Agenda 11/08/2011 Item #16D 611/8/2011 Item 16.D.6.
!gal _Iu
Recommendation to approve and authorize the Chairman to sign the agreement, Verification of
Emergency Preparedness Plan, and Attestation Statement between the Collier County Board of
County. Commissioners and the Area Agency on Aging of Southwest Florida dba Senior Choices of
Southwest Florida and approve a budget amendment to accept the grant award of $43,602 for the
Nutrition Services Incentive Program (NSIP�
OBJECTIVE: Approval and execution of this agreement, Verification of Emergency Preparedness Plan,
Attestation Statement, and budget amendment necessary to accept the grant award funding in the Services
for Seniors Nutrition program.
CON_ IDERATIONS: Housing, Human and Veteran Services began administering the Senior Nutrition
program in January 2008. The program consists of four congregate meal sites as well as home delivered
meals provided to the frail elderly. This existing program serves as a basis to also be eligible to receive
the NSIP grant.
The NSIP grant is intended to provide incentives for the effective delivery of nutritious meals to older
individuals. NSIP allows Collier County to increase the number of and/or the quality of meals
served. The contract period for this grant is October 1, 2011 through September 30, 2012. This grant
program reimburses the County at the rate of $0.68 for each meal served.
FISCAL UWACT: A budget amendment is necessary in FY 12 to recognize grant revenue in the
amount of $43,602 to Human Services Chants Fund (707), Project (33182). No matching funds are
required.
LEGAL CONSMERATIONS: This item has been reviewed by the County Attorney, is legally
sufficient, and requires a majority vote for approval. JAK
GROWTH MANAGEMENT IMPACT: There is no growth management impact from this
recommendation.
RECOMMENDATION: To approve and authorize the Chairman to sign the agreement, Verification of
Emergency Preparedness Plan, and Attestation Statement and approve the budget amendment to
recognize the grant revenue.
Prepared by: Ashlee Franco, Accounting Supervisor
Housing, Human and Veteran Services
Packet Page -910-
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.6.
11/8/2011 Item 16.D.6.
Item Summary: Recommendation to approve and authorize the Chairman to sign the
agreement, Verification of Emergency Preparedness Plan, and Attestation Statement between
the Collier County Board of County Commissioners and the Area Agency on Aging of Southwest
Florida dba Senior Choices of Southwest Florida and approve a budget amendment to accept
the grant award of $43,602 for the Nutrition Services Incentive Program (NSIP).
Meeting Date: 11/8/2011
Prepared By
Name: FrancoAshlee
Title: VALUE MISSING
10/12/20119:03:35 AM
n Submitted by
Title: VALUE MISSING
Name: FrancoAshlee
10/12/20119:03:36 AM
Approved By
Name: NelsonTona
Title: Administrative Assistant, Senior,Parks & Recreation
Date: 10/20/20118:28:32 AM
Name: AckermanMaria
Date: 10/21/20118:32:17 AM
Name: GrantKimberley
Title: Interim Director, HHVS
Date: 10/21/20119:01:13 AM
Name: FoordMarlene
Title: Grant Development & Mgmt Coordinator, Grants
Date: 10/25/20114:03:41 PM
Packet Page -911-
11/8/2011 Item 16.D.6.
Name: RamseyMarla
Title: Administrator, Public Services
Date: 10/25/20115:07:14 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 10/31/2011 1:30:05 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 10/31/20112:31:57 PM
Name: StanleyTherese
Title: Management/Budget Analyst, Senior,Office of Management & Budget
Date: 10/31/20115:15:27 PM
Name: PryorCheryl
Title: Management/ Budget Analyst, Senior,Office of Management & Budget
Date: 11/1/20119:07:52 AM
Name: StanleyTherese n
Title: Management/Budget Analyst, Senior,Office of Management & Budget
Date: 11 /1 /2011 9:13:28 AM
Name: IsacksonMark
Title: Director -Corp Financial and Mgmt Svs,CMO
Date: 11/1/20119:47:21 AM
Packet Page -912-
October 11/8/2011 Item 16.D.6.
AREA AGENCY ON AGING OF SOUTHWEST
FLORIDA, INC dba
SENIOR CHOICES OF SOUTHWEST FLORIDA
STANDARD CONTRACT
NUTRITION SERVICES INCENTIVE PROGRAM
THIS CONTRACT is entered into between Area Agency of Southwest Florida dba Senior Choices of
Southwest Florida (Agency) and Collier County Board of County Commissioners (Contractor) and collectively referred
to as the "Parties." The term contractor for this purpose may designate a vendor, subgrantee or subrecipient, the status to
be further identified in ATTACHMENT III, Exhibit -2 as necessary.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and
WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such
services as an independent contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions hereinafter set forth, the Parties agree as follows:
1. Purpose of Contrac t
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 Docum _n s with *n the Contract
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department and
or Agency handbooks, manuals or desk books, as an integral part of the contract, except to the extent that
the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents
referenced above, the specific provisions and requirements of the contract document(s) shall prevail over
inconsistent provisions in the proposal(s) or other general materials not specific to this contract document
and identified attachments.
3. Term of Contract
This contract shall begin on October 1. 2011 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 North Fort Myers,
Florida, on September 30.2012.
4. Contract Amo un
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an
amount not to exceed $43,602.00, 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.
5. Renewals
By mutual agreement of the Parties, in accordance with s. 287.058(1)(g), F.S., the Agency may renew the
contract for a period not to exceed three years, or the term of the original contract, whichever is longer. The
renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other
costs for the renewal may be charged. Any renewal is subject to the same terms and conditions as the original
contract and contingent upon satisfactory performance evaluations by the Agency and the availability of
funds.
^6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable
regulations.
Packet Page -913-
October 11/8/2011 Item 16.D.6.
standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. ^
508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as
amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The Contractor shall
report any violations of the above to the Agency.
6.1.3 The Contractor, or agent acting for the Contractor, may not use any federal funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any state legislature. If this
contract contains federal funding in excess of $100,000.00, the Contractor must, prior to contract execution,
complete the Certification Regarding Lobbying form, ATTACHMENT H. 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.
6.1.4 In accordance with Appendix A to 2 CFR 215, the Contractor shall comply with Executive Order 11246, Equal
Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in
Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
6.1.5 If this contract contains federal funds and provides services to children up to age 18, the Contractor shall comply
with the Pro - Children Act of 1994 (20 U.S.C. 6081).
6.1.6 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards will
not be made to parties listed on the government -wide Excluded Parties List System, in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." The
Excluded Parties List System contains the names of parties debarred, suspended, or otherwise excluded by
agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order
12549. The Contractor shall comply with these provisions before doing business or entering into subcontracts
receiving federal funds pursuant to this contract. The Contractor shall complete and sign ATTACHMENT V
prior to the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this
contract by the Agency.
6.3 If the Contractor is a non - profit provider and is subject to Internal Revenue Service (IRS) tax exempt
organization reporting requirements (filing a Form 990 or Form 990 -N) and has its tax exempt status revoked for
failing to comply with the filing requirements of the 2006 Pension Protection Act or for any other reason, the
Contractor must notify the Agency in writing within thirty (30) days of receiving the IRS notice of
revocation.
6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Tracking in Persons.
6.5 Unless exempt under 2 CFR Part 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR 170.
6.6 To comply with the Executive order 12989, as amended, and Executive Order No. 11-02, the Contractor
agrees to utilize the U.S. Department of Homeland Security's E -Verify system, https: / /e-
verifv.uscis.gov/emp, to verify the employment eligibility of (1) all persons employed by the Contractor
during the contract term to perform any duties within Florida; and (2) all persons, including
subcontractors, assigned by the contractor to perform work pursuant to this contract. The Contractor
shall also include a requirement in its subcontracts that the subcontractor shall utilize the E -Verify
system to verify the employment eligibility of all persons employed by the subcontractor during the
contract term. Contractors meeting the terms and conditions of the E -Verify System are deemed to be
2
Packet Page -914-
October
11/8/2011 Item 16.D.6.
in compliance with this provision. The Contractor shall complete and sign ATTACHMENT H,
Verification of Employment Status Certification, prior to the execution of this contract.
7. C=liance with State L aw
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced
in all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 The Contractor shall comply with requirements of s. 287.058, F.S. as amended.
7.2.1 The Contractor shall provide units of deliverables, including various client services, and in some instances may
include reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and
accept in writing prior to payment in accordance with s. 215.971, F.S. (1) and (2).
7.2.2 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre -audit and post- audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit bills for any
travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract.
7.2.4 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined in
subsection 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except for
those records which are made confidential or exempt by law. The Contractor's refusal to comply with this
provision will constitute an immediate breach of contract for which the Agency may unilaterally terminate the
contract.
X7.3 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule 41 -2, 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 s. 287.134, F.S.
7.5 The Contractor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the
expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.6 In accordance with s. 287.135 F.S., any contractor on the Scrutinized Companies with Activities in Sudan List or
the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant to s.
215.473 F.S., is ineligible to enter into or renew a contract with the Agency for goods or services of $1 million or
more. Pursuant to s. 287.135 F.S., the Agency may terminate this contract if the Contractor is found to have
submitted a false certification of its status on the Lists or has been placed on the Lists. If this contract
contains $1 million or more, the Contractor shall complete and sign ATTACHMENT G, Certification
Regarding Scrutinized Companies Lists, prior to the execution of this contract.
8. Backoround Screenony
The Contractor shall ensure that, prior to providing services, all persons having access to vulnerable elders and
children, their living area, funds or personal property, or protected health information pertaining to such
individuals, will pass a Level II criminal background screening in accordance with the requirements of s.
