Backup Documents 07/08/2025 Item #16D 5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 6 ® 5
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 7.8.55 BCC Mtg
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Carolyn Noble Community and Human CN 7.8.25
Services
2. County Attorney Office— County Attorney Office
3. BCC Office Board of County
Commissioners
4. Minutes and Records Clerk of Court's Office7/d
PRIMARY CONTACT INFORMATION b
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Staff Carolyn Noble Phone Number 239-450-5186
Contact/ Department
Agenda Date Item was 7.8.25 BCC Mtg Agenda Item Number / �`
Approved by the BCC
Type of Document 3 DAY OF SERVICE AGREEMENTS Number of Original 3 DOCUMENTS
Attached Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK CN
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be Yes
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's YES
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on above date and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County 944 an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the l N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the l an option for
Chairman's signature. this line.
I 6 D 5
FAIN '23BIHFL001
Federal Award Date '8/30/2023
Federal Award Agency Corporation for National
and Community Service
Operating under the
name AmeriCorps
CFDA Name `September 1 lth Day of
Service and
Remembrance
CFDA/CSFA# 94.012
Total Amount of Federal $347,836
Funds Awarded
Subrecipient Name Collier County Sheriff's
Office
UEI# !JDQEQ2KWN966
FEIN 59-6000561
R&D NA
Indirect Cost Rate NA
Period of Performance 110/01/24-09/30/2026
Fiscal Year End 9/30
Monitor End: '12/31/26
AGREEMENT BETWEEN COLLIER COUNTY
AND
COLLIER COUNTY SHERIFF'S OFFICE
DAYS OF SERVICE Grant Program —Collier County September 1 lth Day of Service and Remembrance
THIS AGREEMENT is made and entered into this day of July .2025. by and between Collier
County, a political subdivision of the State of Florida, (COUNTY) having its principal address at 3339
Tamiami Trail East, Suite 213, Naples FL 34112, and Collier County Sheriff's Office (CCSO)
(SUBRECIPIENT), a government agency.having its principal office at 3319 Tamiami Trail East, Naples,
FL 34112.
WHEREAS,the COUNTY has entered into an Agreement with the United States Corporation for
National and Community Service (CNCS), operating under the name AmeriCorps, for a grant to execute
and implement a national service program, pursuant to the National and Community Service Act of 1990
(as amended); and
WHEREAS, the COUNTY and SUBRECIPIENT wish to set forth the responsibilities and
obligations of each in undertaking the September 1 1°i Day of Service project—DOS-25!National Day of
Service and Remembrance grant,.
NOW,THEREFORE, in consideration of the mutual benefits contained herein, it is agreed by the
Parties as follows:
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PART I
SCOPE OF WORK
SUBRECIPIENT shall, in a satisfactory and proper manner and consistent with any standards required as
a condition of providing AmeriCorps September 11th Day of Service program (DOS), as provided herein
and as determined by Collier County Community and Human Services(CHS) Division, perform the tasks
necessary to conduct the program as follows:
Project Name: 1Collier County September 11 th Day of Service and Remembrance
Description of project and outcome: f o honor and pay tribute to those who lost their lives on
September 11, 2001, their families, and those who rose in service in response to that tragedy, as
well as engage residents age 55+ through public educational presentations, safety events, and
increase the use of volunteers to foster better emergency preparedness utilizing the Collier County's
Community Emergency Response Plan (CCERP) and Community Emergency Response Team
(CERT) programs in a one-day of service and remembrance convening.
Project Component One: Supplies for conference including but not limited to the cost associated
with graphics,development and printing of event brochure,agenda,name tags, folders,tote bags.
Project Component Two:Contractual and Consultant Services—Marketing/Printing including costs
associated with graphic design, production and printing of outreach and training materials, print
and digital ads,television and radio spots.
Project Component Three: Other Support Costs—Venue/conference fees including but not limited
to conference space and audio visuals fees; Lunch, beverages, and breakfast and associated set up
and service fees for 350 attendees; AmeriCorps 9/11 Day of Service and RSVP/CERP branded
items for volunteers; printing and delivery costs associated with 650 Emergency Kits which may
include waterproof bags,document holders,headlamps,survival whistles,first aid kits,LED/Solar
lanterns, poncho, and NOAA weather radios; and branded items for 24 presenters and honorees,
including storm jackets, plaques, shirts, and hats and the associated screen printing costs and
delivery/shipping fees.
1.1 GRANT AND SPECIAL CONDITIONS
A. Within sixty (60) calendar days of execution of this Agreement, SUBRECIPIENT must
deliver to CHS for approval, a detailed project schedule for the completion of the project.
B. SUBRECIPIENT must submit the following policies and procedures to CHS within sixty
(60)days of execution of this Agreement:
El Conflict of Interest Policy(COI) and related COI Forms
IN I Procurement Policy
IZ I Sexual Harassment Policy
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®i Fraud, Waste,and Abuse Policy
E®I Language Assistance and Planning Policy(LAP)
®1 Limited English Proficiency Policy(LEP)
C. Limited English Proficiency — Persons who, as a result of national origin, do not speak
English as their primary language and who have limited ability to speak, read, write, or
understand English ("limited English proficient persons" or "LEP persons") may be
entitled to language assistance under Title VI of the Civil Rights Act of 1964(Title VI) in
order to receive a particular service, benefit,or encounter. L1 accordance with Title VI and
its implementing regulations, SUBRECIPIENT agrees to take reasonable steps to ensure
meaningful access to activities funded with CNCS/AmeriCorps Funds by LEP persons.
Any of the following actions could constitute "reasonable steps," depending on the
circumstances: acquiring translators to translate vital documents; advertisements or
notices; acquiring interpreters for face-to-face interviews with LEP persons; placing
advertisements and notices in newspapers that serve LEP persons; partnering with other
organizations that serve LEP populations to provide interpretation, translation, or
dissemination of information regarding the project; hiring bilingual employees or
volunteers for outreach and intake activities; contracting with a telephone line interpreter
service; etc.
1.2 PROJECT DETAILS
A. Project Description/Project Budget
• (Description Federal Year 1 Year 2
Amount FY 24-25 FY 25-26
Project Component 1: Supplies for conference including but $10,645 $3,258 $7,387
not limited to graphic design and printing for the event
brochure,agenda, name tags,folders,tote bags
Project Component Two: Contractual and Consultant $59,950 $10,000 $49,950
Services—Marketing/Printing: including costs associated
with graphic design, production and printing of outreach and
training materials, print and digital ads,television and radio
spots.
Project Component Three: Other Support Costs— $277,241 $158,984 $118,257
Venue/conference fees including but not limited to
conference space and audio visuals fees;cost to provide
lunch, beverages, and breakfast and all associated set up and
service fees for 350 attendees; AmeriCorps 9/11 Day of
Service and RSVP/CERP branded items for volunteers;to
include all printing and delivery costs associated with 650
Emergency Kits which may include waterproof bags,
document holders, headlamps, survival whistles,first aid kits,
LED/Solar lanterns, poncho,and NOAA weather radios; and
branded items including screen printing and delivery for 24
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presenters and honorees, including storm jackets,plaques,
shirts,and hats.
Total Federal Funds: $347,836 $172,242 $175,594
SUBRECIPiENT will accomplish the following checked project tasks:
I Provide Quarterly Reports on project progress
IN Ensure attendance by a representative from executive management at scheduled
partnership meetings, as requested by CHS
Identify Lead Project Manager
(® Provide Steering Committee meeting minutes documenting accomplishments
Design,complete,and publish marketing campaign via radio,tv,etc.
Produce and print outreach and training materials
11Z1 Secure and ensure functionality of registration website
I® Secure conference space, lunch, branded items, and criminal background checks for
volunteers
Purchase conference materials, name tags, folders,tote bags, etc.
(® Document number of volunteers,vendors, and presenters
,® Document list of attendees via sign-in sheet and wait list, if needed
Assemble and distribute 650 emergency kits to event participants
Compile,distribute, and report participant feedback survey
B. Performance Deliverables
Program Deliverable Deliverable Supporting Submission Schedule
Documentation
insurance (Exhibit A- Insurance Certificate (Within 30 days of Agreement
execution and annually within
thirty(30)days of renewal
Special Grant Condition Policies Policies as stated in this (Within sixty(60)days of
(Section 1.1) Agreement( Agreement executiol
Detailed Project Schedule Project Schedule, (Within sixty(60)days of
Agreement execution;
Draft Procurement Documents (Supporting Documentation for Prior to purchase
(Bid Packet)* the procurement of all supplies
and services to include ICE,
MOP, Cost
Reasonableness/Analysis (
Quarterly Progress Report (Exhibit CI (Quarterly reports. Annually
after closeout
Annual Audit Monitoring (Exhibit D 'Annually, within 60 days after
Report FY end
Financial and Compliance Audit (Audit,Management Letter, and (Annually: nine(9)months after
Supporting Documentation FY end for Single Audit OR one
hundred eighty(180) days after
FY end(
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Conflict of Interest Form [Subrecipient Conflict of Interest [Upon execution of the
Disclosure Form agreement for all employees
who work on activities
associated with the grant and
upon hiring of all new
employees
Whistleblower Protections [Exhibit E [Upon execution of the
Affidavit agreement for all employees
who work on activities
associated with the grant and
upon hiring of all new
employees
List of Volunteers List of Volunteers post-event 15 days following event
Event Agenda Agenda 60 days prior to event
List of Participants Sign-In Sheet 15 days following event
Survey Response Summary Summary report of participant [15 days following event
survey responses
* SUBRECIPIENT's Notice to Proceed may be withheld if procurement deliverables are not submitted
in a timely manner, as stated in Section 1.2.C, Performance Deliverables.
