Agenda 12/13/2022 Item #16D 3 (Provide uninterrupted support services to Collier Countys Services for Seniors Program elderly clients)12/13/2022
EXECUTIVE SUMMARY
Recommendation to approve an “After-the-Fact” first amendment and attestation statement with the Area
Agency on Aging for Southwest Florida, Inc., for Community Care for the Elderly and Alzheimer’s Disease
Initiative grant programs to increase the contract amount by $50,000 and $307,985.60, respectively, and
revise the Annual Budget Summary (Attachment VIII & Attachment X), and the supporting Budget
Amendments. (Human Services Grant Fund 707)
OBJECTIVE: To provide uninterrupted support services to Collier County’s Services for Seniors Program elderly
clients.
CONSIDERATIONS: The Community and Human Services (CHS) Division’s Services for Seniors Program
(CCSS) has been providing support to Collier County’s frail and elderly citizens for over thirty (30) years through
the Community Care for the Elderly (CCE), Alzheimer’s Disease Initiative (ADI), and Home Care for the Elderly
(HCE) grant programs. These grants are funded by the Florida Department of Elder Affairs (DOEA) through the
Area Agency on Aging for Southwest Florida (AAASWFL). These grants enable clients to remain in their homes
and live with independence and dignity.
The current Standard Contract for the CCE & ADI programs were approved by the Board of County
Commissioners (Board) on 09/13/2022 (Item 16D8).
The proposed first amendment for CCE 203.22.001 will increase the CCE funding by $50,000 to $1,120,993.48 and
revise the Annual Budget Summary (Attachment VIII). This program provides Personal Care, Homemaking and
Respite services to our elderly clients and will allow us to increase services to our existing seniors or add additional
new clients.
The proposed first amendment for ADI 203.22.001 will increase the ADI funding by $307,985.60 to $984,394.12
and revise the Annual Budget Summary (Attachment X). This program provides clients with Alzheimer’s
assistance to relieve the primary caregiver and provide Personal Care and Homemaking services. This will allow
for an increase in services to our existing seniors and the ability to add new clients to our program.
The increase in funding will allow Services for Seniors to provide case management and services based on current
and projected program needs. The CCE grant has a revised local match in the amount of $124,554.84*, this mat ch
will be partially met through the co-payments received from clients in the amount of $16,262, estimated local
vendor match contribution in the amount of $78,292.84 and local cash match of $30,000.
The following table provides a detailed breakdown of the increased award adjustment:
Program
Component
Project
Number
Current
Budget
Current
Total
Match
Local
Match
Vendor
Match
Current
Co-
Payment
Budget
Community Care
for the Elderly
(CCE)*
33817 $1,070,993.48 $118,999.28 $30,000.00 $72,737.28 $16,262.00
Alzheimer’s
Disease Initiative
(ADI)
33815 $676,408.52 NA $0.00 $0.00 $12,540.00
Total 2022 $1,747,402.00 $118,999.28 $30,000.00 $72,737.28 $28,802.00
Program
Component
Project
Number
Revised
Budget
Revised
Total
Match
Revised
Local
Match
Revised
Vendor
Match
Revised
Co-
Payment
16.D.3
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Requireme
nt
Budget
Community Care
for the Elderly
(CCE)*
33817 $1,120,993.48 $124,554.84 $30,000.00 $78,292.84 $16,262.00
Alzheimer’s
Disease Initiative
(ADI)
33815 $984,394.12 NA $0.00 $0.00 $12,540.00
Total $2,105,387.60 $124,554.84 $30,000.00 $78,292.84 $28,802.00
Program Project
Number
Award
Variance
Total
Match
Variance
Variance
Local
Match
Variance
Vendor
Match
Total Co-
Pay
Variance
Community Care
for the Elderly
(CCE)*
33817 $50,000.00 $5,555.56 $0.00 $5,555.56 $0.00
Alzheimer’s
Disease Initiative
(ADI)
33815 $307,985.60 NA $0.00 $0.00 $0.00
Total $357,985.60 $5,555.56 $0.00 $5,555.56 $0.00
*10% Match is Award divided by .9, multiplied by .1, per grantor requirement s, rounded to the nearest
dollar. The match is reduced by co-payment budget and vendor match contribution.
AAASWFL routinely sends CCSS agreements that require a 30-day turnaround time. This timeframe makes it
impossible to process the documents for the Board’s approval in the time requested by the AAASWFL. The
agreements for CCE and ADI, are being presented “After-the-Fact” because Collier County received the fully
executed agreements from AAASWFL on October 21, 2022. Pursuant to CMA #5330 and Resolution No. 2018-
202, the County Manager authorized the Public Services Department Head to sign the contracts. These contracts are
being presented for Board ratification. Collier County, as the Lead Agency, is responsible to respond to seniors’
needs and managing the spending authority for the Federal and State Funded Services for Seniors programs.
FISCAL IMPACT: Budget Amendments are required to recognize the additional grant revenue in the amount of
$50,000.00 for CCE and $307,985.60 for ADI. The Funds reside in the Human Services Grant Fund 707 Project
33817 (CCE) and 33815 (ADI). Local cash match is available through carry forward (Reserves) in Human Services
Grant Fund (707). The co-pay funds reside in the Human Services Grant Fund 707 Project 33627 (CCE Co-Pay)
and Project 33625 (ADI Co-Pay).
GROWTH MANAGEMENT: There is no Growth Management impact.
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a majority vote for Board
action. -DDP
RECOMMENDATIONS: To approve and authorize an “After-the-Fact” first amendment and attestation
statements with the Area Agency on Aging for Southwest Florida, Inc. for Community Care for the Elderly and
Alzheimer’s Disease Initiative grant programs to increase the contract amount by $50,000 and $307,985.60,
respectively and revise the Annual Budget Summary (Attachment VIII & Attachment X) and the supporting Budget
Amendments. (Human Services Grant Fund 707)
Prepared By: Wendy Klopf Grant Coordinator, Community & Human Service’s Division
ATTACHMENT(S)
1. CCE 203.22.01-_Executed (PDF)
16.D.3
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12/13/2022
2. ADI 203.22.01-_Executed (PDF)
3. (Linked) CCE_203.22 Executed (PDF)
4. (Linked) ADI 203.22_Executed (PDF)
5. Resolution 2018-202 (PDF)
16.D.3
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12/13/2022
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.3
Doc ID: 23769
Item Summary: Recommendation to approve an “After-the-Fact” first amendment and attestation statement with
the Area Agency on Aging for Southwest Florida, Inc., for Community Care for the Elderly and Alzheimer’s
Disease Initiative grant programs to increase the contr act amount by $50,000 and $307,985.60, revision to the
Annual Budget Summary (Attachment VIII & Attachment X), and the supporting Budget Amendments. (Human
Services Grant Fund 707)
Meeting Date: 12/13/2022
Prepared by:
Title: Operations Coordinator – Community & Human Services
Name: Wendy Klopf
11/14/2022 3:33 PM
Submitted by:
Title: Manager - Federal/State Grants Operation – Community & Human Services
Name: Kristi Sonntag
11/14/2022 3:33 PM
Approved By:
Review:
Operations & Veteran Services Jeff Newman Additional Reviewer Completed 11/16/2022 7:32 AM
Community & Human Services Tami Bailey Additional Reviewer Completed 11/16/2022 8:07 AM
Community & Human Services Kristi Sonntag CHS Review Completed 11/16/2022 10:32 AM
Community & Human Services Blanca Aquino Luque Additional Reviewer Completed 11/16/2022 5:18 PM
Public Services Department Jeff Newman PSD Level 1 Reviewer Completed 11/17/2022 12:54 PM
County Attorney's Office Derek D. Perry Level 2 Attorney Review Completed 11/17/2022 1:06 PM
Grants Therese Stanley Level 2 Grants Review Completed 11/28/2022 1:15 PM
Public Services Department Tanya Williams PSD Department Head Review Completed 11/30/2022 7:09 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 11/30/2022 8:55 AM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 12/01/2022 10:10 AM
County Manager's Office Ed Finn Additional Reviewer Completed 12/01/2022 7:19 PM
Grants Therese Stanley Additional Reviewer Completed 12/02/2022 12:37 PM
Community & Human Services Maggie Lopez Additional Reviewer Completed 12/05/2022 8:51 AM
Office of Management and Budget Christopher Johnson Additional Reviewer Completed 12/05/2022 11:27 AM
County Manager's Office Dan Rodriguez Level 4 County Manager Review Completed 12/05/2022 2:32 PM
Board of County Commissioners Geoffrey Willig Meeting Pending 12/13/2022 9:00 AM
16.D.3
Packet Pg. 1726
16.D.3.a
Packet Pg. 1727 Attachment: CCE 203.22.01-_Executed (23769 : AAA-CCE & ADI AMENDMENT 203.22.001 Additional funds)
16.D.3.a
Packet Pg. 1728 Attachment: CCE 203.22.01-_Executed (23769 : AAA-CCE & ADI AMENDMENT 203.22.001 Additional funds)
16.D.3.a
Packet Pg. 1729 Attachment: CCE 203.22.01-_Executed (23769 : AAA-CCE & ADI AMENDMENT 203.22.001 Additional funds)
16.D.3.b
Packet Pg. 1730 Attachment: ADI 203.22.01-_Executed (23769 : AAA-CCE & ADI AMENDMENT 203.22.001 Additional funds)
16.D.3.b
Packet Pg. 1731 Attachment: ADI 203.22.01-_Executed (23769 : AAA-CCE & ADI AMENDMENT 203.22.001 Additional funds)
16.D.3.b
Packet Pg. 1732 Attachment: ADI 203.22.01-_Executed (23769 : AAA-CCE & ADI AMENDMENT 203.22.001 Additional funds)
16.D.3.e
Packet Pg. 1733 Attachment: Resolution 2018-202 (23769 : AAA-CCE & ADI AMENDMENT 203.22.001 Additional funds)
16.D.3.e
Packet Pg. 1734 Attachment: Resolution 2018-202 (23769 : AAA-CCE & ADI AMENDMENT 203.22.001 Additional funds)
(July 2022 - June 2023) ADI 203.22
ALZHEIMER'S DISEASE INITIATIVE PROGRAM STANDARD CONTRACT
COUNTY BOARD OF COUNTY COMMISSIONERS
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and
Count Board of County Commissioners (Contractor), collectively referred to as the “Parties.” The term Contractor for
this purpose may designate a Vendor, Subgrantee, or Subrecipient.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and
WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services
as an independent Contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions set forth herein, the Parties agree as follows:
to exceed $ , subject to the availability of funds. Any costs or services paid for under any other contract
or from any other source are not eligible for payment under this contract.
Renewals:
By mutual agreement of the Parties, in accordance with Section 287.058(1)(g), Florida Statutes (F.S.), the Agency may
renew the contract for a period not to exceed three years, or the term of the original contract, whichever is longer. The
renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs for the
renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and contingent
upon satisfactory performance evaluations by the Agency and the availability of funds.
Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) Part 75 and/or
45 CFR Part 92, 2 CFR Part 200, and other applicable regulations.
If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42
United States Code (U.S.C.) § 7401, et seq.), Section 508 of the Federal Water Pollution Control Act as
amended (33 U.S.C. § 1251, et seq.), Executive Order 11738, as amended, and, where applicable,
Environmental Protection Agency regulations 2 CFR Part 1500. The Contractor shall report any violations
of the above to the Agency.
Neither the Contractor nor any agent acting on behalf of the Contractor may use any federal funds received
in connection with this contract to influence legislation or appropriations pending before Congress or any
state legislature. The Contractor must complete all disclosure forms as required, specifically the
6.1.2
6.1.3
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Purpose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments, forms, and exhibits which constitute the contract document.
Incorporation of Documents within the Contract:
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department handbooks,
manuals and/or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides
to the contrary. In the event of conflict in language among any of the documents referenced above, the specific
provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or
other general materials not specific to this contract document and identified attachments.
Term of Contract:
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1, 202 or on the date the contract has
been signed by the last party required to sign it, whichever is later. It shall end at eleven fifty-nine (11:59) P.M., Eastern
Standard Time June 30, 202.
Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not
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(July 2022 - June 2023) ADI 203.22
Certification and Assurances Attachment, which must be completed and returned to the Contract Manager
prior to the execution of this contract.
In accordance with Appendix II to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92, if applicable.
A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government-wide Excluded Parties List System, in accordance with
the Office of Management and Budget (OMB) guidelines at 2 CFR Part 180 that implement Executive
Orders 12549 and 12689, “Debarment and Suspension.” The Excluded Parties List System contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549. The Contractor shall
comply with these provisions before doing business or entering into subcontracts receiving federal funds
pursuant to this contract. The Contractor shall complete and sign the Certifications and Assurances
Attachment prior to the execution of this contract.
6.1.4
6.1.5
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. § 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. § 1101). Such violation will be cause for unilateral cancellation of
this contract by the Agency.
If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N), and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
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.
To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-116, Contractor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in related
subcontracts a requirement that Subcontractors performing work or providing services pursuant to the state
contract utilize the E-verify system to verify employment of all new employees hired by the Subcontractorduring
the contract term. Contractors meeting the terms and conditions of the E-Verify System are deemed to bein
compliance with this provision.
6.3
6.4
6.5
6.6
7. Compliance with State Law:
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed, and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations including,
but not limited to, the Reference Guide for State Expenditures.
The Contractor shall comply with the requirements of Section 287.058, F.S., as amended.
7.2
7.3
7.3.1
7.3.2
The Contractor shall perform all tasks contained in Attachment I.
The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment I, to be received and accepted by the Agency Contract Manager prior to payment.
The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I, Section III. Method of Payment.
The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre-audit and post-audit.
7.3.3
7.3.4
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7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit invoices
for any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be provided
in this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in Section 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except
for those records which are made confidential or exempt by law. The Contractor’s refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate this contract.
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).
Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
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.
The Agency may, at its option, terminate the Contract if the Contractor is found to have submitted a false
certification as provided under Section 287.135(5), F.S., has been placed on the Scrutinized Companies with
Activities in the Iran Petroleum Energy Sector List, the Scrutinized Companies with Activities in Sudan List, or
the Scrutinized Companies that Boycott Israel List, or if the Contractor has been engaged in business operations
in Cuba or Syria or is engaged in a boycott of Israel.
7.4
7.5
7.6
7.7
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 Agency’s level 2 background screening pursuant to Sections 430.0402(2)-(3), F.S. The Contractor must
also comply with any applicable rules promulgated by the Agency and the Agency for Health Care Administration
regarding implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate compliance with this provision,
Contractor shall submit the Background Screening Affidavit of Compliance (Screening Form) to the Agency within
thirty (30) days of execution of this contract. Should the Agency have a completed Screening Form on file for the
Contractor, a new Screening Form will be required every twelve (12) months.
8.1 Further information concerning the procedures for background screening may be found at
http://elderaffairs.state.fl.us/doea/backgroundscreening.php.
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with, or denial of, service(s) and to address complaints regarding the
termination, suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum, will
provide for notice of the grievance procedure and an opportunity for review of the Subcontractor’s determination(s).
Public Records and Retention:
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall:
10.
10.1.1
10.1.2
Keep and maintain public records required by the Agency to perform the contracted services.
Upon request from the Agency’s custodian of public records, provide the Agency a copy of the requested
records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed
the cost provided in Chapter 119, F.S., or as otherwise provided by law.
Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor to the Agency or will keep and maintain public records required by
the Agency. If the Contractor transfers all public records to the Agency upon completion of the contract,
Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt,
10.1.3
10.1.4
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from public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for retaining public
records. All records stored electronically must be provided to the Agency in a format that is compatible
with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for refusal
by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,papers,
letters, or other material made or received by the Contractor in conjunction with this contract, unless the records
are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and Section
119.07(1), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119,
FLORIDA STATUTES, TO THE CONTRACTOR’S DUTY TO PROVIDE PUBLIC RECORDS
RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
2830 Winkler Avenue, Suite 112
Fort Myers, FL 33916
239-652-6900
10.3 Upon termination of this contract, whether for convenience or for cause as detailed in section 53 of this contract,
the Contractor and Subcontractors shall, at no cost to the Agency, transfer all public records in their possession to
the Agency and destroy any duplicate public records that are exempt, or confidential and exempt, from public
records disclosure requirements. All records stored electronically shall be provided to the Agency in a format that
is compatible with the information technology systems of the Agency.
Audits, Inspections, Investigations: 11.
11.The Contractor shall establish and maintain books, records, and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest, and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and ensure that
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six (6) years after completion of the contract, or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
The Contractor shall ensure that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and federal
auditors, pursuant to 45 CFR Part 75, shall be allowed full access to and the right to examine any of the
Contractor’s contracts and related records and documents pertinent to this specific contract, regardless of the
form in which kept.
The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this contract and
ensure that all related third-party transactions are disclosed to the auditor.
Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing
performed pursuant to Section 20.055, F.S. Contractor further agrees that it shall include in related subcontracts
a requirement that subcontractors performing work or providing services pursuant to this contract agree to
cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant to
11.
11.
11.
11.
11.
11.
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Section 20.055(5), F.S. By execution of this contract the Contractor understands and will comply with this
subsection.
In accordance with Executive Order 20-44 which requires executive agencies to submit a list of entities named
in statute with which a state agency must form a sole-source, public-private agreement or an entity that, through
contract or other agreement with the state, annually receives 50% or more of their budget from the State or from
a combination of State and Federal funds. Any Contractor that meets one or both of the criteria listed must submit
an annual report, including the most recent IRS Form 990, detailing the total compensation for the entities'
executive leadership teams within thirty (30) days of execution of this contract.
11.
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.
The Contractor shall inform the agency of any changes in total executive compensation between the
annual reports as those changes occur.
All compensation reports must indicate what percent of compensation comes directly from the State or
Federal allocations to the contracted entity.
11.8.2
11.8.3
12. Nondiscrimination-Civil Rights Compliance:
12.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.
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.
The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures shall include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the any statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency may, at its discretion, seek a court order requiring compliance with the terms of this
assurance or seek other appropriate judicial or administrative relief including, but not limited to, termination of
the contract and denial of further assistance.
12.
12.
12.
13. Monitoring by the Agency:
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers, documents,
facilities, goods, and services of the Contractor which are relevant to this contract, and to interview any clients,
employees, and Subcontractor employees of the Contractor to assure the Agency of the satisfactory performance of the
terms and conditions of this contract. Following such review, the Agency will provide a written report of its findings to
the Contractor and, where appropriate, the Contractor shall develop a Corrective Action Plan (CAP). The Contractor
hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determinedby the Agency’s Contract
Manager.
Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
14.
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15. Coordinated Monitoring with Other Agencies:
If the Contractor receives funding from one or more State of Florida human service agencies, in addition to the Agency,
then a joint monitoring visit including such other agencies may be scheduled. For the purposes of this contract, and
pursuant to Section 287.0575, F.S., as amended, Florida’s human service agencies shall include the Agency, the
Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities, and the
Department of Veterans’ Affairs. Upon notification and the subsequent scheduling of such a visit by the designated
agency’s lead administrative coordinator, the Contractor shall comply and cooperate with all monitors,inspectors, and/or
investigators.
New Contract(s) Reporting:
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the remaining four
(4) state human service agencies. The notification shall include the following information: (1) 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.
16.
17. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from any
and all claims, demands, actions, and causes of action of whatever nature or character arising out of, or by reason of,
the execution of this contract or performance of the services provided for herein. It is understood and agreed that the
Contractor is not required to indemnify the Agency for claims, demands, actions, or causes of action arising solely out
of the negligence of the Agency.
17.Except to the extent permitted by Section 768.28, F.S., or other Florida law, this Section 17 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
18. Insurance and Bonding:
18.The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance coverage necessary to provide reasonable financial
protections for the Contractor and the clients to be served under this contract. The limits of coverage under each
policy maintained by the Contractor do not limit the Contractor’s liability and obligations under this contract.
The Contractor shall ensure that the Agency has the most current written verification of insurance coverage
throughout the term of this contract. Such coverage may be provided by a self-insurance program established
and operating under the laws of the State of Florida. The Agency reserves the right to require additional insurance
as specified in this contract.
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.
18.
19. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
to give that consent or when authorized by law.
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).
Incident Reporting:
20.
21.
21.The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the Contractor’s
awareness or discovery of conditions that may materially affect the Contractor’s or Subcontractor’s
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ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Agency’s Contract Manager (by telephone) with an email to immediately follow.
The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor, its
Subcontractors, and their employees.
21.
22. Bankruptcy Notification:
During the term of this contract, the Contractor shall immediately notify the Agency if the Contractor, its assignees,
Subcontractors, or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Contractor must also
provide the following information to the Agency: (1) the date of filing of the bankruptcy petition; (2) the case number;
(3) the court name and the division in which the petition was filed (e.g., Northern District of Florida, Tallahassee
Division); and (4) the name, address, and telephone number of the bankruptcy attorney.
23. Sponsorship and Publicity:
23.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 asthe
name of the organization.
The Contractor shall not use the words “Area Agency on Aging for Southwest Florida, Inc. and/or State of
Florida Department of Elder Affairs” to indicate sponsorship of a program otherwise financed, unless specific
written authorization has been obtained by the Agency prior to such use.
23.
24. Assignments:
24.The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency. Any sublicense, assignment, or transfer otherwise occurring without prior written
approval of the Agency shall constitute a material breach of the contract. In the event the State of Florida
approves assignment of the Contractor’s obligations, the Contractor remains responsible for all work performed
and all expenses incurred in connection with this contract.
The State of Florida is, at all times, entitled to assign or transfer, in whole or part, its rights, duties, or obligations
under this contract to another governmental agency in the State of Florida upon giving prior written notice to the
Contractor.
This contract shall remain binding upon the successors in interest of the Contractor and the Agency.
24.
24.
25. Subcontracts:
25.The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor further
agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The Contractor, at
its expense, shall defend the Agency against any such claims.
The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
25.
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 Agency, and that they shall not hold themselves out as employees or agents
of the Agency without prior specific authorization from the Agency. It is the further intent and understanding of the
Parties that the Agency does not control the employment practices of the Contractor and will not be liable for any wage
and hour, employment discrimination, or other labor and employment claims against the
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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.
Payment:
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The AGENCY Contract Manager will have final approval of the Contractor’s invoice submitted for
payment and will approve the invoice for payment only if the Contractor has met all terms and conditions of the contract,
unless the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted
to the Agency’s finance section for budgetary approval and processing. Disputes arising over invoicing and payments
will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor Ombudsman has beenestablished
within the Florida Department of Financial Services and may be contacted at 800-342-2762.
27.
28. Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed, and any interest
attributable to such funds pursuant to the terms and conditions of this contract, that were disbursed to the Contractor by
the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment hasbeen made, the
Contractor shall repay said overpayment immediately without prior notification from the Agency. In the event that the
Agency first discovers an overpayment has been made, the AGENCY Contract Manager will notify the Contractor in
writing of such findings. Should repayment not be made forthwith, the Contractor shall be charged at thelawful rate of
interest on the outstanding balance pursuant to Section 55.03, F.S., after Agency notification or Contractor discovery.
Data Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages of
the computer system. The security over the backed-up data is to be as stringent as the protection required of the primary
systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system backup and
recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance for
Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
Computer Use and Social Media Policy:
The Agency has implemented a Social Media Policy, in addition to its Computer Use Policy, which applies to all
employees, contracted employees, consultants, Other Personal Services (OPS) employees and volunteers, including all
personnel affiliated with third parties, such as, but not limited to, contractors and subcontractors. Any entity that uses
the Agency’s computer resource systems must comply with the Agency’s policy regarding social media. Social Media
includes, but is not limited to, blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like
MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This policy is
available on the Agency’s website at: http://elderaffairs.state.fl.us/doea/financial.php.
Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management, and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer, or agent of the Contractor or Subcontractor shall participate in the
selection or in the award of a contract supported by state or federal funds if a conflict of interest, real or apparent, would
be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her immediate
family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the above individuals,
has a financial or other interest in the firm being selected for award. The Contractor’s or Subcontractor’s officers,
employees, or agents will neither solicit nor accept gratuities, favors, or anything of monetary value from Contractors,
potential Contractors, or parties to Subcontracts. The Contractor’s board members and management must disclose to the
Agency any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) calendar days
of an individual’s original appointment or placement in that position, or, if the individual is serving as an incumbent,
within thirty (30) calendar days of the commencement of this contract. The Contractor’s employees and
29.
30.
31.
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Subcontractors must make the same disclosures described above to the Contractor’s board of directors. Compliance
with this provision will be monitored.
32. Public Entity Crime:
Pursuant to Section 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction
or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a
public entity; may not be awarded or perform work as a Contractor, Supplier, Subcontractor, or Consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the date of
being placed on the Convicted Vendor List.
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.
