Agenda 03/08/2011 Item #16D6
3/8/2011 Item 16.0.6.
EXECUTIVE SUMMARY
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Reco....eDdation to approve ...... authorize theCbirman>t..contract am,~ts
~.Collier CountyBoa.-.iofCounty Comm.~...dth~.A.rea Agency oll~~Qf
SeQ.tlnvest Florida,. me., wllith.reIects a decrease. ofpant~inthe amoupt~f.S.'J_.
for the Home Care for the.ElderJypmgram for FYJl.
OBJF;CTIVE: The. approv~ ofth~ contract ~tsisil1~~.rec()gnizeadecrease of
grant ft1Jlding awarded to the Services for Seniors Program and e~the remaining funds pl'iorto
June 30, 2011.
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CONSIDERATIONS: . Collier County Services for SeniQISp1'Qvidesin-oome sllPportservices to
Collier County's.frailcdderly citizeJ:J.s through grant funding. rec<kived>&oDl the State of Florida
....J)~m~~. 0(EI~r_AtIall:$....__1JI~~_are_fwld~....tr9mJbe_.~~'~,.~n~raL[ev~ny~!-_Qn~Qf.
these pl'9~. includes the Home Care for the Elderly <aCE)prograxn_ .. The abovementioned
~ are intended to provide . in-home support services. toCollierCoun.ty'sfrail elderly citizens.
The adjusted amount offtmding for the Services for Seniorspmgramis $79,277. The original
budget.amendment was ~proved by the Board of COtU1ty CommissiQ~ersMay 25, 2010, agenda
item 16011. While the Heme Care for the Eldedy programcontractua.1&rdecreasel; by SlO,OOO,the
funds will be retained by the AreaA.gency onAging. Therefore the .$lO,OOOcontractdccrease will
have nQ fiscal impact on the County budget.
ProgramCompontnt
HolDe Care for the EIded
F . Decrease
Total Award
GROwmMA.N!!Q~NT.IMP.CT: None
FISCAL IMPACT: .FYII budgetm the Human Services gr8I!tfund707wj.U4ecreaseby$10,OOO.
The Home Care for the Elderly (HCE) grant decrease will' not directly ~!theCounty b\14get.
LEG.AL~ON~~~nONS:This item.. has been reviewedandaPPl'Qved by the CQuuty
Attomey's Office and il; I~gallysufficient.This item requires a simple~jQ~ity vqte.-JBW .
lU;CO~A'I'I,ON~: To approve and authorize the Chairman to. sign anAreaA.g~oll
Aging for Southwest Florida, Inc. "Standard Contract" to refleetactualgrant award fqtthe l{ome
. Care for the Elderly (HCE)prognun in the amount of $79, 277.
PBEPARJIDJlY; Louise Pelletier, Case Management Supervisor, HOUSing, Human8fVete1'an
Services.
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3/8/2011It~f)'l16. 0.6.
COLLIER COUNTY
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Board .ofCounty Corlunissipners
Item Number: 16.0.6.
Item Summary: Re~mmendation to approve aod~thorite the Chairman to sign
contract amendments between CQllier County Board of County COmmissioners and thE! Area
Agency on Aging of Southwest Florida, Inc., which reflec:tsa 4ecrease of grantfunding in the
amount, of $10,000 fer the Home Care for the Elderly..program forFY1!..
MeetinaDate: 3/8/2011
-Prepand?By-
Name:Pel1etierLouise
Title: Supervi$Ol' - Case Managem~t,Housing, Human & Veteran Services
2/1'8120112:17:14 PM
Submitted by
Title: Supervisor~. Case Management,Housing, Human & Veteran Services
Name:. Pelletier Louise
2/181201 L2: 17: 15 PM
Approved By
Name: AlonsoHailey
Title: Administrative Assistant,Domestic Animal Services
Date: 2/18/20113:10:57 PM
Name: KrumbineMarcy
Title: Director - Housing & Human Services,Housing, Human & Veteran Services
Date: 2/18/2011 4:22:25 PM
Name: Ackel1ll81lMaria
Date: 2/22120114:14:09 PM
Name: FoordMarlene
Title: Grant Development & Mgmt Coordinator, Grants.
Date: 2122120114:14:S7PM
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Nam~: ~Marla _
Title:A,dnrinistrator, Public Services
DatC:<2123/201112:39:15PM .
Name: WbiteJennifer
Title: Assistant CountyA$torney.CountYA,~ey
Date: 2124/2011 4:39:10.PM
Name: .KlatzkowJeff
Title: County Attorney,
. Date: 2125/20n 8:19:43 AM
3/8/2011Jt~m 16.0.6.
Name: PryorCheryl
---Tit;le:-MaM~:Sud~~~~Q31ce-of-~~~.._---
.Date: 2125/2011 5:03:49}'IM
N~:..OChs1,.eo
Title: COJmty~er
Date: 212612011 2:38:41 PM
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3/8/2011 Item 16.0.6. .
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Attestation Statement
Agreement/Contract Number HCE 203.10
Amendment Number 2
I, Fred W. Coyle
to
attest that no changes or revisions have been made
(Recipient/Contractor representative)
the content of the above referenced agreement/contract or amendment between the Area Agency on
Aging for Southwest Florida, Inc. and
Collier County Board of 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.
,Chairman
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Signature of Recipient/Contractor representative
Date
Approved as to form and
Legal sufliciency
~~--W.~
Assistant County Attorney
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Revised November 2010
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Amendment 002
Contract No. HCE 203.10
3/8/2011 Item 16.0.6.
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Amendment Page I
STANDARD CONTRACT
AREA AGENCY ON AGING
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Collier County Board of Commissioners
This AMENDMENT, entered into by Area Agency on Aeing for Southwest Florida. Inc.,
hereinafter referred to as the "Agency," and Collier County Board of Corr~missi()ners, hereinafter
referred to as the "recipient," amends contract HCE 203.10.
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The purpose of this amendment is to: (1) decrease Collier County's HCE allocation by $10,000;
(2) revise Attachment nr, Exhibit I; and (3) revise Attachment VII, Budget Summary.
This amendment shall be effective February 10,2011.
AII provisions in the agreement and any attachments thereto in conflict with this amendment
shall be and are hereby changed to conform to this amendment.
AII provisions not in conflict with this amendment are still in effect and are to be performed at
the level specified in the agreement. ~
This amendment and all of its attachments are hereby made a part of this ~greement.
IN WITNESS WHEREOF, the parties hereto have caused this 3 page amt-;:ndment to be executed
by their of1icials there unto duly authorized.
RECIPIENT: Collier County Board of
Commissioners
Area A~ency on Aging for Southwest
Florida, Inc.
Signed by:
Signed by:
Name:
Name: Leigh Anna Nowak
Title:
Title: Board President
Date:
Date:
Federal ill Number: 59-6000558
Fiscal Year End: 09/30
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ATTEST: .
DWIGHT E. BROCK. Clerk
By:
ApprOVed as to form & legal Sufficiency ~
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Assistant County Attorney ~'15
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3/8/2011 Item 16.D.6. .
Amendment 002
Contract No. HCE 203.10
Amendment Page 2
ATTACHMENT ill
EXHIBIT -1
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2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE
FOLLOWING:
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97; F.S.
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Home Care for the Elderly General Revenue/TSTF 65001 $ 79,277.00
Program ~ Collier
TOTAL AWARD $ 79,277.00
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Amendment 002
Contract No. HCE 203.10
~/8/~9.~J_l!~_~~6. 0.6.
Amendment Page 3
A TT ACHMENT VII . r".
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Board of County Commissioners
1. HCE Subsidies
$ 72,704.00
$ 6,573.00
$ 79,277.00
2. HCE Case Management
3. Total .
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July 2009
3/8/2011 Item 16.D.6.
BeE 203.09
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA
STANDARD CONTRACT
HOME CARE FOR THE ELDERLY PROGRAM
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida,
hereinafter refell'ed to as the "Agency" and Collier County Board of County Commissioners. hereinafter
referred to as the "Recipient", and collectively referred to as the IIParties." The term recipient for this
purpose may designate a vendor, subgrantee or subrecipient, the status to be fmther identified in
ATTACHMENT III, Exhibit-2 as necessary.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of celtain services as described herein; and
WHEREAS, the Recipient has demonstrated that it has the requisite expeltise and ability to faithfully
peIform 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 fOlth, the Palties 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 and exhibits, which constitute the contract
document.
2.
Incorporation of Documents within the Contract
The contract will incorporate attachments, proposal(s), state planes), grant agreements relevant
Depaltment of Elder Affairs handbooks, manuals or desk books, as 'an integral palt 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 conh'act shall begin on July 1. 2009 or on the date on which the contract has been signed by
the last party required to sign it, whichever is later. It shall end at midnight, local time in Fort
Myers, Florida, on June 30. 2010.
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 $85.066.00 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 conh'act.
5.
Renewals
By mutual agreement of the parties, in accordance with section 287.058(1)(f). 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 fOlih 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
perfOlmance evaluations by the agency and the availability of funds.
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July 2009
6. Compliance with Federal Law
3/8/2011 Item 16.0.6.
HCE 203.09
6.1. If this contract contains federal fund the provider shall comply with the provisions of 45 CFR 74 r'\
and/or 45 CFR 92, and other applicable regulations.
6.2. If this contract contains federal funds and is over $100,000, the recipient shall comply with all
applicable standards, orders, or regulations issued under section 306 of the Clean Air Act as
amended (42 USC 7401 et seq.), section 508 or the Federal Water Pollution Control Act as
amended (33 USC 1251 et seq.), Executive Order 11738, as amended, and where applicable
Environmental Protection Agency regulations 40 CFR 30. The recipient shall report any
violations of the above to the agency.
6.3. The recipient, or agent acting for the recipient, 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. If this contract contains federal funding in excess of 100,000,
the recipient must, prior to contract execution, complete the Certification Regarding Lobbying
form, ATTACHMENT II. All disclosure forms as required by the Certification Regarding
Lobbying form must be completed and returned to the Contract Manager, prior to payment under
this contract.
6.4. The recipient shall not employ an unauthorized alien. The. agency shall consider the employment
of unauthorized aliens a violation of the Immigration and Nationality Act (8 USC 1324 a) and the
Immigration Refolm and Control Act of 1986 (8 USC 1101). Such violation shall be cause for
unilateral cancellation of this contract by the agency.
6.5.
That if this contract contains $10,000 or more of federal funds, the recipient 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.
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6.6. That if this contract contains federal funds and provides services to children up to age 18, the
recipient shall comply with the Pro-Children Act of 1994 (20 USC 6081).
6.7. That a contract award with an amount expected to equal or exceed $25,000.00 and certain other
contract awards shall not be made to parties listed on the government-wide Excluded Patties List
System, in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders
12549 and 12689, "Debarment and Suspension. II The Excluded Patties List System contains the
names of parties debarred, suspended, or othelwise excluded by agencies, as well as palties
declared ineligible under statutory or regulatory authority other than Executive Order 12549. The
recipient will comply with these provisions before doing business or entering into subcontracts
receiving federal funds pursuant to this contract. The recipient shall complete and sign
ATTACHMENT V prior to the execution of this contract.
7. Compliance with State Law
7.1. That 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. r".
7.2. Requirements of Section 287.058. F.S.
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HCE 203.09
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7.2.1. The recipient will provide units of deliverables, including repOlis, findings, and drafts, as specified
in this contract, which the Contract Manager must receive and accept in writing prior to payment.
7.2.2. The recipient will submit bills for fees or other compensation for services or expenses in sufficient
detail for a proper pre-audit and post-audit.
