and t: provide proof of enrollment in The Employment Eligibility Verification System (E -Verify), operated by the Department of Homelanc Security in partnership with the Social Security Administration at the time of submission of the Vendor's proposal. Company Name � �'! A/ L Print Name �~ �y�'7 Title Signature Date State of L/OdAa- County of 1,ee The signee of these Affidavit guarantees, as evidenced by the sworn affidavit required herein, the truth and accuracy of this affidavit to interrogatories hereinafter made, m c`a U ca r Q 06 w ca LL m Q N rn LO ti a u_ c� w w 0 CL 0 a I W M c� Cn a� w s 07 cc rn LO rn m E t ca w Q Packet Pg. 2194 Col ler CaH11ty ldmInL91f"W" Swviwes DepwbTwt Prom-bme $Mn'� Ws i3ivrml Form 6: Vendor Substitute W - 9 Request for Taxpayer Identification Number and Certification 16. D.4.f In accordance with the Internal Revenue Service regulations, Collier County is required to collect the following information for tax reporting purposes from individuals and companies who do business with the County (including social security numbers if used by the individual or company for tax reporting purposes). Florida Statute 119.071(5) requires that the county notify you in writing of the reason for collecting this information, which will be used for no other purpose than herein stated. Please complete all information that applies to your business and return with your quote or proposal. 1. General Information (provide all information) Taxpayer Name ! (as shown on income tax return) Business Name (f di erent from t H name) 1-Wl n� �b "6-S Com'' LLQ, Address 0�/ H City /506 State _7 Order Information Remit / Payment Information OWWR M�.._ Address 9LIM &2A &=I -JX -_'V7 Address . Z&pj ¢h &gg A(7 Ban ijA U 4,003 an City State zip Zip 3y� City -.5p t4_ A State 44- -► Zip -Sylar �-A. y rn�Srgn�4.�niDLSects Emails�lnp 2. Company Status (check only one) Individual / Sole Proprietor _Corporation Partnership _Tax Exempt (Federal income tax-exempt entity united Liability Company under Internal Revenue Service guidelines IRC 501 3) G (c) Enter the tax classification _ = Partners iv1 3. Taxpayer Identification Number (for tax reportingpurposes only) Federal Tax Identification Number (TIN) (Vendors who do not have a TIN, will be re wired to provide a social security number prior to an award . 4. Sign and Date Form: Certification: Under penalties ofperiury, I certify that the information shown on this form is correct to my knowledge. Signature of S. Date Title r� Phone Number a� Packet Pg. 2195 ® Worker s Compensatton Statutory Limits of F arida Statutes, Chapter 440 and all Federal Government 1: ' Statutory Limits and Requirements 2. ® Employer's Liability 3. ® Commercial General Liability (Occurrence Form) pattemed after the current ISO form 1,000,000_ single limit per occurrence Bodily Injury and Property Damage $_1,000,000 single limit per occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. 4. ® Indemnification To the maximum extent permitted by Florida law, the ContractorNendor shall defend, 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 Contractor/ Vendor or anyone employed or utilized by the ContractorNendor in the performance of this Agreement. 5. ® Automobile Liability $_1,000,000_ Each Occurrence; Bodily Injury & Property Damage, Owned/Non-owned/Hired; Automobile Included 6. ® Other insurance as noted: ❑ Watercraft $ Per Occurrence ❑ United States Longshoreman's and Harborworker's Act coverage shall be maintained where applicable to the completion of the work. $ Per Occurrence ❑ Maritime Coverage (Jones Act) shall be maintained where applicable to the completion of the work. $ Per Occurrence ❑ Aircraft Liability coverage shall he carried in limits of not less than $5,000;000 each occurrence if applicable to the completion of the Services under this Agreement, $ Per Occurrence ❑ Pollution $ Per Occurrence ® Professional Liability/Abuse Coverage $ 1,000,000_ Per claim & in the aggregate ❑ Project Professional Liability $ Per Occurrence ❑ Valuable Papers Insurance $ Per Occurrence ® Crime/Theft Insurance $25,000 Per Occurrence ❑ Technology Errors & Omissions $ Per Occurrence 7. ❑ Bid bond Shall be submitted with proposal response in the form of certified funds, cashiers' check or an irrevocable letter of credit, a cash bond posted with the County Clerk, or proposal bond in a sum equal to 5% of the cost proposal. All checks shall be made payable to the Collier County Board of County Cominissioners on a bank or trust company located in the State of Florida and insured by the Federal Deposit Insurance Corporation. d U ca r Q 06 w ca LL m Q N d rn LO r, a U. M w Packet Pg. 2196 16.D.4.f 8. 0 Performance and Payment For projects in excess of $200,000, bonds shall be submitted with the executed contract Bonds by Proposers receiving award, and written for 100% of the Contract award amount, the cost borne by the Proposer receiving an award. The Performance and Payment Bonds shall be underwritten by a surety authorized to do business in the State of Florida and otherwise acceptable to Owner; provided, however, the surety shall be rated as "A-" or better as to general policy holders rating and Class V or higher rating as to financial size category and the amount required shall not exceed 5% of the reported policy holders' surplus, all as reported in the most current Best Key Rating Guide, published by A.M. Best Company, Inc. of 75 Fulton Street, New York, New York 10038. 9. ® Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is required to meet. The same Vendor shall provide County with certificates of insurance meeting the required insurance provisions. 10. ® Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of the Additional Insured and the Vendor's policy shall be endorsed accordingly. 11. ® The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR Collier County Government, OR Collier County. The Certificates of Insurance must state the Contract Number, or Project Number, or specific Project description, or must read: For any and all work performed on behalf of Collier County. 12. ® On all certificates, the Certificate Holder must read: Collier County Board of Commissioners, 3295 Tamiami Trail East Naples, FL 34112 13. ® Thirty (30) Days Cancellation Notice required. 14. 4111/19 - CC Vendor's insurance Statement We understand the insurance requirements of these specifications and that the evidence of insurability may be required within five. (5) days of the award of this solicitation. The insurance submitted must provide coverage for a minimum of six. (6) months from the date of award. '"�� Name of Firm d/?Y'�//f �liW i� °2 .[Date�1 Vendor Signature Print Name Insurance AgencyP, E!/ Agent Name Telephone Number d V O Q LL a� r CL N m w LO ti w T_ a LL en w r 0 a 0 L a i c 0 t y to M LO c6 c a� t R Q Packet Pg. 2197 I 16.D.4.f I CERTIFICATE OF LIABILITY INSURANCE�DATE(MMlbOlYWY) ' 05/02/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL„ INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of sue h endorsements), PRODUCER NAME CT Joan Randolph Comegys Insurance Agency r"UNE (727) 521 2400 One Beach Drive S. E. Ste, 230 Saint Petersburg INSURED Shifting Sand$ Adult Day Care, LLC 28440 Bonita Crossings Blvd. Unit B7 A!C No Ext E-MAIL joan.randol ph@comegys.com ADDRESS: P aQ 9ys.com INSURER(S) AFFORDING COVERAGE FL 33704 INSURER A: Lloyds of London INSURER 8: INSURER C; INSURER 0: INSURER E: (727) 528-0636 d NAIC FCC U CC O 7 Q Bonita Springs FL 34134 INSURER F: 0 COVERAGES CERTIFICATE NUMBER: 19120 GL/PL REVISION NUMBER: >% THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEN#WITH RESPECT TO WHICH THIS :75- CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, LL EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.MSR ADDL SUB, d :TR TYPE OF INSURANCE INSO WVD PDLIOY NUMSER POLICY EFF P MDP MMlDD1YYYY MMh1 UMRS Q. X COMMERCIAL GENERAL LIABILITY 1,000,D00 DAMAGE EACH OCCURRENCE g' d CLAIMS -MAGE /� OCCUR ._ 50000 A Y I 1 1117349 GEN'L AGGREGATE LIMIT APPLIES PER; PO- X POLICY 1:1 JE T FLOC OTHER: AUTOMOBILE LIABILITY —� ANYAUTO OWNED( j SCHEDULED AUTOS ONLY '❑j AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAS OCCUR EXCESS LIAR H _, _ __ RETENTION AND EMPLOYERS' LIABILITY YIN I ANY PROPRIETO{UPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N / A (Mandatory in NH). 4 Yes, describe under DESCRIPTION OF OPERATIONS b.1— 05/01/2019 1 05/01/2020 EXP BODILY INJURY (per person) BODILY INJURY (Per accident) E.L. EACH DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached in mere space is required) - - Collier County Board of County Commissioners is included as additional insured with respect to General Liability on a primary and non-contributory basis if and to the extent required by written contract. Collier County Board of County Commissioners 3295 Tamiami Trail E. Naples ACORD 25 (2016103) FL 34112 $ $ 5,000 $ 1,000,000 -. ti $ 3,000,000 $ 1,000,000 ILL $ Do r $ O CL - $ 0 W t4 $ t U) In ti r r r:, C d SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE'' . THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. .._,..•+rc. R-Cocri i Al IYt 01988-2015 ACORD CORPORATION. All rights reserve The ACORD name and logo are registered marks of ACORD Packet Pg. 2198 CERTIFICATE OF LIABILITY INSURANCE 16. D.4.f THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLIC BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERl AUTHORh REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endor. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statemen this certificate does not confer rjohts to the certificate holder in lieu of such endorsement(s). PRODUCER' Marsh USA, Inc. 1166 Avenue of the Americas NAME: PHC No AIC No : E-MAIL ADDRE : New York, NY 10036 Attn: Allanta.Certrequest@marsh.com POLICY NUMBER EFF MMIDDIYYYY INSURERS AFFORDING COVERAGE NAI INSURER A; Illinois National Insurance Company 23817 342881 -FL -WC -19-20 815021 INSURED DeasionHR, Inc. INSURER 8 INSURER C : 11101 Roosevelt Blvd N St. Petersburg, FL 33716 ruQ: pro n COVERAGES CERTIFICATE NUMBER: ATL -004948595-01 REVISION NUMBER: 3 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEF INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH " CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TEF EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRPOLICY LTR TYPE OF INSURANCE IN= SUBR POLICY NUMBER EFF MMIDDIYYYY PO EXP MM DDlYYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER. RO- POLICY JECTPRO LOC OTHER_ GENER4LAGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE - LIABILITY ANY AUTO_ _ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NDN -OWNED AUTOS ONLY AUTOS ONLY _ COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) - $ BODILY INJURY (Per accident) $ PROPERTYOAMAGE $ Per accident UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE - EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? � {Mandatory in NH) If yes, describe and ®r DESCRIPTION OF OPERATIONS below NIA WC 023540396 0610112020 X PEROTH- STATUTE ER E.L. EACH ACCIDENT $ 1 E= L. DISEASE - EA EMPLOYEE $ 1 E.L. DISEASE - POLICY LIMIT $ 1. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may Be attached if more space is required) Coverage is provided for only those employees leased to but not subcontractors of Shifting Sands Adult Day Center, LLC Shifting Sands Adult Day Center, LLC I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEF 28410 Bonita Crossings Blvd, Suite B7 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEREC Bonita Springs, FL 34135 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Henry L. Whiting a �- _ Z- (0 - V LL U 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Packet Pg. 2199 Fiarida D ent of State Department of State !.Division of Caroorations 1 _$_eQCM tteco / petalt @y Document Number ! Detail by Entity Name Florida Limited Liability Company SHIFTING SANDS ADULT DAY CENTER, LLC Filing Information Document Number L18000058878 FEI/EIN Number 82-4662042 Date Filed 03/06/2018 State FL Status ACTIVE Principal Address 28410 Bonita Crossings Blvd Suite 7 Bonita Springs, FL 34135 Changed: 05/29/2019 Mailina Address 28410 Bonita Crossings Blvd Suite 7 Bonita Springs, FL 34135 Changed: 05/29/2019 Registered Agent Name & Address RICHARDSON, SCOTT 1579 Whispering Oaks Circle NAPLES, FL 34110 Address Changed: 05/29/2019 Authorized Person(s) Detail Name & Address Title AR RICHARDSON, SCOTT 1579 Whispering Oaks Circle NAPLES, FL 34110 Title MGR WILKINSON, TAMATHA 16. D.4.f Dmsioni OP CORPORATIONS Packet Pg. 2200 1579 Whispering Oaks Circle NAPLES, FL 34110 Annual Reports Report Year Filed Date 2019 05/29/2019 Document Immes 4.5,09)2919.,=�/�Nt4 LBEP .�T. View image in POF fnrrnat 0310612018 .- Florida Um!t90.LlabifityjView image in PDF format Florida Deoarti mart of sUte, Divlalon 4 Curpolmons 16. D.4.f Packet Pg. 2201 c . .,., �✓ '.: a...,,. .. .,'�o .(.• �.cS+...`it''a"'f.3w�'fa.?.?':.:Sc-'YrSS*rra�`br.'_r�1.�xb K � .... ".. . Company ID !Number: 1402649 Approved by: Page 13 of 17 E -Verify MOU for Employers I Revisivri Date 06/01/13 Packet Pg. 2202 ym- Company ID Number: 1402649 Page 14 of 17 E -Verify MOU for Employers I Revision Date 06/01113 7E rn 0 CL 0 L a I s rn LO P7 rn r _ d t V f� w+ w+ Q Packet Pg. 2203 US 16.D.4.f Company ID Number: 1402649 Are you verifying for more than 1 site? If yes, please provide the number of sites verified for in each State: FLORIDA 1 site(s) Page 15 of 17 E -Verify MOU for Employers I Revision Date 06/01/13 Packet Pg. 2204 C6)p1mer County Swvkw Depw"t ProcuremeO semam Dwson Reference Questionnaire Solicitation: 16. D.4.f Reference Questionnaire for: Shiftin Sands Adult Day Center (Tammy Wilkinson) (Name of Company Requesting Reference Information) Shifting Sands Adult Day Center, LLC (Name of Individuals Requesting Reference Information) Name e -l) t4—r Company: Current Client (Evaluator completing reference questionnaire) (Evaluator's Company completing reference) lle4 �.7� �g 4? Email: I S �; , ZO n. FAX: NA Telev one: g _ f„ f Collier County has implemented a process that collects reference information on firms and their key personnel to be used in the selection of firms to perform, this project. The Name of the Company listed in the Subject above has listed you as a client for which they have previously performed work. Please complete the survey. Please rate each criteria to the best of your knowledge on a scale of I to 10, with 10 representing that you were very satisifed (and would hire the firm/individual again) and 1 representing that you were very unsatisfied (and would never hire the firm/indivdival again). If you do not have sufficient knowledge of past performance in a particular area, leave it blank and the item or form will be scored "0." Project Description: Current Client of Center Completion Date: Ongoing Project Budget: NA Project Number of Days: NAA 1 Ability to manage the project costs (minimize change orders to scope). 4/49- 2 Ability to maintain project schedule (complete on-time or early). �6 3 Quality of work. 4 Quality of consultative, advice provided on the prooct. Al 5 Professionalism and ability to manage personnel. 6 Project administration (completed documents, final invoice, final product turnover; invoices; manuals or going forward documentation, etc.) 7 Ability to verbally communicate and document information clearly and succinctly. 8 Abiltity to manage risks and unexpected project circumstances. %Q 9 Ability to follow contract documents, Folicies, procedures, rules, regulations, etc. f� 10 Overall comfort level with hiring the company in the future (customer satisfaction). ! Q TOTAL SCORE OF ALL ITEMS Packet Pg. 2205 16. D.4.f STATE, OF FI.ORIDA TIF,PARTMFNT nF VTI lP0 ARVATDC rrvn U7!'"'Vo �Xxr r r-__ ­.. '. ­ Program/Facility Name, Program/FacilityName: &71� L County:-- -- -- - +AAA/Contractor 1 Address: UCompleted ro,6o r By: City State, Zip Code: V Date: Teleph IV I!, rlvrVKMAI14UN W11HUH WILL HELP YOU COMPLETE THIS FORM. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: 7 For questions 2-5, please indicate the following: Total # White Black Hispanic Other Female Disabled Over 2.Population of area served Source of data Dpi Compare the staff composition to the population. Is staff representative of the population? :1� a, 3.Staffcurrently employedSource of data S✓ �� O Q a v �D 4.Clients currently enrolled/registered Source of data O 9,f v F]jS: D d 5.Advisory/Governing Board if applicable Source of data NO ,001 v 1 t., / v _/ �A*. PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 1. Is an Assurance of Compliance on file with DOEA? N/A ❑ YES NO ❑ 2. Compare the staff composition to the population. Is staff representative of the population? N/A YES NO 3. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, sex, age, religion or disability? N/A ❑ YES NO ❑ 4. Are all benefits, services and facilities available to applicants and participants in an equally effective - manner regardless of race, sex, color, age, national origin, religion or disability? N/A YES NO 5. For in-patient services, are room assignments made without regard to race, color, national origin or disability? N/A YES ❑ NO ❑ 6. Is the program/facility accessible to non-English speaking clients? N/A YES NO 7. Are employees, applicants ami particippu informed of their protection against discrimination? If YES, how? Verbal 2 Written ®'Poster N/A ❑ YES NO ❑ 8. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility. N/A NUMBER 1 Packet Pg. 2206 PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE. 15. Do you have a written affirmative action plan? If NO, explain. YES NO ❑ ❑ Reviewed By In Compliance: YES ❑ NO* .❑ 16. D.4.f 9. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals? N/A YE NO Response Due On -Site ❑ Desk Review ❑ El ❑ PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF NO EXPLAIN 10. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make any necessary modifications? YES NO d L 11. Is there an established grievance procedure that incorporates due process in the resolution of complaints? YES NO V ❑ ❑ ca 12. Has a person been designated to coordinate Section 504 compliance activities? YES NO Q ❑ ❑, 06 w 13. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? YES NO Li ❑ ❑ y d 14. Are auxiliary aids available to assure accessibility of services to hearing and sight -impaired individuals? YES NO ❑ ❑LO ti PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE. 15. Do you have a written affirmative action plan? If NO, explain. YES NO ❑ ❑ Reviewed By In Compliance: YES ❑ NO* .❑ Program Office *Notice of Corrective Action Sent Date Telephone Response Due On -Site ❑ Desk Review ❑ Response Received I I Revised August 2010, Page 2 of t GCA -1t 2 Packet Pg. 2207 1*114I- ■R:3 16. D.4.f GRANT ASSURANCES AND CERTIFICATIONS The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and other agreements/contracts and that all Subcontractors shall certify compliance accordingly. This certificationis a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certification is a prerequisite for malting or entering into this Contract imposed by Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A -I 10). L RECORDS AND DOCUMENTATION The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all contract related records and documentation. The Contractor shall ensure the collection and maintenance of all program related information and documentation on any such system designated by the Agency. Maintenance includes valid exports and backups of all data and systems according to Agency standards. J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS 1. In addition to the requirements of sections 10.1 and 10.2 of the Standard Contract, sections 119.0701(3) and (4) F.S., and any other applicable law, if a civil action is commenced as contemplated by section l 19.0701(4), F.S., and the Agency is named in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the Agency and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made pursuant to Chapter 119, F.S., concerning this contract or services performed thereunder. a. Notwithstanding section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed between the Agency and state agencies or subdivisions defined in section 768.28(2), F.S. 2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions for any person, corporation, foundation, trust, association, group, or other organization, all the financial, business, and membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest Florida, Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a public record shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances. Additionally, I certify this organization does does not provide for institutional memberships. Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are available for inspection if applicable, as stated above. By execution of this contract, Contractor.must include these provisions (A -J) in all related subcontract agreements (if applicable). By signing below, Contractor certifies that the representations outlined in parts A through J above are true and correct. GCA -6 Packet Pg. 2208 —Signature Abil Title of Authorized lRepresentative Street Address Contract. � "� to City, State, Zip code GCA -6 Packet Pg. 2208 16. D.4.f EXHIBIT 1.13 GRANT CERTIFICATIONS AND ASSURANCES 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and 2 CFR Part 200. 