Agenda 07/12/2022 Item #16D15 (Fixed Capital Outlay Certification for previously executed agreement)07/12/2022
EXECUTIVE SUMMARY
Recommendation to authorize the Chairperson to sign a Fixed Capital Outlay Certification for a
previously executed agreement with the Department of Elder Affairs for the Golden Gate Senior
Center Expansion and Hardening Project. (Fund 705 Housing Grant)
OBJECTIVE: Expand opportunities for the Golden Gate Senior Center's programming for seniors and
improve the center's capability to provide resiliency efforts during and after emergency situations.
CONSIDERATIONS: On October 27, 2020 (Agenda Item #1 1D), the Collier County Board of County
Commissioners (Board) approved the Collier County State and Federal Legislative and Administrative
Priorities for 202 1, authorizing a State Appropriations Project Request for the Golden Gate Senior Center
Construction/Expansion Project in the amount of $250,000. This funding will provide for the architectural
and engineering design for construction and expansion of the Golden Gate Senior Center to better serve
community seniors. Increased building size will allow for better organization of programs and activities
and provide much -needed meeting rooms and office space to help address client needs. In the request for
funding, Collier County also committed $250,000 to the project in local leveraged funds. The formal
request was submitted to the Florida Department of Elder Affairs (DOEA) on January 19, 202 1.
Collier County was awarded the $250,000 agreement from the DOEA, funded through the 2021-2022
General Appropriations Act, Specific Appropriations 397A. In addition to expanding activities and
services for seniors, future hardening facilities will improve the Center's capability for resiliency efforts
during and immediately after emergency situations. Other Local and Federal funding will be used to
complete the construction of the building expansion and hardening of the existing building.
The Board of County Commissioners accepted the award, signed the agreement, and authorized the
necessary Budget Amendments in Agenda Item #16132 on January 25, 2022. The Fixed Capital Outlay
Certification is a standard form and is required as part of the agreement.
FISCAL IMPACT: There is no new Fiscal impact associated with this item. The funds reside in Housing
Grant Fund (705), Project 50219. The $250,000 leveraged funds reside in Capital Projects Fund (301).
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this
Item.
LEGAL CONSIDERATIONS: This item has been approved as to form and legality, and requires a
majority vote for Board approval. --DDP
RECOMMENDATION: To authorize the Chairperson to sign a Fixed Capital Outlay Certification for a
previously executed agreement with the Department of Elder Affairs for the Golden Gate Senior Center
Expansion and Hardening Project.
Prepared By: Maria Kantaras, Grants Coordinator, Community and Human Services Division
ATTACHMENT(S)
1. XQ 103 Attachment XIII Fixed Capital Outlay Certification CAO Stamped (PDF)
2. [linked] XQ103-FCO-Approved for Signature - EXECUTED (PDF)
I Packet Pg. 1686 1
07/12/2022
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D. 15
Doe ID: 22571
Item Summary: Recommendation to authorize the Chairperson to sign a Fixed Capital Outlay
Certification for a previously executed agreement with the Department of Elder Affairs for the Golden
Gate Senior Center Expansion and Hardening Project. (Fund 705 Housing Grant)
Meeting Date: 07/12/2022
Prepared by:
Title: — Community & Human Services
Name: Maria Kantaras
06/14/2022 9:46 AM
Submitted by:
Title: Manager - Federal/State Grants Operation — Community & Human Services
Name: Kristi Sonntag
06/14/2022 9:46 AM
Approved By:
Review:
Community & Human Services
Kristi Sonntag
CHS Review
Community & Human Services
Cynthia Balterman
Additional Reviewer
Community & Human Services
Kimberley Grant
Additional Reviewer
Operations & Veteran Services
Kimberley Grant
Additional Reviewer
Public Services Department
Todd Henry
PSD Level 1 Reviewer
Public Services Department
Tanya Williams
PSD Department Head Review
County Attorney's Office
Derek D. Perry
Level 2 Attorney Review
Grants
Erica Robinson
Level 2 Grants Review
Office of Management and Budget
Debra Windsor
Level 3 OMB Gatekeeper Review
County Attorney's Office
Jeffrey A. Klatzkow
Level 3 County Attorney's Office Review
Grants
Therese Stanley
Additional Reviewer
Office of Management and Budget
Susan Usher
Additional Reviewer
County Manager's Office
Amy Patterson
Level 4 County Manager Review
Board of County Commissioners
Geoffrey Willig
Meeting Pending
Completed
06/15/2022 4:28 PM
Completed
06/15/2022 4:31 PM
Skipped
06/15/2022 4:42 PM
Completed
06/15/2022 4:42 PM
Completed
06/16/2022 9:53 AM
Completed
06/16/2022 10:00 AM
Completed
06/20/2022 9:55 AM
Completed
06/21/2022 9:48 AM
Completed
06/21/2022 9:51 AM
Completed
06/21/2022 11:51 AM
Completed
06/29/2022 2:21 PM
Completed
07/01/2022 12:32 PM
Completed
07/05/2022 10:10 AM
07/12/2022 9:00 AM
I Packet Pg. 1687 1
(October 2021 — June 2023)
ATTACHMENT XIII
FIXED CAPITAL OUTLAY CERTIFICATION
The Fixed Capital Outlay Certification acknowledges that Collier County , Owner, hereinafter
referred to as the Contractor, is using state funds in the form of a fixed capital outlay grant in the amount
of $250,000.00 _,to improve, constructor repair real property owned by the Contractor, and in accordance with
executed contract XQ103 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.