33.1.1 IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES THAT ARE THE
SUBJECT OF, OR REQUIRED TO CARRY OUT, THIS CONTRACT SHALL BE PURCHASED FROM
A NONPROFIT AGENCY FOR THE BLIND OR FOR THE SEVERELY HANDICAPPED THAT IS
QUALIFIED PURSUANT TO CHAPTER 413, FLORIDA STATUTES, IN THE SAME MANNER AND
UNDER THE SAME PROCEDURES SET FORTH IN SECTION 413.036(1) AND (2), FLORIDA
STATUTES; AND FOR PURPOSES OF THIS CONTRACT THE PERSON, FIRM, OR OTHER
BUSINESS ENTITY CARRYING OUT THE PROVISIONS OF THIS CONTRACT SHALL BE
DEEMED TO BE SUBSTITUTED FOR THE STATE AGENCY INSOFAR AS DEALINGS WITH
SUCH QUALIFIED NONPROFIT AGENCY ARE CONCERNED.
33.1.2 Pursuant to sections 413.036(1) and (4), F.S., the Contractor shall not be required to procure a product or
service from RESPECT if: (a) the product or service is not available within a reasonable delivery time, (b)
the Contractor is required by law to procure the product or service from any agency of the state, or (c) the
Contractor determines that the performance specifications, price, or quality of the product or service is not
comparable to the Contractor's requirements.
33.1.3 This act shall have precedence over any law requiring state agency procurement of products or services
from any other nonprofit corporation unless such precedence is waived by the Agency in accordance with
its rules.
33.1.4 Additional information about the designated nonprofit agency and the products it offers is available at
http://www.respectofflorida.org.
33.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.
The Contractor shall procure products and/or services required to perform this contract in accordance with
section 946.515, F.S.
33.
33.3.1 IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES WHICH ARE THE
SUBJECT OF, OR REQUIRED TO CARRY OUT, THIS CONTRACT SHALL BE PURCHASED FROM
THE CORPORATION IDENTIFIED UNDER CHAPTER 946, F.S., IN THE SAME MANNER AND
UNDER THE SAME PROCEDURES SET FORTH IN SECTION 946.515(2) AND (4), F.S.; AND FOR
PURPOSES OF THIS CONTRACT THE PERSON, FIRM, OR OTHER BUSINESS ENTITY CARRYING
OUT THE PROVISIONS OF THIS CONTRACT SHALL BE DEEMED TO BE SUBSTITUTED FOR
THIS AGENCY INSOFAR AS DEALINGS WITH SUCH CORPORATION ARE CONCERNED.
The corporation identified is Prison Rehabilitative Industries and Diversified Enterprises, Inc. (PRIDE).
Additional information about PRIDE and the commodities or contractual services it offers is available at
https://pride-enterprises.org/.
33.3.2
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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 Agency, Division of Financial Administration, and must accompany each invoice submitted to
the Agency. The Office of Supplier Diversity (850-487-0915) will assist in furnishing names of qualified
minorities. The Agency’s Minority Coordinator (850-414-2153) will assist with questions and answers. The
CMBE Report is attached to this contract.
34. Patents, Copyrights, Royalties:
If this contract is awarded state funding and if any discovery, invention, or copyrightable material is developed or
produced in the course of or as a result of work or services performed under this contract or in any way connected with
this contract, or if ownership of any discovery, invention, or copyrightable material was purchased in the course of or
as a result of work or services performed under this contract, the Contractor shall refer the discovery, invention, or
copyrightable material to the Agency to be referred to the Department of State. Any and all patent rights or copyrights
accruing under this contract are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to
Section 287.0571(5)(k), F.S., the only exceptions to this provision shall be those that are clearly expressed and
reasonably valued in this contract.
34.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.
If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315 or
45 CFR § 75.322, as applicable.
Notwithstanding the foregoing provisions, if the Contractor or one of its Subcontractors is a university and a
member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency shall
retain a perpetual, fully-paid, nonexclusive license for its use and the use of its Contractors, Subcontractors,or
Assignees of any resulting patented, copyrighted, or trademarked work products.
34.
34.
35. Emergency Preparedness and Continuity of Operations:
35.If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety, or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the AGENCY Contract Manager,
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency of emergency provisions.
In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall remain
responsible for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
35.
36. Equipment:
36.Equipment means: (a) tangible personal property (including information technology systems) having a useful life
of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level
established by the organization for the financial statement purposes, or $5,000.00 [for federal funds - 2 CFR §
200.33 and 45 CFR § 75.2, as applicable], or (b); nonexpendable, tangible personal property of a non-consumable
nature with an acquisition cost of $5,000.00 or more per unit, and expected useful life of at least one (1) year;
and hardback bound books not circulated to students or the general public, with a value or cost of $250.00 or
more [for state funds].
Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, fully document, and notify the AGENCY Contract Manager of any loss, damage, or theft of
equipment.The Contractor shall provide the results of the investigation to the AGENCY Contract Manager.
36.
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36.The Contractor’s property management standards for equipment (including replacement equipment), whether
acquired in whole or in part with federal funds and federally-owned equipment shall, at a minimum, meet the
following requirements and shall include accurately maintained equipment records with the following
information:
36.3.1
36.3.2
Property records must be maintained that include a description of the equipment;
Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
Source of funding for the equipment, including the federal award identification number;
Whether title vests in the Contractor or the federal government;
Acquisition date (or date received, if the equipment was furnished by the federal government);
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);
Location, use and condition of the equipment and the date the information was reported;
Unit acquisition cost; and
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.
A physical inventory must be taken, and the results reconciled with the property records at least once
every two (2) years.
A control system must be developed to ensure adequate safeguards to prevent loss, damage, or theft of
the property. Any loss, damage, or theft must be investigated. 45 CFR § 75.320(d)(3).
Adequate maintenance procedures must be developed to keep the property in good condition.
If the Contractor is authorized or required to sell the equipment, proper sales procedures must be
established to ensure the highest possible return.
36.3.3
36.3.4
36.3.5
36.3.6
36.3.7
36.3.8
36.3.9
36.3.10
36.3.11
36.3.12
36.3.13
36.Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $5,000.00 is part of the cost of carrying out the activities and functions
of the grant awards and title (ownership) will vest in the Contractor [for federal funds see 2 CFR § 200.313(a)
and 45 CFR § 75.320(a), as applicable], subject to the conditions of 2 CFR Part 200 and/or 45 CFR Part 75.
Equipment purchased under these thresholds is considered supplies and is not subject to property standards.
Equipment purchased with funds identified in the budget attachments to agreements covered by this contract or
identified in the sub-agreements with Subcontractors (not included in a cost methodology), is subject to the
conditions of Chapter 273, F.S., rule 60A-1.017, F. A. C., and 2 CFR Part 200 and/or 45 CFR Part 75.
The Contractor shall not dispose of any equipment or materials provided by the Agency or purchased with funds
provided through this contract without first obtaining the approval of the AGENCY Contract Manager. When
disposing of property or equipment the Contractor must submit a written request for disposition instructions to
the Agency’s Contract Manager. The request should include a brief description of the property, purchase price,
funding source, and percentage of state or federal participation, acquisition date and conditionof 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.).
The AGENCY Contract Manager will issue disposition instructions. If disposition instructions are not received
within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized to
proceed as directed in 2 CFR § 200.313 or 45 CFR § 75.320, as applicable.
Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Section 3030b United States Code (U.S.C.). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of Section
216.348, F.S.
36.
36.
36.
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36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information Technology
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is
required for any computer related item costing $1,000.00 or more, including data processing hardware, software,
services, supplies, maintenance, training, personnel, and facilities. The completed ITR worksheet shall be
maintained in the LAN administrator's file and must be provided to the Agency upon request. The Contractor has
the responsibility to require any Subcontractors to comply with the Agency's ITR procedures.
PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http://www.myflorida.com/apps/vbs/adoc/F7740_PUR1000.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract, the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
Use of State Funds to Purchase or Improve Real Property:
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law.
Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the AGENCY Contract Manager, who shall
reducethe decision to writing and serve a copy on the Contractor.
Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency shall
impose financial consequences as stated in Attachment I.
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.
Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
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 Agency or the Contractor unless expressly contained herein or by a written amendment
to this contract signed by both Parties.
Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable,
the other provisions are severable to that void provision and shall remain in full force and effect.
Condition Precedent to Contract Appropriations:
The Parties agree that the Agency’s performance and obligation to pay under this contract are contingent upon an annual
appropriation by the Legislature.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
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47. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this contract
when deemed to be in the State of Florida’s best interest and reduced to a written amendment signed by both Parties.
The Parties shall negotiate compensation for any additional services added.
Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency’s right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
48.
49. Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules, and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor and subject the contract to immediate unilateral cancellation of
the contract at the discretion of the Agency.
Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days after the contract
ending date unless otherwise specified in Attachment I. If the Contractor fails to do so, all right to payment is forfeited
and the Agency shall not honor any requests submitted after the aforesaid time period. Any payment due under the terms
of this contract shall be withheld until all required documentation and reports due from the Contractor and necessary
adjustments thereto have been approved by the Agency.
Renegotiations of Modifications:
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency’s operating budget.
Suspension of Work:
The Agency may, in its sole discretion, suspend any or all activities under the contract or purchase order, at any time,
when in the interest of the State to do so. The Agency shall provide the Contractor written notice outlining the particulars
of suspension. Examples of the reason for suspension include, but are not limited to, budgetary constraints, declaration
of emergency, or other such circumstances. After receiving a suspension notice, the Contractor shall comply with the
notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period agreed to by the
Contractor, the Agency shall either: (1) issue a notice authorizing resumption of work, at which time activity shall
resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the Contractor to any
additional compensation.
Termination:
50.
51.
52.
53.
53. Termination for Convenience. The Agency, by written notice to the Contractor, may terminate this contract in
whole or in part when the Agency determines in its sole discretion that it is in the State’s interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to complete
the continued portion of this contract, if any. The Contractor shall not be entitled to recover any cancellation
charges or lost profits.
Termination for Cause. The Agency may terminate this contract if the Contractor fails to: (1) deliver the product
within the time specified in the contract or any extension, (2) maintain adequate progress, thusendangering
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 fromevents
completely beyond the control, and without the fault or negligence, of the Contractor. If the failure to perform is
caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyondthe control
of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
53.
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Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and remedies
provided by law or under the contract.
Electronic Records and Signature:
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use electronic
signatures to conduct transactions necessary to carry out the terms of this contract. A Contractor that createsand retains
electronic records and uses electronic signatures to conduct transactions shall comply with the requirementscontained in
the Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be fully auditable; are subject
to Florida’s Public Records Law, Chapter 119, F.S.; must comply with contract Section 29, Data Integrity and
Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and maintained by the
Contractor to the same extent as non-electronic records are retained and maintained as required by this contract.
54.
54.The Agency’s authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the Agency only
upon further written consent by the Agency.
Upon request by the Agency, the Contractor shall provide the Agency with non-electronic (paper) copies of
records. Non-electronic (paper) copies provided to the Agency of any document that was originally in electronic
form with an electronic signature must identify the person and the person’s capacity who electronicallysigned the
document on any non-electronic copy of the document.
54.
55. Contract Manager:
The Agency may substitute any Agency employee to serve as the AGENCY Contract Manager.
REMAINDER OF THE PAGE INTENTIONALLY LEFT BLANK
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56. Official Payee and Representatives (Names, Addresses, andTelephoneNumbers):
ADI 203.22
57. All Terms and Conditions Included:
This contract and its Attachments I – XVII, 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 sixty-three (63) page contract to be executed by their
undersigned officials as duly authorized.
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC. CONTRACTOR:
COUNTY BOARD OF COUNTY
COMMISSIONERS
SIGNED BY: SIGNED BY:
NAME: NAME:
TITLE: TITLE:
DATE: DATE:
Federal Tax ID: 59-6
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a.
The Contractor name, as shown on page 1 of this
contract, and mailing address of the official payee to
whom the payment shall be made is:
County Board of County Commissioners
b.
The name of the contact person and street address
where financial and administrative records are
maintained is:
Director
c.
The name, address, and telephone number of the
representative of the Contractor responsible for
administration of the program under this contract is:
d.
The section and location within the Agency where
Requests for Payment and Receipt and Expenditure
forms are to be mailed is:
Area Agency on Aging for Southwest Florida, Inc.
2830 Winkler Ave., Suite 112
Fort Myers, FL 33916
239-652-6922
e. The name, address, and telephone number of the
Contract Manager for this contract is:
Richard Cocchieri, &)2
2830 Winkler Ave, Suite 112
Fort Myers, FL 33916
239-652-6922
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be providedin
writing to the other party.
7DQ\D5:LOOLDPV
3XEOLF6HUYLFH'HSDUWPHQW+HDG
as designee of the County Manager,
pursuant to Resolution No. 2018-202.Approved as to Form and Legality:
_________________________________
Derek D. Perry
Assistant County Attorney CAO
WilliamsTanya
Digitally signed by
WilliamsTanya
Date: 2022.07.25 16:25:38
-04'00'
1 f 63
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_______________________________________
Derek D. Perry
Assistant County Attorney
2022.07.21 09:19:26-04'00'
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(July 2022 - June 2023) ADI 203.22
INDEX OF ATTACHMENTS
ATTACHMENT I ............................................................................................................................................................... 17
STATEMENT OF WORK .................................................................................................................................................. 17
ATTACHMENT II .............................................................................................................................................................. 31
FINANCIAL AND COMPLIANCE AUDIT ....................................................................................................................... 31
ATTACHMENT III ............................................................................................................................................................ 37
CERTIFICATIONS AND ASSURANCES .......................................................................................................................... 37
ATTACHMENT IV ............................................................................................................................................................ 42
ASSURANCES—NON-CONSTRUCTION PROGRAMS ................................................................................................... 42
ATTACHMENT V .............................................................................................................................................................. 44
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST................................... 44
ATTACHMENT VI ............................................................................................................................................................ 49
CONTRACTOR’S STATE CONTRACT LIST .................................................................................................................... 49
ATTACHMENT VIII ......................................................................................................................................................... 51
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES (CMBE FORM) ....................................... 51
ATTACHMENT IX ............................................................................................................................................................ 53
INVOICE REPORT SCHEDULE ...................................................................................................................................... 53
ATTACHMENT X .............................................................................................................................................................. 54
ANNUAL BUDGET SUMMARY ....................................................................................................................................... 54
ATTACHMENT XI ............................................................................................................................................................ 55
REQUEST FOR PAYMENT .............................................................................................................................................. 55
ATTACHMENT XII ........................................................................................................................................................... 56
RECEIPT AND EXPENDITURE REPORT ...................................................................................................................... 56
ATTACHMENT XIII ......................................................................................................................................................... 57
ANNUAL MODEL DAY CARE CENTER TRAINING REPORT ....................................................................................... 57
ATTACHMENT XIV .......................................................................................................................................................... 58
COST REIMBURSEMENT SUMMARY ............................................................................................................................ 58
ATTACHMENT XV ........................................................................................................................................................... 59
SERVICE RATE REPORT ................................................................................................................................................ 59
ATTACHMENT XVI .......................................................................................................................................................... 60
SILVER ALERT PROTOCOLS ......................................................................................................................................... 60
ATTACHMENT XVII ........................................................................................................................................................ 62
AGING AND DISABILITY RESOURCE CENTER (ADRC) SILVER ALERT SERVICES REFERRAL FORM ................. 62
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ATTACHMENT I
STATEMENT OF WORK
ALZHEIMER’S DISEASE INITIATIVE PROGRAM
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
1. Acronyms
Alzheimer’s Disease (AD)
Alzheimer’s Disease Initiative (ADI)
Activities of Daily Living (ADL)
Area Agency on Aging (AAA)
Assessed Priority Consumer List (APCL)
Adult Protective Services (APS)
Client Information and Registration Tracking System (CIRTS)
Community Care for Disabled Adults (CCDA)
Corrective Action Plan (CAP)
Dementia Care & Cure Initiative (DCCI)
Department of Elder Affairs (DOEA or Department)
Florida Administrative Code (F.A.C.)
Florida Statutes (F.S.)
Home Care for Disabled Adults (HCDA)
Instrumental Activities of Daily Living (IADL)
Memory Disorder Clinic (MDC)
Planning and Service Area (PSA)
Summary of Programs and Services (SOPS)
United States Code (U.S.C.)
2. Program-Specific Terms
Area Plan: A plan developed by the Contractor outlining a comprehensive and coordinated service delivery
system in the respective Planning and Service Area, in accordance with Section 306 of the Older Americans
Act (42 U.S.C. § 3026), as amended, and Agency instructions. The Area Plan includes performance measures
and unit rates per service offered per county.
Area Plan Update: A revision to the Area Plan wherein the Contractor enters ADI-specific data into the
CIRTS. An update may also include other revisions to the Area Plan as instructed by the Agency.
Department of Elder Affairs Handbook: An official document of DOEA. The DOEA Handbook includes
program policies, procedures, and standards applicable to agencies which are recipients/providers of DOEA
funded programs. An annual update is provided through a Notice of Instruction (NOI).
Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to
remain independent and in the least restrictive living arrangement.
Memory Disorder Clinic (MDC): Research oriented programs created pursuant to Sections 430.502(1) and
(2), F.S., to provide diagnostic and referral services, conduct basic and service-related multidisciplinary
research, and develop training materials and educational opportunities for lay and professional caregivers of
individuals with AD.
Notice of Instruction (NOI): The Department’s established method to communicate to the Contractor the
requirement to perform a task or activity. NOIs are located on the Department’s website at
http://elderaffairs.state.fl.us/doea/nois.php.
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Proviso: Language used in a general appropriations bill to qualify or restrict the way in which a specific
appropriation is to be expended.
Program Highlights: Success stories, quotes, testimonials, or human-interest vignettes that are used in the
Department’s Summary of Programs and Services (SOPS) to include information that helps tell the story of
how programs and services help elders, families, and caregivers.
Specialized Day Care: Licensed Specialized Alzheimer’s Services Adult Day Care Centers, licensed in
accordance with Section 429.918, F.S., that are considered models because they provide specialized
Alzheimer’s services for AD clients. FloridaHealthFinder.gov provides an up to date listing of all Specialized
Alzheimer’s Services Adult Day Care Centers.
Specialized Alzheimer’s Services: Specialized Alzheimer’s services, offered in day care centers include, but
are not limited to, those listed below:
i. Providing education and training on the specialized needs of persons with Alzheimer’s disease or related
memory disorders and caregivers.
Providing specialized activities that promote, maintain, or enhance the ADI client’s physical, cognitive,
social, spiritual, or emotional health.
Providing therapeutic, behavioral, health, safety, and security interventions; clinical care, and support
services for the ADI client and caregiver.
ii.
iii.
Summary of Programs and Services (SOPS): A document produced by the Department and updated yearly
to provide the public and the Legislature with information about programs and services for Florida’s elders.
B. GENERAL DESCRIPTION
1. General Statement
The purpose of the ADI is to address the special needs of individuals with AD, their families, and caregivers.
2. Alzheimer’s Disease Initiative Program Mission Statement
The ADI program assists persons afflicted with AD and other forms of dementia to live as independently as
possible with support to family members and caregivers.
3. Authority
The relevant authority governing the ADI Program includes:
a.Rule Chapter 58D-1, F.A.C.
b.Sections 430.501, 430.502, 430.503, and 430.504, F.S.; and
c.Catalog of State Financial Assistance (CSFA) Numbers 65004 and 65002.
4. Scope of Service
The Contractor is responsible for the programmatic, fiscal, and operational management of the ADI Program.
The program services shall be provided in a manner consistent with the Contractor’s Area Plan, as updated,
and the current DOEA Handbook, which are incorporated by reference. The Contractor agrees to be bound by
all subsequent amendments and revisions to the DOEA Handbook, and the Contractor agrees to accept all such
amendments and revisions via a NOI.
5. Major Program Goal
The major goal of the ADI Program is to provide services to meet the needs of caregivers and individuals with
AD or other related disorders.
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C. Clients to be Served
1. General Description
The ADI program addresses the special needs of individuals with AD or other related disorders and their
caregivers.
2. Client Eligibility
Clients eligible to receive services under this contract must:
a. Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be suspected of having
AD or a related disorder; or
If enrolled in Specialized Alzheimer’s Services Adult Day Care, be a participant who has a documented
diagnosis of Alzheimer’s disease or a dementia-related disorder (ADRD) from a licensed physician,
licensed physician assistant, or a licensed advanced registered nurse practitioner: and
Not be enrolled in any Medicaid capitated long-term care program.
b.
c.
3. Targeted Groups
Priority for services under this contract will be given to those eligible persons assessed to be at risk of
placement in an institution.
4. Client Determination
The Agency shall have final authority for the determination of client eligibility.
Contract Limits
In no case shall the Contractor be required to incur costs more than the contract amount in providing services
to the clients.
Clients Served
This contract does not provide for direct services to clients other than intake, information and referral services,
and screening.
5.
6.
II. MANNER OF SERVICE PROVISION
A. Service Tasks
To achieve the goals of the ADI program, the Contractor shall perform, or ensure that its subcontractors perform,
the following tasks:
1. Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in Section I.C.2.
2. Assessment and Prioritization of Service Delivery for New Clients
The Contractor shall ensure the following criteria are used to prioritize new clients in the sequence below for
service delivery. It is not the intent of the Agency to remove existing clients from services to serve new clients
being assessed and prioritized for service delivery.
a.Imminent Risk individuals: Individuals in the community whose mental or physical health condition has
deteriorated to the degree that self-care is not possible, there is no capable caregiver, and nursing home
placement is likely within a month or very likely within three (3) months.
b.Service priority for individuals not included above, regardless of referral source, will be determined
through the Agency’s functional assessment administered to each applicant, to the extent funding is
available. The Contractor shall ensure that priority is given to applicants at the higher levels of frailty and
risk of nursing home placement.
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3. Program Services
ADI 203.22
The Contractor shall ensure the provision of program services is consistent with the Contractor’s current Area
Plan, as updated and approved by the Agency, and the current DOEA Handbook.
4. Task Limits
The Contractor shall not perform any tasks related to the project other than those described in this contract
without the express written consent of the Agency.
B. Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for
a period of sixty (60) days or more of the initiation of the subcontract or the performance of the Subcontractor, the
Contractor shall notify the Agency’s Contract Manager and the Agency’s Chief Financial Officer in writing of
such delay. The Contractor shall not permit a Subcontractor to perform services related to this contract without
having a binding Subcontractor agreement executed. The Agency will not be responsible or liable for any
obligations or claims resulting from such action.
1. Copies of Subcontracts
The Contractor shall submit a copy of all subcontracts to the AGENCY Contract Manager within thirty (30)
daysof the subcontract being executed.
2. Monitoring the Performance of Subcontractors
The Contractor shall monitor, at least once per fiscal year, each of its subcontractors, subrecipients, vendors,
and/or consultants paid from funds provided under this contract. The Contractor shall perform fiscal,
administrative, and programmatic monitoring to ensure contractual compliance, fiscal accountability,
programmatic performance, and compliance with applicable state and federal laws and regulations. The
Contractor shall monitor to ensure that the budget is met, the scope of work is accomplished within the
specified time periods, and other performance goals stated in this contract are achieved.
3. Copies of Subcontractor Monitoring Reports
The Contractor shall forward a copy of all subcontractor Monitoring Reports to the AGENCY Contract
Managerwithin thirty (30) days of the report being issued to the Subcontractors, Subrecipients, Vendors,
and/or Consultants.
C. Staffing Requirements
1. Staffing Levels
The Contractor shall assign its own administrative and support staff as necessary to meet the obligations of
this contract and shall ensure that subcontractors dedicate adequate staff accordingly.
Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications as specified in the current DOEA Handbook.
2.
3. Service Times
The Contractor shall ensure the availability of the services listed in this contract at times appropriate to meet
client service needs including, at a minimum, during normal business hours, or as otherwise specified in
proviso or the Subcontractor’s approved service provider application. Normal business hours are defined as
Monday through Friday, 8:00 a.m. to 5:00 p.m. local time.
D. Service Location and Equipment
1. Service Delivery Location
Services will be provided as needed in locations determined by provider to best meet clients’ immediate
needs.
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2. Changes in Location
ADI 203.22
The Contractor shall notify the Agency in writing a minimum of one week prior to making changes in
location that will affect the Agency’s ability to contact the Contractor by telephone or facsimile.
3. Equipment
Contractor shall be responsible for supplying, at its own expense, all equipment necessary for its performance
under the contract including, but not limited to, computers, telephones, copiers, fax machines, maintenance, and
office supplies.
Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation required
to evidence the completion of the tasks specified in this contract.
E.
1. Delivery of Services to Eligible Clients
The Contractor shall ensure the provision of a continuum of services addressing the diverse needs of
individuals with AD and their caregivers. The Contractor shall ensure performance and reporting of the
following services in accordance with the Contractor’s current Agency-approved Area Plan, the current DOEA
Handbook, which is incorporated by reference, and Section II.A. of this contract. Documentation of service
delivery must include a report consisting of the following: number of clients served, number of serviceunits
provided by service, and rate per service unit with calculations that equal the total invoice amount. The
continuum of services provided under this contract include those identified by the following service categories:
a. Respite and Other Services
(1)Caregiver Training/Support.
(2)Case Aide.
(3)Case Management.
(4)Counseling (Gerontological).
(5)Counseling (Mental Health/Screening).
(6)Education/Training.
(7)Emergency Home Delivered Shelf Meals
(8)Home Delivered Meals
(9)Homemaker
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
Housing Improvement
Intake.
Material Aid
Model Day Care.
Personal Care
Respite (Facility-Based).