7.2.3. lfitemized payment for travel expenses is permitted in this contract, the recipient will submit bills
for any travel expenses in accordance with section 112.061, F.S., or at such lower rates as may be
provided in this contract.
7.2.4. The recipient wilf allow public access to all documents, papers, letters, or other public records as
defined in subsection 119.011(11), F.S., made or received by the recipient in conjunction with this
contract except for those records which are made confidential or exempt by law. The recipient's
refusal to comply with this provision shall constitute an immediate breach of contract for which
the agency may unilaterally terminate the contract.
7.3. If clients are to be transported under any agreements an/or contracts incorporating this contract,
the recipient shall comply with the provisions of Chapter 417,F.S., and Rule 41,F.A.C.
7.4. Subcontractors who are on the discriminatory vendor list may not transact business with any
public entity, in accordance with the provisions of section 287.134,F.S.
7.5.
The recipient will comply with the provisions of section 11.062, F.S., and section 216.347,F.S.,
which prohibit the expenditure of contract funds for the purpose of lobbying the legislature,
judicial branch or a state agency.
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8. Grievance Procedures
The recipient shall develop and implement, and ensure that its subcontractors have established,
grievance procedures to process and resolve client dissatisfaction with or denial of service(s), or
address complaints regarding the telmination, suspension or reduction of services, as required for
receipt of funds. These procedures, at a minimum should provide for notice of the grievance
procedure and an opportunity for review of the subcontractor's detelmination(s).
9. Audits. Insnections. Investi2ations. Public Records and Retention
9.1. To establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all income and expenditures of funds provided by the agency under this
contract.
9.2. To retain all client records, financial records, SUPPOliing documents, statistical records, and any
other documents (including electronic storage media) pertinent to this contract for a period of six
(6) years after completion of the contract or longer when required by law. In the event an audit is
required by this contract, records shall be retained for a minimum period of six (6) years after the
audit report is issued or until resolution of any audit findings or litigation based on the terms of
this contract, at no additional cost to the agency.
r--.. 9.3. Upon demand, at no additional cost to the agency, the recipient will facilitate the duplication and
transfer to any records or documents during the required retention period in Paragraph 9.2.
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Jul 2009 3/8/2011 Item 16.0.6.
y HCE 203.09
9.4. To ass~re that these records shall be subject at all reasonable times to inspection, review, copying,
or audIt by Federal, State, or other personnel duly authorized by the agency.
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9.5. At all reasonable times for as long as records are maintained, persons duly authorized by the
agency and Federal auditors, pursuant to 45 CFR 92.36(i)(1O), shall be allowed full access to and
the right to examine any of the recipient's contracts and related records and documents, regardless
of the form in which kept.
9.6. To provide a financial and compliance audit to the agency as specified din this contract and in
ATTACHMENT III and to ensure that all related party transactions are disclosed to the auditor.
9.7. To comply and cooperate immediately with any inspections, reviews, investigations, or audits
deemed necessary by the office of the Inspector General pursuant to s. 20.055,F.S.
10. Nondiscrimination M Civil Rit!:hts Compliance
10.1. The recipient will execute assurances in ATTACHMENT VI 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 recipient further assures that all contractors, subcontractors,
sub grantees, or others with whom it arranges to provide services or benefits in connection 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.
10.2. The recipient will retain, on file, during the term of this agreement a timely, complete and accurate ",..........
Civil Rights Compliance Checklist (ATTACHMENT B).
10.3. The recipient agrees to establish procedures pursuant to federal law to handle complaints of
discrimination involving services or benefits through this contract. These procedures shall include
notifying clients, employees, and participants of the right to file a complaint with the appropriate
federal or state entity.
10.4. These assurances are a condition of continued receipt of or benefit from federal financial
assistance, and are binding upon the recipient, its successors, transferees, and assignees for the
period during which such assistance is provided. The recipient further assures that all
subcontractors, vendors, or others with whom it all'anges 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 recipient understands
that the agency may, at its discretion, seek a cOUli 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 fUliher assistance.
11. Provision of Services
The recipient will provide services in the manner described in A TT ACHMENT I.
12.
Monitorint!: bv the A~encv
The recipient permits persons duly authorized by the agency to inspect and copy any records,
papers, documents, facilities, goods and selvices of the recipient which are relevant to this
contract, and to interview any clients, employees and subcontractor employees of the recipient to
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3/8/2011 Item 16.D.6.
July 2009 HCE 203.09
assure the agency of the satisfactory performance of the terms and conditions of this contract.
Following such review, the agency will deliver to the recipient a written report of its findings and
request for development, by the recipient, of a corrective action plan where appropriate. The
recipient hereby agrees to timely correct all deficiencies identified in the corrective action plan.
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13. Indemnification
13.1. Subject to the limits of section 768.28, f'.S., the recipient 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 provider is not require to indemnify the agency for claims, demands, actions or causes of
action arising solely out of the agency's negligence.
14. Insurance and Bondine:
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14.1. To 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 recipient accepts fuU responsibility for
identifying and determining the type(s) and extent of liability insurance necessary to provide
reasonable financial protections for the recipient and the clients to be served under this contract.
The limits of coverage under each policy maintained by the recipient do not limit the recipient's
liability and obligations under this contract. The recipient 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.
14.2. Throughout the telm of this agreement, the recipient agrees to maintain an insurance bond from a
responsible commercial insurance company covering all officers, directors, employees and agents
of the recipient 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.
15. Confidentiality of Information
The recipient 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.
16. Health Insurance Portability and Accountability Act
Where applicable, to comply with the Health Insurance Portability and Accountability Act (42
use 1320d.), as well as all regUlations promulgated thereunder (45 CFR 160, 162 and 164).
17. Incident ReJ>ortine:
17.1. The recipient shall notify the agency immediately, but no later than forty-eight (48) hours from,
~ the recipient's awareness or discovery of conditions that may materially affect the recipient or
subcontractor's ability to perform, such as problems, delays or adverse conditions which may
impair the ability to meet the objectives of this contract.
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HCE 203.09
17.2. To 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 (l-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is
binding upon both the recipient and its employees.
18. Sponsorshin and Publici~
18.1. As required by section 286.25, F.S., if the recipient 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 (recipient's name) and the State of Florida, Depmiment of Elder
Affairs and The Area Agency on Aging for Southwest Florida, Inc." If the sponsorship reference
is in written material, the words "State of Florida, Department of Elder Affairs and The Area
Agency on Aging for Southwest Florida, Inc. II . shall appear in at least the same size letters or type
as the name of the organization.
18.2 The recipient shall not use the words liThe State of Florida, Depm'tment of Elder Affairs" or "The
Area Agency on Aging for Southwest Florida, Inc." to indicate sponsorship of a program
otherwise financed, unless, specific authorization has been obtained by the agency prior to use.
19. Assienments
19.1. The recipient 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.
19.2. The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights,
duties, or obligations under this contract to another governmental agency in the State of Florida,
upon giving prior written notice to the recipient. In the event the State of Florida approves transfer
of the recipient's obligations, the recipient remains responsible for all work performed and all
expenses incurred in connection with the contract.
19.3. This contract shall remain binding upon the successors in interest of either the recipient or the
agency.
20. Subcontracts
20.1. The recipient is responsible for an work perfOlTIled and for all commodities produced pursuant to
this contract, whether actually furnished by the recipient or its subcontractors. Any subcontracts
shall be evidenced by a written document and subject to any conditions of approval the agency
deems necessary. The recipient fur'ther agrees that the agency shall not be liable to the
subcontractor in any way or for any reason. The recipient, at its expense, will defend the agency
against any such claims.
20.2
The recipient 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 recipient and subcontractor,
will result in a penalty as provided by statute.
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July 2009
3/8/2011 Item 16.0.6.
HCE 203.09
21.
Indeuendent Capacity of Recioient .
It is the intent and understanding of the parties that the recipient, 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 paliies that the agency does not control the employment practices
of the recipient and shall not be liable for any wage and hour, employment discrimination, or other
labor and employment claims against the recipient or its subcontractors. All deductions for social
security, withholding taxes, income taxes, contributions to unemployment compensation funds and
all necessary insurance for the recipient shall be the sole responsibility of the recipient.
22. Payment
Payments will be made to the recipient pursuant to s. 215.422, F.S., as services are rendered and
invoiced by the recipient. The agency's Contract Manager will have final approval of the invoice
for payment, and will approve the invoice for payment only if the recipient 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 Depatiment of Financial Services and may be contacted at (850) 413-5665.
Return of Funds
The recipient will 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 recipient by the agency. In the event that the recipient or its
independent auditor discovers that an overpayment has been made, the recipient 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, on behalf of the agency, will
notify the recipient by letter of such findings. Should repayment not be made forthwith, the
recipient will be charged at the tawful rate of interest on the outstanding balance pursuant to
Section 55.03, F.S., after agency notification or recipient discovery.
24. Data Inteeritv and Safeeuardine Information
The recipient shall insure an appropriate level of data security for the information the contactor is
collecting or using in the performance of this contract. An appropriate level of security includes
approving and tracking all recipient employees that request system 01' information access and
ensuring that user access has been removed from all terminated employees. The recipient, among
other requirements, must anticipate and prepare for the loss of information processing capabilities.
All data and software must be routinely backed up to insure recovery from losses or outages of the
computer system. The security over the backed-up data is to be as stringent as the protection
required of the primary systems. The recipient shall insure all subcontractors maintain written
procedures for computer system back-up and recovery. The recipient shall complete and sign
A TT ACHMENT IV prior to the execution of this contract.
25.
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Conflict of Interest
The recipient will 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 recipient or subcontractor shall participate in selection, or in the award or administration of
an agreement supported by State or Federal funds if a conflict of interest, real or apparent, would
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be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member
of his/her immediately family; (c) his or her partner, or; (d) an organization which employs, 01' is
about to employ, any of the above has a financial or other interest in the fum selected for award. ",..........
The recipient or subcontractor's officers, employees or agents will neither solicit nor accept
gratuities, favors or anything of monetary value from contractors, potential contractors, or paliies
to subcontracts. The recipient's bOal'd members and management must disclose to the agency any
relationship which may be, or may be perceived to be, a conflict or interest within thhiy (30) days
of an individual's original appointment or placement in that position, or if the individual is serving
as an incumbent, within thhiy (30) days of the commencement of this contract. The recipient's
employees and subcontractors must make the Salne disclosures described above to the recipient's
board of directors. Compliance with this provision will be monitored.
26. Public Entity CI'ime
Pursuant to s. 287.133, F.S., the following restrictions are placed on the ability of persons
convicted of public entity crimes to transact business with the agency. A person 01' 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 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 pubic entity; and may not transact business
with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for
CATEGORY TWO for a period of36 months following the date of being placed on the convicted
vendor list.
27. Purchasini!
27.1. To purchase articles which are the subject of or are required to can'y 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 recipient 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.
27.2. To procure any recycled products 01' materials, which are the subject of or are required to canoy out
this contract, in accordance with the provisions of sections 403.7065 and 287.045, F.S.
28. Patents. Copvrie;hts. Rovalties
If any discovery, invention 01' copyrightable material is developed or produced in the course of or
as a result of work or services perfOlmed under this contract, the recipient shall refer the
discovery, invention or material to the agency to be referred to the Department of State. Any and
all patent rights or copyrights accruing under this contract are hereby reserved to the State of
Florida in accordance with Chapter 286, F.S.
29. Emerl!ency Preparedness and Continuity of Operations
29.1. 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 recipient shall within 30 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 ~
recipient shall notify the agency of emergency provisions.