430.0402 and ch. 435, F.S., as amended. These provisions apply to employees, subcontractors, consultants,
direct service providers and volunteers. Consequently, any commitment for employment, purchase of services,
or volunteer program participation will be contingent upon the passing of a Level II background check. The
background screening will include employment history checks as provided in s. 435.03(1), F.S., and both local
and national criminal record checks coordinated through law enforcement agencies.
8.1 For purposes of this section, the term "direct service provider" means a person 18 years of age or older who,
3
Packet Page -915-
October 11/8/2011 Item 16.D.6.
pursuant to a program to provide services to the elderly, has direct, face -to -face contact with a client while
providing services to the client or has access to the client's living areas or to the client's funds or personal
property. This term includes coordinators, managers, and supervisors of residential facilities and volunteers.
9. Grievance Procedures
The Contractor shall develop, implement, and ensure that *its subcontractors have established grievance
procedures to process and resolve client dissatisfaction with or denial of service(s), and address complaints
regarding the termination, suspension or reduction of services, as required for receipt of funds. These
procedures, at a minimum, will provide for notice of the grievance procedure and an opportunity for review of
the subcontractor's determination(s).
is I ti ' A I ;, 1 1 TI� I ITZMM 1 1
10.1 The Contractor shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and assure they
are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
10.2 The Contractor shall retain all client records, financial records, supporting documents, statistical records, and any
other documents (including electronic storage media) pertinent to this contract for a period of six (6) years 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.
103 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period in this section 10.2.
10.4 The Contractor shall assure that the records described in this section 10 will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
10.5 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(1)(10), will be allowed full access to and the right to examine any of
the Contractor's contracts and related records and documents pertinent to this specific contract, regardless of the
form in which kept.
10.6 The Contractor shall provide a financial and compliance audit to the Agency as specified in this contract and in
ATTACHMENT III and ensure that all related third -party transactions are disclosed to the auditor.
10.7 The Contractor shall 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.
Son, I I= ITMO 1 11 1
11.1 The Contractor shall 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
Contractor further assures that all contractors, subcontractors, subgrantees, or others with whom it arranges to
provide services or benefits in connection with any of its programs and activities are not discriminating against
clients or employees because of age, race, religion, color, disability, national origin, marital status or sex.
11.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete and accurate ^
Civil Rights Compliance Checklist (ATTACHMENT B).
4
Packet Page -916-
October
October
11/8/2011 Item 16_D_6
11/8/2011 Item 16.D.6.
11.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination
involving services or benefits through this contract. These procedures will include notifying clients, employees,
and participants of the right to file a complaint with the appropriate federal or state entity.
11.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all subcontractors, vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency may, at its discretion, seek a court order requiring compliance with the terms of this
assurance or seek other appropriate judicial or administrative relief, including but not limited to, termination of
and denial of further assistance.
12. Provision of Services
The Contractor shall provide services in the manner described in ATTACHMENT I.
13. Monitoring by the AgCen=v
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods and services of the Contractor which are relevant to this contract, and to interview
any clients, employees and subcontractor employees of the Contractor to assure the Agency of the
satisfactory performance of the terms and conditions of this contract. Following such review, the Agency
will provide a written report of its findings to the Contractor, and where appropriate, the Contractor shall develop
a corrective action plan. The Contractor hereby agrees to correct all deficiencies identified in the corrective
action plan in a timely manner as determined by the Contract Manager.
14. Coordinated Monitoring with Other Ag n iec
If the Contractor receives funding from one or more of the State of Florida other human service agencies, in
addition to Senior Choices of Southwest Florida and the Department of Elder Affairs, then a joint monitoring
visit including such other agencies may be scheduled. For the purposes of this contract, and pursuant to- s.
287.0575, F.S. as amended, Florida's human service agencies shall include the Department of Children and
Families, the Department of Health, the Agency for Persons with Disabilities, the Department of Veterans
Affairs, and the Department of Elder Affairs. Upon notification and the subsequent scheduling of such a
visit by the designated agency's lead administrative
15. Indemnification
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees
from any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by
reason of the execution of this agreement or performance of the services provided for herein. It is understood
and agreed that the Contractor is not required to indemnify the Agency for claims, demands, actions or
causes of action arising solely out of the Agency's negligence.
15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, this section 15 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in s. 768.28(2), F.S.
16. Insurance and Bondina
16.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by subsection 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for
the Contractor and the clients to be served under this contract. The limits of coverage under each policy
maintained by the Contractor do not limit the Contractor's liability and obligations under this contract. The
Contractor shall ensure that the Agency has the most current written verification of insurance coverage
throughout the term of this contract. Such coverage may be provided by a self - insurance program established
Packet Page -917-
October 11/8/2011 Item 16.D.6.
and operating under the laws of the State of Florida. The Agency reserves the right to require additional
insurance as specified in this contract.
^
16.2 Throughout the term of this agreement, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this contract
by reference in an amount commensurate with the funds handled, the degree of risk as determined by the
insurance company and consistent with good business practices.
17. Confidentiality of Information
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for
any purpose prohibited by state or federal law or regulations except with the written consent of a person legally
authorized to give that consent or when authorized by law.
18. Health Insurance Portahility and Accountability Act
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42
USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
19. Incident Rennrting
19.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contractor or subcontractor's
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Contract Manager (by telephone) with an email to immediately follow.
19.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number
(1- 800- 96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon both the Contractor
and its employees.
20. New Contract(s) Rellolling
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the
remaining four (4) state human service agencies. The notification shall include the following information: (1)
contracting state agency; (2) contract name and number; (3) contract start and end dates; (4) contract amount; (5)
contract description and commodity or service; and (6) Contract Manager name and number. In complying with
this provision, and pursuant to s. 287.0575, F.S. as amended, the Contractor shall complete and provide the
information in ATTACHMENT D.
21. Bankruptcy Notification
During the term of this contract, the Contractor shall immediately notify Senior Choices of Southwest Florida if
the Contractor, its assignees, subcontractors or affiliates file a claim for bankruptcy. Within ten (10) days
after notification, the Contractor must also provide the following information to Senior Choices of Southwest
Florida: (1) the date of filing of the bankruptcy petition; (2) the case number; (3) the court name and the division
in which the petition was filed (e.g., Florida Middle District, Lee County, Fort Myers, Florida); and (4) the name,
address, and telephone number of the bankruptcy attorney.
22. Soon�R and Publicity
22.1 As required by s. 286.25, F.S., if the Contractor is a non - governmental organization which sponsors a program
financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in
publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractor's name)
Senior Choices of Southwest Florida, and the State of Florida, Department of Elder Affairs." If the sponsorship
reference is in written material, the words "Senior Choices of Southwest Florida, and the State of Florida, ^
Department of Elder Affairs" shall appear in at least the same size letters or type as the name of the organization.
6
Packet Page -918-
October 11/8/2011 Item 16.D.6.
22.2 The Contractor shall not use the words "Senior Choices of Southwest Florida, and/or The State of Florida,
Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless specific
1*-141 authorization has been obtained by the Agency prior to use.
23. AL.Lcagnm .
23.1 The Contractor 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.
23.2 The State of Florida is at all times 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
Contractor. In the event the State of Florida approves transfer of the Contractor's obligations, the Contractor
remains responsible for all work performed and all expenses incurred in connection with the contract.
23.3 This contract shall remain binding upon the successors in interest of either the Contractor or the Agency.
24. Subcontracts
24.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor
further agrees that the Agency will not be liable to the subcontractor in any way or for any reason. The
Contractor, at its expense, shall defend the Agency against any such claims.
X24.2 The Contractor shall promptly pay any subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any subcontractor in accordance with s. 287.0585, F.S., unless otherwise
stated in the contract between the Contractor and subcontractor, will result in a penalty as provided by statute.
25. Independent Callne6lj of Contractor -
It is the intent and understanding of the Parties that the Contractor, or any of its subcontractors, are independent
contractors and are not employees of the Agency and shall not hold themselves out as employees or agents of the
Agency without specific authorization from the Agency. It is the further intent and understanding of
the Parties that the Agency does not control the employment practices of the Contractor and will not be liable
for any wage and hour, employment discrimination, or other labor and employment claims against the Contractor
or its subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to
unemployment compensation funds and all necessary insurance for the Contractor are the sole responsibility of
the Contractor.
26. payer
Payments shall be made to the Contractor pursuant to s. 215.422, F.S., as services are rendered and invoiced by
the Contractor. The Contract Manager will have final approval of the invoice for payment, and will approve the
invoice for payment only if the Contractor has met all terms and conditions of the contract, unless the bid
specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted to the
Agency's finance section for budgetary approval and processing. Disputes arising over invoicing and
payments will be resolved in accordance with the provisions of s. 215.422 F.S. A Vendor Ombudsman has been
established within the Department of Financial Services and may be contacted at (850) 413 -5665.
27. Return of Funds
.-� The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed and
7
Packet Page -919-
October 11/8/2011 Item 16.D.6.
any interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to
the Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an
overpayment has been made, the Contractor shall repay said overpayment immediately without prior notification
from the Agency. In the event that the Agency first discovers an overpayment has been made, the Contract
Manager will notify the Contractor in writing of such findings. Should repayment not be made forthwith, the
Contractor shall be charged at the lawful rate of interest on the outstanding balance pursuant to s.
55.03, F.S., after Agency notification or Contractor discovery.
28. Data In HJX and of g •aL rdino Information
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting
or using in the performance of this contract. An appropriate level of security includes approving and tracking all
Contractor employees that request system or information access and ensuring that user access has been removed
from all terminated employees. The Contractor, among other requirements, must anticipate and prepare for the
loss of information processing capabilities. All data and software shall be routinely backed up to ensure recovery
from losses or outages of the computer system. The security over the backed -up data is to be as stringent as the
protection required of the primary systems. The Contractor shall ensure all subcontractors maintain written
procedures for computer system backup and recovery. The Contractor shall complete and sign ATTACHMENT
IV prior to the execution of this contract.
