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Agenda 2/14/2023 Item #16D 2 (Provide unimterupted support services or Collier County Services for Seniors' frail, elderly clients)16.D.2 02/ 14/2023 EXECUTIVE SUMMARY Recommendation to approve an "After -the -Fact" contract Amendment between the Area Agency on Aging for Southwest Florida, Inc. and Collier County Services for Seniors to decrease the contract amount by $7,000 for the Emergency Home Energy Assistance Program -American Recovery Plan and supporting documentation with revision to Budget Summary. (Human Services Grant Fund 707) OBJECTIVE: Provide uninterrupted support services to Collier County Services for Seniors' frail, elderly clients. CONSIDERATIONS: The Community and Human Services (CHS) Division's Services for Seniors program has been providing support to Collier County's frail and elderly citizens for over thirty (30) years through various grant programs. Some of these grants are funded by the Florida Department of Elder Affairs (DOEA) through the Area Agency on Aging of Southwest Florida, Inc. (Agency). These grant fund services enable clients to remain in their homes and live with independence and dignity. The Collier County Services for Seniors Program is responsible for responding to seniors' needs and managing the spending authority for the Federal and State Funded Services for Seniors Programs. Collier County, as the Lead Agency, manages the spending authority for the Emergency Home Energy Assistance Program -American Recovery Plan (EHEAP ARP). As the Lead Agency there is no provision for the County to not accept these funds as this grant is part of the acceptance of the Agency's Older American Act funds. The current service agreement, EHEAP ARP 203.22 in the amount of $96,800 was approved by the Board of County Commissioners (Board) on February 22, 2022, Agenda Item #16D8 effective November 1, 2021. The First Amendment, EHEAP ARP 203.22.01 was approved by the Board on November 8, 2022, Agenda Item #16D4 and extended the funding through March 31, 2023. The proposed Second Amendment. EHEAP ARP 203.22.02 will decrease the funding amount by $7,000 and revise the Budget Summary. Program Component Project Current Revised Required Number Budget Budget Budget Adjustment Emergency Home Energy 33798 $96,800 $89,800 $7,000 Assistance Program-EHEAP ARP This Amendment is being presented "After -the -Fact" because Collier County received the Amendment to decrease funding on January 10, 2023, from the grantor agency, and is required to return it within thirty (30) days. This time frame makes it impossible to process the document for the Board's consideration. Pursuant to CMA# 5330 and Resolution No. 2018-202, the County Manager authorized the Public Services Department Head to sign the agreement. This Amendment is being presented for Board ratification. Collier County, as the Lead Agency, is responsible for responding to seniors' needs and managing the spending authority for the Federal and State Funded Services for Seniors Programs. GROWTH MANAGEMENT IMPACT: There is no Growth Management impact. FISCAL IMPACT: A Budget Amendment has been processed to decrease the grant revenue in the amount of $7,000 within the Human Services Grant Fund (707), Project 33798. LEGAL CONSIDERATIONS: This item has been approved as to form and legality and requires a majority vote for Board approval. -DDP Packet Pg. 1016 16.D.2 02/ 14/2023 RECOMMENDATIONS: To approve an "After -the -Fact" contract Amendment between the Area Agency on Aging for Southwest Florida, Inc. and Collier County Services for Seniors to decrease the contract amount by $7,000 for the Emergency Home Energy Assistance Program -American Recovery Plan and supporting documentation with revision to Budget Summary. Prepared By: Wendy Klopf, Grant Coordinator, Community and Human Services Division ATTACHMENT(S) 1. EHEAP ARPA 203.22.01-Executed (PDF) 2. EHEAP ARPA 203.22.02 exec (PDF) 3. (Linked) EHEAP ARPA 203.22 Executed (PDF) 4. Resolution 2018-202 (PDF) Packet Pg. 1017 16.D.2 02/14/2023 COLLIER COUNTY Board of County Commissioners Item Number: 16.13.2 Doe ID: 24383 Item Summary: Recommendation to approve an "After -the -Fact" contract Amendment between the Area Agency on Aging for Southwest Florida, Inc. and Collier County Services for Seniors to decrease the contract amount by $7,000 for the Emergency Home Energy Assistance Program -American Recovery Plan and supporting documentation with revision to Budget Summary. (Human Services Grant Fund 707) Meeting Date: 02/14/2023 Prepared by: Title: Operations Coordinator — Community & Human Services Name: Wendy Klopf 01/12/2023 2:04 PM Submitted by: Title: Manager - Federal/State Grants Operation — Community & Human Services Name: Kristi Sonntag 01/12/2023 2:04 PM Approved By: Review: Community & Human Services Wendy Klopf CHS Review Community & Human Services Blanca Aquino Luque Additional Reviewer Community & Human Services Maggie Lopez Additional Reviewer Operations & Veteran Services Jeff Newman Additional Reviewer Community & Human Services Tami Bailey Additional Reviewer Public Services Department Todd Henry PSD Level 1 Reviewer Grants Erica Robinson Level 2 Grants Review Public Services Department Tanya Williams PSD Department Head Review County Attorney's Office Derek D. Perry Level 2 Attorney Review Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Grants Therese Stanley Additional Reviewer Office of Management and Budget Christopher Johnson Additional Reviewer Community & Human Services Maggie Lopez Additional Reviewer County Manager's Office Dan Rodriguez Level 4 County Manager Review Board of County Commissioners Geoffrey Willig Meeting Pending Skipped 01/12/2023 1:57 PM Completed 01/17/2023 9:57 AM Completed 01/17/2023 11:24 AM Completed 01/17/2023 12:58 PM Completed 01/17/2023 3:17 PM Completed 01/18/2023 9:10 AM Completed 01/18/2023 9:22 AM Completed 01/26/2023 8:19 AM Completed 01/27/2023 10:42 AM Completed 01/27/2023 10:45 AM Completed 01/27/2023 3:45 PM Completed 01/28/2023 12:00 PM Completed 01/30/2023 10:12 AM Completed 01/30/2023 3:29 PM Completed 02/01/2023 10:52 AM 02/14/2023 9:00 AM Packet Pg. 1018 16.D.2.a November 2021 — March 2023 EHEAP ARPA 203.22.01 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. EMERGENCY HOME ENERGY ASSISTANCE PROGRAM WHEREAS, the purpose of this Amendment is to extend funding through March 31,2023. NOW THEREFORE, in consideration ofthe mutual covenants and obligations set forth herein, the receipt and sufficiency of which are hereby acknowledged, the Parties agree to the following: All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to conform to this Amendment. All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract. This Amendment and all its attachments are hereby made part of the contract. IN WITNESS THEREOF, the Parties hereto have caused this amendment, to be executed by their officials as duly authorized; and agree to abide by the terms, conditions and provisions of this EHEAP amendment as amended. This Amendment is effective on the last date the Amendment has been signed by both Parties. IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned officials as duly authorized. CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS SIGNED BY: WilliamsTanya �� o signed by NAME: TANYA R WILLIAMS DATE: 1 n/ 0700-1 As designee of the County Manager, pursuant to Resolution No. 2018-202. 16111 a :lu Ira I 11512 am go NINI Wel a IN a .'a III clowI DATE: 10/10 /2022 C, 0 Packet Pg. 1019 16.D.2.a ARPA EHEAP 203.22.00 Attestation Statement Agreement/Contract Number: ARPA EHEAP 203.22 Amendment Number 001 I, Tanya R Williams , 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 Collier County Board of County Commissioners (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting, due to the differences in electronic data processing media, which has no affect on the agreement/contract content. W I I I I a m s7a n ` ,� Digitally signed by WilliamsTanya 1 1 1 �/ Date: 2022.10.07 15:42:34-04'00' Signature o ecipien on rac or representative Date As designee of the County Manager, pursuant to Resolution No. 2018-202. 2022.10.05 16:52:34-0 4'00' Derek D Perry Assistant County Attorney Revised August 2007 2 Packet Pg. 1020 16. D.2.b November 2021 — March 2023 EHEAP ARPA 203.22.02 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. EMERGENCY HOME ENERGY ASSISTANCE PROGRAM WHEREAS, the purpose of this Amendment is to decrease funding by $7,000.00 and replace the Budget Summary. NOW THEREFORE, in consideration of the mutual covenants and obligations set forth herein, the receipt and sufficiency of which are hereby acknowledged, the Parties agree to the following: All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to conform to this Amendment. All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract. This Amendment and all its attachments are hereby made part of the contract. IN WITNESS THEREOF, the Parties hereto have caused this amendment, to be executed by their officials as duly authorized; and agree to abide by the terms, conditions and provisions of this EHEAP amendment as amended. This Amendment is effective on the last date the Amendment has been signed by both Parties. IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned officials as duly authorized. CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS WilliamsTanya °i05a1y signed by Wi"'amsTanYe SIGNED BY: Date; 2023.01.1212:44:53-05'00' NAME: Tanya R Williams AREA AGENCY ON AGING FOR SOUTHWEST FL bA, INC SIGNEDBY NAME: Maricela Morado TITLE: Public Service Department Head TITLE: interim ['thief Executive Officer/President DATE: 01.12.2023 DATE: / as designee of the County Manager, pursuant to Resolution No. 2018-202. A oved as to Fo nd Legality: Derek D. Perry Assistant County Attorney CEO Packet Pg. 1021 November 2021 - March 2023 EHEAP ARP ACT BUDGET SUMMARY EMERGENCY HOME ENERGY ASSISTANCE FOR THE ELDERLY PROGRAM COLLIER COUNTY TOTAL ADMINISTRATIVE BUDGET TOTAL OUTREACH BUDGET CRISIS ASSISTANCE TOTAL Total Award EHEAP ARPA 203.22.002 $8,300.00 $13,500.00 $68,000.00 $89,800.00 "Eligible households may be provided with more than one benefit, totaling no more than $5,000.00. The minimum number of individuals to be served crisis energy assistance may reflect duplicated consumers if a consumer receives multiple benefits. Packet Pg. 1022 Im 16. D.2.d RESOLUTION NO. 2018- 2 0 2 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, REPEALING AND SUPERSEDING RESOLUTION NO. 96-268 and 10-122 AND AUTHORIZING THE COUNTY MANAGER OR HIS/HER DESIGNEE TO EXECUTE CERTAIN STANDARD SOCIALISENIOR SERVICES GRANT APPLICATIONS AND CONTRACT DOCUMENTS INCLUDING AMENDMENTS IN COMPLIANCE WITH CMA #5330, GRANT COORDINATION. WHEREAS, the Board of County Commissioners (Board) has the authority to apply for and receive social/senior services grants including the Older American's Act Program (OAA), Community Care for the Elderly Program (CCE), Alzheimer's Disease Initiative Program (ADI), Medicaid Waiver Agreement, the Home Care for the Elderly program (HCE), and USDA Nutritional Supplement Incentive Program, and Emergency Home Energy Assistance Program (EHEAP); and WHEREAS, in order for Collier County's social/senior services grant documents to be submitted in a timely fashion, the Board adopted Resolution No. 96-268 and 10-122 authorizing the County Manager or his/her designee to execute the required standard grant documents; and WHEREAS, Collier County CMA 95330, Grant Coordination, provides authorization for the County Manager or his/her designee to execute certain grant documents and return to the Board of County Commissioners for after -the -fact approval; and WHEREAS, the Board wishes to delegate signature authorization to the County Manager or his/her designee for the above -referenced social/senior services grant programs and as it relates to grant applications, standard contract documents, and major and minor amendments provided that said submissions and contracts require no additional Collier County matching funds. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that the County Manager or his/her designee is hereby authorized to execute grant applications, standard contract documents, and "IN Packet Pg. 1023 16. D.2.d amendments in compliance with CMA H5330, Grant Coordination, for the Older American's Act Program (OAA), Community Care for the Elderly Program (CCE), Alzheimer's Disease .Initiative Program (ADI), Medicaid Waiver Agreement, the Horne Care for the Elderly program (HCE), and USDA Nutritional Supplement Incentive Program, Emergency Home Energy Assistance Program (EHEAP) provided said -submissions and contracts require no additional Collier County matching funds. BE IT FURTHER RESOLVED that this Resolution repeals and supersedes Resolution No. 96-268 and No.10-122. THIS RESOLUTION ADOPTED after motion, second, and majority vote favoring same this j-1 day of J . , -Y , 2018. ATTEST: CRYSTAL K. KiNZEL CLERK :s s By: By: 'A eSt as tp (;€t�PK%gTY CLERK signature only, Approval for form and legality: 3ennl r A. Belpedio Assistant County Attorney tiO 2 Packet Pg. 1024 November 2021 - September 2022 EHEAP ARPA 203.22 FLORIDA .DEPARTMENT OF ELDER AFFAIRS STANDARD CONTRACT THiS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and the 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. WI'TNESSF,TH THAT: WHEREAS, the Agency has determined that it is in need of certain services as described herein; and WHKIt N.AS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform sucliservices as an independent Contractor of the Agency. NOW THEREFORE, in consideration of the services to be perlbrtned and payments to he made, together with the mutual covenants and conditions set forth herein, the Parties agree as follows: 1. Pur ose of Contract: The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments, forms, and exhibits which constitute the contract document. 2. ineorilomtkin or 12uennients 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 contiact docuincnt(s) shall prevail over inconsistent provisions in the proposal(s) or other general materinls not specific to this contract document and identified attachments. 3. Toni of .oritrnet: This contract shall begin at twelve (12:00) A.M., Fastern Standard Time November 1, 2021 or on the date the contract has been signed by the last party required to sign it, whichever is later, It shall end at eleven fifty-nine (11:59) P.M., Eastern 'Standard Time September 30, 2022. 4. Contract Amauit: The Agency agrecs to pay for contracted services according to the terms and conditions of this contract in an arr►ountnot to exceed $96,800.00, subject to the availability of funds. Any costs or services paid for under any other contractor from any other source are not eligible for payment under this contract. M•.;. , # By mutual agreement of the Parties, in accordance with Section 257.058(1)(g), Florida Statutes (F.S,), the Agencymay renew the contract for a period not to exceed three years, or tiie term o-'the original contract, whichever is longer.The renewal price, or method lbr determining a renewal price, is set forth in tlrc bid, proposal, or reply. No ether costsfor (lie renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and contingent upurr satisfactory performance evaluations by the Agency and the availability of funds. 6. Coiiiiiliance with l?ederit l gug 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 T'� andlor 45 CFR Part 92, 2 CFR Part 200, and other applicable regulations. 6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42 United States Code (U.S.C.) § 7401, et seq.), Section 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. § 1251, ct seq.), Executive Order 11738, as amended, and, where applicable, Environmental Protection Agency regulations 2 CFR fart 1500. The Contractor shall report any violations of the above to the Agency. 6.1.3 Neither the Contractor nor any agent acting on behalf of the Contractor may use any federal funds received in connection with this contract to influence legislation or appropriations pending before t:ongress or any state legisiature. The Contractor must complete all disclosure forms as required, specifically the Page 1 of 73 Nr) November 2021 September 2022 EHEAP ARPA 203.22 Certification and Assurances Attachment, which must be completed and returned to the Contract Manager prior to the execution of this contract. 6.1.4 In accordance with Appcnd;x 11 to 2 CFR Part 200, the Contractor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulations 41 CPR Part 60 and in Depailment of Health and Human Set -vices regulations 45 CFR Part 92, if.iliriicable. 6.1.5 A contract award with an amount expecied 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 Managernent and Budget (OMB) guidelines at 2 CFR Pail 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 Milt these provisions before doing Business or entering into subcontracts receiving federal funds pursuant to this contract. The Contractor shall complete and sign the rertifications and Assurances Attachment prior to the execution of this contract. 6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. § 1324a) and the Immigration Reform and Control Act of 1986 (8 U,S.C. § 1101). Such violation will be cause for unilateral cancellation of this contract by the Agency. 6.3 if the Contractor is a non-profit provider and is subject to Internal Revenue Service (Ills) tax exempt organization reporting requirements (filing a form 990 or Form 990-N), and has its tax exempt status revoked for failing to comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation. 6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding 1'rafricking in Persons. 6.5 Unless exempt under 2 CFR § 170.110(b), the Contractor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR fart 170, 6.6 To comply with Presidential L•:xecutive Order 12999, 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 at I new employees hired by Contractor during the contract term. Contractor shal I 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 Subcon ractorduring the contract term. Contractors meeting the terins and conditions of the E-Verify System are deemed to hein compliance with this provision. 7. Coin pliance )loth 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 lava, incla.c'.,*:,�, Florida provisions for conflict of laws. 7.2 If this contract contains state financial assistance Binds, the Contractor shall comply W-.h 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 Fxpenditures. 7.3 The Contractor shal''i comply with the requirements of Section 287.058, FX, as amended. 7.3,1 The Contractor shall perform all tasks contained in Attachment 1. 7.3.2 The Contractor shall provide units of deliverables. including reports, findings, and drafts, as socL:ifred in Attachment 1, to be received and accepted by the AGENCY Contract Manager prior to payment. 7.3,3 The Contactor 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 1I1. Method of Payment, 7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper prc-audit and post -audit. Page 2 ot73 November 2021 - September 2022 EHEAR ARPA 203.22 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 1 12.001, F.S., or at such lower rates as may be provided in this contract. 7,16 The Contractor shall allow public access to all doct.m nt`. 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 Cordractor':s refusal to comply with this provision will constitute an immediate breach of contract I'or which Ilrc Agency cony unilaterally terminate this contract. 7.4 If clients are to be transported under [his contract, the Contractor shall comply with the provisions of Chapter 427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C). 7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in accordance with the provisions of Section 297.134, F.S. 7.6 The Contractor shall comply with the provisions of,.-(:' , • 11.062, F.S., and Section 216.347, T.S., which prohibit the expenditure of contract funds for the purpose of lobbying the legislature, judicial brunch or n state agency. 7.7 The Agency may, at its option, terminate the Contract if the Contractor is found to have submitted a false certification as provided tinder Section 287.135(5), F.S., has been placed on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, the Scrutinized Companies with Activities in Sudan List, or the Scrutinized Companies that Boycott Israel List, or if the Contractor has been engaged in business operations in Cuba or Syria or is engaged in a boycott of Israel. 8. Bnghground Screening: The Contractor shall ensure that file requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met regarding background screening for all persons who meet flue definition ol'a direct service provider and who are not exempt from the Agency's level 2 background screening pursuant to Seclions 430.0402(2)-(3), F.S. The Contractormust also comply with any applicable rules promulgated by the Agency and the Agency for Health CareAchnin'sstration regarding implementation of Section 430.0402 and Chapter 435, F.S, To demonstrate compliance w:ththis provision, Contractor shall submit the Background Screening; Affidavit of Compliance (Screening Forma) 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 }rttps:llelderaffairs.oi-g+'about-trsfbackaround-serccni ne! 9. Grievance Procedures: The Contractor shall develop, implement, and cns:3N that its Subcontractors have established grievance procedures to process and resolve client dissatisfaction with, or decrial 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 Suabcuntractor's determination(s), 10. Public Records and Retention: 10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable law, and shall: 10.1.1 Keep and maintain public records required by the 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 doesnot exceed the cost provided in Chapter i 19, 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 tern) and following completion of the contract if the Contractor does not transfer the records to tl)e Agency. 10.1.4 Upon completion of the contract, ltre 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 requiredby the Agency. If the Contractor transfers all public records to the Agency upon completion of thecontract, Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt, Page 3 of 73 November 2021 - September 2022 EHEAP ARPA 203.22 from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall incet all applicable requirements for retaining public records. All records stored electronically must be provided to the Agency in a format shot is compatiblewith 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 Q17FSTiONS REGARDING THE APPLICATION OF CHAPTER 119, FLOR11DA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS Al: 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 possessionto 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 aformat I�-.it is compatible with the information technology systems of file Agency. 11. Audits. 1n,Sneetions, invest is-lblians: 11.1 Tire Contractor shall establish and mainmin books, records, and documents (including electronic storage media) sufficient to reflect all assets, obligations, unobligated balances, incorne, interest, and expenditures of funds provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and ensurethat they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information should be related to performance and bait cnst data. 11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this contract for a period of six (6) years a[ier completion of the contract, or longer when required by law. In the event an augAt 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 oil the terms of this contract, at no additional cost to the Agency. 11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transferor any records or documents during the required retention period. 11.4 The Contractor shall ensure that the records described in this section will be subject at all reasonable times to inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency. 11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and fWcral Auditors, pursuant to 45 C,FR 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 foam in which kept. 11.6 The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this contract ant ensure that all related third -party transactions are disclosed to the auditor. 11.7 Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing perforated pursuant to Section 20.055, P.S. Contactor furiltuur agrees that it shall include in related subcontracts a requirement that subcontractors performing work or providing services pursuant to this contract agree to Rage 4 of 73 November 2021 - September 2022 EHEAP ARPA 203.22 cooperate with the Inspector Cenral In any investigation, audit, inspection, review, or hearing pursuant t0 Section 20.055(5), F.S. ley execution �) this contract the Contractor understands and will comply with C s subsection. 