Backup Documents 01/25/2022 Item #16D2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 D 2
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attomey Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Maria Kantaras Community and Human MK 1/20/2022
Services
2. County Attorney Office—JAB County Attorney Office 2L t a
3. BCC Office Board of County
Commissioners 4yQ// /c /2
4. Minutes and Records Clerk of Court's Office J
fYS- 1 tatitle2, zw --
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Staff Maria Kantaras,CHS Phone Number 239-252-6141
Contact/ Department
Agenda Date Item was 1/25/2022 ✓ Agenda Item Number 16.D.2
Approved by the BCC
Type of Document GRANT AGREEMENT Number of Original
Attached Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature ST jvIP 0
2. Does the document need to be sent to another agency for additional signatures? If yes, Yes ,V
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. MK
3. Original document has been signed/initialed for legal sufficiency. (All documents to be M�K
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the MK
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's MK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on above date and all changes made during MK MK not
the meeting have been incorporated in the attached document. The County an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the MK N/A is not
BCC,all changes directed by the BCC have been made, and the document is ready for the W' an option for
Chairman's signature. this line.
C;rCb OK)
1 6 D 2 ,.
For Grantor execution,please e-mail signed copy of the agreement to:
Josh Register, Department of Elder Affairs
register]@elderaffairs.o g
Please CC:
Maria Kantaras, Grants Coordinator CHS
Maria.kantaras@colliercountyfl.gov
16D2
Ann P. Jennejohn
From: Ann P.Jennejohn
Sent: Thursday, January 27, 2022 1:39 PM
To: 'registerj@elderaffairs.org'
Cc: 'Maria.Kantaras@colliercountyfl.gov'
Subject: Florida DOEA Standard Contract w/Collier County
Attachments: DOEA Standard Contract w_Collier County.pdf
Good Afternoon,
Please see the attached, approved by the
Collier County Board of County Commissioners
on January 25, 2022, for further processing.
Please return a fully executed copy of the contract
to myself, for the Board's official record.
Thank you.
Ann Jennejohn
BMR Senior Deputy Clerk II
rirk, Clerk to the Value Adjustment Board
Office: 239-252-8406
Fax: 239-252-8408 (if applicable)
•
Ann.Jennejohn@CollierClerk.cow
.re , �^ Office of the Clerk of the Circuit Court
v` ` & Comptroller of Collier County
3299 Tavnianni Trail, Suite #401
Naples, FL 34112-5324
www.CollierClerk.cowt
i
0(October 2021 —June 2023) Q 03oz
FLORIDA DEPARTMENT OF ELDER AFFAIRS
STANDARD CONTRACT
THIS CONTRACT is entered into between the Florida Department of Elder Affairs (Department or DOEA) 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 Department 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 Department.
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 Documents within the Contract:
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 of Contract:
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time October 1, 2021 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 30,2023.
4. Contract Amount:
The Department agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed$250,000.00,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 Department
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 Department 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)Part 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 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 Department.
6.1.3 Neither the Contractor nor any agent acting on behalf of the Contractor may 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
Od
Page 1 of 50
(October 2021 —June 2023) 1.,oD 2
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 II 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 Department 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 Department.
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 Department 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. Compliance 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.
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment I,to be received and accepted by the DOEA 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.
Od
v
Page 2 of 50
(October 2021 —June 2023) 1 t1132
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 Department 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 Department 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.
8. 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 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
Department within thirty (30) days of execution of this contract. Should the Department 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
https://elderaffairs.org/about-us/background-screening/
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. Public 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 Department to perform the contracted services.
10.1.2 Upon request from the Department's custodian of public records, provide the Department 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 Department.
10.1.4 Upon completion of the contract,the Contractor will either transfer,at no cost to the Department,all public
records in possession of the Contractor to the Department or will keep and maintain public records required
by the Department. If the Contractor transfers all public records to the Department upon completion of the
contract,Contractor shall destroy any duplicate public records that are exempt,or confidential and exempt,
J
Page 3 of 50
16D `e
(October 2021 —June 2023) XQ103
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 Department in a format that is compatible
with the information technology systems of the Department.
10.2 The Department 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
Florida Department of Elder Affairs
4040 Esplanade Way
Tallahassee,Florida 32399
850-414-2114
doeapublicrecords@elderaffairs.org
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 Department,transfer all public records in their possession
to the Department 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 Department in a
format that is compatible with the information technology systems of the Department.
11. Audits,Inspections,Investigations:
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 Department 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
Department.
11.3 Upon demand,at no additional cost to the Department,the Contractor shall facilitate the duplication and transfer
of any records or documents during the required retention period.
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 Department.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Department 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 Department 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
0V3
Page 4 of 50
(October 2021 —June 2023) 103
cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant to
Section 20.055(5), F.S. By execution of this contract the Contractor understands and will comply with this
subsection.
11.8 In accordance with Executive Order 20-44 which requires executive agencies to submit a list of entities named
in statute with which a state agency must form a sole-source,public-private agreement or an entity that,through
contract or other agreement with the state,annually receives 50%or more of their budget from the State or from
a combination of State and Federal funds.Any Contractor that meets one or both of the criteria listed must submit
an annual report, including the most recent IRS Form 990, detailing the total compensation for the entities'
executive leadership teams within thirty(30)days of execution of this contract.
11.8.1 The report must include total compensation including salary,bonuses,cashed-in leave,cash equivalents,
severance pay,retirement benefits, deferred compensation,real-property gifts, and any other payout.
11.8.2 The Contractor shall inform the agency of any changes in total executive compensation between the
annual reports as those changes occur.
11.8.3 All compensation reports must indicate what percent of compensation comes directly from the State or
Federal allocations to the contracted entity.
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 Department 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. Monitoring by the Department:
The Contractor shall permit persons duly authorized by the Department 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 Department of the satisfactory
performance of the terms and conditions of this contract. Following such review,the Department 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 Department's Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
040
Page 5 of 50
(October 2021 —June 2023) b 04103
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
Department, 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, 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 Department 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) contracting 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 commodity or 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
Contractor shall complete the Contractor's State Contracts List attached to this contract.
17. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Department 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 Department for claims, demands, actions, or causes of action arising
solely out of the negligence of the Department.
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 Department 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 Department 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 Department 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. Health Insurance Portability and Accountability Act:
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act of 1996,
Public Law 104-191,as well as all regulations promulgated thereunder(45 CFR Parts 160, 162, and 164).
21. Incident Reporting:
21.1 The Contractor shall notify the Department 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
010
Page 6 of 50
(October 2021 —June 2023) 1 6 D 2xQ103
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Department'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. Bankruptcy Notification:
During the term of this contract,the Contractor shall immediately notify the Department 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 Department: (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., Northern District of Florida,
Tallahassee Division);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)and the State of Florida,Department of Elder Affairs." If the sponsorship reference is in written material,
the words"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 "State of Florida, Department of Elder Affairs"to indicate sponsorship
of a program otherwise financed,unless specific written authorization has been obtained by the 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 Department. Any sublicense, assignment, or transfer otherwise occurring without prior written
approval of the Department shall constitute a material breach of the contract. In the event the State of Florida
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 The State of Florida is,at all times,entitled to assign or transfer,in whole or part,its rights,duties,or obligations
under this contract to another governmental agency in the State of Florida upon giving prior written notice to the
Contractor.
24.3 This contract shall remain binding upon the successors in interest of the Contractor and the Department.
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 Department deems necessary. The Contractor
further agrees that the Department will not be liable to the Subcontractor in any way or for any reason. The
Contractor,at its expense,shall defend the Department against any such claims.
25.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Department 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.
26. Independent Capacity of Contractor:
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 Department, and that they shall not hold themselves out as employees or
agents of the Department without prior specific authorization from the Department. It is the further intent and
understanding of the Parties that the Department 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
MO
Page 7 of 50
(October 2021 —June 2023) 1 6 QQ203
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. Payment:
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The DOEA 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
Department'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 800-342-2762.
28. Return of Funds:
The Contractor shall return to the Department 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 Department.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
Department. In the event that the Department first discovers an overpayment has been made, the DOEA 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 Department
notification or Contractor discovery.
29. Data Integrity 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. Social Media and Personal Cell Phone use:
30.1 Inappropriate use of social media and personal cell phones may pose risks to DOEA's confidential and proprietary
information and may jeopardize compliance with legal obligations.By signing this contract,Contractor agrees to
the following social media and personal cell phone use requirements.
30.2 Social Media Defined. The term Social Media and /or personal cellular communication includes, but is not
limited to, social networking websites, blogs, podcasts, discussion forums, RSS feeds, video sharing, SMS
(including Direct Messages (DMs), iMessages, text messages, etc.); social networks like Instagram, TikTok,
Snapchat, Google Hangouts, WhatsApp, Signal,Facebook, Pinterest, and Twitter; and content sharing networks
such as Flickr and YouTube. This includes the transmission of social media through any cellular or online
transmission via any electronic,internet,intranet, or other wireless communication.
30.3 Application to any direct or incidental DOEA or other state business. This contract applies to any DOEA or
other state business conducted on any of the Contractor's, Subcontractor's, or their employees' social media
accounts or through personal cellular communication.
30.4 Application to DOEA and Contractors Equipment. This contract applies regardless of whether the social
media is accessed using DOEA's IT facilities and equipment or equipment belonging to Contractor,
Subcontractor, or their respective employees. Equipment includes, but is not limited to, personal computers,
cellular phones,personal digital assistants, smart watches, or smart tablets.
30.5 Florida Government in the Sunshine,Florida Public Records Law, and HIPAA. Contractor acknowledges
that any DOEA or other state business conducted by social media or through personal cellular communication is
subject to Florida's Government in the Sunshine Law, Florida's Public Records Law (Chapter 119, Florida
Od3
Page 8 of 50
1 602
(October 2021 —June 2023) XQ103
Statutes),and the Health Insurance Portability and Accountability Act(HIPAA).Compliance with these laws and
other applicable laws are further detailed in the contract.
30.6 Prohibited or Restricted Postings. Contractors may not take or post photos or videos of, or include names or
identifying information, about any of DOEA's clients. Any social media posts which include photos, videos, or
names of volunteers, staff, or other affiliates of DOEA may only be posted with the permission of those
individuals. Any such posts related to volunteer service at DOEA may only include individuals over the age of
18.
30.7 Assist DOEA with Communications. Contactors may be asked periodically to assist in distributing certain
DOEA communications through their social media outlets. Any such requests should be posted in adherence to
the social media requirements herein and the other provisions of this contract.
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
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 Department 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 Contractor'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 List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity;may not submit a bid,proposal,or reply 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. Purchasing:
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.
33.1.2 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.
0/0
Page 9 of 50
(October 2021 —June 2023) lx6O 2
33.1.3 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 Department 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.
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.org/.
33.4 The Contractor shall provide a Certified Minority Business Subcontractor Expenditure (CMBE) Report
summarizing the participation of certified suppliers for the current reporting period and project to date. The
CMBE Report shall include the names, addresses, and dollar amount of each certified participant, and a copy
must be forwarded to the Department, Division of Financial Administration, and must accompany each invoice
submitted to the Department. The Office of Supplier Diversity(850-487-0915)will assist in furnishing names of
qualified minorities. The Department's Minority Coordinator (850-414-2153) will assist with questions and
answers. The CMBE Report is attached to this contract.
34. Patents,Copyrights,Royalties:
If this 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 Department to be referred to the 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), F.S.,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 Department
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.
040
Page 10 of 50
(October 2021 —June 2023) Q 1 3
35. Emergency Preparedness and Continuity of Operations:
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 DOEA Contract Manager,
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Department 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].
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 Department upon request. The Contractor shall promptly
investigate,fully document, and notify the DOEA Contract Manager of any loss, damage, or theft of equipment.
The Contractor shall provide the results of the investigation to the DOEA 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.
ors
Page 11 of 50
(October 2021 —June 2023) 1 6 D XQ103
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 Department or purchased with
funds provided through this contract without first obtaining the approval of the DOEA Contract Manager. When
disposing of property or equipment the Contractor must submit a written request for disposition instructions to
the Department'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
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 DOEA 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 Department. 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 Department'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 Department upon
request. The Contractor has the responsibility to require any Subcontractors to comply with the Department's ITR
procedures.
37. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http://dms.myflorida.com/purchasing
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. Use of State Funds to Purchase or Improve Real Property:
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.
Page 12 of 50
16D2
(October 2021 —June 2023) XQ103
39. Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the DOEA Contract Manager,who shall reduce
the decision to writing and serve a copy on the Contractor.
40. Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract,the Department
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 Leon County, Florida.
43. Entire Contract:
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 Department 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 Clause:
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 Appropriations:
The Parties agree that the Department'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 Department 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 Department to exercise or enforce any of its rights under this contract will not constitute or
be deemed a waiver of the Department'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 Department.
50. Final Invoice:
The Contractor shall submit the final invoice for payment to the Department no later than thirty (30) days after 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 Department 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 Department.
Page 13 of 50
1602
(October 2021 —June 2023) XQ 103
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 Department's operating budget.
52. Suspension of Work:
The Department may, in its sole discretion, suspend any or all activities under the contract or purchase order, at any
time, when in the interest of the State to do so. The Department 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
agreed to by the Contractor, the Department 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 Department,by written notice to the Contractor,may terminate this contract
in whole or in part when the Department 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 Department 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
Department. The rights and remedies of the Department 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 Department 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 Department's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Depat lucent. The Contractor is authorized to conduct electronic transactions with the
Department only upon further written consent by the Department.
54.2 Upon request by the Department,the Contractor shall provide the Department with non-electronic(paper)copies
of records. Non-electronic (paper) copies provided to the Department of any document that was originally in
010
Page 14 of 50
1 602
(October 2021 —June 2023) XQ103
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 Manager:
The Department may substitute any Department employee to serve as the DOEA Contract Manager.
REMAINDER OF THE PAGE INTENTIONALLY LEFT BLANK
Page 15 of 50
(October 2021 —June 2023) 1 Xf,)1 p 2
56. Official Payee and Representatives(Names,Addresses,and Telephone Numbers):
The Contractor name,as shown on page 1 of this Collier County Board of County
a. contract, and mailing address of the official payee to Commissioners
whom the payment shall be made is: 3299 Tamiami Trail East,Bldg. F Suite 403
Naples,FL. 34112
The name of the contact person and street address Maggie Lopez
b. where financial and administrative records are 3339 East Tamiami Trail,Bldg. H, Suite 211
maintained is: Naples,FL. 34112
The name, address, and telephone number of the Tami Bailey
c. representative of the Contractor responsible for 3339 East Tamiami Trail,Bldg. H, Suite 211
administration of the program under this contract is: Naples,FL. 34112
239-252-5218
The section and location within the Department where Florida Department of Elder Affairs
d. Requests for Payment and Receipt and Expenditure Division of Financial Administration
forms are to be mailed is: 4040 Esplanade Way, Suite 215
Tallahassee,Florida 32399-7000
Josh Register,FCCM
The name, address, and telephone number of the 4040 Esplanade Way, Suite 250G
e. Contract Manager for this contract is: Tallahassee, Florida 32399-7000
850-414-2148
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 I —XIII, 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 fifty (50) page contract to be executed by their
undersigned officials as duly authorized.