Respite (In-Home).
Respite (In-Facility, Specialized Alzheimer’s services)
Specialized Medical Equipment, Services, and Supplies; and
Transportation.
Shopping Assistance
Telephone Reassurance
b. Memory Disorder Clinics (MDCs)
The Contractor shall maintain coordination with the MDCs, the Alzheimer’s Disease and RelatedDisorders
Research Brain Bank (Brain Bank), and all other components of the ADI, as well as Silver Alert,in the
designated PSA. MDCs are required to provide annual in-service training to all respite, in-facility respite,
and model day care center staff in their designated service areas, and to plan and develop service-related
research projects with model day care center and respite providers. The Contractor shall respond to
requests for statistical data concerning its consumers, based on information requirements of the MDCsand
the Brain Bank, and assist the MDCs in carrying out Silver Alert protocol activities (Attachment XVI)to
include return of the Aging and Disability Resource Center (ADRC) Silver Alert Services Referral Form
(Attachment XVII) to the referring MDC within fourteen (14) days of receipt.
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c. Model Day Care Programs
The Contractor shall ensure Model Day Care Centers supported by this contract develop innovative
therapies and interventions which can be shared with other ADI health and social services personnel and
caregivers via training. Model Day Care Centers supported by this contract must report to the Contractor
all training activities provided to health care and social service personnel and caregivers, as well as serve
as natural laboratories for research.
2. Services and Units of Service
The Contractor shall ensure that the provision of services described in this contract is in accordance with the
current DOEA Handbook and the service tasks described in Section II.A. The Service Rate Report (Attachment
XV) lists the services that can be performed, the highest reimbursement unit rate, the method of payment, and
the service unit type. Units of service will be paid pursuant to the rate established in the Area Plan as updated,
as shown in the Service Rate Report, and approved by the Agency.
3. Administrative Responsibilities
The Contractor shall provide management and oversight of ADI program operations in accordance with the
current DOEA Handbook and the Agency-approved Contractor’s Area Plan and Cost Analysis. Management
and oversight of ADI program operations include the following:
a. Developing a competitive solicitation process for allocation of ADI funds, including appeal procedures for
handling disputes involving Lead Agency.
Preparing and revising the Area Plan update.
Designating appropriate and capable Lead Agencies and establishing vendor agreements at the AAA level,
when applicable for Lead Agency and ADI services according to manuals, rules, and agreement procedures
of AGENCY.
Providing technical assistance to Lead Agencies and vendors to ensure provision of quality services.
Monitoring and evaluating Lead Agencies, subcontractors, and vendors for programmatic and fiscal
compliance.
Appropriately submitting payments to subcontractors.
Arranging in-service training for Lead Agencies at least annually.
Establishing procedures for handling recipient complaints concerning such adverse actions as service
termination, suspension, or reduction.
Ensuring compliance with Client Information and Registration Tracking System (CIRTS) regulations.
Monitoring performance objective achievements in accordance with targets set by the Agency.
Conducting client satisfaction surveys to evaluate and improve service delivery.
Participating in at least one Dementia Care and Cure Initiative (DCCI) task force within the Contractor’s
service area; and
Immediately notifying the Agency’s Emergency Coordinating Officer of any changes to names and
contact information made to the Contractor’s local Emergency Coordinating Officer.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
F. Reports
The Contractor shall respond to additional routine or special requests for information and reports required by the
Agency in a timely manner, as determined by the AGENCY Contract Manager. The Contractor shall establish
reporting due dates for Subcontractors that permit the Contractor to meet the Agency’s reporting requirements.
1. Area Plan Update and All Revisions Thereto
The Contractor is required to submit an annual Area Plan update wherein the Contractor enters ADI-specific
data in the CIRTS. The Contractor may also be required to submit revisions to the Area Plan as instructed by
the Agency.
2. CIRTS Reports
The Contractor shall input ADI-specific data into CIRTS. To ensure CIRTS data accuracy, the Contractor shall
use CIRTS-generated reports which include the following:
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a.
b.
c.
d.
e.
f.
g.
Client Reports.
Monitoring Reports.
Services Reports.
Miscellaneous Reports.
Fiscal Reports.
Aging and Disability Resource Center Reports.
Outcome Measurement Reports.
3. Annual Service Cost Reports
The Contractor shall require subcontractors to submit Annual Service Cost Reports, which reflect actual costs of
providing each service by program. This Annual Service Cost Report provides information for planning and
negotiating unit rates.
4. Lead Agency Spending Report
The Contractor shall submit a Lead Agency Spending Report, in a format provided by the Agency, to the Agency
Contract Manager by the (18th) day of each month. This Lead Agency Report is for all agreements and contracts
between the Contractor and the Agency and must include the following:
a.
b.
A list of all subcontractors and their status regarding surplus/deficit.
The Contractor’s detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
Agency will be resolved; and
Recommendations to transfer funds to resolve surplus/deficit spending. Input from the Contractor’s Board of
Directors on resolution of spending issues, if applicable.
c.
5. Program Highlights
The Contractor shall submit Program Highlights referencing specific events that occurred in SFY/FFY
202-202 by August 30, 202. The Contractor shall provide a new success story, quote, testimonial, or human-
interest vignette. The highlights shall be written for a general audience, with no acronyms or technical terms. For
all agencies or organizations that are referenced in the highlight, the Contractor shall provide a brief
description of their mission or role. The active tense shall be consistently used in the highlight narrative, to
identify the specific individual or entity that performed the activity described in the highlight. The
Contractor shall review and edit Program Highlights for clarity, readability, relevance, specificity, human
interest, and grammar prior to submitting them to the Agency.
G. Records and Documentation
1. Requests for Payment
The Contractor shall maintain documentation to support Requests for Payment that shall be available to the
Agency or authorized individuals, such as the Department of Financial Services, upon request.
2. CIRTS Data and Maintenance
The Contractor shall ensure, monthly, collection and maintenance of client and service information in CIRTS
or any such system designated by the Agency. Maintenance includes accurate and current data, and valid
exports and backups of all data and systems according to Agency standards.
3. CIRTS Address Validation
The Contractor shall work with the Agency to ensure client address are correct in CIRTS for disaster
preparedness efforts. At least annually, and more frequently as needed, the Agency will provide direction on
how to validate CIRTS addresses to ensure these can be mapped. The Contractor will receive a list of
unmatched addressed that cannot be mapped and the Contractor will be responsible for working with the Lead
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Agencies to correct addresses and send a list to the Agency with confirmed addresses. The Agency will use
this information to update maps, client rosters, and unmatched addresses to disseminate to the Lead Agencies.
4. Data Integrity and Back up Procedures
Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system. Data
and software essential to the continued operation of Contractor functions must be backed up. The security
controls over the backup resources shall be as stringent as the protection required of the primary resources. A
copy of the backed-up data shall be stored in a secure, offsite location.
5. Policies and Procedures for Records and Documentation
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available
to the Agency upon request.
H. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
The Contractor must:
a. Ensure the prioritization of clients and provision of services to clients in accordance with Section II.A.
above.
Ensure the provision of the services described in this contract are in accordance with the current DOEA
Handbook and Section II.D. above.
Timely and accurately submit to the Agency all required documentation and reports described in Section
II.E. above; and
Timely (i.e. in accordance with the Annual Budget Summary) and accurately submit the Request for
Payment, the Receipt and Expenditure Report, and the Annual Model Day Care Center Training Report,
and supporting documentation to the Agency.
b.
c.
d.
2. Annual Programmatic Monitoring Report
The Contractor’s performance of the measures in Section II.H.1., above, will be reviewed and documented in
the Agency’s Annual Programmatic Monitoring Report.
Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor via telephone, in writing, and/or on-
site visit(s). The Agency’s determination of acceptable performance shall be conclusive. The Contractor agrees
to cooperate with the Agency in monitoring the progress of completion of the service tasks and deliverables.
The Agency may use, but is not limited to, one or more of the following methods for monitoring:
3.
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
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 evaluation.
Review of progress reports.
Review of customer satisfaction surveys.
Agreed-upon procedures review by an external auditor or consultant.
Limited-scope reviews.
Other procedures as deemed necessary.
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I. Contractor Responsibilities
1. Contractor Accountability
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the
Contractor and are tasks and deliverables for which, by execution of this contract, the Contractor agrees to be
held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of this contract, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant to
this contract.
J. Agency Responsibilities
1. Agency Obligations
The Agency may, within its resources, provide technical support and assistance to the Contractor to assist the
Contractor in meeting the requirements of this contract. The Agency’s support and assistance, or lackthereof,
shall not relieve the Contractor from full performance of contract requirements.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches used to
perform tasks. The absence of the Agency setting forth a specific reservation of rights does not mean that all
other areas of the contract are subject to mutual agreement.
III. METHOD OF PAYMENT
A. Payment Methods Used
The method of payment for this contract is a combination of fixed fee/unit rate, cost reimbursement, and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the Contractor upon
satisfactory completion of the Tasks/Deliverables, as specified in Section II., Manner of Service Provision, andin
accordance with other terms and conditions of this contract.
1. Fixed Fee/Unit Rate
Payments for Fixed Fee/Unit Rate shall not exceed amounts established in the Service Rate Report.
2. Cost Reimbursement
Payment may be authorized only for allowable expenditures which are in accordance with the services
specified in the Service Rate Report. All Cost Reimbursement Requests for Payment must include the Receipt
and Expenditure Report, as well as the Cost Reimbursement Summary Form, beginning with the first month
of this contract. Reimbursement amounts for administrative costs must be reflected on the Cost Reimbursement
Summary Form and include only items contained on the Contractor’s Cost Analysis Form.
3. Advance Payments
The Contractor may request up to two (2) months of advances at the start of the contract period to cover program
administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount
of funds released to the Agency by the State of Florida (budget release). The Contractor’s requests for advance
payments require the written approval of the Agency’s Contract Manager. For the first month’s advance request,
the Contractor shall provide to the Agency’s Contract Manager documentation justifying the need for an
advance and describing how the funds will be distributed. If the Contractor is requesting two
(2) months of advances, documentation must be provided reflecting the cash needs of the Contractor within the
initial two (2) months and should be supported through a cash-flow analysis or other information appropriate
to demonstrate the Contractor’s financial need for the second month of advances. The Contractor must also
describe how the funds will be distributed for the first and second month. If sufficient budget is available, and
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the Agency’s Contract Manager, in his or her sole discretion, has determined that there is justified need for an
advance, the Agency will issue approved advance payments after July 1st of the contract year.
a. Any advance payments the Contractor requests for subcontractors must be distributed within seven (7) days
of receipt of payment from the Agency. The Contractor shall submit to the Agency documentation to
support full distribution of advanced funds with Report Number 5, due to the Department on October
10, 202, in accordance with the Invoice Report Schedule (Attachment IX).
All advance payments retained by the Contractor must be fully expended no later than September 30, 202.
Any portion of advance payments not expended must be recouped on the Request for Payment (Attachment
XI), Report Number 5, due to the Department on October 10, 202, in accordance with the Invoice Report
Schedule (Attachment IX).
All advance payments made to the Contractor shall be reimbursed to the Agency as follows: At least one–
tenth of the advance payment received shall be reported as an advance recoupment on each Request for
Payment (Attachment XI), starting with Report Number 5, in accordance with the Invoice Report Schedule
(Attachment IX).
b.
c.
B. Funding Distribution
The Contractor agrees to distribute funds as detailed in the Area Plan update and the Annual Budget Summary.
Any changes in the total amounts of the funds identified on the Budget Summary form require a contract
amendment.
C. Method of Invoice Payment
Payment shall be made upon the Contractor’s presentation of an invoice after the acceptance and approval by the
Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
1. Have a Remittance Address that corresponds exactly to the “Remit To” address provided to
MyFloridaMarketPlace (MFMP) during registration.
2. Request payment on a monthly basis for the units of services established in the Contractor’s approved Area
Plan, provided in conformance with the requirements as described in the current DOEA Handbook, at the rates
established in the Service Rate Report of this contract. Documentation of service delivery must include a report
consisting of the following: number of clients served, number of service units provided by service, andrate per
service unit with calculations that equal the total invoice amount. Reimbursement amounts for administrative
costs must be reflected on the Cost Reimbursement Summary Form and include only items contained on the
Contractor’s Cost Analysis Form. Any requested changes to the approved budget after the execution of this
contract must be submitted to the AGENCY Contract Manager for written approval. Any change to the total
contract amount requires a contract amendment.
3. The Contractor shall consolidate all subcontractors’ Requests for Payment and Receipt and Expenditure
Reports that support Requests for Payment and shall submit to the Agency using the attached Request for
Payment form, Receipt and Expenditure Report, and Cost Reimbursement Summary for services and
administrative expenses, which must include itemized expenditure categories; and
4. All Requests for Payment shall be based on the submission of monthly Receipt and Expenditure Reports
beginning with the first month of this contract. The schedule for submission of advance requests (when
available) and invoices is listed in the Invoice Schedule.
D. Payment Withholding
Any payment due by the Department under the terms of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments
thereto, including any disallowances.
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E. Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than July 25, 2022.
F. CIRTS Data Entries for Subcontractors
The Contractor must require Subcontractors to enter all required data for clients and services in the CIRTS database
per the current DOEA Handbook and the CIRTS User Manual – Aging Provider Network users (located in
Documents on the CIRTS Enterprise Application Services). Subcontractors must enter this data into the CIRTS
prior to submitting their Requests for Payment and Receipt and Expenditure Reports to the Contractor. The
Contractor shall establish deadlines for completing CIRTS data entry and ensure compliance with due dates for the
Requests for Payment and Receipt and Expenditure Reports that Contractor must submit to the Agency.
G. Subcontractors’ Monthly CIRTS Reports
The Contractor must require Subcontractors to run monthly CIRTS reports and to verify that client and service
data in the CIRTS is accurate. This report must be submitted to the Contractor with the monthly Request for
Payment and Receipt and Expenditure Report and must be reviewed by the Contractor before the Subcontractor’s
Request for Payment and Receipt and Expenditure Reports can be approved by the Contractor.
H. Corrective Action Plan
1. Contractor shall ensure one hundred percent (100%) of the deliverables identified in Section II.E.1-3 of this
contract are performed pursuant to contract requirements.
2. If at any time the Contractor is notified by the AGENCY Contract Manager that it has failed to correctly,
completely, or adequately perform contract deliverables identified in Section II.E.1-3 of this contract, the
Contractor will have ten (10) days to submit a Corrective Action Plan (CAP) to the AGENCY Contract
Manager that addresses the deficiencies and states how the deficiencies will be remedied within a time period
approved by the AGENCY Contract Manager. The Agency shall assess a Financial Consequence for Non-
Compliance on the Contractor as referenced below in Section III.I. of this contract for each deficiency
identified in the CAP which is not corrected pursuant to the CAP. The Agency will also assess a Financial
Consequence for failure to timely submit a CAP.
3. If the Contractor fails to correct an identified deficiency within the approved time period specified in the CAP,
the Agency shall deduct the percentage established below in Section III.I. of this contract from the payment for
the invoice of the following month.
4. If the Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established below in
Section III.I. of this contract for each day the CAP is overdue. The deduction will be made from the payment for
the invoice of the following month.
I. Financial Consequences
The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction
of the Agency according to the requirements referenced in Section II.E. of this contract. The following financial
consequences will be imposed if the deliverables stated do not meet in part or in whole the performance criteria
as outlined in Section II.E. of this contract.
1.Delivery of services to eligible clients as referenced in Section II.A.1-3. and Section II.E.1. of this contract –
Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports, will
result in a 2% reduction of payment per business day. The reduction of payment will begin on the first business
day following the Agency’s notification to the Contractor that the identified deficiency was not cured or
satisfactorily addressed in accordance with the Agency-approved CAP, referenced in Section III.H.
2.Administrative responsibilities as referenced in Section II.E.3. of this contract – Failure to perform
management and oversight of ADI Program operations will result in a 2% reduction of payment per business
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day. The reduction of payment will begin the first business day following the Agency’s notification to the
Contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the
Agency-approved CAP, referenced in Section III.H.
3.Timely submission of a CAP – Failure to timely submit a CAP within ten (10) business days after notification
of a deficiency by the AGENCY Contract Manager will result in a 2% reduction of payment per business day
the CAP is not received. The reduction of payment will begin the first business day following the Agency’s
notification to the Contractor that the identified deficiency was not cured or satisfactorily addressed in
accordance with the Agency approved CAP, referenced in Section III.H.
4.Exceptions may be granted solely, in writing, by the AGENCY contract manager.
IV. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the AGENCY Contract Manager in writing no later than June 30, 2022. Email requests are
considered acceptable.
B. Contractor’s Financial Obligations
1. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all funds provided by the Agency for the purpose specified in this contract.
For each program managed by the Contractor, the Contractor must manage the service dollars in such a manner
to avoid having a wait list and a surplus of funds at the end of the contract period. If the Agency determines
that the Contractor is not spending service funds accordingly, the Agency may transfer funds to other AAAs
during the contract period and/or adjust subsequent funding allocations accordingly, as allowable under state
and federal law.
2. Cost Sharing and Co-payments
Pursuant to 430.204(8), the dollar amount for co-payments associated with any Alzheimer’s Disease Initiative
programs must be calculated by applying the current federal poverty guidelines published by the U.S.
Department of Health and Human Services.
a.No co-payments will be assessed on a client whose income is at, or below, the federal poverty level
(FPL) as established each year by the U.S. Department of Health and Human Services.
b.No client may have their services terminated for inability to pay their assessed co-payment. The
Contractor, in conjunction with provider agencies, must establish procedures to remedy financial
hardships associated with co-payments and ensure there is no interruption in service(s) for inability to
pay. If a client’s co-payment is reduced or waived entirely, a written explanation for the change must
be placed in the client file.
C. Remedies for Nonconforming Services
1.The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,
completely, and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
2.If the Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed
under this contract. In addition, any nonconforming goods and/or services not meeting such standards will not
be reimbursed under this contract. The Contractor’s signature on the Request for Payment Form certifies
maintenance of supporting documentation and acknowledgement that the Contractor shall solely bear the costs
associated with preparing or providing nonconforming goods and/or services. The Agency requires
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immediate notice of any significant and/or systemic infractions that compromise the quality, security, or
continuity of services to clients.
D. Incident Reporting
The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the Contractor’s
awareness or discovery of changes that may materially affect the Contractor or any Subcontractor’s ability to
perform the services required to be performed under this contract and in authorizing proviso. Such noticeshall be
made orally to the AGENCY Contract Manager (by telephone) with an email to immediately follow, which shall
include the Contractor’s plan for provision of services authorized in proviso.
E. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of the Contractor or any Subcontractors and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney’s office, or
other governmental agency, the Contractor shall notify the Inspector General at the Agency immediately. A copy
of all documents, reports, notes, or other written material concerning the investigation, whether in the possession of
the Contractor or Subcontractors, must be sent to the Department’s Inspector General with a summary of the
investigation and allegations.
F. Volunteers
If applicable, the Contractor shall ensure the use of trained volunteers in providing direct services delivered to older
individuals and individuals with disabilities needing such services. If possible, the Contractor shall work in
coordination with organizations that have experience in providing training, placement, and stipends for volunteers
or participants (such as organizations carrying out federal service programs administered by the Corporation for
National and Community Service).
G. Enforcement
1. In accordance with Section 430.04, F.S., the Agency may, without taking any intermediate measures available
to it against the Contractor, rescind the Contractor’s designation as an AAA, if the Agency finds that any of the
following have occurred:
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients, or substantially and negatively affected the operation of services covered pursuant to this contract.
The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds
have been misappropriated.
The Contractor has committed multiple or repeated violations of legal and regulatory requirements,
regardless of whether such laws or regulations are enforced by the Agency, or the Contractor has committed
multiple or repeated violations of Agency standards.
The Contractor has failed to continue the provision or expansion of services after the declaration of a state
of emergency.
The Contractor has failed to adhere to the terms of this contract.
The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets; or
The Contractor has failed to implement and maintain a Agency-approved client grievance resolution
procedure.
b.
c.
d.
e.
f.
g.
2. If the Agency finds that any acts listed in Section IV.G.1.a.-g. above have occurred, in accordance with Section
430.04, F.S., the Agency may, in its sole discretion, take intermediate measures against the Contractor,
including corrective action, unannounced special monitoring, temporary assumption of the operation of one or
more contractual services, placement of the Contractor on probationary status, imposing a moratorium on
Contractor action, imposing financial penalties for nonperformance, or other administrative action pursuant to
Chapter 120, F.S.
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3. In making any determination under this provision, the Agency may rely upon findings of another state or federal
agency, or other regulatory body. Any claims for damages for breach of contract are exempt from administrative
proceedings and shall be brought before the appropriate entity in the venue of Leon County, Florida. In the
event the Agency initiates action to rescind an AAA designation, the Agency shall follow the procedures set
forth in 42 U. S. C. § 3025(b).
END OF ATTACHMENT
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ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Agency, as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see “AUDITS” below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency staff, limited scope audits and/or other procedures. By entering into this contract, the Contractor agrees to
comply and cooperate with any monitoring procedures/processes deemed appropriate by the Agency. In the event the
Agency determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any
additional instructions provided by the Agency to the Contractor regarding such audit. The Contractor further agrees to
comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial
Officer (CFO) or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program-specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial and
Compliance Audit Attachment, Exhibit 2 indicates federal resources awarded through the Agency by this contract. In
determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended should
be in accordance with 2 CFR Part 200. An audit of the Contractor conducted by the Auditor General in accordance with the
provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR § 200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contractor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200, the cost
of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contractor resources
obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization’s fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract’s requirements, including any rules,
regulations, or statutes referenced in the contract. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency contract involved. If not otherwise disclosed as required by 2 CFR
§ 200.510, the schedule of expenditures of federal awards shall identify expenditures by contract number for each contract
with the Agency in effect during the audit period. Financial reporting packages required under this part must be submitted
within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor’s fiscal year end.
PART II: STATE FUNDED
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This part is applicable if the Contractor is a non-state entity as defined by Section 215.97(2), F.S.
ADI 203.22
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in
any fiscal year of such Contractor, the Contractor must have a State single or project-specific audit for such fiscal year in
accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapter 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. Financial
Compliance Audit Attachment, Exhibit 2 indicates state financial assistance awarded through the Agency by this contract.
In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources of state
financial assistance, including state financial assistance received from the Agency, other state agencies, and other non- state
entities. State financial assistance does not include Federal direct or pass-through awards and resources received by anon-
state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the non-state entity’s resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization’s fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract’s requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully disclosed in the
audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 69I- 5.003,
F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. For local governmental entities, financial reporting packages
required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after
the Contractor’s fiscal year end. For non-profit or for-profit organizations, financial reporting packages required under this
part must be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor’s
fiscal year end. Notwithstanding the applicability of this portion, the Agency retains all right and obligationto monitor and
oversee the performance of this contract as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of financial reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part I of
this Financial Compliance Audit Attachment, shall be submitted, when required by 2 CFR § 200.512 by or on behalf of the
Contractor directly to each of the following:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville, IN 47132
Pursuant to 2 CFR § 200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
The Contractor shall submit a copy of any management letter issued by the auditor directly to the Agency.
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Area Agency on Aging for Southwest Florida,
Inc. Richard Cocchieri, &)2
2830 Winkler Ave, Suite 112
Fort Myers, FL 33916
Additionally, copies of financial reporting packages required by this contract’s Financial Compliance Audit Attachment,
Part II, shall be submitted by or on behalf of the Contractor directly to each of the following:
The Agency at the following address:
Area Agency on Aging for Southwest Florida,
Inc. Richard Cocchieri, &)2
2830 Winkler Ave, Suite 112
Fort Myers, FL 33916
The Auditor General’s Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letters, or other information required to be submitted to the Agency pursuant to this contract shall
be submitted timely in accordance with 2 CFR Part 200, F.S., and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part 200
or Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of
six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO, or Auditor General
access to such records upon request. The Contractor shall ensure that audit working papers are made available to the Agency
or its designee, 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 Agency.
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ATTACHMENT II-EXHIBIT 1
AUDIT RELATIONSHIP DETERMINATION PART I:
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub-recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part II of Exhibit 1 are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR § 200.38 and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub-recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006, F.A.C., Contractor has been determined to be:
Vendor not subject to 2 CFR § 200.38 and/or Section 215.97, F.S.
Recipient/sub-recipient subject to 2 CFR §§ 200.86 and 200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and/or state financial assistance, and has been
approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006, F.A.C. [state
financial assistance] and/or 2 CFR § 200.330 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub-
recipient must comply with the following fiscal laws, rules, and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR § 200.416 - § 200.417 – Special Considerations for States, Local Governments, and Indian Tribes*
2 CFR § 200.201 – Administrative Requirements**
2 CFR § 200 Subpart F – Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR § 200.400 - § 200.411 – Cost Principles*
2 CFR § 200.100 – Administrative Requirements
2 CFR § 200 Subpart F – Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR § 200.418 – § 200.419 – Special Considerations for Institutions of Higher Education*
2 CFR § 200.100 – Administrative Requirements
2 CFR § 200 Subpart F – Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§200.400(5)(c).
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**For funding passed through U.S. Health and Human Services, 45 CFR Part 75; for funding passed through U.S.