11.8 In accordance with Executive Order 20-44 which requires -executive agencies to submit a list of entities named in statute with which a state agency trust 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 5-ont a combination of State and Federal funds Any Contractor that meet, one or both of the criteria listed must submit an annual report, including; the most recent IRS four 990, detailing the total r,mpensalion for the enti+ics' executive leadership teams within thirty (30) days of execution of this contract. 11.8.1 The report must include total compensation including salary, bonuses, cashed -in leave, cash equivalents, severance pay, retirement benefits. deferred compensation, real -property gifts, and any other payout. 11.8.2 The Contractor shall inform the agency of any changes in total executive: compensation between the annual reports as those changes occur. 11.8.3 All compensation reports must indicate what percent of compensation utme~s directly from the State or Federal allocations to the contracted entity. 12, Nundiscromination-Civil Rights gipjiance, 12,1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that it will not discriminate against any person in the provision of services or benefits under this contract or in employment because of age, race, religion, color, disability, national origin, marital status, or sex in compliance with state and federal law and regulations. The Contractor further assures that all Contractors, Subcontractors, Sub -grantees, or others with whorl it arranges to provide services or benefits in connection with any of its programs and activities are not discriminating against clients or employees because of age, race, religion, color, disability, national origin, marital status, or sex, 12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete, and accurate Civil Rights Compliance Checklist, attached to this contract. 12.3 The Contractor shall establish procedures pursuant to Ccdsle al 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 life a complaint Frith the appropriate federal or state entity. 12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendors, or others with whom it arranges to provide services or bone' its 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 requi e i ng compliance with the terms ofthis assurance or seek other appropriate judicial or administrative relief including, but not limited to, terininationof the contract and denial of firrther assistance. The Contractor shall permit persons duly authorized by the Agency to insp: c I and copy any records, papers, documents, facilities, goods, and services of the Contractor which are relevant to this contract, and to interview any clients, employees, and Subcontractor employees of the Contractor to assure the Department of the satisfactory perfonnance of the terms and conditions of this contract, Following such review, the Agency will provide a writtenreport 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 CA P in a timely manner as determinedby the Agency's Contract Manager, 14, Provision -of Services: The Contractor shall provide services in the manner described in Attachment I. Page 5 of 73 : _�L November 2021 - September 2022 1 S. Coordinated Monttoring wHit Other Agencies: EHEAP ARPA 203.22 If the Contractor receives funding From one or main! State of Florida human service agencies, in addition to the Agency, then a joint monitoring visit including such other agencies nr«y be sc:l,cduled. 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 Fmnilics, 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 visitby [lie designated agency's lead administrative coordinatn►•, the Contractor shall comply and cooperate N ith all monitors, inspectors, and/or investigators. 16. New Contract($) Re on rung: 'tire t ;ontractor shall notify the Agency wit][. a ten (I O) days of entering into a new contract witli any of the remaining four (4) state human service agencies. The notification shall include the following information: (l ) contracting state agency and [lie 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 andcontact 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 dais contract. 17. Indemnification: The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from any and all claims, demands, actions, and causes of action of whatever nature or character arising out of, or by reason of, the execution of this contract or performance of the services provided for herein. It is understood and agreed that the Contractor is not required to indemnify the Agency for claiins. demands, actions, or causes of action arising solely out of the negligence of the Agency. 17.1 Except to the cxtew permitted by Section 768.28, P.S., or other Florida law, this Section 17 is not applicable to com racts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S. 18. Insurance anti Bonrlitr-. 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 ofFloridn. The Agency reserves the right to require additional insurance as specified in this contract. 18.2 'Throughout the term of this contract, the Contractor shall maintain an insurance bond from a responsible commercial itrsuranee company covering all officers, director:%, employees, and agents of the Contractor authorized to handle funds received or di=pursed 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 pr-:etices. 19. ConfSdentiallty of Information: 20, The Contractor shall 'rot 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. Where applicable, tore 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 CPR Parts 160, 162, and 164). 21. 1 ncidcnt Rep ailing: 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 conditi,rns that may materially affect the Contractor's or Subcontractor's Page 6 of 73 November 2021 -September 2022 22. EHEAP ARPA 203.22 ability to perform the services required to be performed under this contract. Such notice shall be inade orally to the Agency's Contract Manager (by telephone with an email to immediately follow. 21.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number (1-800-96A13USE). As required by Chapters 39 and 415, N.S., this provision is binding upon the Contractor, its Subcontractors, and their employees. 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 Contractormust also provide the following information to the Agency: (1) the date of filing of the bankruptcy petition, (2) the casenumber; (3) the court name and the division in which the petition was filed (e.g., Northern District of Fla: ida, Tallahassee Division); and (4) the name, address, and telephone number of mc bankruptcy attorney. 23. Snonsorshin and 11ubticir)1 23.1 As required by Section 286.25, F.S., if the Contractor is a non -governmental organisation which sponsors a program financed wholly or in Bart 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 riorida, Department ol'Elder AtTairs." If the sponsorship reference is in written material, the words "State of Florida, Department or Elder Affairs" shall appear in at least the sank si7c letters or type as the name of the organization. 23.2 The Contractor shall not use the words "State of Florida, F):;partmcut of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless speciri.c: written authorization has been obtained by the Agency priorto such use. 24, AssiLroments: 24.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written approval of tine 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. 24.2 The State ofPlorida is, at all times, entitled to assign or transfer, in whole or par:, its rights, duties, or obligations under this contract to another nmerilal agency in �1:: State of Florida Von giving prior written notice: to the Contractor. 24.3 This contract shall remain binding upon the: successors in interest of the Contractor and the Agency. 25. ;Subcontracts: 25.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this; contract, whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a written document and subject to any conditions of approval the Agency deems necessary. The Contractor further agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The Contractor, at its expense, shall defend the Agency against any such claims. 25.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment 11-om 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. 26. ind+engadent Capacity of Cnntrnetnr: 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 small not hold themselves ou l US employ+ccs or agents of the Agency without prior specific authorization from tlae Agency. It is the further intent and understanding of the Parties that the Agency does not control the eminlnyment practices of the Cont•actoi and will not be liable for any wage and (lour, employment discrimination, or other labor and employment claims against the. Page 7of73 CAO November 2021 - September 2022 EHEAP ARPA 20$.22 Contractor or its Subcontractors. All deductions lbr social security, withholding taxes, income taxes, contributions to unemployr-:ent compensation funds, and all necessary insurance for the Contractor are the sole responsibility of the Contractor. 27. )payment: Payments shall be made to the Contractor for all completed and approved deliverables (units o{'service} as defined in Attachment 1. The AGENCY Contract Manager will have final approval of the Contractor's invoice submitted for paymentand will approve (lie invoice for payment only if the Contractor has met all terms and conditions of (lie contract, unlessthe bid specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted to theAgency's finance section for budgetary approval and processing. Dispute.y 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 a[ 900-342-2762. 28. Return of Funds: The Contractor shalt 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 overpaymenthtas been made, the Contractor shall repay said overpayment immediately without prior notification from the Agency. In the event that the Agrnc � first discovers an overpayment has been made, the AGENCY Contract Manager will notify [lie Contractor in writing of such findings. Should repayment not be made forthwith, the Contractorshal-I be charged at the lawful rate of interest on the outstanding balance pursuant to Section 55.03, F.S., after Agency notification or Contractor discovery. 29, Data inte,pri ,v and Safeguarding Information: The Contractor shall ensure an appropriaate level of data security forthe information the Contractor is collecting or usir g in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor employees that request sy:5tein 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. Al. data and software shall be routinely backed up to ensure recovery from tosses 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. Me Conti -actor shall ensure a111 .%'l1bLOn11'aCtorS maintain Arritten 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 file execution of this contract. 30. Suchil Aledia and Personnl Cell Plionc use: 30.1 Inappropriate use of social media and personal cell phones may pose risks to itGENCY's confidential and proprietatyinformation and may jeopardize compliance with legal obligations. By signing this contract, Contractor agrees tothe following, social media and personal cell phone use requirements. 30.2 Social Media Defined, The term Social Media and /or personal cellular communication includes, but is not limited to, social networking websites, Flogs, podeasts, discussion forums, RSS feeds, video sharing, SMS (including Direct Messages (DMs), iMessages. text messages, etc.); social networks like Instagram, TikTok, Snapchat, Gongle Hangouts, WhatsApp, Signal, Faccbook, Pinterest, and'T,� fitter; and content sharing networks such w Flickr and YouTube. This includes the transmission of social media through any cellular or online transmission via any electronic, intereet, intranet, or other wireless communication. 30.3 Application to any direct nr incidental AGENCY or other state business. This contract applies to any AGENCY orother state business conducted on any of the Contractor's, Subcontinctor's, or their employees' social media accounts or through personal cellular communication. 30.4 Application to AGENCY and Contractors Equipment. This contract applie.,: regardless of -whether the social media is accessed using AGENCY's IT [aOitics and equipment or equipment belonging to Contractor, Subcontractor, or their respective employees. Equipment includes, bill is not limited to, personal computers, cellular phones, personal digital assistants, smart watclirti, or sanart tablets. 30.5 Florida Government in the Sunshine, Florida Public Records Law, and IIIPAA. Contractor acknowledges that any AGENCY or other state business conducted by social media or through personal cellular communication issubject to Florida's Govcrtanaent in the Sunshine Law, Florida's Public Records Law (Chapter 119, Florida Page 8 of 7314AO+, 1. Novernber 2021 - September 2022 El IEAP ARPA 203.22 Statutes), and the Health insurtance Portability and Accountability Act (HIPAA). Compliance with these laws and other applicable laws are further detailed in the contract. 30.E Prohibited or Restricted Postings. Contractors may not take or post photos or videos of, or include names or identifying information, about any of AGENCY's clients, Any social media posts which include photos, videos, or names ot'volt►ntcers, stall; or other alliliates of AGENCY may only be posted with the permission of those individuals. Any such posts related to volunteer service at AGENCY may only include individuals over the age of I R. 30.7 Assist AGENCY with Communications. Contaciors may he asked periodically to assist in disiributing certain AGENCY communications through their social media outlets. Any such requests should be pc;stcd in adherence to the social media requirements herein and the other provisions of this contract. 31. Conflict of Interests The Contractor shall estab: ish safeguards to prohibit employees, board members, management, and Subcontractors fiorn 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 ofa 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 ofhisthcr immediate family; (c) his or her partner; or (d) an organi7ntion 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 officer.;, employees, or agents will neither solicit nor accept gratuities, favors, or nnythin,g of monetary value from Contractors, potential Contractors, or parties to ;Subcontracts. The Contractor's board members and management most disclose to the Agency any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) calendar days ofan individual's original appointment or placement in tlint position, or, if the individual is serving as anincumbent, within thirty (30) calendar days of the commencement of this contract. The Contractor's employees and Subcontractors must make the same disclosures described above to the Contractor's board of directors. Compliance with this provision will be monitored, 32. Public Entity Crime., Pursuant to Section 297.133, 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 goads 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 ]cases 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 wit `. E any public entity in excess of the the eshold 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 I,ist, 33. Purchasin;_: 33.1 The Contractor shall pi ocure prod:r,Js rind/or services required to perform this contract in accordance with section 413.036, F,S. 33.1.1 IT IS EXPRESSLY l NDFRSTOOD AND ACrRF..ED THAT ANY ARTICLES THAT ARE THE SUBJECT OF, ORREQUIRED TO CARRY OUT, THIS CONTRACT SHAI..,I, 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 SRT FORTH IN SECTION 413,036(1) AND (2), FLORIDA STATUTES; AND FOR PURPOSES OF THIS CONTRACT THE PERSON, FiRM, OR OTi]ER BUSINESS ENTITY CARRYING OUT THE PROVISIONS OF THIS CONTRACT SHALL BE DEEMED TO BE SUBSTITUTED FOR THE STATE AGENCY INSOFAR AS DEALINGS WITH SUCH QUALiI IhD NONPROFIT AGENCY ARE, CONCERNED. 33.1.2 Pursuant to sections 413.036(t) and (4), F.S., the Contractor shall not he 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 (e) the Contractor determines that the perforiv.,Enee specifications, price, or quality of the product or service is not comparable to the Contractor's requirements, Page 9 of 73 November 2021-5epternuer 2022 EHEAP ARPA 203.22 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 oh -is is available at http:(lwwtv.respectofflorido.org. 33.2 The Contractor shall procure any recycled products or materials which are the subject of, or arc required to carry out, this contract when the Department of Management Services determines that those products are available, In accordance with the provisinns of section 403.7065, F.S, 33.3 The Contractor Shall procure products and/or services required to perform this contract in accordance with section 946.515, F.S. 33.3.1 IT IS FXPRE.SSI,Y IINITRSTOOD AND AGREED THAT ANY ARTICLES WHICH ARE THE SUBJEC."I.OF, OR REQUIRED TO CARRY OUT, THIS CONTRACT SHALL BE PURCHASED FROM THE CORPORATION it)Fbt f'1F1F T7 UNDFR CHAPTER 946, F.S., IN THE SAME. MANNER AN' > UNDER THE SAME PROC:FDIIRFS SET FORTH iN SECTION 946515(2) AND (4), F.S.; AND FOR PURPOSES OF THIS CONTRACT THE PERSON, FIRM, OR OTHER BUSiNESS ENTITY CARRYING OUT THE PROVISIONS OF THIS CONTRACTSHALL RE IN-FIVI-1) TO HE. SURST1'i'UTEI) FOR THIS AGENCY INSOFAR AS DF.AIJNGS WITH SUCH CORPORATIi N AREC'ONCFRNFI), 33.3.2 The corporation identified is Prison Rehabilitative industries and Diversified Enterprises, Inc. (PRIDE). Additional information about PRIDE and the com• .::ties or contractual services it affem is available at https:f/pride-enterprises.org/. 33.4 The Agency shall provide a Certified Minority Business Subcontractor Expenditure (CMBE) Report summarizing the participation ofcertified suppliers fnr the current reporting period and project to date. The C..MRE 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 ofqual'fied 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, Capyrights. Ru.valties: 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 lacrformcd under this contract, the Contractor shall refer the discovery, ii ".ration, 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 expressedand 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 prn:suant to this Sectior 34. 34.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CI:R § 200.315 or 4`, CFR § 75.322, as applicable. 34.3 Notwithstanding the foregoing provisions, if'the Contractor or one of its Subcontractors is a university and a member of the State University ,System of Florida, then Section 1004.23, F,S,, shall apply, but the A i.e ney shut) retain a perpetual, fully -paid, nonexclusive license for its use and the use of its Contractors, Subcontractors,or Assignees of any resulting patented, copyrighted, or trademarked work products, Page 10 of 73 CAO November 2021 - Scptemuer 2022 35. Ernel-gpn,;yPrenaredness anti Continuity_of Onerationss EHEAP ARPA 203.22 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 e:recution of this contract, submit to the AGENCY Contract Manag;;r, verification ofan F,mergency Preparedness Plan, In the event of an emergency, the Contractor shall notify the Deparlrment of emergency provisions, 35.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall remain responsible for performance under this contract and must follow procedures to ensure continuity of operations without interruption. 36. Eauinr >r eat: 36.1 Hquipment 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. establisltsd by the organization for the financial statement purposes, or $5,000.00 [for federal fiords - 2 CFR § 200.33 and 45 CFR § 75,2, as applicable], or (b); nnnexpendable, tangible person.fl property o t anon -consumable nature with an acquisition cost of $5,000.00 or more per unit, and expected useful life of at least one (1) year; and hardback bound books not circulated to students or the general public, with a value or cost of $250,00 or more [for state funds], 36.2 Contractors and Subcontractors who are Institutions of higher Education, Hospitals, and Other Non -Profit Organizations shall have written properly 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. " h 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 shal I provide the results of the investigation to the AGENCY Contract Manager 36.3 The Contractor's property management standards for equipment (including replacement equipment), whether acquired in whole or in part with federal funds and federrally-owned equipment shall, at a minimum, meet the following requirements and shall include accurately maintained equipment records with the following information: 36.3.1 Property records must be maintained that include a description of the equipment; 36.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other identification number, 36.3.3 Source of funding for the equipment, including tic federal award identification number; 36.3.4 Whether tit'e vests in the Contractor or the federal government; 36.3.5 Acquisition date (or date received, if the equipment was furnished by the federal government); 36,3,6 Inibrrnation from which one can calculate the percentage of federal participation in the cost of the equipment (not applicable to equipment furnished by the federal government); 36,3.7 Location, use and condition of the equipment and the date the information was reported; 36.3.8 1)nit acquisition cost; and 36.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine current fair market value where a Contractor compensates the federal awarding agency for its share, 36.3.10 A physical inventory -nest be laken, and the results reconciled with the property records at least once every two (2) years. 36,3.11 A control systern mast be developed to ensure adequate safeguards to p•evcnt loss, damage, or thet'. of the property. Any : ss, damage, or theft must be investigated. 45 CFR § 75.320(d)(3). 363.12 Adequate maintenance procedures must be. developed to keep the property in goad condition. Puge 11 of 73 • ,/ -4 November 2021 - September 2022 EHEAP ARPA 203.22 36.3.13 If the Contractor is authorized or required to sell the equipment, proper sales procedures must he established to ensure the highest possible return. 36,4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with state funds with an acquisition cost over S5,000.00 is part of Ilac c ost of carrying out the activities and functions of the grant awards and title (ownership) will vest in the Contractor [for federal funds see 2 C'FR § 200,313(a) and 45 CFR § 75.320(a), ns applicable], subject to the conditions of CFR Part 200 and/or 45 CFR Pail 75. Equipment purchased under these thresholds is considered suppliers and is not subject to property standards. Equipment purchased with finds identified in the budget attachments to agreements covered by ill 4: contract or identified in the sub -agreements with Subcontractors (nut included in a cost methodology), is subject to the conditions of Chapter 273,1 . ., rule 60A-1,017, F. A. C., and 2 CFR Part 200 and/or 45 CFR Part 75. 36.5 I'hc Contractor shall not dispose of any equipment or materials provided by the Agency or purchased with fiends 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 should also indicate the Contractor's proposed disposition of the properly (i.e., transfer ordonation to another agency that administers federal programs, offer of the items for sale, destroy the items, etc.). 36.6 The AGENCY Contract Manager will issue disposition instructions. If disposition instructions are not received within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized to proceed as directed in 2 CFR § 200.313 or 45 CFR § 75.320, as applicable. 36.7 Real property means land (including lane improvements), buildings, structures and appurtenances thereto, hilt excludes movable machinery and equipment. Real property may not be purchased with stale 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, Pail 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 the previsions of Scction 216.348, F.S. 36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must he reformatted and tested prior - to disposal to ensure no confidential information remains. 36.9 The Contractor* roust adhere to the Agency's procedures and standards when purchasing Information 'Technology Resources (ITR) as pail of any agreement(s) incorporating this contract by reference, An ITR workshect is required for any computer related item costing $1,000.00 or more, including data pi ocessing hardware, software, services, supplies, maintenance, training, personnel, and facilities. The completed 1'I'It worksheet shall be maintained in the LAN administrator's I ile and must be provided to the Agency upon request. The Contractor has the responsibility to require any Subcontractors to comply with (lie. Agency's ITR procedures. 