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29.2. In the event, a situation results in a cessation of services by a subcontractor, the recipient will
retain responsibility for performance under this contract and must follow procedures to ensure
continuity of operations without interruption.
30. PUR 1000 Form
The PUR 1000 Form is hereby incorporated by reference. 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.
31. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real propelty are contingent upon
the recipient or political subdivision granting to the state a security interest in the propelty 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 uuther required by law..
32. 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 recipient.
33. No Waiver of Sovereien 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.
34. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Lee County,
Florida.
35. Entire Contract
This contract contains all the terms and conditions agreed upon by the patties. No oral agreements
or representations shall be valid or binding upon the agency or the recipient unless expressly
contained herein or by a written amendment to this contract.
36. Force Maieure
Neither party shall be liable for any delays or failures in performance due to circumstances beyond
its control, provided the party experiencing the force majeure condition provides immediate
written notification to the other patty and takes all reasonable effOlts to cure the condition.
37. Severability Clause
The patties 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.
38. Condition Precedent to Contract: AJmropriations
The parties agree that the agency's performance and obligation to pay under this contract is
contingent upon an annual appropriation by the Legislature. In the event such an appropriation is
not made, the recipient shall not be entitled to file a claims bill.
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39. AdditionIDeletion
The parties agree that the agency reserves the right to add 01' to delete any of the services required
under this contract when deemed to be in the State's best interest. The pa11ies shall negotiate r--...
compensation for any additional services added.
40. Waiver
3/8/2011 Item 16.0.6.
HCE203.09
The delay or failure by the agency to exercise or enforce any of its rights under this contract shall
not constitute 01' be deemed a waiver of the agenc.Y.'s right thereafter to enforce those rights, nor
shall any single or partial exercise of any such right preclude any other or further exercise thereof
or the exercise of any other right.
41. Compliance
The recipient agrees to abide by all applicable CUl1'ent federal statutes, laws, rules and regulations
as well as applicable cun'ent State statutes, laws, rules and regulations. The parties agree that
failure of the recipient to abide by these laws shall be deemed an event of default of the recipient,
and subject the contract to immediate, unilateral cancellation of the contract at the discretion of the
agency.
42. Final Invoice
The recipient shall submit the final invoice for payment to the agency as specified in Section 3.3.5
(date for final request for payment) of ATTACHMENT I. If the recipient 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 reports due fl.'om the recipient and necessary
adjustments thereto have been approved by the agency. r--...
43. Renei!otiations or Modifications
Modifications of the provisions ofthis 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.
44. Termination
44.1. This contract may be terminated by either paliy without cause upon no less than thirty (30)
calendar days notice in writing to the other party unless a sooner time is mutually agreed upon in
writing. Said notice shall be delivered y U.S. Postal Service or any expedited delivery service that
provides verification of delivery or by hand delivery to the Contract Manager or the representative
of the recipient responsible for administration of the contract.
44.2. In the event funds for payment pursuant to this contract become unavailable, the agency may
terminate this contract upon no less than twenty-four (24) hours notice in writing to the provider.
Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that
provides verification of delivery or by hand delivery to the Contract Manager or the representative
of the recipient responsible for administration of the contract. The agency shall be the final
authority as to the availability and adequacy of funds. In the event of termination of this contract
the provider will be compensated for any work satisfactorily completed.
44.3. This contract may be terminated for cause upon no less than twenty-four (24) hours notice in ",..........
writing to the recipient. If applicable, the agency may employ the default provisions in Rule 60A-
1.006(3), F.A.C. Waiver of breach of any provisions of this contract shall not be deemed to be a
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waiver of any other breach and shall not be construed to be a modification of the temlS and
conditions of this contract. The provisions herein do not limit the agency's right to remedies at
law or in equity.
44.4. Failw'e to have performed any contractual obligations with the agency in a manner satisfactory to
the agency will be a sufficient cause for termination. To be terminated as a recipient under this
provision, the recipient must have (1) previously failed to satisfactorily perform in a contract with
the agency, been notified by the agency of the unsatisfactory performance and failed to correct the
unsatisfactory performance to the satisfaction of the agency; or (2) had a contract terminated by
the agency for cause.
45. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
The recipient name, as shown on page 1 of this contract, Collier County Housing and Human Services
3301 East Tamiami Trail
a. and mailing address oftlle official payee to whom the Naples, FL 34] 12
payment shall be made is:
Marcy Krumbine, Director
The name of tile conulct person and stl;eet addi;ess where Collier County Housing and Human Services
b. 3301 East Tamiami Trail, Bldg H
financial and administrative records are maintained is: Naples, FL 34112
(239) 252-2273
Marcy Krumbine, Director
The name, address, and telephone number of the Collier County Housing and Human Services
c. representative of the recipient responsible for 3301 East Tamiami Trail, Bldg H
administration of the program under this contract is: Naples, FL 34112
(239) 252-2273
The section and location within the Agency where Area Agency on Aging for Southwest Florida, Inc.
d. Requests for Payment and Receipt and Expenditure forms 2285 First Street
are to be mailed is: Fort Myers, Florida 33901
Leigh Wade-Schield, Executive Director
e. The name, address, and telephone number of the Contract Area Agency on Aging for Southwest Florida, Inc.
Manager for the Agency for this contract is: 2285 First Street
Fort Myers, Florida 33901
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.
46. All Terms and Conditions Included
This contract and its Attachments I - X, A and B, and 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.
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By signing this contract, thepardes agree thattheyha:Ve teadiandagt'eeto the entire contract.
IN WIlNESS TIIEREOF,tl1e parties .hereto have caused this 40 Pag~ contract, to be execlllecl by theit ~
undersigned officials as duly authorized.
RECEPIENT:
COLLIER COUNTY HOUSING
AND HUMAN SERVICES
" ~. ........' ~
By:
BOARD OF COUNTY COMMISSIONERS
COLyIJ>1 COUN... TY,~L?R1~A
By:A.it~-n-N!t_~ d~
DO 'A FIALA, CHAIRMAN
Approved as to form and
legal sufficiency:
fP!!!:~;u~
Date: July 28. 2009
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY:
~
",l
//
/;;"";'-'l!r-:
NAME: 1Jaomi Maiming
TITLE: Board President
DATE:
FEDERAL ID NUMBER 59-6000558
FISCAL YEAR-END DATE: 9/30
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ATTACHMENT
ATTACHMENT I
ATTACHMENT II
ATTACHMENT III
ATTACHMENT IV
ATTACHMENT V
ATTACHMENT VI
ATTACHMENT VII
ATTACHMENT VIII
A TT ACHMENT IX
~ ATTACHMENTX
ATTACHMENT A
ATTACHMENT B
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INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT DESCRIPTION
PAGE
STATEMENT OF WORK
CERTIFICATION REGARDING LOBBYING
FINANCIAL COMPLIANCE AUDIT ATTACHMENT
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
CERTIFICATION REGARDING DEBARMENT, SUSPENSION
INELIGIBILITY, AND VOLUNTARY EXCLUSION
ASSURANCES - NON-CONSTRUCTION PROGRAMS
HOME CARE FOR THE ELDERLY PROGRAM BUDGET
& RATE SUMMARIES 36
HOME CARE FOR THE ELDERLY INVOICE REPORT SCHEDULE 37
REQUEST FOR PAYMENT 38
RECEIPTS AND EXPENDITURES 39
DEPARTMENT OF ELDER AFFAIRS PROGRAMS AND SERVICES 40
HANDBOOK (ON CD)
DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE 41-44
CHECKLIST AND INSTRUCTIONS
I 4 - 24
25
26-31
32
33
34-35
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ATTACHMENT I
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA
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STATEMENT OF WORK
HOME CARE FOR THE ELDERLY PROGRAM
SECTION I: SERVICES TO BE PROVIDED
1.1. DEFINITION OF CONTRACT TERMS AND ACRONYMS
1.1.1. DEFINITION OF ACRONYMS
Adult Protective Services (APS)
Activities of Daily Living (ADL)
Assessed Priority Consumer List (APCL)
Community Care for Disabled Adults (CCDA)
Community Care for the Elderly (CCE)
Client InfOlmation and Registration Tracking System (CIRTS)
Department of Children and Families (DCF)
Home Care for Disabled Adults (HCDA)
Home Care for the Elderly (HCE)
Institutional Care Program (ICP)
Instrumental Activities of Daily Living (IAD L)
Planning and Service Area (PSA)
Web-based Database System (WebDB)
1.1.2. PROGRAM SPECIFIC TERMS
Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the
Department of Children and Families Services Community Care for Disabled Adults or Home
Care for Disabled Adults services to the depat1mentts community-based services.
",..........
Area Plan: A plan developed by the Area Agency on Aging outlining a comprehensive and
coordinated service delivery system in its planning and service area in accordance with the Section
306 (42 D.S.C. 3026) of the Older Americans Act and Depaliment of Elder Affairs' instructions.
Area Plan Update: A revision to the area plan wherein the Area agency on Aging enters HeE
program specific data in the web-based database system (WebDB). An update may also include
other revisions to the area plan as instructed by the Depaliment of Elder Affairs.
Functional Assessment: A comprehensive, systematic, and multidimensional review of a
personts ability to remain independent and in the least restrictive living alTangement. DOEA Form
701 B is used by case managers to conduct the functional assessment.
1.2. AGENCY MISSION STATEMENT
Mission: To help aging adults, 60 and older, achieve greater independence through awareness of resources
and access to qualified service providers.
Vision: To be the recognized leader in supporting older adults and their families with access to trustworthy
resources and services in their communities while empowering them to live with independence and dignity. ",..........
Values: The Agency believes the residents of Southwest Florida are entitled to:
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. Comprehensive information about their choices of care;
. Timely access to resources and services;
. High standards of quality and performance;
. Personal and professional accountability from all stakeholders.
Lead agencies and local service providers as palmers and stakeholders in Florida's aging services
network are expected to SUPPOlt the agency's mission, vision, and priorities.
1.2.1. Home Care for the Elderly Program Mission Statement
The Home Care for the Elderly Program supports family style living arrangements, on a nonMprofit
basis, as an alternative to nursing homes or other institutional care. Through the program, a
caregiver for three.01' fewer elders living in a private home provides basic services of maintenance
and supervision as well as coordinating other necessary specialized services.
1.3. GENERAL DESCRIPTION
1.3.1. General Statement
Area Agencies on Aging may contract with CCE lead agencies or other case management entities
for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse
some of their expenses each month for caring for the consumer and may receive a Special Subsidy
for other necessary services and essential supplies. Caregivers may be approved for up to three
HCE clients in their home.
1.3.2. Authority
~ The relevant authority governing the HCE program include:
(1) Rule Chapter 58H-l, Florida Administrative Code; and
(2) Sections 430.601 through 430.608. F.S.
1.3.3. Scope of Service
The Area Agency on Aging is responsible for the programmatic, fiscal and operational management of
HCE. The recipient shall provide services in a manner consistent with and described in the agency's
current area plan update and the current Department of Elder Affairs Programs and Services Handbook,
ATTACHMENT A.
1.3.4. Major Program Goals
The major goals of the BCE program are to ensure that:
(1) Basic subsidy is provided to the caregiver to each client and
(2) Special subsidy is provided when essential to the well-being of the client.
1.4. INDIVIDUALS TO BE SERVED
1.4.1. General Description
The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a
nursing home or other institutional settings who can remain in a family style setting through the
provision of subsidies.
