Agenda 11/14/2017 Item #16D1611/14/2017
EXECUTIVE SUMMARY
Recommendation to approve an “after-the-fact” Amendment and Attestation Statement with Area
Agency on Aging for Southwest Florida, Inc. (Agency) and to approve a budget amendment for the
FY17 Older Americans Act Title OAAIII Program to ensure continuous funding for FY17 (Fiscal
Impact of the OAA programs of $11,460 and local match funding of $1,443.88).
OBJECTIVE: To provide uninterrupted support services to Collier County Services for Seniors (CCSS)
elderly clients.
CONSIDERATIONS: CCSS has provided support services to Collier County’s qualified senior citizens
for over thirty years through the Older Americans Act Title III (OAA). This grant is funded by the Florida
Department of Elder Affairs and administered by the Area Agency on Aging for Southwest Florida, Inc.
(Agency).
On January 24, 2017, the Board of Collier County Commissioners (Board) approved the current grant
contract with the Agency (Agenda Item #16.D.6). The contract term is effective, January 1, 2017 through
December 31, 2017. The proposed amendment is the first amendment to the contract.
By means of the proposed amendment, the Agency is increasing program funding for OAAIII as
described in the chart below. The increase in funding will allow CCSS to provide services to additional
clients and additional services to existing clients. The effective date of the amendment is the last date the
Amendment is signed by both Parties.
Program Project
Number
Current Award
Budget
Revised
Budget
Increase/
(Decrease)
Match Fund
Increase/
(Decrease)*
Title III-B
Support Services
33497 $342,711.00 $340,461.00 ($2,250.00) ($250.00)
Title C1
Congregate Meals
33498 $280,887.00 $291,901.00 $11,014.00 $1,223.77
Title C2 Home
Delivered Meals
33499 $256,107.00 $258,599.00 $2,492.00 $276.89
Title III-E
Services
33500 $122,869.00 $124,608.00 $1,739.00 $193.22
NSIP 33489 $51,314.28 $49,779.28 ($1,535.00) $0.00
Total $1,053,888.28 $1,065,348.28 $11,460.00 $1,443.88
*10% Match amount is Award divided by .9, multiplied by .1, per Federal and State calculation requirements.
This item is being presented “after-the-fact” because CCSS received the amendment on September 29,
2017 from the grantor agency with a request for a 30-day turnaround time. This time frame makes it
impossible to process the document for the Board’s consideration within the required time frame.
Pursuant to CMA 5330 and Resolution No. 2010-122, the County Manager authorized Steve Carnell,
Public Services Department Head to sign the amendment. This amendment is being presented for Board
ratification. Collier County, as the Lead Agency, is responsible for responding to seniors’ needs and
manage the spending authority for the Federal and State funded Services for Seniors programs.
FISCAL IMPACT: Budget amendments are required to recognize an increase of $11,460 in grant
revenue and resulting increase of $1,443.88 in the matching requirement in Human Services Grant Fund
707. The total grant award and total match requirement will reside in Fund 707, projects 33497, 33498,
33499, 33500 and 33489. Matching funds are available via carry forward in Human Services Grant Fund
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11/14/2017
707 Reserves supported by prior year revenues.
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact.
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a majority vote
for Board approval. -JAB
RECOMMENDATIONS: To approve an “after-the-fact” Amendment and Attestation Statement with
Area Agency on Aging for Southwest Florida, Inc. for the Services for Seniors Older Americans Act Title
OAAIII Program and a budget amendment to ensure continuous funding for FY17.
Prepared By: Jody Paley, Grants Coordinator, Community and Human Services Division
ATTACHMENT(S)
1. ES OAA 203.17.001 Amendment Final (PDF)
2. [Linked] OAA 203.17 Contract (PDF)
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11/14/2017
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.16
Doc ID: 4060
Item Summary: Recommendation to approve an “after-the-fact” Amendment and Attestation
Statement with Area Agency on Aging for Southwest Florida, Inc. (Agency) and to approve a budget
amendment for the FY17 Older Americans Act Title OAAIII Program to ensure continuous funding for
FY17 (Fiscal Impact of the OAA programs of $11,460 and local match funding of $1,443.88).
Meeting Date: 11/14/2017
Prepared by:
Title: Grants Coordinator – Community & Human Services
Name: Jody Paley
10/24/2017 12:04 PM
Submitted by:
Title: Division Director - Cmnty & Human Svc – Public Services Department
Name: Kimberley Grant
10/24/2017 12:04 PM
Approved By:
Review:
Community & Human Services Dora Carrillo Additional Reviewer Completed 10/24/2017 2:59 PM
Community & Human Services Maggie Lopez Additional Reviewer Completed 10/24/2017 4:59 PM
Public Services Department Kimberley Grant Additional Reviewer Completed 10/25/2017 4:39 PM
Operations & Veteran Services Sean Callahan Additional Reviewer Completed 10/26/2017 5:02 PM
Public Services Department Joshua Hammond Level 1 Division Reviewer Completed 10/26/2017 6:10 PM
Grants Erica Robinson Level 2 Grants Review Completed 10/27/2017 12:53 PM
Public Services Department Steve Carnell Level 2 Division Administrator Review Completed 10/27/2017 4:16 PM
County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 11/01/2017 4:35 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 11/02/2017 7:47 AM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 11/02/2017 8:04 AM
Budget and Management Office Ed Finn Additional Reviewer Completed 11/03/2017 9:28 AM
Grants Therese Stanley Additional Reviewer Completed 11/06/2017 8:32 AM
County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 11/06/2017 10:12 AM
Board of County Commissioners MaryJo Brock Meeting Pending 11/14/2017 9:00 AM
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16.D.16.aPacket Pg. 1221Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1222Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1223Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1224Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1225Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1226Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1227Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1228Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1229Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1230Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
16.D.16.aPacket Pg. 1231Attachment: ES OAA 203.17.001 Amendment Final (4060 : OAA Amendmen #1 to approve budgt amendment for FY17)
January 2017 — December 2017 OAA 203.17
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
STANDARD CONTRACT
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and Collier
County Board of County Commissioners, (Contractor), and collectively referred to as the "Parties." The term Contractor
for this purpose may designate a Vendor, Subgrantee or Subrecipient.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and
WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such
services as an independent Contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the mutual
covenants and conditions hereinafter set forth, the Parties agree as follows:
1. Purpose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments, forms and exhibits, which constitute the contract document.
2. Incorporation of Documents within the Contract:
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department handbooks,
manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides to
the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions
and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other
general materials not specific to this contract document and identified attachments.
3. Term of Contract:
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time January 1, 2017 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 December 31, 2017.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not
to exceed $1.053.888.28 subject to the availability of funds. Any costs or services paid for under any other contract or
from any other source are not eligible for payment under this contract.
5. Renewals:
By mutual agreement of the Parties, in accordance with s. 287.058(1)(g), F.S., the Agency may renew the contract for
a period not to exceed three years, or the term of the original contract, whichever is longer. The renewal price, or
method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs for the renewal may
be charged. Any renewal is subject to the same terms and conditions as the original contract and contingent upon
satisfactory performance evaluations by the Agency and the availability of funds.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, CFR 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 s. 306 of the Clean Air Act as amended (42 U.S.C.
7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.),
Executive Order 11738, as amended, and where applicable Environmental Protection Agency regulations
40 CFR 30. The Contractor shall report any violations of the above to the Agency.
January 2017 — December 2017
OAA 203.17
6.1.3 The Contractor, or agent acting for the Contractor, may not use any federal funds received in connection
with this contract to influence legislation or appropriations pending before the Congress or any state
legislature. The Contractor must complete all disclosure forms as required, specifically the Certification
and Assurances Attachment, which must be completed and returned to the Contract Manager prior to the
execution of this contract.
6.1.4 In accordance with Appendix A to 2 CFR 215, 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 regulation 41 CFR 60 and 45 CFR 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government -wide Excluded Parties List System, in accordance with
the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and
Suspension." The Excluded Parties List System contains the names of parties debarred, suspended, or
otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority
other than Executive Order 12549. The Contractor shall comply with these provisions before doing
business or entering into subcontracts receiving federal funds pursuant to this contract. The Contractor
shall complete and sign the Certifications and Assurances Attachment prior to the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The 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 (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N) and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR Part 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR 170.
6.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116,
Contractor agrees to utilize the U.S. Department of Homeland Security's E -verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in
related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the
state contract utilize the E -verify system to verify employment of all new employees hired by the Subcontractor
during the contract term. Contractors meeting the terms and conditions of the E -Verify System are deemed to be
in compliance with this provision.
7. Compliance with State Law:
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced
in all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
215.971 F.S., and expenditures must be in compliance with laws, rules, and regulations, including, but not limited
to, the Reference Guide for State Expenditures.
7.3 The Contractor shall comply with requirements of s. 287.058, F.S. as amended.
7.3.1 Contractor shall perform all tasks contained in Attachment I.
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OAA 203.17
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment I, to be received and accepted by the contract manager prior to payment.
7.3.3 The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I, Section III. Method of Payment.
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in
sufficient detail for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit bills for
any travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this
contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in subsection 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 Contractors refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate the contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule Chapter 41-2, 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 s. 287.134, F.S.
7.6 The Contractor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the
expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.7 In accordance with s. 287.135 F.S., any Contractor on the Scrutinized Companies with Activities in Sudan. List
or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant
to s. 215.473 F.S., is ineligible to enter into or renew a contract with the Agency for goods or services of
$750,000.00 or more. Pursuant to s. 287.135 F.S., the Agency may terminate this contract if the Contractor is
found to have submitted a false certification of its status on the Lists or has been placed on the Lists. Further,
the Contractor is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to
the finding of false certification. The Contractor shall complete and sign the Certifications and Assurances
Attachment, prior to the execution of this contract.
Background Screening:
The Contractor shall ensure that the requirements of s. 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are
not exempt from the Agency's level 2 background screening pursuant to s. 430.0402(2) -(3), F.S. The Contractor
must also comply with any applicable rules promulgated by the Agency, Department and the Agency for Health
Care Administration regarding implementation of s. 430.0402 and Chapter 435, F.S. To demonstrate compliance
with this provision, Contractor shall submit to the Agency, the Background Screening Affidavit of Compliance
(Screening Form) upon 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 is found at
http://elderaffairs.state.fl.us/Agency/backgxoundscreening.php.
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with or denial of service(s), and address complaints regarding the termination,
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OAA 203.17
January 2017 — December 2017
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 Subcontractors determination(s).
10. Public Records and Retention:
10.1 By execution of this contract, Contractor agrees to comply with all provisions of chapter 119, Florida Statutes, and
any other applicable law, and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the
requested records, or allow the records to be inspected or copied within a reasonable time at a cost that does
not exceed the cost provided in chapter 119, Fla. Stat., 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.
10.1.4 Upon completion of the contract, the Contractor will transfer at no cost to the Agency either, all public
records in possession of the Contractor, or will keep and maintain public records required by the Agency.
If the contractor transfers all public records to the Agency upon completion of the contract, Contractor shall
destroy any duplicate public records that are exempt, or confidential and exempt, from public records
disclosure requirements. If the contractor keeps and maintains public records upon completion of the
contract, the contractor must meet all applicable requirements for retaining public records. The
Agency hereby requests that all records stored electronically must be provided to the Agency in a
format that is compatible with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for
refusal by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,
papers, letters, or other material made or received by the Contractor in conjunction with this contract, unless the
records are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and section
119.07(1), Fla. Stat.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest
Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
(239)652-6900
11. Audits, Inspections. Investigations:
11.1 The Contractor shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and assure
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
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OAA 203.17
January 2017 — December 2017
six (6) years after completion of the contract or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
11.4 The Contractor shall assure 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/or
Department and federal auditors, pursuant to 45 CFR 92.36(1) (10), will be allowed full access to and the right
to examine any of the Contractors contracts and related records and documents pertinent to this specific
contract, regardless of the form in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit Attachment to the Agency as specified in this
contract and ensure that all related third -party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing
performed pursuant to Section 20.055, Florida Statutes. Beginning July 1, 2015, the Contractor further agrees
that it shall include in related subcontracts a requirement that subcontractors performing work or providing
services pursuant to this contract agree to cooperate with the Inspector General in any investigation, audit,
inspection, review, or hearing pursuant to Section 20.055(5), Florida Statutes. By execution of this contract the
Contractor understands and will comply with this subsection.
12. Nondiscrimination -Civil Rights Compliance:
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance
with state and federal law and regulations. The Contractor further assures that all Contractors, Subcontractors,
Sub -grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability, national origin, marital status or sex.
12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete and accurate
Civil Rights Compliance Checklist, attached to this contract.
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency and/or Department may, at its discretion, seek a court order requiring compliance
with the terms of this assurance or seek other appropriate judicial or administrative relief, including but not
limited to, termination of and denial of further assistance.
January 2017 — December 2017 OAA 203.17
13. Monitoring by the Agency
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods, and services of the Contractor which are relevant to this contract, and to interview any
clients, employees, and Subcontractor employees of the Contractor to assure the Agency of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Agency will provide a written
report of its findings to the Contractor, and where appropriate, the Contractor shall develop a Corrective Action Plan
(CAP). The Contractor hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determined
by the Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in ATTACI ENIENT I.
15. Coordinated Monitoring with Other Agencies:
If the Contractor receives funding from one or more of the State of Florida other human service agencies, in addition to
the Area Agency on Aging for Southwest Florida, Inc., then a joint monitoring visit including such other agencies may
be scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human service
agencies shall include the Department of Children and Families, the Department of Health, the Agency for Persons
with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the
subsequent scheduling of such a visit by the designated agency's lead administrative coordinator, the Contractor shall
comply and cooperate with all monitors, inspectors, and/or investigators.
16. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from any
and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the
execution of this agreement or performance of the services provided for herein. It is understood and agreed that the
Contractor is not required to indemnify the Agency for claims, demands, actions or causes of action arising solely out
of the Agency's negligence.
16.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, this section 16 is not applicable to contracts
executed between the Department, Agency and state agencies or subdivisions defined in s. 768.28(2), F.S.
17. Insurance and Bonding:
17.1 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 subsection 768.28(2), F.S., the Contractor accepts full responsibility for identifying
and determining the type(s) and extent of liability insurance 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 Contractors liability and obligations under this contract. The
Contractor shall ensure that the Agency has the most current written verification of insurance coverage
throughout the term of this contract. Such coverage may be provided by a self-insurance program established
and operating under the laws of the State of Florida. The Agency reserves the right to require additional
insurance as specified in this contract.
