Agenda 02/23/2021 Item #16D 3 (AAA After-the-Fact Contract Amendment)02/23/2021
16.D.3
EXECUTIVE SUMMARY
Recommendation to approve "After -the -Fact" contract Amendment, Attestation Statement, and
Budget Amendment with the Area Agency on Aging for Southwest Florida, Inc., Alzheimer's
Disease Initiative grant program for the Collier County Services for Seniors to increase the
allocation, revise Attachment II and Attachment IX and the supporting Budget Amendment.
(Fiscal Impact $24,815.42)
OBJECTIVE: Provide uninterrupted support services to Collier County Services for Seniors' (CCSS)
frail, elderly clients.
CONSIDERATIONS: The Community and Human Services Division's Services for Seniors program
has been providing support to Collier County's frail and elderly citizens for over thirty years through the
Alzheimer's Disease Initiative (ADI) grant program. This grant is funded by the Florida Department of
Elder Affairs (DOEA) through the Area Agency on Aging of Southwest Florida, Inc. (AAA). This grant
funds services to enable clients to remain in their homes and live with independence and dignity.
The current service agreement for ADI estimated funding for 2020-2021 was approved by the Board of
County Commissioners (Board) on June 23, 2020 (Agenda Item #16D10) to prevent disruption in services
and ensure compliance with the grant service agreement requirement. The contract has a one-year term,
effective July 1, 2020 through June 30, 2021, with a three-year renewal option. The fully executed
contract 203.20 for ADI was approved after -the -fact at the Board of County Commissioners (BCC) on
September 08, 2020 (Agenda Item #16D4).
The proposed First Amendment, 203.20.001 will increase the allocation funding by $24,815.42, revise
Attachment II -Exhibit 2-Funding Summary, and revise Attachment IX Budget and Rate Summary.
This Item is being presented "After -the -Fact" because Collier County received the amendment for
additional funding on January 5, 2021 from the grantor agency and is required to return it within thirty
(30) days. This time frame makes it impossible to process the document timely for the Board's
consideration. Pursuant to CMA# 5330 and Resolution No. 2018-202, the County Manager authorized the
Public Services Department Head to sign the agreement. This Amendment is being presented for Board
ratification. Collier County, as the Lead Agency, is responsible for responding to seniors' needs and
managing the spending authority for the Federal and State Funded Services for Seniors programs.
CCSS is also responsible for the collection of client co -payments for the ADI Grants, with a specified
collection goal established by CHS. No Budget Amendment adjustments will be needed for the co -
payment used to support the programs.
The following table provides a detailed breakdown of the FY 20-21 co -payment budget & additional
funding:
Program Component
Project Number
Current Budget
Revised Budget
Increase/ Decrease
ADI
33678
$449,855.00
1 $474,670.42
1 $24,815.42
FISCAL IMPACT: Funding from the Department of Elder Affairs via the Area Agency on Aging under
the 2020 grant award is available in Human Services Grant Fund (707), Project 33678 (ADI). A Budget
Amendment is also required to increase the ADI budget (33678) by $24,815.42.
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact.
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02/23/2021
16.D.3
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a majority vote.
- JAB
RECOMMENDATION: To approve "After -the -Fact" contract Amendment, Attestation Statement, and
Budget Amendment with the Area Agency on Aging for Southwest Florida, Inc., Alzheimer's Disease
Initiative grant program for the Collier County Services for Seniors to increase the allocation, revise
Attachment II and Attachment IX and the supporting Budget Amendment.
Prepared By: Wendy Klopf, Grants Coordinator, Community and Human Services Division
ATTACHMENT(S)
1. ADI 203.20.001-Exec (PDF)
2. (Linked) ADI 203.20-Exec (PDF)
3. Resolution 2018-202 (PDF)
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16.D.3
02/23/2021
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.13.3
Doe ID: 14733
Item Summary: Recommendation to approve "After -the -Fact" contract Amendment, Attestation
Statement, and Budget Amendment with the Area Agency on Aging for Southwest Florida, Inc.,
Alzheimer's Disease Initiative grant program for the Collier County Services for Seniors to increase the
allocation, revise Attachment II and Attachment IX and the supporting Budget Amendment. (Fiscal
Impact $24,815.42)
Meeting Date: 02/23/2021
Prepared by:
Title: Operations Coordinator — Community & Human Services
Name: Wendy Klopf
01/15/2021 4:29 PM
Submitted by:
Title: Manager - Federal/State Grants Operation — Community & Human Services
Name: Kristi Sonntag
01/15/2021 4:29 PM
Approved By:
Review:
Community & Human Services
Kristi Sonntag
CHS Review
Community & Human Services
Akiko Woods
Additional Reviewer
Community & Human Services
Todd Henry
Additional Reviewer
Operations & Veteran Services
Kimberley Grant
Additional Reviewer
Public Services Department
James C French
Public Services Deapartment
Grants
Erica Robinson
Level 2 Grants Review
Public Services Department
James C French
PSD Dept Head Review
County Attorney's Office
Jennifer Belpedio
Level 2 Attorney of Record 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
Dan Rodriguez
Level 4 County Manager Review
Board of County Commissioners
MaryJo Brock
Meeting Pending
Completed
01/20/2021 2:35 PM
Completed
01/20/2021 2:37 PM
Skipped
01/20/2021 2:55 PM
Completed
01/21/2021 5:38 PM
Completed
01/23/2021 1:19 PM
Completed
01/25/2021 2:01 PM
Completed
01/25/2021 9:33 PM
Completed
01/26/2021 8:12 AM
Completed
01/26/2021 8:50 AM
Completed
01/27/2021 8:48 AM
Completed
02/01/2021 4:11 PM
Completed
02/03/2021 12:46 PM
Completed
02/07/2021 1:23 PM
02/23/2021 9:00 AM
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1ti.D.3.a
July 2019 — June 2020 ADI 203.20.001
AREA AGENCY ON AGING FOR SOUTHWESTFLORIDA, INC.
AIJ,HIUMER'S DISEASE INITIATIVE PROGRAM STANDARD CONTRACT
COHAER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Ine, ("Agency") and Collier
County Board of County Commissioners (`Contractor"), amends agreement ADI 203.20.
The purpose of this amendment is to increase allocation funding by amending 4. Contract Amounf, Collier County; increase
allocations by $ 24,815.42; revise ATTACHMENT II -EXHIBIT 2-Funding Summary; and revise ATTACHMENT IX
BUDGET AND RATE SUMMARY.
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in all amount not to
exceed S474,670.42 subject to the availability of funds. Any costs or services paid for under any other contract or from any
other source are not eligible Ibr payment under this contract.
All provisions in the contract and any attachments thuuto in conflict with this Amendinen[ ~hall be and are hereby changed to
conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract.
'Phis Amendment and all its attachments are hereby made part of the contract.
IN WITNESS TIiIrREOF, [lie Parties hereto have caused this amendment, to be executed by their undersigned officials as duly
authorized; and agree to abide by the terms, conditions and provisions of this ADI contract m amended. This Amendment is
eflective on Deccinhcr 29, 2020 upon having been duly signed by both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMISSIONERS SOUTHWEST FLORID�IN
51CiNKI} Ilvr c- ��.. �- SIGNED Fly:` �'�'
NAME: JAMES C FRENCH NAME: NORMA ADORNO
TITLE: PUBLIC SERVICE DEPARTMENT HEAD TiTLE: CEO
DATE: 01/ 12021 DATE:—
i- 2- 2-a2V,
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09130
Duns: 076997790
Approved as to form and legality
\ ; . istant County Attun
1
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16.D.3.a
July 2019 —June 2020
ATTACHMENT II -EXHIBIT 2
FUNDING: SUMMARY
ADI 203.20,001
Note: "Title 2 CFR, as revised, and Section 215.97, F.S., require that the information about Federal Programs and State
Projects included in Attachment 11, Exhibit 1, be provided to the recipient. Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
I. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133 -- Audits of States, Local Governments, and Non -Profit Organisations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL, STATE AWARD
STATE FINANCIAL ASSISTANCE SURIECT TO SECTION 215.97. F.S.
PROGRAM TITLE
FUNDING SOURCE
CSFA
AMOUNT
Alzheimer's Disease Initiative -Collier
General Revenue—TSTF
65.004
$ 474,670.42
TOTAL AWARD
$ 474,670.42
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE. FINANCIAL ASSISTANCE.
Sections 215.91 & 215.971, F.S., Chapter 69I-5, I'.A.C., State Projects Compliance Supplement
Reference Guide for State Fxpenditures
Other fiscal requirements set forth in program laws, rules, and regulations
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16.D.3.a
July 2019 —June 2020
ATTACHMENT IX
ANNUAL BUDGET SUMMARY
AL7,HFIMER'S DISEASE INITIATIVE PROGRAM
for
Collier County Board of County Commissioners
Collier
TOTAL: S 474,670.42
ALLOCATION TOTAL: $ 474,670.42
ADI 203.20,001
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16.D.3.a
Revised August 2007
Attestation Statement
Agreement/Contract Number ADI 203.20
Amendment Number .001
1, JAMES C FRFNCii , attest that no changes or revisions have been made to the
(RecipicntlCmrh•actor reprrsentativc)
content of the above referenced agreernent/contrict or amendment between the Arca Agency roil Aging for
Southwest Florldnand
COLL1Elt COUNTY BOARD OF COMMISSIONERS.
(RecipieutlCon(1•aclor name)
The only exception U) this statement would he for changes in page formatting, oboe to the differences in
electronic data processing media, which has no Aftect on file agreementleontract content.
A
re of Recipient/Contractor representative
Revised August 2007
Date
Approved as to form And legality
h
Ass s nt County At y
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Im
16.D.3.c
RESOLUTION NO. 2018- 2 0 2
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, REPEALING AND SUPERSEDING
RESOLUTION NO. 96-268 and 10-122 AND AUTHORIZING THE
COUNTY MANAGER OR HIS/HER DESIGNEE TO EXECUTE CERTAIN
STANDARD SOCIALISENIOR SERVICES GRANT APPLICATIONS
AND CONTRACT DOCUMENTS INCLUDING AMENDMENTS IN
COMPLIANCE WITH CMA #5330, GRANT COORDINATION.
WHEREAS, the Board of County Commissioners (Board) has the authority to apply for
and receive social/senior services grants including the Older American's Act Program (OAA),
Community Care for the Elderly Program (CCE), Alzheimer's Disease Initiative Program (ADI),
Medicaid Waiver Agreement, the Home Care for the Elderly program (HCE), and USDA
Nutritional Supplement Incentive Program, and Emergency Home Energy Assistance Program
(EHEAP); and
WHEREAS, in order for Collier County's social/senior services grant documents to be
submitted in a timely fashion, the Board adopted Resolution No. 96-268 and 10-122 authorizing
the County Manager or his/her designee to execute the required standard grant documents; and
WHEREAS, Collier County CMA 95330, Grant Coordination, provides authorization for
the County Manager or his/her designee to execute certain grant documents and return to the
Board of County Commissioners for after -the -fact approval; and
WHEREAS, the Board wishes to delegate signature authorization to the County Manager
or his/her designee for the above -referenced social/senior services grant programs and as it relates
to grant applications, standard contract documents, and major and minor amendments provided
that said submissions and contracts require no additional Collier County matching funds.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that the County Manager or his/her
designee is hereby authorized to execute grant applications, standard contract documents, and
"IN
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16.D.3.c
amendments in compliance with CMA H5330, Grant Coordination, for the Older American's Act
Program (OAA), Community Care for the Elderly Program (CCE), Alzheimer's Disease .Initiative
Program (ADI), Medicaid Waiver Agreement, the Horne Care for the Elderly program (HCE), and
USDA Nutritional Supplement Incentive Program, Emergency Home Energy Assistance Program
(EHEAP) provided said -submissions and contracts require no additional Collier County matching
funds.