CONTRACTOR: STATE OF FLORIDA,
COLLIER COUNTY O OUN DEPARTMENT OF ELDER AFFAIRS
COMMISSION
C'
SIGNED BY: • SIGNED BY:
NAME:_ Willi L. McDaniel, Jr., NAME: RICHARD PRUDOM
TITLE: Chairman TITLE: SECRETARY
DATE: 1 1 Z5 1"Z a DATE:
Federal Tax-4 59'•-60005 $
Duns: 07690790. " , Approved as to form and legal,. ,
.0
' r
,,,.���
,,,r`44
C
RI; "i : I K.l ThL,CLERK a /it_
' ,t''` ', " Asant CountyA rn_Y lT 1•
c ., t .• ay IA A •A al; an S Page 16 of 50
signature only.
(October 2021 —June 2023) 1 ft032
INDEX OF ATTACHMENTS
ATTACHMENT I 18
STATEMENT OF WORK 18
ATTACHMENT II 24
FINANCIAL AND COMPLIANCE AUDIT 24
ATTACHMENT III 30
CERTIFICATIONS AND ASSURANCES 30
ATTACHMENT IV 35
ASSURANCES—NON-CONSTRUCTION PROGRAMS 35
ATTACHMENT V 37
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST 37
ATTACHMENT VI 41
CONTRACTOR'S STATE CONTRACT LIST 41
ATTACHMENT VIII 43
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES(CMBE FORM) 43
ATTACHMENT IX 45
STATEMENT OF USE OF FUNDS(ESTIMATED BUDGET) 45
ATTACHMENT X 47
RECEIPTS AND EXPENDITURE REPORT FIXED CAPITAL OUTLAY 47
ATTACHMENT XI 48
COST REIMBURSEMENT SUMMARY FORM 48
ATTACHMENT XII 49
REQUEST FOR PAYMENT FIXED CAPITAL OUTLAY 49
ATTACHMENT XIII 50
FIXED CAPITAL OUTLAY CERTIFICATION 50
Page 17 of 50
1 6D 2 '.
(October 2021 —June 2023) XQ 103
ATTACHMENT I
STATEMENT OF WORK
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
1. DOEA—Florida Department of Elder Affairs.
2. CCBCC - Collier County Board of County Commissioners
B. General Description
1. General Statement- The 2021-2022 General Appropriations Act, Specific Appropriation 397A,has
appropriated$250,000.00 to Collier County Board of County Commissioners,to harden and expand the
existing Golden Gate Senior Center in Collier county. This funding will support the Professional Engineering
and Architectural services needed to expand and improve the Golden Gate Senior Center. Local and Federal
funding will be used to complete the construction and improvements. CCBCC owns the Golden Gate Senior
Center that is being improved in Naples,Florida.
2. Authority-All applicable state and federal laws,regulations, action transmittals,program instructions,review
guides and similar documentation related to the following:
a. Chapter 430,Florida Statutes(F.S.)
b. 2021-2022 General Appropriations Act, Specific Appropriation 397A
3. Scope of Work—The funds appropriated will be used for professional services and consulting needed to design,
improve and expand the Golden Gate Senior Center. Design and construction plans will be produced by a
licensed Architect or Engineer. The funds will support all professional services needed for the design portion
of the project and other funding that is not part of this contract will be used for the construction portion.
Professional services will include design and schematics, construction documents,construction administration,
and Architect or Engineer consulting for the Golden Gate Senior Center. The Contractor shall perform the
work as specified below in Section II.Manner of Service Provision.
II. MANNER OF SERVICE PROVISION
A. Service Tasks,Deliverables and Performance Measures-All goods and services reimbursed through this contract
must be for professional services to design, improve, or expand the Golden Gate Senior Center in Collier County,
located at 4898 Coronado Parkway in Naples, Florida. The Contractor must adhere to the Statement of Use of
Funds(Estimated Budget) included as Attachment IX to this contract. The Attachment IX line-item amounts shall
only be adjusted with prior written approval from the DOEA Contract Manager.The approved line-item adjustment
must include a revised Attachment IX and written amendment to this contract for any line-item change(s) greater
than fifteen percent(15%), with the total amount of all line items not to exceed the total amount found on page one
(1)of this contract,as appropriated.In performing all work utilizing the funds allocated to the project,the Contractor
shall ensure that all subcontractors fully comply with all applicable local, state, and federal laws, rules, and
regulations.
1. Service Task: Security Interest in the Property
A security interest in the property will be obtained:
a. Security Interest-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 completion of the improvements, or as
further required by law. A Security Interest (Attachment XIII)must be filed with the court, in the county
the property is located on, by the owner of the property and a copy provided to the DOEA Contract
Manager.
Page 18 of 50
16D2
(October 2021 —June 2023) XQ103
2. Service Task: Professional Services
Professional services for the Center shall include:
a. Design and Schematics-Engineer,Architect, and Consultant fees needed to design and produce plans for
the Golden Gate Senior Center.
b. Construction Documents-All costs associated with construction documentation for the Golden Gate
Senior Center.
c. Construction Administration-All costs associated with construction administration for the Golden Gate
Senior Center.
d. Consulting-All Architectural,Engineering, and Special consulting needed for the Golden Gate Senior
Center.
3. Deliverables, Source Documentation &Performance Measures
The Contractor must complete all tasks listed in Sections II.A.1-2. above and shall comply with the
requirements stated in the Deliverables Table provided in this section (Section II.A.3.). The Contractor must
submit all required documentation in the time and manner specified in the Deliverables Table to meet the
minimum performance levels required. Each deliverable must be accepted in writing by the DOEA Contract
Manager based on the requirements for each deliverable before the Contractor submits an invoice requesting
payment.
Page 19 of 50
16D2
(October 2021 —June 2023) XQ 103
Deliverables Table
Deliverable 1—Security Interest in the Property
Service Task Minimum Level of Service Financial Consequences
Security Interest in the Granting to the state a security interest in Failure to grant a security interest in
Property-Granting to the state a the property at least to the amount of state the property will result in
security interest in the property as funds provided for at least five(5)years termination of this contract.
stated in Section II.A.1 from the date of purchase, completion of
the construction receiving a certificate of Failure to file with the court will
occupancy, or as further required by law. result in termination of the contract.
A Security Interest(Attachment XIII) Reimbursements to contractor will
must be filed with the court, in the county not be paid until a security interest is
the property is located on,by the owner of granted to the state and a copy is
the property,and a copy provided to the received by DOEA Contract
DOEA Contract Manager. Manager.
Deliverable 2—Professional Services
Service Task Minimum Level of Service Financial Consequences
Professional Services- Contractor shall complete a minimum of Failure to perform the work as stated
Completion of all professional one(1)task listed in Section II.A.2.to in Section II.A.2 or to submit the
services for the Center as stated in submit for reimbursement. required documentation will result in
section II.A.2 non-payment.
The Contractor must obtain certification
from the licensed Engineer or Architect Failure to complete the minimum
using AIA Forms G702 and G703,or level of service will result in non-
their equivalents,certifying what portion payment.
of each task is completed for
reimbursement. Invoices for work or services
performed outside the Term of
As evidence of task completion,the Contract timeframe provided on page
Contractor shall submit to the DOEA one(1)of this contract(Standard
Contract Manager the following required Contract, Section 3. Term of
documentation,as stated in Section III.D.: Contract)will not be paid.
• Licensed Architect or Engineer
certification using AIA Forms G702
and G703,or their equivalent.
• Required DOEA forms.
• Required invoice documentation.
• Signed attestation.
• Detailed vendor invoices.
• Proof of Payment documentation; and
• CMBE expenditure report
(Attachment VIII)
Deliverable 2—Estimated Budget$250,000.00
Total Contract Amount-$250,000.00
4. Task Limits—The Contractor shall not perform any tasks related to the project other than those described in
this contract without the prior express written consent of the Department.
5. Reports- The Contractor shall respond within ten (10) business days to the Department's request for routine
and/or special requests for information and ad hoc reports. The Contractor must establish due dates for any
subcontractors that permit the Contractor to meet the Department's reporting requirements.
n
Page 20 of 50
(October 2021 —June 2023) 442
6. Records and Documentation- The Contractor shall make available to Department staff and/or any party
designated by the Department, 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 Department. Maintenance includes valid exports and backups of all data and systems
according to Department standards.
B. Staffing Requirements
1. Staffing Levels- The Contractor shall assign its own administrative and support staff as needed to perform the
tasks,responsibilities,and duties under the contract. It is the Contractors responsibility to ensure subcontractors
have the appropriate staff needed to perform the tasks,responsibilities, and duties under this contract.
2. Professional Qualifications- The Contractor shall ensure that all subcontractors and/or vendors performing
work related to this contract are certified and/or have licenses in the trade area in which work is being
performed,as required by state and federal law. A licensed Architect/Engineer must sign off on all construction
plans associated with this contract.
3. Staffing Changes- Any employee whose continued presence would be detrimental to the success of this
contract as determined by the Department shall be replaced by the Contractor with an employee of equal or
superior qualifications.The DOEA Contract Manager shall exercise judgment in this matter as approved by the
Department.
4. Subcontractors-The Contractor is permitted to use subcontractors to perform work as required by this contract.
C. Service Location and Equipment
1. Location- All work required by this contract must be performed for the location specified in Section II.A,
specifically the Golden Gate Senior Center, located in Collier County,Florida.
2. Service Times- Work can begin upon execution of this contract. All work associated with this contract must
be performed on or before June 30,2023.
3. Changes in Location-The Contractor shall receive written approval from DOEA's Contract Manager prior to
making any changes in location. Any request to change location shall be made in writing to the DOEA Contract
Manager and Contractor must receive written approval back approving such change.
4. Equipment-The 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.
D. Contractor Responsibilities
1. Contractor Unique Activities-All tasks listed above in Section II.are solely and exclusively the responsibility
of the Contractor and are tasks for which, by execution of this contract, the Contractor agrees to be held
accountable.
2. Coordination with 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.
E. Department Responsibilities
1. Department Obligations-The Department may provide technical support and/or assistance to the Contractor
within the resources of the Department to assist the Contractor in meeting the requirements of this contract.
The Department's support and/or assistance, or lack thereof, shall not relieve the Contractor from full
performance of contract requirements.
040
Page 21 of 50
(October 2021 —June 2023) 4145 D C
2. Department Determinations-The Department reserves the exclusive right to make certain determinations in
the tasks performed and approaches used to perform those tasks. The absence of the Department setting forth
a specific reservation of rights does not mean that all other areas of the contract are subject to mutual agreement.
F. Monitoring and Evaluation Methodology-The Department shall review and evaluate the performance of the
Contractor under the terms of this contract.Monitoring shall be conducted through direct contact with the Contractor
through telephone, in writing,or on-site visit. The primary,secondary, or signatory of the contract must be present
for any on-site programmatic monitoring visit. The Department reserves the right to conduct an unannounced on-
site visit by persons duly authorized by the Department. The Department's determination of acceptable
performance shall be final. The Contractor agrees to cooperate with the Department in monitoring the progress of
completion of the service tasks and deliverables. The Department may use,but is not limited to, one or more of the
following methods for monitoring:
• Desk reviews and analytical reviews;
• Scheduled,unscheduled and follow-up on-site visits;
• Client visits;
• Review of independent auditor's reports;
• Review of third-party documents and/or evaluations;
• Review of progress reports;
• Agreed-upon procedures review by an external auditor or consultant;
• Limited-scope reviews; and/or
• Other procedures as deemed necessary
III. METHOD OF PAYMENT
A. Payment Method Used-This is a Cost Reimbursement contract for funds appropriated by the Florida Legislature.
The total contract amount may not exceed the amount found on page one(1) of this contract, as appropriated. The
Department will pay the Contractor upon satisfactory completion of the Tasks/Deliverables,as specified in Section
II.A., and in accordance with the terms and conditions of this contract.
B. Unit of Service - Payment may be authorized only for allowable expenditures, which are in accordance with the
service tasks and deliverables specified in Section II.A. and the Statement of Use of Funds (Estimated Budget)
(Attachment IX). The Contractor must meet the minimum level of performance stated in this contract in order to
receive payment.
C. Final Invoices-Final contract invoices must be submitted to the Department by Contractor within thirty(30)days
after expiration of the contract.
D. Invoice Instructions and Required Documentation-Payment shall be made upon Contractor's presentation of an
invoice subsequent to the acceptance by the Department of the deliverables shown on the invoice. Funds paid
and/or reimbursed to the Contractor must be in line with the approved estimated budget. When submitting an
invoice for reimbursement,the Contractor shall submit the following information and evidence of completion:
1. AIA Forms G702 and G703-A certification by the licensed Engineer or Architect using AIA forms G702 and
G703,or their equivalents, certifying that the task is complete.
2. Required DOEA Forms - All requests for reimbursement must be submitted to the Department using the
Receipts and Expenditure Report Fixed Capital Outlay (Attachment X), the Cost Reimbursement Summary
Form(Attachment XI), and the Request for Payment Fixed Capital Outlay(Attachment XII).
3. Required Invoice Documentation - Each Contractor invoice must identify the deliverable or line item for
which payment is being requested,the current contract number,an invoice number,the amount being requested
for reimbursement, and the"Remit to"address exactly as it appears in this contract.
Page 22 of 50
��O
(October 2021 —June 2023) xl1c6 D G
7
4. Attestation -The following attestation, signed by the Contractor's representative,must be included with each
invoice submitted by the Contractor: "I hereby certify that the goods and/or services have been received and/or
accepted."
5. Vendor Invoice(s)—The Contractor shall submit a detailed vendor invoice(s)that totals the same amount listed
in the Contractor's invoice. Invoices must include dates and total amount being invoiced.
6. Proof of Payment- This can be a copy of a payment instrument, check number, accounting department detail
sheet, or other documentation, as long as the detailed information corresponds to the copies of the vendor
invoices.
7. Certified Minority Business Expenditure(CMBE)Report Deliverable(Attachment VIII)—This is
considered a deliverable and must be completed in its entirety and submitted with each invoice.
E. Financial Consequence - Failure to perform the services as stated in Section II.A. or to submit the required
documentation will result in non-payment. Invoices for work or services performed outside the timeframe provided
by the term of this contract, as stated on page one (1) of this contract (Standard Contract, Section 3. Term of
Contract),will not be paid.
IV. SPECIAL PROVISIONS
A. Budget Modifications - The Contractor must adhere to the Statement of Use of Funds (Estimated Budget)
(Attachment IX). The Attachment IX line-item amounts shall only be adjusted with prior written approval from the
DOEA Contract Manager. The approved adjustment must include a revised Attachment IX and a written
amendment to this contract for any line-item change(s)greater than fifteen percent(15%),with the total amount of
all line items combined not to exceed the total amount on page one(1)of this contract, as appropriated.
B. General Procurement Standards-Contractor shall not order equipment or supplies,provide services,or perform
any other action related to this contract until notified in writing that this contract has been executed by the
Department. These same actions shall not take place after the contract has expired.