18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies governing this program. SIGN TURF OF AUTHORIZED CERTIFYING OFFICIAL TITLE � APPLICANT ORGANIZATION DATE SUBMITTED GCA _g Packet Pg. 2209 EXHIBIT13 /9- Xrf&-0/- or Collier County Solicitation No. G ANT CERTIFICATIONS AND -ASSURANCES I, T'4— ►c/ A Zpze V-7 , hereby certify that to the best of my knowledge, neither I nor m spouse, dependent child, general partner, or any organization for which I am serving as an officer, director, trustee, general partner or employee, or any person or organization with whom I am negotiating or have an arrangement concerning prospective employment has a financial interest in this matter. I further certify to the best of my knowledge that this matter will not affect the financial interests of any member of my household. Also, to the best of my knowledge, no member of my household; no relative with whom I have a close relationship; no one with whom my spouse, parent or dependent child has or seeks employment; and no organization with which I am seeking a business relationship nor which I now serve actively or have served within the last year are parties or represent a party to the matter. I also acknowledge my responsibility to disclose the acquisition of any financial or personal interest as described above that would be affected by the matter, and to disclose any interest I, or anyone noted above, has in any person or organization that does become involved in, or is affected at a later date by, the conduct of this matter. NO Name Signature A/-Wj Position Date Privacy Act Statement Title I of the Ethics in Government Act of 1978 (5 U.S.C. App.), Executive Order 12674 and 5 CFR Part 2634, Subpart I require the reporting of this information. The primary use. of the information on this form is for review by officials of The Justice Department to determine compliance with applicable federal conflict of interest laws and regulations. Additional disclosures of the information on this report may be made: (1) to a federal, state or local law enforcement agency if the Justice Department becomes aware of a violation or potential violation of law or regulations; (2) to a court or party in a court or federal administrative proceeding if the government is a party or in order to comply with a judge -issued subpoena; (3) to a source when necessary to obtain information relevant to a conflict of interest investigation or decision; (4) to the National Archives and Records Administration or the General Services Administration in records management inspections; (5) to the Office of Management and Budget during legislative coordination on private relief legislation; and (6) in response to a request for discovery or for the appearance of a witness in a judicial or administrative proceeding, if the information is relevant to the subject matter. This confidential certification will not be disclosed to any requesting person unless authorized by law. See also the OGE/GOVT-2 executive branch -wide Privacy Act system of records. GCA -15 16.D.4.f Packet Pg. 2210 16.D.4.f EXHIBIT LB GRANT' C ERI'IFIC:'A'I'IONS AND ASSURANCES GCA -16 a Packet Pg. 2211 16.D.4.f EXHIBIT I.B GRANTCERTIFICATIONS AND ASSURANCES GCA - 17 Packet Pg. 2212 s I r ry . .. .. .. .. III-....- �W t rt y, �. GCA - 17 Packet Pg. 2212 BACKGROUND SCREENING Affidavit of Compliance - Employer AUTHORITY: This form is required annually of all employers to comply with the attestation requirements set forth in section 435.05(3), Florida Statutes. A The term "employer" means any person or entity required by law to conduct background screening, including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Serving Health Insurance Needs of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires employees or has volunteers in service who meet the definition of a direct service provider. See §§ 435.02, 430.0402, Fla. Stat. ➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide services to the elderly, has direct, face-to-face contact with a client while providing services to the client and has access to the client's living area, funds, personal property, or personal identification information as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential facilities; and volunteers." § 430.0402(1)(b), Fla. Stat. ATTESTATIM I 16. D.4.f ..... v111UF1Uncrrcutrve r that the above named employer is in compliance with the provisions of Chapter 435 and section 430.0402, Florida Statutes, regarding level 2 background screening. i �~'� Signature of Representative J � t C� Date STATE OF FLORIDA, COUNTY OF Sworn to (or affirmed) and subscribed before me this °fir cfay of 20_� , b --� y (Name of Representative) who is personally known to _me or produced 4-14 (!�A�rnrn,facr- Print, Type, or Stamp commissioned Name of Notary Public • .► as proof of identification, TRINA W CAR90NNEAU DOEA Form 235, Affidavit of Compliance - Employer, Effective April 2012 _. . 5 Form available at: htt elderaffairs.state.flCommission 4 GGSM(dn 435 (3), F.S. .us en lisp bac roundscreenine.ohn t�P. cF, ,• My Comm.ExplresJul13.2021 Packet Pg. 2213 1 CERTIFICATE OF LIABILITY INSURANCE 16. D.4.g 647u 3/4/2020 THIS CERTIFICATE IS I33UED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOI-Or=R• THI: CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE; BEli-OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE[ REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the cercif(cata hoidar 1s an ADDITIONAL INSURED, the policyfies) must have ADDITIONAL INSURED provisions or be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditiogs of the policy, certain policias may require an endorsement. A staternent of this certificate does not eonfar riahts to the Certificate holder In lieu of such endorsament(s). PRODUCER HYlant Group Inc - Toledo 811 Madison, Ave Toledo OH 43504 INSURED HCR ManorCare, Inc. and its subsidiaries P.O. Box 14086 Toledo OH 43699-0086 419-254-5442 INSURERS AFFORDING COVERAGE INSURER A - insurance Ca of the State of PA C: NAIC 9 19429 COVERAGES CERTIFICATE NUMBER: Fp$9773714 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSLIRANCE LISTED BELOW HAVE BEEN ISSUED TO THE. INSURED NAMED ABOVE FOR THE POLICY PER101 INDICATED. N0TVV1THSTANDING ANY R(=OUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH YHI CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS rXCA HgIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IL LTR - - - TYPE OF INSURANCE A POLICY NUMBER MMfDDNYYY POLICY %P LIMITS i COMMERCIALGENrRAL LIABILITY EACH OCCURRENOS $ PREMISES Ee occu n e $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ _ PERSONAL. & ADV INJURY GEN1 AGGREGATE LIMIT APPLIES PER GENERALAGGREGATE $ PRODUCTS -COMF1OPAGG $ POLICY JF& LOC El S OTHER: A A AUTOMOBILEUAe1LITY j( ANY AUTO CA2991921 GA2991922 611J2019 611/2019 8/112020S1,000,000 6/112020 SINGLE LIMIT Ee _ rQ 61,000,000 8 SODA -Y INJURY (Per 06raon) BODILY INJURY (Per q=ident) S OWNED SCHEDULED AUTOS ONLY AUTOS WIRED NON-0WN1 D AUTOS ONLY Y AUTOS ONLY TY DAMAGE Per ccidmi S S UMBRgLLA LIAR OG4UR E=ACH pGOL)RRENCE $ AGGREGATE $ "CESS LIAB OLAIMS-MADE DED I RETENTIONS $ WORKERS COMPENSATION pp PET TE ERH AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNER7EXECUTfvE E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE 5 OFFI C-7MMEMBER EXCLU DEO? ❑ (Mandatary In NH) NIA E.L. DISEASE -POLICY LIMIT $ if yes desorl4e under ()ESGRlPT1 N OF qPrRATIONS below A A HIRED CAR PHYSICAL. DAMAG3-$46.MO GA2991921 CA2991922 6/112019 611!2019 6/1/2020 6/1/2020 $504 T1,000 Did, Camp. Ded. 0411. bESCRIPTION OF OPERATIONS 1 LOCAMNS 1 VEHICLES (ACORD 191, Additronal Remarks Schedule, may be attached if more space Is required) Hired Car Physical Oamage applies to autos leased for a period not to exceed 30 days. Additional InsuredfLoss Payee applies to all lessors. RE: Arden Courts of Lely Palms #449; 6125 Rattlesnake Hammock Road; Naples, FL 34113 C Collier County Board of County Commissioners 3327 Tamiami Trail East Naples FL 34112-4901 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE GAi4CELLED BEFOR THE EXPIRAMN DATE THEREOF, NOTICE WILL BE DELIVERED ACCORIJANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE chi 1988-2015 ACORD CORPORATION. All rights reservea- ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Packet Pg. 2214 16. D.4.g 12012019 ACC>RbP CERTIFICATE OF LIABILITY INSURANCE DATE 9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OIT ALTER THE COVERAGE AFFORDED BY THE POLICIE BELOW. THIS CERTIrICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN TETE ISSUING INSURER(S), AUTHOR17E REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certifi4ate hoiddir it an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorse+ If Stji3ROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement a this certificate does not confer rights to the Certificate holder in Ileu of such endorsement(s). PRODUCER AIG Captive Management 30 Main Street, Suite 330 Burlington VT 05401-1687 NTA r NAM , PH NE 419-255-1020 Faxpj�A Ig_259-BOU1 E-MAIL ADDRESS! INSURER $ AFFORbING COVERAGE NAIC N 1011!2020 INSUR)=RA; ProMedica IndemnityCorp INSURED HCRMANO-04 INSURER 9: ProMedica Health System Inc. HCR ManorGars, Inc. and its subsidiaries lNSURERC; iNSUPER D: M&ii Stop Code: MSC -S29932 100 Madison Ave Toledo OH 43604 INSURER E: INSURE F REVISION NUMBER_ THIS IS TO CERTIFY THAT THE. POLICIES OF INSURANCE LISTED BELOW HAVE OEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERK; INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ,ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MSR TYPE~ OF INSURANCE —SU —BR POLICY NUMBIR POLICY EFF MrJf0nr Y7Y POLICY mwoumYY LIMITS A X COMMERCIALGENERALUABILITY Y HOR00119 1011!2!)19 1011!2020 EACH OCCURRENCE $1,000000 X CLAIM$ -MADE OCCUR P EMI F occu rents 3 MED EXP (An one parson) $ PERSONAL F.AC)V INJURY S G5N'LAr,O,REGATELIMIT APPLIESPER: GENERALAGGREGATE s3,000,000 POLICY E] JE OT 17 LOC PRODUCTS-COMPlOP AGG 5 $ OTHER: AUTOMOBILE LIABILITY COMBINED S WGLE LIMIT Ea CcidBrlt BODILY INJURY (Per parson) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Pera¢idwit) $ PROPERTY DAMAGE s Pef accidem HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIA13 OCCUR EACHOQ0JRRENCE $ AGGREGATE $ EXCESS LIAB CLAIM$ -MADE DED RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y r N At4YPROPRIETORIPARTNERfEXSCUTIVE ❑ OFFICERIMEMBER EXCLUDED? N r a � PTATUTE ETH E.L. EACH ACOIOEN7 $ E.L. DISEASE , EA EMPLOYEE S (Mandatory In NH) E.L. DISEASE' POLICY LIMIT 3 If Yes describe 4r9er 4ESG�RiPYION OP OPERATION$ below A Healthcare Professlonsl Uablllty HCR,00119 10111201$ 101112020 Each Claim 1,040,000 Aggragota 3,00D.000 DESCRIPTION OF OPERATIONS 11,,OCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached iF more apace is required) Coverage extends to a erationa conducted on Behalf of the Named Insured at ALL looation3. Employee3 & Volunteer$ are included as Additional Insureds wl acting on the behalf of the Insured. Medical Directors & Hospice Team Physicians, while acting In the capacity as a Medical director, are included B3 Insured as required by written Contract. Collier County Board of County Commissioners are included as Additional Insureds, but only as required by written contract. RE: Arden Courts of Lely Palms 11449:6125 Rattlesnake Hammock Road: Naples, FL 34133 SHOULD ANY of THE ABOVE DESCRIBED POLICIES BE GANCEI,LFO BFFOF THE EXPIR2ATION DATE THEREOF, NOTICE WILL BE DEI-IVFR=D ACCORDANCE WITH THE POLICY PROVISiONS- C411ier County Board 4f CQUnty Commissioners 3327 Tamiami Trail East AUTnoRIZEDRPFRCsENTATIVE Naples FL 34112-4901 C41988-2015 ACORD CORPORATION. All rights reservsd. ACORD 25 (2016103) The ACORN name and logo are registered marks of ACORD Packet Pg. 2215 CERTIFICATE OF LIABILITY INSURANCE 16. D.4. h THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND COFFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLIC- BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORu REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endor: If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA, Inc. 1166 Avenue of the Americas New York, NY 10036 Attn: Aflanta.Certrequest@marsh.com 342881 -FL -WC -19-20 INSURED DecisionHR, Inc. . 11101 Roosevelt Blvd N St, Petersburg, FL 33716 815021 INSURERISIAFFORDING COVERAGE I NAIL INSURER A: Illinois National Insurance COVERAGES CERTIFICATE NUMBER; ATL -004948595-01 REVISION NUMBER: 3 23817 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEF INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 1 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TEF EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LT LTR TYPE OF INSURANCE ADDL SPOLICY n POLICY NUMBER MMIDDYYY IY M I ©IYYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ . PREMISES(Ea oceu enoe $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PFR: POLICY D PRO- JECT ❑ LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ... ._.. OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLYE COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per _pe_rson) $ ._..... _...... BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAB EXCESS LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? IN fMandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC 023540396 06101/2020 X I PER 0TH-_ STATUTE ER E.L. EACH ACCIDENT $ 1 E.L. DISEASE - EA EMPLOYEE $ 1 E.L. DISEASE - POLICY LIMIT $ 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Coverage is provided for only those employees leased to but not subcontractors of Shitting Sands Adult Day Center, LLC L9.�:\ili<L7_\l�iCs]�RJ�li1 Shifting Sands Adult Day Center, LLC 28410 Bonita Crossings Blvd, Suite B7 Bonita Springs, FL 34135 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ,BEF THE EXPIRATION DATE THEREOF, NOTICE WILL BE' DELIVEREE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Henry L. WhitingN,.. A.y: .o......... 4 O N — r— r I� 0— r —_ )t) N )0 tm )0 C t tD — t71 to r Q O 1388-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD Packet Pg. 2216 16.D.4. h A� CERTIFICATE OF LIABILITY INSURANCE DAQ5102I20i9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AII END, EXTEND OR ALTER THE COVERAGE AFFORDED BY THEPOLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED subject to the terms and conditions of the policy, P may'require f p cy, certain policies ma re vire an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). :. PRODUCER CONTA NAME CT ,loan Randolph Comegys Insurance Agency PutIcN Ems, (127) 521-2100 1 FMN - (727)528-0626 One Beach Drive S. E. Ste- 230 Saint Petersburg FL 33701 INSURED Shifting Sands Adult Day Care, LLC 28410 Bonita Crossings Blvd. Unit B7 Bonita Springs FL 34134 COVERAGES CERTIFICATE NUMBER: 19120 GUPL L a. joan.randolphocomegys.com TYPE OF INSURANCE ADDRESS: i MMipp(YYYY lNSURER(S) AFFORDING COVERAGE NAIC 4 INSURERA: Lloyds of London Y 1117349 M - INSURER B : EACH OCCURRENCE .S:'I r000,00Q '., y , ; .;_.. MED EXP (Any one petsonl $ 5,000" PERSONAL A ADV INJURY' $ 1,.000,000 INSURER C : GENERALAGGREGATE $ 5,000,000 PRODUCTS - COMPIOPAGG S 1,000,000 Professibnal Liability' 5 1,000,000 AUTOMOBILE INSURER D : 'a - - Q ` INSURER E. BODILY INJURY (Per person) - $ BODILY INJURY (Per acddent) $, PROPER Paracddant�AGE $UMBRE- INSURER F: EXCESS LIAR EXCESS L IAB T OCCUR REVISION NUMBER: THIS IS TO CERTIFY THAT THF POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO €HE INSURED NAMED ABOVE FOR THE POLICY PERIOD TNO#GATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSICNS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ILTR TYPE OF INSURANCE POLICY NUMBER MMipp(YYYY MOv "P umas A X COMMERCIAL GENERAL LIABILITY CLA[MS-MADE ® OCCUR Y 1117349 05101/2019 05!01!2020 EACH OCCURRENCE .S:'I r000,00Q '., y , ; PREMISES(Ea oecurrense $ MED EXP (Any one petsonl $ 5,000" PERSONAL A ADV INJURY' $ 1,.000,000 GEN'LAGGREGATE LIMITAPPLIES PER: X POLSCY ❑ JECr ❑ LOC OTHER: GENERALAGGREGATE $ 5,000,000 PRODUCTS - COMPIOPAGG S 1,000,000 Professibnal Liability' 5 1,000,000 AUTOMOBILE LIABILITY - ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS FARED NON -OWNED AUTOS ONLY AUTOS ONLY - - COMBINED S'INGLE LIMIT $ Ea accident BODILY INJURY (Per person) - $ BODILY INJURY (Per acddent) $, PROPER Paracddant�AGE $UMBRE- EXCESS LIAR EXCESS L IAB HCLAAMS-AAADE OCCUR EACH OCCURRENCE $ AGGREGATE $ . .... . DED RETENTION WORKERS COMPENSATION AND EMPLOYERS` LIABILITY Y I N PROPRIET... ANYCERIMEMS RPPARTNE20XECUTlVE ❑ OFFICERlMEM9ER EXCLUDEp9 (Mandatory in NH) Et yes, describe under DESCRIPTION OF OPERATIONS below NIA - -E H STA UTE FORT . E.L. EACH ACCIDENT $ -' -' .L. DISEASE-EAEMPLpYEE $ E.L. DISEASE -POLICY LIMIT $ .,.... DESCRIPTION VEHICLES(ACORD, 109, Additional Remarks Schedule, may be attaaFed_ttmaraspace 3s required) - Collier County Board of County Commissioners is included as additional insured with respect to General Liability on a primary.and non-contributory basis If and to the extent required by written contract. Collier County Board of County Commissioners 3296 Tamiami Trail E. Naples RNCELLJ1TiON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELUD'SEFORE' -' r` THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN: ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE FL 34112 ! } » ..... _...... n 9988-2015 ACORD CORPORATION. All rights ACORD 25 (2016,M3) The ACORD name and logo are registered marks. of ACORD Packet Pg. 2217 Collier County Solicitation 19-7596 Services for Seniors Prog-Additional Sery-Respite Facility Sery & Adult Day Care Solicitation Designation: Public Collier County Solicitation 19-7596 7/15/2019 5;33 PM p 1 Collier County Solicitation 19-7596 Solicitation 19-7596 Services for Seniors Prog-Additional Serv-Respite Facility Sery & Adult Day Care Solicitation Number 19-7596 Solicitation Title Services for Seniors Prog-Additional Serv-Respite Facility Sery & Adult Day Care Expected Expenditure $150,000.00 (7 his price is expected � not guaranteed) Solicitation Start Date Jul 15, 2019 7:32:18 PM EDT Solicitation End Date Aug 14, 2019 3:00:00 PM EDT Question & Answer End Date Aug 7, 2019 5:00:00 PM EDT Solicitation Contact Barbara Lance Procurement Strategist 239-252.8998 Barbara. Lance@colliercountyfl.gov Contract Duration 3 years Contract Renewal 2 annual renewals Prices Good for 180 days Pre -Solicitation Conference Jul 31, 2019 10:00:00 AM EDT Attendance Is optional Location: A Pre -Bid conference shall be held at: Collier County Procurement Services 3295 Tamiaml Trail East, Bldg C-2 Naples, FL 34112 Solicitation Comments Collier County requires the provision of services based on no more than 30 minutes of travel time between services and clients' primary residence, Collier County is requesting respite services and adult day care to be delivered to Collier County persons sixty years and older under CCE, OAA and to qualifled persons eighteen years or older under ADI. Unless otherwise stated, minimum hours of availability for adult day care are 8:00 am to 5:00 p.m. Monday through Friday, except for federal and state holidays. The hours for Respite Facility services and emergency respite would be available 24 hours/day, 365 days/year. Item Response Form Item 19-7596--01-01 - Services for Seniors Prog-Additional Sery-Resplte Facility & Adult Day Care Quantity 1 each Unit Price _ Delivery Location I✓Y ��Ylr1V t I T ]Yji'i 0' f Vr 5 ip' 0 +0 1. Procurement Services 3295 E. Tamiami Trail Building C2 Naples FL 34112 Qty 1 Description Please submit Evaluation Criteria as outlined In the Solicitation. 7/15/2019 5:33 PM p. 2 Collier County CDP,P C.01 ."i9.ty Administrative SerAw5 Qepari rent Procurement Services Division COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS REQUEST FOR PROPOSAL (RFP) FOR SERVICES FOR SENIORS PROGRAM -ADDITIONAL SERVICES -RESPITE FACILITY SERVICES & ADULT DAY CARE SOLICITATION NO: 19-7596 BARBARA LANCE, PROCUREMENT STRATEGIST PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FLORIDA 34112 TELEPHONE: (239) 252-8998 Barbara.Lance@colliercountyfl.gov (Email) Solicitation 19-7596 This solicitation document is prepared in a Microsoft Word format (Rev 8/7/2017). Any alterations to this document made by the Vendor may be grounds for rejectiwa of proposal, cancellation of any subsequent award, or any other legal remedies available to the Collier County Government. 