17.2 Throughout the term of this agreement, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company and consistent with good business practices.
18. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
to give that consent or when authorized by law.
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January 2017 — December 2017 OAA 203.17
19. Health Insurance Portability and Accountability Act:.
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42 USC
1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
20. Incident Re on rting:
20.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractors awareness or discovery of conditions that may materially affect the Contractor or Subcontractors
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Contract Manager (by telephone) with an email to immediately follow.
20.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor,
Subcontractors, and their employees.
21. New Contract(s) Re ou rting:
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the remaining
four (4) state human service agencies. The notification shall include the following information: (1) contracting state
agency; (2) contract name and number; (3) contract start and end dates; (4) contract amount; (5) contract description
and commodity or service; and (6) Contract Manager name and number. In complying with this provision, and pursuant
to s. 287.0575, F.S. as amended, the Contractor shall complete the Provider's State Contracts List attached to this
contract.
22. Bankrujitcy Notification:
During the term of this contract, the Contractor shall immediately notify the Area Agency on Aging for Southwest
Florida, Inc. if the Contractor, its assignees, Subcontractors or affiliates file a claim for bankruptcy. Within ten (10)
days after notification, the Contractor must also provide the following information to the Area Agency on Aging for
Southwest Florida, Inc.: (1) the date of filing of the bankruptcy petition; (2) the case number; (3) the court name and
the division in which the petition was filed (e.g., Middle District of Florida, Fort Myers, Florida); and (4) the name,
address, and telephone number of the bankruptcy attorney.
23. Sponsorship and Publicity:
23.1 As required by s. 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a program
financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in
publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractors name),
Area Agency on Aging for Southwest Florida, and the State of Florida, Department of Elder Affairs." If the
sponsorship reference is in written material, the words "Area Agency on Aging for Southwest Florida, Inc.,"
and "State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or type as the
name of the organization.
23.2 The Contractor shall not use the words "Area Agency on Aging for Southwest Florida, Inc." and "The State
of Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless
specific authorization has been obtained by the Agency and/or Department prior to use.
24. Assignments:
24.1 The Contactor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer
otherwise occurring without prior written approval of the Agency will constitute a material breach of the
contract.
24.2 The Area Agency on Aging for Southwest Florida, Inc. and/or the State of Florida is at all times entitled to
assign or transfer, in whole or part, its rights, duties, or obligations under this contact to another governmental
agency in the State of Florida, upon giving prior written notice to the Contractor. In the event the Area
7
January 2017 — December 2017 OAA 203.17
Agency on Aging for Southwest Florida and/or the State of Florida approves transfer of the Contractors
obligations, the Contractor remains responsible for all work performed and all expenses incurred in connection
with the contract.
24.3 This contract shall remain binding upon the successors in interest of either the Contractor or 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 ftrrnished 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 from the Agency or other
state agency. Failure to make payments to any Subcontractor in accordance with s. 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
26. Independent Capacity of Contractor:
It is the intent and understanding of the Parties that the Contractor, or any of its Subcontractors, are independent
Contractors and are not employees of the Agency and shall not hold themselves out as employees or agents of the
Agency without specific authorization from the Agency. It is the further intent and understanding of the Parties that the
Agency does not control the employment practices of the Contractor and will not be liable for any wage and hour,
employment discrimination, or other labor and employment claims against the Contractor or its Subcontractors.
All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation
funds and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
27. Payment:
Payments shall be made to the Contractor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the
Contractor. The Contract Manager will have final approval of the invoice for payment, and will approve the invoice
for payment only if the Contractor has met all terms and conditions of the contract, unless the bid specifications,
purchase order, or this contract specify otherwise. The approved invoice will be submitted to the Agency's finance
section for budgetary approval and processing. Disputes arising over invoicing and payments will be resolved in
accordance with the provisions of s. 215.422 F.S. A Vendor Ombudsman has been established within the Department
of Financial Services and may be contacted at 850-413-5665.
28. Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the
Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment has
been made, the Contractor shall repay said overpayment immediately without prior notification from the Agency. In
the event that the Agency first discovers an overpayment has been made, the Contract Manager will notify the
Contractor in writing of such findings. Should repayment not be made forthwith, the Contractor shall be charged at the
lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after Agency notification or Contractor
discovery.
29. Data Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages
of the computer system. The security over the backed -up data is to be as stringent as the protection required of the
January 2017 — December 2017 OAA 203.17
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance
for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
30. Computer Use and Social Media Policy:
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy,
which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel
affiliated with third parties, such as, but not limited to, Area Agencies on Aging and Vendors. Any entity that uses the
Department's computer resource systems must comply with the Department's policy regarding social media. Social
Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social
networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This
policy is available on the Department's website at: http://elderaffairs.state.fl.us/Agency/financial.php.
31. Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer or agent of the Contractor or Subcontractor shall participate in selection,
or in the award of an agreement supported by state or federal funds if a conflict of interest, real or apparent, would be
involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her immediate
family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the above, has a
financial or other interest in the firm selected for award. The Contractor or Subcontractors officers, employees or agents
will neither solicit nor accept gratuities, favors or anything of monetary value from Contractors, potential Contractors,
or parties to Subcontracts. The Contractors board members and management must disclose to the Agency any
relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) calendar days of an
individual's original appointment or placement in that position, or if the individual is serving as an incumbent, within
thirty (30) calendar days of the commencement of this contract. The Contractors employees and Subcontractors must
make the same disclosures described above to the Contractors board of directors. Compliance with this provision will
be monitored.
32. Public Entity Crime:
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction
or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a
public entity; may not be awarded or perform work as a Contractor, Supplier, Subcontractor, or Consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in s. 287.017(2), F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on
the convicted Vendor list.
33. Purchasing:
33.1 The Contractor may purchase articles which are the subject of or are required to carry out this contract from
Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S.,
in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of
this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with PRIDE.
This clause is not applicable to Subcontractors unless otherwise required by law. An abbreviated list of
products/services available from PRIDE may be obtained by contacting PRIDE, 800-643-8459.
33.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to carry
out this contract, in accordance with the provisions of s. 403.7065, F.S.
33.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a
nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S.,
in the same manner and under the same procedures set forth in s. 413.036(1) and (2), F.S. For purposes of this
contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with such
9
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January 2017 — December 2017 OAA 203.17
qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and
the products it offers is available at http://www.respectofflorida.org. This clause is not applicable to
Subcontractors unless otherwise required by law.
33.4 The Contractor shall provide a Minority Business Subcontractor Expenditure (MBE) Report summarizing the
participation of certified and non -certified minority sub -contractors /material suppliers for the current reporting
period, and project to date. The MBE Report shall include the names, addresses, and dollar amount of each
certified and non -certified MBE participant, and a copy of this report must be included with the OAA
monthly payment request reports to the Area Agency on Aging for Southwest Florida, Inc. The Office of
Supplier Diversity (850-487-0915) will assist in furnishing names of qualified minorities. The Florida
Department of Elder Affairs, Minority Coordinator (850- 414-2044) will assist with questions and answers.
34. Patents. Copyrights. Royalties:
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed, produced
or for which ownership was purchased in the course of or as a result of work or services performed under this contract,
the Contractor shall refer the discovery, invention or material to the Agency and/or Department to be referred to
the Department of State. Any and all patent rights or copyrights accruing under this contract are hereby reserved to the
State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only
exceptions to this provision shall be those that are clearly expressed and reasonably valued in the contract.
34.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this section 34.
34.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36.
34.3 Notwithstanding the foregoing provisions, if the Provider or one of its Subcontractors is a university and a
member of the State University System of Florida, then section 1004.23, F.S., shall apply, but the Agency
and/or Department shall retain a perpetual, fully -paid, nonexclusive license for its use and the use of its
Contractors, Subcontractors or Assignees of any resulting patented, copyrighted or trademarked work products.
35. Emergency Preparedness and Continuity of Operations:
35.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of
an emergency preparedness plan. In the event of an emergency, the Contractor shall notify the Agency of
emergency provisions.
35.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall retain
responsibility for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
36. Equipment:
36.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than
one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the
organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable,
tangible personal property of a non -consumable nature with an acquisition cost of $1,000.00 or more per unit,
and expected useful life of at least one year; and hardback bound books not circulated to students or the general
public, with a value or cost of $250.00 or more [for state funds].
36.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; and, (b) a procedure for conducting a physical inventory of equipment at least
once every two years. (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
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January 2017 — December 2017 OAA 203.17
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, frilly document and notify the Contract Manager of any loss, damage, or theft of equipment. The
Contractor shall provide the results of the investigation to the Contract Manager.
36.3 The Contractors property management standards for equipment acquired with Federal funds and federally -owned
equipment shall include accurately maintained equipment records with the following information:
i. A description of the equipment;
ii. Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
iii. Source of the equipment, including the award number;
iv. Whether title vests in the Contractor or the federal government;
V. Acquisition date (or date received, if the equipment was furnished by the federal government) and cost;
vi. Information from which one can calculate the percentage of federal participation in the cost of the
equipment (not applicable to equipment furnished by the federal government);
vii. Location and condition of the equipment and the date the information was reported;
viii. Unit acquisition cost; and
ix. 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.
36.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state fiends with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by the
Agency is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will
vest in the Contractor, subject to the conditions of 2 CFR Part 215 Administrative Requirements (formerly
OMB Circular A-110), Subpart C, paragraph 34. Equipment purchased under these thresholds is considered
supplies and is not subject to property standards. Equipment purchased with funds identified in the budget
attachments to agreements covered by this contract, or identified in the sub -agreements with Subcontractors (not
included in a cost methodology), is subject to the conditions of section 273, F. S. and 60A-1.0017, F. A. C. or
Title 45 CFR Part 74.
36.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or purchased with
funds provided through this contract without first obtaining the approval of the Contract Manager. When
disposing of property or equipment the Contractor must submit a written request for disposition instructions to
the respective 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 Contractors proposed disposition (i.e., transfer or donation to another agency
that administers federal programs, offer the items for sale, destroy the items, etc.).
36.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120
days of the written request for disposition, the Contractor is authorized to proceed as directed in 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A-110).
36.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Sec. 3030b United States Code (USC). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of section
216.348, F. S.
36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
11
January 2017 — December 2017 OAA 203.17
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR
worksheet is required for any computer related item costing $1,000.00 or more, including data processing
hardware, software, services, supplies, maintenance, training, personnel and facilities. The completed ITR
worksheet shall be maintained in the LAN administrator's file and must be provided to the Agency upon
request. The Contractor has the responsibility to require any Subcontractors to comply with the Agency's ITR
procedures.
37. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
hM://www.myflorida.com/apps/vbs/adoc/F7740 PUR1000.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
38. Use of State Funds to Purchase or Improve Real Property:
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least 5 years from the date of purchase or the completion of the improvements or as further required by law.
39. Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the
decision to writing and serve a copy on the Contractor.
40. Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency will
impose financial consequences as stated in the Attachment 1.
41. No Waiver of Sovereign Immunity:
Nothing contained in this agreement 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 will be Leon County, Florida.
43. Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
44. Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
45. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable the
other provisions are severable to that void provision and shall remain in full force and effect.
46. Condition Precedent to Contract A1111ropriations:
The Parties agree that the Agency's and/or Department's performance and obligation to pay under this contract is
contingent upon an annual appropriation by the Legislature.
12
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January 2017 — December 2017 OAA 203.17
47. Addition/Deletion:
The Parties agree that the Agency and/or Department reserves the right to add or to delete any of the services
required under this contract when deemed to be in the State of Florida's best interest and reduced to a written
amendment signed by both Parties. The Parties shall negotiate compensation for any additional services added.
48. Waiver:
The delay or failure by the Agency and/or Department to exercise or enforce any of its rights under this contract will
not constitute or be deemed a waiver of the Agency and/or Department's right thereafter to enforce those rights, nor
will any single or partial exercise of any such right preclude any other or further exercise thereof or the exercise of any
other right.
49. Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor, and subject the contract to immediate, unilateral cancellation of
the contract at the discretion of the Agency.
50. Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days upon the
contract ending date unless otherwise specified in the ATTACHMENT I. If the Contractor fails to submit final request
for payment by the deadline, then all rights to payment may be forfeited and the Agency may not honor any requests
submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all
required documentation and reports due from the Contractor and necessary adjustments thereto have been approved by
the Agency.
51. Renegotiations of Modifications:
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
52. Suspension of Work:
TheAgencymay in its sole discretion suspend any or all activities under the contract or purchase order, at any time,
when in the best interests of the Agency, Department and/or State to do so. The Agency shall provide the
Contractor written notice outlining the particulars of suspension. Examples of the reason for suspension include,
but are not limited to, budgetary constraints, declaration of emergency, or other such circumstances. After receiving
a suspension notice, the Contractor shall comply with the notice and shall not accept any purchase orders. Within
ninety 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 the contract in
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of the contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
53.2 Termination for Cause. The Agency may terminate the contract if the Contractor fails to (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus
endangering performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory,
regulatory, or licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of
default. The Contractor shall continue work on any work not terminated. Except for defaults of Subcontractors
at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the contact arises from
events completely beyond the control, and without the fault or negligence, of the Contactor. If the failure to
13
January 2017 — December 2017
OAA 203.17
perform is caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyond
the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
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.
53.3 Upon expiration or termination of the contract the Contractors and Subcontractors shall transfer all public records
in its possession to the Agency and destroy any duplicate public records that are exempt or confidential and
exempt from public records, disclosure requirements at no cost to the Agency. All electronically stored
records shall be provided to the Agency in a format that is compatible with the Agency's information
technology system(s).
54. Electronic Records and Signature:
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A Contractor that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with the
requirements contained in the Uniform Electronic Transaction Act, s. 668.50, Fla. Stat. All electronic records must be
fully auditable; are subject to Florida's Public Records Law, Ch. 119, Fla. Stat.; must comply with section 29, Data
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and
maintained by the Contractor to the same extent as non -electronic records are retained and maintained as required by
this Agreement.
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 the Agency with non -electronic (paper) copies of
records. Non -electronic (paper) copies provided to the Agency of any document that was originally in
electronic form with an electronic signature must indicate the person and the person's capacity who electronically
signed the document on any non -electronic copy of the document.
REMAINDER OF THE PAGE INTENTIONALL Y LEFT BLANK
14
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OAA 203.17
January 2017 — December 2017
55. Official Payee and Representatives (Names, Addresses, and Telephone Numbersl:
56. All Terms and Conditions Included:
This contract and its Attachments, I — XIV including any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no
provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all
previous communications, representations or agreements, either written or verbal between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, 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:
NAME: STEVE Y. CARNELL
TITLE: PUBLIC SERVICES DEPARTMENT HEAD
DATE: January 12, 2017
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INNC.