1.4.2. Caregiver Requirements
~ (1) Be at least 18 years of age, capable of providing a family-type living environment and
willing to accept responsibility for the social, physical and emotional needs of the care
recipient;
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July 2009
(2)
(3)
(4)
(5)
(6)
3/8/2011 Item 16.0.6.
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Be a relative or a friend who has been accepted by the client as a surrogate family or is a
responsible adult with whom the client has made an arrangement to provide home care
services; ",..........
Be willing to accept responsibility for the social, physical and emotional needs of the care
recipient;
Be physically present to provide supervision and to assist in al1'angement of services for
the client;
Maintain the residential dwelling fi'ee of conditions that pose an immediate threat to the
life, safety, health and well-being of the home care client; and
Be without record of conviction of abuse, neglect or exploitation of another person.
1.4.3. Targeted Groups
Priority for services provided under this contract shall be given to those eligible persons assessed
to be at risk of placement in an institution.
SECTION II: MANNER OF SERVICE PROVISION
2.1. SERVICE TASKS
In order to achieve the goals of the HCE program, the agency shall ensure the following tasks are
performed: .
(1) Client Eligibility Determination as listed in ATTACHMENT I, SECTION 1.4;
(2) Assessment and Prioritization of Eligible Clients;
(3) Delivery of Services to Eligible Clients; and
In addition, the recipient shall monitor the performance of its contractors.
",..........
2.1.1. Assessment and Prioritization of Eligible Clients
The following are the criteria to prioritize new clients for service delivery. It is not the intent of
the agency to remove existing clients from any services in order to serve new clients being
assessed and prioritized for service delivery.
2.1.2. Priority Criteria for Service Delivery:
(1) Individuals in nursing homes under Medicaid who could be transferred to the community;
(2) Individuals in nursing homes whose Medicare coverage is exhausted and may be divelted
to the community;
(3) Individuals in nursing homes that are closing and can be discharged to the community; or
(4) Individuals whose mental or physical health condition has deteriorated to the degree self
care is not possible; there is no capable caregiver, and institutional placement will occur
within 72 hours;
(5) For the purpose of tr8nsitioning individuals receiving Community Care for Disabled
Adults (CCDA) and Home Care for Disabled Adults (HCDA) services through the
Department of Children and Families (DCF) Adult Services to community-based services
provided through the agency, when services are not currently available, area agency on
aging staff and lead agency case managers shall ensure that "Aging Out" individuals are
prioritized for services only after Adult Protective Services (APS) High Risk and Imminent
Risk individuals.
2.1.2.1. Priority Criteria for Service Delivery for Other Assessed Individuals:
The assessment and provision of services should always consider. the most cost effective means of
service delivery. Functional Impairment shall be determined through the depattment's consumer
assessment form administered to each applicant. The most frail individuals not prioritized above
will receive services to the extent funding is available.
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Client Eligibility
Clients eligible to receive services under this contract must:
(1) Be 60 years of age 01' older;
(2) Have income less than the Institutional Care Program (ICP) standard;
(3) Meet the ICP asset limitation;
(4) Be at risk of nursing home placement;
(5) Have an approved adult caregiver living with them who is willing and able to provide care
or assist in alTanging for care; and
(6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated
long-term care program.
2.1.3.1. Basic Subsidy
The basic subsidy is a cash payment made to an approved caregiver each month to reimburse some
expenses incurred in cal'ing for the. client. A basic subsidy is provided for support and
maintenance of the care recipient, including housing, food, clothing, and medical costs not
covered by Medicaid, Medical'e or any other insurance. A basic subsidy shall be paid to approved
caregivers when the client is in the home for any palt of the month. If the client is hospitalized or
in any other temporary institution for 30 days or less, the full basic subsidy payment shall be
provided to the caregiver as if the client were in the home. .
2.1.3.1.1 Calculating the Basic Subsidy
The basic subsidy payment shall be based on the financial status of the client receiving care. In
the event that both a husband and wife are clients, their combine financial status shall be used to
determine the amount of the basic subsidy.
~
2.1.3.2. Special Subsidy Servi~es
Though every eligible HCE client receives a basic subsidy, special subsidy payments are pre- .
authorized and are based on additional specialized medical or health care services, supplies or
equipment needed to maintain the health and well-being of the individual elder. The special
subsidy for additional medical support and special services is a cash payment to reimburse the
costs of any other service or special care not covered by Medicaid, Medicare, or private insurance
when these services are determined to be essential to maintain the well-being of the home care
recipient. A special subsidy shall be paid to approved caregivers when the client is in the home
for any pa11 of the month. All special subsidy services must be pelformed in accordance with the
Department of Elder Affairs Programs and Services Handbook. Special subsidy services include:
~
(1) Adult Day Care;
(2) Adult Day Health Care;
(3) Caregiver Training/Support;
(4) Chore;
(5) Chore (Enhanced);
(6) Counseling (Gerontological);
(7) Counseling (Mental Health/Screening);
(8) Home Delivered Meals;
(9) Home Health Aide Service;
(10) Homemaker;
(11) Housing Improvement;
(12) Material Aid;
(13) Occupational Therapy;
(14) Other;
(15) Outreach;
(16) Personal Care;
(17) Physical Therapy;
(18) Respite (Facility Based or In-Home);
(19) Skilled Nursing Services;
(20) Specialized Medical Equipment,
Services and Supplies;
(21) Speech Therapy; and
(22) Transpoltation.
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2.1.3.3. ACCESS TO AND COORDINATION OF SERVICES
Through intake, case management and case aide services, the HCE client's needs are documented ",..........
and needed services are planned, arranged and cool'dinated for the client.
2.1.4. Monitoring the Performance of Subcontractors
The recipient shall conduct at least one monitoring per year of each subcontractor. The recipient
shall perfOlm fiscal, administrative and programmatic monitoring of each subcontractors to ensure
contractual compliance, fiscal accountability, programmatic performance, and compliance with
applicable state and federal laws an regulations.
2.2. SERVICE LOCATION AND EQUIPMENT
2.2.1. Service Times
The recipient shall ensure the provision of ~he services listed in this contract are available at times
appropriate to meet client service needs at a minimum, during normal business hours. Normal
business hours are defined as Monday tltrough Friday, 8:00am to 5:00pm.
2.3. Equipment
2.3.1. Equipment means: (a) an aliicle 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 (a) the
capitalization level established by the organization for the financial statement purposes, or $5,000
[for federal funds], or (b) nonexpendable, tangible personal prope11y of a nonconsumable nature
with an acquisition cost of $1,000 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 of cost of .
$250 or more [for state funds].
2.3.2. Recipients and sub-contractors who are Institutions of Higher Education, Hospitals, and Other
. Non-Profit Organizations shall have written propeliy management standards in compliance with 2
CFR Part 215 Administrative Requirements (formerly OMB Circular A-lIO) that include: (a) a
property list with all elements identified in the circular; and, (b) a procedure for conducting a
physical inventory of equipment at least once every two years. The propel1y records must be
maintained on file and shall be provided to the agency upon request.
2.3.3. The recipient's property management standards for equipment acquired with public funds and
federally-owned equipment shall include accurately maintained equipment records with the
follo\\ring information:
(1) A description ofthe equipment;
(2) Manufacturer's serial number, model numbel', Federal stock number, national stock
number, or other identification number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the recipient or the Federal Government;
(5) Acquisition date (or date received, if the equipment was furnished by the Federal
Government) and cost;
(6) Information from which one can calculate the percentage of Federal participation in the
cost ofthe equipment (not applicable to equipment fumished by the Federal Government);
(7) Location and condition of the equipment and the date the information was reported;
(8) Unit acquisition cost; and
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Ultimate disposition data, including date of disposal and sales price or the method used to
determine CUTI'ent fair market value where a recipient compensates the Federal awarding
agency for its share.
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2.3.4. Equipment purchased with federal funds with an acquisition cost over $5,000 and equipment
purchased with state funds with an acquisition cost over $1,000 that is part of the cost of carrying
out the activities and functions of the grant awards and Title (ownership) will vest in the recipient,
subject to the conditions of2 CFR Part 215 Administrative Requirements (formerly OMB Circular
A-II0), Subpart C, paragraph .34. Equipment purchased under these thresholds is considered
supplies and is not subject to property standards. Equipment purchased with state funds identified
in .the budget attachments to agreements covered by this contract, or identified in the sub.
agreements with sub-contractors (not included in a cost methodology), is subject to the condition
of section 273, F.S. and 60A-1.0017, F.A.C. or Title 45 CFR part 74.
2.3.5. The recipient shall not dispose of any equipment or materials provided by the agency, or
purchased with funds provided tlU'ough this contract without first obtaining the approval of the
agency's Contract Manager. When disposing of property or equipment the recipient 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, percentage of
state or federal participation, acquisition date and condition of the property. The request should
also indicate the recipient's proposed disposition (Le., transfer or donation to another agency that
administers federal programs, offer the items for sale, destroy the items, etc.).
~
2.3.6. The agency's Contract Manager will issue disposition instructions. If disposition instructions are
not received within 120 days of the written request for disposition, the recipient is authorized to
proceed as directed in 1 CFR Part 215 Administrative Requirements (formerly OMB Circular A-
110).
2.3.7. Real propeliy 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 fund through agreements covered under this contract without the prior
approval of the agency. Real propeliy purchases from Older American Act funds are subject to
the provisions of Title 42, Chapter 35, Subchapter III, Pati A., Sec. 3030b United States Code
(Use). Real property purchases from state funds can only be made through a fixed capital outlay
grants and aids appropriation and therefore are subject to the provisions of section 216.348, F.S.
2.3.8. Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted
and tested prior 0 disposal to ensure no confidential information remains.
2.3.9. the recipient must adhere to the agency's procedures and standards when purchasing Information
Technology Resources (ITR) as patt of any agreement(s) incorporation this contract by reference.
An rTR 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 recipient has the responsibility to require any
subcontractors to comply with the agency's ITR procedures.
~ 2.4 DELIVERABLES
2.4.1. Service Unit
19
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3/8/2011 Item 16.0.6.
July 2009 HCE 203.09
The chart below lists the services that can be performed and the unit of measmement:
Service Unit of Service
Adult Day Care
Adult Day Health Care Housing Improvement
Caregiver Training/Support Intake
Case Aide Occupational Therapy
Case Management Other
Chore Outreach Hour
Chore (Enhanced) Personal Care
Counseling (Gerontological) Physical Therapy
Counseling (Mental Health Screening) Respite (Facility Based or In Home)
Home Health Aide Service Skilled Nursing Services
Homemaker Speech Therapy .
Home Delivered Meals Meal
Material Aid
Other Episode
Specialized Medical Equipment. Services and Supplies
Transportation One-Way Trip
",..........
2.4.2. Programmatic Reports
The recipient is responsible for responding in a timely fashion to routine and/or special requests ",..........
for information and reports required by the agency. The recipient must establish due dates for any
subcontractors that permit the recipient to meet the agency's reporting requirements. Reports and
information that the recipient shall provide to the agency includes, but is not limited to:
2.4.2.2. Client Information and Registration Tracking System (CIRTS) Reports
The recipient is required to use CIRTS repOlts in the web-based CIRTS database system to ensure
CIRTS data accuracy. The repOli categories include:
(1) Client Reports;
(2) Monitoring Reports;
(3) Services Reports;
(4) Miscellaneous RepOlts;
(5) Fiscal Reports;
(6) Aging Resource Center Repolts; and
(7) Outcome Measurement Reports.
2.4.2.3. Senrice Costs Reports
The recipient shall require subcontractors to submit to it semi-annual service cost reports, which
reflect actual costs of providing each service by program. This report provides information for
planning and negotiating unit rates.