29. Computer Use and Social Media Policy
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use
Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all
personnel affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any
entity that uses the Department's computer resource systems must comply with the Department's policy
regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis,
RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing
networks such as flickr and YouTube (ATTACHMENT E).
30. Conflict of Interest
The Contractor shall establish safeguards to prohibit employees, board members, management and
subcontractors from using their positions for a purpose that constitutes or presents the appearance of personal or
organizational conflict of interest or personal gain. No employee, officer or agent of the Contractor or
subcontractor shall participate in selection, or in the award of an agreement supported by state or federal funds if
a conflict of interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee,
officer or agent; (b) any member of his/her immediate family; (c) his or her partner; or (d) an organization which
employs, or is about to employ, any of the above, has a financial or other interest in the firm selected for award.
The Contractor or subcontractor's officers, employees or agents will neither solicit nor accept gratuities, favors or
anything of monetary value from contractors, potential contractors, or parties to subcontracts. The Contractor's
board members and management must disclose to the Agency any relationship which may be, or may be
perceived to be, a conflict of interest within thirty (30) calendar days of an individual's original appointment or
placement in that position, or if the individual is serving as an incumbent, within thirty (30) calendar days of the
commencement of this contract. The Contractor's employees and subcontractors must make the same
disclosures described above to the Contractor's board of directors. Compliance with this provision will be
monitored.
31. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods
or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of
real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or
consultant under a contract with any public entity; and may not transact business with any public entity in excess
of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following
the date of being placed on the convicted vendor list.
8
Packet Page -920-
October
32.
32.1
11/8/2011 Item 16.D.6.
The Contractor may purchase articles which are the subject of or are required to carry out this contract from
Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in
the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of this
contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with PRIDE. This
clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of
products /services available from PRIDE may be obtained by contacting PRIDE, (800) 643 -8459.
32.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to carry
out this contract, in accordance with the provisions of s. 403.7065, F.S.
32.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a
nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S., in
the same manner and under the same procedures set forth in s. 413.036(1) and (2), F.S. For purposes of this
contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with such qualified
nonprofit agency are concerned. Additional information about the designated nonprofit agency and the products
it offers is available at http: / /www.respectofflorida.org. This clause is not applicable to subcontractors unless
otherwise required by law.
33. Patents. CopvrjghtsR y_alties
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed,
produced or for which ownership was purchased in the course of or as a result of work or services performed
under this contract, the Contractor shall refer the discovery, invention or material to the Agency to be
referred to the Department of State. Any and all patent rights or copyrights accruing under this contract are
hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and
2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably
valued in the contract.
33.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this section 33.
33.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36.
34. Emel:gengy Preparedness and ContinuitX of Operations
34.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of
an emergency preparedness plan. In the event of an emergency, the Contractor shall notify the Agency of
emergency provisions.
34.2 In the event a situation results in a cessation of services by a subcontractor, the Contractor shall retain
responsibility for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
35. 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.
9
Packet Page -921-
October 11/8/2011 Item 16.D.6.
Any state funds provided for the purchase of or improvements to real property are contingent upon the
Contractor or political subdivision granting to the state a security interest in the property at least to the amount of?`-,
state funds provided for at least 5 years from the date of purchase or the completion of the improvements or as
further required by law.
37. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce
the decision to writing and serve a copy on the Contractor.
38. Financial Conseflsencec of Non - Performance
If the Contractor fails to meet the minimum level of service or performance identified in this agreement, or that is
customary for the industry, then the Agency must apply financial consequences commensurate with the
deficiency. Financial consequences may include, but are not limited to, contract suspension, refusing payment,
withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of contract
and reacquiring services from an alternate source.
38.1 The Contractor will not be charged with financial consequences, when a failure to perform arises out of causes
that were the responsibility of the Agency.
39. No Waiver of Sovereign Imm unit'
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.
40. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Leon County, Florida.
41. Entire Contract /0—IN
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or
representations shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or
by a written amendment to this contract signed by both Parties.
42. Force Majeure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other
party and takes all reasonable efforts to cure the condition.
43. Severability Clause
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or
unenforceable the other provisions are severable to that void provision and shall remain in full force and effect.
44. Condition Precedent to Contract: Allpronriations
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon
an annual appropriation by the Legislature.
45. AddRion/Deletion
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by
both Parties. The Parties shall negotiate compensation for any additional services added.
46. Waiver
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute
or be deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single
or partial exercise of any such right preclude any other or further exercise thereof or the exercise of any other
right.
10
Packet Page -922-
October
11/8/2011 Item 16.D.6.
47. comp Lance
1011W., The Contractor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to
abide by these laws shall be deemed an event of default of the Contractor, and subject the contract to immediate,
unilateral cancellation of the contract at the discretion of the Agency.
48. Final Invoice
The Contractor shall submit the final invoice for payment to the Agency as specified in section 3.2.1. (date for final
request for payment) of ATTACHMENT 1. If the Contractor fails to submit final request for payment
by the deadline, then all rights to payment may be forfeited and the Agency may not honor any requests
submitted after the aforesaid time period. Any payment due under the terns of this contract may be withheld until
all reports due from the Contractor and necessary adjustments thereto have been approved by the Agency.
49. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect
price level increases and changes in the rate of payment when these have been established through the appropriations
process and subsequently identified in the Agency's operating budget.
50. Termination
50.1 This contract may be terminated by either party 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 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 Contractor responsible for administration of the
contract.
v0.2 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 Contractor. 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 Contractor responsible for administration of the contract. The Agency
will be the final authority as to the availability and adequacy of funds. In the event of termination of this contract, the
Contractor will be compensated for any work satisfactorily completed prior to the date of termination.
50.3 This contract may be terminated for cause upon no less than twenty-four (24) hours notice in writing to the
Contractor. 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 waiver of any other breach and shall not be
construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the
Agency's or the Contractor's rights to remedies at law or in equity.
50.4 Failure 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 contractor under this provision, the contractor 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.
11
Packet Page -923-
October
51. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
11/8/2011 Item 16.D.6.
52. All Terms and Conditions Included
This contract and its Attachments, I — VII, A, B, D, E — H, 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.
12
Packet Page -924-
The Contractor name, as shown on page 1 of this
Collier County Housing, Human and Veteran Services
3339 E Tamiami Trail, Building H
contract, and mailing address of the official payee to
Naples, FL 34112
a.
whom the payment shall be made is:
Kimberly Grant, Director
b.
The name of the contact person and street address where
Collier County Housing, Human and Veteran Services
financial and administrative records are maintained is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
(239) 252 -2273
Kimberly Grant, Director
C.
The name, address, and telephone number of the
Collier County Housing, Human and Veteran Services
representative of the Contractor responsible for
3339 E Tamiami Trail, Building H
administration of the program under this contract is:
Naples, FL 34112
(239) 252 -2273
d.
The section and location within the Agency where
Delores Roussey, Director of Finance
Requests for Payment and Receipt and Expenditure forms
Senior Choices of Southwest Florida
are to be mailed is:
15201 N. Cleveland Ave.
North Fort Myers, Florida 33903
Leigh Wade - Schield, Executive Director
e.
The name, address, and telephone number of the Executive
Senior Choices of Southwest Florida
Director for this contract is:
15201 N. Cleveland Ave.
North Fort Myers, Florida 33903
239 652 -6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party and the notification attached to the originals of this contract.
52. All Terms and Conditions Included
This contract and its Attachments, I — VII, A, B, D, E — H, 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.
12
Packet Page -924-
October
11/8/2011 Item 16.D.6.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, the Parties hereto have caused this 45 page contract, to be executed by their undersigned
officials as duly authorized.
Contractor: COLLIER COUNTY BOARD OF
COUNTY COMMISSIONERS
SIGNED BY:
NAME: Fred W. Coyle
TITLE: Chairman
DATE: November 8, 2011
Federal Tax ID: 59- 6000558
Fiscal Year Ending Date: 9/30
ATTEST:
DWIGHT E. BROCK, CLERK
, DEPUTY CLERK
Sufficiency:
Attorney
13
Packet Page -925-
AREA AGENCY OF SOUTHWEST FLORIDA,
INC., DBA SENIOR CHOICES OF
SOUTHWEST FLORIDA
SIGNED BY:
NAME: LEIGH ANNA NOWAK
TITLE: BOARD PRESIDENT
DATE:
October
11/8/2011 Item 16.D.6.
ATTACHMENT
ATTACHMENT DESCRIPTION
PAGE
ATTACHMENT I
STATEMENT OF WORK
14 -23
ATTACHMENT II
CERTIFICATION REGARDING LOBBYING
25
ATTACHMENT III
FINANCIAL COMPLIANCE AUDIT ATTACHMENT
26 -30
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
31
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
32
INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS /SUBCONTRACTS
ATTACHMENT VI
ASSURANCES — NON - CONSTRUCTION PROGRAMS
33 -34
ATTACHMENT VII
REQUEST FOR REIMBURSEMENT
35
ATTACHMENT A
DEPARTMENT OF ELDER AFFAIRS PROGRAMS AND SERVICES
36
HANDBOOK (ON CD)
ATTACHMENT B
DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE
37 -40
CHECKLIST AND INSTRUCTIONS
ATTACHMENT I)
PROVIDER'S STATE CONTRACTS LIST
41
ATTACHMENT E
DEPARTMENT OF ELDER AFFAIRS' COMPUTER USE POLICY AND ITS
42
SOCIAL MEDIA POLICY
ATTACHMENT F
BACKGROUND SCREENING AFFADAVIT OF COMPLIANCE
43
ATTACHMENT G
CERTIFICATION REGARDING SCRUTININZEDCOMPANIES LISTS
44
ATTACHMENT H
VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
45
14
Packet Page -926-
October
11/8/2011 Item 16.D.6.