7/15/2019 5:33 PM p 4 Collier County Solicitation 19-7596 SOLICITATION PUBLIC NOTICE REQUEST FOR PROPOSAL (RFP) 19-7596 NUMBER: PROJECT TITLE: Services for Seniors Pro ram -Additional Services -Res ite Facili Services & Adult Day Care PRE -PROPOSAL CONFERENCE: July 31, 2019 i Collier County Solicitation 19-7596 Definitions, standards, and requirements of these services are included in the Department of Elder Affairs' Handbook (DOEA Handbook). Those interested in providing the services detailed below must adhere to all requirements in this RFP, in addition to maintaining adherence with the guidelines referenced in the current DOEA Handbook. Lack of knowledge of all requirements of a service listed in the proposal SHALL NOT relieve the provider of liability and obligations under the agreement. Collier County Community & Human Services (CHS) shall lead all service authorization and coordination. To comply with the requirements of the ADI, CCE, and OAA Programs, clients entering the service system will be assessed and prioritized by CHS. Upon determination of the service level to be provided, the CHS will offer the client a listing of service vendors for the specific service(s) outlined within their care plan. Upon the determination of the service, the service levels, and the selected vendor, CHS will contact the vendor agency, and authorize the service, number of hours, and frequency. In keeping with the State policy of client choice of service providers, Collier County does not guarantee a minimum ox maximum number of clients that will be referred, nor a minimum or maximum number of service hours that will be requested during the contract period. CHS shall send the agreed-upon Service Authorization to the chosen provider. These "service authorizations" or "service orders" must contain necessary client information, such as street address, telephone number, and services or items needed, as well as the name and telephone number of the CHS case manager authorizing the service. The County may do so through a competitive and publicly announced selection process, which shall be coordinated through the County's Purchasing Department. Services shall be provided in the manner described in the then current DOER, manual and outlined herein. Services covered by this agreement include, but are not limited to (should funding for additional Senior Services be identified, the County reserves the right to add to the resultant agreements the services, descriptions, rates, etc. by way of a contract addendum): 1. Adult Day Care: A day program of therapeutic social and health activities and day services provided to adults who have functional impairments, in a Florida state licensed, protective environment that provides activities as a non -institutional environment as possible. Provides a safe environment for seniors who need daily supervision and can engage with other seniors. Monday -Friday, 8am-5pm 2. Facility Respite Services: a nursing facility that provides 24 -bow care/365 days and is licensed as a State of Florida Licensed Nursing home. The facility will provide 24/7 nursing care and supervision for days authorized by CHS to assist the senior's caregiver with respite services. 3. Establish protocols for contacting CHS Case Managers in emergency or unusual circumstances and include the documentation requirements (oral and written) in the Service Provider Application. 4. Provide disaster response protocols, plans and services: In the event of a natural disaster (hurricane, tropical storm, tornado, flood, heat wave, etc.), the provider will have staff available to serve those clients in critical need of services, as designated by the CHS Case Managers. 5. Establish a client grievance process: Each service provider agency must have a policy addressing client grievances and/or complaints. 6. Establish and provide staff training: All services provided with funding from DOER require service delivery personnel to have general pre -service orientation and training specific to the service being provided. CHS is responsible for provision of the pre -service training on program and billing requirements to the vendors who are awarded the Proposal. Pre -service orientation also must include: • An overview of the aging process • An overview of the aging network • Communication techniques with the elderly • Observation of abuse, neglect, exploitation and incident reporting Client confidentiality. .NOTE: All "hands-on" service personnel must receive training emphasizing the necessity of Universal Precautions. Aides must have documentation of successful completion of 40 hours required training, and CNAs must have on file a copy of their State of Florida certification. In-service training hours and topics are to be provided at the discretion of the service provider agency and shall meet state requirements. 7. Compile and report program service delivery statistics and other data as identified by CHS. These are reported to the Area Agency on Aging and Department of Elder Affairs in accordance with the reporting requirements developed by the Department. CHS is responsible for entry of data in the Client Information and Registration Tracking System (CIRTS), which generates payment to the service provider agency. 7/15/2019 5:33 PM p 6 Collier County Solicitation 19-7596 8. Maintain complete and accurate records: Service delivery logs, at a minimum, must be legible and contain the name of client, type/s of services and date/s and hoar/s of delivery. The client/caregiver must sign the log at the time of each service visit. The service worker must sign and date the log upon completion and submit it to the service provider agency. 9. Provide complete, clear and accurate invoices: Invoices must be submitted monthly by the following the week once the services have been provided and shall include the services provided. The service week is defined as Monday through Sunday. Monthly invoices will include: • Vendor name • Vendor address • Vendor telephone number • Client name • Services authorized and the service dates • Number of service hours, cost per hour and total cost • Person preparing the report and the date it was prepared 10. Prepare for annual on-site compliance audits by CHS Monitoring Unit team as directed by the CHS Division and/or grant requirements. 1.1 The Proposers will submit a qualifications proposal which will be scored based on the criteria in Evaluation Criteria for Development of Shortlist, which will be the basis for short -listing firms. The Proposers will need to meet the minimum requirements outlined herein in order for their proposal to be evaluated and scored by the COUNTY. The COUNTY will then score and rank the firms and enter into negotiations with the top ranked firm to establish cost for the services needed. The COUNTY reserves the right to issue an invitation for oral presentations to obtain additional information after scoring and before the final ranking. With successful negotiations, a contract will be developed with the selected vendor(s), based on the negotiated price and scope of services and submitted for approval by the Board of County Commissioners. 1.2 The COUNTY will use a Selection Committee in the Request for Proposal selection process. 1.3 The intent of the scoring of the proposal is for respondents to indicate their interest, relevant experience, financial capability, staffing and organizational structure. 1.4 The intent of the oral presentations, if deemed necessary, is to provide the vendors with a venue where they can conduct discussions with the Selection Committee to clarify questions and concerns before providing a final rank. 1.5 Based upon a review of these proposals, the COUNTY will rank the Proposers based on the discussion and clarifying questions on their approach and related criteria, and then negotiate in good faith an Agreement with the top ranked Proposer. 1.6 If, in the sole judgment of the COUNTY, a contract cannot be successfully negotiated with the top-ranked firm, negotiations with that firm will be formally terminated and negotiations shall begin with the firm ranked second. If a contract cannot be successfully negotiated with the firm ranked second, negotiations with that firm will be formally terminated and negotiations shall begin with the third ranked firm, and so on. The COUNTY reserves the right to negotiate any element of the proposals in the best interest of the COUNTY. 1.7 For the development of a shortlist, this evaluation criterion will be utilized by the COUNTY'S Selection Committee to score each proposal. Proposers are encouraged to keep their submittals concise and to include a minimum of marketing materials. Proposals must address the following criteria: Evaluation Criteria Maximum Points 1. Cover Letter / Management Summary 5 Points 2. Certified Minority Business Enterprise 5 Points 3. Business Plan 25 Points 4. Cost of Services to the County 25 Points 5. Experience and Capacity of the Firm 20 Points 6. Specialized Expertise of Team Members 20 Points TOTAL POSSIBLE POIN'T'S 100 Points 7/15/2019 5:33 PM p. 7 Collier County Solleltatlon 19-7596 Tie Breaker: In the event of a tie at final ranking, award shall be made to the proposer with the lower volume of work previously awarded. Volume of work shall be calculated based upon total dollars paid to the proposer in the twenty-four (24) months prior to the RFT submittal deadline. Payment information will be retrieved from the County's financial system of record. The tie breaking procedure is only applied in the final ranking step of the selection process and is invoked by the Procurement Services Division Director or designee. In the event a tie still exists, selection will be determined based on random selection by the Procurement Services Director before at least three (3) witnesses. Each criterion and methodology for scoring is further described below, ***Pro sats must be assembled, at minimum, in the order f the Evaluatio Criteria listed or your proposal maybe deemed non -res onsive*** EVALUATION CRITERIA NO. 1: COVER LETTEWMANAGEMENT SUMMARY (5 Total Points Available) Provide a cover letter, signed by an authorized officer of the firm, indicating the underlying philosophy of the firm in providing the services stated herein. Include the name(s), telephone number(s) and email(s) of the authorized contact person(s) concerning proposal. Submission of a signed Proposal is Vendor's certification that the Vendor will accept any awards as a result of this RFP. EVALUATION CRITERIA NO. 2: CERTIFIED MINORITY„ByNESS ENTERPRISE AND/OR VETERAN BII�SS ENTERPRISE (5 Total Points Available) Submit certification with the Florida Department of Management Service, Office of Supplier Diversity as a Certified Minority Business Enterprise and/or Veteran Business Enterprise. EVALUATION CRITERIA NO. 3! Business Plan (25 Total Points Available) In this tab, include but not limited to: A. Facility Respite: Provide 24 hours per day of care and supervision in a secure facility for seniors, describe intake process and medical screening required. B. Adult Day Care: Provide 8 hours of supervised day care to seniors, describe intake process and medical screening required. I. Detailed plan of approach (including major tasks and sub -tasks) i. Proposer is licensed from the Agency for health Care Administration (AHCA) and has the appropriate license to provide services in Collier or Lee Counties. ii. Proposed by-laws which describes how business is conducted and includes a clear plan for the development/implementation of structured day plan which includes struotured activities and daily schedule. 2. Detailed qualifications of staff and staffing plan. Bilingual (i.e. Spanish/English) and culturally competent staff should be identified. Demonstration of plans for training and oversight to provide care to high risk senior population. 3. Include with the Business Plan or as an attachment, the agency's ability, experience and knowledge to administer a Facility Respite program and/or an Adult hay care program. i. Proposer has to provide an Organizational chart indicating lines of authority and staffing ii. Proposer has supervisory staff on call 24 hours per day/365 days per year, iii. Proposer's Owner/Operator license has never been denied, suspended or revoked by Medicare, Medicaid or any Federal and/or State Agency. 7/15/2019 5:33 PM P. 8 Collier County Solicitation 19-7596 EVALUATION CRITERIA NO. 4: COST OF SERVICES TO THE COUNTY (25 Total Points Available) In this tab you will be provided a list of services needed by the County. Those services with rates, In-kind match and Cost already completed are standard rates in which you will be required to accept. Please sign as an acceptance to the rates if you deem these standard rates to be acceptable. I accept the standard contract rates listed below. tC t, i' t dN ti(i t hsq,v,rr F ,w � o 'AthuLLnt r r,�i �P t<xa#tiny w�I �5ic,'Vf�0\v3 1�Y, U4�QS tit?� � i�i A'gIi�Q1�Ht � VLy i I O7n Al1j'Cy�}X,R"a�;$yl'Yeii � V...�n 1 �' ..b�N��.�Mt'' /�IM1• 0n� 1 ...i. ��•i u Skilled Skilled CCE, I Nursing ADAA, Per Hour $40.00 $4.00 $36.00 Adult CCB, 2 Day are ADI*, Per Hour $13.89 $1.39 $12.50 OAA, Respite CCE, 3 (Facility ADI*, Per Flour $10.417 $1.04 $9.38 Based OAA, The ADI program does not require an to -kind match contribution. nitial pricing is for tgradingoprposes and are subject to chance during Legotiations, with the selected vendor. EVALUATION CRITERIA, NO. 5, EXPERIENCE, AND CAPACITY OF THE FIRM (20 Total Points Available) In this tab, include but not limited to: Provide information that documents your firm's and subcontractors' qualifications to produce the required deliverables, including abilities, capacity, skill, and financial strength, and number of years of experience in providing the required services. • Describe the various team members' successful experience in working with one another on previous projects. The County requires that the vendor submits no fewer than three (3) completed (reference forms from clients during the last 5 years whose projects are of a similar nature to this solicitation as a part of their proposal. Provide information on the projects completed by the vendor that best represent projects of similar size, scope and complexity of this project using the Reference Form attached. Vendors may include two (2) additional pages for each project to illustrate aspects of the completed project that provides the information to assess the experience of the Proposer on relevant project work. EVALUATION CRITERIA NO. 6: SPECIALIZED EXPERTISE OF TEAM MEMBERS (20 Total Points Available) In this tab, include but not limited to: • Description of the proposed contract team and the role to be played by each member of the team. • Attacb brief resumes of all proposed project team members who will be involved in the management of the total package of services, as well as the delivery of specific services. • Attach resumes of any sub -vendors and attach letters of intent from stated sub -vendors must be included with proposal submission. 7/15/2019 5:33 PM P 9 Collier County Solicitation 19-7598 ***Vendor should check off each of the following items as the necessary action is completed (please see, Form 2: Vendor Check List): The Solicitation Submittal has been signed. The Solicitation Pricing Document (Bid Schedule/Quote Schedule/Proposal Pricineetc) has been completed and attached. All applicable forces have been signed and included, along with licenses to complete the requirements of the project. Any addenda have been signed and included. Affidavit for Claiming Status as a Local Business, if applicable, Division of Corporations - Florida Department of State — htt ://dos.m florida.com/sunbiz./ (If work performed in the State). E-Verify/Immigration Affidavit (Memorandum of Understanding). 7/15/2019 5:33 PM p, 10 Collier County Solicitation 19-7596 X17 >fiy. R'f 7,1 tErtiVe'. tif' r" r'an it ptt�:.urr�nt> r>n owt w,5 Form 1: Vendor's Non -Response Statement The sole intent of the Collier County Procurement Services Division is to issue solicitations that are clear, concise and openly competitive, Therefore, we are interested in ascertaining reasons for prospective Vendors not wishing to respond to this Solicitation. If your firm is not responding to this solicitation, please indicate the reason(s) by checking the item(s) listed below and return this form via email noted on the cover page, or mail to Collier County Government, Procurement Services Division, 3295 Tamiami Trail East, BLDG C-2, Naples, FL 34112, We are not responding to the solicitation for the following reason(s): 11 Services requested not available through our company. ❑ Our firm could not meet specifications/scope of work - 0 Specifications/scope of work not clearly understood or applicable (too vague, rigid, etc.) © Project is too small. ❑ Insufficient time allowed for preparation of response. ❑ Incorrect address used. Please correct mailing address: ❑ Other reason(s): Name of Firm: Address: City, State, Zip: Telephone: Email: Representative Signature: Representative Name: pate 7/15/2019 5:33 PM p. 11 Collier County Ani ukghVe Ssr D0S epaitned Pr«:.w�nw_M Gwr3ms Ur�� Form 2: Vendor Check List Solicitation 19-7596 IMPORTANT: THIS SHEET MUST BE SIGNED. Please read carefully, sign in the spaces indicated and return with your Proposal. Vendor should check off each of the following items as the necessary action is completed: ❑ The Solicitation Submittal has been signed. ❑ The Solicitation Pricing Document (Bid Schedule/Quote Schedule/etc,) has been completed and attached. ❑ All applicable forms have been signed and included, along with licenses to complete the requirements of the project. ❑ Any addenda have been signed and included. ❑ Affidavit for Claiming Status as a Local Business, if annlicable. ❑ Division of Corporations - Florida Department of State — btt://dos. rida.corn/ a bW (If work performed in the State). ❑ E-Verify/Immigration Affidavit (Memorandum of Understanding). ALL SUBMITTALS MUST HAVE THE SOLICITATION NUMBER AND TITLE Name of Firm: Address: City, State, Zip: Telephone: Email: Representative Signature: Representative Name: Date 7/15/2019 5:33 PM p. 12 Collier County Solicitation 19-7596 �r17 7fSs ktV?tN'M6hntititit.,� irYle rtrr int P+wz?q'�ir!'.pi11.aN�ncep'(jidlg Form 3: Conflict of Interest Affidavit The Vendor certifies that, to the best of its knowledge and belief, the past and current work on any Collier County project affiliated with this solicitation does not pose an organizational conflict as described by one of the three categories below: Biased ground rules — The firm has not set the "ground rules" for affiliated past or current Collier County project identified above (e.g., writing a procurement's statement of work, specifications, or performing systems engineering and technical direction for the procurement) which appears to skew the competition in favor of my firm. Impaired objectivity — The firm has not performed work on an affiliated past or current Collier County project identified above to evaluate proposals / past performance of itself or a competitor, which calls into question the contractor's ability to render impartial advice to the government. Unequal access to information — The firm has not had access to nonpublic information as part of its performance of a Collier County project identified above which may have provided the contractor (or an affiliate) with an unfair competitive advantage in current or future solicitations and contracts. In addition to this signed affidavit, the contractor / vendor must provide the following: I. All documents produced as a result of the work completed in the past or currently being worked on for the above-mentioned project; and, 2. Indicate if the information produced was obtained as a matter of public record (in the "sunshine") or through non-public (not in the "sunshine") conversation (s), meeting(s), document(s) and/or other means. Failure to disclose all material or having an organizational conflict in one or more of the three categories above be identified, may result in the disqualification for future solicitations affiliated with the above referenced project(s). By the signature below, the firm (employees, officers and/or agents) certifies, and hereby discloses, that, to the best of their knowledge and belief, all relevant facts concerning past, present, or currently planned interest or activity (financial, contractual, organizational, or otherwise) which relates to the project identified above has been fully disclosed and does not pose an organizational conflict. Firm: Signati Print N Title o: 7/15/2019 5:33 PM P. 13 Collier County Solicitation 19-7596 .1'1P11a1F'PYI{y'e `.Ni{%3$r pdCxaiee�nttSEMG4S D(viSI� Form 4: Vendor Declaration Statement BOARD OF COUNTY COMMISSIONERS Collier County Government Complex Naples, Florida 34112 Dear Commissioners: The undersigned, as Vendor declares that this response is made without connection or arrangement with any other person and this proposal is in every respect fair and made in good faith, without collusion or fraud. The Vendor agrees, if this solicitation submittal is accepted, to execute a Collier County document for the purpose of establishing a formal contractual relationship between the firm and Collier County, for the performance of all requirements to which the solicitation pertains. The Vendor states that the submitted is based upon the documents listed by the above referenced Solicitation. Further, the