4898 Coronado Parkway
Naples, FL 34116
2. List the name of the owner of the real property and the contact address for the owner of the real property
Owner - Collier County (a political subdivision of the state of Florida)
Contact - Tanya Williams, Public Services Department Head (Ph.: 239-252-7392; email: tanya.williams@colliercountyfl.go,v)
3339 Tamiami Trail East, Bldg. H, 2nd FL, Naples, FL 34112
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 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 I TITLE
APPLICANT ORGANIZATION
Collier County Board of County Commissioners
Attest:
CRYSTAL K. KINZEL, CLERK
Deputy Clerk
Page 50 of 50
DATE SUBMITTED
Approved as to Forin and Legality:
E
0
co
M
V
0
0
CN
F4.
Derek D. Perry
Assistant County Attomf-.v ILI
I Packet Pg. 1688
(October 2021 — June 2023)
xQ 103
FLORIDA DEPARTMENT OF ELDER AFFAIRS
STANDARD CONTRACT
THIS CONTRACT is entered into between the Florida Department of Elder Affairs [Departmen(or DOER} 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 perforated and payments to be made, together with the
mutual covenants and conditions set forth herein, the Parties agree as follows:
I. 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, proposai(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 an), 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 '1-'ime ,Tune 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 $250,000.01), subject to the availability of funds, Any casts 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 saute 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 lfthis 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 S100,000.00, 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 i-unds received
in connection with this contract to influence legislation or appropriations pending before Congress or any
state iegislature. The Contractor must complete all disclosure forms as required. specifically the
Page 1 of 50
(October 2021 —June 2023)
XQ 103
Certification and Assurances Attachment, which must be completed and returned to the Contract Manager
prior to the execution of this contract.
6.1.4 in accordance with Appendix 11 to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246. Equal Employment Opportunity, as amended by Executive Order 11375 and others. and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
wilt 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 (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
roust 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.
6.0 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-1 16. Contractor agrees to utilise 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 H lorida, and shall be construed, performed. and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
7.2 1171his 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 Deference 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 al i tasks contained in Attachment i.
7.3.2 The Contractor shall provide units of deliverables, including reports. findings, and drafts, as specified in
Attachment 1, to be received and accepted by the DOER 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 fees or other compensation for services or expenses in sufficient detail
for a proper pre -audit and post -audit.
Page 2 of 50
(October 2021 —Junc 2023)
XQ 103
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 retards 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 previsions of Section 297.134, 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 Bovcott Israel. List, or if the Contractor has been engaged in business operations
ill 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)-f3), F.S. The Contractor
must also comply with any applicable miles promulgated by the Department and the Agency for Flealth 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 Iar 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
ltttps:lleldera flat rs.orelabout- uslbackgrotntd-screen in �g/
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have estabiished 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 11.9, 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. Ifthe Contractor transfers all public records to the Department upon completion ofthe
contract, Contractor shall destroy any duplicate pub[ic records that are exempt, or confidential and exempt,
01,
Page 3 of 50
(October 2021 - June 2023)
XQ 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 tile ❑epartmeni.
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 AI 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 1 of the. State Constitution and
Section I] 9.07(l ), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 1.1.9, 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
docapublicreci)rds@,).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 drily 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>; R 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
()Vo
Page 4 of 50
(October 2021 —.Juno 2023)
XQ 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 rnust form a sale -source, public: -private agreement Oran entity that, through
contract or other agreement with the state, annual ly 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
ann1181 reports as those changes occur.
11.8.3 All compensation reports muss 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 Contractorshall 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 1 f this contract contains federal funds, these assurances are a condition of continued receipt of oar 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
❑f the contract and denial of further assistance.
13. Monitoring by the ❑epartmenl:
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:
T-lie Contractor shall provide services in the manner described in Attachment t.
Page 5 of 50
(October 2021 1 — June 2023)
15. Coordinated Monitoring with Other Agencies:
KQ l 03
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.5., as amended, Florida's human service agencies shall include the
❑epartment, the Department of Children and Families, the Department of i Icalth, the Agency for Persons with
Disabilities, and the Departmentof Veterans' Affairs. Upon notification and she 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. 1ndemnifica(ion:
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 pertnitied 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 renewals) 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 types) 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 ally
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
ny�
Page 6 of 50
(October 2021 —.Lune 2023)
XQ 143
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 11otline 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 test (10) days after notification, the Contractor must
also provide the following information to the Department: ( I ) the date of FtIing 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 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 T'he. State of Florida is, at all times, ent.itied to assign or transfer, 'nn 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 Departmeni 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 287.085,1=.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 w i I I
not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the
ow)
Page 7 of 50
(October 2021 —June 2023 )
X Q 103
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 1. The DOEA Contract Manager witI have final approval of the Contractor"s invoice submitted For pay ineni
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 215A22, F.S. A Vendor Ombudsman has been established
within the Florida Department of Financial Services and may be contacted at 800-342-2752,
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
steal I 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 Safe:xuardinj! Information:
The Contractor shal I 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 ensuringthat 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 -tip 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 for 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), Nessages, text messages, etc.); social networks like lnstagram, TikTok,
Snapchat, Google Hangouts, WhatsApp. Signal, Facebook., Pinterest, and Twitter; and content sharing networks
such as Flicks and YouTube. This includes the transmission of social media through any cellular or online
transmission via any electronic, interest, intranet, or other wireless communication.
30.3 Application to any direct or incidental DOEA or other state business. This contract applies to any DOF.A 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 ilirough personal cellular cnmmLin ication is
subject to Florida's Government in the Sunshine Law, Florida's Public Records Law (Chapter 119, Florida
obi
Page 8 of 50
(October 2021 —June 2023)
XQ 103
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 pasted 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.
3I. 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 file 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 gratui€ies, 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 mttst make the same disclosures described above to the Contractor's board of directors. Compliance
with this provision will be monitored.