C. Payment Deliverables
Payment Deliverable Payment Supporting Documentation Submission Schedule
Project Component 1: Supplies for Exhibit B and supporting documents,as Monthly invoices, due
conference- including but not evidenced by check stubs, bank by the 30'i' day of
limited to graphic design and statements, copy of permits, and any each month,
printing for the event brochure, other additional documentation as
agenda, name tags, folders, tote requested.
bags
Project Component Two: Exhibit B and supporting documents,as Monthly invoices, due
Contractual and Consultant evidenced by check stubs, bank by the 3011i day of
Services—Marketing/Printing: statements, copy of permits, and any each month,
including costs associated with other additional documentation as
graphic design, production and requested.
printing of outreach and training
materials, print and digital ads,
television and radio spots.
Project Component Three: Other Exhibit B and supporting documents,as Monthly invoices,due
Support Costs— evidenced by invoices, space rental by the 30"'day of
Venue/conference fees including agreement,check stubs, bank statements, each month.
but not limited to conference documentation regarding website
space and audio visuals fees; cost development, evidence of processing
to provide lunch, beverages, and background checks,etc,and any
breakfast and all associated set up additional documents as needed.
and service fees for 350
attendees; AmeriCorps 9/1 I Day
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of Service and RSVP/CERP
branded items for volunteers; to
include all printing and delivery
costs associated with 650
Emergency Kits which may
include waterproof bags,
document holders, headlamps,
survival whistles, first aid kits,
LED/Solar lanterns, poncho,
and NOAA weather radios; and
branded items including screen
printing and delivery for 24
presenters and honorees,
including storm jackets,plaques,
shirts,and hats.
1.3 PERIOD OF PERFORMANCE
SUBRECIPIENT services shall begin on October 1, 2024, and shall end on September 30, 2026)
unless terminated earlier in accordance with provisions of Paragraph 3.6, Defaults,Remedies, and
Termination.Any Funds not obligated by the expiration date of this Agreement shall automatically
revert to the COUNTY.
The County Manager or designee may extend the term of this Agreement for a period of up to 180
days after the end of the Agreement, following receipt of SUBRECIPIENT's written request
submitted prior to agreement period of performance end date. Extensions must be authorized, in
writing,by formal letter to the SUBRECIPIENT.
1.4 AGREEMENT AMOUNT
The COUNTY agrees to make available 'THREE HUNDRED FORTY-SEVEN THOUSAND,
EIGHT HUNDRED AND THIRTY-SIX DOLLARS AND ZERO CENTS ($347,836.00 for use
by SUBRECIPIENT during the term of the Agreement (hereinafter, shall be referred to as the
"Funds").
Modification to the Budget and Scope may only be made if approved in advance.Cumulative Fund
shifts among line items may be approved administratively by CHS Director or designee for a total
of up to 10 percent(10%) of the total funding agreement and shall not signify a change in scope.
Fund shifts that exceed 10 percent (10%) shall require formal amendment and approval by the
Board of County Commissioners(Board).
The COUNTY shall reimburse SUBRECIPIENT for the performance of this Agreement upon
completion or partial completion of the work tasks, as accepted and approved by CHS.
SUBRECIPIENT may not request disbursement of CNCS/AmeriCorps Funds until needed for
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eligible costs; and all disbursement requests must be limited to the amount needed at the time of
the request. SUBRECIPIENT may expend Funds only for allowable costs resulting from
obligations incurred during the term of this Agreement. Invoices for work performed are required
every month. If no work has been performed during the month, or if SUBRECIPIENT is not yet
prepared to send the required backup,a$0 invoice is required. Explanations will be required if two
consecutive months of$0 invoices are submitted. Payments shall be made to SUBRECIPIENT
[ when requested as work progresses,but not more frequently than once per month. Reimbursement
will not occur if SUBRECIPIENT fails to perform the minimum level of service required by this
Agreement.
COUNTY will pay SUBRECIPIENT Funds available under this Agreement based on information
submitted by SUBRECIPIENT and consistent with an approved budget and COUNTY policy
concerning payments. With the exception of certain advances, payments will be made for eligible
expenses actually incurred by SUBRECIPIENT,not to exceed actual cash requirements.•Payments
will be adjusted by CHS in accordance with advance Fund and program income balances available
in SUBRECIPIENT accounts.In addition,COUNTY reserves the right to liquidate Funds available
• under this Agreement for costs incurred by COUNTY on behalf of SUBRECIPIENT.
CHS may withhold any payment request until approved by CHS for grant compliance and
adherence to any and all applicable Local, State, or Federal requirements, including timely
submission of Performance Deliverables contained in Section 1.2.C. Late submission of
deliverables or evidence of project inactivity may cause payment suspension of any open pay
requests until the required deliverables are received or substantial project progression
gg occurs,as determined by CHS. Except where disputed for noncompliance,payment will be made
upon receipt of a properly completed invoice, and in compliance with sections 218.70-218.80,
} Florida Statutes, otherwise known as the"Local Government Prompt Payment Act."
Final invoices are due no later than 90 days after the end of the Agreement.Work performed during
the term of the Program but not invoiced within 90 days after the end of the Agreement may not be
processed without written authorization from the Program Manager.
1.5 COST PRINCIPLES
s Payments to SUBRECIPIENT are governed by the Federal grant management rules for cost
allowability, found at 2 CFR 200 Subpart E-Cost Principles. For the purposes of this section
(Section 1.5-Cost Principles)of this Agreement,SUBRECIPIENT is defined as described in 2 CFR
200.93. Accordingly, payments will be made on a cost reimbursement basis. Each request for
reimbursement shall identify the associated project and approved project task(s) listed under the
Part I - Scope of Work. SUBRECIPIENT may only incur direct costs that may be attributed
specifically to the Program referenced in the Scope of Work, as defined in 2 CFR 200.413.
SUBRECIPIENT must provide adequate documentation for validating costs incurred. Payments to
SUBRECIPIENT'S contractors and vendors are conditioned upon compliance with the
procurement requirements provided in 2 CFR 200.318-200.327. Allowable costs incurred by
Subrecipients and Contractors shall comply with 2 CFR Subpart E-Cost Principles.
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SUBRECIPIENT may not be subject to 2 CFR 200 Subpart E; however,the COUNTY is and may
impose requirements upon SUBRECIPIENT so that the COUNTY can remain compliant with its
obligation to follow 2 CFR 200 Subpart E. SUBRECIPIENT will use adequate internal controls
and maintain necessary source documentation for all costs incurred and adhere to any other
accounting requirements included in this Agreement.
1.6 NOTICES
Notices required by this Agreement shall be in writing and delivered via mail (postage prepaid),
commercial courier,personal delivery,or sent by facsimile or other electronic means. Either party
may change the address to which notices are to be sent to it by giving written notice of such change
to the other party in the manner herein provided for giving notice. Any notice,request, instruction,
or other document delivered or sent as aforesaid shall be effective on the date of delivery or sending.
All notices and other written communications under this Agreement shall be addressed to the
individuals in the capacities indicated below, unless otherwise modified by subsequent written
notice. •
COLLIER COUNTY ATTENTION:(Dana Sebastian, Grant Manager]
Collier County Government
Community and Human Services Division
3339 Tam iami Trail East, Suite 213
Naples, Florida 34112
Email:1Dana.Sebastian@colliercountyfi.govj
Telephone:1(239)252-52181
SUBRECIPIENT ATTENTION:[Marien Ruiz,[General Accounting Manager{
Collier County Sheriff's Office 1
3319 Tamiami Trail East{
Naples, Florida 341121
Email:{Marien.Ruiz@colliersheriff.org
Telephone:Ip39-252-08521,
Remainder of Page Intentionally Left Blank
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PART II
GRANT CONTROL
REQUIREMENTS
2.1 AUDITS
During the term of this Agreement, SUBRECIPIENT shall submit to the COUNTY an Annual
Audit Monitoring report(Exhibit ID;)no later than 60 days after SUBRECIPIENT'S fiscal year end.
In addition, SUBRECIPIENT shall submit to the COUNTY a financial and compliance Single
Audit report, Management Letter, and supporting documentation nine (9) months (or audited
financial statements, one hundred eighty(180) days for Subrecipients exempt from Single Audit)
after the SUBRECIPIENT'S fiscal year end. The COUNTY will conduct an annual financial and
programmatic review.