37. I'LlIt 10tl11)-Fat'nr. The Pl. !R 1000 Form is hereby incorporated by reference and available at: httpaldms.mv(lorida.catn/nurrhasina 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. Iiowever, if the conflicting teens or conditions in the PUR 1000 Form are required by any seclion of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form shall take precedence. 38, Use of State Fluids s to Purchase or Improve Real Property: Any state funds provided for the purcha�. of or intprovennerts 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 fnw ds provided for at least five (5) years front the date of purchase or the completion of the improvements or as further required by law. Page 12 of 73 C40 November 2021 - September 2022 39. is un to _He jot_ L inn: EHEAP ARPA 203.22 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, 40. Financial Cunsv,�s: If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency shall impose financial consequences as stated in Attachment I. 41. No Waiver of Sgygreogn immunity: Nothing contained in this contract is intended to serve as a waiver of sovereign immunity by any entity to which sovereign immunity may be applicable. 42. Venue: If any dispute arises out of this contract, the venue of such legal recourse shall be I .eon County, Florida. 43. FIntire Contract: This contract contains all the tarns and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the Agency or file Contractor unless expressly contained herein or by a written amendment to this contract signed by both Parties. 44. Force Mrdeure: 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 i?arly and takes all reasonable efforts to cure the condition. Mffi:?=TititM& O7t€1Tt!1' 46. The Parties agree that if a count of competent jurisdiction deems any term or condition heroin void or unenforceable, the other provisions are severable to that void provisicr i and shall remain in full force and effect. The Parties agree that the Agency's performance and obligation to pay under this contract are contingent upon an annual appropriation by the Legislature. 47. Addition/ eletinn: Hie Parties agree that the Agency reserves the right to add or to delete any of the services required under this contract when deemed to he in the State of Florida's best interest and reduced to a written amendment signed by both Parties. The Parties shall negotiate compensation i.br any additional services added. 48. Waiver: The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute orl�e 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 exereise thereof or the exercise of any other right. 49, Con lien inem. The Contractor shall abide by all applicable current federal statutes, laws, rules, and reguulations as well as applicable current state statutes, laws, rides and regulations. The Parties agree that failure of the Contractor to abide by these laws shalt he deemed an event of default of the Contractor and subject the contract to immediate unilateral cancellation of the contract at the discretion of the Agency. 50. Final invoice - The Contractor shall submit the final invoice far payment to the Agency no I;Atr than thirty (30) days after the contract ending date unless otherwise specified in Attachment 1. Ifthe Contractor fails to do so, all right to payment isforfeited and the Agency shall not honor any requests submitted. alter the aforesaid tirne period. Any payment dueunder the terms of this contract shall be withheld until required documentation and reports due from the +Contractorand necessary adjustments thereto have been approved by the Agency. Page 13 of 73 November =l -September 2022 51. Renegotiations of Modifications: EHEAP ARPA 203.22 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 adittstcd retroactively to reflect price Icvcl increases and changes in the rate of payment when these have been established through the appropriations process and subsequently identified in the Agency's operating budget, 52, Susnensifjn U173yorlt: 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 olthe State to do so. '1 he Agency shalt provide the Contractor written notice outliningthe 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 Contractorshall 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. 53. Termination 53.1 Termination for Convenience, The Agency, by written notice to the Contractor, may terminate this contractin whole or in part when the Agency determines in its sole discretion that it is in the States interest to do so.The Contractor shall not fiu•nish any product after it receives the notice of termination, except as necessary to complete OW continued portion of this contract, if a€ v. The Contractor shall not he entitled to recover any cancellation charges or lost prof its, 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, thuyenlangering performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory, regulatory, or licensing requirement. Rule 6OA-1.006(3), F.A.C:., governs the procedure and consequences of default. The Contractor steal I 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 perl'ornr is caused by the default of a Subcontractor at a tier, and if the cause of the default is completely heyondthe control of both the Contractor and the Subcontractor, and without the fault or negligence crreither, the Contractor shall not he I iahle ror any excess costs for failure to perform, unless the subcontracted products were obtainable from other sources in sufficient time for -:i.: Contractor to meet the required delivery schedule. If, aftertermination, it is det�:" : � i tied that the [contractor was not in default, or that the default was excusable, the rights and obligations of &x Parties shall be the same as i the termination had beet) issued for the convenience of the Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and remedies provided by law or under the contract. 54. Electronic Retards and Signatui e� 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 = hall comply with the requirementscontained in the Uniform Electronic Transaction Act, Section 668,50, F.S. All electronic records must be filly auditable; are subject to Florida's Public Records Law, Chapter 119, F.S.; )rust comply with contract Section 21), Data.lntegrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and maintained by the Contractor to the same extent as non -electronic records are retained and maintained as required by this contract. 54.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the Contractor and the Agency, The Contractor is authorized to conduct electronic transactions with the Agency only upon further written consent by the Agency. 54.2 Upon request by the Agency, the Contractor shall provide file Agency with non -electronic (paper) copiesof records. Non-eleetronic (paper) copies provided to the Department of any document that was originally in Page 14 of 73 November 2021 - September 2022 6HEAP ARPA 203 22 electronic form With an electronic signature must identify the person aid the persons capacity ► ho electronically signed the document on any non -electronic copy of the document. 55. Contract Manag The Agency May substitute any Agency employee to serve as the AGENCY Contract Manager REMAINDER OF THE PAGE INTENTIONALL Y LEfY MI.4 NK Page 15 of 73 t4ovembet 2021 - Sep►embar 2022 56. EHEAP ARPA 203.22 Collier County Board of County Commissioners The Contractor name, as shown on page I of this 33391 r Tamiami Trail, Building I I a. contract, and mailing address of the official payee to Naples, FI.341 12 whom the payment shall be made is: Kristi Sonntag, Director The name of the contact person and street address Collier County Board of County Corlunissiziners b. where financial and administrative records are Community and Hunian Services maintained Is: 3339 E Tamiami T►dil, Building H Naples, FL 34112 The name, address, and telephone number of the c, Tepresentative of the Contractor responsible for administration of the program under this contract is: `Hie section and location within the Agency where d. Requests for Payment and Receipt and Expenditure forms are to be mailed is: e' IThe name, address, and telephone number ol'the, Contract Manager for this contract is: Norma Adorno, Chief Executive Officer, 2830 Winkler Ave., Suite 112 Fort Myers, FL 33916 239-652-6900 Area Agency on Aging for Southwest 1 Inc, 2830 Winkler Ave., Suite 112 Fort Myers, FL 33916 Agency on Aging for Southwest Florida, tile. 2830 Winkler Ave., Suite 112 Fart Myers, FL 33916 (239)652-6900 x58279 Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in writing to the other party. 57. All Terms and CandiltIons included: This contract and its Attachments I — XXI, including any exhibits referenced in said attachments, together with any documents incorporated by rel"i;rence, contain all the terms and conditions agreed upon by the Parties. There fire no provisions, terms, conditions, or obligations other than those contained herein, and this contact 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 (lie entire contact. IN WITNESS Wl3ERT:t7F, the Parties hereto have caused this contract to he executed by thcirundersigned officials as duly authorized. CONTRACTOR- COLLIER COIJJXV OARD OF AREA AGENCY ON AGING: FOR COUNTY MirSSION /' SOUTHWEST FLORIDA, INC. SIGP�IAT � SIGNATIlRI+, l NAME NORMA ADORNO TITLE PAR T«n NT i IEAD TITLE DATE_ n i) i{i l7f17? Federal Tax ID: 59-6000558 Duns: 076997790 President/CEO DATE i 2-k-- 2022 Approved as to form and legality 1 — 13 -,)a Assistant County Attorney Page 16 of 73 c'4o Noaemuer 2021 - Seplember 2022 INDEX OF ATTACHMENTS EHEAP ARPA 203.22 ATTACHMENTI...................................................................................WI....,..,........................................I.......18 31ATEMEe'VT OF[YORK.................................................................................................................................. 18 ATTACHMENTII..........................................................................................„...............,...........I......I.............. 37 FINANCIAL AND COMPLIANCE A UDIT..................................................................... ................................. 37 ATTACIMENTIII ....................................................................................................................................t....... 43 CER77MCAITONS AATD ASSURANCES......................................................................................................... 43 ATTACIIMT:NT IV............................................................................................................................................ 48 ASSURANCES 1VOAT COjVSTRIJC770j\']'ROGRAt1IS.................................................................................. 48 ATTACHMENTV.............................................................................................................................................. 50 FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHT S COMPLIANCE CIIEC Kf,ItiT................. 50 ATTACHMENTVI ............................................ ....................................... ............ ,............................................ 54 CONTRA CTOR W ST:111_ CONTRACTLIST ................. .................................................................................. 54 ATTAC'H114EN T VIIL...........nn........n.....r.t......um.n.............n....................n........t..nn.......u........0................... 56 Cls'RTRUE D &/lArORII'Y BUSINESS SURCONTRACT01t Er, X'PENI) MIRES (C,14BE FORM) ...................... 36 ATTACHMENTIX ............................................ .............. ........ ......n......................... ....... .... I ........ 1.................... 58 EHEAP ARP .ACT d UDGIsTS1IMWRY......................................................................................................... 58 ATTACHMENTX.............................................. ................................................................................................ 59 EHEAP ARP ACT ADMINISTRATIVE AND 0I T REACH EXPENSE BUDGET DE, TAIL ............................. 59 ATTACHMENTXI............................................................................................................................................ 60 RECEIPTS AND EXPENDITURE REPORT.......,........................................................................................... 60 ATTACHMENTXII.......................................................................................................................................... 61 REQIJE.STFOR PAYMEN7:.................................. ................ ............................... .................... ....................... 61 ATTACHMENTMIT ......................................................................................................................................... 62 EHEAP ARP ACT IN FOICEREPORT SCHEDULE....................................................................................... 62 ATTACHMENTXIV......................................................................................................................................... 63 STA7E MEDIAN INCOME GUIDELINES.............................................................................................. .. 63 ATTACHMENT" XV...............................................................................................................................n.......... 64 F.FIE,: t P ARP ACT 5O URCES OF INCOME.......................................................... .......................................... 64 I. ATTACHMENT XV....................................................................t.................................................................. 65 WERGENCYHOML'ENERGY ASSISTAMCF, FOR THE ELDEIiLYPROGRAM- API'LIC.t1701V............ 65 ATTACHMIIINT WE........................wu.....m........................w...u......................... ee........................................ 68 EHEAP ARP ACTAPPLIC-11770jVINSTRUCTIOMS.....................................................................................1. GS ATTACHMENTXVIII ..........................n..........n.............................................................................................. 71 EHEAP ARP ACT CLI ,AfT FILE CONTENT CHECKLIST ............................................................................ 71 ATTACHMENTXIX..............................n.......................,....,.n............................................n..n............n......... 72 EHEAPARP ACT RECIPIENT IN.FORMATION .............................................................................. ................ ATTACHIVENT XX............................................... .................n...n.................................................................... 73 SE, RVICE RAIW REPORT............................................................................................................................... 73 Page 17 of 73 November 2021 -September 2022 ATTACHMENT I STATF.MIKNT OF WORK FAI ERGENCY HOME ENERGY ASSISTANCE FOR THE ELDERLY PROGRAM AMERiCAN RESCUE PLAN (ARP) ACT OF 2021 SUPPLEMENTAL GRANT I. SERVICES TO BE PROVIDED A. DEFINITION OF TERMS 6HLAP ARPA 203.22 1. Eighteen (18) hour rule — The tunefrante within which all applications for life -threatens ,g crisis assistance sliall be acted upon, with an eligible action to mediate the crisis being taken and documented in the client file within eighteen (18) hours of the application date stamp. 2. Forty-eight (48) hour rule The timeframe within which all applications for standard crisis assistance shall be acted upon, with an eligible action to mediate the crisis being taken and documented in the client file within forty-eight (48) hours of the application date stamp. 3. Caseworker — Person who is responsible for determining program eligibility by completing the Emergency Home Energy Assistance for the Elderly Program American Rescue Plan Act of 2021 Supplemental Grant (EHF.AP ARP) T:ligibility Worksheet (Attachment XV1) and awarding crisis benefits. 4. Caseworker Signature Date —The date that the client's completed application is processed, eligibility determined, and the crisis resolved. This date shall not be changed. Signatures must be in ink, Rubber-stamped signatures will not be accepted. 5. Categorically Eligible — Applicants will be considered eligible to receive El LEAP services, regardless if their household in is exceeding 150% of the State Median Income Guideline. if any member of their household is receiving Temporary Assistance for Needy Families (TANF). Supplemental Socia' Security (SSI), or Supplemental Nutrition Assistance Program (SNAP) benefits. d. Client Application Date -"rite date the application is completed («nether by:self or with assistance) and signed by the elder. 'i"-iN date shall not be changed. Signatures iuust be in ink, Rubber-stamped signatures will not be accepted. If an elder cannot write their signature on the application, or any other required document, and must sign with an "X," two witnesses are required. T. Crisis - A home cooling or heating crisis exists when an elder has no access to, or is in danger of losing access to, needed home energy. 8. Crisis Assistance Assistance provided to an elder who has no access to, or is in danger of losing access to, needed home energy. 9. hate of Resolution —The date thuL a documented commitment to pay was made to the utili ry vendor to resolve the energy crisis. This date is used as the EHEAP ARP Act Client Enrollment date in the Agency's Client Information and Registration Tracking System (CIRTS). This date shall not be changed. a. The arnount of time elapsed between the Date Stamp and the Date of Resolution shall determine whether or not the eighteen or forty-eight (18/48) !tour rule was met. b. Vendors must be paid within forty-five (45) days of the date of resolution. 1D. Date Stamp The date the application and all required documentation is pr. ; 4nt :1 in acceptable form to intake staff. An inked stamp mtist be used, and the bate shall not be changed. The 18148-hour rule for crisis resolution begins when the application is date stamped. It. Disability — A disabling; condition that causes an cider to be determined eligibl.. to receive Supplement Security Income (SSI) or Social Security Disability Income (SSDI) from the Social Security Administration. 12. Elder —An individual aged sixty (60) years or older. 13. Eligible Action — An action taken by the caseworker to mediate an elder's energy crisis. Eligible actions include: a. Approval of an elder's application; b. Denial of an cider's application pending fiurlher information; Page 18 of 73 November 2021- September 2022 EHEAP ARPA 203.22 c. Denial of an eider's application because the elder is deemed ineligible; d. Contact with a utility vendor to halt utility diseonnec(ion or interruption in services; or e. Written referral to and providing the cider with assistance contacting another agency if £HEAP ARP Act funding is not available or the elder is ineligible. 14. Energy Subsidy - Utility costs paid directly or indirectly to the elder who lives in government —subsidized housing. 15. household — Any individual or group of individuals who are living together as one economic unit for whom residential energy is customarily purchased in commor or who make undesignated payments for energy in the form of rent. 16. Household Member — Persons in a household who share a common kitchen or bath and purchase residential energy in common. 17. intake Worker — Person who accepts the F*HFAP Alai' Act application and required docurnente.ion and may have the responsibuity to determine eligibility or award crisis benefits. 18. Minimunt Level. of Service — Service to a minimum of one household per month. 19. Crisis Assistance Benefit — Payment of heating/cooling energy bill; `he purchase of a heating/cooling device; and/or the repair of a heating/cooling, device. 20. Priority for Assistance — Households with the highest home energy needs and lowest household income, which will be determined by taking into account both the energy burden and the unique situation of such households with members of vulnerable populations, including very young &.ldren, individuals with disabilities, and frail elder individ11818, 21. Provider - The entity that has entered into a contract, subcontract, or Memorandum of Understanding (MOU) to provide services under EIIEAP ARP Act. For the purposes of -Sus contract, the terms "Provider" and "Conti acIuj" may be used interchangeably. 22. Reasonable Promptness - Within fifteen (:5) working days of receiving [lie client's compictcd application. 23. Request for Payment — Submission of actua! monthly expenditures for reimbursement, 24. Service Unit — One individual (elder) served. 25. Social Security Number The number on an eider's Social Security card or the number provided by an award or dctcrmination letter from an entity, such as a government agency, that has already verified the social securi(v number. 26. Supervisory/Peer Review Date The date that a supervisor or peer reviewed the application and documentation and signed the application indicating vendor payment can be made. The intent of the supervisor/peer review is to avoid errors in eligibility determination and payment amounts and to alleviate the possibility of fraud. This date shall not be changed. Signatures must be in ink. Robber -stamped signatures will not be accepted. 27. Verification Date The date the caseworker verified previous Low-income Home Energy Assistance Program (LIHEAP) crisis benefits with the LiiIEAP provider or the minimum amount necessary to resolve the crisis with the utility company. This date shall not be changed, B. GENERAL, DESCRiPTION 1. General Statement The Emergency Horne Energy Assistance for the Elderly Program (EHF;AP) American Rescue Plan (ARP) Act of 2021 Supplemental Grant serves the mission of the Agency by providing home energy assistance aid toelders in the event of a horne energy heating or cooling emergency. The primary purpose of the EH1: AP ARPAct program is to prevent, prepare for, and respond to coronavirtts; including assisting low-income householdswith at least one member aged sixty (60) or olc'.er experiencing; a heating or cooling emergency. Page 19 of 73 I November 2021 - September 2022 2. Aufhorify EHEAP ARPA 203.22 The relevant federal and state authorities governing El IEAP ARP Act are: a. Low Income Home Energy Assistance Act of 1981 ('Title XXVi of the Omnibus Budget Reconciliation Act of 1981, P.L. 97-35), as amended; b. ARP Act of 2011; c. 42 United :Mates rode (U.S.C.) § 8621 et seq.; d. 45 Code of Federal Regulations (CPR) Pail 96, Subpart H (5 ` 96.80 96. �9); e. Section 409,508, Florida Statutes (F.S.) and Rule 73C-26.021(3), Flor ida Administrative Code (F,A.C.); f, N .i le Chapter 73C-26, F.A.C.. g. State of Florida LII IEAP Policies and Procedures Manual; and h. LIHEAP State Plan. 3. Scope of Service The Contractor is responsible for the programmatic, fiscal, and operational management of CIiEAP ARP Act. hligible elders may receive multiple Crisis assistance benefit(s), that combined not to exceed $5,000.00 during the term of this agreement. Kligible, elders riay receive crisis assistance benefits during the period from November 1, 2021 to September 30, 2022. a. The services provided under this contract shall be in a manner consistent with .i.:.: described in Attachment I, Section II: Manner of Service P,.-ovision, Contractor, in collaboration with its EIIEAP ARP Act program partners, shall ensure the following service tasks are completed: (1) Consumer Outreach; (2) Program Partners and StaKeholders Coordination; (3) Flder's Benefit Eligibility Determination; and (4) Benefit Disbursement. 4. Major Program Goals F,HtAP ARP Act is designed to provide crisis assistancc to eligible 'ow -income households with at least one individual aged sixty (60) or older experiencing a heating or cooling emergency. The Summer and Winter Crisis seasons are waived until the ARP Act funding is fully expended. a. Standard Crisis A standard home coaling or heating crisis exists when an eider has no access to, or is in danger of losing access to, needed home energy because one or more of the following conditions is present: (1) The elder has been notified that the energy source for cooling or heating is going to be disconnected; (2) The elder has received a notice indicating the energy source is delinquent or past due; and/or (3) The elder has an energy bill for which the due date has lapsed; b. Life -Threatening Crisis A life -Threatening home cooling or heating oasis exists if one of the following conditions is present: (1) The elder's home cooling or heating energy source has been disconnected; (2) The elder is unable to get delivery of fuel for boating, is out of fuel for heating, or is in danger of being out of fuel for heating; or (3) The cider has other problems with lack of cooling or heating in the home, such as needing to pay a deposit, needing a repair of heating or cooling equipment, or needing an interlm emergency rnea ure to avoid further crisis. Page 20 of 73 t' November 202' - September 2022 C. CI.I F NTS TO BE SERVED 1. General Descripi ion EHEAP ARPA 203,22 EHEAP ARP Act provides for direct client services to elders in low-income households experiencing a home energy heating or cooling emergency. A household with 1-8 individuals receiving LHEAP ARP Act services ntny not have an income above sixty percent (60%) of the State Median Income and for households with 9-or- niore individuals incomes, please refer to the Federal Poverty Guidelines (FPG) Benefits Matrix, as published by the United States Department of health and Hti nan Services, unless the household is determined categorically eligible. 