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BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: County Administrator Bulk Item: Yes X No _ Department: Office of Management & Budget Staff Contact Person/Phone #: Emie Coughlin X4315 AGENDA ITEM WORDING: Approval of various resolutions for the transfer of funds and resolutions for the receipt of unanticipated revenue. ITEM BACKGROUND: See attached schedule of items. PREVIOUS RELEVANT BOCC ACTION: See attached schedule of items. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval TOTAL COST: N/A COST TO COUNTY: N/A BUDGETED: Yes No SOURCE OF FUNDS: N/A REVENUE PRODUCING: Yes No X AMOVNT PER MONTH Year APPROVED BY: County Atty X B Krchasing X Risk Management N/A DOCUMENTATION: DISPOSITION: Revised 11 /06 Included X Not Required AGENDA ITEM # f z O V� � Oj p p t+JJ :�I VI I p pl O� IOi I p� of itA ICI NI C, tD IIN N i E m: N N - 1 ¢ N N' (DI 'i Z N to O!<F.i: O 1 71 N t6; L N Nei tb C C 0 :0- Z Z C; ;o Z E Z = C 0, Z: C ;0 iZ C 01 Z �'I 3d ;E: 'Z �6 ZCL �iU. UU 1of i 'Ci i i 5I 71 oNlIDI ID! i v� i IL I 0 t � I J { I I �II o V I o I M v,, a ILL v w v� ,� V Y Io Icl �ILi 'I of LL m LL- m� �LL� lm , v- U O Q c c� a c c ;c �O m a.Iv - .0 v 'r Iv UU I,0 C 'v r v jv N to UU UU -tl mF ¢,I ¢ ¢ o ¢ ¢ t¢ of III I,� �oIIII III I O l I I O- � � I I tm! 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Q INI (O LI ICI N VC I C LA - N C t0 C 1ml 'l `o'i `o, `oI 71 o EI s 61 E Ea I C C C O C !D C lU C C ', O I lU !b • - O i m l6 I lU i N j O ' O ICI ICI C pY I III I (DI li c a) to 0 ctui ''U �' U U, u wi (D 0 of of 0 E E IC , 0' C O C O SIC O U C I O U, C ', o UI C O U O (p j D N O. _0 —0:O -6 � O Oi 01 I O O, O d O f6 lQ O 'OIL O ?OI IO, lOi �O� O 'O' �O N W W N W W O O Oa- 0 -2 2'a1l �IO l - a a aO ¢ a a ¢ ap CL CL 0. ¢I¢ ', aa iI, L; _ `o OMB Schedule Item Number 1 Resolution No. - 2010 A RESOLUTION CONCERNING THE TRANSFER OF FUNDS WHEREAS, it is necessary for the Board of County Commissioners of Monroe County, Florida, to make budgeted transfers in the Monroe County Budget for the Fiscal Year 2011, now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that there shall be transfers of amounts previously set up in the Monroe County Budget for the Fiscal Year 2011 as, hereinafter set forth to and from the following accounts: Fund # 403 Marathon Airport From: 403-5420-63502-560640 Capital Outlay -Equipment Cost Center #63502 Marathon Airport R&R For the Amount: $2409.04 To: 403-5420-63501-510250 Unemployment Comp Cost Center #63501 Marathon Airport O & M BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above, is hereby authorized and directed to make necessary changes of said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15th day of December, AD 2010. Mayor Murphy Mayor Pro Tern Carruthers Commissioner Wigington Commissioner Neugent Commissioner Rice BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA go (Seal) Attest: DANNY L. KOLHAGE, Clerk Mayor/Chairman Item 1 trsf fund 403 fm 63502 to 63501 OMB Schedule Item Number 2 Resolution No. - 2010 A RESOLUTION CONCERNING THE TRANSFER OF FUNDS WHEREAS, it is necessary for the Board of County Commissioners of Monroe County, Florida, to make budgeted transfers in the Monroe County Budget for the Fiscal Year 2011, now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that there shall be transfers of amounts previously set up in the Monroe County Budget for the Fiscal Year 2011 as, hereinafter set forth to and from the following accounts: Fund # 130 Impact Fees Roadways From: 130-5410-29001-560630 Capital Outlay -Infrastructure Cost Center #29001 Dist 1 Roadway Projects For the Amount: $475,574.00 To: 130-5810-86519-590102 Transfer to Fund 102 Cost Center #86519 Budgeted Transfers 130 BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above, is hereby authorized and directed to make necessary changes of said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15th day of December, AD 2010. Mayor Murphy Mayor Pro Tem Carruthers Commissioner Wigington Commissioner Neugent Commissioner Rice BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA in (Seal) Attest: DANNY L. KOLHAGE, Clerk Mayor/Chairman Item 2 trsf fund 130 fin 29001 to 86519 OMB Schedule Item Number 3 Resolution No. - 2010 A RESOLUTION CONCERNING THE TRANSFER OF FUNDS WHEREAS, it is necessary for the Board of County Commissioners of Monroe County, Florida, to make budgeted transfers in the Monroe County Budget for the Fiscal Year 2011, now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that there shall be transfers of amounts previously set up in the Monroe County Budget for the Fiscal Year 2011 as, hereinafter set forth to and from the following accounts: Fund # 158 Misc Special Revenue Fund From:158-5130-85547-590990 Other Uses Cost Center # 85547 Reserves 158 For the Amount: $7,435.74 To: 158-5690-04558-530410 Phone & Postage Cost Center # 04558 FL Keys Council Handicap From:158-5130-85547-590990 Other Uses Cost Center # 85547 Reserves 158 For the Amount: $180.00 To: 158-5620-21001-530490 Misc Cost Center #21001 Animal Control Citation From:158-5130-85547-590990 Other Uses Cost Center # 85547 Reserves 158 For the Amount: $1,304.60 To: 158-5620-61524-530490 Misc Cost Center #61524 Bayshore Donations From:158-5130-85547-590990 Other Uses Cost Center # 85547 Reserves 158 For the Amount: $27,353.97 To: 158-6030-69801-560640 Capital Outlay -Equipment Cost Center #69801 Ct Tech Public Defender BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above, is hereby authorized and directed to make necessary changes of said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15'h day of December, AD 2010. Mayor Carruthers Mayor Pro Tem Rice Commissioner Wigington Commissioner Neugent Commissioner Murphy BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA go (Seal) Attest: DANNY L. KOLHAGE, Clerk Mayor/Chairman Item 3 rlvr fund 158 85547 trnsfrs OMB Schedule Item Number 4 Resolution No. -2010 A RESOLUTION RESCINDING RESOLUTION NO. 322-2010 WHEREAS, Resolution Number 322 -2010, heretofore enacted for the purpose of receipt of unanticipated funds, contains an erroneous information, and WHEREAS, it is the desire of the Commission to rectify by amendment such errors, now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that Resolution No. 322-2010 previously set up in the Monroe County Budget for the purpose of receipt of unanticipated funds in Fiscal Year 2011 contained certain erroneous information and said resolution, passed and adopted on October 201h, 2010, is hereby rescinded: Fund #125 - Governmental Fund Type Grants Cost Center # 06034 — Recovery Act JAG Prgm Project GG1003 — Recovery Act JAG Prgm Function # 5600 Activity #5630 Official/Division - #1000 Federal Award #2009-SB-B9-0468 CFDA #16.804 Term: 3/1/09 to 2/28/13 Revenue: 125-06034-3316900H Federal Grants — Human Services $36,440.13 ------------- Total Revenue $36,440.13 Appropriations: 125-5630-06034-530490 Miscellaneous $36,440.13 Total Appropriations: $36,440.13 BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above, is hereby authorized and directed to make the necessary changes of said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15`h day of December AD 2010. Mayor Carruthers Mayor Pro Tern Rice Commissioner Wigington Commissioner Neugent Commissioner Murphy BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA 0 (Seal) Attest: DANNY L. KOLHAGE, Clerk Mayor/Chairman Item 4 rescind reso#322-2010 rlvr unant Fund 125 06034 GG1003 Rcvy Act JAG Prgm OMB Schedule Item Number 5 Resolution No. - 2010 A RESOLUTION CONCERNING THE TRANSFER OF FUNDS WHEREAS, it is necessary for the Board of County Commissioners of Monroe County, Florida, to make budgeted transfers in the Monroe County Budget for the Fiscal Year 2011, now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that there shall be transfers of amounts previously set up in the Monroe County Budget for the Fiscal Year 2011 as, hereinafter set forth to and from the following accounts: Fund #163 Court Facilities Fees-602 From: 163-7120-81501-560640 Capital Outlay -Equipment Cost Center #81501 Courthouse Facilities For the Amount: $400,000.00 To: 163-5800-5810-1000-86563-590304 Trsf to Fund 304 Cost Center #86563 Budgeted Transfers 163 BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above, is hereby authorized and directed to make necessary changes of said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15th day of December, AD 2010. Mayor Carruthers Mayor Pro Tem Rice Commissioner Wigington Commissioner Neugent Commissioner Murphy BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA 0 (Seal) Attest: DANNY L. KOLHAGE, Clerk Mayor/Chairman Item 5 trsf fund 163 fm 81501 to 86563 Courthouse Facilities Resolution No. - 2010 OMB Schedule Item Number 6 A RESOLUTION CONCERNING THE RECEIPT OF UNANTICIPATED FUNDS WHEREAS, it is necessary for the Board of County Commissioners of Monroe County, Florida, to increase items to account for unanticipated funds in the Monroe County Budget for the Fiscal Year 2011, now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that the following accounts of the Monroe County Budget for the Fiscal Year 2011, be and the same is hereby increased by the amount hereinafter set forth: Fund #304 One Cent Infrastructure Surtax Cost Center #24000 General Government Project# CG9810 Marathon Courthouse Function # 5100 Activity # 5190 Official/Division #1013 Revenue: 304-381163GT Transfer Fm Fund 163 $50,000.00 Total Revenue $50,000.00 Appropriations: 304-24000-560620-CG9810-560620 Capital Outlay -Building $50,000.00 Total Appropriations: $50,000.00 BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above, is hereby authorized and directed to make the necessary changes of said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15`h day of December AD 2010. Mayor Carruthers Mayor Pro Tern Rice Commissioner Wigington Commissioner Neugent Commissioner Murphy BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Mayor/Chairman (Seal) Attest: DANNY L. KOLHAGE, Clerk Item 6 unant fund 304 24000 CG9810 Mthn Courthouse OMB Schedule Item Number 7 Resolution No. - 2010 A RESOLUTION CONCERNING THE TRANSFER OF FUNDS WHEREAS, it is necessary for the Board of County Commissioners of Monroe County, Florida, to make budgeted transfers in the Monroe County Budget for the Fiscal Year 2011, now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that there shall be transfers of amounts previously set up in the Monroe County Budget for the Fiscal Year 2011 as, hereinafter set forth to and from the following accounts: Fund #148 Plan, Build, Zoning From: 148-5130-85525-590990 Other Uses Cost Center #85525 Reserves-148 For the Amount: $2,000.00 To: 148-54500-590994 Planning Refund Cost Center #54500 Planning Refund BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above, is hereby authorized and directed to make necessary changes of said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15th day of December, AD 2010. Mayor Carruthers Mayor Pro Tem Rice Commissioner Wigington Commissioner Neugent Commissioner Murphy BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA go (Seal) Attest: DANNY L. KOLHAGE, Clerk Mayor/Chairman Item 7 trsf fund 148 fm 85525 to 54500 OMB Schedule Item Number 8 Resolution No. - 2010 A RESOLUTION CONCERNING THE RECEIPT OF UNANTICIPATED FUNDS WHEREAS, it is necessary for the Board of County Commissioners of Monroe County, Florida, to increase items to account for unanticipated funds in the Monroe County Budget for the Fiscal Year 2011 now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that the following accounts of the Monroe County Budget for the Fiscal Year 2011 be and the same is hereby increased by the amount hereinafter set forth: Fund 9125 — Governmental Fund Type Grants Cost Center # 6153710 — Community Care for Disabled Adults Function 5600 Activity 5640 Offcl/Div# 1016 Revenue: 125-6153710-3346900H 125-6153710-38100IGT Total Revenue Appropriations: 125-6153710-510120-Salaries Total Appropriations: State Grants Trnsfr fin Gen. Fund 001 <$11,501.14> <$ 1,277.46> <$12,778.60> <$12,778.60> <$12,778.60> BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above unanticipated funds, is hereby authorized and directed to place funds in said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15t' day of December AD 2010. Mayor Carruthers Mayor Pro Tern Rice Commissioner Wigington Commissioner Neugent Commissioner Murphy LIN (Seal) Attest: DANNY L. KOLHAGE, Clerk BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Mayor/Chairman Item 8 uant fund 125 ccda kg065 FY10-11 6153710 amend#1 Resolution No. - 2010 OMB Schedule Item Number 9 A RESOLUTION AMENDING RESOLUTION NUMBER 415-2010 WHEREAS, Resolution Number 415-2010, heretofore enacted for the purpose of receiving unanticipated funds, contains an erroneous information, and WHEREAS, it is the desire of the Commission to rectify by amendment such errors, now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that Resolution No. 415-2010 previously set up in the Monroe County Budget for the purpose of receiving unanticipated funds in Fiscal Year 2011 contained certain erroneous information and said resolution, passed and adopted on November 17th , 2010 is hereby amended: Fund #125 - Governmental Fund Type Grants Cost Center # 06019 — Residential Substance Abuse Treatment Project GG1109 — Monroe County Jail Incarceration Program Function # 5600 Activity #5630 Official/Division - #1000 Contract # 2011-RSAT-MONR-I-A9-004 Grant Year: 9/01/2010-8/31/2011 Revenue: 125-06019-3312000S Federal Grants - Public Safety $50,000.00 125-06019-381101GT Transfer from Fund 101 $16,232.18 Total Revenue $66,232.18 Appropriations: 125-5630-06019-530490 Miscellaneous $66,232.18 Total Appropriations: $66,232.18 BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above unanticipated funds, is hereby authorized and directed to place funds in said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15t' day of December AD 2010. Mayor Carruthers Mayor Pro Tern Rice Commissioner Wigington Commissioner Neugent Commissioner Murphy BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Mayor/Chairman (Seal) Attest: DANNY L. KOLHAGE, Clerk Item 9 amend reso#415-2010 unapt 125 06019 RSAT06019 RSAT Resolution No. - 2010 OMB Schedule Item Number 10 A RESOLUTION AMENDING RESOLUTION NUMBER 416-2010 WHEREAS, Resolution Number 416-2010, heretofore enacted for the purpose of receiving unanticipated funds, contains an erroneous information, and WHEREAS, it is the desire of the Commission to rectify by amendment such errors, now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, that Resolution No. 416-2010 previously set up in the Monroe County Budget for the purpose of receiving unanticipated funds in Fiscal Year 2011 contained certain erroneous information and said resolution, passed and adopted on November 17th , 2010 is hereby amended: Fund # 125 Govt. Fund Type Grants From: 125-5640-6153209-530409 Cost Center #6153209 C2 OAA For the Amount: $1,096.00 To: 125-5640-6153210-530409 Cost Center #6153210 Older Americans Act C2 From: 125-5640-6153809-530409 Cost Center 96153809 Comm Care For The Elderly For the Amount: $1,096.00 To: 125-5640-6153810-530409 Cost Center #6153810 Comm Care For The Elderly Vehicle Maintenance Charge Vehicle Maintenance Charge Vehicle Maintenance Charge Vehicle Maintenance Charge BE IT FURTHER RESOLVED BY SAID BOARD, that the Clerk of said Board, upon receipt of the above unanticipated funds, is hereby authorized and directed to place funds in said items, as set forth above. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15`h day of December AD 2010. Mayor Carruthers Mayor Pro Tern Rice Commissioner Wigington Commissioner Neugent Commissioner Murphy BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA go (Seal) Attest: DANNY L. KOLHAGE, Clerk Mayor/Cbairman Item 10 amend reso#416-2010 trsf fin 6513809 to 6153810 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Bulk Item: Yes X No Division: OMB Staff Contact Person: Lisa Tennyson Phone #: 292-4444 AGENDA ITEM WORDING: Approval of Inter -local Agreements with the City of Key West, the City of Marathon and Islamorada related to their partnerships with the County in the State Energy Grant from Florida Energy and Climate Commission (Grant #ARSO10). ITEM BACKGROUND: See below. PREVIOUS RELEVANT BOCC ACTION: On October 20, 2010, the BOCC approved the Grant Agreement for Grant #ARSO10 from the Florida Energy and Climate Commission. The grant includes partnership participation with the City of Key West, the City of Marathon and Islamorada. The partners have entered into inter -local agreements with the County to solidify their obligations under the grant. CONTRACT/AGREEMENT CHANGES: None STAFF RECOMMENDATIONS: Approval TOTAL COST: 3 290 185 INDIRECT COST: BUDGETED: Yes x No DIFFERENTIAL OF LOCAL PREFERENCE: N/A COST TO COUNTY:_ $353,548 (in -kind only) SOURCE OF FUNDS: Grant #ARSO10 REVENUE PRODUCING: Yes _ No X AMOUNT PER MONTH Year _ ov APPROVED BY: County Atty Kurchasing Risk Management N -4 DOCUMENTATION: Included X Not Required DISPOSITION: Revised 7/09 AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: City of Key West, City of Effective Date: 12/15/10 Marathon and Islamorada. Expiration Date: 4 30 12 Contract Purpose/Description: Grant provides funding for energy reduction initiatives. Grant includes partner participation with the City of Key West, City of Marathon and Islamorada. The partners are entering into inter -local agreements with the Countv to solidifv their obligations under the grant. Contract Manager: Lisa Tennyson (Name) for BOCC meeting on 4444 OMB/Grants (Ext.) (Department) enda Deadline: CONTRACT COSTS Total Dollar Value of Contract: $3 290,185 Current Year Portion: $ Budgeted? Yes® No ❑ Account Codes: Grant: $2,687,288 tzs - otv�3-53a�D - C,� ���`I-S3h3yo County Match: County match:$354K Key West match:$94K Marathon match:$107K Islamorada match:$48K ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes qDat In Needed Division Director %Q Yes❑ No[3 Risk Manageent�p�kf P Yes[] No[g/ vi �� � O.M.B./Purc;iasi'tig ii _ate-10 Yes❑ No[/ County Attorney ������ Yes❑ Now Comments: OMB Form Revised 9/11/95 MCP #2 Date Out k RESOLUTION NO. 10-303 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF KEY WEST, FLORIDA, AUTHORIZING THE ATTACHED INTERLOCAL AGREEMENT BETWEEN THE CITY OF KEY WEST AND MONROE COUNTY FOR ENERGY EFFICIENCY & CONSERVATION BLOCK GRANT (EECBG), FLORIDA ENERGY COMMISSION OF THE STATE OF FLORIDA GRANT AGREEMENT NO. ARS010; PROVIDING FOR AN EFFECTIVE DATE WHEREAS, in Resolution No. 09-268 the City Commission adopted a Climate Action Plan and directed the City Manager to apply for grants to fund the plan; and WHEREAS, the City of Key West, in partnership with the Board of Commissioners of Monroe County, City of Marathon and Islamorada, City of Islands obtained an EECBG grant under the Florida Energy and Climate Commission Grant Agreement No. ARS010, pursuant to the American Recovery and Reinvestment Act in order to implement a comprehensive energy savings project which includes several cross - jurisdictional and individual community energy savings activities; and WHEREAS, it is necessary for parties under the Grant Agreement to enter into an interlocal agreement to define the contributions of each party under the Grant Agreement; WHEREAS, with funding through the EECBG grant and in -kind assistance from the City and Keys Energy Services, the City of Key West intends to retrofit lighting in six public parks with energy efficient light fixtures. Page 1 of 2 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF KEY WEST, FLORIDA, AS FOLLOWS: Section 1: That the attached Interlocal Agreement between Monroe County and the City Of Key West regarding State of Florida, Florida Energy Commission Grant Agreement No. ARS010 is approved. Section 2: That this Resolution shall go into effect immediately upon its passage and adoption and authentication by the signature of the presiding officer and the Clerk of the Commission. Passed and adopted by the City Commission at a meeting held this 19 day of October 2010. Authenticated by the presiding officer and Clerk of the Commission on October 20 , 2010. Filed with the Clerk October 20 2010. ATT T CHERYL SMIT , CITY CLERK A., /! UY (5. Page 2 of 2 INTERLOCAL AGREEMENT BETWEEN MONROE COUNTY AND THE CITY OF KEY WEST FOR JOINT PARTICIPATION IN GRANT AGREEMENT # ARS010 THIS INTERLOCAL AGREEMENT is made and entered into this 15-tr day of �) E e r, b —t/ 2010, by and between the MONROE COUNTY BOARD OF COMMISSIONERS, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, FL 33040 ("COUNTY") and the CITY OF KEY WEST, whose address is ("CITY"). WITNESSETH WHEREAS, the STATE OF FLORIDA, EXECUTIVE OFFICE OF THE GOVERNOR, FLORIDA ENERGY COMMISSION ("COMMISSION") has entered into a Grant Agreement NO. ARSO10 ("Grant Agreement") with the COUNTY to provide financial assistance for the Energy Efficiency and Conservation Project in which the COUNTY is the named grantee on the Grant Agreement, and WHEREAS, the United States Department of Energy (USDOE) awarded funding to the COMMISSION pursuant to USDOE through American Recovery and Reinvestment Act (AARA) Grant Agreement No. DE-E0000241, and WHEREAS, the COUNTY and the CITY developed a mutual project, which would include mutual participation with various entities to assist both the incorporated and unincorporated areas of the Florida Keys to improve energy conservation for the citizens of Monroe County, and WHEREAS, the CITY has agreed to participate along with the COUNTY under the Grant Agreement #ARSO10, and the CITY has developed certain project tasks for the benefit of its citizens. The CITY agrees to participate, contribute its resources pursuant to the requirements of the Grant Agreement in order to secure finding for the project tasks defined by the CITY. WHEREAS, The sole purpose of this Interlocal Agreement is to define the contributions of the parties under the Grant Agreement, and WHEREAS, CITY acknowledges that COUNTY will serve as the grantee/recipient under the Grant Agreement, and WHEREAS, CITY hereby agrees to abide by the requirements of the Grant Agreement entered into between the COMMISSION and the COUNTY, and WHEREAS, this Interlocal Agreement is entered into pursuant to the authority provided in Florida Statute 163.01, known as the Florida Interlocal Cooperation Act of 1969, and NOW THEREFORE, in consideration of the mutual understandings and agreements set forth herein, the COUNTY and CITY agree as follows: INCORPORATION BY REFERENCE - The provisions of that certain document entitled "FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO 10" (Grant Agreement) and its attachments is incorporated by reference as Exhibit A to this Interlocal Agreement and made a part hereof as if fully set forth in the body of the Interlocal Agreement and all laws, rules and regulations relating thereto are also incorporated by reference. PROJECT TASKS — CITY has developed certain project tasks to be funded by the Grant Agreement, and CITY and COUNTY agree that they are to be bound by the Grant Agreement, and CITY is responsible to provide COUNTY all the documentation and/reporting relative to the CITY'S project tasks which are required under the Grant Agreement. TERM - The term of this Agreement begins on the date of execution by both parties and ends no later than April 30, 2012, the date the Grant Agreement ends unless earlier terminated or extended under the provisions of the Grant Agreement. 4. DOCUMENT REVIEW AND COMPLIANCE — CITY agrees to comply with the Grant Agreement and its attachments in its entirety, references in this agreement to specific paragraphs of the Grant Agreement are for convenience only. For purposes of the agreement between COUNTY and CITY any obligations called for under the Grant Agreement to be performed by the grantee related to CITY project tasks will also apply as if fully set out between the CITY and COUNTY. RESPONSIBILITY OF CITY - CITY agrees to perform those project tasks attributable to CITY in the Grant Agreement and to provide the matching funds either in -kind or financial as provided in the Grant Agreement; and to provide to the COUNTY all the required reports, attachments fully completed, invoices or other documentation required by COMMISSION in order for CITY to be approved for reimbursement related to a project task. 6. FUNDS — CITY acknowledges and agrees that funding for its tasks under the Grant Agreement will be provided from the COMMISSION through the COUNTY on a reimbursement rather than an up -front basis; and that COUNTY is not financially responsible to CITY for funds expended by CITY which are not approved by COMMISSION. CITY also acknowledges and agrees that expended funds will be reimbursed as approved by the COMMISSION and related to each individual request for reimbursement submitted to the COUNTY by the CITY. All funds shall be distributed and expended in accordance with the Grant Agreement. CITY agrees that it shall not receive advances of any type from the COUNTY. All reimbursements to CITY are dependent on approval of specific reimbursement requests submitted from the CITY as paid by the COMMISSION. REIMBURSEMENT. All reimbursement requests from CITY shall be submitted to COUNTY, not directly to the COMMISSION. (a) Reimbursement requests shall be submitted to COUNTY and properly documented by CITY as required in the Grant Agreement. All reimbursement requests under this Interlocal Agreement and the Grant Agreement shall be submitted using the Attachment B of the Grant Agreement, Payment Request Summary Form, fonnat in detail sufficient for a proper pre -audit and post -audit thereof. CITY shall submit to COUNTY a properly completed Attachment B, Payment Request Summary Form, with supporting documentation of allowable costs, including the final reimbursement request, as described in paragraph 4.D. of the Grant Agreement. (b) CITY agrees and acknowledges that pursuant to the Grant Agreement at paragraph 4.C., ten percent (10%) of each approved reimbursement request shall be retained by the COMMISSION pending the compliance with Section 8 of the Grant Agreement, and that this amount will not be distributed to CITY prior to being received by COUNTY. (c) If a Request for Reimbursement from CITY does not comply with the Grant Agreement requirements under the Grant Agreement the COUNTY will confer with CITY to identify what the COMMISSION requires in order for the CITY to be able to comply and receive reimbursement. It is the responsibility of the CITY to provide the necessary documentation or other requirements. (d) Upon distribution of funds from the COMMISSION to the COUNTY, the COUNTY shall distribute the reimbursement received from the COMMISSION to the CITY for items related to the individual reimbursement request being paid by the COMMISSION. (e) All reimbursements under the Grant Agreement shall be in compliance with the laws, rules, and regulations applicable to the expenditure of State and Federal funds. The State of Florida guidelines for allowable costs include, but not limited, to the Florida Department of Financial Services' Reference Guide for State Expenditures located at http://www.niyfloridacfo.com. Federal program guidelines for allowable costs and related topics are listed in Attachment E of the Grant Agreement, Federal Regulations and Attachment F of the Grant Agreement, Federal Funding Grantee, Sub -grantee and Contractor Provisions. The CITY shall provide to COUNTY a detailed listing of expenditures made under the Grant Agreement as support for the Payment Request Summary Form. The listing shall include, at a minimum, a description of the goods or services purchased, date of the transaction, check or voucher number, amount paid and vendor name. (f) In addition, to the requirements contained in paragraphs 4.C. & D of the Grant Agreement, the COMMISSION may periodically request additional proof of a transaction to evaluate the appropriateness of costs to the Grant Agreement pursuant to State of Florida guidelines. When requested by the COMMISSION related to a transaction performed by the CITY, the CITY shall provide the required information to COUNTY within 20 calendar days of such request, so that COUNTY can comply with the Grant Agreement and provide this information to the COMMISSION within 30 calendar days of receipt of such request pursuant to paragraph 4.E. of the Grant Agreement. 8. REPORTING — The Grant Agreement requires various reports, including but not limited to Monthly Progress Reports, Annual Reports, and Final Reports. CITY shall complete reports, provide documents or information as requested by COUNTY in the manner described in the Grant Agreement for the project tasks under it's control and for it's benefit. CITY recognizes that failure to comply with the reporting jeopardizes funding for the entire grant for CITY, COUNTY and for other cities. CITY agrees to complete Monthly Reports in a timely manner and to provide the reports, documents or information documents or information to COUNTY at least 48 hours before the Monthly report is due from the COUNTY to the COMMISSION, at least 5 calendar days before the Annual documents or information report is due from the COUNTY to the COMMISSION, and at least 5 calendar days before the Final Report is due from the COUNTY to the COMMISSION. COMPLIANCE MONITORING — CITY agrees to cooperate with the COUNTY and to participate in any compliance monitoring which may be required pursuant to the Grant Agreement, including but not limited to the requirements of paragraph 10 of the Grant Agreement. CITY further agrees to provide to the COUNTY the documentation required by the COMMISSION related to CITY'S project tasks due to compliance monitoring. 10. TERMINATION — If the COMMISSION terminates the Grant Agreement this Interlocal Agreement will automatically be terminated; termination by COMMISSION is set out in the Grant Agreement, including but not limited to, paragraphs IOC, 11, 12, 13, 14, and 15. Tennination may also occur by mutual agreement of the parties. 11. NOTICES - Whenever either party desires to give notice unto the other, it must be given by written notice, sent by registered United States mail, with return receipt requested, and sent to: FOR COUNTY FOR CITY County Administrator City Manager 1100 Simonton Street Jim Scholl Key West, Florida 33040 Key West, Florida 33040 ►amp Monroe County Grants Administrator 1100 Simonton Street Key West, FL 33040 Either of the parties may change, by written notice as provided above, the addresses or persons for receipt of notices. 12. UNAVAILABILITY OF FUNDS - If the COUNTY learns that funding cannot be obtained under the Grant Agreement or cannot be continued at a level sufficient to allow for the services specified herein, this Interlocal Agreement may then be terminated immediately, at the option of the COUNTY, by written notice of termination delivered in person or by mail to the CITY at its address specified above. The parties acknowledge that the COUNTY has no finding without the funding by the COMMISSION and agree that the COUNTY has no liability for funds expended by the CITY that were not covered for any reason by the COMMISSION. 13. PERFORMANCE AND OBLIGATION — The COUNTY'S performance and obligation to pay under this Interlocal Agreement is contingent upon an annual appropriation by the Board of County Commissioners and upon the COMMISSION'S performance and obligation to pay under the Grant Agreement which is contingent upon annual appropriation by the Legislature of the State of Florida and the availability of federal funding for the specific purpose of funding the COMMISSION'S obligations under the Grant Agreement. In the event of a State revenue shortfall, withdrawal of State budget authorization and/or rescission of federal funding, the total funding will be reduced accordingly. The COMMISSION, in accordance with direction from the Governor and/or the Florida Legislature, shall be the final determiner of the availability of any funds. 14. COMPLIANCE WITH LAWS AND REGULATIONS - In providing all services pursuant to this Interlocal Agreement, the CITY shall abide by all statutes, ordinances, riles, and regulations pertaining to, or regulating the provision of, such services, including those now in effect and hereafter adopted. Any violation of said statutes, ordinances, rules, or regulations shall constitute a material breach of this agreement. 15. MAINTENANCE OF BOOKS AND RECORDS - CITY agrees to maintain books, records, and documents directly pertinent to performance under the Grant Agreement and this Interlocal Agreement in the same manner as set out in paragraph 17 of the Grant Agreement. CITY agrees to provide the books, records and documents to the COUNTY in order for the COUNTY to comply with the Grant Agreement. 16. SUBCONTRACTING — Parties may hire contractors to achieve the individual project tasks applicable to their jurisdiction under the Grant Agreement. CITY agrees to comply with, and to include in subcontracts, all the applicable federal, state, and local health and safety rules and regulations required in the Grant Agreement or this Interlocal Agreement. 17. FLORIDA STATUTE SECTION 768.28 — Each party agrees that it shall be solely responsible for the negligent or wrongful acts of its employees and agents. However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity or the provisions of Section 768.28, Florida Statutes. 18. DISPUTES - COUNTY and CITY agree that they will seek to resolve any disputes between them regarding their responsibilities as soon as possible and at the lowest level reasonable, in order to conserve the resources of the parties. The parties further agree to use their best efforts to assure speedy and non -confrontational resolution of any and all disputes between them. In the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Interlocal Agreement, the prevailing party shall be entitled to reasonable attorney's fees and court costs, as an award against the non -prevailing party, and shall include attorney's fees and courts costs in appellate proceedings, as an award against the non -prevailing party. Mediation proceedings initiated and conducted pursuant to this Interlocal Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the circuit court of Monroe County. 19. AMENDMENT AND ASSIGNMENT - No agent, employee, or other representative of either party is empowered to modify or amend the terms of this Interlocal Agreement, unless executed with the same formality as this document with approval of the COMMISSION. This Interlocal Agreement or duties under the Grant Agreement shall not be assignable by either party unless such assignment is first approved by the COMMISSION. 20. SEVERABILITY - If any term, covenant, condition or provision of this Interlocal Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. COUNTY and CITY agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. 21. INDEPENDENT CONTRACTORS, WORKERS COMPENSATION — (a) CITY and its employees, volunteers, agents, vendors and subcontractors shall be and remain independent contractors and not agents or employees of the COUNTY or the COMMISSION with respect to all of the acts and services performed by and under the terms of this agreement. COUNTY and its employees, volunteers, agents, vendors and subcontractors shall be and remain independent contractors and not agents or employees of the CITY or the COMMISSION with respect to all of the acts and services performed by and under the terms of this Interlocal Agreement. (b) CITY will be self -insured against or will secure and maintain during the life of this agreement, Workers Compensation for all of its employees connected with the work of this agreement. CITY shall require their subcontractors similarly to provide Workers Compensation Insurance for all of the latter's employees unless such employees are covered by the protection afforded by the CITY. Such coverage shall comply fully with Florida's Worker's Compensation Law. This Agreement shall not in any way be construed to create a partnership, association or any other kind of joint undertaking, enterprise or venture between the parties. 22. WAIVER OF PROVISIONS - The failure of either party to this Interlocal Agreement to object to or to take affirmative action with respect to any conduct of the other which is in violation of the terms of this agreement shall not be construed as a waiver of the violation or breach, or of any future violation, breach or wrongful conduct. 23. PROCESS FOR APPROVAL - This Interlocal Agreement shall be approved by the CITY initially and after approval by the CITY shall be presented to the Board of County Commissioners for approval of the COUNTY. The Interlocal Agreement may be executed in several counterparts, each of which shall be deemed an original and such counterparts shall constitute one and the same instrument. 24. AUTHORITY - Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary governmental action, as required by law. 25. ENTIRE AGREEMENT - (a) It is understood and agreed that the entire agreement of the parties is contained herein and that this Interlocal Agreement supersedes all oral agreements and negotiations between the parties relating to the subject matter hereof as well as any previous agreements presently in effect between the parties relating to the subject matter hereof. (b) Any alterations, amendments, deletions, or waivers of the provisions of this Interlocal Agreement shall be valid only when expressed in writing and duly signed by the parties. IN WITNESS WHEREOF, the parties to this Interlocal Agreement have caused their names to be affixed hereto by the proper officers thereof for the purposes herein expressed at Monroe County, Florida, on the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, Clerk By: Deputy Clerk Date: Witnesa r Ke West Print Name Date: �0 '-2.€ -- 0 BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA in Mayor/Chairman Date: CITY O Y WE By: Title: Mayor Date: ID !� % /?!� FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS THIS AGREEMENT is entered into between the STATE OF FLORIDA, EXECUTIVE OFFICE OF THE GOVERNOR (EOG), FLORIDA ENERGY AND CLIMATE COMMISSION whose address is 600 South Calhoun Street, Suite 251, Tallahassee, Florida 32399-0001 (hereinafter referred to as the "Commission") and the MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, whose address is 1100 Simonton Street, Key West, FL 33040-3110 (hereinafter referred to as "Grantee" or "Recipient"), a local government, to provide financial assistance for the Keys Energy Conservation Initiative. In consideration of the promises and mutual agreements contained herein, the Commission and the Grantee acknowledge and agree as follows: 1. The United States Department of Energy (USDOE) awarded funding to the Commission pursuant to USDOE through American Recovery and Reinvestment Act (ARRA) Grant Agreement No. DE- EE0000241. The Grantee shall be a sub -grantee of federal financial assistance from USDOE. The Grantee is responsible for complying with the appropriate state and federal guidelines in the performance of its activities pursuant to this Agreement. 2. The Grantee agrees to perform in accordance with the terms and conditions set forth in this Agreement, its attachments and exhibits named and incorporated by reference. For purposes of this Agreement the terms "Grantee" and "Recipient" are used interchangeably. 3. This Agreement shall begin upon execution by both parties and end no later than March 31, 2012, inclusive. If allowed by USDOE, this Agreement shall be effective upon execution for purposes of reimbursement of allowable costs resulting from obligations incurred and meeting the cost share or match requirements as described in Attachment A, Grant Work Plan. Profit to the Grantee, or any of its subgrantees, is prohibited by 10 Code of Federal Regulations (CFR) Part 600. This Agreement may be amended to revise Attachment A, Grant Work Plan, if additional funding is made available by the USDOE and/or the Florida Legislature. 4. A. The Grantee shall be eligible for reimbursement of allowable costs resulting from obligations incurred during the term of this Agreement. The Commission shall reimburse the Grantee for allowable costs on a not more frequently than monthly cost reimbursement basis in an amount not to exceed $2,687,288 after receipt and approval by the Commission's Grant Manager of satisfactory reports and documentation as required in this Agreement. The parties agree that the Grantee is responsible for providing a minimum match of $602,896 toward the project described in Attachment A, Grant Work Plan. All cost sharing or match shall meet any applicable federal requirements. B. Prior written approval from the Commission's Grant Manager shall be required for changes between approved, funded budget categories up to 10% of the total, approved Grant funds. Approval of such changes will be contingent upon submission of a revised Project Budget. Budget category changes greater than 10%, the addition of previously unapproved or unfunded budget categories or the addition of previously unapproved or unfunded budget line -items, will require a formal written amendment to the Agreement. The Commission agrees to review a request by the Grantee to modify Attachment A, Grant Work Plan, should the Grantee find, after receipt of competitive bids, that the project described in Attachment A, Grant Work Plan, cannot be accomplished for the current estimated project cost. If the Commission agrees to a modification of Attachment A, Grant Work Plan, it may be modified not to exceed the awarded funding identified above. Any such modification would be by formal written amendment, in accordance with Section Grant Agreement No. ARS010, Page I of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 37. Nothing in this Section or Agreement is intended nor implies to guarantee approval of a request to modify or adjust Attachment A, Grant Work Plan, or the available project funding. C. All reimbursement requests under this Agreement shall be submitted using the Attachment B, Payment Request Summary Form, format in detail sufficient for a proper pre -audit and post -audit thereof. The Grantee shall submit a properly completed Attachment B, Payment Request Summary Form, with supporting documentation of allowable costs, including for the final reimbursement request, as described below in paragraph 4.D. Ten percent of each approved reimbursement request shall be retained by the Commission pending Grantee's compliance with Section 8. D. All reimbursements under this Agreement shall be in compliance with the laws, rules and regulations applicable to the expenditure of State and federal funds. The State of Florida guidelines for allowable costs include, but are not limited, to the Florida Department of Financial Services' Reference Guide for State Expenditures located at h ://www.mvfloridacfo-com. Federal program guidelines for allowable costs and related topics are listed in Attachment E, Federal Regulations and Attachment F, Federal Funding Grantee, Sub -grantee and Contractor Provisions. The Grantee must provide a detailed listing of expenditures made under this Agreement as support for the Payment Request Summary Form. The listing shall include, at a minimum, a description of the goods or services purchased, date of the transaction, check or voucher number, amount paid and vendor name. All requests for reimbursement of travel expenses shall be in accordance with the travel requirements including mandated forms required by Section 112.061, Florida Statutes. E. In addition to the requirements contained in paragraphs 4.0 & D above, the Commission may periodically request additional proof of a transaction to evaluate the appropriateness of costs to the Agreement pursuant to State of Florida guidelines. When requested, this information must be provided within 30 calendar days of such request. 5. The Commission's performance and obligation to pay under this Agreement is contingent upon an annual appropriation by the Legislature of the State of Florida and the availability of federal funding for the specific purpose of funding the Commission's obligations under this Agreement. In the event of a State revenue shortfall, withdrawal of State budget authorization and/or rescission of federal funding, the total funding may be reduced accordingly. The Commission, in accordance with direction from the Governor and/or the Florida Legislature, shall be the final determiner of the availability of any funds. �. The Grantee shall submit, using Attachment C, Monthly Progress Report, monthly updates. to describe the project progress, work performed, problems encountered, problem resolution, schedule updates and proposed work for the next reporting period. Attachment B, Payment Request Summary Form may not be submitted more frequently than on a monthly basis and must be accompanied by an Attachment C, Monthly Progress Report, for the corresponding month. Attachment C, Monthly Progress Reports shall be submitted to the Commission no later than three calendar days following the completion of the monthly reporting period. The Commission's Grant Manager may request additional information if the Commission's Grant Manager determines it is necessary. The Commission's Grant Manager shall have ten calendar days to review deliverables and payment requests submitted by the Grantee. The Grantee shall submit an Annual Report 15 calendar days after the end of the first year of the project, if the term of the project exceeds one year. The Annual Report shall provide a narrative detailing and evaluating the accomplishments and impact of the project in the prior twelve months. The Annual Report shall follow the format described in Attachment K, Annual Report. The Grantee shall also submit a Final Report 15 calendar days prior to the expiration date of the Agreement. The Final Report will provide a final narrative detailing and evaluating the accomplishments and impact of the project. The Final Report will include an evaluation of the energy savings directly attributable to the project, projections of estimated energy savings expected to accrue from the project and policy recommendations, which may be helpful in implementing other projects of a similar nature. Pursuant to Grant Agreement No. ARS010, Page 2 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 paragraph 4.C, 10% of the total Agreement amount identified in paragraph 4.A will be withheld until receipt and approval of the Final Report. 9. Each party agrees that it shall be solely responsible for the negligent or wrongful acts of its employees and agents. However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity or the provisions of Section 768.28, Florida Statutes. 10. A. Commission staff will perform compliance monitoring during the term of the Agreement, in addition to the review of Monthly Progress Reports, but not less than once a year, to ensure Agreement compliance. Monitoring shall include, but not be limited to, periodic review of compliance with Agreement service delivery, as described in Attachment A, Grant Work Plan as documented in Attachment C, Monthly Progress Reports and also which includes a review of all Agreement requirements including the Attachments. The Commission reserves the right for any Commission staff to make scheduled or unscheduled, announced or unannounced compliance monitoring visits at any site where services are delivered pursuant to this Agreement. B. For each on -site compliance monitoring visit, Commission staff will provide an oral exit interview and a written monitoring report to the Grantee. C. If issues of non-compliance are identified in the monitoring report, a written Corrective Action Plan (CAP) may be required of the Grantee. If required, the CAP shall be submitted to the Commission's Grant Manager within ten calendar days of receipt of the monitoring report. If a CAP is required of the Grantee, failure to correct deficiencies after thirty calendar days from the date -of -receipt of a written monitoring report notating the deficiencies may result in a determination of breach of Agreement and termination of services. If a CAP is not required of the Grantee, the Commission may proceed under Section 11 and/or Section 14. 11. The Commission may terminate this Agreement at any time in the event of the failure of the Grantee to fulfill any of its obligations under this Agreement. Prior to termination, the Commission shall provide 30 calendar days written notice of its intent to terminate and shall provide the Grantee an opportunity to consult with the Commission regarding the reason(s) for termination. If this Agreement is terminated, the Commission shall only pay for those acts satisfactorily completed under this Agreement prior to the date of termination. The Commission shall not pay the Grantee for any work performed after such termination, except as described in Section 14.F. 12. The Commission may terminate this Agreement for convenience by providing the Grantee with 30 calendar days written notice. If this Agreement is terminated, the Commission shall only pay for those acts satisfactorily completed under this Agreement prior to the date of termination. The Commission shall not pay the Grantee for any work performed after such termination, except as described in Section 14.F. 13. This Agreement may be unilaterally terminated by the Commission for refusal by the Grantee to allow public access to all documents, papers, letters or other material made or received by the Grantee in conjunction with this Agreement, unless the records are exempt from Section 24(a), Article I of the Florida Constitution and Chapter 119, Florida Statutes. If this Agreement is terminated, the Commission shall only pay for those acts satisfactorily completed under this Agreement prior to the date of termination. The Commission shall not pay the Grantee for any work performed after such termination, except as described in Section 14.F. 14. If the Grantee materially fails to comply with the terms and conditions of this Agreement, including any Federal or State statutes, rules or regulations, applicable to this Agreement, the Commission may take one or more of the following actions, as appropriate for the circumstances. A. Temporarily withhold cash payments pending correction of the deficiency by the Grantee. Grant Agreement No. ARS010, Page 3 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 B. Disallow (that is deny both use of funds and any applicable matching credit for) all or part of the cost of the activity or action not in compliance. C. Wholly or partly suspend or terminate this Agreement. D. Withhold further awards for the project or program. E. Take other remedies that may be legally available. F. Costs of the Grantee resulting from obligations incurred by the Grantee during a suspension or after termination of the Agreement are not allowable unless the Commission expressly authorizes them in the notice of suspension or termination. G. The remedies identified above, do not preclude the Grantee from being subject to debarment and suspension under Presidential Executive Orders 12549 and 12689. 15. A. In accordance with Presidential Executive Order 12549, Debarment and Suspension (10 CFR Part 606, later moved to 2 CFR Part 901), the Grantee shall agree and certify that neither it, nor its principals, is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and, that the Grantee shall not knowingly enter into any lower tier contract, or other covered transaction, with a person who is similarly debarred or suspended from participating in this covered transaction, unless authorized in writing by USDOE to the Commission. B. Upon execution of this Agreement by the Grantee, the Grantee shall complete, sign and return a copy of Attachment G, Certification Regarding Debarments, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Federally Funded Transactions. C. As required by paragraphs A and B above, the Grantee shall include the language of this Section and Attachment G, Certification Regarding Debarments, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Federally Funded Transactions, in all subcontracts and sub -grants or lower tier agreements executed to support the Grantee's work under this Agreement. 16. The Grantee shall maintain books, records and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles. The Commission, the State of Florida, USDOE or their authorized representatives shall have access to such records for audit purposes during the term of this Agreement and for five years following Agreement completion. In the event any work is subcontracted, the Grantee shall similarly require each subcontractor to maintain and allow access to such records for audit purposes. 17. A. The Grantee shall retain and maintain all records referenced in Section 16 and make such records available for an audit as may be requested. Such records shall include independent auditor working papers, books, documents and other evidence, including but not limited to, vouchers, bills, invoices, requests for payment and other supporting documentation, which, according to generally accepted accounting principles, procedures and practices, sufficiently and properly reflect all program costs expended in the performance of this Agreement. B. The Grantee agrees to comply with the audit requirements of Section 215.97, Florida Statutes, and those found in Attachment D, Special Audit Requirements as applicable. C. The Grantee shall include the audit and record keeping requirements described above and in Attachment D, Special Audit Requirements, in all subcontracts and assignments with sub -grantees of funds according to Section 215.97, Florida Statutes. For purposes of this Agreement, "sub - recipient" shall be defined in accordance with Section 215.97(2)(x), Florida Statutes. Grant Agreement No. ARS010, Page 4 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 D. The Grantee must provide copies of any audit referencing this Agreement, the audit transmittal letter, and any response to such audit to the Commission within 30 calendar days of its receipt. The Grantee should confer with its chief financial officer, audit director or contact the Commission for assistance with questions pertaining to the applicability of these requirements. 18. A. The Grantee may subcontract work under this Agreement upon the condition that each Attachment C, Monthly Progress Report, contains a current list of subcontractors, the amount of each subcontract and a short description of work to be performed by that subcontractor. The Grantee shall be solely responsible for all work performed and all expenses incurred in connection with the development and implementation of the services, programs and activities under this Agreement whether directly performed or by subcontract. B. The Grantee shall not enter into subcontracts in which the Commission or USDOE could be held liable to a subcontractor for any expenses or liabilities. The Grantee shall defend and hold the Commission and USDOE harmless of any liabilities, as applicable by Florida laws, incurred under any of the subcontracts entered into by the Grantee. The Grantee shall be liable for all work performed and all expenses incurred as a result of any subcontract. C. The Grantee is encouraged to use small businesses, including minority, woman and service - disabled veteran -owned businesses as subcontractors or sub -vendors under this Agreement. The Grantee shall report to the Commission in each, Attachment C, Monthly Progress Report, its expenditures with minority, woman and service -disabled veteran -owned businesses. The directory of State of Florida certified minority, woman and service -disabled veteran -owned businesses can be accessed from the website of the Department of Management Services, Office of Supplier Diversity. The Attachment C, Monthly Progress Report, shall contain the names and addresses of the minority, woman and service -disabled veteran -owned businesses; the aggregate dollar figure disbursed that month for each business; the time period; type of goods or services and whether the business is minority, woman or service -disabled veteran -owned. If no expenditures were made to minority, woman and service -disabled veteran -owned businesses, the Grantee shall state "None" on that portion of the Attachment C, Monthly Progress Report. 19. The Grantee agrees to permanently refrain from using or mentioning its association with the Commission in advertisements, letterhead, business cards, etc. The Grantee's project with the Commission may be generally stated and described in the Grantee's professional resume. The Grantee may not give the impression in any event or manner, that the Commission endorses or recommends the Grantee. 20. A. The Grantee certifies that no Federal appropriated funds have been paid or will be paid, on or after December 22, 1989, by or on behalf of the Grantee, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress, in connection with the awarding, renewal, amending or modifying of any Federal contract, grant, or cooperative agreement. If any non -Federal funds are used for lobbying activities as described above, the Grantee shall submit Attachment I, Standard Form-LLL, Disclosure of Lobbying Activities, and shall file quarterly updates of any material changes. The Grantee shall require the language of this certification to be included in all subcontracts, and all subcontractors shall certify and disclose accordingly. [10 CFR Part 601 ] B. In accordance with Section 216.347, Florida Statutes, the Grantee is hereby prohibited from using funds provided by this Agreement for the purpose of lobbying the Legislature, the judicial branch or a State agency. C. Pursuant to the Lobbying Disclosure Act of 1995, any organization described in Section 501(c)4 of the Internal Revenue Code of 1986 shall not be eligible for subgrants under this Agreement, unless Grant Agreement No. ARS010, Page 5 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 such organization warrants that it does not, and will not, engage in lobbying activities prohibited by the Act as a special condition of the subgrant. This restriction does not apply to loans made pursuant to approved revolving loan programs or to contracts awarded using proper procurement procedures. 