2.4.2.3. SurpluslDeficit Report
The recipient will submit a consolidated surplus/deficit report in a format provided by the agency ~
to the agency's Contract Manager by the 25th of each month. This report is for all agreements
and/or contracts between the recipient and the agency. The rep0l1 will include the following:
20
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July 2009
(1)
(2)
",..........
(3)
(4)
(5)
(6)
3/8/2011 Item 16.0.6.
HCE 203.09
A list of all subcontractors and their current status regarding surplus or deficit;
The recipient's detailed plan on how the surplus or deficit spending exceeding the
threshold specified by the agency will be resolved;
Recommendations to transfer funds to resolve surplus/deficit spending;
Input from the recipient's Board of Directors on resolution of spending issues, if
applicable.
Number of clients currently on Assessed Priority Consumer List (APCL) that receive a
priority ranking score of 4 or 5; and
Number of clients currently on the APCL designated as Imminent Risk.
2.4.3. Records and Documentation.
The recipient will ensure the collection and maintenance of client and service information on a
monthly basis from the Client Information andRegistration Tracking System (CIRTS) or any such
system designated by the agency. Maintenance includes valid exports and backups of all data and
systems according to agency standards.
2.4.4. The recipient must ensure all data for HCE subsidies are entered in the Client Information and
Registration Tracking System (CIRTS) by the 15th of each month, HCE subsidy data entered into
the CIRTS by the 15th of the month will be for payments incun'ed between the 16th of the
previous month and the 15th of the current month. Case management data entered into the CIRTS
by the 15th of the month will be for units of service provided during the previous month from the
16th and up to and including the 15th of the current month or case management units of service
may be entered according to the recipient schedule, in aggregate on the 31 st or daily, weekly or
monthly.
~
2.4.4.1.Each recipient and subcontractor, among other requirements must 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 recipient 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. The
recipient shall maintain written policies and procedures for computer system backup and recovery
and shall have the same requirement in its contracts and/or agreements with subcontractors. These
policies and procedures shall be made available to the agency upon request.
2.4.5. The recipient will ensure data entry for HCE subsidies will cease on the 15th of the month and the
CIRTS Monthly Service Utilization Report, by consumer and by worker identification is verified,
corrected, celtified no later than the 20th of the month in which the repOlt is generated.
2.4.6. The recipient will ensure copies of receipts for all HCE special subsidies of $150 and over will
accompany the Monthly Utilization Report. Payment of HCE special subsidies will not be
processed until sUPPOlting documentation is received by the agency no later than the 20th of the
month in which the report is generated.
2.5. PROGRAM EVALUATION AND PERFORMANCE SPECIFICATIONS
~
2.5.1. Outcomes
(1) The recipient shall timely submit to the agency all repolis described in ATTACHMENT
I, SECTION 2.4, REPORT;
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July 2009
(2)
(3)
3/8/2011 Item 16.0.6.
HCE 203.09
The recipient shall timely submit to the agency all information described in
ATTACHMENT I, SECTION 2.4.3., RECORDS AND DOCUMENTATION;
The recipient shall ensure services in this contract are in accordance with the current r'\
Department of Elder Affairs Programs and Services Handbook.
2.5.1.2. The performance of the recipient in providing the services described in this contract shall be
measured by the current area plan strategies for the following criteria:
(1) Percent of most frail elders who remain at home or in the community instead of going into
a nursing home;
(2) Average monthly savings per consumer for home and communitywbased care versus
nursing home care for comparable group clients;
(3) Percent of elders assessed with high or moderate risk environments who improved their
environment score;
(4) Percent of new service recipients with highwrisk nutrition scores whose nutritional status
improved;
(5) Percent of new service recipients whose ADL assessment score has been maintained or
(6) Percent of new service recipients whose IADL assessment score has been maintained or
improved;
(7) Percent of family and family-assisted caregivers who self-report they are likely to provide
care;
(8) Percent of caregivers whose ability to provide care is maintained or improved after one
year of service intervention (as determined by the caregiver and the assessor);
(9) Percent of customers who are at imminent risk of nursing home placement who are served
with community based services.
2.5.1.3. Monitoring and Evaluation Methodology
The agency will review and evaluate the performance of the recipient under the terms of this
contract. Monitoring shall be conducted through direct contact with the recipient through
telephone, in VI'l'iting, or an onsite visit. The agency's determination of acceptable performance
shall be conclusive. The recipient agrees to cooperate with the agency in monitoring the progress
of completion of the service tasks and deliverables.
",..........
2.6. AGENCY RESPONSIBILITIES
2.7.1. Program Guidance and Technical Assistance
The agency will provide to the recipient guidance and technical assistance as needed to ensure the
successful fulfillment of the contract by the recipient.
2.7.2. Contract Monitoring
The agency shall, at its own discretion, conduct monitoring concernmg any aspect of the
recipient's performance of this contract.
SECTION III: METHOD OF PAYMENT
3.1.
General Statement of Method of Payment
The method of payment for this contract includes advances, cost reimbursement for administration
costs, and fixed rate for services. The recipient shall ensure fixed rates for services include only
those costs that are in accordance with all applicable state and federal statutes and regulations and
are based on audited historical costs in instances where an independent audit is required. The
recipient shall consolidate all requests for payment from subcontractors and expenditure reports
22
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July 2009
that support requests for payment and shall submit to the
(ATTACHMENT IX) and 105H (ATTACHMENT X).
3/8/2011 Item 16.0.6.
HCE 203.09
agency on forms 106H
",..........
3.1.1. The recipient agrees to distribute funds as detailed the Budget Summary, ATTACHMENT VII to
this contract. Any changes in the total amounts of the funds identified on the Budget Summary
form require a contract amendment.
3.2. Advance Payments
3.2.1. The recipiept may request up to two 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 funs released to the agency by the State of Florida ("budget release").
The recipient shall provide agency's Contract Manager documentation justifying the need for an
advance and describing how the funds will be distributed.
3.2.2. The recipient's requests for advance require the approval of the agency's Contract Manager. If
sufficient budget is available, the agency will issue approved advance payments after July 1, 2008.
3.2.3. Requests for the third through the twelfth months 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, if available is shown on ATTACHMENT VIII to this contract.
3.2.4. All advance payments made to the recipient shall be recouped in accordance with the Invoice
Schedule, ATTACHMENT VIII to this contract.
~
3.2.5. The recipient may temporarily place advanced funds in an insured interest bearing account. All
interest earned on contract fund advances must be returned to the agency within thirty (30) days of
the end of each quarter of the contract period.
3.3. Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for payment shall
be on DOEA forms 106H (ATTACHMENT IX) and 10SH (ATTACHMENT X). Duplication
or replication of both forms via data processing equipment is permissible, provided all data
elements are in the same format as included on Department of Elder Affairs' forms.
3.3.1. All payment requests 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
and invoices is ATTACHMENT VIII to this contract.
3.3.2. Any payment due by the depaliment under the terms of this contract may be withheld pending the
receipt and approval by the depaliment of all financial and programmatic reports due from the
recipient and any adjustments thereto, including any disallowance not resolved as outlined in
section 22 of this contract.
3.3.3. Payment may be authorized only for allowable expenditures, which are in accordance with the
limits specified in ATTACHMENT VII, Budget Summary.
~ 3.3.4. Date for Final Request for Budget Revisions
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3/8/2011 Item 16.0.6.
July 2009 HCE 203.09
Final requests for budget revisions or adjustments to contract funds based on expenditures for
services provided through June 30, 2009, must be submitted to the COEA Contract Manager by
July 10,2009. ",..........
3.3.5. Date for Final Request for Payment
The final request for payment will be due to the agency no later than August 15.2010.
3.5. Documentation for Payment
The recipient shall maintain documentation to support payment requests that shall be available to
the department or authorized individuals upon request. Such documentation shall be provided
upon request to the agency or the Department of Financial Services.
3.5.1. The recipient must ensure all data for HCE subsidies are entered in the Client Information and
Registration Tracking System (CIRTS) by the 15th of each month. HCE subsidy data entered into
the CIRTS by the 15th of the month will be for payments incurred between the 16th of the
previous month and the 15th of the CUI1"ent month. Case management data entered into the CIRTS
by the 15th of the month will be for nits of service provided during the previous month from the
16th and up to and including the 15th of the current month or case management units of service
may be entered according to the recipient schedule, in aggregate on the 31st or daily, weekly or
monthly. The recipient will ensure data entry for HCE subsidies will cease on the 15th of the
month and the CIRTS Monthly Service Utilization Report, by consumer and by worker
identification is generated. The recipient will ensure the Monthly Utilization Report, by consumer
and by worker identification is verified, corrected, certified no later than the 20th of the month n
which the report is generated.
3.5.2. The agency will require recipients to enter all required data per the Department of Elder Affairs'
CIRTS Policy Guidelines for clients and services in the CIRTS database. The data must be
entered into the CIRTS before the recipients submit their request for payment and expenditure
reports to the agency. The recipient shall establish time frames to assure compliance with due
dates for the requests for payment and expenditure reports to the agency.
",..........
3.5.3. The agency will require recipients to run monthly CIRTS repOlts and verify client and service data
in the CIRTS is accurate. This report must be submitted to the agency with the monthly request
for payment and expenditure report and must be reviewed by the agency before the recipient's
request for payment and expenditure reports can be approved by the agency.
",..........
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July 2009
3/8/2011 Item 16.D.6.
HCE 203..09
ATTACIIMEN'r II
,-......
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
AGREEMENTS
The undersigned certifies, to the best of his 01' her knowleqge and belief, that:
(I) No federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any state or federal agency,a
member of congress, an officer or employee of congress, an employee of a member of congress, .or an
officer or employee of the state legislature, in connection with the awarding of any federal grallt, the
making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendlllent, or modification of any federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any persoll for
influencing or attempting to influence an officer or employee of any agency, a member of congress, an
officer or employee of congress, or an employee of a member of congress in connection with this fedel'al
contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Foml-
LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3)
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 oJ' emplo>'ee of congress, 01' an emp.1oyee of a membel' of congress in connection with this federal
contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-
LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
~
This certification is a material representatiol1. of fact upon which reliance wasplaceg when this transaction was
made or entered into. Submission of this celtificatiol1 is a prerequisite for making or entering into this
transaction imposed by section 1352, Title 31, U.s. Code. Any person who failsto file therequired celtification
shall be subject to a civil penalty of not less tban $10,000.00 and not more than $100,000.00 for each such
faila'lfJ
'trrrnA.,/
Signature
1 .,.
~M~.
July 28. 2009
Date:
DOlllla Fiala. Chairman
Name of Authorized Individual
HCE 203.09
Application 01' Agreement Number
Collier County Board ofCoullty Commissiol1ers
3301 Tamiami Trail East
Naples, Florida 341 12
Name and Address of Organization
C~~
Assistant County Attorney
ATIE ST: . ,;,'. "Ji i'; S ft ",
~DW.. I.~ T.. E..IB.R. O.C..~I.".!. (~'.'I.kF~;.I:..l.':. <01.........~ :..~.....,...f...' ';;t.:.....~~11.'.
. ~iH'~
By. _ UJ..,M~_~: :. ':.~. ',., ..,'~- . -. .
· fIt<e;.t,.., ~" J~"'i",.""
,1{liHrtt'f'~ onl. "',
~
DOHA Fonn 103
(Revised Nov 2002)
25
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July 2009
DOEA Form 103
3/8/2011 Item 16.0.6.