2. Client Eligibility To be cligibtc for services under this contract, and to receive assistance, an elder must; a. Be aged sixty (60) or older; b. Reside in the Li IEAP ARP Act service area (Planning and Service Area) at thy: timo the home energy costs were incurred; c. Complete and return an EHEAP ARP Act application with all required ial`armation and verification to Contractor, while funds remain available; d. Provide a fuel bill or other dMimentation evidencing an energy emergency and an obligation to pay for home energy costs for !l w home in which they live; e. Possess a total gross household income of not more than sixty percent (60%) of the Office of Management and Bridget (OMB) state inedixn income level for the size of the household with I-i5 individuals and for households with 9-or-more individuals incomes, please refer to the FPG Benefits Matrix, in accordance with Section LC.3A., or be determined categorically eligible. to receive FHl~AP benefits; f. Be experiencing one or more verifiable home cooing or heating crises; g. Not he a resident of a group living; taeility or a home where the cost of residency is at least partially paid (or subsidized) through a foster care or residential program ai i ministered istered by the state; h. Not he a student living in x dormitory; and 1. Legally reside in the State of Florida. 3. Client Determination Contractor shall begin taking applications for EHEAP ARP Act services upon execution of this contract and continue taking applications until the contract expires or funds are exhausted. Contractor will not accept applications when funds are exhausted for a particular time period, Contractor shall: a. Provide assistance to elders in completing Agency -provided applications for assistance •:ncl detenmining eligibility; b. Ensure that no one is excluded from program participation on the grounds of race, color, national origin, sex, or age, and ensure that such persons shall not be subjected to disci i nination under any activity funded in wholo or in pail with these funds; c. Treat homeowners and these who rent equitably under this contract; d. Calculate the income cligibi:ity of the elder by using the past thirty (30) days earnings for all occupants of the household annualized or the chi,-r's current economic situation and reference the current year EHEAP ARP Act Sources of Income (Attachment XV) to determine what is considered allowable income. Contractor shall proceed as follows: (1) 'Total household income with 1-3 individuals cannot exceed sixty percent (60%) of the current State Median income Guidelines (Attachment X1V) and for households with 9-or-mare individuals income, please refer to the FPG Benefits Matrix, unless the household is determined categorically eligible; i. Stimulus payments from the federal government in relation to Tine Coronavirus Disease will not be considered income and will not be considered in determining a household's State Median Income (60% or below). Page 21 of 73 November 2021 - September 2022 EHEAP ARPA 203.22 ii. Any type of unemployment. (2) Obtain a self -declaration from household members aged eighteen (18) years or older claiming zero income. Self -declarations mist be completed and signed by the household member who is claiming zero income. i. Zero income can be determined with proof' of elient employment termination or self -declaration. ii. Zero income can be determined at the time of application and projected forward (current economic status), instead of using the past 30 days. If applicable, clients should note the reason for zero income related to C OVI1) 19, iii. A.though not counted as income for eligibility purposes, excluded h conic sources may be used to determine how a household is meeting its expenses. e. Determine if all or part of the cider's utility costs are paid directly (utility reimbursement) or indirectly (utility allowance) by the government if the elder lives in government -subsidized housing. Contractor shall proceed as follows; (1) If total home heating or cooling costs are included in the rent and the elder has no obligation to pay any portion of the costs, then the elder is not eligible for assistance; and (2) If there is a Florida Section R ([ lousing. Choice Voucher Program) or a Public Housing Authority (PHA) Program energy subsidy available to the elder during the period covered by the utility bill, then the elder is only eligible for partial assistance. The energy subsidy for the period covered by the utility bill mast be subtracted from the allowable FHFAP ARP Act benefit calculated for the household. f. Use program qualification approvals or notifications from TANF, SSI, or SNAP to document household size and income of elders, or to determine and document categorical eligibility to receive EHEAP benefits. The benefit level to be provided to elders receiving TANF, SSI, and SNAP shal l be the same as that provided to other qualified elders; g. Obtain a signed statement of m..'{ i.cnancc from the elder explaining how basic living expenses (i.e., food, shelter, and t:<rnsportntion are being provided) if the total jai..,(d-oid income is less than fifty percent (50%) of the current State Median Income Guidelines and no one in the household is receiving SNAP; h. Ensure elders receive no more than the household crisis assistance cap of $5,000.00. (I) Flders may apply for and receive multiple crisis assistance benefit; (f) Water, sewer, garbage, and fi -c, etc, charges r•iay not be paid; (2) Crisis assistance benefit may consist of payment of more than one energy obligation in the following allowable categories for a household to resolve a single crisis; (1) Utility payments for heating/cooling bill assistance for electric, gas, propane, wood, coal, or refillable fuels; (i) Temporary emergency shelter (if needed due to energy-rciated crisis); (it) Payment to landlords (when utility costs are included in rent); (iii) Repairs or replacements to heating/cooling units (as long as the amount is within the benefit limits and the work is done by a licensed contractor); (Iv) Deposits to connect or restore energy; (v) [.ate ferry, disconnect fees, and reconnect fees; (vi) Charges from a previous account held by the: applicant that is now closed; (vil) Taxes and fees associated with the client's utirity hill towards the energy portion. In some cases, where the utility vendor combines all the other fees and taxes, which also includes non -hone energy services, such taxes and fees can he paid with EI [EAP ARP Act funding. Example; to a case where taxes for other services are commingled with taxes for hume energy services, proceed with paying the .axes portion of the bill; Pege 22 of 73 November 2021 - September 2022 EHEAP ARPA 203.2 (vlii) Other allowable payments are those related to the start-up of services, including reasonable connection or reconnection fees, delivery Ices, deposits, and other fees related to the start -tip of service; (N) Pre -pay home energy usage: a. The elder is within seven days of using the remaining balance of Ilse pre -purchased energy source, the elder's power is currently disconnected/shut off, or the elder needs a deposit. b. The benefit amount for pre -paid account shall be for one month's energy usage and may include other allowable costs; (x) The purchase or repair of fans, blankets, air conditioners, and/or portable heaters in addition to heatingluouling bill assistance; and (xi) Crisis situations which may involve a heater or air conditioner that is powered by both gas and cbxlricity, in which case both energy obligations are eligible for a crisis benefit. (xil) Payment to landlord when utility costs are included in the older's rent is allowable; and (01) Payment for tempoeary emergency shelter is a I owable if due to energy related crisis i. M no case shall the Contractor be required to incur costs in excess of the fttll contract amount to provide services to the clients. 11. MANNER OF SERVICE PROVISION A, SERVICE TASKS In order to achieve the goals of EHEAP ARP Act, Contractor shall ensure the fallowing tasks are performed: I . Hnsure that all eligible ciders meet the requirements of Section i.C.2, of this contract; 2. Ensure that all energy assistance payments made to home energy vendors comply with the requirements of Section II.A.14A. of this agreement; 3. Implement appropriate program management and operational controls to ensure all applications for crisis assistance are acted upon with an eligible action to mediate the crisis within eighteen or forty-eight (18/48) hours of the application date stattip, and document in the client Zile that the crisis was resolved within eighteen or forty-eight (18/48) hours; 4. Provide all elders approved for EHF:AP ARP Act funding with a written Notice of Approval and Appeal an agency letterhead within fifteen (15) working days of crisis resolution. The written Notice of Approval and Appeal shall include: a. Type and amount of assistaiL,:c; b. Name of the home energy vendor to be paid on elder's behalf; c. The next date when the elder will be eligible to apply for further assistance; and d. Contractor's appeal process. e. Signature, date, and contact 'information of agency's authori7Rd representative. 5. Provide nil elders whose El LEAP ARP Act applications were denied with a written Notice of Denial and Appeal on agency letterhead within fifteen (15) working days of receiving the elder's application. The written Notice of Genial and Appeal shall contain: a. Name of the elder; h. Date of application; c. Type of bcnetit sought; d. Reason(s) for denial; Page 23 of 73 f.y o November 2021 - September 2022 e. Statement on Contractor's benefit limits, if applicable, E Contractor's appeal process; g. Explanation of circumstances under which the elder may reapply; h. Information or documentation needed for the elder to reapply; i. The name, address, and phone number applicable to the appeal process; and j. Number of days the elder has to file the appeal. k. Signature, date and contact intorrnation of agency's authorized representative. EHEAP ARPA 203,22 6. Maintain cow under appeal procedures that provide an opportunity for a fair administrative hearing to elders whose applications for assistance are deified or whose applications are not acted upon with reasonable promptness; 7. Provide an opportunity for elders to file a written appeal or complaint with Contractor'; Program Supervisor within ten (10) working days of receipt of the written Notice of Denial and Appeal. a- Upon receipt of a validly filed appeal or complaint, Contractor must respond in writing within ten (10) working days; b, Elders may appeal Contractor's first response by filing Its obiections to the response with Contractor's Director. Executive Director- or Board Chair, as applicable, within live (5) working days of receipt of the first response; and e. I Ipon receipt of a validly filed objection to the first response, Contractor mast respond in writing [within ten (10) working days, and the response trust clearly state the final outcome of the appeal, that -ho decision is final, and if applicable, the circumstances under which the elder may reapply for services, 8. Post appeal provisions in a prominent place and in plain view at all locations where [!HEAP ARP Act applications are received; 9. Ensure all ineligible applicants and applicants denied crisis assistance, when EHEAP ARP Act fiends are not available or are insufficient to meet their eivergency Ii ne energy needs, are referred to and assisted in securing help through other community resources; 10. Ensure no consumer fees are charged to, nor donations accepted from, an elder as a prerequisite for receiving 1 1IEAP ARP Act benefits. Post in a conspicuous place at all locations where l;l IEAP ARP Act applications are received the following notice: "No money, cash, or checks will be requested or received from customers inthe EHEAP office. if an employee asks for money, report this to the agency executive director or Agency head."; 11. Compare LIIIEAP ARP Act records and FHEAP ARP Act records for households with elderly members to avoid exceeding the household crisis benulit cap and maintain documentation sufficient to ensure compliance with this requirement, 12. Maintain a written policy and implement procedures to protect and secure elder applicants' information and social security numbers in order to protect their identities from theft or fraud. This policy shall address the handling of both paper and electronic records and files. Contractor shall, in collecting; elders' social security numbers, use the Notice Regarding Collection of Social Security Numbers, which is incorporated into this contract by reference, (Notice of Instruction -4071113-1-1-SWCBS, htip:/feldcraftairs.state.tl.tiVdoeoinotices/July 13iLIHF,A P°fn'2t}NoticeO/o2Ore°i�2USoc•iaialo20Secur•i ty°io2ONLimb ers°Yo2t7Cinal..pd1). The Notice Regarding Collection of Social Security Numbers shall be signed by the elder and retained in the client file; 13. Consumer Outreach E.nsurc that households in all counties within the service area wishing to benefit from the program have the opportunity to do so. Contractor shall undertake consumer outreach initiatives in all counties within the service area designed to inform potentially eligible households about El iLA." ARP Act. Outreach efforts must focus on elderly households with disahled individuals, young children, and where the highest percentage of the household income is required to pay �,)r their home ener.P�. Specirc outreach, initiatives shall include, but are not limited to: Page 24 of 73 r November 2C21 -September 2022 EHEAP ARPA 203.22 a. Informing all service area local agencies, non -profits, and similar organizations that are in mgUlar contact with the low-income population about the EHEAP ARP Act program, especially those serving seniors; b. Encouraging EHEAP ARP Act program participation through local television and radio programs, and placing announcements of the El LEAP ARP Act program in media community calendars; c. Developing and implementing a written procedure for making home visits to households with homebound elderly persons in order to assist with the completion of the program application when other assistance is not available; d. Making visits to provide inflornmtion and/or mal: ng presentations about El LEAP ARP Act in response to requests by local congregational centers serving elderly or disabled l,ersons; and e. Providing information concerning the local weatherization program to all persons who request it (including organizations that provide outreach activities), E Maintaining an EHEAP Outreach Activity Report to demonstrate to the; Agency that outreach efforts to inform Ixltentially eligible households about EHEAP are conducted to target households in all counties. 14. Program Partners and Stakeholder Coordination Contractor shall coordinate services with other program partners and stakeholders to prevent the duplication of services, facilitate referrals, and improve the efficiency of services for consumers. ['.,ordination activities shall include, but not be limited to: a. Communicating with the DHO LTHEAP contractors in their respective service areas to prevent exceeding the household crisis assistance cap to elders; b. Developing a new, or continuing an existing, MOU with the Weatherizntiort Assistance Program (WAP) in the service area. The MOU shall cctail cooperative efforts and describe the actions that will be taken by both parties to ensure coordination and referrals. The MOU shall be reviewed and renewed at yeast every five years. Contractor, in coordination with the local WAP agent;.•, Shall develop a system by which elders who have received more than three EIIEAP or LIHEAP benefits"in the last eighteen (18) months and who are homeowners are referred to a WAP provider. Contractor shall maintain copies of all MOUs; c. Establishing a now, or raa,i-irtring an existing, MOU with service area LIIIEAP contractors. Each MOU shall ensure coordination of services, avoid duplication of assistance, and increase the quality of services provided to elders. The MOU shall direct L.1HFAP providers to refer elders aged sixty (60) ol- older to EI IEAP providers for energy assistance. The MOU shall be reviewed and renewed at least every five (5) years. Contractor shall maintain copies orall MOUs. MOUs with local LII IEAP al encics shall be updated if the contracting parties change. The M. OUs must be applicable to Contractor's current EHEAP requirements and guidelines; d. Developing agreements with home energy vendors that benefit deters. Contractor shall maintain copies of all vendor agreements. All current EHEAP agreements between Contractor and home energy vendors are valid under the EHEAP ARP Act contract. All agreements between Contractor and hone energy vendors shall contain the following conditions: (1) The beginning and ending date of the Vendor Agreement; (2) The Contractor's reprcesentarive(s) authorized to resolve a crisis situation and make a payment commitnrtnto ,behalfofanolder; (3) The home energy vendor's representative(s) authorized to resolve a crisis; (4) A description of how energy payments will be made directly to the home energy vendor on behalf of the EHEAP eligible customer; (5) Assurance from the horse energy vendor flint no household receiving EHEAP assistance,.;,ill he treated adversely because of such assistance under applicable provisions of state law or public tegulatory requirements; (b) Assurance that the home energy vendor will not discriminate, either in the cost of goods supplied or the services provided, against the eligible household on whose behalf payments art made; Page 25 of 73 1 November 2021 September 2022 EHEAP ARPA 203.22 (7) A statement that only energy -related elements of a utility bill are to be paid. Water, sewer, garbage, and fire, etc. charges are not covered as part of the utility bill of tite household. I Iowevet, EI IEAP u�:t allow an exception with water that is used for air conditioning, i.e, an evaporated cooler; (8) A statement that Contractor may not pay for charges that result from illegal activities such as a worthless check or meter tampering, and that the home energy vendor is aware that those charges are the responsibility of the elder; (9) Assurance from the home energy vendor that when the benefit amount to the elder does not pay for the complete charges owed by an elder, the eider is responsible for the remaini:zg amount owed; (10) Details on how the home energy vendor will assist Contractor in verirying true elder's account information and, in the case of crisis assistance, make timely commitments to resolve tlw crisis. A process should be in place to verify the current amount o,ved and the minimum amount necessary to resolve the crisis situation; (11) Contractor's commitment to make payment to the home energy vendor within forty-five (45) days of the dale of crisis resolution; (12) Assurance from the home energy vendor that when EHEAP payments made to the vendor cannot be applied to the elder's account, the funds will be returned to Contractor or, with Contractor's approval, applied to another eligible custorner's account; (13) Assurance that the Contractor shall collect a signed A..,thorizatlon for Release of General and/or Confidential Information for EHFA P Data fi-om each eligible elder and ensure the signed releases are available for inspection by the home energy vendor; (14) Assurance that the home energy vendor is aware that as long as signed Authorization for Release of General and/or Confidential I uformation for FHEAP Data ai e. collected and available, the horse energy vendor will provide the requested customer data to DEC1; (115) The agreement will be reviewed by both parties at least every five (5) years; (16) The agreement roust be signed by n representative of bosh Contractor and the vendor who has authority to bind the entity and enter into such commitments; and (0) The home energy vendor, with the exception of municipal providers. must be in "uctive" status with. the State of Florida (http;//sturbiz.or.g earch.html). The business name tin the vendor agreement must match the legal business name on the State of Florida Sunbiz website; and 15. Comply with the Federal Financial Accountability and Transparency Act (FFATA) by securing a Dun and Bradstreet Numbering System (DUNS) number (w%,w.dnb.com) and maintaining an active and current profile in the System for Award Management (SAM) (www.sam.gov). B. STAFFING REQUIREWNTS 1. Use of Suhenntraetors If an entity other than the Contractor provides any service required under this contract. the Contractor shall ensure the following requirements are n.et, a. Eligible entities that provide outreach, perform intake, make eligibility determinations, or ]process benefit payments must be one of the following: (1) A Local City Government; (2) A Local County Government; (3) A Community -Based Grganizatiow, (4) A Faith -Based Organization; or (5) A State Community Services Agency. b. For the tcrin of this contract, each month Subcontractor shall provide to Contractor the following information; Page 26 of 73 November 2021 - September 2022 F HEAP ARPA 203.22 (1) The total number of individuals served with crisis assistance for the reporting tnortth; (2) The total number of individuals ineligible or denied assistance during -he reporting month; (3) The total number of individuals served by referral to othcc community resources fbr .�:j:_y assistance during the reporting month; and (4) The tot -A amount of funding expended tot, crisis assistance per county for the reporting month, c, r ntities providing; any service required under this contract must comply with the FFATA. This includes ,Ct a<mg a DUNS number (wwvwµ.dnh,coin) and maintaining an active and current profile in the System for Award Management (SAM) (►:-Fyw4.sam.f!nx ). d. Entities must maintain current written agreements in the following Formats vr: th service providers: (1) A MOU shall be executed by both parfics if a service provider performs :any service required under this contract and is paid for providing specific services without a direct pass -through of federal funds. The M+OU shall clearly state program expectations and the role and responsibilities of each entity. Contractor shall submit a copy of all MOUs to the Agency'-, Contract Manager within thirty (30) days of the contract execution dale: and (2) An EHEAP ARP Act subcontract shall he executed by both parties if a service provider performs any service required under this contract and is awarded a direct pass -through of federal funds to operate the program and provide program ser vices. Contractor small submit a copy of all subcontracts to the Agency's Contract Manager within thirty (30) days of the contract execution date. e. Eligible entities must provide the service provider commensurate compensation for the delivery of administrative and outreach activities and for the delivery of crisis benefits. Commensurate compensation of administration and outreach activities shall include cost-reirnbursernent of actual expenses or a negotiated rate for specific activities. f. If any of the work require d under this contract is subcontracted, Contractor shall include in the subcontract that the subcontractor is bound by the terms of this contract, is bound by all applicable state and federal laws and regulations and shall hold the Agency and Contractor hat7niess against all claims of any nature arising out of the subcontractor's performance of work under this contract to the extent allowed and required by law. g. Subcontractor shall not be permitted to perform services related to this contract without an executed subcontract and an approved Provider Cost Analysis or MOU verifying that subcontractor's staff is paid from non-federal resources or is compensated for such activities by El IEAP ARP Act. In accordance with Sections 25-26 of the Standard Contract, the Agency shall not be responsible or liable for any obligations or claims resulting from any subcontract. It. Contractor shall document the subcontractor's progress in performing its work under this contract in the quarterly report. i. For each subcontractor, Contractor shall provide a written statement to the Agency regarding whether that subcontractor is a minority vendor, as defined in Section 288.703, F.S. j, If this contract involves the use of a subcontractor or third party, then Contractor shall not delay the implementation of its agreement with the subcontractor. If any circumstances occur that may result in a delay of the initiation of the subcontract or in the performance of the subcontractor for a period of sixty (00) days or more, Contractor shall notify the Agency's Contract Manager and the Agency's Chiel"Financial Officer in writing of such delay. C. SERVICE DELIVERY t. Service Delivery Location Contractor shall ensure that the services provided under this contract are available to residents within each county in the Planning and Service Area (PSA)': , in -person service, telephone, and/or outer electronic means. 