21. The Grantee shall comply with all applicable federal, state and local rules and regulations. The Grantee acknowledges that this requirement includes compliance with all applicable federal, state and local health and safety rules and regulations. The Grantee further agrees to include this provision in all subcontracts issued as a result of this Agreement. 22. The Grantee agrees to comply with, and include as appropriate in subcontracts, the applicable regulations listed in Attachment E, Federal Regulations, and the provisions contained in Attachment F, Federal Funding Grantee, Sub -grantee and Contractor Provisions. 23. The Commission's Grant Manager for this Agreement is identified below. Commission Grant Mana er: Mandy Norman Florida Energyand Climate Commission Executive Office of the Governor 600 South Calhoun Street, Suite 251 Tallahassee, FL 32399-0001 Telephone No.: 850-487-3800 Fax No.: 850-922-9701 E-mail Address: Mand .norman �Lm orida.com 24. The Grantee's Representative for this Agreement is identified below. Lisa Tenn son Monroe Coun Board of Coun Commissioners Grants Administrator 1100 Simonton Street Ke West, FL 33040-3110 Telephone No.: 305-2924444 Fax No.: 305-292-4515 E-mail Address: Tenn son -list cLmonroecoun -fl. ov Grantee D-U-N-S : 073876757 Grantee CCR Registration Expiration Date: 5/21/2011 25. To the extent required by law, the Grantee will be self -insured against, or will secure and maintain during the life of this Agreement, Workers' Compensation Insurance for all of its employees connected with the work of this project. The Grantee shall require the subcontractor similarly to provide Workers' Compensation Insurance for all of the latter's employees unless such employees are covered by the protection afforded by the Grantee. Such self-insurance program or insurance coverage shall comply fully with the Florida Workers' Compensation law. The Grantee shall provide, and cause each subcontractor to provide, adequate insurance satisfactory to the Commission, for the protection of its employees not otherwise protected if any class of employees engaged in hazardous work under this Agreement is not protected under Workers' Compensation statutes. Documentation of all insurance coverage(s) required below, shall be submitted by the Grantee to the Commission. Upon expiration of documented proof of insurance coverage, the Grantee shall submit proof of continued insurance coverage to the Commission within 30 calendar days of insurance coverage expiration. Grant Agreement No. ARS010, Page 6 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 26, The Grantee, as an independent contractor and not an agent, representative, or employee of the Commission, agrees to carry adequate liability and other appropriate forms of insurance. The Commission shall have no liability except as specifically provided in this Agreement. 27. The Grantee covenants that it presently has no interest and shall not acquire any interest which would conflict in any manner or degree with the performance of services required. 28. The Grantee is authorized to purchase five current model vehicles, for use in performing the services described in Attachment A, Grant Work Plan. The Grantee must obtain written approval, in advance, of the vehicle type proposed for purchase and shall produce at least two written quotes for comparable vehicles prior to the vehicle purchase being authorized by the Commission. Upon satisfactory completion of this Agreement, with Commission approval, the Grantee may retain ownership of the non-expendible personal property or equipment purchased under this Agreement. However, the Grantee shall complete and sign Attachment J, Property Reporting Form, and submit it to the Commission as an attachment to the Attachment B, Payment Request Summary Form, in which these costs are documented for reimbursement or match. The following terms shall apply: A. The Grantee shall have use of the non -expendable personal property or equipment for the authorized purposes of the contractual arrangement as long as the required work is being performed. B. The Grantee is responsible for the implementation of adequate maintenance procedures to keep the non -expendable personal property or equipment in good operating condition. C. The Grantee is responsible for the implementation of manufacturer required maintenance procedures to keep the vehicles in good operating condition. D. The Grantee shall secure and maintain comprehensive collision and general automobile liability coverage for the vehicles during the term of this Agreement. The Grantee is responsible for any applicable deductibles. E. The Grantee is responsible for any loss, damage, or theft of, and any loss, damage, or injury caused by the use of, non -expendable personal property or equipment purchased with state funds and held in his possession for use in a contractual arrangement with the Commission. F. The Grantee is responsible for the purchase of, and shall maintain a current State of Florida tag and registration for all vehicles purchased under the Agreement. 29. The employment of unauthorized aliens by any Grantee/vendor is considered a violation of Section 274A(e) of the Immigration and Nationality Act. If the Grantee/vendor knowingly employs unauthorized aliens, such violation shall be cause for unilateral cancellation of this Agreement. The Grantee shall be responsible for including this provision in all subcontracts with private organizations issued as a result of this Agreement. 30, A. No person on the grounds of race, creed, color, national origin, age, sex or disability shall be excluded from participation in, be denied the proceeds or benefits of, or be otherwise subjected to discrimination in performance of this Agreement. Grant Agreement No. ARSO10, Page 7 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 B. The Grantee agrees to comply with 10 CFR Part 1040 "Nondiscrimination in Federally Assisted Programs." C. The Grantee affirms that it is aware of the provisions of Section 287.134(2)(a), Florida Statutes, and that at no time has the Grantee been placed on the Discriminatory Vendor List. The Grantee further agrees that it shall not violate such law and acknowledges and agrees that placement on the list during the term of this Agreement may result in the termination of this Agreement. D. The Grantee affirms that it is aware of the provisions of Section 287.133(2)(a), Florida Statutes, and that at no time has the Grantee been convicted of a Public Entity Crone. The Grantee agrees that it shall not violate such law and further acknowledges and agrees that any conviction during the term of this Agreement may result in the termination of this Agreement. The Grantee shall insert a provision in accordance with this paragraph in all subcontracts for services in relation to this Agreement. 31. Land acquisition is not authorized under the terms of this Agreement. 32. A. If the Grantee brings to the performance of this Agreement pre-existing intellectual property, the Grantee shall retain all rights and entitlements to that pre-existing intellectual property. B. All patent rights, copyrights, and data rights must be in accordance with 10 CFR Part 600 as referenced in Attachment H, Intellectual Property Provisions. C. If, during the course of the Agreement, the Grantee modifies a pre-existing invention to the point where it is a new invention, patentable in its own right, or if any discovery or subject invention arises or is developed in the course of, or as a result of, work or services performed under this Agreement, or in any way connected herewith, the Grantee shall retain the entire right, title, and interest to each discovery or subject invention, subject to the provisions of this Section. With respect to any subject invention in which the Grantee retains title, the Commission shall have*a royalty -free, nonexclusive, transferable, irrevocable, paid up license to practice or have practiced for, or on behalf of, the Commission or the State of Florida the subject invention and sublicense the same. D. In the event that any books, manuals, films, software, databases, or other copyrightable material are produced, which are intended to be made available to the public, the Grantee shall notify the Commission. The Commission shall have a royalty -free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use the work, and to authorize others to do the same. The Grantee hereby grants the Commission full authority and right to modify or create derivative works of, or allow others to modify or create derivative works on behalf of the Commission, any publications first produced under this Agreement. Any content submitted to the Commission which is asserted to be exempt under Florida's Public Records Act, Chapter 119, Florida Statutes, shall be clearly marked "business proprietary", "exempt," "confidential," or "trade secret" (as applicable), with the statutory basis for such claim of exemption, confidentiality, or trade secret specifically identified in writing. Failure to identify any such content shall constitute a waiver of any claimed exemption, confidentiality, or trade secret. E. The terms and conditions specified in Section 32 shall also apply to any subcontracts made under this Agreement. The Grantee shall be responsible for informing the subcontractor of the provisions of this Section and obtaining disclosures. 33. The Grantee is encouraged to publish or otherwise make publicly available the results of the work conducted under this Agreement. USDOE requires an acknowledgement of Federal support. A disclaimer Grant Agreement No. ARSO10, Page 8 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 must appear in the publication of any material, copyrighted or not, which was based on or developed under this Agreement, as follows: Acknowledgement: "This material is based upon work supported by the U.S. Department of Energy and the Florida Energy and Climate Commission under Award Number DE-EE000024 L" Disclaimer: "This report was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor any agency thereof, nor any of their employees, nor any of their contractors, subcontractors or their employees, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or any third parry's use or the results of such use of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof or its contractors or subcontractors. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof." 34. The Grantee is permitted to develop software or databases under the terms and conditions of this Agreement, including Section 32. 35. The Parties agree they will seek to resolve any disputes between them regarding their responsibilities as soon as possible and at the lowest level reasonable, in order to conserve the resources of the Parties. The Parties further agree to use their best efforts to assure speedy and non -confrontational resolution of any and all disputes between them. 36. This Agreement is executed and entered into in the State of Florida and shall be construed, performed and enforced in all respects in accordance with the laws and rules of the State of Florida. Any litigation arising under this Agreement shall be brought in the appropriate court in Leon, County, Florida, applying Florida Law. 37. This Agreement represents the entire agreement of the parties. Any alterations, variations, changes, modifications or waivers of provisions of this Agreement shall only be valid when they have been reduced to writing, duly signed by each of the parties and attached to the original of this Agreement, unless otherwise provided herein. 38. The following Attachments are incorporated into this Agreement: Attachment Attachment Attachment Attachment Attachment Attachment Attachment Attachment Attachment Attachment Attachment A Grant Work Plan B Payment Request Summary Form C Monthly Progress Report D Special Audit Requirements E Federal Regulations F Federal Funding Grantee, Sub -grantee and Contractor Provisions G Debarment and Suspension Form H Intellectual Property Provisions I Disclosure of Lobbying Activities J Property Reporting Form K Annual Report Grant Agreement No. ARS010, Page 9 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 IN WITNESS WHEREOF, the parties have caused this Agreement to be duly executed, the day and year last written below. MONROE OF COUK Date:— OCT 2 0 2010 AT, 4 T V� 11--- , Zo- STATE OF FLORIDA, EXECUTIVE OFFICE OF THE GOVERNOR, Florida Ener and Climate Commission By: a,'� /a Alexander , Alexander ack Program Administrator Date: / I / �� �;/o Grant Agreement No. ARS010, Page 10 of 65 ATTACHMENT A GRANT WORK PLAN FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS A. PROJECT TITLE: Keys Energy Conservation Initiative B. PROJECT LOCATION: Monroe County, Florida C. PROJECT BACKGROUND: Monroe County will implement a comprehensive energy savings project, in partnership with the City of Key West, City of Marathon and Islamorada, Village of Islands, which will include several cross -jurisdictional and individual community energy savings activities. The Grantee has identified eight projects to execute a wide assortment of energy savings activities which will benefit 96% of the Keys population. The activities include installation of solar water heaters, energy efficiency outreach and education, retrofitting sports lighting, retrofitting outdoor lighting, development of an Energy Efficiency and Conservation Strategy (EECS), energy audits, purchase of hybrid vehicles and replacement of street lighting poles. Affordable Residential Solar Water Heaters The Grantee, in partnership with Habitat for Humanity (1-14H), will install or replace conventional hot water heaters with solar hot water heaters in low to moderate income households. The Grantee will also issue rebates for solar water heaters. This component of the conservation initiative will be coordinated with NexGENergy and Monroe County's Weatherization program. Energy Efficiency Educational Video Communication and Outreach The Grantee will facilitate the production of a 15-minute video and radio segment for National Public Radio (NPR) to highlight the Keys Energy Conservation Initiative 2010. The educational and outreach materials will be available on local government websites and television channels. The materials will be disseminated by CD, DVD and email. Additionally, the Grantee will hold 12 educational workshops for commercial and residential energy efficiency measures. Outreach components of this project will increase the number of Green Living and Education (GLEE) Certified Green Business Partnerships by 100%. Retrofit Local Park Ball Field Lighting The Grantee will retrofit lighting in six public parks with new energy efficient light fixtures. The parks include the Clayton Sterling Sports Complex, Dewitt Roberts Softball Field, Rosa Hernandez Softball Field, George Mira Football Field, Nelson English Park and Pepe Hernandez Park. These parks are located in the City of Key West. Greenhouse Gas Emissions Inventory, Energy Audits and Outdoor Lighting Retrofit Phase 1: Greenhouse Gas (GHG) Emissions Inventory — The Grantee will select a consultant to conduct a greenhouse gas emissions inventory for the City of Marathon. A final report will document the results and recommended strategies for implementation. Phase 2: Energy Audits — The Grantee will hire a consultant to conduct community residential and commercial energy audits and an energy audit for City facilities in the City of Marathon. The results of the studies will be made available to residents and the business community. Phase 3: Outdoor Lighting Retrofit — The Grantee will conduct an outdoor lighting retrofit for Sombrero Beach Road street lights and Marathon Community park lights. The contractor will retrofit 250 outdoor lights. Grant Agreement No. ARSO 10, Page 11 of 65 ATTACHMENT A GRANT WORK PLAN EECS Development The Grantee will utilize technical assistance consulting services to assist a team of interdepartmental county staff members with the formulation of an energy efficiency, energy conservation and energy usage strategy. The strategy will identify the means to achieve goals, metrics for measuring progress, timelines for implementation, financing mechanisms and staff assignments. The SECS will ensure sustained benefits of the grant funds beyond the grant period. County Facilities Energy Audit and Retrofit The Grantee will implement energy efficiency measures, based upon audit findings, at four Monroe County facilities, located in Key West, with a total square footage of 197,823 and an annual energy cost of $534,019. An energy audit will allow the Grantee to develop base -line energy use and an in-depth report of quantifiable energy conservation recommendations to determine the most cost effective improvements and to ensure the best possible use of the retrofit funds. The building retrofits will emphasize efficiency and may include retrofit lighting, insulation, heating, ventilation and air-conditioning (HVAC) upgrades, training programs for operation and facility users and monitoring systems. Hybrid Vehicle Purchase The Grantee will reduce GHG emissions by upgrading the County fleet with five hybrid electric vehicles which represents 10% of the administrative fleet. The vehicles will replace five conventional gas -powered vehicles. Replacement of Street Lighting Poles The Grantee will replace interior street lighting, dog park lighting and security lighting in Founders Park and the Administrative & Public Safety Headquarters parking lot located within the park. This work will consist of stripping 90 existing poles, removing current heads, inspecting each post for damage, repairing damage, preparing poles for new solar heads to be installed, adjusting and strengthening mounts, adding mounting brackets and installation of solar heads. In addition, 10 new light poles will be installed at Plantation Hammock Preserve, Plantation Tropical Reserve, Hurricane Monument and Library Parks. The parks to receive retrofits through this component of the project are located in Islamorada, Village of Islands. D. PROJECT OBJECTIVES: • Objective 1: To reduce power consumption within the county by procuring and installing residential solar water heaters in a minimum of 20 low or moderate income households. • Objective 2: To create an educational workshop for commercial and residential energy efficiency measures and a 15-minute video and radio segment to highlight the Keys Energy Conservation Initiative 2010. • Objective 3: To reduce power consumption within the county by procuring and installing energy efficient outdoor sports lighting in six public parks. • Objective 4: To reduce power consumption within the county by conducting a greenhouse gas emissions inventory, energy audits and 250 outdoor lighting retrofits for the City of Marathon. • Objective 5: To reduce fossil fuel emissions in transportation, building, and other applicable public and private sectors by developing and implementing an Energy Efficiency and Conservation Strategy. • Objective 6: To reduce power consumption within the county by implementing energy efficiency measures as recommended by an energy audit of four county facilities. • Objective 7: To reduce GHG and energy consumption within the county by upgrading the county vehicle fleet with hybrid electric vehicles. • Objective 8: To reduce the annual power consumption within the county by procuring and installing 100 solar powered light emitting diode (LED) street lighting poles. Grant Agreement No. ARS010, Page 12 of 65 ATTACHMENT A GRANT WORK PLAN E. PROJECT DESCRIPTION: The Grantee has identified eight project(s) that will greatly reduce power consumption therefore reducing utility charges and equipment maintenance fees. The following tasks will be performed in order to meet the project objectives outlined above. Task 1 - Affordable Residential Solar Water Heaters (Objective 1): • Task 1a: Select a vendor following the procurement procedures outlined in 10 CFR 600, for solar water heater purchase and installation • Task lb: Coordinate with 1-141-1 to establish an eligible homeowner application • Task lc: Select a vendor, negotiate and execute contract • Task lc: Oversee installation of solar water heaters in 20 qualified affordable homes • Task 1d: Coordinate with Keys Energy to provide solar water heater rebates of $450 each • Task le: Submit a report to the Commission including photographs of the installed solar water heaters, utility bills documenting energy reduction, a list of applicants and invoices from both the manufacturer and the installer Task 2 - Energy Efficiency Educational Video Communication and Outreach (Objective 2): • Task 2a: Execute contract with Environmental Education Foundation • Task 2b: Develop video content • Task 2c: Produce video, upload to county website and provide to local governments for distribution • Task 2d: Produce radio segment for Radio Green Earth show on NPR • Task 2e: Coordinate educational outreach technical assistance workshops for businesses and residents • Task 2f: Increase the number of GLEE Certified Green Business partnerships by 100% • Task 2g: Submit a copy of all educational materials and video to the Commission documenting the energy efficiency conservation impacts of the project Task 3 - Retrofit Local Park Ball Field Lighting (Objective 3): • Task 3a: Select a vendor following the procurement procedures outlined in 10 CFR 600, to install ballpark lighting • Task 3b: Oversee installation of ballpark lights in six public parks • Task 3c: Submit a report to the Commission including photographs of the installed lighting, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer Task 4 - Greenhouse Gas Emissions Inventory, Energy Audits and Outdoor Lighting Retrofit (Objective 4): • Task 4a Select a vendor following the procurement procedures outlined in 10 CFR 600, 1) a greenhouse gas emissions inventory, 2) a community energy audit and 3) city energy audits • Task 4b: Select a vendor following the procurement procedures outlined in 10 CFR 600, to install outdoor lighting • Task 4c: Define scope of work to identify audit needs • Task 4d: Conduct site inspections • Task 4e: Complete data gathering and analysis for completion of 600 audits • Task 4f. Oversee installation of 250 outdoor lights • Task 4g: An audit report will be created to establish baseline emissions inventory for a base year and for a forecast year to identify emissions reduction targets for the forecast year and identify recommended actions, policies and measures • Task 4h: Submit the final audit report to the Commission and photographs of the installed lighting, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer Task 5 - EECS Development (Objective 5): • Task 5a: The Grantee will develop a scope of work for the EECS • Task 5b: Select a vendor following the procurement procedures outlined in 10 CFR 600, for a technical assistance consultant to assist with plan development and data • Task 5c: Develop EECS for county facilities and operations including energy efficiency, energy conservation and energy usage goals • Task 5d: Provide the Commission with an electronic copy of the EECS. Grant Agreement No. ARSO10, Page 13 of 65 ATTACHMENT A GRANT WORK PLAN Task 6 — County Facilities Energy Audit and Retrofit (Objective 6): • Task 6a: Select a vendor following the procurement procedures outlined in 10 CFR 600, for an engineering firm to conduct Grade Energy Audits for four county facilities located in Key West • Task 6b: Create a scope of work and construction bid documents based on energy audit findings • Task 6c: Implementation and installation of energy efficiency measures as approved by the Commission and recommended in the audit report • Task 6d: Submit a report to the Commission including the audit report, photographs of the installed systems, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer Task 7 - Hybrid Vehicle Purchase (Objective 7): • Task 7a: Prepare purchase order for five hybrid vehicles following the procurement procedures outlined in 10 CFR 600. • Task 7b: Finalize purchase of vehicles • Task 7c: Paint and decal vehicles to increase awareness of alternative fuel vehicles • Task 7d: Conduct a training workshop for drivers and maintenance staff • Task 7e: Submit a report to the Commission including photographs of the hybrid vehicles, records of savings and invoices Task 8 - Replacement of Street Lighting Poles (Objective 8): • Task 8a: Identify and designate locations for new light poles • Task 8b: Select a vendor following the procurement procedures outlined in 10 CFR 600, for electricians to retrofit 90 existing poles • Task 8c: Obtain quotes or advertise for the purchase of 100 solar powered light fixtures • Task 8d: Identify existing underground utilities and mark sites for new poles • Task 8e: Award contract and purchase order for 100 fixtures • Task 8f. Installation of new light poles • Task 8g: Submit a report to the Commission including photographs of the installed street lighting poles, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer F. PROJECT MILESTONES/DELIVERABLES/OUTPUTS: The tables below identify the month of the project each task will start and be accomplished for all eight components of the Keys Energy Conservation Initiative. 1. Affordable Residential Solar Water Heaters No. Task/Activity Description Deliverables/ Outputs Start Month Deadline 1 Select a vendor following the Submit RFP to Commission Month Procurement procedures outlined in 10 CFR 600, for solar water 1 2 heater purchase and installation 2 Develop application for eligible Submit application to Commission homeowners 2 2 3 Oversee installation of solar water Contract executed for installation heaters in 20 homes and materials purchased. Copies of 3 16 invoices sent to the Commission 4 Coordinate with the Provide homeowners with Weatherization program to assist recommendations homeowners with additional 5 16 retrofits Coordinate rebates with Keys Use rebates to increase # solar 5 Ener y Final Report heaters to be installed Submit a report including 10 16 6 photographs of the installed water 18 18 heaters, utility bills and invoices Grant Agreement No. ARS010, Page 14 of 65 ATTACHMENT A GRANT WORK PLAN Grant Agreement No. ARS010, Page 15 of 65 ATTACHMENT A GRANT WORK PLAN 2. Energv Efficiency Educational Video Communication and nntraaph No. Task/Activity Description Deliverables/ Outputs Start Month Deadline Month 1 Execute contract with Contract approved an signed by Environmental Education Board of County Commissioners 2 3 Foundation 2 Develop content and produce Submit outline of content to energy educational video Commission and place on County 3 9 website 3 Produce radio segment Radio segment broadcasted on NPR 10 12 4 Coordinate 12 technical Training workshops and public assistance workshops for business educations sessions complete, a list and residents of attendees and evaluations forms 10 16 provided to the Commission 5 Final Report Submit a report including educational materials created with 18 18 funds 3. Retrofit Local Park Ball Field Lighting No. Task/Activity Description Deliverables/ Outputs Start Month Deadline 1 Solicit RFP for ballpark lighting Contractor selected for installation Month of lighting 1 6 2 Oversee installation of ballpark Lighting installed in six public li hts arks 6 11 3 Final Report Submit a report including photographs of the light retrofit, 11 13 utilit bills and invoices 4. Greenhouse Gas Emissions Inventory_ FnProv endue ..d n...a.,... r :,....:... n_.__�. No. Task/Activity Description Deliverables/ Outputs Start Month Deadline 1 Select a vendor following the Submit RFP to Commission Month procurement procedures outlined in 10 CFR 600, 1) a greenhouse gas emissions inventory, 2) a 1 4 community energy audit and 3) ci energy audits 2 Select a vendor following the Submit RFP to Commission procurement procedures outlined in 10 CFR 600, for outdoor 2 4 lighting installation 3 Sign contract with consultants Consultants selected to conduct GHG inventory, community energy 4 5 audit and city energy audit 4 Define scope of work and identify Submit scope of work to audit needs Commission 5 8 5 Site inspections, measurements Consultant will draft final report for and data analysis City approval 8 14 6 Oversee installation of outdoor 250 outdoor lights installed li tin 10 14 7 Final Report Final audit reports submitted to Commission 15 16 Grant Agreement No. ARSO 10, Page 16 of 65 ATTACHMENT A GRANT WORK PLAN 5. EECS Develonment No. Task/Activity Description Deliverables/ Outputs Start Month Deadline I Develop scope of work for EECS Scope of work complete 1 Month 3 2 Select a vendor following the Consultant assisted with plan procurement procedures outlined development and data gathering in 10 CFR 600, for a technical 3 6 assistance consultant to assist with plan development and data 3 Develop EECS for county EECS adopted by Board of County facilities and operations including Commissioners energy efficiency, energy 6 13 conservation and energy usage oats 4 Final Report Final EECS submitted to Commission �14��l 6. County Facilities F,nersry Audit anti Ratrnf.t No. Task/Activity Description Deliverables/ Outputs Start Month Deadline 1 Select a vendor following the Agreement signed and approve by Month procurement procedures outlined Board of County Commissioners in 10 CFR 600, for an engineering firm to conduct Grade Energy 1 2 Audits for four county facilities located in Key West 2 Conduct energy audit Detailed investment grade audit submitted to County2 2 3 Define scope of work for retrofits Submit scope of work to as recommended in energy audit Commission 3 6 4 Execute contract for facility Board of County Commissioners retrofits approval and execution 6 9 5 Complete installation of energy Installation documentation efficiency retrofits complete 9 18 6 Complete measurement and Energy saving calculations verification documented 17 18 7 Final Report Submit a final report to include evidence of energy savings as a 18 18 result of the ener audit 7. Hvbrid Vehicle Purchase No. Task/Activity Description Deliverables/ Outputs Start Month Deadline 1 Prepare purchase order for five Vehicles ordered Month hybrid vehicles following the procurement procedures outlined 1 2 in 10 CFR 600. 2 Finalize purchase of vehicles and Vehicles arrive arrival 2 6 3 Paint and decal vehicles Vehicles painted and decaled to increase awareness of alternative 6 7 fuel vehicles 4 Conduct a training workshop for Workshops and training completed drivers and maintenance staff 8 11 FTJ7��� Submit a report to the Commission including of the hybrid 12 12 Grant Agreement No. ARSO 10, Page 17 of 65 ATTACHMENT A GRANT WORK PLAN vehicles, records of savings and invoices Grant Agreement No. ARSO10, Page 18 of 65 ATTACHMENT A GRANT WORK PLAN 8. ReDlacement of Street Liuhtinn PnIPQ No. Task/Activity Description Deliverables/ Outputs Start Month Deadline 1 Select a vendor following the Electrician selected Month procurement procedures outlined in 10 CFR 600, for electricians to 1 3 retrofit 90 existing poles 2 Obtain quotes for the purchase of Solar light fixtures purchased solar powered li t fixtures 3 4 3 Identify existing underground Sites prepared for installation utilities and mark sites for new 3 8 poles 4 Installation of new light poles Light poles installed 4 g 5 Final Report Submit a report to the Commission including photographs of the installed street lighting poles, utility 9 9 bills and invoices Grant Agreement No. ARS010, Page 19 of 65 ATTACHMENT A GRANT WORK PLAN G. PROJECT BUDGET: The budget below summarizes the project by Funding Category. All dollar amounts are rounded to the nearest whole dollar value. Cost Share: Matching Funds and Funding Category Grant Funds Other In -Kind Contributions Funding Source of Funds L Salaries $109,614.00 $270,831.52 Monroe County, Habitat for Humanity, OF/GITF, City of Key West GR, City of Marathon GR, UF, Islamorada GR 2. Fringe Benefits $32,884.00 Monroe County, UF, City of Key West GR, $76,096.27 Islamorada GR 3. Travel (if authorized) $0.00 $7,549.00 Monroe County 4. Supplies/Other $8,125.00 Monroe County, Habitat for Humanity, Green Expenses $83,663.00 Living and Energy Education Inc, City of Key West GR, Islamorada GR 5. Equipment $ 111,875.00 $0.00 Keys Energy Services, Federal Tax Credit 6. Contractual Services $2,424,790.00 Monroe County, NexGENergy, Environmental $164,757.00 Education Foundation, KEYS Energy, City of Marathon GR, Cameron -Cole LLC 7. Indirect (if authorized) $0.00 $0.00 N/A Total Project Budget $2,687,288.00 $602 896.79 Total Project Cost $3290 184.79 = Grants Funds + Cost Share Cost Share Percents a 18.3% = Cost Share / Total Project Cost H. TOTAL BUDGET BY TASK: The project budget below summarizes the project by Project Task. Project Tasks correspond to the "Project Description" section. All dollar amounts are rounded to the nearest whole doll 1 ar va ue. Cost Share: Matching Funds and Project Task Grant Funds Other In -Kind Contributions Matching Funds Source 1 Complete Residential Solar $130,000.00 $47,281.00 Monroe County, Habitat for Humanity Water Heater 2 Complete Energy $30,000.00 $105,661.00 OF/GITF, Monroe County, Green Living Education and Outreach and Energy Education, Inc, Environmental Education Foundation 3 Complete Bail Park Light $744,790.00 $113,985.42 City of Key West, KEY Energy Retrofit 4 Complete GHG Inventory, $400,000.00 $110,972.89 City of Marathon Audit and Lighting 5 Com lete EECS $20,000.00 $96,364.48 UF, Monroe County, Cameron -Cole LLC 6 Complete County Facilities $700,000.00 $69,400.03 Monroe County Audit and Retrofit 7 Complete Purchase of $120,000.00 $4,78100 Monroe County H bn Vehicles 8 Complete Solar Park $400,000.00 $48,243.00 Islamorada Li htin 9 on Project Admin $142,498.00 $7,591.00 Monroe County and Re o— - Totals: $2.687,288.00 $602,896.79 Total Project Cost: $3,290,784.79 = Grant Funds + Cost Share Grant Agreement No. ARSO 10, Page 20 of 65 ATTACHMENT A GRANT WORK PLAN I. BUDGET DETAIL: Using the definitions provided below, the detailed, line -item budget clarifies the Budget Summary shown in Section G. Budget Category Sub -Totals have been rounded to the nearest whole dollar value. Up to 10% of grant funds may be used for administrative costs, excluding the cost of meeting reporting requirements of the program. Administrative costs are defined as: allowable, reasonable, and allocable Direct and Indirect costs related to overall management of the awarded grant (including travel). For each budget line -item, the appropriate column identifies if the cost is: 1) Grant or Match, 2) a Direct cost used to calculate Indirect Costs (if approved) and 3) whether the cost is Administrative in nature. A description of what is required for each budget category is as follows: 1. Salaries -Identify the persons to be compensated for work on this project by name (if known), position, and title. Show the hourly cost and total hours to be charged for each person or position. Divide annual salaries by 2080 hours and nine month academic salaries by 1560 hours, to find the hourly rate. 2. Fringe Benehts - Multiply the rate by the total salaries to which fringe benefits apply. If the rate is variable, explain and show calculations. 3. Travel - List trips by their purpose and/or destination. Indicate the number of days for each trip. The Commission will only reimburse for travel at the appropriate State of Florida rate (Section 112.061, Florida Statutes), using the forms referenced in Attachment B, Payment Request Summary Form. Be prepared to provide the Commission with details on costs utilized to calculate the "Amount Budgeted" for each trip. 4. Supplies & Other Expenses - List expendable supplies by category description, unit costs and quantity. List other expenses not included in any of the above categories. Examples would be printing, copying, postage, communications, etc. Non -expendable equipment valued at less than $1,000 may be listed also. Include only expenses directly related to the project, not expenses of a general nature. For Match only, list costs related to donated real property such as land (not to exceed the fair market value of the property). 5. Equipment - List non -expendable personal property/equipment valued at $1,000 or more by description, unit cost, and quantity. Computers and data-processing equipment should be described in detail. 6. Contractual Services - Subcontractors should provide the same information required by this budget table, with the following exceptions: (a) when professional services are provided at a pre-existing approved rate or fee shown on the budget; or (b) the subcontract is to be obtained competitively. For either (a) or (b), show an estimated maximum amount. 7. Indirect Costs/Rate — Indirect Costs are not authorized. 8. 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UQUWU Fes-v� C� Qfs!A o 00 F- C7 i y o . � � '.nn '.fin J�Jj� G r�� �r U � V�� �1 �1 / /-� �/•1� �uW- ¢u uw mac° UcDrr--L— w U It I - I - Cl) O 69 ~ w 000^ y y r- 00 O G's 69 69 r los 601) U ds ro 0 u a d � L rh .0 V/ L r 4"i O � E'" U 69 69tn O O O O O O O II Cy II II o ono oro N O� fV oo .� r O M 69 - N 00 69 p N N V E" U > s9 ds y a W �t o � 3 � II II II II Ih II II it o U O CD <71 oc U. 000 00 h r U. hpo cep rn GO-) a � ° � U O ,, o 14 +yr q � � v 00 N cC 40 a e s^ � .v, �+ O � •p Q z cd C, ee i; •L D api 4. Q a � W Q v a 9 c C7 CIS Grantee: :Mailing Address: Grant Agreement No.: Date Of Request: Amount Requested:$. FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT B PAYMENT REQUEST SUMMARY FORM STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS Grantee's Representative: Reimbursement Request No.: Reimbursement Period: to Percent Matching Required: PROJECT EXPENDITURES SUMMARY SECTION CATEGORY OF EXPENDITURE AMOUNT OF THIS REQUEST TOTAL CUMULATIVE PAYMENTS MATCHING FUNDS TOTAL CUMULATIVE MATCHING FUNDS 1. Salaries $ $ $ $ 2. Fringe Benefits $ $ $ $ 3. Travel if authorized $ $ $ $ 4. Supplies/Other Expenses $ $ $ $ 5. Equipment $ $ $ $ 6. Contractual Services $ $ $ $ 7. Indirect Costs jif authorized TOTAL AMOUNT EXPENDED Less Retainage* 10% of TOTAL AMOUNT EXPENDED $ $ $ $ $ $ $ $ $ $ $ $ $ $ TOTAL AMOUNT TO BE REIMBURSED $ AGREEMENT AMOUNT $ Less TOTAL AMOUNT EXPENDED: $ TOTAL AVAILABLE BALANCE $ e cumulative Retainage amounts all be reimbursed on the Final Reimbursement Request, upon approval of the Final Report by the Commission's Grant Manager. GRANTEE CERTIFICATION The undersigned certifies that the amount being requested for reimbursement above is ror items that were cnarged to and utilized Grantee's Representative's Signature Print Name Telephone Number for the above cited grant activities. Grantee's Fiscal Agent Print Name Telephone Number Grant Agreement No. ARSO10, Page 29 of 65 u iI Q U} Q U} U} U} a Q .fin. C Z ,, C Z Mc Z N C Z 0 C'.O C'. O C.. m (Q C. m 2 o U a) ma) m o p p p p O p II it it ❑ L p L CLj C m� I I CLj C 11 II 75 m� m g m C� o U a m > � 0 a) � ds � E U E v ` a cn 0 Q o ao M o v a ID 6 in 3 C U (D a �� �t � m a yk N o a 'a a) m (C C: o "CL a) Co m C� t m oil U m m U �o m a mY m `� o o' ci °� a m o 0 U m �+ (D r� 64 N a) C O Q. _ o m 0 m a a o z. CL 0 a) -6 m w- p 0 o0'oz� a m C� qa� m o a c m 0 F 0 e3 Q fry W 64 V N m v- O @ 0 O y C m 0o ff c C CL O Q fn C i 0O c CL O EH x " W fft C L v 3 vi O a� O > ~ x to z E ai W I- O U - c. a) LU o m o a C. 3 O >r p CL a a) y rn a W �y+� o W rs > 3 O m m o m o -o w z > E °1 td �j 1- z N z FO- N �U} -0 o} w. o Q QU �m C m 0 N U 0 `°UZ -- U 0 cuUZ U O E Q Fu 7 ci C 0 � o� �aa O - c C C o 'C 69 n u u n E �3 ° .o C j t0 a' a► >, C' w C to O d .� m N 3 c -Z c o -a oZ o c c a Q �w iDa� E U LL 0 c J O v� omc aUa> LO •c 0 fl 2m'W CO O O4Oy` oZ0 OZ 10 O ma m o U)— m o w. e a W c a) Ca 0 3 j v o v o c v E o m D o ,ado 5 �a L n Y y3 6 ca coC a) Y ` o n o c Q U Q 64 Q 69 69 r > > c x aa) > p a Q C d o _ ,V ar:° �a U m = O G a)o cn U) ._ V fn >3 G7 4- �, 0 -o R ; w� o c o m c V 4g 3 cr 0 O E° G O O E W a 'ci Z n: G cc°i G C y O E Z C O Z C O Z C .«. y Z 0� a O ct1 O Cl. 0)U V O in .. V O U y V O U y 0 U V L U L L L Cq II II 0 II 0 11 U `L°2� L2� �2 m22 O O O O c m C O E b9 V E -yp U o` •U O Q o ` I_ O al O O a7 od Q w �C y O C O p M O a.o m c U M ►- � m U a' y it y O a -0 a> m g 45 0 cCD y °' Z a) L m p c m�d U m t 69 M U mm in +� a a) �* od m o U pmp 69 � rfl 69 a) m O c LCL CIL7 !Q �, w op a as o �' m 2 Q 2 tL L Q o m c .� to ca O' Q U9 y ag Y C O c O O U (n C75 cu O Ccu c C y: y ZZ L m Q cn p c m o � > CL x ►� w .G fA m = y O 75 > U 3 O a� 0 1`- x L s m Z W L o a)W o —CL @ a aCL o C 0 c L y rp C a) w > 0 ro w m o o To Z > o E o O Z z N tr> � � oZ .s -,-�Z a QU} QU} 04'r V H L O L V cn o °i0U in o o ioU Q ym o o Z U Z �jCo =EE 0 5 U V V c "M c o v g c o cL� E 0 -c " Ucx to c � O E c E �3-0 >, c cn C, $ .. c O -a o o cn m r oo�y�Z � 0)MCL5z o CD o a ¢ !Dn.m mQ' g ,c c y Z c O D c ma3� p_ p coo o *r m cEio E Q' F--' c a o •= � (2) CL m eta) o c� �U � mcr y o Z� m C Q y o J 0 a pm U Cn E•.' O a U Q 4� L mY mY W w cl OZ c 03 O L.� E" O C L (D 0V0 (COL VD 1p a1 W Z W -: C U L) 3 v V (D L) 0) Z m d a m � .. o c O o o Qm U Q 69 Q 69 064 N CL m° c C w m° > 50 oaoim CL Q c .. m O c v ;d N O ra O O O a W cA .6 n 0 Cl >� 3 m O E o C O m° EU W co FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 INSTRUCTIONS FOR COMPLETING PAYMENT REQUEST SUMMARY FORM GRANTEE: Enter the name of the Grantee's agency, as reflected on your Grant Agreement, MAILING ADDRESS: Enter the reimbursement mailing address. GRANT AGREEMENT NO.: This is the six -digit number on your Grant Agreement. DATE OF REQUEST: This is the date the Grantee is submitting the request for reimbursement. AMOUNT REQUESTED: This is the amount on the "TOTAL AMOUNT TO BE REIMBURSED" line for the "AMOUNT OF THIS REQUEST' column. GRANTEE'S REPRESENTATIVE: This is the person identified as Grantee's Representative in the Grant Agreement. REIMBURSEMENT REQUEST NO.: This is the number of the reimbursement request, not the month number. The first reimbursement request submitted shall be number 1 and subsequent reimbursement requests shall be numbered in ascending numerical order. REIMBURSEMENT PERIOD: This is the beginning date (dd/mrn/yyyy) and ending date (dd/mmtyyyy) of the reimbursement period. PERCENT MATCHING REQUIRED: Enter the Match requirement here, as reflected on the approved Attachment A, Grant Work Plan. PROJECT EXPENDITURES SUMMARY SECTION "AMOUNT OF THIS REQUEST" COLUMN: Enter the amount paid during the reimbursement period. Provide accurate costs and do not round figures to the nearest whole dollar value. All costs included in the reimbursement request must agree with the approved Project Budget in the current Attachment A, Grant Work Plan of your Grant Agreement. Do not request reimbursement for costs that do not have an associated, approved, funded budget category or approved, funded budget line - item in the current Project Budget. Do not claim items that are not specifically identified in the current Budget Detail as reflected in Section I of the current Attachment A, Grant Work Plan. • Enter the column total on the "TOTAL A -MOUNT EXPENDED" line. The figures reflected for each approved budget category must correspond with the budget category amount reflected on the associated Grant Reimbursement Detail Form. • For the "Less Retainage" line, calculate 10% of the "TOTAL AMOUNT EXPENDED" for this reimbursement request; this figure must be shown in brackets (e.g. <$X,XXX.XX>) to reflect that the amount will be deducted from the "TOTAL AMOUNT EXPENDED ". • For the "TOTAL AMOUNT TO BE REIMBURSED" line, deduct the "Less Retainage" amount from the "TOTAL AMOUNT EXPENDED ". • For the "AGREEMENT AMOUNT', enter the total amount of the Grant Agreement. For the "Less TOTAL AMOUNT EXPENDED" line, enter the total amount expended as reflected on this reimbursement request and all previous reimbursement requests. • For the "TOTAL AVAILABLE BALANCE" line, deduct the "Less TOTAL AMOUNT EXPENDED" amount from the "AGREEMENT AMOUNT". • For only the Final Reimbursement Request, the Grantee may request reimbursement of all previously deducted Retainage on the condition that the Final Report for the project has been submitted and approved by the Commission's Grant Manager. To request reimbursement of Retainage, reflect the cumulative amount of Retainage as a positive figure (no brackets) in the "Less Retainage" line and add it to the "TOTAL AMOUNT EXPENDED" to reflect the final "TOTAL AMOUNT TO BE REIMBURSED" amount. "TOTAL CUMULATIVE PAYMENTS" COLUMN: Enter the cumulative amounts previously submitted for reimbursement to date for each approved, funded budget category. Provide accurate costs and do not round figures to the nearest whole dollar value. • On the "Less Retainage" line, enter the total cumulative amount of Retainage deducted from all reimbursement requests. • On the "TOTAL AMOUNT TO BE REIMBURSED" line, deduct the cumulative "Less Retainage" amount from the cumulative "TOTAL AMOUNT EXPENDED". • The Final Reimbursement Request must show the total of all reimbursements; first through the final reimbursement (this amount cannot exceed the approved, funded budget amount for each budget category). Enter the column total on the "TOTALS" line. Grant Agreement No. ARS010, Page 34 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 "MATCHING FUNDS" COLUMN: Enter the amount documented as Match for the reimbursement period. Provide accurate costs and do not round figures to the nearest whole dollar value. This needs to be shown under specific budget categories according to the currently approved Attachment A, Grant Work Plan. • Enter the total for all budget categories on the "TOTAL AMOUNT EXPENDED" line for this column. • Enter the total Match budget amount on the "AGREEMENT AMOUNT' line for this column. This amount must correspond with the minimum Match amount specified in Section 4.A of the Grant Agreement and as reflected on the currently approved Attachment A, Grant Work Plan. • Enter the total cumulative amount of this and any previous Match documented on the "LESS TOTAL AMOUrVT EATENDED" line for this column. • Deduct the "LESS TOTAL AMOUNT EXPENDED" from the "AGREEMENT AMOUNT' for the amount to enter on the "TOTAL AVAILABLE BALANCE' line. "TOTAL CUMULATIVE MATCHING FUNDS" COLUMN: Enter the cumulative amount documented to date for Match by budget category. Enter the total of all budget categories on the line titled "TOTALAMOUNT EXPENDED." The Final Reimbursement Request must reflect the total of all documented Match, beginning with the first Match documentation through the final Match documentation, etc. The proportion of cumulative Matching funds as of the final Match documentation must equate to the Cost Share Percentage as reflected on the current, approved Attachment A, Grant Work Plan of the Grant Agreement. If insufficient "TOTAL CUMULATIVE MATCHING FUNDS" are submitted, the Final Reimbursement Request of grant funds shall be reduced to ensure that the Cost Share Percentage GRANTEE CERTIFICATION: The Payment Request Summary Form must be signed by both the Grantee's Representative as identified in the Grant Agreement and the Grantee's Fiscal Agent to be approved for reimbursement. NOTE: If requesting reimbursement for travel, you must include copies of all travel receipts and a copy of the Commission's properly completed travel reimbursement form (in the format approved by the Department of Financial Services, Chief Financial Officer) that has been signed by both the traveler and the traveler's supervisor. Grant Agreement No. ARSO10, Page 35 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 INSTRUCTIONS FOR COMPLETING GRANT REIMBURSEMENT DETAIL and MATCH DOCUMENTATION DETAIL Provide a detailed, line -item description using the worksheet provided for each Budget Category of funds Grantee is requesting for reimbursement or documentation of Match. Costs listed on the Grant Reimbursement Detail must reflect information on supporting documentation, must correspond with the approved Project Budget, the Payment Request Summary Form — Project Expenditures Summary Section and accompanying supporting documentation. The description of each line -item must include the month and year that the item was received; this month and year must fall within the Reimbursement Period. Any line -item with a corresponding month and year prior to the Reimbursement Period must be accompanied by a statement that this cost was not included in a prior Reimbursement Request. For each budget line -item, identify if the cost is: 1) Grant or Match, 2) a Direct cost used to calculate Indirect Costs (if approved), and 3) whether the cost is Administrative in nature. Provide accurate costs and do not round the amounts to the nearest whole dollar value. Supporting documentation for each amount for which reimbursement is being requested must: 1) list the item that has been paid for, 2) be submitted in the order in which items are shown on the Grant Reimbursement Detail and the Match Documentation Detail and 3) be either highlighted or circled. Check numbers may be provided in lieu of copies of the actual checks. If an item was purchased with a credit card, reflect "paid by credit card" on Grant Reimbursement Detail or the Match Documentation Detail, in lieu of a check number and provide vendor receipt reflecting that the item was paid by credit card (this can be hand written) along with a copy of related credit card statement (credit card number and other confidential information may be blacked out). Each piece of documentation must clearly reflect the dates of service. Only expenditures for budget categories and budget line -items in the approved Project Budget will be reimbursed or documented as Match. Listed below are the types of documentation and examples of minimum requirements. (1) Salaries: A payroll register or similar documentation should be maintained. The payroll register should show gross salary charges, fringe benefits, other deductions and net pay. If an individual for whom reimbursement is being claimed is paid by the hour, a document reflecting the hours worked times the rate of pay will be acceptable. (2) Fringe Benefits: Fringe Benefits should be supported by invoices showing the amount paid on behalf of the employee, e.g., insurance premiums paid. If the Grant Agreement specifically states that fringe benefits will be based on a specified percentage rather than the actual cost of fringe benefits, then the calculation for the fringe benefits amount must be shown. Exception: Governmental entities are not required to provide check numbers or copies of checks for fringe benefits. (3) Travel: Reimbursement for travel must be in accordance with Section 112.061, Florida Statutes, including submission of the claim on the approved state travel form that has been signed and dated by the traveler and the traveler's supervisor and copies of all travel receipts must also be attached. For additional information on documentation of travel costs, contact the assigned Commission Grant Manager. (4) Supplies - Other Expenses: Reimbursement will be made based on paid invoices/receipts. (5) Equipment: Reimbursement will be made based on paid invoices/receipts. Attachment J, Property Reporting Form, must be properly completed, signed and attached to the Attachment B, Payment Request Summary Form for each item of equipment requested for reimbursement or match documentation. (6) Contractual Services: Reimbursement will be made based on paid invoices/receipts. Subcontractors must be listed on Attachment C, Monthly Progress Report, for the corresponding reimbursement period. (7) Indirect Costs: If the Grant Agreement allows recovery of Indirect Costs, the calculation of these costs must be based upon direct costs reflected in the corresponding reimbursement period, utilizing the Indirect Cost rate in the approved Project Budget. Grant Agreement No. ARS010, Page 36 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO 10 ATTACHMENT C MONTHLY PROGRESS REPORT STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARD Grant Agreement No.: ARS010 Grantee Name: Grantee Address: Grantee's Representative: Telephone No.: Monthly Reporting Period: Project Number and Title: A. Provide a summary of project accomplishments to date. (Include a comparison of actual accomplishments to the objectives established for the period. If goals were not met, provide reasons why.) B. Provide an update on the number of jobs created or retained, quantify the reduction of greenhouse gasses and the energy saved in kWh or BTU. C. Provide an update on the estimated time for completion of the project and an explanation for any anticipated delays. Grant Agreement No. ARS010, Page 37 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 D. Provide any additional pertinent information including, when appropriate, analysis and explanation of cost overruns or high unit costs. E. Identify below, and attach copies of, any relevant work products being submitted for the project for this reporting period (e.g., report data sets, links to on-line photographs, etc.) F. Provide a project Grant Budget update, comparing the Grant Project Budget to actual costs to date. Grant Grant Grant Budget Total Grant Expenditures Expenditures this Grant Project Category Project Prior to this Reporting Period Funding Balance Budget Reporting Period 1. Salaries 2. Fringe Benefits 3. Travel (if authorized) 4. Supplies/Other Expenses 5. Equipment 6, Contractual Services 7. Indirect Costs (if authorized S. Total of all Grant Budget Categories Grant Agreement No. ARS0l0, Page 38 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 G. Provide a project Match Budget update, comparing the Match Project Budget to actual costs to date. Match Match Match Budget Total Match Expenditures Expenditures this Match Project Category Project Prior to this Reporting Period Funding Balance Budget Reporting Period 1. Salaries 2. Fringe Benefits 3. Travel (if authorized) 4. Supplies/Other Expenses 5. Equipment 6, Contractual Services 7. Indirect Costs if authorized 8. Total of all match Budget Categories H. REPORTING Activities: [GRANT MANAGER NOTE: All of the tables below may not be required for this Agreement Please choose the appropriate metric(s) for the funded activity and include only the appropriate tables for each Agreement on a nroiect to proiect basix 1 Retrofits - Number of Buildings Retrofitted Ft. Retrofitted Building Energy Audit*,,, Number of Audits Performed Floor Space Audited Auditor's Projection of Energy Saved Grant Agreement No. ARSO10, Page 39 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 Loans Grants and.,: '- Incentivesv: Number of Loans Given Monetary value of Loans Given Number of Grants Given Monetary value of Grants Given Renewable Energy.; :Market Development,.,,-'. � Number of Solar Energy Systems Installed Total Capacity of Solar Energy Systems Number of Wind Energy Systems Installed Total Capacity of Wind Energy S stems Number of other Renewable Energy Systems Installed Total Capacity of other Renewable Energy Systems Grant Agreement No. ARS010, Page 40 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 Transportation, Number of Alternative Fuel Vehicles Purchased Number of Vehicle Conversions to Alternative Energy Number of New Alternative Fueling Stations Number of Carpools and Vanpools Formed Number of Energy Efficient Traffic Signals Installed Number of Street Lane Miles for which Synchronized Traffic Signals were Installed Workshops Training,." and Educadon, Number of Workshops, Training and Education Sessions Held Number of People Attending Workshops, Training and Education Sessions Jobs Created.; Number of Direct Jobs Created Number of Indirect Jobs Created Actual Worker Head Count Number of FTE Job Equivalents Grant Agreement No. ARS010, Page 41 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 Energy Savings,,, Reduction in Natural Gas Consumption (mmcf) Reduction in Electricity Consumption (MWh) Reduction in Electricity Demand (MW) Reduction in Natural Gas Consumption (mmcf) Reduction in Fuel Oil Consumption ( allons) Reduction in Propane Consumption (gallons) Reduction in Gasoline and Diesel Consumption _(gallons) Amount of wind - powered electric generating capacity installed Amount of electricity generated from wind systems (MWh) Renewable Energy:, . " Capacity ancik Generation Amount of photovoltaic generating capacity installed (MW) Amount of electricity generated from photovoltaic systems (MWh) Amount of electric generating capacity from other renewable sources installed (MW) Amount of electricity generated from other renewable sources (MWh) Emission Reductions,, Tons Carbon Emission Reduction (CO2 Equivalent) Tons of Sulfur Dioxide Emission Reduction (CO2 Equivalent) Tons of Nitrogen Oxide Emission Reduction (CO2 Equivalent) Tons of Carbon Monoxide Emission Reduction (CO2 Equivalent) 1. SUBCONTRACTOR LIST Grant Agreement No. ARS010, Page 42 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO 10 The Grantee may subcontract work under this Grant Agreement without the prior approval of the Grant Manager, upon the condition that each Monthly Progress Report must contain a current list of subcontractors, as required in Section 18.A of the Grant Agreement. *[f rantee does not have subcontractors, please state 'None' below Name oit Current.Total,Amount� Descriptions of Work_' Subcontractor ',,_ Address ofeach Subcontract, Performed i J. MINORITY/WOMAN/SERVICE-DISABLED VETERAN -OWNED BUSINESS LIST The Grantee is encouraged to use small businesses, including minority, woman and service -disabled veteran - owned businesses as subcontractors under this Grant Agreement. As required in Section 18.0 of the Grant Agreement, the Grantee is required to report information concerning their use of such businesses in each Monthly Progress Report. *If grantee does not have any subcontracts with minority/woman service -disabled veteran- owned businesses, please state `None' below Total Amount,, Type of Busines*- Paid to Business, Description of (Minoritq, . during tbi Goods/Servicm Woman F Name or.,"4, Reportlnip Reportlnr: k ; provided by��,n . Service-dtsableW'11 Business- Addtesta Period (monthlt Period:: _ R'nsinesx �prpr��..