vendor agrees that if awarded a contract for these goods and/or services, the vendor will not be eligible to compete, submit a proposal, be awarded, or perform as a sub -vendor for any future associated with work that is a result of this awarded contract. I WITNESS WHEREOF, WE have hereunto subscribed our names on this 1 � day of Sf 20 J qin the County of `C , in the State of F t— Firm's Legal Name: .. r A "55 I I i AA� City, State, Zip Code: Florida Certificate of Authority Document Number Federal Tax Identification Number *CCA # or CAGE Code *Only if Grant Funded `TQx zb# 3L-4 71 ly f r'71 b'7 Telephone: E — S SO Signature by: (Typed and written) Title: 7/15/2018 5:33 PM p 14 Collier County Additional Contact Information Send payments to: (required if different from Company name used as payee above) Contact name: Title: Address: City, State, ZIP Telephone: Email: Office servicing Collier County to place orders (required if different from above) Contact name: Title: Address: City, State, ZIP Telephone: Email: Solicitation 19-7595 7/15/2019 5:33 PM P. 15 Collier County Solicitation 19-7596 COX, .AtJmut6 "uer' oelt- tYrr9em 8 jfuiC� iF:1yJsiro Form 5: Immigration Affidavit Certification This Affidavit is required and should be signed, notarized by an authorized principal of the firm and submitted with formal solicitation submittals. Furtber, Vendors are required to enroll in the E -Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the Vendor's proposal. Acceptable evidence consists of a copy of the properly completed E -Verify Company profile page or a copy of the fully executed E -Verify Memorandum of Understanding for the company. Failure to include this Affidavit and acceptable evidence of enrollment in the E-Verifv program may deem the Vendor's Proposal as non- responsive. Collier County will not intentionally award County contracts to any Vendor who knowingly employs unauthorized alien workers, constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e) Section 274A(e) of the Immigration and Nationality Act ("INA"). Collier County may consider the employment by any Vendor of unauthorized aliens a violation of Section 274A (e) of the INA. Such Violation by the recipient of the Employment provisions contained in Section 274A (e) of the INA shall be grounds for unilateral termination of the contract by Collier County. Vendor attests that they are fully compliant with all applicable immigration laws (specifically to the 1986 Immigration Act and subsequent Amendmem(s)) and agrees to comply with the provisions of the Memorandum of Understanding with E -Verify and to provide proof of enrollment in The Employment Eligibility Verification System (E -Verify), operated by the Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the Vendor's proposal. Company Name Print Name Signature State of County of C— NVv The signee of these Affidavit guarantees, as evidenced by the sworn affidavit required herein, the truth and accuracy of this affidavit to interrogatories hereinafter made. 7!15!2019 5:33 PM p 16 Collier County Solicitation 19-7596 aanvwyummg it7ep�vnnnc Form 6: Vendor Substitute W — 9 Request for Taxpayer Identification Number and Certification In accordance with the Internal Revenue Service regulations, Collier County is required to collect the following information for tax reporting purposes from individuals and companies who do business with the County (including social security numbers if used by the individual or company for tax reporting purposes). Florida Statute 119.071(5) requires that the county notify you in writing of the reason for collecting this information, which will be used for no other purpose than herein stated. Please complete all information that applies to your business and return with your quote or proposal. 1. General Information (provide all information) Taxpayer Name ri r1l (as shown on income tax return) Business Nani;M, f rent from t er name%) V Address L . City �s State Zip Order Information 2. Company Status (check only one) Remit / Payment Informations be,�ti�eil`tRu`t r� a �t�ri�• I J / Sole Proprietor Corporation Parknership !_Individual �ax F_xempt (Federal income tax-exempt entity Limited Liability Company under Internal Revenue Service guidelines IRC 501 (c) 3) Enter the tax classification 3. Taxpayer Identification Number (for tax reporting purposes only) Federal Tax Identification Number (TIN) (Vendors who do not have a TIN, will be required to provide asocial security number prior to an award). 4. Sign and Date Form: Certification: Unde'penaltieojperjury, lcertify that the in brmat n shown on this orm is correct to m knowledge Sign *e Dat Title .r - P one Ni-�,%i� 7/15/2019 5:33 PM p. 17 1. Worker's Compensation 2, M Employer's Liability 3. ® Commercial General Liability (Occurrence Form) patterned after the current ISO form Collier County Solicitation 19-7596 Statutory Limits of Florida Statutes, Chapter 440 and all Federal Government P Statutory Limns and Requirements $1,000,000_ single limit per occurrence Bodily Injury and Property Damage $_1,000,000 single limit per occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. 4. ® Indemnification To the maximum extent permitted by Florida law, the Contractmy/Vendor shall defend, 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 Contractor/ Vendor or anyone employed or utilized by the Contractor/Vendor in the performance of this Agreement. 5. ® Automobile Liability $ 1,000,000_ Each Occurrence; Bodily Injury & Property Damage; Owned/Non-owned/Hized; Automobile Included 6. ® Other insurance as noted: ❑ Watercraft $ Per Occurrence ❑ United States Longshoreman's and Harborworker's Act coverage shall be maintained where applieablc to the completion of the work. $ Per Occurrence ❑ Maritime Coverage (Jones Act) shall be maintained where applicable to the completion of the work. $ Per Occurrence ❑ Aircraft Liability coverage shall be carried in limits of not less than $5,000,000 each occurrence if applicable to the completion of the Services under this Agreement. S Per Occurrence © Pollution $ Per Occurrence ® Professional Liability/Abuse Coverage $ 1,000,000_ Per claim & in the aggregate ❑ Project Professional Liability $ Per Occurrence ❑ Valuable Papers Insurance $ Per Occurrence ® Crime/Tbeft Insurance $25,000 Per Occurrence ❑ Technology Errors & Omissions $ Per Occurrence 7. 0 Bid bond Shall be submitted with proposal response in the form of certified funds, cashiers' check or an irrevocable letter of credit, a cash bond posted with the County Clerk or proposal bond in a sum equal to 5% of the cost proposal. All checks shall be made payable to the Collier County Board of County Commissioners on a bank or trust company located in the State of Florida and insured by the Federal Deposit Insurance Corporation. 7/15/2019 5:33 PM P 19 8. 0 Performance and Payment Bonds Collier County Solicitation 19-7596 For projects in excess of $200,000, bonds shall be submitted with the executed contract by Proposers receiving award, and written for 100% of the Contract award amount, the cost borne by the Proposer receiving an award. The Performance and Payment Bonds shall be underwritten by a surety authorized to do business in the State of Florida and otherwise acceptable to Owner; provided, however, the surety shall be rated as "A" or better as to general policy holders rating and Class V or higher rating as to financial size category and the amount required shall not exceed 5% of the reported policy holders' surplus, all as reported in the most current Best Key Rating Guide, published by A.M. Best Company, Inc. of 75 Fulton Street, New York, New York 10038. 9. ® Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is required to meet. The same Vendor shall provide County with certificates of insurance meeting the required insurance provisions. 10. M Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Vendor's policy shall be endorsed accordingly. I1. ® The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OIL Collier County Government, OR Collier County. The Certificates of Insurance must state the Contract Number, or Project Number, or specific Project description, or must read: For any and all work performed on behalf of Collier County, 12, M On all certificates, the Certificate Holder must read: Collier County Board of Commissioners, 3295 Tamiami Trail East, Naples, FL 34112 13. ® Thirty (30) Days Cancellation Notice required. 14. 4/11/19 -CC Vendor's Insurance Statement We understand the insurance requirements of these specifications and that the evidence of insurability may be required within five (5) days of the award of this solicitation. The insurance submitted must provide coverage for a minimum of six (6) months from the date of award. Name of Firm Vendor Signature Print Name Insurance Agency Agent Name a-uvVan a sir 7/15/2019 5:33 PM p 20 Solicitation: of Company, Collier County ,l CIO Pdtrtlhtisltuhee.�5tbry f Pla."+XuM.ent,'}Ervicer>'�1jti+�jjCP! Reference Questionnaire Reference Information) Solicitation 19-7596 Name:' MCA V1 U Y) V) f— TYo� Company: (Evaluator completing reference questionnaire) (Evaluator's Company completing reference) FAX: Collier County has implemented a process that collects reference information on firms and their key personnel to be used in the selection of firms to perform this project. The Name of the Company listed in the Subject above has listed you as a client for which they have previously performed work. Please complete the survey. Please rate each criteria to the best of your knowledge on a scale of 1 to 10, with 10 representing that you were very satisifed (and would hire the firm/individual again) and I representing that you were very unsatisfied (and would never hire the firm/indivdival again). If you do not have sufficient knowledge of past performance in a particular area, leave it blank and the item or form will be scored "0." Project Description: Project Budget: Completion Date: Project Number of Days: V15=19 5:33 PM p 21 1 Ability to manage the project costs minimize change orders to scope). J ( g op ) 2 Ability to maintain project schedule (complete on-time or early). 3 Quality of work. 4 Quality of consultative advice provided on the project. 5 Professionalism and ability to manage personnel. 6 Project administration (completed documents, final invoice, final product turnover; invoices; manuals or going forward documentation, etc.) 7 Ability to verbally communicate and document information clearly and succinctly, 9 Abiltity to manage risks and unexpected project circumstances - 9 Ability to follow contract documents, policies, procedures, rules, regulations, etc. 10 Overall comfort level with hiring the company in the future (customer satisfaction). TOTAL SCORE OF ALL ITEMS V15=19 5:33 PM p 21 Collier County Solicitation 19-7596 EXHIBIT LA FEDERAL CONTRACT PROVISIONS U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (ADMINISTRATION ON AGING) AND FLORIDA DEPARTMENT OF ELDER AFFAIRS CFDA 93.OXX (CSFA 65.010) The supplemental conditions contained in this section are intended to cooperate with, to supplement, and to modify the general conditions and other specifications. In cases of disagreement with any other section of this contract, the Supplemental Conditions shall govern. Contractor means an enti that receives a contract. The services performed by the awarded Contractor shall be in compliance with the provisions of Title 45 CFR Part 75; and/or, 2 CFR Part 200; and/or Title 45 Chapter XIII Part 1321 and/or other applicable regulations. It shall be the awarded Contractor's responsibility to acquire and utilize the necessary manuals and guidelines that apply to the work required to complete this project. In general, 1) The contractor (including all subcontractors) must insert these contract provisions in each lower tier contracts (e.g. subcontract or sub -agreement); 2) The contractor (or subcontractor) must incorporate the applicable requirements of these contract provisions by reference for work done under any purchase orders, rental agreements and other agreements for supplies or services; 3) The prime contractor is responsible for compliance with these contract provisions by any subcontractor, lower -tier subcontractor or service provider. FEDERAL STATUTORY AUTHORITY Older Americans Act of 1965 (OAA), as amended (42 U.S.0 § 3001 et seq., as amended by Public Law 114-144; 106-501; Section 20.41) OLDER AMERICANS ACT PROGRAM FUNDS OAA, Title 111, Section 307(a)(10) OAA, Title III B - Supportive Services; Title 45 Public Welfare (45 CFR 132 1) Chapter XIII Office of Human Development Services, Department of Health and Human Services Part 1321.65 Grants to State and Community Programs on Aging; Part 1321,67 Service Contributions FLORIDA STATUTORY AUTHORITY TITLE XXX (Social Welfare); Chapter 430 (Elder Affairs) CONTRACT COMPLIANCE OVERVIEW Under the Florida Department of Elder Affairs Older Americans Act, the contractor must comply with the contract documentation, conform to state and AAA policies, and comply with federal and state statutory and regulatory requirements. (Ref. - Department of .Elder Affairs Programs and Services FXandbook, Chapter 4, Page 22; July 2018: Older Americans Act.). The contractor will comply with the intent of Title III to provide for formula grants to State agencies on aging to stimulate the development or enhancement of comprehensive and coordinated community-based systems resulting in a continuum of services to older persons with special emphasis on older individuals with the greatest economic or social need, with particular attention to low-income minority individuals. (Ref - Title 45 CFR 1321) (,int.': FloridaDapt. offider-Affairs'Honee and Conemuniry+-Rased Se/+Aces Handbook) FCF-l/Aevised 01-14-19 7115(2019 5:33 PM p. 22 Collier County Solicitation 19-7596 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICE'S FEDERAL CONTRACT PROVISIONS x$100,000 Administrative, Contractual, or Legal .Remedies (Ref. 41 U.S.C. 1908, 2 CFR § 200 Appendix 11(A) Unless otherwise provided in this contract, all claims, counter -claims, disputes and other matters in question between the local government and the contractor, arising out of or relating to this contract, or the breach of it, will be decided by arbitration, if the parties mutually agree, or in a Florida court of competent jurisdiction. Access to Records and Reports (Reference: 2 CFR § 200.333, 2 CFR § 200.336) The contractor/vendor agrees to maintain all books, records, accounts and reports required under this contract for a period of not less than three years after the date of termination or expiration of this contract, except in the event of litigation or settlement of claims arising from the performance of this contract, in which case the Contractor agrees to maintain same until the Purchaser, the Grantor Administrator. the Comptroller General, or any of their duly authorized representatives, have disposed of all such litigation, appeals, claims or exceptions related thereto. Furthermore, the County shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement of its Contractors. Byrd Anti -Lobbying Amendment (31 U.S.C. 1352) (Reference 2 CFR § 200 Appendix II (7) Vendors must certify it will not and has not used Federal appropriated funds have been paid or will be paid, by or to any person or organization for influencing or attempting to influence an officer or employee of an 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. The certification includes any lobbying with non -Federal funds that takes place in connection with obtaining any Federal award. Civil Rights The contractor or a subcontractor who is the recipient of Federal funds (or assumes others with whom it arranges to provide services or benefits in connection with any of its programs and activities or assures others with whom it arranges to provide services or benefits to participants or employees) must comply with Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color, or national origin (45 CFR 80), and Statutes and Regulations enforced by the Office of Civil Rights, U.S. Department of Health and Human Services, as follow: Section 504 of the Rehabilitation Act of 1973, as amended (29 USC § 794), prohibits discrimination against otherwise qualified individuals on the basis of disability in programs and activities receiving financial assistance from HHS 45 CFR 84 and/or programs or activities conducted by HHS 45 CFR 85 in the provision of benefits and under the ADA that does not: a. Exclude a person with a disability from a program or activity; b. .Deny a person with a disability the benefits of a program or activity; c. Afford a person with a disability an opportunity to participate in or benefit from a benefit or service that is not equal to what is afforded others; d. Provide a benefit or service to a person with a disability that is not as effective as what is provided others; e. Provide different or separate benefits or services to a person with a disability unless necessary to provide benefits or services that are as effective as what is provided otbers; or, f. Apply eligibility criteria that tend to screen out persons with disabilities unless necessary for the provision of the service, program or activity. (Kql: Flo4da Dept, of Elder Affairs' Home and Comneunily-Based Services Handbook) FCP-2/R.evised 01-14-19 7/15/2019 5:33 PM p. 23 Collier County Solicitation 19-7596 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS Section 508 of the Rehabilitation Act of 1973, as amended, (29 USC § 794(d)) prohibits discrimination on the basis of disability in electronic and information technology as they relate to programs and activities conducted by HHS. The Age Discrimination Act of 1975, as amended (42 USC § 610 1) prohibits discrimination on the basis of age in programs or activities receiving Federal flnaucial assistance 45 CFR 90; and/or programs or services receiving HHS financial assistance 45 CFR 91; Title 11 of the Americans with Disabilitles Act (28 CFR Part 35), relating to Nondiscrimination on the Basis of Disability in State and Local Government Services 2010 ADA Standards for Accessible Design; The Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended, as relating to confidentiality of alcohol and drug abuse patient records; Section 1908 of the Public Health Service Act (42 USC § 300w-7) prohibits discrimination on the basis of age, race, color, national origin, disability, sex (gender), or religion in programs, services, and activities funded by Preventative Health and Health Services Block Grants. Federal Health Care Conscience Protection Statutes (42 USC § 300a-7; 42 USC § 300a-7; 42 USC § 238n and the Weldon Amendment (Continuing Appropriations Resolution, Pub. L. No. 113-164, Sec. 101(a) (Sept. 19, 2015); Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws, which prohibit recipients of certain Federal funds from discriminating against certain health care providers who refuse to participate in certain health care services on religious or moral grounds. Section 1557 of the Affordable Care Act prohibits discrimination on the basis of disability by entities that operate a health program or activity. 