2. Service Times Contractor shall provide the services listed in this contract during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5,00 p.m. local time, excluding holidays and force majeurc. Page 27 of 73 r1V November 2021 - September 2022 EHEAP ARPA 203.22 3. Contractor shall publish its service delivery location, tall -free telephone number, and normal business hours in available forms of media (i.e. newspapers, radio, television, website, publications, etc.). D. DELIVERABLES 1. Deliverables a. Certification that Contractor must operatc during its regular business hours, as identified in Section II.C.2. of this contract. b. Contractor slrall provide the minimum level of service per month in each courtly sewed, as defined in Section LA.17, 2. Source Documentation The deliverables shall be reported monthly on Contractor's monthly financial status reports. Successful completion of the deliverables shall he determined by the Agency's receipt of Contractor's EHEAP ARP Act Receipts and Expenditure Report (Attachment XI) and CHEAP ARP Act Request for Payment (AttachntentXtl) containing the number of individuals served with crisis assistance; number of individuals ineligible or denied assistance; number of applicants served by referral to other community resources for energy assistance;a summary of funds expended per county for the reporting month using the 1•:l-IRAP ARP Act Cost Reimbursement Summary form (Attachment XIX); and the certification required in Section III, E,2. 3. records and Documentation Contractor will maintain a separate record (paper and C;lKi S) for each F.HF.AP ARP Act applicantthat includes the following, as applicable: a. The EHFAP ARP Act Application and Eligibility Work -sheet (Attachment XVI) completed and signed by Contractor and the elder. The application must be approved by a supervisor or peer prior to payment remittance. Contractor is responsible for using the most recent application, eligibility worksheet, and EHFAP ARP Act Application and Eligibility iWotksheet Instructions (Attachment XVII) issued by the Agency. (1) If Contractor approves an application, one elderly member of the household must be registered in CiRTS using the EIiEAP ARP Act Application and Eligibility Workshee: (Attachment XVI); or (2) If Contractor denies an application, the cldvr must be registered in CiRTS using the EHEAP ARP Act Application and Eligibility Worksheet (Attachment XVI). b, The eider's name, address, sex, and age; c. Names, ages and current identification documentation (no more than one year expired) of all household members; d. Social Security numbers and documentation of those numbers for all household members, or the citation to the applicable exemption; e. Signed notice regarding the collection of Social Security numbers (Notice of Instruction #O71113-1-1- SWCHS, htyxNelder affairs.state. tl.us/doetr!nol's_ce JJuly 13f L1HE- AP%2ONotice°ra2f?re%2{)Social° �OSecurity°oa3f N umbers%2QFinai.pdI); f, income amount and method of verification for all household members; g, Income documentation to support eligibility that is representative of the elder's eurrent economic situation; h. Statement of self-dcclaration of income, if applicable; 1. A signed statement of how basic living expenses (Le,, fond, shelter, and transportation) arc being provided if the total household Income is less than fifty percent (5O%) of the current State Median Income Guidelines and no one in the household is receiving SNAP assistance; j. Documentation of the elder's obligation(s) to pay an energy bill :or the residence in which they 1. eve: (1) The elder's utility bill must include detail to identity unallownble categories of assistance resulting from charges for water, sewer, garbage, and fire, etc.; charges resulting from meter -tampering and Page 28 of 73 November 2021 - September 2022 F1 FAP ARPA 203.22 returned checks; and other charges that are not energy -related and are not required For cooling/heating the household, (2) Use of the most current utility tiill(s) which provides the vendor's name and address, account holder's name and physical address, account number, and ainount(s) due is required. If an alder's utility bill, cutoff notice, door -hanger notice, or similar documentation does not include all of this information, Contractor must document the verified missing :nfartnation by writing the information on the utility bill and on the El IEAP ARP Act Application and Eligibility Worksheet (Attachment XVI). k. Signed Authorization for Release of General and/or Confidential Information for LIHEAP/EHEAF Federal Reporting or a statement on the application which states that the eider refused to sign the waiver; 1. Copias ol'approval or denial letters, including those related to the initial application and all appeals, which are provided to the eider; m. ICprelbrence is given due to a disability, documentation of such disability that includes disability income or a physician's statement; n. Documentation of referrals to LIHEAP and WAP; o, Notation if F.HFAP ARP Act prevented a disconnection or restored an energy disruption, p. Documentation of coordination with LIHEAP providers to avoid exceeding the individual crisis cap for households with elderly residents; q. Proof of payment made to vendors; r. Documentation of eniculation of benefits for elders living in subsidized housing; s. Documented calculation of crisis benefits for elders whose energy hill includes unallowable charges; and t. Completed £I LEAP ARP Act Client File Content Checklist (Attar hnient XX Ill). K PERFORMANCE SPECIFICATIONS 1. Reports Contractor Is responsible for responding in a timely fashion to additional routine and/or special requests for information and reports requi red by the, Agency. Contractor must establish due dates for any subcontractor' sreport that permits Contractor to meet the Agency's reporting requirements. a. Contractor, shall report monthly on Contractor's FFiEAP ARP Act Request for Payment (Attachment XII) as delineated in Section II.E. Le. of this contract. b. Administrative and Outreach Expense Budget Detail Contractor shall submit to the Agency's EHEAP Contract Manager the FHEAP ARP Act Administrative and Outreach Expense Budget Detail (Attachment X). The EHEAP ARP Act Administrative and Outreach Expense Budget Detail shall �:learly delineate planned expenditures for funds retained by theContractor and funds subcontracted. The EHEAP ARP Act Adinninish-ative and Outreach Expense Budget Detail shall include all Contractor positions, by title, to be paid with these funds and shall detail the estimated number of hours, the hourly wage, and the estimated salary to be paid by EHEAP ARP Act Funding sources, estimated Hours, and hourly wage shall be identified forthe balance of salary whercEHEAP ARP Act funds arc used to pay less than one hundred percent (100%) of the salary. c. Provider Cost Analysis State of Florida Chief Financial Officer Memorandum No. 02 (released October 3, 2012), requires Contractor to provide assistance to the Agency's Contract !Manager in completing the DOEA Cost Analysis for Non -Competitively Procared Contracts In Excess of Category 11. (1) The Contractor shalt submit a completed Cost Analysis which shall reflect Administrative, Outreach, and Crisis Service allocations as delineated on the EHEAP ARP Act Budget Summary (Attachment IX) and must he sufficient to explain the expenditures' allowability, allocability, and reasonableness. The Cost Analysis shall be submitted and approved by the Agency prior to execution of this contract. All subsequent amendments that affect [lie budget shall also be submitted and approved by tite Agency prior to any change. Page 29 of 73 + , November 2021 - September 2022 d. Monthly Client Service Report EHEAP ARPA 203,22 i u! the term of this contract, each month, Contractor shall provide to the Agency, by tite 1511 of cacti month for the preceding month, the fallowing information: (1) The total number of households served per county; (2) The total amount of funding expended for crisis assistance; per county; (3) The total number of households served by refer: a I to other community resources for energy assistance; and (4) The total number ofhouscholds ineligible or denied crisis assistance. e. CHEAP Outreach Activity Report Contractor shall ensure the '.jse of outreach ellbrts that will inform potentially -ligible households about EHEAP. Tile EHEAP Outreach Activity Report is due on the f 5rt' day liollowing the end of each quarter and shall consist of the following: (1) Date; (2) County; (3) Location Address; (4) )description of Activity; and (5) blame and Position of Staff. f. Program Effectiveness Reports Contractor agrees to provide to the Agency any additional service reports requested by the Agency concerning the effectiveness of the program and shall include any statistics and information that the Agency may requite. The reporting period shall begin with the cffcctive bate of this contract in a fnrmatand according to a schedule provided by the Agency for each repnrt. 2. Monitoringand Evaluation Me lurdology Contractor shall monitor its performance under this contract, as well as that of its subcontractors, subrecipients and consultants who are paid from funds provided under this contract, to ensure that ttte scope of work is accomplished within the specified time periods and budgets set and that other performance goals stated in this contract are achieved. Stich review shall he made for each function or activity set forth in this contract and reported in the gt.arici.ly report. n. Contractor shall review completed El IEAP ARP Act applications in accordance with the EHF,AP ARP Act Client File Content Checklist (Attachment XXIII). b. The Agency shall, at its own discretion, conduct investigations concerning any aspect of Contractor's performance of this contract. c. The Agency shall conduct a ftill onsite review of Contractor at least once during each three-year period. Contractor shall allow the Agency to carry out monitoring, evaluation, and technical assistance, and shall ensure the cooperation of its employees, tend of any subcontractors with whom Contractor contracts to carry out program activities. d. I'he Agency shall conduct desk review activities throughout the year to -monitor contactual program requirements. e. The Agency shall conduct FHEAP intake site visits. f. In conjunction with onsite monitoring visits and desk review activities, the Agency shall review a sample of completed El IEAP ARP Act client files in accordance with the EHEAP ARP Act Client File Content Checklist, (Attachment XXll1). g. The Agency shall conduct fallow -up reviews including prompt return visits to Contractors that fail to meet the goals, standards, and requirements established by the state and federal funding agency. F, CONTRACTOR RESPONSIBILITES 1. Make vendor payments directly to fuel and/or home energy providers on behalf of eligible elders. Page 30 of 73 November 2021 -September 2022 EHEAP ARPA 203.22 2. Determine the correct amount of each crisis benefit based on the minimum necessary amount needed to resolve the crisis, but not more than the itern limit- or total limit set by the Agency. 3. Filcourage households to seek assistance prior to incurring nun-cmergy penalties such as disconnect/reconnect fees, additional deposits, interest, or late payments. 4. Provide R14" :AP ARP Act crisis services to households with elders in every county" within the service area. H. The Contractor shall provide oversight to ensure Ow each county within their survicc area receives the minimum level of crisis services monthly, as delineated in Section T.A. i 7; and b. EHEAP ARP Act funded staff shall make themselves available in all undersorvcd counties ns needed, to ensure that the minimum level of service is tnct. 5. Make crisis benefit payments to vendors on behalf of approved elders wilhin forty-five (45) days of the date of crisis resolution. 6. Make payments on behalf of those elders with the highest hcnne energy heeds and the lowest jiOusehold income, which will be determined by taping into account both the energy burden and the unique situation of households that result from having members of a vulnenable population, including very young children, the disabled and frail QI&is. 7. Refund to the Agency, with non-federal funds, all funds incorrectly paid on behalf of elders that cannot he collected from the elder. 8. Develop adequate procedures to ensure EHEAP ARP Act fiends are appropriately budgeted and expended in all counties within Contractor's service area. Procedures should include referral to other' community agencies when funds budgeted for a particular i i+me period are exhausted and elders are subsequently denied. 9. Develop monitoring and oversight procedures to ensure that administrative costs that exceed the contracted EHEAP ARP Act administrative award to Contractor or Subcontractor are paid from non-federal sources.. 10. Develop adequate procedures to address the use of EHEAP ARP Act funds for elders who are on oxygen support or a "Lifeline Program" and must have power, 11. Develop a written policy regarding the use of fiends for repairing or replacing ltcating or cooling, equipment. The procedures anust address the conditions tinder which an elder is eligible for such fiords and what constitutes an emergency rc'sated to lack of heating or cooling. 12. Ensure providers and appropriate staff participate in training opportunities scheduled by the Agency to cover EHEAP ARP Act policies and procedures. U. Ensure the provision of training for all providers and staff members assigned responsibilities within the program. 14. Maintain an EHEAP Policies and Procedures Manual to serve as a local resource for program administration, training, and reference. The KHF.AP Policies and Procedures Manual shall be distributed to all subcontractors that provide any service under EIIEAP ARP Act. The EHEAP Policies and Procedures Manual shall be reviewed during, and in accordance with, the Agency's EHEAP contract monitoring schedule, and shall include the following: a. The State of Florida LTl IEAP Policies and Procedures Manual; h, An MQU or Subcontract with EHEAP ATOP Act providers; c, An MOU with all Service area LII IEAP ARP Act providers; d. An MQU with all service area WAP providers; e. Contractor's cost alloention methodology; f. Written policies and procedures to ensure 11rat all energy assistance payments nnade to hnine energy vendors comply with the requirements of the Vendor Agreement; g. Adequate procedures to ensure that EHEAP ARP Act funds are appropriately budgeted and rspended in all counties within Contractor's service area; It. Policies regarding, the detection and prevention of fraud and abase of program funds; Page 3' of 73 November 2021 - September 2022 EHEAP AREA 203.22 i. Policies that address serving family inembers and employees; j. Politics and procedures to secure applicant Social Security Numbers in order to protect applicants' identities; k. Procedures for computer system backup and recovery; I. Procedures for referral or access assistance to .he "Lifeline Program"; nt. A policy outlining the criteria to determine if a houschold has a "home energy crisis" and the information and/or documentation required to verify the crisis; n. Policies and procedures 1'or determining the eligibility of elders applying for RHI?AP ARP Act; o. policies which encourage households to seek assistance prior to incurring non -energy penalties such disconnect/reconnect fees, additional deposits, interest, or late payments; 11, procedures referring elderly homeowners who have received more than three energy benefits (ETTEAP or LIFIEAP) in the last eighteen (18) nonth3 to the WAP provider; q. A policy concerning the use of Funds for the purchase or repair of licaling or cooling equipment; r. Policies and procedures which detail allowable iimeframes for elders to sulmit required documentation, if missing at the time of application; s. A resource guide, or the utilization of the information and Referral database (ReferNET), to access other energy assistance resources available at the local level to provide referrals to elders when EIIEAP ARP Act funding is not available, or they do not qualify; t. Consumer appeal procedures that provide an opportunity for a fair administrative licaring at the provider level to elders whose applications for assistance are denied, or whose applications are not acted upon with reasonable promptness; and u. Policies and procedures for conducting home visits to home -bound elders for completion of the program application or eligibility determination when other assistance is not available. 15. Notwithstanding that tasks for which the Contractor is held accountable involve coordin...ion with other entities in performing this contract, the failure of other entities dues not alleviate the Contractor from any accountability for tasks or services that the Contractor is ; o!igated to perform pursuant to this contract. G. AGENCY RESPONSIBILITIES 1. The Agency may provide technical support and assistance to the Contractor within the resources of the Agency to assist the Contractor in meeting the requirements of this contract. The support and assistance, or,ack thereof, shall not relieve the Contractor from fill performance of contract requirements. 1. The Agency will provide to Contractor the State of Florida i.IT IEAP Policies and Procedures Manual. TheState of Florida. LiHEAP Policies arJ Procedures Manual will provide information and procedures needed to administer EHEAP ARP Act in Florida. a. This contract excludes all provisions of the State of Florida LIHHAP Policies and Procedures Manual in reference to LIHEAP Regular Home Energy Annual Benefits. b, To the e.itent any conflict arises between this contract and any mcorporwrz reference contained herein, this contract shall have precedence. III. METAOD OF PAYMENT' A. PAYMENT METHOD USED The Method of Payment for this contract is cost reimbursement, 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 11, Manner of Service Provision, and in accordance with other terms and conditions of this contract. Page 32 of 73 November 2021 -September 2022 1. Cost Reimbursement 9 WAP � r•.- 203,22 The Contractor agrees to distribute funds as detailed in the EHEAP ARP Act budget Summary (Attachment IX) attached to this contract. Any change in allocation of categorical or total amounts of funds identified on the EI IEAP ARP Act Budget Summary form require a contract amendment. Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in Attachment IX. All Cost Reimbursement C:IICAP ARP Act Requests for Payment must include the actual hHNAP ARP Act Receipts and Expenditure Reports beginning with the first month of this contract. a. Budget Summary Contractor agrees to implement the distribution of funds as detailed in the EHEAP ARP Act Budget Summary (Attachment IX). An amendment is required to change category allocations or the: total amount of this contract. (1) Administrative Expense Administrative expenses include costs for general administration and coordination of the program, including direct and indirect costs. '['his includes the salaries, fringe benefits (i.e. insurance, retirement, etc.), rent, utilities, travel, etc, associated with financial and administrative management of the program. The use of other federal funds to supplement the administrative operations of F14F.AP ARP Act, above and beyond the; budgeted amount, is prohibited. Administrative costs that exceed the contracted EHEAP ARP Act administrative award to Contractor or subcontractor must be paid from non-federal sources. Contractors must have adequate procedures for monitoring and oversight to ensure compliance. (2) Outreneh Expense Outreach expenses are those costs incur-ed in delivering El IEAP ARP Act services that are not purely administrative in nature. This may include staff and subcontractor expvrr4.5 such as mlaries, hinge benefits (i.e. insurance, retirement, etc.), rent, utilities, travel, etc. for those employees performing Outreach and intake. ['Outreach expense shall not include senor management expense, except when outreach and intake involving direct contact with elders occurs. Documentation to support this exception shall be maintained by Contractor and available upon � cqutst. c. Indirect Cost Rate Per 2 C.F.R. § 200.331(a)(4), Subrecipients of federal awards are required to have an approved, federally recognized indirect cost rate negotiated between the Subrecipient and the Federal Government. If no such rate exists. then the Subrecipient shall have either a rate negotiated with the Agency (in compliance with 2 C.l~',R. Pail 200), or a de rninimis indirect cost rate as defined in 2 C.P.R. § 200.414(1), Subrecipientshall maintain its current Indirect Cost Rate Proposal and make the proposa! available upon request, If Subrecipicnl chooses to use the de minimis rate, Subrecipient shall make sore it is entitled to use that rate and include a statement to that effect. Subrecipient is not obligated to establish an indirect cost rate if Subrecipient does not charge an indirect cost rate. 2. Advance Payments Advance payments will not he issued for this project. B. 'I'.x: final request for payment is due to the Agency no later than October 30, 2022. C. METHOD OF INVOICE PAYMENT Payment shall be made upon Contractor's presentation of art invoice subsequent to the acceptance and approval by the Department of the deliverables on the invoice. The form and substance of each invoice submitted by Contractor shall he as follows_ 1. Have Remittance Address [lint corresponds exactly to the "Remit To" address provided to My Florida MarketPlace (MFMP) during registration; 2. Request payment for services as established in the FHF.AP ARP Act Service Irate Repurt (Attachment XXI),. 3. Contractor shall consolidate all Requests for Payment from subcontractors and Receipts and Expenditure Reports that support requests for payment and shall submit them to the Agency using the RHEAP ARP Act Page 33 of 73 C", 40 November 2021 - September 2022 EHEAP ARPA 203.22 Receipts and Expenditure Report (Attachment XI), EHEAP ARP Act Request for Payment (Attachment X11), and El LEAP ARP Act Cost Rchrrbursement Summary (.attachment X X); a. Contractor shall include required supporting documentation as delineated in Section III.E. with the cost reimbursement portion of the invoice. D. PAYMENT WITHHOLDiNG Any payment due by the Agency under the ternis of this contract may be withheld pending the receipt and approval by the Department of all financial and programmatic reports due from the Contractor, and any adjustznentsthereto, including any disallowance not resolved. E. SUPPORTING DOCUMENTATiON REQUIREMENTS For the reporting month, Contractor shall include the following with Request for Paymen,: I. The number of individuals served that include: a, The number of individuals served with crisis assistance du-ing the reporting month; h. The number of individuals ineligible or denied assistance during the reporting month; c, The number of individuals referred to other community resources for energy assistance during the reporting month; 2. Certification that Contractor operated 6 )1 i rig its normal business hours during the reporting month; 3. 'fhe total amount of funding expended for crisis assistance per county for the reporting period; and 4. The Certified Minority Business Subcontract Expenditure Form (C:MB , Form) (Attachment Vill), if applicable. F, FINANCIAL CONSEQUENCES Failure to meet the deliverables described in this contract may result is a financial consequence and may result in the redistribution of funding. Contractor shall ensure the provision of services and the successful completion of deliverables as set forth in this contract. t. The Agency shall not reimburse any expenditures associated with Dcliverablee not accepted by the; Agency as successfully completed; however, this does not preclude Contractor from receiving payment for such expenditures upon successful completion of the deliverable. 