SIGNED BY:`y%U'Jt/I.tDVI/l-P
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE: 1190
15
Approved as to form and legality CAB,
Assistunt County Attorney
The Contractor name, as shown on page 1 of this
Collier County Board of County Commissioners
3339 E Tamiami Trail, Building H
a.
contract, and mailing address of the official payee to
Naples, FL 34112
whom the payment shall be made is:
The name of the contact person and street address
Kimberley Grant, Director
Collier County Board of County Commissioners
b.
where financial and administrative records are
%Community and Human Services
maintained is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
Kimberley Grant, Director
The name, address, and telephone number of the
Collier County Board of County Commissioners
C.
representative of the Contractor responsible for
%Community and Human Services
administration of the program under this contract is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
(239) 252-2273
d'
The section and location within the Agency where
Area Agency on Aging for Southwest Florida, Inc.
Requests for Payment and Receipt and Expenditure
15201 North Cleveland Avenue, Suite 1100
forms are to be mailed is:
North Fort Myers, FL 33903
Tammy Rhoades, Vice President of Finance
e.
The name, address, and telephone number of the
Area Agency on Aging for Southwest Florida, Inc.
Contract Manager for this contract is:
15201 North Cleveland Avenue, Suite 1100
North Fort Myers, FL 33903
(239)652-6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party and the notification attached to the originals of this contract.
56. All Terms and Conditions Included:
This contract and its Attachments, I — XIV including any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no
provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all
previous communications, representations or agreements, either written or verbal between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, 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:
NAME: STEVE Y. CARNELL
TITLE: PUBLIC SERVICES DEPARTMENT HEAD
DATE: January 12, 2017
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INNC.
SIGNED BY:`y%U'Jt/I.tDVI/l-P
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE: 1190
15
Approved as to form and legality CAB,
Assistunt County Attorney
OAA 203.17
January 2017 — December 2017
INDEX OF ATTACHMENTS
ATTACHMENTI....................................................................................
STATEMENTOF WORK........................................................................................................................................17
ATTACHMENTII...................................................................................
FINANCIALAND COMPLIANCE A UDIT....................................................................................................... 34
ATTACHMENTIII..................................................................................
39
FUNDING SUMMARY..................................................................................................................
ATTACHMENTIV..................................................................................
CERTIFICATIONSAND ASSURANCES.......................................................................................................... 40
ATTACHMENTV...................................................................................
ASSURANCES—NON-CONSTR UCTION PROGRAMS................................................................................... 44
ATTACHMENTVI..................................................................................
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST. 46
ATTACHMENTVII..................................................................................
PROVIDER'S STATE CONTRACTS LIST........................................................................................................ 50
ATTACHMENTVIII.................................................................................
BACKGROUNDSCREENING......................................................................................................................... 51
ATTACHMENTIX..................................................................................
MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES (MBE FORM) .............................................. 52
ATTACHMENTX...................................................................................
BUDGETand RATE SUMMARY...................................................................................................................... 54
ATTACHMENTXI..................................................................................
INVOICESCHEDULE...................................................................................................................................... 57
ATTACHMENTXII..................................................................................
REQUESTFOR PAYMENT.............................................................................................................................. 58
ATTACHMENTXIII.................................................................................
RECEIPTSAND EXPENDITURE REPORT.................................................................................................... 59
ATTACHMENTXIV.................................................................................
COST REIMBURSEMENT SUMMARY ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ......... 63
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STATEMENT OF WORK
OAA 203.17
ATTACHMENTI
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
1. Contract Acronyms
Area Agency on Aging (AAA)
Activities of Daily Living (ADL)
Alliance of Information & Referral Systems (AIRS)
Assessed Priority Consumer List (APCL)
Adult Protective Services (APS)
Client Information and Registration Tracking System (CIRTS)
Chronic Disease Self -Management Education (CDSME)
Chronic Disease Self -Management Program (CDSMP)
Department of Elder Affairs (DOEA)
Dietary Reference Intake (DRI)
Evidence -Based Disease Prevention and Health Promotion (EBDPHP)
Information and Referral (I & R)
Instrumental Activities of Daily Living (IADL)
National Council on Aging (NCOA)
Nutrition Services Incentive Program (NSIP)
Older Americans Act (OAA)
Planning and Service Area (PSA)
State of Florida (State)
United States Department of Agriculture (USDA)
United States Department of Health and Human Services (USDHHS)
2. Program Specific Terms
Area Plan: A pian developed by the AAA outlining a comprehensive and coordinated service delivery system
in its PSA in accordance with Section 306 (42 U.S.C. 3026) of the OAA and Department instructions.
Area Plan Update: A revision to the Area Plan wherein the AAA enters OAA specific data in CIRTS. An
update may also include other revisions to the Area Plan as instructed by the Department.
Child: An individual who is not more than eighteen (18) years of age or an individual with disability.
Criteria: A standard which the Administration on Aging/Administration for Community Living set for the
Title III D Program. AoA/ACL's standard criterion consists of three tiers: Minimal Criteria, Intermediate
Criteria, and Highest Level Criteria.
Family Caregiver: An adult family member, or another individual, who is an informal provider of in-home
and community care to an older individual.
Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance,
including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment,
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OAA 203.17
January 2017 — December 2017
requires substantial supervision because the individual behaves in a manner that poses a serious health or safety
hazard to the individual or to another individual.
Grandparent: A grandparent or step -grandparent of a child, or a relative of a child by blood, marriage or
adoption and who lives with the child; is the primary caregiver of the child because the biological or adoptive
parents are unable or unwilling to serve as the primary caregiver of the child; and has a legal relationship to the
child, such as legal custody or guardianship, or is raising the child informally.
Living Healthy: Also known as CDSMP for the State of Florida.
B. General Description
1. General Statement
The primary purpose of the OAA Program is to foster the development and implementation of comprehensive
and coordinated systems to serve older individuals. These systems assist older individuals to attain and maintain
maximum independence with supportive services.
The NSIP provides incentives for the effective delivery of nutritious meals to older individuals. NSIP allows
programs to increase the number and/or the quality of meals served. NSIP is a cash allotment or commodity
program that supplements funding for food used in meals served under the OAA. Florida has opted for
cash payments in lieu of donated foods.
2. Authority
The relevant authority governing OAA Title III and NSIP are the following:
a. Catalog of Federal Domestic Assistance No. 93.043, 93.044, 93.045, 93.052, and 93.053;
b. Older Americans Act of 1965, as amended 2016;
c. Older Americans Act of 1965, as amended 2016, section 311 (42 U.S.C. § 3030a;
d. 42 U.S.C. 303, 42 U.S.C. 604;
e. Rule 58A-1, Florida Administrative Code (FAC); and
f. Section 430.101, Florida Statutes (F. S.).
3. Scope of Service
The Contractor is responsible for the programmatic, fiscal, and operational management of the OAA Title III13,
Title IIIC1, Title IIIC2, Title IIIE Programs and NSIP, within its designated PSA. The program services
shall be provided in a manner consistent with the current Agency's current Area Plan, as updated, and the
current DOEA Programs and Services Handbook, which are incorporated by reference. The Contractor shall
use the NSIP funding to supplement funding for food used in meals served by OAA Nutrition Program
Providers.
4. Major Program Goals
The major goals of the OAA Program are to improve the quality of life for older individuals, preserve their
independence and prevent or delay costlier institutional care. These goals are achieved through the
implementation of a comprehensive and coordinated service system that provides a continuum of service
alternatives and effective delivery of nutritious meals that meet the diverse needs of elders and their caregivers.
C. Clients to be Served
1. General Description
The OAA Program gives preference to individuals with the greatest economic and social need, with particular
attention to low-income older individuals, including those that are low-income minorities, have limited English
proficiency, and older individuals residing in rural areas.
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2. Client Eligibility
a. OAA Title III
Consumers shall not be dually enrolled in an OAA Program and a Medicaid capitated Long -Term Care
Program, with the exception of consumers in need of OAA Legal Assistance services and OAA Congregate
Nutrition Services, including transportation to and from congregate meal sites.
b. NSIP
Meals served to an elderly individual, funded in whole or in part under the Medicaid Waiver, Home Care
for the Elderly, Community Care for the Elderly Programs, or other means tested programs may not be
included in the NSIP count.
c. OAA Title HIB, Supportive Services
i. Individuals must be age sixty (60) or older; and
ii. Information and Referral/Assistance services are provided to individuals regardless of age.
d. OAA Titles IIICl and IIIC2, Nutrition Services, General
General factors that shall be considered in establishing priority for nutrition services, include those older
persons who meet the following:
i. Cannot afford to eat adequately;
ii. Lack the skills or knowledge to select and prepare nourishing and well-balanced meals;
iii. Have limited mobility which may impair their capacity to shop and cook for themselves; or
iv. Have a disabling illness or physical condition requiring nutritional support or have been screened at a
high nutritional risk.
e. OAA Title IHCl, Congregate Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in Section I.C. Lc, above,
individuals must be mobile, not homebound, and physically, mentally, and medically able to attend a
congregate nutrition program. Individuals eligible to receive congregate meals include the following:
i. Individuals age sixty (60) or older;
ii. Any spouse (regardless of age) who attends the dining center with his/her eligible spouse;
iii. Persons with a disability, regardless of age, who reside in a housing facility occupied primarily by older
individuals where congregate nutrition services are provided;
iv. Disabled persons who reside at home with and accompany an eligible person to the dining center; and
v. Volunteers, regardless of age, who provide essential services on a regular basis during meal hours.
f. OAA Title IHC2, Home Delivered Nutrition Services
In addition to meeting the general nutrition services eligibility requirements as listed in Section I.C.l.c,
individuals must be homebound and physically, mentally, or medically unable to attend a congregate
nutrition program. Individuals eligible to receive home delivered meals include the following:
i. Individuals age sixty (60) or older who are homebound by reason of illness, disability or isolation;
ii. The spouse of a homebound eligible individual, regardless of age, if the provision of the collateral meal
supports maintaining the person at home;
iii. Individuals with disabilities, regardless of age, who reside at home with eligible individuals and are
dependent on them for care; and
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January 2017 — December 2017
iv. Persons at nutritional risk who have physical, emotional or behavioral conditions, which would make
their presence at the congregate site inappropriate; and persons at nutritional risk who are socially or
otherwise isolated and unable to attend a congregate nutrition site.
g. OAA Title IIIE, Caregiver Support Services
Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows:
L Family caregivers of individuals age sixty (60) or older;
ii. Grandparents [age fifty -five (55) or older] or older individuals [age fifty-five (55), or older] who are
relative caregivers;
iii. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease
and related disorders with neurological and organic brain dysfunction and for grandparents or older
individuals who are relative caregivers who provide care for children with severe disabilities; and
iv. For respite and supplemental services, a family caregiver must be providing care for an older individual
who meets the definition of the term "frail" as defined in this contract, I.A.2.
II. MANNER OF SERVICE PROVISION
A. Service Tasks
To achieve the goals of the OAA Program, the Contractor shall perform or ensure that its Subcontractors perform,
the following tasks
1. Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in section LC.2.
2. Targeting and Screening New Clients for Service Delivery
The Contractor shall develop and implement policies and procedures consistent with OAA targeting and
screening criteria.
3. Program Services
The Agency shall ensure the provision of program services is consistent with the Agency's current area plan,
as updated and approved by the Department, and the current DOEA Programs and Services Handbook.
4. Program Eligibility Requirements
a. Eligibility Criteria
Entities must meet the following criteria in order to be eligible for program participation:
i. An agency that has received a grant under the OAA Title III [OAA section 311(42 U.S.C.3030a)]; and
ii. A nutrition service provider that serves meals and is under the jurisdiction, control, management and
audit authority of the Area Agency on Aging and the Department of Elder Affairs.
b. Provider's Nutrition Service Operations
The Contractor shall ensure the nutrition service operations of the provider meet the requirements of
ATTACHMENT I are met, as well as any other applicable regulations and policies prescribed current
AGENCY Programs and Services Handbook by the Department of Health and Human Services, USDA,
state, and local health departments or any other agency designated to inspect meal quality for the State.
c. Prescribed Nutritional Requirements
The Contractor shall ensure that each meal provided under this NSIP contract meets the following criteria:
i. Comply with the current Dietary Guidelines for Americans, published by the Secretaries of the
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OAA 203.17
January 2017 — December 2017
Department of Health and Human Services and the Department of Agriculture; and
ii. Provide a minimum of 33 1/3 percent of the dietary reference intakes/adequate intakes for an age 70+
female as established by the Food and Nutrition Board of the National Academy of Sciences.
d. Food Origin and Commodities Requirements
Consistent with existing requirements of the Nutrition Services Incentive Program, the Contractor and its
service providers may use NSIP cash to purchase foods of U.S. origin for their nutrition projects under Title
III of the OAA. NSIP funds must be used to expand meal services to older adults.
B. Use of Subcontractors
If this contract involves the use of a Subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for a
period of sixty (60) days or more the initiation of the subcontract or the performance of the Subcontractor, the
Contractor shall notify the Agency's Contract Manager and the Agency's Vice President of Finance Officer in writing
of such delay. The Contractor shall not permit a Subcontractor to perform services related to this agreement without
having a binding Subcontractor agreement executed. The Agency will not be responsible or liable for any
obligations or claims resulting from such action.
1. Copies of Subcontracts
The Contractor shall submit a copy of all subcontracts to the Contract Manager within thirty days of the
subcontract being executed.
2. Monitoring the Performance of Subcontractors
The Contractor shall monitor, at least once per year, each of its Subcontractors, Subrecipients, Vendors, and/or
Consultants paid from funds provided under this contract. The Contractor shall perform fiscal, administrative
and programmatic monitoring to ensure contractual compliance, fiscal accountability, programmatic
performance and compliance with applicable state and federal laws and regulations. The Contractor shall
monitor to ensure that time schedules are met, the budget and scope of work are accomplished within the
specified time periods, and other performance goals stated in this contract are achieved.
a. The Contractor shall require subcontractors to enter all required data per the Agency's CIRTS Policy
Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS
before the subcontractors submit their Request for Payment and Expenditure Reports to the Contractor.