SUBRECIPIENT must fully clear any deficiencies noted in audit reports within 30 days after its
receipt of the report. SUBRECIPIENT's failure to comply with the above audit requirements will
constitute a violation of this Agreement and may result in the withholding of future payments.
SUBRECIPIENT hereby agrees to obtain an annual agency audit conducted in accordance with
current COUNTY policy concerning Subrecipient audits and 2 CFR 200.501.
Federal Award amounts expended shall be determined in accordance with guidelines established
by 2 CFR Part 200,Subpart F-Audit Requirements.
2.2 RECORDS AND DOCUMENTATION
SUBRECIPIENT shall maintain sufficient records, in accordance with 45 CFR Chapter XXV Part
2500,et seq.,to dete►inine compliance with the requirements of this Agreement,the United States
. for National and CommunityService CNCS Program, operating under the name
► • Corporation o ( ) g p g
AmeriCorps,and all other applicable laws and regulations.This documentation shall include but is
not limited to,the following:
A. All records required by CNCS/AmeriCorps regulations.
B. Public records that ordinarily and necessarily would be required by the COUNTY to
perform the service.
C. SUBRECIPIENT shall make available to the COUNTY or CHS at any time upon request,
all reports, plans, surveys, information, documents, maps, books, records, and other data
procedures developed, prepared, assembled, or completed by SUBRECIPIENT for this
Agreement. Materials identified in the previous sentence shall be in accordance with
generally accepted accounting principles (GAAP), procedures, and practices, which
sufficiently and properly reflect all revenues and expenditures of Funds provided directly
{}}: or indirectly by this Agreement, including matching funds and Program Income. These
records shall be maintained to the extent of such detail to properly reflect all net costs,
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direct and indirect labor, materials, equipment, supplies and services, and other costs and
expenses of whatever nature for which reimbursement is claimed under the provisions of
this Agreement.
D. Upon completion of all work contemplated under this Agreement,copies of all documents
and records relating to this Agreement shall be surrendered to CHS, if requested. In any
event, SUBRECIPIENT shall keep all documents and records in an orderly fashion,and in
a readily accessible, permanent, and secured location for three (3) years after the date of
COUNTY'S submission of the final performance report to CNCS/AmeriCorps, as
prescribed in 2 CFR 200.334 and 45 CFR Chap.XXV,2551.25,However,if any litigation,
claim,or audit is started before the expiration date of the three(3)year period,the records
will be maintained until all litigation, claim, or audit findings involving these records are
resolved. If SUBRECIPIENT ceases to exist after the closeout of this Agreement, it shall
notify the COUNTY in writing, of the address where the records will be kept, as outlined
in 2 CFR 200.337. SUBRECIPIENT shall meet all requirements for retaining public
records and transfer, at no cost to COUNTY, all public records in SUBRECIPIENT'S
possession upon termination of the Agreement, and destroy any duplicate, exempt, or
confidential public records that are free from public records disclosure requirements. All
records stored electronically must be provided to the COUNTY in a format that is
compatible with the COUNTY'S information technology systems.
IF SUBRECIPIENT HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO
{ SUBRECIPIENT'S DUTY TO PROVIDE PUBLIC RECORDS
RELATING TO THIS AGREEMENT, IT SHALL CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT 239-252-5837,
Angel.Bates(ucolliercountyfl.gov, 3299 Tamiami Trail East,
Naples, FL 34112.
E. SUBREC1PIENT shall take reasonable cybersecurity and other measures to safeguard
information including protected personally identifiable information (PII) and other types
of information in accordance with 2 CFR 200.303(e). This includes information that
CNCS/AmeriCorps or the COUNTY designates as sensitive, or other information the
COUNTY considers sensitive and is consistent with applicable Federal, State, and Local
laws regarding privacy and responsibility over confidentiality.
F. SUBRECIPIENT shall provide the public with access to public records on the same terms
and conditions that the COUNTY would provide the records, and at a cost that does not
exceed the cost provided in Chapter 119, Florida Statutes or as otherwise provided by law.
SUBRECIPIENT shall ensure that exempt or confidential public records that are free from
public records disclosure requirements are not disclosed, except as authorized by 2 CFR
200.337 and 2 CFR 200.338.
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2.3 MONITORING
SUBRECIPIENT agrees that CHS may carry out no fewer than one(1) annual on-site monitoring
visit and evaluation of project activities, as determined necessary. At the COUNTY's discretion,a
desktop review may be conducted in lieu of an on-site visit. The continuation of this Agreement is
dependent upon satisfactory evaluations, Upon request by CHS, SUBRECIPIENT shall submit
information and status reports required by CHS or CNCS/AmeriCorps,to enable CHS to evaluate
said progress and allow for completion of CHS's required reports. SUBRECIPIENT shall allow
on-site monitoring by CHS or CNCS/AmeriCorps. Such site visits may be scheduled or
unscheduled, as determined by CHS or CNCS/AmeriCorps.
At any time during normal business hours and as often as the COUNTY(and/or its representatives)
may deem necessary, SUBRECIPIENT shall make available for review, inspection, or audit all
records, documentation, and any other data relating to all matters covered by the Agreement.
COUNTY will monitor SUBRECIP1ENT'S performance in an attempt to mitigate fraud, waste,
abuse, or non-performance, based on goals and performance standards as stated, with all other
applicable laws, regulations, and policies governing the Funds provided under this Agreement,
further defined by 2 CFR 200.332.Substandard performance,as determined by CHS,will constitute
noncompliance with this Agreement. If SUBRECIPIENT does not take corrective action within a
reasonable time period after being notified by CHS, Agreement suspension or termination
procedures will be initiated. SUBRECIPIENT agrees to provide CNCS/AmeriCorps, the
CNCS/AmeriCorps Office of Inspector General, the General Accounting Office, the COUNTY,
and/or the COUNTY's internal auditor(s)access to all records related to performance of activities
in this Agreement.
2.4 PREVENTION OF FRAUD,WASTE,AND ABUSE
SUBRECIPIENT shall establish, maintain, and utilize internal control systems and procedures
necessary to prevent,detect,and correct incidents of fraud,waste,and abuse in the performance of
this Agreement, and provide proper and effective management of all Program and Fiscal activities
of the Agreement. SUBRECIPIENT'S internal control systems and all transactions and other
significant events shall be clearly documented,and the documentation shall be readily available for
monitoring by the COUNTY.
SUBRECIPIENT shall provide COUNTY with complete access to all of its records, employees,
and agents for the purpose of monitoring or investigating the performance of this Agreement.
SUBRECIPIENT shall fully cooperate with COUNTY's efforts to detect, investigate, and prevent
fraud, waste, and abuse.
SUBRECIPIENT may not discriminate against any employee or other person who reports a
violation of the terms of this Agreement or any law or regulation to the COUNTY or any
appropriate law enforcement authority, if the report is made in good faith.
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2.5 CORRECTIVE ACTION
Corrective action plans may be required for noncompliance, nonperformance, or unacceptable
performance under this Agreement. Penalties may be imposed for failure to implement or make
acceptable progress on such corrective action plans.
To effectively enforce COUNTY Resolution No.2013-228, CHS has adopted an escalation policy
to ensure continued compliance by Subrecipients, Developers, or any entity receiving grant funds
from CHS. The escalation policy for noncompliance is as follows:
1. Initial noncompliance may result in the COUNTY issuing Findings or Concerns to
SUBRECIPIENT, which requires SUBRECIPIENT to submit a corrective action
plan to CHS within 10 business days following issuance of the report.
• Any pay requests that have been submitted to CHS for payment will be held
until the corrective action plan has been submitted and accepted.
• CHS will be available to provide Technical Assistance (TA) to
SUBRECIPIENT, as needed, in order to correct the noncompliance issue.
2. If SUBRECIPIENT fails to submit the corrective action plan to CHS in a timely
manner, CHS may require SUBRECIPIENT to return a portion of the awarded
grant Funds to the COUNTY.
• CHS may require SUBRECIPIENT to return upwards of 5 percent of the
award amount to the COUNTY, at the discretion of the Board.
• SUBRECIPIENT may be denied future consideration, as set forth in
Resolution No. 2013-228.
3. If SUBRECIPIENT remains noncompliant Or repeats an issue that was previously
corrected, and has been informed by CHS of their substantial noncompliance by
certified mail, CHS may require SUBRECIPIENT to return to the COUNTY a
portion of the awarded grant amount, or the amount of the CDBG investment for
acquisition of the properties conveyed.
• CHS may require SUBRECIPIENT to return upwards of 10 percent of the
award amount to the COUNTY, at the discretion of the Board.
• SUBRECIPIENT will be considered in violation of Resolution No.2013-228.
4. If after repeated notification, SUBRECIPIENT continues to be substantially
noncompliant, CHS may recommend termination of the Agreement or award.
• CHS will make a recommendation to the Board to immediately terminate the
Agreement. SUBRECIPIENT will be required to repay all Funds disbursed by
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CHS for the terminated project. This includes the amount invested by the
COUNTY for the initial acquisition of properties or other activities,
• SUBRECIPIENT will be considered in violation of Resolution No. 2013-228.