HCE 203.09
FINANCIAL AND COMPLIANCE AUDIT
ATTACHMENT ITI
~
The administration of resources awarded by the Area Agency on Aging of Southwest Florida, Inc. to the provider
may be subject to audits and/or monitoring by the Area Agency on Aging of 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 Area Agency on Aging of Southwest Florida, Inc. In the event the
Area Agency on Aging of Southwest Florida, Inc. detel1nines that a limited scope audit of the provider is
appropriate, the provider agrees to comply with any additional instructions provided by the Area Agency on Aging
of Southwest Florida, Inc. to the provider regarding such audit. The provider further agrees to comply and
cooperate with any inspections, reviews, investigations, or audits deemed necessalY by the Director of Finance of
the Area Agency on Aging of Southwest Florida, Inc.
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 A133, as revised.
",..........
hl the event that the provider expends $500,000.00 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-I33,
as revised. EXHIBIT 1 to this agreement indicates Federal resources awarded through the Department of Elder
Affairs 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 Depaliment of Elder Affairs.
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 ofOMB Circular A-133, as revised, wiII meet the requirements of this pati.
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 Subpalt C ofOMB Circular A-I33, as revised.
If the provider expends less than $500,000.00 in Federal awards in its fiscal year, an audit conducted in accordance
with the provisions of OMB Circular A-I33, as revised, is not required. hl the event that the provider expends less
than $500,000.00 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 (Le.,
the cost of such audit must be paid fi'om 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 Area Agency on Aging of Southwest Florida, Inc. shall be
based on the agreement's requirements, including any rules, regulations, 01' 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 Area Agency on Aging of Southwest Florida, Inc. shall be
fully disclosed in the audit repOli with reference to the Area Agency on Aging of Southwest Florida, Inc. agreement
involved. If not otherwise disclosed as required by Section .3 IO(b)(2) of OMB Circular A-I33, as revised, the
schedule of expenditures of Federal awards shall identify expenditures by agreement number for each agreement
26
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3/8/2011 Item 16.0.6.
July 2009 HCE 203.09
with the Department of Elder Affairs in effect during the audit period. Financial repOlting packages required under
this palt must be submitted within the earlier ono days after receipt of the audit repOlt or 9 months after the end of
the provider's fiscal year end.
~
PART II: STATE FUNDED
This part is applicable if the provider is a non-state entity as defined by Section 215.97(2), Florida Statutes.
In the event that the provider expends a total amount of state financial assistance equal to or in excess of
$500,000.00 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,
Florida Statutes; applicable mles of the Depaltment of Financial Services; and Chapters 10.550 (local governmental
entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. EXHIBIT I to this
agreement indicates state financial assistance awarded through the Department of Elder Affairs 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 fi'om the Department of Elder Affait.s, other
state agencies, and other non-state entities. State financial assistance does not include Federal direct 01' pass-
through awards and resources received by a non-state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Palt II, paragraph 1, the provider shall ensure that the audit
complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial
reporting package as defined by Section 215.97(2), Florida Statutes, 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 $500,000.00 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, Florida
Statutes, is not required. In the event that the provider expends less than $500,000.00 in state financial assistance in
its fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, Florida
Statutes, the cost of the audit must be paid from the non-state entity's resources (i.e., the cost of such an audit must
be paid from the 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 Area Agency on Aging of Southwest Florida, Inc. 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 Area Agency on Aging of Southwest Florida, Inc. shall be fully disclosed
in the audit report with reference to the Area Agency on Aging of Southwest Florida, Inc. agreement involved. If
not otherwise disclosed as required by Rule 691-5.003, Fla. Admin. Code, the schedule of expenditures of state
financial assistance shall identify expenditures by agreement number for each agreement with the Area Agency on
Aging of Southwest Florida, Inc. in effect during the audit period. Financial reporting packages required under this
pati must be submitted within 45 days after delivelY 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 th is poJtion, the Area Agency on Aging of Southwest Florida, Inc. retains
all right and obligation to monitor and oversee the perfornlance of this agreement as outlined throughout this
document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of repOlting 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-I33,
~ as revised, by or on behalf ofthe provider directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. at each of the following addresses:
27
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July 2009
3/8/2011 Item 16.0.6.
HCE 203.09
Leigh Wade-Schield, Executive Director
Area Agency on Aging COl' Southwest Florida, Inc.
2285 First Stl'eet
Fort Myers, Florida 33901
r"-
The Federal Audit Clearinghouse designated in OMB Circular A-I33, as revised (the number of copies required by
Sections .320 (d)(l) and (2), OMB Circular A-I33, as revised, should be submitted to the Federal Audit
Clearinghouse), at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jefferson,~ 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(t), OMB Circular A-B3, 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, toThe Area Agency on Aging of Southwest Florida, Inc. at each of the following addresses:
Leigh Wade-Schield, Executive Directol'
Area Agency on Aging fOl' Southwest FloIida, Inc.
2285 Fh'st Street
Fort Myers, Florida 33901
r",
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or
on behalf ofthe provider directly to each of the following:
The Area Agency on Aging of Southwest Florida, Inc. at each of the following addresses:
Leigh Wade-Schield, Executive Director
Area Agency on Aging for Southwest Florida, Inc.
2285 First Street
Fort Myers, Florida 33901
The Auditor General's Office at the following address:
State of Florida AuditOl' 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 Area Agency on Aging for
Southwest Florida, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-
133, Florida Statutes, 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 Area Agency on Aging for Southwest Florida, Inc.
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 repOlting r'"
package was delivered to the provider in correspondence accompanying the repOlting package.
28
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~
,,-.......
~
July 2009
PART IV: RECORD RETENTION
3/8/2011 Item 16.D.6.
HCE 203.09
The provider shall retain sufficient records demonstrating its compliance with the terms ofthis agreement for a
period of six years from the date the audit report is issued, and shall allow the Area Agency on Aging for Southwest
Florida, Inc. or its designee, the Director of Finance access to such records upon request. The provider shall ensure
that audit working papers are made available to the Area Agency on Aging for Southwest Florida, Inc. or its
designee, Director of Finance upon request for a period of six years from the date the audit report is issued, unless
extended in writing by the Area Agency on Aging for Southwest Florida, Inc.
29
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1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
AGREEMENT CONSIST OF THE FOLLOWING:
3/8/2011 Item 16.0.6.
HCE 203.09
ATTACHMENT ill
EXHIBIT 1
~
July 2009
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO TInS AGREEMENT
CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
"..........
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97, F.S.
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Home Care for the Elderly
Pro~ram - Collier General Revenue 65001 $85.066.00
TOTAL AWARD $85.066.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT
TO THIS AGREEMENT ARE AS FOLLOWS:
~
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July 2009
ATTACHMENT III
3/8/2011 Item 16.0.6.
HCE 203.09
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EXHIBIT -2
PART I: AUDIT RELATIONSHIP DETERMINATION
Providers who receive state or federal resources mayor may not be subject to the audit requirements of OMB Circular A-I33,
as revised, and/or Section 215.97, Fla. Stat. Providers who are detelmined to be recipients or subrecipients of federal awards
and/or state fmancial assistance may be subject to the audit requirements ifthe audit threshold requirements set forth in Palt I
and/or Part II of Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements
ofOMB Circular A-133, as revised, 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 fmancial assistance, must
comply with applicable programmatic and fiscal compliance requirements.
In accordance with Sec. 210 ofOMB Circular A-B3 and/or Rule 69I~5.066, FAC, provider has been determined to be:
~ Vendor or exempt entity and not subject to OMB Circular A-133 and/or Section 215.97, F.S.
_X_Recipientlsubrecipient subject to OMB Circular A-133 and/or Section 25.97, F.S.
NOTE: If a provider is detennined to a recipient/subrecipient of federal and or state financial assistance and has been approved
by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691-.006(2), FAC [state fmancial
assistance] and Section _ADO OMB Circular A-B3 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal
awards or state matching funds on Federal awards and W110 are detennined 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 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A-
87)*
OMB Circular A-I 02 - Administrative requirements
OMB Circular A. 133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set fOl111 in program laws, rules and regulations.
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non-Profit Organizations (FOlmerly OMB Circular A-22-Cost
Principles)*. '" .
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A-II 0 - Admmlstratlve
Requirements)
OMS Circular A-133 -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 220 Cost Principles for Educational Institutions OMS (Fonnerly Circular A-2I-Cost Principles)*
2 CFR 2I5Administrative Requirements (Formerly OMB Circular A-II O-Administrative Requirements)
OMB Circular A-I33 -Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations.
*Some Federal programs may be exempted fi'om compliance with the Cost Principles Circulars as noted in the OMB
Circular A-133 Compliance Supplement, Appendix 1.
~
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are detennined to be a
recipient/subrecipient, m\lst comply with the following fiscal laws, rules and regulations:
Section 215-97, Fla. Stat.
Chapter 619-5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State expenditures
Other fiscal requirements set forth in program laws, rules and regulations.
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HCE203.09
ATTACHMENT IV
July 2009
CERTIFICATION REGARDING DATA INTEGRITY cOMPLIANCE
FOR AGREEMENTS, GRANTS, LAND AND
COOPERATIVE AGREEMENTS
~
The undersigned, an authorized. representative of the recipient namedinthe contract or agreenlent to which this
form is an attachment, hereby certifies that:
(1)
(2)
(3)
The recipient and any sub-contractors of services under this contract have financial management systems
capable of providing celiain 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 offul1ds for all agreement supported activities; and 93) the
comparison of outlays with budgeted amounts for each award. The inability to process information in
accordance with these requirements could result inareturtl of grand funds that have not been accounted for
properly.
Management Information Systems used by the recipient, sub-contractor(s) or any outside entity on which
the recipient 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, recipient(s) will take immediate action to assure data integrity.
If this contract includes the provision of hard.ware, 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 recipient (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 recipient agrees to
immediately make required COll'ections 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.
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(4) !herecipie.nt and any sub-con~ractor(s) of services under this contract warrant their policies .and procedures
mclude a dIsaster plan to prOVIde for service delivery to continue in case of an emergency including
emergencies arising from data integrity compIianc~ issues.
The recipient shall require that the language of this certification be included in all subagreements,
subgrants, and other agreements and that all sub-contractors shall celtify compliance accordinoly.
This cel1ification is a material representation of fact upon which reliance was placed when thi; transaction
wasma~e o~ y teredinto. Subn:ission ofthis certificatiol1 isa prerequisite for making or entering into this
transacttorl fl. osed by OMB. C Cilyc" ula:: A-I 02 and 2 CPR Palt 2..15 (formerly OMB Circular A-II 0).
A. . a~-/}
'th?-~ .' /L-t:l:...I.::~.,. July 28. 2009 ",
Signature Date: .
Donna Fiala. Chairman
Name of Authorized Individual
Collier County Board of County Commissioners
3301 Tamiami Trail East
Naples, Florida 34112
Nameanci Address of Organizatioll
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DOEA Fonll 103
(Revised Noy 2002)
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HCE 203..09
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ATTACHMENT
CERTIFICATION REGARDING DEPARTMENT, SUSPENSION, INELIGffiILlTYAND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1)
The prospective contractor certifies, by signing this celtification,ueithel' itnorits principals are presently
debated, suspended, proposed for debarment, declared ineligible, or v()luutarily excludedfi'ompalticipation
in this transaction by any federal depalimentor agency.
(2)
Where the p ~ pective contractor is unable to certifY to any of the statements in this celtifica.tion, such
pto,pecli p ,:icipOnI Sh~h an. e.pIOn.tion 10 this ce':ification.