C. Contract Modifications - The DOEA Contract Manager has the authority to modify and/or extend deliverable
deadlines. All deliverable extension requests must be made to the DOEA Contract Manager,in writing,thirty(30)
days prior to the required deadline. All approvals for deliverable extensions must be communicated, in writing,by
the DOEA Contract Manager to the Contractor and are subject to the discretion of the Department. The request and
the approval must occur prior to the established deadline. An e-mail writing(request and response) is considered
acceptable.
D. Security Interest- Pursuant to section 287.05805, F.S., and Section 38 of the Standard Contract, the Contractor
shall execute and deliver a security interest(Attachment XIII)or other appropriate document to the DOEA Contract
Manager prior to receiving any funds under this contract.Requirements stated in this section are considered service
tasks and deliverables.The Contractor's failure to meet this provision will result in non-payment and/or immediate
termination of this contract.
END OF ATTACHMENT I
CA�
Page 23 of 50
1602
(October 2021 —June 2023) XQ 103
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Department to the Contractor may be subject to audits and/or monitoring
by the Department, 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 Department 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 Department. In the event
the Department determines that a limited scope audit of the Contractor is appropriate,the Contractor agrees to comply with
any additional instructions provided by the Department 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 Department 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 Department. 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 Department 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 Department shall be fully
disclosed in the audit report with reference to the Department 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 Department 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.
PART II: STATE FUNDED
CA 0
Page 24 of 50
(October 2021 —June 2023) XOt 04 ® C.
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 Department 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 Department, 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(8), 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 Department 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 Department shall be fully disclosed in
the audit report with reference to the Department 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 Department 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 Department 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 SUBMISSION
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 directly to the Department.
CN°
Page 25 of 50
(October 2021 —June 2023) X436 U n 2
Florida Department of Elder Affairs
Attn: Audit Repository
4040 Esplanade Way, Suite 235S
Tallahassee,Florida 32399-7000
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 Department at the following address:
Florida Department of Elder Affairs
Attn: Audit Repository
4040 Esplanade Way, Suite 235S
Tallahassee,Florida 32399-7000
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 Department 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 Department 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 Department 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 Department or its designee, CFO, 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 Department.
CPO
Page 26 of 50
(October 2021 —June 2023) X4036 D 2
ATTACHMENT II-EXHIBIT 1
PART I: AUDIT RELATIONSHIP DETERMINATION
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 II 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 69I-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 department to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-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,Local Governments,and Indian Tribes*
2 CFR§200.201 —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
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§200.400(5)(c).
Page 27 of 50 CPO
(October 2021 —June 2023) * 83 2
**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 69I-5,F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules,and regulations
CAO
Page 28 of 50
(October 2021 —June 2023) XQ103
ATTACHMENT II-EXHIBIT 2 1 6 D 2
FUNDING SUMMARY(2021-2023)
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 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#): FEDERAL 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—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
Golden Gate Senior Center The 2021-2022 General Appropriations Act, 65.013 $250,000.00
Specific Appropriation 397A
TOTAL AWARD $250,000.00
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 69I-5,F.A.C., State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules, and regulations
CAO
Page 29 of 50
(October 2021 —June 2023) 1 x6i 0
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
DOEA 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 Certification(29 CFR Part 95 and 45 CFR Part 75)
B. Certification Regarding Lobbying(29 CFR Part 93 and 45 CFR Part 93)
C. Nondiscrimination& Equal Opportunity Assurance(29 CFR Part 37 and 45 CFR Part 80)
D. Certification Regarding Public Entity Crimes,section 287.133,F.S.
E. Association of Community Organizations for Reform Now (ACORN) Funding Restrictions Assurance
(Pub. L. 111-117)
F. Scrutinized Companies Lists and No Boycott of Israel Certification,section 287.135,F.S.
G. Certification Regarding Data Integrity Compliance for Contracts, Agreements, Grants, Loans, and
Cooperative Agreements
H. Verification of Employment Status Certification
I. Records and Documentation
J. Certification Regarding Inspection 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
connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,
Page 30 of 50
(October 2021 —June 2023) ixton J
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification L.
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 WIA Title I-financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964(Pub.L. 88-352),as amended,and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services(45 CFR Part 80),to the end that,in accordance
with Title VI of that Act and the Regulation,no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Department.
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 Department.
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 Department.
5. Title IX of the Education Amendments of 1972(Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation,no person in the United States shall, on the basis of sex,be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Department.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices including job application procedures,hiring,firing,advancement,compensation,training,and other terms,
conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits, and all other employment-related activities.
7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws
listed above. This assurance applies to Contractor's operation of the WIA Title I—financially assisted program or
activity,and to all contracts Contractor makes to carry out the WIA Title I—financially assisted program or activity.
Page 31 of 50
(October 2021 —June 2023) 110 2
Contractor understands that 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 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
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act,2010,Division E,Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers(including subcontracts,sub-grants and contracts under grants,loans and cooperative agreements)and that all sub-
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION
287.135,F.S.
In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized
Companies that Boycott Israel List and that it is not 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
Department 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.
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
CAS
Page 32 of 50
(October 2021 —June 2023) 61D 2
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.
5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency,including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Department, 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 Department staff and/or any party designated by the Department 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 Department. Maintenance
includes valid exports and backups of all data and systems according to Department standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of Section 10 of the Standard Contract,sections 119.0701(3)and(4)F.S.,and any other
applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Department is
named in the civil action, Contractor agrees to indemnify and hold harmless the Department for any costs incurred by
the Department and any attorneys' fees assessed or awarded against the Department 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 Department 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 (Florida Department of
Elder Affairs)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.
CAO
Page 33 of 50
l 6D '
(October 2021 —June 2023) XQ 103
Additionally,I certify this organization does y does not provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Department are
available for inspection if applicable,as stated above.
By execution of this contract, Contractor must include these provisions (A-J) in all related subcontract agreements (if
applicable).
By signing below,Contractor certifies that the representations outlined in parts A through J above are true and correct.
Lam' C, 3339 East Tamiami Trail,Bldg. H Suite 211
Signature a Title of Aut orized Repr sentative Street Address
Collier County Board of County Commissioners Naples,FL 34112
Contractor Date City, State,Zip code
O� .. a
kiltLwYyy Approved as to form and legality
AL;K; Z CLERK
LOC . —C) -)(3.962_____,
Assi nt County Att
y - 032 'L, .. .•'� \ ,
At bChallt11I18 � \
\IPt l \�
signature ony. CAO
Page 34 of 50
(October 2021 —June 2023) 1Q630 2
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average forty-five(45)minutes per response, including time
for reviewing instructions, searching existing data sources,gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden,to the Office of Management and Budget. Paperwork Reduction Project(0348-0043),
Washington,DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency. Further,certain federal awarding agencies may require applicants to certify to
additional assurances.If such is the case,you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional,managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost)to ensure proper planning,management,and
completion of the project described in this application.
2. Will give the awarding agency,the Comptroller General of the United States,and if appropriate,the state,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.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed
standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personnel Administration(5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a)Title VI of
the Civil Rights Act of 1964(P.L. 88-352)which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683 and §§ 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended(29 U.S.C.
§794),which prohibits discrimination on the basis of handicaps; (d)the Age Discrimination Act of 1975, as amended
(42 U.S.C. §§6101-6107),which prohibits discrimination on the basis of age;(e)the Drug Abuse Office and Treatment
Act of 1972(P.L. 92-255),as amended,relating to nondiscrimination on the basis of drug abuse;(f)the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g)Sections523 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 (j) 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.
CAO
Page 35 of 50
(October 2021 —June 2023) )1 16 D 2
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and §§ 7324-7328), which
limit the political activities of employees whose principal employment activities are funded in whole or in part with
federal funds.
9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. §§276a to 276a-7),the Copeland
Act (40 U.S.C. § 276c and 18 U.S.C. § 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§
327-333),regarding labor standards for federally assisted construction sub-contracts.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order(EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. § 1451 et seq.); (f) conformity of federal actions to State(Clear Air)Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974,as amended(P.L. 93-523); and(h)protection of
endangered species under the Endangered Species Act of 1973, as amended(P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. § 1721 et seq.)related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. § 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §469a-1 et seq.).
14. Will comply with P.L.93-348 regarding the protection of human subjects involved in research,development,and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. § 2131 et seq.)
pertaining to the care,handling, and treatment of warm blooded animals held for research,teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. §4801 et seq.), which prohibits the use
of lead-based paint in construction or rehabilitation of residence structures.
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.
SIGNATURE FA, ORIZED RT G FICIAL TITLE
c• Chw a/rn
APPLICA ORGANIZATION DATE SUBMITTED
Collier County Board of C'ourity Commissioners //aS/
g•-•
ATT1rS t ` 3 { Approved as to form and legality
CRYST4L F, tER>
•
'� � CAO
sy. c oc. . Page 36 of 50 Ass giant County Atto4y"
sianature an . sty n
(October 2021 —June 2023) 1Q16 D 2
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name County AAA/Contractor
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:
Total# % % % % %
For questions 2-5 please indicate the following: White Black Hispanic Other Female Disabled Over 40
2.Population of area served Source of data:
3. Staff currently employed Effective date:
4.Clients currently enrolled/registered Effective date:
5.Advisory/Governing Board if applicable
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 DOEA? N/A YES NO
El El 1=1
7. Compare the staff composition to the population. Is staff representative of the population? N/A YES NO
El
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 YES 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 employees,applicants and participants informed of their protection against discrimination? If YES,how? N/A YES NO
Verbal❑Written❑Poster❑ ❑ ❑ ❑
C40
Page 37 of 50
(October 2021 —June 2023) 'X € 2
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
El El El
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?
El 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? If NO,explain. YES NO
❑ ❑
DOE,A l'SE ONL1
Reviewed by In Compliance: YES ❑ NO* ❑
Program Office *Notice of Corrective Action Sent / /
Date Telephone Response Due / /
On-Site ❑ Desk Review ❑ Response Received / /
10
Page 38 of 50
1 6 D 2
(October 2021 —June 2023) XQ 103
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.
2. 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
right to file a complaint of discrimination with either the Department 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)and the issues involved(e.g. services or employment,placement,
C40
Page 39 of 50
(October 2021 —June 2023) lx4 d3 2
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 policies and practices 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,CFR45 CFR§ 84.7(b).
17. Programs or facilities that employ 15 or more persons shall designate at least one person to coordinate its efforts to
comply with Part 84 of Title 45, CFR. 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 or facilities that employ 15 or more persons shall 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 or 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.
Page 40 of 50 CAO
16Dd
M
O
a
V4.1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
G1 3
O C O
WV Q � -en- - - - - i -4fi- - s� -en- -en- -en- -el- -en- -* - - - n-
a
—
o o
a
a w o I
s
a
t; d
a pf
4, a
c c
a
U E
d
u u E
T. p
- c m
-I � w
o
U o0
g c a
o >.
z as
O o to
W W o 3
a
Fi
C.d Cl)
D .
a • ad c a
'et .4 W 0 w o
O
a
,r�.i to ino°'n
z a
C.) cE
Cd a) a
a o
O 61
U
N a► w w
o � R a E"
r, O V
cl ;"'' a
N O
°' U x
O
ll
NrOl O g -r°o u
�./ U z d w
o
O +--1 N M in lO I\ CO Cr) O
0 ,-i N M C1' Ln LC) I." CO CT' ,i ,--i ,i ,--1 ,--i ri ri ,i ,--i ri N
0
'7®
1 602
(October 2021 —June 2023) XQ103
ATTACHMENT VII
BACKGROUND SCREENING
Ron DeSantis
T)cpartmcnt ofGovernor
ELDER AFFAIRS
Richard Prudom
STATE OF FLORIDA Secretary
BACKGROUNDSCREENING
Attestation 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 screenings,
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 (DOEA), and any other person or entity which hires employees or has volunteers in service
who meet the definition of a direct service provider.See§§435.02,430.0402,Fla.Stat.
➢ A direct service provider is"a person 18 years of age or older who,pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the
client and has access to the client's living area, funds, personal property, or personal identification
information as defined in s. 817.568. The term includes coordinators, managers, and supervisors of
residential facilities and volunteers."§430.0402(1)(6),Fla.Stat.
ATTESTATION:
As the duly authorized representative of
Collier County Board of County Commissioners
Employer Name
3339 Tamiami Trail E Naples FL 34112
located at
Street Address City State ZIP code
1 William L. McDaniel, Jr., Chairman do hereby affirm under penalty of
Name of Representative
perjury that the above-named employer is in compliance with the provisions of Chapter 435 and section
430.0402, Flori egarding level 2 background screening.
C62 ° //c2,002..
•
Signature f Representative Date
DOEA Form,23i,AtteStation ofCDmpliance-Employer,Effective Jamra,y 19,2021 Section 435.05(3),
F.S.Form' ailablea,Itillllps:Y/e7efenectir3.oigiirp-contenNuploads/doeaform-235-attestation-of-compliance-emploier.ptl/
A"TEES"I a ». ��< Approved as to form and legality
CRY+S&TAL K.MN? CLERK (1 •O
43. Page 42 of 50 \ Ck
Ass stint County Att Zy
�.......4irn nn
1 6 D ?
(October 2021 —June 2023) XQ 103
ATTACHMENT VIII
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES(CMBE FORM)
CMBE FORM MUST ACCOMPANY INVOICES SUBMITTED TO DOEA
CONTRACTOR NAME:
DOEA CONTRACT NUMBER:
*REPORTING PERIOD-FROM: TO:
*(DATE RANGE OF RENDERED SERVICES,MUST MATCH INVOICE SUBMITTED TO DOEA)
DOEA CONTRACT MANAGER:
REPORT ALL EXPENDITURES MADE TO CERTIFIED MINORITY BUSINESS(SUBCONTRACTORS).
CONTACT DOEA CMBE COORDINATOR FOR ANY QUESTIONS, AT 850-414-2153.
SUBCONTRACTOR NAME SUBCONTRACTOR'S CMBE EXPENDITURES
FEID
DOEA USE ONLY--REPORTING ENTITY(DIVISION,OFFICE,ETC)
SEND COMPLETED FORMS VIA INTEROFFICE MAIL TO:JUSTIN TAYLOR
CMBE COORDINATOR,CONTRACT ADMINISTRATION&PURCHASING,TALLAHASSEE,FLORIDA 32399-7000.
Page 43 of 50
I 6D2
(October 2021 —June 2023) XQ103
If unsure if subcontractor is a certified minority supplier,click on the hyperlink below. Enter the name of the supplier,click
"search". Only Certified Minority Business Entities will be displayed.
https://osd.dms.myflorida.com/directories
INSTRUCTIONS
(A) ENTER THE COMPANY NAME AS IT APPEARS ON YOUR DOEA CONTRACT.
(B) ENTER THE DOEA CONTRACT NUMBER.
(C) ENTER THE SERVICE PERIOD MATCHING THE CURRENT INVOICE'S SERVICE PERIOD.