�.p�.► This report is submitted in accordance with the reporting requirements of Grant Agreement No. ARSO 10 and accurately reflects the activities and costs associated with the subject project. Signature of Grantee's Representative Date Grant Agreement No. ARSO 10, Page 43 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT D SPECIAL AUDIT REQUIREMENTS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS 'The administration of resources awarded by the Florida Energy and Climate Commission (hereinafter referred to as the "Commission") to the recipient (hereinafter referred to as the "grantee" or "recipient'), may be subject to audits and/or monitoring by the Commission, as described in this attachment. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A-133 and Section 215.97, F.S., as revised (see "AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by Commission staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this Agreement, the recipient agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Commission. In the event the Commission determines that a limited scope audit of the recipient is appropriate, the recipient agrees to comply with any additional instructions provided by the Commission to the recipient regarding such audit. The recipient further agrees to comply and cooperate with any inspections, reviews, investigations or audits deemed necessary by the Chief Financial Officer or Auditor General. AUDITS PART I: FEDERALLY FUNDED This part is applicable if the recipient is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. 1. In the event that the recipient expends $500,000 or more in Federal awards in its fiscal year, the recipient must have a single or program -specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised. In determining the Federal awards expended in its fiscal year, the recipient shall consider all sources of Federal awards. 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 recipient conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the requirements of this part. 2. In connection with the audit requirements addressed in Part I, paragraph 1. the recipient shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised. 3. If the recipient 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 recipient 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 an audit must be paid from recipient resources obtained from other than Federal entities). 4. The recipient may access information regarding the Catalog of Federal Domestic Assistance (CFDA) via the internet at http:/i12.46245.173/cfda/cfda.html. Grant Agreement No. ARS010, Page 44 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION PART II: STATE FUNDED GRANT AGREEMENT NO. ARSO10 This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2)(m), Florida Statutes. 1. In the event that the recipient expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal year of such recipient, the recipient must have a State single or project -specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. In determining the state financial assistance expended in its fiscal year, the recipient shall consider all sources of state financial assistance, including state financial assistance received from the Commission, 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. 2. In connection with the audit requirements addressed in paragraph 1, the recipient shall ensure that the audit complies with the requirements of Section 215.97, Florida Statutes. This includes submission of a financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. 3. If the recipient expends less than $500,000 in state financial assistance in its fiscal year, an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In the event that the recipient 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 non - state entity's resources (i.e., the cost of such an audit must be paid from the recipient's resources obtained from other than State entities). 4. The recipient must include the record keeping requirements found herein in subcontractor agreements entered into for work required under terms of this Agreement. In the executed subcontract, the recipient shall provide each subcontractor of state financial assistance the information needed by the subcontractor to comply with the requirements of Section 215.97, Florida Statutes. Pursuant to Section 215.97, Florida Statutes, the recipient shall review and monitor subcontractor audit reports and perform other procedures as specified in the agreement with the subcontractor, which may include onsite visits. The recipient shall require subcontractors, as a condition of receiving state financial assistance, to permit the independent auditor of the recipient, the Commission, the Chief Financial Officer, the Chief Inspector General and the Auditor General access to the subcontractor's records and independent auditor's working papers as necessary to comply with the requirements of Section 215.97, Florida Statutes. �. For information regarding the Florida Catalog of State Financial Assistance (CSFA), a recipient should access the Florida Single Audit Act website located at https://apps.tldfs comlfsaa for assistance. In addition to the above websites, the following websites may be accessed for information: The Florid Legislature's Website at http://www.lee.state fl us/Welcome/index cfm, the State of Florida's website at http://www.mvtlorida.com/, the Department of Financial Services' Website at http://www.fldfs.com/ and the Auditor General's Website at 11ttp://-,vww.state. fl us/audsen. 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 Attachment shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the recipient directly to each of the following: A. The Florida Energy and Climate Commission at the following address: Audit Director or Grant Manager Florida Energy and Climate Commission Executive Office of the Governor 600 South Calhoun Street, Suite 251 Tallahassee, FL 32399-0001 Grant Agreement No. ARS010, Page 45 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 B. 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 IOth Street Jeffersonville, IN 47132 C. Other Federal agencies and pass -through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. 2 Pursuant to Section .320(f), OMB Circular A-133, as revised, the recipient shall submit a copy of the reporting package described in Section .320(c), OMB CircularA-133, as revised, and any management letters issued by the auditor, to the Commission at the following address: Audit Director or Grant Manager Florida Energy and Climate Commission Executive Office of the Governor 600 South Calhoun Street, Suite 251 Tallahassee, FL 32399-0001 Copies of financial reporting packages required by PART II of this Attachment shall be submitted by or on behalf of the recipient directly to each of the following: A. The Florida Energy and Climate Commission at the following address: Audit Director or Grant Manager Florida Energy and Climate Commission Executive Office of the Governor 600 South Calhoun Street, Suite 251 Tallahassee, FL 32399-0001 B. The Auditor General's Office at the following address: State of Florida Auditor General Room 401, Claude Pepper Building I I I West Madison Street Tallahassee, Florida 32399-1450 RECORD RETENTION The recipient shall retain sufficient records demonstrating its compliance with the terms of this Agreement for a period of five years from the date the audit report is issued and shall allow access to such records upon request by the Commission or its designee, Chief Financial Officer or Auditor General. The recipient shall ensure that audit working papers are made available to the Commission or its designee, Chief Financial Officer or Auditor General upon request for a period of three years from the date the audit report is issued, unless extended in writing by the Commission. Grant Agreement No. ARSO10, Page 46 of 65 3 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT E FEDERAL REGULATIONS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO . MERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS Formal regulations concerning administrative procedures for USDOE grants appear in Title 10 of the Code of Federal Regulations. Grant program administrative regulations appear in Part 600. Other USDOE regulations also impact grant programs. The following list contains regulations and Office of Management and Bud et Circulars which may apply to the work performed under this Agreement. 2 CFR 176 Award Terms for Assistance Agreements that include funds under the American Recovery and Reinvestment Act of 2009, Public Law 111-5 2 CFR 901 Nonprocurement Debarment and Suspension 10 CFR 600 Financial Assistance Rules 10 CFR 601 New Restrictions on Lobbying 10 CFR 607 10 CFR 1039 Government wide requirements for drug -free work place financial assistance) Uniform relocation assistance and real property acquisition for federal and federally assisted programs 10 CRF 1040 Nondiscrimination in Federally Assisted Programs or Activities 10 CFR 1041 Enforcement of Nondiscrimination on the basis of handicap in programs or activities conducted by USDOE 10 CFR 1042 Nondiscrimination on the basis of sex in education programs or activities receiving federal financial assistance Other Federal Regulations 45 CFR Subtitle A — Appendix E to Part 74 Principles for Determining Costs Applicable to Research and Development Under Grants and Contracts with Hospitals 48 CFR 31 Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with cost principles acceptable to the federal agency Office of Management and Budget Circulars A-21 Cost Principles for Educational Institutions A-87 Cost Principles for State, Local, and Indian Tribal Governments A-102 Grants and Cooperative Agreements with State and Local Governments A-110 Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals, and Other Non -Profit Organizations —Non A-122 Cost Principles for -Profit Organizations A-133 Audit Requirements Grant Agreement No. ARS010, Page 48 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT F FEDERAL FUNDING GRANTEE, SUBGRANTEE AND CONTRACTOR PROVISIONS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS All subgrants and contracts awarded by the Grantee, including small purchases, shall contain the following provisions as applicable: 1. Equal Employment Opportunity - All contracts shall contain a provision requiring compliance with E.O. 11246 Equal Employment Opportunity," as amended by E.O. 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and as supplemented by regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." E. Copeland "Anti -Kickback" Act (18 U.S.C. 874 and 40 U.S.C. 276c) - All contracts and subgrants in excess of $2,000 for construction or repair awarded by recipients and subrecipients shall include a provision for compliance with the Copeland "Anti -Kickback" Act (18 U.S.C. 874), as supplemented by Department of Labor regulations (29 CFR part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that each contractor or subrecipient shall be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. The recipient shall report all suspected or reported violations to the Federal awarding agency. 3. Davis -Bacon Act, as amended (40 U.S.C. 276a to a-7) - When required by Federal program legislation, all construction contracts awarded by the recipients and subrecipients of more than $2,000 shall include a provision for compliance with the Davis -Bacon Act (40 U.S.C. 276a to a-7) and as supplemented by Department of Labor regulations (29 CFR part 5, "Labor Standards Provisions Applicable to Contracts Governing Federally Financed and Assisted Construction"). Under this Act, contractors shall be required to pay wages to laborers and mechanics at a rate not less than the minimum wages specified in a wage determination made by the Secretary of Labor. In addition, contractors shall be required to pay wages not less than once a week. The recipient shall place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation and the award of a contract shall be conditioned upon the acceptance of the wage determination. The recipient shall report all suspected or reported violations to the Federal awarding agency. 4. Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333) - Where applicable, all contracts awarded by recipients in excess of $2000 for construction contracts and in excess of $2,500 for other contracts that involve the employment of mechanics or laborers shall include a provision for compliance with Sections 102 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333), as supplemented by Department of Labor regulations (29 CFR part 5). Under Section 102 of the Act, each contractor shall be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than 1 % times the basic rate of pay for all hours worked in excess of 40 hours in the work week. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. 5. Rights to Inventions :Made Under a Contract or Agreement - Contracts or agreements for the performance of experimental, developmental, or research work shall provide for the rights of the Federal Government and the recipient in any resulting invention in accordance with 10 CFR part 600.325, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding agency. Grant Agreement No. ARSO 10, Page 49 of 65 FLORIDA ENERGY, AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 6. Clean Air Act (42 U.S.C. 7401 et seq.), and the Federal Water Pollution Control Act (33 U.S.C. 1251 et seq.), as amended - Contracts and subgrants of amounts in excess of $100,000 shall contain a provision that requires the recipient to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401 et seq.) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251 et seq.). Violations shall be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). 7. Byrd Anti -Lobbying Amendment (31 U.S.C. 1352) - Contractors who apply or bid for an award of $100,000 or more shall file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier shall also disclose any lobbying with non -Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the recipient. 8. Debarment and Suspension (E.O.s 12549 and 12689) - No contract shall be made to parties listed on the General Services Administration's List of Parties Excluded from Federal Procurement or Nonprocurement Programs in accordance with E.O.s 12549 and 12689, "Debarment and Suspension." This list contains the names of parties debarred, suspended, or otherwise excluded by agencies, and contractors declared ineligible under statutory or regulatory authority other than E.O. 12549. Contractors with awards that exceed the small purchase threshold shall provide the required certification regarding its exclusion status and that of its principal employees. 9. Section 508 of the Federal Water Pollution Control Act, as amended (33 U.S.C. 1368) and Section 1424(e) of the Safe Drinking Water Act, (42 U.S.C. 300h-3(e)) - Contracts and subgrants of amounts in excess of $100,000 shall contain a provision that requires the recipient to agree to comply with all applicable standards, orders or regulations issued pursuant to Section 508 of the Federal Water Pollution Control Act, as amended (33 U.S.C. 1368) and Section 1424(e) of the Safe Drinking Water Act, (42 U.S.C. 300h-3(e)). Violations shall be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). 10. Compliance 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 sex; (b) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 795), which prohibits discrimination on the basis of handicaps; (c) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (d) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (e) 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; (f) Sections 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; (g) Title Vill 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; (h) any other nondiscrimination provisions in the specific statute(s) made; and, (i) the requirements of any other nondiscrimination statute(s) which may apply. 11. Compliance 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. 12. Compliance with the provision 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. 13. 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. Grant Agreement No. ARS010, Page 50 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 14. Compliance with environmental standards which may be prescribed 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 EP 11738, (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplain 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 (Clean Air) Implementation Plans under Section 176(c) of the Clean 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). 15. Compliance with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 16. 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.) 17. Compliance with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 18. Compliance 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 bloodied animals held for research, teaching, or other activities supported by this Agreement. 19. Compliance 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. 20. Compliance with the mandatory standards and policies relating to energy efficiency which are contained in the State energy conservation plan issued in accordance with the Energy Policy and Conservation Act (Pub. L. 94-163, 89 Stat. 871). 21. Assist the Commission in complying with the State Energy Conservation Program as described in the Code of Federal Regulations, Title 10, Parts 420 and 450 and guidance issued by the U.S. Department of Energy and subsequent guidance issued by the U.S. Department of Energy; the Financial Assistance Rules described in Title 10, Part 600, as well as those regulations concerning the use of oil overcharge recovery funds. 22. The Commission reserves the right to transfer equipment acquired under this grant as provided in Title 10, Part 600.117. The Recipient can obtain a release of this right upon application containing certain commitments. 23. Compliance with the Buy American Act (41 U.S.C. 10a-10c) By accepting funds under this Agreement, the Grantee agrees to comply with sections 2 through 4 of the Act of March 3, 1933, popularly known as the "Buy American Act." The Grantee should review the provisions of the Act to ensure that expenditures made under this Agreement are in accordance with it. It is the sense of the Congress that, to the greatest extent practicable, all equipment and products purchased with funds made available under this Agreement should be American -made. 24. Preservation of open and competition and government neutrality towards contractors' labor relations on federally funded construction projects a. Unless in conflict with State or local laws, you must ensure that bid specifications, project agreement, or other controlling documents in construction contracts awarded pursuant to this agreement, or pursuant to a subaward to this agreement, do not: I. Require or prohibit bidders, offerors, contractors, or subcontractors to enter into or adhere to agreements with one or more labor organizations, on the same or other related construction project(s); or Grant Agreement No. ARSO 10, Page 51 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 2. Otherwise discriminate against bidders, offerors, contractors, or subcontractors for becoming or refusing to become or remain signatories or otherwise to adhere to agreements with one or more labor organizations, on the same or other related construction project(s). b. The term "construction contract" as used in this provision means any contract for the construction, rehabilitation, alteration, conversion, extension, or repair of buildings, highways, or other improvements to real property. C. Nothing in this provision prohibits bidders, offerors, contractors, or subcontractors from voluntarily entering into agreements with labor organizations. 25. Compliance with the provision included in Title XV and Title XVI of Public Law 111-5, the American Recovery and Reinvestment Act of 2009. 26. Segregation of Costs — Recipients must segregate the obligations and expenditures related to funding under the Recovery Act. Financial and accounting systems should be revised as necessary to segregate, track, and maintain these funds apart and separate from other revenue streams. No part of the funds from the Recovery Act shall be commingled with any other funds or used for a purpose other than that of making payments for costs allowable for Recovery Act projects. 27. False Claims Act — Recipient and sub -recipients shall promptly refer to the DOE or other appropriate Inspector General any credible evidence that a principle, employee, agent, contractor, sub -grantee, subcontractor, or other person has submitted a false claim under the False Claims Act or has committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity or similar misconduct involving those funds. Grant Agreement No. ARS010, Page 52 of 65 2. 3. FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT G CERTIFICATION REGARDING DEBARMENTS, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION -LOWER TIER FEDERALLY FUNDED TRANSACTIONS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS The undersigned hereby certifies that neither it nor its principals is presently debarred, suspenproposed for debarment, ded, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. The undersigned also certifies that it and its principals: (a) Have not within a three-year period preceding this certification been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in conr=tioo with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction, violation of Federal or State anti -oust statutes or commission of embezzlement. theft, forgery, bribery, faisiftption or destJvctiort of records, making false statements, or receiving stolen property. (b) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph 2(a) of this Certification; and (c) Have not within a three-year period preceding this certification had one or more public transactions (Federal, State or focal) terminated for cause or default. Where the undersigned is unable ro cenify to any of the statements in this certification, an explanation shall be attached to this ccrtification. Dated this 5th Crant Agreement No. ARS011 i ypea Namertitte Monroe County BOCC Recipient's Firm Name 1100 Simonton Street Strew Address 2-213 Building, Suite Number Key West FL 33040 City/State/Zip Code FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 INSTRUCTIONS FOR CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION - LOWER TIER FEDERALLY FUNDED TRANSACTIONS I . By signing and submitting this form, the certifying party is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the certifying party knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, Florida Energy and Climate Commission (Commission) or agencies with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The certifying party shall provide immediate written notice to the person to whom this contract is submitted if at any time the certifying party learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549, You may contact the person to which this contract is submitted for assistance in obtaining a copy of those regulations. 5. The certifying party agrees by submitting this contract that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier contract, or other covered transaction with a person who is proposed for debarment under 48 CFR 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the Commission or agency with which this transaction originated. 6. The certifying party further agrees by executing this contract that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all contracts or lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not is proposed for debarment under 48 CFR 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List (Telephone No. (202) 5014740 or (202) 5014873.) 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Commission or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Grant Agreement No. ARSO10, Page 54 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT H Intellectual Property Provisions (NRD-1003) Nouresearch and Development STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS Nonprofit organizations are subject to the intellectual property requirements at 10 CFR 600.136(a), (c) and (d). All other organizations are subject to the intellectual property requirements at 10 CFR 600.136(a) and (c). 600.136 Intangible property. (a) Recipients may copyright any work that is subject to copyright and was developed, or for which ownership was purchased, under an award. USDOE reserves a royalty -free, nonexclusive and irrevocable right to reproduce, publish or otherwise use the work for Federal purposes, and to authorize others to do so. (c) USDOE has the right to: (1) Obtain, reproduce, publish or otherwise use the data first produced under an award; and (2) Authorize others to receive, reproduce, publish, or otherwise use such data for Federal purposes. (d)(1) In addition, in response to a Freedom of Information act (FOIA) request for research data relating to published research findings produced under an award that were used by the Federal Government in developing an agency action that has the force and effect of law, the USDOE shall request, and the Recipient shall provide, within a reasonable time, the research data so that they can be made available to the public _through the procedures established under the FOIA. If the USDOE obtains the research data solely in response to a FOIA request, the agency may charge the requester a reasonable fee equaling the full incremental cost of obtaining the research data. This fee should reflect the costs incurred by the agency, the recipient, and applicable subrecipients. This fee is in addition to any fees the agency may assess under the FOIA (5 U.S.C. 552(a)(4)(A)). Grant Agreement No. ARSO 10, Page 55 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT I DISCLOSURE OF LOBBYING ACTIVITIES STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS kpproved by OMB 0348-0046 Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a. initial filing b. grant bb . initial award b. material change c. cooperative agreement post -award d. loan For Material Change Only: e. loan guarantee f loan insurance yea quarter date of last report 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name El Prime ElSubawardee and Address of Prime: Tier , if known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, ifapplicable: 8. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual, last name, first name, ,tf: different from No. /0a) (last name, first name, W): (attach Continuation Sheet(') SF-LLL 4, i necessa ) It. Information requested through this form is authorized by title 31 U.S.C. Signature: section 1352. This disclosure of lobbying activities is a material print Name representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Title: Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil Telephone No.: Date: penalty of not less than $10.000 and not more than $100,000 for each such failure. Federal Use Only: Authorized for Local Reproduction Standard Form - LLL (Rev 7 - 97) Grant Agreement No. ARS010, Page 56 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity 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 a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by the reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the lst tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks "Subawardee", then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI). 11. The certifying official shall sign and date the form, print his/her name, title and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. Grant Agreement No. ARS0i0, Page 57 of 65 z Z F � �o F � UW Cc) w U� d wF�ar� a� w z w a o L' F �� W w a` ti z Z LU Zz W H z WU S� W = E UAg M R Z 2d OW =s M iy LL M OWo L� d O W LLIW wWw ~ H OL o�W o A$ O a� 3 dZ o gIL d m soLU Z L �t< yzy �U.V ui Z r6 W FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT K ANNUAL REPORT STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARD Grant Agreement No.: ARS010 Grantee Name: Grantee Address: Grantee's Representative: Telephone No.: Annual Reporting Period: Project Number and Title: A. Provide a summary of project accomplishments to date. (Include a comparison of actual accomplishments to the objectives established for the period. If goals were not met, provide reasons why.) B. Provide an update on the number of jobs created or retained, quantify the reduction of greenhouse gasses and the energy saved in kWh or BTU. C. Provide an update on the estimated time for completion of the project and an explanation for any anticipated delays. Grant Agreement No. ARS010, Page 59 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 D. Provide any additional pertinent information including, when appropriate, analysis and explanation of cost overruns or high unit costs. E. Identify below, and attach copies of, any relevant work products being submitted for the project for this reporting period (e.g., report data sets, links to on-line photographs, etc.) Grant Agreement No. ARS010, Page 60 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 H. REPORTING Activities: [GRANT MANAGER NOTE• All of the tables below may not be reQuired for this 4Qreemen� Please choose the appropriate metric(s) for the funded activity and include only the Proiect basis.l annronriate tables for each Agreement on a nroiect to Number of Number of Buildings Retrofitted [Audits erformed Ft. Retrofitted Floor SpaceAudited Auditor's Projection of Energy Saved Grant Agreement No, ARSOl0, Page 61 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 Loans; Grants and Number of Loans Given Monetary value of Loans Given Number of Grants Given Monetary value of Grants Given Number of Solar Energy Systems Installed Total Capacity of Solar Energy Number of Wind Energy Systems Installed Total Capacity of Wind Energy Number of other Renewable Energy Systems Installed Total Capacity of other Renewable Renewable Energy, Grant Agreement No. ARS010, Page 62 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 Tran ortation<: �_ Number of Alternative Fuel Vehicles Purchased Number of Vehicle Conversions to Alternative Energy Number of New Alternative Fueling Stations Number of Carpools and Vanpools Formed Number of Energy Efficient Traffic Si nals Installed Number of Street Lane Miles for which Synchronized Traffic Signals were Installed Number of Workshops, Training and Education Sessions Held Number of People Attending Workshops, Training and Education Sessions Number of Direct Jobs Created Number of Indirect Jobs Created Actual Worker Head Count Number of FTE Job Eauivalentc Workshops; Training, and Educatfom is Created'= Grant Agreement No. ARS010, Page 63 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 Energy Savin s> Reduction in t of Natural Gas ltaic Consumption ing mmc (MW' pgenerated Reduction in t of Electricity ty d fromConsumption (r,t,kan,N ltaic Amount of electric generating capacity from Reduction in Electricity Demand other renewable (xrw1 sources installed Reduction in Amount of Natural Gas electricity Consumption generated from (mac fl other renewable Reduction in Fuel sources MWh Oil Consumption Reduction in Propane Consumption Reduction in Gasoline and [Reduction ons Carbon Diesel mission ConsumptionT (CO2 (onlln".l Amount of wind- Tons of Sulfur powered electric Dioxide generating capacity ssion installed uction (CO2 Amount ofelectricity kEuivalent generated from s of Nitrogen wind systems Oxide Emission (MWh) Reduction (CO2 Tons of Carbon Monoxide Emission Reduction (CO2 Renewable Energy Capacity- and �<_ Generation; Grant Agreement No. ARSO10, Page 64 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO 10 1. SUBCONTRACTOR LIST The Grantee may subcontract work under this Grant Agreement without the prior approval of the Grant Manager, upon the condition that each Monthly Progress Report must contain a current list of subcontractors, as required in Section 18.A of the Grant Agreement. *I rantee does not have subcontractors, olease state 'None' below Name of _F_ Current Total Amount ycontractoDescription of Work::`. r Address each Subcontract, Per}ormeA- J. MINORITY/WOMAN/SERVICE-DISABLED VETERAN -OWNED BUSINESS LIST The Grantee is encouraged to use small businesses, including minority, woman and service -disabled veteran - owned businesses as subcontractors under this Grant Agreement. As required in Section 18.0 of the Grant Agreement, the Grantee is required to report information concerning their use of such businesses in each Monthly Progress Report. *Ifgrantee does not have any subcontracts with minorityiwoman/service-disabled veteran- owned businesses, please state 'None' below Amount Type of Business Business.- ;' Description ou (Minority,::r_. Name oft "_ . g.this_' Reporting,rting; � �_ LI Goods/ServicesWoman,Business. � provided by' � Service-disabled:Address; Periad thiod._ Bnsinesa �..re�s......a,.Av This report is submitted in accordance with the reporting requirements of Grant Agreement No. ARSO 10 and accurately reflects the activities and costs associated with the subject project. Signature of Grantee's Representative Date Grant Agreement No. ARSO 10, Page 65 of 65 C cc Sponsored by: Hemstadt CITY OF MARATHON, FLORIDA RESOLUTION 2010-112 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF MARATHON, FLORIDA APPROVING AN INTERLOCAL AGREEMENT BETWEEN THE CITY OF MARATHON AND MONROE COUNTY FOR JOINT PARTICIPATION IN GRANT AGREEMENT NO. ARS 010 IN THE AMOUNT OF $497,535.60; AUTHORIZING THE MAYOR TO EXECUTE THE AGREEMENT ON BEHALF OF THE CITY; AND PROVIDING FOR AN EFFECTIVE DATE WHEREAS, the State of Florida, Executive Office of the Governor, Florida Energy and Climate Commission has entered into Grant Agreement No. ARS 010 with Monroe County to provide financial assistance for the Energy Efficiency and Conservation Project in which the County is the named grantee on the Grant Agreement, and the United States Department of Energy awarded funding through the American Recovery and Reinvestment Act; and WHEREAS, the grant award is $400,000.00 with a local match requirement of $97,535.60 for a project total of $497,535.60 (the "Grant Funding"); and WHEREAS, Monroe County ("County"), the City of Marathon ("City"), and other local government entities have developed a grant project list to assist both the incorporated and unincorporated areas of the Florida Keys to improve energy conservation for the citizens of Monroe County; and WHEREAS, the City will use a portion of the Grant Funding to perform an energy audit of the City's facilities, retro fitting lights on Sombrero Beach Road and retro fitting lights and electrical components in City Parks (the "Project"); and WHEREAS, the City and County desire to enter into an Interlocal Agreement so that the City may receive a share of the Grant Funding for the Project. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF MARATHON, FLORIDA, THAT: Section 1. The above recitals are true and correct and incorporated herein. Section 2. The Interlocal Agreement between the City and the County, a copy of which is attached hereto as Exhibit "A," together with such non -material changes as may be acceptable to the City Manager and approved as to form and legality by the City Attorney is hereby approved. The Mayor is authorized to execute the Agreement on behalf of the City. Section 3. This resolution shall take effect immediately upon its adoption. PASSED AND APPROVED BY THE CITY COUNCIL OF THE CITY OF MARATHON, FLORIDA, THIS 26t6 DAY OF OCTOBER, 2010. THE CITY OF MARATHON, FLORIDA f�. Ginger Sn d, Mayor AYES: Keating, Ramsay, Worthington, Snead NOES: None ABSENT: Cinque ABSTAIN: None ATTEST: Diane Clavier, City Clerk (City Seal) APPROVED AS TO FORM AND LEGALITY FOR THE USE AND RELIANCF OFkHE CITY OIJMARATHON, FLORIDA ONLY: INTERLOCAL AGREEMENT BETWEEN MONROE COUNTY AND THE CITY OF MARATHON, FOR JOINT PARTICIPATION IN GRANT AGREEMENT NO.ARS O10 THIS INTERLOCAL AGREEMENT is made and entered into this 0-�' day of 2010, by and between the MONROE COUNTY BOARD OF COMMISSIONERS, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, FL 33040 ("COUNTY") and the CITY OF MARATHON, whose address is 9805 Overseas Highway, Marathon, Florida 33050 WITNESSETH WHEREAS, the STATE OF FLORIDA, EXECUTIVE OFFICE OF THE GOVERNOR, FLORIDA ENERGY AND CLIMATE COMMISSION ("COMMISSION") has entered into a Grant Agreement NO. ARS010 ("Grant Agreement") with the COUNTY to provide financial assistance for the Energy Efficiency and Conservation Project in which the COUNTY is the named grantee on the Grant Agreement, and WHEREAS, the United States Department of Energy (USDOE) awarded funding to the COMMISSION pursuant to USDOE through the American Recovery and Reinvestment Act (ARRA) Grant Agreement No. DE-E0000241, and WHEREAS, the COUNTY and the CITY developed a mutual project, which would include mutual participation with various entities to assist both the incorporated and unincorporated areas of the Florida Keys to improve energy conservation for the citizens of Monroe County, and WHEREAS, the CITY has agreed to participate along with the COUNTY under the Grant Agreement No. ARSO10; and the CITY has developed certain project tasks for the benefit of its citizens. The CITY agrees to participate, contribute its resources pursuant to the requirements of the Grant Agreement in order to secure funding for the project tasks defined by the CITY. WHEREAS, the sole purpose of this Interlocal Agreement is to define the contributions of the parties under the Grant Agreement, and WHEREAS, CITY acknowledges that COUNTY will serve as the grantee/recipient under the Grant Agreement, and WHEREAS, CITY hereby agrees to abide by the requirements of the Grant Agreement entered into between the COMMISSION and the COUNTY, and WHEREAS, this Interlocal Agreement is entered into pursuant to the authority provided in Florida Statute 163.01, known as the Florida Interlocal Cooperation Act of 1969, and NOW THEREFORE, in consideration of the mutual understandings and agreements set forth herein, the COUNTY and CITY agree as follows: INCORPORATION BY REFERENCE - The provisions of that certain document entitled "FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010" (Grant Agreement) and its attachments is incorporated by reference as Exhibit A to this Interlocal Agreement and made a part hereof as if fully set forth in the body of the Interlocal Agreement and all laws, rules and regulations relating thereto are also incorporated by reference. 2. PROJECT TASKS — CITY has developed certain project tasks to be funded by the Grant Agreement, and CITY and COUNTY agree that they are to be bound by the Grant Agreement, and CITY is responsible to provide COUNTY with all the documentation and/reporting relative to the CITY'S project tasks which are required under the Grant Agreement. 3. TERM - The term of this Agreement begins on the date of execution by both parties and ends no later than April 30, 2012, the date the Grant Agreement ends unless earlier terminated or extended under the provisions of the Grant Agreement. 4. DOCUMENT REVIEW AND COMPLIANCE — CITY agrees to comply with the Grant Agreement and its attachments in its entirety, references in this agreement to specific paragraphs of the Grant Agreement are for convenience only. For purposes of the Agreement between COUNTY and CITY, any obligations called for under the Grant Agreement to be performed by the grantee related to CITY project tasks will also apply as if fully set out between the CITY and COUNTY. 5. RESPONSIBILITY OF CITY - CITY agrees to perform those project tasks attributable to CITY in the Grant Agreement and to provide any matching funds either in -kind or financial as provided in the Grant Agreement; and to provide to the COUNTY all the required reports, attachments fully completed, invoices or other documentation required by COMMISSION in order for CITY to be approved for reimbursement related to a project task. 6. FUNDS — CITY acknowledges and agrees that funding for its tasks under the Grant Agreement will be provided from the COMMISSION through the COUNTY on a reimbursement rather than an up -front basis; and that COUNTY is not financially responsible to CITY for funds expended by CITY which are not approved by COMMISSION. CITY also acknowledges and agrees that expended funds will be reimbursed as approved by the COMMISSION and related to each individual request for reimbursement submitted to the COUNTY by the CITY All funds shall be distributed and expended in accordance with the Grant Agreement. CITY agrees that it shall not receive advances of any type from the COUNTY. All reimbursements to CITY are dependent on approval of specific reimbursement requests submitted from the CITY as paid by the COMMISSION. 7. REIMBURSEMENT. All reimbursement requests from CITY shall be submitted to COUNTY, not directly to the COMMISSION. (a) Reimbursement requests shall be submitted to COUNTY and properly documented by CITY as required in the Grant Agreement. All reimbursement requests under this Interlocal Agreement and the Grant Agreement shall be submitted using the Attachment B of the Grant Agreement, Payment Request Summary Form, format in detail sufficient for a proper pre -audit and post -audit thereof. CITY shall submit to COUNTY a properly completed Attachment B, Payment Request Summary Form, with supporting documentation of allowable costs, including the final reimbursement request, as described in paragraph 4.1). of the Grant Agreement. (b) CITY agrees and acknowledges that pursuant to the Grant Agreement at paragraph 4.C., ten percent (10%) of each approved reimbursement request shall be retained by the COMMISSION pending the compliance with Section 8 of the Grant Agreement, and that this amount will not be distributed to CITY prior to being received by COUNTY. (c) If a Request for Reimbursement from CITY does not comply with the Grant Agreement requirements under the Grant Agreement the COUNTY will confer with CITY to identify what the COMMISSION requires in order for the CITY to be able to comply and receive reimbursement. It is the responsibility of the CITY to provide the necessary documentation or other requirements. (d) COUNTY shall promptly submit all Payment or Reimbursement Requests received from CITY to the COMMISSION. Upon distribution of funds from the COMMISSION to the COUNTY, the COUNTY shall promptly distribute the reimbursement received from the COMMISSION to the CITY for items related to the individual reimbursement request being paid by the COMMISSION. (e) All reimbursements under the Grant Agreement shall be in compliance with the laws, rules, and regulations applicable to the expenditure of State and Federal funds. The State of Florida guidelines for allowable costs include, but not limited, to the Florida Department of Financial Services' Reference Guide for State Expenditures located at http://www.myfloridacfo.com. Federal program guidelines for allowable costs and related topics are listed in Attachment E of the Grant Agreement, Federal Regulations, and Attachment F of the Grant Agreement, Federal Funding Grantee, Sub -grantee, and Contractor Provisions. The CITY shall provide to COUNTY a detailed listing of expenditures made under the Grant Agreement as support for the Payment Request Summary Form. The listing shall include, at a minimum, a description of the goods or services purchased, date of the transaction, check, or voucher number, amount paid and vendor name. (f) In addition, to the requirements contained in paragraphs 4.C. & D of the Grant Agreement, the COMMISSION may periodically request additional proof of a transaction to evaluate the appropriateness of costs to the Grant Agreement pursuant to State of Florida guidelines. When requested by the COMMISSION related to a transaction performed by the CITY, the CITY shall provide the required information to COUNTY within 20 calendar days of such request, so that COUNTY can comply with the Grant Agreement and provide this information to the COMMISSION within 30 calendar days of receipt of such request pursuant to paragraph 4.E. of the Grant Agreement. 8. REPORTING — The Grant Agreement requires various reports, including but not limited to Monthly Progress Reports, Annual Reports, and Final Reports. CITY shall complete reports, provide documents or information as requested by COUNTY in the manner described in the Grant Agreement for the project tasks under its control and for its benefit. CITY recognizes that failure to comply with the reporting jeopardizes funding for the entire grant for CITY, COUNTY and for other cities. CITY agrees to complete Monthly Reports in a timely manner and to provide the reports, documents or information documents or information to COUNTY at least 48 hours before the Monthly report is due from the COUNTY to the COMMISSION, at least 5 calendar days before the Annual documents or information report is due from the COUNTY to the COMMISSION, and at least 5 calendar days before the Final Report is due from the COUNTY to the COMMISSION. 9. COMPLIANCE MONITORING — CITY agrees to cooperate with the COUNTY and to participate in any compliance monitoring which may be required pursuant to the Grant Agreement, including but not limited to the requirements of paragraph 10 of the Grant Agreement. CITY further agrees to provide to the COUNTY the documentation required by the COMMISSION related to CITY'S project tasks due to compliance monitoring. 10. TERMINATION — If the COMMISSION terminates the Grant Agreement, this Interlocal Agreement will automatically be terminated; termination by COMMISSION is set out in the Grant Agreement, including but not limited to, paragraphs IOC, 11, 12, 13, 14, and 15. Termination may also occur by mutual agreement of the parties. COUNTY shall provide CITY with any written notice of termination of the Grant Agreement received from the COMMISSION within five (5) days of receipt of said termination notice. 11. NOTICES - Whenever either party desires to give notice unto the other, it must be given by written notice, sent by registered United States mail, with return receipt requested, and sent to: FOR COUNTY : County Administrator 1100 Simonton Street Key West, Florida 33040 F.1110M Monroe County Grants Administrator 1100 Simonton Street Key West, FL 33040 FOR CITY: City Manager 9805 Overseas Highway Marathon, Florida, 33050 Either of the parties may change, by written notice as provided above, the addresses or persons for receipt of notices. 12. UNAVAILABILITY OF FUNDS - If the COUNTY learns that funding cannot be obtained under the Grant Agreement or cannot be continued at a level sufficient to allow for the services specified herein, this Interlocal Agreement may then be terminated immediately, at the option of the COUNTY, by written notice of termination delivered in person or by mail to the CITY at its address specified above. The parties acknowledge that the COUNTY has no funding without the funding by the COMMISSION and agree that the COUNTY has no liability for funds expended by the CITY that were not covered for any reason by the COMMISSION. 13. PERFORMANCE AND OBLIGATION — The COUNTY'S performance and obligation to pay under this Interlocal Agreement is contingent upon an annual appropriation by the Board of County Commissioners and upon the COMMISSION'S performance and obligation to pay under the Grant Agreement which is contingent upon annual appropriation by the Legislature of the State of Florida and the availability of federal funding for the specific purpose of funding the COMMISSION'S obligations under the Grant Agreement. In the event of a State revenue shortfall, withdrawal of State budget authorization and/or rescission of federal funding, the total funding will be reduced accordingly. The COMMISSION, in accordance with direction from the Governor and/or the Florida Legislature, shall be the final determiner of the availability of any funds. 14. COMPLIANCE WITH LAWS AND REGULATIONS - In providing all services pursuant to this Interlocal Agreement, the CITY shall abide by all statutes, ordinances, rules, and regulations pertaining to, or regulating the provision of, such services, including those now in effect and hereafter adopted. Any violation of said statutes, ordinances, rules, or regulations shall constitute a material breach of this agreement. 15. MAINTENANCE OF BOOKS AND RECORDS - CITY agrees to maintain books, records, and documents directly pertinent to performance under the Grant Agreement and this Interlocal Agreement in the same manner as set out in paragraph 17 of the Grant Agreement. CITY agrees to provide access to the books, records, and documents to the COUNTY in order for the COUNTY to comply with the Grant Agreement. 16. SUBCONTRACTING — Parties may hire contractors to achieve the individual project tasks applicable to their jurisdiction under the Grant Agreement. CITY agrees to comply with, and to include in subcontracts, all the applicable federal, state, and local health and safety rules and regulations required in the Grant Agreement or this Interlocal Agreement. 17. FLORIDA STATUTE SECTION 768.28 — Each party agrees that it shall be solely responsible for the negligent or wrongful acts of its employees and agents. However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity or the provisions of Section 768.28, Florida Statutes. 18. DISPUTES - COUNTY and CITY agree that they will seek to resolve any disputes between them regarding their responsibilities as soon as possible and at the lowest level reasonable, in order to conserve the resources of the parties. The parties further agree to use their best efforts to assure speedy and non -confrontational resolution of any and all disputes between them. In the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Interlocal Agreement, the prevailing party shall be entitled to reasonable attorney's fees and court costs, as an award against the non -prevailing party, and shall include attorney's fees and courts costs in appellate proceedings, as an award against the non -prevailing party. Mediation proceedings initiated and conducted pursuant to this Interlocal Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the circuit court of Monroe County. 19. AMENDMENT AND ASSIGNMENT - No agent, employee, or other representative of either party is empowered to modify or amend the terms of this Interlocal Agreement, unless executed with the same formality as this document with approval of the COMMISSION. This Interlocal Agreement or duties under the Grant Agreement shall not be assignable by either party unless such assignment is first approved by the COMMISSION. 20. SEVERABILITY - If any term, covenant, condition or provision of this Interlocal Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. COUNTY and CITY agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. 21. INDEPENDENT CONTRACTORS, WORKERS COMPENSATION — (a) CITY and its employees, volunteers, agents, vendors and subcontractors shall be and remain independent contractors and not agents or employees of the COUNTY or the COMMISSION with respect to all of the acts and services performed by and under the terms of this agreement. COUNTY and its employees, volunteers, agents, vendors and subcontractors shall be and remain independent contractors and not agents or employees of the CITY or the COMMISSION with respect to all of the acts and services performed by and under the terms of this Interlocal Agreement. (b) CITY will be self -insured against or will secure and maintain during the life of this agreement, Workers Compensation for all of its employees connected with the work of this agreement. CITY shall require their subcontractors similarly to provide Workers Compensation Insurance for all of the latter's employees unless such employees are covered by the protection afforded by the CITY. Such coverage shall comply fully with Florida's Worker's Compensation Law. This Agreement shall not in any way be construed to create a partnership, association or any other kind of joint undertaking, enterprise or venture between the parties. 22. WAIVER OF PROVISIONS - The failure of either party to this Interlocal Agreement to object to or to take affirmative action with respect to any conduct of the other which is in violation of the terms of this agreement shall not be construed as a waiver of the violation or breach, or of any future violation, breach or wrongful conduct. 23. PROCESS FOR APPROVAL - This Interlocal Agreement shall be approved by the CITY initially and after approval by the CITY shall be presented to the Board of County Commissioners for approval of the COUNTY. The Interlocal Agreement may be executed in several counterparts, each of which shall be deemed an original and such counterpart shall constitute one and the same instrument. 24. AUTHORITY - Each party represents and warrants to the other that the execution, delivery, and performance of this Agreement have been duly authorized by all necessary governmental action, as required by law. 25. ENTIRE AGREEMENT - (a) It is understood and agreed that the entire agreement of the parties is contained herein and that this Interlocal Agreement supersedes all oral agreements and negotiations between the parties relating to the subject matter hereof as well as any previous agreements presently in effect between the parties relating to the subject matter hereof. (b) Any alterations, amendments, deletions, or waivers of the provisions of this Interlocal Agreement shall be valid only when expressed in writing and duly signed by the parties. IN WITNESS WHEREOF, the parties to this Interlocal Agreement have caused their names to be affixed hereto by the proper officers thereof for the purposes herein expressed at Monroe County, Florida, on the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, Clerk By: Deputy Clerk Date: BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Date: Mayor/Chairman v i_..: .. _ ::t CITY OF MARATHON Mayor Date: ( (—AD�A i i c) Attest: City Clerk Approved As To Form And Legal Sufficiency For The Use And Reliance Of Tf e gitl Of Marathon, Flprida Only: City #545745 vl FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS THIS AGREEMENT is entered into between the STATE OF FLORIDA, EXECUTIVE OFFICE OF THE GOVERNOR (EOG), FLORIDA ENERGY AND CLIMATE COMMISSION whose address is 600 South Calhoun Street, Suite 251, Tallahassee, Florida 32399-0001 (hereinafter referred to as the "Commission") and the MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, whose address is 1100 Simonton Street, Key West, FL 33040-31 l0 (hereinafter referred to as "Grantee" or "Recipient"), a local government, to provide financial assistance for the Keys Energy Conservation Initiative. In consideration of the promises and mutual agreements contained herein, the Commission and the Grantee acknowledge and agree as follows: l . The United States Department of Energy (USDOE) awarded funding to the Commission pursuant to USDOE through American Recovery and Reinvestment Act (ARRA) Grant Agreement No. DE- EE0000241. The Grantee shall be a sub -grantee of federal financial assistance from USDOE. The Grantee is responsible for complying with the appropriate state and federal guidelines in the performance of its activities pursuant to this Agreement. 2. The Grantee agrees to perform in accordance with the terms and conditions set forth in this Agreement, its attachments and exhibits named and incorporated by reference. For purposes of this Agreement the terms "Grantee" and "Recipient" are used interchangeably. 3. This Agreement shall begin upon execution by both parties and end no later than March 31, 2012, inclusive. If allowed by USDOE, this Agreement shall be effective upon execution for purposes of reimbursement of allowable costs resulting from obligations incurred and meeting the cost share or match requirements as described in Attachment A, Grant Work Plan. Profit to the Grantee, or any of its subgrantees, is prohibited by 10 Code of Federal Regulations (CFR) Part 600. This Agreement may be amended to revise Attachment A, Grant Work Plan, if additional funding is made available by the USDOE and/or the Florida Legislature. 