The Contractor shall establish time frames to ensure compliance with due dates for the Requests for
Payment and Expenditure Reports to the Agency.
b. The Contractor shall require subcontractors to run monthly CIRTS reports and verify client and service
data in the CIRTS is accurate. This report must be submitted to the Contractor with the monthly Request
for Payment and Expenditure Report and must be reviewed by the Contractor before the subcontractor's
Request for Payment and Expenditure Reports can be approved by the Contractor.
c. The Contractor shall require subcontractors to report on outreach activities at least semi-annually using a
uniform reporting format established by the Contractor. The format must include the following information:
number and type of provider events or activities; date and location; total number of participants at each
event or activity; individual service needs identified; and referral sources or information provided.
C. Staffing Requirements
1. Staffing Levels
The Contractor shall dedicate the staff necessary to meet the obligations of this contract and ensure that
subcontractors dedicate adequate staff, accordingly.
2. Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications as specified in the DOEA Programs and Services Handbook.
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3. Service Times
The Contractor shall ensure the availability of services listed in this contract at times appropriate to meet client
service needs, at a minimum during normal business hours. Normal business hours are defined as Monday
through Friday, 8:00 a.m. to 5:00 p.m.
D. Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation required to
evidence the completion of the tasks specified in this contract.
1. Delivery of Services to Eligible Clients
The Contractor shall ensure the provision of a continuum of services that meets the diverse needs of elders and
their caregivers. The Contractor shall ensure the performance and reporting of the following services in
accordance with the Agency's current Department -approved Area Plan, the current DOEA Programs and
Services Handbook, which is incorporated by reference, and Section H.A. 1-4 of this contract. Documentation
of service delivery must include a report consisting of the following: number of clients served, number of
service units provided by service, and rate per service unit with calculations that equal the total invoice amount.
The services include the following categories:
a. Supportive Services (M Program) - Supportive services include a variety of community-based and
home -delivered services that support the quality of life for older individuals by helping them remain
independent and productive. Services include the following:
i. Adult Day Care/Adult Day Health xvii. Recreation;
Care; xviii. Emergency Alert Response;
ii. Caregiver Training/Support; xix. Escort;
iii. Case Aid/Case Management; XX. Health Support;
iv. Chore Services; xxi. Home Health Aid;
v. Companionship; xxii. Homemaker;
A. Counseling (Gerontological and xxiii. Housing Improvement;
Mental Health);
vii. Education/Training; xxiv. Information;
viii. Legal Assistance; xxv. Intake;
ix. Material Aid; xxvi. Interpreter/Translating;
x. Occupational Therapy; xxvii. Referral/Assistance;
A Outreach; xxviii. Respite Services;
xii. Personal Care; xxix. Screening/Assessment
xiii. Physical Therapy; xxx. Speech Therapy
xxxi. Telephone Reassurance; and
xiv. Shopping Assistance;
xv. Skilled Nursing xxxii. Transportation
xvi. Specialized Medical Equipment,
Services, and Supplies
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b. Congregate Nutrition Services (MCI Program)
Nutrition Services are provided in congregate settings and are designed to reduce hunger and food
insecurity, promote socialization and the health and well-being of older individuals by assisting them to
gain access to nutrition and other disease prevention and health promotion services. Services include the
following:
i. Congregate meals;
ii. Congregate meals screening;
iii. Nutrition education and nutrition counseling; and
iv. Outreach.
c. Home Delivered Nutrition Services (1HC2 Program)
In-home nutrition services are provided to reduce hunger and food insecurity; promote socialization and
the health and well-being of older individuals by assisting such individuals to gain access to nutrition and
other disease prevention and health promotion services. Services include the following:
L Home delivered meals;
ii. Nutrition education and counseling;
iii. Outreach; and
iv. Screening/Assessment.
d. Caregiver Support Services (ME Program)
The following services are intended to provide direct help to caregivers, assist in the areas of health,
nutrition and financial literacy, and assist caregivers in making decisions and problem solving related to
their caregiving roles and responsibilities:
L Adult Day Care/Adult Day Health vii. Intake;
Care; viii. Outreach;
ii. Caregiver Training/Support;
ix. Powerful Tools for Caregivers;
iii. Counseling (Gerontological and X. Referral/Assistance;
Mental Health);
iv. Education/Training; xi. Respite Services;
v. Financial Risk Reduction (Assessment xii. Screening/Assessment;
and Maintenance); xiii. Stress -Busting Program for Family Caregivers; and
vi. Information; xiv. Transportation.
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January 2017 — December 2017 OAA 203.17
(1) Caregiver Support Supplemental Services (HIES Program)
At least ten (10) percent, but no more than twenty (20) percent, of the total Title ME funds
shall be used to provide supplemental support services. The following services are provided
to complement the care provided by caregivers:
(a) Chore Services;
(b) Housing Improvement;
(c) Legal Assistance;
(d) Material Aid; and
(e) Specialized Medical Equipment, Services and Supplies.
(2) Caregiver Support Grandparent Services (IREG Program)
At least five (5) percent, but no more than ten (10) percent, of the total Title HIE funds shall
be used to provide support services to grandparents and older individuals who are relative
caregivers. Services for grandparents or older individuals who are relative caregivers
designed to help meet their caregiving obligations include the following:
(a) Caregiver Training/Support;
(b) Child Day Care;
(c) Counseling (Gerontological and Mental Health);
(d) Education/training;
(e) Legal Assistance;
(f) Outreach;
(g) Referral/Assistance;
(h) Screening/Assessment;
(i) Sitter; and
0) Transportation.
2. Services and Units of Services
The Contractor shall ensure the provision of the services described in the contract in accordance with the
current Department of Elder Affairs Programs and Services Handbook and the service tasks described
in Section II.A.
3. Administrative Responsibilities
The Contractor shall provide management and oversight of OAA Program operations in accordance
with the current DOEA Programs and Services Handbook and the Department -approved Agency's
Area Plan. Management and oversight of OAA program operations include the following:
a. Review routine and special reports submitted by Subcontractors and vendors.
b. Provide technical assistance to Subcontractors and vendors to ensure provision of quality services.
c. Monitor and evaluate subcontractors and vendors for programmatic and fiscal compliance.
d. Appropriately submit payments to subcontractors.
e. Establish procedures for handling recipient complaints concerning such adverse actions as
service termination, suspension or reduction in services.
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i. Complaint Procedures
The Contractor shall develop and implement complaint procedures and ensure that
subcontractors develop and implement complaint procedures to process and resolve
client dissatisfaction with services. Complaint procedures shall address the quality and
timeliness of services, provider and direct service worker complaints, or any other advice
related to complaints other than termination, suspension or reduction in services that require
the grievance process as described in Appendix D, Department of Elder Affairs Programs
and Services Handbook. The complaint procedures shall include notification to all clients
of the complaint procedure and include tracking the date, nature of complaint, and the
determination of each complaint.
L Ensure compliance with Client Information and Registration Tracking System (CIRTS) regulations.
g. Monitor performance objective achievements in accordance with targets set by the Agency.
h. Conduct client satisfaction surveys to evaluate and improve service delivery.
E. Reports
The Contractor shall respond to additional routine and/or special requests for information and reports required
by the Agency in a timely manner as determined by the Contract Manager. The Contractor shall establish
reporting deadlines and due dates for Subcontractors that permit the Contractor to review and validate the data,
and meet the Agency's reporting requirements.
1. Client Information and Registration Tracking System (CIRTS) Reports
Contractor shall input OAA -specific and NSIP-specific data into CIRTS. To ensure CIRTS data accuracy,
the Contractor shall use CIRTS-generated reports which include the following:
a. Client Reports;
b. Monitoring Reports;
c. Services Reports;
d. Miscellaneous Reports;
e. Fiscal Reports; and
L Outcome Measurement Reports.
2. Service Cost Reports
The Contractor shall require subcontractors to annually submit to the Contractor service cost
reports, which reflect actual costs of providing each service. This Annual Service Cost Report
will be due by February 15, of each year. The report will include actual costs for performing all
services during the preceding calendar year. Supporting documentation must accompany the
report which will include General Ledger, Trial Balance and/or Statement of Revenue and
Expenditures along with a narrative explanation and justification of increases.
Any multi-year contracts entered into with service providers on or after the effective date of this
contract shall contain a provision requiring the contract's parties to re-evaluate the contract's
reimbursement rates on an annual basis. The Contractor may annually renegotiate rates based on
factors including but not limited to a review of sustainability, the respective consumer price index,
or current market conditions. However, it is the intent of the Department and/or Agency that the
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January 2017 — December 2017 OAA 203.17
quality of services provided to current program recipients not be reduced. Unit Cost
Methodology worksheets must be submitted by August 1 of each year, if a rate increase is being
requested.
3. Surplus/Deficit Report
The Contractor shall submit a Consolidated Surplus/Deficit Report, in a format provided by the Agency to
the Agency's Contract Manager by the 18th of each month, "Lead Agency Spending Report." This
Consolidated Surplus/Deficit Report is for all agreements and/or contracts between the Contractor and
the Agency and must include the following:
a. A list of all subcontractors and their current status regarding surplus/deficit;
b. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified
by the Agency will be resolved;
c. Recommendations to transfer funds to resolve surplus/deficit spending;
d. Input from the Contractor's Board of Directors on resolution of spending issues, if applicable;
4. OAA National Aging Program Information System (NAPIS) Report
Data required for the OAA NAPIS Report that is not recorded in CIRTS will be provided to the
Area Agency Contract Manager in the format and on the date established by the Agency.
5. Program Highlights
The Contractor shall submit Program Highlights referencing specific events that occurred in FFY 2016 by
September 1, 2017. The Contractor shall provide a new success story, quote, testimonial, or human -interest
vignette. The highlights shall be written for a general audience, with no acronyms or technical terms. For
all agencies or organizations that are referenced in the highlight, the Contractor shall provide a brief
description of their mission or role. The active tense shall be consistently used in the highlight narrative, in
order to identify the specific individual or entity that performed the activity described in the highlight. The
Contractor shall review and edit Program Highlights for clarity, readability, relevance, specificity, human
interest, and grammar, prior to submitting them to the Agency.
6. Invoices
The Contractor shall submit complete and accurate monthly invoices as referenced in Section IIl, Method
of Payment
F. Records and Documentation
1. The Contractor shall maintain documentation to support Requests for Payment that shall be available to the
Agency or authorized individuals, such as Department of Financial Services, upon request.
2. CIRTS Data and Maintenance
The Contractor shall ensure, on a monthly basis, collection and maintenance of client and service
information in CIRTS or any such system designated by the Agency. Maintenance includes accurate and
current data, and valid exports and backups of all data and systems according to Agency standards.
3. Data Integrity and Back up Procedures
Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system.
Data and software essential to the continued operation of contractor functions must be backed up. The
security controls over the backup resources shall be as stringent as the protection required of the primary
resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location.
4. Policies and Procedures for Records and Documentation
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The Contractor shall maintain written policies and procedures for computer system backup and recovery
and shall have the same requirement of its subcontractors. These policies and procedures shall be made
available to the Agency upon request.
G. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
At a minimum, the Contractor must:
a. The Contractor shall ensure the provision of the services described in this contract are in accordance
with the current DOEA Programs and Services Handbook and Section II.A.1-4 of this contract.
b. The Contractor shall timely submit to the Agency all documentation and reports described in
ATTACHMENT I, Section H.E.
c. The Contractor shall timely, in accordance with ATTACHMENT XII, and accurately submit
to the Agency ATTACHMENTS XIH.
d. The Contractor shall develop and document strategies in the Area Plan to support the Agency's
standard of performance achievement, including increases for the following:
i. Percent of most frail elders who remain at home or in the community instead of going into a nursing
home;
ii. Percent of APS referrals who are in need of immediate services to prevent further harm who are
served within seventy-two (72) hours;
W. Percentage of active clients eating two or more meals per day;
iv. Percent of new service recipients whose ADL assessment score has been maintained or improved;
v. Percent of new service recipients whose IADL assessment score has been maintained or improved;
A. After service intervention, the percentage of caregivers who self-report being very confident about
their ability to continue to provide care; and
vii. Percent of customers who are at imminent risk of nursing home placement who are served with
community based services.
e. The Contractor's performance of these measures will be reviewed and documented in the Agency's
Annual Programmatic Monitoring Reports.
2. Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, or
an on-site visit. The Agency's determination of acceptable performance shall be conclusive. The
Contractor agrees to cooperate with the Agency in monitoring the progress of completion of the set -vice
tasks and deliverables. The Agency may use, but is not limited to, one or more of the following methods for
monitoring:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled, and follow-up on-site visits;
c. Client visits;
d. Review of independent auditor's reports;
e. Review of third -party documents and/or evaluation;
f. Review of progress reports;
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g. Review of customer satisfaction surveys;
h. Agreed-upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and
j. Other procedures as deemed necessary.
3. Performance Definitions
"Work day" shall mean a provider's staff member's eight (8) hour work period, unless specifically noted
otherwise "Day" shall mean a calendar day, unless specifically noted otherwise.
H. Contractor Responsibilities
1. Contractor Accountability
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of
the Contractor, and for which, by execution of the contract, the Contractor agrees to be held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with
other entities in performing the requirements of the contract; the failure of other entities does not
alleviate the Contractor from any accountability for tasks or services that the Contractor is obligated to
perform pursuant to this contract.
I. Agency Responsibilities
1. Agency Obligations
The Agency will provide technical support to assist the Contractor in meeting the requirements of this
contract.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches.
The absence of the Agency setting forth a specific reservation of rights does not mean that all other
areas of the contract are subject to mutual agreement.
III.METHOD OFPAYMENT
A. Payment Method Used
Method of Payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and
advance payments, subject to the availability of funds and Contractor performance. The Agency will
pay the Contractor upon satisfactory completion of the Tasks/Deliverables, as specified in Section
II.D., and in accordance with other terms and conditions of the contract.
1. Fixed Fee/Unit Rate
Payments for Fixed Fee/Unit Rate shall not exceed amounts established in ATTACHMENT X.
2. Fixed Rate
Payments for NSIP Fixed rate shall not exceed the number of units of service at the prospective
rate identified below:
Service to be Provided
Unit of Service
Unit Rate
Eligible Congregate and Home Delivered Meals
I unit = 1 meal
$.72
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January 2017 — December 2017
3. Cost Reimbursement
The Contractor agrees to distribute funds as detailed in the Area Plan Update and the Budget
Summary, ATTACHMENT XI, to this contract. Any changes in the total amounts of the funds
identified on the 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 XI. All Cost Reimbursement Request for Payment must include the actual
Expenditure Reports beginning with the first month of the contract.