(D) ENTER ALL CERTIFIED MINORITY BUSINESS EXPENDITURES FOR THE TIME PERIOD COVERED BY
THE INVOICE:
1. ENTER CERTIFIED MINORITY BUSINESS NAME.
2. ENTER THE CERTIFIED MINORITY BUSINESS FEID NUMBER.
3. ENTER THE CERTIFIED MINORITY BUSINESS CMBE NUMBER.
4. ENTER THE AMOUNT EXPENDED WITH THE CERTIFIED MINORITY BUSINESS FOR THE TIME
PERIOD COVERED BY THE INVOICE.
(E) MBE FORM MUST ACCOMPANY INVOICE PACKAGE SUBMITTED TO DOEA FINANCIAL
ADMINISTRATION FOR PROCESSING.
(F) FINANCIAL ADMINISTRATION WILL FORWARD ALL COMPLETED CMBE FORMS TO CONTRACT
ADMINISTRATION&PURCHASING OFFICE.
C4O
Page 44 of 50
1 6pz
(October 2021 —June 2023) XQ103
ATTACHMENT IX
STATEMENT OF USE OF FUNDS(ESTIMATED BUDGET)
SENIOR CENTERS
STATEMENT OF USE OF FUNDS
Sr.Center Total
Project Name: Golden Gate Senior Center Expansion&Hardening State Matching Other
Total Project Budget: $3,494,521 FCO Funds Non-FCO Funds Project
Funds Funds
TYPE AND SOURCE OF FUNDS:
Federal Grant(s) CDBG-MIT Hardening
Other State Funds(i.e.,DCA)
City/County Grant(s)
Senior Centers FCO Grant $250,000.00
Private Contributions/Donations
In-Kind Expenditure Credits
Total Funds Available From All Sources $250,000.00 $ - $ - $
SITE WORK
Parking Lot
Walks/Driveways
Awnings/Covered Walkways
Drainage/Retention Pond
Trees/Landscaping $20,000.00
Fencing
Sig nage
Other(Turn lane installation) $100,000.00
Other(Remove and repair obstructions) $220,000.00
Total $ - $ - $ 340,000.00 $
INTERIOR
I ns ulationNVeatherization
Plumbing
Heating/Air Conditioning
Electrical
Flooring
Masonry
Ceiling/Acoustics
Railing/Guards
Elevators
Other(Interior Hardening) $810,031.00
Total $ - $ - $ 810,031.00 $
Page 45 of 50
1 602
(October 2021 —June 2023) XQ103
EXTERIOR
Roofing/Siding $168,000.00
Doors/Windows $300,000.00
Porches,Decks,Patios
Septic Tank $205,000.00
Sewer Hook-Up(City/County)
Generator(Gas Powered) $493,400.00
Other(Exterior Hardening) $383,230.00
Total $ - $ - $ 1,549,630.00 $
FIXTURES/EQUIPMENT/APPLIANCES
Security/Alarm System
Telephone System
Smoke Detectors
Emergency/First Aid Stations
Kitchen Appliances
Cabinets/Counter Tops
Bathroom Fixtures
Lighting Fixtures
Other(FF&E) $175,000.00
Total $ - $ 175,000.00 $ - $
PROFESSIONAL SERVICES
Architect/Engineer/Special Consultant $250,000.00
Schematic Design Phase
Design Development Phase
Construction Document Phase
Bidding
Construction Administration $119,860.00
Other(Please Specify)
Total $ 250,000.00 $ - $ 119,860.00 $
OTHER(Please Specify)
Local match $250,000.00
Total $ - $ 250,000.00 $ - $
TOTAL PROJECT COST $ 250,000.00 $ 425,000.00 $ 2,819,521.00 $
`?O
Page 46 of 50
1 602
(October 2021 —June 2023) X l 03
ATTACHMENT X
RECEIPTS AND EXPENDITURE REPORT FIXED CAPITAL OUTLAY
RECEIPTS AND EXPENDITURE REPORT FIXED CAPITAL OUTLAY
This Report Period
RECIPIENT NAME.ADDRESS.PHONE#and FEID# Program Funding Source From To
Contract Perod
General Revenue Contract #
Inwice#
CERTIFICATION I certify to the best of my knowledge and belief that this report is complete and correct and all the outlays herein are for the purposes set forth in the
above c otrxt
Prepa-ed by Date Apprv`ed by: Date
1.Approved 2.Requested 3.Receipts 4.Total Receipts 5.Percent of
PART A:BUDGETED INCOME/RECEIPTS Contract Budget Receipts for this Reimbursed Year to (Box 2+Box 3.) Approved Budget
Report Date (Box 4.IBox 1.)
1 State Funds 0 00 0(p 0 00 ' 0 00 " ;Ol vr01
2 TOTAL RECEIPTS 0 00 0 00 0 OC 0 00 ' gO.IV'Of
1.Approved Budget 2.Requested 3.Expenditures 4.Total 5.Percent of
PART B:EXPENDITURES Expenditures For Reimbursed Year to Expenditures (Box Approved Budget
(Identify Une Item Categones from Approied Budget) This Report Date 2+Box 3) (Box 4.IBox 1.)
1 Site Work 0 00 0 00 0 00 r 0 00 r #0IV/0!
2 Interior 0 00 0 00 0 00 ' 0 00 ' #DIV/O!
3 Exterior 000 000 000 ' 000 r #DIV/O!
4 Fixtures 0 00 0 00 0 00 ' 0 00 ' #DIV/0!
5 Professional Service 0 00 0 00 0 00 ' 0 00 ' #DIV/0!
6 Other 0 00 0 00 0 00 r 0 00 ' #0IV/0!
7 TOTAL EXPENDITURES 0 00 0 00 0 00 0 00 rr #DIV/0!
DOEA forth 105t reused 9(2020
Page 47 of 50
(October 2021 —June 2023) A11* 0 2
ATTACHMENT XI
COST REIMBURSEMENT SUMMARY FORM
Cost Reimbursement Summary
Contract#
Report Number:
Budget
Category Description Number of units Amount
c
0
E
E
TOTAL ADMINISTRATION $0.00
a
0
W
TOTAL EXPENSES $0.00
,
Page 48 of 50 ��
1 6DZ
(October 2021 —June 2023) XQ103
ATTACHMENT XII
REQUEST FOR PAYMENT FIXED CAPITAL OUTLAY
REQUEST FOR PAYMENT
FIXED CAPITAL OUTLAY
RECPIENT NAME,ADDRESS,PHONE#and FED PAYMENT REQUEST: This Request Period:
From To
Regular hvoice#
Supplemental Contract#
Contract Period
CERTFICATION:I hereby certifythat this request conforms with the terms of the above contract.
Prepared by Date: Approved by Date:
PART A: BUDGET SUMMARY FCO
1.Approved Contract Amount $0.00
2.Previous Funds Received for Contract Period $0.00
3.Contract Balance $0.00
4.Previous Funds Requested and Not Received for Contract Period $0.00
5.Contract Balance $0.00
PART B: CONTRACT FUNDS REQUEST
1.Net Expenditures For Month(DOEA Form 105f,Part B Line 7) $0.00
2.TOTAL $0.00
PART C: NET FUNDS REQUESTED
1_Total Funds Requested $0.00
(Part B,Line 2)
DOEA form 106f,revised 3/2017
Page 49 of 50
16Q32
Ann P. Jennejohn
From: KantarasMaria <Maria.Kantaras@colliercountyfl.gov>
Sent: Wednesday, February 23, 2022 9:18 AM
To: Ann P.Jennejohn
Subject: FW:XQ103 Florida DOEA Standard Contract w/Collier County
Attachments: XQ103 -FCO-Approved for Signature - signed.pdf
Hello Anne,
I received the subject executed agreement directly from Joshua Register at the DOEA.
I'm forwarding it to you in the case that Joshua Register didn't also send it to you independently.
If you did already receive it from Joshua, please disregard this email.
Respectfully,
�vlaria .Kantaras
Grants Coordinator
Community and Human Services Division
3339 East Tamiami Trail, Suite 211
Naples, FL 34112
239-252-6141
Maria.Kantaras@colliercountyfl.gov
~! E1' GOLLYi.ty
Making Our Community Stronger:One life,one home,one project at a time.
How was our service?
Click here to take the survey.
Grants: Click here.
Internal Partners: Click here.
From:Joshua Register<Registerj@elderaffairs.org>
Sent: Monday, February 21, 2022 3:07 PM
To: KantarasMaria <Maria.Kantaras@colliercountyfl.gov>
Cc: BaileyTami<Tami.Bailey@colliercountyfl.gov>
Subject:XQ103 Florida DOEA Standard Contract w/Collier County
EXTERNAL EMAIL:This email is from an external source. Confirm this is a trusted sender and use extreme caution when
opening attachments or clicking links.
Good Afternoon,
I wanted to let you know that contract XQ103 between the Department of Elder Affairs and Collier County
Board of County Commissioners, has been executed. You may begin work on the project per the contract
terms.
i
1 602
(October 2021 —June 2023) XQ103
ATTACHMENT XIII
FIXED CAPITAL OUTLAY CERTIFICATION
The Fixed Capital Outlay Certification acknowledges that , Owner, hereinafter
referred to as the Contractor, is using state funds in the form of a fixed capital outlay grant in the amount
of ,to improve, construct or repair real property owned by the Contractor, and in accordance with
executed contract between the Contractor and the State of Florida,Department of Elder Affairs,
Hereinafter referred to as the"Department". The following items must be completed by the Contractor:
1. State the legal address of the real property that is being improved by the fixed capital outlay grant.
2. List the name of the owner of the real property and the contact address for the owner of the real property.
3. In accordance with section 287.05805,F.S. (2017), and Section 38 of this contract and Section IV.D. of
Attachment I,the Contractor shall execute and deliver a security interest or other appropriate document securing the
interest of the Department, in the total amount of funds received under this contract, in the improvements,renovations,
and personality being purchased with funds received under this contract. The Department's security interest shall last for
at least five(5)years from the date of completion of the improvements and during this time the Contractor is prohibited
from selling,transferring,mortgaging,or assigning the Department's interest in the leasehold, improvements,renovations,
or personality, unless the Department approves, in writing,the sale,transfer,mortgage,or assignment.
4. The Contractor shall continue the operation,maintenance,repair, and administration of the property in accordance
with the purposes for which the funds were originally appropriated and for at least five(5)years from the date of
completion of the improvements. If the Contractor fails to operate, maintain,repair, and administer the property in
accordance with the purposes for which the funds were originally granted,the Contractor shall return to the Department,
no later than upon demand by the Department,the total amount of funds received under this contract, less 20%of that
total amount for each full year for which the property was used for such purposes after the date of completion of the
improvements.
5. The Department shall be immune from civil or criminal liability resulting from acts or omissions of the Contractor
and the Contractor's agents, employees, or assigns.
6. The Department shall execute a satisfaction of security interest upon full compliance by the Contractor with the
terms of this contract.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
APPLICANT ORGANIZATION DATE SUBMITTED
Collier County Board of County Commissioners
O
Page 50 of 50
16D2 -
(October 2021 --June 2023) XQI03
FLORIDA DEPARTMENT OF ELDER AFFAIRS
STANDARD CONTRACT
THIS CONTRACT is entered into between the Florida Department of Elder Affairs(Department or DOEA) 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 Department 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 Department.
NOW THEREFORE, in consideration of the services to be performed and payments to he made,together with the
mutual covenants and conditions set forth herein, the Parties agree as follows:
1. Purpose of Contract:
The purpose ofthis 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 Documents within the Contract:
The contract will incorporate attachments,proposal(s),state plan(s),grant agreements,relevant Department handbooks,
manuals and/or desk hooks,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 of Contract:
This contract shall begin at twelve(12:00) A.M., Eastern Standard Time October 1, 2021 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 30,2023.
4. Contract Amount:
The Department agrees to pay for contracted services according to the terms and conditions ofthis contract in an amount
not to exceed$250,000.00,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 Department
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 hid,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 Department and the availability of funds.
6. Compliance with Federal Law:
6.1 !I 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) Part 75 and/or
45(.'FR 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 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 Department.
6.1.3 Neither the Contractor nor any agent acting on behalf of the Contractor may 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
Page 1 of 50
(October 2021 - June 2023) XQ103
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 II 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 I lealth and f luman
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 Department 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. § 1 101). Such violation will be cause for unilateral cancellation of
this contract by the Department.
6.3 if the Contractor is a non-profit provider and is subject to Internal Revenue Service(IRS)tax exempt organization
reporting requirements(tiling 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 Department in writing within thirty(30)days of receiving the IRS notice of revocation.
6.4 'l'he Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR § I70.1 10(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
1 1-116, 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 F.-Verify System are deemed to be
in compliance with this provision.
7. Compliance with State l.,aw:
7.1 This contract is executed and entered into in the State of Florida,and shall he 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 he 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 1.
7.3.2 The Contractor shall provide units of deliverables, including reports. findings, and drafts, as specified in
Attachment i, to be received and accepted by the DOEA 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 1,Section Ill. Method of Payment.
7.3.4 The Contractor shall submit bills for tees or other compensation for services or expenses in sufficient detail
for a proper pre-audit and post-audit.
0
Page 2 of 50
169E
(October 2021 June 2023) XQ103
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 Department 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 Department 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 Fist,or if the Contractor has been engaged in business operations
in Cuba or Syria or is engaged in a boycott of Israel.
8. 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 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
Department within thirty(30)days of execution of this contract. Should the Department 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
https://el de raffa i rs.org/about-us/backgrou nd-sc reen i n g'
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. Public 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 Department to perform the contracted services.
10.1.2 Upon request from the Department's custodian of public records, provide the Department 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 Department.
10.1.4 Upon completion of'the contract,the Contractor will either transfer,at no cost to the Department,all public
records in possession of the Contractor to the Department or will keep and maintain public records required
by the Department. lithe Contractor transfers all public records to the Department upon completion of the
contract,Contractor shall destroy any duplicate public records that are exempt.or confidential and exempt,
Page 3 of 50
1602
(October 2021 -- June 2023) XC)103
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 Department in a format that is compatible
with the information technology systems of the Department.
10.2 'Elie Department 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 1 1 9.07(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
Florida Department of Elder Affairs
4040 Esplanade Way
Tallahassee,Florida 32399
850-414-2114
doea pu b l icrecordsaeldera ffa i rs.org
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 Department,transfer all public records in their possession
to the Department 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 Department in a
format that is compatible with the information technology systems of the Department.
11. Audits, inspections,Investigations:
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 Department 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
Department.
11.3 Upon demand,at no additional cost to the Department.the Contractor shall facilitate the duplication and transfer
of any records or documents during the required retention period.
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 Department.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Department and
federal auditors,pursuant to 45 C'FR Part 75,shall he 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 Department 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
OVD
Page 4 of 50
1 6 D 2
(October 2021 June 2023) XQ103
cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant to
Section 20.055(5), F.S. E3y, execution of this contract the Contractor understands and will comply with this
subsection.
11.8 In accordance with Executive Order 20-44 which requires executive agencies to submit a list of entities named
in statute with which a state agency must form a sole-source,public-private agreement or an entity that,through
contract or other agreement with the state,annually receives 50%or more of their budget from the State or from
a combination of State and Federal funds.Any Contractor that meets one or both of the criteria listed must submit
an annual report, including the most recent IRS Form 990, detailing the total compensation for the entities'
executive leadership teams within thirty (30)days of execution of this contract.