BE IT FURTHER RESOLVED that this Resolution repeals and supersedes Resolution
No. 96-268 and No.10-122.
THIS RESOLUTION ADOPTED after motion, second, and majority vote favoring same
this j-1 day of J . , -Y , 2018.
ATTEST:
CRYSTAL K. KiNZEL CLERK
:s
s
By: By:
'A eSt as tp (;€t�PK%gTY CLERK
signature only,
Approval for form and legality:
3ennl r A. Belpedio
Assistant County Attorney
tiO
2
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July 2020 to June 2021 ADI 203.20
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM STANDARD CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and Collier
County Board of County Commissioners (Contractor), collectively referred to as the "Parties." The term Contractor for this
purpose may designate a Vendor, Subgrantee, or Subrecipient.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and WHEREAS,
the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services as
an independent Contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions set forth herein, the Parties agree as follows:
1. Purpose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments, forms, and exhibits which constitute the contract document.
2. Incorporation of Docurnen within the ntract:
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department handbooks,
manuals and/or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides
to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions
and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other
general materials not specific to this contract document and identified attachments.
3. Term ntrac
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1, 2020 or on the date the contract has
been signed by the last party required to sign it, whichever is later. It shall end at eleven fifty-nine (11:59) P.M., Eastern
Standard Time June 30, 2021.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not
to exceed $449,855.00 subject to the availability of funds. Any costs or services paid for under any other contract or from
any other source are not eligible for payment under this contract.
5. Renewals:
By mutual agreement of the Parties, in accordance with Section 287.058(1)(g), Florida Statutes (F.S.), the Agency may
renew the contract for a period not to exceed three years, or the term of the original contract, whichever is longer. The
renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs for
the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and
contingent upon satisfactory performance evaluations by the Agency and the availability of funds.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) 75 and/or 45
CFR Part 92, 2 CFR Part 200, and other applicable regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under 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
July 2020 to June 2021
ADI 203.20
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.
6.1.3 Neither the Contractor not agent acting on behalf of the Contractor may not use any federal funds received
in connection with this contract to influence legislation or appropriations pending before Congress or
any state legislature. The Contractor must complete all disclosure forms as required, specifically the
Certification and Assurances Attachment, which must be completed and returned to the Contract Manager
prior to the execution of this contract.
6.1.4 In accordance with Appendix 11 to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government -wide Excluded Parties List System, in accordance with
the Office of Management and Budget (OMB) guidelines at 2 CFR Part 180 that implement Executive
Orders 12549 and 12689, "Debarment and Suspension." The Excluded Parties List System contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549. The Contractor 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.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized 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.
6.3 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.
6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR § 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR Part 170.
6.6 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-116, Contractor agrees 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. 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 of all new employees hired by the Subcontractor
during the contract term. Contractors meeting the terms and conditions of the E-Verify System are deemed to be in
compliance with this provision.
7. Como] iance with State Law:
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed, and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations including, but
not limited to, the Reference Guide for State Expenditures.
7.3 The Contractor shall comply with the requirements of Section 287.058, F.S., as amended.
7.3.1 The Contractor shall perform all tasks contained in Attachment I.
July 2020 to June 2021
ADI 203.20
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment 1, to be received and accepted by the Agency Contract Manager prior to payment.
7.3.3 The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I, Section III. Method of Payment.
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit invoices
for any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be provided
in this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in Section 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except for
those records which are made confidential or exempt by law. The Contractor's refusal to comply with this
provision will constitute an immediate breach of contract for which the Agency may unilaterally terminate
this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
7.6 The Contractor shall comply with the provisions of Section 11.062, F.S., and Section 216.347, F.S., which prohibit
the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.7 The Area Agency may, at its option, terminate the Contract if the Contractor is found to have submitted a false
certification as provided under section 287.135(5), F.S., has been placed on the Scrutinized companies with
Activities in the Iran Petroleum Energy Sector List, the Scrutinized Companies with Activities in Sudan List, or
the Scrutinized Companies that Boycott Israel List, or if the Contractor has been engaged in business operations
in Cuba or Syria or is engaged in a boycott of Israel.
S. Background Screening:
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Department's level 2 background screening pursuant to Sections 430.0402(2)-(3), F.S. The
Contractor must also comply with any applicable rules promulgated by the Agency and/or Department and the Agency
for Health Care Administration regarding implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate
compliance with this provision, Contractor shall submit the Background Screening Affidavit of Compliance
(Screening Form) to the Agency within thirty (30) days of execution of this contract. Should the Agency have a
completed Screening Form on file for the Contractor, a new Screening Form will be required every twelve (12)
months.
8.1 Further information concerning the procedures for background screening may be found at
ht- ://elderaffairs.state.fl.u.s,'doea.'backtrroundscreenin 7. h .
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with, or denial of, service(s) and to address complaints regarding the termination,
suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum, will provide for
notice of the grievance procedure and an opportunity for review of the Subcontractor's determination(s).
10. ,Mic Records and Retention:
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
July 2020 to June 2021
AoI 203.20
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency 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 Chapter 119, F.S., or as otherwise provided by law.
10.1.3 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 Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor to the Agency or will keep and maintain public records required by
the Agency. If the Contractor transfers all public records to the Agency upon completion of the
contract, 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 Agency in a format that is compatible with
the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for refusal
by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents, papers,
letters, or other material made or received by the Contractor in conjunction with this contract, unless the records
are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and Section
119.07(1), F.S.
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:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
239-652-6900 or 866-413-5337
10.3 Upon termination of this contract, whether for convenience or for cause as detailed in Section 53 of this contract, the
Contractor and Subcontractors shall, at no cost to the Agency, transfer all public records in their possession to the
Agency and destroy any duplicate public records that are exempt, or confidential and exempt. from public records
disclosure requirements. All records stored electronically shall be provided to the Agency in a format that is
compatible with the information technology system of the Agency.
11. Audits, Inspections, Investisat4ns:
11.1 The Contractor shall establish and maintain books, records, and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest, and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and ensure that
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six (6) years after completion of the contract, or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
4
July 2020 to June 2021
AD] 203.20
11.4 The Contractor shall ensure that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and
federal auditors, pursuant to 45 CFR Part 75, shall be allowed full access to and the right to examine any of the
Contractor's contracts and related records and documents pertinent to this specific contract, regardless of the
form in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this contract and
ensure that all related third -party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing
performed pursuant to Section 20.055, F.S. Contractor further agrees that it shall include in related subcontracts
a requirement that subcontractors performing work or providing services pursuant to this contract agree to
cooperate with the Inspector General in any investigation, audit, inspection, review, or hearingpursuant to Section
20.055(5), F.S. By execution of this contract the Contractor understands and will comply with this subsection.
12. Nondiscrimination -Civil Rights Compliance:
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance
with state and federal law and regulations. The Contractor further assures that all Contractors, Subcontractors,
Sub -grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability, national origin, marital status, or sex.
12.2 During the term of this contract, the Contractor shall complete, and retain on file a timely, complete and accurate
Civil Rights Compliance Checklist, attached to this contract.
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures shall include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendors,
or others with whom it arranges to provide 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 any statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency may, at its discretion, seek a court order requiring compliance with the terms of this
assurance or seek other appropriate judicial or administrative relief including, but not limited to, termination of
the contract and denial of further assistance.
13. Monitorino.bythe Agengv.
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods, and services of the Contractor, which are relevant to this contract; and to interview any
clients, employees, and Subcontractor employees of the Contractor to assure the Agency of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Agency will provide a written report
of its findings to the Contractor and, where appropriate, the Contractor shall develop a Corrective Action Plan (CAP).
The Contractor hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determined by the
Agency's Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
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15. Coordinated Monitoring with Other Agencies:
If the Contractor receives funding from one or more State of Florida human service agencies, in addition to the
Agency and/or Department of Elder Affairs, then a joint monitoring visit including such other agencies may be
scheduled. For the purposes of this contract, and pursuant to Section 287.0575, F.S., as amended, Florida's human
service agencies shall include the Department of Elder Affairs, the Department of Children and Families, the
Department of Health, the Agency for Persons with Disabilities, and the Department of Veterans' Affairs. Upon
notification and the subsequent scheduling of such a visit by the designated agency's lead administrative coordinator,
the Contractor shall comply and cooperate with all monitors, inspectors, and/or investigators.
16. New Contract(s) Reporting:
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the remaining
four (4) state human service agencies. The notification shall include the following information: (1) contacting state
agency and the applicable office or program issuing the contract; (2) contract name and number; (3) contract start and
end dates; (4) contract amount; (5) contract description and community of service; and (6) Contract Manager name and
contact information. In complying with this provision, and pursuant to Section 287.0575, F.S., as amended, the
Provider shall complete the Provider's State Contracts List. List attached to this contract.
17. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from any
and all claims, demands, actions, and causes of action of whatever nature or character arising out of, or by reason of, the
execution of this contract or performance of the services provided for herein. It is understood and agreed that the
Contractor is not required to indemnify the Agency for claims, demands, actions, or causes of action arising solely out
of the negligence of the Agency.
17.1 Except to the extent permitted by Section 768.28, F.S., or other Florida law, this Section 17 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
18. Insurance and Bonding:
18.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance coverage necessary to provide reasonable financial
protections for the Contractor and the clients to be served under this contract. The limits of coverage under
each policy maintained by the Contractor do not limit the Contractor's liability and obligations under this
contract. The Contractor shall ensure that the Agency has the most current written verification of insurance
coverage throughout the term of this contract. Such coverage may be provided by a self-insurance program
established and operating under the laws of the State of Florida. The Agency reserves the right to require
additional insurance as specified in this contract.
18.2 Throughout the term of this contract, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees, and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company, and consistent with good business practices.
19. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
to give that consent or when authorized by law.
20. HealthJos
-,grance.EgEtatility and Accountability Act:
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42 USC
§ 1320d.), as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164).
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21. Incident Reporting:
ADl 203.20
21.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contractor's or
Subcontractor's ability to perform the services required to be performed under this contract. Such notice shall
be made orally to the Agency's Contract Manager (by telephone) with an email to immediately follow.
21.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor,
its Subcontractors, and their employees.
22. Bankruntev Notification:
During the term of this contract, the Contractor shall immediately notify the Agency if the Contractor, its assignees,
Subcontractors, or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Contractor must also
provide the following information to the Agency: (1) the date of filing of the bankruptcy petition; (2) the case number;
(3) the court name and the division in which the petition was filed (e.g., Middle District of Florida, Fort Myers, Florida);
and (4) the name, address, and telephone number of the bankruptcy attorney.
23. Sponsorship and Publicity:
23.1 As required by Section 286.25, F.S., if the Contractor is a non -governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in
publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractor's name),
the Area Agency on Aging for Southwest Florida Inc. and/or the State of Florida, Department of Elder Affairs." If
the sponsorship reference is in written material, the words "Area Agency on Aging for Southwest Florida, Inc. and
the State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or type as the name
of the organization.
23.2 The Contractor shall not use the words "Area Agency on Aging for Southwest Florida, Inc. and/or the State of
Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless specific
written authorization has been obtained by the Agency and/or Department prior to such use.