ATTACHMENT I
� SENIOR CHOICES OF SOUTHWEST FLORIDA
STATEMENT OF WORK
NUTRITION SERVICES INCENTIVE PROGRAM
SECTION I: SERVICES TO BE PROVIDED
1.1 DEFINITIONS OF CONTRACT TERMS AND ACRONYMS
1.1.1 DEFINITIONS OF ACRONYMS
Area Agency on Aging (AAA)
Client Information and Registration Tracking System (CIRTS) Dietary Reference Intake (DRI)
Nutrition Services Incentive Program (NSIP) Older Americans Act (OAA)
Planning and Service Area (PSA)
United States Department of Agriculture (USDA) State of Florida (State)
1.1.2 PROGRAM SPECIFIC TERMS
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 U.S.C. 3026) of the OAA
n and Agency and/or Department instructions.
Area Plan Update: A revision to the area plan wherein the area agency on aging enters OAA program specific
data in the CIRTS. An update may also include other revisions to the area plan as instructed by the Agency and/or
Department.
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.
1.3 GENERAL DESCRIPTION
1.3.1 General Statement
The NSIP is intended to provide incentives for the effective delivery of nutritious meals to older individuals.
NSIP allows programs to increase the number and /or the quality of meals served. The NSIP is intended to
provide incentives for the effective delivery of nutritious meals to older individuals. NSIP is a cash allotment
or commodity program that supplements funding or food used in meals served under the OAA. Florida has
opted for cash payments in lieu of donated foods.
1.3.2 Authority
(1) Older Americans Act of 2006, as amended, Section 311;
(2) 42 U.S.C. 303a, 42 U.S.C. 604, 42 U.S.C. 3057; and
15
Packet Page -927-
October
(3) Section 430.101, Florida Statutes.
11/8/2011 Item 16.D.6.
1.3.2.1 Incorporation of Reference Memoranda
In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer -
Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by
reference:
(1) CFO Memo No. 02: Release date, August 20,2010;
(2) CFO Memo No. 03: Release date, June 29,2010; and
(3) CFO Memo No. 06: Release date, June 30, 2010.
1.3.3 Scope of Service
The Contractor is responsible for the programmatic, fiscal and operational management of the NSIP,
involving oversight of the nutrition service operations of its subcontracted providers. The services
provided under this contract shall be in a manner consistent with and described in the Contractor's current
area plan update and DOEA Program and Summary Handbook, ATTACHMENT A.
1.3.3.1 In fulfilling the terms of this agreement, the Contractor's scope of services shall consist of completion of
the following service tasks: (1) Client Eligibility Determination; (2) Program Eligibility Compliance; (3)
Program Coordination and Oversight; (4) Ensuring Compliance with Prescribed Nutrition Requirements;
(5) Ensuring Compliance with Prescribed Food Origin Requirements; and (6) Compliance with Program
Reporting and Records Management Requirements.
1.3.3.2 The Contractor shall use the NSIP funding under this contract to supplement funding for food used in
meals served under the OAA.
1.3.4 Term of Provision of Services
The term of this contract for the delivery of services shall be as referenced in Section 3. of the Standard Contract.
However, for the purpose of settling upon the appropriate meal reimbursement rate, as provided by USDA, the
contract shall remain open until December 31, 2012. Notwithstanding this three (3) month reconciliation period,
this contract makes no provisions for the payment of any services provided beyond September 30, 2012.
1.3.5 Major Program Goals
The major goals of the NSIP program are as follows:
(1) To supplement funding for food used in meals served by OAA Nutrition Program Providers; and
(2) Provide incentives for the effective delivery of nutritious meals to older individuals.
1.4 INDIVIDUALS TO BE SERVED
1.4.1 Client Eligibility Determination
1.4.1.1 Congregate Meals
Client eligibility for congregate meals is as follows:
(1) Individuals age 60 or older;
(2) Spouses (regardless of age) attending the dining center with their eligible spouse;
(3) Persons with a disability, regardless of age; residing in a housing facility occupied primarily by older
individuals where congregate nutrition services are provided;
(4) Persons with disabilities residing at home with and accompanying an eligible person to the dining center;
and
(5) Volunteers, regardless of age, providing essen 1 aal services on a regular basis during meal hours.
Packet Page -928-
October 11/8/2011 Item 16.D.6.
1.4.1.2 Home Delivered Meals
Client eligibility for congregate meals is as follows:
(1) Individuals age 60 or older who are homebound by reason of illness, disability or isolation;
(2) The recipient's spouse of a homebound eligible individual, regardless of age if the provision of the
collateral meal supports maintaining the person at home;
(3) Individuals with a disability, regardless of age, residing at home with eligible individuals and are dependent
on them for care;
(4) Persons at nutritional risk having physical, emotional or behavioral conditions, which would make their
presence at the congregate site inappropriate; and
(5) Persons at nutritional risk who are socially or otherwise isolated and unable to attend a congregate nutrition
site.
1.4.2 Restrictions
Meals served to an elderly individual funded in whole or in part under the Medicaid Waiver, Home Care for the
Elderly or Community Care for the Elderly Programs or other means tested programs may not be included in the
NSIP count.
SECTION II: MANNER OF SERVICE PROVISION
2.1 SERVICE TASKS
2.1.1 Task List
In order to achieve the goals of the NSIP, the Contractor shall ensure the following tasks are performed:
(1) Client Eligibility Determination;
(2) Program Eligibility Requirements;
(3) Program Coordination and Oversight;
(4) Ensuring Compliance with Prescribed Nutrition Requirements;
(5) Ensuring Compliance with Prescribed Food Origin Requirements;
(6) Compliance with Program Reporting and Records Management Requirements; and
() Monitoring the Performance of Subcontractors.
2.1.1.1 Client Eligibility Determination
Client eligibility determination as listed in ATTACHMENT I, section 1.4.1.
2.1.1.2 Program Eligibility Requirements
Entities considered to be eligible for program participation must meet the following criteria:
(1) Be an agency that has received a grant under the OAA Title III must serve the meal (Ref. OAA section
311(42 U.S.C.3030a)); and
(2) Be a nutrition service provider who is under the jurisdiction, control, management and audit authority of
Senior Choices of Southwest Florida and the Department of Elder Affairs must serve the meal.
2.1.1.3 Oversight of Provider's Nutrition Service Operations
The Contractor shall oversee the nutrition service operations of the provider to ensure that the requirements
of Attachment I, Sections 2.1.1.1 and 2.1.1.2 are met as well as any other applicable regulations and policies
�-. prescribed by the Department of Health and Human Services, USDA, state and local health departments or
any other agency designated to inspect meal quality for the State.
17
Packet Page -929-
October 11/8/2011 Item 16.D.6.
2.1.1.4 Prescribed Nutritional Requirements
The Contractor shall ensure that each meal provided under this NSIP contract meet the following criteria:
(1) Comply with the current Dietary Guidelines for Americans, published by the secretaries of the
Department of Health and Human Services and the Department of Agriculture; and
(2) Provide a minimum of 33 1/3 percent of the dietary reference intakes /adequate intakes for an age 70+
female as established by the Food and Nutrition Board of the National Academy of Sciences.
2.1.1.5 Food Origin and Commodities Requirements
Consistent with existing requirements of the Nutrition Services Incentive program, the Contractor and its
service providers may use NSIP cash to purchase foods of U.S. origin for their nutrition projects under Title
III of the OAA. NSIP funds must be used to expand meal services to older adults.
2.1.1.6 Compliance with Program Reporting and Records Management Requirements
(1) The Contractor shall ensure that all program reporting requirements evidencing service delivery are
timely met. The Contractor must establish interim report submittal due dates for its providers or
subcontractors to permit the Contractor to meet the Agency reporting deadlines.
(2) In addition to any special reports that may
comply with the reporting and records
ATTACHMENT I, sections 2.4.2 — 2.4.2.5.
be requested by the Agency, the Contractor shall
management requirements as referenced in this
2.1.1.7 Use of Subcontractors and Monitoring the Performance of Subcontractors
(1) If this contract involves the use of a subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the subcontractor. If any 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 performance of the
subcontractor, the Contractor shall notify the Contract Manager and the Agency's Director of Finance n
in writing of such delay.
(2) The Contractor shall not permit a subcontractor to perform services related to this agreement without
having a binding subcontractor agreement executed. In accordance with Section 24.1 of the Standard
Contract, the Agency will not be responsible or liable for any obligations or claims resulting from such
action.
(3) The Contractor will monitor at least once per year each of its subcontractors, subrecipients,
vendors and/or consultants paid from funds provided under this contract. The Contractor will perform
fiscal, administrative and programmatic monitoring to ensure contractual compliance, fiscal
accountability, programmatic performance, and compliance with applicable state and federal laws and
regulations. The Contractor will monitor to ensure that time schedules are met, the budget and scope of
work are accomplished within the specified time periods and other performance goals stated in this
contract are achieved.
2.2 SERVICE TIMES AND LOCATION
2.2.1 Service Times
The Contractor shall ensure the provision of the 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 through Friday, 8:00am to 5:00pm.
2.3 EQUIPMENT
23.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than
one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the n
organization for the financial statement purposes, or $5,000.00 [for federal funds]; or (b) nonexpendable,
tangible personal property of a nonconsumable nature with an acquisition cost of $1,000.00 or more per unit, and
18
Packet Page -930-
October 11/8/2011 Item 16.D.6.
expected useful life of at least one year; and hardback bound books not circulated to students or the general
public, with a value or cost of $250.00 or more [for state funds].