Department of Education, 34 CFR Part 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws, rules, and regulations:
Sections 215.97 & 215.971, F.S.
Chapter 69I-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
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ATTACHMENT II-EXHIBIT 2
FUNDING SUMMARY (202-202)
Note: Title 2 CFR, as revised, and Section 215.97, F.S., require that the information about Federal Programs and State
Projects included in Attachment II, Exhibit 1, be provided to the recipient. Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133 – Audits of States, Local Governments, and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97, F.S.
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Sections 215.97 & 215.971, F.S., Chapter 69I-5, F.A.C., State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
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PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Alzheimer’s Disease Initiative General Revenue 65.004
TOTAL AWARD
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
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(July 2022 - June 2023) ADI 203.22
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
AGENCY will not award this contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES.
Inperformance of this contract, Contractor provides the following certifications and assurances:
A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 75)
B. Certification Regarding Lobbying (29 CFR Part 93 and 45 CFR Part 93)
C. Nondiscrimination & Equal Opportunity Assurance (29 CFR Part 37 and 45 CFR Part 80)
D. Certification Regarding Public Entity Crimes, section 287.133, F.S.
E. Association of Community Organizations for Reform Now (ACORN) Funding Restrictions Assurance
(Pub. L. 111-117)
F.
G.
Scrutinized Companies Lists and No Boycott of Israel Certification, section 287.135, F.S.
Certification Regarding Data Integrity Compliance for Contracts, Agreements, Grants, Loans, and
Cooperative Agreements
Verification of Employment Status Certification
Records and Documentation
H.
I.
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS – PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal department or agency;
Have not within a three-year period preceding this contract been convicted or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or
local) with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
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.
2.
3.
4.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all
sub-recipients and contractors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING – CERTIFICATION FOR CONTRACTS, GRANTS, LOANS,
AND COOPERATIVE AGREEMENTS.
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
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the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form – LLL, “Disclosure Form to Report
Lobbying,” in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all
sub-recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by 31
U.S.C. § 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON- DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I-financially assisted program
or activity.
Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance
with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Agency.
Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in
accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Department.
The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant to
the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance
with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of,
be excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Department.
Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Department.
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.
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws
listed above. This assurance applies to Contractor’s operation of the WIA Title I – financially assisted program or
activity, and to all contracts Contractor makes to carry out the WIA Title I – financially assisted program or activity.
2.
3.
4.
5.
6.
7.
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Contractor understands that DOEA and the United States have the right to seek judicial enforcement of the
assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all
sub-recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform AGENCY immediately upon any change of
circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions pertaining
to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all sub-
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION
287.135, F.S.
In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized
Companies that Boycott Israel List and that it is not engaged in a boycott of Israel.
If this contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135, F.S.,
Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the
Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it is not engaged in business
operations in Cuba or Syria.
Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may result in the
Agency terminating this contract and the submission of a false certification may subject Contractor to civil penalties and
attorney fees and costs, including any costs for investigations that led to the finding of false certification.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this contract.
G.CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS,
GRANTS, LOANS, AND COOPERATIVE AGREEMENTS
1.The Contractor and any Subcontractors of services under this contract have financial management systems capable
of providing certain information, including: (1) accurate, current, and complete disclosure of the financialresults of
each grant-funded project or program in accordance with the prescribed reporting requirements; (2) the source and
application of funds for all contract supported activities; and (3) the comparison of outlays with budgeted amounts
for each award. The inability to process information in accordance with these requirements could result in a return
of grant funds that have not been accounted for properly.
2.Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported, transmitted, or calculated have been assessed and verified
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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.
If this contract includes the provision of hardware, software, firmware, microcode, or imbedded chip technology,
the undersigned warrants that these products are capable of processing year-date dependent data accurately. All
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
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.
3.
4.
5.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland
Security's E-verify system to verify the employment eligibility of all new employees hired by Contractor during the
contract term to perform employment duties pursuant to this contract, and that any subcontracts include an express
requirement that Subcontractors performing work or providing services pursuant to this contract utilize the E-verify
system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract
term.
The Contractor shall require that the language of this certification be included in all sub-agreements, sub-grants, and
other agreements/contracts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by
Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A-110).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any andall
contract related records and documentation. The Contractor shall ensure the collection and maintenance of all
program related information and documentation on any such system designated by the Agency. Maintenance
includes valid exports and backups of all data and systems according to Agency standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of Section 10 of the Standard Contract, sections 119.0701(3) and (4) F.S., and any other
applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is named
in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the Agency
and any attorneys’ fees assessed or awarded against the Agency from a Public Records Request made pursuant to
Chapter 119, F.S., concerning this contract or services performed thereunder.
a. Notwithstanding section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Agency and state agencies or subdivisions defined in section 768.28(2), F.S.
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership
contributions for any person, corporation, foundation, trust, association, group, or other organization, all the financial,
business, and membership records of such an entity which pertain to the public agency (Florida Department of
Elder Affairs) are public records. Section 119.07, F.S, states that every person who has custody of such a public record
shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances.
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Additionally, I certify this organization does does not provide for institutional memberships.
ADI 203.22
Contractor’s signature below attests that records pertaining to the dues or membership application by the Agency areavailable
for inspection if applicable, as stated above.
By execution of this contract, Contractor must include these provisions (A-J) in all related subcontract agreements (if
applicable).
By signing below, Contractor certifies that the representations outlined in parts A through J above are true and correct.
41 of 63
Signature and Title of Authorized Representative Street Address
Contractor Date City, State, Zip code
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as designee of the County Manager,
pursuant to Resolution No. 2018-202.
Approved as to Form and Legality:
_________________________________
Derek D. Perry
Assistant County Attorney
Appppppppppppppppppppppppppppppppppppppppppprprprpppprprprrprprrprprppprrpppppprrrppprrrrrprrrrprppprrrrpppprrrpprrrprprrprprrpprrppprprppprrrppprprprprrrrpprrrrprprrrrrrrrrrrrrrrrprrroved as to Form and Legality:
_________________________________________________________________________________________________________________________________________________________________
Derek D. Perry
Assistant County Attorney
CAO
WilliamsTanya Digitally signed by WilliamsTanya
Date: 2022.07.25 16:28:20 -04'00'
(July 2022 - June 2023) ADI 203.22
ATTACHMENT IV
ASSURANCES—NONCONSTRUCTION PROGRAMS
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes, or presents the
appearance of, personal or organizational conflict of interest or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed
standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683 and §§ 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
§ 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended
(42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment
Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug
abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific
statute(s) under which application for federal assistance is being made; and (j) the requirements of any other
nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
42 of 63
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response,
including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and
completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect
of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget.
Paperwork Reduction Project (0348-0043), Washington, DC 20503.
CAO
(July 2022 - June 2023) ADI 203.22
8.Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and §§ 7324-7328), which
limit the political activities of employees whose principal employment activities are funded in whole or in part with
federal funds.
9.Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. §§ 276a to 276a-7), the Copeland
Act (40 U.S.C. § 276c and 18 U.S.C. § 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§ 327-
333), regarding labor standards for federally assisted construction sub-contracts.
10.Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11.Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. § 1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection of
endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. § 1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13.Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. § 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. § 469a-1 et seq.).
14.Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15.Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. § 2131 et seq.)
pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16.Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. § 4801 et seq.), which prohibits the use
of lead- based paint in construction or rehabilitation of residence structures.
17.Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18.Will comply with all applicable requirements of all other federal laws, executive orders, regulations, and policies
governing this program.
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SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
APPLICANT ORGANIZATION DATE SUBMITTED
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3XEOLF6HUYLFHV'HSDUWPHQW+HDG7DQ\D5:LOOLDPV
Tanya R. Williams, as designee of the County
Manager, pursuant to Resolution No. 2018-202.
Approved as to Form and Legality:
_________________________________
Derek D. Perry
Assistant County Attorney
&R&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&OOLHU&RXQW\%RDU\GRI&RXQW\&RPP\G
ApApApAApApApAApApAAApAAApAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAprrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrroved as to Form anannnnnannnnnnnnnnannnnnannnnnnnnanannnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnannnnnd d dddddd ddddd ddddddd d ddddddd dddddddddddddd d d Legality:
___________________________________________________________________
Derek D. Perry
Assistant County Attorney CAO
WilliamsTanya
Digitally signed by
WilliamsTanya
Date: 2022.07.25 16:28:41
-04'00'
(July 2022 - June 2023) ADI 203.22
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU
COMPLETE THIS FORM.
1.Briefly describe the geographic area served by the program/facility and the type of service provided:
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or
NO, EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA?N/A YES NO
7. Compare the staff composition to the population. Is staff representative of the population?N/A YES NO
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
origin, sex, age, religion, or disability?
N/A YES NO
9. Are all benefits, services and facilities available to applicants and participants in an equally effective manner
regardless of race, sex, color, age, national origin, religion, or disability?
N/A YES NO
10.For in-patient services, are room assignments made without regard to race, color, national origin or disability?N/A YES NO
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For questions 2-5 please indicate the following: Total # %
White
%
Black
%
Hispanic
%
Other
%
Female
%
Disabled
%
Over 40
2.Population of area served Source of data:
3.Staff currently employed Effective date:
4.Clients currently enrolled/registered Effective date:
5.Advisory/Governing Board if applicable
Program/Facility Name County AAA/Contractor
Address Completed By
City, State, Zip Code Date Telephone
CAO
(July 2022 - June 2023)
11.Is the program/facility accessible to non-English speaking clients?
ADI 203.22
N/A YES NO
N/A YES NO 12. Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
Verbal Written Poster
13. Give the number and current status of any discrimination complaints regarding services or employment filed
against the program/facility.
N/A NUMBER
14.Is the program/facility physically accessible to mobility, hearing, and sight-impaired individuals?N/A YES NO
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE
EMPLOYEES. IF NO, EXPLAIN.
15. Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals and to make any
necessary modifications?
YES NO
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
the basis of disability?
YES NO
19. Are auxiliary aids available to ensure accessibility of services to hearing and sight-impaired individuals?YES NO
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(July 2022 - June 2023) ADI 203.22 PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF
$50,000.00 OR MORE.
20.Do you have a written affirmative action plan? If NO, explain.YES NO
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Reviewed by In Compliance: YES NO*
Program Office *Notice of Corrective Action Sent / /
Date Telephone Response Due / /
On-Site Desk Review Response Received / /
DOEA USE ONLY
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(July 2022 - June 2023) ADI 203.22
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city, or other locality. If the program/facility serves a
specific target population such as adolescents, describe the target population. Also, define the type of service provided.
Enter the percent of the population served by race, sex, disability, and over the age of 40. The population served includes
persons in the geographical area for which services are provided such as a city, county or other regional area. Population
statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census
containing Florida population statistics. Include the source of your population statistics. (“Other” races include
Asian/Pacific Islanders and American Indian/Alaskan Natives.)
Enter the total number of full-time staff and their percent by race, sex, disability, and over the age of 40. Include the
effective date of your summary.
Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list their
percent by race, sex, disability, and over the age of 40. Include the date that enrollment was counted.
a.Where there is a significant variation between the race, sex, or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons.
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.
Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR Part 80. This is usually a standard part of the
contract language for DOEA Recipients and their Sub-grantees. 45 CFR § 80.4(a).
Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the population
is Hispanic, is there a comparable percentage of Hispanic staff?
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.
Participants or clients must be provided services such as medical, nursing, and dental care, laboratory services, physical
and recreational therapies, counseling, and social services without regard to race, sex, color, national origin, religion,
age, or disability. Courtesy titles, appointment scheduling, and accuracy of record keeping must be applied uniformly
and without regard to race, sex, color, national origin, religion, age, or disability. Entrances, waiting rooms, reception
areas, restrooms, and other facilities must also be equally available to all clients. 45 CFR § 80.3(b).
For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin, or
disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a different
race, color, national origin, or disability. 45 CFR § 80.3(a).
The program/facility and all services must be accessible to participants and applicants, including those persons who may
not speak English. In geographic areas where a significant population of non-English speaking people live, program
accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy or plan for
service, such as a current list of names and telephone numbers of bilingual individuals who will assist in the provision of
services. 45 CFR § 80.3(a).
Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any other interested parties. 45 CFR § 80.6(d). This should include information on their
right to file a complaint of discrimination with either the Agency or the U.S. Department of Health and Human Services.
The information may be supplied verbally or in writing to every individual or may be supplied through the useof an equal
opportunity policy poster displayed in a public area of the facility.
Report number of discrimination complaints filed against the program/facility. Indicate the basis (e.g. race, color, creed,
sex, age, national origin, disability, and/or retaliation) and the issues involved (e.g. services or employment, placement,
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
47 of 63
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(July 2022 - June 2023) ADI 203.22
termination, etc.). Indicate the civil rights law or policy alleged to have been violated along with the name and address
of the local, state, or federal agency with whom the complaint has been filed. Indicate the current status of the complaint
(e.g. settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.).
14. The program/facility must be physically accessible to mobility, hearing, and sight-impaired individuals. Physical
accessibility includes designated parking areas, curb cuts or level approaches, ramps, and adequate widths to entrances.
The lobby, public telephone, restroom facilities, water fountains, and information and admissions offices should be
accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters, and
serving lines should be observed for accessibility. Elevators should be observed for door width and Braille or raised
numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an
appropriate height for mobility impaired individuals.
15. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four-step process:
a. Evaluate, with the assistance of disabled individual(s)/organization(s), current policies and practices that do not or
may not comply with Section 504;
Modify policies and practices that do not meet Section 504 requirements.
Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these policies and
practices; and
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).
b.
c.
d.
16. Programs or facilities that employ 15 or more persons shall adopt grievance procedures that incorporate appropriate due
process standards and that provide for the prompt and equitable resolution of complaints alleging any action prohibited
by Part 84 of Title 45, CFR45 CFR § 84.7(b).
17. Programs or facilities that employ 15 or more persons shall designate at least one person to coordinate its efforts to
comply with Part 84 of Title 45, CFR. 45 CFR § 84.7(a).
18. Programs or facilities that employ 15 or more persons shall take appropriate initial and continuing steps to notify
participants, beneficiaries, applicants, and employees that the program/facility does not discriminate on the basis of
handicap in violation of Section 504 and Part 84 of Title 45, CFR. Methods of initial and continuing notification may
include the posting of notices, publication in newspapers and magazines, placement of notices in publications of the
programs or facilities, and distribution of memoranda or other written communications. 45 CFR § 84.8(a).
19. Programs or facilities that employ 15 or more persons shall provide appropriate auxiliary aids to persons with impaired
sensory, manual, or speaking skills where necessary to afford such persons an equal opportunity to benefit from the
service in question. Auxiliary aids may include, but are not limited to, brailed and taped materials, interpreters, and other
aids for persons with impaired hearing or vision. 45 CFR § 84.52(d).
20. Programs or facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement, and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR Part 60
and Title VI of the Civil Rights Act of 1964, as amended.
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(July 2022 - June 2023) ADI 203.22 ATTACHMENT VI CONTRACTOR’S STATE CONTRACTLIST Contractor'sStateContract ListREPORT PERIOD: From: CONTRACTOR INFORMATION: To:Name: Address: FEID: Phone: Email: Contact: Contract/ Program Name State Agency/ Program Start Date End Date Description of Contract Purpose/Types of Services Contract Manager Contract Amount Contract # Phone # $ - $ - $ - $ - $ - $ - $ - $ - $ - 10 $ - 11 $ - 12 $ - 13 $ - 14 $ - 15 $ - 16 $ - 17 $ - 18 $ - 19 $ - 20 $ - Total SIGNATURE: DATE: 49 of 63 CAO
(July 2022 - June 2023)
Page 50 of 63
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
BACKGROUND SCREENING
BACKGROUNDSCREENING
Attestation of Compliance -Employer
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
client and has access to the client’s living area, funds, personal property, or personal identification
information as defined in s. 817.568. The term includes coordinators, managers, and supervisors of
residential facilities and volunteers.” § 430.0402(1)(b), Fla. Stat.
ATTESTATION:
As the duly authorized representative of
Employer Name
located at ,
Street Address City State ZIP code
I, 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, Florida
Statutes, regarding level 2 background screening.
Signature of Representative Date
DOEA Form 235, Attestation of Compliance - Employer, Effective January 19, 2021 Section
435.05(3),
F.S. Form available at: http://elderaffairs.state.fl.us/english/backgroundscreening.php
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ATTACHMENT VIII
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES (CMBE FORM)
CMBE FORM MUST ACCOMPANY INVOICES SUBMITTED TO DOEA
CONTRACTOR NAME
DOEA CONTRACT NUMBER: _ _
*REPORTING PERIOD-FROM: _ _ TO:
*(DATE RANGE OF RENDERED SERVICES, MUST MATCH INVOICE SUBMITTED TO DOEA)
DOEA CONTRACT MANAGER
REPORT ALL EXPENDITURES MADE TO CERTIFIED MINORITY BUSINESS (SUBCONTRACTORS).
CONTACT DOEA CMBE COORDINATOR FOR ANY QUESTIONS, AT 850-414-2153.
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DOEA USE ONLY -- REPORTING ENTITY (DIVISION, OFFICE, ETC)
SEND COMPLETED FORMS VIA INTEROFFICE MAIL TO: JUSTIN TAYLOR
CMBE COORDINATOR, CONTRACT ADMINISTRATION & PURCHASING, TALLAHASSEE, FLORIDA 32399-
7000.
SUBCONTRACTOR NAME SUBCONTRACTOR’
S FEID
CMBE EXPENDITURES
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(July 2022 - June 2023) ADI 203.22
If unsure if subcontractor is a certified minority supplier, click on the hyperlink below. Enter the name of the supplier, click
“search”. Only Certified Minority Business Entities will be displayed.
https://osd.dms.myflorida.com/directories
INSTRUCTIONS
(A)ENTER THE COMPANY NAME AS IT APPEARS ON YOUR DOEA CONTRACT.
(B)ENTER THE DOEA CONTRACT NUMBER.
(C)ENTER THE SERVICE PERIOD MATCHING THE CURRENT INVOICE’S SERVICE PERIOD.
(D)ENTER ALL CERTIFIED MINORITY BUSINESS EXPENDITURES FOR THE TIME PERIOD COVERED BY
THE INVOICE:
1.
2.
3.
4.
ENTER CERTIFIED MINORITY BUSINESS NAME.
ENTER THE CERTIFIED MINORITY BUSINESS FEID NUMBER.
ENTER THE CERTIFIED MINORITY BUSINESS CMBE NUMBER.
ENTER THE AMOUNT EXPENDED WITH THE CERTIFIED MINORITY BUSINESS FOR THE TIME
PERIOD COVERED BY THE INVOICE.
MBE FORM MUST ACCOMPANY INVOICE PACKAGE SUBMITTED TO DOEA FINANCIAL
ADMINISTRATION FOR PROCESSING.
FINANCIAL ADMINISTRATION WILL FORWARD ALL COMPLETED CMBE FORMS TO CONTRACT
ADMINISTRATION & PURCHASING OFFICE.
(E)
(F)
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ATTACHMENT IX
INVOICE REPORT SCHEDULE
ALZHEIMER’S DISEASE INITIATIVE
Report Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Based On
July Advance*
August Advance*
July Expenditure Report
August Expenditure Report
September Expenditure Report
October Expenditure Report
November Expenditure Report
December Expenditure Report
January Expenditure Report
February Expenditure Report
March Expenditure Report
April Expenditure Report
May Expenditure Report
June Expenditure Report
Final Request for Pay ent
Submit to State on This Date
July 1
July 1
August 10
September 10
October 10
November 10
December 10
January 10
February 10
March 10
April 10
May 10
June 10
July 10
July 25
Legend: * Advance based on projected cash need.
Note # 1: Report #1 for Advance Basis Contracts cannot be submitted to the Agency prior
to July 1 or until the contract with the Agency has been executed and a copy sent
to DFS. Actual submission of the vouchers to DFS is dependent on the accuracy
of the expenditure report.
All advance payments made to the Contractor shall be returned to the Agency as
follows: one – tenth of the advance payment received shall be reported as an
advance recoupment on each request for payment, starting with report number five
(5). The adjustment shall be recorded in Part C, Line 1 of the report (Attachment
XI).
Note # 2:
Note # 3: Submission of expenditure reports may or may not generate a payment request.
final expenditure report reflects funds due back to the Agency, payment is to
accompany the report.
If a
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ATTACHMENT X
ANNUAL BUDGET SUMMARY
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
for
County Board of County Commissioners
TOTAL:
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ATTACHMENT XI
REQUEST FOR PAYMENT
ALZHEIMERS DISEASE INITIATIVE PROGRAM
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RECIPIENT NAME, ADDRESS, PHONE# and FEID# TYPE OF REPORT :
A. PAYMENT REQUEST:
Regular
B. METHOD OF PAYMENT:
Advance Reimbursement
Contract #
Contract Period Report Period
Invoice #
PSA
CERTIFICATION: I hereby certify to the best of my knowledge that this request is complete and correct and conforms with the terms and the purposes of the above contract.
Prepared by: Date: Approved by: Date:
PART A: BUDGET SUMMARY
1. Approved Contract Amount
2. Previous Funds Received for Contract Period
3. Contract Balance (line 1 minus line 2)
4. Previous Funds Requested and Not Received for Contract Period
5. Contract Balance (line 3 minus line 4)
(1)
Respite
(2)
Projects
(3)
Specialized Day Care TOTAL
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
PART B: CONTRACT FUNDS REQUEST
1. Anticipated Cash Needs (1st - 2nd month, Attach Justification)
2. Net Expenditures For Month
(DOEA Form 105Z Part B, Line 3)
3. TOTAL
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
PART C: NET FUNDS REQUESTED
1. Less Advance Applied
2. Contract Funds are Hereby Requested for (Part B, Line 3
minus Part C, Line 1)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
List of Services / Units / Rates provided - See attached report.
DOEA FORM 106Z
Revised 05/18
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(July 2022 - June 2023) ADI 203.22
ATTACHMENT XII
RECEIPT AND EXPENDITURE REPORT ALZHEIMERS
DISEASE INITIATIVE PROGRAM
PROVIDER NAME, ADDRESS, PHONE # and FEID#
CONTRACT # _
PROGRAM FUNDI NG :
CONTRACT PEROD
RESPITE
REPORT PERIOD
PROJECTS _
REPORT #
SPECIALIZED DAY CARE
INVOICE #
PSA
CERTIFICATION : I certify to the best of my knowled ge and belief that the report is complete and correct and all outlays
herein are for purposes set forth in the contract.
Prepared by : Date :_ _ Approved by: _Date :
PART A : BUDGETED INCOME/ RECEIPTS 1. Approved
Budget
2. Actual Receipts
For This Report
3. Total Receipts
Year to Date
4. Percent of
Approved Budget
1. State Funds
2. Program Income
3. Local Cash Match
4. SUBTOTAL: CASH RECEIPTS
5. Local In-Kind Match
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
#DIV/0
!
#DIV/0
6. TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/0!
1. Approved
Budget
2. Expenditures
For This Report
3. Expenditures
Year to Date
4. Percent of
Approved Budget
PART B : EXPENDITURES
1. Administrative Services
2. Service Subcontractor(s)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
#DIV/0!
#DIV/0!
3. TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/0!
PART C : OTHER REVENUE AND EXPENDITURES II. Interest: III. Advance Recouped
I. Program Income (PI)
1. ADI: PI Collected YTD
1. Earned on GR Advance $
2. Return of GR Advance $ $ $
(Includes co-payments collected)
PART D : CO-PAYMENTS
3. Other Earned $
CURRENT MONTH YEAR-TO-DATE
1. Total of Co-payments assessed
2. Total of Co-payments collected
(For Tracking Purposes only)
$
$
$
$
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ATTACHMENT XIII
ANNUAL MODEL DAY CARE CENTER TRAINING
REPORT ALZHEIMER’S DISEASE INITIATIVE PROGRAM
Model Day Care Center Name:
_ _
_ _
_ _
The purpose of the model day care program must be to provide service delivery to persons suffering from Alzheimer's
disease or a related memory disorder and training for health care and social service personnel in the care of persons having
Alzheimer's disease or related memory disorders. This report documents the required training for the State Fiscal Year July
1st through June 30th.