24. Assignments:_
24.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency. Any sublicense, assignment, or transfer otherwise occurring without prior written
approval of the Agency shall constitute a material breach of the contract. In the event the State of Florida
and/or the Area Agency on Aging for Southwest Florida, Inc. approves assignment of the Contractor's
obligations, the Contractor remains responsible for all work performed and all expenses incurred in connection
with this contract.
24.2 This contract shall remain binding upon the successors in interest of the Contractor and the Agency.
25. Subcontracts:
25.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor further
agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The Contractor,
at its expense, shall defend the Agency against any such claims.
25.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
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26. Independent Canacity of Contractor:
ADI 203.20
It is the intent and understanding of the Parties that the Contractor and any of its Subcontractors are independent
Contractors and are not employees of the Agency, and that they shall not hold themselves out as employees or agents
of the Agency without prior specific authorization from the Agency. It is the further intent and understanding of the
Parties that the Agency does not control the employment practices of the Contractor and will not be liable for any
wage and hour, employment discrimination, or other labor and employment claims against the Contractor or its
Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment
compensation funds, and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
27. Pa men
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The Agency Contract Manager will have final approval of the Contractor's invoice submitted for payment
and will approve the invoice for payment only if the Contractor has met all terms and conditions of the contract, unless
the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted to
the Agency's finance section for budgetary approval and processing. Disputes arising over invoicing and payments
will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor Ombudsman has been established
within the Florida Department of Financial Services and may be contacted at 800-3)42-2762.
28. Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed, and any
interest attributable to such funds pursuant to the terms and conditions of this contract, that were disbursed to the
Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment has
been made, the Contractor shall repay said overpayment immediately without prior notification from the Agency. In
the event that the Agency first discovers an overpayment has been made, the Agency Contract Manager will notify
the Contractor in writing of such findings. Should repayment not be made forthwith, the Contractor shall be charged at
the lawful rate of interest on the outstanding balance pursuant to Section 55.03, F.S., after Agency notification or
Contractor discovery.
29. Data Intearity and Safeguarding information:
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.
30. Computer Use and Social Media Policy:
The Department has implemented a Social Media Policy, in addition to its Computer Use Policy, which applies to all
employees, contracted employees, consultants, Other Personal Services (OPS) employees 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: hnp:!/elderaffairs. state. fl.us"doealfinancial.phtp.
31. Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management, and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer, or agent of the Contractor or Subcontractor shall participate in the
selection or in the award of a contract supported by state or federal funds if a conflict of interest, real or apparent, would
July 2020 to June 2021
ADl 203.20
be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her immediate
family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the above
individuals, has a financial or other interest in the firm being selected for award. The Contractor's or Subcontractor's
officers, employees, or agents will neither solicit nor accept gratuities, favors, or anything of monetary value from
Contractors, potential Contractors, or parties to Subcontracts. The Contractor's board members and management
must disclose to the Agency any relationship which may be, or may be perceived to be, a conflict of interest within
thirty (30) calendar days of an individual's original appointment or placement in that position, or, if the individual is
serving as an incumbent, within thirty (30) calendar days of the commencement of this contract. The Contractor's
employees and Subcontractors must make the same disclosures described above to the Agency's board of directors.
Compliance with this provision will be monitored.
32. Public Entity Crime:
Pursuant to Section 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor Last following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction
or 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 Consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the date of
being placed on the Convicted Vendor List.
33. PurchasinE:
33.1 The Contractor shall procure products and/or services required to perform this contract in accordance with
section 413.036, F.S.
33.1.1 IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES THAT ARE THE
SUBJECT OF, OR REQUIRED TO CARRY OUT, THIS CONTRACT SHALL BE PURCHASED
FROM A NONPROFIT AGENCY FOR THE BLIND OR FOR THE SEVERELY
HANDICAPPED THAT IS QUALIFIED PURSUANT TO CHAPTER 413, FLORIDA
STATUTES, IN THE SAME MANNER AND UNDER THE SAME PROCEDURES SET FORTH
IN SECTION 413.036(1) AND (2), FLORIDA STATUTES; AND FOR PURPOSES OF THIS
CONTRACT THE PERSON, FIRM, OR OTHER BUSINESS ENTITY CARRYING OUT THE
PROVISIONS OF THIS CONTRACT SHALL BE DEEMED TO BE SUBSTITUTED FOR THE
STATE AGENCY INSOFAR AS DEALINGS WITH SUCH QUALIFIED NONPROFIT
AGENCY ARE CONCERNED.
331.2 Pursuant to sections 413.036(1) and (4), F.S., the Contractor shall not be required to procure a
product or service from RESPECT if: (a) the product or service is not available within a reasonable
delivery time, (b) the Contractor is required by law to procure the product or service from any agency
of the state, or (c) the Contractor determines that the performance specifications, price, or quality of
the product or service is not comparable to the Contractor's requirements.
33.13 This act shall have precedence over any law requiring state agency procurement of products or
services from any other nonprofit corporation unless such precedence is waived by the Agency in
accordance with its rules.
33.1.4 Additional information about the designated nonprofit agency and the products it offers is available
at http://www,respectofflorida.org.
33.2 The Contractor shall procure any recycled products or materials, which are the subject of, or are required
to carry out, this contract when the Department of Management Services determines that those products
are available, in accordance with the provisions of section 403.7065, F.S.
33.3 The Contractor shall procure products and/or services required to perform this contract in accordance with
section 946.515, F.S.
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ADI 203.20
33.3.1 IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES WHICH ARE THE
SUBJECT OF, OR REQUIRED TO CARRY OUT, THIS CONTRACT SHALL BE PURCHASED
FROM THE CORPORATION IDENTIFIED UNDER CHAPTER 946, F.S., IN THE SAME
MANNER AND UNDER THE SAME PROCEDURES SET FORTH IN SECTION 946.515(2)
AND (4). F.S.; AND FOR PURPOSES OF THIS CONTRACT THE PERSON, FIRM, OR OTHER
BUSINESS ENTITY CARRYING OUT THE PROVISIONS OF THIS CONTRACT SHALL BE
DEEMED TO BE SUBSTITUTED FOR THIS AGENCY INSOFAR AS DEALINGS WITH SUCH
CORPORATION ARE CONCERNED.
33.3.2 The corporation identified is Prison Rehabilitative Industries and Diversified Enterprises, Inc.
(PRIDE). Additional information about PRIDE and the commodities or contractual services it offers
is available at https:,''pride-enterprises.or`.
34. Patents, Coyvriahts, Royalties:
Ifthis contract is awarded state funding and if any discovery, invention, or copyrightable material is developed or produced
in the course of or as a result of work or services performed under this contract or in any way connected with this contract,
or if ownership of any discovery, invention, or copyrightable material was purchased in the course of or as a result of
work or services performed under this contract, the Contractor shall refer the discovery, invention, or copyrightable
material to the Agency to be referred to the Agency and/or Department of State. Any and all patent rights or
copyrights accruing under this contract are hereby reserved to the State of Florida in accordance with Chapter 286, F.S.,
Pursuant to Section 287.0571(5)(k), as amended, the only exceptions to this provision shall be those that are clearly
expressed and reasonably valued in this contract.
34.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this Section 34.
34.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315 or
45 CFR § 75.322, as applicable.
34.3 Notwithstanding the foregoing provisions, if the Contractor or one of its Subcontractors is a university and a
member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency shall
retain a perpetual, fully -paid, nonexclusive license for its use and the use of its Contractors, Subcontractors, or
Assignees of any resulting patented, copyrighted, or trademarked work products.
35. Frner6enev PreUaredness and CgntimpiLv of erations:
35.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety, or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency Contract Manager,
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency of emergency provisions.
35.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall remain
responsible for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
36. Equipment:
36.1 Equipment means: (a) tangible personal property (including information technology systems) having a useful life of
more than one year and a per -unit acquisition cost which equals or exceeds the lesser of the capitalization level
established by the organization for the financial statement purposes, or $5,000.00 [for federal funds - 2 CFR
§ 200.33 and 45 CFR § 75.2, as applicable], or (b); nonexpendable, tangible personal property of a non-
consumable nature with an acquisition cost of $5,000.00 or more per unit, and expected useful life of at least one
(1) year; and hardback bound books not circulated to students or the general public, with a value or cost of
$250.00 or more [for state funds].
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ADI 203.20
36.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, fully document, and notify the Agency Contract Manager of any loss, damage, or theft of
equipment. The Contractor shall provide the results of the investigation to the Agency Contract Manager.
36.3 The Contractor's property management standards for equipment (including replacement equipment), whether
acquired in whole or in part with federal funds and federally -owned equipment shall, at a minimum, meet the
following requirements and shall include accurately maintained equipment records with the following information:
36.3.1 Property records must be maintained that include a description of the equipment;
36.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
36.3.3 Source of funding for the equipment, including the federal award identification number;
36.3.4 Whether title vests in the Contractor or the federal government;
36.3.5 Acquisition date (or date received, if the equipment was furnished by the federal government);
36.3.6 Information from which one can calculate the percentage of federal participation in the cost of the
equipment (not applicable to equipment furnished by the federal government);
36.3.7 location, use and condition of the equipment and the date the information was reported;
36.3.8 Unit acquisition cost; and
36.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
36.3.10 A physical inventory must be taken and the results reconciled with the property records at least once
every two (2) years.
36.3.11 A control system must be developed to ensure adequate safeguards to prevent loss, damage, or theft of
the property. Any loss, damage, or theft must be investigated. 45 CFR § 75.320(d)(3).
36.3.12 Adequate maintenance procedures must be developed to keep the property in good condition.
36.3.13 If the Contractor is authorized or required to sell the equipment, proper sales procedures must be
established to ensure the highest possible return.
36.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $5,000.00 is part of the cost of carrying out the activities and functions of
the grant awards and title (ownership) will vest in the Contractor [for federal funds see 2 CFR § 200.313(a) and
45 CFR § 75.320(a), as applicable], subject to the conditions of 2 CFR Part 200 and/or 45 CFR Part 75.
Equipment purchased under these thresholds is considered supplies and is not subject to property standards.
Equipment purchased with funds identified in the budget attachments to agreements covered by this contract or
identified in the sub -agreements with Subcontractors (not included in a cost methodology), is subject to the
conditions -of Chapter 273, F.S., rule 60A-1.017, F. A. C., and 2 CFR Part 200 and/or 45 CFR Part 75.
36.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or purchased with funds
provided through this contract without first obtaining the approval of the Agency Contract Manager. When
disposing of property or equipment the Contractor must submit a written request for disposition instructions to
the Agency's Contract Manager. The request should include a brief description of the property, purchase
price, funding source, and percentage of state or federal participation, acquisition date and condition of the
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AD] 203.20
property. The request should also indicate the Contractor's proposed disposition of the property (i.e., transfer
or donation to another agency that administers federal programs, offer of the items for sale, destroy the items,
etc.).
36.6 The Agency Contract Manager will issue disposition instructions. If disposition instructions are not received
within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized to proceed
as directed in 2 CFR § 200.313 or 45 CFR § 75.320, as applicable.
36.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Section 3030b United States Code (U.S.C.). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of Section
216.348, F.S.
36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior to
disposal to ensure no confidential information remains.
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information Technology
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is
required for any computer related item costing $1,000.00 or more, including data processing hardware,
software, services, supplies, maintenance, training, personnel, and facilities. The completed ITR worksheet
shall be maintained in the LAN administrator's file and must be provided to the Agency upon request. The
Contractor has the responsibility to require any Subcontractors to comply with the Agency's ITR procedures.
37. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
lhtt):;;hvww.m -tlorida.coin'aL) s/vbsladoc/F"7740 PUR1000.W
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract, the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
38. Use9f State Funds to Purchase or Improve Real .Pro eI rly:_
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law.
39. Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the Agency Contract Manager, who shall reduce
the decision to writing and serve a copy on the Contractor.
40. Financial nse uences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency shall
impose financial consequences as stated in Attachment I.
41. No Waiver of Sovereign Immunity:
Nothing contained in this contract is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
42. Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
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43. Futire Contract:
ADI 203.20
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
44. Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
45. Severability Claww:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable, the
other provisions are severable to that void provision and shall remain in full force and effect.
46. Condition Precedent to Contract Annronriations_
The Parties agree that the Agency's performance and obligation to pay under this contract are contingent upon an
annual appropriation by the Legislature.
47. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both
Parties. The Parties shall negotiate compensation for any additional services added.
48. Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
49. Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules, and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor and subject the contract to immediate unilateral cancellation of
the contract at the discretion of the Agency.
50. Final invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days upon the
contract ending date unless otherwise specified in Attachment I. If the Contractor fails to do so, all right to payment is
forfeited and the Agency shall not honor any requests submitted after the aforesaid time period. Any payment due under
the terms of this contract shall be withheld until all required documentation and reports due from the Contractor and
necessary adjustments thereto have been approved by the Agency.
51. Renegotiations of Modifications:
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
52. Susuension of Work:
The Agency may, in its sole discretion, suspend any or all activities under the contract or purchase order, at any time,
when in the best interest of the State to do so. The Agency shall provide the Contractor written notice outlining the
particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary
constraints, declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor
shall comply with the notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period
July 2020 to June 2021
agreed to by the Contractor, the Agency shall either: (1) issue a notice authorizing resumption of work at which time
activity shall resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the
Contractor to any additional compensation.
53. Termination:
53.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate this contract in
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of this contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
53.2 Termination for Cause. The Agency may terminate this contract if the Contractor fails to: (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus
endangering performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory,
regulatory, or licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of
default. The Contractor shall continue work on any work not terminated. Except for defaults of Subcontractors
at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the contract arises from
events completely beyond the control, and without the fault or negligence, of the Contractor. If the failure to
perform is caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyond
the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and remedies
provided by law or under the contract.
54. Electronic Records and Signature:
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this contract. A Contractor that creates
and retains electronic records and uses electronic signatures to conduct transactions shall comply with the requirements
contained in the Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be fully
auditable; are subject to Florida's Public Records Law, Chapter 119, F.S.; must comply with contract Section 29, Data
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and
maintained by the Contractor to the same extent as non -electronic records are retained and maintained as required by
this contract.
54.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the Agency
only upon further written consent by the Agency.
54.2 Upon request by the Agency, the Contractor shall provide the Agency with non -electronic (paper) copies of
records. Non -electronic (paper) copies provided to the Agency of any document that was originally in electronic
form with an electronic signature must identify the person and the person's capacity who electronically signed the
document on any non -electronic copy of the document.
55. Contract Mana"er:_
The Agency may substitute any Agency employee to serve as the Agency Contract Manager.
REMAINDER OF THE PAGE INTENTIONALL Y LEFT BLANK
14 ��
O
July 2020 to June 2021
56. Official Payee and Representatives (Names. Addresses and Telephone Numbers):
The Contractor name, as shown on page 1 of this
a. contract, and mailing address of the official payee to
whom the payment shall be made is:
The name of the contact person and street address
b. where financial and administrative records are
maintained is:
The name, address, and telephone number of the
G representative of the Contractor responsible for
administration of the program under this contract is:
d The section and location within the Agency where
Requests for Payment and Receipt and Expenditure
forms are to be mailed is:
e. ' The name, address, and telephone number of the
Contract Manager for this contract is:
ADI 203.20
3329 E Tamiami Trail, Buildi
H Naples, FL 34112
Collier County Board of County Commissioners
%Community and Human Services
3339 E Tamiami Trail, Building H
Naples, FL 34112
Collier County Board of County Commissioners
%Community and Human Services
3339 E Tamiami Trail, Building H
Naples, FL 34112
Area Agency on Aging for Southwest Florida, Inc.
15201 North Cleveland Avenue, Suite 1100
North Fort Myers, FL 33903
Norma Adomo, COO
Area Agency on Aging for Southwest Florida, Inc.
15201 North Cleveland Avenue, Suite 1100
North Fort Myers, FL 33903
239-652-6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party.
57. All Terms and Conditions included:
This contract and its Attachments, 1— XII including any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no
provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all
previous communications, representations, or agreements, either written or verbal, between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned officials
as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD
OF COUNTY C7S .ONERS
SIGNED BY:
NAME: Stephen Y Carrell
TITLE: Public Service Department Head
DATE: tJ 9 2, o
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30
Duns: 076997790
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY: A�-.
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE: 7 iG - 7.0
Approved as to forni and IeLpfity
15
Assistant County Attorn
July 2020 to June 2021
INDEX OF ATTACHMENTS
ATTACHMENT I
ADI 203.20
STATEMENTOF WORK............................................................................................................................. 17
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT................................................................................................... 30
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES...................................................................................................... 36
ATTACHMENT IV
ASSURANCES—NON-CONSTR UCTION PROGRAMS................................................................................ 41
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST .................
43
ATTACHMENT VI
PROVIDER'S STATE CONTRACT LIST. ............................................................................ ........................
47
ATTACHMENT VII
BACKGROUND SCREENING.....................................................................................................................
48
ATTACHMENT VIII
INVOICE REPORT SCHEDULE.....................................................................................
........... 49
ATTACHMENT IX
ANNUAL BUDGET SUMMARY...................................................................................................................
50
ATTACHMENT X
REQUESTFOR PAYMENT.........................................................................................................................
51
ATTACHMENT XI
RECEIPT AND EXPENDITURE REPORT...................................................................................................
52
ATTACHMENT XII
SERVICERATE REPORT............................................................................................................................
53
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July 2020 to June 2021
ATTACHMENT I
STATEMENT OF WORK
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
Acronyms
Alzheimer's Disease (AD)
Alzheimer's Disease Initiative (ADI)
Activities of Daily Living (ADL)
Area Agency on Aging (AAA)
Assessed Priority Consumer List (APCL)
Adult Protective Services (APS)
Client Information and Registration Tracking System (CIRTS)
Community Care for Disabled Adults (CCDA)
Corrective Action Plan (CAP)
Dementia Care & Cure Initiative (DCCI)
Department of Elder Affairs (DOEA or Department)
Florida Administrative Code (F.A.C.)
Florida Statutes (F.S.)
Home Care for Disabled Adults (HCDA)
Instrumental Activities of Daily Living (IADL)
Memory Disorder Clinic (MDC)
Planning and Service Area (PSA)
Summary of Programs and Services (SOPS)
United States Code (U.S.C.)
2. Program -Specific Terms
ADI 203.20
Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery
system in the respective Planning and Service Area, in accordance with Section 306 of the Older Americans
Act (42 U.S.C. § 3026), as amended, and Department instructions. The Area Plan includes performance
measures and unit rates per service offered per county.
Area Plan Update: A revision to the Area Plan wherein the Agency and/or contractor enters ADI-specific
data into the CIRTS. An update may also include other revisions to the Area Plan as instructed by the
Agency and/or Department.
Department of Elder Affairs Handbook: An official document of DOEA. The DOEA Handbook includes
program policies, procedures, and standards applicable to agencies which are recipients/providers of DOER
funded programs. An annual update is provided through a Notice of Instruction (NOI).
Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to
remain independent and in the least restrictive living arrangement.
Memory Disorder Clinic (MDC): Research oriented programs created pursuant to Sections 430.502(1) and (2),
F.S., to provide diagnostic and referral services, conduct basic and service -related multidisciplinary research,
and develop training materials and educational opportunities for lay and professional caregivers of individuals
with AD.
Notice of Instruction (NOI): The Department's established method to communicate to the Agency, Contractor,
and subcontractor the requirement to perform a task or activity. NOIs are located on the Department's website
at http://elderaffairs.state.fl.us/doea/nois,php.
Proviso: Language used in a general appropriations bill to qualify or restrict the way in which a specific
appropriation is to be expended.
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ADI 203.20
Program Highlights: Success stories, quotes, testimonials, or human -interest vignettes that are used in the
Agency's Summary of Programs and Services (SOPS) to include information that helps tell the story of how
programs and services help elders, families, and caregivers.
Specialized Day Care: Licensed Specialized Alzheimer's Services Adult Day Care Centers, licensed, in
accordance with Section 429.918, F.S., that are considered models because they provide specialized Alzheimer's
services for AD clients. FloridaHealthFinder.gov provides an up to date listing of all Specialized Alzheimer's
Services Adult Day Care Centers.
Specialized Alzheimer's Services: Specialized Alzheimer's services, offered in day care centers include, but
are not limited to, those listed below:
i. Providing education and training on the specialized needs of persons with Alzheimer's disease or related
memory disorders and caregivers;
ii. Providing specialized activities that promote, maintain, or enhance the ADI client's physical, cognitive,
social, spiritual, or emotional health; and
iii. Providing therapeutic, behavioral, health, safety, and security interventions; clinical care, and support
services for the ADI client and caregiver.
Summary of Programs and Services (SOPS): A document produced by the Department and updated yearly
to provide the public and the Legislature with information about programs and services for Florida's elders.
B. GENERAL DESCRIPTION
1. General Statement
The purpose of the ADI is to address the special needs of individuals with AD, their families, and caregivers.
2. Alzheimer's Disease Initiative Program Mission Statement
The ADI program assists persons afflicted with AD and other forms of dementia to live as independently as
possible with support to family members and caregivers.
3. Authority
The relevant authority governing the ADI Program includes:
a. Rule Chapter 58D-1, F.A.C.;
b. Sections 430.501, 430.502, 430.503, and 430.504, F.S.; and
c. The Catalog of State Financial Assistance (CSFA) Numbers 65004 and 65002.
4. Scope of Service
The Contractor is responsible for the programmatic, fiscal, and operational management of the ADI Program.
The program services shall be provided in a manner consistent with the Agency's Area Plan, as updated, and
the current DOEA Handbook, which are incorporated by reference. The Contractor agrees to be bound by all
subsequent amendments and revisions to the DOEA Handbook, and the Contractor agrees to accept all such
amendments and revisions via a NOI.
S. Major Program Goal
The major goal of the ADI Program is to provide services to meet the needs of caregivers and individuals with
AD or other related disorders.
C. Clients to be Served
1. General Description
The ADI program addresses the special needs of individuals with AD or other related disorders, and their
caregivers.
18
July 2020 to June 2021 ADI 203.20
2. Client Eligibility
Clients eligible to receive services under this contract must:
a. Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be suspected of having
AD or a related disorder; or
b. If enrolled in Specialized Alzheimer's Services Adult Day Care, be a participant who has a documented
diagnosis of Alzheimer's disease or a dementia -related disorder (ADRD) from a licensed physician,
licensed physician assistant, or a licensed advanced registered nurse practitioner; and
c. Not be enrolled in any Medicaid capitated long-term care program.
3. Targeted Groups
tD
Priority for services under this contract will be given to those eligible persons assessed to be at risk of
placement in an institution.
4. Client Determination
The Agency shall have final authority for the determination of client eligibility.
5. Contract Limits
In no case shall the Contractor be required to incur costs in excess of the contract amount in providing services
to the clients.
II. MANNER OF SERVICE PROVISION
A. Service Tasks
To achieve the goals of the ADI program, the Contractor shall perform, or ensure that its subcontractors perform,
the following tasks:
I. Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in Section I.C2.
