Backup Documents 11/14/2017 Item #16D16 16016
COMMUNITY AND HUMAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Martha Verg ra, Board Minutes and Records
FROM: Jody Pale rants Coordinator, CHS
DATE: November 9, 2017
RE: Amendments between Area Agency on Aging for Southwest Florida, Inc and
Collier County (2016 & 2017 HCE, CCE & ADI & 2017 OAA)
Please find attached a fully executed documents that were approved by the BCC on the day listed
below for recording in Minutes and Records. Feel free to contact me if you have any questions.
BCC Approved on November 14,2017 Item 16D1(p
Thank you for your assistance.
Amendment .001 OAA 203.17.001 16131 6
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
OLDER AMERICANS ACT TITLE III
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commisisoners, ("Contractor"), amends agreement OAA 203.17.
The purpose of this amendment is to amend contractual language,replace attachments,and amend 4. Contract Amount, and
increase the allocation for Collier County by$11,460; (some allocations might have been carry-forward); and revise
ATTACHMENT III and ATTACHMENT X Budget Summary.
1. Disregard the following(21. New Contract(s)Reporting) contract language of Standard Contract:
21. New Contract(s)Reporting:
The Contractor shall notify the Agency within ten(10)days of entering into a new contract with any of the remaining four
(4) state human service agencies. The notification shall include the following information: (1) contracting state
agency and the applicable office or program issuing the contract; (2) contract name and number; (3) contract start and
end dates; (4) contract amount; (5) contract description and commodity or service; (6) Contract Manager name and
contact information. In complying with this provision, and pursuant to Section 287.0575, F.S., as amended, the
Contractor shall complete the Provider's State Contracts List,ask Area Agency for a copy of this form.
2. Section 7.7 of Standard Contract is hereby replaced.
7.7 In accordance with Section 287.135, F.S., any Contractor on the Scrutinized Companies with Activities in Sudan
List, the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or the Scrutinized
Companies that Boycott Israel List (Lists), created pursuant to Section 215.473, F.S. and 215.4725, F.S., or is
engaged in a boycott of Israel, or is engaged in business operations in Cuba or Syria, is ineligible to enter into or
renew a contract with the Agency and/or Department for goods or services of $1,000,000 or more.
Pursuant to Section 287.135, F.S., the Agency and/or Department 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 or is
engaged in a boycott of Israel or has been engaged in business operations in Cuba or Syria. 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.
3. Section 10 of Standard Contract,Public Records and Retention,is hereby replaced.
10. Public Records and Retention:
10.1 By execution of this contract,Contractor agrees to all provisions of Chapter 119,F.S.,and any other
applicable law,and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the
requested records or allow the records to be inspected or copied within a reasonable time at a cost that
does not exceed the cost provided in chapter 119,F.S.,or as otherwise provided by law.
10.1.3 Ensure that public records that are exempt or confidential and exempt, from public records disclosure
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Amendment .001 OAA 203.17.001 1 6 01
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor, 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 shall meet all applicable requirements for retaining public records. All
records stored electronically must be provided to the Agency in a format that is compatible with the
information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for
refusal by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,
papers, letters, or other material made or received by the Contractor in conjunction with this contract, unless the
records are exempt,or confidential and exempt,from Section 24(a)of Article I of the State Constitution and Section
119.07(1),F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest
Florida,Inc.
15201 N Cleveland Ave.,Suite 1100
North Fort Myers,FL 33903
(239)652-6900
4. Page 14 of Original Contract, Section 55. Contract Manager, is hereby added.
55. Contract Manager
The Agency may substitute any Agency employee to serve as the Agency Contract Manager.
5. ATTACIIMENT III-Exhibit 2,Funding Summary, is hereby replaced.
6. ATTACHMENT IV,Certifications and Assurances, is hereby replaced.
7. ATTACHMENT X,Budget Summary,is hereby replaced.
8. Amend 4. Contract Amount
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 $1,065,348.28 or the rate schedule, 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.
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Amendment .001 OAA 203.17.001 1 6 01 6
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby
changed to conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified
in the contract.