4. Advance Payments
The Contractor may request up to two (2) months of advances at the start of the contract period to
cover program administrative and service costs. The payment of an advance will be
contingent upon the sufficiency and amount of funds released to the Agency by the State of Florida
("budget release"). The Contractor's requests for advance require the approval of the Agency
Contact Manager. The Contractor shall provide the Agency Contract Manager documentation
justifying the need for an advance and describing how the funds will be distributed. If sufficient
budget is available, the Agency will issue approved advanced payments after January 1 st of the
contract year. Advance payments will not be issued for NSIP.
a. Any advanced payments the Contactor requested for subcontractors must be distributed within seven
days of receipt of payment from the Agency. The Contractor shall submit to the Agency
documentation to support full distribution of advanced funds with report number 5, due to the
Agency on April 9, 2017, in accordance with the Invoice Schedule, ATTACHMENT XI to this
contact.
b. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: one—
tenth of the advance payment received shall be reported as an advance recoupment on each Request for
Payment, starting with report number five, in accordance with the Invoice Schedule, ATTACHMENT
XI to this contract.
C. Interest earned on advances must be identified separately by source of funds, state or federal.
Contractors shall maintain advances of federal funds in FDIC interest bearing accounts unless otherwise
exception is made in accordance with 45 CFR 74.22(k). Earned interest must be returned to the
Agency at the end of each quarter of the contract period.
B. Funding Distribution
The Contractor agrees to distribute funds as detailed in this contract and the area plan update. Any changes in
the total amounts of the funds identified in this contract, number of service units, or unit rate require a contract
amendment.
C. Method of Invoice Payment
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and
approval by the Agency of the deliverables shown on the invoice. The form and substance of each invoice
submitted by the Contractor shall be as follows:
1. Have a Remittance Address that corresponds exactly to the "Remit To" address provided to MFMP during
registration;
2. Request payment on a monthly basis for the units of services as established in the Agency's approved
Area Plan, provided in conformance with the requirements as described in the DOEA Programs and Services
Handbook, at the rates established in ATTACHMENT X of the contract. Documentation of service
delivery must include a report consisting of the following: number of clients served, number of service units
provided by service, and rate per service unit with calculations that equal the total invoice amount.
29
OAA 203.17
January 2017 — December 2017
Any requested changes to the approved budget subsequent to the execution of the contract, must be
submitted to the Contract Manager for approval. Any change to the total contract amount requires a formal
amendment;
3. The Contractor shall consolidate all Request for Payment from subcontractors and Expenditure Reports that
support requests for payment and shall submit to the Agency using forms, Request for Payments
(ATTACEMENT XII), Receipt and Expenditure Reports (ATTACHMENT XIII), and Cost
Reimbursement Summary (ATTACHMENT XIV).
4. The Contractor shall include with its fixed fee/unit rate portion of the invoice, the units of services provided
based on rates as established in ATTACHMENT X of the contract, number of clients, and the rates for
the services provided in conformance with the requirements as described in the deliverables and service
tasks. Clearly state the provider name, the report month, and the invoice number.
5. All Requests for Payment shall be based on the submission of actual monthly Expenditure Reports
beginning with the first month of the contract The schedule for submission of advance requests (when
available) and invoices is Invoice Schedule, ATTACEMENT XI.
D. Payment Withholding
Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Contractor and any
adjustments thereto, including any disallowance not resolved.
E. Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than February 15, 2018.
F. CIRTS Data Entries for Subcontractors
The Contractor must require Subcontractors to enter all required data for clients and services in the CIRTS
database per the DOEA Programs and Services Handbook and the CIRTS User Manual — Aging Provider
Network users (located in Documents on the CIRTS Enterprise Application Services). Subcontractors must
enter this data into the CIRTS prior to submitting their requests for payment and expenditure reports to the
Contractor. The Contractor shall establish deadlines for completing CIRTS data entry and to assure compliance
with due dates for the requests for payment and expenditure reports that Contractor must submit to the
Agency.
G. Subcontractors' Monthly CIRTS Reports
The Contractor must require Subcontractors to run monthly CIRTS reports and verify client and service data in
the CIRTS is accurate. This report must be submitted to the Contractor with the monthly request for payment
and expenditure report and must be reviewed by the Contractor before the Subcontractor's request for payment
and expenditure reports can be approved by the Contractor.
H. Corrective Action Plan
1. Contractor shall ensure 100% of the deliverables identified in Section II. D. 1-3 of this contract, are
performed pursuant to contract requirements.
2. If at any time the Contractor is notified by the Agency Contract Manager that it has failed to correctly,
completely, or adequately perform contract deliverables identified in Section II. D. 1-3 of this contract, the
Contractor will have 10 days to submit a Corrective Action Plan ("CAP") to the Agency Contract Manager
that addresses the deficiencies and states how the deficiencies will be remedied within a time period
approved by the Agency Contract Manager. The Agency shall assess a Financial Consequence for Non -
30
OAA 203.17
January 2017 — December 2017
Compliance on the Contractor as referenced in Section III.I of this contract for each deficiency identified
in the CAP which is not corrected pursuant to the CAP. The Agency will also assess a Financial
Consequence for failure to timely submit a CAP.
3. If the Contractor fails to correct an identified deficiency within the approved time period specified in the
CAP, the Agency shall deduct the percentage established in Section III. I. of this contract, from the
payment for the invoice of the following month.
4. If Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established in
Section III. I. of this contract for each day the CAP is overdue. The deduction will be made from the
payment for the invoice of the following month.
I. Financial Consequences
The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the
satisfaction of the Agency according to the requirements referenced in Section ILD of this contract. The
following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the
performance criteria as outlined in Section II. D. of this contract.
1. Delivery of services to eligible clients as referenced in Section ILA.2 and Section II.D.1 of this contract
— Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS
reports, will result in a 2% reduction of payment per business day. The reduction of payment will begin
on the first business day following the Agency's notification to the Contractor that the identified
deficiency was not cured or satisfactorily addressed in accordance with the Agency -approved CAP,
referenced in Section II. H.
2. Services and units of services as referenced in Section II.D.2 of this contract — Failure to provide
services in accordance with the current DOEA Programs and Services Handbook, the service tasks
described in Section ILA, ATTACHMENT X, and submission of required documentation will
result in a 2% reduction of payment per business day. The reduction of payment will begin the first
business day following the Agency's notification to the Contractor that the identified deficiency is not
cured or satisfactorily addressed in accordance with the Agency approved CAP, referenced in Section II.
H.
3. Administrative duties as referenced in Section II.D.3 of this contract — Failure to perform management
and oversight of Program operations will result in a 2% reduction of payment per business day. The
reduction of payment will begin the first business day following the Agency's notification to the
Contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with
the Agency approved CAP, referenced in Section III. H.
4. Timely submission of a CAP — Failure to timely submit a CAP within 10 business days after notification
of a deficiency by the Agency Contract Manager will result in a 2% reduction of payment per business
day the CAP is not received. The reduction of payment will begin the first business day following the
Agency's notification to the Contractor that the identified deficiency was not cured or satisfactorily
addressed in accordance with the Agency approved CAP, referenced in Section II. H.
5. Exceptions may be granted solely, in writing, by the Agency contract manager.
IV. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided
services must be submitted to the Agency Contract Manager in writing no later than December 31, 2017;
email requests are considered acceptable.
31
January 2017 — December 2017 OAA 203.17
B. Contractor's Financial Obligations
1. Matching, Level of Effort, and Earmarldng Requirements
The Contractor will assure, through a provision in subcontracts, a match requirement of at least 10
percent of the cost for services funded through this contract. The subcontractor's match will be made in
the form of cash and/or in-kind resources. The Contractor shall report match by title each month. At
the end of the contract period, the Contractor must properly match OAA funds that require a match.
2. Consumer Contributions
Consumer contributions are to be used under the following terms:
a. The Contractor assures compliance with Section 315 of the OAA as amended in 2006, in regard
to consumer contributions;
b. Voluntary contributions are not to be used for cost sharing or matching;
c. Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; and
d. Voluntary contributions are to be used only to expand services.
3. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all federal, state, and other funds provided by the Agency for the
purpose specified in the contract. The Contractor must manage the service dollars in such a manner so as
to avoid having a wait list and a surplus of funds at the end of the contract period, for each program managed
by the Contractor. If the Agency determines that the Contractor is not spending service funds accordingly,
the Agency may transfer funds to other AAAs during the contract period and/or adjust subsequent
funding allocations accordingly, as allowable under state and federal law.
4. Title III Funds
The Contractor assures compliance with Section 306 of the OAA, as amended in 2006, that funds received
under Title III will not be used to pay any part of a cost (including an administrative cost) incurred by the
Contractor to maintain a contractual or commercial relationship that is not carried out to implement Title
III.
C. Remedies for Nonconforming Services
1. The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,
completely and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
2. If the Contractor fails to meet the prescribed quality standards for services, such services will not be
reimbursed under this contract. In addition, any nonconforming goods (including home delivered meals)
and/or services not meeting such standards will not be reimbursed under this contract. The Contractor's
signature on the Request for Payment Form certifies maintenance of supporting documentation and
acknowledgement that the Contractor shall solely bear the costs associated with preparing or providing
nonconforming goods and/or services. The Agency requires immediate notice of any significant and/or
systemic infractions that compromise the quality, security or continuity of services to clients.
D. Enforcement
1. In accordance with Section 430.04, F.S., the Agency may, without taking any intermediate measures
available to it against the Contractor, rescind the Contractors designation as a lead agency, if the Agency
finds that any of the following have occurred:
32 ,
v
January 2017 — December 2017 OAA 203.17
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety
of clients served, or substantially and negatively affected the operation of services covered pursuant to
this contract.
b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual
funds have been misappropriated.
c. Contractor has committed multiple or repeated violations of legal and regulatory standards, regardless
of whether such laws or regulations are enforced by the Agency, or the Contractor has committed or
repeated violations of Agency standards.
d. The Contractor has failed to continue the provision or expansion of services after declaration of a state
of emergency.
e. The Contractor has failed to adhere to the terms of this contract.
f. The Agency may, at its sole discretion, in accordance with Section 430.04, F.S., take immediate
measures against the Contractor, including: Corrective action, unannounced special monitoring,
temporary assumption of the operation of one or more contractual services, placement of the Contractor
on probationary status, imposing a moratorium on Contractor action, imposing financial penalties for
nonperformance, or other administrative action pursuant to Chapter 120, F.S.
g. In making any determination under this provision the Agency may rely upon findings of another
state or federal agency, or other regulatory body. Any claims for damages for breach of contract are
exempt from administrative proceedings and shall be brought before the appropriate entity in the venue
of Lee County. In the event the Agency initiates action to rescind an area agency on aging
designation, the Agency shall follow the procedures set forth in 42 U.S.C. 3025(b).
E. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of the Contractor or any Subcontractors and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that
the allegations will be referred to the State Attorney, a law enforcement agency, the United States
Attorney's office, or governmental agency, the Contractor shall notify the Contract Manager immediately. A
copy of all documents, reports, notes, or other written material concerning the investigation, whether in the
possession of the Contractor or Subcontractors, must be sent to the Contract Manager with a summary of
the investigation and allegations.
REMAINDER OF PAGE INTENTIONALL Y LEFT BLANK
33
January 2017 — December 2017
FINANCIAL AND COMPLIANCE AUDIT
OAA 203.17
I_rW 1I:���a-0"I
The administration of resources awarded by the Agency to the provider may be subject to audits and/or monitoring by the
Area Agency on Aging for Southwest Florida, Inc., as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 215.97, F.S.,
(see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the Agency staff,
limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this
agreement, the provider agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by
the Agency. In the event the Agency determines that a limited scope audit of the provider is appropriate, the provider agrees
to comply with any additional instructions provided by the Agency to the provider regarding such audit. The provider
further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the
Chief Financial Officer (CFO) or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular
A-133, as revised.
In the event that the provider expends $750,000.00 or more in federal awards during its fiscal year, the provider must have
a single or program -specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised.
EXHIBIT 2 to this agreement indicates federal resources awarded through the Agency by this agreement. In
determining the federal awards expended in its fiscal year, the provider shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended
should be in accordance with the guidelines established by OMB Circular A-133, as revised. An audit of the provider
conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the
requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the provider shall fulfill the requirements relative
to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised.
If the provider expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A-133, as revised, is not required. In the event that the provider expends less than $750,000.00
in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of OMB Circular
A-133, as revised, the cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid
from provider 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 agreements with the Agency shall be based on the agreement's requirements, including any
rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the
matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Agency
shall be fully disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc.
agreement involved. If not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A-133, as revised, the
schedule of expenditures of federal awards shall identify expenditures by agreement number for each agreement 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 provider's fiscal year end.
34 OCAO
January 2017 — December 2017 OAA 203.17
PART II: STATE FUNDED
This part is applicable if the provider is a non -state entity as defined by Section 215.97(2), F.S.
In the event that the provider expends a total amount of state financial assistance equal to or in excess of $750,000.00 in
any fiscal year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider 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 Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General. EXHIBIT 2 to this agreement indicates state financial assistance awarded
through the Agency by this agreement. In determining the state financial assistance expended in its fiscal year, the
provider shall consider all sources of state financial assistance, including state financial assistance received from the
Agency, other state agencies, and other nonstate entities. State financial assistance does not include Federal direct or
pass-through awards and resources received by a nonstate entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part Il, paragraph 1, the provider shall ensure that the audit complies
with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as defined by
Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations),
Rules of the Auditor General.
If the provider expends less than $750,000.00 in state financial assistance in its fiscal year (for fiscal years ending September
30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, F.S., is not required. In the
event that the provider expends less than $750,000.00 in state financial assistance in its fiscal year and elects to have an
audit conducted in accordance with the provisions of Section 215.97, F.S., the cost of the audit must be paid from the
nonstate entity's resources (i.e., the cost of such an audit must be paid from the provider resources obtained from other than
State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Agency shall be based on the agreement's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching
requirement was met for each applicable agreement. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency agreement involved. If not otherwise disclosed as required by
Rule 69I-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by
agreement number for each agreement with the Agency in effect during the audit period. Financial reporting
packages required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12
months after the provider's fiscal year end for local governmental entities. Non-profit or for-profit organizations are
required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the provider'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 agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by
PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on
behalf of the provider directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. at each of the following addresses:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, Vice President of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
35 9
January 2017 — December 2017 OAA 203.17
The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections
.320 (d)(1) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at the
following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10' Street
Jeffersonville, IN 47132
Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as
revised.