2. Assessment and Prioritization of Service Delivery for New Clients
The Contractor shall ensure the following criteria are used to prioritize new clients in the sequence below for
service delivery. It is not the intent of the Agency to remove existing clients from services in order to serve new
clients being assessed and prioritized for service delivery.
a. Imminent Risk individuals: Individuals in the community whose mental or physical health condition has
deteriorated to the degree that self -care is not possible, there is no capable caregiver, and nursing home
placement is likely within a month or very likely within three (3) months.
b. Service priority for individuals not included above, regardless of referral source, will be determined
through the Agency's functional assessment administered to each applicant, to the extent funding is
available. The Contractor shall ensure that first priority is given to applicants at the higher levels of frailty
and risk of nursing home placement.
3. Program Services
The Contractor shall ensure the provision of program services is consistent with the Agency's current Area Plan,
as updated and approved by the DOEA, and the current DOEA Handbook.
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ADI 203.20
4. Task Limits
The Contractor shall not perform any tasks related to the project other than those described in this contract
without the express written consent of the Agency.
B. Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for
a period of sixty (60) days or more of the initiation of the subcontract or the performance of the Subcontractor, the
Contractor shall notify the Agency's Contract Manager and the Agency's Chief Financial Officer in writing of
such delay. The Contractor shall not permit a Subcontractor to perform services related to this contract without
having a binding Subcontractor agreement executed. The Agency will not be responsible or liable for any
obligations or claims resulting from such action.
1. Copies of Subcontracts
The Contractor shall submit a copy of all subcontracts to the Agency Contract Manager within thirty (30) days
of the subcontract being executed.
2. Monitoring the Performance of Subcontractors
The Contractor shall monitor, at least once per fiscal year, each of its subcontractors, subrecipients, vendors,
and/or consultants paid from funds provided under this contract. The Contractor shall perform fiscal,
administrative, and programmatic monitoring to ensure contractual compliance, fiscal accountability,
programmatic performance, and compliance with applicable state and federal laws and regulations. The
Contractor shall monitor to ensure that the budget is met, the scope of work is accomplished within the
specified time periods, and other performance goals stated in this contract are achieved.
3. Copies of Subcontractor Monitoring Reports
The Contractor shall forward a copy of all subcontractor Monitoring Reports to the Agency Contract
Manager within thirty (30) days of the report being issued to the Subcontractors, Subrecipients, Vendors,
and/or Consultants.
C. Staffing Requirements
1. Staffing Levels
The Contractor shall assign its own administrative and support staff as necessary to meet the obligations of
this contract and shall ensure that subcontractors dedicate adequate staff accordingly.
2. Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications as specified in the current DOEA Handbook.
3. Service Times
The Contractor shall ensure the availability of the services listed in this contract at times appropriate to meet
client service needs including, at a minimum, during normal business hours, or as otherwise specified in proviso
or the Subcontractor's approved service provider application. Normal business hours are defined as Monday
through Friday, 8:00 a.m. to 5:00 p.m. local time.
D. Service Location and Equipment
1. Service Delivery Location
Services will be provided as needed in locations determined by provider to best meets clients'
immediate needs.
r• �
July 2020 to June 2021
ADI 203.20
2. Changes in Location
The Contractor shall notify the Agency in writing a minimum of one week prior to making changes in
location that will affect the Agency's ability to contact the Contractor by telephone or facsimile.
3. Equipment
Contractor shall be responsible for supplying, at its own expense, all equipment necessary for its performance
under the contract including, but not limited to, computers, telephones, copiers, fax machines, maintenance and
office supplies.
E. Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation required
to evidence the completion of the tasks specified in this contract.
1. Delivery of Services to Eligible Clients
The Contractor shall ensure the provision of a continuum of services addressing the diverse needs of
individuals with AD and their caregivers. The Contractor shall ensure performance and reporting of the
following services in accordance with the Agency's current Department -approved Area Plan, the current
DOEA Handbook, which is incorporated by reference, and Section II.A. of this contract. Documentation of
service delivery must include a report consisting of the following: number of clients served, number of
service units provided by service, and rate per service unit with calculations that equal the total invoice amount.
The continuum of services provided under this contract include those identified by the following service
categories:
a. Respite and Other Services
(1) Case Aide;
(2) Case Management;
(3) Respite (Facility -Based);
(4) Respite (In -Home);
(5) Respite (In -Facility, Specialized Alzheimer's services);
(6) Specialized Medical Equipment, Services, and Supplies;
(7) Transportation;
(8) Shopping Assistance — COVID-19; and
(9) Telephone Reassurance — COVID-19
2. Services and Units of Service
The Contractor shall ensure that the provision of services described in this contract is in accordance with the
current DOEA Handbook and the service tasks described in Section II.A. The Service Rate Report lists the
services that can be performed, the highest reimbursement unit rate, the method of payment, and the service
unit type. Units of service will be paid pursuant to the rate established in the Area Plan as updated, as shown in
the Service Rate Report, and approved by the Agency.
E. Reports
The Contractor shall respond to additional routine or special requests for information and reports required by the
Agency in a timely manner, as determined by the Agency Contract Manager. The Contractor shall establish
reporting due dates for Subcontractors that permit the Contractor to meet the Agency's reporting requirements.
1. CIRTS Reports
The Contractor shall input ADI-specific data into CIRTS. To ensure CIRTS data accuracy, the Contractor shall
use CIRTS-generated reports which include the following:
a. Client Reports;
b. Monitoring Reports;
c. Services Reports;
d. Miscellaneous Reports;
21
July 2020 to June 2021 AD[ 203.20
e. Fiscal Reports;
f Aging and Disability Resource Center Reports; and
g. Outcome Measurement Reports.
2. Annual Service Cost Reports
a. The Agency shall require Contractors to annually submit to the Agency Service Cost Reports, which reflect
actual costs of providing each service by program. This Annual Service Cost Report will be due by
February 25, of each year. This report will include actual costs for performing all services during the
preceding calendar year. Supporting documentation must accompany the report, which will include General
Ledger, Trial Balance and/or Statement of Revenue and Expenditures along with a narrative explanation and
justification of rate differences. This Unit Cost Methodology Report provides information for planning and
negotiating unit rates.
b. Any multi -year contracts entered into with service providers on or after the effective date of this contract
shall contain a provision requiring the contract's parties to re-evaluate the contract's reimbursement rates on
an annual basis. The Contractor may annually renegotiate rates based on factors including but not limited to
a review of sustainability, the respective consumer price index, or current market conditions. However, it is
the intent of the Department and/or Agency that the quality of services provided to current program recipients
not be reduced. Unit Cost Methodology worksheets, along with supporting documentation and narrative
explanation, must be submitted by April 15 of each year, if a rate increase is being requested for any service
in the next contract year.
3. Lead Agency Spending Report
The Contractor shall submit a Lead Agency Spending Report, in a format provided by the Agency, to the
Agency Contract Manager by the 18th of each month. This Lead Agency Spending Report is for all agreements
and contracts between the Contractor and the Agency and must include the following:
a. A list of all contracts and their current status regarding surplus/deficit;
b. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by
the Agency will be resolved; and
c. Recommendations to transfer funds within the PSA to resolve surplus/deficit spending
4. Program Highlights
The Contractor shall submit Program Highlights referencing specific events that occurred in SFY/FFY 2019-2020
by August 30, 2020. The Contractor shall provide a new success story, quote, testimonial, or human -interest
vignette. The highlights shall be written for a general audience, with no acronyms or technical terms. For all
agencies or organizations that are referenced in the highlight, the Contractor shall provide a brief description of
their mission or role. The active tense shall be consistently used in the highlight narrative, in order to identify the
specific individual or entity that performed the activity described in the highlight. The Contractor shall review
and edit Program Highlights for clarity, readability, relevance, specificity, human interest, and grammar prior to
submitting them to the Agency.
G. Records and Documentation
L Requests for Payment
The Contractor shall maintain documentation to support Requests for Payment that shall be available to the
Agency or authorized individuals, such as the Department of Financial Services, upon request.
2. CXRTS Data and Maintenance
The Contractor shall ensure, on a monthly basis, collection and maintenance of client and service information
in C1RTS or any such system designated by the Agency. Maintenance includes accurate and current data, and
valid exports and backups of all data and systems according to Agency standards.
22
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AD[ 203.20
3. CIRTS Address Validation
The Contractor shall work with the Area Agency on Aging for Southwest Florida, to ensure client addresses are
correct in CIRTS for disaster preparedness efforts. At least annually, and more frequently as needed, the Agency
will provide direction on how to validate CIRTS addresses to ensure these can be mapped. The Agency will
receive a list of unmatched addresses that cannot be mapped and the Agency will be responsible for working with
the Lead Agencies to correct addresses. The Area Agency will send a list to the Department of Elder Affairs with
confirmed addresses. The Agency and/or Department will use this information to update maps, client rosters, and
unmatched addresses to disseminate to the Lead Agencies.
4. Data Integrity and Back up Procedures
Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system. Data
and software essential to the continued operation of Contractor functions must be backed up. The security
controls over the backup resources shall be as stringent as the protection required of the primary resources. A
copy of the backed -up data shall be stored in a secure, offshe location.
5. Policies and Procedures for Records and Documentation
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available
to the Agency upon request.
H. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
The Contractor must:
a. Ensure the prioritization of clients and provision of services to clients in accordance with Section II.A. of
this contract.
b. Ensure the provision of the services described in this contract are in accordance with the current DOEA
Handbook and Section II.D of this contract;
c. Timely and accurately submit to the Agency all required documentation and reports described in
Section ILE of this contract; and
d. Timely (i.e. in accordance with the Annual Budget Summary) and accurately submit the Request for
Payment, the Receipt and Expenditure Report, and supporting documentation such as CIRTS Reports
to the Agency.
2. Annual Programmatic Monitoring Report
The Contractor's performance of the measures in Section N.H.I., above, will be reviewed and documented in
the Agency's Annual Programmatic Monitoring Report.
3. Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor via telephone, in writing, and/or on -
site visit(s). The primary, secondary, or signatory of the contract must be available for any on -site programmatic
monitoring visit. The Agency's determination of acceptable performance shall be conclusive. The Contractor
agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks and
deliverables. The Agency may use, but is not limited to, one or more of the following methods for
monitoring:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled, and follow-up on -site visits;
c. Client visits;
d. Review of independent auditor's reports;
23
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July 2020 to June 2021 AD[ 203.20
e. Review of third -parry documents and/or evaluation;
i Review of progress reports;
g. Review of customer satisfaction surveys;
h. Agreed -upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and/or
j. Other procedures as deemed necessary.
I. Contractor Responsibilities
1. Contractor Accountability
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the
Contractor and are tasks and deliverables for which, by execution of this contract, the Contractor agrees to be
held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of this contract, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant
to this contract.
I Agency Responsibilities
1. Agency Obligations
The Agency may, within its resources, provide technical support and assistance to the Contractor to assist
the Contractor in meeting the requirements of this contract. The Agency's support and assistance, or lack
thereof, shall not relieve the Contractor from full performance of contract requirements.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches used to
perform tasks. The absence of the Agency setting forth a specific reservation of rights does not mean that all
other areas of the contract are subject to mutual agreement.
III. METHOD OF PAYMENT
A. Payment Methods Used
The method of payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the Contractor upon
satisfactory completion of the Tasks/Deliverables, as specified in Section II., Manner of Service Provision, and in
accordance with other terms and conditions of this contract.
1. Fixed Fee/Unit Rate
Payments for Fixed Fee/Unit Rate shall not exceed amounts established in the Service Rate Report.