2. If Contractor fail% to be open and available for services according to its regular business hours as identified in Section I1.C.2. of this contract, excluding weekends or state and federal holidays, Contractor shall pay to the Agency financial consequences for such failure, unless the Agency waives such failure in writing bascdupon its determination that the failure was due to factors beyond the control of Contractor. 3. Contractor's failure to operate according to its regular business hours shall result in an assessment of a financial consequence in the amount of$10.00 per day. 4. Any amounts due from financial consequences shall be paid by Contractor out of non-redcra,' funds. G. REMEDIES -NONCONFORMING SERVICES Contractor shall ensure that all participants served under this contract are eligible for the program and that all monthly and/or quarterly performance reports and financial records are maintained for each reporting period and submitted as stipulated in this contract. 1. Any nonconforming program service, performance report, or f i,uancia'. accord not meeting the aforementioned requirements is not eligible for reimbursement under this program. Contractor shall solely bear the costs associated with enrolling, training, reporting and/or managing the program. Contractor shall give immediate notice to the Department of any significant and/or systemic infraction that compromises Contractor's ability to provide participant services, to achieve programmatic performance, or to provide sound financial mnnagement of the program. Page 34 of 73 November 2021 - September 2022 II. CONSUQUENCES FOR NON-COMPLIANCE EHEAP ARPA 203.22 Conlractor shall ensure that one hundred percent (100%) of the deliverables idenlifled in this contract are performed pursuant to contract requ ircine tits, The deliverables described in Section II.D. are identified as maior deliverables in this contract. 1. If at any time the Contractor is notified by the Agency's Contruct Manager that it has failed to correctly, completely, or adequately perrorm these major deliverables, the Contractor will have ten (10) days to submit a Corrective Action Plan (CAP) to the Contract Manager that addresses the deficiencies and states how the deficiencies will lac remedied within a tithe period approved by the Contract Manager, The Agency shall assess a Financial Consequence: for Non -Compliance on the Contractor 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 CAi'. If Contractor fails to timely submit a CAP, the Agency shall deduct 1%of the monthly value of the administrative finds in the contract for each day the CAP is overdue, beginning the I", day after notification by the Contract Manager of the deficiency. The deduction will be made from the payment for the invoice of the following month. 2. in the event that Contractor fails to correct an identified deficiency within the approved time period specified in the CAP, the Agency shall deduct, from the payment for the invoice of the following month, 1% of the monthly value of the administrative funds in the contract for each day the deficiency is not corrected. The Agency may also deduct, from the payment foi° the invoice of the fol lowing month, 1% of the monthly value of the administrative funds in the contract for each &iy the Contractor fails to timely submit a CAP, IV. SPECIAL PROVISIONS A. The following is incorporated by reference: 1. State of Florida LIIICAP Policies and Procedures Manual. B. Modifications The Agency shall not be obligated to reimburse Contractor for expenditures in excess of tlic: funded amount o#iris contract unless and until the Department officially approves such expcnditues by executing a writtenniodification to the original contract, signed by both parties. 1. Contractor roust use a Agency approved budget modification process. 2. For the purpose of transferring funds, [tic following are considered budget categories: (1) Administration, (2) Outreach, and (3) Crisis Assistance, C. Enforcement 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 progains 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, RS., if the Agency finds that anyof 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 an aging services program; b, Tito Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds have been misappropriated; c. The Contractor has committed multiple or repeated violations of legal and regulatory requirements or Agency standards; d. The Contactor has failed to continue the provision or expansion of services after ttte declarntion of a state of emergency; Page 35 of 73 C110 November 2021 - Seple ij� 2022 EHEAP ARPA 203.22 e. 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 previsions specifically provided by statute or rule adopted by the Agency; f. The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently manage program budgets; or g. The Contractor has failed to implement and maintain a Agency -approved client grievance resolution procedure. 2. In making any determination tinder this provision, the Agency inay rely upon findings of another state or federal agency or other regulatory body. Any claims for damages for breach of contract are exempt t'ronl administrative proceedings and shall be brought before the appropriate entity in the venue of f.eon County, Florida, to 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). END OF.3MCHMENT Page 36 of 73 I 1 November 2021 - Sep�lember 2022 EHEAP ARPA 203.22 ATTACHMENT 11 FINANCIAI . AND COMPLIANCE AUDIT Tile 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 OMH 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 olhcr procedures. By entering into this contract, the Contractor agrecsto 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, tlic Contractor agrees to comply withany additional instructions provided by the Agency to the Contractor regarding such audit. The Contractor further agrees to comply and cooperate with any inspections, reviews, invcstigntions, or audits deemed necessary by the Chief Financial Officer (CFO) or Auditor General, AUDITS PART 1; FEDERALLY FUNDED ]'his part is applicable if the Contractor is a Stale 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 tite provisions off 2 CFR Pat 200. Financial and Compliance Audit Attachment, Fxhibit 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. 'I he 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 Mari 1, paragraph 1, the Contractor shall fulfill the requirements relative to auditce responsibilities as provided in 2 CFR § 200.50'8- if the Contractor expends less than $750,000.00 in federal awards in its fiscal year, all audit conducted in accordanec with the provisions of 2 CFR Part 200 is not required, 1 ti ttre event that the Contractor expends less than $750,000.00 in federal awards in its fiscal year and elects to have un 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 bawd on the contract's requirements, including anyrules, regulations, or statutes relcrenced in the contract. The financial statements shall disclose whether or nut the thatching rcquircnlcnt 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 cadi 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 fiscalyear end. PART 11; STATE FUNDED Page 37 of 73 'L November 2021 -September 2022 CHEAP ARPA 203.22 This part is applicable if the Contractor is a non -state entity as defined by 'Section 215.97(2), F.S. In the event that the Contractor expends a total amount of state financial ussistunce equal to or in excess of $750,000.00 in any fiscal year of such Contractor, lhu 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 Atlachrnent, 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, incl tiding state financial assistance received from the Agency, other state agencies, and other non -slate entities. Slate 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 fart II, paragraph 1, the Contractor shall ensure that the audit complies with the requirements of' Section 215,97(g), 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, in 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 slate financial assistance in its fiscal year and elects to have an audit conducted in accordance Willi the provisions of Section 215.97, F.S., the cost of the audit must he paid from the non -state entity's resources (i.e., the cost of such an audit mast he paid from the Contractor resources obtained from other than State entities). An audit conducted in accordance with this pant shall cover the entire organization for the urgaliication''s tiscai year. Compliance findings related to contracts With the Agency shall be, based on the contract's , erttimments, 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 tally disclosed in the audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 691- 5.003, F.A,C,, the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each contract with the Agency in effect during the audit period. For .ocal governmental entities, financial reporting packages required under this part must be submitted within 45 days alter 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 thus part must be submitted within 45 days after delivery of the audit report, but no later than 9 months afterthe 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 CPR 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 Fast 10"' Street Jeffersonville, IN 47132 Pursuant to 2 CFR § 200.512, all other Federal agencies, pass -through entities and others interested in a r-porting package and data collection form must obtain it by accessing the Federal Audit Ciearinghutisc. Tile Contractor shall submit a copy of any management letter issued by the auditor directly to the Agency. Page 38 of 13 C! November 2021 -September 2022 EHEAD ARPA 203.22 Florida Department of Elder Affairs Attn: Audit Repository 4040 Esplanade Way, tin ite 2355 Tallahassee, Florida 32399-7000 Additionally, copies of financial reporting packages required by this i:ortract's Financial Compliance Audit Attachment, Part 1I, shall be submitted by or on belialf'ol'the Contractor direeb to each of the following: 'i 3ic Agency at the following address: Florida Department of hider AtIbirs Attn: Audit Repository 4040 Esplanade Way, Suite 235E Tallahassee, Florida 32399-7000 The Auditor General's Office at the following address: State of Florida Auditor General Claude Pepper Building, Room 574 111 West Madison Street Tallahassee, Florid;i 32399-1450 Any reports, management letters, or other information required to be submitted to the Agency pursuant to this contractshall be submitted timely in accordance with 2 0711 Pail 200, F.S., and Chapter 10.550 (local governmental entities) or 10.6SO (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 Pa►1200 or Chapter 10.550 (local gover mental entities) or 10.650 (nonprofit and for-prolit organizations), Mules of the Auditor Genera', should indicate the [late that the reporting package was delivered to the Contractor in correspondence accompanying the reporting package. PART iV: RECORD RL'TENTION 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 woorking papers are made available to the Agency or its designee, CFO, or Auditor General upon request fur a period of six (6) years front the date the audit report is issued, unless extended in vvi iting by the Agency. Page 39 of 73 November 202' - Septembe, 2022 ATTACHMENT H-EXHIBIT I PART I: AUDIT RELATIONSHIP I)FTVRMiNATION EHEAP ARPA 203,22 Contractors who receive state or federal resources may or may not he subject to the audit requirements of'2 CFR Fart 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 sub'cel to the audit requirements if the audit threshold requirements set forth in Part t and/or Part 11 of Fxhibit l are met, Contractors who have been determined to be venders are riot sirbjcet to the audit requirements of CFR § 200.38 and/or Section 215.97, KS. Regardless of whether the audit requirements are inet, Contractors who have been determined to he recipients or sub -recipients of Federal awards and/or state financial assistance must comply with applicable progranunatiic and fiscal compliance requirements. In accordance with 2 CFR fart 200 and/or Rule 69I-5.006, F,A,C., Contractor has been determined to be: Vendor not subj cl 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 orgarria,ations are exempt; for state financial assistance projects, public universities, community colleges, district school boards, branches of state (Florida) government, and charter schools are exempt. r .\,:-mpt organizations must comply with all compliance requirements set forlln wit'nin the contract or award document. NOTE: if a Contractor is determined to be a i-ccipient'sub-recipient of federal and/or state financial assistance, and has been approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691-5.006, r,A,C. [state financial assistance] and/or 2 CFR § 200.330 [federal awards]. PART II: FISCAL COMPLIANCE REsQUIREMFNTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS, Contractors who receive Fedorrl awards, state maintenance of effort fiends, or state matching Rm& on Fcdcral awards and who are determined to he a sub - recipient must comply with the following fiscal laws, rules, and regulatiotns' 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 sot forth in program laws, rules, and regulations NON-PROFIT ORGANIZATIONS MUST FOLLOW: 2 CPR § 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 Considcratimi, for iml itutions 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 law--. rules, and regulations *Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR §200.400(5)(c). Page 40 of 73 , .y November 2021 - September 2022 EHEAP ARPA 203.22 "For funding passed through U.S. I lealth and Human Services, 45 CFR Fart 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 lobe a recipient/sub-recipient must comply with the following fiscal laws, roles, and regulations: Sections 215.97 & 215.971, F.S. Chapter (Of-S, F.A.C. State Prqjccls Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules, and regulations Page 41 of 73 November 2021 - September 2022 EMEAP ARPA 203.22 ATTACIIMENT II -EXHIBIT 2 FUNDING SUMMARY (2021-2022) Note: 'Title 2 CFR, as revised, and Section 215,97, H.S., require that the information about Federal Programs and State Projects included in Attachment 11, Exhibit 1, be pro-v:ded to the recipient. Information contained herein is a prediction of finding sources and related amounts based on the contract budget. 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: GRANT AWARD (FAIN#): 2102FLE5C6 FEDERAL AWARD DATE: Mal -eh 11, 2021 BUNS NUMBER: 9661 1: 1837 Emergency Home Encrgy Assistance for the Elderly Program — American Rescue Plan (ARP) Act of2021 Supplemental Grant TOTAL FEDERAL AWARD FUNDING SOURCE CFI?A j AMOUN' United States Department of 93,568 $96,800.00 Health and Human Services COM PLIANCE REQUIREMENTS APPLICABLE TO THE FEDt: RAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: FFDFRAL FUNDS: 2 CFK Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. OMB Circular A-1 33 —Audits of States, Local Governments, and Non -Profit Organizations 2. S1 ATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE, FOLLOWING: MATCIIING RESOURCES FOR FEDERA I PROGRAM TITLE 6 STATE FINANCIAL ASSISTANCE PROGRAM TITLE TOTAL AWARD SOURCE SUSJKCT TO SECTION 215.97, F.S. I FUNDING SOURCE CSFA I AMOUNT COMPLIANCE RVQUIREMENTS APPLICABLt+ TO STATE RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: STATE FINANCIAL ASSISTANCE Sections 215.97 & 215.971, F.S., Chapter 691-5, P.A.C., State Projects Compli:u„cz Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules, and regulations Page 42 of 73 1040 November 2021 - September 2022 EHEAP ARPA 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; ccrtilications and assurances; A. Dekai-rijent and!L:Witkafionkrt 95-ancl 45 CFK Pall 25) B. 1 tWo - riling Lohbny- C. ►111 iscrim i t afirin & Eq 01111ort u , t Pa rf 37 and 45 CFR Part 8LU D. Association !n . it Cilmeq.k 1' . f i\ ! 1 1' Rexti-ictions Assurance 11 11 _ rty Organizatioal LQXReform F. 1 Scmitinized 11 No Boycott of f l 1 Certification Clkoperative Reearding Win 1ptegHty Compliance1 1 s i. rl i i r! Agreement. VerificationH. 1 a111 1. Records and Doculnentatlan. J. Certification .to i 1 I of Public Records A. CI• WIWICATION 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 Agcvcy or agency; 2. Have not within a three-year period preceding this contract been convicted or had a civil jtidgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or perfoi ill ing 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 destniction of reo wds, making False statements, or receiving stolen property; 3. Are not presently indicted or otherwise criminally or civilly cltarged by a government entity (Federal, State, or local) with commission of any of the offensess enumerated in paragraph A.2. of this certification; and/or 4. Flave not within a three-year period preceding this applicationfproposal had one or more ptiblic transactions (rederal, State, or local) terminated for cause of default. The undersigned shall require that language of this certification be included h- the documents for all subcontracts at all tiers (including subcontracts, sub -grants, and contracts tinder grants, loans, and cooperative agreernents) and that all sub -recipients and contractors shall provide this certification accordingly. B. CERTIFICATION REGARDING LOBBYING —CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATI VE ACRE, EMENTS. The undersigned Contractor certifies, i the best of its knowledge and belief, that: No Fedetal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, Page 43 of 73 November 2021 - September 2022 EHEAP ARPA 203.22 the entering into of an;, cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. If any funds other t'ian 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 rand: :si ncd shall require that language of this ceRii it ution be included in the documents for all subcontracts at ill 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 n prerequisite for making or entering into this contract imposed by 31 1J.5.C. § 1352. Any person who tails to file the required certification shall lye 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 OPPOW11' N ITY ASSURANCE (29 CFR P.Allcr 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 oil the basis of race, color, religion, sex, national origin, age, disability, political affiliation, or belief, and against beneficiaries on the basis of either cilizenshiplstatus as a lawfully admitted immigrant authorized to work in the United States or participation in any VIA Title 1-financially assisted program or activity. 2. Title VI of file Civil Rights Act of 1964 (Pub. L. 88-352), as arnendcd, and all requirements imposed by or pursuant to the Regulation of the Department of Health and I Iuman Services (45 CFR Part 80), to the end that, in accordance with Title VI of that Act and Ilrc Regulation, no person in the United States shall, on the ground of race, color, nr national origin, be excluded from participation in, be denied t11e benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. 3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, rind all requirements imposed by or pursunnt to the Regulation of the Department of Health and Human Services (45 CFI;` Part 84), to the end that, in accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in (lie UErited Slates shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under array program or activity for which the Applicant receives Federal financial assistance from the Agency. 4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the c•rid flint, in accordance with the Act and the Regulation, no person in the United States shall, on the hasis or age, be denied the benefits of, be excluded from participation in, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. 5. Title IX of the Cducation Amendments of 1972 (Pub. r . 92-318), as amended, and all requirements firposed 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 fi•orn the Agency. 6. The American with Disabilities Act of 1990 (Pub. L. 101-336), �diichprohibits discrimination in all employment practices including job application procedures, hiring, firing, advancement, compensation, training, and other terns, conditions, and privileges ofemployment. It appliesto i ruitment, advertising, tenure, layoff, leave, fringe benefits, and all other employment -related activities, 7. Contractor also assures that it will comply with 29 CFR Part 37 and all other reguliltions 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 — finnncially assisted program or activity. Page 44 of 73 November 2021 September 2022 EHEAP ARPA 203.22 Contractor understands that AGENCY and the United States have the right to seek j udicial 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. CERTII+ICATiON REGARDING PUBLIC ENTITY CRIMES, .SECTION 287.133, F.S. Contractor hereby certifies that neither it, rur any person or afti liatc of Contractor, has been convicted of a Public Entity Crime as defined in section 287.133, r.S., nor placed on (lie 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 OR.GANV iTiONS 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 finding resh-ictions 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. It 1-242), provides that appropriations made under Pub. L. 111-117 are available under the conditions provided by Nut). L. It 1-117, 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 tinder grants, loans and cooperative agreements) and that all sub - recipients and contractors shall provide this assurance accordingly. F. SCRUTINIZED COMPANIES LISTS AND NO Boa carT OF ISRAEL CERTIFICATION, SECTION 287.135, F.S. In accordance with section 287.135, F.S., Contractor hereby certifies that it has not bw;en 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 $ I 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 Scrutinizes] 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.5., the submission of a false certification may result in the Agency terminating this contract and the submission of a lbise certification may subject Contractor to civil penaltiesand attorney fees and costs, including any costs for investigatioris that led to the finding of false certification. If Contractor is unable to certify any of the statements in ,his certification, Contractor shall attach an explanation to this contract. G. CERTIFICATION RFGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS 1. The Contractor and any ;Subcontractors of services tender this contract have financial management systems capable of providing curtain information, including. (1) accurate, current, and complete discicnuM of the financialresults of each grant -funded pri pircl or program in accordance with the prescribed reporting requirements; (2) the source and application of finds for all contact 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, tmmnritted, or calculated have been assessed and verified Page 45 of 73 November 2021 - September 2022 EHEAPARPA 203.22 to be capable of processing data accurately, including year -date dependent data. For those systems% identified to be non -compliant, Contractors will lake immediate action to assure data integrity. 3. If this contract includes the pi-ovision of hardware, 'iro, firmware, microcode, or imbedded chip technology, the undersigned warrants that these products are capable of processing ar-date dependent data accurately. All versions of these products of bred by the Contractor (represented by the undersigned) and pivchascd by the state will be verified for accuracy and integrity of data prior to transfer. 4. In the event of any decrease in functionality related to time .and date related codes and internal subroutines that impede the hardware or software programs frorn operating properly, the Contractor ab*rees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted Herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the essence. 5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures include a disaster plan to provide for service delivery to conlintru Ill case of an emergency, Including emergencies arising from data integrity compliance issues. H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland Security's E-verify system to verify the employment eligibility of all new employees hired by Contractor during the contract term to perform employment duties pursuant to this contract, and that any subcontracts include an express requirement that Subcontractors performing work or providing services pursuant to this contract utilize the F.-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 shrill o +-t! fy compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this contract was i rck or entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by Circulars A-102 and 2 CFR fart 200 .::i,.! 