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Actual Training Events Number Health
Care
Professionals
Trained
Number Social
Services
Personnel
Trained
Total People
Trained
Training Title:
Date:
Training summary:
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(July 2022 - June 2023) ADI 203.22
ATTACHMENT XIV
COST REIMBURSEMENT SUMMARY
Contract#
Report (invoice) Number: _
58 of 63
Budget
Category Description
Number of
units Service Date Amount
C: 0
-.;::;
.'i:E
"C
c:(
TOTAL ADMINISTRATION $0.00
"Q)'
"C':
Q) C. ><
w
TOTAL EXPENSES $0.00
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(July 2022 - June 2023) ADI 203.22
ATTACHMENT XV
SERVICE RATE REPORT
59 of 63
SERVICE REIMBURSEMENT
UNIT RATE
METHOD OF
PAYMENT UNIT TYPE
CASE AIDE $ Fixed Fee / Unit Rate HOURS
CASE MANAGEMENT Fixed Fee / Unit Rate HOURS
RESPITE IN-FACILITY $1 Fixed Fee / Unit Rate HOURS
RESPITE IN-HOME $ Fixed Fee / Unit Rate HOURS
SHOPPING ASSISTANCE $34.12 Fixed Fee / Unit Rate ONE-WAY
TRIP
SPECIALIZED MEDICAL EQUIPMENT SERVICES,
AND SUPPLIES Cost Reimbursement EPISODES
TELEPHONE REASSURANCE $1 Fixed Fee / Unit Rate EPISODES
TRANSPORTATION )L[HG)HH8QLW5DWHONE-WAY
TRIP
$
$
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(July 2022 - June 2023) ADI 203.22
ATTACHMENT XVI
DEPARTMENT OF ELDER AFFAIRS
SILVER ALERT PROTOCOLS
1.Designated Memory Disorder Clinic (MDC) staff shall subscribe to the Department of Elder Affairs Silver Alert Listserv
by entering their email address at http://lists.elderaffairs.org/listmanager/listinfo/silveralert. By subscribing toreceive
Silver Alert notifications, MDCs are automatically notified via email whenever a Silver Alert is issued.
2.When notification of a Silver Alert is received by the MDC, each Clinic Coordinator or designee reviews the
information to determine:
a)The county the endangered person is missing from, and
b)The law enforcement agency that is reporting the Silver Alert. (The MDC that provides services in the county of
the reporting law enforcement agency is responsible for following up on all Silver Alerts in that county.)
3. The MDC or designee contacts the reporting law enforcement agency to obtain the caregiver/contact person’s name,
phone number and address to enable the MDC coordinator or designee to follow up and assist the family with
information and resources. The MDC Coordinator or designee completes the upper portion of the referral form
(Attachment XVII) including the caregiver/contact person information.
If it is determined that the endangered person resides in another county, then the MDC coordinator or designee will
contact the MDC serving the county of residence and send the referral form within one to three (1-3) business days.
4. The MDC Coordinator or designee in the county of residence will contact the caregiver/contact person in a timely
manner [upon receipt of contact information from law enforcement or within three (3) business days.] This activity is
reported under number 6, “phone information/support/counseling,” on the MDC Quarterly Report form (Attachment
IX).
(Note: If the endangered person has been recovered at the time of this contact, the MDC Coordinator will proceed with
steps 1 and 2 as indicated below under “Upon Recovery of Endangered Person.”)
Upon Recovery of Endangered Person
The MDC shall contact the caregiver/contact person:
1. MDC Coordinator or designee shall assess the situation and provide Alzheimer’s disease/dementia information and
referrals as needed. The MDC Coordinator or designee shall offer to make a referral to the Aging and Disability
Resource Center (ADRC).
2. If the caregiver/contact person consents to the ADRC referral, then the MDC Coordinator or designee shall send the
Silver Alert Services Referral Form (Attachment XVII) to the ADRC serving the county of residence and inform the
caregiver/contact person that a representative from the ADRC will contact them. This activity shall be reported under
number 4, “Referrals,” on the MDC Quarterly Report form (Attachment IX).
If the MDC makes a referral to the ADRC:
1. ADRC initiates contact with the caregiver.
2. ADRC provides information regarding community resources and makes referrals as appropriate for caregiver and
endangered person. The ADRC may also, screen the endangered person for services.
3. Within fourteen (14) business days, the ADRC completes the Silver Alert Services Referral Form and sends a copy
back to the MDC noting all services and referrals provided and/or arranged.
4. The MDC retains the Silver Alert Services Referral Form.
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Compilation of Data
Each MDC will track Silver Alerts in the designated service areas to ensure that follow-up has been completed and
disposition noted after the endangered person is returned home.
A copy of Silver Alert Referral Form, regardless of outcome, shall be emailed to the DOEA Contract Manager at
memorydisorderclinic@elderaffairs.org
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ATTACHMENT XVII
DEPARTMENT OF ELDER
AFFAIRS
62 of 63
Notes/ Comments:
Services/Referrals Provided by ADRC:
Endangered Person Name:
Address:
City: State: Zip Code:
Age: DOB:
Lives with Caregiver:
Yes / No
Lives Alone:
Yes / No
Caregiver Name: Relationship:
Phone: Alternate Phone:
Date of Referral Received: Referring MDC:
MDC Contact Name: MDC Phone:
ADRC: ADRC Contact Person:
ADRC Phone: County:
Notes/Comment:
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(July 2022 - June 2023) ADI 203.22
1. ADRC initiates contact with the caregiver.
2. ADRC provides information regarding community resources and makes referrals as appropriate for caregiver and
endangered person. The ADRC may also screen the endangered person for services.
3. Within fourteen (14) business days, the ADRC completes the ADRC Silver Alert Services Referral Form and sends a
copy back to the MDC noting all services and referrals provided and/or arranged.
4. The MDC retains the Silver Alert Services Referral Form.
Compilation of Data
Each MDC will track Silver Alerts in the designated service areas to ensure that follow-up has been completed and
disposition noted after the endangered person is returned home.
No modifications are to be made to this form unless authorized by DOEA.
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Revised August 2007
Attestation Statement
Agreement/Contract Number_
Amendment Number
I, , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
.
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
Signature of Recipient/Contractor representative Date
Revised August 2007
$',
7DQ\D5:LOOLDPV
&ROOLHU&RXQW\%RDUGRI&RXQW\&RPPLVVLRQHUV
as designee of the County Manager,
pursuant to Resolution No. 2018-202.
Approved as to Form and Legality:
_________________________________
Derek D. Perry
Assistant County Attorney
Apppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppprprprprprrprprprpprpprprrpprrppppprpprprpprprprrroooooovoooooooooooooooooooooooooooooooooooooooooooooooooed as to Form mmmm anananananaaaananananananaaaanaaanaannnnaaanannnaaaaannnaaananannnaaananaaanaanaannaannnnaaannaannannnnnnd Legality:
_______________________________________________________
Derek D. Perry
Assistant County Attorney
CAO
WilliamsTanya Digitally signed by WilliamsTanya
Date: 2022.07.25 16:29:03 -04'00'
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
COMMUNITY CARE FOR THE ELDERLY
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc., (Agency) and Collier
County Board of County Commissioners (Contractor), collectively referred to as the "Parties." The term Contractor for
this purpose may designate a Vendor, Subgrantee or Subrecipient.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and
WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such
services as an independent Contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the mutual
covenants and conditions set forth herein, the Parties agree as follows:
(July 2022 - June 2023) CCE 203.22
Purpose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments, forms, and exhibits which constitute the contract document.
Incorporation of Documents within the Contract:
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Agency handbooks,
manuals and/or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides
to the contrary. In the event of conflict in language among any of the documents referenced above, the specific
provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or
other general materials not specific to this contract document and identified attachments.
Term of Contract:
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1, 2022 or on the date the contract has
been signed by the last party required to sign it, whichever is later. It shall end at eleven fifty-nine (11:59) P.M., Eastern
Standard Time June 30, 2023.
Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not
to exceed $1,070,993.48 subject to the availability of funds. Any costs or services paid for under any other contract or from
any other source are not eligible for payment under this contract.
Renewals:
By mutual agreement of the Parties, in accordance with Section 287.058(1)(g), Florida Statutes (F.S.), the Agency may
renew the contract for a period not to exceed three years, or the term of the original contract, whichever is longer. The
renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs for
the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and
contingent upon satisfactory performance evaluations by the Agency and the availability of funds.
Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
1.
2.
3.
4.
5.
6.
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.
If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42
United States Code (U.S.C.) § 7401, et seq.), Section 508 of the Federal Water Pollution Control Act as
amended (33 U.S.C. § 1251, et seq.), Executive Order 11738, as amended, and, where applicable,
Environmental Protection Agency regulations 2 CFR Part 1500. The Contractor shall report any violations
of the above to the Agency.
Neither the Contractor nor any agent acting on behalf of the Contractor may use any federal funds received
in connection with this contract to influence legislation or appropriations pending before Congress or any
state legislature. The Contractor must complete all disclosure forms as required, specifically the
6.1.2
6.1.3
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Certification and Assurances Attachment, which must be completed and returned to the Contract Manager
prior to the execution of this contract.
In accordance with Appendix II to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and
Human Services regulations 45 CFR Part 92, if applicable.
A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government-wide Excluded Parties List System, in accordance with
the Office of Management and Budget (OMB) guidelines at 2 CFR Part 180 that implement Executive
Orders 12549 and 12689, “Debarment and Suspension.” The Excluded Parties List System contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549. The Contractor shall
comply with these provisions before doing business or entering into subcontracts receiving federal funds
pursuant to this contract. The Contractor shall complete and sign the Certifications and Assurances
Attachment prior to the execution of this contract.
6.1.4
6.1.5
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. § 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. § 1101). Such violation will be cause for unilateral cancellation of
this contract by the Agency.
If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N), and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
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.
To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-116, Contractor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in
related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the
state contract utilize the E-verify system to verify employment of all new employees hired by the Subcontractor
during the contract term. Contractors meeting the terms and conditions of the E-Verify System are deemed to be
in compliance with this provision.
6.3
6.4
6.5
6.6
7. Compliance with State Law:
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed, and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations including,
but not limited to, the Reference Guide for State Expenditures.
The Contractor shall comply with the requirements of Section 287.058, F.S., as amended.
7.2
7.3
7.3.1
7.3.2
The Contractor shall perform all tasks contained in Attachment I.
The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment I, to be received and accepted by the Agency Contract Manager prior to payment.
The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I, Section III. Method of Payment.
The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre-audit and post-audit.
7.3.3
7.3.4
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7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit invoices
for any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be provided
in this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in Section 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except
for those records which are made confidential or exempt by law. The Contractor’s refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate this contract.
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).
Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
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.
The Agency may, at its option, terminate the Contract if the Contractor is found to have submitted a false
certification as provided under Section 287.135(5), F.S., has been placed on the Scrutinized Companies with
Activities in the Iran Petroleum Energy Sector List, the Scrutinized Companies with Activities in Sudan List, or
the Scrutinized Companies that Boycott Israel List, or if the Contractor has been engaged in business operations
in Cuba or Syria or is engaged in a boycott of Israel.
7.4
7.5
7.6
7.7
8. Background Screening:
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Department’s level 2 background screening pursuant to Sections 430.0402(2)-(3), F.S. The Contractor
must also comply with any applicable rules promulgated by the Agency and the Agency for Health Care Administration
regarding implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate compliance withthis provision,
Contractor shall submit the Background Screening Affidavit of Compliance (Screening Form) to the Agency within
thirty (30) days of execution of this contract. Should the Agency have a completed Screening Form onfile for the
Contractor, a new Screening Form will be required every twelve (12) months.
8.1 Further information concerning the procedures for background screening may be found
http://elderaffairs.state.fl.us/doea/backgroundscreening.php.
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with, or denial of, service(s) and to address complaints regarding the
termination, suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum, will
provide for notice of the grievance procedure and an opportunity for review of the Subcontractor’s determination(s).
Public Records and Retention:
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the
requested records or allow the records to be inspected or copied within a reasonable time at a cost that does
not exceed the cost provided in Chapter 119, F.S., or as otherwise provided by law.
10.1.3 Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor to the Agency or will keep and maintain public records required by the
Agency. If the Contractor transfers all public records to the Agency upon completion of the contract, Contractor
shall destroy any duplicate public records that are exempt, or confidential and exempt,
10.
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from public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for retaining public
records. All records stored electronically must be provided to the Agency in a format that is compatible
with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for
refusal by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,
papers, letters, or other material made or received by the Contractor in conjunction with this contract, unless the
records are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and
Section 119.07(1), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR’S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
2830 Winkler Ave, Suite 112
Fort Myers, FL 33916
239-652-6900
10.3 Upon termination of this contract, whether for convenience or for cause as detailed in section 53 of this contract,
the Contractor and Subcontractors shall, at no cost to the Agency, transfer all public records in their possession to
the Agency and destroy any duplicate public records that are exempt, or confidential and exempt, from public
records disclosure requirements. All records stored electronically shall be provided to the Agency in a format that
is compatible with the information technology systems of the Agency.
Audits, Inspections, Investigations: 11.
11.1 The Contractor shall establish and maintain books, records, and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest, and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and ensure
that they are used solely for the purposes authorized under this contract. Whenever appropriate, financial
information should be related to performance and unit cost data.
The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six (6) years after completion of the contract, or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer
of any records or documents during the required retention period.
The Contractor shall ensure that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and
federal auditors, pursuant to 45 CFR Part 75, shall be allowed full access to and the right to examine any of the
Contractor’s contracts and related records and documents pertinent to this specific contract, regardless of the
form in which kept.
The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this contract
and ensure that all related third-party transactions are disclosed to the auditor.
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
11.2
11.3
11.4
11.5
11.6
11.7
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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.
In accordance with Executive Order 20-44 which requires executive agencies to submit a list of entities named
in statute with which a state agency must form a sole-source, public-private agreement or an entity that, through
contract or other agreement with the state, annually receives 50% or more of their budget from the State or from
a combination of State and Federal funds. Any Contractor that meets one or both of the criteria listed must submit
an annual report, including the most recent IRS Form 990, detailing the total compensation for the entities'
executive leadership teams within thirty (30) days of execution of this contract.
11.8
11.8.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.
The Contractor shall inform the agency of any changes in total executive compensation between the
annual reports as those changes occur.
All compensation reports must indicate what percent of compensation comes directly from the State or
Federal allocations to the contracted entity.
11.8.
11.8.
12. Nondiscrimination-Civil Rights Compliance:
12.1 The Contractor shall execute Assurances as stated in the Assurances-Non-Construction Programs Attachment thatit
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.
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.
The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures shall include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the any statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency may, at its discretion, seek a court order requiring compliance with the terms of this
assurance or seek other appropriate judicial or administrative relief including, but not limited to, termination of
the contract and denial of further assistance.
12.2
12.3
12.4
Monitoring by the Agency:
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods, and services of the Contractor which are relevant to this contract, and to interview any
clients, employees, and Subcontractor employees of the Contractor to assure the Agency of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Agency will provide a written
report of its findings to the Contractor and, where appropriate, the Contractor shall develop a Corrective Action Plan
(CAP). The Contractor hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determined
by the Department’s Contract Manager.
Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
13.
14.
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15. Coordinated Monitoring with Other Agencies:
If the Contractor receives funding from one or more State of Florida human
CCE 203.22
service agencies, in addition to the
Agency, then a joint monitoring visit including such other agencies may be scheduled. For the purposes of this
contract, and pursuant to Section 287.0575, F.S., as amended, Florida’s human service agencies shall include the
Agency, the Department of Children and Families, the Department of Health, the Agency for Persons with
Disabilities, and the Department of Veterans’ Affairs. Upon notification and the subsequent scheduling of such a visit
by the designated agency’s lead administrative coordinator, the Contractor shall comply and cooperate with all monitors,
inspectors, and/or investigators.
New Contract(s) Reporting:
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the remaining four
(4) state human service agencies. The notification shall include the following information: (1) 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.
Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from any
and all claims, demands, actions, and causes of action of whatever nature or character arising out of, or by reason of,
the execution of this contract or performance of the services provided for herein. It is understood and agreed that the
Contractor is not required to indemnify the Agency for claims, demands, actions, or causes of action arising solely
out of the negligence of the Agency.
16.
17.
17.1 Except to the extent permitted by Section 768.28, F.S., or other Florida law, this Section 17 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
18. Insurance and Bonding:
18.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance coverage necessary to provide reasonable financial
protections for the Contractor and the clients to be served under this contract. The limits of coverage under each
policy maintained by the Contractor do not limit the Contractor’s liability and obligations under this contract.
The Contractor shall ensure that the Agency has the most current written verification of insurance coverage
throughout the term of this contract. Such coverage may be provided by a self-insurance program established
and operating under the laws of the State of Florida. The Agency reserves the right to require additional
insurance as specified in this contract.
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.
18.2
Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
to give that consent or when authorized by law.
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).
Incident Reporting:
19.
20.
21.
21.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor’s awareness or discovery of conditions that may materially affect the Contractor’s or Subcontractor’s
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ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Agency's Contract Manager (by telephone) with an email to immediately follow.
The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor, its
Subcontractors, and their employees.
21.2
Bankruptcy Notification:
During the term of this contract, the Contractor shall immediately notify the Agency if the Contractor, its assignees,
Subcontractors, or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Contractor must
also provide the following information to the Agency: (1) the date of filing of the bankruptcy petition; (2) the case
number; (3) the court name and the division in which the petition was filed (e.g., Northern District of Florida,
Tallahassee Division); and (4) the name, address, and telephone number of the bankruptcy attorney.
22.
Sponsorship and Publicity: 23.
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.
The Contractor shall not use the words “State of Florida, Department of Elder Affairs” to indicate sponsorship
of a program otherwise financed, unless specific written authorization has been obtained by the Agency and
Department prior to such use.
23.2
24. Assignments:
24.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency. Any sublicense, assignment, or transfer otherwise occurring without prior written
approval of the Agency shall constitute a material breach of the contract. In the event the State of Florida
approves assignment of the Contractor’s obligations, the Contractor remains responsible for all work performed
and all expenses incurred in connection with this contract.
The State of Florida is, at all times, entitled to assign or transfer, in whole or part, its rights, duties, or obligations
under this contract to another governmental agency in the State of Florida upon giving prior written notice to the
Contractor.
This contract shall remain binding upon the successors in interest of the Contractor and the Agency.
24.2
24.3
25. Subcontracts:
25.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor further
agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The Contractor, at
its expense, shall defend the Agency against any such claims.
The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other
state agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
25.2
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 Agency, and that they shall not hold themselves out as employees or
agents of the Agency without prior specific authorization from the Agency. It is the further intent and understanding
of the Parties that the Agency does not control the employment practices of the Contractor and will notbe liable for any
wage and hour, employment discrimination, or other labor and employment claims against the
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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.
Payment:
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The Agency Contract Manager will have final approval of the Contractor’s invoice submitted for payment
and will approve the invoice for payment only if the Contractor has met all terms and conditions of the contract, unless
the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted to the
Agency's finance section for budgetary approval and processing. Disputes arising over invoicing and payments will
be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor Ombudsman has been established
within the Florida Department of Financial Services and may be contacted at 800-342-2762.
27.
Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed, and any
interest attributable to such funds pursuant to the terms and conditions of this contract, that were disbursed to the
Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment has
been made, the Contractor shall repay said overpayment immediately without prior notification from the
Agency. In the event that the Agency first discovers an overpayment has been made, the Agency Contract
Manager will notify the Contractor in writing of such findings. Should repayment not be made forthwith, the Contractor
shall be charged at the lawful rate of interest on the outstanding balance pursuant to Section 55.03, F.S., after Agency
notification or Contractor discovery.
Data Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages of
the computer system. The security over the backed-up data is to be as stringent as the protection required of the primary
systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system backup and
recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance for
Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
Computer Use and Social Media Policy:
The Agency has implemented a Social Media Policy, in addition to its Computer Use Policy, which applies to all
employees, contracted employees, consultants, Other Personal Services (OPS) employees and volunteers, including all
personnel affiliated with third parties, such as, but not limited to, contractors and subcontractors. Any entity that uses
the Agency's computer resource systems must comply with the Agency's policy regarding social media. Social Media
includes, but is not limited to, blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social
networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This
policy is available on the Department's website at: http://elderaffairs.state.fl.us/doea/financial.php.
Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management, and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer, or agent of the Contractor or Subcontractor shall participate in the
selection or in the award of a contract supported by state or federal funds if a conflict of interest, real or apparent, would
be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her immediate
family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the above individuals,
has a financial or other interest in the firm being selected for award. The Contractor’s or Subcontractor’s officers,
employees, or agents will neither solicit nor accept gratuities, favors, or anything of monetary value from Contractors,
potential Contractors, or parties to Subcontracts. The Contractor’s board members and management must disclose to
the Agency any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30)
calendar days of an individual’s original appointment or placement in that position, or, if the individual is serving as an
incumbent, within thirty (30) calendar days of the commencement of this contract. The Contractor’s employees and
28.
29.
30.
31.
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Subcontractors must make the same disclosures described above to the Contractor’s board of directors. Compliance
with this provision will be monitored.
32. Public Entity Crime:
Pursuant to Section 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction
or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a
public entity; may not be awarded or perform work as a Contractor, Supplier, Subcontractor, or Consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the date of
being placed on the Convicted Vendor List.
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.
33.1.IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES THAT ARE THE
SUBJECT OF, OR REQUIRED TO CARRY OUT, THIS CONTRACT SHALL BE PURCHASED FROM
A NONPROFIT AGENCY FOR THE BLIND OR FOR THE SEVERELY HANDICAPPED THAT IS
QUALIFIED PURSUANT TO CHAPTER 413, FLORIDA STATUTES, IN THE SAME MANNER AND
UNDER THE SAME PROCEDURES SET FORTH IN SECTION 413.036(1) AND (2), FLORIDA
STATUTES; AND FOR PURPOSES OF THIS CONTRACT THE PERSON, FIRM, OR OTHER
BUSINESS ENTITY CARRYING OUT THE PROVISIONS OF THIS CONTRACT SHALL BE
DEEMED TO BE SUBSTITUTED FOR THE STATE AGENCY INSOFAR AS DEALINGS WITH
SUCH QUALIFIED NONPROFIT AGENCY ARE CONCERNED.
33.1.Pursuant to sections 413.036(1) and (4), F.S., the Contractor shall not be required to procure a product or
service from RESPECT if: (a) the product or service is not available within a reasonable delivery time, (b)
the Contractor is required by law to procure the product or service from any agency of the state, or (c) the
Contractor determines that the performance specifications, price, or quality of the product or service is not
comparable to the Contractor's requirements.
33.1.This act shall have precedence over any law requiring state agency procurement of products or services
from any other nonprofit corporation unless such precedence is waived by the Agency in accordance
with its rules.
33.1.Additional information about the designated nonprofit agency and the products it offers is available at
http://www.respectofflorida.org.
33.2 The Contractor shall procure any recycled products or materials which are the subject of, or are required to carry
out, this contract when the Department of Management Services determines that those products are available, in
accordance with the provisions of section 403.7065, F.S.
The Contractor shall procure products and/or services required to perform this contract in accordance with
section 946.515, F.S.
33.3
33.3.1 IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES WHICH ARE THE
SUBJECT OF, OR REQUIRED TO CARRY OUT, THIS CONTRACT SHALL BE PURCHASED FROM
THE CORPORATION IDENTIFIED UNDER CHAPTER 946, F.S., IN THE SAME MANNER AND
UNDER THE SAME PROCEDURES SET FORTH IN SECTION 946.515(2) AND (4), F.S.; AND FOR
PURPOSES OF THIS CONTRACT THE PERSON, FIRM, OR OTHER BUSINESS ENTITY CARRYING
OUT THE PROVISIONS OF THIS CONTRACT SHALL BE DEEMED TO BE SUBSTITUTED FOR
THIS AGENCY INSOFAR AS DEALINGS WITH SUCH CORPORATION ARE CONCERNED.
33.3.2 The corporation identified is Prison Rehabilitative Industries and Diversified Enterprises, Inc. (PRIDE).
Additional information about PRIDE and the commodities or contractual services it offers is available at
https://pride-enterprises.org/.
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33.4 The Contractor shall provide a Certified Minority Business Subcontractor Expenditure (CMBE)
CCE 203.22
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 Agency, Division of Financial Administration, and must accompany each invoice
submitted to the Agency. The Office of Supplier Diversity (850-487-0915) will assist in furnishing names of
qualified minorities. The Agency's Minority Coordinator (850-414-2153) will assist with questions and answers.
The CMBE Report is attached to this contract.
34. Patents, Copyrights, Royalties:
If this contract is awarded state funding and if any discovery, invention, or copyrightable material is developed or
produced in the course of or as a result of work or services performed under this contract or in any way connected with
this contract, or if ownership of any discovery, invention, or copyrightable material was purchased in the course of or
as a result of work or services performed under this contract, the Contractor shall refer the discovery, invention, or
copyrightable material to the Agency to be referred to the Agency and Department of State. Any and all patent rights
or copyrights accruing under this contract are hereby reserved to the State of Florida in accordance with Chapter286,
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.
If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315 or
45 CFR § 75.322, as applicable.
Notwithstanding the foregoing provisions, if the Contractor or one of its Subcontractors is a university and a
member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency shall
retain a perpetual, fully-paid, nonexclusive license for its use and the use of its Contractors, Subcontractors, or
Assignees of any resulting patented, copyrighted, or trademarked work products.
34.2
34.3
35. Emergency Preparedness and Continuity of Operations:
35.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety, or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency Contract
Manager, verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall
notify the Agency of emergency provisions
In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall remain
responsible for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
35.2
36. Equipment:
36.1 Equipment means: (a) tangible personal property (including information technology systems) having a useful life
of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level
established by the organization for the financial statement purposes, or $5,000.00 [for federal funds - 2 CFR §
200.33 and 45 CFR § 75.2, as applicable], or (b); nonexpendable, tangible personal property of a non-consumable
nature with an acquisition cost of $5,000.00 or more per unit, and expected useful life of at least one (1) year;
and hardback bound books not circulated to students or the general public, with a value or cost of $250.00 or
more [for state funds].
Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, fully document, and notify the Agency Contract Manager of any loss, damage, or theft ofequipment.
The Contractor shall provide the results of the investigation to the Agency Contract Manager.
36.2
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36.3 The Contractor’s property management standards for equipment (including replacement equipment),wheather acquired in whole or in part with federal funds and federally-owned equipment shall, at a minimum, meet the
following requirements and shall include accurately maintained equipment records with the following
information:
36.3.
1
Property records must be maintained that include a description of the equipment;
Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
Source of funding for the equipment, including the federal award identification number;
Whether title vests in the Contractor or the federal government;
Acquisition date (or date received, if the equipment was furnished by the federal government);
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);
Location, use and condition of the equipment and the date the information was reported;
Unit acquisition cost; and
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.
3
36.3.
4
36 3
36.3.
7
36.3.
8
36.3.10 A physical inventory must be taken, and the results reconciled with the property records at least once
every two (2) years.
36.3.11 A control system must be developed to ensure adequate safeguards to prevent loss, damage, or theft of
the property. Any loss, damage, or theft must be investigated. 45 CFR § 75.320(d)(3).
36.3.12 Adequate maintenance procedures must be developed to keep the property in good condition.
36.3.13 If the Contractor is authorized or required to sell the equipment, proper sales procedures must be
established to ensure the highest possible return.
36.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $5,000.00 is part of the cost of carrying out the activities and functions
of the grant awards and title (ownership) will vest in the Contractor [for federal funds see 2 CFR § 200.313(a)
and 45 CFR § 75.320(a), as applicable], subject to the conditions of 2 CFR Part 200 and/or 45 CFR Part 75.
Equipment purchased under these thresholds is considered supplies and is not subject to property standards.
Equipment purchased with funds identified in the budget attachments to agreements covered by this contract or
identified in the sub-agreements with Subcontractors (not included in a cost methodology), is subject to the
conditions of Chapter 273, F.S., rule 60A-1.017, F. A. C., and 2 CFR Part 200 and/or 45 CFR Part 75.
The Contractor shall not dispose of any equipment or materials provided by the Agency or purchased with funds 36.5
provided through this contract without first obtaining the approval of the Agency Contract Manager. When disposing of
property or equipment the Contractor must submit a written request for disposition instructions to the Agency's
Contract Manager. The request should include a brief description of the property, purchase price, funding source, and
percentage of state or federal participation, acquisition date and condition of the property. The request shouldalso
indicate the Contractor’s proposed disposition of the property (i.e., transfer or donation to another agency that
administers federal programs, offer of the items for sale, destroy the items, etc.).
36.6 The Agency Contract Manager will issue disposition instructions. If disposition instructions are not received
within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized to
proceed as directed in 2 CFR § 200.313 or 45 CFR § 75.320, as applicable.
Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Section 3030b United States Code (U.S.C.). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of Section
216.348, F.S.
36.7
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36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information Technology
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is required
for any computer related item costing $1,000.00 or more, including data processing hardware, software, services,
supplies, maintenance, training, personnel, and facilities. The completed ITR
worksheet shall be maintained in the LAN administrator's file and must be provided to the Agency upon
request. The Contractor has the responsibility to require any Subcontractors to comply with the Agency's ITR
procedures.
PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http://www.myflorida.com/apps/vbs/adoc/F7740_PUR1000.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract, the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
Use of State Funds to Purchase or Improve Real Property:
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law.
Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the Agency Contract Manager, who shall reduce
the decision to writing and serve a copy on the Contractor.
Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency shall
impose financial consequences as stated in Attachment I.
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.
Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Leon County, Florida.
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 Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable,
the other provisions are severable to that void provision and shall remain in full force and effect.
Condition Precedent to Contract Appropriations:
The Parties agree that the Agency's performance and obligation to pay under this contract are contingent upon an
annual appropriation by the Legislature.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
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Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida’s best interest and reduced to a written amendment signed by both
Parties. The Parties shall negotiate compensation for any additional services added.
Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules, and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor and subject the contract to immediate unilateral cancellation of
the contract at the discretion of the Agency.
Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days after the contract
ending date unless otherwise specified in Attachment I. If the Contractor fails to do so, all right to payment is forfeited
and the Agency shall not honor any requests submitted after the aforesaid time period. Any payment due under the
terms of this contract shall be withheld until all required documentation and reports due from the Contractor and
necessary adjustments thereto have been approved by the Agency.
Renegotiations of Modifications:
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
Suspension of Work:
The Agency may in its sole discretion, suspend any or all activities under the contract or purchase order, at any time,
when in the best interest of the State to do so. The Agency shall provide the Contractor written notice outlining the
particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary constraints,
declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor shall
comply with the notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period agreed
to by the Contractor, the Agency shall either: (1) issue a notice authorizing resumption of work, at which time activity
shall resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the Contractor to
any additional compensation.
Termination:
53.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate this contract
47.
48.
49.
50.
51.
52.
53.
in whole or in part when the Agency determines in its sole discretion that it is in the State’s interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to complete
the continued portion of this contract, if any. The Contractor shall not be entitled to recover any cancellation
charges or lost profits.
53.2 Termination for Cause. The Agency may terminate this contract if the Contractor fails to: (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus endangering
performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory, regulatory, or licensing
requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences ofdefault. The Contractor shall
continue work on any work not terminated. Except for defaults of Subcontractors at any tier, the Contractor shall not
be liable for any excess costs if the failure to perform the contract arises from events completely beyond the control,
and without the fault or negligence, of the Contractor. If the failure to perform is caused by the default of a Subcontractor
at any tier, and if the cause of the default is completely beyond the control ofboth the Contractor and the Subcontractor,
and without the fault or negligence of either, the
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Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If,
after termination, it is determined that the Contractor was not in default, or that the default was excusable, the
rights and obligations of the Parties shall be the same as if the termination had been issued for the convenience
of the Agency. The rights and remedies of the Agency in this clause are in addition to any other
rights and remedies provided by law or under the contract.
Electronic Records and Signature:
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use electronic
signatures to conduct transactions necessary to carry out the terms of this contract. A Contractor that create s and retains
electronic records and uses electronic signatures to conduct transactions shall comply with the requirementscontained in
the Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be fully auditable; are subject
to Florida’s Public Records Law, Chapter 119, F.S.; must comply with contract Section 29, Dat a 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.
54.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the
Agency only upon further written consent by the Agency.
Upon request by the Agency, the Contractor shall provide the Agency with non-electronic (paper) copies
of records. Non-electronic (paper) copies provided to the Agency of any document that was originally in
54.2
electronic form with an electronic signature must identify the person and the
electronically signed the document on any non-electronic copy of the document.
Contract Manager:
person’s capacity who
55.
The Agency may substitute any Agency employee to serve as the Agency Contract Manager.
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56. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
CCE 203.22
57. All Terms and Conditions Included:
This contract and its Attachments I – XIV, 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-six (56) page contract to be executed by their
undersigned officials as duly authorized.
CONTRACTOR: COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY: SIGNED BY:
NAME: NAME:
TITLE: TITLE:
DATE: DATE
Federal Tax ID: 59-6000558
Page 15 of 56
a.
The Contractor name, as shown on page 1 of this
contract, and mailing address of the official payee to
whom the payment shall be made is:
Collier County Board of County Commissioners
3339 E Tamiami Trail, Building H
Naples, FL 34112
b.
The name of the contact person and street address
where financial and administrative records are
maintained is:
Kristi Sonntag, Director
Collier County Board of County Commissioners
3339 E Tamiami Trail, Building H
Naples, FL 34112
c.
The name, address, and telephone number of the
representative of the Contractor responsible for
administration of the program under this contract is:
Kristi Sonntag, Director
Collier County Board of County Commissioners
3339 E Tamiami Trail, Building H
Naples, FL 34112
239-252-2273
d.
The section and location within the Agency where
Requests for Payment and Receipt and Expenditure
forms are to be mailed is:
Area Agency on Aging for Southwest Florida, Inc.
2830 Winkler Ave., Suite 112
Fort Myers, FL 33916
239-652-6922
e. The name, address, and telephone number of the
Contract Manager for this contract is:
Richard Cocchieri, CFO
2830 Winkler Ave., Suite 112
Fort Myers, FL 33916
239-652-6922
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided
in writing to the other party.
7DQ\D5:LOOLDPV
3XEOLF6HUYLFHV'HSDUWPHQW+HDG
as designee of the County Manager, pursuant to Resolution No. 2018-202.
Approved as to Form and Legality:
_________________________________
Derek D. Perry
Assistant County Attorney CAO
WilliamsTanya Digitally signed by WilliamsTanya
Date: 2022.07.25 16:30:06 -04'00'
Federal Tax ID:59 6000558
Apprprprprprrprrprprprrprpprprpprrprpprpprppppppppppppppppppppppppppppppppppppppppppppppppovvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvved as to Form annnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnd dddddddddddddddddddddddddddddddddddddddddddddddddddd LeLLLLLLLLLLLLLLLLLLLLLLLLLgagagagagagagaagaaagagagaaaaagaaaaagagagaagagaaaaagagaaaaaaaagaaaagagaaagagaggaggggggggggggggggglilllllllllltyytytytytytytytyyytytytytyyyyyyyyyyytyyyyyyyyyytyyytyyytytttyytyttyttyyyyy:
___________________________________
Derek D. Perry
Assistant County Attorney
2022.07.21 09:24:34-04'00'
25
Maricela Morado
Interim Chief Executive Officer/President
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
7/28/2022
(July 2022 - June 2023) CCE 203.22
INDEX OF ATTACHMENTS
ATTACHMENT I ............................................................................................................................................... 17
STATEMENT OF WORK .................................................................................................................................. 17
ATTACHMENT II ............................................................................................................................................. 33
FINANCIAL AND COMPLIANCE AUDIT ....................................................................................................... 33
ATTACHMENT III ............................................................................................................................................ 39
CERTIFICATIONS AND ASSURANCES .......................................................................................................... 39
ATTACHMENT IV ............................................................................................................................................ 44
ASSURANCES—NON-CONSTRUCTION PROGRAMS .................................................................................... 44
ATTACHMENT V. ............................................................................................................................................. 46
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST .................. 46
ATTACHMENT VI ............................................................................................................................................ 50
CONTRACTOR’S STATE CONTRACT LIST .................................................................................................... 50
ATTACHMENT VII ........................................................................................................................................... 51
BACKGROUND SCREENING. .......................................................................................................................... 51
ATTACHMENT VIII ......................................................................................................................................... 52
ANNUAL BUDGET SUMMARY ........................................................................................................................ 52
ATTACHMENT IX. ............................................................................................................................................ 53
INVOICE REPORT SCHEDULE ...................................................................................................................... 53
ATTACHMENT X .............................................................................................................................................. 54
REQUEST FOR PAYMENT .............................................................................................................................. 54
ATTACHMENT XI ............................................................................................................................................ 55
RECEIPT AND EXPENDITURE REPORT ...................................................................................................... 55
ATTACHMENT XII ........................................................................................................................................... 56
SERVICE RATE REPORT ................................................................................................................................ 56
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STATEMENT OF WORK
I. SERVICES TO BE PROVIDED
A Definitions of Terms
1. Contract Acronyms
Activities of Daily Living (ADLs)
Area Agency on Aging (AAA)
Access Priority Consumer List (APCL)
Adult Protective Services (APS)
Adult Protective Services Referral Tracking Tool (ARTT)
Code of Federal Regulations (CFR)
Corrective Action Plan (CAP)
Community Care for the Disabled Adult (CCDA)
Community Care for the Elderly (CCE)
Client Information and Registration Tracking System (CIRTS)
Department of Children and Families (DCF)
Florida Administrative Code (F.A.C.)
Florida Department of Elder Affairs (DOEA or Department)
Florida Statutes (F.S.)
Home Care for Disabled Adults (HCDA)
Instrumental Activities of Daily Living (IADLs)
Notice of Instruction (NOI)
Planning and Service Area (PSA)
Summary of Programs and Services (SOPS)
Program Specific Terms
Administrative Funding: Contract dollars that are allocated to support the Contractor’s expenses incurred in
the management and operation of the CCE Program, as stipulated in this contract.
Adult Protective Services Referral Tracking Tool (ARTT): A system designed to track DCF APS referrals
to AAAs and CCE Lead Agencies for victims of second party abuse, neglect, and exploitation who need home
and community-based services as identified by APS staff.
Aging Out: The condition of reaching sixty (60) years of age and being transitioned from DCF’s CCDA or
HCDA services to DOEA’s community-based services.
Area Plan: A plan developed by the Contractor outlining a comprehensive and coordinated service delivery
system in its PSA in accordance with Section 306 of the Older Americans Act (42 U.S.C. § 3026) and
Department instructions. The Area Plan includes performance measures and unit rates per service offered per
county.
Area Plan Update: A revision to the Area Plan wherein the Contractor enters CCE-specific data in the CIRTS.
An update may also include other revisions to the Area Plan as instructed by the Department.
Department of Elder Affairs Programs and Services Handbook (DOEA Handbook): An official documentof
DOEA. The DOEA Handbook includes program policies, procedures, and standards applicable to agencies
which are recipients of DOEA-funded programs, and providers of program-funded services. An annual update
is provided through a NOI.
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2.
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Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to
remain living independently in the least restrictive living arrangement.
Lead Agency: An agency designated by the AAA at least every six (6) years through competitive procurement
which provides case management to all CCE clients and ensures service integration and coordination of service
providers within the community care service system.
NOI: DOEA’s established method to communicate to the Contractor and subcontractor the requirements to
perform specific tasks or activities in a particular manner. NOIs are located on the DOEA website at
http://elderaffairs.state.fl.us/doea/nois.php.
Program Highlights: Success stories, quotes, testimonials, or human-interest vignettes that are used in the
SOPS to demonstrate how programs and services help elders, families, and caregivers.
Summary of Programs and Services (SOPS): A document produced by DOEA and updated yearly to provide
the public and the Legislature with information about programs and services for Florida’s elders.
Vulnerable Adult in Need of Services: A vulnerable adult who has been determined by a protective
investigator to be suffering from the ill effects of neglect not caused by a second party perpetrator and is in need
of protective services or other services to prevent further harm.
General Description B.
1. General Statement
The primary purpose of the CCE Program is to prevent, decrease, or delay premature or inappropriate and
expensive placement of elders in nursing homes and other institutions.
Community Care for the Elderly Mission Statement
The CCE Program assists functionally impaired elderly persons in living dignified and reasonably independent
lives in their own homes or in the homes of relatives or caregivers through the development, expansion,
reorganization, and coordination of various community-based services. The program provides a continuum of
care so that functionally impaired elderly persons age sixty (60) and older may be assured the least restrictive
environment suitable to their needs.
Authority
The relevant authority governing the CCE Program includes:
a. Sections 430.201-430.207, F.S.;
b. Rule Chapter 58C-1, F.A.C.; and
c. The Catalog of State Financial Assistance (CSFA) Number 65.010.
Scope of Service
The Contractor is responsible for the programmatic, fiscal, and operational management of CCE Program. The
program services shall be provided in a manner consistent with the Contractor’s current Area Plan, as updated,
and the current DOEA Handbook, which are hereby incorporated by reference. The Contractor agrees to be
bound by all subsequent amendments and revisions to the DOEA Handbook, and the Contractor agrees to accept
all such amendments and revisions via a NOI.
Major Program Goals
The major goals of the CCE Program are to preserve the independence of elders and prevent or delay costlier
institutional care through a community care service system that provides case management and other in-home
and community services as needed under the direction of a lead agency, and to provide a continuum of service
alternatives that meets the diverse needs of functionally-impaired elders.
2.
3.
4.
5.
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C.Clients to be Served
CCE 203.22
General Description
The CCE Program provides a continuum of services for functionally-impaired elders age sixty (60) and older.
Client Eligibility
To receive services under this contract, an applicant must:
a.Be at least sixty (60) years of age and be functionally impaired pursuant to Section 430.203(7), F.S., as
determined through the functional assessment and at least an annual reassessment; or
b.Be aging out as defined in Section I.A.2. of this contract.
c.Clients cannot be dually enrolled in the CCE Program and a Medicaid-capitated long-term care program.
Targeted Groups
Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk
of placement in an institution or who are abused, neglected, or exploited.
Client Determination
The Agency shall have final authority for the determination of client eligibility.
1.
2.
3.
4.
II.MANNER OF SERVICE PROVISION
A.Service Tasks
To achieve the goals of the CCE Program, the Contractor shall perform, or ensure that its subcontractors perform,
the following tasks:
1.Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in Section I.C.2.
2.Assessment and Prioritization of Service Delivery for New Clients
The Contractor shall ensure the following criteria are used to prioritize new clients for service delivery in the
sequence below. It is not the intent of the Agency to remove existing clients from services to serve new
clients being assessed and prioritized for service delivery.
DCF APS High Risk individuals: The Contractor shall ensure that pursuant to Section 430.205(5)(a), F.S.,
those elderly persons who are determined by DCF APS to be vulnerable adults in need of services, pursuant
to Section 415.104(3)(b), or to be victims of abuse, neglect, or exploitation who need immediate services
to prevent further harm, and are referred by APS, shall be given primary consideration for receiving CCE
services. As used in this subsection, "primary consideration" means that an assessment and services must
commence within seventy-two (72) hours after referral to the Agency or as established in accordance with
local protocols developed between Agency service contractors and APS. The Contractor shall follow
guidelines for DCF APS High Risk referrals established in the APS Operations Manual, which is
incorporated by reference.
For DCF APS Low, Intermediate, and High-Risk Referrals for individuals enrolled in a Medicaid long-
term care program at the time of referral to the Contractor or subcontractor, the Contractor shall:
i.Ensure that the intake entity contacts and notifies the DCF APS protective investigator that the referral
was not accepted because the referred individual is enrolled in a Medicaid long-term care program; and
ii.Ensure that the intake entity notes that the referred individual is enrolled in a Medicaid long-term care
program in the ARTT as the reason for rejection.
Imminent Risk individuals: Individuals in the community whose mental or physical health condition has
deteriorated to the degree that self-care is not possible, there is no capable caregiver, and nursing home
placement is likely within one (1) month or very likely within three (3) months.
a.
b.
c.
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Aging Out individuals: Individuals receiving CCDA and HCDA services through DCF’s Adult Services
transitioning to community-based services provided through the Agency when DCF’s services are
not currently available
d.
e.Service priority for individuals not included in a., c., or d. above, regardless of referral source, will be
determined through the Agency's functional assessment administered to each applicant, to the extent
funding is available. The Contractor shall ensure that priority is given to applicants at the higher levels of
frailty and risk of nursing home placement. For individuals assessed at the same priority and risk of
nursing home placement, priority will be given to applicants with the lesser ability to pay for services.
3.Referrals for Medicaid Waiver Services
The Contractor must require subcontractors, through the performance of the client assessment, to identify
potential Medicaid eligible CCE clients and to refer these individuals for application for Medicaid Waiver
services.
The Contractor must require individuals who have been identified as being potentially Medicaid Waiver
eligible to apply for Medicaid Waiver services to receive community-based services. These individuals may
only receive CCE services while the Medicaid Waiver eligibility determination is pending. If the client is
found ineligible for Medicaid Waiver services for any reason other than failure to provide required
documentation, then the individual may continue to receive CCE services.
The Contractor must advise individuals who have been identified as being potentially Medicaid Waiver
eligible of the responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services
while the eligibility determination is being processed.
a.
b.
c.
4.Program Services
The Contractor shall ensure the provision of program services is consistent with the Contractor’s current Area
Plan, as updated and approved by the DOEA, and the current DOEA Handbook.
Use of Subcontractors
If this contract involves the use of a Subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for
a period of sixty (60) days or more of the initiation of the subcontract or the performance of the subcontractor, the
Contractor shall notify the Agency Contract Manager and the Agency Chief Financial Officer in writing of such
delay. The Contractor shall not permit a subcontractor to perform services related to this Contract without having
a binding subcontractor agreement executed prior to the Subcontractor's performance. The Agency will not be
responsible or liable for any obligations or claims resulting from such action.
B
Copies of Subcontracts
The Contractor shall submit a copy of all subcontracts to the Department’s Contract Manager within thirty
days of the subcontract being executed.
Monitoring the Performance of Subcontractors
The Contractor shall monitor, at least once per year, each of its Subcontractors, Subrecipients, Vendors, and/
or Consultants paid from funds provided under this contract. The Contractor shall perform fiscal,
administrative, and programmatic monitoring to ensure contractual compliance, fiscal accountability,
programmatic performance, and compliance with applicable state and federal laws and regulations. The
Contractor shall monitor to ensure that the budget is met, the scope of work is accomplished within the
specified time periods, and all other performance goals stated in this contract are achieved.
Copies of Subcontractor Monitoring Reports
The Contractor shall forward a copy of ail subcontractor monitoring reports to the Agency's Contract
Manager within thirty (30) days of the report being issued to the subcontractors, subrecipients, vendors, and/
or consultants.
1.
2.
3.
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C Staffing Requirements
1. Staffing Levels
The Contractor shall dedicate its own staff as necessary to meet the obligations of this contract and ensure that
subcontractors dedicate adequate staff accordingly.
Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications as specified in the current DOEA Handbook.
Service Times
The Contractor shall ensure the availability of services listed in this contract at times appropriate to meet client
service needs including, at a minimum, during normal business hours. Normal business hours are defined as
Monday through Friday, 8:00 a.m. to 5:00 p.m. local time.
2.
3.
D Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation required to
evidence the completion of the tasks specified in this contract.
1. Delivery of Service to Eligible Clients
The Contractor shall ensure the provision of a continuum of services that meets the diverse, individual, and
assessed needs of each functionally-impaired elder. The Contractor shall ensure that performance and reporting
of the following services are in accordance with the Contractor’s current Department-approved Area Plan, the
current DOEA Handbook, and Section II.A.1.-4., of this contract. Documentation of service delivery must
include a report consisting of the following: number of clients served, number of service units provided by
service, and rate per service unit with calculations that equal the total invoice amount. The services include the
following categories:
a. Core Services for Programmatic Operation
The Contractor shall ensure that core services include a variety of home-delivered services, day care
services, and other basic services that are most needed to prevent unnecessary institutionalization. The
Contractor shall not directly provide core services to clients. Core services, to be provided at the unit rate
identified in the Contractor’s Area Plan, as updated, include the following:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Adult Day Care;
Chore Services;
Companionship;
Escort;
Financial Risk Reduction;
Home Delivered Meals;
Homemaker;
(8) Housing Improvement;
(9) Legal Assistance;
(10)
(11)
(12)
(13)
(14)
Pest Control Services;
Respite Services;
Shopping Assistance;
Telephone Reassurance; and
Transportation.
b. Health Maintenance Services
The Contractor shall ensure that health maintenance services are made available as necessary to help
maintain the health of functionally-impaired elders. These services are limited to medical therapeutic
services and non-medical prevention services. Typical services to be provided at the unit rate identified in
the Contractor’s Area Plan, as updated, include the following:
(1) Adult Day Health Care;
(2) Emergency Alert Response;
(3) Gerontological Counseling;
(4) Health Support;
(5) Home Health Aide;
(8)
(9)
(10)
(11)
(12)
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Nutrition Counseling;
Occupational Therapy;
Personal Care;
Physical Therapy;
Skilled Nursing Services;
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(6) Medication Management;
(7) Mental Health
Counseling/Screening;
c. Other Support Services
CCE 203.22 (13) Specialized Medical Equipment,
Services, and Supplies; and
Speech Therapy. (14)
The Contractor shall ensure that support services expand the continuum of care options to assist
functionally-impaired elders and their caregivers. Support services to be provided at the unit rate identified
in the Contractor’s Area Plan, as updated, include the following:
(1)
(2)
(3)
Caregiver Training/Support;
Case Aid;
Case Management;
(4) Intake;
(5) Material Aid; and
(6) Other services, as approved by the Department.
2. Service Units
The Contractor shall ensure that the provision of services described in this contract is in accordance with the
current DOEA Handbook and the service tasks described in Section II.A. Attachment XIV, Service Rate
Report, lists the services that can be performed, the highest reimbursement unit rate, the method of payment,
and the service unit type. Units of service will be paid pursuant to the rate established in the Contractor’s Area
Plan as updated, as shown in Attachment XIV, and approved by the Department.
Administrative Responsibilities
The Contractor shall provide management and oversight of CCE Program operations in accordance with the
current DOEA Handbook and the Department-approved Contractor’s Area Plan and Cost Analysis.
Management and oversight of CCE Program operations include the following:
3.
a. Developing a competitive solicitation process for allocation of CCE funds, including appeal procedures for
handling disputes involving the Lead Agency;
Developing an Area Plan and updating it annually, at a minimum, as directed by the Department;
Designating appropriate and capable Lead Agencies and establishing vendor agreements at the AAA level,
when applicable for Lead Agency and CCE services according to manuals, rules, and agreement procedures
of DOEA;
Providing technical assistance and training to Lead Agencies, subcontractors, and vendors to ensure
provision of quality services;
Monitoring and evaluating Lead Agencies, subcontractors, and vendors for fiscal, administrative, and
programmatic compliance;
Appropriately and timely submitting payments to subcontractors;
Arranging in-service training for Lead Agencies at least annually;
Establishing procedures for handling recipient complaints and ensuring that subcontractors develop and
implement complaint procedures to process and resolve client dissatisfaction with services. Complaint
procedures shall address the quality and timeliness of services, Contractor and direct service worker
complaints, and any other issues related to complaints (other than termination, suspension or reduction in
services) that require the grievance process as described in Appendix D of the current DOEA Handbook.