2. Cost Reimbursement
Payment may be authorized only for allowable expenditures which are in accordance with the services specified
in the Service Rate Report. All Cost Reimbursement Requests for Payment must submit the Request for Payment
as well as the Receipt and Expenditure Report beginning with the first month of this contract.
3. Advance Payments
The Contractor may request up to two (2) months of advances at the start of the contract period to cover program
administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount
24
July 2020 to June 2021
ADI 203.20
of funds released to the Agency by the State of Florida ("budget release"). The Contractor's requests for
advance payments require the written approval of the Agency's and/or DOEA's Contract Manager. For the
first month's advance request, the Contractor shall provide to the Agency Contract Manager documentation
justifying the need for an advance and describing how the funds will be distributed. If the Contractor is requesting
two (2) months of advances, documentation must be provided reflecting the cash needs of the Contractor within
the initial two (2) months and should be supported through as cash -flow analysis or other information appropriate
to demonstrate the Contractor's financial need for the second month of advances. The Contractor must also
describe how the funds will be distributed for the first and second month. If sufficient budget is available, and
the Agency's and/or Department's Contract Manger, in his or her sole discretion, has determined that there is
justified need for an advance, the Agency will issue approved advance payments after July I" of the contract
year.
a. Any advance payments the Contractor requests for subcontractors must be distributed within seven (7) days
of receipt of payment from the Agency. The Contractor shall submit to the Agency documentation to
support full distribution of advanced funds with Report Number 5, due to the Agency on October 10, in
accordance with the Invoice Report Schedule, Attachment VIII.
b. All advance payments retained by the Contractor must be fully expended no later than September 3)0, 2020.
Any portion of advance payments not expended must be recouped on the Request for Payment Report,
Attachment X, Number 5, due to the Agency on October 10, 2020, in accordance with the Invoice Report
Schedule, Attachment VIII.
c. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: At least one —
tenth of the advance payment received shall be reported as an advance recoupment on each Request for
Payment, Attachment X, starting with Report Number 5, in accordance with the Invoice Report Schedule,
Attachment VIII,
B. Funding Distribution
The Contractor agrees to distribute funds as detailed in the Area Plan update and Invoice Report Schedule. Any
changes in the total amounts of the funds identified on the Annual Budget Summary form require a contract
amendment.
C. Method of Invoice Payment
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval
by the Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
1. Have a Remittance Address that corresponds exactly to the "Remit To" address provided to
MyFloridaMarketPlace (MFMP) during registration;
2. Request payment on a monthly basis for the units of services established in the Agency's approved Area Plan,
provided in conformance with the requirements as described in the current DOEA Handbook., at the rates
established in the Service Rate Report of this contract. Documentation of service delivery must include a
report consisting of the following: number of clients served, number of service units provided by service, and
rate per service unit with calculations that equal the total invoice amount. Any requested changes to the
approved budget subsequent to the execution of this contract must be submitted to the Agency Contract
Manager for written approval. Any change to the total contract amount requires a contract amendment;
3. The Contractor shall consolidate all subcontractors' Requests for Payment and Receipt Expenditure Reports
that support Requests for Payment and shall submit to the Agency using the attached Request for Payment
form, Receipt and Expenditure Report, which must include itemized expenditure categories; and
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AD[ 203.20
4. All Requests for Payment shall be based on the submission of monthly Receipt and Expenditure Reports
beginning with the first month of this contract. The schedule for submission of advance requests (when
available) and invoices is listed in the Invoice Schedule.
D. Payment Withholding
Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments
thereto, including any disallowances.
E. Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than July 25. 2021.
F. CIRTS Data Entries for Subcontractors
The Contractor shall be required to enter all required data for clients and services in the CIRTS database per the
current DOEA Handbook and the CIRTS User Manual — Aging Provider Network users (located in Documents on
the CIRTS Enterprise Application Services). Contractors must enter this data into the CIRTS prior to
submitting their Requests for Payment and Receipt Expenditure Reports to the Contractor. The Agency shall
establish deadlines for completing CIRTS data entry and ensure compliance with due dates for the requests for the
Requests for Payment and Receipt and Expenditure Reports that Contractor must submit to the Agency.
G. Contractors' Monthly CIRTS Reports
The Agency must require Contractors to run monthly CIRTS reports and verify that client and service data in the
CIRTS is accurate. This report must be submitted to the Agency with the monthly Request for Payment and
Expenditure Report and must be reviewed by the Agency before the Contractor's Request for Payment and
Expenditure Reports can be approved by the Agency.
CIRTS Reports: (Listed under Services 93) Monthly & YTD Service Units with Unduplicated Client Counts; and
Listed under Services #6) Monthly & YTD Services Reported by Program and Service Summary Report)
H. Corrective Action Plan
I. Contractor shall ensure one -hundred percent (100%) of the deliverables identified in Section II.E.1-2 of this
contract are performed pursuant to contract requirements.
2. If at any time the Contractor is notified by the Agency Contract Manager that it has failed to correctly,
completely, or adequately perform contract deliverables identified in Section II.E.1-2 of this contract, the
Contractor will have ten (10) days to submit a Corrective Action Plan (CAP) to the Agency Contract Manager
that addresses the deficiencies and states how the deficiencies will be remedied within a time period approved
by the Agency Contract Manager. The Agency shall assess a Financial Consequence for Non -Compliance on
the Contractor as referenced below in Section III.I. of this contract for each deficiency identified in the CAP which
is not corrected pursuant to the CAP. The Agency will also assess a Financial Consequence for failure to timely
submit a CAP.
3. If the Contractor fails to correct an identified deficiency within the approved time period specified in the CAP,
the Agency shall deduct the percentage established below in Section III.I. of this contract from the payment
for the invoice of the following month.
4. If the Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established below
in Section III.I. of this contract for each day the CAP is overdue. The deduction will be made from the payment
for the invoice of the following month.
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July 2020 to June 2021
I. Financial Consequences
ADI 203.20
The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction
of the Agency according to the requirements referenced in Section II.E. of this contract. The following financial
consequences will be imposed if the deliverables stated do not meet in part or in whole the performance criteria as
outlined in Section II.E. of this contract.
1. Delivery of services to eligible clients as referenced in Section II.A.1-2. and Section II.E.1. of this contract —
Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports, will
result in a 2% reduction of payment per business day. The reduction of payment will begin on the first business
day following the Agency's notification to the Contractor that the identified deficiency was not cured or
satisfactorily addressed in accordance with the Agency -approved CAP, referenced in Section III.H.
2. Failure to perform management and oversight of ADI Program operations will result in a 2% reduction of
payment per business day. The reduction of payment will begin the first business day following the Agency's
notification to the Contractor that the identified deficiency was not cured or satisfactorily addressed in
accordance with the Agency -approved CAP, referenced in Section IIIH.
3. Timely submission of a CAP — Failure to timely submit a CAP within ten (10) business days after notification
of a deficiency by the Agency Contract Manager will result in a 2% reduction of payment per business day the
CAP is not received. The reduction of payment will begin the first business day following the Agency's
notification to the Contractor that the identified deficiency was not cured or satisfactorily addressed in
accordance with the Agency approved CAP, referenced in Section IIIH.
4. Exceptions may be granted solely, in writing, by the Agency contract manager.
IV. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the Agency Contract Manager in writing no later than June 30, 2021. Email requests are
considered acceptable.
B. Contractor's Financial Obligations
Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all funds provided by the Agency for the purpose specified in this
contract. For each program managed by the Contractor, the Contractor must manage the service dollars in such
a manner so as to avoid having a wait list and a surplus of funds at the end of the contract period. If the
Agency determines that the Contractor is not spending service funds accordingly, the Agency may transfer
funds to other provider agencies during the contract period and/or adjust subsequent funding allocations
accordingly, as allowable under state and federal law.
2. Cost Sharing and Co -payments
Pursuant to Section 430.204(8), the dollar amount for co -payments associated with any Alzheimer's Disease
Initiative programs must be calculated by applying the current federal poverty guidelines published by the U.S.
Department of Health and Human Services.
a. No -co -payments will be assessed on a client whose income is at, or below, the federal poverty level (FPL)
as established each year by the U.S. Department of Health and Human Services.
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ADI 203.20
b. No client may have their services terminated for inability to pay their assessed co -payment. The
Contractor, in conjunction with the Agency, must establish procedures to remedy financial hardships
associated with co -payments and ensure that there is no interruption in service(s) for inability to pay. If a
client's co -payment is reduced or waived entirely, a written explanation for the change must be placed in the
client file.
C. Remedies for Nonconforming Services
1. The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,
completely, and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
2. If the Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed
under this contract. In addition, any nonconforming goods and/or services not meeting such standards will not
be reimbursed under this contract. The Contractor's signature on the Request for Payment Form certifies
maintenance of supporting documentation and acknowledgement that the Contractor shall solely bear the costs
associated with preparing or providing nonconforming goods and/or services. The Agency requires
immediate notice of any significant and/or systemic infractions that compromise the quality, security or
continuity of services to clients.
D. Incident Reporting
The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the Contractor's
awareness or discovery of changes that may materially affect the Contractor or any Subcontractor's ability to
perform the services required to be performed under this contract and in authorizing proviso. Such notice shall be
made orally to the Agency Contract Manager (by telephone) with an email to immediately follow, which shall
include the Contractor's plan for provision of services authorized in proviso.
E. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of the Contractor or any Contractors and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or
other governmental agency, the Contractor shall notify the Contract Manager at the Agency immediately. A copy
of all documents. reports, notes, or other written material concerning the investigation, whether in the
possession of the Contractor or Subcontractors, must be sent to the Agency's Contractor Manager with a summary of
the investigation and allegations.
F. Volunteers
If applicable, the Contractor shall ensure the use of trained volunteers in providing direct services delivered to older
individuals and individuals with disabilities needing such services. If possible, the Contractor shall work in
coordination with organizations that have experience in providing training, placement, and stipends for volunteers
or participants (such as organizations carrying out federal service programs administered by the Corporation for
National and Community Service).
G. Enforcement
1. In accordance with Section 430.04, F.S., the Department may, without taking any intermediate measures
available to it against the Contractor, rescind the Contractor's designation as an Lead Agency, if the Department
finds that any of the following have occurred:
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients, or substantially and negatively affected the operation of services covered pursuant to this contract;
b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds
have been misappropriated;
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ADI 203.20
c. The Contractor has committed multiple or repeated violations of legal and regulatory requirements,
regardless of whether such laws or regulations are enforced by the Agency, or the Contractor has
committed multiple or repeated violations of Agency and Department standards;
d. The Contractor has failed to continue the provision or expansion of services after the declaration of a state
of emergency;
e. The Contractor has failed to adhere to the terms of this contract;
f. The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets; or
g. The Contractor has failed to implement and maintain an Agency -approved client grievance resolution
procedure.
2. If the Department and/or Agency finds that any acts listed in Section IV.G.La.-g. above have occurred, in
accordance with Section 430.04, F.S., the Department and/or Agency may, its sole discretion, in accordance with
Section 430.04, F.S., take intermediate measures against the Contractor, including corrective action,
unannounced special monitoring, temporary assumption of the operation of one or more contractual services,
placement of the Contractor on probationary status, imposing a moratorium on Contractor action, imposing
financial penalties for nonperformance, or other administrative action pursuant to Chapter 120, F.S.
3. In making any determination under this provision, the Agency may rely upon findings of another state or
federal agency, or other regulatory body. Any claims for damages for breach of contract are exempt from
administrative proceedings and shall be brought before the appropriate entity in the venue of Lee County,
Florida. In the event the Department and/or Agency initiates action to rescind a lead agency designation, the
Department and/or Agency shall follow the procedures set forth in 42 U. S. C. § 3025(b).