4. A. The Grantee shall be eligible for reimbursement of allowable costs resulting from obligations incurred during the term of this Agreement. The Commission shall reimburse the Grantee for allowable costs on a not more frequently than monthly cost reimbursement basis in an amount not to exceed $2,687,288 after receipt and approval by the Commission's Grant Manager of satisfactory reports and documentation as required in this Agreement. The parties agree that the Grantee is responsible for providing a minimum match of $602,896 toward the project described in Attachment A, Grant Work Plan. All cost sharing or match shall meet any applicable federal requirements. B. Prior written approval from the Commission's Grant Manager shall be required for changes between approved, funded budget categories up to 10% of the total, approved Grant funds. Approval of such changes will be contingent upon submission of a revised Project Budget. Budget category changes greater than 10%, the addition of previously unapproved or unfunded budget categories or the addition of previously unapproved or unfunded budget tine -items, will require a formal written amendment to the Agreement. The Commission agrees to review a request by the Grantee to modify Attachment A, Grant Work Plan, should the Grantee find, after receipt of competitive bids, that the project described in Attachment A. Grant Work Plan, cannot be accomplished for the current estimated project cost. If the Commission agrees to a modification of Attachment A, Grant Work Plan, it may be modified not to exceed the awarded funding identified above. Any such modification would be by formal written amendment, in accordance with Section Grant Agreement No. ARSO10, Page 1 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 37. Nothing in this Section or Agreement is intended nor implies to guarantee approval of a request to modify or adjust Attachment A, Grant Work Plan, or the available project funding. C. All reimbursement requests under this Agreement shalt be submitted using the Attachment B, Payment Request Summary Form, format in detail sufficient for a proper pre -audit and post -audit thereof. The Grantee shall submit a properly completed Attachment B, Payment Request Summary Form, with supporting documentation of allowable costs, including for the final reimbursement request, as described below in paragraph 4.D. Ten percent of each approved reimbursement request shall be retained by the Commission pending Grantee's compliance with Section 8. D. All reimbursements under this Agreement shall be in compliance with the laws, rules and regulations applicable to the expenditure of State and federal funds. The State of Florida guidelines for allowable costs include, but are not limited, to the Florida Department of Financial Services' Reference Guide for State Expenditures located at http://www.myfloridacfo.com. Federal program guidelines for allowable costs and related topics are listed in Attachment E, Federal Regulations and Attachment F, Federal Funding Grantee, Sub -grantee and Contractor Provisions. The Grantee must provide a detailed listing of expenditures made under this Agreement as support for the Payment Request Summary Form. The listing shall include, at a minimum, a description of the goods or services purchased, date of the transaction, check or voucher number, amount paid and vendor name. All requests for reimbursement of travel expenses shall be in accordance with the travel requirements including mandated forms required by Section 112.061, Florida Statutes. E. In addition to the requirements contained in paragraphs 4.0 & D above, the Commission may periodically request additional proof of a transaction to evaluate the appropriateness of costs to the Agreement pursuant to State of Florida guidelines. When requested, this information must be provided within 30 calendar days of such request. 5. The Commission's performance and obligation to pay under this Agreement is contingent upon an annual appropriation by the Legislature of the State of Florida and the availability of federal funding for the specific purpose of funding the Commission's obligations under this Agreement. In the event of a State revenue shortfall, withdrawal of State budget authorization and/or rescission of federal funding, the total funding may be reduced accordingly. The Commission, in accordance with direction from the Governor and/or the Florida Legislature, shall be the final determiner of the availability of any funds. 6. The Grantee shall submit, using Attachment C, Monthly Progress Report, monthly updates. to describe the project progress, work performed, problems encountered, problem resolution, schedule updates and proposed work for the next reporting period. Attachment B, Payment Request Summary Form may not be submitted more frequently than on a monthly basis and must be accompanied by an Attachment C, Monthly Progress Report, for the corresponding month. Attachment C, Monthly Progress Reports shall be submitted to the Commission no later than three calendar days following the completion of the monthly reporting period. The Commission's Grant Manager may request additional information if the Commission's Grant Manager determines it is necessary. The Commission's Grant Manager shall have ten calendar days to review deliverables and payment requests submitted by the Grantee. 7. The Grantee shall submit an Annual Report 15 calendar days after the end of the first year of the project, if the term of the project exceeds one year. The Annual Report shall provide a narrative detailing and evaluating the accomplishments and impact of the project in the prior twelve months. The Annual Report shall follow the format described in Attachment K, Annual Report. The Grantee shall also submit a Final Report 15 calendar days prior to the expiration date of the Agreement. The Final Report will provide a final narrative detailing and evaluating the accomplishments and impact of the project. The Final Report will include an evaluation of the energy savings directly attributable to the project, projections of estimated energy savings expected to accrue from the project and policy recommendations, which may be helpful in implementing other projects of a similar nature. Pursuant to Grant Agreement No. ARS010, Page 2 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 paragraph 4.C, 10% of the total Agreement amount identified in paragraph 4.A will be withheld until receipt and approval of the Final Report. 9. Each party agrees that it shall be solely responsible for the negligent or wrongful acts of its employees and agents. However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity or the provisions of Section 768.28, Florida Statutes. 10. A. Commission staff will perform compliance monitoring during the term of the Agreement, in addition to the review of Monthly Progress Reports, but not less than once a year, to ensure Agreement compliance. Monitoring shall include, but not be limited to, periodic review of compliance with Agreement service delivery, as described in Attachment A, Grant Work Plan as documented in Attachment C, Monthly Progress Reports and also which includes a review of all Agreement requirements including the Attachments. The Commission reserves the right for any Commission staff to make scheduled or unscheduled, announced or unannounced compliance monitoring visits at any site where services are delivered pursuant to this Agreement. B. For each on -site compliance monitoring visit, Commission staff will provide an oral exit interview and a written monitoring report to the Grantee. C. If issues of non-compliance are identified in the monitoring report, a written Corrective Action Plan (CAP) may be required of the Grantee. If required, the CAP shall be submitted to the Commission's Grant Manager within ten calendar days of receipt of the monitoring report. If a CAP is required of the Grantee, failure to correct deficiencies after thirty calendar days from the date -of -receipt of a written monitoring report notating the deficiencies may result in a determination of breach of Agreement and termination of services. If a CAP is not required of the Grantee, the Commission may proceed under Section 11 and/or Section 14. 11. The Commission may terminate this Agreement at any time in the event of the failure of the Grantee to fulfill any of its obligations under this Agreement. Prior to termination, the Commission shall provide 30 calendar days written notice of its intent to terminate and shall provide the Grantee an opportunity to consult with the Commission regarding the reason(s) for termination. If this Agreement is terminated, the Commission shall only pay for those acts satisfactorily completed under this Agreement prior to the date of termination. The Commission shall not pay the Grantee for any work performed after such termination, except as described in Section 14.F. 12. The Commission may terminate this Agreement for convenience by providing the Grantee with 30 calendar days written notice. If this Agreement is terminated, the Commission shall only pay for those acts satisfactorily completed under this Agreement prior to the date of termination. The Commission shall not pay the Grantee for any work performed after such termination, except as described in Section 14.F. 13. This Agreement may be unilaterally terminated by the Commission for refusal by the Grantee to allow public access to all documents, papers, letters or other material made or received by the Grantee in conjunction with this Agreement, unless the records are exempt from Section 24(a), Article I of the Florida Constitution and Chapter 119, Florida Statutes. If this Agreement is terminated, the Commission shall only pay for those acts satisfactorily completed under this Agreement prior to the date of termination. The Commission shall not pay the Grantee for any work performed after such termination, except as described in Section 14.F. 14. If the Grantee materially fails to comply with the terms and conditions of this Agreement, including any Federal or State statutes, rules or regulations, applicable to this Agreement, the Commission may take one or more of the following actions, as appropriate for the circumstances. A. Temporarily withhold cash payments pending correction of the deficiency by the Grantee. Grant Agreement No. ARS010, Page 3 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 B. Disallow (that is deny both use of fiords and any applicable matching credit for) all or part of the cost of the activity or action not in compliance. C. Wholly or partly suspend or terminate this Agreement. D. Withhold further awards for the project or program. E. Take other remedies that may be legally available. F. Costs of the Grantee resulting from obligations incurred by the Grantee during a suspension or after termination of the Agreement are not allowable unless the Commission expressly authorizes them in the notice of suspension or termination. G. The remedies identified above, do not preclude the Grantee from being subject to debarment and suspension under Presidential Executive Orders 12549 and 12689. 15. A. In accordance with Presidential Executive Order 12549, Debarment and Suspension (10 CFR Part 606, later moved to 2 CFR Part 901), the Grantee shall agree and certify that neither it, nor its principals, is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and, that the Grantee shall not knowingly enter into any lower tier contract, or other covered transaction, with a person who is similarly debarred or suspended from participating in this covered transaction, unless authorized in writing by USDOE to the Commission. B. Upon execution of this Agreement by the Grantee, the Grantee shall complete, sign and return a copy of Attachment G, Certification Regarding Debarments, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Federally Funded Transactions. C. As required by paragraphs A and B above, the Grantee shall include the language of this Section and Attachment G, Certification Regarding Debarments, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Federally Funded Transactions, in all subcontracts and sub -grants or lower tier agreements executed to support the Grantee's work under this Agreement. 16. The Grantee shall maintain books, records and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles. The Commission, the State of Florida, USDOE or their authorized representatives shall have access to such records for audit purposes during the term of this Agreement and for five years following Agreement completion. In the event any work is subcontracted, the Grantee shall similarly require each subcontractor to maintain and allow access to such records for audit purposes. 17. A. The Grantee shall retain and maintain all records referenced in Section 16 and make such records available for an audit as may be requested. Such records shall include independent auditor working papers, books, documents and other evidence, including but not limited to, vouchers, bills, invoices, requests for payment and other supporting documentation, which, according to generally accepted accounting principles, procedures and practices, sufficiently and properly reflect all program costs expended in the performance of this Agreement. B. The Grantee agrees to comply with the audit requirements of Section 215.97, Florida Statutes, and those found in Attachment D, Special Audit Requirements as applicable. C. The Grantee shall include the audit and record keeping requirements described above and in Attachment D, Special Audit Requirements, in all subcontracts and assignments with sub -grantees of funds according to Section 215.97, Florida Statutes. For purposes of this Agreement, "sub - recipient" shall be defined in accordance with Section 215.97(2)(x), Florida Statutes. Graul Agreement No. ARSO10, Page 4 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 D. The Grantee must provide copies of any audit referencing this Agreement, the audit transmittal letter, and any response to such audit to the Commission within 30 calendar days of its receipt. The Grantee should confer with its chief financial officer, audit director or contact the Commission for assistance with questions pertaining to the applicability of these requirements. 18. A. The Grantee may subcontract work under this Agreement upon the condition that each Attachment C, Monthly Progress Report, contains a current list of subcontractors, the amount of each subcontract and a short description of work to be performed by that subcontractor. The Grantee shall be solely responsible for all work performed and all expenses incurred in connection with the development and implementation of the services, programs and activities under this Agreement whether directly performed or by subcontract. B. The Grantee shall not enter into subcontracts in which the Commission or USDOE could be held liable to a subcontractor for any expenses or liabilities. The Grantee shall defend and hold the Commission and USDOE harmless of any liabilities, as applicable by Florida laws, incurred under any of the subcontracts entered into by the Grantee. The Grantee shall be liable for all work performed and all expenses incurred as a result of any subcontract. C. The Grantee is encouraged to use small businesses, including minority, woman and service - disabled veteran -owned businesses as subcontractors or sub -vendors under this Agreement. The Grantee shall report to the Commission in each, Attachment C, Monthly Progress Report, its expenditures with minority, woman and service -disabled veteran -owned businesses. The directory of State of Florida certified minority, woman and service -disabled veteran -owned businesses can be accessed from the website of the Department of Management Services, Office of Supplier Diversity. The Attachment C, Monthly Progress Report, shall contain the names and addresses of the minority, woman and service -disabled veteran -owned businesses; the aggregate dollar figure disbursed that month for each business; the time period; type of goods or services and whether the business is minority, woman or service -disabled veteran -owned. If no expenditures were made to minority, woman and service -disabled veteran -owned businesses, the Grantee shall state "None" on that portion of the Attachment C, Monthly Progress Report. 19, The Grantee agrees to permanently refrain from using or mentioning its association with the Commission in advertisements, letterhead, business cards, etc. The Grantee's project with the Commission may be generally stated and described in the Grantee's professional resume. The Grantee may not give the impression in any event or manner, that the Commission endorses or recommends the Grantee. 20. A. The Grantee certifies that no Federal appropriated funds have been paid or will be paid, on or after December 22, 1989, by or on behalf of the Grantee, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress, in connection with the awarding, renewal, amending or modifying of any Federal contract, grant, or cooperative agreement. If any non -Federal funds are used for lobbying activities as described above, the Grantee shall submit Attachment I, Standard Form-LLL, Disclosure of Lobbying Activities, and shall file quarterly updates of any material changes. The Grantee shall require the language of this certification to be included in all subcontracts, and all subcontractors shall certify and disclose accordingly. [ 10 CFR Part 601 ] B. In accordance with Section 216.347, Florida Statutes, the Grantee is hereby prohibited from using funds provided by this Agreement for the purpose of lobbying the Legislature, the judicial branch or a State agency. C. Pursuant to the Lobbying Disclosure Act of 1995, any organization described in Section 501(c)4 of the Internal Revenue Code of 1986 shall not be eligible for subgrants under this Agreement, unless Grant Agreement No. ARS010, Page 5 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 such organization warrants that it does not, and will not, engage in lobbying activities prohibited by the Act as a special condition of the subgrant. This restriction does not apply to loans made pursuant to approved revolving loan programs or to contracts awarded using proper procurement procedures. 21. The Grantee shall comply with all applicable federal, state and local rules and regulations. The Grantee acknowledges that this requirement includes compliance with all applicable federal, state and local health and safety rules and regulations. The Grantee further agrees to include this provision in all subcontracts issued as a result of this Agreement. 22. The Grantee agrees to comply with, and include as appropriate in subcontracts, the applicable regulations listed in Attachment E, Federal Regulations, and the provisions contained in Attachment F, Federal Funding Grantee, Sub -grantee and Contractor Provisions. 23. The Commission's Grant Manager for this Agreement is identified below. Commission Grant Manager: Mandy Norman Florida Energy and Climate Commission Executive Office of the Governor 600 South Calhoun Street, Suite 251 Tallahassee, FL 32399-0001 Telephone No.: 850487-3800 Fax No.: 850-922-9701 E-mail Address: M' andy.norman(wmyflorida.com 24. The Grantee's Representative for this Agreement is identified below. Lisa Tennyson Monroe County Board of County Commissioners Grants Administrator 1100 Simonton Street Key West, FL 33040-3110 —Telephone No.: 305-2924444 Fax No.: 305-2924515 E-mail Address: Tenn son -list e- monroecoun -fl. ov Grantee D-U-N-S : 073876757 Grantee CCR Registration Expiration Date: 5/21/2011 25. To the extent required by law, the Grantee will be self -insured against, or will secure and maintain during the life of this Agreement, Workers' Compensation Insurance for all of its employees connected with the work of this project. The Grantee shall require the subcontractor similarly to provide Workers' Compensation Insurance for all of the latter's employees unless such employees are covered by the protection afforded by the Grantee. Such self-insurance program or insurance coverage shall comply fully with the Florida Workers' Compensation law. The Grantee shall provide, and cause each subcontractor to provide, adequate insurance satisfactory to the Commission, for the protection of its employees not otherwise protected if any class of employees engaged in hazardous work under this Agreement is not protected under Workers' Compensation statutes. Documentation of all insurance coverage(s) required below, shall be submitted by the Grantee to the Commission. Upon expiration of documented proof of insurance coverage, the Grantee shall submit proof of continued insurance coverage to the Commission within 30 calendar days of insurance coverage expiration. Grant Agreement No. ARSO10, Page 6 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 26, The Grantee, as an independent contractor and not an agent, representative, or employee of the Commission, agrees to carry adequate liability and other appropriate forms of insurance. The Commission shall have no liability except as specifically provided in this Agreement. 27, The Grantee covenants that it presently has no interest and shall not acquire any interest which would conflict in any manner or degree with the performance of services required. 28. The Grantee is authorized to purchase five current model vehicles, for use in performing the services described in Attachment A, Grant Work Plan. The Grantee must obtain written approval, in advance, of the vehicle type proposed for purchase and shall produce at least two written quotes for comparable vehicles prior to the vehicle purchase being authorized by the Commission. Upon satisfactory completion of this Agreement, with Commission approval, the Grantee may retain ownership of the non-expendible personal property or equipment purchased under this Agreement. However, the Grantee shall complete and sign Attachment J, Property Reporting Form, and submit it to the Commission as an attachment to the Attachment B, Payment Request Summary Form, in which these costs are documented for reimbursement or match. The following terms shall apply: A. The Grantee shall have use of the non -expendable personal property or equipment for the authorized purposes of the contractual arrangement as long as the required work is being performed. B. The Grantee is responsible for the implementation of adequate maintenance procedures to keep the non -expendable personal property or equipment in good operating condition. C. The Grantee is responsible for the implementation of manufacturer required maintenance procedures to keep the vehicles in good operating condition. D. The Grantee shall secure and maintain comprehensive collision and general automobile liability coverage for the vehicles during the term of this Agreement. The Grantee is responsible for any applicable deductibles. E. The Grantee is responsible for any loss, damage, or theft of, and any loss, damage, or injury caused by the use of, non -expendable personal property or equipment purchased with state funds and held in his possession for use in a contractual arrangement with the Commission. The Grantee is responsible for the purchase of, and shall maintain a current State of Florida tag and registration for all vehicles purchased under the Agreement. 29. The employment of unauthorized aliens by any Grantee/vendor is considered a violation of Section 274A(e) of the Immigration and Nationality Act. If the Grantee/vendor knowingly employs unauthorized aliens, such violation shall be cause for unilateral cancellation of this Agreement. The Grantee shall be responsible for including this provision in all subcontracts with private organizations issued as a result of this Agreement. 30. A. No person on the grounds of race, creed, color, national origin, age, sex or disability shall be excluded from participation in, be denied the proceeds or benefits of, or be otherwise subjected to discrimination in performance of this Agreement. Grant Agreement No. ARS010, Page 7 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 B. The Grantee agrees to comply with 10 CFR Part 1040 "Nondiscrimination in Federally Assisted Programs." C. The Grantee affirms that it is aware of the provisions of Section 287.134(2)(a), Florida Statutes, and that at no time has the Grantee been placed on the Discriminatory Vendor List. The Grantee further agrees that it shall not violate such law and acknowledges and agrees that placement on the list during the term of this Agreement may result in the termination of this Agreement. D. The Grantee affirms that it is aware of the provisions of Section 287.133(2)(a), Florida Statutes, and that at no time has the Grantee been convicted of a Public Entity Crime. The Grantee agrees that it shall not violate such law and further acknowledges and agrees that any conviction during the term of this Agreement may result in the termination of this Agreement. The Grantee shall insert a provision in accordance with this paragraph in all subcontracts for services in relation to this Agreement. 31. Land acquisition is not authorized under the terms of this Agreement. 32. A. If the Grantee brings to the performance of this Agreement pre-existing intellectual property, the Grantee shall retain all rights and entitlements to that pre-existing intellectual property. B. All patent rights, copyrights, and data rights must be in accordance with 10 CFR Part 600 as referenced in Attachment H, Intellectual Property Provisions. C. If, during the course of the Agreement, the Grantee modifies a pre-existing invention to the point where it is a new invention, patentable in its own right, or if any discovery or subject invention arises or is developed in the course of, or as a result of, work or services performed under this Agreement, or in any way connected herewith, the Grantee shall retain the entire right, title, and interest to each discovery or subject invention, subject to the provisions of this Section. With respect to any subject invention in which the Grantee retains title, the Commission shall have a royalty -free, nonexclusive, transferable, irrevocable, paid up license to practice or have practiced for, or on behalf of, the Commission or the State of Florida the subject invention and sublicense the same. D. In the event that any books, manuals, films, software, databases, or other copyrightable material are produced, which are intended to be made available to the public, the Grantee shall notify the Commission. The Commission shall have a royalty -free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use the work, and to authorize others to do the same. The Grantee hereby grants the Commission full authority and right to modify or create derivative works of, or allow others to modify or create derivative works on behalf of the Commission, any publications first produced under this Agreement. Any content submitted to the Commission which is asserted to be exempt under Florida's Public Records Act, Chapter 119, Florida Statutes, shall be clearly marked "business proprietary", "exempt," "confidential," or "trade secret" (as applicable), with the statutory basis for such claim of exemption, confidentiality, or trade secret specifically identified in writing. Failure to identify any such content shall constitute a waiver of any claimed exemption, confidentiality, or trade secret. E. The terms and conditions specified in Section 32 shall also apply to any subcontracts made under this Agreement. The Grantee shall be responsible for informing the subcontractor of the provisions of this Section and obtaining disclosures. 33. The Grantee is encouraged to publish or otherwise make publicly available the results of the work conducted under this Agreement. USDOE requires an acknowledgement of Federal support. A disclaimer Grant Agreement No. ARS010, Page 8 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 must appear in the publication of any material, copyrighted or not, which was based on or developed under this Agreement, as follows: Acknowledgement: "This material is based upon work supported by the U.S. Department of Energy and the Florida Energy and Climate Commission under Award Number DE-EE0000241.- Disclaimer: "This report was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor any agency thereof, nor any of their employees, nor any of their contractors, subcontractors or their employees, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or any third parry's use or the results of such use of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof or its contractors or subcontractors. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof." 34. The Grantee is permitted to develop software or databases under the terms and conditions of this Agreement, including Section 32, 35. The Parties agree they will seek to resolve any disputes between them regarding their responsibilities as soon as possible and at the lowest level reasonable, in order to conserve the resources of the Parties. The Parties further agree to use their best efforts to assure speedy and non -confrontational resolution of any and all disputes between them. 36. This Agreement is executed and entered into in the State of Florida and shall be construed, performed and enforced in all respects in accordance with the laws and rules of the State of Florida. Any litigation arising under this Agreement shall be brought in the appropriate court in Leon, County, Florida, applying Florida Law. 37. This Agreement represents the entire agreement of the parties. Any alterations, variations, changes, modifications or waivers of provisions of this Agreement shall only be valid when they have been reduced to writing, duly signed by each of the parties and attached to the original of this Agreement, unless otherwise provided herein. 38. The following Attachments are incorporated into this Agreement: Attachment A Grant Work Plan Attachment B Payment Request Summary Form Attachment C Monthly Progress Report Attachment D Special Audit Requirements Attachment E Federal Regulations Attachment F Federal Funding Grantee, Sub -grantee and Contractor Provisions Attachment G Debarment and Suspension Form Attachment H Intellectual Property Provisions Attachment I Disclosure of Lobbying Activities Attachment J Property Reporting Form Attachment K Annual Report Grant Agreement No. ARSO10, Page 9 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 IN WITNESS WHEREOF, the parties have caused this Agreement to be duly executed, the day and year last written below, MONROE COUNTY BOARD OF COUNTY COMMISSIONERS By:_ Sylvia Murphy County Mayor Date: TC E t- STATE OF FLORIDA, EXECUTIVE OFFICE OF THE GOVERNOR, Florida Energy and Climate Commission By: Alexander Mack Program Administrator Date: Grant Agreement No. ARS010, Page 10 of 65 ATTACHMENT A GRANT WORK PLAN FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS A. PROJECT TITLE: Keys Energy Conservation Initiative B. PROJECT LOCATION: Monroe County, Florida C. PROJECT BACKGROUND: Monroe County will implement a comprehensive energy savings project, in partnership with the City of Key West, City of Marathon and Islamorada, Village of Islands, which will include several cross jurisdictional and individual community energy savings activities. The Grantee has identified eight projects to execute a wide assortment of energy savings activities which will benefit 96% of the Keys population. The activities include installation of solar water heaters, energy efficiency outreach and education, retrofitting sports lighting, retrofitting outdoor lighting, development of an Energy Efficiency and Conservation Strategy (SECS), energy audits, purchase of hybrid vehicles and replacement of street lighting poles. Affordable Residential Solar Water Heaters The Grantee, in partnership with Habitat for Humanity (1-14H), will install or replace conventional hot water heaters with solar hot water heaters in low to moderate income households. The Grantee will also issue rebates for solar water heaters. This component of the conservation initiative will be coordinated with NexGENergy and Monroe County's Weatherization program. Energy Efficiency Educational Video Communication and Outreach The Grantee will facilitate the production of a 15-minute video and radio segment for National Public Radio (NPR) to highlight the Keys Energy Conservation Initiative 2010. The educational and outreach materials will be available on local government websites and television channels. The materials will be disseminated by CD, DVD and email. Additionally, the Grantee will hold 12 educational workshops for commercial and residential energy efficiency measures. Outreach components of this project will increase the number of Green Living and Education (GLEE) Certified Green Business Partnerships by 100%. Retrofit Local Park Ball Field Lighting The Grantee will retrofit lighting in six public parks with new energy efficient light fixtures. The parks include the Clayton Sterling Sports Complex, Dewitt Roberts Softball Field, Rosa Hernandez Softball Field, George Mira Football Field, Nelson English Park and Pepe Hernandez Park. These parks are located in the City of Key West. Greenhouse Gas Emissions Inventory, Energy Audits and Outdoor Lighting Retrofit Phase L Greenhouse Gas ('GHG) Emissions Inventory — The Grantee will select a consultant to conduct a greenhouse gas emissions inventory for the City of Marathon. A final report will document the results and recommended strategies for implementation. Phase 2: Energy Audits — The Grantee will hire a consultant to conduct community residential and commercial energy audits and an energy audit for City facilities in the City of Marathon. The results of the studies will be made available to residents and the business community. Phase 3: Outdoor Lighting Retrofit — The Grantee will conduct an outdoor lighting retrofit for Sombrero Beach Road street lights and Marathon Community park lights. The contractor will retrofit 250 outdoor lights. Grant Agreement No. ARS010, Page 11 of 65 ATTACHMENT A GRANT WORK PLAN EECS Development The Grantee will utilize technical assistance consulting services to assist a team of interdepartmental county staff members with the formulation of an energy efficiency, energy conservation and energy usage strategy. The strategy will identify the means to achieve goals, metrics for measuring progress, timelines for implementation, financing mechanisms and staff assignments. The EECS will ensure sustained benefits of the grant funds beyond the grant period. County Facilities Energy Audit and Retrofit The Grantee will implement energy efficiency measures, based upon audit findings, at four Monroe County facilities, located in Key West, with a total square footage of 197,823 and an annual energy cost of $534,019. An energy audit will allow the Grantee to develop base -line energy use and an in-depth report of quantifiable energy conservation recommendations to determine the most cost effective improvements and to ensure the best possible use of the retrofit funds. The building retrofits will emphasize efficiency and may include retrofit lighting, insulation, heating, ventilation and air-conditioning (HVAC) upgrades, training programs for operation and facility users and monitoring systems. Hybrid Vehicle Purchase The Grantee will reduce GHG emissions by upgrading the County fleet with five hybrid electric vehicles which represents 10% of the administrative fleet. The vehicles will replace five conventional gas -powered vehicles. Replacement of Street Lighting Poles The Grantee will replace interior street lighting, dog park lighting and security lighting in Founders Park and the Administrative & Public Safety Headquarters parking lot located within the park. This work will consist of stripping 90 existing poles, removing current heads, inspecting each post for damage, repairing damage, preparing poles for new solar heads to he installed, adjusting and strengthening mounts, adding mounting brackets and installation of solar heads. In addition, 10 new light poles will be installed at Plantation Hammock Preserve, Plantation Tropical Reserve, Hurricane Monument and Library Parks. The parks to receive retrofits through this component of the project are located in Islamorada, Village of Islands. D. PROJECT OBJECTIVES • Objective 1: To reduce power consumption within the county by procuring and installing residential solar water heaters in a minimum of 20 low or moderate income households. • Objective 2: To create an educational workshop for commercial and residential energy efficiency measures and a 15-minute video and radio segment to highlight the Keys Energy Conservation Initiative 2010. • Objective 3: To reduce power consumption within the county by procuring and installing energy efficient outdoor sports lighting in six public parks. • Objective 4: To reduce power consumption within the county by conducting a greenhouse gas emissions inventory, energy audits and 250 outdoor lighting retrofits for the City of Marathon. • Objective 5: To reduce fossil fuel emissions in transportation, building, and other applicable public and private sectors by developing and implementing an Energy Efficiency and Conservation Strategy. • Objective 6: To reduce power consumption within the county by implementing energy efficiency measures as recommended by an energy audit of four county facilities. • Objective 7: To reduce GHG and energy consumption within the county by upgrading the county vehicle fleet with hybrid electric vehicles. • Objective 8: To reduce the annual power consumption within the county by procuring and installing 100 solar powered light emitting diode (LED) street lighting poles. Grant Agreement No. ARSO10, Page 12 of 65 ATTACHMENT A GRANT WORK PLAN E. PROJECT DESCRIPTION: The Grantee has identified eight project(s) that will greatly reduce power consumption therefore reducing utility charges and equipment maintenance fees. The following tasks will be performed in order to meet the project objectives outlined above. Task I - Affordable Residential Solar Water Heaters (Objective 1): • Task la: Select a vendor following the procurement procedures outlined in 10 CFR 600, for solar water heater purchase and installation • Task lb: Coordinate with 1-141-1 to establish an eligible homeowner application • Task lc: Select a vendor, negotiate and execute contract • Task lc: Oversee installation of solar water heaters in 20 qualified affordable homes • Task ld: Coordinate with Keys Energy to provide solar water heater rebates of $450 each • Task le: Submit a report to the Commission including photographs of the installed solar water heaters, utility bills documenting energy reduction, a list of applicants and invoices from both the manufacturer and the installer Task 2 - Energy Efficiency Educational Video Communication and Outreach (Objective 2): • Task 2a: Execute contract with Environmental Education Foundation • Task 2b: Develop video content • Task 2c: Produce video, upload to county website and provide to local governments for distribution • Task 2d: Produce radio segment for Radio Green Earth show on NPR • Task 2e: Coordinate educational outreach technical assistance workshops for businesses and residents • Task 2f: Increase the number of GLEE Certified Green Business partnerships by 100% • Task 2g: Submit a copy of all educational materials and video to the Commission documenting the energy efficiency conservation impacts of the project Task 3 - Retrofit Local Park Sall Field Lighting (Objective 3): • Task 3a: Select a vendor following the procurement procedures outlined in 10 CFR 600, to install ballpark lighting • Task 3b: Oversee installation of ballpark lights in six public parks • Task 3c: Submit a report to the Commission including photographs of the installed lighting, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer Task 4 - Greenhouse Gas Emissions Inventory, Energy Audits and Outdoor Lighting Retrofit (Objective 4): • Task 4a Select a vendor following the procurement procedures outlined in 10 CFR 600, 1) a greenhouse gas emissions inventory, 2) a community energy audit and 3) city energy audits • Task 4b: Select a vendor following the procurement procedures outlined in 10 CFR 600, to install outdoor lighting • Task 4c: Define scope of work to identify audit needs • Task 4d: Conduct site inspections • Task 4e: Complete data gathering and analysis for completion of 600 audits • Task 4f: Oversee installation of 250 outdoor lights • Task 4g: An audit report will be created to establish baseline emissions inventory for a base year and for a forecast year to identify emissions reduction targets for the forecast year and identify recommended actions, policies and measures • Task 4h: Submit the final audit report to the Commission and photographs of the installed lighting, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer Task 5 - EECS Development (Objective 5): • Task 5a: The Grantee will develop a scope of work for the EECS • Task 5b: Select a vendor following the procurement procedures outlined in 10 CFR 600, for a technical assistance consultant to assist with plan development and data • Task 5c: Develop EECS for county facilities and operations including energy efficiency, energy conservation and energy usage goals • Task 5d: Provide the Commission with an electronic copy of the EECS. Grant Agreement No. ARSO10, Page 13 of 65 ATTACHMENT A GRANT WORK PLAN Task 6 — County Facilities Energy Audit and Retrofit (Objective 6): • Task 6a: Select a vendor following the procurement procedures outlined in 10 CFR 600, for an engineering Firm to conduct Grade Energy Audits for four county facilities located in Key West • Task 6b: Create a scope of work and construction bid documents based on energy audit findings • Task 6c: Implementation and installation of energy efficiency measures as approved by the Commission and recommended in the audit report • Task 6d: Submit a report to the Commission including the audit report, photographs of the installed systems, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer Task 7 - Hybrid Vehicle Purchase (Objective 7): • Task 7a: Prepare purchase order for five hybrid vehicles following the procurement procedures outlined in 10 CFR 600. • Task 7b: Finalize purchase of vehicles • Task 7c: Paint and decal vehicles to increase awareness of alternative fuel vehicles • Task 7d: Conduct a training workshop for drivers and maintenance staff • Task 7e: Submit a report to the Commission including photographs of the hybrid vehicles, records of savings and invoices Task 8 - Replacement of Street Lighting Poles (Objective 8): • Task 8a: Identify and designate locations for new light poles • Task 8b: Select a vendor following the procurement procedures outlined in 10 CFR 600, for electricians to retrofit 90 existing poles • Task 8c: Obtain quotes or advertise for the purchase of 100 solar powered light fixtures • Task 8d: Identify existing underground utilities and mark sites for new poles • Task 8e: Award contract and purchase order for 100 fixtures • Task 8f: Installation of new light poles • Task 8g: Submit a report to the Commission including photographs of the installed street lighting poles, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer F. PROJECT MILESTONES/DELIVERABLES/OUTPUTS: The tables below identify the month of the project each task will start and be accomplished for all eight components of the Keys Energy Conservation Initiative. 1. Affordable Residential Solar Water Heaters No. Task/Activity Description Deliverables/ Outputs Start Month Deadline Month I Select a vendor following the Submit RFP to Commission procurement procedures outlined 1 2 in 10 CFR 600, for solar water heater purchase and installation 2 Develop application for eligible Submit application to Commission 2 2 homeowners 3 Oversee installation of solar water Contract executed for installation heaters in 20 homes and materials purchased. Copies of 3 16 invoices sent to the Commission 4 Coordinate with the Provide homeowners with Weatherization program to assist recommendations 5 16 homeowners with additional retrofits 5 Coordinate rebates with Keys Use rebates to increase # solar 10 16 Energy heaters to be installed 6 Final Report Submit a report including photographs of the installed water 18 18 heaters, utility bills and invoices Grant Agreement No. ARSO10, Page 14 of 65 ATTACHMENT A GRANT WORK PLAN Grant Agreement No. ARS010, Page 15 of 65 ATTACHMENT A GRANT WORK PLAN Z. Energy Efficiency Educational Video Communication and Outreach No. Task/Activity Description Deliverables/ Outputs Start Month Deadline Month 1 Execute contract with Contract approved an signed by Environmental Education Board of County Commissioners 2 3 Foundation 2 Develop content and produce Submit outline of content to energy educational video Commission and place on County 3 9 website 3 Produce radio segment Radio segment broadcasted on NPR 10 12 4 Coordinate 12 technical Training workshops and public assistance workshops for business educations sessions complete, a list and residents of attendees and evaluations forms 10 16 rovided to the Commission 5 Final Report Submit a report including educational materials created with 18 18 funds 3. Retrofit Local Park Ball Field Lighting No. Task/Acdvity Description Deliverables/ Outputs Start Month Deadline Month i Solicit RFP for ballpark lighting Contractor selected for installation of lighting 1 6 2 Oversee installation of ballpark Lighting installed in six public li is arks 6 11 3 Final Report Submit a report including photographs of the light retrofit, 11 13 utility bills and invoices 4. Greenhouse Gas Emissions Inventory,Energy Audits and Outdoor Lighting Retrofit No. Task/Activity Description Deliverables/ Outputs Start Month Deadline Month 1 Select a vendor following the Submit RFP to Commission procurement procedures outlined in 10 CFR 600, 1) a greenhouse gas emissions inventory, 2) a 1 4 community energy audit and 3) ci energy audits 2 Select a vendor following the Submit RFP to Commission procurement procedures outlined in 10 CFR 600, for outdoor 2 4 lighting installation 3 Sign contract with consultants Consultants selected to conduct GHG inventory, community energy 4 5 audit and city energy audit 4 Define scope of work and identify Submit scope of work to audit needs Commission 5 8 5 Site inspections, measurements Consultant will draft final report for and data analysis Cityapproval 8 14 6 Oversee installation of outdoor 250 outdoor lights installed lighting 10 14 7 Final Report I Final audit reports submitted to Commission 15 16 Grant Agreement No. ARSO 10, Page 16 of 65 ATTACHMENT A GRANT WORK PLAN 5. EECS Development No. Task/Activity Description Deliverables/ Outputs Start Month Deadline Month 1 Develop scope of work for EECS Scope of work complete 1 3 2 Select a vendor following the Consultant assisted with plan procurement procedures outlined development and data gathering in 10 CFR 600, for a technical 3 6 assistance consultant to assist with plan development and data 3 Develop EECS for county EECS adopted by Board of County facilities and operations including Commissioners energy efficiency, energy 6 13 conservation and energy usage pals 4 Final Report Final SECS submitted to Commission 14 14 6. County Facilities Ener2v Audit and Retrofit No. Task/Activity Description Deliverables/ Outputs Start Month Deadline Month 1 Select a vendor following the Agreement signed and approve by procurement procedures outlined Board of County Commissioners in 10 CFR 600, for an engineering firm to conduct Grade Energy 1 2 Audits for four county facilities located in Key West 2 Conduct energy audit Detailed investment grade audit submitted to County 2 3 Define scope of work for retrofits Submit scope of work to as recommended in energy audit Commission 3 6 4 Execute contract for facility Board of County Commissioners retrofits approval and execution 6 9 5 Complete installation of energy Installation documentation efficient retrofits complete 9 l 8 6 Complete measurement and Energy saving calculations verification documented 17 18 7 Final Report Submit a final report to include evidence of energy savings as a 18 18 result of the energy audit 7. Hvbrid Vehicle Purchase No. Task/Activity Description Deliverables/ Outputs Start Month Deadline Month 1 Prepare purchase order for five Vehicles ordered hybrid vehicles following the procurement procedures outlined 1 2 in 10 CFR 600. 2 Finalize purchase of vehicles and Vehicles arrive arrival 2 6 3 Paint and decal vehicles Vehicles painted and decaled to increase awareness of alternative 6 7 fuel vehicles 4 Conduct a training workshop for Workshops and training completed drivers and maintenance staff 8 I 1 5 Final Report Submit a report to the Commission including hoto hs of the h brid 12 12 Grant Agreement No. ARSO10, Page 17 of 65 ATTACHMENT A GRANT WORK PLAN vehicles, records of savings and invoices Grant Agreement No. ARS010, Page 18 of 65 ATTACHMENT A GRANT WORK PLAN 8. Reniacement of Street Liehtine Poles No. Task/Activity Description Deliverables! Outputs Start Month Deadline Month 1 Select a vendor following the Electrician selected procurement procedures outlined 1 3 in 10 CFR 600, for electricians to retrofit 90 existing poles 2 1 Obtain quotes for the purchase of Solar light fixtures purchased 3 4 solar powered light fixtures 3 Identify existing underground Sites prepared for installation utilities and mark sites for new 3 8 poles 4 Installation of new light poles Light poles installed 4 8 5 Final Report Submit a report to the Commission including photographs of the 9 9 installed street lighting poles, utility bills and invoices Grant Agreement No. ARSO 10, Page 19 of 65 ATTACHMENT A GRANT WORK PLAN G. PROJECT BUDGET: The budget below summarizes the project by Funding Category. All dollar amounts are rounded to the nearest whole dollar value. Cost Share: Matching Funds and Funding Category Grant Funds Other In -Kind Contributions Funding Source of Funds 1. Salaries $109,614.00 $270,831.52 Monroe County, Habitat for Humanity, OF/GITF, City of Key West GR, City of Marathon GR, UF, Islamorada GR 2. Fringe Benefits $32,884.00 Monroe County, UF, City of Key West GR, $76,096.27 Islamorada GR 3. Travel if authorized) $0.00 $7,549.00 Monroe County 4. Supplies/Other $8,125.00 Monroe County, Habitat for Humanity, Green Expenses $83,663.00 Living and Energy Education Inc, City of Key West GR, Islamorada GR 5. Equipment $ 111,875.00 $0.00 Keys Energy Services, Federal Tax Credit 6. Contractual Services $2,424,790.00 Monroe County, NexGENergy, Environmental $164,757.00 Education Foundation, KEYS Energy, City of Marathon GR, Cameron -Cole LLC 7. Indirect (if authorized) $0.00 $0.00 N/A Total Project Budget $2 687,288.00 $602,896.79 Total Project Cost _ -Grants Funds +Cost Share $3 9l! 184.79 Cost Share Percentage 18.3% = Cost Share / Total Project Cost H. TOTAL BUDGET BY TASK: The project budget below summarizes the project by Project Task. Project Tasks correspond to the "Project Description" section. All dollar amounts are rounded to the nearest whole dollar value. Cost Share: Matching Funds and Project Task Grant Funds Other In -Kind Contributions Matching Bootee Funds 1 Complete Residential Solar $130,000.00 $47,281.00 Monroe County, Habitat for Humanity Water Heater 2 Complete Energy $30,000.00 $105,661.00 OF/GITF, Monroe County, Green Living Education and Outreach and Energy Education, Inc, Environmental Education Foundation 3 Complete Ball Park Light $744,790.00 $113,985.42 City of Key West, KEY Energy Retrofit 4 Complete GHG Inventory, $400,000.00 $110,972.89 City of Marathon Audit and Lighting 5 Complete EECS $20,000.00 $96,364A8 UF, Monroe County, Cameron -Cole LLC 6 Complete County Facilities $700,000.00 $69,400.03 Monroe County Audit and Retrofit 7 Complete Purchase of $120,000.00 $4,78100 Monroe County Hybrid Vehicles 8 Complete Solar Park $400,000.00 $48,243,00 Islamorada Lighting 9 Ongoing Project Admin $142,498,00 $7,591.00 Monroe County and Reporting Totals: $2,687,298.00 1 $602,896.79 Total Project Cost: F=Grant Funds + Cost Share $3,290,784.79 Grant Agreement No. ARSO 10, Page 20 of 65 ATTACHMENT A GRANT WORK PLAN 1. BUDGET DETAO,: Using the definitions provided below, the detailed, line -item budget clarifies the Budget Summary shown in Section G. Budget Category Sub -Totals have been rounded to the nearest whole dollar value. Up to 10% of grant funds may be used for administrative costs, excluding the cost of meeting reporting requirements of the program. Administrative costs are defined as: allowable, reasonable, and allocable Direct and Indirect costs related to overall management of the awarded grant (including travel). For each budget line -item, the appropriate column identifies if the cost is: 1) Grant or Match, 2) a Direct cost used to calculate Indirect Costs (if approved) and 3) whether the cost is Administrative in nature. A description of what is required for each budget category is as follows: 1. Salaries - Identify the persons to be compensated for work on this project by name (if known), position, and title. Show the hourly cost and total hours to be charged for each person or position. Divide annual salaries by 2080 hours and nine month academic salaries by 1560 hours, to find the hourly rate. 2. Fringe Benefits - Multiply the rate by the total salaries to which fringe benefits apply. If the rate is variable, explain and show calculations. 3. Travel - List trips by their purpose and/or destination. Indicate the number of days for each trip. The Commission will only reimburse for travel at the appropriate State of Florida rate (Section 112.061, Florida Statutes), using the forms referenced in Attachment B, Payment Request Summary Form. Be prepared to provide the Commission with details on costs utilized to calculate the "Amount Budgeted" for each trip. 4. Supplies & Other Expenses - List expendable supplies by category description, unit costs and quantity. List other expenses not included in any of the above categories. Examples would be printing, copying, postage, communications, etc. Non -expendable equipment valued at less than $1,000 may be listed also. Include only expenses directly related to the project, not expenses of a general nature. For Match only, list costs related to donated real property such as land (not to exceed the fair market value of the property). 5. Equipment - List non -expendable personal property/equipment valued at $1,000 or more by description, unit cost, and quantity. Computers and data-processing equipment should be described in detail. 6. Contractual Services - Subcontractors should provide the same information required by this budget table, with the following exceptions: (a) when professional services are provided at a pre-existing approved rate or fee shown on the budget, or (b) the subcontract is to be obtained competitively. For either (a) or (b), show an estimated maximum amount. 7. Indirect Costs/Rate — Indirect Costs are not authorized. 8. Total Budjzet Category — Show the total of all line -items within a Budget Category. 9. Total Budget - Show the total of all categories. 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F ° U II II If Y � o U F 69 Z 5R II if 0 v W y �y3 R y u a �u� o * # O F _ L w JI y o O y U R a U GJ A T1 CC = o � F 69 Vui C4 C L CL R CL R o U v � H � O U � � U Cl a o d � z N S S O r DO O 69 �O t1 00 O IO M Q U 6A, 69 6 9 64 �CpQ fiH Jw av+ R O F + + + + + + + S SS SS S S 00 69 N_ h 00 O M 64 r- fV 00 y ° 4:3 64 U a R C7 03 0 F II II If II III II II 11 00 L It oc It 00 r- ° C V1 I'- 00 00 00 oG O th 69 � _ 00 00 O m E's ... h N ven d b oa L Vl ° U R O F _ oa u L y � y y y N �Ri 0 C ^fti O a o a F cn w F- vn W U M 4 v1 �6 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT B PAYMENT REQUEST SUMMARY FORM STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS Grantee: Grantee's Representative: Mailing Address: Grant Agreement No.: Date Of Request: Amount Requested:$ Reimbursement Request No.: Reimbursement Period: Percent Matching Required: to PROJECT EXPENDITURES SUMMARY SECTION CATEGORY OF EXPENDITURE AMOUNT OF THIS REQUEST TOTAL CUMULATIVE PAYMENTS MATCHING FUNDS TOTAL CUMULATIVE MATCHING FUNDS 1. Salaries $ $ $ $ 2. Fringe Benefits $ $ $ $ 3. Travel if authorized $ $ $ $ 4. Supplies/Other Expenses $ $ $ $ 5. Equipment $ $ $ $ 6. Contractual Services $ $ $ $ 7. Indirect Costs if authorized $ $ $ 1 $ TOTAL AMOUNT EXPENDED Less Retainage* 10% of TOTAL AMOUNT EXPENDED _$ $ $ $ $ $ TOTAL AMOUNT TO BE REIMBURSED $ $ AGREEMENT AMOUNT $ $ Less TOTAL AMOUNT EXPENDED: $ $ TOTAL AVAILABLE BALANCE $ $ I I he cumulative Ketainage amount shall be reimbursed on the Final Reimbursement Request, upon approval of the Final Report by the Commission's Grant Manager. GRANTEE CERTIFICATION The undersigned certifies that the amount being requested for reimbursement above is for items that were charged to and utilized only for the above cited grant activities. Grantee's Representative's Signature Grantee's Fiscal Agent Print Name Print Name Telephone Number Telephone Number Grant Agreement No. ARSO 10, Page 29 of 65 A Z E 0 z 15 —70 U LJ L) Tj- u 5 Y-1 Ti —lJ u L7 all OW fn CL im CL L) m CL 04 0 w S lt co .... ...... 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Z mid m(D o ai� "O ` ~ ci Z 4: U 2 CD -� 0 3 ova roz W o «� m i �c x O c 0 3 I Q E Qi U o om v� a �vo c co >C �W Qb� ** 0 C 0-1 72 > y U m C 0-0 o c i +. moco 0 UA Z o ui z 7, Z ;A z L) L) Z q 0 T t; u a) M 0 LI c 0 C , ) �75 EL L co Cc L , L s Uas o 4 co 44 CL 0 W :Z 0 Ln OA 0 CL x Ww uSri '41 ui 40 CL I W) u C E AIR Im a Q a at N C1 it o �„ w p O 5U 0O O V Nm v a�N a�N�CD A c C ea cQ tm 0 C C (II O V 2 I to O Ug �0 (�C �i� 6 0 2 �ov0, a t i cl- v O � C �D O U Z N N rn Z C W C t p LL O (D O w a Q JCL gQ 2 c CO c a c ,= p •m o. ro E tOi .a 0g �cm c=ic�pm OO m rLm� y°y iQy J p pVcD OOa N CL V. ui mY mY oa Uam p Co y�Qm O mp mU .QwW H �w l!d 2 �c a; G► $ U00j (90 2 O C ' U E(D Q Q � a° L m o\ a °m >Uo O c'o m c o v U .. c v- c !0 O V 0 C ram.