Pursuant to Sections .320(f), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the
Area Agency on Aging for Southwest Florida, Inc. at each of the following addresses:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, Vice President of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on behalf
of the provider directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. at each of the following addresses:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, Vice President of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letter, or other information required to be submitted to the Agency pursuant to this agreement
shall be submitted timely in accordance with OMB Circular A-133, F.S., and Chapters 10.550 (local governmental entities)
or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Providers, when submitting financial reporting packages to the Agency for audits done in accordance with OMB
Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules
of the Auditor General, should indicate the date that the reporting package was delivered to the provider in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement 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 provider shall ensure that audit working papers are made available to the
Agency, or its designee, CFO, or Auditor General upon request for a period of six (6) years from the date the audit
report is issued, unless extended in writing by the Agency.
36 0
OAA 203.17
January 2017 — December 2017
ATTACHMENT II, EXIIIBIT I
PART I: AUDIT RELATIONSHIP DETERNIINATION
Providers who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part
§200.500, and/or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients of federal
awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set
forth in Part I and/or Part II of Exhibit 1 is met. Providers who have been determined to be vendors are not subject to the
audit requirements of 2 CFR Part §200.3 8, and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements
are met, providers who have been determined to be recipients or subrecipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part §200 and/or Rule 69I-5.006, FAC, provider has been determined to be:
Vendor not subject to 2 CFR Part §200.38 and/or Section 215.97, F.S.
X Recipient/subrecipient subject to 2 CFR Part §200.86 and §200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part §200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a provider is determined to be a recipient/subrecipient of federal and or state financial assistance and has been
approved by the department to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-.5006, FAC [state
financial assistance] and 2 CFR Part §200.330[federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a
subrecipient must comply with the following fiscal laws, rules and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part §200.416 — Cost Principles*
2 CFR Part §200.201 — Administrative Requirements**
2 CFR Part §200.500 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part §200.400-.411— Cost Principles*
2 CFR Part §200.100 — Administrative Requirements
2 CFR Part §200.500 — 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 Part §200.418 — Cost Principles*
2 CFR Part §200.100 — Administrative Requirements
2 CFR Part §200.500 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
37 @D0
January 2017 — December 2017
OAA 203.17
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the 2
CFR Part §200.400(5) (c).
**For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S.
Department of Education, 34 CFR 80.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient/subrecipient must comply with the following fiscal laws, rules and regulations:
Section 215.97, Fla. Stat.
Chapter 69I-5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
REMAINDER OF PAGE INTENTIONALL Y LEFT BLANK
38 'Ad
January 2017 — December 2017
FUNDING SUMMARY
OAA 203.17
/:,I 0 kffo 11,10_WL oil I
Note: Title 2 CFR §20033 I,as revised, and Section 215 97(5), Florida Statutes, require thatthe information about federal programs
and State Projects beliovidedtothe Recipient and are stated in The Financial And Compliance Audit Attachment And Exhibit 1.
Financial And Compliance Audit Attachment, Exhibit 2 -Funding Summary Provides Information Regardingthe Funding Sources
Applicable tothiscontract, contained herein, is aprediction offunding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
COLLIER COUNTY
GRANT AWARD (FAIN#): 17AAFLT3SS, 17AAFLT3CM, 17AAFLT3HD, 17AAFLT3PH, 17AAFLT3FC
DUNS NUMBER: 833441814
FEDERAL AWARD DATE: OCTOBER 20, 2016
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Older Americans Act Title HIB —
Transportation
U.S. Health and Human Services
93.044
$ 14,918.00
Support Services
$ 327,793.00
$ 342,711.00
Total HIB
OAA Title IIIC1 — Congregate Meals
U.S. Health and Human Services
93.045
$ 280,887.00
Total HIC1
OAA Title III C2 — Home Delivered Meals
Total HIC2
U.S. Health and Human Services
93.045
$ 256,107.00
Older Americans Act Title HI E
Services (Title III E)
$ 104,437.00
Supplement Services (Title III ES)
U.S. Health and Human Services
93.052
$ 12,287.00
Grandparent Services (Title III EG)
$ 6,145.00
Total HIE
$ 122,869.00
NSIP
U.S. Health and Human Services
93.053
$ 51,314.28
TOTAL FEDERAL AWARD
$1,053,888.28
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards/
OMB Circular A-133 — Audits of States, Local Governments, and Non -Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING.
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO
THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97, F.S., Chapter 69I-5, FL Admin Code, Reference Guide for State Expenditures, Other fiscal requirements set forth in
program laws, rules and regulations.
919
January 2017 — December 2017
CERTIFICATIONS AND ASSURANCES
OAA 203.17
ATTACHMENT IV
AGENCY will not award this Contract unless Contractor completes the CERTIFICATIONS AND ASSURANCES contained in
this Attachment. In performance of this Contract, Contractor provides the following certifications and assurances:
A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 74)
B. Certification Regarding Lobbying (29 CFR Part 93 and 45 CFR Part 931
C. Nondiscrimination & Equal Opportunity Assurance (29 CFR Part 37 and 45 CFR Part 80)
D. Certification Regarding Public Entity Crimes, section 287.133, F.S.
E. Association of Community Organizations for Reform Now (ACORN) Funding Restrictions Assurance (Pub. L.
111-117)
F. Certification Regarding Scrutinized Companies Lists, section 287.135, F.S.
G. Certification Regarding Data Integrity Compliance for Agreements Grants, Loans and Cooperative Agreements
H. Verification of Employment Status Certification
I. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS —
PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered
transactions by a Federal department or agency;
2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered against them
for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public
(Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes
or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements,
or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State or local) with
commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal,
State, or local) terminated for cause of default.
B. CERTIFICATION REGARDING LOBBYING — Certification for Contracts, Grants, Loans, and Cooperative Agreements.
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
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 employees of
40
,r
January 2017 — December 2017 OAA 203.17
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub -
recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this Contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31
U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART 80).
As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal opportunity
provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination against
all individuals in the United States on the basis of race, color, religion, sex national origin, age, disability, political
affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted immigrant
authorized to work in the United States or participation in any WIA Title I -financially assisted program or activity;
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant to
the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance with
Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or national
origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any
program or activity for which the Applicant receives Federal financial assistance from the Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112) as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in accordance with
Section 504 of that Act, and the Regulation, no otherwise qualified handicapped individual in the United States shall,
solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
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 end that, in accordance with the
Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of, be excluded
from participation in, or be subjected to discrimination under any program or activity for which the Applicant receives
Federal financial assistance from the Agency.
5. Title IX of the Educational Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded from
participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education program or
activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), prohibits discrimination in all employment practices,
including, job application procedures, hiring, firing, advancement, compensation, training, and other terms, conditions,
and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe benefits, and all other
employment-related activities, and;
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed
above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or activity, and
to all agreements Contractor makes to carry out the WIA Title I — financially assisted program or activity. Contractor
understands that Agency and the United States have the right to seek judicial enforcement of the assurance.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
41
CAO
January 2017 — December 2017
OAA 203.17
Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform Agency immediately upon any change of circumstances
regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions pertaining to
ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub. L. 111-117). The
Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that appropriations made under Pub.
L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers
(including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub recipients
and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS CERTIFICATION, SECTION 287.135, F.S.
If this Contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135, F.S.,
Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the
Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List. Both lists are created pursuant to section
215.473, F.S.
Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may subject Contractor
to civil penalties, attorney's fees, and/or costs.
If Contractor is unable to certify to any of the statements in this certification, Contractor shall attach an explanation to this
Contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS
AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have financial management systems capable of
providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each
grant -funded project or program in accordance with the prescribed reporting requirements; (2) the source and application
of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award.
The inability to process information in accordance with these requirements could result in a return of grant funds that
have not been accounted for properly.
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the Contractor
is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be capable of
processing data accurately, including year -date dependent data. For those systems identified to be non-compliant,
Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions of
these products offered by the Contractor (represented by the undersigned) and purchased by the state will be verified for
accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede
the hardware or software programs from operating properly, the Contractor agrees to immediately make required
corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge
to the state, and without interruption to the ongoing business of the state, time being of the essence.
The Contractor and any Subcontractors of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data
integrity compliance issues.
42 9
January 2017 — December 2017
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
OAA 203.17
As a condition of contracting with the Agency, the 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 Agreement utilize the E -verify
system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract term.
The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and other
agreements and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB
Circulars A-102 and 2 CFR Part 200, and 215 (formerly OMB Circular A-110).
I. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of sections, 10.1, 10.2 of the Standard contract, and 119.0701(3) and (4) Fla. Stat., and
any other applicable law, if a civil action is commenced as contemplated by s. 119.0701(4), Fla. Stat., and the Agency is
named in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the
Agency, and any attorneys' fees assessed or awarded against the Agency from a Public Records Request trade
pursuant to chapter 119, Fla. Stat., concerning this contract or services performed thereunder.
2. Section 119.01(3), Fla. Stat., states if public funds are expended by an agency in payment of dues or membership
contributions for any person, corporation, foundation, trust, association, group, or other organization, all the financial,
business, and membership records of such an entity which pertain to the public agency (Area Agency on Aging for
Southwest Florida) are public records. Section 119.07, Florida Statutes, 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.
Additionally, I certify this organization does X does not
provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Department
are available for inspection as stated above.
By signing below, Contractor certifies the representations outlined in parts A through I above are true and correct.
AA1 V -W
Public Services Department Head
(Signature and Title of Authorized Representative)
Collier County Board of County Commissioners
3339 Tamiami Trail E., Suite 217
(Street)
Naples, FL 34112
(Contractor) (Date) (City, State, ZIP Code)
Approved as to form and legality
Assistant County Attorney OP\�
`
43 `�
January 2017 – December 2017
ASSURANCES—NON-CONSTRUCTION PROGRAMS
OAA 203.17
ATTACHMENT V
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §4728-4763) relating to prescribed standards
for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
§794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended
(42 U.S.C. §6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment
Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §523 and 527 of the Public Health Service
Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific
statute(s) under which application for federal assistance is being made; and 0) the requirements of any other
nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
44 Q
January 2017 — December 2017 OAA 203.17
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §1501-1508 and 7324-7328), which limit
the political activities of employees whose principal employment activities are funded in whole or in part with federal
funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §276a to 276a-7), the Copeland Act
(40 U.S.C. 276c and 18 U.S.C. §874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §327-333),
regarding labor standards for federally assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
It. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. §1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection
of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §2131 et seq.)
pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §4801 et seq.), which prohibits the use of
lead- based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and OMB Circular No. A-133, Audits of States, Local Governments, and Non -Profit
Organizations.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies
governing this program.
Assistunt County Attorney
OAA 203.17
January 2017 — December 2017
ATTACHMENT VI
cTArrV n1W UT num A "UP eRTATFNT nF F.T.DFR AFFATRC CIVH. RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name: Collier County Services for Seniors
County: Collier
AAA/Contractor: AAA of Southwest
Hispanic
P
Other
Florida
Address: 3339 Tamiami Trail E., Suite 211
Completed By: Lisa N.
Source of data: DOEA
Carr
City, State, Zip Code: Naples, FL 34112
Date: 1/12/17
Telephone: 23-252-2339
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
a. Briefly describe the geographic area served by the program/facility and the type of service provide: Collier County Community and Hamar
Services is situated over a 2,300 square mile area. Collier County Community and Human Services provides in-home care, facility adult day care, case managemen
and nutrition services to frail, elderly residents of Collier County.
For questions 2-5 please indicate the foll
2. Population of area served
3. Staff currently employed
4. Clients currently enrolled/registered
5. Advisory/Governing Board if applicable
)win g:
Total # White
Black
Hispanic
P
Other
Female
Disabled
Over 40
Source of data: DOEA
123,199 88.4 %
2.9 %
7.7%
1%
53.9%
n/a
100%
Effective date: 1/10/2017
10 3
2
4
1
9
0
9
Effective date: 1/10/2017
457 135
38
186
98
64%
n/a
100%
4.
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?
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO EXPLAIN.
1.
Is an Assurance of Compliance on file with AGENCY?
N/A
YES
NO
❑
■
❑
2.
Compare the staff composition to the population. Is staff representative of the population?
N/A
YES
NO
❑-
❑
3.
Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
N/A
YES
NO
origin, sex, age, religion or disability?
❑
❑
4.
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?
5.
For in-patient services, are room assignments made without regard to race, color, national origin or disability?
N/A
YES
NO
6.
For in-patient services, are room assignments made without regard to race, color, national origin or disability?
N/A
YES
NO
7.
Is the program/facility accessible to non-English speaking clients?
N/A
YES
NO
8.
Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
N/A
YES
NO
Verbal El Written Poster t��
❑
■
❑
46
X401
OAA 203.17
January 2017 — December 2017
9. Give the number and current status of any discrimination complaints regarding services or employment fled
N/A NUMBER
against the program/facility.
�I
10. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals?
N/A
YES NO
❑
!J ❑
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF NO
EXPLAIN.
11. Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make any
YES
NO
necessary modifications?
El
❑
12. Is there an established grievance procedure that incorporates due process in the resolution of complaints?
YES
NO
❑
❑
13. Has a person been designated to coordinate Section 504 compliance activities?
YES
NO
14. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on
YES
NO
the basis of disability?
❑
n
15. Are auxiliary aids available to assure accessibility of services to hearing and sight -impaired individuals?
YES
NO
❑
❑
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE. YES
NO
16. Do you have a written affirmative action plan? If NO, explain.
Reviewed By In Compliance: YES NO*
Program Office *Notice of Corrective Act ion Sent—/—
Date
ent/Date Telephone Response Due
On -Site Desk Review Response Received—L /
47
OAA 203.17
January 2017 — December 2017
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 and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population statistics
can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing
Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific
Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for AGENCY Recipients and their Subgrantees, 45 CFR 80.4 (a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. 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, 45 CFR 80.3 (b) (6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a)
and 45 CFR 80.1 (b) (2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin,
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting
rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b).
11. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability, 45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist
in the provision of services, 45 CFR 80.3 (a).
48 00
OAA 203.17
January 2017 — December 2017
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested parties. This should include information on their right to file a
complaint of discrimination with either the Area Agency on Aging for Southwest Florida, Inc., Florida
Department of Elder Affairs or the U.S. Department of HHS. The information may be supplied verbally or in
writing to every individual, or may be supplied through the use of an equal opportunity policy poster displayed in
a public area of the facility, 45 CFR 80.6 (d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or 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,
e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes
designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public
telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door
widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines
should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers.
Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an
appropriate height for mobility impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
1. With the assistance of a disabled individual/organization, evaluate current practices and policies which do
not comply with Section 504.