32. Public Entitv 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
servicesto 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; inay not submit bids, proposals, or replies on leases of real property to a
public entity; may not be awarded or perfonn 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 THAI' 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 TI IAT IS
QUALIFIED PURSLJANTTO C1 [APTER 413. FLORIDA STATUTES, IN THE SAME MANNER AND
UNDER THE SAME PROCEDURES SET FORTH IN SECTION 413.036(I) 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 WITII
SUCH QUALIFIED NONPROFIT AGENCY ARE CONCERNED.
33.1,2 Pursuant to sections 413.036(l ) 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 specificat'sons, price, or quality of the product or service is not
comparable to the Contractor's requirements.
ovo
Pap g of 50
(October 2021 — June 2023)
XQ 103
33.1.3 '['his 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
h ttp: //ww w. res p ecto ffl or i d a. o rg.
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 THAI' 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
FINDER THE SAME PROCEDURES SET FORTH 1N 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 SUBSTITUTE❑ 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
hilps://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 Administrations, and must accompany cach invoice
submitted to the Department. The Office of Supplier ❑'sversity (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, Ro►•.elties;
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 or 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 CPR § 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 Systern 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.
Page 10 of.50
(October 2021 — June 2023)
35, Emergency Preparedness and_Continuity of ❑aerations-.
XQ 103
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 ofentergency 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 tallow procedures to ensure continuity of operations
Without interruption.
36. Equipment:
36.1 Equipment means: (a) tangible personal property (including information technology systems) havinga useful lire
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 non -consumable
nature with an acquisition cost of $5,000,00 or more per unit, and expected useful life of at least one ( l) 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 fart 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 DOER 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 fiords and federally -owned equipment shall, at a minimwn, meet the
fallowing 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 for date received, ifthe 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.
36.3.111 A control system must be developed to ensure adequate safeguards to prevent loss, damage, or theft of
the property. Any loss, damage, or theti 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.
Page 1 I of 50
(October 2021 — June 2023) XQ 103
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
slate funds with an acquisition cost over $5,000.00 is parl 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 oft 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 identilied 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 CPR 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 Departments Contract Manager. The request should include a brief description of the property, purchase
price, funding source, and percentage oi' 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 ❑DEA 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 alder Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter 11I,
Part A., Section 3030b United States Code (U.S.C.). Rcal property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and there Fore 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
work -sheet 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:
htte.Hdrn s. my fl on da.cont/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. Flowever, 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 Deal 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
(October 2021 —June 2023)
39. Dispute Resolution_
XQ103
Any dispute concerning performance ofthe contract shall be decided by the DCE'A. Contract Manager, who shall reduce
the decision to writing and serve a copy on the Contractor.
40. Financial Consequences:
Ifthe 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 Cotmty, 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 Ma'eure:
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. Severahility 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 ol`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 Deparintent no later than thirty (30) days after the
contract ending date unless otherwise specified in Attachment 1. 1fthe Contractor fails to do so, all right to payment is
forfeited and the Department shall not Itonor 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. OAJ
Page 13 of 50
(October 2021 — June 2023)
xQ 103
51. Renesotiations 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 subscgoently 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: ( 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 of a Subcontractor at any tier, and ifthe cause ofthe 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 insufficient 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 tinder 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 shalt comply with the requirernents
contained in the Uniforrn Electronic Transaction Act, Section 668.50, F.S. All electronic records must he fully
auditable. are subject to Florida's Public Records Law, Chapter 119, !-S.; must comply with cow ract 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 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
(October2021—.1une?023)
XQ 103
electronic form with an electronic signature must identify the person and the person-s capacity who electronically
signed the document on any non-clectTonic copy of the document.
SS. Contract Manager:
The Department may substitute any Department employee to serve as the DOER Contract Manager.
REMAINDER OF THE PAGE INTENTIONALL PLEFT BLANK
Page 15 of 50
(October 2021 —.lone 2023 )
56. Official Paxcc�ndltcpt•csentatiyes Names, Addresses, and Telephone Numbers)_
X Q 103
"The Contractor name, as shown on page I of this
Collier County Board of County
a.
contract, and mailing address of the official payee to
Commissioners
3299 Tamiami 'frail 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. 341 12
The name, address, and telephone number of the
Tami Bailey
3339 East Tamiami "frail, Bldg. H, Suite 211
C.
representative of the Contractor responsible for
Naples, FL. 34112
administration of the program under this contract is:
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. Florida32399-7000
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:
"Phis 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:
COLLIER COUNTY 2D O .O
COMMISSIT1111 ' .
(� _ L
SIGNED 13Y:
NAME: WillidL. McDaniel, Jr.,
TITLE: Chairman
DATE: 1 5
Federal Tax'1QW�59- 6000555
Duns:07699 )90 '
r ,
CRYSF l K.[C�N; ai-,t='LERK
`-At
test as.f All off
signature only.
STATE OF FLORIDA,
DEPARTMENT OF ELDER AFFAIRS
14111?haG ZG Xlwehaol
S I GNE D BY:Michelle Branham (Feb 17,202209:51 EST)
NAME: MICHELLE BRANHAM
'I 1'1'LI:: SECRETARY
DATE: Feb 17, 2022
Approved as to form and 1q,d
�N, r k A�
Ass"Isfarilt Cotulty
Page 16 of 50 ��
(October 2021 — J«ne 2023) XQ103
INDEX OF ATTACHMENTS
ATTACHMENTI...............................................................................................................................................18
STATEMENT OF WORK........
18
ATTACHMENTH...............................................................................—.................-----......................................