45 CFR 80. The contractor must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80, Clean Air Act and Federal Water Pollution Control Act (Applicable to contracts containingfederal funds and over $100,000) The Contractor shall comply with all applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42 United States Code (U. S.C.) 7401, et seq.), Section 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency regulations, 2 CFR Part 1500. The Contractor shall report any violations of the above to the Agency. Computer Use and Social Media Policy The Florida Department of Elder Affairs has implemented a Social Media Policy, in addition to its Computer Use Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third parties, such as, but not limited to, contractors and subcontractors. Any entity that uses the Department's computer resource systems must comply with the Department's policy regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This policy is available on the Department's website at: http://cld,Laffair5.sWtc.fl.us/dggL/finane.al. h Debarment and Suspension (Reference 2 CFR § 200 Appendix 11 (1) Contract awards that exceed the small purchase threshold and certain other contract awards shall not be made to parties listed on the government wide Excluded Parties List System in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1986 Comp., p. 189) and 12689 (3 CFR Part 1989 Comp., p. 235), "Debarment and Suspension." The Excluded Parties hist System in SAM contains the names of parties debarred, suspended, or otherwise excluded (Ref.: Florida Deer. of5fde),,tffai s' Home and Conzmzmiry-Baaed Seniices handbook) PCP-3iRevised Om4-I9 7/15/2019 5:33 PM p P4 Collier County Solicitation 19-7596 EXHIBIT LA FEDERAL CONTRACT PROVISIONS by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. The successful bidder, by administering each lower tier subcontract that exceeds $25,000 as a "covered transaction", must verify each lower tier participant of a "covered transaction" under the project is not presently debarred or otherwise disqualified from participation in this federally assisted project. The Contractor shall comply with these provisions before doing business or entering into subcontracts receiving federal funds Pursuant to this contract. The Contractor shall complete and sign the Certifications and Assurances Attachment prior to the execution of this contract. Aiversity (Reference 2 CFR § 200.321) The County is dedicated to fostering the continued development and economic growth of small, minority-, women-, and service -disabled veteran business enterprises. All contracting and subcontracting opportunities afforded by this solicitationicontract are strongly encouraged to contribute as both Contractors and Sub - Contractors. Firms may be required to submit documentation addressing diversity and describing the efforts being made to encourage the participation of small, minority-, women-, and service -disabled veteran business enterprises. Inforriation on Certified Minority Business Enterprises (CMBE) and Certified Service -Disabled Veteran Business Enterprises (CSDVBF) is available from the Office of Supplier Diversity at: http://dmLmyflorida.com/o[her ro rams/office of su ier diversit osd/ Energy Policy and Conservation Act - (Reference 2 CFR § 200 Appendix 11(H) The contractor shall comply with any mandatory standards and policies relating to energy efficiency which are contained in the F 1 o r i d a state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub. L. 94-163, 89 Stat. 871, 42 U.S.0 Section 620 1) Equal Employment Opportunity (Appendix II, 2 CFR Part 200; Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and Department of Labor 41 CFR Part 60; Dept. of Health and Human Services 45 CFR Part 80; 45 CFR Part 92, if applicable). The Contractor shall not discriminate against any employee or applicant for employment because of race, age, creed, color, sex or national origin. The Agency will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, age, creed, color, sex, or national origin. Such action shall include, but not be limited to, the following: Employment upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. Contractors must insert a similar provision in all subcontracts, except subcontracts for standard commercial supplies or raw materials. E -verify, Presidential Executive Order 12989; Florida Executive Order Number 11-116 Vendors/Contractors/Subcontracts: 1. Agree to utilize the U.S. Department of Homeland Security's E -verify system to verify the employment of all new employees hired by Contractor during the contract term; and 2. Contractor shall include in related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the state contract utilize the E -verify system to verify employment eligibility of all new employees hired by the Subcontractor during the contract terra. HIPAA Privacy Rules, 4 CFR Part 160 and Suparts A and E of part 164 The Third Party subrecipient will comply with HIPAA requirements to appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. Immigration and Nationality Act The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of un- authorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this contract by the Agency. (Ref.: Florida Dept. gfElder4jTairs'k/ome and Community -Eased Services Handbook) FCP-0/P.vised 0l-1419 7/15/2019 5:33 PM p. 26 Collier County Solicitatlon 19-7596 EXHIBIT LA FEDERAL CONTRACT PROVISIONS No Government Obligation to Third Parties - The Federal Government is not a party to this contract and is not subject to any obligations or liabilities to the non -Federal entity, contractor, or any other party pertaining to any matter resulting from the contract." Nondiscrimination The Contractor will 1. not discriminate against any person in the provision of services or benefits under this contract or in employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance with state and federal law and regulations. 2. Assumes others with whom it arranges to provide services or benefits in connection with any of its programs and activities are not discriminating against clients or employees because of age, race, religion, color, disability, national origin, marital status or sex. And 3. Assures others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines, and standards. Pension Protection Act of 2006 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization reporting requirements (filing a Form. 990 or Form 990-N) and has its tax exempt status revoked for failing to comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation. Procurement of Recovered Materials (Reference 2 CFR § 200.322) Contractor and subcontractor agree to comply with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act, and the regulatory provisions of 40 CFR Part 247. (1) In the performance of this contract, the Contractor shall make maximum use of products containing recovered materials that are EPA designated items unless the product cannot be, acquired (i) Competitively within a timeframe providing for compliance with the contract performance schedule; (ii) Meeting contract performance requirements; or (iii) At a reasonable price. (2) Information about this requirement is available at EPA's Comprehensive Procurement Guidelines web site�http://www.epa.gov/. The list of EPA -designate items is available at https://www.epa.gov/smm comprebetisive-procurement-guideline-cpg-program. Program Fraud and False or Fraudulent Statements of belated Acts The contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements) applies to the contractor's actions pertaining to this contract. Termination for Cause and Convenience See County's Standard Terms and Conditions. Trafficking in Persons The Contractor and subcontractors shall comply with Title 2 CFR Part 175 and 2 CFR § 175.15 provisions applicable to a private entity, as defined in 2 CFR 17525. Transparency Act Unless exempt under 2 CFR § 170.11 O(b), the Contractor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR Part 170. (Ref: Ftorida Dept. ofF.tder Affairs' Home and Commtmity-Baaed Services Handbook) FCP-5/Revised 01-14-19 7/15/2019 5:33 PM p. 26 Collier County Solicitation 19.7596 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS STATE CONTRACT PROVISIONS Administrative Procedures Act, Section 120.57(2), P.S. additional procedures far particular cases. In a matter initiated as a result of agency action proposing to determine the substantial interests of a party, the party's timely petition for hearing may challenge the proposed agency action based on a rule that is an invalid exercise of delegated legislative authority or based on an alleged unadopted rule. Data Integrity and Safeguarding Information, Uniform Electronic Transaction Act, Section 668.50, F.S.; Public Records Law, Chapter 119, Section 29, F.S The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages of the computer system, The security over the backed -up data is to be as stringent as the protection required of the primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract. Discriminatory Vendors List, Section 287.134, F.S. In accordance with Section 287.134, Florida Statutes, an entity or affiliate who has been placed on the discriminatory vendor list may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity. Equal Employment Opportunity The Contractor shall not discriminate against any employee or applicant for employment because of race, age, creed, color, sex or national origin. The Agency will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, age, creed, color, sex, or national origin. Such action shall include, but not be limited to, the following: Employment upgrading, demotion, or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. Contractors must insert a similar provision in all subcontracts, except subcontracts for standard commercial supplies or raw materials. Inspections (Meals) The Contractor must agree to notify the Nutrition Provider within 24 hours of any sanitation inspection and provide a copy of the report. Inspector General Cooperation, Section 20.055(5), F.S. The Parties agree to comply with Section 20.055(5), Florida Statutes, for the inspector general to have access to any records, data and other information deemed necessary to carry out his or her duties and incorporate into all subcontracts the obligation to comply with Section 20.055(5), Florida Statutes. Interest of Members of Congress No member of or delegate to the Congress of the United States shall be admitted to any share or part of this contract or to any benefit arising therefrom. (Ref.: Florida Dept. ofEidsr A(fairs'Hvnie and Community -Based Services Handbook) FCP-6/Revised 0 1 -14-19 7/15/2019 5:33 PM p P7 Collier County Solicitation 19-7596 EXHIBIT LA FEDERAL CONTRACT PROVISIONS Interest of Public Officials No member, officer, or employee of the public body or of a local public body during his tenure or for two years thereafter shall have any interest, direct or indirect, in this contract or the proceeds thereof For purposes of this provision, public body shall include municipalities and other political subdivisions of States; and public corporations, boards, and commissions established under the laws of any State. No member, officer, or employee of the MPO or of a local public body during his tenure or for two years thereafter shall have any interest, direct or indirect, in this contract or the proceeds thereof. Lobbying No funds received pursuant to this Agreement may be expended for lobbying the Legislature, the judicial branch or a state agency. (Re(: Florida Dept of Elder Affafrs'.Home and Community -Based Services Handbook) FCP-7/Revised 01-14-19 7/15/2019 5'33 PM p. 28 1::X1111317 1.13 Collier County Solicitation 19-7596 GRAM-'CER"11HCATIONS AND ASSURAti�('FS GRANT CERTIFICATIONS AND ASSURANCES THE FOLLOWING DOCUMENTS NEED TO BE RETURNED WITH SOLICITATION DOCUMENTS BY DEADLINE TO BE CONSIDERED RESPONSIVE. Page Certification and Form GCA 2-6 Attachment III - Certifications and Assurances A- A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 75) B. Certification Regarding Lobbying (29 CFR Part 93 and 45 CFR Part 93 ) C. Nondiscrimination & Equal Opportunity Assurance (29 CFR Part 37 and 45 CFR Part 80) D. Certification Regarding Public Entity Crimes, section 287.133. F.S. E. Association of Community Organizations for Reform Now (ACORN) Funding Restrictions Assurances (Pub. L. 111-117) F. Scrutinized Companies Lists and No Boycott of Israel Certification, section 287.135. F.S. G. Certification Regarding Data Integrity Compliance for Contracts, Agreements, Grants, Loans and Cooperative Agreements H. Verification of Employment Status Certification 1. Records and Documentation J. Certification Regarding Inspection of Public Records GCA - 7-9 Attachment IV —Assurances Non -Construction Programs GCA - 10-13 Attachment V — Civii Ri hts Compliance Checklist GCA - 14 Attachment VII — Background Screening Affidavit or Compliance - Employer GCA - 15 Conflict of Interest Certification GCA - 16 Anticipated DBE, M/WBE or VETERAN Participation., Statement GCA - 17 Bid Opportunity List for Commodities and Contractual Services and Professional Consultant Services 7115/2019 5:33 PM p 29 Collier County Solicitation 19-7596 EXB. 1.E GRANT ASSURANCES AND CERTIFICATIONS ATTACHMENT III CERTIFICATIONS AND ASSURANCES Agency will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES- In performance of this contract, Contractor provides the following certifications and assurances: A. Debarment 82d Susliension a r- r 45 CFR Par[ 75) B. i• r r 93 and r C. i r is rn _& Equal OggortUajLLAssuranceand 45 CFR Part 80) D. _err RegaLdiDg.Ublicres r section E. _err of rr .a. ■ OrganizaUgzLjaLReform Now O:.\Funding Restrigtions Assurance F. 5S=tinized ConiVwjjL%jjjjL2nd No Bolcott of Israel Certification, G. CooggLittive n RegaLdjuLRata Integrity Corriglignce Agreements for H. Verificillign of EmIlloymenta _e .i 1. Records r Documentation J. -Certification Rerarding Inspection -[ r A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS — PRIMARY COVERED TRANSACTION. The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals: I. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by a Federal department or agency; 2. Have not within a three-year period preceding this Contract been convicted or had a civiljudgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph A,2. of this certification; and/or 4. Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause of default. The undersigned shall require that language of this certification be included in the documents for all subcontracts at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients and contractors shall provide this certification accordingly. GCA -2 7(1512019 5:33 PM P. 30 Collier County Solicitation 19-7596 EXIT, 1.13 GRANT ASSURANCES AND CERTIFICATIONS B. CERTIFICATION REGARDING LOBBYING —CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS. The undersigned Contractor certifies, to the best of its knowledge and belief, that: 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 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. 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 employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The undersigned shall require that language of this certification be included in the documents for all subcontracts atall tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients and contractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. C. NON- DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART 80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal opportunity provisions of the following laws: 1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability, political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program or activity. 2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. 3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. GCA -3 7/15/2019 5:33 PM P. 31 Collier County Solicitation 19.7596 EXB. LB GRANT ASSURANCES AND CERTIFICATIONS 4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of, be excluded from participation in, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. 5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CPR Part 86), to the end that, in accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education program or activity for which the Applicant receives Federal financial assistance from the Agency. 6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment practices, including job application procedures, hiring, firing, advancement, compensation, training, and other terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe benefits, and all other employment-related activities. 7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or activity, and to all contracts Contractor makes to carry out the WIA Title I — financially assisted program or activity. Contractor understands that the Agency and/or DOEA and the United States have the right to seek judicial enforcement of the assurance. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients and contractors shall provide this assurance accordingly. A. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S. Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list. Contractor understands and agrees that it is required to inform Agency immediately upon any change of circumstances regarding this status. E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING RESTRICTIONS ASSURANCE (Pub. L. 111-117). As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub. L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub - recipients and contractors shall provide this assurance accordingly. F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION 287.135, F.S. In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized Companies that Boycott Israel List and that it is not participating in a boycott of Israel. rcA-4 7/15/2019 5:33 PM p. 32 Collier County Solicitation 19-7596 EXB. 1.B GRANT ASSURANCES AND CERTIFICATIONS If this Contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135, F.S., Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan list or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it does not have business operations in Cuba or Syria. Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may result in the Agency terminating this contract and the submission of false certification may subject Contractor to civil penalties and attorney fees and costs, including any costs for investigations that led to the finding of false certification. GCA -3 If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to this Contract. G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS 1. The Contractor and any Subcontractors of services under this contract have financial management systems capable of providingcertain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant -funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all contract supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly. 2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the Contractor is dependent for data that is to be reported, transmitted, or calculated have been assessed and verified to be capable of processing data accurately, including year -date dependent data. For those systems identified to be non-compliant, Contractors will take immediate action to assure data integrity. 3. If this contract includes the .provision of hardware, software, firmware, microcode, or imbedded chiptechnology, the undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions of these products offered by the Contractor(represented by the undersigned) and purchased by the state will be verified for accuracy and integrity of data prior to transfer. a. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the Contractor agrees to immediatelymake required corrections to restore hardware and software programs to the same level of functionality as warranted herein., at no charge to the state, and without interruption to the ongoing business of the state, time being of the essence. 5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies arising from data integrity compliance issues. H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of homeland Security's E -verify system to verify the employment eligibility of all new employees hired by Contractor during the contract term to perform employment duties pursuant to this contract, and that any subcontracts include an express requirement that Subcontractors performing work or providing services pursuant to this Contract utilize the E -verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract term. GCA -5 7/15/2019 5:33 PM P. 33 Collier County Solicitation 19-7596 EXB• 1.13 GRANT ASSURANCES AND CERTIFICATIONS The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and other agreements/contracts and that all Subcontractors shall certify compliance accordingly. This certification is a material representation of fact upon which, reliance was placed when this Contract was made or entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A-110). I. RECORDS AND DOCUMENTATION The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all contract related records and documentation. The Contractor shall ensure the collection and maintenance of all program related information and documentation on any such system designated by the Agency. Maintenance includes valid exports and backups of all data and systems according to Agency standards. J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS 1. In addition to the requirements of sections 10.1 and 10.2 of the Standard Contract, sections 119.0701(3) and (4) F.S., and any other applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is named in the civil action, Contractor agrees to indemnify and bold harmless the Agency for any costs incurred by the Agency and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made pursuant to Chapter 119, F.S., concerning this contract or services performed thereunder. a. Notwithstanding section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed between the Agency and state agencies or subdivisions defined in section 768.28(2), F.S. 2, Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions for any person, corporation, foundation, trust, association, group, or other organization, all the financial, business, and membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest Florida, Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a public record shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances. Additionally, 1 certify this organization does does not --provide for institutional memberships. Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are available for inspection if applicable, as stated above. By execution of this contract, Contractor must include these provisions (A -J) in all related subcontract agreements (if applicable). By signing below, Contractor certifies that the representations outlined in parts A through J above are true and correct. A /1 /I / ASinataand Title of Autbotized Representative Street Address b:&17,)bl 4'Vtte, Zrp code Contractor Watet GCA -6 7/15/2019.5[33 PM p. 34 Collier County Solicitation 19-7596 EXHIBIT LB GRANT CERTIFICATIONS AND ASSURANCES ATTACHMENT IV ASSURANCES--NON-CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE. OF MANAGEMENT ANn BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain, of these assurances may not be applicable to your project or program. If you have questions please contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified.. 1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, tbroughany authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awardingagency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §47284763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P -L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title Di of the Education Amendments of 1972, as amended (20 U.S.C. § 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex, (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps, (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism, (g) §523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing, (i) any other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being made; and 6) the requirements of any other nondiscrimination statute(s) which may apply to the application. GCA -7 7/15/2019 5:33 PM P. 35 Collier County Solicitation 19-7596 EXHIBIT 1.13 GRANT CERTIkICATIONS AND ASSURANCES 7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of federal participation inpurchases. 8. Will comply, as applicable, with the provisions of the Match Act (5 U.S.C. §1501-1508 and 7324-7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with federal funds. 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C. §874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §327-333), regarding labor standards for federally assisted construction sub -contracts. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10;000.00 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplain in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §1451 et seq.); (f) conformity of federal actions to State (Clear .Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §469a-1 et seq-). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance, 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §4801 et seq.), which prohibits the use of lead- based paint in construction or rehabilitation of residence structures. GCA -8 7/15/2019 5:33 PM p. 36 Collier County Solicitation 19-7596 EXHIBIT 1.13 GRANT CERTIFICATIONS AND ASSURANCES 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and 2 CPR Part 200- 18, Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies governing this program. SIG ATURE OF AU ORIZED CER G OFFICIAL TITLE �yl�& vdiW �/1 C APPLICANT ORGANIZATION DA'Z'E SUBMIT ED Y) 1 ` el Prrdoi f -s 0� tt IWLS 0 GCA -9 7/15/2019 5:33 PM p. 37 Collier County Solicitation 19-7596 STATE OF FLORIDA DEPARTMENT OF FT.DFR ARVATRC rTvtT. RTf-mTC rnmpt TAN!'R rlavd-irr reT FrograuVFaplit ame: /t �� � � 11! County: e� AAA/Contractor Address: l LP W�.UCfG ,�i. Completed By Ci ,State, Zt Cpde: 17ate;021 Uq TelephoneAq rAn 11: nr,Au 4 CAE A A I AUAAEu AIN e A RUC I IUNe M OR ILLUS A KA I'A V E AN k'ORMA TION WHICH WILL HELP YOU COMPLETE THIS FORM, 1. Briefly describe the geographic area served by the program/facility and the type of service provided: For questions 2-5, please indicate the following: Total" White Black Hispanic Other Femate Disabled Over 4 2.Fopulation of area served Source of data 3. Staff currently employed Source of data 3. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, sex, age, religion or disability? 4,Clients currently enrolled/registered Source of data YES NO ❑ 5.Advisory/Goveming Board if applicable Source of data PART IT: USE A SEPARATE SHEET OF PAPER FOR ANY ESPLANATTONS IREOUTRING MORE SPACE. I. Is an Assurance of Compliance on file with DOEA? N/A YES NO ❑ 9 ❑ 2. Compare the staff composition to the population. Is staff representative of the population? N/A YES NO 3. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, sex, age, religion or disability? N/A ❑ YES NO ❑ 4. Are all benefits, services and facilities available to applicants and participants in an equally effective manner regardless of race, sex, color, age, national origin, religion or disability? X//A Li YE$ ix NO 5. For in-patient services, are room assignments made without regard to race, color, national origin or disability? 6. Is the pmgram/facility accessible to non-English speaking clients? N/A ❑ YES V NO ❑ 7. Are employees, applicants and participants informed of their protection against discrimination? If YES, how? Verbal [AWritteNCI Poster © / YE� NO 8. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facihty, N/A NUMBER 1 7/15/2019 5:33 PM p. 38 Collier County Solicitation 19-7596 9. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals? N/A El YES NO ❑ Program Office *Notice of Corrective Action Sent / Date PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EDAPLOYEES. EXPLAIN 10. Has a self-evaluation been conducted to identify any barriers to serving disabled Individuals, and to make any necessary modifications? YE§ IF NO NO El On -Site ❑ Desk Review ❑ - Response Received / 11. Is there an established grievance procedure that incorporates due process in the resolution of complaints? YE NO 12. Has a person been designated to coordinate Section 504 compliance activities? YES NQ 13. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? YES T' NO ❑ 14. Are auxiliary aids available to assure accessibility of services to hearing and sight -impaired individuals? S NO D YI PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE. 15. Do you have a written affirmative action plan? If NO, explain. YE5 NO Reviewed By In Compliance: VES ❑ NO* ❑ Program Office *Notice of Corrective Action Sent / Date Telephone Response Due On -Site ❑ Desk Review ❑ - Response Received / Revised August 2010, Page 2 of 2 GCA -11 2 7/15/2019 5:33 PM p. 39 Collier county Solicitation 19-7696 INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST 1. Describe the geographic service area such as a district, county, city or other locality. If the prograrr/facility serves a specific target population such as adolescents, describe the target population. Also, define the type of service provided. 2. Enter the percent of the population served by race and sex. The population served includes persons in the geographical area for which services are provided such as a city, county or other regional area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific Islanders and American Indian/Alaskan Natives.) 3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of your summary. 4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list their percent by race, sex and disability. Include the date that enrollment was counted. 5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no advisory or governing board, leave this section blank. 6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the contract language for DOEA recipients and their sub -grantees, 45 CFR 80.4 (a). 7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the population is Hispanic, is there a comparable percentage of Hispanic staff? 8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability in the population, the program/facility has the responsibility to determine the reasons for such variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6). 9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a) and 45 CFR 80.1 (b) (2), 10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services, physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin, religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting rooms, reception areas, testrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b). 11. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin or disability, .Also, residents must not be asked whether they are willing to share accommodations with persons of a different race, color, national origin, or disability, 45 CFR 80.3 (a). 12. The program/facility and all services must be accessible to participants and applicants, including those persons who may not speak English. In geographic areas where a significant population of non-Englisb speaking people live, program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist in the provision of services, 45 CFR 80.3 (a). GCA -12 3 7/15/2019 5:33 PM p, 40 Collier County Solicitation 19-7596 13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their participants, beneficiaries or any other interested parties. This should include information on their right to file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The information may be supplied verbally or in writing to every individual, or may be supplied through the use of an equal opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6 (d). 14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color, creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement, termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address of the local, state or Federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc. 15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, resttooms, recreation areas, counters and serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility impaired individuals. 16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self- evaluation to identify any accessibility barriers. Self-evaluation is a four step process! a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not comply with Section 504. b. Modify policies and practices that do not meet Section 504 requirements. c. Take remedial steps to eliminate any discrimination that has been identified. d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been followed.), 45 CFR 84.6. 17. Programs or facilities that employ 15 or mote persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b)- 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply with Section 504.45 CFR 84.7 (a). 19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads, and other appropriate written communication, 45 CFR 84.8 (a). 20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide equally effective services, 45 CFR 84.52 (d). 21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60 and Title VI of the Civil .Rights Act of 1964, as amended. DOER Fenn 101-t3, Revised August 2010 GCA - 13 4 7/15/201 g 5;33 PM p. 41 Collier County Solicitation 19-7596 1.: 11.113JT I.B GRANT CERTIFiC'A1I(=2NS AND ASSI!RANC:1:!S 19--r-7sgV Collier County Solicitation No. COLLIER COUNTY Conflict of Interest Certification hereby certify that to the best of my knowledge, neitherWnor my spouse, depeKdent child, general partner, or any organization for which I am serving as an officer, director, trustee, general partner or employee, or any person or organization with whom I am negotiating or have an arrangement concerning prospective employment has a financial interest in this matter - 1 further certify to the best of my knowledge that this matter will not affect the financial interests of any member of my household. Also, to the best of my knowledge, no member of my household; no relative with whom 1 have a close relationship; no one with whom my spouse, parent or dependent child has or seeks employment; and no organization with which, I am seeking a business relationship nor which I now serve actively or have served within the last year are parties or represent a party to the matter. I also acknowledge my responsibility to disclose the acquisition of any financial or personal interest as described above that would be affected by the matter, and to disclose any interest 1, or anyone noted above, has in any person or organization that does become involved in, or is affected at a later date by, the conduct of this matter. Privacy Act Statement Title I of the Ethics in Government Act of 1978 (5 U.S.C. App.), Executive Order 12674 and 5 CFR Part 2634, Subpart I require the reporting of this information. The primary use of the information on this form is for review by officials of The Justice Department to determine compliance with applicable federal conflict of interest laws and regulations. Additional disclosures of the information on this report may be made: (1) to a federal, state or local law enforcement agency if the Justice Department becomes aware of a violation or potential violation of law or regulations; (2) to a court or party in a court or federal administrative proceeding if the government is a party or in order to comply with a judge -issued subpoena; (3) to a source when necessary to obtain information relevant to a conflict of interest investigation or decision; (4) to the National Archives and Records Administration or the General Services Administration in records management inspections; (5) to the Office of Management and Budget during legislative coordination on private relief legislation; and (6) in response to a request for discovery or for the appearance of a witness in a judicial or administrative proceeding, if the information is relevant to the subject matter. This confidential certification will not be disclosed to any requesting person unless authorized by law. See also the OGE/GOVT-2 executive branch -wide Privacy Act system of records. GCA -15 7/15/2019 5:33 PM p. 43 EXHIBIT 1.13 Collier County Solicitation 19-7596 GRANT CMTII°ICATIONS AND ASSURANCIS: COLLIER COUNTY ANTICIPATED DISADVANTAGED, MINORITY, WOMEN OR VETERAN PARTICIPATION STATEMENT YAlf be med£ted, tlpygrdBpfa statuses wdl require the PRfME'to eMw pruiY a r vu6 iW emom: or prmide so documentation that wlid, OM KV E I 5�oasu ' um I � O W ORK R" M I (S'ee.BeWwt E I DSU515 MER I PENS OtOFMNWFERRACT Stf9MrFTER U lRey. 1 "1 11 NOTE: This infacmadon is used ovie w MPC paaicipatian oe%dralh-funded �acts."Eeawitipa'ted Ers'Ear MBE amoVW i9 Wtyu V Brit x911 M bocolna part. of the codradual temns.. This fo must bewbmined ut time of respun Loa sokiubon- ifandwhan aswaxded a[aunty conRlact, the prima w0i tm adcee to "Ag dw infoYmion fprthe grata tomplianre files. GCA - 16 7/15/2019 5'33 PM P, 44 PRIME MD NUMBER CON9lC4C{fr DOLtAKE.AMOUNT `',/�P[RIMEfdAM.lp N I 1, 4 I OQ'? ,% L�-J ,CY) v .gk DAM&—cFRTN[o 615AMFAGui.. Y 5T EAC VrW OFTMISO ftTRAd ._ IMEW WORM EN7F VSE? iDBE? Y 4�ONSrRUCF10N �' Y OR PAVE A SMALL PlWVANTAGEU flMATION PRQM7NG 5MALLSUSINISS Me£, Y CONVULT"ON7 Y N I? ASEAVICE�ISABUDVEFERAN? Va 0 v ® OTNEe' v N SPA 6A2 Y N IS ilil55NBME:SCONA REVbSRYN� Y N FFYES-REVISION NUMBER OM KV E I 5�oasu ' um I � O W ORK R" M I (S'ee.BeWwt E I DSU515 MER I PENS OtOFMNWFERRACT Stf9MrFTER U lRey. 1 "1 11 NOTE: This infacmadon is used ovie w MPC paaicipatian oe%dralh-funded �acts."Eeawitipa'ted Ers'Ear MBE amoVW i9 Wtyu V Brit x911 M bocolna part. of the codradual temns.. This fo must bewbmined ut time of respun Loa sokiubon- ifandwhan aswaxded a[aunty conRlact, the prima w0i tm adcee to "Ag dw infoYmion fprthe grata tomplianre files. GCA - 16 7/15/2019 5'33 PM P, 44 fJcfa eniearr n, lER AFFAIRS: l �;ln i t� nvy_ioii7(tj,l7� BACKGROUND SCREENING Affidavit of Compliance - Employer AUTHORITY: This form is required annually of all employers to comply vyith the attestation requirements set forth in section 436:06(3), Florida. Statute's. A The. term. 'employer" means, any person orentity required by law to conduct, background screening, including but not limited to, Area Agencies on Aging/Aging (and Olsabllity) Resource. Centers,. Lead Agencies; and Service. Providersthat contract directly or indirectly with the pepartment of ElderAffairs (OOEA), and any other person or entity which hires employees or hasvolunteers in service who meet.. the definition of a direct service provider. See §§ 435.04.430:01102, Fla. Stat. ➢ A, direct. Service provider is "a person 18 years of ageor' older who; pursuant to •a program to provide .services to the elderly, has direct, face-tca face contact with a client while providing services to the client and has,acress to the dient's:living area, fgnds, personal property, or personal: identification information as deflned'In, s. 83.7.568. Theterm Includes q'oordinatgrs, managers, and supervisors of residential facilities; and volunteers-" § 430,0402(i)(13);. Fla.5tat. ATTESTATION: n .p As the duly authorized representative of .EmptoyerNoome located /0MY4K/- x-10alc,h— 39d hereby affirm under penalty of perjury that the above named employer is; in compliance with the provisions. of Chapter 435 and section 430,Of192,. Florida .Statutes, regarding level 2ckgrou.ndscreening. &Iigneof.Representative pate STATE OF FLORIDA, COUNTY OF QOMail Sworn to (or affirmed) and subscribed before me this la day of `C 20_L61, by (Name of Representative) who is personally known. to me nr produced1✓�L iM%1�nR�>'1? 3 b as proof Of identification, PrJnt, TYpe, or. stampCommi55ioned Name of Notary Public. OOEA Form 235, Affidavit of Compliance •Employer, Etfech4e Septeltiat:77.,, 7057 a,mxXC,�t\ Pon availableat htto;llgl�aoffeirssFatR'°flys(en¢Ilsh/6atle¢roundSoneehttlG.ptio Notary Pudllo -State dl Florida3 CommissionN GG 061473My Comm. Expires Jan 10, 8021 9mMedliffough NLbIMFNeIYy AFM. LAJ M.31T 1,B ra Collier County Solicitation 19-7596 GRANT CERTIFIC"ATIONS .ANI? ASSURANC F,'S cF4GlCR COtFNTY GpAlvr'GM74.:Tu,y6JTF;F�FiM �10 QPpOjrrUWITY UST FOR COMMODITI€5 AND CONTRACTUAL SERVICES AMD PROFESSIONAL CONSULTANT SERVICES PRm,C C.oratratlw,dPra me LunnaFl`�vr: Addy acrd pl n Number ProcnpdneBq Ndmbw/Adyeatas rd Flumher: 1 '1— !S OF the fist Wow ini hrtendedto bB a lisshlgaFfinus that orG, n Wemyft m. pardrjPaFa ME, Rujec t numbemd nAllh'e. The Ps[must indu&the 'DrM bidding" quaff as prone, mv,91 as subs andsupplg ° gcuAngfor Garj3Pa[Ipn-Mme wntractuas and cnmsuR�lnts m1L:t provide MEMmabnR torFuumbes 1,2,3,and: 4; EPA 4oWd Prmnde 3SW irdormatpRthey hawe For Numbers 9p p,7, and B. Thniormmust be muted with the bid Paden,, I. Federai Yaxiumomber': —^( qj .DBE & ARmpI DMEN Recapts 2, Karrn Name: f Jogi Ne 515 A than $ i mdtion 3- Phone Number:; — Be[wrcen$1-B ul�ryipn 4. Address Bey4eeN S5 -1A asMllimn 7-[] smboo rxSur IWween$ iG- 5 mi lion ryf]�L¢a� I$r_"7:-111 3 sujocvkp d[ More than s Is minion 5. 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QUESTIONS Solicitation 19-7596 1.1 Direct questions related to this RFP to the Collier County Procurement Services Division Online Bidding System website: iittps://www.bidsyrtc.cotn/bidsync-cas/. 1.2 Proposers must clearly understand that the only official answer or position of the County will be the one stated on the Collier County Procurement Services Division Online Bidding System website. For general questions, please call the referenced Procurement Strategist noted on the cover page. 2. PRE -PROPOSAL CONFERENCE 2.1 The purpose of the pre proposal conference is to allow an open forum for discussion and questioning with County staff regarding the RFP with all prospective vendors having an equal opportunity to bear and participate. Oral questions will receive oral responses, neither of which will be official, nor become part of the RFP. Only written responses to written questions will be considered official, and will be included as part of the RFP as an addendum. 2.2 All prospective vendors are strongly encouraged to attend, as, this will usually be the only pre -proposal conference for this solicitation. If this pre -proposal conference is denoted as "mandatory", prospective Vendors must be present in order to submit a proposal response. 3. COMPLUNCE WITH Proposals must be in strict compliance with this RFP. Failure to comply with all provisions of the RFS may result in disqualification. 4. AMBIGUITY. CONFLICT. OR OTHER ERRORS IN THE RFP it is the sole responsibility of the vendor if they discovers any ambiguity, conflict, discrepancy, omission or other error in the RFP, to immediately notify the Procurement Professional, noted herein, of such error in writing and request modification or clarification of the document prior to submitting the proposal. The Procurement Professional will make modifications by issuing a written revision and will give written notice to all parties who have received this RFP from the Procurement Services Division. 5. PROPOSALS, PRESENTATIONS, AND PROTEST COSTS The County will not be liable in any way for any costs incurred by any Vendor in the preparation of its proposal in response to this RFP, nor for the presentation of its proposal and/or participation in any discussions, negotiations, or, if applicable, any protest procedures. 6. VALIDITY OF PROPOSALS No proposal can be withdrawn after it is opened unless the vendor makes their request in writing to the County. ,All proposals shall be valid for a period of one hundred eighty (180) days from the submission date to accommodate evaluation and selection process. 