If SUBRECIPIENT has multiple agreements with the COUNTY, and is found to be
noncompliant, the above sanctions may be imposed across all awards, at the Board's
discretion.
2.6 REPORTS
Reimbursement may be contingent upon the timely receipt of complete and accurate reports
required by this Agreement,and on the resolution of monitoring findings identified pursuant to this
Agreement, as deemed necessary by the County Manager or designee. Reports showing lack of
project activity may result in the withholding of payment or issuance of a Notice of Non-
Compliance.
During the term of this Agreement,SUBRECIPIENT shall submit quarterly progress reports to the
COUNTY on the 10th day of January,April, July, and October,respectively, for the prior quarter
period end. As part of the report submitted in October, SUBRECIPIENT agrees to include a
comprehensive final report covering the agreed-upon Program objectives, activities, and
expenditures including but not limited to, performance data on client feedback with respect to the
goals and objectives set forth in Exhibit 10, the reporting form to be used in fulfillment of this
requirement. Other reporting requirements may be required by the County Manager or designee if
the Program changes, the need for additional information or documentation arises, or if legislative
amendments are enacted. Reports and requested documentation not received by the due date shall
• be considered delinquent and may be cause for default and termination of this Agreement.
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PART III
TERMS AND CONDITIONS
3.1 SUBCONTRACTS
No part of this Agreement may be assigned or subcontracted without the written consent of the
COUNTY and CNCS/AmeriCorps, which consent, if given at all,shall be at the COUNTY's and
CNCS/AmeriCorps' sole discretion and judgment. SUBRECIPIENT shall cause all provisions of
this Agreement in its entirety to be included in and made a part of any subcontract executed in the
performance of this Agreement.
3.2 GENERAL COMPLIANCE
SUBRECIPIENT agrees to comply with the requirements of 45 CFR Chap.XXV,Part 2500 et seq.
(the U.S. Corporation for National and Community Service regulations concerning AmeriCorps
Days of Service Grants) The AmeriCorps Days of Service program was funded through the
National and Community Service Act of 1990, as amended. SUBRECIPIENT agrees to comply
with all other applicable laws, regulations, and policies governing the Funds provided under this
Agreement. SUBRECIPIENT further agrees to utilize Funds available under this Agreement to
supplement rather than supplant funds otherwise available.
SUBRECIPIENT is prohibited from using Funds provided herein, or personnel employed in the
administration of the program, for political activities, inherently religious activities, lobbying,
political patronage, and/or nepotism activities.
3.3 AMENDMENTS
The COUNTY or SUBRECIPIENT may amend this Agreement at any time, provided that such
amendments make specific reference to this Agreement, are executed in writing, signed by a duly
authorized representative of each organization, and approved by the COUNTY'S Board. Such
amendments shall not invalidate this Agreement, nor relieve or release the COUNTY or
SUBRECIPIENT from its obligations under this Agreement.
The COUNTY may, in its discretion, amend this Agreement to conform with Federal, State, or
Local governmental guidelines, policies, available funding amounts, or other reasons. If such
amendments result in a change in the funding, scope of services, or schedule of the activities to be
undertaken as part of this Agreement, such modifications will be incorporated only by written
amendment,signed by both COUNTY and SUBRECIPIENT.
3.4 AVAILABILITY OF FUNDS
The parties acknowledge that the Funds originate from AmeriCorps Days of Service grant funds
and must be implemented in full compliance with all of CNCS/AmeriCorps' rules and regulations
and any agreement between COUNTY and CNCS/AmeriCorps governing the Days of Service
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Funds pertaining to this Agreement. In the event of curtailment or non-production of said Federal
Funds, or the reduction of CNCS/AmeriCorps Funds to the COUNTY to a level that the County
Manager determines to be insufficient to adequately administer the project,the financial resources
necessary to continue to pay SUBRECIPiENT all or any portion of the Funds will not be available.
In either event,the COUNTY may terminate this Agreement,which shall be effective as of the date
it is determined by the County Manager or designee, in his/her sole discretion and judgment, that
the Funds are no longer available.In the event of such termination, SUBRECIPIENT agrees that it
will not look to, nor seek to hold the COUNTY, nor any individual member of the County
Commissioners and/or County Administration, personally liable for the performance of this
Agreement, and the COUNTY shall be released from any further liability to SUBRECIPIENT
under the terms of this Agreement.
3.5 GRANTEE RECOGNITION/SPONSORSHIPS
SUBRECIPIENT agrees that all notices, informational pamphlets, press releases, advertisements,
descriptions of program sponsorships, research reports, and similar public notices,whether printed
or digitally prepared and released by SUBRECIPIENT for, on behalf of, and/or about the Program
shall include the statement:
"FINANCED IN PART BY CORPORATION FOR NATIONAL AND
COMMUNITY SERVICE AND COLLIER COUNTY COMMUNITY
AND HUMAN SERVICES DIVISION"
The statement shall appear in the same size letters or type as the name of the SUBRECIPIENT.
This design concept is intended to disseminate key information to the general public regarding the
development team and to foster civic engagement through service and volunteering. If this
Agreement results in any copyrightable material or inventions, CHS and/or the COUNTY reserve
the right to royalty-free,non-exclusive,and irrevocable license to reproduce,publish,or otherwise
use; and authorize others to use the work or materials for governmental purposes.
3.6 DEFAULTS,REMEDIES,AND TERMINATION
In accordance with 2 CFR 200.341, this Agreement may be terminated for convenience by either
the COUNTY or SUBRECIPIFNT, in whole or in part, by setting forth the reasons for such
termination,the effective date, and in the case of partial terminations,the portion to be terminated.
However,in the case of a partial termination, if the COUNTY determines that the remaining portion
of the award will not accomplish the purpose for which the award was made, the COUNTY may
terminate the award in its entirety.This Agreement may also be terminated by the COUNTY if the
award no longer effectuates the program goals or grantor agency priorities.
The following actions or inactions by SUBRECIPIENT shall constitute a Default under this
Agreement, in compliance with 2 CFR 200,Appendix II (A):
A. Failure to comply with any of the rules, regulations, or provisions referred to herein; or
such statutes, regulations, executive orders, and CNCS/AmeriCorps guidelines, policies,
or directives as may become applicable at any time.
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B. Failure,for any reason,to fulfill its obligations under this Agreement in a timely and proper
manner.
C. Ineffective or improper use of Funds provided under this Agreement.
D. Submission of reports that are incorrect or incomplete in any material respect.
E. Submission of any false certification.
F. Failure to materially comply with any terms of this Agreement,
G. Failure to materially comply with the terms of any other agreement between the COUNTY
and SUBRECIPIENT relating to the project.
In the event of any default by SUBRECIPIENT under this Agreement,the COUNTY may seek any
combination of one or more of the following remedies, in compliance with 2 CFR 200, Appendix
1I (B):
A. Require specific performance of the Agreement in whole or in part.
B. Require the use of, or change in, professional property management, if applicable.
C. Require SUBRECIPIENT to immediately repay to the COUNTY all CNCS/AmeriCorps
Funds received under this Agreement.
D. Apply sanctions, if COUNTY determines them to be applicable.
E. Stop all payments until identified deficiencies are corrected.
F. Terminate this Agreement by giving written notice to SUBRECIPIENT specifying the
effective date of such termination. If the Agreement is terminated by the COUNTY, as
provided herein, SUBRECIPIENT shall have no claim of payment or benefit for any
incomplete project activities undertaken under this Agreement.
3.7 SUSPENSION AND DEBARMENT
SUBRECIPIENT certifies that neither it nor its principals are presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in this
transaction by a Federal Department or agency. In addition, SUBRECIPIENT shall not knowingly
enter into any lower tier contract, or other covered transaction, with a suspended or debarred
contractor or vendor,as outlined in Executive Orders 12549 (1986)and 12689 (1989), Suspension
and Debarment, and 2 CFR 200.214, as further detailed in Section 4.13.
3.8 INSURANCE
SUBRECIPIENT shall not commence any work and/or services pursuant to this Agreement until
all required insurance, as outlined in Exhibit A and 2 CFR 200.310, has been obtained. Said
insurance shall be carried continuously during SUBRECIPIENT'S performance under the
Agreement.
3.9 ADMINISTRATIVE REQUIREMENTS
SUBRECIPIENT agrees to perform the Scope of Work in compliance with the Grant Budget and
Scope of Work (Part I), Uniform Administrative Requirements, Cost Principles and Audit
Requirements for Federal Awards(2 CFR 200 et seq.),and Federal Regulations for the AmeriCorps
Days of Service Grant(45 CFR Chapter XXV Part 2500 et seq.).
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3.10 PURCHASING
SUBRECIPIENT is required to follow Federal Procurement standards (2 CFR 200,317 through
200,327)and Collier County's Procurement Ordinance#2017-08,as amended. A conflict between
Federal and COUNTY procurement requirements will result in the more stringent law being
applied. Current COUNTY purchasing thresholds are:
Range: Competition Required
$0-$50,000 3 Written Quotes
$50,001+ Formal Solicitation OTB,RFP,etc,)
All project tasks specified in Part I Scope of Work shall be performed by SUBRECIPIENT
employees, or put out to competitive bidding, under a procedure acceptable to the COUNTY and
Federal requirements. SUBRECIPIENT shall enter into contracts with the lowest,responsible, and
qualified bidder. SUBRECIPIENT shall manage and CHS shall monitor contract administration.