24
FINANCIAL AND COMPLIANCE A UDIT .....................
ATTACHMENTIII............................................................................................................................................
34
C ERTIFICATIONSAND ASSURANCES.........................................................................................................
30
ATTACHMENTIV............................................................................................................................................
35
ASSURANCES NON -CONSTRUCTION PROGRAMS...................•-----•.......................................................
35
ATTACHMENTV..............................................................................................................................................
37
FLO IDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLL4NCE CHECKLIST .................
37
ATTACHMENTVI..............................................................................................................:.............................
41
CONTRACTOR 'SSTATE CONTRACT LIST....................................................................................................41
ATTACHMENTVIII.........................................................................................................................................
43
CERTIFIED MINORITY BUSINESS SUBCONTR, I C TOR EXPENDITURES (CMBE FORM) ......................
43
ATTACHMENTIX............................................................................................................................................
45
.STATEMENT OF t1SE OF FUNDS (ES TlAfATED BUDGET) ........................................................................
45
ATTACHMENTX..............................................................................................................................................
47
RECEIPTS AND EXPENDITURE REPORT FLX-.'I) CAPITAL OUTLAW .......... -........................ ....................
47
ATTACHMENTXI............................................................................................................................................
48
COST REIMBURSEMENT SUMMARY FORM ............................
ATTACHMENTXII..........................................................................................................................................
49
REQUEST FOR PAYMENT FIXED CAPIT.4L OUTLAY................................................................................
49
ATTACHMENTXIII.........................................................................................................................................
54
FIXED CAPITAL 0 UTLAY CER TIFICA TION ................................................................................................
50
Page 17 of 50
(October 2021 -- June 2023)
XQ 103
ATTACHMENT 1
STATEMENT OF WORK
I. ,SERVICES TO RE PROVIDED
A. Definitions of Terms
L DOEA -- Florida Department of Elder Affairs.
2. CCACC -Collier County Board of County Commissioners
S. General Description
I. General Statement- The 2021-2022 General Appropriations Act, Specific Appropriation 397A, has
appropriated $250,000.00 to Collier County Hoard 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 finding 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 11. Manner of Service Provision.
ll. MA.NNER OF SERVIC EPRO P7S10N
A. Service Tasks, Deliverables and Performance Messures- 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 DOER 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.
( I ) 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.
I. 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 atrtount 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 X111) 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
(October 2021 - Rule 2023)
XQ 103
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 adtn'snistration for the Golden Gate
Senior Center.
d. Consulting- All Architectural, Engineering, and Special consulting needed for the Golden Gate Senior
Center.
I Deliverables, Source Documentation & Performance Measures
The Contractor must complete all tasks listed in Sections I1.A.1-2. above and shall comply with the
requirements stated in the Deliverables Table provided in this section (Sections 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 DOER Contract
Manager based on the requirements for each deliverable before the Contractor submits an invoice requesting
payment.
G
Page 19 of 50
(October 2021 —June 2023)
XQ 103
Deliverables Table
Deliverable I -- 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 ilie state a
the property at least to the amount of state
the property will result in
security interest in the property as
finds provided for at least five (5) years
termination of this contract.
stated in Section 1I-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 be paid until asecurity 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 NA-,er.
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 H.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-paymem.
The Contractor must obtain certification
from the licensed Engineer or Architect
Failure to complete the minimum
using A I A 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 II1.D.:
Contract) will not be paid.
■ Licensed Architect or Engineer
certification using AIA Fonns G702
and G703, or their equivalent.
■ Required DOEA forms.
■ Required invoice documentation.
• Signed attestation.
• Detailed vender invoices.
• Proof of Payment documentation; and
• CMBE expenditure report
(Attachment u i i i)
Deliverable
2 —Estimated Budget $250,000.00
Total Contract Amount $250,000.0U
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
n
�G
(October 2021 — .lone 2Q23)
XQ 103
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 witi an employee of equal or
superior quali Iications. The DOEA Contract Manager shall exercise judgment in this matter as approved by the
De partm ent.
4. Subcontractors- The Contractor is permitted to use subcontractors to perform work as required by this contract.
C. Service Location and Fquipment
1. Location- All work required by this contract must be performed For the location specified in Section I [.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 .tune 30, 2023.
3. Changes in Locatiou- The Contractor shall receive written approval from DOEA 's Contract Manager prior to
snaking 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 11. are solely and exclusively the responsibility
of the Contractor and are tasks for which, by execution of this contract. the Contractor agrees to he held
accountable.
2. Courdinatiou 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 lank thereof, shall not relieve the Contractor from ful[
performance of contract requirements.
010
Page 21 of 50
(October 1-021 -,lone 2023)
XQ 103
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 ail 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 ofthis contract. Monitoring shall be conducted through direct contact with the Contractor
through telephone, in writing, or on -site visit. `rhe 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 ofthe 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;
0 Limited -scope reviews; and/or
• Other procedures as deemed necessary
Ill. ME HOD OF PAYMENT
A. Payment Method Used -This its 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) ofthis contract, as appropriated. The
Department will pay the Contractor upon satisfactory completion of the Tasks/Deliverables, as specified in Section
11.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 11.A, and the Statement of Use of Funds (Estimated Budget)
(Attachment IX). The Contractor roust 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
alter 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:
I. ALA 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 reirnbursernent 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 X11).
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 nuinber, the amount being requested
for reimbursement, and the "Remit to" address exactly as it appears in this contract.
Page 22 of 50
C>
10
(October 1-021 - June 2023)
XQ 103
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 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 inust be completed in its entirety and submitted with each invoice.