215 (formerly OMH Circular A-110). I. RECORDS AND DOCUMENTATION The Contractor agrees to snake available to Agency stalrandfor 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 119,070](3) and (4) F,S., and any other applicable law, if a civil action is commenced as cot winplated 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 far- any costs incurred bythe Agency and any attonicys' fees assessed or awarded against the Agency from a Public Records Request made pursuant to Chapter 119, F.S., concerning this contract or services perfonned thereunder. a. Not-Anthstanding 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., slates 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 organisation, 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 l 19.07, RS, 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. Page 46 of 73 , P November 2021 - Seplember 2022 EHEAP ARPA 203.22 Additionally, I certify this organization does ® 6"s :lot ❑ Provide for institutional memberships. Contractor's signature below attests that records pertaining to the dues or membership application by file Agency areavailable for inspection if applicable, as stated above. By execution of this contract, Contractor must includc these provisions (A-J) in all related subcontract agreements (if applicable). By signing below, Contractor certifies that file representations outlined in parts A through J abovc arc true and correct. 3339 TAMIAMI TRAIL E tative I Street Address COLLIER COUNTY BOARD OF COUNTY COMMISSIONRItS NAPLES. FL 34112 Contractor � bate i City, State, Zip code Approved as to form and legality "-Sft' (-1!)--�9 Assistant County Attorney Page 47 of 73 November 2021 - Septomber 2022 ATTACHMENT 1V ASSURANCKS— N() N-CONSTRUCTION PROGRAMS EHEAP ARPA 203.22 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 nna':'.uail:ing the data needed and completing and reviewing the collection of Information. Send camtnctits regarding the: hurden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Suugo. paperworh Reduction Project (0348-0043), Washington, UC: 20503, _ PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUi)GET, SEND iT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. ;Vote: Certain of those 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 applie-ants to certify to additional assurances. If such Is the ease, you will be notified, 1. ilas the legdl 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, managcmcut, 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 accordancc with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from Ming their pos''tions fora purpose that constitutes, or presents the appearance of; personal or org;anizAtionai conflict of intemst or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Wiil comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) reLing 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 1{). 6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a)'I'itle VI of the Civil Rights Act of 1964 (11.1,. 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 §§ 1685-106), which prohibits discriminution on the basis of sex; (c) Section 504 of the Rehabiiitution 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'1'reatment 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. 91-016), 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 drag abase patient records; (h)Title Vill of the Lind] Rights Act of 1968 (42 U.S.C. § 3001 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 far federal assistance is being, made; and O the requirements of any other nondiscrimination statutc(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Tites II and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for Ihir 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 prglitct purposes regardless of federal participation in purchases. Page 48 of 73 November 2021 - September 2022 EHEAP ARPA 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 tine political activities of employees whose princi;-At 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.t_:. §§ 276a to 276a-7), [lie 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 meat e. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) enstitution of environmental duality control measures under the National Environmental Policy Act of 1969 (P.L, 91-1.90) 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; (c) assurance of project consistency with the approved State management program developed under the Coastal Zone Managemont Act of 1972 (16 U.S.C. § 1451 et %eq.); (f) conformity of federal actions to State (Clear Air) implementation Phr.. under Section 1.76(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 tinder tine Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection of endangered species under tine Endangered Species Act of 1973, as amended (P.L. 93-205). 12 Will comply with the Wild and Scenic Rivers c'. 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 (lie awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. § 470), FO 11593 (identification and protection of historic prop:::lies), 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 ct seq,) pertaining to the care, handling, and treatment of warm blooded animals held for research, leaching, 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. NATIJRE OF,, 1UY ]QRt'fGU,t:gk]'1H YIN(i.O r4CIAL I TiTLE APPLICANT ORr-,KiZATION DATE: SUBMITTED [•(lr ! II It r`r rT IMTV nn&Rn nF Ml INTY COMMIR.RTONPRS n ,r; i 1 ; �r)I-) Approved as to farm and legality Page 49 or 73 Assistant County Attorney November 2021 - September 2022 EHEAP ARPA 203.22 ATTACHMENT V FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST PwVrninlFa6lily Name C'aunty AANContraiclor Address Completed By City, State, Zip Code Date t Wept tolie PART 1: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORNIATION WHICH WILL HELP YOU U011 YI,K]'Ll THIS FORM. 1. Briefly describe the geographic area served by the program/facility and the type ofservice provided: For questions 2-5 pluase Indicate (lie tbl 2. Population of area served 3, Staff currently cmpinved 4. Clients currently enrolied1registered 5. AdvisorylGovernink Bourd if applicable lowivr: Total# Whitc Black goo Hispanic Other Famalc Disabled Over40 Sourceof data: P.ffeelive date: Effective date: PART II: USE A SEPARATE, ST—IrET OF PAPER FOR ANY EXPLANATIONS RE, QUI RING NI ORE SPACE. IF ItiTlA or NO, EXPI Alti. S. Is an Assurance of Compliance on file with DOEA? NIA YES NO ❑ ❑ u ?. Compare the staiTcomposition to the population. I s staff representative of the population? NIA YES NO ❑ ❑ ❑ 8. Are eligibility xquirements for services applio: to clients and applicants without regard to mace, color, national NIA ❑ YTS ❑ NO ❑ origin, sex, age, religion, or disability? 9. Are all benefits, services and facilities available to applicants and participants in an equally effective manner N/A YES NO regardless of race, sex, color, age, national origin. religion, or disability? U 10. For in -patient services, are room assignments made without regm-d to race, color, stational origin or disability? N/A 1' HAS NO ❑ ❑ ❑ 11. Is the program/facility accessible to non-English speaking clients? N/A YES NO ❑ ❑ ❑ 12.Are employees, applic:finis and participants informed of their protection against discrimination? if YES, bone? N/A VPS NO Verbal ❑ Written ❑ Poster ❑ ❑ ❑ ❑ Page 50 of 73 rr*t v+ November 2021 - September 2022 EHEAP ARPA 203.22 13.Give the number and current status of any discrimination complaints regarding services or employment tiled N/A NUMBER against the programlfacility. 14. Is tlic program/facility physically accessible to mobility, hearing, and sight -impaired individuals? NIA YES NO ❑ ❑ ❑ PART II t. T11 F FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES FYI 111 IS Olt NIORE EMPLOYEES. Ih' NO, EXPLAIN. IS.Has as a self -evaluation hecn conducted to identify any barriers to serving disabled individuals and to make an}, YES NO noccssary modifications? ❑ 16. is thee: an established grievance procedure that incorporates due process in the resolution of complaints? YES NO ❑ ❑ 17, 1las a person been dcxignatcd to coordinate Section 504 compliance activities? YES NO ❑ U 18.Do recruitment and notification materials advi r applicants, employees, and participants of nondiscrimination on YES NO the basis ordisabilily? ❑ 13 19.Arc auxiliary aids available to ensure accessibility orsmvices to hearing and sight -impaired individuals? YES NO ❑ ❑ PART IV., rOR PROGRANI.S OR FACILITIES WI M 50 OR RIORE 01PLOYEES AND FF,DFRAL C rNTRAL CS OF550,000.00 OR AMU, 20. Do you have a written affirmative action plan? IFNO, explain. YES NO - ❑ ❑ I Itevi e►ve _ - Pro •am 0111ce Date Telepi►onc On -Site: Desk Review In Compilance: YES jJ NO* *Notice ofCotrvetive Action Sent, Receive Page 51 of 73 C24 IN 2021 - September 2022 EHEAP ARPA 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. 2. Enter the percent of the population served by race, sex, disability, and over the age of 40. The population served includes persons in the geographical area for which services are provided such as a city, county or other regional area. Population statistics can be obtained 11-orn local chambers of commerce, libraries, or any publication from the 1980 Census containing Florida population statistics. include the source or your population statistics. ("Other" races include Asian/Pacific Islanders and American indian/Alaskan Natives.) 3. Enter the total number of full-time staff and their percent by race, sex, disahility, and over the age of 40. Include the effective date of your summary. 4. Enter tine total number of clients who are enrolled, registered or currently served by the program or lbeility, and list their percent by race, sex, disability, and over the age of 40. Include the date that enrollment was counted. a. Where there is a significant variation between the race, sex, or ethnic composition of the clients and their availability in the population, the program/facility has the responsibility to determine the reasons for such variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when programs are sanctioned to serve target populations such as elderly or disabled persons. 5. Enter the total number of' advisory board members and their percent by race, sex, disability, and over the age of 40. If there is no advisory or governing board, leave this section blank. 6. Each recipient of federal financial assistance muss have on 31c an assurance flint 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 UCII>>i Recipients and their Sub -grantees. 45 CFR § 80.4(a). 7. Is the race, sex, and national origin of the staff reflective of the general population? For example, i f 10% of the population is Hispanic, is there a comparable percentage of Hispanic staff? 8. Do eligibility requirements unlawfully exclude persons in protected groups fi-orn 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 § 803(a) and 45 CFR § 80.1. 9. Participants or clients roust 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 he applied uniformly and without regard to race, sex, color, national origin, religion, age, or disability. Entrances, waiting morns, reception areas, restroonns, and other facilities must also be equally available to all clients. 45 CFR § 80.3(b). 10. For in -patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin, or disability. Also, residents must not be asked whether they are willing to share accom- i tmlatioas with persons of a different rdee, color, national origin, or disability. 45 CFR § 80.3(a). 11. The program/facility and all services must be accessible to participants and applicants, including those persons who may not speak English. In geographic veas where a significant population of non-English speaking pcoplc 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 ofnannes and telephone numbers of bilingual individuals who will assist in the provision of services. 45 CFR § 80.3(a). 12. Programs!facilities must make information regarding the nondiscriminatory provisions of Title VI available to their participants, beneficiaries, or any other interested parties. 45 CFR § 80.5(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 inibrnration may be supplied verbally or in writing to every individual or may be supplied through tine uscof an equal opportunity policy poster displayed in a public area of the facility. Page 62 of 73,E November 2021- Seplember 2022 EWEAP ARPA 203.22 13. Report number of discrimination complaints filed against the progranv'facility. Indicate the basis (e.g, race, color, creed, sex, age, national origin, disability, and/or retaliation) and the issues involved (e.g. services nr employment, placement, termination, etc.). Indicate the civil rights law or policy alleged to have been violated along with the name and address of the local, state, or federal agency with whom the complaint has been filed. Indicate the current status of the complaint (e.g. settled, no reasonable cause found, failure to concilia'. , 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, cur!) cuts or level approaches, ramps, and adequate widths to entrances. The lobby, public telephone, restrootn facilities, water fountains, and information and admissions offices should be accessible. I) ooi widths and traffic areas of administrative offices, cafeterias, restroorns, 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-evaluatinn is a four -step process: a. Evaluate, with the assistance of disabled individual(s),'organization(s), current policies and practices that do not or may not comply with Section 504; b. Modify policies and practices that do not meet Section 504 requirements. c. Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these policies and practices; and d. Maintain self -evaluation on file, including a list of the interested persons consulted, a description of areas examined, and any problems identified, and a description of any modifications made and of any remedial stems taken 45 CFR 84.6. crhis checklist may be used to satisfy this requirement if these four steps have been followed). 16. Programs or facilities that employ 15 or more persons shall adopt grievance procedures that incorporate appropriate due process standards and that provide for the prompt and equitable resolution of complaints alleging any action prohibited by Pant 84 of Title 45, CFR45 CFR § 84.7(b). 17. Programs or facilities that employ 15 or more persons shy 11 designate at least one person to coordinate its etici Is to comply with Part 84 of Title 45, CFR. 45 CPR § 84.7(a). 18. Programs or facilities that employ 15 or more persons shall take appropriate initial and continuing steps to notify participants, beneficiarie& applicants, and employees that are prograrnlfacility does not discriminate on the basis of handicap in violation of Seclk)n 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 1 ,; or more persons shall provide appropriate auxiliary aids to persons with unpaired 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 CPR § 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 `tic Cavil Rights Act of 1964, as amended. Page 53 of 73 C No 4+ 4di- 4A- 40ir Vl- IJI- Ve � Vr AA 40 tfl- -b*r tPr Aft 401- Vp tIr AA- 4A r�-, I I M a I- to 0 1-1 w m .04 '"m 'D f, w 0 —4 -4 " 4 CAO November 2021 • September 2022 Mpartrmwl at' ELb ER AFFA 5TXIT,, Or MOM DA BACKGrROUND SCREENING BACKGROUNDSCREENING Attestatimi of Compliance -Employer AUTHORITY: This forth is required annually of all employers tit comply With the attestation requirements set forth in section 435.(15(3), Florida Stntutes. EHEAP ARPA 203.22 Ron DVS111ttis Ne, v ruor Richard Prudoin Seenvarr )0, The term "employer" means any person or entity required by law to conduct background screenings, including but not limited to, Area Agencies on Agi: - Aging and Disability Resource Cenlers, .cad Agencies, and Service Providers that contract directly or indirectly with the Department of Elder Affairs (DO A), and any other pei-min or entity which hires employees or has volunteers in service who meet the definition ofa direct service provider, See §§ 435.02, 430,0402, Fla. Slat. Y A direct service provider is "a person 18 years of rile fir older who, pursuant to a program to provide services to the elderly, has dirt -A, face-to-face contact with a c i�rnt while providing services to the client and has access to (Ile 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(l)(h), Fla.Stat- ATTESTATION: As the duly authorized representative of COT T TFn COT ►hTTY ROAR D 011 ('01IA.1TY t 11MMMSIONER9 Emp7lojwr Nante located at ; - ,i '1 l l i vi iR1i-11i L i-..l: NAPLES Ef. 341 i 2 _ StreetAdciresx city Stak Z11' code I, DANIEL R RODRIQUEZ do hcrcby affirm under penalty of Name of Representative perjury that the above -named employer is in compliance with the provisions of Chaptcr 435 and section 430.0402, Florida Statutes, regarc ng level 2 background screening. signature of Rep . erjtatlt?C Date WE'A Awn 235. Attestation of Caaiphaftce - Employer, !sfjecthy Jane a ,19. 202) Section 435.04..4;, F.S rovirlatwilable at: hu.pr. 4avetr•ilm-a 09vr011' Approved as to farm and legality Page 55 of 73 Assistant County Attorney CAO November 2021 September 2022 EHEAa ARNA 203.22 ATTACHMENT VIII CERTIFIED WNORITY BUSINKSS SUBCONTRAC-i OR EXPENDITURES (CMBE FORM) CA4BE FO MMUST ACC0 fPANY INVOICES SUBMITTED TO DOEA CONTRACTOR NAME: DORA CONTRACT NUMBER: *REPORTING PERIOD -FROM: TO: *(DATE RANGE OF RENDERED SERVICES, MUST MATCII INVOICE SUBMITTED TO DOEA.) DORA CONTRACT MANAGER: COVIACT I1OM CMBR COORDINATOR ATOR FOR f1NY QUESTIONS, AT 8S0-4I9-2I53. SUBC:ONTRACTORNAMF SUBCONTRACTOR'S CMDE EXPENDITURES FF IO DORA USE, ONLY -- REPORTING ENTITY (DIVISION, OFFICE, ETC) _ SEND COMPLETED NORMS VIA INTEROFRCE MAIL TO: JUSTIiN TAYLOR CMBE COORDINATOR, CONTRACT ADMINISTRATION & PURCHASINt;JALLAIIASSEE, FLORIDA 32399-7000. I.funsttre ifstibcontn4ctor is a click on the huedink below. _ Entcr ilic name ofthesup ier, click "search". Only Ceitified Minority Business Fntitics will be displayed, Page 56 of 73 CAO November 2021 - September 2022 httlis://qsd.dws.in_y florida.win/directories l,vs7wu(,,711()N8 EHEAP ARPA 203.22 (A) ENTER THE COMPANY NAME AS IT APPEARS ON YOUR DOFA C0,14TRACT. (n) ENTER THE DOEA CONTRACT NUMBER. (C) ENTER THE SERVICE PERIOD MATCHING THE CURRENT INVOICE'S SERVICE PERIOD. (D) ENTER ALL CERTIFIED MINORITY BUSINESS FIX PFNDITI)RES, FOR TIIE TIME PERIOD COVFR RD BY TI M. INVOICE: 1. ENTFR CERTIFIED MINORITY BUSINESS NAME. 2. ENTER,rHl-'CFRl'IFIFD MINORITY BUSINESS FEID NUMBFR, 3. ENTER THE CERTIFIED MINORITY BUSINESS CMRR NUMBER. 4. ENTER THE, AMOUNT EXPENDED WITH THE CFRTIFIED MINORITY BUSINESS FOR THE TIME PERIOD COVFRFl`) BY THE INVOICE. (E) MBE FORM MUST ACCOMPANY INVOICE PACKAGE SUBMITTED TO DOER FINANCIAL ADMINISTRATION FOR PROCESSING. (F) FINANCIAL ADMINISTRATION WILL FORWARD Aid, COMPI.F.1 ED CMBE FORMS TO CONTRACT ADMINISTRATION & P1 JRCI iAS rNG OFFICE. Page 57 of 73 CAO November 2021 - Septomber 2022 EHEAP ARPA 203.22 EIIEAPARP ACT B1:1]f;i r4I:MMARY EMERGENCY IfOME ENERGY ASSISTANCE FOR THE ELDERLY PROGRAM COLT, i l R COUNIN IIPP21 Total Award TOTAL ADMINISTRATIVE BUDGET $11,300.00 TurA1. OUTREACH BUDGET $13,500.00 CRISIS ASSISTANCE $75,000.00 TOTAL $96,800.00 *Eligible households may he provided with more than one benefit, totaling no more than $5,000.00. The minimum number of individuals to he served crisis energy assistance may reflect duplicated consumers if a consumer receives multiple benefits. Page 68 of 73 November 2021 - September 2022 EHEAP ARPA 203.22 EHEAP ARP ACT ADMINISTRATIVE AND OUTREACH EXPENSE BUDGET DETAIL PSA CONTRACT # Emergency Home Energy Assistance Program - ARP 2oa:.-2022 Administrative & outreach Expense Budget Detail AdministrationSubtotal S Outreach Subtotal - Total - Page 69 of 73 104o November 2021 - September 2022 RECEIPTS AND EXPENDITURE REPORT EMERGENCY HOME ENERGY ASSISTANCE PROGRAM AMERICAN RESCUE PLAN FUNDING .'l',' T AWIMS. PIIIONER:,'X i E r s 1§ogrunr FurKYirm Su;ucg : ... l y CvnlJact Parmd Et ICAP - American Rama Plan (Eurargc,xy Hvnw Energy Repoli Period _ A3sibtdnce for DF] Elderty Program) Report # hnti" k CERTIFICATION. curbiy iu Um best at mgknoWtidgm rind Uallel thal this ropers Is corn{.Yaia and a€, cuuays tmrein aru tux purposes srsi bAb EHEAP ARPA 203.22 in the cgntract. Proparodtry: Oato: PART A:BU13C3ETmtJINC:<')AIEIRECEIPTS Aprrrovodby: 1.APprcVol' _Datu: 3.Tg1diRvcvipts 4.Pcrcalr4o' 7Ark ARuLLij,6 t wid For - i • Report Year bs Jarc App oved Budget 1.AgreemantAm"nt SLDo 50.00 S0.00 1: 2. TOTAL ACMEMENT AhiOLINT 6000 50.00 2. Dponddures 40_00 3. Exporrdrlurvs 4. Percent of PART B • EXPENDITURES 1_ Appmvod Sudaet Fer This Report Year to Da a Approved Budget t. Administration S0.00 50.00 £troa _ 2.Oubcuch $000 MOD 50.00 e 3. Crisis Services S0,00 $0.00 Sn.08 _ 4, Waathor RalatedSamous 50.00 50OD W.00 _ 76 5. TOTAL EXPENDITUR17.5 50A0 $0.00 S0 00 _ DOEA FORM 105PARP Page 60 of 73 NovemUer 2021 -September 2022 ATTACHMENT XII REQUEST FOR PAYMENT EMERGENCYHOME ENERGY ASSISTANCE PROGRAM AIVERICAN RESCUE PLAN FUNDING IIAME,ADDRESS, PHONE# and FEIN TYPE OF REPORT Crontri-A Contu,t Henan I:svi:'•:e Y ------ WEAP ARPA 203.22 CERTIFICATI N: bare urtTjtlsatinllrequestlsTtnaCaitafmy nd'as:d{tatot>3cumpsat3anaooTr»standcooferme'niththeiirmrilrtneatrarsoontra,t Prepsretibj:------------ Bata ;pproveaay`e--- --_ Cut:: ------ PART A: SUDGETSIkitAARY ADV.iNITRATVI 4UTREACH CRISIS WEATHER TOTAL SERVICES &ERVCeS SERVICES RELAT€D S0,00 t�.r(v so {) ra,{n $0.00 I. Approval contaatArnount 2_ PrsY.nnt Fundi Ra7etwsd for to 00 i$*.CJ to Chi $0 00 Contact Period 3. c0tradEllin" :,ar1 i aniivs rr12} VD.C.0 O.C7 $o_CQ to.00 4 0NiV.t'i:t F U n 0 1 Retiue 11:4 and Hot $I:.09 $A C: 10.0 $0.C4 to 00 R3,ened rr contaotPrriod S contnetsJuncip f,tm lfnmr .nv4; Woo 1016 t+i.06 $A Cry 10A6 PART 19 COUTRACT FUNDS REOUE $T I. N3tECpancitlrral Foruonth WHO 1A.C?0 vs Cie IDOE4 Form I03P, Part S. Lira 51 2. TOTAL iOX# S5.w So.W WC-0 St.60 PART C: 14ET FUIIDS REQUE STED i.TOTAL FUNDSREGUESTEO t4N OkO PART O. SERVFCE III FORMA T.0% Humor I ndlvfduat 1 urwd W IM orfirl a tl itti tVA Coring the report montu: NumooTof Tndivtdvalt ire:Igtblov donlod altittarce dur,ngtra repertmantn; Humpi:rar InctvEdullt t3raad ty rttiEril � abtarcotrrroun�y rait+urC51 forener$y sal�liance duHng the rtwrtmantn: C1111LI atian /tttwont: Conirmbf ner*" tArktet thIt It n11 ae3n opon an#opera{ ng oLiing itt normal OnItIneFa houti for th:laPolirig mbntn,? 1 Ile writad In W Statement at mii. Isdon. of the 9 HEA.P con trio t nC. u1 -WA U I 113 •1 Page 61 of 73 0,1 November 2021 - September 2022 Report Number 2 3 4 5 6 8 9 10 12 ATTACHMENT XIII CHEAP Alit' ACT INVOICE REPORT SCHEDULE Based Cpou November Invoice December Invoicc January Invoice February N larch Invoice April Invoice May Invoice June Invoice July Invoice August Invoice September Invoice Final Request for Payment Date Due to the Agency December 9, 2021 January 9, 2022 Fcbrtfa:•% 9, 2022 March 9, 2022 Apri19, 2022 May 9, 2022 ,Tune 9, 2022 Jul,,9, 21 I'?2 August 9, 2022 September 9, 2022 October 9, 2022 October 15, 2022 Note I Advance payments will not be issued with the project. EHEAP ARPA 203.22 Note 2 Submission or invoices may or may not generate a payment request. If final invoice reflects funds due back to the Agency, payment is to accompany the final invoice. Page 62 of 73 November 2021 - September 2022 A TACNMEN'r xiv STATE MEDIAN INCOME GUIDELINES LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP) STATE MEDIAN INCOME GUIDELINES, EFFECTIVE OCTOBER 1, 2021 PEOPLE IN THE HOUSEHOLD - 1— 2 3 EHEAP ARPA 203.22 60% SMI $25,296 $335079 $40,563 $48,646 30 13 $67,132 Please refer to the Federal Poverty Guidelines (F"PG) Benefits Matrix for income ranges for households with 9-or-,More individuals. *These figures are based on the 2022 U.S, Department of Health and human Senices (HIAS) poverty guidelines published in the FedowlRgirleron Februaq 1, 2021. Page 63 of 73 F November 2021- September 2022 ATTACHMENT XV EHEAN ARP ACT SOURCES OF INCOME EMERGENCY HOME ENERGY ASSISTANCE VO11 TI W FI.f)F RLY — ARP ACT FY 2021/2022 SOURCES OF INCOME EFFECTIVE June 1, 2020 ]NCi.IMED fiXCi.tt171 f1 SOURCES OF INCOME SOURCS*JUF [IVCURlL+ (Includes total annual cash receipts before taxes from all suurcvs) 1. Aloney wales acid salaries before arty deductions 2. Net receipts from non-f<imi employ -neat (rcccipts front a persnn', own unincorporated husineas, professional enterprise, or partnership, After deductions for bvslness expenses) 3. Net receipts from farm self-employment (receipt.- (runt a form which one operates as an Owner, renter, or slturecruppM, after deductions for farm operating expenses) 4. 107,C,lllg]R i AY,LIEN7'S RKQ,0 it Social Security Railroad retirement Strike benefits from union fiinds Workcr's compensation vetemn's payments Public Assistance ur "Temporary Assistance for Needy l+amities (I'ANP), Supplemental Security Income, and nuti-frdcrrlly fvaidcd General Assistance fir Generol ilelief money paynientg, I. Pryments to foster children age 18 or older received through tltc Independent Living Prognuu EHEAP ARPA 203.22 1. 