CHS shall have access to all records and documents related to the Project.
In accordance with 2 CFR 200.323, SUBRECIPIENT shall procure items that contain the highest
percentage of recovered materials practicable, consistent with maintaining a satisfactory level of
completion,per 2 CFR 200,Appendix II (J)and 2 CFR 200,323.
3.11 GRANT CLOSEOUT PROCEDURES
SUBRECIPIENT'S obligation to the COUNTY shall not end until all closeout requirements are
completed. SUBRECIPIENT may close out the project with the COUNTY after the;expiration of
the Agreement. lActivities during this closeout period shall include but are not limited to making
final payments; disposing of program assets (including the return of all unused materials,
i;. equipment, and receivable accounts to the COUNTY); and determining the custodianship of
records. Notwithstanding the foregoing, the terms of this Agreement shall remain in effect during
any period that SUBRECIPIENT has control over CNCS/AmeriCorps Funds. in addition to the
records retention outlined in section 2.2 (Records and Documentation) of this Agreement,
SUBRECIPIENT shall comply with section 119.02I, Florida Statutes, regarding records
maintenance, preservation, and retention. A conflict between State and Federal records retention
requirements will result in the more stringent law being applied, such that the record must be held
for the longer duration, SUBRECIPIENT must return to the COUNTY any balance ofunobligated
Funds that have been advanced or paid, and any Funds paid exceeding the amount
SUBRECIPIENT is entitled to under the terms and conditions of this Agreement.SUBRECIPIENT
shall also produce records and information complying with section 215.97, Florida Statutes, the
Florida Single Audit Act. Closeout procedures must take place in accordance with 2 CFR 200.344.
l 3.12 CONFLICT OF INTEREST
SUBRECIPIENT covenants that no person under its employ,who presently exercises any functions
or responsibilities in connection with the Project, has any personal financial interest, direct or
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indirect, in the Program, which would conflict in any manner or degree with the performance of
this Agreement;and that SUBRECIPIENT shall not employ or subcontract with any person having
any conflict of interest. The SUBRECIPIENT covenants that it will comply with all provisions of
45 CFR Chapter XXV 2544 et seq.,"Conflict of Interest",2 CFR 200.318,and the State and County
statutes, regulations, ordinances, or resolutions governing conflicts of interest. All
SUBRECIPIENT employees who work on activities associated with this Agreement shall complete
the Subrecipient/DeveloperNendor Conflict of Interest Disclosure Form prior to execution of this
ff Agreement. Any employees hired later during the period of performance for this Agreement who
will work on activities associated with this Agreement shall also complete and submit to the
COUNTY the Conflict of Interest Disclosure Form.
SUBRECIPIENT will notify the COUNTY in writing and seek COUNTY approval, prior to
entering into any contract with an entity owned in whole or in part by a covered person,or an entity
owned or controlled in whole or in part by SUBRECIPIENT. The COUNTY may review the
proposed contract to ensure that the contractor is qualified,and the costs are reasonable. Approval
of an identity of interest contract will be in the COUNTY's sole discretion. This provision is not
intended to limit SUBRECIPIENT'S ability to self-manage the projects using its own employees.
3.13 DUPLICATION OF EFFORT •
SUBRECIPIENT certifies that costs for work to be performed under this Agreement and any
subcontract do not duplicate any costs charged against any other contract, subcontract, or other
source, in accordance with 48 CFR 1331.205-70. SUBRECIPENT agrees to advise the COUNTY
in writing of any other contract or subcontract it has performed or is performing which involves
work directly related to the purpose of this Agreement.
3.14 SEVERABILITY
Should any provision of this Agreement be determined unenforceable or invalid, such
determination shall not affect the validity or enforceability of any other section or part thereof.
3.15 MISCELLANEOUS
SUBRECIPIENT and COUNTY each binds itself, its partners, successors, legal representatives,
and assigns of such other party in respect to all covenants of this Agreement.
SUBRECIPIENT represents and warrants that the financial data, reports, and other information it
furnished to the COUNTY regarding the Program are accurate and complete, and financial
disclosures fairly represent the financial position of SUBRECIPIENT.
SUBRECIPIENT understands that client information collected under this Agreement is private and
the use or disclosure of such information, when not directly connected with the administration of
the COUNTY'S or SUBRECIPIENT's responsibilities with respect to services provided under this
Agreement, is prohibited unless written consent is obtained from such person receiving service.
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SUBRECIPIENT certifies that it has the legal authority to receive the Funds under this Agreement,
and its governing body has authorized the execution and acceptance of this Agreement.
SUBRECIPIENT also certifies that the undersigned person has the authority to legally execute and
bind SUBRECIPIENT to the terms of this Agreement.
The section headings and subheadings contained in this Agreement are included for convenience
only and shall not limit or otherwise affect the terms of this Agreement.
The Grant Documents shall be construed in accordance with and governed by the laws of the State
of Florida, without giving effect to its provisions regarding choice of laws.
All activities authorized by this Agreement shall be subject to and performed in accordance with
the provisions of the terms and conditions of the Agreement between the COUNTY, the
Regulations,all applicable Federal,State,and Municipal laws,ordinances,regulations,orders,and
guidelines, including but not limited to any applicable regulations issued by the COUNTY.
Electronic Signatures. This Agreement,and related documents entered into in connection with this
Agreement, are signed when a parry's signature is delivered by facsimile, e-mail, or any other
electronic medium. These signatures must be treated in all respects as having the same force and
effect as original signatures.
3.16 WAIVER
The COUNTY'S failure to act with respect to a breach by SUBRECIPIENT does not waive its
right to act with respect to subsequent or similar breaches. The COUNTY'S failure to exercise or
enforce any right or provision shall not constitute a waiver of such right or provision.
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PART IV
GENERAL PROVISIONS
4.1 24 CFR Chapter XXV,2500 et seq.,as amended-All the regulations regarding the Days of Service
program. https://www.ecfr.gov/current/title-45/subtitle-B/chapter-XXV
4.2 Hatch Act: The SUBRECIPIENT shall comply with the Hatch Act, 5 USC 1501-1508 and shall
ensure that no funds provided, nor personnel employed under this Agreement,shall be in any way
or to any extent engaged in the conduct of political activities in violation of Chapter 15 Title V of
the USC Federal Register : Political Activity-State or Local Officers or Employees; Federal
Employees Residing in Designated Localities; Federal Employees
4.3 Title VI of the Civil Rights Act of 1964 as amended,
https://www.archives.gov/milestone-documents/civil-rights-act
4.4 Purchase of American-Made Equipment and Products: SUBRECIPIENT assures that, to the
greatest extent practicable,all equipment and products purchased with funds made available under
this Agreement will be American-made.
4.5 SUBRECIPIENT shall not assign or transfer any interest in this Agreement without the prior
written consent of the COUNTY thereto; provided, however, that claims for money due or to
become due to SUBRECIPIENT from CHS under this Agreement may be assigned to a bank, trust
company, or other financial institution without such approval.Notice of any such assignment or
transfer shall be furnished promptly to CHS.
4.6 Age Discrimination Act of 1975, Executive Order 11063,and Executive Order 11246 as amended
by Executive Orders 11375, 11478, 12107, and 12086.
Age Discrimination Act of 1975
https://www.govinfo.gov/content/pkg/USCODE-1996-title42/pdf/USCODE-1996-title42-
chap76.pdf
11246: https://www.dol.gov/ofccp/regs/statutes/eo11246.htm
11375: Amended by EO 11478
11478: https://www.archives.gov/federal-register/codification/executive-order/11478.htm 1
12107: https://www.archives.gov/federal-register/codification/executive-order/12107.htm1
12086: https://www.archives.gov/federal-register/codification/executive-order/12086.html
4.7 The Americans with Disabilities Act of 1990:
https:/Iwww.hug.gov/program offices/fair housing equal opp
Americans with Disabilities Act of 1990, As Amended I ADA.gov
4.8 2 CFR 200 et seq-Uniform Administrative Requirements, Cost Principles, and Audit
requirements for Grants and Agreements.
https://www.ecfr.gov/current/title-2/subtitle-A/chapter-11/part-200
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4.9 2 CFR 200.15 Never contract with the enemy. Federal agencies, recipients, and subrecipients are
subject to the guidance implementing Never Contract with the Enemy in 2 CFR part 183.
https://www.ecfi'.gov/current/title-2/subtitle-A/chapter-I I/part-200/subpart-C/section-200.215
https://www.ecfr.gov/current/title-2/subtitle-A/chapter-1/part-183
4.10 2 CFR 200.216 — Prohibition on certain telecommunications and video surveillance services or
equipment. COUNTY and SUBRECIPIENT are prohibited from obligating or expending loan or
grant funds to: 1)procure or obtain;2)extend or renew a contract to procure or obtain;3)enter into
a contract(or extend or renew a contract)to procure or obtain equipment,services,or systems that
use(s) covered telecommunications equipment or services as a substantial component of any
system,or as critical technology as part of any system.