+ +O' yj O _ 9 _ �+ O € � H r 0 a0+ m 7 0 0 0 O O ` � .U. � ti m >3 >5 y�> O C ° _ U w U m , 3 1 9_�pp Z Z ti 8 O Ak FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 INSTRUCTIONS FOR COMPLETING PAYMENT REQUEST SUMMARY FORM GRANTEE: Enter the name of the Grantee's agency, as reflected on your Grant Agreement. MAILING ADDRESS: Enter the reimbursement mailing address. GRANT AGREEMENT NO.: This is the six -digit number on your Grant Agreement. DATE OF REQUEST: This is the date the Grantee is submitting the request for reimbursement. AMOUNT REQUESTED: This is the amount on the "TOTAL AMOUNT TO BE REIMBURSED" line for the "AMOUNT OF THIS REQUEST' column. GRANTEE'S REPRESENTATIVE: This is the person identified as Grantee's Representative in the Grant Agreement. REIMBURSEMENT REQUEST NO.: This is the number of the reimbursement request, not the month number. The first reimbursement request submitted shall be number 1 and subsequent reimbursement requests shall be numbered in ascending numerical order. REIMBURSEMENT PERIOD: This is the beginning date (dd/mm/yyyy) and ending date (dd/mm/yyyy) of the reimbursement period. PERCENT MATCHING REQUIRED: Enter the Match requirement here, as reflected on the approved Attachment A, Grant Work Plan, PROJECT EXPENDITURES SUMMARY SECTION "AMOUNT OF THIS REQUEST" COLUMN: Enter the amount paid during the reimbursement period. Provide accurate costs and do not round fivures to the nearest whole dollar value. All costs included in the reimbursement request must agree with the approved Project Budget in the current Attachment A, Grant Work Plan of your Grant Agreement. Do not request reimbursement for costs that do not have an associated, approved, funded budget category or approved, funded budget line - item in the current Project Budget. Do not claim items that are not specifically identified in the current Budget Detail as reflected in Section 1 of the current Attachment A, Grant Work Plan. • Enter the column total on the "TOTAL .AMOUNT EXPENDED" line. The figures reflected for each approved budget category must correspond with the budget category amount reflected on the associated Grant Reimbursement Detail Form. • For the "Less Retainage" line, calculate 10% of the "TOTAL AMOUNT EXPENDED" for this reimbursement request; this figure must be shown in brackets (e.g. <$X,XXX.XX>) to reflect that the amount will be deducted from the "TOTAL AMOUNT EXPENDED ". • For the "TOTAL AMOUNT TO BE REIMBURSED" line, deduct the "Less Retainage" amount from the "TOTAL AMOUNT EXPENDED ". • For the "AGREEMENT AMOUNT', enter the total amount of the Grant Agreement. For the "Less TOTAL AMOUNT EXPENDED" line, enter the total amount expended as reflected on this reimbursement request and all previous reimbursement requests. • For the "TOTAL AVAILABLE BALANCE" line, deduct the "Less TOTAL AMOUNT EXPENDED" amount from the "AGREEMENT AMOUNT". • For only the Final Reimbursement Request, the Grantee may request reimbursement of all previously deducted Retainage on the condition that the Final Report for the project has been submitted and approved by the Commission's Grant Manager. To request reimbursement of Retainage, reflect the cumulative amount of Retainage as a positive figure (no brackets) in the "Less Retainage" line and add it to the "TOTAL AMOUNT EXPENDED" to reflect the final "TOTAL AMOUNT TO BE REIMBURSED" amount. "TOTAL CUMULATIVE PAYMENTS" COLUMN: Enter the cumulative amounts previously submitted for reimbursement to date for each approved, funded budget category. Provide accurate costs and do not round figures to the nearest whole dollar value. On the "Less Retainage" line, enter the total cumulative amount of Retainage deducted from all reimbursement requests. On the "TOTAL AMOUNT TO BE REIMBURSED" line, deduct the cumulative "Less Retainage" amount from the cumulative "TOTAL AMOUNTEXPENDED". The Final Reimbursement Request must show the total of all reimbursements; first through the final reimbursement (this amount cannot exceed the approved, funded budget amount for each budget category). Enter the column total on the "TOTALS" line. Grant Agreement No, ARSO 10, Page 34 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 "MATCHING FUNDS" COLUMN: Enter the amount documented as Match for the reimbursement period. Provide accurate costs and do not round figures to the nearest whole dollar value. This needs to be shown under specific budget categories according to the currently approved Attachment A, Grant Work Plan. • Enter the total for all budget categories on the "TOTAL AMOUNT EXPENDED" line for this column. • Enter the total Match budget amount on the "AGREEMENT AMOUNT' line for this column. This amount must correspond with the minimum Match amount specified in Section 4.A of the Grant Agreement and as reflected on the currently approved Attachment A, Grant Work Plan. • Enter the total cumulative amount of this and any previous Match documented on the "LESS TOTAL .AMOUNT EXPENDED" line for this column. • Deduct the "LESS TOTAL AMOUNT EXPENDED" from the "AGREEMENT AMOUNT' for the amount to enter on the "TOTAL A lAAILABLE BALANCE" line. "TOTAL CUMULATIVE MATCHING FUNDS" COLUMN: Enter the cumulative amount documented to date for Match by budget category. Enter the total of all budget categories on the line titled "TO TALAMOUNT EXPENDED." The Final Reimbursement Request must reflect the total of all documented Match, beginning with the first Match documentation through the final Match documentation, etc. The proportion of cumulative Matching funds as of the final Match documentation must equate to the Cost Share Percentage as reflected on the current, approved Attachment A, Grant Work Plan of the Grant Agreement. If insufficient "TOTAL CUMULATIVE MATCHING FUNDS" are submitted, the Final Reimbursement Request of grant funds shall be reduced to ensure that the Cost Share Percentage GRANTEE CERTIFICATION: The Payment Request Summary Form must be signed by both the Grantee's Representative as identified in the Grant Agreement and the Grantee's Fiscal Agent to be approved for reimbursement. NOTE: If requesting reimbursement for travel, you must include copies of all travel receipts and a copy of the Commission's properly completed travel reimbursement form (in the format approved by the Department of Financial Services, Chief Financial Officer) that has been signed by both the traveler and the traveler's supervisor. Grant Agreement No. ARSO10, Page 35 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 INSTRUCTIONS FOR COMPLETING GRANT REIMBURSEMENT DETAIL and MATCH DOCUMENTATION DETAIL Provide a detailed, line -item description using the worksheet provided for each Budget Category of funds Grantee is requesting for reimbursement or documentation of Match. Costs listed on the Grant Reimbursement Detail must reflect information on supporting documentation, must correspond with the approved Project Budget, the Payment Request Summary Form — Project Expenditures Summary Section and accompanying supporting documentation. The description of each line -item must include the month and year that the item was received; this month and year must fall within the Reimbursement Period. Any line -item with a corresponding month and year prior to the Reimbursement Period must be accompanied by a statement that this cost was not included in a prior Reimbursement Request. For each budget line -item, identify if the cost is: 1) Grant or Match, 2) a Direct cost used to calculate Indirect Costs (if approved), and 3) whether the cost is Administrative in nature. Provide accurate costs and do not round the amounts to the nearest whole dollar value. Supporting documentation for each amount for which reimbursement is being requested must: 1) list the item that has been paid for, 2) be submitted in the order in which items are shown on the Grant Reimbursement Detail and the Match Documentation Detail and 3) be either highlighted or circled. Check numbers may be provided in lieu of copies of the actual checks. If an item was purchased with a credit card, reflect "paid by credit card" on Grant Reimbursement Detail or the Match Documentation Detail, in lieu of a check number and provide vendor receipt reflecting that the item was paid by credit card (this can be hand written) along with a copy of related credit card statement (credit card number and other confidential information may be blacked out). Each piece of documentation must clearly reflect the dates of service. Only expenditures for budget categories and budget line -items in the approved Project Budget will be reimbursed or documented as Match. Listed below are the types of documentation and examples of minimum requirements. (1) Salaries: A payroll register or similar documentation should be maintained. The payroll register should show gross salary charges, fringe benefits, other deductions and net pay. If an individual for whom reimbursement is being claimed is paid by the hour, a document reflecting the hours worked times the rate of pay will be acceptable. (2) Fringe Benefits: Fringe Benefits should be supported by invoices showing the amount paid on behalf of the employee, e.g., insurance premiums paid. If the Grant Agreement specifically states that fringe benefits will be based on a specified percentage rather than the actual cost of fringe benefits, then the calculation for the fringe benefits amount must be shown. Exception: Governmental entities are not required to provide check numbers or copies of checks for fringe benefits. (3) Travel: Reimbursement for travel must be in accordance with Section 112.061, Florida Statutes, including submission of the claim on the approved state travel form that has been signed and dated by the traveler and the traveler's supervisor and copies of all travel receipts must also be attached. For additional information on documentation of travel costs, contact the assigned Commission Grant Manager. (4) Supplies - Other Expenses: Reimbursement will he made based on paid invoices/receipts. (5) Equipment: Reimbursement will be made based on paid invoices/receipts. Attachment J, Property Reporting Form, must be properly completed, signed and attached to the Attachment B, Payment Request Summary Form for each item of equipment requested for reimbursement or match documentation. (6) Contractual Services: Reimbursement will be made based on paid invoices/receipts. Subcontractors must be listed on Attachment C, Monthly Progress Report, for the corresponding reimbursement period. (7) Indirect Costs: If the Grant Agreement allows recovery of Indirect Costs, the calculation of these costs must be based upon direct costs reflected in the corresponding reimbursement period, utilizing the Indirect Cost rate in the approved Project Budget. Grant Agreement No. ARS010, Page 36 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT C MONTHLY PROGRESS REPORT STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARD Grant Agreement No.: ARS010 Grantee Name: Grantee Address: Grantee's Representative: Telephone No.: Monthly Reporting Period: Project Number and Title: A. Provide a summary of project accomplishments to date. (Include a comparison of actual accomplishments to the objectives established for the period. If goals were not met, provide reasons why.) B. Provide an update on the number of jobs created or retained, quantify the reduction of greenhouse gasses and the energy saved in kWh or BTU. C. Provide an update on the estimated time for completion of the project and an explanation for any anticipated delays. Grant Agreement No, ARSO 10, Page 37 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 D. Provide any additional pertinent information including, when appropriate, analysis and explanation of cost overruns or high unit costs. E. Identify below, and attach copies of, any relevant work products being submitted for the project for this reporting period (e.g., report data sets, links to on-line photographs, etc.) F. Provide a project Grant Budget update, comparing the Grant Project Budget to actual costs to date. Grant Grant Grant Budget Total Grant Expenditures Expenditures this Grant Project Category Project Prior to this Reporting Period Funding Balance Budget Reportin2 Period 1. Salaries 2. Fringe Benefits 3. Travel (if authorized) 4. Suppties/Other Expenses 5. Equipment 6, Contractual Services 7. Indirect Costs (if authorized 8. Total of all Grant Budget Categories Grant Agreement No. ARS010, Page 38 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 G. Provide a project Match Budget update, comparing the Match Project Budget to actual costs to date. Match Match Match Budget Total Match Expenditures Expenditures this Match Project Category Project Prior to this Reporting Period Funding Balance Budget Reporting Period 1. Salaries 2. Fringe Benefits 3. Travel (if authorized) 4. Supplies/Other Expenses 5. Equipment 6, Contractual Services 7. Indirect Costs if authorized 8. Total of all match Budget Categories H. REPORTING Activities: (GRANT MANAGER NOTE: All of the tables below may not be required for this AjLreement. Please choose the appropriate metric(s) for the funded activity and include only the appropriate tables for each Agreement on a project to protect basis. i ,BNtEIl�t�tt��A�tdib Number of Audits Performed Floor Space Audited Auditor's Projection of Energy Saved Grant Agreement No. ARSO10, Page 39 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANI' AGREEMENT NO. ARS010 t4ow tons tad Number of Loans Given Monetary value of Loans Given Number of Grants Given Monetary value of Grants Given Grant Agreement No, ARS010, Page 40 of 65 Number of Solar Energy Systems Installed Total Capacity of Solar Energy Systems Number of Wind Energy Systems Installed Total Capacity of Wind Energy S stems Number of other Renewable Energy Systems Installed Total Capacity of other Renewable Energy Systems FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 Number of Alternative Fuel Vehicles Purchased Number of Vehicle Conversions to Alternative Energy Number of New Alternative Fueling Stations Number of Carpools and Vanpools Formed Number of Energy Efficient Traffic Signals Installed Number of Street Lane Miles for which Synchronized Traffic Signals were Installed Grant Agreement No. ARSO 10, Page 41 of 65 try etti�trtit�t Number of Workshops, Training and Education Sessions Held Number of People Attending Workshops, Training and Education Sessions Number of Direct Jobs Created Number of Indirect Jobs Created Actual Worker Head Count Number of FTE Job Equivalents FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 Reduction in Natural Gas Consumption (mmcf) Reduction in Electricity Consumption MWh Reduction in Electricity Demand (MW) Reduction in Natural Gas Consumption (mmcfl Reduction in Fuel Oil Consumption (gallons) Reduction in Propane Consumption (gallons) Reduction in Gasoline and Diesel Consumption (gallons) Amount of wind - powered electric generating capacity installed Amount of electricity generated from wind systems (MWh) ae"W" b Amount of photovoltaic generating capacity installed (MW) Amount of electricity generated from photovoltaic systems (MWh) Amount of electric generating capacity from other renewable sources installed (MW) Amount of electricity generated from other renewable sources (MWh) Tons Carbon Emission Reduction (CO2 E uivalent Tons of Sulfur Dioxide Emission Reduction (CO2 E uivalent) Tons of Nitrogen Oxide Emission Reduction (CO2 Equivalent) Tons of Carbon Monoxide Emission Reduction (CO2 Equivalent) SUBCONTRACTOR LIST Grant Agreement No. ARSO10, Page 42 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 The Grantee may subcontract work under this Grant Agreement without the prior approval of the Grant Manager, upon the condition that each Monthly Progress Report must contain a current list of subcontractors, as required in Section 18.A of the Grant Agreement. 'IJ rantee does not have subcontractors, lease state 'None' below %uaa of but TOW �t ` cr#►1i is Addteaft sw#rat rik�� J. MINORITY/WOMAN/SERVICE-DISABLED VETERAN -OWNED BUSINESS LIST The Grantee is encouraged to use small businesses, including minority, woman and service -disabled veteran - owned businesses as subcontractors under this Grant Agreement. As required in Section 18.0 of the Grant Agreement, the Grantee is required to report information concerning their use of such businesses in each Monthly Progress Report. *If grantee does not have any subcontracts with minority/woman/service-disabled veteran- owned businesses, please state `None' below Pttrid to amb"m vwripom of 041"rhy, d >>1 i�rrl+k" Wept, , 1�1 aC . - _ R+t ►att� — �1 by I&Oko-MoMed This report is submitted in accordance with the reporting requirements of Grant Agreement No. ARSO10 and accurately reflects the activities and costs associated with the subject project. Signature of Grantee's Representative Date Grant Agreement No. ARSO 10. Page 43 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT D SPECIAL AUDIT REQUIREMENTS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS The administration of resources awarded by the Florida Energy and Climate Commission (hereinafter referred to as the "Commission") to the recipient (hereinafter referred to as the "grantee" or "recipient"), may be subject to audits and/or monitoring by the Commission, as described in this attachment. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A-133 and Section 215.97, F.S., as revised (see "AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by Commission staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this Agreement, the recipient agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Commission. In the event the Commission determines that a limited scope audit of the recipient is appropriate, the recipient agrees to comply with any additional instructions provided by the Commission to the recipient regarding such audit. The recipient further agrees to comply and cooperate with any inspections, reviews, investigations or audits deemed necessary by the Chief Financial Officer or Auditor General. AUDITS PART I: FEDERALLY FUNDED This part is applicable if the recipient is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. 1. In the event that the recipient expends $500,000 or more in Federal awards in its fiscal year, the recipient must have a single or program -specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised. In determining the Federal awards expended in its fiscal year, the recipient shall consider all sources of Federal awards. 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 recipient conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the requirements of this part. 2. In connection with the audit requirements addressed in Part I, paragraph 1. the recipient shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised. 3. If the recipient expends less than $500,000 in Federal awards in its fiscal year, an audit conducted in accordance with the provisions of OMB Circular A-1 33, as revised, is not required. In the event that the recipient 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 an audit must be paid from recipient resources obtained from other than Federal entities). 4. The recipient may access information regarding the Catalog of Federal Domestic Assistance (CFDA) via the internet at http:,,/12.46.245.173/cfda/cfda.html. Grant Agreement No. ARS010, Page 44 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 PART II: STATE FUNDED This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2)(m), Florida Statutes. 1. In the event that the recipient expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal year of such recipient, the recipient must have a State single or project -specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. In determining the state financial assistance expended in its fiscal year, the recipient shall consider all sources of state financial assistance, including state financial assistance received from the Commission, 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. 2. In connection with the audit requirements addressed in paragraph 1, the recipient shall ensure that the audit complies with the requirements of Section 215.97, Florida Statutes. This includes submission of a financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. 3. If the recipient expends less than $500,000 in state financial assistance in its fiscal year, an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In the event that the recipient 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 non - state entity's resources (i.e., the cost of such an audit must be paid from the recipient's resources obtained from other than State entities). 4. The recipient must include the record keeping requirements found herein in subcontractor agreements entered into for work required under terms of this Agreement. In the executed subcontract, the recipient shall provide each subcontractor of state financial assistance the information needed by the subcontractor to comply with the requirements of Section 215.97, Florida Statutes. Pursuant to Section 215.97, Florida Statutes, the recipient shall review and monitor subcontractor audit reports and perform other procedures as specified in the agreement with the subcontractor, which may include onsite visits. The recipient shall require subcontractors, as a condition of receiving state financial assistance, to permit the independent auditor of the recipient, the Commission, the Chief Financial Officer, the Chief Inspector General and the Auditor General access to the subcontractor's records and independent auditor's working papers as necessary to comply with the requirements of Section 215.97, Florida Statutes. 5. For information regarding the Florida Catalog of State Financial Assistance (CSFA), a recipient should access the Florida Single Audit Act website located at https:/,'apps.fldfs.coni/fsaa for assistance. In addition to the above websites, the following websites may be accessed for information: The Florid Legislature's Website at http://www.leg.state.fl.us,'Welcome/index.cfni, the State of Florida's website at http://www.myflorida.com/. the Department of Financial Services' Website at h!T://www.fldfs_com/ and the Auditor General's Website at http://'wv"v..state.fl.us/audgen. 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 Attachment shall be submitted, when required by Section .320 ('d), OMB Circular A-133, as revised, by or on behalf of the recipient directly to each of the following: A. The Florida Energy and Climate Commission at the following address: Audit Director or Grant Manager Florida Energy and Climate Commission Executive Office of the Governor 600 South Calhoun Street, Suite 251 Tallahassee, FL 32399-0001 Grant Agreement No. ARS010, Page 45 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO1O B. 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 loth Street Jeffersonville, IN 47132 C. Other Federal agencies and pass -through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. 2. Pursuant to Section .320(f), OMB Circular A-133, as revised, the recipient shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letters issued by the auditor, to the Commission at the following address: Audit Director or Grant Manager Florida Energy and Climate Commission Executive Office of the Governor 600 South Calhoun Street, Suite 251 Tallahassee, FL 32399-0001 Copies of financial reporting packages required by PART II of this Attachment shall be submitted by or on behalf of the recipient directly to each of the following: A. The Florida Energy and Climate Commission at the following address: Audit Director or Grant Manager Florida Energy and Climate Commission Executive Office of the Governor 600 South Calhoun Street, Suite 251 Tallahassee, FL 32399-0001 B. The Auditor General's Office at the following address: State of Florida Auditor General Room 401, Claude Pepper Building I I I West Madison Street Tallahassee, Florida 32399-1450 RECORD RETENTION The recipient shall retain sufficient records demonstrating its compliance with the terms of this Agreement for a period of five years from the date the audit report is issued and shall allow access to such records upon request by the Commission or its designee, Chief Financial Officer or Auditor General. The recipient shall ensure that audit working papers are made available to the Commission or its designee, Chief Financial Officer or Auditor General upon request for a period of three years from the date the audit report is issued, unless extended in writing by the Commission. Grant Agreement No. ARSO10, Page 46 of 65 G O p aU � Q Q 00 00 mc G N oc 7E .5 � Q o J � o rq U a C � 4, G QA d � ar ate+ 7.. Uz00 a a a a � W o o ¢ G Ca y to u � � 7 0 iC 'v o CU a~i 'O 5 W O ►. Ca o r; W O � O � L. L a G L y, r° G w' v L 7 H a 5 .C7 i a c° Q v � w 0 ar 0 U C 5 c, d o Q C w U Ln 0 a d a d .c 6! 'O v w 3 d u 4 3 v a a� as � o u az O .v. ' 0 O aU Q W � � G O V1 rl N 0 G u 9 0 0 o � u � q U a Q o U � � o 0 y 0 U � U Z Y N h w 0 a c v a a o +0r aq 5 v w 3 d u L az 00 r- 00 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT E FEDERAL REGULATIONS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS Formal regulations concerning administrative procedures for USDOE grants appear in Title 10 of the Code of Federal Regulations. Grant program administrative regulations appear in Part 600, Other USDOE regulations also impact grant programs. The following list contains regulations and Office of Management and Bud et Circulars which mayapply to the work performed under this Agreement. 2 CFR 176 Award Terms for Assistance Agreements that include funds under the American Recovery and Reinvestment Act of 2009, Public Law 111-5 2 CFR 901 Nonprocurement Debarment and Suspension 10 CFR 600 Financial Assistance Rules 10 CFR 601 New Restrictions on Lobbying 10 CFR 607 Government wide requirements for drug -free work lace fmancial assistance) 10 CFR 1039 Uniform relocation assistance and real property acquisition for federal and federally assisted programs 10 CRF 1040 Nondiscrimination in Federally Assisted Programs or Activities 10 CFR 1041 Enforcement of Nondiscrimination on the basis of handicap in programs or activities conducted by USDOE 10 CFR 1042 Nondiscrimination on the basis of sex in education programs or activities receiving federal financial assistance Other Federal Regulations 45 CFR Subtitle A — Appendix E to Part 74 Principles for Determining Costs Applicable to Research and Development -Under Grants and Contracts with Hospitals 48 CFR 31 Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with cost principles acceptable to the federal agency Office of Management and Budget Circulars A-21 Cost Principles for Educational Institutions A-87 Cost Principles for State, Local, and Indian Tribal Governments A-102 Grants and Coo erative Agreements with State and Local Governments A-110 Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals, and Other Non -Profit Organizations A-122 Cost Principles for Non -Profit Organizations A-133 Audit Requirements Grant Agreement No. ARS010, Page 48 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT F FEDERAL FUNDING GRANTEE, SUBGRANTEE AND CONTRACTOR PROVISIONS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS All subgrants and contracts awarded by the Grantee, including small purchases, shall contain the following provisions as applicable: 1. Equal Employment Opportunity - All contracts shall contain a provision requiring compliance with E.O. 11246, "Equal Employment Opportunity," as amended by E.O. 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and as supplemented by regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." 2. Copeland "Anti -Kickback" Act (18 U.S.C. 874 and 40 U.S.C. 276c) - All contracts and subgrants in excess of $2,000 for construction or repair awarded by recipients and subrecipients shall include a provision for compliance with the Copeland "Anti -Kickback" Act (18 U.S.C. 874), as supplemented by Department of Labor regulations (29 CFR part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that each contractor or subrecipient shall be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. The recipient shall report all suspected or reported violations to the Federal awarding agency. 3. Davis -Bacon Act, as amended (40 U.S.C. 276a to a-7) - When required by Federal program legislation, all construction contracts awarded by the recipients and subrecipients of more than $2,000 shall include a provision for compliance with the Davis -Bacon Act (40 U.S.C. 276a to a-7) and as supplemented by Department of Labor regulations (29 CFR part 5, "Labor Standards Provisions Applicable to Contracts Governing Federally Financed and Assisted Construction"). Under this Act, contractors shall be required to pay wages to laborers and mechanics at a rate not less than the minimum wages specified in a wage determination made by the Secretary of Labor. In addition, contractors shall be required to pay wages not less than once a week. The recipient shall place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation and the award of a contract shall be conditioned upon the acceptance of the wage determination. The recipient shall report all suspected or reported violations to the Federal awarding agency. 4. Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333) - Where applicable, all contracts awarded by recipients in excess of $2000 for construction contracts and in excess of $2,500 for other contracts that involve the employment of mechanics or laborers shall include a provision for compliance with Sections 102 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333), as supplemented by Department of Labor regulations (29 CFR part 5). Under Section 102 of the Act, each contractor shall be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than l %a times the basic rate of pay for all hours worked in excess of 40 hours in the work week. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. 5. Rights to Inventions Made Under a Contract or Agreement - Contracts or agreements for the performance of experimental, developmental, or research work shall provide for the rights of the Federal Government and the recipient in any resulting invention in accordance with 10 CFR part 600.325. "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding agency. Grant Agreement No. ARSO1 O, Page 49 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 6. Clean Air Act (42 U.S.C. 7401 et seq.), and the Federal Water Pollution Control Act (33 U.S.C. 1251 et seq.), as amended - Contracts and subgrants of amounts in excess of $100,000 shall contain a provision that requires the recipient to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401 et seq.) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251 et seq.). Violations shall be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). Byrd Anti -Lobbying Amendment (31 U.S.C. 1352) - Contractors who apply or bid for an award of $100,000 or more shall file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier shall also disclose any lobbying with non -Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the recipient. 8. Debarment and Suspension (E.O.s 12549 and 12689) - No contract shall be made to parties listed on the General Services Administration's List of Parties Excluded from Federal Procurement or Nonprocurement Programs in accordance with E.O.s 12549 and 12689, "Debarment and Suspension." This list contains the names of parties debarred, suspended, or otherwise excluded by agencies, and contractors declared ineligible under statutory or regulatory authority other than E.O. 12549. Contractors with awards that exceed the small purchase threshold shall provide the required certification regarding its exclusion status and that of its principal employees. 9. Section 508 of the Federal Water Pollution Control Act, as amended (33 U.S.C. 1368) and Section 1424(e) of the Safe Drinking Water Act, (42 U.S.C. 300h-3(e)) - Contracts and subgrants of amounts in excess of $100,000 shall contain a provision that requires the recipient to agree to comply with all applicable standards, orders or regulations issued pursuant to Section 508 of the Federal Water Pollution Control Act, as amended (33 U.S.C. 1368) and Section 1424(e) of the Safe Drinking Water Act, (42 U.S.C. 300h-3(e)). Violations shall be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). 10. Compliance 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 sex; (b) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 795), which prohibits discrimination on the basis of handicaps; (c) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (d) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (e) 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; (f) Sections 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; (g) 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; (h) any other nondiscrimination provisions in the specific statute(s) made; and, (i) the requirements of any other nondiscrimination statute(s) which may apply. 11. Compliance 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. 12. Compliance with the provision 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. 13. 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. Grant Agreement No. ARS010, Page 50 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 14. Compliance with environmental standards which may be prescribed 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 EP 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplain 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 (Clean Air) Implementation Plans under Section 176(c) of the Clean 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.1.. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205). 15. Compliance with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 16. 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.) 17. Compliance with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 18. Compliance 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 bloodied animals held for research, teaching, or other activities supported by this Agreement. 19. Compliance 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. 20. Compliance with the mandatory standards and policies relating to energy efficiency which are contained in the State energy conservation plan issued in accordance with the Energy Policy and Conservation Act (Pub. L. 94-163, 89 Stat. 871). 21. Assist the Commission in complying with the State Energy Conservation Program as described in the Code of Federal Regulations, Title 10, Parts 420 and 450 and guidance issued by the U.S. Department of Energy and subsequent guidance issued by the U.S. Department of Energy; the Financial Assistance Rules described in Title 10, Part 600, as well as those regulations concerning the use of oil overcharge recovery funds. 22. The Commission reserves the right to transfer equipment acquired under this grant as provided in Title 10, Part 600.117. The Recipient can obtain a release of this right upon application containing certain commitments. 23. Compliance with the Buy American Act (41 U.S.C. I0a-10c) By accepting funds under this Agreement, the Grantee agrees to comply with sections 2 through 4 of the Act of March 3, 1933, popularly known as the "Buy American Act." The Grantee should review the provisions of the Act to ensure that expenditures made under this Agreement are in accordance with it. It is the sense of the Congress that, to the greatest extent practicable, all equipment and products purchased with funds made available under this Agreement should be American -made. 24. Preservation of open and competition and government neutrality towards contractors' labor relations on federally funded construction projects a. Unless in conflict with State or local laws, you must ensure that bid specifications, project agreement, or other controlling documents in construction contracts awarded pursuant to this agreement, or pursuant to a subaward to this agreement, do not: 1. Require or prohibit bidders, offerors, contractors, or subcontractors to enter into or adhere to agreements with one or more labor organizations, on the same or other related construction project(s); or Grant Agreement No, ARSO10, Page 51 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 2. Otherwise discriminate against bidders, offerors, contractors, or subcontractors for becoming or refusing to become or remain signatories or otherwise to adhere to agreements with one or more labor organizations, on the same or other related construction project(s). b. The term "construction contract" as used in this provision means any contract for the construction, rehabilitation, alteration, conversion, extension, or repair of buildings, highways, or other improvements to real Property c. Nothing in this provision prohibits bidders, offerors, contractors, or subcontractors from voluntarily entering into agreements with labor organizations. 25. Compliance with the provision included in Title XV and Title XVl of Public Law 111-5, the American Recovery and Reinvestment Act of 2009. 26. Segregation of Costs — Recipients must segregate the obligations and expenditures related to funding under the Recovery Act. Financial and accounting systems should be revised as necessary to segregate, track, and maintain these funds apart and separate from other revenue streams. No part of the funds from the Recovery Act shall be commingled with any other funds or used for a purpose other than that of making payments for costs allowable for Recovery Act projects. 27. False Claims Act — Recipient and sub -recipients shall promptly refer to the DOE or other appropriate Inspector General any credible evidence that a principle, employee, agent, contractor, sub -grantee, subcontractor, or other person has submitted a false claim under the False Claims Act or has committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity or similar misconduct involving those funds. Grant Agreement No. ARS010, Page 52 of 65 I FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT G CERTIFICATION REGARDING DEBARMENTS, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION -LOWER TIER FEDERALLY FUNDED TRANSACTIONS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS The undersigned hereby certifies that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. The undersigned also certifies that it and its principals: (a) Have not within a three-year period preceding this certification been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State anti-trust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. (b) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph 2.(a) of this Certification; and (c) Have not within a three-year period preceding this certification had one or more public transactions (Federal, State or local) terminated for cause or default. Where the undersigned is unable to certify to any of the statements in this certification, an explanation shall be attached to this certification. Dated this day of 20 By Authorized Signature!Recipient Typed Name/Title Recipient's Firm Name Street Address Building, Suite Number City/State/Zip Code Area Codegclephone Number Grant Agreement No. ARS010, Page 53 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 INSTRUCTIONS FOR CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION - LOWER TIER FEDERALLY FUNDED TRANSACTIONS I . By signing and submitting this form, the certifying party is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the certifying party knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, Florida Energy and Climate Commission (Commission) or agencies with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The certifying parry shall provide immediate written notice to the person to whom this contract is submitted if at any time the certifying party learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this contract is submitted for assistance in obtaining a copy of those regulations. 5. The certifying party agrees by submitting this contract that, should the proposed covered transaction he entered into, it shall not knowingly enter into any lower tier contract, or other covered transaction with a person who is proposed for debarment under 48 CFR 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the Commission or agency with which this transaction originated. 6. The certifying party further agrees by executing this contract that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all contracts or lower tier covered transactions and in all solicitations for Tower tier covered transactions. T A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not is proposed for debarment under 48 CFR 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List (Telephone No. (202) 501-4740 or (202) 5014873.) 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Commission or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Grant Agreement No. ARS010, Page 54 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT H Intellectual Property Provisions (NRD-1003) Nonresearch and Development STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS Nonprofit organizations are subject to the intellectual property requirements at 10 CFR 600.136(a), (c) and (d). All other organizations are subject to the intellectual property requirements at 10 CFR 600.136(a) and (c). 600.136 Intangible property. (a) Recipients may copyright any work that is subject to copyright and was developed, or for which ownership was purchased, under an award. USDOE reserves a royalty -free, nonexclusive and irrevocable right to reproduce, publish or otherwise use the work for Federal purposes, and to authorize others to do so. (c) USDOE has the right to: (1) Obtain, reproduce, publish or otherwise use the data fast produced under an award, and ('2) Authorize others to receive, reproduce, publish, or otherwise use such data for Federal purposes. (d)(1) In addition, in response to a Freedom of Information act (FOIA) request for research data relating to published research findings produced under an award that were used by the Federal Government in developing an agency action that has the force and effect of law, the USDOE shall request, and the Recipient shall provide, within a reasonable time, the research data so that they can be made available to the public through the procedures established under the FOIA. If the USDOE obtains the research data solely in response to a FOIA request, the agency may charge the requester a reasonable fee equaling the full incremental cost of obtaining the research data. This fee should reflect the costs incurred by the agency, the recipient, and applicable subrecipients. This fee is in addition to any fees the agency may assess under the FOIA (5 U.S.C. 552(a)(4)(A)). Grant Agreement No. ARSO10, Page 55 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT I DISCLOSURE OF LOBBYING ACTIVITIES STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS Approved by OMB 0348-0046 Compete this form to disclose lobbying activities pursuant to 31 U_S.C. 1352 (See revue for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑ ❑ a. contract a. bid/offer/application a. initial filing b. grant b. initial award b. material change c. cooperative agreement c, post -award d. loan For Material Change Only: e. loan guarantee f loan insurance year quarter date of last report___ _ 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: ❑ Prime ❑ Subawardee Tier if known: Congressional District, iii known: Congressional District, ifknown: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, iJ'applicable: 8. Federal Action Number, if known: 9. Award Amount, ifknown: b 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (ifindividual, Iasi name, first name, MI): different from No. 10a) ("last name, first name, MI): (attach Continuation Sheets) SF-LLL4, i necessary) Signature: Il. Information requested through this form is authorized by tine 31 U.S.C. section 1352_ This disclosure of lobbying activities is a material print Name' representation of fact upon which reliance was placed by the tier above when this transaction wag made or entered into. This disclosure is required pursuant to 31 0 S.C. 1352. This information will be reported to Title: Congress semi-annually and will be available for public inspection. .Any person who faits to file the required disclosure shall be subject to a civil Telephone No.: Date: penalty of not less than $10,000 and not more than $100.000 for each such failure. Federal Use Only: Authorized for Local Reproduction Standard Form - LLL (Rev 7 - 97) Grant Agreement No. ARSO10, Page 56 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity 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 a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by the reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks "Subawardee", then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-"-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI). 11. The certifying official shall sign and date the form, print his/her name, title and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348 046. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. Grant Agreement No. ARS010, Page 57 of 65 Z U d d H3 Wd OCOO � WW CL cm w � a V75 W r W W W At 0 3 ww a v EtlJm a G. �z gcEtt-- o a- omt'c Wp c rnrn LU Z U N cC1.0 U) uj O%2 p C C Q cO a�� O o A io E me _c Bow ��fOT O a i � g� gv� w S44€ Via£ � c o O y 7 d g O C C E C 1�o vE� Z �$ aEp O � V ui SQ't5 g�o ; vc c W a J `i v C c 21 Lo W" FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT K ANNUAL REPORT STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARD Grant Agreement No.: ARS010 Grantee Name: Grantee Address: Grantee's Representative: Telephone No.: Annual Reporting Period: Project Number and Title: A. Provide a summary of project accomplishments to date. (Include a comparison of actual accomplishments to the objectives established for the period. If goals were not met, provide reasons why.) B. Provide an update on the number of jobs created or retained, quantify the reduction of greenhouse gasses and the energy saved in kWh or BTU. C. Provide an update on the estimated time for completion of the project and an explanation for any anticipated delays. Grant Agreement No. ARS010. Page 59 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 D. Provide any additional pertinent information including, when appropriate, analysis and explanation of cost overruns or high unit costs. E. Identify below, and attach copies of, any relevant work products being submitted for the project for this reporting period (e.g., report data sets, links to on-line photographs, etc.) F. Provide a project Grant Budget update, comparing the Grant Project Budget to actual costs to date. Grant Grant Grant Budget Total Grant Expenditures Expenditures this Grant Project Category Project Prior to this Reporting Period Funding Balance Budget Reporting Period 1. Salaries 2. Fringe Benefits 3. Travel (if authorized) 4. Supplies/Other Expenses 5. Equipment 6, Contractual Services 7. Indirect Costs if authorized) 8. Total of all Grant Budget Categories Grant Agreement No. ARSO10, Page 60 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 G. Provide a project Match Budget update, comparing the Match Project Budget to actual costs to date. Match Match Match Budget Total Match Expenditures Expenditures this Match Project Category Project Prior to this Reporting Period Funding Balance Budget Reporting Period 1. Salaries 2. Fringe Benefits 3. Travel (if authorized) 4. Supplies/Other Expenses 5. Equipment 6, Contractual Services 7. Indirect Costs if authorized) 8. Total of all match Budget Categories H. REPORTING Activities: [GRANT MANAGER NOTE. All of the tables below may not be required for this Agreement, Please choose the appropriate metric(s) for the funded activity and include only the appropriate tables for each Agreement on a proiect to proiect basis.I Number of Buildings Retrofitted Ft. Retrofitted Grant Agreement No. ARSO10, Page 61 of 65 Number of Audits Performed Floor Space Audited Auditor's Projection of Energy Saved FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 Number of Loans Given Monetary value of Loans Given Number of Grants Given Monetary value of Grants Given Grant Agreement No. ARSO 10, Page 62 of 65 ��1rMIt Number of Solar Energy Systems Installed Total Capacity of Solar Energy Systems Number of Wind Energy Systems Installed Total Capacity of Wind Energy Systems Number of other Renewable Energy Systems Installed Total Capacity of other Renewable Energy Systems FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 Number of Alternative Fuel Vehicles Purchased Number of Vehicle Conversions to Alternative Energy Number of New Alternative Fueling Stations Number of Carpools and Vanpools Formed Number of Energy Efficient Traffic Signals Installed Number of Street Lane Miles for which Synchronized Traffic Signals were Installed Grant Agreement No. ARSO10, Page 63 of 65 Number of Workshops, Training and Education Sessions Held Number of People Attending Workshops, Training and Education Sessions Number of Direct Jobs Created Number of Indirect Jobs Created Actual Worker Head Count Number of FTE Job Equivalents FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 gnaw 4XVINO Reduction in Natural Gas Consumption (mmcf) Reduction in Electricity Consumption (MWh) Reduction in Electricity Demand (MW) Reduction in Natural Gas Consumption (mmcf) Reduction in Fuel Oil Consumption (gallons) Reduction in Propane Consumption (gallons) Reduction in Gasoline and Diesel Consumption (gallons) Amount of wind - powered electric generating capacity installed Amount of electricity generated from wind systems (MWh) Grant Agreement No. ARSO10, Page 64 of 65 Amount of photovoltaic generating capacity installed (MW) Amount of electricity generated from photovoltaic systems (MWh) Amount of electric generating capacity from other renewable sources installed (MW) Amount of electricity generated from other renewable sources (MWh) Tons Carbon Emission Reduction (CO2 E uivalent) Tons of Sulfur Dioxide Emission Reduction (CO2 E uivalent Tons of Nitrogen Oxide Emission Reduction (CO2 Equivalent) Tons of Carbon Monoxide Emission Reduction (CO2 Equivalent) FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 1. SUBCONTRACTOR LIST The Grantee may subcontract work under this Grant Agreement without the prior approval of the Grant Manager, upon the condition that each Monthly Progress Report must contain a current list of subcontractors, as required in Section 18.A of the Grant Agreement. *I%�.rrantee does not have subcontractors, r1ease state 'None' belo", Nam of Currettt "I" t rNr nt Description of Work Su rontrn t r _ Addrt" oi' e t h nlh ettntra t Performed J. MINORITY/WOMAN/SERVICE-DISABLED VETERAN -OWNED BUSINESS LIST The Grantee is encouraged to use small businesses, including minority, woman and service -disabled veteran - owned businesses as subcontractors under this Grant Agreement. As required in Section 18.0 of the Grant Agreement, the Grantee is required to report information concerning their use of such businesses in each Monthly Progress Report. *Ifgrantee does not have anv subcontracts with minority/xoman/service-disabled veteran- owned businesses, please state 'None ' below 'atrt of Business., Address Reporting Period rrppt .A Total A at paid to Busintis during this Reporting ti...,. Period 0e ription of tku"W'.4"'ices provided by, �.. Bnrin s Type of Rusinvis t'Iinorit , Woman, Service -disabled veteran-o : This report is submitted in accordance with the reporting requirements of Grant Agreement No. ARS010 and accurately reflects the activities and costs associated with the subject project. Signature of Grantee's Representative Grant Agreement No, ARSO10, Page 65 of 65 Date RESOLUTION NO. 10-11-77 A RESOLUTION OF THE VILLAGE COUNCIL OF ISLAMORADA, VILLAGE OF ISLANDS, FLORIDA, ACCEPTING A GRANT AGREEMENT WITH THE FLORIDA ENERGY AND CLIMATE COMMISSION FOR FINANCIAL ASSISTANCE WITH AN ENERGY EFFICIENCY AND CONSERVATION PROJECT; APPROVING AN INTERLOCAL AGREEMENT WITH THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS FOR JOINT PARTICIPATION IN THE GRANT AGREEMENT; AUTHORIZING VILLAGE OFFICIALS TO TAKE ALL STEPS NECESSARY TO FINALIZE AND IMPLEMENT THE TERMS AND CONDITIONS OF THE GRANT AGREEMENT AND INTERLOCAL AGREEMENT; AUTHORIZING THE VILLAGE MANAGER TO EXECUTE THE INTERLOCAL AGREEMENT; APPROVING A BUDGET AMENDMENT; AND PROVIDING FOR AN EFFECTIVE DATE WHEREAS, Islamorada, Village of Islands (the "Village") in coordination with Monroe County (the "County"), the City of Key West ("Key West") and the City of Marathon ("Marathon") developed a mutual project, which would include mutual participation with various entities to assist both the incorporated and unincorporated areas of the Florida Keys to improve energy conservation and applied for a Florida Energy and Climate Commission Grant (the "Grant") for the energy conservation project; and WHEREAS, the Grant application required designation of a lead grantee to act as fiscal agent and assume direct reporting responsibilities, and the County has accepted the lead grantee role for the Grant; and WHEREAS, the United States Department of Energy ("USDOE") awarded funding to the County through the American Recovery and Reinvestment Act ("AARA") Grant Agreement No. DE-E0000241; and WHEREAS, the Grant is being administered by the Florida Energy and Climate tti1� �U Coat Of ofoulNk1 14% Monroe County and Islamorada, Village of Islands, a copy of which is attached hereto as Exhibit 1, for joint participation in the Grant Agreement, together with such non -material changes as may be acceptable to the Village Manager and approved as to form and legality by the Village Attorney, is approved. Section 4. Authorization to Village Officials. The Village Manager and Village Attorney are authorized to take all steps necessary to finalize and implement the terms and conditions of the Grant Agreement and the Interlocal Agreement. Section 5. Execution of Interlocal Agreement. The Village Manager is authorized to execute the Interlocal Agreement on behalf of the Village. Section 6. Approval of Budget Amendment. The Village Council approves a budget amendment to increase the FY 10-11 Infrastructure Fund grant revenues by $360,000.00 and increase the FY 10-11 Infrastructure Fund expenditure budget by $400,000.00, resulting in a $40,000.00 reduction in the projected year end FY 10-11 Infrastructure Fund fund balance. Section 7. adoption. Effective Date. This Resolution shall take effect immediately upon its PASSED AND ADOPTED this 4ch day of November, 2010. Motion to adopt by Councilman Philipson; seconded by Councilman Johnson. FINAL VOTE AT ADOPTION Mayor Michael Reckwerdt YES Vice Mayor Don Achenberg YES Councilman Bob Johnson YES Councilman Ken Philipson YES Councilman Dave Purdo YES 3 INTERLOCAL AGREEMENT BETWEEN MONROE COUNTY AND THE ISLAMORADA, VILLAGE OF ISLANDS, FOR JOINT PARTICIPATION IN GRANT AGREEMENT # ARS010 THIS INTERLOCAL AGREEMENT is made and entered into this day of e e i,- 6 ✓ , 2010, by and between the MONROE COUNTY BOARD OF COMMISSIONERS, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, FL 33040 ("COUNTY") and the ISLAMORADA, VILLAGE OF ISLANDS, whose address is 86800 Overseas Highway, Islamorada, Florida 33036 ("VILLAGE"). WITNESSETH WHEREAS, the STATE OF FLORIDA, EXECUTIVE OFFICE OF THE GOVERNOR, FLORIDA ENERGY AND CLIMATE COMMISSION ("COMMISSION") has entered into a Grant Agreement NO. ARSO10 ("Grant Agreement") with the COUNTY to provide financial assistance for the Energy Efficiency and Conservation Project in which the COUNTY is the named grantee on the Grant Agreement, and WHEREAS, the United States Department of Energy (USDOE) awarded funding to the COMMISSION pursuant to USDOE through the American Recovery and Reinvestment Act (AARA) Grant Agreement No. DE-E0000241, and WHEREAS, the COUNTY and the VILLAGE developed a mutual project, which would include mutual participation with various entities to assist both the incorporated and unincorporated areas of the Florida Keys to improve energy conservation for the citizens of Monroe County, and WHEREAS, the VILLAGE has agreed to participate along with the COUNTY under the Grant Agreement #ARS010, and the VILLAGE has developed certain project tasks for the benefit of its citizens. The VILLAGE agrees to participate, contribute its resources pursuant to the requirements of the Grant Agreement in order to secure funding for the project tasks defined by the VILLAGE. WHEREAS, the sole purpose of this Interlocal Agreement is to define the contributions of the parties under the Grant Agreement, and WHEREAS, VILLAGE acknowledges that COUNTY will serve as the grantee/recipient under the Grant Agreement, and WHEREAS, VILLAGE hereby agrees to abide by the requirements of the Grant Agreement entered into between the COMMISSION and the COUNTY, and WHEREAS, this Interlocal Agreement is entered into pursuant to the authority provided in Florida Statute 163.01, known as the Florida Interlocal Cooperation Act of 1969, and NOW THEREFORE, in consideration of the mutual understandings and agreements set forth herein, the COUNTY and VILLAGE agree as follows: 1. INCORPORATION BY REFERENCE - The provisions of that certain document entitled "FLORIDA ENERGY AND CLIMATE COMMISSION GRANT detail sufficient for a proper pre -audit and post -audit thereof. VILLAGE shall submit to COUNTY a properly completed Attachment B, Payment Request Summary Form, with supporting documentation of allowable costs, including the fmal reimbursement request, as described in paragraph 4.D. of the Grant Agreement. (b) VILLAGE agrees and acknowledges that pursuant to the Grant Agreement at paragraph 4.C., ten percent (10%) of each approved reimbursement request shall be retained by the COMMISSION pending the compliance with Section 8 of the Grant Agreement, and that this amount will not be distributed to VILLAGE prior to being received by COUNTY. (c) If a Request for Reimbursement from VILLAGE does not comply with the Grant Agreement requirements under the Grant Agreement the COUNTY will confer with VILLAGE to identify what the COMMISSION requires in order for the VILLAGE to be able to comply and receive reimbursement. It is the responsibility of the VILLAGE to provide the necessary documentation or other requirements. (d) COUNTY shall promptly submit all Payment or Reimbursement Requests received from VILLAGE to the COMMISSION. Upon distribution of funds from the COMMISSION to the COUNTY, the COUNTY shall promptly distribute the reimbursement received from the COMMISSION to the VILLAGE for items related to the individual reimbursement request being paid by the COMMISSION. (e) All reimbursements under the Grant Agreement shall be in compliance with the laws, rules, and regulations applicable to the r. iditure of State and Federal funds. The State of Florida guidelines for allowable cysts include, but not limited, to the Florida Department of Financial Services' Referenee Guide for State Expenditures located at http://www.myfloridacfo_conL Federal program guidelines for allowable costs and related topics are listed in Attachment L of the Grant Agreement, Federal Regulations and Attachment F of the Grant Agreement, Federal Funding Grantee, Sub -grantee and Contractor Provisions. The VILLAGE shall pwvide to COUNTY a detailed listing of expenditures made under the Grant .Agreement as support for the Payment Request Summary Form. The listing sbaH include, at a minimum, a description of the goods or services purchased, date of the transaction, check or voucher number, amount paid and vendor name. (f) In addition, to the requirements contained in paragraphs 4.C. & D of the Grant Agreement, the COMMISSION may periodically request additional proof of a transaction to evaluate the appropriateness of costs to the Grant Agreement pursuant to State of Florida guidelines. When requested by the COMMISSION related to a transaction performed by the VILLAGE, the VILLAGE shall provide the required information to COUNTY within 20 calendar days of such request, so that COUNTY can comply with the Grant Agreement and provide this information to the COMMISSION within 30 calendar days of receipt of such request pursuant to paragraph 4.E. of the Grant Agreement. 