E. Financial Consequence - Failure to perform the services as stated in Section H.A. or to submit the required
documentation will result in non-payment. Invoices for work or services performed outside the timefrante provided
by the term of this contract, as stated on page one (1) of this contract (Standard Contract, Section 3. Term of
Contract), wi I I not be paid.
IV. SPECIAL PROYISIONS
A. Budget Modifications - The Contractor must adhere to the Statement of Use of Funds (Estimated Budget)
(Attachment 1X). The Attachment IX line -item amounts shall only be adjusted with prier 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 a -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 XI11) 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 OFATTACHMENT I
Page23 of 50 CA()
(October 2021 —.tune 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.
MONITQRING
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 organisation 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 ofthis part.
In connection with the audit requirements addressed in Part 1, paragraph 1. the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR § 200.508.
If [lie 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 in et for each applicable contract. A€I qucstioned 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 identiry 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
Page 24 of 50
GAO
(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.O0 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 organia_ations), Rules of the Auditor General. Financial
Compliance Audit Attachmeni, 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 firiancial 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 file audit requirements addressed in Part 11, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.971.8y. 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 [O.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 mast 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 organisation'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 riot 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. 1f 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 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 fart 1 of
this Financial Compliance Audit Attachment, shall be submitted, when required by 2 CFR § 200.512 by or on belialf of the
Contractor directly to each of the following -
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10'J' 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 Atidit Clearinghouse.
The Contractor shall submit a copy of any management letter issued by the auditor directly to the Department.
C?L0
Page 25 of 50
(October 2021 —.June 2023)
XQ 103
Florida Department of Elder A (fairs
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 Attachmenl..
Part 11, small be submitted by or on belialf of the Contractor dir_ ectly to each oFthe following:
The Department at the 'Fallowing 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-I450
Any reports, management letters, or other information required to he 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 nrganizations), Rules of the Auditor General, as appiicable.
Contractors, when submitting financial reporting packages to the Department for audits done in accordance with 2 C F R fart
200 or Chaptcr 10.550 (local governmental entities) or 10.650 (nonprofit and Far -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.
Page 26 of 50 G
(October 202 l -- June 2023)
XQ 103
ATTACHMENT II -EXHIBIT 1
PART l: 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 andlar
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part 1
and/or Part II of Exhibit l are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR § 20038 and/or Section 215,97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic. and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 691-5.006, F.A.C., Contractor has been determined to be:
Vendor not subject to 2 CFR § 20038 and/or Section 215.97. F.S.
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 (F Iorida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If 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 § 200.4t 8 — § 200.419 -- Special Considerations for Institutions of Higher Education*
2 CF R § 200.I00 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other Fiscal requirements set forth in program laws, piles, and regulations
*Some Federal programs may be exempted Crum compliance with the Cost Principles Circulars as noted in 2 CFR
§200.400(5)(c).
Page 27 of 50 cxo
(October 2021 —June 2023)
XQ 103
**For binding passed through U-S. Health and 1 luman Services, 45 CFR Part 75; for funding passed through U.S.
Department of Education. 34 CVR Part 90.
STATE FINANCIAL ASSISTANCE. Contractors wh❑ receive state financial assistance and who are detennined to be a
recipient/sub-recipient must comply with the hollowing fiscal laws. rules, and regulations:
Sections 215.97 & 215.971, F.S.
Chapter 691-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws. rules, and regulations
CAO
Page 28 of 50
(October 2021 -- June 2023)
XQ 103
ATTACHMENT H-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 11, Exhibit 1, be provided to the recipient. Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
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
C--FDA
AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CI=R 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,
Specific Appropriation 397A
65,013
$250,000.00
TOTAL AWARD
1 $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 Cornpliance Suppiernent
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
GAO
Page 29 of 50
(October 2021 —June 2023) \Q 143
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
DOEA will not award this contract finless Contractor completes this CERTIFICATIONS AND ASSURANCES. in
performance of this contract, Contractor provides the following certifications and assurances:
A. Debarment and Sus ension Certification 29 CFR Part_95 and 45 CFR Part 75)
B. Certification Re ardin g Lobbvin 29 CFR Part 93 and 45 CFR Part 93
C. Nondiscrimination & Eg ual Opportuni 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 Or anizations 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 1ntvgrfty Compliance for Contracts, Agreements, Grants, Loans, and
Cooperative Agreements
H. Verification of Fm ployment Status Certification
I. Records and .Documentation
J. Certification Regardinlz 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. [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 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?. 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 belies; 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 malting of any Federal grant, the making of any Federal loan,
C'No
Page 30 of 50
(October 2021 — June 2023)
XQ l 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 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 employer 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 he included in the documents for ail 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 (W€A), (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 W1A 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
discriminations tinder any program or activity for which the Applicant receives Federal financial assistance from the
Department.
3. Section 504 ofthe Rehabilitation Act of 1973 (Pub. L. 93-1 12), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and 1-1uman 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 lieaIth and 1-1uman Services (45 CFR Part 91), to the end that, in accordance
with the Act and thc: 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 sub;ecled to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Department.
5. Title I of the P_ducation Amendments of 1972 (Pub. L. 92-318), as arnended, 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 W1A Title 1 - financially assisted program or
activity, and to all contracts Contractor makes to carry out the W I A Title € — financially a-"isted program or activity.
CNO
Page 31 of 50
(October 2021 —.line 2023 )
XQ103
Contractor understands that DOE,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 Puhlic 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 inforni ❑OEA 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 P, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 20I1, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. I i 1-117 are available under the conditions provided by Pub. L. 1 11-1 17.