https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-C
4.11 Immigration Reform and Control Act of 1986
S.1200 -99th Congress(1985-1986): Immigration Reform and Control Act of 1986
Congress.gov I Library of Congress
4.12 SUBRECIPIENT must certify that it will provide drug-free workplaces, in accordance with the
Drug-Free Workplace Act of 1988 (41 USC 701).
https://www.gpo.gov/fdsys/granule/USCODE-2009-title4l/USCODE-2009-title4l-chap 10-
sec70l
4.13 SUBRECIPIENT certifies that neither it, nor its principals, is presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in this
transaction by any Federal Department or agency; and the SUBRECIPIENT shall not knowingly
enter into any lower tier contract, or other covered transaction, with a person who is similarly
debarred or suspended from participating in this covered transaction as outlined in Executive
Orders 12549(1986)and 12689(1989), Suspension and Debarment, and 2 CFR 200.214.
https://www.archives.gov/federal-register/codification/executive-order/12549.htm 1
https•l/www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200
4.14 SUBRECIPIENT agrees to comply with the following OMB Circulars whichever is applicable and
agrees to adhere to the accounting principles and procedures required therein, utilize adequate
internal controls, and maintain necessary source documentation for all costs incurred. These
requirements are enumerated in 2 CFR 200,et seq.
4.15 Single Audits shall be conducted annually, in accordance with 2 CFR 200.501, and shall be
submitted to the COUNTY nine(9)months after the end of the SUBRECIPIENT'S fiscal year.The
SUBRECIPIENT shall comply with the requirements and standards of 2 CFR 200 Subpart F,
Section 500, SUBRECIPIENTS exempt from Single Audit requirements shall submit financial
statements to the COUNTY one hundred eighty(180)days after the end of the SUBRECIPIENT'S
fiscal year.Per 2 CFR 200,345, if this Agreement is closed out prior to the receipt of an audit report,
the COUNTY reserves the right to recover any disallowed costs identified in an audit after such
closeout. eCFR :: 2 CFR Part 200 Subpart F--Audit Requirements
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4.16 No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,
to any person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, 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,the entering into of any cooperative agreement,and the extension,
continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or
cooperative agreement. If any funds, other than Federal appropriated funds have been paid or will
be paid to any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member
of Congress, in connection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report
Lobbying", in accordance with its instructions. The undersigned shall require that the language of
this certification be included in the award documents for all sub-awards at all tiers (including
subcontracts, sub-grants, contracts under grants, loans, and cooperative agreements) and that all
SUBRECIPIENTS shall certify and disclose accordingly.
4.17 Travel reimbursement will be based on the U,S. General Services Administration (GSA) per diem
rates in effect at the time of travel. SUBRECIPIENT shall obtain written approval from CHS for
any outside travel outside the metropolitan area with funds provided under this Agreement.
https://www.gsa.gov/portal/content/104877
4.18 Any rule or regulation determined to be applicable by CNCS/AmeriCorps.
4.19 Limited English Proficiency: SUBRECIPIENT agrees to take reasonable steps to provide
meaningful access to the program/project and activities funded under this Agreement for persons
with limited English proficiency pursuant to information located at http://www.lep.gov.
4.20 Arrest and Conviction Records: Federal and state laws restrict use of arrest and conviction records
in the employment context,except when specifically authorized. SUBRECIPIENT agrees to avoid
the misuse of arrest or conviction records to screen applicants for employment or employees for
retention or promotion that may have a disparate impact based on race or national origin, resulting
in unlawful employment discrimination unless use is otherwise specifically authorized by law. See
https://ojp.gov/about/ocr/pdfs/UseofConviction_Advisory.pdf for more details.
4.21 False Claim; Criminal, or Civil Violation: SUBRECIPIENT must promptly refer to COUNTY any
credible evidence that a principal,employee,agent, contractor, subgrantee,subcontractor, or other
person has either (i) submitted a false claim for grant funds under the False Claims Act or (ii)
committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery,
gratuity, or similar misconduct involving subaward agreement funds
18 U.S.Code§ 1001 -Statements or entries generally I U.S.Code I US Law I LII/Legal Information
Institute(cornell.edu)
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Beneficiaries are subject to this False Claims Act that include the fo►lowing: 31 U.S.C.3729- False
claims - Document in Context - USCODE-2010-title31-subtitle111-chap37-subchaplll-sec3729
(govinfo.gov)
31 U.S. Code § 3729 - False claims I U.S. Code I US Law I LII / Legal Information Institute
(cornell.edu)
4.22 Political Activities Prohibited: None of the Funds provided directly or indirectly under this
Agreement shall be used for any political activities or to further the election or defeat of any
candidates for public office. Neither this Agreement nor any Funds provided hereunder shall be
utilized in support of any partisan political activities or activities for or against the election of a
candidate for an elected office.
4.23 Text Messaging: Pursuant to Executive Order 13513, "Federal Leadership on Reducing Text
Messaging While Driving," 74 Federal Register 51225 (October 1, 2009), CNCS/AmeriCorps
encourages recipients and subrecipients to adopt and enforce policies banning employees from text
messaging while driving any vehicle during the course of performing work funded by
CNCS/AmeriCorps and to establish workplace safety policies and conduct education,awareness,
► and other outreach to decrease crashes caused by distracted drivers.
Executive Order 13513 --Federal Leadership on Reducing Text Messaging while Driving
whitehouse.gov(archives.gov)
4.24 Trafficking in Persons: SUBRECIPIENT agrees to, at any tier, comply with all applicable
requirements(including requirements to report allegations)pertaining to prohibited conduct related
to the trafficking of persons, whether on the part of the SUBRECIPIENT and any employees of
SUBRECIPIENT. The details of SUBRECIPIENT'S obligations related to prohibited conduct
related to the trafficking of persons are posted at:
https://oip.gov/funding/Explore/ProhibitedConduct-Trafficking.htm.
eCFR :: Appendix A to Part 175,Title 2 -- Award Term
Pursuant to Florida Statues 787.06, SUBRECIPIENT attests that it does not use coercion for labor
or services. SUBRECIPIENT shall provide an affidavit, under penalty of perjury, signed by an
' officer or representative of the organization attesting that it does not use coercion for labor services.
http:l/www.leg.state.fl.us/Statutes/index.cfin?App_mode=Display_Statute&U RL=0700-
f 0799/0787/Sections/0787.06.htm I
4.25 Association of Community Organizations for Reform Now (ACORN): SUBRECIPIENT
understands and acknowledges that it cannot use any Federal Funds,either directly or indirectly, in
support of any contract or subaward to either ACORN or its subsidiaries, without the express prior
written approval of OJP.
4.26 Prohibition of Gifts to COUNTY Employees - No organization or individual shall offer or give,
either directly or indirectly, any favor, gift, loan, fee, service, or other item of value to any
COUNTY employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics
Ordinance No.2004-05, as amended,and County Administrative Procedure 5311.
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Florida Statute:
https://www.Iawserver.com/law/state/Florida/statutes/florida_statutes chapter_i 12_part _iii
Other possible site:
http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0100-
0199/01 12/0112PartIllContentslndex.html&StatuteYear=2021&Title=%2D%3 E202 1%2D%3 EC
hapter%201 12%2D%3 EPart%20111
Collier County-
http://www.colliergov.net/home/showdocument?id=35137
4.27 Order of Precedence-in the event of any conflict between or among the terms of any of the Contract
Documents,the-terms of the Agreement shall take precedence over the terms of all other Contract
Documents, except that the terms of any Supplemental Conditions shall take precedence over the
Agreement. To the extent any conflict in the terms of the Contract Documents cannot be resolved
by application of the Supplemental Conditions, if any, or the Agreement, the conflict shall be
resolved by imposing the more strict or costly obligation under the Contract Documents upon the
Contractor at Owner's discretion.
•
4.28 Venue-Any suit of action brought by either party to this Agreement against the other party,relating
to or arising out of this Agreement, must be brought in the appropriate federal or state courts, in
Collier County,FL which courts have sole jurisdiction on all such matters. (No reference required
for this item).
4.29 Dispute Resolution-Prior to the initiation of any action or proceeding permitted by this Agreement
to resolve disputes between the parties, the parties shall make a good faith effort to resolve any
such disputes by negotiation. Any situations when negotiations, litigation, and/or mediation shall
be attended by representatives of SUBRECIPIENT with full decision-making authority and by
COUNTY'S staff person who would make the presentation of any settlement reached during
negotiations to COUNTY for approval. Failing resolution, and prior to the commencement of
depositions in any litigation between the parties arising out of this Agreement, the parties shall
attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator
certified by the State of Florida. Should either party fail to submit to mediation as required
hereunder, the other party may obtain a court order requiring mediation under section 44.102,
Florida Statutes.The litigation arising out of this Agreement shall be adjudicated in Collier County,
Florida, if in state court; and the US District Court, Middle District of Florida, if in federal court.