11.8.1 The report must include total compensation including salary,bonuses,cashed-in leave,cash equivalents.
severance pay, retirement benefits,deferred compensation,real-property gifts,and any other payout,
t 1.8.2 The Contractor shall inform the agency of any changes in total executive compensation between the
annual reports as those changes occur.
11.8.3 All compensation reports must indicate what percent of compensation comes directly from the State or
Federal allocations to the contracted entity.
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 Department 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. Monitoring by the Department:
'The Contractor shall permit persons duly authorized by the Department 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 Department of the satisfactory
performance of the terms and conditions of this contract. Following such review,the Department 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 Department's Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
cc )
Page 5 of 50
16D2
(October 202I June 2023) XQ103
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
Department, then a joint monitoring visit including such other agencies may he 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, 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 Department within ten(I0)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) contracting 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 commodity or 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
Contractor shall complete the Contractor's State Contracts List attached to this contract.
17. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Department and its agents and employees from
any and all claims, demands, actions, and causes of action of whatever nature or character arising out or, 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 Department for claims, demands, actions, or causes of action arising
solely out of the negligence of the Department.
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 Department 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 extensions) 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 Department 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 Department 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 trader 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. Confidentialitl 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. Health Insurance Portability and Accountability Act:
Where applicable, the Contractor shall comply with the Health insurance Portability and Accountability Act of 1996,
Public l.aw 104-191,as well as all regulations promulgated thereunder(45 CFR Parts 160, 162,and 164).
21. Incident Reporting:
21.1 "Hie Contractor shall notify the Department 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
Page 6of50
16De
(October 2021 --June 2023) XQ103
ability to perform the services required to be performed under this contract. Such notice shall he made orally to
the Department'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. Bankruptcy Notification:
During the term of this contract,the Contractor shall immediately notify the Department 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 Department: (l)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., Northern District of Florida.
Tallahassee Division):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)and the State of Florida. Department of Elder Affairs." If the sponsorship reference is in written material,
the words"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 "State of Florida, Department of Elder Affairs"to indicate sponsorship
of a program otherwise financed,unless specific written authorization has been obtained by the 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 Department. Any sublicense, assignment.or transfer otherwise occurring without prior written
approval of the Department shall constitute a material breach of the contract. in the event the State of Florida
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 The State of Florida is,at all times,entitled to assign or transfer, in whole or part,its rights,duties,or obligations
under this contract to another governmental agency in the State of Florida upon giving prior written notice to the
Contractor.
24.3 This contract shall remain binding upon the successors in interest of the Contractor and the Department.
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 Department deems necessary. The Contractor
further agrees that the Department will not be liable to the Subcontractor in any way or for any reason. The
Contractor,at its expense.shall defend the Department against any such claims.
25.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Department or other
state agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585,1'.5., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
26. Independent Capacity of Contractor:
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 Department, and that they shall not hold themselves out as employees or
agents of the Department without prior specific authorization from the Department. It is the further intent and
understanding of the Parties that the Department 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
CND
Page 7 of 50
16D2
(October 2021 -- June 2023)
XQ103
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. Payment:
Payments shall be made to the Contractor for all completed and approved deliverables (units of service)as defined in
Attachment I. The DOEA 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 hid specifications,purchase order,or this contract specify otherwise. The approved invoice will be submitted to the
Department'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 800-342-2762.
28. Return of Funds:
The Contractor shall return to the Department 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 Department. 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
Department. In the event that the Department first discovers an overpayment has been made, the DOEA Contract
Manager will notify the Contractor in writing of such findings. Should repayment not be made forthwith,the Contractor
shall he charged at the lawful rate of interest on the outstanding balance pursuant to Section 55.03.F.S.,after Department
notification or Contractor discovery.
29. Data Integrity and Safeguarding Information:
i he 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. Social Media and Personal Cell Phone use:
30.1 Inappropriate use of social media and personal cell phones may pose risks to DOP.A's confidential and proprietary
information and may jeopardize compliance with legal obligations. By signing this contract,Contractor agrees to
the following social media and personal cell phone use requirements.
30.2 Social Media Defined. The term Social Media and /or personal cellular communication includes. hut is not
limited to. social networking websites, blogs, podcasts, discussion forums, RSS feeds, video sharing. SMS
(including Direct Messages (DMs), iMessages, text messages, etc.); social networks like Instagram, TikTok,
Snapchat, Google Hangouts, WhatsApp, Signal, Facebook, Pinterest,and Twitter;and content sharing networks
such as Flickr and YouTube. This includes the transmission of social media through any cellular or online
transmission via any electronic,interim, intranet,or other wireless communication.
30.3 Application to any direct or incidental DOEA or other state business. This contract applies to any DOEA or
other state business conducted on any of the Contractor's, Subcontractor's, or their employees' social media
accounts or through personal cellular communication.
30.4 Application to DOEA and Contractors Equipment. This contract applies regardless of whether the social
media is accessed using I)ORA's I'i' facilities and equipment or equipment belonging to Contractor,
Subcontractor, or their respective employees. Equipment includes, hut is not limited to, personal computers,
cellular phones,personal digital assistants,smart watches,or smart tablets.
30.5 Florida Government in the Sunshine, Florida I'uhlic Records Law,and HIPAA. Contractor acknowledges
that any DOEA or other state business conducted by social media or through personal cellular communication is
subject to Florida's Government in the Sunshine law, Florida's Public Records Law (Chapter 119. Florida
D
Page 8 of'5t1
16D2 .
(October 2021 -June 2023) XQ i 03
Statutes),and the Health Insurance Portability and Accountability Act(HIPAA).Compliance with these laws and
other applicable laws are further detailed in the contract.
30.6 Prohibited or Restricted Postings. Contractors may not take or post photos or videos of, or include names or
identifying information, about any of DOFA's clients. Any social media posts which include photos, videos, or
names of volunteers. staff. or other affiliates of DOEA may only he posted with the permission of those
individuals. Any such posts related to volunteer service at DOEA may only include individuals over the age of
18.
30.7 Assist DOEA with Communications. Contactors may be asked periodically to assist in distributing certain
DOLA communications through their social media outlets. Any such requests should be posted in adherence to
the social media requirements herein and the other provisions of this contract.
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
be involved. Such a conflict would arise when:(a)the employee,officer or agent;(h)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 Department any relationship which may he. 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 Contractor'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 List following a
conviction for a public entity crime may not submit a hid, 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. Purchasing:
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 SEA LE. BE PURCI EASES)FROM
A NONPROFIT AGENCY FOR THE BLIND OR FOR THE SEVERELY HANDICAPPED THAT IS
QUALIFIED PURSUANT TO CHAPTER 413,FLORIDA STATUTES,IN THEE,SAME MANNER AND
UNDER THE SAME PROCEDURES SET FORTH IN SECT ION 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.
33,1.2 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.
010
Page 9 of 50
16D2
(October 2021 - June 2023) XQ 103
33.1.3 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 Department 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 Service 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.
33.3.1 IF IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES WHICH ARE THE
StJBJEC'T OF,OR REQUIRED TO CARRY OUT.THIS CONTRACT SI TALL 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.org/.
33.4 The Contractor shall provide a Certified Minority Business Subcontractor Expenditure (CMBE) Report
summarizing the participation of certified suppliers for the current reporting period and project to date. The
CMBE Report shall include the names, addresses, and dollar amount of each certified participant, and a copy
must he forwarded to the Department, Division of Financial Administration, and must accompany each invoice
submitted to the Department. The Office of Supplier Diversity(850-487-0915)will assist in furnishing names of
qualified minorities. The Department's Minority Coordinator (850-414-2153) will assist with questions and
answers. The CMBE Report is attached to this contract.
34. Patents,Copyrights, Royalties:
If this 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 Department to be referred to the 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). E.S., the only exceptions to this provision shall be those that are clearly expressed
and reasonably valued in this contract.
34.1 lithe 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 ot'the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Department
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.
010
Page 10 of 50
16D2
(October 2021 - June 2023) XQ103
35, Emergency Preparedness and ('ontinuits-of Operations:
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 DOEA Contract Manager,
verification of an Emergency Preparedness Plan. in the event of an emergency, the Contractor shall notify the
Department 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 (i)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].
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.'i'lie property records must
be maintained on file and shall be provided to the Department upon request. The Contractor shall promptly
investigate,fully document,and notify the DOEA Contract Manager of any loss, damage,or theft of equipment.
The Contractor shall provide the results of the investigation to the DOEA 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.N 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 he investigated. 45 CFR §75.320(d)(3).
36.3.12 Adequate maintenance procedures must he developed to keep the property in good condition.
O )
Page I I of 50
1 6 D 2No
(October 2021 June 2023) XQ 103
36.3.13 If the Contractor is authorized or required to sell the equipment, proper sales procedures must he
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 C'FR Part 75.
36.5 The Contractor shall not dispose of any equipment or materials provided by the Department or purchased with
funds provided through this contract without first obtaining the approval of the DOEA Contract Manager. When
disposing of property or equipment the Contractor must submit a written request for disposition instructions to
the Department'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
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 DORA 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 Department. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42,Chapter 35,Subchapter Ill,
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 Department's procedures and standards when purchasing Information
Technology Resources (1TR) as part of any agreement(s) incorporating this contract by reference. An 1TR
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 lTR
worksheet shall be maintained in the LAN administrator's file and must be provided to the Department upon
request,The Contractor has the responsibility to require any Subcontractors to comply with the Department's 1TR
procedures.
37. I'UR 1000 Form:
I he Pt IR 1000 Form is hereby incorporated by reference and available at:
http://dms.myflorida.com/purchasing
In the event of any conflict between the Pt.tR 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 arc required by any section of the Florida Statutes,the terms or conditions contained
in the PUR 1000 Form shall take precedence.
38. Use of State Funds to Purchase or improve ReaI I'rr,pertv:
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 slate 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.
Page 12 of 50
1602
(October2021 --June 2023) XQI03
39. Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the[X)IA Contract Manager,who shall reduce
the decision to writing and serve a copy on the Contractor.
40. Financial Consequences:
lithe Contractor tails to meet the minimum level of service or performance identified in this contract, the Department
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 Leon County. Florida.
43. Entire Contract:
'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 Department or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
44. Force Maieure:
The Parties will not he 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 Clause:
'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. C onditnn Precedent to Contract Appropriations:
The Parties agree that the Department'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 Department 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:
I he delay or failure by the Department to exercise or enforce any of its rights under this contract will not constitute or
be deemed a waiver of the Department'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 Department.
50. Final Invoice:
The Contractor shall submit the final invoice for payment to the Department no later than thirty (30) days after 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 Department 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 Department.
01'
Page 13 of 50
1 6
(October 2021 June 2023) XQ103
51. Renctotiations of Modifications:
Modifications of the provisions of this contract shall he 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 Department's operating budget.
52. Suspension of Work:
The Department may, in its sole discretion, suspend any or all activities tinder the contract or purchase order, at any
time, when in the interest of the State to do so. The Department 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
agreed to by the Contractor, the Department shall either: (I) 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 Department,by written notice to the Contractor,may terminate this contract
in whole or in part when the Department 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 Department 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 ofa 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 he 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 he the same as if the termination had been issued for the convenience of the
Department. The rights and remedies of the Department 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 Department authorizes, hut 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,C'hapter 119. F.S.;must comply with contract Section 29, Data
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must he 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 Department's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Department. The Contractor is authorized to conduct electronic transactions with the
Department only upon further written consent by the Department.
54.2 Upon request by the Department,the Contractor shall provide the Department with non-electronic(paper)copies
of records. Non-electronic (paper)copies provided to the Department of any document that was originally in
Page 14 of 50 �
1602
(October 202I June 2023) XWI033
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 Manager:
The Department may substitute any Department employee to serve as the DC)F?A Contract Manager.
REMAINDER OF THE PAGE INTENTIONALLY LEFT RANK
Page 15 of 50
1 6 D 2
(October 2021 —June 2023)
XQ103
56.Official Payee and Representatives(Names,Addresses,and Telephone Numbers_
The Contractor name, as shown on page 1 of this Collier County Board of County
a. contract, and mailing address of the official payee to Commissioners
3299 Tamiami Trail Fast, Bldg. F'Suite 403
whom the payment shall be made is:
Naples. FI.. 34112
The name of the contact person and street address Maggie Lopez
b. where financial and administrative records are 3339 East Tamiami Trail, Bldg. H, Suite 211
maintained is: Naples. FL.34I 12
The name,address,and telephone number of the Tami Bailey
c. representative of the Contractor responsible for 3339 East Tamiami frail, Bldg. H.Suite 211
administration of the program under this contract is: Naples, FL. 34112
239-252-5218
The section and location within the Department where Florida Department of Elder Affairs
d. Requests for Payment and Receipt and Expenditure Division of Financial Administration
forms are to be mailed is: 4040 Esplanade Way, Suite 215
Tallahassee, Florida 32399-7000
Josh Register, FCCM
The name, address, and telephone number of the 4040 Esplanade Way,Suite 250G
C.
Contract Manager for this contract is: Tallahassee, Florida 32399-7000
850-414-2148
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 I - XIII, 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 fitly (50) page contract to be executed by their
undersigned officials as duly authorized.
CONTRACTOR: STATE OF FLORIDA,
COLLIER COUNTY D O ()UN DEPARTMENT OF ELDER AFFAIRS
COMMISSION At
heae itaehaw
SIGNED BY:
SIGNED BY:Michelle Branham(Feb 17,202209:51EST)
NAME:_ Williant L. McDaniel, Jr., NAME: MICHELLE BRANHAM
TITLE: Chairman TITLE: SECRETARY
DATE: t '.Z.S t ka DATE: Feb 17,2022
Federal Taxi LOr59ii50005$�
Duns:07695l�1790 Approved as to Form and leg,dl
•
��`�'"`�� Ass ant County A riicy `y
•
'''Attest as t al lan s Page 16 of 50
signature anty. `�
160 'Z
(October 2021 - June 2023)
INDEX OF ATTACHMENTS
ATTACHMENT I
ttt
,STATEMENT OF WORK
18
ATTACHMENT II
24
F'INANC'IAL AND('OMPLIANC'EAUDIT
ATTACHMENT III 30
30
CERTIFICATIONS IC'ATIONS AND ASSURANCES
30
ATTACHMENT IV
35
ASSURAN('FS--NON-CONSTRUCTION PROGRAMS
35
ATTACHMENT V
37
FLORIDA DEPARTMENT OF ELDER AFFAIRS C'IY11. RIGHTS COMPLIANCE CHECKLIST 37
ATTACHMENT VI
41
CONTRACTOR s S'7A"!'E CONTRACT LIST
-11
ATTACHMENT VIII
43
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES(C"MBE FORM)
43
ATTACHMENT IX
45
STATEMENT OF USE OF FUNDS(ESTIMATED BUDGET)
45
ATTACHMENT X
47
RECEIPTS AN!)EXPENDITURE REPORT FI EI, "•1PITAL OUTLAY. 47
ATTACHMENT XI
48
COST REIMBURSEAfENT SUMMARY FORM
48
ATTACHMENT XII
49
REQUEST FOR PA)MENT FIXED CAPITAL OUTLAY 49
ATTACHMENT XIII
50
I/ EDD('4EMI OUTLAY CERTIFICATION SO
Page 17 cif 50
1 6 D
(October 2021 June 2023)
XQ103
ATTACHMENT I
STATEMENT OF WORK
I. SERVICES TO HE PROVIDED
A. Definitions of Terms
1. DOEA Florida Department of Elder Affairs.
2. CCBCC -Collier County Board of County Commissioners
B. General Description
I. General Statement- The 2021-2022 General Appropriations Act, Specific Appropriation 397A, has
appropriated$250,000,00 to Collier County Board of County Commissioners,to harden and expand the
existing Golden Gate Senior Center in Collier county. This funding will support the Professional Engineering
and Architectural services needed to expand and improve the Golden Gate Senior Center. Local and Federal
funding will he used to complete the construction and improvements. CCBCC owns the Golden Gate Senior
Center that is being improved in Naples. Florida.