H. Contract Modifications
The Agency's Contract Manager has the authority to modify and/or extend deliverable deadlines. All
deliverable extension requests must be made, in writing prior to the required deadline, to the Agency's
Contract Manager. All approvals for deliverable extensions must be communicated, in writing, by the Agency's
Contract Manager to Contractor and are subject to the discretion of the Agency's Contract Manager. The
requests and the approval must occur prior to the established deadline. An email writing (request and response) is
considered acceptable.
END OFATTACHMENT I
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July 2020 to June 2021
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
ADI 203.20
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Agency as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits
by the Agency staff, limited scope audits and/or other procedures. By entering into this contract, the Contractor agrees to
comply and cooperate with any monitoring procedures/processes deemed appropriate by the Agency. In the event the
Agency determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any
additional instructions provided by the Agency to the Contractor regarding such audit. The Contractor further agrees to
comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial
Officer (CFO) or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program -specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial
and Compliance Audit Attachment, Exhibit 2 indicates federal resources awarded through the Agency by this contract. In
determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended should
be in accordance with 2 CFR Part 200. An audit of the Contractor conducted by the Auditor General in accordance with the
provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR § 200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contractor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200, the cost
of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contractor resources
obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any rules,
regulations, or statutes referenced in the contract. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency contract involved. If not otherwise disclosed as required by
2 CFR § 200.510 the schedule of expenditures of federal awards shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. Financial reporting packages required under this part must be
submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's fiscal
year end.
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July 2020 to June 2021
PART II: STATE FUNDED
AD! 203.20
This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), F.S.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in
any fiscal year of such Contractor, the Contractor must have a State single or project -specific audit for such fiscal year in
accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapter 10.550 (local
governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General_ Financial
Compliance Audit Attachment, Exhibit 2 indicates state financial assistance awarded through the Agency by this
contract. In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources
of state financial assistance, including state financial assistance received from the Agency, other state agencies, and other
non -state entities. State financial assistance does not include Federal direct or pass -through awards and resources received
by a non -state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97($), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the non -state entity's resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully disclosed in the
audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 69I-5.003,
F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. For local governmental entities, financial reporting packages
required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after
the Contractor's fiscal year end. For non-profit or for -profit organizations, financial reporting packages required under this
part must be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor's
fiscal year end. Notwithstanding the applicability of this portion, the Agency retains all right and obligation to monitor and
oversee the performance of this contract as outlined throughout this document and pursuant to law.
PART III: REPORT SUBNIISSION
Copies of financial reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part I of this
Financial Compliance Audit Attachment, shall be submitted, when required by 2 CFR § 200.512 by or on behalf of the
Contractor directly to each of the following:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville, IN 47132
Pursuant to 2 CFR § 200.512, all other Federal agencies, pass -through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
The Contractor shall submit a copy of any management letter issued by the auditor to the Agency at the following address:
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July 2020 to June 2021 ADI 203.20
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Chad Tripp, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by this contract's Financial Compliance Audit Attachment,
Part II, shall be submitted by or on behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, lnc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Chad Tripp, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letters, or other information required to be submitted to the Agency pursuant to this contract shall
be submitted timely in accordance with 2 CFR Part 200, F.S., and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for -profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part 200
or Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of
six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO, or Auditor
General access to such records upon request. The Contractor shall ensure that audit working papers are made available to
the Agency or its designee, Contract Manager, or Auditor General upon request for a period of six (6) years from the date
the audit report is issued, unless extended in writing by the Agency.
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ATTACHMENT II -EXHIBIT I
PART I: AUDIT RELATIONSHIP DETERMINATION
ADI 203.20
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub -recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part 11 of Exhibit 1 are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR § 200.38, and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 691-5.006, F.A.C., Contractor has been determined to be:
Vendor not subject to 2 CFR § 200.38 and/or Section 215,97, F.S.
X Recipient/sub-recipient subject to 2 CFR §§ 200.86 and 200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for -profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and/or state financial assistance, and has been
approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691-5.006, F.A.C. [state
financial assistance] and/or 2 CFR § 200.330 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub -
recipient must comply with the following fiscal laws, rules, and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR § 200.416 - § 200.417 — Special Considerations for States, Focal Governments and Indian Tribes*
2 CFR § 200201 — Administrative Requirements**
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR § 200.400 - § 200.411 — Cost Principles*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F —Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR § 200.418 — § 200,419 — Special Considerations for Institutions of Higher Education*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
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ADI 203.20
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§ 200.400(5)(c).
**For funding passed through U.S. Health and Human Services, 45 CFR Part 75; for funding passed through U.S.
Department of Education, 34 CFR Part 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws, rules and regulations:
Sections 215.97 & 215.971, F.S.
Chapter 691-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
34 �p
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ATTACHMENT II -EXHIBIT 2
FUNDING SUMMARY
ADI 203.20
Zj2tt. Title 2 CFR, as revised, and Section 215.97, F.S., require that the information about Federal Programs and State
Projects included in Attachment II, Exhibit 1, be provided to the recipient. Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN##): TiTDERAL AWARD DATE:
DUNS NUMBER:
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200 -T Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133 —Audits of States, Local Governments, and Non -Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97, F.S.
PROGRAM TITLE
FUNDING SOURCE
CSFA
AMOUNT
Alzheimer's Disease Initiative
General Revenue—TSTF
65.004
$ 449,855.00
TOTAL AWARD
$ 449,855.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Sections 215.97 & 215.971, F.S., Chapter 691-5, F.A.C., State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
35`'��°t
July 2020 to June 2021 ADI 203.20
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
The 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 and Suspension Certifcation (29 CFR Part 95 and 4; CFR Part 75)
B.CertificationRegarding Lobbying 29 CFR Part 9 an 45 CFR Part 9
C. N n iscriminati n & Egual 01212ortunity Assurance 29 CFR Part 37-and 45 CFR Par
D. Certification Regarding Public Entity Crimes section 287.133 F.S.
E. Association of mm ni rganizati ns for Reform N w A RN ]Funding Restricti ns Assurance(Pub.
L. 111-117)
F. Scrutinized Companies Lists and No_I3o�cott of Israel Certification, eecti_on 287.135, F.S.
G. Certification Regarding Data Integrity Compliance for Contracto,, Agreements ;rantsLoans, an
Cooperative Agreements
H. Verification of Emj2loyment Status Certification
I. Records and Documentation
J. Certifigation Regar ing Ino,12etion of Public 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,
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.
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
36 O �9
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ADl 203.20
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 at all
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 W IA Title 1-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 Department
and/or 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.
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.
S. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements unposed 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.
37
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ADI 203.20
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 Area Agency and DOEA 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
pertainingto 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. I I 1-117 are available under the conditions provided by Pub. L. I I1-117.
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 certifies that it has not been placed on the Scrutinized Companies that
Boycott Israel List and that it is not engaged in a boycott of Israel.
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 is not engaged in 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.
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.
a
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July 2020 to June 2021
ADI 203.20
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 chip technology,
the undersigned warrants that these products are capable of processing year -date dependent data accurately. All
versions of these products offered by the Contractor {represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
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.
S. 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.
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 Section 10 of the Standard Contract, and sections 119.0701(3) and (4) F.S., and any
other applicable law, if a civil action is commenced as contemplated by section 119.070](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
39
July 2020 to June 2021
AD[ 203.20
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 agreement, 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.
3339 Tamiami Trail E Suite 211
Stephen Y Carnell, Public Service Department Head
Signature and Title of Authorized Representative
Street Address
Collier County Board of County Commiisimars
Noples,FT,,411?
Contractor Date 1
City, State, Zipcode
AIiprov ,c to form and legality
psi' Cant Coun�Attolrl
40
July 2020 to June 2021
ATTACHMENT IV
ASSURANCES —NON -CONSTRUCTION PROGRAMS
AD] 203.20
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, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes, or presents the
appearance of, personal or organizational conflict of interest or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
S. 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) Sections 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 () the requirements
of any other nondiscrimination statute(s) which may apply to the application.
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.
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ADI 203.20
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) 115I4; (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.
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.
AUTHORIZED CF., ,XFYING OFFICIAL I TITLE
Stephen Y Carnell `° I Public Service De artment Head
APPLICANT ORGANIZATION DATE
Collier County Board of County Commissioners 7 /i_3%,-;_0
42 Approved as to form and legality
00
Assistant County Attornc
July 2020 to June 2021
ADI 203.20
ATTACHMENT V
FLORIDA DEPARMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name
County
AAA/Provider
Address
Completed By
City, State, Zip Code
Date
Telephone
PART I: READ THE ATTACHED 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 Poll
2. Population of area served
3. Staff currently employed
4. Clients currently enrolled/registered
5. Advisory/Governing Board if applicable
owing: Total #f 1 White Black Hispanic Other Female Disabled Over 40
Source of data:
Effective date:
Effective date:
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO, EXPLAIN.
6. Is an Assurance of Compliance on file with DOER? N/A YES NO
❑ ❑ ❑
7. Compare the staff composition to the population. Is staff representative of the population? N/A YES NO
❑ ❑ ❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national N/A YES NO
origin, sex, age, religion, or disability? ❑ ❑ ❑
9. Are all benefits, services and facilities available to applicants and participants in an equally effective manner N❑/A Q S El
NO
regardless of race, sex, color, age, national origin, religion, or disability?
10. For in -patient services, are room assignments made without regard to race, color, national origin or disability? N/A YES NO
11. Is the program/facility accessible to non-English speaking clients? N/A YES NO
❑ ❑ ❑
12. Are em loyees, applicants and articipants informed of their protection against discrimination? If YES, how? N/A YES NO
Verbal LJ Written ❑ Poster FI ❑ ❑ ❑
43
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO, EXPLAIN.
6. Is an Assurance of Compliance on file with DOER? N/A YES NO
❑ ❑ ❑
7. Compare the staff composition to the population. Is staff representative of the population? N/A YES NO
❑ ❑ ❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national N/A YES NO
origin, sex, age, religion, or disability? ❑ ❑ ❑
9. Are all benefits, services and facilities available to applicants and participants in an equally effective manner N❑/A Q S El
NO
regardless of race, sex, color, age, national origin, religion, or disability?
10. For in -patient services, are room assignments made without regard to race, color, national origin or disability? N/A YES NO
11. Is the program/facility accessible to non-English speaking clients? N/A YES NO
❑ ❑ ❑
12. Are em loyees, applicants and articipants informed of their protection against discrimination? If YES, how? N/A YES NO
Verbal LJ Written ❑ Poster FI ❑ ❑ ❑
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ADI 203.20
13. Give the number and current status of any discrimination complaints regarding services or employment filed N/A NUMBER
against the program/facility. ❑
14. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals? N/A YES NO
❑ ❑ ❑
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF
NO, EXPLAIN.
15. Has as a self -evaluation been conducted to identify any barriers to serving disabled individuals and to make any YES NO
necessary modifications? ❑ ❑
16. Is there an established grievance procedure that incorporates due process in the resolution of complaints? YES NO
❑ ❑
17. Has a person been designated to coordinate Section 504 compliance activities? YES NO
18. Do recruitment and notification materials advise applicants, employees, and participants of nondiscrimination on YES NO
the basis of disability? 7 El
19. Are auxiliary aids available to ensure accessibility of services to hearing and sight -impaired individuals? YES NO
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF S50,000.00 OR MORE.