BY ENTERING INTO THIS AGREEMENT, COLLIER COUNTY AND THE SUBRECIPIENT
EXPRESSLY WAIVE ANY RIGHTS EITHER PARTY MAY HAVE TO A TRIAL BY JURY
OF ANY CIVIL LITIGATION RELATED TO, OR ARISING OUT OF, THIS AGREEMENT.
https://www.flsenate.gov/Laws/Statutes/20 12/44.1 02
4.30 As provided in §287.133,Florida Statutes,by entering into this Agreement or performing any work
in furtherance hereof,the SUBRECIPIENT certifies that it, its affiliates,suppliers,subcontractors,
and consultants who will perform hereunder, have not been placed on the convicted vendor list
maintained by the State of Florida Department of Management Services within the 36 months
immediately preceding the date hereof.
This notice is required by § 287.133 (3)(a), Florida Statutes.
http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display Statute&Search String=&UR
L=0200-0299/0287/Sections/0287.133.htm 1
;COLLIER COUNTY SHERIFF'S OFFICE.
DOS-25
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4.31 Florida Statutes section 448.095 Employment Eligibility. Per Florida Statutes section 448.095(3),
all Florida private employers are required to verify employment eligibility for all new hires
beginning January 1,2021. Eligibility determination is not required for continuing employees hired
prior to January 1,2021.
http:I/www.leg.state.fl.us/statutes/index.cfm?App mode=Display_Statute&URL=0400-
0499/0448/0448.html
For purposes of satisfying the requirement of this condition regarding verification of employment
eligibility, the SUBRECIPIENT shall participate in, and use, E-Verify (www.e-verify.gov),
provided an appropriate person authorized to act on behalf of the recipient (or subrecipient) uses
E-Verify(and follows the proper E-Verify procedures, including in the event of a "Tentative Non-
confirmation"or a"Final Non-confirmation")to confirm employment eligibility for each hiring for
a position in the United States that is or will be funded(in whole or in part)with award funds.
Questions about E-Verify should be directed to DHS. For more information about E-Verify visit
the E-Verify website (https://www.e-verify.gov/) or email E-Verify at E-Verify@dhs.gov. E-
Verify employer agents can email E-Verify at E-VerifyEmployerAgent@dhs.gov.
dhs.gov.
4.32 Florida Statutes section 713.20, Part 1, Construction Liens
Statutes&Constitution :View Statutes : Online Sunshine(state.fl.us)
4.33 Florida Statutes section 119.021 Records Retention
Statutes&Constitution :View Statutes : Online Sunshine(state.fl.us)
4.34 Florida Statutes section 119.071, Contracts and Public Records
http://www.leg.state.fl.us/Statutes/index.cfin?App_mode=Di splay_Statute&URL=0100-
0199/0119/Sections/0119.071.htm l
4.35 OSHA. Where SUBRECIPIENT employees are engaged in activities not covered under the
Occupational Safety and Health Act of 1970, they shall not be required or permitted to work, be
trained, or receive services in buildings or surroundings or under working conditions which are
unsanitary, hazardous, or dangerous to the participant's health or safety.
4.36 Right to Know.Participants employed or trained for inherently dangerous occupations,e.g., fire or
police jobs, shall be assigned to work in accordance with reasonable safety practices. The
SUBRECIPIENT will comply with all applicable"Right to Know"Acts.
4.37 Whistleblower Protections:
a. In accordance with 2 CFR 200.217 and 41 U.S.C. § 4712, the SUBRECIPIENT may not
discharge, demote, or otherwise discriminate against an employee in reprisal for disclosing
to any of the list of persons or entities provided below, information that the employee
reasonably believes is evidence of gross mismanagement of a federal contract or grant, a
gross waste of federal funds, an abuse of authority relating to a federal contract or grant, a
substantial and specific danger to public health or safety, or a violation of law, rule, or
regulation related to a federal contract (including the competition for or negotiation of a
contract)or grant.
b. The list of persons and entities referenced in the paragraph above includes the following:
i. A member of Congress or a representative of a committee of Congress;
ii. An Inspector General;
iii. The Government Accountability Office;
iv, A Treasury employee responsible for contract or grant oversight or management;
COLLIER COUNTY SHERIFF'S OFFICE
DOS-25
National Day of Service and Remembrance C.4o Page 25
16D5
v. An authorized official of the Department of Justice or other law enforcement agency;
vi. A court or grand jury;or
vii. A management official or other employee of Recipient, contractor, or subcontractor
who has the responsibility to investigate, discover, or address misconduct.
The SUBRECIPIENT shall inform its employees in writing of whistleblower rights and remedies
provided under 2 CFR 200.217 and 41 U.S.C. § 4712, in the predominant native language of the
workforce.
https://uscode.house.gov/view.xhtmI?req=(title:41%20section:4712%20edition:prelim)
All SUBRECIPIENT employees directly involved with activities associated with this Agreement
shall complete and submit to the COUNTY the Collier County Whistleblower Protections
Certification form (Exhibit!F) prior to execution of this Agreement. Any new employees hired
during the period of performance of this Agreement shall also complete and submit the form to the
COUNTY.
ENTIRE AGREEMENT. This Agreement constitutes the entire agreement between COUNTY and
SUBRECIPIENT for the use of Funds received under this Agreement and it supersedes all prior or
contemporaneous communications and proposals, whether electronic, oral, or written between COUNTY
and SUBRECIPIENT with respect to this Agreement.
•
(Signature Page to Follow)
ii
p6
- ;COLLIER COUNTY SHERIFF'S OFFICE
DOS-25 .
National Day of Service and Remembrance C Page 26
16D5
IN WITNESS WHEREOF, the SUBRECIPIENT and COUNTY,have each respectively, by an authorized
person or agent,hereunder set their hands and seals on the date first written above.
ATTEST: AS TO COUNTY;
CRYSTAL K. EL, CLERK
BOARD OF COUNTY COMMISSIONERS
.,f
COLLIER COUNTY, FLORIDA
Deputy Clerk
llttest as o Chairman's' By,onto• : , IBA.f.,„744,,,a€4010.4"—
SAURS, CHAIRPERSOW
Dated: f. .its
/226
{ $A L} Date: 7/g/ is
AS TO SUBRECIPIENT:
WI ESS S:
!COLLIER COUNTY SHERIFF'S OFFICE
4�Gw
Witn .s#1 Signature
By:
Pot ri e , 41/i SUBRECI IENT SIGNATORY NAME TITLFJ
Witness#1 Printed Name Xe two"Ass�, S/i e -. 1414
t ` Date:
Witnes ignat ire
[Please provide evidence of signing authority]
Witness#2 Prided Narhe
Appi f • d legality:
effre . w
Collier ou Attorney1
Date: 01
;COLLIER COUNTY SHERIFF'S OFFICE
DOS-25
National Day of Service and Remembrance �1 J Page 27
f�
16D5
l
EXHIBIT"E
COLLIER COUNTY COMMUNITY & HUMAN SERVICES
WHISTLEBLOWER PROTECTIONS AFFIDAVIT
SUBRECIPIENT Name: "Collier County Sheriffs Office
SUBRECIPIENT Address: 13339 Tamiami Trail East, Suite 213,Naples FL 341121
Project Name: "Days of Service Grant Program—Collier County September 11 th Day of Service
and Remembrance "
Project No: DOS-25
In accordance with 2 CFR 200.217 and 41 U.S.C. § 4712, SUBRECIPIENT may not discharge,
demote, or otherwise discriminate against an employee in reprisal for disclosing to any of the list
of persons or entities provided below, information that the employee reasonably believes is
evidence of gross mismanagement of a federal contract or grant, a gross waste of federal funds, an
abuse of authority relating to a federal contract or grants,a substantial and specific danger to public
health or safety,or a violation of law,rule,or regulation related to a federal contract(including the
competition for or negotiation of a contract) or grant.
(
The list of persons and entities referenced in the paragraph above includes the following:
• A member of Congress or a representative of a committee of Congress
• An Inspector General
• The Government Accountability Office
• A Treasury employee responsible for contract or grant oversight or management
• An authorized official of the Department of Justice or other law enforcement agency
• A court or grand jury
• A management official or other employee of SUBRECIPIENT, contractor, or
subcontractor who has the responsibility to investigate, discover, or address misconduct
SUBRECIPIENT shall inform its employees in writing of whistleblower rights and remedies
provided under section 41 U.S.C. § 4712, in the predominant native language of the workforce.
By signing this affidavit, I certify that "Collier County Sheriffs Office will comply with all
Whistleblower rights and protections for its employees.