The undersigned shall require that language of this assurance be included in the docurents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreerents) 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.
lrthis contract is in the amount of $l 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 certif (cation, 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 afl contract supported activities; and (3) the comparison of out 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
Page32 of50 Cali
(October 2021 —.tune 2023)
XQ 103
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. AiI
versions ofthese 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. [n 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
require([ corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
S. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies
arising From data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Department, Contractor certifies the use of the U.S. Department of Homeland
Security's F-verify system to verify the employment eligibility of all new employees hired by Contractor during the
contract terni 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 F-verify
system to verify the employment eligibility of all new employecs hired by the Subcontractor during the entire contract
term.
'The Contractor shalt require that the language of this certification be included in all sub-agreetnen€s, sub -grants, and
other agrecittents/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 an 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 1 19.0701(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 1 19.0 ] (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 1 19,07, F.S, states that every person who has custody of such a public record
shalt permit the record to be inspected and copied by any person desiring to do so. under reasonable circumstances.
Page 33 of 50 CAO
(October 2021 —June 2023) XQ103
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 a above are true and correct.
3339 East Tamiami Trail, Bldg. H Suite 211
Signature a Title of Aut orized Rep sentative
Street Address
Collier County Board of County Commissioners
Naples, FL 34112
Contractor Date
City, State, Zip code
XLJtVT ,L j_pNZF.L CLERK
]0C
AtteS'�s't�nCt� alrman`�
"'nature only.
Approved as to form and Iegality
Ass , i�t County Att y
CAO
Page 34 of 50
(October 2021 - .tune 2023)
XQ 103
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
f'or 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 ror reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
PLEASE ❑O NUT 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 ii'appropriate. the state, through arty
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.
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 tinder one of the 19 statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personae] 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 V1 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 Art of 1973, as amended (29 U.S.C.
§ 794), which prohibits discritnination 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 Aicohoiism Prevention, Treatment and Rehabilitation Act of 1970 (1`.1.. 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 19112 (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 V I I I of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific
statute(s) under which application for federal assistance is being made; and 0) the requirements of any other
nondiscrimination statute(s) which may apply to the application.
7. Will comply. or has already complied, with the requirements of Titles 11 and 111 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. 'f hese requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
CAO
Page 35 of 50
(October 20211 — June 2023)
xQ l 03
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 1 1738; (c) protection of wetlands
pursuant to UO 11990. (d) evaluation of flood hazards in tloodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management prograin developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. § 1451 et seq.); (f) confonnity of federal actions to State (Clear Airy 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 drinki rig water under the Safe ❑rinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection ❑f
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 (I6 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 liistoric 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 (1 b 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,
SIGNATTURRE/F ;��O1ZE.D RT G "FILIAL TITLE,, ,
APPLICA fntvy
RGANiLA'['ION DATE SUBMITTED
Collier Co Board,of County Commissioners
A 1'TI
CRYS`iAL. � '3 I... C.GER�
"1*
by �� Page 36 of 50
S
sionafurP4ni .
Approved as to form and legality
— �\ CLA3 ��_ - CAA
AssQnt County AttVI�7_
(October 2021 — June 2023)
XQ 1 U3
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name County AAA/Contractor
Address Completed By
City, State, Zip Code Da14 Telephone
PAKI 1: REAl) "1 HIS A"I"I"At'III:D INSTRIICTIONS FOR II.L[rSTRATIVI; IiVFOlkNln1-ION WIIIC]I WILL tIEF.P YOIi CO><iPI_,I, Il::
THIS FORM.
1. Briefly describe the geographic area served by the progratn/facility and the type of service provided;
For quest ions 2-5 please indicate the tot
2. Population of area served
3. Staffcurrently employed
4. Clients currently enrolled/registered
5. Advisory lGovern irig Board ifapplicable
lowing:
focal #
%
White
%
Black
%
Hispanic
%
Other
0/0
1=emmile
%
Disabled
Over44
Source of data -
Effective date:
Effective date:
PART II: [ISE A SEPARATE st1LET 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
❑
❑
❑
7.
Compare the staff composition to the population. Is staff representative of the population?
NIA
YES
NO
❑
❑
❑
8.
Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
NIA
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
NIA
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 programMacility accessible to non-English speaking clients?
NIA
YES
NO
❑
❑
❑
12. Are employees, applicants and participants informed of their protection against discrimination? if YES, how?
N/A
YES
NO
Verbal ❑ Written ❑ Poster ❑
❑
❑
❑
CCAp
Page 37 of 50
(October 2021 — .1une 2023)
XQ 103
13. Give the number and current status of any discrimination complaints regarding services or employment filed NIA NUMBER
against the program/facility. ❑
14. Is the program/facility physically accessible to mobility. hearing, and sight -impaired individuals?
NIA
YES NO
❑
❑ ❑
PART III: TIT FOLLOW]NC QUESTIONS APPLY TO PROGRAMS AND FACILITIES W1TI] 15 OR MORE EMPLOYEES. I 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?
❑
❑
19.Are auxiliary aids available to ensure accessibility of services to hearing and sight -impaired individuals?
YES
NO
❑
❑
PART IV: FOR PROGRAMS OR FACILITIES WITII 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $59,1100.00 OR MORE.
20. Do you have a written affirmative action plan? If NO, explain.
YES
NO
❑
❑
Reviewed by
In Compliance: YES ❑ NQ* ❑
Program Office
*Notice of Corrective Action Sent 1 1
Date Telephone
Response Due 1 1
On -Site ❑ Desk Review ❑
Response Received 1 1
��D
Page 38 of 50
(October 2021 —June 2023) XQ103
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECIUAST
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.
Z. 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 sunmary.
4. Enter the total m:mber 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 rile an assurance that the program will be conducted in
compliance with ail 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 ofthe staff reflective of the general population? For example, if 10%oftlie population
is Hispanic, is there a comparable percentage of Hispanic staff?