The complaint procedures shall include notification to all clients of the complaint procedure and include
tracking the date, nature of complaint, and the determination of each complaint;
Ensuring compliance with CIRTS regulations;
Monitoring performance objective achievements in accordance with targets set by the Department; and
Conducting annual client satisfaction surveys to evaluate and improve service delivery.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
E. Reports
The Contractor shall respond within ten (10) business days, or within deadlines established by the Department, to
the Department’s request for routine and/or special requests for information and ad hoc reports. The Contractor
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must establish due dates for any subcontractors that permit
requirements
CCE 203.22
the Contractor to meet the Agency's reporting
CIRTS Reports
The Contractor shall ensure timely input of CCE-specific data into CIRTS. To ensure CIRTS data accuracy,
the Contractor shall use CIRTS-generated reports which include the following:
a. Client Reports;
b. Monitoring Reports;
c. Services Reports;
d. Miscellaneous Reports;
e. Fiscal Reports;
f. Aging and Disability Resource Center Reports; and
g. Outcome Measurement Reports.
Annual Service Cost Reports
a. The Agency shall require Contractors to annually submit to the Agency Contract Manager Service Cost Reports,
which reflect the actual costs of providing each service by program. This Annual Service Cost Report will be due
by February 25, of each year. This report will include actual costs for performing all services during the preceding
calendar year. Supporting documentation must accompany the report, which will include General Ledger, Trial
Balance and/or Statement of Revenue and Expenditures along with a narrative explanation and justification of
rate differences. This Annual Service Cost Report provides information for planning and negotiating unit rates.
1.
2.
b. Any multi-year contracts entered into with service providers on or after the effective date of this contract shall
contain a provision requiring the contract's parties to re-evaluate the contract's reimbursement rates on an annual
basis. The Contractor may annually renegotiate rates based on factors including but not limited to a review of
sustainability, the respective consumer price index, or current market conditions. However, it is the intent of the
Department and/or Agency that the quality of services provided to current program recipients not be reduced.
Unit Cost Methodology worksheets, along with supporting documentation and narrative explanation, must be
submitted by April 15 of each year, if a rate increase is being requested for any service in the next contract year.
Surplus/Deficit Reports
The Contractor shall submit a Consolidated Surplus/Deficit Report, in a format provided by the Agency, to the
Department’s Contract Manager by the 18th of each month. This Consolidated Surplus/Deficit Report is for
all agreements and contracts between the Contractor and the Agency and must include the following:
a. A list of all contracts and their current status regarding surplus/deficit;
b. The Contractor’s detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
Agency will be resolved;
c. Recommendations to transfer funds within the PSA to resolve surplus/deficit spending;
d. Input from the Agency's Board of Directors on resolution of spending issues, if applicable;
3.
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Cost Analysis
The Contractor shall submit a completed DOEA Cost Analysis for Non-Competitively Procured Contracts in
Excess of Category II to the Department’s Contract Manager by June 30th of each year.
Co-Pay Collections Report
The Contractor shall submit a consolidated annual co-payment collections report to the Department’s Contract
Manager by July 25, 202, using Attachment 5, located in Appendix B of the current DOEA Handbook.
Program Highlights
The Contractor shall submit Program Highlights referencing specific events that occurred in SFY/FFY
202-202 by August 30, 202. The Contractor shall provide a new success story, quote, testimonial, or human-
interest vignette. The highlights shall be written for a general audience, with no acronyms or technical terms.
For all agencies or organizations that are referenced in the highlight, the Contractor shall provide a brief
description of their mission or role. The active tense shall be consistently used in the highlight narrative, to
identify the specific individual or entity that performed the activity described in the highlight. The Contractor
shall review and edit Program Highlights for clarity, readability, relevance, specificity, human interest,
grammar, prior to submitting them to the Agency.
4.
5.
6.
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F. Records and Documentation
Requests for Payment
The Contractor shall maintain documentation to support Requests for Payment (Attachment XI) that shall be
available to the Agency or authorized individuals, such as the Department of Financial Services (DFS),
upon request.
CIRTS Data and Maintenance
The Contractor shall ensure monthly collection and maintenance of client and service information in CIRTS or
any such system designated by the Agency.
CIRTS Address Validation
The Contractor shall work with the Agency to ensure client addresses are correct in CIRTS for disaster
preparedness efforts. At least annually, and more frequently as needed, the Agency will provide direction on
how to validate CIRTS addresses to ensure these can be mapped. The Contractor will receive a list of
unmatched addresses that cannot be mapped and the Contractor will be responsible for working with the Lead
Agencies to correct addresses, and send a list to the Agency with confirmed addresses. The Agency will use
this information to update maps, client rosters, and unmatched addresses to disseminate to the Lead
Agencies.
Data Integrity and Back up Procedures
Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system. Data
and software essential to the continued operation of Contractor functions must be backed up. The security
controls over the backup resources shall be as stringent as the protection required of the primary resources. A
copy of the backed-up data shall be stored in a secure, offsite location.
Policies and Procedures for Records and Documentation
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available
to the Agency upon request.
1.
2.
3.
4.
5.
G. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
The Contractor must:
Ensure the prioritization of clients and provision of services to clients in accordance with Section II.A.2. of
this contract;
Ensure the provision of the services described in this contract are in accordance with the current DOEA
Handbook and Section II.A.1.-4 and Section II.D.1.-3. of this contract;
Timely and accurately submit to the Agency all required documentation and reports described in
Section II.E.;
Timely and accurately submit to the Agency Attachments XI, XII, and XIII, and supporting
documentation, in accordance with Attachment X, Invoice Report Schedule; and
Develop and document strategies in the Area Plan to support the Department’s standard of performance
achievement, including increases for the following:
i. Percentage of most frail elders who remain at home or in the community instead of going into a nursing
home;
ii. Percentage of active clients eating two or more meals per day;
iii. Percentage of new service recipients whose ADL assessment score has been maintained or improved;
a.
b.
c.
d.
e.
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iv. Percentage of new service recipients whose IADL assessment score has been maintained or improved;
v. After service intervention, the percentage of caregivers who self-report being very confident about their
ability to continue to provide care;
vi. Percentage of clients who are at imminent risk of nursing home placement who are served with
community-based services;
vii. Percentage of APS referrals who need immediate services to prevent further harm who are served
within seventy-two (72) hours; and
viii. Percentage of elders assessed with high or moderate risk environments who improved their
environment score.
The Contractor’s performance of the measures in Section II.G.1. above will be reviewed and documented in the
Department’s Annual Programmatic Monitoring Report.
Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, and/or
on-site visit(s). The primary, secondary, or signatory of the contract must be available for any on-site
programmatic monitoring visit. The Department’s determination of acceptable performance shall be conclusive.
The Contractor agrees to cooperate with the Agency in monitoring the progress of completion of the service
tasks and deliverables. The Agency may use, but is not limited to, one or more of the following methods for
monitoring:
2.
3.
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 evaluation;
Review of progress reports;
Review of customer satisfaction surveys;
Agreed-upon procedures review by an external auditor or consultant;
Limited-scope reviews; and
Other procedures as deemed necessary by the Agency.
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
H Contractor Responsibilities
1. Contractor Accountability
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the
Contractor and are tasks and deliverables for which, by execution of this contract, the Contractor agrees to be
held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of this contract, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant to
this contract.
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I. Agency Responsibilities
1. Agency Obligations
CCE 203.22
The Agency may, within its resources, provide technical support and/or assistance to the Contractor to assist the
Contractor in meeting the requirements of this contract. The Department’s technical support and/or
assistance, or lack thereof, shall not relieve the Contractor from full performance of contract requirements.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches used to
perform tasks required by this contract. The absence of the Agency setting forth a specific reservation of
rights does not mean that all other areas of the contract are subject to mutual agreement.
III. METHOD OF PAYMENT
Payment Methods Used
The method of payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the Contractor
upon satisfactory completion of the Tasks/Deliverables, as specified in Section II.D., and in accordance with other
terms and conditions of this contract.
A
Fixed Fee/Unit Rate
Payment for Fixed Fee/Unit Rates shall not exceed amounts established in the Service Rate Report (Attachment
XIV) per unit of service.
Cost Reimbursement
Payment may be authorized only for allowable expenditures which are in accordance with the services specified
in the Service Rate Report (Attachment XIV). All Cost Reimbursement Requests for Payment must include a
Receipt and Expenditure Report (Attachment XII) as well as a Cost Reimbursement Summary form
(Attachment XIII), beginning with the first month of this contract. Reimbursement amounts for administrative
costs must be reflected on the Cost Reimbursement Summary form (Attachment XIII) and include only items
contained on the Contractor’s Cost Analysis form. The Agency reserves the right to review supporting
documentation for any cost reimbursement requests.
Advance Payments
The Contractor may request up to two (2) months of advances at the start of the contract period to cover program
administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount of
funds released to the Agency by the State of Florida (budget release). The Contractor’s requests for
advance payments require the written approval of the Department’s Contract Manager. For the first month’s
advance request, the Contractor shall provide to the Department’s Contract Manager documentation justifying
the need for an advance and describing how the funds will be distributed. If the Contractor is requesting two
(2) months of advances, documentation must be provided reflecting the cash needs of the Contractor within the
initial two (2) months and should be supported through a cash-flow analysis or other information appropriate
to demonstrate the Contractor’s financial need for the second month of advances. The Contractor must also
describe how the funds will be distributed for the first and second month. If sufficient budget is available, and
the Department’s Contract Manager, in his or her sole discretion, has determined that there is justified need for
an advance, the Agency will issue approved advance payments after July 1st of the contract year.
a. Any advance payments the Contractor requests for subcontractors must be distributed within seven (7) days
of receipt of payment from the Agency. The Contractor shall submit to the Agency documentation to
support full distribution of advanced funds with Report Number 5, due to the Agency on October 25, 2021,
in accordance with the Invoice Report Schedule (Attachment X).
b. All advance payments retained by the Contractor must be fully expended no later than September 30, 2021.
Any portion of advance payments not expended must be recouped on the Request for Payment (Attachment
XI), Report Number 5, due to the Agency on October 25, 2021, in accordance with the Invoice Report
Schedule (Attachment X).
1.
2.
3.
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c. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: At least
one–tenth of the advance payment received shall be reported as an advance recoupment on each Request
for Payment (Attachment XI), starting with Report Number 5, in accordance with the Invoice Report
Schedule (Attachment X).
Funding Distribution
The Contractor agrees to distribute funds as detailed in the Area Plan update and the Annual Budget Summary
(Attachment IX). Any changes in the total amounts of the funds identified on the Annual Budget Summary form
require a contract amendment.
Method of Invoice Payment
Payment shall be made upon the Contractor’s presentation of an invoice subsequent to the acceptance and approval
by the Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
B
C
Have a Remittance Address that corresponds exactly to the “Remit To” address provided to
MyFloridaMarketPlace (MFMP) during registration;
Request payment monthly for the units of services established in the Contractor’s approved Area Plan, provided
in conformance with the requirements as described in the current DOEA Handbook, at the rates established in
the Service Rate Report (Attachment XIV) of the contract. Documentation of service delivery must include a
report consisting of the following: number of clients served, number of service units provided by service, and
rate per service unit with calculations that equal the total invoice amount. Reimbursement amounts for
administrative costs must be reflected on the Cost Reimbursement Summary form (Attachment XIII) and
include only items contained on the Contractor’s Cost Analysis form. Any requested changes to the approved
budget subsequent to the execution of this contract must be submitted to the Department’s Contract Manager
for written approval. Any change to the total contract amount requires a formal contract amendment;
The Contractor shall consolidate all subcontractors’ Requests for Payment and Expenditure Reports that support
Requests for Payment and shall submit the consolidated information to the Agency using forms Request for
Payment (Attachment XI), Receipt and Expenditure Report (Attachment XII), and Cost Reimbursement
Summary (Attachment XIII) for services and administrative expenses, which must include itemized expenditure
categories; and
All Requests for Payment shall be based on the submission of monthly Receipt and Expenditure Reports
beginning with the first month of this contract. The schedule for submission of advance requests (when
available) and invoices is set forth in the Invoice Report Schedule (Attachment X).
1.
2.
3.
4.
D. Payment Withholding
Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments
thereto, including any disallowance not resolved.
Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than August 15, 2022.
CIRTS Data Entries for Subcontractors
The Contractor shall require subcontractors to enter all required data for clients and services in the CIRTS database
in accordance with the current DOEA Handbook and the CIRTS User Manual – Aging Provider Network users
(located in Documents on the CIRTS Enterprise Application Services). Subcontractors must enter this data into the
CIRTS prior to submitting their Requests for Payment and Expenditure Reports to the Contractor. The Contractor
shall establish deadlines for completing CIRTS data entry and ensure compliance with due dates for the Requests
for Payment and Receipt and Expenditure reports that Contractor must submit to the Agency.
Subcontractors’ Monthly CIRTS Reports
The Contractor shall require subcontractors to run monthly CIRTS reports and to verify that client and service data
in the CIRTS is accurate. This report must be submitted to the Contractor with the monthly Request for Payment
E
F.
G
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and Receipt and Expenditure Report and must be reviewed by the Contractor before the subcontractor’s request
for Payment and Receipt and Expenditure Reports can be approved by the Contractor.
Corrective Action Plan H
1. Contractor shall ensure one hundred percent (100%) of the deliverables identified in Section II.D.1.-3. of this
contract are performed pursuant to contract requirements.
If at any time the Contractor is notified by the Department’s Contract Manager that it has failed to correctly,
completely, and/or adequately perform contract deliverables identified in Section II.D.1.-3. of this contract, the
Contractor will have ten (10) days to submit a CAP to the Department’s Contract Manager that addresses the
deficiencies and states how the deficiencies will be remedied within the time approved by the Department’s
Contract Manager. The Agency shall assess a Financial Consequence for Non-Compliance on the
Contractor as referenced in Section III.I. of this contract for each deficiency identified in the CAP which is not
corrected pursuant to the CAP. The Agency will also assess a financial consequence for failure to timely
submit a CAP.
If the Contractor fails to correct an identified deficiency within the approved time specified in the CAP, the
Agency shall deduct the percentage established in Section III.I. of this contract from the payment for the
invoice of the following month.
If the Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established in Section
III.I. of this contract for each day the CAP is overdue. The deduction will be made from the payment for the
invoice of the following month.
2.
3.
4.
Financial Consequences
The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the
satisfaction of the Agency according to the requirements referenced in Section II.D. of this contract. The
following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the
performance criteria as outlined in Section II.D. of this contract:
I.
1. Delivery of services to eligible clients as referenced in Section II.A.1.-2. and Section II.D.1 of this contract –
Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports, will
result in a two percent (2%) reduction of payment per business day. The reduction of payment will begin on the
first business day following the Department’s notification to the Contractor that the identified deficiency was
not cured or satisfactorily addressed in accordance with the Agency-approved CAP, referenced in Section
III.H.;
Services and units of services as referenced in Section II.D.2. of this contract – Failure to provide services in
accordance with the current DOEA Handbook, the service tasks described in Section II.A., and the Service Rate
Report (Attachment XIV), and/or failure to submit required documentation will result in a two percent (2%)
reduction of payment per business day. The reduction of payment will begin the first business day following
the Department’s notification to the Contractor that the identified deficiency is not cured or satisfactorily
addressed in accordance with the Agency approved CAP, referenced in Section III.H.;
Administrative duties as referenced in Section II.D.3. of this contract – Failure to perform management and
oversight of CCE Program operations will result in a two percent (2%) reduction of payment per business day.
The reduction of payment will begin the first business day following the Department’s notification to the
Contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the
Agency-approved CAP, referenced in Section III.H.;
Timely submission of a CAP – Failure to timely submit a CAP within ten (10) business days after notification
of a deficiency by the Department’s Contract Manager will result in a two percent (2%) reduction of payment
per business day the CAP is not received. The reduction of payment will begin the first business day following
the Department’s notification to the Contractor that the identified deficiency was not cured or satisfactorily
addressed in accordance with the Agency-approved CAP, referenced in Section III.H.; and
Exceptions may be granted solely, in writing, by the Department’s Contract Manager.
2.
3.
4.
5.
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IV. SPECIAL PROVISIONS
CCE 203.22
Final Budget and Funding Revision Requests A
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the Department’s Contract Manager in writing no later than June 30, 2022; email requests are
considered acceptable.
Contractor’s Financial Obligations B
Matching, Level of Effort, and Earmarking Requirement
The Contractor must provide a match of at least ten percent (10%) of the cost for all CCE services. The match
must be made in the form of cash and/or in-kind resources. At the end of the contract period, all CCE funds
expended must be properly matched. State funds shall not be used to match another state-funded program.
Cost Sharing and Co-Payments
Pursuant to Section 430.204(8), F.S., and Rule 58C-1.007, F.A.C., the dollar amount for co-payments associated
with CCE must be calculated by applying the current federal poverty guidelines published by the U.S.
Department of Health and Human Services.
1.
2.
No co-payments will be assessed on a client whose income is at, or below, the federal poverty level (FPL)
as established each year by the U.S. Department of Health and Human Services.
No client may have their services terminated for inability to pay their assessed co-payment. The Contractor,
in conjunction with provider agencies, must establish procedures to remedy financial hardships associated
with co-payments and ensure there is no interruption in service(s) for inability to pay. If a client’s co-
payment is reduced or waived entirely, a written explanation for the change must be placed in the client
file.
Co-payments include only the amounts assessed to consumers by subcontractors or the amounts consumers
opt to contribute in lieu of an assessed co-payment. The consumer’s contribution must be equal to or greater
than the assessed co-payment. Co-payments collected in the CCE Program can be used as part of the local
match, as detailed above in Section IV.B.1.
a.
b.
c.
Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all funds provided by the Agency for the purpose specified in this
contract. The Contractor must manage the service dollars in such a manner as to avoid having a wait list and a
surplus of funds at the end of the contract period. If the Agency determines that the Contractor is not
spending service funds accordingly, the Agency may transfer funds to other AAAs during the contract
period and/or adjust subsequent funding allocations accordingly, as allowable under state and federal law.
Contract Limits
In no case shall the Contractor be required to incur costs in excess of the contract amount in providing services
to clients.
3.
4.
Remedies for Nonconforming Services C
The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,
completely, and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
If the Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed
under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services
not meeting such standards will not be reimbursed under this contract. The Contractor’s signature on the
Request for Payment form certifies maintenance of supporting documentation and acknowledgement that the
Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or
services. The Agency requires immediate notice of any significant and/or systemic infractions that
compromise the quality, security, or continuity of services to clients.
1.
2.
D. Incident Reporting
The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor’s awareness or discovery of changes that may materially affect the Contractor or any subcontractor’s
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ability to perform the services required to be performed under this contract and in authorizing provison. Such
notice shall be made orally to the Department’s Contract Manager (by telephone) with an email to immediately
follow, including the Contractor’s plan for provision of services authorized in proviso.
Investigation of Criminal Allegations
Any report that implies criminal intent on the part of the Contractor or any subcontractors and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney’s office, or
other governmental agency, the Contractor shall notify the Inspector General at the Agency immediately. A copy
of all documents, reports, notes, or other written material concerning the investigation, whether in the
possession of the Contractor or subcontractors, must be sent to the Department’s Inspector General with a summary
of the investigation and allegations.
Volunteers
The Contractor shall ensure the use of trained volunteers in providing direct services delivered to older individuals
and individuals with disabilities needing such services. If possible, the Contractor shall work in coordination with
organizations that have experience in providing training, placement, and stipends for volunteers or participants
(such as the Senior Community Service Employment Program or organizations carrying out federal service
programs administered by the Corporation for National and Community Service).
Enforcement
E
F.
G
In accordance with Section 430.04, F.S., the Agency shall rescind designation of an area agency on aging or
take intermediate measures against the Contractor, including corrective action, unannounced special
monitoring, temporary assumption of operation of one or more programs by the Agency, placement on
probationary status, imposing a moratorium on Contractor action, imposing financial penalties for
nonperformance, or other administrative action pursuant to Chapter 120, F.S., if the Agency finds that any of
the following have occurred:
1.
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients, or substantially and negatively affected the operation of an aging services program;
The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds
have been misappropriated;
The Contractor has committed multiple or repeated violations of legal and regulatory requirements or
Agency standards;
The Contractor has failed to continue the provision or expansion of services after the declaration of a state
of emergency;
The Contractor has exceeded its authority or otherwise failed to adhere to the terms of this contract with
the Agency or has exceeded its authority or otherwise failed to adhere to the provisions specifically
provided by statute or rule adopted by the Agency;
The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets; or
The Contractor has failed to implement and maintain a Agency-approved client grievance resolution
procedure.
b.
c.
d.
e.
f.
g.
In making any determination under this provision, the Agency may rely upon findings of another state or
federal agency or other regulatory body. Any claims for damages for breach of contract are exempt from
administrative proceedings and shall be brought before the appropriate entity in the venue of Leon County,
Florida. In the event the Agency initiates action to rescind an area agency on aging designation, the
Agency shall follow the procedures set forth in 42 U.S.C. § 3025(b).
2.
H Contract Modifications
The Department’s Contract Manager has the authority to modify and/or extend deliverable deadlines. All
deliverable extension requests must be made to the Department’s Contract Manager, in writing, prior to the
required deadline. All approvals for deliverable extensions must be communicated, in writing, by the
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Agency's Contract Manager to the Contractor and are subject to the discretion of the Agency's Contract
Manager. The requests and the approval must occur prior to the established deadline. An e-mail writing (request
and response) is considered acceptable.
END OF ATTACHMENT
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ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Agency, as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see “AUDITS” below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency staff, limited scope audits and/or other procedures. By entering into this contract, the Contractor agrees to
comply and cooperate with any monitoring procedures/processes deemed appropriate by the Agency. In the event the
Agency determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any
additional instructions provided by the Agency to the Contractor regarding such audit. The Contractor further agreesto
comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial
Officer (CFO) or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program-specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial and
Compliance Audit Attachment, Exhibit 2 indicates federal resources awarded through the Agency by this contract. In
determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended should
be in accordance with 2 CFR Part 200. An audit of the Contractor conducted by the Auditor General in accordancewith the
provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR § 200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contractor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200, the cost
of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contractor resources
obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization’s fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract’s requirements, including any
rules, regulations, or statutes referenced in the contract. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency contract involved. If not otherwise disclosed as required by 2
CFR § 200.510, the schedule of expenditures of federal awards shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. Financial reporting packages required under this part must be
submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor’s fiscal
year end.
PART II: STATE FUNDED
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This part is applicable if the Contractor is a non-state entity as defined by Section 215.97(2), F.S.
CCE 203.22
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in
any fiscal year of such Contractor, the Contractor must have a State single or project-specific audit for such fiscal year in
accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapter 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. Financial
Compliance Audit Attachment, Exhibit 2 indicates state financial assistance awarded through the Agency by this contract.
In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources of state
financial assistance, including state financial assistance received from the Agency, other state agencies, andother non-
state entities. State financial assistance does not include Federal direct or pass-through awards and resources received by a
non-state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the non-state entity’s resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization’s fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract’s requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully disclosed in the
audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 69I-5.003,
F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. For local governmental entities, financial reporting packages
required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after
the Contractor’s fiscal year end. For non-profit or for-profit organizations, financial reporting packages required under this
part must be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor’s
fiscal year end. Notwithstanding the applicability of this portion, the Agency retains all right and obligation to monitor
and oversee the performance of this contract as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of financial reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part I of
this Financial Compliance Audit Attachment, shall be submitted, when required by 2 CFR § 200.512 by or on behalf of the
Contractor directly to each of the following:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville, IN 47132
Pursuant to 2 CFR § 200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
The Contractor shall submit a copy of any management letter issued by the auditor directly to the Agency.
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Area Agency on Aging for Southwest Florida, Inc.
Attn: Rick Cocchieri, CFO
280 Winkler Ave, Suite 112
Ft Myers, Florida 33916
Additionally, copies of financial reporting packages required by this contract’s Financial Compliance Audit Attachment,
Part II, shall be submitted by or on behalf of the Contractor directly to each of the following:
The Agency at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Rick Cocchieri, CFO
280 Winkler Ave, Suite 112
Ft Myers, Florida 33916
The Auditor General’s Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letters, or other information required to be submitted to the Agency pursuant to this contract shall
be submitted timely in accordance with 2 CFR Part 200, F.S., and Chapter 10.550 (local governmental entities) or
10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part
200 or Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of
six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the Director, or Auditor
General access to such records upon request. The Contractor shall ensure that audit working papers are made available to
the Agency or its designee, Director, or Auditor General upon request for a period of six (6) years from the date the audit
report is issued, unless extended in writing by the Agency.