2. Modify policies and practices that do not meet Section 504 requirements.
3. Take remedial steps to eliminate any discrimination that has been identified.
4. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps
have been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Section 504.45 CFR 84.7 (b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper
ads, and other appropriate written communication, 45 CFR 84.8 (a).
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters
for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide
equally effective services, 45 CFR 84.52 (d).
21. Programs/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 60
and Title VI of the Civil Rights Act of 1964, as amended.
49 0
O
r
o ma
o 0
0
Q
I
v
Ln
frt
f1
\iT
(Vrt\'
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0
D
i
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r
U)'
rt
January 2017 — December 2017
DEPARTS\4ENT OF
ELDER
AFFAIRS
STATE OF FLORIDA
OAA 203.17
ATTACHMENT VIII
BACKGROUND SCREENING
Affidavit of Compliance - Employer
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
➢ The term "employer" means any person or entity required by law to conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §§
435.02, 430.0402, Fla. Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has access to the client's living area, funds, personal property, or personal identification information
as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities; and volunteers." § 430.0402(1)(b), Fla. Stat.
ATTESTATION:
As the duly authorized representative of Collier County Community and Human Services
Employer Name
located at 3339 Tamiami Trail East Suite 211 Naples FL 34112,
Street Address city State ZIP code
I, Kimberley Grant, Director of Community and Human Services do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402, Florida Statutes, regarding level 2 background screening.
JSign0 -
Sig nature
ature of Representative Date
STATE OF FLORIDA, COUNTY OF Collier MY COMMISSION#EE 876607
o;
EXPIRES: May 20, 2017
•� �f��1d�' Bonded ThN Notary Public UndeiwrAers
Sworn to (or affirmed) and subscribed before me this day of J !by -
KI✓ (Name of Representative) who is personally known
to me or produdd as proof of identification.
2( I'S c I. �A nu
Print, Type, or Stamp Commissioned Name of Notary Public Notary Public
DOEA Form 235, Affidavit of Compliance - Employer, Effective April 2012
Form available at: http://elderaffairs.state.fl.us/english/backaroundscreenins.php
51
Section 435.05(3), F.S.
January 2017 — December 2017
OAA 203.17
ATTACHMENT IX
MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES (MBE FORM)
MBE FORM MUST ACCOMPANY INVOICES SUBMITTED TO AGENCY.
PROVIDER NAME:
AGENCY CONTRACT NUMBER:
*REPORTING PERIOD -FROM: TO:
*(DATE RANGE OF RENDERED SERVICES, MUST MATCH INVOICE SUBMITTED TO
AGENCY) AGENCY CONTRACT MANAGER:
RE ORT ALL EXPENDITURES ITURES MADE TO SUBCONTRACTORS_ INDICATE WHICH SUBCONTRACTORS
ARE CERTIFIED MBE AND MINORITY NON-PROFIT ORGANIZATIONS OR MBE BUT ARE NOT A
/,ITTITTTTTn T,mT A C+ 711r1rTxTTT\ YXT Q1rf V11"-kT'1QQ ^1!1'2 UT "13MA QWAr"T'rUQ ilii cTr_NATF"(-X RF/N(_lN_
CONTACT BYRON SAPER FOR ANY QUESTIONS AT 850-414-2044.
SUBCONTRACTOR
NAME
SUBC_ ONTRAC TOR'S
GMBE
NON-
CMBE
SUBCONTRAC TOR'S
PERIOD
EXPENDITURES
FEID
CMBE NUMBER
AGENCY USE ONLY -- REPORTING ENTITY (DIVISION, OFFICE, ETC)
SEND COMPLETED FORMS VIA INTEROFFICE MAIL TO: DAWN SWEENEY & AAA will forward to BRYON SAPER,
MBE COORDINATOR, CONTRACT ADMINISTRATION & PURCHASING, TALLAHASSEE, FLORIDA 32399-7000.
52 Qat
January 2017 — December 2017 OAA 203.17
I. DEFINITIONS.-
MINORITY
EFINITIONS.MINORITY PERSON MEANS A LAWFUL, PERMANENT RESIDENT OF FLORIDA WHO IS:
56. AN AFRICAN AMERICAN, A PERSON HAVING ORIGINS IN ANY OF THE RACIAL GROUPS OF THE AFRICAN
DIASPORA, REGARDLESS OF CULTURAL ORIGIN.
57. A HISPANIC AMERICAN, A PERSON OF SPANISH OR PORTUGUESE CULTURES WITH ORIGINS IN SPAIN,
PORTUGAL, MEXICO, SOUTH AMERICA, CENTRAL AMERICA, OR THE CARIBBEAN, REGARDLESS OF RACE.
58. AN ASIAN AMERICAN, A PERSON HAVING ORIGINS IN ANY OF THE ORIGINAL PEOPLES OF THE FAR EAST,
SOUTHEAST ASIA, THE INDIAN SUBCONTINENT, OR THE PACIFIC ISLANDS, INCLUDING THE HAWAIIAN
ISLANDS PRIOR TO 1778.
59. A NATIVE AMERICAN, A PERSON WHO HAS ORIGINS IN ANY OF THE INDIAN TRIBES OF NORTH AMERICA
PRIOR TO 1835, UPON PRESENTATION OF PROPER DOCUMENTATION THEREOF AS ESTABLISHED BY RULE OF
THE DEPARTMENT OF MANAGEMENT SERVICES.
60. AN AMERICAN WOMAN.
61. SERVICE VETERAN, ANY PERSON THAT HAS SERVED IN THE U.S. MILITARY. THIS PERSON DOES NOT HAVE
TO BE CLASSIFIED AS BEING A MINORITY PERSON CLASSIFIED IN A-E ABOVE.
SMALL BUSINESS MEANS AN INDEPENDENTLY OWNED AND OPERATED BUSINESS CONCERN THAT EMPLOYS 100
OR FEWER PERMANENT FULL-TIME EMPLOYEES AND HAS A NET WORTH OF NOT MORE THAN $3,000,000 AND AN
AVERAGE NET INCOME, AFTER FEDERAL INCOME TAXES, OF NOT MORE THAN $2,000,000.
CERTIFIED MINORITY BUSINESS ENTERPRISE MEANS A business which has been certified by the certifying organization or
jurisdiction in accordance with s. 287.0943(1) and (2).
NON -CERTIFIED MINORITY BUSINESS MEANS A SMALL BUSINESS WHICH IS AT LEAST 51 PERCENT OWNED AND
OPERATED BY A MINORITY PERSON(S).
MINORITY NON-PROFIT ORGANIZATION MEANS A NOT-FOR-PROFIT ORGANIZATION THAT HAS AT LEAST 51
PERCENT MINORITY BOARD OF DIRECTORS, AT LEAST 51 PERCENT MINORITY OFFICERS, OR AT LEAST 51
PERCENT MINORITY COMMUNITY SERVED.
II INSTRUCTIONS
1. ENTER THE COMPANY NAME AS IT APPEARS ON YOUR AGENCY CONTRACT.
2. ENTER THE AGENCY CONTRACT NUMBER.
3. ENTER THE SERVICE PERIOD MATCHING THE CURRENT INVOICE'S SERVICE PERIOD.
4. ENTER ALL SUBCONTRACTOR EXPENDITURES FOR THE TIME PERIOD COVERED BY THE INVOICE:
(1) ENTER SUBCONTRACTOR'S NAME.
(2) ENTER THE SUBCONTRACTOR'S FEID NUMBER.
(3) PLACE A CHECKMARK TO DESIGNATE THE SUBCONTRACTOR AS A CERTIFIED MINORITY BUSINESS
ENTERPRISE.
(4) PLACE A CHECKMARK TO DESIGNATE THE SUBCONTRACTOR AS A MINORITY NON-PROFIT
ORGANIZATION OR A NON -CERTIFIED MINORITY BUSINESS EXPENDITURE.
(5) ENTER THE SUBCONTRACTOR'S CMBE NUMBER. THE SUBCONTRACTOR CAN PROVIDE YOU WITH THIS
NUMBER IF THEY ARE CERTIFIED.
(6) ENTER THE AMOUNT EXPENDED WITH THE SUBCONTRACTOR FOR THE TIME PERIOD COVERED BY THE
INVOICE.
5. MBE FORM MUST ACCOMPANY INVOICE PACKAGE SUBMITTED TO AGENCY FINANCIAL
ADMINISTRATION FORPROCESSING.
6. FINANCIAL ADMINISTRATION WILL FORWARD ALL COMPLETED MBE FORMS TO CONTRACT
ADMINISTRATION & PURCHASING OFFICE
53 1
January 2017 — December 2017
Budget Summary
OLDER AMERICANS ACT BUDGET SUMMARY
OAA 203.17
ATTACHMENT X
CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY
1. Title III B Support Services $ 342,711.00
2. Title III C1 Congregate Meals $ 280,887.00
3. Title III C2 Home Delivered Meals $ 256,107.00
4. Title III E Services $ 122,869.00
5. NSIP $ 51,314.28
TOTAL $1,053,888.28
54
a
January 2017 - December 2017
Rate Summary
OLDER AMERICANS ACT RATE SUMMARY
OAA 203.17
CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY
IIIB
Services
Total Cost Reimbursement Rate
Adult Day Care
12.83
11.55
Case Aide
33.89
30.50
Case Management
60.00
54.00
Chore
23.33
21.00
Chore (Enhanced)
30.33
27.30
Companionship
23.33
21.00
Emergency Alert Response
1.31
1.18
Escort
21.67
19.50
Homemaker
21.50
19.35
Housing Improvement
100% Cost
90% of Cost
Material Aid
100% Cost
90% of Cost
Personal Care
25.67
23.10
Respite In -Facility
12.83
11.55
Respite In -Home
25.67
23.10
Screening and Assessment
60.00
54.00
Shopping Assistance
21.00
18.90
Skilled Nursing Services
42.00
37.80
Specialized Medical Equipment, Services, and
Supplies
100% Cost
90% of Cost
Transportation
100% Cost
100% of Cost
55
C1,0
January 2017 - December 2017
Services
COLLIER COUNTY
IIIE, IIIES, & IIIEG
Total Cost
OAA 203.17
Reimbursement Rate
HIE - Adult Day Care
$ 12.83
$ 11.55
Direct Pay Respite
$ 16.67
$ 15.00
Respite In -Facility
$ 12.83
$ 11.55
Respite In -Home
$ 25.67
$ 23.10
Screening & Assessment
$ 60.00
$ 54.00
IIIES-- Chore
$ 23.33
$ 21.00
Enhanced Chore
$ 30.33
$ 27.30
Specialized Medical Equipment, Service &
Supplies
100% Cost
90% of Cost
Material Aid
100% Cost
90% of Cost
IIIEG- Child Day Care
$ 16.67
$ 15.00
Screening/Assessment
$ 60.00
$ 54.00
COLLIER COUNTY
C-1 & C-2
Services Total Cost Reimbursement Rate
C1
Congregate Meals
$ 9.88
$ 8.90
Nutrition Education
$ 1.80
$ 1.62
Congregate Meal Screening
$31.12
$28.00
Outreach
$4.80 per person
$4.32 per person
C2
Home Delivered Meals
$ 9.77
$ 8.80
Nutrition Education
$ 1.80
$ 1.62
Screening & Assessment
$60.00
$54.00
Outreach
$4.80 per person
$4.32 per person
5
ICA
January 2017 — December 2017
Report Number
1
2
0
6
7
9
10
11
12
13
14
15
16
INVOICE SCHEDULE
Based On
January Advance*
February Advance*
January Expenditure Report
February Expenditure Report
March Expenditure Report
April Expenditure Report
May Expenditure Report
June Expenditure Report
July Expenditure Report
August Expenditure Report
September Expenditure Report
October Expenditure Report
November Expenditure Report
December Expenditure Report
Final Expenditure and Request for Payment
Closeout Report
Legend: * Advance based on projected cash need.
OAA 203.17
ATTACHMENT XI
Submit to Agency
On This Date
January 1
January 1
February 9 *See Note 94*
March 9
April 9
May 9
June 9
July 9
August 9
September 9
October 9
November 9
December 9
January 9
February 15
March 1
Note # 1: Report #1 for Advance Basis Agreements cannot be submitted to the Agency prior to
January 1 or until the agreement with the Agency has been executed.
Note #2: Report numbers 5 through 14 shall reflect an adjustment of one-tenth of the total advance
amount, on each of the reports, repaying advances issued the first two months of the agree-
ment. The adjustment shall be recorded in Part C, 1 of the report (ATTACHMENT XII).
Note # 3: Submission of expenditure reports may or may not generate a payment request. If final
expenditure report reflects funds due back to the Agency, payment is to accompany the
report.
Note #4: ALL Expenditure Reports are due by 12:00 p.m. on the 9th of each month. IF the 91h falls
on a Saturday, then the report will be due by the 8th by 12:00 p.m. AND IF the 9th falls
on a Sunday, the report will be due by the 10th by 12:00 p.m. Actual submission of the
vouchers to Dept. of Elder Affairs is dependent on the accuracy of the expenditure report
which is verified and paid by CIRTS data only.
57 00P
January 2017 — December 2017
OAA 203.17
ATTACHMENT XII
REQUEST FOR PAYMENT
OLDER AMERICANS ACT
Providertlante, Address and Phone #:
Type of Report:
This Report Period:
F rom: To.
Report #
F+.d%nnce
Contract
Contract Period:
Reimbursement
01101/16 - 12/31116
CE RTIFICATIOII : I certify to the best of my knoviledge and belaefthat this report is complete and all outlays herein are for purposes set brth
in the contract.
Prepared By —_ _ pate: approved By. Date:
PART A:
(tj
2)
t'1
(4)
(5}
BUDGET SUMMARY
it 3
u1
i8iC2
IIIE
TOT+uL
1. A.ppro,.ed
Contract Amount.
50.00
50.00
GO. CO
S4.CC
2. Precious Funds
RE CEPJED br
Contract perirod
50:40
50.00
50.00
50.00
-C.CO
?. Contract Balance
$0.00
4, Precious Funds
RE Q UE STE D and
Not Received.
SC.4G
54. CC
50. CC
SC.CC
$0.00
S. Contract Balanic
$0.00
PART B:
FUNDS REQUESTED
Expenditures
[I!r5Net
For555
or M cath
54,44
5U. CC
(t 1
£4.44
54.44
CC(5 (n
J4.4iL
PART C:
NET FUNDS REQUESTED:
1. Leas Ad%ence Payment
Hereby Requested For
SO,CC
SC. 01,14
SC. CC
S0,00
2. Contract Funds are
Hereby Requested For
January 2017 - December 2017
OAA 203.17
ATTACHMENT XIII
RECEIPTS AND EXPENDITURE REPORT
OLDER AMERICAN ACT
Provider Ila rne,Address and Phone #.