2. Authority-All applicable state and federal laws,regulations,action transmittals, program instructions, review
guides and similar documentation related to the following:
a. Chapter 430,Florida Statutes(F.S.)
b. 2021-2022 General Appropriations Act. Specific Appropriation 397A
3, Scope of Work—The funds appropriated will be used for professional services and consulting needed to design,
improve and expand the Golden Gate Senior Center. Design and construction plans will be produced by a
licensed Architect or Engineer. The funds will support all professional services needed for the design portion
of the project and other funding that is not part of this contract will he used for the construction portion.
Professional services will include design and schematics,construction documents,construction administration,
and Architect or Engineer consulting for the Golden Gate Senior Center. The Contractor shall perform the
work as specified below in Section 11. Manner of Service Provision.
II. MANNER OF SERVICE PROVISION
A. Service Tasks,Deliverables and Performance Measures-All goods and services reimbursed through this contract
must be for professional services to design. improve, or expand the Golden Gate Senior Center in Collier County,
located at 4898 Coronado Parkway in Naples. Florida. The Contractor must adhere to the Statement of Use of
Funds(Estimated Budget)included as Attachment IX to this contract. The Attachment IX line-item amounts shall
only be adjusted with prior written approval from the DOEA Contract Manager.The approved line-item adjustment
must include a revised Attachment iX and written amendment to this contract for any line-item changes)greater
than fifteen percent(15%), with the total amount of all line items not to exceed the total amount found on page one
(1)of this contract,as appropriated.In performing all work utilizing the funds allocated to the project,the Contractor
shall ensure that all subcontractors fully comply with all applicable local. state, and federal laws, rules, and
regulations.
1, Service Task: Security interest in the Property
A security interest in the property will he obtained:
a. Security Interest-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 completion of the improvements. or as
further required by law. A Security interest (Attachment XIII)must he tiled with the court, in the county
the property is located on, by the owner of the property and a copy provided to the DOEA Contract
Manager.
Page 18 of 50 C�
160
(October 2021 --June 2023)
XQ103
2. Service Task: Professional Services
Professional services for the Center shall include:
a, Design and Schematics- Engineer,Architect,and Consultant tees needed to design and produce plans for
the Golden Gate Senior Center.
b. Construction Documents- All costs associated with construction documentation for the Golden Gate -
Senior Center.
r. Construction Administration-All costs associated with construction administration for the Golden Gate
Senior Center.
d. Consulting-All Architectural. Engineering,and Special consulting needed for the Golden Gate Senior
('enter.
3, Deliverables,Source Documentation & Performance Measures
The Contractor must complete all tasks listed in Sections tl.A.l-2. above and shall comply with the
requirements stated in the Deliverables Table provided in this section (Section It.A.3.). The Contractor must
submit all required documentation in the time and manner specified in the Deliverables Table to meet the
minimum performance levels required. Each deliverable must he accepted in writing by the DOEA Contract
Manager based on the requirements for each deliverable before the Contractor submits an invoice requesting
payment.
Page 19 of 50 C"
1 6 D 2 4
(October 2021 June 2023)
X Q 103
Deliverables Table
Deliverable 1—Security Interest in the Property
Service Task Mini
mum Level of Service Financial Consequences
Security Interest in the Granting to the state a security interest in Failure to grant a security interest in
Property-Granting to the state a the property'at least to the amount of state the property will result in
security interest in the property as funds provided for at least five(5)years termination of this contract.
stated in Section II.A.I from the date of purchase,completion of
the construction receiving a certificate of Failure to file with the court will
occupancy,or as further required by law. result in termination of the contract.
A Security Interest(Attachment XIIi) Reimbursements to contractor will
must be filed with the court, in the county not he paid until a security interest is
the property is located on, by the owner of granted to the state and a copy is
the property,and a copy provided to the received by D{.)LA Contract
DOEA Contract Manager. Manager.
Deliverable 2—Professional Services
Service'task Minimum Level of Service Financial Consequences
Professional Services- Contractor shall complete a minimum of Failure to perform the work as stated
Completion of all professional one(1)task listed in Section 1I.A.2. to in Section Il.A.2 or to submit the
services for the Center as stated in submit for reimbursement.
section II.A.2 required documentation will result in
non-payment.
The Contractor must obtain certification
from the licensed Engineer or Architect Failure to complete the minimum
using AlA Forms G702 and G703.or level of service will result in non-
their equivalents.certifying what portion payment.
of each task is completed for
reimbursement. Invoices for work or services
performed outside the Term of
As evidence of task completion,the Contract timeframe provided on page
Contractor shall submit to the DOEA one(I)of this contract(Standard
Contract Manager the following required Contract, Section 3.Term of
documentation, as stated in Section 111.D.: Contract)will not be paid.
• Licensed Architect or Engineer
certification using AIA Forms G702
and G703,or their equivalent.
• Required DOEA forms.
• Required invoice documentation.
• Signed attestation.
• Detailed vendor invoices.
• Proof of Payment documentation;and
• CMBE expenditure report
(Attachment VIII)
Deliverable 2 F'timatcdl 13ntl it S251),000.00
_ I oat Contract :11nUlittt-$250,000.00
4. Task Limits— The Contractor shall not perform any tasks related to the project other than those described in
this contract without the prior express written consent of the Department.
5. Reports- The Contractor shall respond within ten (10) business days to the Department's request for routine
and/or special requests for information and ad hoc reports. The Contractor must establish due dates for any
subcontractors that permit the Contractor to meet the Department's reporting requirements.
Page 20 of 50
'yCe
16D2
(October 2021 -June 2023) XQ103
6. Records and Documentation- The Contractor shall make available to Department staff and/or any party
designated by the Department, 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 Department. Maintenance includes valid exports and backups of all data and systems
according to Department standards.
R. Staffing Requirements
1. Staffing Levels-The Contractor shall assign its own administrative and support staff as needed to perform the
tasks,responsibilities,and duties under the contract. It is the Contractors responsibility to ensure subcontractors
have the appropriate staff needed to perform the tasks, responsibilities,and duties under this contract.
2. Professional Qualifications- The Contractor shall ensure that all subcontractors and/or vendors performing
work related to this contract are certified and/or have licenses in the trade area in which work is being
performed,as required by state and federal law. A licensed Architect/Engineer must sign off on all construction
plans associated with this contract.
3. Staffing Changes- Any employee whose continued presence would he detrimental to the success of this
contract as determined by the Department shall be replaced by the Contractor with an employee of equal or
superior qualifications.The DOEA Contract Manager shall exercise judgment in this matter as approved by the
Department.
4. Subcontractors-The Contractor is permitted to use subcontractors to perform work as required by this contract.
C, Service Location and Equipment
I. Location- All work required by this contract must be performed for the location specified in Section 11.A,
specifically the Golden Gate Senior Center. located in Collier County, Florida.
2. Service Times- Work can begin upon execution of this contract. All work associated with this contract must
he performed on or before June 30, 2023.
3. Changes in Location-The Contractor shall receive written approval from DOEA's Contract Manager prior to
making any changes in location. Any request to change location shall he made in writing to the DOE A Contract
Manager and Contractor must receive written approval back approving such change.
4. Equipment- The 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.
1). Contractor Responsibilities
I. Contractor Unique Activities-All tasks listed above in Section II.are solely and exclusively the responsibility
of the Contractor and are tasks for which, by execution of this contract, the Contractor agrees to be held
accountable.
2. Coordination with 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.
E. Department Responsibilities
I. Department Obligations-The Department may provide technical support and/or assistance to the Contractor
within the resources of the Department to assist the Contractor in meeting the requirements of this contract.
'the Department's support and/or assistance, or lack thereof, shall not relieve the Contractor from full
performance of contract requirements.
Page 21 of 50
(October 2021 June 2023) XQ I03
2. Department Determinations-The Department reserves the exclusive right to make certain determinations in
the tasks performed and approaches used to perform those tasks. The absence of the Department setting forth
a specific reservation of rights does not mean that all other areas of the contract are subject to mutual agreement.
F. Monitoring and Evaluation Methodology-The Department shall review and evaluate the performance of the
Contractor under the terms of this contract.Monitoring shall be conducted through direct contact with the Contractor
through telephone, in writing.or on-site visit. The primary,secondary,or signatory of the contract must be present
for any on-site programmatic monitoring visit. The Department reserves the right to conduct an unannounced on-
site visit by persons duly authorized by the Department. The Department's determination of acceptable
performance shall he final. The Contractor agrees to cooperate with the Department in monitoring the progress of
completion of the service tasks and deliverables.The Department may use, but is not limited to,one or more of the
following methods for monitoring:
• Desk reviews and analytical reviews;
• Scheduled, unscheduled and follow-up on-site visits;
• Client visits;
• Review of independent auditor's reports:
• Review of third-party documents and/or evaluations:
• Review of progress reports;
• Agreed-upon procedures review by an external auditor or consultant;
• Limited-scope reviews;and/or
• Other procedures as deemed necessary
III, METHOD OF PAYMENT
A. Payment Method Used-This is a Cost Reimbursement contract for funds appropriated by the Florida legislature.
The total contract amount may not exceed the amount found on page one(i)of this contract, as appropriated. The
Department will pay the Contractor upon satisfactory completion of the Tasks/Deliverables,as specified in Section
II.A.,and in accordance with the terms and conditions of this contract.
B. Unit of Service - Payment may be authorized only for allowable expenditures, which are in accordance with the
service tasks and deliverables specified in Section II.A. and the Statement of Use of Funds (Estimated Budget)
(Attachment iX). The Contractor must meet the minimum level of performance stated in this contract in order to
receive payment.
C. Final Invoices-Final contract invoices must be submitted to the Department by Contractor within thirty(30)days
atter expiration of the contract.
D. Invoice Instructions and Required Documentation-Payment shall he made upon Contractor's presentation of an
invoice subsequent to the acceptance by the Department of the deliverables shown on the invoice. Funds paid
and/or reimbursed to the Contractor must be in line with the approved estimated budget. When submitting an
invoice for reimbursement.the Contractor shall submit the following information and evidence of completion:
1. MA Forms G702 and G703-A certification by the licensed Engineer or Architect using AlA forms G702 and
(r703,or their equivalents,certifying that the task is complete.
2. Required DOEA Forms - All requests for reimbursement must be submitted to the Department using the
Receipts and Expenditure Report Fixed Capital Outlay (Attachment X). the Cost Reimbursement Summary
Form (Attachment Xi),and the Request for Payment Fixed Capital Outlay(Attachment XII).
3. Required Invoice Documentation - Each Contractor invoice must identify the deliverable or line item for
which payment is being requested,the current contract number,an invoice number,the amount being requested
for reimbursement,and the"Remit to"address exactly as it appears in this contract.
CP
Page 22 of SONG
1602
(October 2021 ---June 2023) X(71(13
4. Attestation - The following attestation, signed by the Contractor's representative, must be included with each
invoice submitted by the Contractor:"I hereby certify that the goods and/or services have been received and/or
accepted."
S. Vendor Invoices)- The Contractor shall submit a detailed vendor invoices)that totals the same amount listed
in the Contractor's invoice. Invoices must include dates and total amount being invoiced.
6. Proof of Payment-This can be a copy of a payment instrument,check number,accounting department detail
sheet, or other documentation, as long as the detailed information corresponds to the copies of the vendor
invoices.
7. Certified Minority Business Expenditure(CMBE) Report Deliverable(Attachment VIiI)-This is
considered a deliverable and must he completed in its entirety and submitted with each invoice.
E. Financial Consequence - Failure to pertiomt the services as stated in Section Ii.A. or to submit the required
documentation will result in non-payment. Invoices for work or services performed outside the timeframe provided
by the term of this contract, as stated on page one (I) of this contract (Standard Contract. Section 3. Term of
Contract), will not be paid.
IV. SPECIAL PROVISIONS
A. Budget Modifications - The Contractor must adhere to the Statement of Use of Funds (Estimated Budget)
(Attachment IX). The Attachment IX line-item amounts shall only be adjusted with prior written approval from the
I)OIA Contract Manager. The approved adjustment must include a revised Attachment IX and a written
amendment to this contract for any line-item change(s)greater than fifteen percent(15%),with the total amount of
all line items combined not to exceed the total amount on page one(I)of this contract,as appropriated.
B. General Procurement Standards-Contractor shall not order equipment or supplies,provide services.or perform
any other action related to this contract until notified in writing that this contract has been executed by the
Department.These same actions shall not take place after the contract has expired.
C. Contract Modifications - The IX)EA Contract Manager has the authority to modify and/or extend deliverable
deadlines. All deliverable extension requests must be made to the DOEA Contract Manager, in writing,thirty(30)
days prior to the required deadline. All approvals for deliverable extensions must be communicated, in writing,by
the DOEA Contract Manager to the Contractor and are subject to the discretion of the Department. The request and
the approval must occur prior to the established deadline. An e-mail writing(request and response) is considered
acceptable,
D. Security interest - Pursuant to section 287.05805, F.S., and Section 38 of the Standard Contract, the Contractor
shall execute and deliver a security interest(Attachment XI I1)or other appropriate document to the DOEA Contract
Manager prior to receiving any funds under this contract. Requirements stated in this section are considered service
tasks and deliverables.The Contractor's failure to meet this provision will result in non-payment and/or immediate
termination of this contract.
END OF ATTACHMENT 1
Page 23 of 50 f��3 0
16D. 2
(October 2021 -June 2023) XQ 103
ATTACHMENT Ii
FINANCIAL ANI)COMPLIANCE AUDIT
The administration of resources awarded by the Department to the Contractor may be subject to audits and/or monitoring
by the Department,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-Al oils" below), monitoring procedures may include, but not he limited to,on-site visits
by the Department 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 Department. In the event
the Department determines that a limited scope audit of the Contractor is appropriate,the Contractor agrees to comply with
any additional instructions provided by the Department 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 Department 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 Department. The determination of amounts of Federal awards expended
should be in accordance with 2 CFR Pan 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 I, 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 Department 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 Department shall he fully
disclosed in the audit report with reference to the Department contract involved. If not otherwise disclosed as required by
2 ('FR § 200.510, the schedule of expenditures of federal awards shall identity expenditures by contract number for each
contract with the Department in effect during the audit period. Financial reporting packages required under this part must
be submitted within the earlier of 30 days alter receipt of the audit report or 9 months after the end of the Contractor's fiscal
year end.