This Amendment and all its attachments are hereby made part of the contract.
IN WITNESS THEREOF, the Parties hereto have caused this amendment, to be executed by their undersigned
officials as duly authorized; and agree to abide by the terms, conditions and provisions of this OAA contract as
amended. This Amendment is effective on the last date the Amendment has been signed by both Parties.
CONTRACTOR: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR
COUNTY COMMISSIONERS SOUTHWEST FLORIDA,INC.
SIGNED BY: ' ; � � 6/,M, SIGNED BY: �G >
k//
NAME. ..gv hV ea(A,f 1 NAME: MARIANNE G LORINI
•
TITLE: 1)4W r eM 4 �u b)IC cerVitc ITLE: PRESIDENT/CEO
DATE: (C/ (ail ? DATE: /0)30/1'7
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
Approved as to form and legality
c ;R, =
Assistant County uprney 0
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Amendment .001 OAA 203.17.001 1 6 0 1 6
ATTACHMENT IV
CERTIFICATIONS AND ASSURANCES
DOEA will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A. Debarment and Suspension Certification(29 CFR Part 95 and 45 CFR Part 75)
B. Certification Regarding Lobbying(29 CFR Part 93 and 45 CFR Part 93)
C. Nondiscrimination & Equal Opportunity Assurance(29 CFR Part 37 and 45 CFR Part 80)
D. Certification Regarding Public Entity Crimes,section 287.133,F.S.
E. Association of Community Organizations for Reform Now(ACORN)Funding Restrictions Assurance (Pub.L.
111-117)
F. Certification Regarding Scrutinized Companies Lists,section 287.135,F.S.
G. Certification Regarding Data Integrity Compliance For Contracts, Agreements, Grants, Loans And
Cooperative Agreements
H.Verification of Employment Status Certification
I. Records and Documentation
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS—PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies to the best of its knowledge and belief,that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded
from covered transactions by a Federal department or agency;
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.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers(including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements)and that all sub
recipients and contractors shall provide this certification accordingly.
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Amendment .001 OAA 203.17.001 1601 6
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 employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all sub-
recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this Contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31 •
U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than$100,000 for each such failure.
C. NON DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR
PART 80). -As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and
equal opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits
discrimination against all individuals in the United States on the basis of race, color, religion, sex national origin,
age, disability, political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a
lawfully admitted immigrant authorized to work in the United States or participation in any WIA Title I-fmancially
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
Department and/or 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 fmancial
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
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Amendment .001 OAA 203.17.001 1 6 0 1 6
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 Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed
by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86),to the end that,
in accordance with Title IX and the Regulation,no person in the United States shall,on the basis of sex,be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all
employment practices, including,job application procedures, hiring, firing, advancement, compensation, training,
and other terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff,
leave, fringe benefits, and all other employment-related activities.
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed
above. This assurance applies to Contractor's operation of the WIA Title I— financially assisted program or activity,
and to all contracts, Contractor makes to carry out the WIA Title I—financially assisted program or activity. Contractor
understands that the Agency and/or DOEA and the United States have the right to seek judicial enforcement of the
assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all sub
recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES,SECTION 287.133,F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in section 287.133,F.S.,nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform Agency and/or DOEA immediately upon any change of
circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE(Pub.L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010,Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub.L. 111-117 are available under the conditions provided by Pub.L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all sub
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS 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 participating in a boycott of Israel, is not listed on either the Scrutinized
Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy
Sector List, and that it does not have business operations in Cuba or Syria. 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.
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Amendment .001 OAA 203.17.001 16016
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to this
Contract.
G.CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS,
AGREEMENTS, GRANTS,LOANS AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have fmancial management systems
capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial
results of each grant-funded project or program in accordance with the prescribed reporting requirements; (2) the
source and application of funds for all contract supported activities; and(3)the comparison of outlays with budgeted
amounts for each award. The inability to process information in accordance with these requirements could result in a
return of grant funds that have not been accounted for properly.