12. UNAVAILABILITY OF FUNDS - If the COUNTY learns that funding cannot be obtained under the Grant Agreement or cannot be continued at a level sufficient to allow for the services specified herein, this Interlocal Agreement may then be terminated immediately, at the option of the COUNTY, by written notice of termination delivered in person or by mail to the VILLAGE at its address specified above. The parties acknowledge that the COUNTY has no funding without the funding by the COMMISSION and agree that the COUNTY has no liability for funds expended by the VILLAGE that were not covered for any reason by the COMMISSION. 13, PERFORMANCE AND OBLIGATION — The COUNTY' S performance and obligation to pay under this Interlocal Agreement is contingent upon an annual appropriation by the Board of County Commissioners and upon the COMMISSION'S performance and obligation to pay under the Grant Agreement which is contingent upon annual appropriation by the Legislature of the State of Florida and the availability of federal funding for the specific purpose of funding the COMMISSION'S obligations under the Grant Agreement. In the event of a State revenue shortfall, withdrawal of State budget authorization and/or rescission of federal funding, the total funding will be reduced accordingly. The COMMISSION, in accordance with direction from the Governor and/or the Florida Legislature, shall be the final determiner of the availability of any funds. 14. COMPLIANCE WITH LAWS AND REGULATIONS - In providing all services pursuant to this Interlocal Agreement, the VILLAGE shall abide by all statutes, ordinances, rules, and regulations pertaining to, or regulating the provision of, such services, including those now in effect and hereafter adopted. Any violation of said statutes, ordinances, rules, or regulations shall constitute a material breach of this agreement. 15. MAINTENANCE OF BOOKS AND RECORDS - VILLAGE agrees to maintain books, records, and documents directly pertinent to performance under the Grant Agreement and this Interlocal Agreement in the same manner as set out in paragraph 17 of the Grant Agreement. VILLAGE agrees to provide access to the books, records and documents to the COUNTY in order for the COUNTY to comply with the Grant Agreement. 16. SUBCONTRACTING — Parties may hire contractors to achieve the individual project tasks applicable to their jurisdiction under the Grant Agreement. VILLAGE agrees to comply with, and to include in subcontracts, all the applicable federal, state, and local health and safety rules and regulations required in the Grant Agreement or this Interlocal Agreement. 17. FLORIDA STATUTE SECTION 768.28 — Each party agrees that it shall be solely responsible for the negligent or wrongful acts of its employees and agents. However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity or the provisions of Section 768.28, Florida Statutes. are covered by the protection afforded by the VILLAGE. Such coverage shall comply fully with Florida's Worker's Compensation Law. This Agreement shall not in any way be construed to create a partnership, association or any other kind of joint undertaking, enterprise or venture between the parties. 22. WAIVER OF PROVISIONS - The failure of either party to this Interlocal Agreement to object to or to take affirmative action with respect to any conduct of the other which is in violation of the terms of this agreement shall not be construed as a waiver of the violation or breach, or of any future violation, breach or wrongful conduct. 23. PROCESS FOR APPROVAL - This Interlocal Agreement shall be approved by the VILLAGE initially and after approval by the VILLAGE shall be presented to the Board of County Commissioners for approval of the COUNTY. The Interlocal Agreement may be executed in several counterparts, each of which shall be deemed an original and such counterparts shall constitute one and the same instrument. 24. AUTHORITY - Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary governmental action, as required by law. 25. ENTIRE AGREEMENT — (a) It is understood and agreed that the entire agreement of the parties is contained herein and that this Interlocal Agreement supersedes all oral agreements and negotiations between the parties relating to the subject matter hereof as well as any previous agreements presently in effect between the parties relating to the subject matter hereof. (b) Any alterations, amendments, deletions, or waivers of the provisions of this htterlocal Agreement shall be valid only when expressed in writing and duly signed by the parties. IN WITNESS WHEREOF, the parties to this Interlocal Agreement have caused their names to be affixed hereto by the proper officers thereof for the pauposes herein expressed at Monroe County, Florida, on the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, Clerk By: Deputy Clerk Date: Attest: :I , ",0" 4 - - Village Cler Anuroved as to Form a Leal S Village VP BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By: Mayor/Chairman Date: ISLAMORADA, VILL GE OF ISLANDS Q By: noN , -0 01 If I ayor ate: "a 0 INTERLOCAL AGREEMENT BETWEEN MONROE COUNTY AND THE ISLAMORADA, VILLAGE OF ISLANDS, FOR JOINT PARTICIPATION IN GRANT AGREEMENT # ARSO10 THIS INTERLOCAL AGREEMENT is made and entered into this 5 day of 1�EL� e &- b 4y' , 2010, by and between the MONROE COUNTY BOARD OF COMMISSIONERS, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, FL 33040 ("COUNTY") and the ISLAMORADA, VILLAGE OF ISLANDS, whose address is 86800 Overseas Highway, Islamorada, Florida 33036 ("VILLAGE"). WITNESSETH WHEREAS, the STATE OF FLORIDA, EXECUTIVE OFFICE OF THE GOVERNOR, FLORIDA ENERGY AND CLIMATE COMMISSION ("COMMISSION") has entered into a Grant Agreement NO. ARSO10 ("Grant Agreement") with the COUNTY to provide financial assistance for the Energy Efficiency and Conservation Project in which the COUNTY is the named grantee on the Grant Agreement, and WHEREAS, the United States Department of Energy (USDOE) awarded funding to the COMMISSION pursuant to USDOE through the American Recovery and Reinvestment Act (AARA) Grant Agreement No. DE-E0000241, and WHEREAS, the COUNTY and the VILLAGE developed a mutual project, which would include mutual participation with various entities to assist both the incorporated and unincorporated areas of the Florida Keys to improve energy conservation for the citizens of Monroe County, and WHEREAS, the VILLAGE has agreed to participate along with the COUNTY under the Grant Agreement #ARSO10, and the VILLAGE has developed certain project tasks for the benefit of its citizens. The VILLAGE agrees to participate, contribute its resources pursuant to the requirements of the Grant Agreement in order to secure funding for the project tasks defined by the VILLAGE. WHEREAS, the sole purpose of this Interlocal Agreement is to define the contributions of the parties under the Grant Agreement, and WHEREAS, VILLAGE acknowledges that COUNTY will serve as the grantee/recipient under the Grant Agreement, and WHEREAS, VILLAGE hereby agrees to abide by the requirements of the Grant Agreement entered into between the COMMISSION and the COUNTY, and WHEREAS, this Interlocal Agreement is entered into pursuant to the authority provided in Florida Statute 163.01, known as the Florida Interlocal Cooperation Act of 1969, and NOW THEREFORE, in consideration of the mutual understandings and agreements set forth herein, the COUNTY and VILLAGE agree as follows: 1. INCORPORATION BY REFERENCE - The provisions of that certain document entitled "FLOR1DA ENERGY AND CLIMATE COMMISSION GRANT detail sufficient for a proper pre -audit and post -audit thereof. VILLAGE shall submit to COUNTY a properly completed Attachment B, Payment Request Summary Form, with supporting documentation of allowable costs, including the final reimbursement request, as described in paragraph 4.D. of the Grant Agreement. (b) VILLAGE agrees and acknowledges that pursuant to the Grant Agreement at paragraph 4.C., ten percent (10%) of each approved reimbursement request shall be retained by the COMMISSION pending the compliance with Section 8 of the Grant Agreement, and that this amount will not be distributed to VILLAGE prior to being received by COUNTY. (c) If a Request for Reimbursement from VILLAGE does not comply with the Grant Agreement requirements under the Grant Agreement the COUNTY will confer with VILLAGE to identify what the COMMISSION requires in order for the VILLAGE to be able to comply and receive reimbursement. It is the responsibility of the VILLAGE to provide the necessary documentation or other requirements. (d) COUNTY shall promptly submit all Payment or Reimbursement Requests received from VILLAGE to the COMMISSION. Upon distribution of funds from the COMMISSION to the COUNTY, the COUNTY shall promptly distribute the reimbursement received from the COMMISSION to the VILLAGE for items related to the individual reimbursement request being paid by the COMMISSION. (e) All reimbursements under the Grant Agreement shall be��=,,.;ompliance with the laws, rules, and regulations applicable to the expenditure vJ' State and Federal funds. The State of Florida guidelines for allowable costs ineludc, but not limited, to the Florida Department of Financial Services' Reference Guide %r- State Expenditures located at http://www.myfloridacfo.com. Federal program guidclines for allowable costs and related topics are listed in Attachnent E of the Grant e':j�,reement, Federal Regulations and Attachment F of the Grant Agreement, Federai 1--unding Grantee, Sub -grantee and Contractor Provisions. The VILLAGE shall provide to COUNTY a detailed listing of expenditures made under the Grant Agreera.m as support for the Payment Request Summary Form. The listing shall inchrde, at a minimum, a description of the goods or services purchased, date of the transaction, check or voucher number, amount paid and vendor name. (f) In addition, to the requirements contained in paragraphs 4.C. & D of the Grant Agreement, the COMMISSION may periodically request additional proof of a transaction to evaluate the appropriateness of costs to the Grant Agreement pursuant to State of Florida guidelines. When requested by the COMMISSION related to a transaction performed by the VILLAGE, the VILLAGE shall provide the required information to COUNTY within 20 calendar days of such request, so that COUNTY can comply with the Grant Agreement and provide this information to the COMMISSION within 30 calendar days of receipt of such request pursuant to paragraph 4.E. of the Grant Agreement. 12. UNAVAILABILITY OF FUNDS - If the COUNTY learns that funding cannot be obtained under the Grant Agreement or cannot be continued at a level sufficient to allow for the services specified herein, this Interlocal Agreement may then be terminated immediately, at the option of the COUNTY, by written notice of tennination delivered in person or by mail to the VILLAGE at its address specified above. The parties acknowledge that the COUNTY has no funding without the funding by the COMMISSION and agree that the COUNTY has no liability for funds expended by the VILLAGE that were not covered for any reason by the COMMISSION. 13. PERFORMANCE AND OBLIGATION — The COUNTY'S performance and obligation to pay under this Interlocal Agreement is contingent upon an annual appropriation by the Board of County Commissioners and upon the COMMISSION'S performance and obligation to pay under the Grant Agreement which is contingent upon annual appropriation by the Legislature of the State of Florida and the availability of federal funding for the specific purpose of funding the COMMISSION'S obligations under the Grant Agreement. In the event of a State revenue shortfall, withdrawal of State budget authorization and/or rescission of federal funding, the total funding will be reduced accordingly. The COMMISSION, in accordance with direction from the Governor and/or the Florida Legislature, shall be the final determiner of the availability of any funds. 14. COMPLIANCE WITH LAWS AND REGULATIONS - In providing all services pursuant to this Interlocal Agreement, the VILLAGE shall abide by all statutes, ordinances, rules, and regulations pertaining to, or regulating the provision of, such services, including those now in effect and hereafter adopted. Any violation of said statutes, ordinances, rules, or regulations shall constitute a material breach of this ag=ment. 35_ A AE'kTTENANCE OF BOOKS AND RECORDS — VILLAGE agrees to maintain books., .records, and documents directly pertinent to performance under the Grant Agreement and this Interlocal Agree t in the same manner as set out in paragraph 17 of the Grant Agreement. VILLAGE agrees to provide access to the books, records and documents to the COUNTY in order for the COUNTY to comply with the Grant Agreement. 16. SUBCONTRACTING — Parties may hire contractors to achieve the individual project tasks applicable to their jurisdiction under the Grant Agreement. VILLAGE agrees to comply with, and to include in subcontracts, all the applicable federal, state, and local health and safety rules and regulations required in the Grant Agreement or this Interlocal Agreement. 17. FLORIDA STATUTE SECTION 768.28 — Each party agrees that it shall be solely responsible for the negligent or wrongful acts of its employees and agents. However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity or the provisions of Section 768.28, Florida Statutes. are covered by the protection afforded by the VILLAGE. Such coverage shall comply fully with Florida's Worker's Compensation Law. This Agreement shall not in any way be construed to create a partnership, association or any other kind of joint undertaking, enterprise or venture between the parties. 22. WAIVER OF PROVISIONS - The failure of either party to this Interlocal Agreement to object to or to take affirmative action with respect to any conduct of the other which is in violation of the terms of this agreement shall not be construed as a waiver of the violation or breach, or of any future violation, breach or wrongful conduct. 23. PROCESS FOR APPROVAL - This Interlocal Agreement shall be approved by the VILLAGE initially and after approval by the VILLAGE shall be presented to the Board of County Commissioners for approval of the COUNTY. The Interlocal Agreement may be executed in several counterparts, each of which shall be deemed an original and such counterparts shall constitute one and the same instrument. 24. AUTHORITY - Each parry represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary governmental action, as required by law. (a) It is understood and agreed that the entire agreement of the parties is contained herein and that this Interlocal Agreement supersedes all oral agreements and negotiations between the parties relating to the subject matter hereof as well as any previous agreements presently in effect between the parties relating to the subject matter hereof. (b) Any alterations, amendments, deletions, or waivers of the provisions of this Interlocal Agreement shall be valid only when expressed in writing and duly signed by the parties. IN WITNESS WHEREOF, the parties to this Interlocal Agreement have caused their names to be affixed hereto by the proper officers thereof for the purposes herein expressed at Monroe County, Florida, on the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, Clerk By: Deputy Clerk Date: Attest: k� Village Clerk Approved as to Form,ankea i c Village BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By: Mayor/Chairman Date: ISLAMORADA, VILLAGE OF ISLAND Exhibit A FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS THIS AGREEMENT is entered into between the STATE OF FLORIDA, EXECUTIVE OFFICE OF THE GOVERNOR (EOG), FLORIDA ENERGY AND CLIMATE COMMISSION whose address is 600 South Calhoun Street, Suite 251, Tallahassee, Florida 32399-0001 (hereinafter referred to as the "Commission") and the MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, whose address is 1100 Simonton Street, Key West, FL 33040-3110 (hereinafter referred to as "Grantee" or "Recipient"), a local government, to provide financial assistance for the Keys Energy Conservation Initiative. In consideration of the promises and mutual agreements contained herein, the Commission and the Grantee acknowledge and agree as follows: 1. The United States Department of Energy (USDOE) awarded funding to the Commission pursuant to USDOE through American Recovery and Reinvestment Act (ARRA) Grant Agreement No. DE- EE0000241. The Grantee shall be a sub -grantee of federal financial assistance from USDOE. The Grantee is responsible for complying with the appropriate state and federal guidelines in the performance of its activities pursuant to this Agreement. 2. The Grantee agrees to perform in accordance with the terms and conditions set forth in this Agreement, its attachments and exhibits named and incorporated by reference. For purposes of this Agreement the terms "Grantee" and "Recipient" are used interchangeably_ 3. This Agreement shall begin upon execution by both parties and end no later than March 31, 2012, .inclusive. If allowed by USDOE, this Agreement shall be cgxtive upon execution for purposes of reimbursement of allowable costs resulting from obligations hmanxi,and meeting the cost share or match regnbements as described in Attachment A, Gantt Work Plan. Profit to the Grantee, or any of its subgrantees, is prohibited by 10 Code ofFederal Regulations (CFR) Part tr`til1. This Agreement may be amended to =viw Attachment A, Grant Work Plan, if additional fimding is ma&smilable by the USDOE and/or the Florida Legislattim. 4. A. The Grantee shall beeligible for of allowable costs resulting from obligations incurred during the term of this Agreement. The Commission shall reimburse the Grantee for allowable casts on a not more fivquently than monthly cost reimbursement basis inan ammint not to exceed $2,637" after receipt and approval by the Commission's Grant Manager of satisfactory reports mid xlxc:wzk= ation as required in this Agreement. The parties aswe that the Grantee is responsible for providing a minimum match of $602,896 toward the projectdescribed in Attachment A, Grant Work Plan. All cost sharing or match shall meet any applicable federal requirements. B. Prior written approval from the Commission's Grant Manager shall be required for changes between approved, funded budget categories up to 10% of the total, approved Grant funds. Approval of such changes will be contingent upon submission of a revised Project Budget. Budget category changes greater than 10%, the addition of previously unapproved or unfunded budget categories or the addition of previously unapproved or unfunded budget line -items, will require a formal written amendment to the Agreement. The Commission agrees to review a request by the Grantee to modify Attachment A, Grant Work Plan, should the Grantee find, after receipt of competitive bids, that the project described in Attachment A, Grant Work Plan, cannot be accomplished for the current estimated project cost. If the Commission agrees to a modification of Attachment A, Grant Work Plan, it may be modified not to exceed the awarded funding identified above. Any such modification would be by formal written amendment, in accordance with Section Grant Agreement No. ARS010, Page 1 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 paragraph 4.12, 10% of the total Agreement amount identified in paragraph 4.A will be withheld until receipt and approval of the Final Report. 9. Each party agrees that it shall be solely responsible for the negligent or wrongful acts of its employees and agents. However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity or the provisions of Section 768.28, Florida Statutes. 10. A. Commission staff will perform compliance monitoring during the tens of the Agreement, in addition to the review of Monthly Progress Reports, but not less than once a year, to ensure Agreement compliance. Monitoring shall include, but not be limited to, periodic review of compliance with Agreement service delivery, as described in Attachment A, Grant Work Plan as documented in Attachment C, Monthly Progress Reports and also which includes a review of all Agreement requirements including the Attachments. The Commission reserves the right for any Commission staff to make scheduled or unscheduled, announced or unannounced compliance monitoring visits at any site where services are delivered pursuant to this Agreement. B. For each on -site compliance monitoring visit, Commission staff will provide an oral exit interview and a written monitoring report to the Grantee. C. If issues of non-compliance are identified in the monitoring report, a written Corrective Action Plan (CAP) may be required of the Grantee. If required, the CAP shall be submitted to the Commission's Grant Manager within ten calendar days of receipt of the monitoring report If a CAP is required of the Grantee, failure to correct deficiencies after thirty calendar days from the date -of -receipt of a written monitoring report notating the deficiencies may result in a determination of breach of Agreement and termination of services. If a CAP is not required of the Grantee, the Commission may proceed under Section I I and/or Section 14. 11. The Commission nmy ierminate this Agreement at any time in the event of the failure of the Grantee to fulfill any of itsvb3igwAz ss under this Agreement. Prior to termination, the Commission shall provide30 calendar days writtenjwtice of its intent to terminate and shall provide the Grantee an opportunity to consult with the Cum regarding the reason(s) for termination. If this Agreement is terminated, the Commission shall only pay for those acts satisfactorily completed under this Agreement prior to the date of termination. The Commission shall not pay the Grantee for any work performed after such termination, except as domed in Secfim 14.F_ 12. The Commission may termite this Agreement for convenience by providing the Grantee with 30 calendar days written notice, if this Agreement is terminated, the Commission shall only pay for those acts sxtisfackn* completed under this Agreement prior to the date of termination. The Commission shall not pay the Grant€x fwiiny work performed after such termination, except as described in Section 14.F. 13. This Agreement maybe unilaterally terminated by the Commission for refusal by the Grantee to allow public access to all documents, papers, letters or other material made or received by the Grantee in conjunction with this Agreement, unless the records are exempt from Section 24(a), Article I of the Florida Constitution and Chapter 119, Florida Statutes. If this Agreement is terminated, the Commission shall only pay for those acts satisfactorily completed under this Agreement prior to the date of termination. The Commission shall not pay the Grantee for any work performed after such termination, except as described in Section 141. 14. If the Grantee materially fails to comply with the terms and conditions of this Agreement, including any Federal or State statutes, rules or regulations, applicable to this Agreement, the Commission may take one or more of the following actions, as appropriate for the circumstances. A. Temporarily withhold cash payments pending correction of the deficiency by the Grantee. Grant Agreement No. ARS010, Page 3 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 D. The Grantee must provide copies of any audit referencing this Agreement, the audit transmittal letter, and any response to such audit to the Commission within 30 calendar days of its receipt. The Grantee should confer with its chief financial officer, audit director or contact the Commission for assistance with questions pertaining to the applicability of these requirements. 18. A. The Grantee may subcontract work under this Agreement upon the condition that each Attachment C, Monthly Progress Report, contains a current list of subcontractors, the amount of each subcontract and a short description of work to be performed by that subcontractor. The Grantee shall be solely responsible for all work performed and all expenses incurred in connection with the development and implementation of the services, programs and activities under this Agreement whether directly performed or by subcontract. B. The Grantee shall not enter into subcontracts in which the Commission or USDOE could be held liable to a subcontractor for any expenses or liabilities. The Grantee shall defend and hold the Commission and USDOE harmless of any liabilities, as applicable by Florida laws, incurred under any of the subcontracts entered into by the Grantee. The Grantee shall be liable for all work performed and all expenses incurred as a result of any subcontract. C. The Grantee is encouraged to use small businesses, including minority, woman and service - disabled veteran -owned businesses as subcontractors or sub -vendors under this Agreement. The Grantee shall report to the Commission in each, Attachment C, Monthly Progress Report, its expenditures with minority, woman and service -disabled veteran -owned businesses. The directory of State of Florida certified minority, woman and service -disabled veteran -owned businesses can be accessed from the website of the Department of Management Services, Office of Supplier Diversity. The Attachment C, Monthly Progress Report, shall contain the names and addresses of the minority, woman and service -disabled veteran -owned businesses; the aggregate dollar figure disbursed that month for each business; the time period; type of goods or services and whether the business is minority, woman or service -disabled veteran -owned. If no expenditures were made to minority, woman and service -disabled veteran -owned businesses, the Grantee shall state "None" on that portion of the Attachment C, Monthly Progress Report. 19. The Grantee agrees to permanently refrain from using or mentioning its association with the Commission in advertisements, letterhead, business cards, etc. The Grantee's project with the Commission may be generally stated and described in the Grantee's professional resume. The Grantee may not give the impression in any event or manner, that the Commission endorses or recommends the Grantee. 20. A. The Grantee certifies that no Federal appropriated fimds have been paid or will be paid, on or after December 22, 1989, by or on behalf of the Grantee, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress, in connection with the awarding, renewal, amending or modifying of any Federal contract, grant, or cooperative agreement. If any non -Federal funds are used for lobbying activities as described above, the Grantee shall submit Attachment I, Standard Form-LLL, Disclosure of Lobbying Activities, and shall file quarterly updates of any material changes. The Grantee shall require the language of this certification to be included in all subcontracts, and all subcontractors shall certify and disclose accordingly. [ 10 CFR Part 601 ] B. In accordance with Section 216.347, Florida Statutes, the Grantee is hereby prohibited from using funds provided by this Agreement for the purpose of lobbying the Legislature, the judicial branch or a State agency. C. Pursuant to the Lobbying Disclosure Act of 1995, any organization described in Section 501(c)4 of the Internal Revenue Code of 1986 shall not be eligible for subgrants under this Agreement, unless Grant Agreement No. ARsolo, Page 5 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO, ARS010 26. The Grantee, as an independent contractor and not an agent, representative, or employee of the Commission, agrees to carry adequate liability and other appropriate forms of insurance. The Commission shall have no liability except as specifically provided in this Agreement. 27. The Grantee covenants that it presently has no interest and shall not acquire any interest which would conflict in any manner or degree with the performance of services required. 28. The Grantee is authorized to purchase five current model vehicles, for use in performing the services described in Attachment A, Grant Work Plan. The Grantee must obtain written approval, in advance, of the vehicle type proposed for purchase and shall produce at least two written quotes for comparable vehicles prior to the vehicle purchase being authorized by the Commission. Upon satisfactory completion of this Agreement, with Commission approval, the Grantee may retain ownership of the non-expendible personal property or equipment purchased under this Agreement. However, the Grantee shall complete and sign Attachment J, Property Reporting Form, and submit it to the Commission as an attachment to the Attachment B, Payment Request Summary Form, in which these costs are documented for reimbursement or match. The following terms shall apply: A. The Grantee shall have use of the non -expendable personal property or equipment for the authorized purposes of the contractual arrangement as long as the required work is being performed. B. The Grantee is responsible for the implementation of adequate maintenance procedures to keep the non -expendable personal property or equipment in good operating condition. C. The Grantee is responsible for the implementation of manufacturer required maintenance procedures to keep the vehicles in good operating condition. X The Grantee shall secure and maintain comprehensive collision and general automobile liability coverage for the vehicles during the term of this Agreement the Grtritee is responsible for any applicable dedinctil4es. T. 'The Grantee is responsible for any loss, damage, or tbefr 4 and any loss, damage, or injury caused by the use of, nowexpendable personal property or equipment purchased with state funds and held in his possession for use in a contractual arrangement with the Commission. F. The Grantee is responsible for the purchase of, and shall maintain a cmxeat Sate of Florida tag and registration for all vehicles purchased under the Agreement. -rnployment of unauthorized aliens by any Grantee/vendor is considered a violation of Section 274A(e) of the Immigration and Nationality Act. If the Grantee/vendor knowingly employs unauthorized aliens, such violation shall be cause for unilateral cancellation of this Agreement. The Grantee shall be responsible for including this provision in all subcontracts with private organizations issued as a result of this Agreement. 30. A. No person on the grounds of race, creed, color, national origin, age, sex or disability shall be excluded from participation in, be denied the proceeds or benefits of, or be otherwise subjected to discrimination in performance of this Agreement. Grant Agreement No. ARSO10, Page 7 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS910 must appear in the publication of any material, copyrighted or not, which was based on or developed under this Agreement, as follows: Acknowledgement: "This material is based upon work supported by the U.S. Department of Energy and the Florida Energy and Climate Commission under Award Number DE-EE000024 L" Disclaimer: "This report was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor any agency thereof, nor any of their employees, nor any of their contractors, subcontractors or their employees, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or any third parry's use or the results of such use of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof or its contractors or subcontractors. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof." 34. The Grantee is permitted to develop software or databases under the terms and conditions of this Agreement, including Section 32. 35. The Parties agree they will seek to resolve any disputes between them regarding their responsibilities as soon as possible and at the lowest level reasonable, in order to conserve the resources of the Parties. The Parties further agree to use their best efforts to assure speedy and non -confrontational resolution of any and all disputes between them. 36. This Agreement is executed and entered into in the State of Florida and shall be construed, performed and enforced in all respects in accordance with the laws and rules of the State of Florida. Any litigation arising under this Agreement shall be brought in the appropriate court in LCM, County, Florida, applying Florida Law. 37- This Agreement represents the entire agreement of the parties. Any alterations, variations, changes, modifications or waivers of provisions of this Agreement shall only be valid when they have been reduced to writing, duly signed by each of the parties and attached to the original of this Agreement, unless otherwise provided herein. 38- The following Attachments are incorporated into this A&: Attachment A Grant Work Plan Attachment B Payment Request Summary Form Attachment C Monthly Progress Report Attachment D Special Audit Requirements Attachment E Federal Regulations Attachment F Federal Funding Grantee, Sub -grantee and Contractor Provisions Attachment G Debarment and Suspension Form Attachment H Intellectual Property Provisions Attachment I Disclosure of Lobbying Activities Attachment J Property Reporting Form Attachment K Annual Report Grant Agreement No. ARSO10, Page 9 of 65 ATTACHMENT A GRANT WORK PLAN FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS A. PROJECT TITLE: Keys Energy Conservation Initiative B. PROJECT LOCATION: Monroe County, Florida C. PROJECT BACKGROUND: Monroe County will implement a comprehensive energy savings project, in partnership with the City of Key West, City of Marathon and Islamorada, Village of Islands, which will include several cross jurisdictional and individual community energy savings activities. The Grantee has identified eight projects to execute a wide assortment of energy savings activities which will benefit 96% of the Keys population. The activities include installation of solar water heaters, energy efficiency outreach and education, retrofitting sports lighting, retrofitting outdoor lighting, development of an Energy Efficiency and Conservation Strategy (EECS), energy audits, purchase of hybrid vehicles and replacement of street lighting poles. Affordable Residential Solar Water Heaters The Grantee, in partnership with Habitat for Humanity (H4H), will install or replace conventional hot water heaters with solar hot water heaters in low to moderate income households. The Grantee will also issue rebates for solar water heaters. This component of the conservation initiative will be coordinated with NexGENergy and Monroe County's Weatherization program. Energy Efficiency Educational Video Communication and Outreach The Grantee will facilitate the production of a 15-minute video and radio segment for National Public Radio (NPR) to highlight the Keys Energy Conservation Initiative 2010. The educational and outreach materials will be available on local government websites and television channels. The materials will be disseminated by CD, DVD and email. Additionally, the Grantee will hold 12 educational workshops for commercial and residential energy efficiency measures. Outreach components of this project will increase the number of Green Living and Education (GLEE) Certified Green Business Partnerships by 100%. Retrofit Local Park Ball Field Lighting The Grantee will retrofit lighting in six public parks with new energy efficient light fixtures, The parks include the Clayton Sterling Sports Complex, Dewitt Roberts Softball Field, Rosa Hernandez Softball Field, George Mira Football Field, Nelson English Park and Pepe Hernandez Park. These parks are located in the City of Key West. Greenhouse Gas Emissions Inventory, Energy Audits and Outdoor Lighting Retrofit Phase 1: Greenhouse Gas (GHG) Emissions Inventory — The Grantee will select a consultant to conduct a greenhouse gas emissions inventory for the City of Marathon. A final report will document the results and recommended strategies for implementation. Phase 2: Energy Audits — The Grantee will hire a consultant to conduct community residential and commercial energy audits and an energy audit for City facilities in the City of Marathon. The results of the studies will be made available to residents and the business community. Phase 3: Outdoor Lighting Retrofit — The Grantee will conduct an outdoor lighting retrofit for Sombrero Beach Road street lights and Marathon Community park lights. The contractor will retrofit 250 outdoor lights. Grant Agreement No. ARS010, Page 1 I of 65 ATTACHMENT A GRANT WORK PLAN E. PROJECT DESCRIPTION: The Grantee has identified eight project(s) that will greatly reduce power consumption therefore reducing utility charges and equipment maintenance fees. The following tasks will be performed in order to meet the project objectives outlined above. Task 1 - Affordable Residential Solar Water Heaters (Objective 1): • Task la: Select a vendor following the procurement procedures outlined in 10 CFR 600, for solar water heater purchase and installation • Task lb: Coordinate with H41-1 to establish an eligible homeowner application • Task lc: Select a vendor, negotiate and execute contract • Task lc: Oversee installation of solar water heaters in 20 qualified affordable homes • Task Id: Coordinate with Keys Energy to provide solar water heater rebates of $450 each • Task le: Submit a report to the Commission including photographs of the installed solar water beaters, utility bills documenting energy reduction, a list of applicants and invoices from both the manufacturer and the installer Task 2 - Energy Efficiency Educational Video Communication and Outreach (Objective 2): • Task 2a: Execute contract with Environmental Education Foundation • Task 2b: Develop video content • Task 2c: Produce video, upload to county website and provide to local governments for distribution • Task 2d: Produce radio segment for Radio Green Earth show on NPR • Task 2e: Coordinate educational outreach technical assistance workshops for businesses and residents • Task 2f: Increase the number of GLEE Certified Green Business partnerships by 100% • Task 2g: Submit a copy of all educational materials and video to the Commission documenting the energy efficiency conservation impacts of the project Task 3 - Retrofit Local Park Ball Field Lighting (Objective 3): • Task 3a: Select a vendor following the procurement procedures outlined in 10 CFR 600, to install ballpark lighting • Task 3b: Oversee installation of ballpark lights in six public parks • Task 3c: Submit a report to the Commission including photographs of the installed fightiAg, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer Task 4 - Greenhouse Gas Emissions Inventory, Energy Audits and Outdoor Lighting Retrofit (Objective 4): • Task 4a Select a vendor following the proewement procedures outlined in 10 CFR 600, 1) a greenhouse gas emissions inventory, 2) a community energy audit and 3) city energy audits Task 4b: Select a vendor following the went procedures outlined in I0 CFR 6K to install outdoor lighting • Task 4c: Define scope of work to identify audit needs • Task 4< : Conduct site inspections • Task-4e: Complete data gathering and analysis for completion of 600 audits • Task 4h Oversee installation of 250 outdoor lights • Task 4g: An audit report will be created to establish baseline emissions inventory %r a base year and for a forecast year to identify emissions reduction targets for the forecast year and identify recommended actions, policies and measures • Task 4h: Submit the final audit report to the Commission and photographs of the installed lighting, utility bills documenting energy reduction, and invoices from both the manufacturer and the installer Task 5 - EECS Development (Objective 5): • Task 5a: The Grantee will develop a scope of work for the EECS • Task 5b: Select a vendor following the procurement procedures outlined in 10 CFR 600, for a technical assistance consultant to assist with plan development and data • Task 5c: Develop SECS for county facilities and operations including energy efficiency, energy conservation and energy usage goals • Task 5d: Provide the Commission with an electronic copy of the SECS. Grant Agreement No. ARSO10, Page 13 of 65 ATTACHMENT A GRANT WORK PLAN Grant Agreement No. ARSO 10, Page 15 of 65 ATTACHMENT A GRANT WORK PLAN 5. EECS Develonment No. Task/Activity Description Deliverables/ Outputs Start Month Deadline 1 DevelopMonth scope of work for EECS Scope of work com fete l 3 2 Select a vendor following the Consultant assisted with plan procurement procedures outlined development and data gathering in 10 CFR 600, for a technical 3 6 assistance consultant to assist with plan development and data 3 Develop EECS for county EECS adopted by Board of County facilities and operations including Commissioners energy efficiency, energy 6 13 conservation and energy usage goals 4 Final Report Final EECS submitted to Commission 14 14 6. County Facilities Eneruv Audit and t2atrnrt No. Task/Activity Description Deliverables/ Outputs Start Month Deadline Month I Select a vendor following the Agreement signed and approve by procurement procedures outlined Board of County Commissioners in 10 CFR 600, for an engineering firm to conduct Grade Energy 1 2 Audits for four county facilities located in Key West 2 Conduct energy audit Detailed investment grade audit submitted to County2 2 3 Define scope of work for retrofits Submit scope of work to as recommended in energy audit Commission 3 6 4 Execute contract for facility Board of County Commissioners retrofits approval and execution 6 9 5 Complete installation of energy Installation documentation efficiency retrofits Iete 9 18 6 Complete measurement and Energy saving calculations verification documented 17 18 7 Final Report Submit a final report to include evidence ofcuergy savings as a 18 18 result of the audit 7. HYbrid Vehicle Purchase No. Tasld ctivity Description Deliverables/ Outputs Start Month Deadline 1 Prepare purchase order for five Vehicles ordered Month hybrid vehicles following the procurement procedures outlined 1 2 in 10 CFR 600. 2 Finalize purchase of vehicles and Vehicles arrive arrival 2 6 3 Paint and decal vehicles Vehicles painted and decaled to increase awareness of alternative 6 7 fuel vehicles 4 Conduct a training workshop for Workshops and training completed drivers and maintenance staff 8 11 5 Final Report Submit a report to the Commission inrlittfing photo hs of the h rid 12 12 Grant Agreement No. ARSO10, Page 17 of 65 ATTACHMENT A GRANT WORK PLAN 8. Replacement of Rtrpvt i.iuht;nn P.1— No. Task/Activity Description Deliverables! Outputs Start Month Deadline 1 Select a vendor following the Electrician selected Month procurement procedures outlined in 10 CFR 600, for electricians to 1 3 retrofit 90 existing poles 2 Obtain quotes for the purchase of Solar light fixtures purchased solar powered light fixtures 3 4 3 Identify existing underground Sites prepared for installation utilities and mark sites for new 3 8 poles 4 Installation of new light poles Light poles installed 4 g 5 Final Report Submit a report to the Commission including photographs of the installed street lighting poles, utility 9 9 bills and invoices Grant Agreement No. ARS010, Page 19 of 65 ATTACHMENT A GRANT WORK PLAN 1. BUDGET DETAIL: Using the definitions provided below, the detailed, line -item budget clarifies the Budget Summary shown in Section G. Budget Category Sub -Totals have been rounded to the nearest whole dollar value. Up to 10% of grant funds may be used for administrative costs, excluding the cost of meeting reporting requirements of the program. Administrative costs are defined as: allowable, reasonable, and allocable Direct and Indirect costs related to overall management of the awarded grant (including travel). For each budget line -item, the appropriate column identifies if the cost is: 1) Grant or Match, 2) a Direct cost used to calculate Indirect Costs (if approved) and 3) whether the cost is Administrative in nature. A description of what is required for each budget category is as follows: 1. Salaries - Identify the persons to be compensated for work on this project by name (if known), position, and title. Show the hourly cost and total hours to be charged for each person or position. Divide annual salaries by 2080 hours and nine month academic salaries by 1560 hours, to find the hourly rate. 2. Fringe Benefits - Multiply the rate by the total salaries to which fringe benefits apply. If the rate is variable, explain and show calculations. 3. Travel - List trips by their purpose and/or destination. indicate the number of days for each trip. The Commission will only reimburse for travel at the appropriate State of Florida rate (Section 112.061, Florida Statutes), using the forms referenced in Attachment B, Payment Request Summary Form. Be prepared to provide the Commission with details on costs utilized to calculate the "Amount Budgeted" for each trip. 4. Supplies & Other Expenses - List expendable supplies by category description, unit costs and quantity. List other expenses not included in any of the above categories. Examples would be printing, copying, postage, communications, etc. Non -expendable equipment valued at less than $1,000 may be listed also. Include only expenses directly related to the project, not expenses of a general nature. For Match only, list costs related to donated real property such as land (not to exceed the fair market value of the property). 5. Eguipmgnt - List non -expendable personal property/equipment valued at $1,000 or more by description, unit cost, and quantity. Computers and data-processing equipment should be described in detail. 6. Contractual Semites - Subcontractors should provide the same information required by this budget table, with the following exceptions: (a) when professional services are provided at a pre-existing approved race or fee shown on the budget; or (b) the subcontract is to be obtained competitively. For either (a) or (b), slow an estimated maximum amount 7. Indirect Costsmate — Indirect Costs are not authorized. 8. Total Budget Category— Show.the totalofall line -items within a Budget Category. 9. Total Budget - Show the total of all categories. 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ARS010 ATTACHMENT B PAYMENT REQUEST SUMMARY FORM STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS Grantee: Grantee's Representative: Mailing Address: Grant Agreement No.: Reimbursement Request No.: Date Of Request: Reimbursement Amount Requested:$, Period: to Percent Matching Required: PROJECT EXPENDITURES SUMMARY SECTION AMOUNT OF TOTAL MATCHING TOT CATEGORY OF EXPENDITURE THIS REQUEST CUMULATIVE FUNDS AL CUMULATIVE PAYMENTS MATCHING 1. Salutes S FUNDS S $ S 2. Fringe Benefits S S $ $ 3. Travel if authorized S S 4. Suppiles/Other Expenses S S 5. Equipment s S s- s 6. Contractual Services = s � �. S __.� ,�-,_.— �S 7. Indirect Costs if authorized S S is for items tnat were charged to and utilized only for the above cited grant activities. Grantee's Representative's Signature Grantee's Fiscal Agent Print Name Print Name Telephone Number Telephone Number Grant Agreement No. ARS010, Page 29 of 65 E o? c NqZ E QV� QU> ,m �ac,o E� w N 0 0 2 V � o o o Uo�"Z O V C ,a m `Q 6z b c Ix 0 to .q Q s cz •noZ a�i? c c a`°LL Q Eno _ 0- .€ 0 oin LL O i Co9 g 13 C m m C m C •O z O 1° W a O .0 p m a 0.5 m 0 p 6 QUa Coocc N qy ~ o O mU U h= orb w ac c t`. m z ) 0-5o m :. A 40. vi W� g Li 12 �= U 2 .a- CL 13 'o M O U' to � U � fA H 4t L O � � Q o \ •�.• tll C O @ 2 C 'Q U c k LU m e >- O Q CCC Q V @ - 4 C U O f fR Cl) C m ° Q 0 y ° g= 0 N O y Z '.t . .+ N F7 U ♦+ i- o' A CD a<n �'.g m « -0 m c m v > 3 ii o' U '�' C O 46 CD mo EU c �2 W ui Z Z 4) 0 I- 0 0 QUA v O} QU ho� 0 0 2 0' N .-• N p G cc)Q p, c �+ O O y U Q U U U C? V U _ f0 } C G 5 C C d t> Q *0 (;i II U Q Q G `L N O U 11 ` II C O � � C,, Q G O �� N ma = ��� " 3 c � = N � �? Cp CL a .0 � G 0 a. O V � G tfr = 0 w m m 0O m m O to FO- � t v� pQ n78m02 'c OEoc°'i �Fimm> .9.980� o J CD ��mcl: mUm 's;QH U cx o Q ��o aa� z z m ft m 4 3 cs L 0 o ww� x u 69 O c c oQ 0 E 69 Q v° 64 Lo 6Uo y c o m CL 0 (Q3 >� x w °'>> �— Q Q U Q c0 N 0.0 C €y O �, m ? o o f' OQ C a'm C m t c° m N Cd f! E>Z t� �S>L. ° O N O C 3 G1 O G 0 L)CD W cEoO Q EV Z m r a o w 0 M M t a 0 0 Q d v E 0 6 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 "MATCHING FUNDS" COLUMN: Enter the amount documented as Match for the reimbursement period. Provide accurate costs and do not round figures to the nearest whole dollar value. This needs to be shown under specific budget categories according to the currently approved Attachment A, Grant Work Plan. • Enter the total for all budget categories on the "TOTAL AMOUNTEXTEtVDED" line for this column. • Enter the total Match budget amount on the "AGREEMENT AMOUNT' line for this column. This amount must correspond with the minimum Match amount specified in Section 4.A of the Grant Agreement and as reflected on the currently approved Attachment A, Grant Work Plan. • Enter the total cumulative amount of this and any previous Match documented on the "LESS TOTAL AMOUNT EXPENDED" line for this column. • Deduct the "LESS TOTAL AMOUNTEXPENDED" from the "AGREEMENTAMOUNT' for the amount to enter on the "TOTAL AVAILABLEBALANCE" line. "TOTAL CUMULATIVE MATCHING FUNDS" COLUMN: Enter the cumulative amount documented to date for Match by budget category. Enter the total of all budget categories on the line titled "TOTALAMOUNT EXPENDED." The Final Reimbursement Request must reflect the total of all documented Match, beginning with the first Match documentation through the final Match documentation, etc. The proportion of cumulative Matching funds as of the final Match documentation must equate to the Cost Share Percentage as reflected on the current, approved Attachment A, Grant Work Plan of the Grant Agreement. If insufficient "TOTAL CUMULATIVE MATCHING FUNDS' are submitted, the Final Reimbursement Request of grant funds shall be reduced to ensure that the Cost Share Percentage GRANTEE CERTIFICATION: The Payment Request Summary Form must be signed by both the Grantee's Representative as identified in the Grant Agreement and the Grantee's Fiscal Agent to be approved for reimbursement. NOTE: If requesting reimbursement for travel, you must include copies of all travel receipts and a copy of the Commission's properly completed travel reimbursement form (in the format approved by the Department of Finances# Services, Chief Financial Officer) that has been signed by both the traveler and the traveler's supervisor. Grant Agreement No. ARS010, Page 35 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 ATTACHMENT C MONTHLY PROGRESS REPORT STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARD Grant Agreement No.: ARS010 Grantee Name: Grantee Address: Grantee's Representative: Telephone No.: Monthly Reporting Period: Project Number and Title: A. Provide a summary of project accomplishments to date. (Include a comparison of actual accomplishments to the objectives established for the period. If goals were not met, provide reasons why.) B. Provide an update on the number of jobs created or retained, quantify the reduction of greenhouse gasses and the tumjty saw in kWh or BTU. C. Provide an update on the imated dime for completion of the project and an explanation for any anticipated delays. Grant Agreement No. ARSO 10, Page 37 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 G. Provide a project Match Budget update, comparing the Match Project Budget to actual costs to date. Match Match Match Budget Total Match Expenditures Expenditures this Match Project Category Project Prior to this Reporting Period Funding Balance Budget Re ortin Period 1. Salaries 2. Fringe Benefits 3. Travel (if authorized) 4. Supplies/Other Expenses 5. Equipment 6, Contractual Services 7. Indirect Costs if authorized 8. Total of all match Budget Categories H. REPORTING Activities: [GRANT MANAGER NOTE All of the tables below may not be required for this Agreement. Please_choose the WrWiate metric(s)for the fund activity and include only the aanronriate tables for each Agreement en a nroiect to nroiect basis.? Number of Number of Buildings Audits Retrofitted Performed Floor Space S . Ft. Retrofm d 1 Audited Auditor's Projection of Energy Saved Grant Agreement No. ARSO10, Page 39 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 Transportation Number of Alternative Fuel Vehicles Purchased Number of Vehicle Conversions to Alternative Energy Number of New Alternative Fueling Stations Number of Carpools and Vanpools Formed Number of Energy Efficient Traffic -Signals Installed Number of Street Lane Miles for which Synchronized Traffic Signals were Installed Grant Agreement No. ARSO10, Page 41 of 65 Workshops, Training and Education Number of Workshops, Training and Education Sessions Held Number of People Attending Workshops, Training and Education Sessions Jobs Created Number of Direct Jobs Created Number of Indirect Jobs Created Actual Worker Head Count Number of FTE Job Equivalents FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 The Grantee may subcontract work under this Grant Agreement without the prior approval of the Grant Manager, upon the condition that each Monthly Progress Report must contain a current list of subcontractors, as required in Section I &A of the Grant Agreement. *If rantee does not have subcontractors, please state 'Nonebelow Name of Current Total Amount Description of Work Subcontractor Address of each Subcontract Performed J. MINORTTY/WOMAN/SERVICE-DISABLED VETERAN -OWNED BUSINESS LIST The Grantee is encouraged to use small businesses, including minority, woman and service -disabled veteran - owned businesses as subcontractors under this Grant Agreement. As required in Section I &C of the Grant Agreement, the Grantee is required to report information concerning their use of such businesses in each Monthly Progress Report. *If grantee does not have any subcontracts with minority/woman/service-disabled veteran- owned businesses, please state 'None' below Badness Address Reporting Period month Total Amount Paid to Business daring this Reporting Period Description of Goods/Services provided by Business Type of Business (Minority, Woman, Service -disabled veteran -owned This report is submitted in accordance with the reporting requirements of Grant Agreement No. ARSO10 and accurately reflects the activities and costs associated with the subject project. Signature of Grantee's Representative Grant Agreement No. ARS010, Page 43 of 65 Date FLORIDA ENERGY AND CLIMATE COMMISSION PART II: STATE FUNDED GRANT AGREEMENT NO. ARSO 10 This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2)(m), Florida Statutes. 