PART iI:STATE FUNDED
•
'=eft
Page 24 of 50
1602
(October 2021 - June 2023) XQ103
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 Department 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 Department, 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(8), 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, U.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 he 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 Department 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 Department shall be fully disclosed in
the audit report with reference to the Department contract involved. If not otherwise disclosed as required by Rule 691-
5.003, F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for
each contract with the Department in effect during the audit period. For local governmental entities, financial reporting
packages required under this part must he 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 Department retains all right and
obligation to monitor and oversee the performance of this contract as outlined throughout this document and pursuant to
law.
PART HI: REPORT SUBMISSION
Copies of financial reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Pan I of
this Financial Compliance Audit Attachment,shall he 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 10'''Street
,ieffersonvillc, 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 directly to the Department.
co
Page 25 of 50
16112
(October 2021 -- June 2023) XQIO3
Florida Department of Elder Affairs
Attn: Audit Repository
4040 Esplanade Way,Suite 235S
Tallahassee,Florida 32399-7000
Additionally, copies of financial reporting packages required by this contract's Financial Compliance Audit Attachment,
Part II,shall he submitted by or on behalf of the Contractor directly to each of the following:
The Department at the following address:
Florida Department of Elder Affairs
Mtn: Audit Repository
4040 Esplanade Way,Suite 235S
Tallahassee,Florida 32399-7000
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 Department 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 Department 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 1V: 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 Department or its designee, the (TO, or Auditor
General access to such records upon request. The Contractor shall ensure that audit working papers are made available to
the Department or its designee.CFO.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 Department.
C NC)
Page 26 of 50
1 6 D 2
(October 2021 -June 2023) XQ I I ;
ATTACHMENT II-EXHIBIT 1
PART 1: AUDIT RELATIONSHIP DETERMINATION
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 II of Exhibit I are met. Contractors who have been determined to he 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 he 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 department 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, Local Governments,and Indian Tribes*
2 CFR §200.201 - Administrative Requirements**
2('FR § 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 Ciuide 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
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§200.400(5)(c).
Page 27 of 50 ('��
i6D2
(October 2021 -•June 2023) XQ103
**For funding passed through U.S. Health and lluman 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 he 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
Referenee Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules,and regulations
Page 28 of 50
1 6 D 2
(October 2021 June 2023) XQ 10,
ATTACHMENT II-EXHIBIT 2
FUNDING SUMMARY(2021-2023)
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 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.
I. FEDERAL RESOURCES AWARDED TO THE SIJBRECII'IENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
. ..... .....................
GRANT
AWARD(F:AIN#): FEDERAL AWARD DATE:
DUNS NUMBER:
PROGRAM 'I I l I.E FUNDING SOURCE CFDA AMOUNT
TOT: I. FEDERAL .AWARD
COMPLIAN('I. Riot IRE MENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS COMER ACT 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 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
To FAl. til \'iI \\\ kill)
I'I N 'IAL ASSISTANCE SUBJECT TO SECTION 215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
hate Senior Center The 2021-2022 General Appropriations Act,
Specific Appropriation 397.A 65.013 $250,000.00
101 AL .AAA AIM $250,000.00
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
f.o
Page 29 of 50
1602
(October 202 I —June 2023) M.,t 1 t)3
ATTACHMENT III
CERTIFICATIONS ANI)ASSURANCES
DOEA 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 Certification (29('FR Part 95 and 45 CFR fart 75)
B. Certification Regarding Lobbying t29('FR fart 93 and 45('FR Part 93)
C. Nondiscrimination& Equal Opportunity Assurance(29 CFR Part 37 and 45 CFR Part 80)
I), Certification Regarding Public Entity Crimes,section 287.133,F.S.
E. Association of Community Organizations for Reform Now(ACORN) Funding Restrictions Assurance
(Pub. L. III-1 l7)
F. Scrutinized Companies Lists and No Boycott of Israel Certification,section 287.135, F.S.
C, Certification Regarding Data Integrity Compliance for Contracts, Agreements, Grants, Loans, and
Cooperati<<• Agreements
H. Verification of Employment Status Certification
I. Records and Documentation
,t. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS—PRIMARY COVE:RED TRANSACTION.
'the undersigned Contractor certifies, to the best of its knowledge and belief,that it and its principals:
I. Are not presently debarred, suspended, proposed for debarment, declared ineligible. or voluntarily excluded from
covered transactions by a Federal department or agency;
2. !lave 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 Stale
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
connection with the awarding of any Federal contract.the making of any Federal grant.the making of any Federal loan,
c?'CI
Page 3t)of50
1 6 D 2
(October 2021 --- June 2023) X(,)I 03
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 he 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 - [FL, '`Disclosure Form to Report
Lobbying,"in accordance with its instructions.
The undersigned shall require that language of this certification he 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 he subject to a civil penalty of not less than
S 10,000 and not more than$100,000 for each such failure.
C. NON-DISCRIMINATION& EQUAL OPPORTUNiTY ASSURANCE(29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race,color,religion,sex, national origin. age,disability,
political affiliation,or belief.and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title i-financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964(Pub.L. 88-352).as amended,and all requirements imposed by or pursuant
to the Regulation of the Department of Flealth 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.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. 1.. 93-1 12), 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 Department.
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.
he excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Department.
5. Title IX of the Education Amendments of 1972(Pub. L. 92-318),as amended,and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services(45 CFR Part 86), to the end that, in
accordance with Title iX and the Regulation, no person in the United States shall,on the basis of sex,be excluded
from participation in. be denied the benefits of. or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Department.
6. The American with Disabilities Act of 1990(Pub. I.. 101-336), which prohibits discrimination in all employment
practices including job application procedures,hiring,firing.advancement,compensation,training,and other terms,
conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits,and all other employment-related activities.
7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws
listed above. This assurance applies to Contractor's operation of the WIA Title I -- financially assisted program or
activity,and to all contracts Contractor makes to carry out the WIA'title 1-• financially assisted program or activity.
C:NC)
Page 3 I of 50
16a2
(October 2021 —June 2023) XQ103
Contractor understands that IX)F:A 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 DOFA immediately upon any change of circumstances
regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE(Pub. L. II 1-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act,20I0,Division E.Section 5 1 1 (Pub.
I,. 111-117). The Continuing Appropriations Act, 2011. Sections 101 and 103 (Pub. 1.. 111-242), provides that
appropriations made under Pub. L. 1 1 1-117 are available under the conditions provided by Pub. L. 1 1 1-1 17.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers(including subcontracts,sub-grants and contracts under grants,loans and cooperative agreements)and that all sub-
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION,SECTION
287.135, F.S.
in accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized
Companies that Boycott Israel List and that it is not 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, P.S.,
Contractor hereby certities 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, T.S.. the submission ofa false certification may result in the
Department terminating this contract and the submission ofa 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 lbr each award. The inability to process information in accordance with these requirements
could result in a return of grant funds that have not been accounted for properly.
2, Management Information Systems used by the Contractor, Subcontractors,or any outside entity on which the
Contractor is dependent for data that is to he reported,transmitted,or calculated have been assessed and verified
Page 32 of 50
1602
(October 2021 -,tune 2023) XQ103
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.
5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Department,Contractor certifies the use of the U.S. Department of liomeland
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 t verify
system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract
term.
Fite 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-1 10).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Department staff and/or any party designated by the Department 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 Department. Maintenance
includes valid exports and backups of all data and systems according to Department standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
I. in addition to the requirements of Section 10 of the Standard Contract.sections 119.0701(3)and(4)F.S.,and any other
applicable law, if'a civil action is commenced as contemplated by section 119.0701(4). F.S., and the Department is
named in the civil action,Contractor agrees to indemnify and hold harmless the Department for any costs incurred by
the Department and any attorneys' fees assessed or awarded against the Department 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 Department 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 (Florida Department of
Elder Affairs)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.
A�?
Page 33 of 5t1
I
(October 2021 - June 2023)
XQ 103
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 Department arc
available for inspection if applicable, as stated above.
By execution of this contract, Contractor must include these provisions (A-J) in all related subcontract agreements (it'
applicable).
By signing below,Contractor certifies that the representations outlined in parts A through J above are true and correct.
3339 East Tamiami Trail, Bldg. II Suite 211
Signature a Title of Aut orized Rep sentative Street Address
Collier County Hoard of County Commissioners Naples, FL 34112
Contractor Date City,State,Zip code
6).1. NzEL„CLERK Approved as to form and legality
.L"itY0 K )cI
• R ' iC7 ,
•
Ass . nt County Att y `.
Attes nnatttre only. `.\
GAO
Page 34 of 50
I6D
(October 2021 --June 2023) XO I U3
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average forty-five(45)minutes per response,including time
for reviewing instructions,searching existing data sources,gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information.
including suggestions for reducing this burden,to the Office of Management and Budget. Paperwork Reduction Project(0348-0043).
Washington,DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET,SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. if you have questions please
contact the awarding agency. Further,certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case,you will be notified.
1. Has the legal authority to apply for federal assistance,and the institutional,managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost)to ensure proper planning.management,and
completion of the project described in this application.
2. Will give the awarding agency,the Comptroller General of the United States,and if appropriate. the state,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.
5. Will comply with the intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed
standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personnel Administration(5 C.F.R.900, Subpart F').
6. Will comply with all federal statutes relating to nondiscrimination. These include hut 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;
(h)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.1..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)Sections523 and 527 oldie Public Health
Service Act of 1912(42 II.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 (I) 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 Ill of the uniform Relocation Assistance.
and Real Property Acquisition Policies Act of 1970 (P.1.. 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.
CAO
Page 35of50
16D2
(October 2021 -June 2023) XQ103
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.
I I. Will comply with environmental standards which may he prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.I,. 91-190) and
Executive Order(LU) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to FO 1 1990: (d)evaluation of flood hazards in floodplains in accordance with EO 11988; (c)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.i..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.
f 3. 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.
SIGNATURE )F ( IORII/F:I) 'RT G zEICIAL TITLE
C/iai ' e
••
APPLICA ORGANIZATION DATE SUBMITTED
Collier County Board of County Commissioners ,' /
A l r t • ? Approved as to form and legality
CRYe$T41 1zEL ERK
C.�`'--1\ C./ CAO
13Y:
.. •' Papne 36 of 50 AsInt County Att�}1j 5,--
sianature on
1602
(October 2021 -June 2023)
xQlu.3
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name County AAA/Contractor
Address Completed By
City.State,Zip Code I)ate Telephone
PART I:READ THE ATTAt'ill u INSTRI ('TIONS FOR Il.I.tSTRAI'IYE:INFORM•A FION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
For questions 2-5 please indicate the following: l'otal#
White Black Hispanic Other Female Disabled Over 4(1
2. Population of area served Source of data:
3.St afT current ly employed Effective date:
4.C'lient5.currently enrollediregstered Effective date:
S.Advisory/Governing Board if applicable
PART II: INN:A SEPARATE SHEET OF PAPER FOR ANY E XI'I kti\I IONS RFQI IRIN(:MORE SPACE:. IF N/A or NO,EXPLAIN.
L. Is an Assurance of Compliance on file with DOEA? 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? ❑ 0 ❑
9. Are all benefits,services and facilities available to applicants and participants in an equal l} effective manner N/A YES NO
regardless of race,sex,color,age,national origin,religion,or disability? ❑ ❑ ❑
Ill. 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 employees,applicants and participants informed of their protection against discrimination? If YES,how? N/A YES NO
Verbal❑ Written❑Poster❑ ❑ ❑ 0
clo
Page 37 of 50
16D2
(October 2021 June 2023) XQ103
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.TIIE FOLI,OWI\(;Q1 LS I IO\S APPLY.TO PROGRAMS AND FACILITIES WITH IS OR MORE EMPLOYEES. IF NO,
EXPLAIN,
IS. Ilas 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. I las a person been designated to coordinate Section 504 compliance activities? YES NO
❑ 0
18. Do recruitment and notification materials advise applicants,employees,and participants of nondiscrimination on YES NO
the basis of disability? ❑ ❑
19.Are auxiliary aids available to ensure accessibility of services to hearing and sight-impaired individuals'? 1 LS NO
❑ ❑
PART IV:FOR PROGRAMS OR FACILITIES wail 50 OR MORE EMPLOYEES AND FEUERAI coNTRAcrs OF S50,000.00 OR\IOR}..
20. Do you have a written affirmative action plan? If NO,explain. YES NO
D ❑
DOI:A LSE ONLY
Reviewed by In Compliance: YES ❑ NO* ❑
Program O11i,-e *Notice of Corrective Action Sent / /
Date Telephone Response Due / /
On-Site ❑ L)esk Review ❑ Response Received / _/
Page 38 of 50
16D2
(October 2021 —June 2023) XQi03
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.
2. 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 he 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 arc 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 hoard, 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%ante 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).
i I. 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
right to file a complaint of discrimination with either the Department or the U.S. Department of Health and I luman
Services. The information may be supplied verbally or in writing to every individual or may be supplied through the use
ot-an equal opportunity policy poster displayed in a public area of the facility.
13. Report number of discrimination complaints tiled against the program/facility. indicate the basis(e.g.race,color,creed.
sex,age. national origin,disability, and/or retaliation)and the issues involved(e.g.services or employment,placement,
Page 39 of 50
1 6 D 2
(October 2021 June 2023) XQ103
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 he 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 he
accessible. t)oor widths and traffic areas of administrative offices,cafeterias, restrooms, recreation areas,counters.
and serving lines should he 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 harriers. Self-evaluation is a four-step process:
a. Evaluate, with the assistance of disabled individual(s)/organization(s),current policies and practices 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.CF R45 CFR §84.7(b).
17. Programs or facilities that employ 15 or more persons shall designate at least one person to coordinate its efforts to
comply with Part 84 of Title 45,CFR. 45 CFR § 84.7(a).
18. Programs or facilities that employ IS 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 or facilities that employ 15 or more persons shall 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 or facilities with 50 or more employees and $50,000.(t) 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.
Page 40 of 50 cAO
1 6 13 2
en
0
X i
t4.. 111111111 . 1111111111 !
..+7 bao Z
.i.o el,..,
•E c E ••
iii- +A-
0 tfl- IA. 4A- tft- . +Pr +A tA. +ft li•' :• k.)
.--
' -
......
.-. 0 4 • 2
' 2 0 C m...
0
.0
a.
I
1
1 t iti
2 40Cri
4-' -
CC
0 M
In
)
ta 4.1
E E
ci) .i.,
1 c•
0
u'*-0
I-4
a)
g C a
0 a.
'; i**
v 0
4 L) • 4.1 0,_
. 0 5
tT.4 P.1 o.
.... '01`
.6o '
E o c)
C
(...)
41mola 44
,.„
tol on a th el
0 1 „
1 6-
C.) • c E
CC:1 ot m
at 6.
1.4 4 al
.4.—) 0
= 111 h.
V, O.