Name: l
Signature:I
Title: I
Your typed name here represents your electronic signature
ISUBRECIPIENT NAME
CDXX-XX
Project Name c,,O
1 6 D 5
PART V
EXHIBITS
EXHIBIT A
INSURANCE REQUIREMENTS
The SUBRECIPIENT shall furnish to Collier County Board of County Commissioners, c/o Community
and Human Services Division, 3339 Tamiami Trail East, Suite 213,Naples, Florida 34112, Certificate(s)
of Insurance evidencing insurance coverage that meets the requirements as outlined below:
1. Workers' Compensation as required by Chapter 440, Florida Statutes.
2. Commercial General Liability, including products and completed operations insurance, in the
amount of$1,000,000 per occurrence and $2,000,000 aggregate. Collier County Board of County
Commissioners must be shown as an additional insured with respect to this coverage.
3. Automobile Liability Insurance covering all owned, non-owned and hired vehicles used in
connection with this Agreement, in an amount not less than $1,000,000 combined single limit for
combined Bodily Injury and Property Damage.
li
DESIGN STAGE(IF APPLICABLE)
In addition to the insurance required in I —3 above,a Certificate of Insurance must be provided as follows:
4. Professional Liability Insurance, in the name of the SUBRECIPIENT or the licensed design
professional employed by the SUBRECIPIENT, in an amount not less than $1,000,000 per
occurrence/$1,000,000 aggregate providing for all sums which the SUBRECIPIENT and/or the
design professional shall become legally obligated to pay as damages for claims arising out of the
services performed by the SUBRECIPIENT or any person employed by the SUBRECIPIENT in
connection with this Agreement.This insurance shall be maintained for a period of two (2)years
after the certificate of Occupancy is issued.
CONSTRUCTION PHASE(IF APPLICABLE)
in addition to the insurance required in 1 — 4 above, the SUBRECIPIENT shall provide, or cause its
Subcontractors to provide, original certificates indicating the following types of insurance coverage prior
to any construction:
5. Completed Value Builder's Risk Insurance on an "All Risk"basis, in an amount not less than one
hundred(100%)percent of the insurable value of the building(s)or structure(s). The policy shall
be in the name of Collier County Board of County Commissioners and the SUBRECIPIENT.
6. In accordance with the requirements of the Flood Disaster Protection Act of 1973(42 U.S.C.4001),
the SUBRECIPIENT shall assure that for activities located in an area identified by the Federal
Emergency Management Agency(FEMA)as having special flood hazards, flood insurance under
SUBRECIPIENT NAME
CDXX-XX
Project Name
0
1 6D 5
the National Flood Insurance Program is obtained and maintained, as a condition of financial
assistance for acquisition or construction purposes(including rehabilitation).
OPERATION/MANAGEMENT PHASE(IF APPLICABLE)
After the Construction Phase is completed and occupancy begins, the following insurance must be kept in
Agreement:
g'
force throughout the duration of the loan and/or A r
g
7. Workers' Compensation as required by Chapter 440, Florida Statutes.
8. Commercial General Liability including products and completed operations insurance in the
amount of$1,000,000 per occurrence and $2,000,000 aggregate. Collier County Board of County
Commissioners must be shown as an additional insured with respect to this coverage.
9. Automobile Liability Insurance covering all owned, non-owned and hired vehicles used in
connection with this Agreement in an amount not less than $1,000,000 combined single limit for
combined Bodily Injury and Property Damage.
l 0. Property Insurance coverage on an"All Risk"basis, in an amount not less than one hundred(100%)
of the replacement cost of the property. Collier County Board of County Commissioners must be
shown as a Loss payee,with respect to this coverage A.T.1.M.A.
I I. Flood Insurance coverage for those properties found to be within a flood hazard zone, for the full
replacement values of the structure(s) or the maximum amount of coverage available through the
National Flood Insurance Program (NFIP).The policy must show Collier County Board of County
Commissioners as a Loss Payee A.T.I.M.A.
ISUBRECIPtENT NAME
CDXX-XX
Project Name
•A0
16D5
EXHIBIT B
COLLIER COUNTY COMMUNITY&HUMAN SERVICES
SECTION I: REQUEST FOR PAYMENT
•
SUBRECIPIENT Name:(Collier County Sheriffs Office
SUBRECIPIENT Address: 13339 Tamiami Trail East,Suite 213,Naples FL 34112 I
Project Name: IDAYS OF SERVICE Grant Program
Project No:(DOS-25 j Payment Request#� J
Total Payment Minus Retainage
Period of Availability: J through l
Period for which the Agency has incurred the indebtednes Ithroughl
SECTION II: STATUS OF FUNDS
Subrecipient CHS Approved
1.Grant Amount Awarded $ 1$
2, Total Amount of Previous Requests i$
3.Amount of Today's Request(Total expenditures this $ 1$
period minus retainage, if applicable)
4.Current Grant Balance(Grant Amount minus previous 1$ 1$
requests minus today's request)
By signing this report, I certify to the best of my knowledge and belief that the information contained in
this report is true,complete and accurate. I am aware that any false, fictitious,or fraudulent'information,or
the omission of any material fact, may subject me to criminal, civil, or administrative penalties for fraud,
false statements, false claims, or otherwise (U.S. Code Title 18, Sections 2, 1001, 1343 and Title 31,
Sections 3729-3730 and 3801-3812).
Signature Date
Title
Authorizing Grant Coordinator Authorizing Grant Accountant
Supervisor(Approval required $14,999 and Division Director(Approval Required
below) $15,000 and above)
SUBRECIPIENT NAME
CDXX-XX
Project Name ICAO
16D5
EXHIBIT C
QUARTERLY PERFORMANCE REPORT DATA
The COUNTY is required to submit Performance Reports to AmeriCorps. The COUNTY reports
information on a quarterly basis. To facilitate in the preparation of such reports, SUBRECIPIENT shall
submit the information contained herein within ten (10) days of the end of each calendar quarter. At
COUNTY's discretion,SUBRECIPIENT may be required to enter the information collected on this exhibit
into an online grant management system.
Subrecipient Name: Collier Count Sheriff's Office Date: I
Project Title: [Day of Service I Project#: IDOS-25
Program Contact: Telephone Number:
Date of Event:I I Event Location:
Date of Steering Committee Meeting:
Speakers Secured:
Items Purchased to Date: Cost
Supplies for conference materials; brochures, agenda, folders,etc.
Marketing campaign, web site development/support
Conference space, lunch, branded items.
Branded items
Criminal background checks
650 Emergency Kits
Transportation for event participants
Total for Items Purchased
Interventions:
Measure Type Measure Target Actual Progress
Output OUTPT88498
Marketing Agenda published 160 days prior
I �
Progress Report:
Measure Type Measure Target Actual Progress
Outcome OUTCM88499
#of Volunteers
Project Hours
#of emergency kits
distributed
tt of attendees
I# on waitlist
#of feedback surveys
completed &results
summarized
Signature Page to Follow
ISUBRECIPIENr NAME
CDXX-XX
Project Name CAO
16D5
I hereby certify the above information is true and accurate.
Name:
Signature:I
Title: I
Your typed name here represents your electronic signature
ISUBRECIPIENT NAME
CDXX-XX
Project Name ,AO
16D5
EXHIBIT D
ANNUAL AUDIT MONITORING REPORT
Circular 2 CFR Part 200.332 requires Collier County to monitor subrecipients of Federal awards to determine if
subrecipients are compliant with established audit requirements (Subpart F). Accordingly, Collier County requires
that all appropriate documentation is provided regarding the organization's compliance. In determining Federal
awards expended in a fiscal year, the subrecipient must consider all sources of Federal awards, based on when
the activity related to the Federal award occurs, including any Federal award provided by Collier County. The
determination of amounts of Federal awards expended shall be in accordance with the guidelines established by
2 CFR Part 200, Subpart F — Audit Requirements. This form may be used to monitor Florida Single Audit Act
(Florida Statutes Section 215.97) requirements.
Subrecipient Name !Collier County Sheriff's Office
First Date of Fiscal Year(MM/DD/YY) Last Date of Fiscal Year(MM/DD/YY)
110/01/25 1 ;09/30/2025
Total Federal Financial Assistance Expended Total State Financial Assistance Expended during
during most recently completed Fiscal Year most recently completed Fiscal Year
Check A. or B. Check C if applicable
A. The federal/state expenditure threshold for our fiscal year ending as indicated above has been
(� met, and a Single Audit as required by 2 CFR Part 200 Subpart F has been completed or will be
completed by! I. Copies of the audit report and management letter are attached
or will be provided within 30 days of completion.
B. We are not subject to the requirements of OMB 2 CFR Part 200, Subpart F because we:
Did not exceed the expenditure threshold for the fiscal year indicated above
n !ElAre a for-profit organization
[Q Are exempt for other reasons—explain I !
An audited financial statement is attached and if applicable, the independent auditor's
management letter.
C. Findings were noted, a current Status Update of the responses and corrective action plan is
included separate from the written response provided within the audit report. While we
❑j understand that the audit report contains a written response to the finding(s), we are requesting
an updated status of the corrective action(s) being taken. Please do not provide just a copy of
the written response from your audit report, unless it includes details of the actions, procedures,
policies, etc. implemented and when it was or will be implemented.
Certification Statement
I hereby certify that the above information is true and accurate.
Signature Date
Print Name and Title
06/18
ISUBRECIPIENT NAME
CDXX-XX
Project Name CAO