7. METHOD OF SOURCE SELECTION 7.1 The County is using the Competitive Sealed Proposals methodology of source selection for this procurement, as authorized by Ordinance Number 2017.08, establishing and adopting the Collier County Procurement Ordinance. 7.2 If the County receives proposals from less than three (3) Finns, the Procurement Director shall review all the facts and determine if it is in the best interest of the County to solicit additional proposals or request that the Selection Committee rank order the received proposals. 8. EVALUATION OF PROPOSALS 8.1 The County's procedure for selecting is as follows: 7/15/2019 5:33 PM p. 63 Collier County Solicitatlon 19-7596 8.1.1 The Procurement Services Director shall appoint a selection committee to review all proposals submitted. 8.1.2 The Request for Proposal is issued. 8.1.3 Subsequent to the receipt closing date for the proposals, the Procurement Professional will review the proposals received and verify each proposal to determine if it minimally responds to the requirements of the published RFP. 8.1.4 Selection committee meetings will be open to the public and publicly noticed by the Procurement Services Division. 8.1.5 In an initial organization meeting, the selection committee members will receive instructions, the submitted proposals, and establish the next selection committee meeting date and time. After the first meeting, the Procurement professional will publicly announce all subsequent committee meeting dates and times. The subsequent meeting dates and times will be publicly posted with at least one (1) day advanced notice, 8.1.6 Selection committee members will independently review and score each proposal based on the evaluation criteria stated in the request for proposal using the Individual Selection Committee Score and Rank Form and prepare comments for discussion at the next meeting. The Individual Selection Committee Score and Rank Form is merely a tool to assist the selection committee member in their review of the proposals. 8.1.7 At the publicly noticed selection committee meeting, the members will present their independent findings / conclusions / comments based on their reading and interpretation of the materials presented to each other, and may ask questions of one another. Time will be allowed for public comment. 8.1.8 Collier County selection committee members may consider all the material submitted by the Proposer and other information Collier County may obtain to determine whether the Proposer is capable of and has a history of successfully completing projects of this type, including, without limitation, additional information Collier County may request, clarification of proposer information, and/or additional credit information. 8.1.9 Once the individual scoring has been completed, the Procurement professional will read the results publicly. The committee will make a determination if oral presentations are needed and which firms will be invited to give oral presentations by short listing the proposals submitted. The selection committee may ask for additional information, present materials, interview, ask questions, etc. The members may consider any and all information obtained tbxough this method in formulating their final ranking. 8.1.10 The selection committee's overall rank of firms in order of preference (from highest beginning with a rank of one (1) to the lowest) will be discussed and reviewed by the Procurement Professional. 6y final tabulation, and having used all information presented (proposal, presentation, references, etc.), the selection committee members will vote and thus create a final ranking and staff will subsequently enter into negotiations. 8.2 The County reserves the right to withdraw this RFP at any time and for any reason, and to issue such clarifications, modifications, addendums, and/or amendments as it may deem appropriate, including, but not limited, to requesting supplemental proposal information. 8.3 .Receipt of a proposal by the County offers no rights upon the proposer nor obligates the County in any manner. 8.4 Acceptance of the proposal does not guarantee issuance of any other governmental approvals. 9. REFERENCES The County reserves the right to contact any and all references submitted as a result of this solicitation. 10. RESERVE�I Collier County reserves the right in any solicitation to accept or reject any or all bids, proposals or offers; to waive minor irregularities and technicalities; or to request resubmission. Also, Collier Countv reserves the right to accept all or any part of any bid, proposal, or offer, and to increase or decrease quantities to meet additional or reduced 7/15/2019 5'33 PM p 84 Collier County Solicitation 19-7596 requirements of Collier County. Notwithstanding any other provisions of this Article, if none or only one responsive and responsible bid or proposal is received following any solicitation, the County Manager, or designee, reserves the right to reject all bids, proposals or offers and to negotiate with any responsible providers to secure the best terms and conditions in the sole interest of the County unless otherwise provided by law. 11. INSURANCE AND BONDING REQUIREMENTS 11.1 The Vendor shall at its own expense, carry and maintain insurance coverage from responsible companies duly authorized to do business in the State of Florida as set forth in the Insurance and Bonding attachment of this solicitation. The Vendor shall procure and maintain property insurance upon the entire project, if required, to the full insurable value of the scope of work - 11.2 The County and the Vendor waive against each other and the County's separate Vendors, Contractors, Design Vendor, Subcontractors agents and employees of each and all of them, all damages covered by property insurance provided herein, except such rights as they may have to the proceeds of such insurance. The Vendor and County shall, where appropriate, require similar waivers of subrogation from the County's separate Vendors, Design Vendors and Subcontractors and shall require each of them to include similar waivers in their contracts. 11.3 Collier County shall be responsible for purchasing and maintaining, its own liability insurance. 11.4 Certificates issued as a result of the award of this solicitation must identify "For any and all work performed on behalf of Collier County." 11.5 The General Liability Policy provided by Vendor to meet the requirements of this solicitation shall name Collier County, Florida, as an additional insured as to the operations of Vendor under this solicitation and shall contain a severability of interests provisions. 11.6 Collier County Board of County Commissioners shall be named as the Certificate Holder. The Certificates of Insurance must state the Contract Number, or Project Number, or specific Project description, or must read: For any and all work performed on behalf of Collier County. The "Certificate Holder" should read as follows: Collier County Board of Coundy Commissioners Naples, Florida 11.7 The amounts and types of insurance coverage shall conform to the minimum requirements set forth in Insurance and Bonding attachment, with the use of Insurance Services Office (ISO) forms and endorsements or their equivalents. If Vendor has any self-insured retentions or deductibles under any of tile below listed minimum required coverage, Vendor must identify on the Certificate of Insurance the nature and amount of such self- insured retentions or deductibles and provide satisfactory evidence of financial responsibility for such obligations. All self-insured retentions or deductibles will be Vendor's sole responsibility. 11.8 Coverage(s) shall be maintained without interruption from the date of commencement of the Work until the date of completion and acceptance of the scope of work by the County or as specified in this solicitation, whichever is longer. 11.9 The Vendor and/or its insurance carrier shall provide 30 days written notice to the County of policy cancellation or non renewal on the part of the insurance carrier or the Vendor. The Vendor shall also notify the County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non -renewal or material change in coverage or limits received by Vendor from its insurer and nothing contained herein shall relieve Vendor of this requirement to provide notice. In the event of a reduction in the aggregate limit of any policy to be provided by Vendor hereunder, Vendor shall immediately take steps to have the aggregate limit reinstated to the full extent permitted under such policy. 11.10 Should at any time the Vendor not maintain the insurance coverage(s) required herein, the County may terminate the Agreement or at its sole discretion shall be authorized to purchase such coverage(s) and charge the Vendor for such coverage(s) purchased. if Vendor fails to reimburse the County for such costs within thirty (30) days after demand, the County has the right to offset these costs from any amount due Vendor under this Agreement or any other agreement between the County and Vendor. The County shall be under no obligation 7/15/2019 5133 PM P. 65 Collier County Solicitation 19-7596 to purchase such insurance, nor shall it be responsible for the coverage(s) purchased or the insurance company or companies used. The decision of the County to purchase such insurance coverage(s) shall in no way be construed to be a waiver of any of its rights under the Contract Documents. 11.11 If the initial or any subsequently issued Certificate of Insurance expires prior to the completion of the scope of work, the Vendor shall furnish to the County renewal or replacement Certificate(s) of Insurance not later than ten (10) calendar days atter the expiration date on the certificate. Failure of the Vendor to provide the County with such renewal certificate(s) shall be considered justification for the County to terminate any and a]1 contracts. 12. ADDITIONAL ITEMS AND/OR SERVICES Additional items and / or services may be added to the resultant contract, or purchase order, in compliance with the Procurement Ordinance. 13. COUNTY'S RIGHT TO INSPECT The County or its authorized Agent shall have the right to inspect the Vendor's facilities/project site during and after each work assignment the Vendor is performing. The County reserves the right to take into consideration a vendor's past performance under a prior or current County contract when it is considering the granting of a new contract, the assignment of a work order, or any additional work. Past poor performance may result in the County deeming the vendor noa-responsible and therefore refraining from awarding such work. 14. VENDOR PERFOILI174.NCE (',VALUATION The County has implemented a Vendor Performance Evaluation System for all contracts awarded in excess of $25,000. To this end, vendors will be evaluated on their performance upon completion/termination of this Agreement. 15. ADDITIONAL TERMS AND CONDITIONS OF CONTRACT 15.1 The selected Vendor shall be required to sign a standard Collier County contract. 15.2 The resultant contract(s) may include purchase or work orders issued by the County's project manager. 15.3 The County reserves the right to include in any contract document such terms and conditions, as it deems necessary for the proper protection of the rights of Collier County. A sample copy of this contract is available upon request. The County will not be obligated to sign any contracts, maintenance and/or service agreements or other documents provided by the Vendor. 15.4 The County's project manager shall coordinate with the Vendor / Contractor the return of any surplus assets, including materials, supplies, and equipment associated with the scope or work. 16. PUBLIC RECORDS, COMPLIANCE 16.1 Florida Public Records Law Chapter 119, including specifically those contractual requirements in 119.0701(2)(a) - (b) as follows: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East Suite 102 7/15/2019 5:33 PM p. 66 Collier County Naples, FL 34112-5746 Telephone: (239) 252-8383 16.2 The Contractor must specifically comply with the Florida Public Records Law to: 16.2.1 Keep and maintain public records required by the public agency to perform the service. Solicitation 19-7596 16.2.2 Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 16.2.3 Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. 16.2.4 Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public records required by the public agency to perform the service. If the Contractor transfers all public records to the public agency upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. 17. WORK ORDERS ON FIXED TERM CONTRACTS 17.1 The County reserves the right to order such services from selected firms as may be required during said period, but does not guarantee any minimum or maximum services to be ordered during the period specified from any given firm. Work Order service assignments shall be at the sole discretion of the County. 17.2 Agreements issued that are determined to be "CONTINUING CONTRACTS" where services will be requested by Work Orders in excess of $200,000 shall be approved by the Board of County Commissioners. 17.3 Should any project that is active on a work order extend past the contract termination date, that work order will be active and extended as necessary until completion of such project. 18. PAYMENT METHOD 18.1 Payments are made in accordance with the Local Government Prompt Payment Act, Chapter 218, Florida Statures. Vendor's invoices must include: 18.1.1 Purchase Order Number 18.1.2 Description and quantities of the goods or services provided per instructions on the County's purchase order or contract. Invoices shall be sent to: Board of County Commissioners Clerk's Finance Department ATTN: Accounts Payable 3299 Tamiami Trail East, Suite 700 Naples FL 34112 Or Emailed to: hccauclerka@collierelerk.com 18.2 Payments will be made for articles and/or services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of contract. Any untimely 7115/2019 5:33 PM p. 67 Collier County Solicitation 19-7596 submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this agreement. 18.3 In instances where the successful contractor may owe debts (including, but not limited to taxes or other fees) to Collier County and the contractor has not satisfied nor made arrangement to satisfy these debts, the County reserves the right to off -set the amount owed to the County by applying the amount owed to the vendor or contractor for services performed of for materials delivered in association with a contract. 18.4 Invoices shall not reflect sales tax. After review and approval, the invoice will be transmitted to the Finance Division for payment. Payment will be made upon reecipt of proper invoice and in compliance with Chapter 218 Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." Collier County reserves the right to withhold and/or reduce an appropriate amount of any payment for work not performed or for unsatisfactory performance of Contractual requirements. 19. ENVIRONMENTAL HEALTH AND SAFETY 19.1 All Vendors and Sub Vendors performing service for Collier County are required and shall comply with all Occupational Safety and Health Administration (OSHA), State and County Safety and Occupational Health Standards and any other applicable rules and regulations. Vendors and Sub Vendors shall be responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site. All firewall penetrations must be protected in order to meet Fire Codes. 19.2 Collier County Government has authorized OSTIA representatives to enter any Collier County facility, property and/or right-of-way for the purpose of inspection of any Vendor's work operations. This provision is non- negotiable by any department and/or Vendor - 19.3 All new electrical installations shall incorporate NFPA 70E Short Circuit Protective Device Coordination and Arc Flash Studies where relevant as determined by the engineer. 19.4 All electrical installations shall be labeled with appropriate NFPA 70E arch flash boundary and PPE Protective labels - 20. POLLUTION PREVENTION The vendor is required to implement industry relevant pollution prevention and best management practices. Should pollution incidents occur, Collier County Pollution Control must be notified immediately. 21. LICENSES 21.1 The Vendor is required to possess the correct Business Tax Receipt, professional license, and any other authorizations necessary to carry out and perform the work required by the project pursuant to all applicable Federal, State and Local Law, Statute, Ordinances, and rules and regulations of any kind. Additionally, copies of the required licenses must be submitted with the proposal response indicating that the entity proposing, as well as the team assigned to the County account, is properly licensed to perform the activities or work included in the contract documents. Failure on the part of any Vendor to submit the required documentation may be grounds to deem Vendor non-responsive. A Vendor, with an office within Collier County is also required to have an occupational license. 21.2 All State Certified contractors who may need to pull Collier County permits or call in inspections must complete a Collier County Contractor License registration form and submit the required fee. After registering the license/registration will need to be renewed thereafter to remain "active" in Collier County. 21.3 If you have questions regarding professional licenses contact the Contractor Licensing, Community Development and Environmental Services at (239) 252-2431, 252-2432 or 252-2909. Questions regarding required occupational licenses, please contact the Tax Collector's Office at (239) 252.2477. 22. SURVIVABILITY The Vendor agrees that any Purchase Order/Work Order/Solicitation Documents that extends beyond the expiration date of the original Solicitation will survive and remain subject to the terms and conditions of that Agreement until 7/15/2019 5!33 PM p. 68 Collier County the completion or termination. 23. PRINCIPAL/COLLUSION S9110t2tion 19-7596 By submission of this Proposal the undersigned, as Vendor, does declare that the only person or persons interested in this Proposal as principal or principals is/are named therein and that no person other than therein mentioned has any interest in this Proposal or in the contract to be entered into; that this Proposal is made without connection with any person, company or parties making a Proposal, and that it is in all respects fair and in good faith without collusion or fraud. 24. RELATION OF COUNTY It is the intent of the parties hereto that the Vendor shall be legally considered an independent Vendor, and that neither the Vendor nor their employees shall, under any circumstances, be considered employees or agents of the County, and that the County shall be at no time legally responsible for any negligence on the part of said Vendor, their employees or agents, resulting in either bodily or personal injury or property damage to any individual, firm, or corporation. 25. TERMINATION Should the Vendor be found to have failed to perform services in a manner satisfactory to the County, the County may terminate this Agreement immediately for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of non performance. In the event that the award of this solicitation is made by the Procurement Services Director, the award and any resultant purchase orders may be terminated at any time by the County upon thirty (30) days written notice to the awarded vendor(s) pursuant to the Board's Procurement Ordinance. 26. LOBBYING After the issuance of any solicitation, no current or prospective vendor or any person acting on their behalf, shall contact, communicate with or discuss any matter relating to the solicitation with any Collier County employee or elected or appointed official, other than the Procurement Services Director or his/her designees. This prohibition ends upon execution of the final contract or upon cancellation of the solicitation. Any current or prospective vendor that lobbies any Collier County employee or elected or appointed official while a solicitation is open or being recommended for award (i) may be deemed ineligible for award of that solicitation by the Procurement Services Director, and (ii) will be subject to Suspension and Debarment outlined in section Twenty-eight of County Ordinance 2011-09. 