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ATTACHMENT II-EXHIBIT 1
AUDIT RELATIONSHIP DETERMINATION PART I:
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub-recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part II of Exhibit 1 are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR § 200.38 and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub-recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006, F.A.C., Contractor has been determined to be:
_ Vendor not subject to 2 CFR § 200.38 and/or Section 215.97, F.S.
X_ Recipient/sub-recipient subject to 2 CFR §§ 200.86 and 200.93 and/or Section 215.97, F.S.
_ Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and/or state financial assistance, and has
been approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006,
F.A.C. [state financial assistance] and/or 2 CFR § 200.330 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub-
recipient must comply with the following fiscal laws, rules, and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR § 200.416 - § 200.417 – Special Considerations for States, Local Governments, and Indian Tribes*
2 CFR § 200.201 – Administrative Requirements**
2 CFR § 200 Subpart F – Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR § 200.400 - § 200.411 – Cost Principles*
2 CFR § 200.100 – Administrative Requirements
2 CFR § 200 Subpart F – Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR § 200.418 – § 200.419 – Special Considerations for Institutions of Higher Education*
2 CFR § 200.100 – Administrative Requirements
2 CFR § 200 Subpart F – Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§200.400(5)(c).
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**For funding passed through U.S. Health and Human Services, 45 CFR Part 75; for funding passed through US
Department of Education, 34 CFR Part 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws, rules, and regulations:
Sections 215.97 & 215.971, F.S.
Chapter 69I-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
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ATTACHMENT II-EXHIBIT 2
FUNDING SUMMARY (2022-2023)
Note: Title 2 CFR, as revised, and Section 215.97, F.S., require that the information about Federal Programs and State
Projects included in Attachment II, Exhibit 1, be provided to the recipient. Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133 – Audits of States, Local Governments, and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97, F.S.
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Sections 215.97 & 215.971, F.S., Chapter 69I-5, F.A.C., State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
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PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Community Care for the Elderly General Revenue 65.010 éöñõüõñþþøóùýå
TOTAL AWARD $1,070,993.48
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
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ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
DOEA will not award this contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 75)
B. Certification Regarding Lobbying (29 CFR Part 93 and 45 CFR Part 93)
C. Nondiscrimination & Equal Opportunity Assurance (29 CFR Part 37 and 45 CFR Part 80)
D. Certification Regarding Public Entity Crimes, section 287.133, F.S.
E. Association of Community Organizations for Reform Now (ACORN) Funding Restrictions Assurance
(Pub. L. 111-117)
F.
G.
Scrutinized Companies Lists and No Boycott of Israel Certification, section 287.135, F.S.
Certification Regarding Data Integrity Compliance for Contracts, Agreements, Grants, Loans, and
Cooperative Agreements
Verification of Employment Status Certification
Records and Documentation
H.
I.
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS – PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal department or agency;
Have not within a three-year period preceding this contract been convicted or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or
local) with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
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.
2.
3.
4.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all
sub-recipients and contractors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING – CERTIFICATION FOR CONTRACTS, GRANTS, LOANS,
AND COOPERATIVE AGREEMENTS.
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
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the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form – LLL, “Disclosure Form to Report
Lobbying,” in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all
sub-recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by 31
U.S.C. § 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON- DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I-financially assisted program
or activity.
Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance
with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Department and Agency.
Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in
accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Department and Agency.
The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance
with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of,
be excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
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.
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws
listed above. This assurance applies to Contractor’s operation of the WIA Title I – financially assisted program or
activity, and to all contracts Contractor makes to carry out the WIA Title I – financially assisted program or activity.
2.
3.
4.
5.
6.
7.
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Contractor understands that DOEA and the United States have the right to seek judicial enforcement of the
assurance.
CCE 203.22
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all
sub-recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform DOEA immediately upon any change of circumstances
regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions pertaining
to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all sub-
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION
287.135, F.S.
In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized
Companies that Boycott Israel List and that it is not engaged in a boycott of Israel.
If this contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135, F.S.,
Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the
Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it is not engaged in business
operations in Cuba or Syria.
Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may result in the
Agency terminating this contract and the submission of a false certification may subject Contractor to civil penalties and
attorney fees and costs, including any costs for investigations that led to the finding of false certification.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS,
GRANTS, LOANS, AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have financial management systems
capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial
results of each grant-funded project or program in accordance with the prescribed reporting requirements; (2) the
source and application of funds for all contract supported activities; and (3) the comparison of outlays with
budgeted amounts for each award. The inability to process information in accordance with these requirements
could result in a return of grant funds that have not been accounted for properly.
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
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(July 2022 - June 2023) CCE 203.22
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.
If this contract includes the provision of hardware, software, firmware, microcode, or imbedded chip technology,
the undersigned warrants that these products are capable of processing year-date dependent data accurately. All
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
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.
3.
4.
5.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland
Security's E-verify system to verify the employment eligibility of all new employees hired by Contractor during the
contract term to perform employment duties pursuant to this contract, and that any subcontracts include an express
requirement that Subcontractors performing work or providing services pursuant to this contract utilize the E-verify
system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract
term.
The Contractor shall require that the language of this certification be included in all sub-agreements, sub-grants, and
other agreements/contracts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by
Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A-110).
RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all contract
related records and documentation. The Contractor shall ensure the collection and maintenance of all program related
information and documentation on any such system designated by the Agency. Maintenance includes valid exports and
backups of all data and systems according to Agency standards.
I.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
In addition to the requirements of Section 10 of the Standard Contract, sections 119.0701(3) and (4) F.S., and any other
applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is
named in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the
Agency and any attorneys’ fees assessed or awarded against the Agency from a Public Records Request made
pursuant to Chapter 119, F.S., concerning this contract or services performed thereunder.
a. Notwithstanding section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Agency and state agencies or subdivisions defined in section 768.28(2), F.S.
1.
Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership
contributions for any person, corporation, foundation, trust, association, group, or other organization, all the financial,
business, and membership records of such an entity which pertain to the public agency (Florida Department of
Elder Affairs) are public records. Section 119.07, F.S, states that every person who has custody of such a public record
shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances.
2.
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Additionally, I certify this organization does does not provide for institutional memberships.
CCE 203.22
Contractor’s signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection if applicable, as stated above.
By execution of this contract, Contractor must include these provisions (A-J) in all related subcontract agreements (if
applicable).
By signing below, Contractor certifies that the representations outlined in parts A through J above are true and correct.
Page 43 of 56
Signature and Title of Authorized Representative Street Address
Contractor Date City, State, Zip code
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as designee of the County Manager, pursuant to Resolution No. 2018-202.
Approved as to Form and Legality:
_________________________________
Derek D. Perry
Assistant County Attorney
Apppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppprprprprprprprpppprpprpppppprprpprprpppppprpprpppppprppprrpppprprprpprrrpprprrrppppprrprprprprrprprrrrrrrrrrrrrrrrrrrrrrrrrrrroved as to Form and Legality:
______________________________________________________________________________________________________________________________________________________________________
Derek D. Perry
Assistant County Attorneyyyyy
CAO
WilliamsTanya Digitally signed by WilliamsTanya
Date: 2022.07.25 16:30:38 -04'00'
07/25/22
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 2022 - June 2023) CCE 203.22
ATTACHMENT IV ASSURANCES—
NON-CONSTRUCTION PROGRAMS
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes, or presents the
appearance of, personal or organizational conflict of interest or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed
standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683 and §§ 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
§ 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended
(42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment
Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug
abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific
statute(s) under which application for federal assistance is being made; and (j) the requirements of any other
nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
Page 44 of 56
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
CAO
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 2022 - June 2023) CCE 203.22
8.Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and §§ 7324-7328), which
limit the political activities of employees whose principal employment activities are funded in whole or in part with
federal funds.
9.Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. §§ 276a to 276a-7), the Copeland
Act (40 U.S.C. § 276c and 18 U.S.C. § 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§ 327-
333), regarding labor standards for federally assisted construction sub-contracts.
10.Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11.Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. § 1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection of
endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. § 1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13.Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. § 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. § 469a-1 et seq.).
14.Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15.Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. § 2131 et seq.)
pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16.Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. § 4801 et seq.), which prohibits the use
of lead- based paint in construction or rehabilitation of residence structures.
17.Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18.Will comply with all applicable requirements of all other federal laws, executive orders, regulations, and policies
governing this program.
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SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
APPLICANT ORGANIZATION DATE SUBMITTED
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Tanya R. Williams, as designee of the County Manager,
pursuant to Resolution No. 2018-202.
Approved as to Form and Legality:
_________________________________
Derek D. Perry
Assistant County Attorney
Apprrprrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrovoovvovoovovovvvvoovovovoovovvoovovvoovovovvvvvvvovvvvvvvvvvvvvvvvvved as to Form and dddddd ddddddd Legality:
__________________________________________________________________________________________________________________________________
Derek D. Perry
Assistant County Attorney CAO
WilliamsTanya
Digitally signed by
WilliamsTanya
Date: 2022.07.25 16:31:03
-04'00'
25
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 2022 - June 2023) CCE 203.22
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1.Briefly describe the geographic area served by the program/facility and the type of service provided:
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO, EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA? N/A YES NO
7. Compare the staff composition to the population. Is staff representative of the population?N/A YES NO
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
origin, sex, age, religion, or disability?
N/A YES NO
9. Are all benefits, services and facilities available to applicants and participants in an equally effective manner
regardless of race, sex, color, age, national origin, religion, or disability?
N/A YES NO
10.For in-patient services, are room assignments made without regard to race, color, national origin or disability?N/A YES NO
11.Is the program/facility accessible to non-English speaking clients?N/A YES NO
N/A YES NO 12. Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
Verbal Written Poster
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For questions 2-5 please indicate the following: Total # %
White
%
Black
%
Hispanic
%
Other
%
Female
%
Disabled
%
Over 40
2.Population of area served Source of data:
3. Staff currently employed Effective date:
4. Clients currently enrolled/registered Effective date:
5.Advisory/Governing Board if applicable
Program/Facility Name County AAA/Contractor
Address Completed By
City, State, Zip Code Date Telephone
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13. Givethe number and current status of any discrimination complaints regarding services or employment filed
against the program/facility.
N/A NUMBER
14.Is the program/facility physically accessible to mobility, hearing, and sight-impaired individuals?N/A YES NO
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF NO,
EXPLAIN.
15. Has as a self-evaluation been conducted to identify anybarriers to serving disabled individuals and to make any
necessary modifications?
YES NO
16.Is there an established grievance procedure that incorporates due process in the resolution of complaints?YES NO
17.Has a personbeen designated to coordinate Section 504 compliance activities?YES NO
18. Do recruitment and notification materials advise applicants, employees, and participants ofnondiscrimination on
the basis of disability?
YES NO
19.Are auxiliary aids available to ensure accessibility of services to hearing and sight-impaired individuals?YES NO
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTSOF $50,000.00 OR MORE.
20.Do you have a written affirmative action plan? If NO, explain.YES NO
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Reviewed by In Compliance: YES NO*
Program Office *Notice of Corrective Action Sent / /
Date Telephone Response Due / /
On-Site Desk Review Response Received _ / /
DOEA USE ONLY
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ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
Describe the geographic service area such as a district, county, city, or other locality. If the program/facility serves a
specific target population such as adolescents, describe the target population. Also, define the type of service provided.
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.)
Enter the total number of full-time staff and their percent by race, sex, disability, and over the age of 40. Include the
effective date of your summary.
Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list their
percent by race, sex, disability, and over the age of 40. Include the date that enrollment was counted.
a.Where there is a significant variation between the race, sex, or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons.
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.
Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR Part 80. This is usually a standard part of the
contract language for DOEA Recipients and their Sub-grantees. 45 CFR § 80.4(a).
Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the population
is Hispanic, is there a comparable percentage of Hispanic staff?
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.
Participants or clients must be provided services such as medical, nursing, and dental care, laboratory services, physical
and recreational therapies, counseling, and social services without regard to race, sex, color, national origin, religion,
age, or disability. Courtesy titles, appointment scheduling, and accuracy of record keeping must be applied uniformly
and without regard to race, sex, color, national origin, religion, age, or disability. Entrances, waiting rooms, reception
areas, restrooms, and other facilities must also be equally available to all clients. 45 CFR § 80.3(b).
For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin, or
disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a
different race, color, national origin, or disability. 45 CFR § 80.3(a).
The program/facility and all services must be accessible to participants and applicants, including those persons who may
not speak English. In geographic areas where a significant population of non-English speaking people live, program
accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy or plan for
service, such as a current list of names and telephone numbers of bilingual individuals who will assist in the provision
of services. 45 CFR § 80.3(a).
Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any other interested parties. 45 CFR § 80.6(d). This should include information on their
right to file a complaint of discrimination with either the Agency or the U.S. Department of Health and Human
Services. The information may be supplied verbally or in writing to every individual or may be supplied through the use
of an equal opportunity policy poster displayed in a public area of the facility.
Report number of discrimination complaints filed against the program/facility. Indicate the basis (e.g. race, color, creed,
sex, age, national origin, disability, and/or retaliation) and the issues involved (e.g. services or employment, placement,
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Page 48 of 56 CAO
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(July 2022 - June 2023) CCE 203.22
termination, etc.). Indicate the civil rights law or policy alleged to have been violated along with the name and address
of the local, state, or federal agency with whom the complaint has been filed. Indicate the current status of the complaint
(e.g. settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.).
14. The program/facility must be physically accessible to mobility, hearing, and sight-impaired individuals. Physical
accessibility includes designated parking areas, curb cuts or level approaches, ramps, and adequate widths to entrances.
The lobby, public telephone, restroom facilities, water fountains, and information and admissions offices should be
accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters,
and serving lines should be observed for accessibility. Elevators should be observed for door width and Braille or
raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed
at an appropriate height for mobility impaired individuals.
15. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four-step process:
a. Evaluate, with the assistance of disabled individual(s)/organization(s), current policies and practices that do not or
may not comply with Section 504;
Modify policies and practices that do not meet Section 504 requirements.
Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these policies and
practices; and
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).
b.
c.
d.
16. Programs or facilities that employ 15 or more persons shall adopt grievance procedures that incorporate appropriate due
process standards and that provide for the prompt and equitable resolution of complaints alleging any action prohibited
by Part 84 of Title 45, CFR45 CFR § 84.7(b).
17. Programs or facilities that employ 15 or more persons shall designate at least one person to coordinate its efforts to
comply with Part 84 of Title 45, CFR. 45 CFR § 84.7(a).
18. Programs or facilities that employ 15 or more persons shall take appropriate initial and continuing steps to notify
participants, beneficiaries, applicants, and employees that the program/facility does not discriminate on the basis of
handicap in violation of Section 504 and Part 84 of Title 45, CFR. Methods of initial and continuing notification may
include the posting of notices, publication in newspapers and magazines, placement of notices in publications of the
programs or facilities, and distribution of memoranda or other written communications. 45 CFR § 84.8(a).
19. Programs or facilities that employ 15 or more persons shall provide appropriate auxiliary aids to persons with impaired
sensory, manual, or speaking skills where necessary to afford such persons an equal opportunity to benefit from the
service in question. Auxiliary aids may include, but are not limited to, brailed and taped materials, interpreters, and other
aids for persons with impaired hearing or vision. 45 CFR § 84.52(d).
20. Programs or facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement, and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR Part 60
and Title VI of the Civil Rights Act of 1964, as amended.
Page 49 of 56 CAO
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 2022 - June 2023) CCE 203.22 ATTACHMENT VI CONTRACTOR’S STATE CONTRACT LIST Contractor's State Contract List REPORT PERIOD: From: To: CONTRACTOR INFORMATION: Name: Address: FEID: Phone: Email: Contact: SIGNATURE: TITLE: DATE: Page 50 of 56 Contract # Contract/ Program Name State Agency/ Program Start Date End Date Description of Contract Purpose/Types of Services Contract Manager Phone # Contract Amount 1 $ - 2 $ - 3 $ - 4 $ - 5 $ - 6 $ - 7 $ - 8 $ - 9 $ - 10 $ - 11 $ - 12 $ - 13 $ - 14 $ - 15 $ - 16 $ - 17 $ - 18 $ - 19 $ - 20 $ - Total CAODocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 2022 - June 2023) CCE 22
BACKGROUND SCREENING
BACKGROUNDSCREENING
Attestation of Compliance -Employer
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 directservice provideris “a person 18 years of age or older who, pursuant to a program to provide
client and has access to the client’s living area, funds, personal property, or personal identification
information as defined in s. 817.568. The term includes coordinators, managers, and supervisors of
residential facilities and volunteers.” § 430.0402(1)(b), Fla. Stat.
ATTESTATION:
As the duly authorized representative of
Employer Name
located at ,
Street Address City State ZIP code
I, 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, Florida Statutes, regarding level 2 background screening.
Signature of Representative Date
DOEA Form 235, Attestation of Compliance - Employer, Effective January 19, 2021
F.S. Form available at: http://elderaffairs.state.fl.us/english/backgroundscreening.php
Section 435.05(3),
Page 51 of 58
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
CAO
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 2022 - June 2023) CCE 203.22
ATTACHMENT VIII
ANNUAL BUDGET SUMMARY
CCE
Collier County Board of County Comissioners
1.CCE Services Allocation $1,070,993.48
Total $1,070,993.48
Page 52 of 56 CAO
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 2022 - June 2023) CCE 203.22
ATTACHMENT IX
INVOICE REPORT SCHEDULE
Report Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Based On
July Advance*
August Advance*
July Invoice
August Invoice
September Invoice
October Invoice
November
Invoice December
Invoice January
Invoice February
Invoice March
Invoice April
Invoice
May Invoice
Submit to Agency on This Date
July 1
July 1
August 11
September 11
October 11
November 11
December 11
January 11
February 11
March 11
April 11
May 11
June 11
July 11
15 Final Invoice July 25
Legend: * Advance based on projected cash need.
Note # 1: Report #1 for Advance Basis Agreements cannot be submitted to the Area Agency Aging for
Southwest Florida, Inc. prior to July 1 or until the agreement with the Agency has been executed
and a copy sent to Area Agency Aging for Southwest Florida, Inc. . Actual submission of the
vouchers to Agency is dependent on the accuracy of the expenditure report.
Note # 2: Report numbers 5 through 14 shall reflect an adjustment of at least one-tenth of the total advance
amount, on each of the reports, repaying advances issued the first two months of the agreement. The
adjustment shall be recorded in Part C, 1 of the report
Note #3: Submission of expenditure reports may or may not generate a payment request. If final expenditure
report reflects funds due back to the Agency, payment is to accompany the report.
Page 53 of 56 CAO
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 2022 - June 2023) CCE 203.22
ATTACHMENT X
REQUEST FOR PAYMENT
COMMUNITY CARE FOR THE ELDERLY
RECIPIENT NAME, ADDRESS, PHONE# and FEID# TYPE OF PAYMENT : Contract # _ _
Regular _ Contract Period
Report Period
Advance _ _ Report # _
Invoice # _
PSA _
CERTIFICATION: I hereby certify to the best of my knowledge that this request or refund conforms with the terms and the purposes of the above contract.
Prepared by:_ Date:_ Approved by: _ Date: _
PART A: BUDGET SUMMARY CCE Admin. CCE Services TOTAL
1. Approved Contract Amount $ 0.00 $ 0.00 $ 0.00
2. Previous Funds Received for Contract Period $ 0.00 $ 0.00 $ 0.00
3. Contract Balance (line 1 minus line 2) $ 0.00 $ 0.00 $ 0.00
4. Previous Funds Requested and Not Received for Contract Period $ 0.00 $ 0.00 $ 0.00
5. CONTRACT BALANCE (line 3 minus line 4) $ 0.00 $ 0.00 $ 0.00
PART B: CONTRACT FUNDS REQUEST
1. Anticipated Cash Need (1st - 2nd months) $ 0.00 $ 0.00 $ 0.00
2. Net Expenditures For Month
(DOEA Form 105C, Part B, Line 4)
$ 0.00 $ 0.00 $ 0.00
3. TOTAL $ 0.00 $ 0.00 $ 0.00
PART C: NET FUNDS REQUESTED
1. Less Advance Applied $ 0.00 $ 0.00 $ 0.00
2. TOTAL FUNDS REQUESTED (Part B Line 3, minus Part C Line 1) $ 0.00 $ 0.00 $ 0.00
List of Services / Units / Rates provided - See attached report.
DOEA FORM 106C
Revised 06/08/16
Page 54 of 56
CAO
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 2022 - June 2023) CCE 203.22
ATTACHMENT XI
RECEIPT AND EXPENDITURE REPORT
DOEA FORM 105C
Revised 06/10/16
Page 55 of 56
PROVIDER NAME, ADDRESS, PHONE # and FEID# Program Funding :
CCE Admin.
CCE Services _
PSA
Contract # _ _
Contract Period
Report Period Report # _
Invoice # _
CERTIFICATION : I certify to the best of my knowledge and belief that the report is complete and correct and all outlays
herein are for purposes set forth in the contract.
Prepared by : Date : Approved by : Date :
PART A : BUDGETED INCOME / RECEIPTS
1. State Funds
2. Program Income
3. Local Cash Match
4. SUBTOTAL: CASH RECEIPTS
5. Local In-Kind Match
6.TOTAL RECEIPTS
1. Approved
Budget
2. Actual Receipts
For This Report
3. Total Receipts
Year to Date
4. Percent of
Approved Budget
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
#DIV/0
!
#DIV/0
!
#DIV/0
!
PART B : EXPENDITURES
1. Administrative Services
2. Service Subcontractor(s)
3. Adult Protective Services
4.TOTAL EXPENDITURES
1. Approved
Budget
2. Expenditures
For This Report
3. Expenditures
Year to Date
4. Percent of
Approved Budget
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
#DIV/0
!
#DIV/0
!
#DIV/0
!
PART C : OTHER REVENUE AND EXPENDITURES
I. Program Income (PI)
1. CCE: PI Collected YTD $ (I
III. Advance Recouped
$ _ _
II. Interest:
1. Earned on GR Advance $ _
2.Return of GR Advance $_
3.Other Earned $ _
PART D : CO-PAYMENTS CURRENT MONTH YEAR-TO-DATE
1. Total of Co-payments assessed $ $ _
2.Total of Co-payments collected $ $ _ (For Tracking Purposes only)
CAO
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
(July 202 – June 202) CCE 203.
ATTACHMENT XII
SERVICE RATE REPORT
SERVICE
FY 21/22
REIMBURSEMENT
UNIT RATE
METHOD OF
PAYMENT UNIT TYPE
$'8/7'$<&$5('$< )L[HG)HH8QLW5DWHV '$<6
CASE AIDE $30.50 Fixed Fee/Unit Rate HOURS
CASE MANAGEMENT $.00 Fixed Fee/Unit Rate HOURS
CHORE $2 Fixed Fee/Unit Rate HOURS
CHORE (ENHANCED) $36.00 Fixed Fee/Unit Rate HOURS
COMPANIONSHIP $21.00 Fixed Fee/Unit Rate HOURS
EMERGENCY ALERT RESPONSE $1. Fixed Fee/Unit Rate ONE DAY
HOME DELIVERED MEALS $7.00 Fixed Fee/Unit Rate MEALS
HOMEMAKER $25.44 Fixed Fee/Unit Rate HOURS
HOUSING IMPROVEMENT Cost Reimbursement Cost Reimbursement EPISODE
OTHER SERVICES Cost Reimbursement Cost Reimbursement EPISODE
MATERIAL AID Cost Reimbursement Cost Reimbursement EPISODE
PERSONAL CARE $25.44 Fixed Fee/Unit Rate HOURS
PEST CONTROL (INITIATION) )L[HG)HH8QLW5DWHEPISODE
PEST CONTROL (MAINTENANCE) )L[HG)HH8QLW5DWHEPISODE
RESPITE IN - FACILITY $10.29 Fixed Fee/Unit Rate HOURS
REPITE IN - HOME $25.44 Fixed Fee/Unit Rate HOURS
SHOPPING ASSISTANCE $34.12 Fixed Fee/Unit Rate ONE-WAY TRIP
SKILLED NURSING SERVICES $ Fixed Fee/Unit Rate HOURS
SPECIALIZED MEDICAL
EQUIPMENT, SERVICES, AND
SUPPLIES
Cost Reimbursement Cost Reimbursement EPISODE
TELEPHONE REASSURANCE $1 Fixed Fee/Unit Rate EPISODE
TRANSPORTATION )L[HG)HH8QLW5DWHTRIPS
Page 56 of 56 CAO
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5
Revised August 2007
Attestation Statement
Agreement/Contract Number_
Amendment Number
I, , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
.
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
Signature of Recipient/Contractor representative Date
Revised August 2007
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as designee of the County Manager, pursuant to Resolution No. 2018-202.
Approved as to Form and Legality:
_________________________________
Derek D. Perry
Assistant County Attorney
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____________________________________________________________________________________________________________________________
Derek D. Perry
Assistant County Attorney
CAO
WilliamsTanya Digitally signed by WilliamsTanya
Date: 2022.07.25 16:31:25 -04'00'25
DocuSign Envelope ID: 032787B5-D52A-441B-9F92-13CC4D3E69F5