43
0 VI
(....) ......._
.. ..
1.)) a)C1:3
-
Cr .... i I-, c •.-e
7 I c 2 cz
0 g
, i j
7
cn 1,-.. •.,, Ite
el
CD 0 ."
-
el .....)
CI -
.-, 1...., •-.
i4....a .,
=
el -•
.CD
4 -
c...1 —
L, 7. < u..
1.)
o
c) ,-I NI en NI- U") VD e, CO CI CD
CD .
(2,
'.1
1 6 D 2
(October 2021 -June 2023) xQ 103
ATTACHMENT VII
BACKGROUND SCREENING
Ron DeSantis
Department of Governor
ELDER AFFAIRS
Richard Prudom
STATE OF FLORIDA
Secretary
—
BACKGROUNDSCREENING
Attestation of Compliance-Employer
AUTHORITY:This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3),Florida Statutes.
A The term"employer"means any person or entity required by law to conduct background screenings,
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(DOEA),and any other person or entity which hires employees or has volunteers in service
who meet the definition of a direct service provider.See§§435.02,430.0402,Fla.Stat.
A A direct service provider is"a person 18 years of age or older who,pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the
client and has access to the client's living area,funds, personal property,or personal identification
information as defined in s. 817.568.The term includes coordinators, managers,and supervisors of
residential facilities and volunteers."§430.0402(1Xb),Fla.Stat.
ATTESTATION;
As the duly authorized representative of
Collier County Board of County Commissioners
Employer Name
3339'ratniami Trail E Naples FL 34112
located at
Street Address City State ZIP code ,
1 William 1.. McDaniel, Jr.,Chairman
do hereby affirm under penalty of
Name of Representative
perjury that the above-named employer is in compliance with the provisions of Chapter 435 and section
430.0402,Flori- . egarding level 2 background screening.
(-1-)Alle, Air. OP. /Ill.
Signature ./Representative Date
DOEA Fora 235,.attestation ofC tuupliartce-Employer,Effective January 19,202/ Secrion 435.05(3),
r;
F.S.Pa n*aflalble ai3.hups.iAdtniiJJ•arc.ary up-ronrrnt uploaJs`rf xa form-IJS-attestauon-e jeomplmncr-empiurer.txif
qi :''' Approved as to form and legality
CR\' TAL K.K1N7.FI CLERK ( t ty
f,
Page 42 of 50 AR, t'j
t3Y: ,.1• 1,.4,e*.a.`'0 ','.^ 1 Ass ant County Au g
....,.,.,item nn y
160
(October 2021 June 2023)
ht1103
ATTACHMENT VIII
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES(CMBF, FORM)
CAME FORM MUST ACCOMPANY INVOICES SUBMITTED TO DOEA
CONTRACTOR NAME:
DOEA CONTRACT NUMBER:
*REPORTING PERIOD-FROM: TO:
*(DATE RANGE OF RENDERED SERVICES,MUST MATCH INVOICE SUBMITTED TO DOEA)
DOEA CONTRACT MANAGER:
REPORT ALL EXPENDITURES MADE TO CERTIFIED MINORITY BUSINESS(SUBCONTRACTORS).
CONTACT'DOEA CAME COORDINATOR FOR ANY QUESTIONS,AT 850-114-2153.
SUBCONTRACTOR NAME SUBCONTRACTOR'S CMBE EXPENDITURES
FEW
DOEA USI;()NUN -- RI I'OR"I I NG ENTITY(DIVISION OFFICE,E, ETC)
SEND COMP! I 1 1 I) 1 ( (k\IS VIA INI'EROFFIC'I' R AU, I O a' IN I AYI.OR
(MIII ('((t (k1)I\:A I((k, ( ()NTRAC I ADMINPN I kA I I().N X I'C 'RCI I>1�I'v( I=tit I AFIASSEF., FI,ORIDA 32399-7000.
0
G
Page 43 of 50
1 6 0 2
(October 2021 - June 2023)
X()103
If unsure ifsubcontractor is a certified minority supplier,click on the hyperlink below. Enter the name of the supplier,click
"search". Only Certified Minority Business Entities will be displayed.
hups://osd.dms.myflorida.comidirectories
INSTRUCTIONS
(A) ENTER THE COMPANY NAME AS IT APPEARS ON YOUR DOEA CONTRACT,
(B) ENTER TUE.DOEA CONTRACT NUMBER.
(C) ENTER THE SERVICE PERIOD MATCHING THE CURRENT INVOICE'S SERVICE PERIOD.
(1)) ENTER ALL CERTIFIED MINORITY BUSINESS EXPENDITURES FOR THE TIME PERIOD COVERED BY
THE INVOICE:
I. ENTER CERTIFIED MINORITY BUSINESS NAME.
2. ENTER THE CERTIFIED MINORITY BUSINESS FETID NUMBER.
3, ENTER THE CERTIFIED MINORITY BUSINESS CMBE NUMBER.
4. ENTER THE AMOUNT EXPENDED WITH THE CERTIFIED MINORITY BUSINESS FOR THE TIME
PERIOD COVERED BY THE INVOICE.
(E) MBE FORM MUST ACCOMPANY INVOICE PACKAGE SUBMITTED TO DOEA FINANCIAL
ADMINISTRATION FOR PROCESSING.
(F) FINANCIAL ADMINISTRATION WILL FORWARD ALL COMPLETED CMBE FORMS TO CONTRACT
ADMINISTRATION& PURCHASING OFFICE.
Page 44 of SO
I6EJ 2
(October 2021 June 2023)
V.)10.3
ATTACHMENT IX
STATEMENT OF USE OF FUNDS(EsTIN1 FED BUDGET)
SENIOR CENTERS
STATEMENT OF USE OF FUNDS
Sr.Center t
Project Name:Golden Gate Senior Center Expansion&Hardening State Matching Other Total
P
Total Project Budget: $3,494,521 FCO Funds Non-FCO Funds roject
Funds
Funds
TYPE AND SOURCE OF FUNDS:
Federal Grant s
CDBG-MIT Hardenin.
Other State Funds(i.e.,DC )
City/County Grant(s)
Senior Centers FCO Grant $250,000.00
Private Contributions/Donations
In-Kind Expenditure Credits
Total Funds Available From All Sources $250,000.00 $ - $ - $
SITE WORK
Parkin. Lot
Walks/Driveways
Awnings/Covered Walkways
Dratsge/Retention Pond
Trees/Landscaping
$20 000.00
Fencing
Signage
Other(Turn lane installation)
$100,000.00 al
Other(Remove and re.ar obstructions
$220,000.00
Total $ - $ 340,000.00 $
INTERIOR
Insulation/Weatherization
Plumbing
HeatingAir Conditioning
Electrical
Flooring
Masonry
Ceiling/Acoustics
Railing/Guards
Elevators
Other(Interior Hardening) $810,031.001.
Total - $ - $ 810,031.00
'7
e„,
0
Page 45 of 50
1 6 D 2
(October 2021 ,funs 2021)
XQ 103
EXTERIOR
Roofing/Sidingy
Doors/VUindows —_-- — $168,000.00
__________ 5300.000.00
Porches,Decks,Patios
Septic Tank —.
Sewer Hook-U (Ci /Coun
$205,000.00
Generator(Gas Powered)
Other(Exterior Hardening) _ $493,400.00
—__- $383,230.00
Total — $ - $ __ - $ 1,549,630.00 $
FIXTURE*IEQUIPMENT/APPLIANCEE
- --
SeCiBrity/Aiarnl
'Telephone System
_._. —_.
Smoke Detectors I 4 _--_-.
Emergency/First Aid Stations
Kitchen Appliances
---------------
Cabinets/Counter Tops ---------,
Bathroom Fixtures — --
Lighting Fixtures ------- _____
Other(FF&E)
— --_---- __ $175,000-00_
Total $ - ,$ 175,000.00 $ - $
PROFESSIONAL SERVICES
Architect/Engineer/Special Consultant $250.000.00
Schematic Design Phase A
Design Development Phase
onstruction Document Phase
Bidding — —
Construction Administration $119 880 00
Other(Please Sperafy)
Total — {
$ 250,000.00 $ - ,$ 119,860.00 $
OTHER(Please Specify)
Local match $250,000.00
Total .—-.---__...---______
TOTAL PROJECT COST $ 250,000.00 $ 425.000.00 $ 2,819,521.00 $
Page 46 of 50
16D2
(October 2021 . June 2023) XQ 103
ATTACHMENT X
RECEIPTS ANI) E:XPENI)ITURE REPORT FIXED C'APITAI,OUTLAY
RECEIPTS AND EXPENDITURE REPORT FIXED CAPITAL OUTLAY
Iles Report Penod
RECIPIENT NAME ADOFESS,PNONBk and Ma Pidgin'Fvdinp Souce Fan To
Contract Penod __-
General Revenue Contract x
rotate it
W
CERTIFICATION 1 certify to the best at my knowledge and behel that Iles report es complete and coned and all the allays heron are br the piposes set tot'Inthe
abet c cr 1ratt
Prepared by Date Aprro ed tH Date
I Approved 2.Rpwtaed 3.Receipts 4 Total Receipts 5.Percent of
PART k BUCGETED INCOME/RECEIPTS Contract Budget Receipts for is Reimbursed Year to (Box 2.+Box 3.) Approved Budge
_Report Oats (Box AlBox 1.)
1 State Feuds 0 00 0 CO 0 00 r 0 00 r YOIV:OO
2 TOTAL RECEIPTS 0 00 0 00 0 00 0 00 r arlIV+O,
I.Approved Budget 2.Redwood 3.Ex penditwws 4.Total S.Percent of
PART B:laPEt-DtTURES Expendttxes For Reimbursed Year to Expendtures(Box Approved Budget
(Identity Lmetem Categories tan Apposed Budget) This Report Oast 2+Box 3) (Boot 4.JBox 1.)
1 Srte W Mt 0 00 0 00 0 00 r 0 00 " it31VI01
2 Ile= 0 00 0 00 0 00 r 0 00 r itOMO^
3 Exterior 000 000 000 ' 000 r rrmoi
4 Futures 000 000 000 r 000 r *twos
5 Prvdessronei Seruce 0 00 0 00 0 00 ' 0 CO ' R)tV/0
B Other 0 00 0 CO 0 00 ' 0 CO r A4NV/0t
7 TOTAL EXPENDITURES 000 0 00 0 00 0 CO r VDtV101
DOEA ban 1061 reused 9/2020
Page 47 of 50
16D2
(October 2021 June 2023) XCf 1 U3
ATTACHMENT XI
COST REIMBURSEMENT SUMMARY FORM
Cost Reimbursement Summary
Contract S
Report Number:
Budget
Calory._._ Oaacdplon Number of untie
Amount
c
0
TOTAL ADMINISTRATION SO 00
x
w
—_. TOTAL EXPENSES $O.00
Page 48 of'50 �'�
1602
(October 2021 ---June 2023)
XQ 103
ATTACHMENT XII
REQUEST FOR PAYMENT FIXED CA I NI. Ott I k
REQUEST FOR PAYMENT
FIXED CAPITAL OUTLAY
RECPENT NAME,ADDRESS PHONEe and FEDe PA'YMENT REQUEST. This Request Period
From To
Regular Moica#
Supplemental Corlact
Contract Penod
CERTEICATION I hereby certify that this request conforms with the terms of the above contract
Prepared by _Date -_.._-- Approved by__ Date
PART A. BUDGET SUMMARY FCO
1 Approved Contract Amount S0 00
2.Previous Funds Received for Contract Penod SO 00
3 Contract Balance 50 00
4.Previous Funds Requested and NotR•cMved for Contract Period SO 00
5 Contract Balance SO 00
PART 8 CONTRACT FUNDS REQUEST
1.Net ExperrdRues For Month(DOEA Form 105f,Part B Line 7) SO 00
2.TOTAL SO 00
PART C NET FUNDS REQUESTED
1 Total Funds Requested SO 00
(Part B,Line 2)
DOEA tom 106f,revised 32017
Page 49 of 50
I6Dr
(October 2021 —June 2023)
ATTACHMENT XI I I
FIXED CAPITAL OUTLAY CERTIFICATION
The Fixed Capital Outlay Certification acknowledges that
referred to as the Contractor, is using state funds in the form of a fixed capital outlay grant in the{amountwner, hereinatier
of ,to improve,construct or repair real property owned by the Contractor,and in accordance with
executed contract between the Contractor and the State of Florida, Department of Elder Affairs,
I lereinafter referred to as the"Department". The following items must be completed by the Contractor:
1. State the legal address of the real property that is being improved by the fixed capital outlay grant.
?. List the name of the owner of the real property and the contact address for the owner of the real property.
3. In accordance with section 287.05805, F.S. (2017), and Section 38 of this contract and Section IV.D,of
Attachment 1,the Contractor shall execute and deliver a security interest or other appropriate document securing the
interest of the Department,in the total amount of funds received under this contract, in the improvements,renovations,
and personality being purchased with funds received under this contract. The Department's security interest shall last for
at least five(5)years from the date of completion of the improvements and during this time the Contractor is prohibited
from selling,transferring, mortgaging,or assigning the Department's interest in the leasehold, improvements, renovations,
or personality,unless the Department approves, in writing, the sale, transfer,mortgage,or assignment.
4. The Contractor shall continue the operation, maintenance, repair,and administration of the property in accordance
with the purposes for which the funds were originally appropriated and for at least five(5)years from the date of
completion of the improvements. If the Contractor fails to operate, maintain,repair,and administer the property in
accordance with the purposes for which the funds were originally granted,the Contractor shall return to the Department.
no later than upon demand by the Department,the total amount of funds received under this contract, less 20%of that
total amount for each full year for which the property was used for such purposes after the date of completion of the
improvements.
5. The Department shall he immune from civil or criminal liability resulting from acts or omissions of the Contractor
and the Contractor's agents,employees,or assigns.
6. The Department shall execute a satisfaction of security interest upon full compliance by the Contractor with the
terms of this contract.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAI. TITLE
APPLICANT ORGANIZATION 1)tTE SUBMITTED
Collier County Board of County Commissioners
Page 50 of 50
16g
XQ103 -FCO- Approved for Signature
Final Audit Report 2022-02-17
Created: 2022-02-04
By: James Norris(Norrisj@elderaffairs.org)
Status: Signed
Transaction ID: CBJCHBCAABAAZposfNvTneVN5s1W02_W6SrM-in5wy2
"XQ103 -FCO- Approved for Signature" History
Document created by James Norris (Norrisj@elderaffairs.org)
2022-02-04-2:04:20 PM GMT-IP address:204.156.227.59
Document emailed to Michelle Branham (branhamm@elderaffairs.org) for signature
2022-02-04-2:05:34 PM GMT
Email viewed by Michelle Branham branhamm elderaffairs.or
( @ 9)
2022-02-16-2:51:55 PM GMT-IP address:73.104.105.203
Document e-signed by Michelle Branham (branhamm@elderaffairs.org)
Signature Date:2022-02-17-2:51:44 PM GMT-Time Source:server-IP address:73.104.105.203
Q Agreement completed.
2022-02-17-2:51:44 PM GMT
ea Adobe Sign