2.3.2 Contractors and subcontractors who are Institutions of Higher Education, Hospitals, and Other Non - Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A -110) that include: (a) a property list with all the
elements identified in the circular; and, (b) a procedure for conducting a physical inventory of equipment at least
once every two years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. Any loss, damage, or theft of
equipment shall be investigated and fully documented and the Contractor shall promptly notify the Contract
Manager.
2.3.2.1 The Contractor's property management standards for equipment acquired with federal funds and federally owned
equipment shall include accurately maintained equipment records with the following information:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number, 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 Contractor 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 of the
equipment (not applicable to equipment furnished by the federal government);
n () Location and condition of the equipment and the date the information was reported;
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine current
fair market value where a Contractor compensates the federal awarding agency for its share.
2.3.3 The Contractor must adhere to the Agency's procedures and standards when purchasing Information Technology
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is
required for any computer related item costing $1,000.00 or more, including data processing hardware, software,
services, supplies, maintenance, training, personnel and facilities. The completed ITR worksheet shall be
maintained in the LAN administrator's file and must be provided to the Agency upon request. The Contractor
shall ensure subcontractors comply with the Agency's ITR procedures.
2.3.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by the
Agency is part of the cost of carrying out the activities and functions of the grant awards and title (ownership) will
vest in the Contractor, subject to the conditions of 2 CFR Part 215 Administrative Requirements (formerly OMB
Circular A -110), Subpart C, paragraph 34. Equipment purchased under these thresholds is considered
supplies and is not subject to property standards. Equipment purchased with funds identified in the budget
attachments to agreements covered by this contract, or identified in the sub - agreements with subcontractors (not
included in a cost methodology), is subject to the conditions of section 273, F. S. and 60A- 1.0017, F. A. C. or
Title 45 CFR Part 74.
2.3.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or purchased with funds
provided through this contract, without first obtaining the approval of the Contract Manager. When disposing of
property or equipment, the Contractor must submit a written request for disposition instructions to the Contract
Manager. The request should include a brief description of the property, purchase price, funding
19
Packet Page -931-
October 11/8/2011 Item 16.D.6.
source, percentage of state or federal participation, acquisition date and condition of the property. The request
should also indicate the Contractor's proposed disposition (e.g., transfer or donation to another agency that
administers federal programs, offer the items for sale, destroy the items).
2.3.5.1 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120
days of the written request for disposition, the Contractor is authorized to proceed as directed in 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A -110).
2.3.5.2 Any permanent storage devices (e.g., hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
2.3.6 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Sec. 3030b United States Code (USC). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of section
216.348, F. S.
2.4 DELIVERABLES
2.4.1 Service Unit
The Contractor shall provide the services described in the contract in accordance with the current Agency's
and/or Department of Elder Affairs Programs and Services Handbook. The chart below lists the services that
can be performed and the unit of measurement:
Service Unit of Service
Congregate Meals Meal
Home Delivered Meals Meal
2.4.2 Reports and Reporting Requirements
The Contractor shall adhere to the reporting and records management requirements outlined below. The
Contractor shall respond to additional routine and/or special requests for information and reports required by
the Agency, within 5 days of receipt of the Agency request.
2.4.2.1 Area Plan Update and All Revisions Thereto
The Contractor is required to submit an area plan update wherein the Contractor enters OAA specific data in
the CIRTS.
2.4.2.2 CIRTS Reports
The Contractor is required to use CIRTS reports in the web -based CIRTS database system to ensure CIRTS
data accuracy. The report categories are as follows:
(1) Client Reports;
(2)
Monitoring Reports;
(3)
Services Reports;
(4)
Miscellaneous Reports;
(5)
Fiscal Reports;
(6) Aging Resource Center Reports; and
() Outcome Measurement Reports.
20
Packet Page -932-
October
2.4.2.3 Service Costs Reports
The Contractor shall require subcontractors to
which reflect actual costs of providing each
planning and negotiating unit rates.
11/8/2011 Item 16.D.6.
submit to the Contractor semi - annual service cost reports,
service by program. This report provides information for
2.4.2.4 Surplus/Deficit Report
The Contractor shall submit a consolidated surplus /deficit report in a format provided by the Agency to the
Contract Manager by the 25th of each month. This report is for all agreements and/or contracts between
the Contractor and the Agency. The report consists of the following:
(1) A list of all subcontractors and their current status regarding surplus or deficit;
(2) The Contractor's detailed plan on how the surplus or deficit spending exceeding the threshold specified
by the Agency will be resolved;
(3) Recommendations to transfer funds to resolve surplus /deficit spending;
(4) Input from the Contractor's Board of Directors on resolution of spending issues, if applicable;
(5) Number of clients currently on Assessed Priority Consumer List (APCL) that receive a priority ranking
score of 4 or 5; and
(6) Number of clients currently on the APCL designated as Imminent Risk.
2.4.2.5 Records Management and Documentation
The Contractor shall ensure the collection and maintenance of client and service information on a monthly
basis from the CIRTS or any such system designated by the Agency. Maintenance includes valid exports
and backups of all data and systems according to Agency standards.
2.4.2.6 Background Screening Affidavit of Compliance
To demonstrate compliance with section 8 of the Standard Contract, the Contractor shall submit
ATTACHMENT F, Background Screening Affidavit of Compliance annually, by October 15th.
2.5 PERFORMANCE SPECIFICATIONS
2.5.1 Outcomes and Outputs
(1) The Contractor shall submit timely to the Agency all reports described in ATTACHMENT I,
section 2.4.2 Reports; and
(2) The Contractor shall ensure services in this contract are in accordance with the current Agency
and/or Department of Elder Affairs Programs and Services Handbook.
2.5.2 Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this
contract in accordance with this ATTACHMENT I, section 2.7.2. The Agency's determination of
acceptable performance shall be conclusive. The Contractor agrees to cooperate with the Agency in
monitoring the progress of completion of the service tasks and deliverables.
2.5.3 Remedies- Nonconforming Services
The Contractor shall ensure that all participants served under this agreement are eligible for the program, all
21
Packet Page -933-
October 11/8/2011 Item 16.D.6.
meals served and reimbursed under this agreement are compliant with the prescribed nutritional
requirements referenced in ATTACHMENT I, sections 2.1.1.3 — 2.1.1.5, monthly and/or quarterly
performance reports and financial records are maintained for each reporting period and submitted as
stipulated in this ATTACHMENT I, section 2.4.2.
2.53.1 Any nonconforming meals not meeting such nutritional and food origin requirements shall not be eligible for
reimbursement under this program. The costs associated with preparing or providing nonconforming meals
shall be borne solely by the Contractor. The Agency requires immediate notice of any significant and/or
systemic infractions that compromise the quality, safety or nutritional value of meals served to clients; and
the Contractor's ability to provide meals, to achieve programmatic performance or to provide sound financial
management of the program.
2.6 CONTRACTOR'S FINANCIAL OBLIGATIONS
2.6.1 Use of Service Dollars and Assessed Priority Consumer List Management
The Contractor is expected to spend all federal, state and other funds provided by the Agency, for the
purpose specified in each contract. The Contractor must manage the service dollars in such a manner so as to
avoid having a wait list and a surplus of funds at the end of the contract period for each program managed by
the Contractor. If the Agency determines that the Contractor is not spending service funds accordingly, the
Agency may transfer funds to other planning and service areas during the contract period and/or
adjust subsequent funding allocations accordingly as allowable under state and federal law.
2.6.1.1 The Contractor agrees to distribute funds as detailed in this contract and the area plan update. Any changes in
the total amounts of the funds identified in this contract, number of meals served or meal rate require a
contract amendment.
2.7 AGENCY RESPONSIBILITIES
2.7.1 Program Guidance and Technical Assistance
The Agency will provide the Contractor with guidance and technical assistance as needed to ensure the
successful fulfillment of the contract by the Contractor.
2.7.2 Contract Monitoring
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, or an
on -site visit. The Agency's determination of acceptable performance shall be conclusive. The Contractor
agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks and
deliverables. The Agency may use, but is not limited to, one or more of the following methods for
monitoring:
(1) Desk reviews and analytical reviews;
(2) Scheduled, unscheduled and follow -up on -site visits;
(3) Client visits;
(4) Review of independent auditor's reports;
(5) Review of third -party documents and/or evaluation;
(6) Review of progress reports;
(7) Review of customer satisfaction surveys;
(8) Agreed -upon procedures review by an external auditor or consultant;
(9) Limited -scope reviews; and
(10) Other procedures as deemed necessary.
22
Packet Page -934-
October
SECTION III: METHOD OF PAYMENT
11/8/2011 Item 16.D.6.
3.1 STATEMENT OF METHOD OF PAYMENT
This is a fixed rate contract. The Agency shall make payment to the Contractor for provision of services up
to a maximum number of units of service and at the prospective rate stated below:
Service to be Provided
Unit of Service
Unit Rate
Eligible Congregate and
Allocation
Home Delivered Meals
1 unit = 1 meal
$0.68
The prospective rate is based on the estimated OAA grant award.
COLLIER
Service to be
Provided
Unit of Service
Unit Rate
Maximum Units
Allocation
64,121
Eligible Congregate
I unit= I meal
$0.68
and Home Delivered
$43,602
Meals (Under OAA
and ARRA
23
Packet Page -935-
October
3.2 REQUESTS FOR PAYMENT
3.2.1 Date for Final Request for Payment
11/8/2011 Item 16.D.6.
(1) The final request for payment is due to the Agency no later than December 10, 2012. This contract is
for services provided during the 2011 Federal Fiscal Year beginning October 1. 2011 through
September 30. 2012; however, the contract is in effect through December 10. 2012. The additional
three months (October 1. 2012 through December 10. 2012) are to allow rates to be adjusted for the
service period. This contract shall automatically terminate after the final rate for the federal fiscal year
has been established and the release of final payments are authorized by the Agency.