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported,transmitted or calculated, have been assessed and verified 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.
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines
that impede the hardware or software programs 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.
5. 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.
II.VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Area Agency on Aging for Southwest Florida,Inc.,Contractor certifies the use of
the U.S.Department of Homeland Security's E-verify system to verify the employment eligibility of all new employees
hired by Contractor during the contract term to perform employment duties pursuant to this contract and that any
subcontracts include an express requirement that Subcontractors performing work or providing services pursuant to this
Contract utilize the E-verify system to verify the employment eligibility of all new employees hired by the Subcontractor
during the entire contract term. •
The Contractor shall require that the language of this certification be included in all sub-agreements, sub-grants, and
other agreements/contracts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
Circulars A-102 and 2 CFR Part 200,and 215 (formerly OMB Circular A-110).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all contract
related records and documentation.The Contractor shall ensure the collection and maintenance of all program related
information and documentation on any such system designated by the Agency.Maintenance includes valid exports and
backups of all data and systems according to Agency standards.
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6 Amendment .001 OAA 203.17.001 1 6 D 1
J. 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) F.S., and any
other applicable law, if a civil action is commenced as contemplated by Section 119.0701(4), F.S., and the Agency is
named in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the
Agency,and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made pursuant
to Chapter 119,F.S., concerning this contract or services performed thereunder.
a.Notwithstanding Section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Department and state agencies or subdivisions defined in Section 768.28(2),F.S.
2. Section 119.01(3), F.S. states if public funds are expended by anagency 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, Inc.) are public records. Section 119.07, F.S., states 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 does not provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection as stated above.
By execution of this contract, Contractor must include these provisions in all related subcontract agreements(if applicable).
By execution of this contract, Contractor must include these provisions (A-J) in all related subcontract agreements (if
applicable).
By signing below, Contractor certifies the representations outlined in parts A through J above,are true and correct.
(t7M i D'etqa.f
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Signature and Title of Authorized Representative, Street Address
CO((ler CG,lF1 I RAO OreiMl\kl
Contractor I.vYY1vsS Imoi6 Date City,State,Zip code
In)2y)17
Approved as to form and legality
Assistant County Corney \1
t)-("51)
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Amendment .001 OAA 203.17.001 I 6
ATTACHMENT III
FUNDING SUMMARY
Note: Title 2 CFR§200331,as revised,and Section 21597(5),Florida Statutes,require that the information about federal programs
and State Proj ects be p-ovided tothe 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 to this contract,containedherein,isapredictionoffmdingsourcesand 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:076997790 FEDERAL AWARD DATE: OCTOBER 20,2016
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Older Americans Act Title IIIB—
Transportation U.S. Health and Human Services 93.044 $ 14,918.00
Support Services $ 325,543.00
Total 11113 $ 340,461.00
OAA Title IIIC1 —Congregate Meals U.S. Health and Human Services 93.045 $ 291,901.00
Total HICI
OAA Title III C2—Home Delivered Meals
Total IIIC2 U.S. Health and Human Services 93.045 $ 258,599.00
Older Americans Act Title III E
Services(Title III E) $ 106,176.00
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 117E $ 124,608.00
NSIP U.S.Health and Human Services 93.053 $ 49,779.28
TOTAL FEDERAL AWARD $1,065,348.28
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.
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Amendment .001 OAA 203.17.001
16D1
ATTACHMENT X
Budget Summary
OLDER AMERICANS ACT BUDGET SUMMARY
CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY
1. Title III B Support Services $ 340,461.00
2. Title III Cl Congregate Meals $ 291,901.00
3. Title III C2 Home Delivered Meals $ 258,599.00
4. Title III E Services $ 124,608.00
5. NSIP $ 49,779.28
TOTAL $1,065,348.28
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1 6 0 1 6
Revised August 2007
Attestation Statement
Agreement/Contract Number 203.17
Amendment Number 001
I,Steve 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
II
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.
aw
Signature of Re ipient/ -tractor representative Date
d
Approved as to form and legality
Assistant County Att) ey (�
0\
Revised August 2007