S. 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 roust 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
disabiiity. Also, residents must not be asked whether they are willing to share accommodations with persons of a
different race, colas-, 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 inay 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 with will assist in the provision
of services. 45 CFR § 80.3(a).
12. Programs/facilities must maize information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any ether 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 informations 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 involver) (e.g. services or employment, placement,
CA ❑
Page 39 of 50
{October 202I —,lone 2023)
XQ 103
termination, etc.}, indicate the civil rights law or policy alleged to have been violated along witli the name and address
ofthe local, state, or federal agency with whom the complaint has been filed. Indicate the current status nfthe 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, restroonts, 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 Rehabiiitation Act of 1973 requires that a recipient of federai 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)lorganiaation(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 rcmediat 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 Cf R § 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 programlf'acility does not discriminate on the basis of
handicap in violation of Sections 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. AuxiIiar-v aids may include., but are not limited to, brai led and taped materials, interpreters, and other
aids for personas 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
f r5
O
d
X
F"
Ck
wo
a
H
dU
G�
F
z
O
U
W
E�
Q
H
Q
E-r
U
O
U
C/7
U
ct
4-4
U
a�
Cd
cin
Cr]
a
U
0
i-.
a
f
n�o
(October 2021 — June 2023)
Dcpartmcnr vi
ELD ER AFFAI R5
STATE OF FLORIDA
ATTACHMENT VII
BACKGROUND SCREENING
BACKGROUNDSCREENING
Attestation of Complianee -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.
XQ 1 03
Ron DcSantis
Governor
Richard Prudona
Stererary
➢ 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. 8I7.568. The term includes coordinators, managers, and supervisors of
residential facilities and volunteers." § 430.0402(1)(b), F[a.Stat.
ATTESTATION:
As the duly authorized representative of
Collier County Board of County Cornrnissioners
Employer Name
located at 3339 `Fainiatni Trail L Naples FL 34112
Street Address
City slate
ZIP code
I, 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 rding level 2 background screening.
Signature rfRp,,,et,1iV'e Date
DOF.A Fonn215, Attearwion clCbmphance - Employer, Effective January 19, 2021 Section 435A.5(3),
F.S. Faro¢itg3lr;gihikps:Jefdrrjfairs.ntg.hrp-raiuenr•uplouefs�ifneafprnr•235-ar►esrarrnn-njrnnrpliarrce-emplotierprlf
Approved as to form and legality
C R'1�-'�•AL I4. MZEi CLEM 9
Page 42 of 50 C,O
HY 1
. Ass ant County —At y
;; n,t+ttre nn
(October 2021 — June 2023)
ATTACHMENT VIII
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES (CMBE FORM)
CMBE FORM MUST ACCOMPANYINVOICES SUBMITTED TO DOEA
CONTRACTOR NAME:
DOEA CONTRACT NUMBER:.
XQ 103
*REPORTING PERIOD -FROM: TO:
*(DATE RANGE OF RENDERED SERVICES, MUST MATCH INVOICE SUBMITTED TO DOEA)
DOER CONTRACT MANAGER:
REPORT ALL EXPENDITURES MADE TO CERTIFIED MINORITY BUSINESS (SUBCONTRACTORS).
CONTACT DOEA CMBE COORDINATOR FOR ANY UESTIO�V.S AT 85D-MI 4-2I 53.
SUBCONTRACTOR NAME SUBCONTRACTOR'S CMBE EXPENDITURES
FEW
DOEA USE ONLY — REPORTING ENTITY (DIVISION, OFFICE, ETC)
SEND COMPLETED FORMS V1A INTEROFFICE MAIL TO: JUSTIN TAYLOR
CMBE COORDINATOR, CONTRACT ADMINISTRATION & PURCHASING, TALLAHASSEE, FLORIDA 32399-7000.
Page 43 of 50
(.October 2021 —June 2023)
XQ 103
If unsure if subcontractor is a certified minority supplier. click on the hyperlink below. Enter the name of the supplier, click
"search". Only Certified Minori Business Entities will be dis la ed.
htt s:llosd.dms.mvfio:•ida.coirldirectories
INST RUCT'ION,5
(A) ENTER THE COMPANY NAME AS IT APPEARS ON YOUR DOER CONTRACT.
(B) ENTER'I"III~ DOER 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 CERTIFIE❑ MINORITY BUSINESS NAME.
2. ENTER THE CERTIFIE❑ 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) ]VIBE 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.