(2) In the event that the final reimbursement rate is greater or less than the rate in ATTACHMENT I,
Section 3.1, then this contract shall be appropriately adjusted upon notice from the Contract Manager.
3.2.2 Documentation for Payment
The Contractor shall submit all requests for reimbursement in accordance with policy regarding reimbursable
meals and CIRTS policy regarding data entry for reimbursable meals. All requests for reimbursement will
include the following:
(1) The Contractor shall submit the request for reimbursement shall be submitted on DOEA Form 117nsip
revised 9/11, NSIP Request for Reimbursement, (ATTACHMENT VII);
(2) The Contractor shall submit a CIRTS report with DOEA Form I I7nsip revised 9/11 as supporting
documentation for the total number of meals reported. The CIRTS report must match the number of meals
reported on DOEA Form 117nsip revised 9/11;
(3) Duplication or replication of the DOEA form 117nsip revised 9/11 via data processing equipment is
permissible but replication must include all data elements in the same format as included on the n
Departmental form; and
(4) The due date for the request for reimbursement and report(s) is no later than the 10th day of the month
following the month being reported, except for the final request for reimbursement (December 2012)
which is no later than December 10, 2012.
3.2.2.1 The Contractor shall maintain documentation to support payment requests that shall be available to the
Agency or authorized individuals, such as Department of Financial Services, upon request.
3.2.2.2 Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of complete and accurate financial and programmatic reports due from the Contractor
and any adjustments thereto, including any disallowance not resolved as outlined in Section 26 of the Standard
Contract.
24
Packet Page -936-
October 11/8/2011 Item 16.D.6.
ATTACHMENT II
n CERTIFICATION REGARDING LOBBYING CERTIFICATION
FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) 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
legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of
any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of
congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying,"
in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all sub -
awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans and cooperative agreements)
and that all subcontractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil
penalty of not less than $10,000 and not more than $100,000 for each such failure.
Signature
Fred W. Coyle, Chairman
Name of Authorized Individual
Board of County Commissioners, Collier County, FL
Name and Address of Organization
ATTEST:
DWIGHT E. BROCK, CLERK
CLERK
ArastFform and legal Sufficiency:
� ty Att0
11/8/2011
Date
NSIP 203.12
Application or Agreement Number
25
Packet Page -937-
October
FINANCIAL AND COMPLIANCE AUDIT
11/8/2011 Item 16.D.6.
ATTACHMEENT III
The administration of resources awarded by Senior Choices of Southwest Florida to the provider may be subject to audits and/or
monitoring by Senior Choices of Southwest Florida, 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 of 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 Senior Choices of Southwest
Florida. In the event the Agency determines that a limited scope audit of the provider is appropriate, the provider agrees to
comply with any additional instructions provided by the Agency to the provider regarding such audit. The provider further
agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Director of
Finance or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non - profit organization as defined in OMB Circular A-
133, as revised.
In the event that the provider expends $500,000 or more in federal awards during its fiscal year, the provider must have a single
or program - specific audit conducted in accordance with the provisions of OMB Circular A -133, as revised. EXHIBIT 1 to this
agreement indicates federal resources awarded through Senior Choices of Southwest Florida 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 Senior Choices of Southwest Florida. The determination of amounts of federal awards expended
should be in accordance with the guidelines established by OMB Circular A -133, as revised. An audit of the provider
conducted by the Auditor General in accordance with the provisions of OMB Circular A -133, as revised, will meet the
requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the provider shall fulfill the requirements relative to
auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised.
If the provider expends less than $500,000 in federal awards in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A -133, as revised, is not required. In the event that the provider expends less than $500,000 in
federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of OMB Circular A-
133, as revised, the cost of the audit must be paid from non - federal resources (i.e., the cost of such audit must be paid from
provider resources obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Senior Choices of Southwest Florida shall be based on the
agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements
shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and
liabilities due to Senior Choices of Southwest Florida shall be fully disclosed in the audit report with reference to Senior Choices
of Southwest Florida agreement involved. If not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A -133,
as revised, the schedule of expenditures of federal awards shall identify expenditures by agreement number for each agreement
with Senior Choices of Southwest Florida in effect during the audit period. Financial reporting packages required under this
part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the
provider's fiscal year end.
PART II: STATE FUNDED
This part is applicable if the provider is a nonstate 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 in any fiscal
year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider must have a State single or
26
Packet Page -938-
October
11/8/2011 Item 16.D.6.
project - specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the
n Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit
organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded through
the Senior Choices of Southwest Florida by this agreement. In determining the state financial assistance expended in its fiscal
year, the provider shall consider all sources of state financial assistance, including state financial assistance received
from the Senior Choices of Southwest Florida, other state agencies, and other nonstate entities. State financial assistance does
not include federal direct or pass - through awards and resources received by a nonstate entity for federal program matching
requirements.
In connection with the audit requirements addressed in Part 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 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 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
nonstate entity's resources (i.e., the cost of such an audit must be paid from the provider resources obtained from other than
State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Senior Choices of Southwest Florida 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
Senior Choices of Southwest Florida shall be fully disclosed in the audit report with reference to Senior Choices of Southwest
Florida agreement involved. If not otherwise disclosed as required by Rule 69I- 5.003, Fla. Admin. Code, the schedule of
expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with Senior
/'Choices of Southwest Florida in effect during the audit period. Financial reporting packages required under this part must be
submitted within 45 days after delivery of the audit report, but no later than 12 months after the provider's fiscal year end for
local governmental entities. Non- profit or for -profit organizations are required to be submitted within 45 days after delivery of
the audit report, but no later than 9 months after the provider's fiscal year end. Notwithstanding the applicability of this portion,
Senior Choices of Southwest Florida retains all right and obligation to monitor and oversee the performance of this
agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A -133, as revised, and required by PART I
of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A -133, as revised, by or on behalf of the
provider directly to each of the following:
Senior Choices of Southwest Florida at each of the following addresses:
Senior Choices of Southwest Florida
Attn: Leigh W. Schield, Executive Director
15201 N. Cleveland Avenue, Ste 1100
North Fort Myers, Florida 33903
Phone: (239) 652 -6900
The Federal Audit Clearinghouse designated in OMB Circular A -133, as revised (the number of copies required by Sections
.320 (d)(1) and (2), OMB Circular A -133, as revised, should be submitted to the Federal Audit Clearinghouse), at the following
address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10'h Street
Jeffersonville, IN 47132
Other Federal agencies and pass - through entities in accordance with Sections .320 (e) and (f), OMB Circular A -133, as revised.
27
Packet Page -939-
October
11/8/2011 Item 16.D.6.
Pursuant to Sections .320(f), OMB Circular A -133, as revised, the provider shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A -133, as revised, and any management letter issued by the auditor, to Senior
Choices of Southwest Florida at each of the following addresses:
Senior Choices of Southwest Florida
Attn: Leigh W. Schield, Executive Director
15201 N. Cleveland Avenue, Ste 1100
North Fort Myers, Florida 33903
Phone: (239) 652 -6900
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on behalf of
the provider directly to each of the following:
Senior Choices of Southwest Florida at each of the following addresses:
Senior Choices of Southwest Florida
Attn: Leigh W. Schield, Executive Director
15201 N. Cleveland Avenue, Ste 1100
North Fort Myers, Florida 33903
Phone: (239) 652 -6900
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399 -1450
Any reports, management letter, or other information required to be submitted to Senior Choices of Southwest Florida
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 Senior Choices of Southwest Florida for audits done in accordance
with OMB Circular A -133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations),
Rules of the Auditor General, should indicate the date that the reporting package was delivered to the provider in
correspondence accompanying the reporting package.
PART IV: RECORD RETENTION
The provider shall retain sufficient records demonstrating its compliance with the terns of this agreement for a period of six
years from the date the audit report is issued, and shall allow Senior Choices of Southwest Florida or its designee, the CFO
or Auditor General access to such records upon request. The provider shall ensure that audit working papers are made available
to Senior Choices of Southwest Florida, or its designee, CFO, or Auditor General upon request for a period of six years from
the date the audit report is issued, unless extended in writing by Senior Choices of Southwest Florida.
28
Packet Page -940-
n
11/8/2011 Item 16.D.6.
October 1VZ!)lr LVJ.1L
EXHIBIT —1
n
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
AGREEMENT CONSIST OF THE FOLLOWING:
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Nutrition Services Incentive Program
Older Americans Act
93.053
$43,602.00
TOTAL FEDERAL AWARD
$ 43,602.00
TOTAL FEDERAL AWARD
$43,602.00
COLLIER
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Nutrition Services Incentive Program
Older Americans Act
93.053
$ 43,602.00
TOTAL FEDERAL AWARD
$ 43,602.00
29
Packet Page -941-
October
PART I: AUDIT RELATIONSHIP DETERMINATION
11/8/2011 Item 16.D.6.
ATTACHMENT III
Exhibit -2^
Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A -133, as
revised, and/or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and/or state
financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of
Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB 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 financial assistance, must comply with applicable
programmatic and fiscal compliance requirements.
In accordance with Sec. 210 of OMB Circular A -133 and/or Rule 691 - 5.006, 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 Recipient/subrecipient subject to OMB Circular A -133 and/or Section 215.97, F.S.
NOTE: If a provider is determined to be 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 69I- .006(2), FAC [state financial assistance] and
Section _ .400 OMB Circular A -133 [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 who are determined to be a subrecipient, must comply with the following fiscal laws,
rules and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)*
OMB Circular A -102 — Administrative Requirements
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON - PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non - Profit Organizations (Formerly OMB Circular A -122 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
Requirements)
OMB 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 OMB (Formerly Circular A -21 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
*Some Federal programs may be exempted from 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 determined to be a
recipient/subrecipient, must comply with the following fiscal laws, rules and regulations:
Section 215.97, Fla. Stat.