~~. Julv 28.2009
Date
1.
Collier County Board of Count): .Commissioners
Title Agency/Organization ,,\~'''''. ' :'/', I 'f. ..
! . ptrl-E,~~:.;'. ..,;'l
Assistant County At ol'l1ey .' . .. DVtllEi,Hi.t;:: mFIOCf{,~6eil':;~' 7r_
(Celiification signature should be same as Contract s1~Df ~li"" ... ... .' _ -) ; ~!f(-
~ . .... V",,--l. '" ~-"-':........t.'Z'_:-'-_~.~~,:~_.:..~:-.. ... ~_.. __..._. """'_~""~
Instructio.ns far Certificatian \, \..,' ',.. "t ...., .t~<6lij h~l'Vil! 1
\,'<S,ftittit uP.... 'f/i~'"
The terms (covered transaction," "debalTed," "suspended," "ineligible," "low~i;:ti~~;'coV.~j:ed'tr~nsaction,"
"Person," "Primary covered transaction,'l and "voluntarily excluded," asus.ed hereii( h:ave the uleanings set
out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020) as
supplemented by2CFR 376.10-376.995). You may contact the Contract Manager for assistance in
obtaining a copy of those regulations.
~
2. This celtification isa mateJ'ialrcpl'esentation of facts upon which reliance was pla.c.ed when the .palties
entered into thistransaction. Ifit is later determined that the recipient knowingly rendered an erroneous
celiification,in addition to. other remedies available to the federal government the Agency may pursue
available remedies, including suspensionandfor debarment.
3. The recipient will provide immediate written notice to the Contract Manager ifat any time the recipient
learns that its certification was erroneolls when submitted or has become erroneous by reason of changed
cil'cumstances. The recipient may decide the method mId frequency by which it determines the .eligibility
of its principals. Each pmticipant to a loweI' tier covered transaction may, but is not required to, check the.
Excluded Parties List System (EPLS).
4. The recipient will include a "Celiificatioll Regarding Debal'ment, Suspension, Ineligibility and Voluntary
Exclusion 'Lower Tier Covered Transaction" inaUits lower tier covered transactions and in all
solicitations for lower tiel' covered transactions.
5. The I'ecipient agrees that it shall not knowingly enter into an)' lower tier covered transaction with a person
who is debarred, suspended, determined ineligible 01' voluntarily e~c1udecl from participation, unless
otherwise authorized by the federal government.
6.
If the recipient knoWingly enters into a lOWer tier covered transaction with a person who is suspended,
debaned, ineligiblel or voluntarily excludedfi'om palticipationin this transaction, in addition to other
remedies available. to the federal govenuuent, the Agency may pursue available remedies, including
suspension, and/or debarment.
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7. The recipient may rely upon a certification of a prospective participant in a low~r tier covered transaction,
unless it knows that the certification is el'1'ol'leous.
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July 2009
3/8/2011 Item 16.0.6.
HCE 203.09
ATTACHMENT VI
ASSURANCES-NON-CONSTRUCTION PROGRAMS
~
Public reporting burden for this collection of information is estimated to average 45 minutes per response, incl~ding time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completmg and
reviewing the collection ofinfonnation. Send comments regarding the burden estimate or any other s=aspect of this collection
of infonnation, 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 or these assurances may not be applicable to your project or program. !fyou 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 projecf cost) to ensure proper platl.riing, management, and
completion of the project described in this applications.
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.
r-....
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
ofOPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpalt F).
6. Will comply with aU Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI
of the Civil Rights Act of 1964 (PL. 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 V.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 V.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 (PL. 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 ]912 (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 V.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 CD 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 unifOlm Relocation Assistance
and Real Property Acquisition Policies Act of ] 970 (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 palticipation in
purchases.
~
8. Will comply, as applicable, with the provisions of the Hatch Act (5 V.S.C., 1501-]508 and 7324-7328), which limit
34
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3/8/2011 Item 16.0.6.
July 2009 .... ... . HCE203.09
the politicatactivitiesof employees whose principal emplo)'mentactivities are funded.in wl1oleofIhpall with Federal
funds.
~
9.
WiII comply, asappIlcable, with the provisions ofthe Davis-Bacon Act (4() n.s.C., 276ato 276a-7),tlte Copeland Act
(40 V.S.C. 276cand .18 V.S.C., 874) and the Contract Work Hours and Safety Standards Act (40 V.S.C., 327.,333),
regarding labor standards forfederalJy assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase requirements of section 102(a) of the Flood DIsaster
Projection Act of 1973 (P.L 93-234) which requires recipients ina special flood hazard area to palticipate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. WiII comply with envil"onmentaJ 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) 115 I 4; (b) notification of violating facilities pursuantto EO I 738 (c) protection of wetlands
pursuant toEO 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 V.S.C. 1451 et seq.); (f) conformity of Federal actions of State (Clear Air) Implementation Plans under
Section 176(c) or the Clear Air Act of 1955, as amended (42 V.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, (Pol. 93-205).
12. Will cOll1plywith the Wild and Scenic Rivers Act of 1968(16 V.S.C. 172let seq.) related to protecting components
or potential componentsofthe 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 V.S.C. 470), EO 11593 (identification and protection of historic propertie.s), and the
Archaeological and Historic Preservation Act of 1974 (16 V.S.C. 469a-1 et seq).
~
14.
Wilfcomply with P;L, 93-348 regarding the protection of human subjects involved in research, development, and
related activities suppolled by this award ofassistance.
15. Will comply With the Laborat01Y Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 V.S.C.. 213let seq.)
pertaining to tIle care, handling, andtreiltnlenfofwarni 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 V.s.C..4801 et seq:), which prohibits the use of
leaci- based paint illconstmction or rehabilitation of residence structures.
17. Will cause to be perforuied the required [mancial ahd cOl'11plianceaudits illaccordarice with the Single Audit Act
Amendments of 1996 and OMBCircular No. A-B3, Audits of States, Local Governments, and NOll-Profit
Organizations.
18. Will comply witII aHappIicablerequirementsof all other Federal laws, executive orders, regulations and policies
governing this program.
('"
SIGNATU ~(lAIlTHDRJZED C~T;YIN~OFFICIAL
ff~ e:ti~__
Donna Fiala
TITLE
Ch!\irman
35
i:.")
t\T~rES.r:_~,. . "~';.:
~~~~:
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.tA^~...__
APPLICANT ORGANIZATION
DATE SUBMITTED
Collier Coullty Board of County Commissioners
Housing and Human Services Department
July 28,2009
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~~
Assistant CountyAttomey
July 2009
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Services for Seniors
1. HCE Subsidies
2. HCE Case Management
3. Total
$78,493.00
$ 6,573.00
$85,066.00
HOME CARE FOR THE ELDERLY PROGRAM
RATE SUMMARY
Collier County Services for Seniors
<\>'$ERVICES.
Case Management
Case Aide
3/8/2011 Item 16.0.6.
HCE 203.09
ATTACHMENT VII
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:REiIl\1lJ~E:l\fEN'l'JlAl'E.. ....... .
$50.51
$25.81
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July 2009
3/8/2011 Item 16.0.6.
HCE203.09
ATTACHMENT VIII
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HOME CARE FOR THE ELDERLY
INVOICE SCHEDULE
Report Submit to State
Number Based On On This Date
July Advance* July 1
2 August Advance* July 1
3 September Advance* July 1
4 July Expenditure August 20
5 August Expenditure September 20
6 September Expenditure October 20
7 October Expenditure November 20
8 November Expenditure December 20
9 December Expenditure JanualY 20
10 JanualY Expenditure February 20
11 Febmary Expenditure March 20
~. 12 March Expenditure April 20
13 April Expenditure May 20
14 May Expenditure June 20
15 June Expenditure July 20
16 Final Expenditure and Closeout RepOlt July 25
Legend: * Advance based on projected cash need.
Note #1:
Report # 1 for Advance Basis Contracts cannot be submitted to the Depmiment of Financial
Services (DFS) prior to July 1 01' until the agreement with the depaltment has been executed and a
copy sent to DFS. Actual submission of the vouchers to DFS is dependent on the accuracy of the
expenditure repmi.
Report numbers 13, 14 and 15 shall reflect an adjustment of one third of the total advance amount,
on each of the three repOlts respectively, repaying advances for the first three months of the
contract. The adjustment shall be recorded in Palt C, 1 of the repOlt (Attachment X).
Submission of expenditure reports may 01' may not generate a payment request. Iffinal
expenditure report reflects funds due back to the department, payment is to accompany the repOli.
Note #2:
Note #3:
Revised May 2006
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3/8/2011 Item 16.0.6.
HCE 203.09
July 2009
ATTACHMENT IX
REQUEST FOR PAYMENT
HOME CARE FOR THE ELDERLY PROGRAM
RECIPIENT NAME. ADDRESS, PHONEII and FEID# TYPE OF REPORT: THIS REQUEST PERIOD:
FOR
A PAYMENT REQUEST:
Regular_ Supplemenlal_ REPORTII_
B. METHOD OF PAYMENT: CONTRACT#
Advance_
P1;A#
CERTIFICATION: I hereby certify Ihal this requesl or refund conforms wllh thelerms of the above contract.
prepared By: Dale: Approved
Bu: Dale
PART A: BUDGET (1) (2) (3) TOTAL
SUMMARY: AM Admln Case Subsidies
Mgmt.
1. Approved Contract
Amount S $ $ S $ $__
2. Previous Funds Received For - - - -
Contract Period
3. Contracl Balance
4. Previous Funds Requesled
For Contract Period
5. Contract Batance
PART B; CONTRACT FUNDS
REQUEST:
1. Anllcipated Cash Needs
(151. 2nd. & :lid months)
2. Nel Expendilures For Monlh
(DOEA Form 10SH. Part B
Line 12)
3. Exlraoolinary Cash Needs
(AItadl Doe.)
4. Tolal
PART C: NET FUNDS
REQUESTED:
1. Less Over edvance
2. Con\lact Funds Ive Hereby
Requested For (Part B line 4
minus Part Cline 1)
OOEA FORM l06H. Daled Jan2001
M:\CONTRACT ADMJNJSTll.ATIO~'\I'ROGRAllf CONTRACTS\lICE\lICF. MASTER CONTRACT 062408.DOC
38
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July 2009
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HCE 203.09
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RECIPIENT NAME, ADDRESS. PHONE' and FEIO# PROGRAM FUNDING SOURCE: THIS REPORT PERIOD:
FROM TO
AM Admin. :
CONTRACT
Case ManagGmenl : PERIOD
Subsidies: CONTRACT#_
Basic:
Special: REPORT'
PSAJI
CERnFICATION: I certify to the best of my knowledge and belief tflat the report /s complete and correct and all outlays herein are for purposes
set forth In the contract.
Prepared By: Date: Approved By:
Date:
PART A: BUDGETED INCOMEJRECEIPTS 1. Approved 2. Actual 3. Total 4 Percent of
8udget Receipts for Receipts Approved
This Report Year to Date Budget
1. State Funds............................................... $ $ S - %
2. TOTAl RECEiPTS...................................... $ $ $ _%
PART B: EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percenl of
8udget For This Report Year to Date Approved
Budget
1. AM Program Administration...................... $ $ S _'Yo
2. SelVice Subcontractor: Case Management... $ $ S - %
3. Service Subcontractor (s) . Subsidy Pm!. $ S $ - %
3a. Basic Subsidy.......................... $ $
3b. Speetal Subsidy....................... S $
4. Total Expenditures................................... $ $ $ - %
PART C: OTHER REVENUE AND EXPENDITURES
I. Interesl:
1. Earned on GR Advance $_
2. Rln. of GR Advance $
3. Olher Earned $_
RECEIPTS AND EXPENDITURES
HOME CAnE FOR THE ELDERLY PROGRAM
ATTACHMENT X
DOEA FORM 10SH. Dated Oc1.9~
,,-....,
39
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July 2009
3/8/2011 Item 16.0.6.