'AI'ft'r>il�r1�1NS Any Assets drawn down -,s withdrawids front it [xink, the..". le of pro[", a house nr a car. 2. "1 u. Rcfunda 3. Gifts 4. Loans S. Lump -sum inhentances fi. One-time insurance payments 7. Foster Care Payments* B. Compensation for injury 9. Combat cone pay to the luilitary 1 t)..•lrloptior Subsidies Ii. Reverse t\lortgage V.-lyrnents 12. ti0N-CA;rljiiTNIiGI"[:S (a) I-mplayer-paid or union paid portion ofivalth insurance or other emputyer henefits 6. Training stipend-, 7. Alimony S. Child Support '). Soal Secutity11cucft Gandshus for Non-liaymcntof 13. School Loans. (Ihc total amount of aim Social security Retirement benefit including the garnished dedu: firm must be used when calculating the appluant's income.) 10, ;+lilitnry family allotmrnr or nthcr relntL•ar strppurt Ferri It fsunily tttetnbvr fir someone not living in the. household 11. Private pensions 12, Government,.nnpluyeepersions(includiugmiliMry retirement pay) 13, Regular insurance or annuity Payments Id, Lducodunid Assistance; Grants, Vellowships, Assistantships, College or University Scholarships — Only count as income those f kndq, specifically allotted for living Menses 15. Dividends 10. Interest 17. Nrrrental income 18, net royalties 19. Periodic receipts from ct;tatcs or trusts 20. Nct g timblitig or lottery vvinaings (b) Food or housing receiver] Wien of wapes (c) llie voluc of food and fuel produced and consumed oil farms. (d) 'llie imprtrd volur of rent from o%wicr-occupied non -farm or farm homing. (c) Federal nor cash bertefn programs -ich as Mtdicarc, Nfediatid, Food Stanips, school lunclics, and harming assistance. Supple rental security income (SSi) benefits cannot be garnished for any reason f c4 • a recipient received an overintymcut of be-tulls. The total amount of the SSI bencrit minus the garnished deduction for rec(mpment mitt be used when calculating tlae applicant's income. rPenous whose cost of residence is paid through a fnsrcr care or residential program administered by the state tanqpqt be counted ns household memhens. 14, 8iinuthns payments front die federal government in relation to the Corona%irus Di case will not he considered income anti will not be considered in determining a houseliotd's State Median Income Level 05D°/a or beluw). 15. Any type of unemptuymcut payments will not he counted as income. Page 64 of 73 ",e r November 2021 - September 2022 EHEAP ARPA 203.22 ATTACHMENT XVI RMI+ RGENCV HOME ENERGY ASSISTANCE FOR THE ELDERLY PROGRAM - APPLICATION Name: (First, M, Last) ❑ EHEAP ❑ Heating Season U Cooling Season El EHEAP ARP Date of birth: Age: SSN: Service address: City: Date 5t:intls Florida County: Zip Cudc: Phone: intake worker's mime: Gender: ❑ Male ❑ Female 0 Other Number of people in the household: Marital Status: ❑ Married 0 Pannercd ❑ Single 0 Separated 0 Divorced ❑ Widotved 1'honc: Race: ❑ White ❑ Black/African American ❑ Asian 0 Dative Hawaiian/Pacinc Islander U American indianlAlaska Native ❑ tither LtllnicitY: 0Ilispanic/1-atino 0 Other Primary Laitgunge: 0 English ❑ Spanish U 01her _ Docs client have limited ability reading, writing, speaking, or understanding the English language? ❑ Yes ❑ No Is the client a veteran? 11 Ycs ❑ No Was client referred to lite local Veteran's Aifaiii off red 0 Yes ❑ No U NIA Applicant's imxamc typu(s): Applicant's monthly income amount: Nana: Income type(s): Age: SSN: l Monthly income amount; Nance: Imcoine type(s): Age: SSN: Monthly income amount: Name: Income type(s): Age: SSN: Monthly income amount: Nume: Income type(s): SSN: Monthly income amount: Age: Is there a child 5 years of age or younger in the household? 0 Yes 0 No If Yes, select all that applies: I7 0-2 years old ❑ 3-5 years old Is there an individual with a disability in the household? 0 Yes ❑ No Is the applicant a U.S. vitiven or on alien law hilly admilted for permanent residence? 0 Yes 0 No Is the applicant a hnm=vrrer? ❑ Ycs ❑ No Does applicant live in government subsidizcd housing, such as Section 8? 0 Yes 0 No If yes, provide the complex name: If yes, does the hnu whold receive an energy subsidy'? U Yes ❑ No i)oes applicant live: in a student dormitory, adult %roily care home, or any kind of group living facility? ❑ Yes 17 No If=, provide the facility name: Have you or any memher or your household received energy assistance in d1C Carrcirt season? ❑ Yes []No Ryes, provide the name of Ageney: Type ctfAssislanm: n Crisis ❑ Ilomc Encrgy ❑ Weather -Related Date: Whit is the primary source of home heating? (select one) Cl klectricity n Nulurul Gas ❑ Propane U %Vood/Coal 0 Refillable Fowls Does household use supplemental treating source? 0 Electricity ❑ Wood/Coal 13 N/A - Air condilioningunit type;! U CCnlral A/C D WinduwA Va11 A/C U bans ❑ Other —specify (including evaporative cooler) Section Five: EnelrU Crisits Explzination Client Attestation and Signature Page 65 of 73 CA O November 2021 - September 2022 ❑ I lorne cooling or heating energy source has been disconnected. (Life -Threatening) ❑ Unable to get delivery of fuel, is out of heel, or is in danger of icing out of foci for heating. affe- 77weatenUrgl Other prublenis with lack of cooling or heating In the home, such as needing to pay a deposit, repair nfcquipmenl, or interim emergency measure to avoid further crisls. (r Ffe- Tin -eate) iirlL,) EHEAP ARPA 203.22 Tlic information provided on this application, is to the best of my knowledge, true and complete. I understand that priority in prnviding assislance will be given to those hnuacholds with the lowest income ant) greatest need, i.e. those households in which the elderly, disabled, medically needy, or children reside. I authorize the agency to make benefit payments directly to my cncrgy ". pplicr. i inn aware that after I have provided all the information rcquestcd to delcrmine my eligibility, if l ant applying for crisis assistance, the agency has 18 hours to act upon Illy application will, an eligible action. 111111 also ahvare that if 1 am not appmvcd ill- denied within the tune allowed, or not approved for file correct amount, I have a right to appeal the decision. (If you sign with an ",K' two witnesses arc required.) ❑ Notified that the energy source for cooling or heating is going to be disconnected. (Standard) Client Signature: ❑ Received a notice indicating the energy source lute: bill is delinquent or past duc. (Stwedard) IJ Has an energy source bill for %v hich the due date has lapsed. lStrma",, rc A" CUQ7SX11QL'1.VUV rI &$lAIVEH.A"J10R1z"yG T11C RCLF-.iS&r1ff,EN,�ER,IJ..LNOJUR{YJNRI)P1T/dL NFDR IA7Y NMR 1XMJW FfEI)WUL.MEPOR11NQ *Your Social security Number (SSN) is confidential under l ", We may not collect your SSN unless we explain tlic reason for collecting your SSN in writing and provide the applicable statutory authority for doing so, Certain provisions of Chapter 430, Florida Statutes, read with Section 119,07 l(5), Florida Statutes, spccifncifl ly authorize the Depurlatenl of Elder Affairs (DOEA) and its designated staff/employccs to collect SSNs when authorized by law or when collection ofSSNs is imperative to the perforinance of i]t7EA's statutorily assigned duties. The Agency is collecting your social security nun -her as part of its rv�, ponsibility to provide Emergency Ilo a Energy Assistmice, DMAFormll,t I&V2021 Emergency Home Energy Assistance for the Elderly Program - Eligibility Workshect Steel, calcul,dral 01u State Aledlan Income (SMI) Culdellues Annualize, all household income, hcrc slitm ins iucowl, effective 10(l/2021. - Cot CliI'll iolvi or %%like Ci knil:tt ow, ill this Select the annual income limit by household size: 1. Add all gross monthly earned and 100% of Max Income Value (NOV) 50% ofMIV unearned income from the past 30 days of all household members. ❑ 1..........$25,296 $ 12,648 ❑ 2..........$33,079 $ 16,540 ❑ 3..........$40,863 $ 20A31 2. Add Medicare Premium (S .50), ❑ 4..........$48,646 $ 24,323 if not included in SSA aitwuntunt. ❑ 5..........$56,430 $ 28,215 ® 6.......... $64,213 $ 32,106 3. Add Medicure Pan D, if.ipplicable. ❑ 7..........$65,672 $ 32,836 Ll 8.......... $67.132 $ 33,566 4, To annualize, multiply the monthly Iota] by 12 months. (Please refer to the Federal Poverty (iuidelines (FPG) Benefits Annual Ilousehold income Matrix for income rages for households with 9-or-moire S individuals.) If the total annual household incomw is less than Stu°%of thecanent State Median income for household size (using churt ubove), ❑ Categorical] y Eligii}le and an one in the household is recei�•iag SNAP assistance-, the applicant must provide a sikr cd stntl:nicut of Iron basio livuig expenses(Lk ., food, shelter and inoWnation) are n-ovidcd far thehousehold. t.. floll Energy Vendor #1 Other Vendor 01 Contact wade with LIHEAP provider to Nanhe: Name: verify previous crisis assistunce. Conlect Person: Date of contact: Account Number: Accounu'Voucher Date: Number: I IRS the applicant received LIBEAP crisis assistance during the current season? Minimum Amount Due: Amount Due: 0 Yes ❑ No Pago 66 of 73 � i m November 2021- September 2022 EHEAP ARPA 203.22 ® Repair Existing ❑ Blanket Heating or Cooling Verilicatitrn and Commitment Contact Person; Ll Portable Ian 1~quipmcnt If the minimum amount due is more than Date: n Space Heater ❑ Window A/C El Emergency Shelter ❑ Other the past due amount, did the energy vendor verify that this amount is required? ❑ Yes ❑ NO L.: NIA F.neruv Vendor• 92 Other Vendor #2 Name: Name: Account Number: Account/Voucher Date: Number; Il the minimum amount due to resolvC the Minimum Antnunt Due: Amount Due: Crisis is more than the maximum allowed, explain how the balance of the amount due D Blanket ❑ Repair Existing will be paid if approved for FI MAP crisis Verification and Commitment heating or Cooling assistance. ❑ Portable ran Equipment t:'ontact Person: M Space Heater ❑ Emergency Shelter Date: ❑ Window A/C U Other (1 y Total Energy Vendors S (4)Tutal Other Vendors $ Is the nam� on the fuel hill brat ofthe (2)Rnergy Subsidy S Total EHEAPEHEAPBenefit Add applicants. p Yes ❑ No (3) Water, Sewer, Garbage, Fire, etc. Total Encrt;► Veador (t) & $ If no, provide name on bill: •l�otat Other Vendor(�t� (4) Deduct (2&3) from (1) $ Section Eight: Weathffi7gflon Asgiqtance 4• Mhe applicant 6 a homeowner, has helshe received more than three i IMAP or FIIEAP benefits in the last 18 nronths? ❑ Yes ❑ No ❑ N/A If the ansxver to [lie previous question is "yes", was the applicant referred to WAP? ❑ Ycs ❑ No ❑ N/A If ttrc answer to the last question is "no", explain:- 7 n of die HeatinglCooliag Eacrgy� Crisis occurred within 18148 hours, by the follnwing eligible actiun(s): (Select all that apply)_ roval ofapplication L.l Et-IFAP hcncfit prtnwL:d disconnection nntitnrent made in vendor ❑ EHEAP benefit restored energy already disconnected ❑ Denial of Application, pending additimral information CJ Yes, client signed waiver ❑ Denial of Application, ineligible ❑ No, client refused to sign waiver ❑ Written referral and assistance to access other commnnily resources Case Worker Signature Appi-oval Signature pp Case Worker's Name: Supervisor/Peers None: C;i.w Worker's Signature: Nupc.r� isorftcr's Si g ndure: Date: Date: Agcnq Numa: Arcticy Namc: DOEA Form It 4 - t ^2021 Page 67 of 73 CAO November 2021 - September 2022 ATTACHMENT XVII EHEAP ARP ACT APPLICATION INSTRUCTIONS Section One: ADnlieant (Age 60 and older) information Complete Section One in its entirety. Special notes: The Winter and Sumpter Seasons are waived wider the ARP Act. FHE4P ARPA 203.22 V The Date Stamp is the official application date; ✓ The intake Worker (with name And phone number recorded) is the person who accepts the application and required documentation; ✓ The applicant's income type(!) and monthly income amount is recorded in this section, and 1/'0117'1ictd is tlNer►ifinc ilo b tvr,l rf �r�{i(aflt/c', t't�r7r)r{c r� tl7e./iCht /zJ,c:r�titt'{J{+: Section Two: Additional lJousehold Members Information Complete Scction Two by listing additional household members and providing the information reyucsted. Special notes; At a mininnnn, the nnnie(s), age(s), and Social Security number(s) of each additional household )'amber is required; ✓ You will be attaching a calculator tape of the household's income calculations in (lye section provided on the EHEAP ARP Act Fligibility Worksheets and V 111all./held fR (.{i?it;T!)ffned fo lit' not f:fluipleiv i{i'ojivkll�}' 4Ntt'f';T7g N.-A. Section "Three: Househg1d Characteristics Complete Section Three by answering each''Yes" or "No" question and providing additional information if applicable. Special note: +r� /� cf7r}' lii;lG.7f.Y 6{dl{:'f"f7ilJfifG{li) irt,� J)t>( t7/)�a}t.'tfFv{�!, ('O17f�1jt'ft.' �{ft'llcklti %t!.'t'it7t'`YIIh'� �?;E�. Section Tow: Ifeadn,e and Cooling Information Complete Section Four by answering each question. Special note: �` 1�-�rnv./i{•!cl is c%;lcyf-r:fir7��c11u l,E� Jfcrl :r��l:fi<•tTlrlc. �'u7f7trCttr� 111c fie itt f?l' tittt��7`1�� ,1'.d. Section Five, VYicrU Ci-isia Explanation Section Five is completed by choosing the best possible explanation for the applicant's crisis and obtaining their signature and date of signature. Special note: ✓ !f trn��-tic'ltlis r{etc�f�fff77.!,itrr fie: rani c7l:fifir;t:�{i{e', [vr;ff7r{t;tt� C6tt';ittlrl h�� tartc!t'PJ7,�; Clicut AtIeStolipLi gtid 5fg nt = The applicant should head the attestation statement. if the applicant is unable to read the attestation statement, the intake worker should read it to them before they sign and date the application. At this point, the intake worker should Dave the applicant sign the waiver authorizing thy: release of general and/or confidential information for LIHEAPIEHEAP ARP Act federal reporting. CIRTS will require you to verify that either the waiver has been signed or that the client has refused to sign. Page 68 of 73 CAO November 2021 - September 2022 EHEAP ARPA 203,22 Section Six: ineorrie Eligibility bility Determination Complete Section Six by stapling the calculator tape in the space provided, entering the annual int one, and checking the appropriate number of individuals in the household to determine the household annual income limit. Special notes: ✓ if the applicant is over -income and received TANF, SSI, or SNAP, che. the cz te,., „ ical eligibility box and include the appropriate documentation in client file. Adjacent to the annual income limit by household size is the fifty percent (50%) of poverty amount by household size, if the annual household income is below the amount for the household size, AND the household does not receive SNAP, the applicant 111Mt provide a written statement of how basic living expenses are provided for tlic household, Specific to ARP Act, the following is not counted as income when determining income eligibility for the household. o Stimulus payments from the federal government In relation to the Cororw0rus Disease; and a Any type of unemployment payments will not be counted as income. Section SeVID, Y.endo . Benefit. and_Verifigatjon Infni•mati ►n Complete Section Seven by completing in its entirety. Special notes: ✓ Eligible elders may receive multiple crisis assistance bcnefit(s), that combined not to exceed $5,000.00. ✓ The minimum amount due is the amount provided to you during the verification process with the home energy vendor. ✓ For those applicants receiving an energy subsidy, the minimum amount di . will be reduced by the energy subsidy amount listed on the applicant's public housing lease to determine the total EHEAP ARP Act benefit, The energy subsidy is deducted from home energy vendor payments only. It is allowable to make several crisis benefit payments for a household to resolve a single crisis and/or one or more benefits from EHEAP ARP Act finding. This may include the purchase of blankets, portable fans, space heaters, and/or repair of existing heating/cooling equipment, in addition to energy bill assistance, that combined does not exceed the crisis assistance cap of $5,000, ✓ Crisis situations that Involve a heater or air conditioner hat is powered by both gas and electricity are eligible for a crisis benefit payment to both home energy vendors. ✓ .Allowable utility categories for heating/cooling bill assistance include the following: ■ Electricity; ■ Natural Gas; ■ Propane; ■ Wood/Coral; and ■ Refillable fiicls; v' Crisis benefits may also he used for the following: ■ Pre -pay energy; ■ Purchase of blankets, portable fans, space ltcaters, and window air conditioners; ■ Repair of an existent; heating/cooling unit; ■ Deposits to connect or restore energy; ■ i . ate fees and disconnect and reconnect fees; Pacge 6.9 of November 2021 - Sepiember 2022 EHEAP ARPA 203.22 ■ Charges from a previous account held by the elder that is now closed; Payment to landlord when utility costs are included in the elder's rent; and Temporary emergency sheiter, if due to energy Mated crisis. WateAt sewer. garbage, and fire. eta. MAY NOT be paid i F.HFA P ARP Act funds. Utility WIN tha include charges that are not direcdv related to coaling and hMing will be reduced by the amounts for these charees. ✓ Charges incurred due to ilieg.al_activities, sueh as a worthless check or meter 10111perin8, MAYNOT be paid with EHEAP ARP Act tbnds, ✓ /f ;'7J:+1',}!+.'{t� f �' i%L'1C;J'iG7ljCLe fr,. r+}P f1t+1 t7ft/)(le;fJ{)/t,', CiJJJtft,{,,'Je3 �{fe! /Jr'{i{ {'1' t'Jl1r:'7'!J?!,' %4� .•i- +SCetion F,igttit4 Agntherization Assistance Program (1NV,& j,Rfc eiTnt Complete Section Eight in its entirety. Special notes: ✓ When determining the number of LIREAP or EHHAP ARP Act crisis henefils the applicant has had, you will include the current application in the Count, provided the application is approved. Refer bads to Section Seven, to the information obtained from the LIHEAP provider. Section Nine: Resolution of Crisis Complete Section Nine by selecting all that applies to this applicant and application lour services. Special notes: ✓ The left-hand selections indicate that the application has been acted upon within the 18148 hour requirement. +� If the selection is made to deny the application pending additional information from the client, the 18/48 hours has been met and sloes not repeat itself when the client returns with the pending information. You have already met the requirement. +� {j s7kiW�f%r?%GeJ t c L/t'fi?t'iIJTJtL'�l Ni {Jc dill (7{��)lit'+7{�/t:. a: rJlltli{�'ti' !ltd.' fl t't*�"{ Irl% t'7xlc'I`ti;; `Ji''rl. Case Worker Signature To complete this section, the individual who completes the EHEAP ARP Act Eligibility Worksheet, determines income eligibility, and provides the commitment to the utility vender must sign and complete the requested information. Special note: V if you are 11,v applicant, or a friend, relative, or employee of the applicant, you cannot determine the eligibility or award EHEAP ARP Act benefits. This application must be processed by someone who is not the applicant or n friend, relative, or employee of the applicant. To complete this section, the signer is attesting that he/she has reviewed the application for completeness, determined that a.I required documentation is included, and verified that the annual household income calculation and FF.HFAP ARP Act benefit awarded are correct. Pape 70 of 73 0 November 2021 - September 2022 EMPAP ARP ACT CLIENT PILE CONTENT CHECKLIST EHEAP ARPA 203.22 ELDER'S NAME; PSA# AGFNCY APPROVAL DENIAL NAME OF WORKER APPLICATION DATE CV -PSIS I SOLUT ION DMI, C FCK DATE PROGRAM REQUIREMENTS MONITORED Yes tia NIA CO-MMENTB i. Individual client Cite for the elder inrl.i,lcti cansumcr's name, address, scx, and age. 2. Household contnins a member 60 or older 3. The household is in :he Florida county covered by the contract. d• .All household incmhers are listed aril their naine, age, DOD, and incomes) are included. 5 Client file contains doctunentatinn of Social Security n:ttnbem for all household alembef3, or citation to the applicable exemption. h. Client file contains signed notice regarding collection of social security nuumher(s). flic client file contains oMcial income documents for al l household members and TANF, SSI, or SNAP documentation, ifcategoricallfcligibic. iL If income is self -declared, is there self -declaration form signed by each individual household member (i ff years orage or older) lacking income verification or claiming zero income? The housclwld's tuldl gruss im mne tailh I-8 individuals incomes is calcitlalel earrectly and is at or 9. below 60y'o of the State Median 111conte and for households with 9•om-now individuals, please refer to Me Federal Povr rty riaifddinn lienefns ktalrN, w ihe hous.liold isdetbtnrirwl1,ilo ric-q lly el:Li1:U Statement ofhow basin livingexpenses (I e , food, shelter and transportation) arc briny provided if 10. total househuld income is less than 500/c of the current rederal Poverty Guidelines and no one in the household is receiving.SNAP assistance. 11 Checked that elder does not live in s:tfdcnt dormitory. adult fornily care home, or any kind of group living facility. 12 Verified and dounncr:tcd household has not received IMPAP Crisis Assistance during the some heating or cooling season. 13, Documentation of Weatheriralion Assistance Program (WAP) refeiral, if applicable. 14 Copies of fuel bills, or other supporting documentation as proofof energy crisis, for the residence in which they reside. 15 Signed copy ofAuthorization for Release omencral andforConfidential lnPannation, I h Onfy eligible components ofthe utility bill are paid to resolve tht: crlsi% 17 Only the rninirnunl necessary to resolve the crisis is paid. If a different amount is required by the utility company, provide additional infonnalion an the Eligibility Worksheet. 18 Crisis energy benefit +vas reduced by unallowable charges, such as: water, server, garbage. and fire, ck , ifupplicable. 19. Crisis energy benefit wmi reduced by energy subsidy, if applicable. 20. Energy crisis resolved within 18 or 48 hours by an eligible action. ` 21 Written notice of approval or dcnlal for services that includes appeal pmcedures is !slued within 15 nvrking days of elipibihty determination. 22, Appropriate benefit provided. 2.1 All required sections of the application are signed nod dated by the elder, staff, and supervison4mcr ITIOR to paylnun, 24. Proof of payiiient to vendor 25. Place completed DOEA Form 211 in client tile. INSTRUMONS, A check inark In thr Yes column indicates the reguirement has been met. A check nurrk in tare M_o col wirn indicates the requirement has not been met or is questioruible. EReh "No" mark must be explained under"r'i7 �11tEAiTS". SupcivisorJPeer Signature t7OE A FORM 211 1 if U20a 1 C onqumer rile fAlunitorirtg Date Page 71 of 73 November 2021 - September 2022 EHEAP ARP ACT RECIPIENT INFORMATION EHEAP APR Act RECIPI"NT INFORMATION FEDERAL YEAR; 2021/2022 CONTRACT PERIOD: November 1, 2021 to September 30, 2022 1. f'IANNING & SERVICE AREA: 11. CONTRACT NUMBER: CONTRACT AMOUNT: r —� III. COUNTIES TO DESERVED. IV. GENERALADMINISTRATIVf:lNFt7RMATION a. Recipient: Recipient Address: Telephone: Fax: website: — — — b. Executive Director or Telephone: Ertail Address: c. President/Chairman Ad & ess: Telephone: Fax: Email Address: d. Program Contacts; Nanw Title: Telephone: Email Address: Name: Titli;- Telephone: Email Address: e. Fiscal Contacts: Narne: Title. Telephone: Emat Address: Nani e: Title: Telephone: Entail Address: f. Person(s) authorized to sign reports and/or contracts: ,g. AgencVg FEib Number: I I Agrancy's DUNS h. AUptT OUE DATE: Audit(o are due bythe end of the Ninth month foll3wing the end of the agency's fiscal year. Recipient Fiscal Year: 7 thru F--� Audit DLle to DOER: updated e/stl2ui EHEAP ARPA 203.22 Page 72 o' 73 A0 rlov?,nher 2021 -September 2022 SERVICE RATE REPORT Yl,Mjl?A.Nl; PMERGENCY HOME ENERGY ASSISTANCE FOR THE ELDERLY PROGRAM - ARP ACT 'EHEAP ARPA 203.22 CATEGORY Federally Fundcd From 11/0112021 to 09/30/2022 SERVICE MET110D OF PAYMENT IIIGEI REIMBURSEMENT RATE UNIT TYPE Adrnmisti-ation ADAXMSTPATnT C0STSx Cost ReLinbursement Cast Reitnbursernent EPISODE Outrenh OUTRFWR COSTS" Coot Rihnbunnement Co91 Rennbursernent EPISODE Crisis Assistance CRISIS ENERGY ASSISTANCE BENEFITS* Coat Reiuntursemcin I Cost Reanbursenrent EPISODE ":1s stipulated in contract, these sen-ices are prax•ided on a cost reimbursement basis. Page 73 ot73 1 ,A() Attestation Statement Agreement/Cunlract dumber EAEAP ARPA 203.22 Amendment Number 0 1,_n,!iNT P I P 12nnR?r.LiP? • attest that nn changes or revisions have been matte to the (RecipientlCuntractur veprexentative) content of the above referenced agr nice l Tact or amendment between the Area Agency on Aging for Soutl st Sluritla and s (RceipientlCun=ent 1 4 The only exception to would be for changes In page formatting, due to the differences in electronic data processing media, which has no effect on the agreemeut/contract content, C'QUIER COUNTY BOARD OF COMMISSIONERS 01! �C?u_-2 Signature of Recipient/Contractor representative Date Approved as to form and legality Assistant County Attorney Revised August 2007