1. In the event that the recipient expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal year of such recipient, the recipient must have a "State single or project -specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. In determining the state financial assistance expended in its fiscal year, the recipient shall consider all sources of state financial assistance, including state financial assistance received from the Commission, other state agencies and other nonstate entities. State financial assistance does not include Federal direct or pass -through awards and resources received by a nons Federal program matching requirements. late entity for 2. In connection with the audit requirements addressed in paragraph 1, the recipient shall ensure that the audit complies with the requirements of Section 215.97, Florida Statutes. This includes submission of a financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. 3. If the recipient expends less than $500,000 in state financial assistance in its fiscal year, an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In the event that the recipient 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 non - state entity's resources (i.e., the cost of such an audit must be paid from the recipient's resources obtained from other than State entities). 4. The recipient must include the record keeping requirements found herein in subcontractor agreements entered into for work required under terms of this Agreement. In the executed subcontract, the recipient shall provide each subcontractor of state financial assistance the information needed by the subcontractor to comply with the requirements of Section 215.97, Florida Statutes. Pursuant to Section 215.97, Florida Statutes, the recipient shall review and monitor subcontractor audit reports and perform other procedures as specified in the agreement with the subcontractor, which may include onsite visits. The recipient shall require subcontractors, as a condition of receiving state financial assistance, to permit the independent auditor of the recipient, the Commission, the Chief Financial Officer, the Chief Inspector General and the .Auditor Gerimi amess to the subcontractor's records and independent auditor's working papers as necessary to comply with the requirements of Section 215.97, Florida Statutes. S. For information regarding the Florida Catalog of State Fimine;iat Assistance (CSFA), a recipient should access the Florida Single Audit Act website located at,httns (/a_nns fldfs c/ saa for as,�ic3ance, In addition to the above -wcbsites, the following websites may bed for information: The Florid Legislature's Website at h9ty://www.lee state fl us/Welcome/indsx c,A fine State �afF�,.idaas website at http://www.myi7orida coin/, the Department of Financial Services' Website at put-p-.Jfw sv.t vwn/ and the Auditor General's Website at h"://www.state.fl,.us/audgen. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by Part 1 of this Attachment shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the recipient directly to each of the following: A. The Florida Energy and Climate Commission at the following address: Audit Director or Grant Manager Florida Energy and Climate Commission Executive Office of the Governor 600 South Calhoun Street, Suite 251 Tallahassee, FL 32399-0001 Grant Agreement No, ARS010, Page 45 of 65 2 r \ 6A \ < 5 / FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT F FEDERAL FUNDING GRANTEE, SUBGRANTEE AND CONTRACTOR PROVISIONS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS All subgrants and contracts awarded by the Grantee, including small purchases, shall contain the following provisions as applicable: 1. Equal Employment Opportunity - All contracts shall contain a provision requiring compliance with E.O. 11246, "Equal Employment Opportunity," as amended by E.O. 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and as supplemented by regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." 2. Copeland "Anti -Kickback" Act (18 U.S.C. 874 and 40 U.S.C. 276c) - All contracts and subgrants in excess of $2,000 for construction or repair awarded by recipients and subrecipients shall include a provision for compliance with the Copeland "Anti -Kickback" Act (18 U.S.C. 874), as supplemented by Department of Labor regulations (29 CFR part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that each contractor or subrecipient shall be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. The recipient shall report all suspected or reported violations to the Federal awarding agency. 3. Davis -Bacon Act, as amended (40 U.S.C. 276a to a-7) - When required by Federal program legislation, all construction contracts awarded by the recipients and subrecipients of more than $2,000 shall inc u& a provision for compliance with Ar Davis -Bacon Act (40 U.S.C. 276a to a-7) and as supplemented by Deft of Labor regulations (29 CF.III.pw.5, ".Labor Standards Provisions Applicable to Contracts Governing Federally .T red and Assisted C "). Under this Act, contractors shall be required to pay wages to laborers and rrxxtaau ics at a rate not Icss Than tbe min!imuut wages specified in a wage determination made by the Secretory of Labor. In addition, mntracim."l.be required to pay wages not less than once a week. The recipient shall place a c opy of the curd pomahft i&qqr,.Aen issued by the Department of Labor in each solicitation and the award of a contract s be candidoned upon the acceptance of the wage determination. The recipient shalt report Alf suspected or reporwi viokd= la $be T.a *feral awarding agency. 4. Contract Work Hems aad Safety 'Sitadards Act (40 U.S.C. 327-333) - Where applicable, aH contmcts awarded by recipients in excess aS2000 for construction contracts and in excess of $2,500 for other contracts IMt involve the employment of mechanics or laborers shall include a provision for compliance with SectionsID! and IU? of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333), as supplemented by Department of Labor regulations (29 CFR part 5). Under Section 102 of the Act, each contractor shall be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than 1 % times the basic rate of pay for all hours worked in excess of 40 hours in the work week. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. 5. Rights to Inventions Made Under a Contract or Agreement - Contracts or agreements for the performance of experimental, developmental, or research work shall provide for the rights of the Federal Government and the recipient in any resulting invention in accordance with 10 CFR part 600.325, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding agency. Grant Agreement No. ARS010, Page 49 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 14. Compliance with environmental standards which may be prescribed 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 EP 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplain 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.); (0 conformity of Federal actions to State (Clean Air) Implementation Plans under Section 176(c) of the Clean 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). 15. Compliance with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 16. 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.) 17. Compliance with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 18. Compliance 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 bloodied animals held for research, teaching, or other activities supported by this Agreement. 19. Compliance 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. 20, Compliance with the mandatory standards and policies relating to energy efficiency which are contained in the State energy conservAtipm Plan issued in accordance with the Energy Policy and Conservali Art (Pub. L. 94-163, 89 Stat. 871). 21. Assist the Commission in evmpbring with the State Energy Conservation Program as described in the Code of Federal Regulations, Title 10, Parts 420 and 450 and guidance issued by the U.S. Department 8f Energy and subsequent guidance issued by the U.S. Department of Energy; the Financial Awe Rules described ,in T ie 18, PW# 4146, As well as those regulations concerning the use of oil overehrrre r+ t_ry funds. 22. The Commission reserves the right to transfer equipment acquired under this grant as provided in Title 10, Part 600.117. The Reeipiemt tan obtain a release of this right upon application containing certain commitments. 23. Compliance with the Buy American Act (41 U.S.C. 10a-10c) By accepting funds under this Agreement, the Grantee agrees to comply with sections 2 through 4 of the Act of March 3, 1933, popularly known as the "Buy American Act." The Grantee should review the provisions of the Act to ensure that expenditures made under this Agreement are in accordance with it. It is the sense of the Congress that, to the greatest extent practicable, all equipment and products purchased with funds made available under this Agreement should be American -made. 24. Preservation of open and competition and government neutrality towards contractors' labor relations on federally funded construction projects a. Unless in conflict with State or local laws, you must ensure that bid specifications, project agreement, or other controlling documents in construction contracts awarded pursuant to this agreement, or pursuant to a subaward to this agreement, do not: 1. Require or prohibit bidders, offerors, contractors, or subcontractors to enter into or adhere to agreements with one or more labor organizations, on the same or other related construction project(s); or Grant Agreement No. ARS010, Page 51 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT G CERTIFICATION REGARDING DEBARMENTS, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION -LOWER TIER FEDERALLY FUNDED TRANSACTIONS STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS The undersigned hereby certifies that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. The undersigned also certifies that it and its principals: (a) Have not within a three-year period preceding this certification been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State anti-trust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. (b) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph 2.(a) of this Certification; and (c) Have not within a three-year period preceding this certification had one or more public transactions (Federal, State or local) terminated for cause or default. Where the undersigned is unable to certify to any of the statements in this certification, an explanation shall be attached to this certification. Dated this day of 20 By Authorized Signature/Recipient Typed Name/Title Recipient's Firm Name Street Address Building, Suite Number City/State/Zip Code Area Code/Telephone Number Grant Agreement No. ARSO 10, Page 53 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 ATTACHMENT H Intellectual Property Provisions (NRD-1003) Nonresearch and Development STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARDS Nonprofit organizations are subject to the intellectual property requirements at 10 CFR 600.136(a), (c) and (d). All other organizations are subject to the intellectual property requirements at 10 CFR 600.136(a) and (c). 600.136 Intangible property. (a) Recipients may copyright any work that is subject to copyright and was developed, or for which ownership was purchased, under an award. USDOE reserves a royalty -free, nonexclusive and irrevocable right to reproduce, publish or otherwise use the work for Federal purposes, and to authorize others to do so. (c) USDOE has the right to: (1) Obtain, reproduce, publish or otherwise use the data first produced under an award; and (2) Authorize others to receive, reproduce, publish, or otherwise use such data for Federal purposes. NX1) In addition, in response to a Freedom of Information act (F01A) request for research data relating to pul)W' d ucsearch findings produced under an award that were used by the Feder! C"ven meat in developing an agency action 9M-has the force and effect of law, the USDOE shall request, .and the Recipient gall previ&, within a reasonable tom, .M'Ttsearch data so that they can be made available to the public through the pyres established under the FOIA. If the dI.MOE obtains the research data solely in response to a FOIA request, the agency may charge the requester a reasonable fee epaling the full incremental cost of obtaining the research data. This fee should reflect the costs incurred by the any, the recipient, and applicable subrecipients. This fee is in addition to Xiy %es the agemy may assess under the F01A (3 I7. . 5-52(a)(4)(A))• Grant Agreement No. ARS010, Page 55 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO10 INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity 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 a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. U this is a followup report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by the reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks "Subawardee", then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7 Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number folr grants, cooperative agreements, ls, and loan commitments. & Eater the most appropriate Federal identifying member avaflab5e fior the Federal action identified in itrffi 1 (e.g., Request far Proposal (RFP) number; Invitation for Did (IFB) number; grant announcement number; the contract, grant, or loan award number, .the application/proposal control number assigned by the Federal agency). Include prefixes, a g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI). 11. The certifying official shall sign and date the form, print his/her name, title and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this Information collection is OMB No. 0348-0046. Public reporting burden for this collection of Information is estimated to average 30 minutes per response. Including time for reviewing Instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Bud a Pa erwork Reduction Project 0348-0046 Washin on D.C. 20503. Grant Agreement No. ARS010, Page 57 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARSO 10 ATTACHMENT K ANNUAL REPORT STATE OF FLORIDA GRANT ASSISTANCE PURSUANT TO AMERICAN RECOVERY AND REINVESTMENT ACT UNITED STATES DEPARTMENT OF ENERGY AWARD ment No.: ARS010tee Name•e Address:sentative: a Tele hone No.: n Period: and Title: A. Provide a summary of project accomplishments to date. (Include a comparison of actual accomplishments to the objectives established for the period. If goals were not met, provide reasons why.) B. Provide an update on the number of jobs created or retained, quantify the reduction of greenhouse gasses and the energy saved in kWh or BTU. C. Provide an update on the estimated time for completion of the project and an explanation for any anticipated delays. Grant Agreement No. ARS010, Page 59 of 65 FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 H. REPORTING Activities: LgRANT MANAGER NOTE. • All of the tables below y Aot be reouired for this Aereement Please choose the appropriate metric(s) for the funded octiri a, i e annronriate tables for each Agreement on a proiect to project basis 1 l ��a�."' '�.-- -- - Number of Buildings Retrofitted Ft. Retrofitted Grant Agreement No. ARSO10, Page 61 of 65 BUD Ener Audits Number Performed ier Space Audited ..Auditor's Projection of EnergySaved FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 Number of Alternative Fuel Vehicles Purchased Number of Vehicle Conversions to Alternative Ener Number of New Alternative Fueling Stations Number of Carpools and Van ools Formed Number of Energy Efficient Traffic Signals Installed Number of Street Lane Miles for which Synchronized Traffic Signals were Installed Grant Agreement No. ARSOI 0, Page 63 of 65 Workshops, Training Number of Workshops, Training and Education Sessions Held Number of People Attending Workshops, Training and Education Sessions Jobs Created Number of Direct Jobs Created Number of Indirect Jobs Created Actual Worker Head Count Number of FTE Job Equivalents FLORIDA ENERGY AND CLIMATE COMMISSION GRANT AGREEMENT NO. ARS010 I. SUBCONTRACTOR LIST The Grantee may subcontract work under this Grant Agreement without the prior approval of the Grant Manager, upon the condition that each Monthly Progress Report must contain a current list of subcontractors, as required in Section I &A of the Grant Agreement. '/ rantee does not have subcontractors, lease state 'None' below Name of contractor Address Cur rent Tom Amonnt Description of Work J' MINORITY/WOMAN/SERVICE-DISABLED VETERAN -OWNED BUSINESS LIST The Grantee is encouraged to use small businesses, including minority, owned businesses as subcontractors under this Grant Agreement. woman and service -disabled veteran_ in Section I&C Of the G Agreement, the Grantee is required to report information concerning t s reeiir use of such businesses in each nt Monthly Progress Report. *If grantee does not have an subcontracts with minori Avornan/sen ice -disabled i eteran- owned businesses state 'None' below Y ry 1d`rase Total Amount Paid to Business D TSavbb-Axabled pe GfBuaiuess Nameat during thisrting Description o,fit,, Reporting C-00"ervice>=tn, Rosiness Addrsss Period (month) Pp�t PM-Aded by This report is submitted in accordance with to reporting requirements of Grant Agreement No. ARS010 and accurately reflects the activities and costs associated with the subject project. Signature of Grantee's Representative Date Grant Agreement No. ARS01 o, Page 65 of 65 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12/15/2010 Division: Public Works Bulk Item: Yes ____ No X Department: Public Works Staff Contact Person/Phone #: Dent Pierce/292-4560 AGENDA ITEM WORDING: Approval of a Resolution requesting the Florida Department of Transportation develop short-term and long-range plans to correct drainage issues on US 1 at Summerland Key, ITEM BACKGROUND: There are shoulder drainage issues on US 1 at Summerland Key, particularly at the bike path located between West Shore Drive and Caribbean Drive, and standing water can cause safety and potential health issues for the public and the businesses in this area. PREVIOUS RELEVANT BOCC ACTION: n/a CONTRACT/AGREEMENT CHANGES: n/a STAFF RECOMMENDATIONS: Approval. TOTAL COST: n/a INDIRECT COST: n/a BUDGETED: Yes No DIFFERENTIAL OF LOCAL PREFERENCE: n/a COST TO COUNTY: SOURCE OF FUNDS: REVENUE PRODUCING: Yes _ No AMOUNT PER MONTH Year APPROVED BY: County Atty. OMB/Purchasing Risk Management DOCUMENTATION: Included x Not Required DISPOSITION: AGENDA ITEM # RESOLUTION NO. -2010 A RESOLUTION OF THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS RESPECTFULLY REQUESTING THE FLORDIA DEPARTMENT OF TRANSPORTATION DEVELOP SHORT-TERM AND LONG-RANGE PLANS TO CORRECT DRAINAGE ISSUES ON US1 AT SUMMERLAND KEY. WHEREAS, there are shoulder drainage issues on US 1 at Summerland Key in Monroe County, particularly at the bike path located between West Shore Drive and Caribbean Drive; and WHEREAS, standing water can cause safety and potential health issues for the public and the businesses in this area; and WHEREAS, short-term solutions need to be identified until long-range plans can be implemented, NOW THEREFORE BE IT RESOLVED BY THE BOARD OF COUNTY COMMSSIONERS OF MONROE COUNTY, FLORIDA, that: 1) The Monroe County Board of County Commissioners respectfully requests the Florida Department of Transportation develop short-term and long-range plans to correct US 1 drainage issues on Summerland Key. 2) The Clerk of the Board is hereby requested to forward a certified copy of this Resolution to the Florida Department of Transportation. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting held on the 15" day of December, 2010. Mayor Heather Carruthers Mayor Pro Tern David Rice Commissioner Kim Wigington Commissioner George Neugent Commissioner Sylvia Murphy (SEAL) BOARD OF COUNTY COMMISSIONERS Attest: DANNY L. KOLHAGE, CLERK OF MONROE COUNTY, FLORIDA By: By: Deputy Clerk Mayor/Chairman BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12/15/10 Division: Public Works Bulk Item: Yes X No _ Department:_ Fleet Management Staff Contact Person/Phone #: Rov_Sanchez / 292-3572 AGENDA ITEM WORDING: Approval to transfer title and County vehicle number ID# 1401-598 (serial number IGCGG25R921176183) to the Girl Scout Council of Tropical Florida, Inc. ITEM BACKGROUND: County surplus vehicle 1401-598 is a 2002 Chevrolet 2500 cargo van in need of multiple repairs that is scheduled to be re -advertised after previously receiving no bids. Per attached documentation, Steve Hope, Chief Financial Officer of the Girl Scout Council of Tropical Florida, Inc. requested that a vehicle be transferred to their Council as they are in need of a truck to tow/move equipment, etc. PREVIOUS RELEVANT BOCC ACTION: At a previous BOCC meeting, the Board granted permission to advertise County ID# 1401-598 for bids at a minimum price of $3,000.00. After receiving no bids, the Board granted permission at a later meeting to advertise the same vehicle with the minimum acceptable bid listed at $1,500.00 CONTRACT/AGREEMENT CHANGES: n/a STAFF RECOMMENDATIONS: Approval. TOTAL COST: n/a INDIRECT COST: BUDGETED: Yes No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: n/a SOURCE OF FUNDS: n/a REVENUE PRODUCING: Yes _ No X AMOUNT PER MONTH Year APPROVED BY: County Atty _ OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: Revised 7/09 AGENDA ITEM # TO: Dent Pierce, Director Public Works Division �- FROM: Roy Sanchez, Director Fleet Management Department DATE: November 5, 2010 RE: Agenda Submission / Information Memo The attached BOCC agenda item is a result of a request from the Chief Financial Officer of the Girl Scout Council of Tropical Florida, Inc. for a County surplus truck to be transferred with title. As required, we have confirmed that the Council is a 501(3) (c) organization as per the attached memo provided by Steve Hope, Chief Financial Officer of the Girl Scout Council of Tropical Florida, Inc. It is recommended by the Fleet Management Department that County ID# 1401-598 be transferred with title to the Girl Scout Council of Tropical Florida, Inc. Thank you. BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY MEETING DATE: December 15, 2010 BULK ITEM: Yes X No DIVISION: Public Works DEPARTMENT: Public Works STAFF CONTACT PERSON/PHONE NO.: Beth Leto/292-4560 AGENDA ITEM WORDING: Approval of renewal agreement with The Utility Board of the City of Key West, Florida, for lease of the Big Pine Key Animal Control Facility. ITEM BACKGROUND: Keys Energy Service has agreed to renew the lease for the Big Pine Animal Control Facility for one additional year. PREVIOUS RELEVANT BOCC ACTION: On July 16, 2008, the Board approved the original lease. CONTRACT/AGREEMENT CHANGES: Renews lease for one additional year. Renewal term ends at midnight on August 31, 2011. STAFF RECOMMENDATION: Approval. TOTAL COST: $0 INDIRECT COST: n/a BUDGETED: Yes x No DIFFERENTIAL OF LOCAL PREFERENCE: n/a COST TO COUNTY: same SOURCE OF FUNDS: REVENUE GENERATED: Yes No x APPROVED BY: Co. Atty.: _ :Ot� rchasing: Risk Management: DOCUMENTATION: INCLUDE_ NOT REQUIRED: _ DISPOSITION: AGENDA ITEM #: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: UTILITY BOARD OF THE Contract # CITY OF KEY WEST Effective Date: 09/01/2010 Expiration Date: 08/31/2011 Contract Purpose/Description: One-year lease renewal for Big Pine Key Animal Control Facility Contract Manager: Beth Leto (Name) for BOCC meeting on December 15, 2010 Total Dollar Value of Contract: $0 Budgeted? Yes ❑ No ❑ Grant: $ County Match: $ Estimated Ongoing Costs: $ n/a /yr. (Not included in dollar value above) 4560 Public Works - #1 (Ext.) (Department/Stop #) Agenda Deadline: November 30, 2010 CONTRACT COSTS ADDITIONAL COSTS For: (e.g., maintena Current Year Portion: $0 Account Codes: Division Director Risk Mament O.M.B,/PLC ha ng County Attorney Comments: Date In 11 750 ) l l'Zi - i 11/24/2010 CONTRACT REVIEW Changes Needed , - - Reviewer Yes❑ No�IF Yes[ No❑',� Yes❑ No-�`��.. - Yes❑ No® Christine Limbert-Barrows Date Out I l �Lt _� o 11/24/2010 RENEWAL AGREEMENT FOR LEASE OF BIG PINE KEY ANIMAL CONTROL FACILITY THIS RENEWAL AGREEMENT is made and entered into this 15th day of December, 2010, between Monroe County (LESSEE) and the Utility Board of the City of Key West, Florida (LESSOR) in order to renew the agreement dated July 23`d, 2008, and 1. In accordance with Section 1 c of the agreement, the County hereby exercises its option to renew the Agreement for an additional one (1) year term. The renewal term will end at midnight on August 315`, 2011. 2. In all other respects, the agreement between the parties dated July 23, 2008, remains in full force and effect. IN WITNESS WHEREOF, the parties hereto executed this agreement on the date as written below. (SEAL) BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA ATTEST: DANNY L. KOLHAGE, CLERK By: Deputy Clerk Date: ATTEST: By... Lynne E. da, Secretary Date: By: Mayor Heather Carruthers Date: UTILITY BOARD OF THE CITY OF KEY WEST, FLORIDA y �. Lou Hernandez, Chairman Date: _ _11.m ..r 0�2 it myi ^e e w3 ,� $ a:. i a . w9 i 4 A, .a ; ` @ °u' •, i b O i a d ; .. t `" � LEASE AGREEIMEINIT TO OPERAT17- ANIMAL, CONTROL FACILT-1-Y 0is,aQreement mad-eihisyof,2008, between the Utility Board ofthe City ofKey Vvest' Florida, m utility board created by special Act Vfthe Florida LegiSlatune, its successors and assigns (the "LESSOR") having an address of 1001 James Street, Key West, Florida 33040, and Mlonroe County, Florida, a political Subdivision of the State o/ Florida, its successors and assigns, having an address of 1100 Simonton Street, Key West, Florida (the "LESSEE"). In consideration oftheir mutual promises made here, the parties agree as follmvs: WITNESSETW Ia. LESSOR dues hereby lease to LESSEE according to the terms and provisions herein, a portion Of the property ("premises") located at 279 Industrial Road in Big Pine Key, Florida. (See "Exhibit -A" attached hereto which contains the Site Drawing, "Exhibit-B°attached hereto which contains the Legal property , description), and "Exhibit-C^ attached hereto which is a picture of the front view of the premises to be 1t.The initial term will befor two (2)yeas, beginning at midnight on the first day, which shall be on the 1* day of September, 2008 and ending aLmidnight on the last day of the initial lease term' which shall be on the 3{y°day ofAugust, 2O1O. tc LESSEE may also begranted two (2)additional one (1) year renewal terms. The LESSEE must be in compliance with all lease terms and conditions as a prerequisite to exercising the option to renew. The LESSEE must provide to the LESSOR a written notice of its intent to exercise said option at least sixty (60) days prior to the expiration of the current Leese term. The re -negotiation of the Lease terms will commence upon receipt ofLE5EE'Snotice and written consent ofthe LESSOR. 1d. If LESSOR decides not to extend this lease hereof as per paragraph 1(c) above, LESSOR shall allow LESSEE sixty (6O)days to vacate said premises, provided however LESSEE shall be required to pay LESSOR the same equal monthly rent installments during such sixty(6O) day period. le. SURRENDER OF PREMISES ATEND 0FTERM - Upon the expiration of the term hereof or sooner termination of this lease as herein provided, LESSEE agrees to sunender and yield possession of the demised premises peacefully and without further notice, and in good order and condition but subject to ordinary wear and reasonable use thereof. 2.Rent: The rent to be paid byLESSEE toLESSOR inthe first term of this Lease Agreement shall beOne Dollar ($LOO) per year; which rental shall be payable on or before the t*day of September of every year as long as this Lease Agreement remains in effect. Upon exercise of the option for additional lease terms, the rent amount will also bere-negotiated pursuant 0oparagraph l(c). }Xx(,All xou|'oil m`|i«x,rom16f'x>UH l.`[N 6 17Iwm 3,Use mfPremises: 3a. LESSEE agrees to use said premises only for animal control services. Said anima/ control semicesshaU only be Vedonn-ted in the 8rUmwing designated areas of the premises� office�/spoy neuter clinic with bathroorn, and kennels, 3b. LESSEE agreestn provide office space and bathroom for LESSOR. Additionally, LESSEE agrees to keep premises in good condition and to enable LESSOR to "host" occasional educaduna| hours o/ adjacent property with a brief lecture/presentation in the office space preceding the tour. LESSOR will provide five (5)days notice prior iuany such educational tuur. 3c. LESSEE must maintain the premises in good repair and condition at all times, including the interior and exterior of the premises. LESSEE must keep the premises in a clean, sanitary, and safe condition at all bmes. The plumbing and other facilities must not be used for any other purposes other than that for which they were constructed, and no foreign substances of any kind may be deposited in the facilities, and the expense of any breakage, stoppage or damage resulting from the violation of this provision by LESSEE will be borne by LESSEE. LESSEE agrees to observe, comply with, and execute promptly at its sole expense during the term of this lease, all laws, rules, requirements, orders, directives, codes, ordinances and regulations of governmental authorities and agencies and of insurance carders which relate to LESSEE'S use or occupancy of the premises. LESSEE must not allow or cause the use of the premises in anyway that constitutes either public or private nuisance or in any way that unreasonably interferes with any other lessees mneighbors tothe premises. 36. Upon reasonable notice LESSOR or its authorized representative may enter the leased premises at any reasonable time for the purpose ofinspecting the leased premises or for performing the LESSOR'S duty of care and maintenance. 4.0uiet Enjoyment: Upon the payment by LESSEE ofthe rents provided, and upon the observation and performance of all the covenants, terms and conditions on LESSEE'S part to be observed and performed, LESSEE shall peacefully and quietly hold and enjoy the subject premises for the term hereby demise without hindrance or interruption by LESSOR or any other person or persons lawfully or equitably claiming by, through or under LESSOR, subject, nevertheless, to the terms ofthe lease. 5. Care and Maintenance of Premises: Sa. LESSEE takes said premises in their present condition except for such repairs and alterations as may be expressly herein provided. 5b. LESSOR'S DUTY OF [ARE AND MAINTENANCE — LESSOR will keep the roof, structural part cfthe floor, walls and other structural parts of the building in good repair. LESSOR will be responsible for closing shutters at LESS]R's discretion in the event o/a storm watch or warning, B(K(Animx|[oum`| |mm(M,26m}|)< 2n[U/ * 11 2omx 5c LESSEE�SDUTY OFCARE AND MAINTENANCE — 5c).. LESSEE shall, after taking possession of said premises and until termination of this lease and !he actual removal from the premises, at/\sown expense, care for and maintain said premises /na reasonably safe and serviceable condition, except for ,structural pads of the building. LESSEE will furnish its own interior deconsdnQ. LESSEE will not permit urallow said premises to bedamaged ur depredated in value byany act urnegligence o(the LESSEE, its agents oremployees. 5c2. LESSEE shall Vedb/m and be responsible for the cost of all repairs and/or maintenance necessary for all ^mechanica|s" including, but not limited to, air conditioning, water, heater, and plumbing, and to keep the demised premises in good order, repair and condition. Sc3. LESSEE agrees to keep faucets closed so as to prevent waste of water and flooding of the premises and to promptly take care of any leakage or stoppage in any of the water or waste pipes. Sc4. LESSEE shall have the right during the term of this Lease Agreement to construct, re -construct, re- model, paint, decorate and re -decorate the leased portion of the property; provided however, that all such improvements iothe demised premises by LESSEE shall conform hoall applicable building codes, regulations, and prior written approval from LESSOR is obtained, written approval by LESSOR shall not be unreasonably withheld. All improvements remaining on the demised premises at the expiration or upon the termination of the Lease Agreement shall become the property of LESSOR. If at the expiration or termination of this agreement LESSEE wishes Uo leave the improvements onthe property, LESSEE shall obtain written approval from LESSOR. LESSOR has the sole right to reject the leaving of such improvements and require LESSEE to remove improvements from the subject property. If LESSEE fails to remove the improvements that a) LESSEE leaves on site and b) LESSOR requests removal, LESSOR shall have the sole right to remove LESSEE'S improvements from the premises. LESSEE shall beresponsible toreimburse LESSOR for all costs and expenses associated with the removal and disposal of LESSEE'S personal property and improvements, Sc5. LESSEE shall secure all windows doors, and gates of the premises and shall lock all entrances and openings to the premises after normal business hours. In the event of pending storm notifications, LESSEE shall secure all windows, doors, gates, cages, and equipment stored on ground level of the premises and shall lock all entrances and openings tothe premises before vacating the premises when a"Watrh''is issued, Further, LESSEE agrees to notify LESSOR that storm preparations have been completed. Failure of the same shall constitute adefault ufthis Lease. 5c6. LESSEE will maintain a chain link fence along the boundaries ofthe demised premises. This hence shall be of gauge and dimensions comparable to the fencing now in place. It shall be LESSEE'S responsibility and obligation, during the term of this lease, to maintain said chain link hence in a state of good repair; that is, said fence shall be maintained in on erect condition and free ofgaps or holes so that it will, during the Lernn |KxC\ninm|Lmon`| | «u-�!(o*2mm)|}8 J^(/0 027Ims of this lease, serve its intended purpose of preventing or deferring trespassing or encroaching Upon the Premises adjoining 'the demised prernises along itS southern bOUndary. Sc7. LESSEE has the right and privilege of attaching, affixing, or painting or exhibiting signs on the hznce surrounding the leased premises provided the signs describe the an/mn| control services provided and the hours ofoperation, and donot damage the fence, 6. Taxes; LESSEE agrees to pay all required county property or building taxes, sales taxes, licenses and lees which may occur from time to time during the term of this Lease. 7. Governmental Requirements: LESSEE shall be required to obtain any required permits, variances andr/orspecial exceptions from all other authorities tooperate this facility. 8. Assignment and Subletting: This lease may not be sold, transferred, or assigned ,n full or pad without the written permission of LESSOR. Any purported assignment without such prior written consent shall be null and void. LESSEE shall not have the right to sublet this lease or any portion of this lease or property. 9. Insurance Requirements: By the signing of this lease, LESSEE agrees without reservations, to the insurance requirements specified herein. 9a. The insurance provided by LESSEE pursuant to this lease shall apply on a primary basis and any other insurance provided by LESSOR shall be excess of and not contributory to the insurance provided by LESSEE. 9b^ LESSEE shall provide LESSOR with current proof of coverages required, in the form of an {irkgi[sd certified Certificate ofInsurance properly signed by the authorized agent ofthe insurance company. The insurance company moat be authorized to transact business within the State of Florida. The agent of the insurance company must bc licensed to sell the insurance coverages required under this Lease Agreement. 9c. Commercial Insurance: The insurance shall cover those sources of liability which *muN be covered by the latest edition of the standard Commercial General Liability Coverage Form (ISO Form CG00-01)as filed for use /n Florida without the attachment ofrestrictive endorsements other than the elimination of medical payments and fire damage legal liability. During the term of this Lease, except as specifically provided herein, LESSEE shall provide and maintain, at his sole cost and expense, the following insurance coverages with indicated limits of liability are mandatory under this Lease Agreement: General Aggregate $1,000000.00 Products/[umpketedDpenatkon $1,000,000m Personal and Advertising Injury $ 500,000M Each Occurrence $1,000,000M Fire Legal Liability Limit $ lOO,OUU.00 Sid. Property, Windstorm, and Flood Insurance: LESSEE will provide LESSOR with evidence of Pnopmrty, 'Windstorm, and Flood Insurance with Um/La of coverages based on the cunent replacement cost of the structure, Wul' \nimu|["om`|Lm,uK0o2^(1K)|`8 |"[|o 9e. Certificate of Insurance: Before commencing work, LESSEE shall furnish LE5SUA with a certificate or cerUfcates ofill sumnce s|gned by an authorized representative of the insunerfs) evidencing the insurance required, The Certificates of lnsurance shall provide that the LESSEE shall endeavor to give notice prior to cancellation or oestrict|onVfcoverage. 9t Additional Named Insured: The Utility Board of the City of Key West, Florida shall be included as an additional named insured for the coverages above. 10. Utilities: LESSEE agrees to comply with al/ applicable County codes and proper use of, and to pay for, the installation and use of electricity (account number 8781609, meter number '36574), water (meter number — 65069648), sewer, solid waste, and other utilities to the subject premises. LESSEE shall be responsible for all impact fees associated with utilities. 11.Observation mfLaws and Ordinances: 11a. LESSEE agrees to observe, comply with and execute promptly, at their expense, during the term hereof, all laws, rules, requirements, orders, directives, ordinances and regulations and any and all governmental authorities oragencies and of all municipal departments, bureaus, boards and officials due to its use or occupancy of the subject premises, and to obtain and maintain during the term thereof any and all certificates, licenses, and other documents necessary for lawful occupation and operation, 11b. This agreement shall be governed by and construed in accordance with the laws of the State of Florida, In the event that any cause ofaction or administrative proceeding is instituted for the enforcement or interpretation of this Lease Agreement, the LESSOR and LESSEE agree that venue will lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida, The LESSOR and LESSEE agree that, /n the event of conflicting interpretations of the berms or a benn of this Agreement by or between any of them, the issue shall be submitted to mediation prior to the institution of any other administrative orlegal proceeding. This Agreement shall not bcsubject tzArbitration, 12. Defaults: In the event that LESSEE fails, within thirty (30) days after notice, to cure any default of any obligations owed by LESSEE to LESSOR under this Lease Agreement then, in that event LESSOR shall have the right to terminate this Lease Agreement and to enter upon the leased premises and again have, repossess and enjoy the same as if this Lease Agreement had not been made. 13. Attmrney's Fees: Should any cause of action or administrative proceeding arise out of this Lease in connection with the enforcement or interpretation of this Lease between LESSOR and LESSEE, the prevailing party shall be entitled to reasonable aUorncy's fees, court costs, investigative, and ou('of-pucketexpenses, as an award against the non -prevailing party. Mediation proceeding initiated and conducted pursuant to this Agreement shall be /n accordance with the Florida Rules of Ov/| Procedure and usual and customary procedures required by the SixteenLh]ud[c/a| Circuit in and for Monroe County, Florida, |KvC Animoi(\vnm||cxsc('4,2m)NCm 5.`[|V o2��xm 14. Entire Agneanment: This ieosc se'B hzrth all covenants, promises' agreements and understandings between LESSOR, ond LESSEE concerning the subject prernises. No modification or waiver of terms Vf1his AgreemenLshall bebinding, un|ess(nwnUnQ,anda|ynedbyadu|yauthurizmdnepreyentaUveofLESSUAand LESSEE, 15. Partial Invalidity: If any term, covenant or addition of this lease or the application thereof to any person or circumstance shall, to any extent, be invalid or unenforceable, insofar as is reasonable the remainder ufthis lease, o, the application of such term, covenantor condition to persons or circumstances other than those asho which it is held invalid or unenforceable, shall not bcaffected thereby and each term, covenant or condition of this lease shall be valid and be enforced to the fullest extent permitted by law. 16. Hazardous Materials: 16a. No petroleum products orother potentially hazardous materials including, but not limited to, oil -based paints, solvents, cleaners, or other chernicals, shall be used or stored on the leased property. 16b. Construction and industrial activities that may cause soil, water, orair contamination are pnoh/bited. Any uses, other than animal control services, must be approved by LESSOR, in writing, prior to commencing such activities on the leased property. 16c. Solid Waste: No solid waste ballowed to accumulate on the leased property. Adistinction between storage of usable materials and accumulated solid waste will be mutually agreed upon by LESSEE and LESSOR. LESSEE, at its own expense, will maintain on the property a solid waste container, with an active disposal schedule, which is large enough to handle any dey-ko-day refuse. 17'Manner ofPayment and Giving Notice: Division Director, Community Services Utility Board of the City of Key West Monroe County, Florida General Manager &[EO 1100Simonton Street, Suite 2'2S7 1001James Street Key West, Florida 33040 Key West, Florida 33040 18. Indemnity and Hold Harmless: The LESSOR and LESSEE are covered under F.5. 768.28. Each agrees to be fully responsible for acts and omissions cftheir agents or employees to the extent permitted by law, Nothing he -rein is intended to serve as a waiver o[sovereign immunity by any party to which sovereign immunityapp|/es. Nothing herein shall be construed asconsent byeither party ho be sued by third parties in any matter arising out of this Lease Agreement, 8()(,'uima|[o""m|/^n*U62wm>|/8 6.,[10 (')- �mm I ,N V,/ITNESS THEREOF, the pat -ties hereunto executed this lease the day and year first vrrlitten above. ATTEST: By Lynne E. Tejeda, as Secretary As to the LESSOR: UTILITY BOARD OF THE Cal Y OF KEY ',/VEST, FLORTDA By: Lou Hernandez, as its Chairman As to the LESSEE: MONROE COUNTY, A POLITICAL SUBDIVISION OF THE STATE OF FLORIDA By: BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By: Mario Di Gennaro, as Mayor ri- 2008 , as Deputy Clerk MONROE COUNTY ATTORNEY APPROVED AS TO FORM: CHRISTINEJ` LIMBERT-BARROWS ASSISTANT COUNTY ATTORNEY Date Bo( (' A11!11u11 ( owrol I c"Isc (()(- , (";)�) D'7 �j If) ! -!lljo� Ex Agirgal Cpntrod F4 -T—HW,-M—A—NDems` —t STM PLM Mscll sl�r"T 7711 (i62018 ) 1 8 of 10 The property to be leased is located on 8ig Pine Key in Monroe County, Florida and is described as follows: A pad of the Northwest Quarter of the Southwest Quarter of Section 25, Township 66 South, Range 29 East, on Big Pine Key, Monroe County, Florida, and being more particularly described by metes and bounds as follows: COMMENCING at the Northwest Corner of the Southwest Quarter, 1320 feet to the Northwest Corner of Silas Knowles Subdivision, as recorded in Plat Book 1, at Page 61 of the Public Records of Monroe County, Florida; thence bear East, 50 feet to the POINT OF BEGINNING of the parcel hereinafter described; from said POINT OF BEGINNING, continue East, 280 feet; thence bear North, 70 feet; thence bear West, 280 feet; thence bear South, 70 feet, back to the POINT OF BEGINNING, containing 0.45 acres. )Wx[Ammu|C^n,u`|/Lx,uI Exhibit "C" — Picture of Property to be Leased (I)S 1() of 1() 6 _" lot !S BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: Public Works Bulk Item: Yes x No _ Department: Facilities Maintenance Staff Contact Person/Phone #:John W. King/292-4531 AGENDA ITEM WORDING: Approval of a Business Lease with Ships Way, Inc. for Commissioner Neugent's office space on Big Pine Key. ITEM BACKGROUND: On December 141,2010, the current lease to occupy space from Ships Way, Inc. will expire. The lessor, in accordance with the original lease dated December 9, 1998, as renewed, granted an option to renew for the four-year period ending December 14, 2010, and has granted another option to renew for an additional four-year period terminating December 14, 2014. PREVIOUS RELEVANT BOCC ACTION: On December 9, 1998, the BOCC granted approval and authorized execution of a Business Lease Agreement for office space in Big Pine for Commissioner Neugent. On November 21, 2002, the BOCC granted approval to renew a Business Lease with Ships Way, Inc. for Commissioner's office space. On November 15, 2006, the BOCC approved execution of a renewal Business Lease with Ships Way, Inc. for continuance of Commissioner's office space. CONTRACT/AGREEMENT CHANGES: Monthly rent to be $1,147.37 with possible annual increases of up to three percent (3%) based on the Consumer Price Index. The lease is to commence on December 15, 2010 and terminate on December 14, 2014. STAFF RECOMMENDATIONS: Approval TOTAL COST:$13,768.44 INDIRECT COST: N/A BUDGETED: Yes X No _ (possible annual increase up to 3% thereafter) DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: same SOURCE OF FUNDS: REVENUE PRODUCING: Yes moo( X A,40UNT PER MONTH Year $ APPROVED BY: County Atty bM / haling Risk Management DOCUMENTATION: Inclu ed X Not Required DISPOSITION: _ AGENDA ITEM # Revised 1 /09 M E M O R A N D U M DATE: November 16, 2010 TO: Dent Pierce, Division Director Public Works FROM: John W. King, Sr. Director Lower Keys Operations RE: Agenda Item — December 15, 2010 BOCC Meeting Business Lease — Ships Way, Inc. On November 21, 2006, the BOCC authorized execution of a four-year Business Lease with Ship's Way, Inc. for Commissioner Neugent's office located at the Shops of Ships Way, 25 Ships Way, Big Pine Key, On December 14, 2010, the current lease with Ships Way, Inc. will expire, however, this lease does provide for one option to renew for another four-year period. The new business lease calls for monthly payments of $1,147.3 7 with the first year commencing December 15, 2010, and possible annual increases up to three percent (3%) depending on the Consumer Price Index for each of the remaining years until expiration December 14, 2014. I hereby request approval to execute this business lease with Ships Way, Inc. JWK/jbw Enclosures MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Ships Way, Inc. Contract # Effective Date: 12/15/10 Expiration Date: 12/14/14 Contract Purpose/Description: To lease 813.5 square feet for Commissioner Neu ent's office — four year lease Contract Manager: Jo B. Walters 4549 Facilities Maint/Stop #1 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 12/15/10 A enda Deadline: 11/30/10 CONTRACT COSTS Total Dollar Value of Contract: $ 13,768.44 (yr 1) Budgeted? Yes® No ❑ Account Codes: _ Grant: $ N/A County Match: $ N/A Estimated Ongoing Costs: $_ (Not included in dollar value above Current Year Portion: $ 11,473.70 -00101-530-440- ADDITIONAL COSTS /yr For: maintenance, etc. CONTRACT REVIEW Changes Date Out Division Director Date In 3i7 ('0 Needed (� Reviewer Yes❑ No V� D ( d 0 Risk Mana em nt g Yes❑ No� c� t �( O.M.B./Purr ing JLLJ la Yes❑ No[ County Attorney t�A 0 Yes❑ No� j Z Comments: OMB Form Revised 2/27/01 MCP #2 BUSINESS LEASE THIS AGREEMENT, entered into this K day of il. z' C r►a•'U� 2010, between SHIPS WAY, INC. hereinafter called "lessor" or "landlord", party of the first part, and THE COUNTY OF MONROE, hereinafter called "lessee" or "tenant", party of the second part: WITNESSETH, that said lessor does this day lease unto said lessee, and said lessee does hereby hire and take as tenant under said lease, the space described as follows: An office comprised of 813.5 square feet, located in the building known as The Shops of Ships Way, 25 Ships Way, Big Pine Key, situated in Monroe County, Florida, to be used and occupied by the lessee as an office and for no other purposes or uses whatsoever, for the term of four (4) Years, beginning December 15, 2010, and ending December 14, 2014, the rent to be paid as follows: Upon the signing of this lease, $1,147.37 is to be applied to the first months rent, including a pro -rated amount for any part month; and $1,147.37 on the first day of each month thereafter. Annually, on the anniversary of this lease, there may be an increase of up to three (3) percent, in the monthly rent payment which shall be based on the Consumer Price Index Monroe County's performance and obligation to pay under this contract, is contingent upon an annual appropriation by the BOCC. Payment shall be in arrears and pursuant to Florida Local Government Prompt Payment Act. The lessee is a political subdivision of the State of Florida and, therefore, is not subject to state sales tax. All payments are to be made by mail to the lessor at: 29438 Saratoga Avenue, Big Pine Key, Florida 33043. The following express stipulations and conditions are made a part of this lease and are hereby agreed to by all parties: FIRST: The lessee shall not assign, nor sub -let the premises, or any part thereof, nor use the same, or any part thereof, for any other purpose than as above stipulated, nor make any alteration therein, or additions thereto, without the written consent of the lessor, and all additions, fixtures, or improvements which may be made by the lessees, except movable office furniture, shall become the property of the lessor and remain upon the premises as a part thereof, and be surrendered with the premises at the termination of the lease. SECOND: All personal property, placed or moved in the premises above described, shall be at the risk of the lessees or owners thereof, and lessor shall not be liable for any damage to said personal property or to the lessee, arising from the bursting or leaking of water pipes, or from any act of negligence of any other co -tenant or occupant of the building or of any other person whomsoever, absent negligence on the part of the lessor. There will be no outside storage without the written consent of the lessor. THIRD: The tenant shall promptly execute and comply with all statutes. ordinances, rules, orders, regulations, and requirements of the Federal, State, and City Government and of any and of all their departments and bureaus applicable to said premises, for the correction, prevention, and abatement of nuisances of other grievances, in, upon, or connected with said premises during said term, and shall also promptly comply with and execute all rules, orders, and regulations of the Southeastern Underwriters Association for the prevention of fires, at its own cost and expense. FOURTH: In the event that the premises shall be destroyed or so damaged or injured by fire or other casualty during the life of this agreement, whereby the same shall be rendered untenantable, then the lessor shall have the right to render said premises tenantable by repairs within ninety (90) days therefrom. If said premises are not rendered tenantable within said time, it shall be optional with either party hereto to cancel this lease, and in the event of such cancellation the rent shall be paid only to the date of such fire or casualty. The cancellation herein mentioned shall be evidenced in writing. FIFTH: The prompt payment of the rent for said premises upon the dates named, and the faithful observance of the rules and regulations printed upon this lease, which are hereby made a part of this covenant, are the conditions upon which this lease is made and accepted, and any failure on the part of the Lessee to comply with the terms of said lease, or any of said rules and regulations now in existence, shall be at the option of the lessor to work a breach of this contract. Lessor shall give the tenant notice of breach in writing and Lessee shall have 14 business days to remedy the breach. SIXTH: If the lessee shall abandon or vacate said premises before the end of the term of this lease, or shall suffer the rent to be in arrears, the lessor may, at his option, forthwith terminate this lease or he may enter said premises as the agent of the lessee, without being liable in any way therefore, and relet the premises with or without any furniture that may be therein, at such price and upon such terms and for such duration of time as the lessor may determine, and receive the rent therefore, applying the same to the payment of the rent due by the presents, and if the full rental herein provided shall not be realized by the lessor over and above the expenses to the lessor in such re -letting, the said lessee shall pay the deficiency, and if more than the full rental is realized lessor will pay over to said lessee the excess upon demand. SEVENTH: In any civil action brought to enforce the provisions of this lease, the party in whose favor a judgment has been rendered may recover reasonable court costs, including attorney's fees, from the non -prevailing party. EIGHTH: The lessee agrees that it will pay all charges for rent, changing the filter on the air conditioning unit, electricity or other illumination, and for all water used on said premises. The lessee agrees also to pay any additional costs incurred from excessive refuse disposal should they occur. NINTH: The lessor, or any of his agents, shall have the right to enter the subject rental premises with a 24-hour notice (except in an emergency) during all reasonable hours, to examine the same to make such repairs, additions, or alterations as may be deemed necessary for the safety, comfort, or preservation thereof, or of said building, or to exhibit said premises and to put or keep upon the doors or windows thereof a notice "For Rent" at any time within thirty (30) days before the expiration of this lease. The right of entry shall likewise exist for the purpose of removing placards, signs, fixtures, alterations, or additions, which do not conform to this agreement, or to the rules and regulations of the building. Landlords shall give tenant prior reasonable notice of their intent to enter premises. TENTH: The Lessee hereby accepts the premises in the condition they are in at the beginning of this lease and agrees to maintain said premises in the same condition, order, and repairs as they are at the commencement of said term, excepting only reasonable wear and tear arising from the use thereof under this agreement, and to make good to said lessor immediately upon demand, any damage to water apparatus, or electric lights or any fixture, appliances or appurtenances of the said premises, or of the building, caused by any act or neglect of lessees, or any person or persons in the employ or under the control of the lessee. ELEVENTH: It is expressly agreed and understood by and between the parties to this lease that the lessor shall not be liable for any damage or injury by water, which may be sustained by the lessees or any other person, or for any other damage or injury resulting from the carelessness, negligence, or improper conduct on the part of any other lessees, or agents, or employees, or by reason of the breakage, leakage, or obstruction of the water, sewer, or soil pipes, or other leakage in or about the said building. TWELFTH: If lessees shall become insolvent or if bankruptcy proceedings shall be begun by or against lessees before the end of the lease term, lessor is hereby irrevocably authorized at its option, to forthwith cancel this lease, as for a default. Lessor may elect to accept rent from such receiver, trustee, or other judicial officer during the term of the occupancy in their fiduciary capacity without affecting lessor's rights as contained in this contract, but no receiver, trustee, or other judicial officer shall ever have any right, title, or interest in or to the described property by virtue of this contract. THIRTEENTH: This contract shall bind lessor and their assigns or successors, and the heirs, assigns, administrators, legal representatives, executors or successors as the case may be, of the lessees. FOURTEENTH: It is understood and agreed between the parties hereto that the time is of the essence of this contract and this applies to all terms and conditions contained herewith. FIFTEENTH: It is understood and agreed between the parties hereto that written notice by certified mail or delivered to the premises leased hereunder shall constitute sufficient notice to lessee, and written notice by certified mail or delivered to the above stated address of lessor shall constitute sufficient notice to the lessor, to comply with the terms of this contract. SIXTEENTH: The rights of the lessor under the foregoing shall be cumulative, and failure on the part of the lessor to exercise promptly any rights given hereunder shall not operate to forfeit any of the said rights. SEVENTEENTH: It is further understood and agreed between the parties hereto that any charges against lessees by lessor for services or for work done on the premises by order of lessees or otherwise accruing under this contract shall be considered as rent due and shall be included in any lien for rent due and unpaid. EIGHTEENTH: It is hereby understood and agreed that any signs or advertising to be used, including awnings, in connection with the premises leased hereunder shall be first submitted to lessor for approval before installation of same, and maintained in an acceptable condition. NINETEENTH: The lessees, and its customers and invitees, shall have the right, during the term of the lease, to use the parking area or areas owned by the lessor and located adjacent to the premises, of which the leased premises form a part, in common with the tenants occupying other portions of the entire building. The lessees covenants and agrees, however, that it will not permit its employees or concerns making deliveries to or from the leased premises to use any portion of the parking area or areas other than such reasonable portion as lessor shall set apart for such purpose. The North parking area shall be designated for employee parking, and it shall be most appreciated by all if that regulation is enforced. TWENTIETH: Lessee is a self -insured political subdivision of the State of Florida and shall, at its own expense, at all times during the term of this lease, maintain insurance which will insure the lessor against liability for injury in or death of persons, or loss or damage to their property occurring in or about the demised premises. The insurance coverage shall not waive any immunity lessee has pursuant to State Statute. TWENTY-FIRST: If the tenant fails to pay rent due and the default continues for three (3) days, excluding Saturdays, Sundays, and legal holidays, after delivery of written demand by the landlord for payment of the rent or possession of the premises, landlord may terminate the rental agreement. The three (3) day notice shall contain a statement in substantially the following form: You are hereby notified that you are indebted to us in the sum of dollars for the rent and use of the premises (address of lease premises, including County), Florida, now occupied by you and we demand payment of the rent, or possession of the premises, within three (3) days (excluding Saturday, Sunday, and legal holidays) from the date and delivery of this notice, to wit: on or before the day of 20 TWENTY-SECOND: In the absence of actual knowledge of abandonment, it shall be presumed that the tenant has abandoned the rental unit if tenant is absent from the premises for a period of time equal to one-half the time for periodic rental payments. However, this presumption shall not apply if the rent is current or the tenant has notified the landlord of an intended absence and there are no breaches outstanding. TWENTY-THIRD: Unless stated otherwise herein, the landlord and tenant shall refer to Florida Statutes Chapter 83, Part 1. TWENTY-FOURTH: All notices and payments under this lease shall be given to: For Landlord: Judy A. Shephard 29438 Saratoga Avenue Big Pine Key, FL 33043 For Monroe County: Public Works 1100 Simonton Street Key West, FL 33040 OPTION TO RENEW: Lessor grants to lessee an option to renew this lease for a period of four (4) years after the expiration of its original term, on the same conditions of this lease. Lessees shall give lessor written notice of its intention to renew this lease thirty (30) days prior to the expiration of this lease. IN WITNESS WHEREOF, the parties hereto have hereunder executed this instrument for the purpose herein expressed, the day and year above written. Attest: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Deputy Clerk SHIPS WAY, INC. RA Mayor ATTEST ;�. By: y`Sh �phard,�V�e dent 4Dvid S. Shephard, Se tary E C0UNT_�y-1aTTO NE , R9VED Ai3 70. w� -TANT C NTY ATTORNEY ��Z� Date BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Bulk Item: Yes x No _ Division: Public Works Department: Facilities Maintenance Staff Contact Person/Phone #:John W. King/292-4531 AGENDA ITEM WORDING: Approval of a Lease Agreement with Southernmost Homeless Assistance League (SHAL) for office space at the Gato Building, 1100 Simonton Street, Key West, FL ITEM BACKGROUND: SHAL has been leasing office space in the Gato Building since January 2009 when space became available. In December 2009, SHAL renewed their lease for this space and added an additional office. As the lease has been satisfactory for both parties, SHAL has requested a new one-year lease commencing January 14, 2011 and terminating January 13, 2012 for office 1-192 only (96 square feet) at the rate of $50.21 per square foot. PREVIOUS RELEVANT BOCC ACTION: At the January 28, 2009 BOCC meeting, the BOCC approved a one-year agreement with SHAL for office space. On December 16, 2009, the BOCC approved a lease renewal. CONTRACT/AGREEMENT CHANGES: New Agreement STAFF RECOMMENDATIONS: Approval TOTAL COST: -0- INDIRECT COST: N/A BUDGETED: Yes X No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: same SOURCE OF FUNDS: REVENUE PRODUCING: Yes X No AMOUNT PER MONTH Year S 4,820.16 APPROVED BY: County A 0 urcha ing Risk Management ement DOCUMENTATION: Included X ot Required DISPOSITION: AGENDA ITEM # Revised 1/09 M E M OR AND U M DATE: November 15, 2010 TO: Dent Pierce, Division Director Public Works FROM: John W. King, Sr. Director Lower Keys Operations RE: Agenda Item — December 15, 2010 BOCC Meeting Lease Agreement for Office Space at the Gato Building Southernmost Homeless Assistance League (SHAL) SHAL has been leasing office space in the Gato Building since January 2009 when space became available. In December 2009, SHAL renewed their lease for this space and added an additional office. As the lease has been satisfactory for both parties, SHAL has requested a new one-year lease commencing January 14, 2011 and terminating January 13, 2012 for office 1-192 only (96 square feet) at the rate of $50.21 per square foot. I hereby request approval of this one-year lease agreement with SHAL to commence January 14, 2011 and terminate January 13, 2012. JWK/jbw Enclosures MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Southernmost Homeless Contract # Assistance League Effective Date: January 14, 2011 Expiration Date: January 13, 2012 Contract Purpose/Description: Lease Agreement with SHAL for offices ace in the Gato Building, Key West, Florida Contract Manager: Jo B. Walters 4549 Facilities Maint/Stop #1 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 12/15/10 Agenda Deadline: 11/30/10 CONTRACT COSTS/REVENUE Total Dollar Value of Contract: $ 4,820.16 Current Year Portion: $ 3,615.12 Budgeted? Yes X No ❑ Account Codes: Urn i - 7>to2-cg '�:,Cr - Grant: $ N/A - - - - County Match: $ N/A - - - - Estimated Ongoing Costs: $_ (Not included in dollar value above ADDITIONAL COSTS /yr For: CONTRACT REVIEW Changes D to In Needed Division Director 3 1 Ir Yes❑ Not { Risk Manag ent �< i "_ � � _ Yes ❑ No ❑� O.M.B./Pur asN2g f 1 -2-mod-/® Yes❑ No 1 County Attorney Yes❑ No Comments: )MB Form Revised 2/27/01 MCP #2 iti etc. Date Out 111361 3A 0. LEASE AGREEMENT MONROV Cni ryry SOUT HOMELESS A -.QYQ-r " N-CE LEAGUE This Agreement is made and entered into by MONROE COUNTY. a Political subdivision of the State or Florida, whose address is I 100 Simonton Street, Key West, Ft. 33040, (CO(jNTY or the LESSOR), and Southernmost homeless Assistance League (SfiAL or the LESSEE), a not -for -profit corporation incorporated in the State of Florida, whose address is P.O. Box 2990, Key West, FL 33045-2990. WHEREAS, the BOCC leases Premises to other governmental agencies and not -for -profit organizations servicing the County community; and WHEREAS, SRAL has requested use of County office space, and WHEREAS, SHALL provides support to homeless programs in the community; and WHEREAS, the COUNTY owns an Office building known as the Gato Building at 1100 Simonton Street, Key West, Florida; and WHEREAS. the Gato Building has a number of vacant offices due to reduction of the County workfiorce; and h WHEREAS, the BOCC has determined that is in the best interests of Monroe County to lease 96 square feet of office space at the Gato Building; NOW THEREFORE, IN CONSIDERATION of the promises contained herein the parties agree to the following: I. PROPERTY. The COUNTY leases exclusively to the LESSEE 96 square feet of of r Ice space, # I - 192, adjacent to the lobby of the Social Services Suite in the Gato Building and which ' shown on Exhibit A, hereafter the premises. Exhibit A is attached and made a part of is Agreement. this 2. TERM. The term of this Agreement is one (1) year running from January 12, 2011 through January 11. 