C'ICG
Page 44 oF50
(October 2021 —June 2023)
ATTACHMENT IX
STATEMENT OF USE OF FUNDS (ESTIMATED BUDGET)
XQ103
SENIOR CENTERS
STATEMENT OF USE OF FUNDS
Project Name: Golden Gate Senior Center Expansion & Hardening
Total Project Budget: $3,494,521
TYPE AND SOURCE OF FUNDS:
Sr. Center
state
FCO
Funds
Matching
Funds
Other
Nan-FCO Funds
Total
Project
Funds
Federal Grant(s)
CDBG-MIT Hardenin
Other State Funds i.e., DCA
Ci /Co unty Grants)
Senior Centers FC❑ Grant
$250,000.00
Private Contributions/Donations
In -Kind Expenditure Credits
Total Funds Available From All Sources
S 250,000.00
$ -
$ -
$ _
SITE WORK
Parking Lot
Walks/DrIvewa s
Awnin slCovered Walkways
Drainage/Retention Pond
Trees/LandscapingTrees/Landscaping
$20,000,00
Fencing
Si page
Other (Turn lane installation)
$100,000.00
Other (Remove and repair obstructions)
$220,000,00
Total
$ -
$ -
$ 340,000.00
$ -
INTERIOR
I nsulationNVeatherization
Plumbing
Heating/Air Conditioning
E fectrical
Flooring
Masonry
Ceiling/Acoustics
Railing/Guards
Elevators
Other (Interior Hardening)
$810,031.00
Total
$
$
$ 810,031.00
$
Page 45 of 50
(October 2021 — June 2023)
xp103
Roofing/Siding
DoorslWindows
Porches, becks, Patios
Septic Tank
$168.000.00
$300.000.00
$205,000.00
Sewer Hook -Up (City/County)
Generator (Gas Powered)
Other (Exterior Hardening)
Total
$
$ -
$493,400.00
$383,230.00
$ 1,549,630,00
$
FIXTURES11EQUIPMENTIAPPLIANCES
5ecuritylAlarm System
Telephone System
Smoke Detectors
EmergencylFirst Aid Stations
Kitchen Appliances
Cabin etslCounter Tops
Bathroom Fixtures
Lighting Fixtures
Other (FF & E)
$175,000.00
Total
$ -
$ 175,000,00
$
PROFESSIONAL
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
$ 250,000M
$ -
$
TOTAL PROJECT COST
$ 250,000A0 1
$ 425,000.00
$ 2,819,521,04 1
$ -
C,110
Page 46 of 50
(October 2021 — June 2023)
ATTACHMENT X
RECEIPTS AND EXPENDITURE REPORT FIXED CAPITAL OUTLAY
XQ ] 03
RECEIPTS AND EXPENDITURE REPORT FIXED CAPITAL OUTLAY
Tits Rgrart Period
RECIPIENT NAME ADDRESS, PHONE# and FEIDR
Prc-prn Scu:e
From
To
Contract Period
General Revenue
Cornract #
Imace#
CERTMCATION I certify 0 the best of my krnvrledge and gelid the this report is complete and c arecl a-d all the outlays heren are for the purposes set forth in the
above c aYracI
Prepared by
Date Approved by
Gate
1. Approved
2. Requested
3. Receipts
A Taal Receipts
5- Pereemof
PART A: BUDGETED 1NCO IvEJ RECEIFTS
Contact Budget
Receipts for this
A4im6ursed Year to
(Box 2 + Box 3.)
Approved Budget
Report
Date
(Box 4,Box 1.)
1 Slate Funds
0 v
0 04
0 0D
IPolwor
2 TOTAL RE CEIPTS
0 CID
0 CID
0 40
000
#DIWOr
1- Approved Budget
2 Requested
3. Expenditures
4, Tca1
5. Percent of
PART B : EXPENDITURES
dertity Line Item Categories hm A pprowd
Budget)
t_xPen ditures For
This Report
Reirn6urwd Year to
Dale
Expenditure's (Box
2+ Box 3
Approved Budget
[Sox 4.Box 1.)
1 Sae Work - ..
000
000
000
D 00
VDIVID1
2 tritenor--
000
000
000
000
IV10}
3 Exterior ..... .... ... .........
000
0.00
0.00
0. OD
F#olYlO}
4 Fixtures- .. .. ................. .....
000
000
DOD
000
r#DIV10(
5 PrakssimaFService.... ..... ........ ..
.....
000
000
0-00
000
#DIVAH
B Other ............... ................. ......
000
0.00
000
000
#DIV10I
7 TOTAL EXPE NOITURES
000
0.01)
0.00
000
p471Vr01
DOER ivrm 105f, rewed 9'MID
Page 47 of 50
C,10
(October 2021 — June 2023)
ATTACHMENT XI
COST RFIMBURSEMENT SUMMARY FORM
Cost Reimbursement Summary
Contract #
Report Number:
XQ 103
Page 48 of 50
(October 2021 — June 2023)
ATTACHMENT X11
REQUEST FOR PAYMENT FIXED CAPITAL OUTLAY
XQ 103
REQUEST FOR PAYMENT
FIXED CAPITAL OUTLAY
RECIPENT NAME, ADDRESS, PHONE# and FEIDli
PAYMENT REQUEST :
This Request Period
From To
Regular
liwaice A
Supplemental
Cc rYract u
Contract Period
CERTFIGATION: I hereby certifythatthis 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 Panod
$0_Q0
3. Contract Balance
$0.00
A. Previous Funds Requested and Not Resehrad for Contract Period
$0.00
5. Contract Balance
$0.00
PART B; CONTRACT FUNDS REQUEST
1. Net Experidilk" s ForMorth [DO EA Fom1105f, PertB 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 312017
Page 49 of 50
(October 2021 —June 2023)
ATTACHMENT XHI
FIXED CAPITAL OUTLAY CERTIFICATION
XQ 103
The Fixed Capital Outlay Certification acknowledges that . Owner, hereinafter
referred to as the Contractor, is using state funds in the form of 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 Llder Affairs,
Ifereinafter referred to as the ``Deparmment". The following items must be completed by the Contractor:
1. State the legal address of tile 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 tinder 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, improvenicnts, renovations,
or personality, unless the Department approves, in writing, the sate, 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 live (5) years from the date of
completion ofthe 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 shaII 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 corpletion 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
Ierms (if this contract.
SIGNAT[IRE OF AIJTIiORiZED CERTIFYING ❑FFICIAI. TITLE
APPLICANT ORGANIZATION DATE SLIBMITTED
Collier County Beard of County Commissioners
n
c
Page 50 of 50
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: CBJCHBCAABAAZposfNvTneVN5s1 W02_W6SrM-in5vvy2
"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.org)
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
Agreement completed.
2022-02-17 - 2:51:44 PM GMT
Adobe Sign