20. Do you have a written affirmative action plan? UNO, explain. YES NO
❑ ❑
Reviewed by
In Compliance: YES LJ NO* LJ
Program Office
*Notice of Corrective Action Sent I I
Date Telephone
Response Due / /
On -Site ❑ Desk Review ❑
Response Received I I
44
July 2020 to June 2021 ADI 203.20
ATTACHMENT V
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.
Enter the percent of the population served by race, sex, disability, and over the age of 40. 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, disability, and over the age of 40. 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, disability, and over the age of 40. Include the date that enrollment was counted.
a. 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.
5. Enter the total number of advisory board members and their percent by race, sex, disability, and over the age of 40.
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 Part 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. 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.
9. 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).
10. 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).
11. 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).
12. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any other interested parties. 45 CFR § 80.6(d). This should include information on their
45 ��a�
July 2020 to June 2021
ADI 203.20
right to file a complaint of discrimination with either the Area Agency on Aging for Southwest Florida, Inc. and/or the
Florida Department of Elder Affairs or the U.S. Department of Health and Human Services. 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.
13. Report number of discrimination complaints filed against the program/facility. Indicate the basis (e.g. race, color, creed,
sex, age, national origin, disability, and/or 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 of the
complaint (e.g. settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.).
14. The program/facility must be physically accessible to mobility, hearing, and sight -impaired 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, and 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.
15. 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. Evaluate, with the assistance of disabled individual(s)/organization(s), current practices and policies that do not or
may not comply with Section 504;
b. Modify policies and practices that do not meet Section 504 requirements;
c. Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these policies and
practices; and.
d. Maintain self -evaluation on file, including a list of the interested persons consulted, a description of areas
examined, and any problems identified, and a description of any modifications made and of any remedial steps
taken 45 CFR §. 84.6. (This checklist may be used to satisfy this requirement if these four steps have been
followed.)
16. Programs or facilities that employ 15 or more persons shall adopt grievance procedures that incorporate appropriate due
process standards and that provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Part 84 of Title 45, CFR § 84.7(b).
17. Programs or facilities that employ I5 or more persons shall designate at least one person to coordinate its efforts to
comply with Part 84 of Title 45, CFR § 84.7(a).
18. Programs or facilities that employ 15 or more persons shall take appropriate initial and continuing steps to notify
participants, beneficiaries, applicants, and employees that the program/facility does not discriminate on the basis of
handicap in violation of Section 504 and Part 84 of Title 45, CFR. Methods of initial and continuing notification may
include the posting of notices, publication in newspapers and magazines, placement of notices in publications of the
programs or facilities, and distribution of memoranda or other written communications. 45 CFR § 84.8(a).
19. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual, or speaking skills where necessary to afford such persons an equal opportunity to benefit from the service
in question. Auxiliary aids may include, but are not limited to, brailed and taped materials, interpreters, and other aids for
persons with impaired hearing or vision. 45 CFR § 84.52(d).
20. 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 Part 60
and Title VI of the Civil Rights Act of 1964, as amended.
46
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LL
July 2020 to June 2021
ATTACHMENT V I
BACKGROUND SCREENING
ADI 203.20
y'e �, BACKGROUND SCREENING
I.I. DFR AFFAIR
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 (and Disability) Resource Centers, Lead
Agencies, and Service Providers that contract directly or indirectly with the Department of Elder Affairs
(DOER), 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 its "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.
ATTESTATION:
As the duly authorized representative of
Employer Nome
located at
Street Address city State ZIP code
I, do hereby affirm under penalty of perjury
Name of Representative
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
STATE OF FLORIDA, COUNTY OF
Date
Sworn to (or affirmed) and subscribed before me this day of , 20 by
(Name of Representative) who is personally known
to me or produced as proof of identification.
Print, Type, crStamp Cc mmissioned Name of Notary PuUc Notary Public
ODEA Form 235, Affidavit of Comp €lance -Employer, Effective September 21, 2017 section
435M(3), F.S. Form available at: http://elderaffairs.state.fi.us/enpliish/backrroundscreeninFPhp
48
July 2020 to June 2021
ATTACHMENT VIII
INVOICE REPORT SCHEDULE
ALZHEIMER'S DISEASE INITIATIVE
Report Number Based On
I
July Advance*
2
August Advance*
3
July Expenditure Report
4
August Expenditure Report
5
September Expenditure Report
6
October Expenditure Report
7
November Expenditure Report
8
December Expenditure Report
9
January Expenditure Report
10
February Expenditure Report
1 I
March Expenditure Report
12
April Expenditure Report
13
May Expenditure Report
14
June Expenditure Report
15
Final Request for Payment
Legend: * Advance based on projected cash need
ADI 203.20
Submit to Agency on This Date
July I
July I
August 10
September 10
October 10
November 10
December-10
January 10
February 10
March 10
April 10
May 10
June 10
July 10
July 25
Note # 1: Report 91 for Advance Basis Contracts cannot be submitted to the Area Agency
on Aging for Southwest Florida, Inc. prior to July I or until the contract with the
Agency has been executed and a copy sent to the Area Agency on Aging for
Southwest Florida, Inc. Actual submission of the vouchers to the Agency is
dependent on the accuracy of the expenditure report.
Note # 2: Report numbers 5 through 14 shall reflect an adjustment of at least one -tenth of
the total advance amounts, repaying advances issued the first two months of the
agreement. All advance payments made to the Contractor shall be returned to
the Agency and reported as an advance recoupment on each request for
payment. The adjustment shall be recorded in Part C, Line 1 of the report
(ATTACHMENT X).
Note # 3: Submission of expenditure reports may or may not generate a payment request.
If final expenditure report reflects funds due back to the Agency, payment is to
accompany the report.
Note # 4: ALL Expenditure Reports are due by 12:00 p.m. on the 1 Oth of each month. IF
the 1 Oth falls on a Saturday, then the report will be due by the 9th by 12:00 p.m.
AND IF the loth falls on a Sunday, the report will be due by the I lth by 12:00
p.m. Actual submission of the vouchers to Dept. of Elder Affairs is dependent
on the accuracy of the expenditure report, which is verified and paid by CIRTS
data only.
49
July 2020 to June 2021
ADi 203.20
ATTACHMENT IX
ANNUAL BUDGET SUMMARY
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
for
Collier County Board of County Commissioners
Collier
TOTAL: S 449,855.00
ce
July 2020 to June 2021
ADI 203.20
ATTACHMENT X
REQUEST FOR PAYMENT
ALZHEIMERS
DISEASE INITIATIVE
PROGRAM
RECIPIENT NAME, ADDRESS, PHONE# and FEID#
TYPE OF REPORT :
Contract #
Contract Period
A. PAYMENT REQUEST:
Report Period
Regular
Report #
B. METHOD OF PAYMENT:
Invoice #
Advance Reimbursement
PSA 8
CERTIF€CATION: I hereby certify to the best of my knowledge that this request is complete and correct and conforms with the terms and the purposes of the above
contract. To the best of my knowledge, all CIRTS
is accurate and correct.
Prepared by: Date:
Approved by:
Date:
(1)
(2)
PART A: BUDGET SUMMARY
Respite
S ectalized
Services
TOTAL
1. Approved Contract Amount
$0.00
$0.00
$0.00
2. Previous Funds Received for Contract Period
$0.00
$0.00
$0.00
3. Contract Balance (line 1 minus line 2)
$0.00
$0.00
$0.00
4. Previous Funds Requested and Not Received for Contract Period
$0.00
$0.00
$0.00
5. Contract Balance (line 3 minus line 4)
$0,00
$0.00
$0.00
PART B: CONTRACT FUNDS REQUEST
1. Anticipated Cash Needs (1st • 2nd month, Attach Justification)
$0.00
$0.00
$0,00
2, Net Expenditures for Month
$0,00
$0.00
$0.00
(DOEA Form 105Z Part B, Line 3)
3. TOTAL
$0.00
$0,00
$0.00
PART C: NET FUNDS REQUESTED
1. Less Advance App€ied
$0.00
$0.00
$0.00
2. Contract Funds are Hereby Requested for (Part B, Line 3
$0.00
$0.00
$0.00
minus Part C, tine 1)
List of Services ! Units / Rates provided - See attached report.
DOEA FORM 106Z
Reeised 05l18
51
July 2020 to June 2021
AD] 203.20
ATTACHMENT XI
RECEIPT AND EXPENDITURE REPORT
ALZHEIMERS DISEASE INITIATIVE PROGRAM
PROVIDER NAME, ADDRESS, PHONE # and FEID#
CONTRACT #
PROGRAM FUNDING:
CONTRACT PERIOD
RESPITE
REPORT PERIOD
PROJECTS
REPORT #
SPECIALIZED DAY CARE
INVOICE #
PSA 8
CERTIFICATION: I certify to the best of my knowledge and belief that the report is complete and correct and all outlays
herein are for purposes set forth in the contract. To the best of my knowledge, all CIRTS is accurate and correct.
Prepared by: Date ; Approved by : Date
PART A: BUDGETED INCOME! RECEPTS
1. Approved
2, Actual Receipts
3. Total Receipts
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
$0.00
$0.00 R
$0.00
#DIVIO!
1. State Funds
2. Program Income
$0.00
$0.00
$0.00
#0IVIQ!
3. Local Cash Match
$0.00
$0.00
$0,00 '
#DIVIOI
4, SUBTOTAL; CASH RECEIPTS
5. Local In -Kind Match
6. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIVICI
PART B; EXPENDITURES
1. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
$0.00
$0.00
$0.00
#DIVIC!
1. Administrative Services
2. Service Subcontractor(s)
$0.00
$0.00
$0.00 `
#DIVIC!
3. Alzhe!mer's Association
$0.00
$0.00
$0.00
#DIVIC!
4. Jewish Family & Community Serv!ces
$0.00
$0.00
$0.00
#DIVIC!
5. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV101
PART C: OTHER REVENUE AND EXPENDITURES
u, Interest:
ill. Advance Recouped
I. Program Income (PI)
1. Earned on GR Advance $
$0.00
1. ADI: PI Collected YTO $
2. Return of GR Advance $
(Includes co -payments collected)
3. Other Earned $
PART D: CO -PAYMENTS CURRENT MONTH YEAR-TO-DATE
1. Total of Cc -payments assessed $0.00 $0.00
2. Total of Co -payments collected $0.00 $0.00
(For Tracking Purposes only)
DOEA FORM 105Z
Revised 05Ha
52
July 2020toJune 2021
ATTACHMENT XII
SERVICE RATE REPORT
Rate Summary
Collier
DELIVERABLES
Case Aide:
Case Management:
Respite In -Facility:
Respite In -Home -
Shopping Ass ista nce—COVID-19**
Telephone Reassurance—COVID-19"
Specialized Medical Equipment, Services and Supplies
Transportation
ADI 203.20
HIGHEST
REIMBURSEMENT METHOD OF
UNIT RATE PAYMENTS
$33.88 Fixed Fee 1 Unit Rate
$60.00 Fixed Fee / Unit Rate
$11.44 Fixed Fee / Unit Rate
$25.02 Fixed Fee 1 Unit Rate
$34.12 Fixed Fee/Unit Rate
Per ONE-WAY TRIPS
$13.40 Fixed Fee/Unit Rate
Per EPISODE
Cost Reimbursement
Cost Reimbursement
"Effective April 1, 2020. Please note these two services are temporary and will be reevaluated once the Governor's
Executive Order has been lifted.
53
Revised August 2007
Attestation Statement
Agreement/Contract Number 203.20
Amendment Number na
1, Stephen Y Carnell , attest that no changes or revisions have been made to the
(Rccip icnt/Con tractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier Countv Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreementicontract content.
Approved a_s to form and legality
Ass' t County Atto I •y
Revised August 2007
c