Chapter 69I -5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
30
Packet Page -942-
October 11/8/2011 Item 16.D.6.
n CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE ATTACHMENT IV
FOR AGREEMENTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is
an attachment, hereby certifies that:
(1) The Contractor and any subcontractors of services under this contract have financial management systems capable of
providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each
grant- funded project or program in accordance with -the prescribed reporting requirements; (2) the source and
application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts
for each award. The inability to process information in accordance with these requirements could result in a return of
grant funds that have not been accounted for properly.
(2) Management Information Systems used by the Contractor, subcontractor(s), or any outside entity on which the
Contractor is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be
capable of processing data accurately, including year -date dependent data. For those systems identified to be non-
compliant, contractor(s) will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions
of these products offered by the Contractor (represented by the undersigned) and purchased by the State will be
verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted herein,
at no charge to the State, and without interruption to the ongoing business of the state, time being of the essence.
(4) The Contractor and any subcontractor(s) of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from
data integrity compliance issues.
The Contractor shall require that the language of this certification be included in all subagreements, subgrants, and other
agreements and that all subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
OMB Circulars A -102 and 2 CFR Part 215 (formerly OMB Circular A -110).
Collier Co= Board of Co= Commissioners 3339 Tamiami Trail E. Naples, FL 34112
Name and Address of Contractor
Chairman
11/2/2011
Signature Title Date
Fred W. Coyle
Name of Authorized Signer
(Revised June 2008)
�TTEST: A*asrnm nd legal Sufficienc
NIGHT E. BROCK, CLERK
DEPUTY CLERK e 31 et Page -943-
October 11/8/2011 Item 16.D.6.
ATTACHMENT V,,
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1) The Contractor certifies, 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) Where the Contractor is unable to certify to any of the statements in this certification, such prospective
participant shall attach an explanation to this certification.
11/8/2011
Signature Date
Chairman Collier County Board of Commissioners
Title Agency /Organization
(Certification signature should be same as Contract signature.)
ATTEST: �ortn and legal Sufficiency:
DWIGHT E. BROCK, CLERK
DEPUTY CLERK J� o eAt ome AIM41
Instructions for Certification
1. The terms "covered transaction, debarred, suspended, ineligible, " lower tier cov' ered transaction," "person,"
"primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the sections
of rules implementing Executive Order 12549. (2 CFR 180.5 - 180.1020, as supplemented by 2 CFR 376.10-
376.995). You may contact the Contract Manager for assistance in obtaining a copy of those regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered into
this transaction. If it is later determined that the Contractor knowingly rendered an erroneous certification, in
addition to other remedies available to the federal government, the Agency may pursue available remedies, including
suspension and/or debarment.
3. The Contractor will provide immediate written notice to the Contract Manager if at any time the Contractor learns
that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.
The Contractor may decide the method and frequency by which it determines the eligibility of its principals. Each
participant to a lower tier covered transaction may, but is not required to, check the Excluded Parties List System
(EPLS).
4. The Contractor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for
lower tier covered transactions.
5. The Contractor 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 Contractor 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, and /or debarment.
7. The Contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is
not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the
certification is erroneous.
(Revised June 2008)
32
Packet Page -944-
October 11/8/2011 Item 16.D.6.
ATTACHMENT VI
ASSURANCES — NON - CONSTRUCTION PROGRAMS
bublic reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of
information. Send continents regarding the burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348- 0043), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If
such is the case, you will be notified.
1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds
sufficient to pay the non - Federal share of project cost) to ensure proper planning, management, and completion of the project described
in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a
proper accounting system in accordance with generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C..47284763) relating to prescribed standards for merit
systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit
System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights
Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C.. 1681 -1683, and 1685- 1686), which prohibits discrimination on the basis of sex; (c)
Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C., 794), which prohibits discrimination on the basis of handicaps;
(d) the Age Discrimination Act of 1975, as amended (42 U.S.C., 6101- 6107), which prohibits discrimination on the basis of age; (e)
the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to nondiscrimination on the basis of drug abuse;
(f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91 -616), as
amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g), 523 and 527 of the Public Health Service Act
of 1912 (42 U.S.C., 290 dd -3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title
VIII of the Civil Rights Act of 1968 (42 U.S.C.. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing
of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being
made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or whose
property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property
acquired for project purposes regardless of Federal participation in purchases.
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C., 1501 -1508 and 7324 - 7328), which limit the political
activities of employees whose principal employment activities are funded in whole or in part with Federal funds.
r, 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C., 276a to 276a -7), the Copeland Act (40 U.S.C. 276c
and 18 U.S.C..874) and the Contract Work Hours and Safety Standards Act (40 U.S.C., 327 -333), regarding labor standards for
federally assisted construction subagreements.
33
Packet Page -945-
October 11/8/2011 Item 16.D.6.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973
(P.L. 93 -234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if
the total cost of insurable construction and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality
control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514; (b) notification
of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in
floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program
developed under the Coastal Zone Management Act of 1972 (16 U.S.C., 1451 et seq.); (f) conformity of Federal actions to State (Clear
Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C., 7401 et seq.); (g) protection of
underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93 -523); and (h) protection of
endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93 -205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C.. 1721 et seq.) related to protecting components or potential
components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C.,470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic
Preservation Act of 1974 (16 U.S.C..469a -1 et seq.).
14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related activities
supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C., 2131 et seq.) pertaining to the care,
handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U. S.C., 4801 et seq.), which prohibits the use of lead- based paint
in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 19!,,
and OMB Circular No. A -133, Audits of States, Local Governments, and Non - Profit Organizations.
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this
program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
Chairman
APPLICANT ORGANIZATION I DATE SUBMITTED
Collier County Board of Commissioners 1 11/8/2011
ATTEST:
DWIGHT E. BROCK, CLERK
, DEPUTY CLERK
34
:y:
Packet Page -946-
October
October 2011
REQUEST FOR REIMBURSEMENT
Nutrition Services Incentive Program
11/8/2011 Item 16.D.6.
ATTACHMENT VII
NSIP 2012
PROVIDER NAME, ADDRESS, PHONE
# AND FEID #
AGENCY NAME
Payment Request:
From: 9 1 11 To: 9/30/11
Report # :
Contract Period:
Address
Regular
9/1/11 to 9/30/12 I
City, State Zipcode
Supplemental
Contract # NSIP
Ph
FEID# -
PSA # 8
CERTIFICATION: I hereby certify that to the best of my knowledge the information in this report is accurate and complete and
that all outlays reported herein were for purposes set forth in the contract documents.
Prepared by: Date: App oved by: Date:
PART A: REIMBURSEMENT
COMPUTATION
YEAR TO DATE
CURRENT MONTH
CONGREGATE
HOME DELIVERED
CONGREGATE
HOME DELIVERED
1. Number of Meals Served
2. Line 1 times $ 0.680000 per Meal
3. Total
Grand Total
Total Reimbursement
Requested
PART B: CONTRACT SUMMARY
4. Approved Contract Amount
$
5. Reimbursement Requested and not
Received
r
6. Contract Balance
$
7. Amount to be Reimbursed - This
Report
$
8. Contract Balance
$
vvcr+ rvmm i i i "wp revisea ai_i i
35
Packet Page -947-
October 11/8/2011 Item 16.D.6.
ATTACEMENT A
Department of Elder Affairs Programs & Services Handbook, provided on CD.
Also, available at the Department's Intranet site under, "Publications ". /1*N
36
Packet Page -948-
October
11/8/2011 Item 16.D.6.
CTATF. HEFT. nRiilAllF.PeRTMT1yTr1T>G'i.nru ALTATDC
ATTACHMENT B
CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name:
County:
AAA/Contractor
Collier County
Collier
YES
Address:
Completed By:
3339 Tamiami Trail E., Suite 211
Louise Pelletier
City, State, Zip Code:
Naples, FL 334112
Date:
November 8, 2011
Telephone:239- 252 -2696
rAx i I: xLAU I nL A 1 IAI.nLL IAb I Kul. I IvNb rvx ILLUb I KAI I V E INrURMA1ION WHICH WILL HELP YOU COMPLETE THIS
FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
2. POPULATION OF AREA SERVED.
% Other I % Female
313,505 1 66.3% 1 5.5% 1 25.1%
3. STAFF CURRENTLY EMPLOYED. Effective date: 11/8/2011
Total # % White % Black % Hispanic % Other % Female % Disabled
4. CLIENTS CURRENTLY ENROLLED OR REGISTERED. Effective date: 11 /8/2011
Total # % White % Black % Hispanic % Other % Female % Disabled %Over 40
5. ADVISORY OR GOVERNING BOARD. IF APPLICABLE.
PART H: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE.
6. Is an Assurance of Compliance on file with DOEA? If N/A or NO, explain.
N/A
YES
NO
'—'�' 7. Compare the staff composition to the population. Is staff representative of the population?
If NIA or NO, explain.
N/A
YES
NO
❑
❑
❑
8. Compare the client composition to the population. Are race and sex characteristics representative of the
population? If N/A or NO, explain.
N/A
YES
NO
❑
❑
❑
9. Are eligibility requirements for services applied to clients and applicants without regard to race, color,
national origin, sex, age, religion or disability? If N/A or NO, explain.
N/A
YES
NO
❑
❑
❑
10. Are all benefits, services and facilities available to applicants and participants in an equally effective
manner regardless of race, sex, color, age, national origin, religion or disability? If N/A or NO, explain.