HCE 203.09
ATTACHMENT A
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Department of Elder Affairs Programs and Services Handbook, provided on CD.
Also, available at the Department's Intranet site under, "Publications."
40
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r---....
r---....
2010
Contract Renewal No. HCE 203.10
3/8/2011 Item 16.0.6.
r i1l;~ I
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AREA AGENCY ON AGING
FOR SOUTHWEST FLORIDA, INC.
CONTRACT RENEWAL FORM
Home Care for tbe Elderly Program (HCE)
CONTRACT RENEWAL #HCE 203.10
ORIGINAL CONTRACT # HCE 203.09
This RENEWAL, entered into by the Area Agency on Aging for Southwest Florida, hereinafter
referred to as the "agency," and Collier County Board of Commissioners, hereinafter referred
to as the "recipient," amends contract renewal HCE 203.10.
As stated on Page I, Paragraph 5, of Contract #HCE 203.09, the agency is exercising its option
to renew this contract if mutually agreed to by both parties. This renewal will begin on July 1,
2010 and end on June 30,2011 and the contract amount for this renewal period will not exceed
$89.277.00.
Additionally, this renewal (1) amends Paragraph 4 of the Standard Contract; (2) amends
Paragraph 45 of the Standard Contract; (3) introduces Paragraph 2.1.4.1 of Attachment I; (4)
introduces Paragraph 2.1.5 of Attachment I; (5) amends Paragraph 3.3; (6) revises and replaces
Attachment III, Exhibit-I; (7) revises and replaces Attachment V, Certification Regarding
Debarment; (8) revises and replaces Attachment VII, Budget SummarylRate Summary; (9)
~ revises and replaces Attachment VIII, Invoice Report Schedule; and (10) updates all ancillary
dates as appropriate.
(1) Paragraph 4 of the Standard Contract is hereby amended to read:
4. Contract Amount
The agency agrees to pay for contracted services according to the tenns and conditions of
this contract in an amount not to exceed $89.277.00. 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.
(2) Paragraph 45 of the Standard Contract is hereby amended to read:
45. Official Payee and Representatives (Names, Addresses and Telephone Numbers)
a.
The contractor name, as shown on
page 1 of this contact, and mailing
address of the official payee to whom
the a ent shall be made is:
Collier County Housing, Human and Veteran Services
3301 East Tamiami Trail
Naples, FL 34112
b.
The name of the contact person and
street address where financial and
administrative records are maintained
IS:. .
Marcy Krwnbine, Director
Collier County Housing, Human and Veteran Services
3301 East Tamiami Trail
Naples, FL 34112
(239) 774-8154
Packet Page -990-
2010
Contract Renewal No. HCE 203.10
3/8/2011 Item 16.0.6.
.t'age ~
The name, address and telephone Marcy Krumbine. Director ~
number ofthe representative ofthe Collier County Housing, Human and Veteran Servicl
c. contractor responsible for 3301 East Tamiami Trail
administration of the program under Naples. FL 34112
this contract is: (239) 774-8154
The section and locations within the
d. agency where Requests for Payment Area Agency on Aging for Southwest Florida, Inc.
and Receipt and Expenditure forms 15201 N. Cleveland Avenue Ste 1100
are to be mailed is: North Fort Myers, FL 33903-2717
Leigh Wade-Schield, Executive Director
The name. address. and telephone Area Agency on Aging for Southwest Florida, Inc.
e. number of the Contract Manager for 15201 N. Cleveland Avenue Ste 1100
the agency for this contract is: North Fort Myers, FL 33903-2717
(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.
(3) Paragraph 2.1.4.1 of Attachment I is hereby introduced to read:
2.1.4.1 Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the recipient shall
not delay the implementation of its agreement with the subcontractor. If any
circumstances occur that may result in a delay for a period of 60 days or more of the
initiation of the subcontract or in the perfomlance ofthe subcontractor, the recipient shall ~
notify the agency's Contract Manager and the agency's Director of Finance in writing of
such delay.
The recipient shall not permit a subcontractor to perform services related to this
agreement without having a binding subcontractor agreement executed. In accordance
with Paragraph 21 of the Standard Agreement, the agency will not be responsible or
liable for any obligations or claims resulting from such action.
(4) Paragraph 2.1.5 of Attachment I is hereby introduced to read:
2.1.5 Remedies-Nonconformin~ Services
The recipient shall ensure that all activities and/or benefits provided and reimbursed
under this contract are compliant with the requirements referenced in Paragraphs 1.4.1 -
1.4.3, and 2.1 - 2.1.4.1.
Any nonconforming activities and/or benefits shall not be eligible for reimbursement
under this program. The costs associated with providing nonconforming activities and/or
benefits shall be borne solely by the contractor. The agency requires immediate notice of
any significant and/or systemic infractions that compromise activities and/or benefits
provided.
(5)
3.3
Paragraph 3.3 of Attachment I is hereby amended to read:
Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for
payment shall be on DOEA forms 106H (Attachment IX) and 105H (Attachment X).
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(9) AttachrnentVTII, Invoice Report Schedule is hereby replaced with the revised
AttachrnentVIIl, Invoice Report Schedule and attached hereto.
(10) All related attachments, exhibits, and schedules that contain ancillary dates are hereby
amended as appropriate to concur with the applicable contract period. Ancillary dates
affected shall. include but not be limited to the final request for payment, the final request
for budget revisions and any other dates that affect specific contract tenns or provisions.
Thisrenewal shall be effective on July 1,2010. Alltem1s and conditions of said original
contract and any supplements and amendments thereto in conflict with this renewal shall be and
are hereby changed to confonn with this renewal.
All provisions not in conflict with this renewal are still in effect and are to be perfonned at the
~ level specified in the agreement.
This renewal and all of its attachments are hereby made a part of this agreement.
IN WITNESS 'WHEREOF, the parties hereto have caused this 7 page renewal to be executed by
their officials thereunto duly authorized. I
ATTEST:
DWIGHT E BROCK., Clerk
By:
Deputy Clerk
BOARD OF COUNTY COMMISSIONERS
COLLIERCOtJ"NfY, FLORIDA
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( - /". \. /" r /14'
By:" ~C~ .Cd: ./f.:...LY/ .
Leo E. Ochs, Jr., County,Managcr
{ . I..... j
L 'I
0(?;?r; fOil
June 22,2010
Date;
Approved as to form and
legal sufficiency
~~
Assistant County Attorney .
AREA AGENCY ON AGING FOR
SOUTHWEfT FLORIDA
By: ~<j\([I~,AJv-tJtt:4-
Leigh Ann~ Nowak, Board President
Date:
~ Federal Tax ill: 59-6000558
Fiscal Year Ending: 09/30
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUA..NT TO THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS
AGREEMENT CONSIST OF THE FOLLOWING:
MA TCHL'\'G RESOlJRCES FOR FEDER<\L PROGR..\.MS
PROGRAM TITLE I FUNDING SOURCE
t I
i
CFDA
I
r"..
STATE FINAt"lCIAL ASSISTANCE StillJECT TO Sec. 215.97 F.S.
PROGRAM TITLE FUNDING SOURCE CFDA
I General Revenue
Home Care for the Elderly
Pro ram ~ Collier
65001
I
$89.277.00
(1) The prospective contractor cenifies, by signing this certification, neither it nor its principals is presently
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this.
transaction by any federal department or agency.
(2) \\'here the prospective contractor is unable to certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this certification.
~~j[)f!il>1Y---
Signature ..... .. .. .... ../1
County Manalrer ( /
Title
Collier Countv Board of Commissioners
Agency/Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification
L The tenus. "covered transaction," "debarred,""suspended," "ineligible," "lower tier covered transaction,"
"pefson, " "primary covered transaction." and "voluntarily excluded,"as used herein, have the meanings set out in
the sections ofmles implementing Executive Order 12549. (2 CFR 180.5-180.1020, as supplemented by 2 CFR
376.10-376.995). Youmay contact the Contract Manager for assistance in obtaining a cDpyof those regulations.
~.
2. This certification is a material representation of facts upon which reliance was placed when the panies
entered into this transaction. If it is later detennined that the recipient knowingly rendered an erroneous
certification, in addition to other remedies available to the federal government the Agency may pursue available
remedies, including suspension andlor debarment.
3. The recipient will provide immediate written notice to the Contract Manager if at any time the recipient
learns that its cenification was erroneous when submitted or has become erroneous by reason of changed
circumstances. Tbe recipient may decide the method and frequency by which it determines the eligibility of its
principals. Each participanttoa lower tier covered transaction may, but is not required to, check the Excluded
PartiesListSystem (EPLS).
4. The recipient will include a "Certification Regarding Debarment. Suspension, Ineligibility und Voluntary
Exclusion- 'Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for
Jowertier covered transactions.
5. The recipient agrees that it shall not knowingly enter into any lower tier covered transaction with a person
who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise
authorized by the federal government.
6. If the recipient knowingly enters into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies
available to the federal government, the Agency may pursue available remedies, including suspension, andlor
debarment
7. The recipient may re1yupon acertification of a prospective participant in a lower tier covered transaction,
that is not debarred, suspended, ineliJ::,rible, or voluntarily excluded from the covered transaction. unless it knows that
the certification is erroneous.
2010
Contract Renewal No. HCE 203.10
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Board of County Commissioners
HCE Subsidies
HCE Case Management
Total
$82,704.00
$ 6,573.00 .
$89,277.00
HOME CARE FOR THE ELDERLY PROGRAM
RATE SUMMARY
Collier County Services for Seniors
':.:::':~~,:%,;~,~b;:::,:;~~~~6~~~~:~E~'~~~~,.\)jf~~;;...~. ;,
Case Management
Case Aide
3/8/2011 Item 16.0.6.
Yage ()
~
ATT ACHMENT VII
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.~JlWl~E~~'~~H:
$50.00
$27.78
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2010
~
Report
Number
~
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Legend: *
Contract Renewal No. HCE 203.10
3/8/2011 Item 16.0.6.
Page 7
ATTACHMENT VIII
HOME CARE FOR THE ELDERLY
INVOICE SCHEDULE
Based On
July Advance*
August Advance*
July Expenditure
August Expenditure
September Expenditure
October Expenditure
November Expenditure
December Expenditure
January Expenditure
February Expenditure
March Expenditure
April Expenditure
May Expenditure
June Expenditure
Final Expenditure and Closeout Report
Submit to Agency
On This Date
July 1
July 1
August 20
September 20
October 20
November 20
December 20
January 20
February 20
March 20
April 20
May 20
June 20
July 20
August 1
Advance based on projected cash need.
Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging prior
to July 1 or WItil the contract with the department has been executed and a copy
sent to DFS. Actual submission of the vouchers to AAA is dependent on the
accuracy of the expenditure report.
Note #2: Report numbers 13 and 14 shall reflect an adjustment of one half of the total advance
amount, on each of the two reports respectively, repaying advances for the first two
months of the agreement. The adjustment shall be recorded in Part C, 1 of the report
(Attachment IX).
Submission of expenditure reports mayor may not generate a payment request. If final
expenditure report reflects funds due back to the agency, payment is to accompany the
report.
Note #3:
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