Program Funding Source:
This Report Pericid:
From: To:
Title III
Report
C1
Contract #
Contract Period:
01101116 -12131115
CERTIFICATION: t certify to the best ofmy knos,Aedge and belief that this report is complete and all outlays herein are br purposes set brth
in the contract.
Prepared by: -Date, Approved by, Date
PARTA: BUDGETED INCOME/ RECEIPTS
1.Appro.ed
2. Actual Receipts
3. Total Receipts
(5�
Budget
For This Report
Year to Date
Approwd Budget
1. federal Funds
50.00
SO.00
50.00
0.00%
2 State Funds
$0.00
50.00
SO.00
0.00%
S Other, In -Kind & Local Match
50,:00
$0.00
50.00
0.00%
4. P rogram Income
50.00
50.00
$0.00
0.00%
5, TOTAL RECEIPTS
50 CO
$000
$0.00
0.00%
PART® : EXP E14DRU RES
1. r`pprowd
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Yeartu Date
Appru,&d Budget
1, All 111C Services
$0,00
50,00
50.00
0,04%
2 TOTAL EXPE14DRU RES
59 00
50 GG
sc, W
0.00%
PARTC : OTHER EXPENDITURES
(ForTracking Purposes only)
1. Match
a. Other and In -Kind
50.00
50.00
50.00
0.00%
b_ Local Match
$0.00
$0.00
50.00
0.00%
2 Program Income
50.00
50.00
50.00
0.00%
3. TOTAL OTHE R
50 00
s4 00
50 GO
0.00%
59
&
OAA 203.17
January 2017 — December 2017
RECEIPTS AND EXPENDITURE REPORT
OLDER AMERICAN ACT
Provider Name, Addrressand Phone #:
Program Funding Source:
ThisReport Period:
From: To:
Title III
Report #
C2
Contract #
Contract Period:
01101/16 -12131116
CE RTIFICA1I011 : I certify to the best ofmy kno%,Aedge and beliefthat this report is complete and all outlays herein are br purposes set forth
in the contract.
Prepared by : Date : Approved by, Date:
PARTA: BUDGETED INCOME/ RECEIPTS
1, Approved
2. Actual Receipts
3. Total Receipts
(5)
Budget
For This Report
Yearto Date
Approved Budget
1_ Federal Funds
SO -00
50.00
$0-00
0.00°%
2 State Funds
SO.00
50.00
$0.00
0.00%
3. Other, In4(Ind & Lord btatch
$0.00
50.00
50.00
0.00%
4_ Program Income
50.00
50.00
SO.00
0A0°%
5, TOTAL RE CE kPTS
50 00
50 00
$0,00
0.00%
PARTS: EVE14DITURE S
1, Approved
2. Expenditures
3. Expenditures
4, Percent of
Budget
For This Report
Yearto Date
Approved Budget
I. All PIC1 Seruces
50,00
50,00
50,00
0,00°%
2 TOTAL EXPENDITURE S
SG co
Sc 0c
50 CC
0,00°%
PART : OTHER EXPENDITURES
(ForTracking Purposes only)
1. Match
a_ Other and In4(ind
SO.00
$0.00
50.00
0.00%
b. Local Match
50.00
50:00
WA
0.00%
2 Program income
SO.00
$0.00
WOO
0.00°%
1 TOTAL OTHER
$0.00
$0.40
$0.00
0.00°%
60 lam,
OAA 203.17
January 2017 - December 2017
RECEIPTS AND EXPENDITURE REPORT
OLDER AMERICAN ACT
Provider Name, Addressand Phone #:
Program Funding Source:
This Report Period
From: To:
Title Ill
Report #
E
Contrad
Contract Period:
01101118 -12/31116
CE RTFICATIOU : I certify to the best ofmy knovdedge and belief that this repo is complete and all outlays herein are for purposes set bdh
in the contract_
Prepared by ; Date : Apprwed by: Date :
PARTA: BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts (5)
Budget For This Report Year to Date Approved Budget
1. Federal Funds $0.00 50,00 50.00 Ho%
2 State Funds $0.00 $O-00 $0.00 0.00%
3. Other, In -Kind & Loral Match 50.00 50.00 50.00 0.00%
4 Program Income 50.00 50,00 50.00 0.00%
5 TOTAL RECEIPTS $000 $O CO 50. 00 0.00%
PARTS: EXPENDITURES
1. Approved
2_ Expenditures
3_ ExpendRures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. All 1f SeMoes
50.00
50.00
50.00
0.00%
2 TOTAL EXPENDITURES
$0.00
$0.00
so. 00
0.00°x6
PART C : OTHE R EXP E 11 DITU RE S
(ForTraeking Purposes orgy)
1. M atch
a. tither and In -Kind
50.00
$000
50.00
0.00%
b. Local Match
SO.00
.5Q00
$01.00
0.00%
2 Program Income
$0.00
50.00
50.00
0.00%
3, TOTAL OTHER
$0.00
$C CO
50.00
0.00%
61
SAO
January 2017 — December 2017
RECEIPTS A ND EXPENDITURE REPORT
OAA 203.17
PROVIDER NAME, ADDRESS, PHONE# and FEW
PROGRAM FUNDING SOURCE
TITLE III
NSIP
Contract #
Contract Period
Report Period
Report #
Invoice #
I
CERTIFICATION: I hereby certify that to the best of my knowledge the information in this report is accurate and complete and that all outlays reported herein were for pu a
set forth in the contract documents.
Pre aced by: Date: roved by:
Date
I I
i
j
PART A: EXPENDITURE COMPUTATION
YEAR TO DATE
CURRENT MONTH
CONGREGATE HOME DELIVERED
CONGREGATE HOME DELIVERED
I
1. Number of Meals Served
0
0
0
0
2. Line 1 Times $ .72 cents per Meal
$0.00
$0.00
$0.00
$0.00
I
J
Year To Date Total Meals
0
Current Month Total Meals
0
Year To Date Total Reimbursed $0.00 Total Current Expenditures 1
$0.00
PART B: CONTRACT SUMMARY
1. A roved Contract Amount
2. Actual Receipts for this Report
I
$0.00
$0.00
3. Total Receipts Year to Date
$0.00
I
I
�
i
i
I
DOEA Form 105as NSIP revised 11/17/18
62 9
January 2017 - December 2017
OAA 203.17
ATTACHMENT XIV
Please include the following CIRTS reports:
For all unit rate services:
Monthly and YTD Service Units with Unduplicated Client Counts
Please be sure that the YTD units tie out to this report,
For cost reatibursement services:
Services Reported by Program and Service Report
Run from 01/01 /16 through the current month end.
Please be sure that all YTD dollars are equal to or less than the YTD amounts on this report.
63
G
Unit Cost Report
Older Americans Act
IIIB
From: To:
Report n
Contract R
Contract Period:
01/01/16 -12/31/16
Unit Rate Services
Retro's
Units this
tv1011th
Total
Units this
Request
YTD Units
Rate
Earned this
Period
Earnest YTD
ADC
0.00
0.00
0.00
0.00
SO.00
50 00
$0.00
CA
0.00
0.00
0.00
0.00
SO.00
SO.LC
$0.00
CHO
0.00
0.00
0.010
0.00
$0.00
S0 00
50.00
ECHO
0.00
0.00
0.01;
0.00
SO.00
SO.00
SO.00
CrA
0,00
a. -O.0
G.00
0.00
50-00
510,00
SO.00
COMP
a.W
a,aa
O,flcj
0.00
SG -00
50.00
$0.00
EAR
0.00
0.00
0.00
0.00
SO -00
50.00
SO.00
ESC
0.00
0.00
0.00
0.00
SO.00
SO -00
SO.00
Hrv1K
0.00
0.00
0 00
0.00
1 SO -00
SO.00
50.00
HII
0-00
0.00
Q.QQ
0-00
i51
SQ QQ
11;Q�0
PECA
OJOI
a,00
0.00
0.00-
50,00
1 $0-00
SO.00
RESP
0.00
0.00
O.Oo
0.00
50.00
Nt 00
SO OO
SA
0.00
0.00
0-00
0.00
SO.00
50,00
50.00
SCAS
0.00
0.00
0.00
$0.00
' ;';E
10.00
Cost Reimb Services
:::::::::•;•:::::::::::::•:::;::.::�:,,:•::::•::
HOltvl
0.00
0.00
0.00
Varies
SO.00
SO.00
MATE
0-00
0.00
0.00
Varies
$0.00
$0.00
SC�t4
0.00
0.a0
0-00
Varies
SO.00
sa'oa
TRS
0-.00
0,00
0,00
Wades
S0_00
S0,0a
Total
50.00
$0.00
Please include the following CIRTS reports:
For all unit rate services:
Monthly and YTD Service Units with Unduplicated Client Counts
Please be sure that the YTD units tie out to this report,
For cost reatibursement services:
Services Reported by Program and Service Report
Run from 01/01 /16 through the current month end.
Please be sure that all YTD dollars are equal to or less than the YTD amounts on this report.
63
G
January 2017 - December 2017 OAA 203.17
Please include the following CIRTS report:
Monthly and YTD Service Units with Unduplicated Client Counts
Please be stare that the YTD units tie out to this report,
:E
Unit Cost Report
I=ron; To:
Older Americans Act
Report rt
IIIC1
Contract
Contract Period_
01/01/10 - 12131/10
Unit Rate Services
Retro's
Units this
Total
Units this
YTD Units
Rate
Eamed this.
Earned YTD
Month
Period
Request
CNT
0.00
0.00
0.00
0.00
SO -00
SO.00
S0.00
NTED
0.00
0.00
0.00
0.00
50.00
50.00
S0.00
NTSC
0.00
0.00
0.00
0.00
S0.00
$0.00
50.00
NUC01
0.00
0.00
0.00
0.00
50.00
S0.00
SO.00
pTR
0..40
O,ao
1 00
0..00
50,.00
$0.00
$0,00
Total
0.001
0.0o
1
$0.00
1 $0.00
Please include the following CIRTS report:
Monthly and YTD Service Units with Unduplicated Client Counts
Please be stare that the YTD units tie out to this report,
:E
January 2017 - December 2017
OAA 203.17
"(5)
Please include the following CIRTS report:
Monthly and YTD Service Units with Unduplicated Client Counts
Please be sure that the YTD units tie out to this report.
65
C��
Unit Cost Report
From To:
Older Americans Act
Report #
IIIC2
Contract #
Contract Period:
01/01/16 -12/31/16
Unit Rate Services
Metro's
1lnitsthls
Total
Units this
YTD Units
Rate
Earoedthis,
Earned YTD
Month
Re nest
Period
HDM
0.00
0.00
0.00
0.00
WOO
$0.00
50.00
NTED
0.00
0.00
0.00
0.00
50.00
SO.00
$0.00
NUCO1
0.00
0.00
0.00
0.00
$0.00
$0.00
$0.00
OTR
0.00
0.00
0.00
0.00
50.00
SO -00
S0.00
SCAS
0.00
0.00
0.00
0.00
50.00
50.00
50.00
Total
0.00
0.00
50.40
$0.00
"(5)
Please include the following CIRTS report:
Monthly and YTD Service Units with Unduplicated Client Counts
Please be sure that the YTD units tie out to this report.
65
C��
January 2017 December 2017
OAA 203.17
Please include the following CIRTS reports:
For all unit rote services-
Monthly and YTD Service Units with Unduplicated Client Counts
Please be sure that the YTD units tie out to this report.
For cost reimbursement services:
Services Reported by Program and Service Report
Run from 01101116 through the current month end.
Please be sure that all YTD dollars are equal to or less than the YTD amounts on this report.
66
OHO
Unit Cost Report
Older Americans Act
HIE
From: To.
Report #
Contract _
Contract Period:
01/01/16 -12131116
Unit Rate Services - IIIE
Retro's
Units this
twlonth
Total
Units this
Request
YTD Units
Rate
Earned this
Period
Earned YTO
ADC
0.00
0.00
0.00
0.00
50.00
$0.00
$0.00
DPRESP
0.00
0.00
0.00
0.00
50.00
$0.00
50.00
RESF
0.00
0.00
0.00
0.00
50.00
SO.00
50.00
RESP
0.00
1 0.00
0.00
0.00
S0.00
SMO
$0.00
SCAS
0.00
0.001
0.00
1 0.00
$0.00
SO 00
SO 00
Unit Rate Services tllE G
CTSG
0.00
0.00
0.00
0.00
50.00
50.00
50.00
DCC
0.00
0.00
0.00
0.00
SO.00
50.00
SHO
DPSIT
0.00
0.00
0.00
0.00
50.00
$0.00
50.00
SCAS
0.00
0.00
O GC
0.00
5I
SO 00
50.00
e vst e'
R tmb Servs -HIES
:�. :.
HOI[A
0..00
no
0.,00
Varies
SO.00
0.00:
MATE
0.00
0.00
0.00
0.00
Varies
50.00
0.00
SCStdI
0.00
0.00
0.00
0.00
Varies
50.00
0.00
Total_- ---- - -- -
0.00
50.00
`i:'. G
Please include the following CIRTS reports:
For all unit rote services-
Monthly and YTD Service Units with Unduplicated Client Counts
Please be sure that the YTD units tie out to this report.
For cost reimbursement services:
Services Reported by Program and Service Report
Run from 01101116 through the current month end.
Please be sure that all YTD dollars are equal to or less than the YTD amounts on this report.
66
OHO
VERIFICATION OF EMERGENCY PREPAREDNESS PLAN
Contract # OAA 203.17
I, Stephen Y C:arnell certify that Collier County Board of County Commissioners
Name of authorized contractor representative) (Name of contractor)
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made available to the Area Agency on Aging for Southwest Florida, Inc. upon
requ t.
i
Signature o authorized contractor representative
Public Services Department Head
Title
January 12, 2017
Date
Collier County Government
Company
October 2008
Approved as to form and legality
Assistant County Attorney
1.\N.
(9
Revised August 2007
Attestation Statement
Agreement/Contract Number OAA 203.17
Amendment Number
I,__ Steve Y. Carnell , 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.
n� - " 1 & i / - I., / January 12, 2017
Signature of Recipie /Contractor representative Date
Revised August 2007
Approved as to form and legality
Assistant County Attorney
�a�
`1,1,\\ 7
G