27. CERTIFICATE OF AUTHORITY TO CONDUCT BUSINESS M THE STATE OF FLORIDA (FL Statute 607.1501) In order to be considered for award, firms must be registered with the Florida Department of State .Divisions of Corporations in accordance with the requirements of Florida Statute 607.1501 and provide a certificate of authority (www-sunbiz.org/search.html) prior to execution of a contract. A copy of the document may be submitted with the solicitation response and the document number shall be identified. Firms who do not provide the certificate of authority at the time of response shall be required to provide same within five (5) days upon notification of selection for award. If the firm cannot provide the document within the referenced timeframe, the County reserves the right to award to another firm. 28. SINGLE PROPOSAL Each Vendor must submit, with their proposal, the required forms included in this RFP. Only one proposal from a legal entity as a primary will be considered. A legal entity that submits a proposal as a primary or as part of a partnership or joint venture submitting as primary may not then act as a sub -vendor to any other firm submitting under the same RFP. if a legal entity is not submitting as a primary or as part of a partnership orjoint venture as a primary, that legal entity may act as a sub -vendor to any other firm or firms submitting under the same RFP. All submittals in violation of this requirement will be deemed non-responsive and rejected from further consideration. 29. PROTEST PROCEDURES 29.1 With respect to a protest of the terms, conditions and specifications contained in a solicitation, including any 7/15/2019 5:33 PM P. 69 Collier County Solicitation 19-7596 provisions governing the methods for evaluation of bids, proposals or replies, awarding contracts, reserving rights for further negotiation or modifying or amending any contract, the protesting party shall file a notice of intent to protest within three (3) days, excluding weekends and County holidays, after the first publication, whether by posting or formal advertisement of the solicitation. The formal written protest shall be filed within five (5) days of the date the notice of intent is filed. Formal protests of the terms, conditions and specifications shall contain all of the information required for the Procurement Services Director, to render a decision on the formal protest and determine whether postponement of the bid opening or proposal/response closing time is appropriate. The Procurement Services Director's decision shall be considered final and conclusive unless the protesting party files an appeal of the Procurement Services Directors decision. 29.2 Any actual proposer or respondent to who desires to protest a recommended contract award shall submit a notice of intent to protest to the Procurement Services Director within three (3) calendar days, excluding weekends and County holidays, from the date of the initial posting of the recommended award. 29.3 All formal protests with respect to a recommended contract award shall be submitted in writing to the Procurement Services Director for a decision. Said protests shall be submitted within five (5) calendar days, excluding weekends and County holidays, from the date that the notice of intent to protest is received by the Procurement Services Director, and accompanied by the required fee. 29.4 Complete form and instructions for formal protest are set forth in Section 23 of Collier County Ordinance 2017- 08. The protesting party must have standing as defined by established Florida case law to maintain a protest. 30. PUBLIC ENTITY CRIME A person or affiliate who has been placed on the convicted Vendor list following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply ou a contract with a public entity for the construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or vendor under a contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s- 287.017 for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted Vendor list. 31. SECURITY AND BACKGROUND CHECKS 31.1 The Contractor is required to comply with County Ordinance 2004-52, as amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the costs of providing background checks by the Collier County Facilities Management Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment verifications and other related records. Contractor shall be required to maintain records on each employee and make them available to the County for at least four (4) years. 31.2 All of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor 1D badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. 31.3 The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL - FMOPSQcolliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of $500 per incident. 31.4 CCSO requires separate fingerprinting prior to work being performed in any of their locations. This will be coordinated upon award of the contract. If there are additional fees for this process, the vendor is responsible for all costs. 7/15/2019 5:33 PM p. 70 Collier County 32. CONFLICT OF INTEREST Solicitation 19-7596 Vendor shall complete the Conflict of Interest Affidavit included as an attachment to this RFP document, Disclosure of any potential or actual conflict of interest is subject to County staff review and does not in and of itself disqualify a firm from consideration. These disclosures are intended to identify and or preclude conflict of interest situations during contract selection and execution. 33. MOHIBITION 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, the current Collier County Ethics Ordinance and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any contract held by the individual and/or firm for cause. 34. IMMIGRATION LAW AFFIDAVIT CERTIFICATION 34.1 Statutes and executive orders require employers to abide by the immigration laws of the United States and to employ only individuals who are eligible to work in the United States. 34,2 The Employment Eligibility Verification System (E -Verify) operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA), provides an Internet -based means of verifying employment eligibility of workers in the United States; it is not a substitute for any other employment eligibility verification requirements. The program will be used for Collier County formal Invitations to Bid (ITB) and Request for Proposals (RFP) including Request for Professional Services (RFP) and construction services. 34.3 Exceptions to the program: 34.3.1 Commodity based procurement where no services are provided. 34.3.2 Where the requirement for the affidavit is waived by the Board of County Commissioners 34.4 Vendors/ Bidders are required to enroll in the E -Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the Vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E -Verify Company Profile page or a copy of the fully executed E -Verify Memorandum of Understanding for the company. Vendors are also required to provide the Collier County Procurement Services Division an executed affidavit certifying they shall comply with the E -Verify Program. The affidavit is attached to the solicitation documents. If the Bidder/Vendor does not comply with providing the acceptable E -Verify evidence and the executed affidavit the bidder's / Vendor's proposal may be deemed non- responsive. 34.5 Additionally, Vendors shall require all subcontracted Vendors to use the E -Verify system for all purchases not covered under the "Exceptions to the program" clause above. 34.6 For additional information regarding the Employment Eligibility Verification System (E -Verify) program visit the following website: http://www.dhs.gov/E-Verify. It shall be the Vendor's responsibility to familiarize themselves with all rules and regulations governing this program. 34.7 Vendor acknowledges, and without exception or stipulation, any firm(s) receiving an award shall be fully responsible for complying with the provisions of the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended and with the provisions contained within this affidavit. Failure by the awarded firm(s) to comply with the laws referenced herein or the provisions of this affidavit shall constitute a breach of the award agreement and the County shall have the discretion to unilaterally terminate said agreement immedtately- ❑ Yes © No 711512019 5:33 PM p, 71 Collier County Solicitation 19-7596 Certification: I certify that I am in agreement, to the best of my knowledge, with the Instructions To Proposers above. 7/15/2019 5:33 PM p. 72 Collier County PURCHASE ORDER TERMS AND CONDITIONS 1.1 Offer Sollcltation 19-7596 This offer is subject to cancellation by the COUNTY without notice if not accepted by VENDOR within fourteen (14) days of issuance. 1.2 Acceptance and Confirmation This Purchase Order (including all documents attached to or referenced therein) constitutes the entire agreement between the parties, unless otherwise specifically noted by the COUNTY on the face of this Purchase Order. Each delivery of goods and/or services received by the COUNTY from VENDOR shall be deemed to be upon the terms and conditions contained in this Purchase Order. No additional terms may be added and Purchase Order may not be changed except by written instrument executed by the COUNTY. VENDOR is deemed to be on notice that the COUNTY objects to any additional or different terms and conditions contained in any acknowledgment, invoice or other communication from VENDOR, notwithstanding the COUNTY'S acceptance or payment for any delivery of goods and/or services, or any similar act by VENDOR. 1.3 Inspection 1.3.1 All goods and/or services delivered hereunder shall be received subject to the COUNTY'S inspection and approval and payment therefore shall not constitute acceptance. All payments are subject to adjustment for shortage or rejection. All defective or nonconforming goods will be returned pursuant to VENDOR'S instruction at VENDOR'S expense. 1,3.2 To the extent that a purchase order requires a series of performances by VENDOR, the COUNTY prospectively reserves the right to cancel the entire remainder of the Purchase Order if goods and/or services provided early in the term of the Purchase Order are non conforming or otherwise rejected by the COUNTY. 1.4 Shipping and Invoices 1.4.1 a) All goods are FOB destination and must be suitably packed and prepared to secure the lowest transportation rates and to comply with all carrier regulations. Risk of loss of any goods sold hereunder shall transfer to the COUNTY at the time and place of delivery; provided that risk of loss prior to actual receipt of the goods by the COUNTY nonetheless remain with VENDOR. 1.4.2 b) No charges will be paid by the COUNTY for packing, crating or cartage unless otherwise specifically stated in this Purchase Order. Unless otherwise provided in Purchase Order, no invoices shall be issued nor payments made prior to delivery. Unless freight and other charges are itemized, any discount will be taken on the full amount of invoice. 1.4.3 c) All shipments of goods scheduled on the same day via the same route must be consolidated. Each shipping container must be consecutively numbered and marked to show this Purchase Order number. The container and Purchase Order numbers must be indicated on bill of lading. Packing slips must show Purchase Order number and must be included on each package of less than container load (LCL) shipments and/or with each car load of equipment. The COUNTY reserves the right to refuse or return any shipment or equipment at VENDOR'S expense that is not marked with Purchase Order numbers. VENDOR agrees to declare to the carrier the value of any shipment made under this Purchase Order and the full invoice value of such sbipment. 1.4.4 d) All invoices must contain the Purchase Order number and any other specific information as identified on the Purchase Order. Discounts of prompt payment will be computed from the date of receipt of goods or from date of receipt of invoices, whichever is later. Payment will be made upon receipt of a proper invoice and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act," and, pursuant to the Board of County Commissioners Purchasing Policy. 1.5 'Time Is Of the Essence Time for delivery of goods or performance of services under this Purchase Order is of the essence. Failure of VENDOR to meet delivery schedules or deliver within a reasonable time, as interpreted by the COUNTY in its sole judgment, shall entitle the COUNTY to seek all remedies available to it 7/15/2019 5:33 PM p. 73 Collier County Solicitation 19.7596 at law or in equity. VENDOR agrees to reimburse the COUN'T'Y for any expenses incurred in enforcing its rights. VENDOR further agrees that undiscovered delivery of nonconforming goods and/or services is not a waiver of the COUNTY'S right to insist upon further compliance with all specifications. 1.6 Changes The COUNTY may at any time and by written notice make changes to drawings and specifications, shipping instructions, quantities and delivery schedules within the general scope of this Purchase Order. Should any such change increase or decrease the cost of, or the time required for performance of the Purchase Order, an equitable adjustment in the price and/or delivery schedule will be negotiated by the COUNTY and VENDOR. Notwithstanding the foregoing, VENDOR has an affirmative obligation to give notice if the changes will decrease costs. Any claims for adjustment by VENDOR must be made within thirty (30) days from the date the change is ordered or within such additional period of time as may be agreed upon by the parties. 1.7 Warranties VENDOR expressly warrants that the goods and/or services covered by this Purchase Order will conform to the specifications, drawings, samples or other descriptions furnished or specified by the COUNTY, and will be of satisfactory material and quality production, free from defects and sufficient for the purpose intended. Goods shall be delivered free from any security interest or other lien, encumbrance or claim of any third party. These warranties shall survive inspection, acceptance, passage of title and payment by the COUNTY. 1.8 Statutory Conformity 1.8.1 Goods and services provided pursuant to this Purchase Order, and their production and transportation shall conform to all applicable laws, including but not limited to the Occupational Health and Safety Act, the Federal Transportation Act and the fair Labor Standards ,Act, as well as any law or regulation noted on the face of the Purcbase Order. 1.9 Advertising No VENDOR providing goods and services to the COUNTY shall advertise the fact that it has contracted with the COUNTY for goods and/or services, or appropriate or make use of the COUNTY'S name or other identifying marks or property without the prior written consent of the COUNTY'S Purchasing Department. 1.10 Indemnification VENDOR shall defend, indemnify and hold harmless the COUNTY from any and all claims, including claims of negligence, costs and expenses, including but not limited to attorneys' fees, arising from, caused by or related to the injury or death of any person (including but not limited to employees and agents of VENDOR in the performance of their duties or otherwise), or damage to property (including property of the COUNTY or other persons), which arise out of or are incident to the goods and/or services to be provided hereunder. 1.11 Warranty of Non Infringement 1.11.1 VENDOR represents and warrants that all goods sold or services performed under tbis Purchase Order are: a) in compliance with applicable laws; b) do not infringe any patent, trademark, copyright or trade secret; and c) do not constitute unfair competition. 1. 11.2 VENDOR shall indemnify and hold harmless the COUNTY from and against any and all claims, including claims of negligence, costs and expense, including but not limited to attomeys' fees, which arise from any claim, suit or proceeding alleging that the COUNTY'S use of the goods and/or services provided under this Purchase Order are inconsistent with VENDOR'S representations and warranties in section 11 (a). 1. 11.3 If any claim which arises from VENDOR'S breach of section I I (a) has occurred, or is likely to occur, VENDOR may, at the COUNTY'S option, procure for the COUNTY the right to continue using the goods or services, or replace or modify the goods or services so that they become non infringing, (without any material degradation in performance, quality, functionality or additional cost to the COUNTY). 7/1512919 5:33 PM p• 74 Collier County 1, 12 Insurance Requirements Solicitation 19-7596 The VENDOR, at its sole expense, shall provide commercial insurance of such type and with such terms and limits as may be reasonably associated with the Purchase Order. Providing and maintaining adequate insurance coverage is a material obligation of the VENDOR. All insurance policies shall be executed through insurers authorized or eligible to write policies in the State of Florida. 1.13 Compliance with Laws To fulfilling the terms of this Purchase Order, VENDOR agrees that it will comply with all federal, state, and local laws, rules, codes, and ordinances that are applicable to the conduct of its business. By way of noo-exbaustive example, this shall include the American with Disabilities Act and all prohibitions against discrimination on the basis of race, religion, sex creed, national origin, handicap, marital status, or veterans' status. Further, VENDOR acknowledges and without exception or stipulation shall be fully responsible for complying with the provisions of the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended. Failure by the awarded firm(s) to comply with the laws referenced herein shall constitute a breach of the award agreement and the County shall have the discretion to unilaterally terminate said agreement immediately. Any breach of this provision may be regarded by the COUNTY as a material and substantial breach of the contract arising from this Purchase Order. 1.14 Force Majeure Neither the COUNTY nor VENDOR shall be responsible for any delay or failure in performance resulting from any cause beyond their control, including, but without limitation to war, strikes, civil disturbances and acts of nature. When VENDOR has knowledge of any actual or potential force majeure or other conditions which will delay or threatens to delay timely performance of this Purchase Order, VENDOR shall immediately give notice thereof, including all relevant information with respects to what steps VENDOR is taking to complete delivery of the goods and/or services to the COUNTY. 1.15 Assignment 1.16 Taxes VENDOR may not assign this Purchase Order, nor any money due or to become due without the prior written consent of the COUNTY. Any assignment made without such consent shall be deemed void. Goods and services procured subject to this Purchase Order are exempt from Florida sales and use tax on real property, transient rental property rented, tangible personal purchased or rented, or services purchased (f lorida Statutes, Chapter 212), and from federal excise tax. 1.17 Annual Appropriations The COUNTY'S performance and obligation to pay under this Purchase Order shall be contingent upon an annual appropriation of funds. 1.18 Termination This Purchase Order may be terminated at any time by the COUNTY upon 30 days prior written notice to the VENDOR. This Purchase Order may be terminated immediately by the COUNTY for breach by VENDOR of the terms and conditions of this Purchase Order, provided that COUNTY has provided VENDOR with notice of such breach and VENDOR has failed to cure within 10 days of receipt of such notice. 1.19 General 1.19.1 a) This Purchase Order shall be governed by the laws of the State of Florida. The venue far any action brought to specifically enforce any of the terms and conditions of this Purchase Order shall be the Twentieth Judicial Circuit in and for Collier County, Florida 1. 19.2 b) Failure of the COUNTY to act immediately in response to a breach of this Purchase Order by VENDOR shall not constitute a waiver of breach. Waiver of the COUNTY by any default by VENDOR hereunder shall not be deemed a waiver of any subsequent default by VENDOR. 7/15/2019 5!33 PM p. 75 Collier County Solicitation 19-7596 1. 19.3 c) All notices under this Purchase Order shall be sent to the respective addresses on the face page by certified mail, return receipt requested, by overnight courier service, or by personal delivery and will be deemed effective upon receipt. Postage, delivery and other charges shall be paid by the sender. A party may change its address for notice by written notice complying with the requirements of this section. 1.19.4 d) The Vendor agrees to reimbursement of any travel expenses that may be associated with this Purchase Order in accordance with Florida Statute Chapter 112.061, Per Diem and Travel Expenses for Public Officers, employees and authorized persons. 1.19.5 e) In the event of any conflict between or among the terms of any Contract Documents related to this Purchase Order, the terms of the Contract Documents shall take precedence over the terms of the Purchase Order. To the extent any terms and /or conditions of this Purchase Order duplicate or overlap the Terms and Conditions of the Contract Documents, the provisions of the Terms and/or Conditions that are most favorable to the County and/or provide the greatest protection to the County shall govern. 7/15/2019 5:33 PM p. 76 Collier County Question and Answers for Solicitation #19-7596 - Services for Seniors Prog- Additional Serv-Respite Facility Sery & Adult Day Care There are no questions associated with this Solicitation. Question Deadline: Aug 7, 2019 5:00:00 PM Epi Solicitation 19-7596 77 7/15/2019 5:33 PM p.