N/A
YES
NO
❑
❑
❑
11. For in- patient services, are room assignments made without regard to race, color, national origin
or disability? If N/A or NO, explain.
N/A
YES
NO
❑
❑
❑
12. Is the program/facility accessible to non - English speaking clients? If N/A or NO, explain.
N/A
YES
NO
❑
❑
❑
37
Packet Page -949-
October
11 /.Q /7 (11 1 l f'n r" 4 a n M
October 11/8/2011 Item 16.D.6.
13. Are employees, applicants and participants informed of their protection against discrimination? If YES,
Reviewed By
In Compliance: YES ❑ NO* ❑
Program Office
how? Verbal ❑ Written ❑ Poster ❑ If N/A or NO, explain.
N/A
YES
NO
On -Site ❑ Desk Review ❑
❑
❑
❑
14. Give the number and current status of any discrimination complaints regarding services or employment filed
against the program/facility.
N/A
NUMBER
D
15. Is the program/facility physically accessible to mobility, hearing, and sight- impaired individuals? If N/A or
NO, explain.
N/A
YES
NO
❑
D
❑
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITI115 OR MORE EMPLOYEES.
16. Has a self - evaluation been conducted to identify any barriers to serving disabled individuals, and to make
any necessary modifications? If NO, explain.
YES
NO
❑
❑
17. Is there an established grievance procedure that incorporates due process in the resolution of complaints? If
NO, explain.
YES
NO
❑
❑
18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain.
YES
NO
❑
❑
19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination
on the basis of disability? If NO, explain.
YES
NO
❑
❑
20. Are auxiliary aids available to assure accessibility of services to hearing and sight - impaired individuals? If
NO, explain.
YES
NO
❑
❑
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE.
21. Do you have a written affirmative action plan? If NO, explain.
YES
NO
❑
❑
xevisea August 2U U, Page 2 of 2
38
Packet Page -950-
Reviewed By
In Compliance: YES ❑ NO* ❑
Program Office
*Notice of Corrective Action Sent
Date
Telephone
Response Due
On -Site ❑ Desk Review ❑
Response Received
xevisea August 2U U, Page 2 of 2
38
Packet Page -950-
October
11/8/2011 Item 16.D.6.
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves a
specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population statistics
can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing
Florida population statistics. Include the source of your population statistics. ( "Other" races include Asian/Pacific
Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full -time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex and disability. Include the date that enrollment was counted.
Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA recipients and their sub - grantees, 45 CFR 80.4 (a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on -site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a) and
45 CFR 80.1 (b) (2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin,
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting
rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b).
11. For in- patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin
or disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a
different race, color, national origin, or disability, 45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non - English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist in
the provision of services, 45 CFR 80.3 (a).
39
Packet Page -951-
October
11/8/2011 Item 16.D.6.
13. Programs /facilities must make information regarding the nondiscriminatory provisions of Title VI available to their/—,.,
participants, beneficiaries or any other interested parties. This should include information on their right to file a
complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The
information may be supplied verbally or in writing to every individual, or may be supplied through the use of an
equal opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6 (d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement,
termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address
of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled,
no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated
parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone,
restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic
areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed
for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls
for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility
impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self -
evaluation to identify any accessibility barriers. Self - evaluation is a four step process:
a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not
comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self - evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have n
been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Section 504.45 CFR 84.7 (b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads,
and other appropriate written communication, 45 CFR 84.8 (a).
20. Programs /facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters
for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide
equally effective services, 45 CFR 84.52 (d).
21. Programs /facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60 and
Title VI of the Civil Rights Act of 1964, as amended.
DOER Form 101 -B, Revised August 2010
40
Packet Page -952-
2
H
z
w
U
Q
o
F-
U-
v
M
O
N
FIA
4-J
4J
V
L
a.J
C-
0
V
Q)
ru
cn
Y)
O
CL-
L
1l
0
v
L
u
D
O
oG
W
a
F-
0
CL
W
Ce
�k y
� U
L E
a w
z
W
� y d
0 E
IL
z ¢ LL
11 /Qi)nI I i +,!% 16.D.6.
Packet Page -953-
F
Q
O
WW
M
October 11/8/2011 Item 16.D.6.
ATTACHMENT E
n
Department's Computer Use Policy and its Social Media Policy, provided on CD.
42
Packet Page -954-
October
/ \
11/8/2011 Item 16.D.6.
ATTACHMENT F
13P�.e=� OF low
... BACKGROUND SCREENING
ELIDE Affidavit of Com liance
AFFAIRS P
timl►7E W rL=ft
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 436.06(3), Florida Statutes.
➢ The term "employer" means any person or entity required by law to conduct background screening,
Including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Service Providers, Diversion
Providers, and any other person or entity which hires employees or has volunteers in service who meet
the definition of a direct service provider. See §§ 435.02, 430.0402, Fla. Stat
9 A direct service provider Is a person at least 18 years of age who, pursuant to a program to provide
services to the elderly, has direct face- to-face contact with a client while providing services, or has access
to the client's living area, funds, or personal property.A direct service provideralso includes coordinators,
managers, and supervisors of residential facilities; and volunteers. § 430.0402, Fla. Stat.
ATTESTATION:
As the duly authorized representative of UIV cf Co::;l+� plcx *t nQ ; himun Lvl v than
Employer Na e
}J��- } ^ (�� yy� /� �/� t '` ` �r y y� (- �/!( tj� �
located at✓` /+:J ' r� W 7�i N.� 1 1{ 1�U1.,' �.�,�,jY R. �\ al \�l'i {� {r \. 1 l .�1�I l _7
I, ht rn IJC..(IQ U 1 Mt. do hereby affirm under penalty of perjury,
Name of Repretentative
that level 2 background screening has been conducted in compliance with the provisions of Chapter 435
and section 430.0402, Florida Statutes.
Signa 1P re If Representative
it D1211 1) .�
Date'
STATE OF FLORIDA, COUNTY OF CC 1 Ii Z r
Sworn to (or affirmed)) and subscribed before me this 21 day of � cmr 20_L1, by
�� 11,E CTYZQCIt, (Name of Representative) who is personally known
o as proof of identification.
OW Notary Public State of Florida
;4 My co P Franco �(��j��� �+ 1
My Commission EE087085 W ,I
Notary Public
DOEA Form 235, Affidavit of Compliance, Effective 9 -IAA Section 435.05(3), F.S.
'Previous versions of this form will not beaccapted" Form available atbtto, / /aWeraf its. sm e. fl. us /enalish /badgroundseraenina.oho
43
Aped as tee fOrTrl & jerqol sufficiency
"..." ssis nt (';Quntar
Packet Page -955-
October 11/8/2011 Item 16.D.6.
ATTACHMENT G
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to which
this form is an attachment, hereby certifies that:
(1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or
submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized
Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran
Petroleum Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a proposal for,
or enter into or renew a contract with Senior Choices of Southwest Florida (Agency) for goods or services
of $1 million or more.
(2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false certification
to the Agency is subject to civil penalties, attorney's fees and costs and any costs for investigations that led
to the finding of false certification.
(3) The Contractor understands that the contract to which this form is an attachment may be terminated by the
Agency if the Contractor submits a false certification or has been placed on the Lists.
This certification, required by Florida law, is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a prerequisite for making or n
entering into this transaction.
N/A
Signature
(Same as contract signature)
Chairman
Title
Collier County Board of County Commissioners
Company Name
44
Packet Page -956-
11/8/2011
Date
October
Verification of Employment Status Certification
11/8/2011 Item 16.D.6.
ATTACHMENT H
As a condition of contracting with Area Agency of Southwest Florida, Inc. dba Senior Choices of Southwest
Florida, Collier County Board of County Commissioners, hereby referred to as contractor certifies the use of
the U.S. Department of Homeland Security's E -Verify system to verify employment eligibility of (a) all
persons employed during the contract term to perform employment duties within the State of Florida and (b)
all persons (including subcontractors) assigned by the contractor to perform work pursuant to the contract
with Senior Choices of Southwest Florida.
11/8/2011
Signature Date
(Same as contract signature)
Chairman
Title
Collier County Board of County Commissioners
^Company Name
ATTEST: Appr a] as o rm and legal Sufficiency:
DWIGHT E. BROCK, CLERK
DEPUTY CLERK 5vAIA. unty Atto
,.-� 45
Packet Page -957-
11/8/2011 Item 16.D.6.
VERIFICATION OF EMERGENCY PREPAREDNESS PLAN
Contract # NSIP 203.12
I, Fred Covle , certify that Collier County Board of Commissioners
(Name of authorized contractor representative) (Name of contractor)
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made available to the Area Agency on Aging for Southwest Florida, Inc. (AAA)
dba Senior Choices of Southwest Florida upon request.
Fred W. Coyle
Signature of authorized contractor representative
Chairman
11/8/2011
Date
ATTEST: Approval t form and legal Sufficiency:
DWIGHT E. BROCK, CLERK
DEPUTY CLERK 'i_ it TY) I . r.
October 2008
Packet Page -958-
11/8/2011 Item 16.D.6.
Attestation Statement
Agreement/Contract Number NSIP 203.12
Amendment Number 0
I, Fred W. Coyle , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida, Inc. dba Senior Choices of Southwest Florida and
C_ ollier County Board of Commissioners.
(RecipientlContractor 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.
Fred W. Coyle, Chairman
Signature of Recipient/Contractor representative
11/8/2011
Date
AAA Contract Manager to initial and date indicating signatures /initials appropriate on all documents; ready
for AAA designee signature
initial date
Revised November 2010
ATTEST:'
DWIGHT E. BROCK, CLERK
,DEPUTY CLERK
Approval VAtt.rm,�,e fficiency:
�!
Packet P age -959-