2012. USE AND CONDITIONS. The Premises shall he used solely for the Premises are used for any other " 11 CO V -1-- -, , e - UIN I V snail have the option ofirnmediately terminating this Agreement. LESSEE shall not permit any use of the premises in any manner that would Obstruct or interfere with any COUNTY functions and duties. The LESSF .,E will further urther use and occupy said premises in a careful and Proper manner, and not commit any waste thereon. LESSEE will not cause, or allow to be caused, any nuisance or Objectionable activity ot' any nature on the premises. Any activities in any way involving hazardous materials or substances of any kind whatsoever, either as those terms may be defined under any state or federal laws or regulations or as those terms are understood in common usage, are specifically prohibited. The LESSEE will not use or occupy said premises for any unlawful purpose and will, at LFSSEF's sole -lost and expense, conform to and obey any present or future SHAL Lease Agreement Page I of7 laws, ordinance and/or rules, regulations, requirements and orders of governmental authorities or agencies respecting the use arid occupation of said premises. These covenants of the LESSEE shall also be binding on the use of the personnel, volunteers or clients of LESSEE in accessing any common areas of the Gato Building. No signs of any kind will be permitted on the external facade of the building or in the parking lot. A sign no larger than 8 '/'2 " X I I " may be posted at the entry door to the premises. 4. RENT. For the use of the premises, the LESSEE must pay the COUNTY the sum of $4,820.16 per year, for 96 square feet of office space at 550.21 per square foot, which rental sum is due in monthly installments of $401.68 on the first day of the month payable in advance. The twelve monthly payments shall be remitted to Monroe County Clerk's Office, 500 Whitehead Street, Key West, FL 33040. Additional consideration from each party: a. Utilities Electricity, office maintenance, office cleaning, and local phone calls will be provided by LESSOR at no additional cost to LESSEE, unless the occupation of the premises has a significant impact on any of such costs to LESSOR, in which case the parties will either renegotiate the consideration or mutually terminate this agreement. b. SHAL shall be entitled to use the common areas of the Gato Building, such as bathrooms, and the Social Services Suite, such as the lobby and conference room, incidental to the purpose of their occupancy of the premises. c. SHAL shall have access to LESSOR's deaf and/or hearing impaired services upon SHAL's timely notification in a form acceptable by both parties to the County Administrator's office, or its designee, any time this service is required. All costs incurred by SHAL's use of the services shall be at SHAL's sole cost and expense. 5. TAXES. The LESSEE must pay all taxes and assessments, including any -sales or use tax, levied by any government agency with respect to the LESSEE's operations on the premises. 6. INSURANCE. LESSEE shall, throughout the term of this lease, maintain general liability insurance in a minimum amount of Three Hundred Thousand Dollars f$300,000)0); vehicle liability insurance in a minimum of Three Hundred Thousand Dollars ($300.000.00); and worker's compensation insurance for bodily injury or death to any one person or number of persons in any one occurrence in an amount not less than One any Thousand Dollars ($100,000.00) unless waived or modified by County Risk Management per Administrative Instruction 4709. 'Me insurance Policy (or policies) shall name Monroe County as an additional insured. The LESSEE must keep in full force and effect the required insurance during the term of this Agreement. If the insurance policies originally purchased which meet the requirements of this lease are canceled, terminated or reduced in coverage, then the LESSEE must immediately I substitute complying policies so that no gap in coverage occurs. Copies of current policy certificates shall be filed with the COUNT Y whenever acquired or amended. 7. LOS-NDI[TION OF PRENUSES. The LESSEE must keep the premises in good order and condition. The LESSEE must promptly repair damage to the premises. At the end of the term of this Agreement, the LESSEE must surrender the premises to the COUNTY in the same good order and condition as the premises were on the commencement of the term, normal wear and tear excepted. The LESSEE is solely responsible for any improvements to land and appurtenances placed on the premises. SHAL Lease Agreement Rage 2 co f 7 8. IMPROVEMENTS. No structure or improvernenv., of any kind shall be placed upon the land without prior approval in writing by the County Administrator and building pert -nits issued by the COUNTY and any other agency, federal or state, required by law. Any such structure or improvements shall be constructed in a good and workmanlike manner at LESSEE's sole cost and expense. Subject to any landlord's lien, any structures or improvements constructed by LESSEE shall be removed by the LESSEE at LESSEE's sole cost and expense, by midnight on the day of termination of this Agreement or extension hereof, and the land restored as nearly as practical to its condition at the time this agreement is executed unless the Board of County Commissioners accepts in writing delivery of the premises together with any structures or improvements constructed by LESSEE. Portable or temporary advertising signs are prohibited. LESSEE shall perform, at the sole expense of LESSEE, all work required in the preparation of the property or premises hereby leased for occupancy by LESSEE; and LESSEE does hereby accept the leased property or premises as now being in fit and tenantable condition for all purposes of LESSEE. COUNTY reserves the right to inspect the leased area and to require whatever adjustment to structures or improvements as COUNTY, in its sole discretion, deems necessary. Any adjustments shall be done at LESSEE's sole costs and expense. Any building permits sought by LESSEE shall be subject to permit fees. 9. HOLD HARMLESS. The LESSEE is liable for and must fully defend, release, discharge, indemnify and hold harmless the COUNTY, the members of the County Commission, County officers and employees, and County agents and contractors, and the State, its off -jeers and employees, from and against any and all claims, demands, causes of action, losses, costs and expenses of whatever type - including investigation and witness costs and expenses and attorneys' fees and costs - that arise out of or are attributable to the LESSEE's operations on the premises except for those claims, demands, damages, liabilities, actions, causes of action, losses, costs and expenses that are the result of the sole negligence of the COUNTY. The LESSEE's purchase of the insurance required under this Agreement does not release or vitiate its obligations under this paragraph. 10. NON-DISCRIMINATION. The LESSEE for itself, its personal representatives, successors in interest, and assigns, as a part of the consideration hereof, does hereby covenant and agree that that there will be no discrimination against any person, and it is expressly understood that upon a deten-nination by a court, of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. The LESSEE for itself, its personal representatives, successors in interest, and assigns, as a part of the consideration hereof, does hereby covenant and agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil Rights Act of] 964 (PL 88-352) which prohibits discrimination on the basis of race, color or national origin; 2)'Fitle IX of the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of handicaps, 4) The Age Discrimination Act of 1975, as aryiended (42 USC ss. 6101-6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PI, 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 06) The Comprehensive Alcohol Abuse and Alcoholism Prevention. Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 ('42 USC ss. 690dd-3 and SHAL Lease Agreement Page 3 of 7 290ec-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; 8)Title VIlf of the Civil Rights Act of 1968 (42 USC s. et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 UISC s. 1201 Note), as maybe amended from time to time, relating to nondiscrimination on the basis of disability; 10) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. It. TERMINATION. The COUTNTY may treat the LESSEE in default and terminate this Agreement immediately, without prior notice, upon failure of LESSEE to comply with any provision of this Agreement. LESSEE may terminate this Agreement upon giving thirty days prior written notice to COUNTY. 12. DEFAULT -WAIVER. The waiver by the LESSEE or the COUNTY of an act or omission that constitutes a default of an obligation under this Agreement does not waive another default of that or any other obligation. 13. ASSIGNMENT. The LESSEE may not assign this Agreement or assign or subcontract any of its obligations under this Agreement without the approval of the COUNTY's Board of County Commissioners. All the obligations of this Agreement will extend to and bind the legal representatives, successors and assigns of the LESSEE and the COUNTY. 14. SUBORDINATION. This Agreement is subordinate to the laws and regulations of the United States, the State of Florida, and the COUNTY, whether in efTect on commencement of this lease or adopted after that date. 15. GOVERNING LAW, VENUE, INTERPRETATION. This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to contracts made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the COUNTY and LESSEE agree that venue will lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. The COUNTY and LESSEE agree that, in the event of conflicting interpretations of C� the terms or a term of this Agreement by or between any of them the issue shall be submitted to mediation prior to the institution of any other administrative or legal proceeding. 16. SEVERA.BILITY. If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The COUNTY and LESSEE agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. 17. ATTORNEY'S FEES and COSTS. The COUNTY and LESSEE agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to SHAL Lease Agreement Page 4 of 7 reasonable attorneys fees, court costs, investigative, and out-of-pocket expenses, as an award against the non -prevailing party, and shall include attorney's fees, courts costs, investigative, and out-of-pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the circuit court of Monroe County. 18. BINDING EFFECT. The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the COUNTY and LESSEE and their respective legal representatives, successors, and assigns. 19. AUTHORITY. Each party represents and warrants to the other that the execution. delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law. 20. CLAIMS FOR FEDERAL OR STATE AID. LESSEE and COUNTY agree that LESSEE shall be, and is, empowered to apply for, seek, and obtain federal and state funds to further the purpose of this Agreement; provided that all applications, requests, grant proposals, and funding solicitations shall be approved by COUNTY party prior to submission, 21. ADJUDICATION OF DISPUTES OR DISAGREEMENTS. COUNTY and LESSEE agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If no resolution can be agreed upon within 30 days after the first meet and confer session, the issue or issues shall be discussed at a public meeting of the Board of County Commissioners. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida law. 22. COOPERATION. In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, COUNTY and LESSEE agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. COUNTY and LESSEE specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. 23. COVENANT OF NO INTEREST. COUNTY and LESSEE covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and that the only interest of each is to perforin and receive benefits as recited in this Agreement. 24. LODE OF ETMCS. COUNTY agrees that officers and employees of the COUNTY recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, but not limited to, regarding, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. 2 5, PUBLIC ACCESS. The COUNTY and LESSEE shall allow and permit reasonable access to, and inspection of all documents, papers, letters or other materials in its possession or tinder its control subject to the provisions of Chapter H 9, Florida Statutes, and made or received by the COUNTY and LESSEE in conjunction with this Agfeen-ient; and the COUNTY shall have SHAL Lease Agreement Page 5 of 7 the right to unilaterally cancel this Agreement upon violation of this Provision by LESSEE 26. NON-WALVER, OF IMMUNITY. Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the C01JNTY and the LESSEE in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract entered into by the COUNTY be required to contain any provision for waiver. 27. PRIVILEGES AND IMMUNITIES. All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the COUNTY, when performing their respective functions under this Agreement within the territorial limits of the COUNTY shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the COUNTY. 28. LEGAL OBLIGATIONS_ AND RESPONSIBILITES: Non -Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the COUNTY, except to the extent permitted by the Florida constitution, state statute, and case law. 29. NON -RELIANCE BY NON-PARTIES. No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third -party claim or entitlement to or benefit of any service or program contemplated hereunder, and the COUNTY and LESSEE agree that neither the COUNTY nor the LESSEE or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. 30. ATTESTATIONS. LESSEE agrees to execute such documents as the COUNTY may reasonably require, including a Public Entity Crime Statement, an Ethics Statement, and a W Drug -free Workplace Statement. 31. NO PERSONAL LIABILI'IFY. No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or he subject to any personal liability or accountability by reason of the execution of this Agreement. 32. EXECUTION IN 'COUNTERPARTS. This Agreement may be executed in any number of counterparts, each of which shall he regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by singing any such counterpart. 41- 33, SECTION READINGS.Section headings have been inserted in this Agreement as a SHAL Lease Agr"ment Page 6 of 7 matter of convenience of reference only, and it is agreed that Such section headings are not a part of this Agreement and will not be used in the interpretation of any provision of this Agreement. 34. MUTUAL REVIEW. This agreement has been careftilly reviewed by LESSEE and COUNTY, therefore this agreement is not to be construed against either party on the basis of authorship. 35. NOTICES. Notices in this Agreement, unless otherwise specified, must be sent by certified mail to the following: I COUNTY: LESSEE County Administrator Mark Szurek, Chair 1100 Simonton Street Southernmost Homeless Assistance League (SHAL) Key Vest, IL 33040 P. O. Box 2990 Key West, FL 33045- 2990 36. PEL,VfIONIHIP. OF PARTIES. SHAL is, and shall be, in the performance of all works, services, and activities under this Agreement, an independent agency, and not an employee, agent or servant of the BOCC. SHAL shall exercise control, direction, and supervision over the personnel and volunteers who use the premises. SHAL shall have no authority whatsoever to act on behalf arid/or as agent for the BOCC in any promise, agreement or representation other than specifically provided for in this agreement. The BOCC shall at no time be legally responsible for any negligence on the part of SHAL, its employees, agents or volunteers, resulting in either bodily or personal injury or property damage to any individual, property or corporation. 37. FULL UNDERSTANDING. This Agreement is the parties' final mutual understanding. It replaces any earlier agreements or understandings, whether written or oral. This Agreement cannot be modified or replaced except by another written and signed agreement. 38. EFFECTIVE DATE, This Agreement will take effiect on January 12. 2011. IN WITNESS WHEREOF, each party has caused this Agreement to be executed by its duly authorized representative. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK By Deputy Clerk (SEAL) A-17FE ' ST: Witness By Title BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By Mayor/Chairman SOUTHERNMOST HOMELESS ASSIS"I'ANCE 1,1--'AGLJE By Title Address: S.SO4 Phone: k s HAL Lease Agreement �PE D P �O' A . ����7 AS UNTY ATTORN Y Page 7 of 7 ar_ E 9 - 7 �12 If'_�� BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date:December 15, 2010 Division:Emergency Services Bulk Item: Yes X No _ Department: Emergency Management Staff Contact Person/Phone # Jose Tezanos / 305-289-6325 AGENDA ITEM WORDING: Approval of a Florida Division of Emergency Management (FDEM) Award Letter for delivery of Position ICS Training (IMT) and WebEOC in the amount of $8,500.00, no county match required; and authorization for the County Administrator to execute any other required documentation in relation to the application process. ITEM BACKGROUND: In accordance with the provisions of Federal fiscal Year 2010 Homeland Security Grant Program (SHSGP), FDEM has provided Monroe County an award letter Federal grant number 201 O-SS-TO-0092 which outlines condition to provide ICS training and WebEOC plug in to the EM Constellation state software. We inust have this award letter signed by an authorized official and returned prior to the execution of the Federally Funded Subgrant Agreement. We should not expend any fiends until we receive a fully executed. agreement from FDEM. PREVIOUS RELEVANT BOARD ACTION: None CONTRACT/AGREEMENT CHANGES: None STAFF RECOMMENDATIONS: It is appropriate to accept this FDEM Award. A revenue cost center is requested of OMB. TOTAL COST: 8,500.00 INDIRECT COST: BUDGETED: Yes No X DIFFERENTIAL OF LOCAL PREFERENCE: N/A COST TO COUNTY. $ 0.00 SOURCE OF FUNDS: Grant REVENUE PRODUCING: Yes X A rNo AMOUNT PER MONTH Year APPROVED BY: County Atty X fz OMB/Purchasing X Risk Management X DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 7/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: State of Florida DEM Contract #2010 SS-TO-0092 Effective Date: August 1, 2010 Expiration Date: January 31, 2013 Contract Purpose/Description: Approval of a Florida Division of Emergency Management (FDEM) Award Letter for delivery of Position ICS Training (IMT) and WebEOC in the amount of $8,500.00, no county match required; and authorization for the County Administrator to execute any other required documentation in relation to the application process. A revenue cost center is requested of OMB Contract Manager: Jose Tezanos 6325 14 (Name) (Ext,) (Department/Stop #) for BOCC meeting on Dec 15, 2010 Agenda Deadline: Nov 30, 2010 CONTRACT COSTS Total Dollar Value of Contract: $ 8,500.00 Current Year Portion: $ 8,500.00 Budgeted? Yes❑ No ® Account Codes: —GE - Grant: $ 8,500.00 - - - County Match: $ 0 - - - - ADDITIONAL COSTS Estimated Ongoing Costs: $ lyr For: (Not included in. dollar value above) (eg. maintenance. CONTRACT REVIEW etc. Changes Date Out Date In Needed R vi Division Director �,� ! �' Yes❑ NoB— Risk Management Yes❑ No❑ O.M.B./Purchasing Yes❑ No❑ County Attorney Yes❑ No❑ Comments: UM13 Form Revised 2/27/01 MCP #2 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: State of Florida DEM Contract #2010 SS-TO-0092 Effective Date: August 1, 2010 Expiration Date: January 31, 2013 Contract Purpose/Description: Approval of a Florida Division of Emergency Management (FDEM) Award Letter for delivery of Position ICS Training (IMT) and WebEOC in the amount of $8,500.00, no county snatch required; and authorization for the County Administrator to execute any other required documentation in relation to the application process. A revenue cost center is requested of OMB Contract Manager: Jose Tezanos 6325 14 (Naive) (Ext.) (Department/Stop #) for BOCC meeting on Dec 15, 2010 Agenda Deadline: Nov 30, 2010 CONTRACT COSTS Total Dollar Value of Contract: $ 8,500.00 Current Year Portion: $ 8,500.00 Budgeted? Yes❑ No ® Account Codes: —GE - Grant: $ 8,500.00 - - - - County Match: $ 0 - - - - ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. maintenance, utiliti CONTRACT REVIEW Changes Date Out Division Director Date In Needed Reviewer Yes[:] No[:] Risk Manage ent 1-0 Yes❑ Nolo/TO O.M.B./Purc ing 1� I tb 10 Yes❑ NoZ t N !6a f 11) County Attorney kYes❑ No !{ ZFJ l D Comments: VMB Vorm Kevtsed 2I2111U l MC;1' #) Ti1P aY �� y : q _ Yid STATE OF FLORIDA �+ DIVISION OF EMERGENCY MANAGEMENT CHARLIE CRIST Governor November 12, 2010 SUBGRANTEE: Monroe County DAVID HALSTEAD Director ISSUE NUMBER PROJECT TITLE FINAL ALLOCATION 10 Delivery of Position 1CS Training (IMT) $4,000.00 10 WebEOC $4,500.00 GRANT PERIOD: August 1, 2010 — January 31, 2013 AWARD TOTAL: $8,500.00 FEDERAL GRANT NO: 2010-SS-TO-0092 STATE AGREEMENT NO: Provided Upon Execution In accordance with the provisions of Federal Fiscal Year 2010 Homeland Security Grant Program, the Florida Division of Emergency Management hereby awards to the foregoing Subgrantee a grant in the amount shown above. Payment of Funds: This Award Letter must be signed by the Official Authorized to Sign in the space below and the original returned to the Florida Division of Emergency Management before execution of your agreement. The subgrantee should not expend any funds until they receive a fully executed agreement from the Florida Division of Emergency Management and all Special Conditions are satisfied. Grant funds will be disbursed to subgrantees (according to the approved project budget) upon receipt of evidence that items have been invoiced, deliverables have been received and that funds have been expended (i.e., invoices, contracts, itemized expenses, canceled checks, etc.). Supplantation: The Act requires that subgrantees provide assurance that subgrant funds will not be used to supplant or replace local or state funds or other resources that would otherwise have been available for homeland security activities. In compliance with that mandate, I certify that the receipt of federal funds through Florida Division of Emergency Management shall in no way supplant or replace state or local funds or other resources that would have been made available for homeland security activities. Conditions: I certify that I understand and agree that funds will only be expended for those projects outlined in the funding amounts as individually listed above. I also certify that 1 understand and agree to comply with the general and fiscal terms and conditions of the grant including special conditions; to comply with provisions of the Act governing these funds and all other federal laws; that all information is correct; that there has been appropriate coordination with affected agencies; that I am duly authorized to commit the applicant to these requirements; and that all agencies involved with this project understand that all federal funds are limited to a thirty -month (30) period. FLORIDA RECOVERY OFFICE • DIVISION HEADQUARTERS • STATE LOGISTICS RESPONSE CENTER 36 Skyline Drive 2555 Shumard Oak Boulevard 2702 Directors Row Lake Mary, FL 32746-6201 Taliahassee, FL 32399-2100 Orlando, FL 32809-5631 Tel: 850-413-9969 • Fax: 850-488-1016 www.FloridaD!Saster.ora SPECIAL CONDITIONS 1. The grantee and any subgrantee shall comply with the most recent version of the Administrative Requirements, Cost Principles, and Audit Requirements. A non-exclusive list of regulations commonly applicable to DHS grants are listed below: A. Administrative Requirements 1. 44 CFR Part 13, Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments 2. 2 CFR Part 215, Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Non -Profit Organizations (OMB Circular A-110) B. Cost Principles 1. 2 CFR Part 225, Cost Principles for State, Local and Indian Tribal Governments (OMB Circular A-87) 2. 2 CFR Part 220, Cost Principles for Educational Institutions (OMB Circular A-21) 3. 2 CFR Part 230, Cost Principles for Non -Profit Organizations (OMB Circular A-122) 4. Federal Acquisition Regulations (FAR), Part 31.2 Contract Cost Principles and Procedures, Contracts with Commercial Organizations C. Audit Requirements 1. OMB Circular A-133, Audits of States, Local Governments, and Non -Profit Organizations 2. Recipient understands and agrees that it cannot use any federal funds, either directly or indirectly, in support of the enactment, repeal, modification or adoption of any law, regulation or policy, at any level of government, without the express prior written approval of FEMA. 3. The recipient agrees that a[[ allocations and use of funds under this grant will be in accordance with the FY 2010 Homeland Security Grant Program (HSGP) guidance and application kit. 4. The recipient shall not undertake any project having the potential to impact Environmental or Historical Preservation (EHP) resources without the prior approval of FEMA, including but not limited to ground disturbance, construction, modification of structures, and purchase and use of sonar equipment. Recipient must comply with all conditions placed on the project as the result of the EHP review. Any change to the approved project scope of work will require re-evaluation for compliance with these EHP requirements. If ground -disturbing activities occur during project implementation, the recipient must ensure monitoring of ground disturbance, and if any potential archeological resources are discovered, the recipient will immediately cease construction in that area and notify FEMA and the appropriate State Historic Preservation Office. Any construction activities that have been initiated without the necessary EHP review and approval will result in a non-compliance finding and will not be eligible for FEMA funding. 5. A. Provision applicable to a recipient that is a private entity. You as the recipient, your employees, subrecipients under this award, and subrecipients' employees may not: a. Engage in severe forms of trafficking in persons during the period of time that the award is in effect; b. Procure a commercial sex act during the period of time that the award is in effect; or c. Use forced labor in the performance of the award or subawards under the award. We as the Federal awarding agency may unilaterally terminate this award, without penalty, if you or a subrecipient that is a private entity: a. Is determined to have violated a prohibition in paragraph A.1 of this award term; or b. Has an employee who is determined by the agency official authorized to terminate the award to have violated a prohibition in paragraph A.1 of this award term through conduct that is either: i. Associated with performance under this award; or ii. Imputed to you or the subreciplent using the standards and due process for imputing the conduct of an individual to an organization that are provided in 2 CFR Part 180, "OMB Guidelines to Agencies on Governmentwide Debarment and Suspension (Non -procurement)," as implemented by our agency at 2 CFR Part 3000. B. Provisions applicable to a recipient other than a private entity. We as the Federal warding agency may unilaterally terminate this award, without penalty, if a subrecipient that is a private entity: 1. Is determined to have violated a prohibition in paragraph A.1 of this award term; or 2. Has an employee who is determined by the agency official authorized to terminate the award to have violated a prohibition in paragraph A.1 of this award term through conduct that is either: a. Associated with performance under this award; or b. Imputed to you or the subrecipient using the standards and due process for imputing the conduct of an individual to an organization that are provided in 2 CFR Part 180, "OMB Guidelines to Agencies on Government wide Debarment and Suspension (Non -procurement)," as implemented by our agency at 2 CFR Part 3000. C. Provision applicable to any recipient. 1. You must inform us immediately of any information you receive from any source alleging a violation of a prohibition in paragraph A.1 of this award term. 2. Our right to terminate unilaterally that is described in paragraph A.2 or B of this section: a. Implements section 106(g) of the Trafficking Victims Protection Act of 2000 (TVPA), as amended (22 U.S.C. 7104(g)), and b. Is in addition to all other remedies for noncomplicance that are available to us under this award. 3. You must include the requirements of paragraph A.1 of this award term in any subaward you make to a private entity. 6. Definitions. For purposes of this award term: "Employee" means either: a. An individual employed by you or a subrecipient who is engaged in the performance of the project or program under this award; or b. Another person engaged in the performance of the project or program under this award and not compensated by you including, but not limited to, a volunteer or individual whose services are contributed by a third party as an in -kind contribution toward cost sharing or matching requirements. 2. "Forced labor" means labor obtained by any of the following methods: the recruitment, harboring, transportation, provision or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery. "Private entity" means: a. Any entity other than a State, local government, Indian Tribe, or foreign public entity, as those terms are, defined in 2 CFR 175.25. b. Includes: i. A nonprofit organization, including any nonprofit institution of higher education, hospital, or tribal organization other than one included in the definition of Indian Tribe at 2 CFR 175.25(b). ii. A for -profit organization. 4. "Severe forms of trafficking in persons," "commercial sex act," and "coercion" have the meanings given at section 103 of the TVPA, as amended (22U.S.C. 7102). A. "Classified national security information," as defined in Executive Order (EO) 12958, as amended, means information that has been determined pursuant to EO 12958 or any predecessor order to require protection against unauthorized disclosure and is marked to indicate its classified status when in documentary form. B. No funding under this award shall be used to support a contract, subaward, or other agreement for goods or services that will include access to classified national security information if the award recipient has not been approved for and has access to such information. C. Where an award recipient has been approved for and has access to classified national security information, no funding under this award shall be used to support a contract, subaward, or other agreement for goods or services that will include access to classified national security information by the contractor, subawardee, or other entity without prior written approval from the DHS Office of Security, Industrial Security Program Branch (ISPB), or, an appropriate official within the Federal department or agency with whom the classified effort will be performed. D. Such contracts, subawards, or other agreements shall be processed and administered in accordance with the DHS "Standard Operating Procedures, Classified Contracting by States and Local Entities," dated July 7, 2008; EOs 12829, 12958, 12968, as amended; the National Industrial Security Program Operating Manual (NISPOM); and/or other applicable implementing directives or instructions. All security requirement documents are located at: http://www.dhs.gov/xor)nbix/grants/index.shtm E. Immediately upon determination by the award recipient that funding under this award will be used to support such a contract, subaward, or other agreement, and prior to execution of any actions to facilitate the acquisition of such a contract, subaward, or other agreement, the award recipient shall contact ISPB, or the applicable Federal department or agency, for approval and processing instructions. DHS Office of Security ISPB contact information: MONRQF, COUNTY ATTORNEY Email: DD254AdministrativeSecurit dhs. ov APP VE AS O Mail: Department of Homeland Security C NTHIA L. HALL Office of the Chief Security Officer ASSISTAI T COUNTY ATTORNEY ATTN: ASD/Industrial Security Program Branch Date ---.• Ir!-/',- Utd Washington, D.C. 20528 ACCEPTANCE FOR THE SUBGRANTEE: Signature of Official Authorized to Sign for Grantee Signature of State Administrative Agency BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: Countv Administrator Bulk Item: Yes X No _ Department: Engineering/Project Mana ement/Wastewater Staff Contact Person/Phone #: Judy Clarke X 4329 AGENDA ITEM WORDING: Approval of a First Amendment to design build contract with Structural Preservation Systems, LLC, for the Geiger Creek Bridge Repair Design Build Project, to comply with revised Florida Department of Transportation (FDOT) requirements. ITEM BACKGROUND: This Amendment does not change the contract price. The Amendment includes FDOT requirements to previously approved contracts to adhere to revised guidelines. The Design Build contract includes federal requirements in accordance with the American Recovery and Reinvestment Act of 2009. FRE VIOUS RELEVANT BOCC ACTION: At the January 20, 2010 BOCC meeting the board approved execution of the design/build contract with Structural Preservation Systems, LLC for the Geiger Creek Bridge Repair project. LOIN 1 RAC1'/AGREEMENT CHANGES: Amend Agreement to remove any statements that reference the amending of FHWA Form 1273. Amend Agreement to include the Davis Bacon Act Wage Determination General Decision FL299 as Attachment E. STAFF RECOMMENDATIONS: Approval to Amend the Agreement as stated above. TOTAL COST: N/A INDIRECT COST: BUDGETED: Yes X No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: N/A SOURCE OF FUNDS: REVENUE PRODUCING: Yes _ No X AMOUNT PER MONTH Year APPROVED BY: County Att� OMB/Purchasing Risk Management DOCUMENTATION: Included Not Required DISPOSITION: Revised 7/09 AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Structural Preservation Contract # Systems, LLC. Effective Date: December 15, 2010 Expiration Date: January 17, 2011 Contract Purpose/Description: Amendment to satisfy FDOT requirements — No change in Budget Contract Manager: Judy Clarke 4329 Engineering41 (Name) (Ext.) (Department/Stop #) for BOCC meeting on December 15, 2010 Agenda Deadline: November 30, 2010 CONTRACT COSTS Total Dollar Value of Contract: $ -0- Current Year Portion: $ n/a Budgeted? Yes❑ No ❑ Account Codes: 125 - 2.2,5-G mo,�bi -5303yo Grant: $ _ County Match: $ Estimated Ongoing Costs: $0/yr (Not included in dollar value above) ADDITIONAL COSTS For: CONTRACT REVIEW Changes Date In Needed Division Director " -L -/0 YesQ No[ Risk Manageirient LL'13, (D Yes❑ No1V Pi6- �J . g * O.M.B./Puie\h in1(-14--'0 YesQ No County Attorney C 1 1 q 1V YesQ No® Comments: VJ1v1D rV1111 RGvibuu LILI/V1 lvlllr ffL Date Out 0 0 FIRST AMENDMENT TO CONTRACT FOR THE GEIGER CREEK BRIDGE REPAIR DESIGN BUILD PROJECT THIS First AMENDMENT to the Contract for the Geiger Creek Bridge Repair Design Build Project ("AGREEMENT") entered into between MONROE COUNTY ("COUNTY") and Structural Preservation Systems, LLC; ("CONTRACTOR") is made and entered into this 15`h day of December, 2010, in order to amend the AGREEMENT, as follows: WITNESSETH WHEREAS, on the 20`h day of January, 2010, the parties entered into the AGREEMENT for the Geiger Creek Bridge Repair Design Build Project; and WHEREAS, in order to close out the project and to comply with the Florida Department of Transportation directives, Article 7.11 of the AGREEMENT is hereby amended as set forth below; and WHEREAS, Florida Department of Transportation requires that the applicable Wage Rate General Decision for Federally funded construction projects be attached to the Contract; NOW THEREFORE, IN CONSIDERATION of the mutual promises contained herein, the parties hereby agree as follows: 1. Article 7.11 of the AGREEMENT shall be amended to delete portions of the present wording and to read only as follows: FHWA Form 1273: Form 1273 is attached hereto as Attachment C and made a part of this contract. The Contractor will adhere to all provisions in FHWA Form 1273. 2. The AGREEMENT shall be amended to include the Davis Bacon Act Wage Determination General Decision FL299 as attached hereto and made a part of the Agreement as Attachment E. 3. The remaining terms of the AGREEMENT, not inconsistent herewith, shall remain in full force and effect. REMAINDER OF PAGE 1 LEFT INTENTIONALLY BLANK SIGNATURE PAGE ONLY TO FOLLOW Page 1 of 2 IN WITNESS WHEREOF, the parties hereto have executed this Amendment on the date stated above. Attest: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE By: COUNTY, FLORIDA Deputy Clerk By: Mayor/Chairman Witness Witness Attest: CON OR By: by: /2z/�� Title: MONROE APPRPYe D ,-NS TO FORM: Page 2 of 2 is �l) f �X P L — ttAA�j CHRISTINE M, UMBERT-RARROVIS ASSISTANT 00-Ui`TY )67TORNEY Date Davis Bacon Act Wage Determination General Decision FL299 ATTACHMENT E GENERAL DECISION: FL20100299 03/12/2010 FL299 Date: March 12, 2010 General Decision Number: FL20100299 03/12/2010 Superseded General Decision Number: FL20080299 State: Florida Construction Type: Highway Counties: Glades, Hardee, Hendry and Monroe Counties in Florida. HIGHWAY CONSTRUCTION PROJECTS Modification Number Publication Date 0 03/12/2010 SUFL2009-196 08/05/2009 Rates Fringes CARPENTER, Including Formwork .... $ 11.97 0.00 CEMENT MASON/CONCRETE FINISHER ... $ 10.05 0.00 LABORER: Asphalt Raker .......... $ 9.75 2.19 LABORER: Common or General ...... $ 9.94 0.00 LABORER: Flagger................$ 9.43 0.00 LABORER: Pipelayer..............$ 8.33 0.00 OPERATOR: Backhoe/Excavator..... $ 10.42 0.00 OPERATOR: Bulldozer .............$ 11.69 0.00 OPERATOR: Distributor ........... $ 10.38 0.00 OPERATOR: Grader/Blade .......... $ 13.78 0.00 OPERATOR: Loader ................$ 10.33 0.00 OPERATOR: Milling Machine ....... $ 10.08 0.00 OPERATOR: Oiler .................$ 9.58 0.00 OPERATOR: Paver .................$ 11.59 2.10 OPERATOR: Roller ................$ 10.23 0.00 OPERATOR: Screed ................$ 11.70 0.00 OPERATOR: Tractor ...............$ 8.15 0.00 TRUCK DRIVER: 4 Axle Truck ...... $ 11.18 1.60 TRUCK DRIVER: Lowboy Truck ...... $ 11.86 0.00 of 3 10/8/2010 1:43 PM TRUCK DRIVER: Dump Truck ......... $ 17,00 0.00 ---------------------------------------------------------------- WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. Unlisted classifications needed for work not included within the scope of the classifications listed may be added after award only as provided in the labor standards contract clauses (29 CER 5.5(a)(1)(ii)). In the listing above, the "SU" designation means that rates listed under the identifier do not reflect collectively bargained wage and fringe benefit rates. Other designations indicate unions whose rates have been determined to be prevailing. WAGE DETERMINATION APPEALS PROCESS 1.) Has there been an initial decision in the matter? This can be: * an existing published wage determination * a survey underlying a wage determination * a Wage and Hour Division letter setting forth a position on a wage determination matter * a conformance (additional classification and rate) ruling On survey related matters, initial contact, including requests for summaries of surveys, should be with the Wage and Hour Regional Office for the area in which the survey was conducted because those Regional Offices have responsibility for the Davis -Bacon survey program. If the response from this initial contact is not satisfactory, then the process described in 2.) and 3.) should be followed. With regard to any other matter not yet ripe for the formal process described here, initial contact should be with the Branch of Construction Wage Determinations. Write to: Branch of Construction Wage Determinations Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 !of 3 10/8/2010 1:43 PM 2.) If the answer to the question in 1.) is yes, then an interested party (those affected by the action) can request review and reconsideration from the Wage and Hour Administrator (See 29 CFR Part 1.8 and 29 CFR Part 7 ) . Write to: Wage and Hour Administrator U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 The request should be accompanied by a full statement of the interested party's position and by any information (wage payment data, project description, area practice material, etc.) that the requestor considers relevant to the issue. 3.) If the decision of the Administrator is not favorable, an interested party may appeal directly to the Administrative Review Board (formerly the Wage Appeals Board). Write to: Administrative Review Board U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 4.) All decisions by the Administrative Review Board are final. END OF GENERAL DECISION s of 3 10/8/2010 1:43 PM I :1.!._ 7 ,-i_ 1 - 'I1 11�'il Section 00500 Standard Form of Agreement Between Owner and Design/Builder Where the basis ofpayment is a STIPULATED SUM AGREEMENT Made as of the 206 day of January in the year of Two Thousand and Ten. BETWEEN the Owner: Monroe County Board of County Commissioners 1100 Simonton Street Key West, Florida 33040 and the Design/Builder. Structural Preservation Systems, LLC 2001 Blount Road Pompano Beach, Florida 33069 For the following Project: Geiger Creek Bridge Repair Design Build Project Scope: The Scope of Work shall include, but not be limited to, all work shown and listed in the Request for Proposal OUP), the Design/Builders Technical Proposal and Bid Price Proposal. The Design/Builder is required to provide a complete job as contemplated by the RFP, the Technical Proposal, Bid Price Proposal, all drawings, specifications and submittals, which are a part of this Agreemem. Oversight for Owner is: MACTEC Engineering and Consulting, Inc. 3100 Overseas Highway Marathon, Florida 33050 The Owner and Design/Builder agree as set forth below. �� -C = CJ 1YAW STANDARDFORMOFAGRERA NTBErWEENOWNE AM (jV, 1 O ryl t G� 4 n Tie Contract Dom The Contract Documenta ooflsist of this Agreement, Cofldi6om of the Contract (General, Suppiemadwy and other Ca O°s� the R for haposals QW)� the DeftVBwI&n TcchWW Pmposd, Bid Price Proposal, Dnwh4M SpeaiSations and Su6mittob, hramMw Regrew sod Docummis, MUMIooe Stile, Addenda issued prior b ®eention of this Agreement, odker docOMeats listed in this Agreement and Modifications issued saw eeoecution of this Agreement. These form the Ceatract, afld are as filly a part of the Cambia as if dtadod to this Apecmeat or repeated herein. The Cambia represents She entire Md hdegnftd agreement between the parties herein and supersedes prior negotmons, reprasentstions or , eidher writrea or oraL 2 Tie Work of this Contract 11e D=MWBmlder shall wwwk the eatae wart desrritred M the Contract Documeatk acept to the indent -IN ificaQy indicated in the Coact Documents to be the responsibft of others, a as follow:: Scope of Wadi as specified in the Request for proposal, the Design Build Fnm's TedzdW proposd sod Bid Price Pmposd for this p t&d and in Specification Section 00300. The contract oomtibalex the entire and between the Owner and the DesigolBm'Ner with reference to the Geiger Creek Bridge Repair ARTICLE 3 Dabs of Comummement and Sabstadthd Completion 3.1 The date of co®encement is the date fiam which the Centred Trine of Panrgraph 32 is meaaueed, and dwH be the dde of this Agreement, as first wreten above, unless a different dale is stated below or provision is made f r the daft tD be firmed in a notice to proceed b=nd by the Owner as staled io Secd= 00350, Mr'bdowe Schedule, Unless the deft of eamnu ncem a is eatabliished by a notice to proceed issued by the Owner, the DesigolBmMer dIaH aotst+y the Owns, do ogh the Di eclor ofFAgroearieg Services. is wig not hu than five days be%re oonomencias the wart. Tie daft of araaweaee dry be the date wwftd in dw Notice to, Proceed, hawed to the Da kwaaMw 32 The Dea rMailder" achieve Snbalafai Completion of the entire wart flat borer than One Hundred and Twa ly (IM Days after the Date of Commencement, subject to 8d3o6taMnb of the Contract Trade as provided by fhe CeatractDocrmrent MQUAWMDAMM Liquideled damages wM be booed cc the Sd*tastid Completion Daft fix all wadi, modified by all app and Odwsi m in time as set forth by the Dneelor of En&owirg Service's aignahae of approver on tire Cafificeb of �Compltion. The lie, mhkd damages W& below droll be utrTiad to deter�e the amoaat of Ggaidated CO�NIRACT ores rear FIRST 3ECOM 31grDAY & DAYS UnderS0.000.00 $5015� 1S 5100AY SSO,000.00-S"1.9".00 IODADIDAY 200.00MAY 750.ONDAY sIOO,O OM 4",q".00 200AO/DAY 500.00/DAY 2,000ANDAY ssOO+MA and Up 500.00/DAY 1,000MMAY 3,5WANDAY The DedgdBuildees nm vay of damages and sob remedy for nay delay tamed by the Owner shall be an Weasion of time on the Coafract IMM STAN]tiRDFCRMCFAt i'BET%BNO TAMAAprnvr;t*XWX g Owl% 00MD-2 Costnwt Sttta 4.1 The owner sbdd pay rho Dosigo/Bm'Ider in ceh>rea - fords for the DeaignBmlder's pafizainoce of the Contract, for the Geiger Creek Bridge Repok Design Baird lrsjert the sum of Eight Hadred Seventy -tee Traasud Mw liadra 1 Z%W Thnee said Zers/144 l>oMm ( rn,90A" subject to additions and deductions as provided in the Contract Documents. 41 The Contract Seas is based upon the fbilowing dtamames, if any, which are de scriW in the Ceatract Documents and use hereby accepted by the owner. none 43 Unit prices, if any, use as fnliowc As specified in Bid Price Proposal. 5.1 Based up= Apptieatioos for Payment submitted by the Deaigo/Bu ider to rho Director of Bogineeriog Services, and upon approval for payment issued by the Director of Foyoeering Servicak the owner shall make progress payments on accoant of the Contract Sum to the DesholBmlde r as provided below and elsewhere in the Coalract Docomeats. 51 The period covered by each Application for payment sbali be as calendar mood► axft on the but day of the month, a as follows: 53 Payment will be made by the owner in acorn daahoe with the Florida Loot Government Prompt Payment Act 21R Florida Statutes SA Each Application for Payment shell be based upon the Schedule of V*hws submigad by tha Des4p/Builder in a000rdaooe with the Contact Dock. The Schedule of Values shell alloca6e the entire Contract Sum among the various pcatioos of the Work and be prghned in such fors and sopt: oted by such data to sobdaetiase its aocroscy as the owner may requim This scbedolq unless objected to by rho owner, shell be awed as a basis for reviewmg the ma's APPlicohoen for PaymcuL 53 Applications for Payment shell indicate the percentage of completion of each portion of the work as of the end of the period covered by the Application for Psymoot. 5.6 Subject to the provisions of the Contract Documents, the amount of cub progress payment shall be oompoled U follows: 5.&1 Tabe that potion ofthe Contrast Sam properly allocable to completed work as determined by multiplying the paoao-ge completion of each portion of the Work by the sbare afthe total Contract Sam allocated to tut portion of the Wodr in the Sdwdhfe of Vahra, ins ieI i ge ofISQpraut (10%} Pending Sad determination of and to the Owner of cimmyes in the Wade, amoa . cot in dispose may be included in applic tiom for Payment. The auroont of CIMM to be allowed by the DesignSuilder to the Owner for a deletion or change which results in a not dareaae in rho Contract Son slid be the act cod to the Owner, leas Overhead, Profit and Documented Costs' I prior to the Change Regaed, as iodhcated in the oosresaI Tina Hoe item in the Approved Schedule of Vdm for the line item as confirmed by the Director of Faghmmieg Saviors. When both adds ions and credits covering rsadased Work or s ubditudons are involved in a dhim a the allowance for ovabead and profit sbald be figured on to basis of oat ioceaae, if any, with respect to tut change 5.6.2 Add Chet portion of the Contract Som property allocable to materials and equipment delivered and suitably stored at rho site for subsequent incorporation in tha eompWed eoasfru - (or, if approved in advance by the Owner, svkd* stored off the site at a locationagreed upon in writing), ken rslaihage of T.m lend (la): 116AM SE N,IARDFKNt C OWNER AM (sesrOBj 00500-3 5.63 Subtract dare aggregate ofprevious payments made by the Owner, and 5.6.4 Subtract amonds, if nary, for which the Dsec.'lor ofFAginaming Services or Arcbbmt has wi/9 &M or nonified a Certi mk for Payment as provided in Paagrsph 9.5 of the General 000ditioeos. 5.7 The progress paymrat amomt deb®ined in axardaace wide Paragraph 5.6 shall be fiad,er modified u,der the following wooers: 5.7.1 Add, upon Sol dMtW Completion of the Work, a s® sUlriciM t b increase the total payments b YnW percent (90%) of &e Contract Sum, less sock amomb as the Director ofEnpwomg Services recommends and the Architect debentmes for is mpb to Work and msealed clown; and 5.7.2 Add, if fed oampletion of the Wale is thmeaR materially &*eyed through no tank of the DesigOlBm'idey my additional amomla payable in accordance vft Subparagraph 9.103 of the General C 0&d= . 5.9 Reduction or lemon of rehdnae, if any, shall be as follows: Now 59 The Comfy will wkbhold progress pea 1 from the DestolBaiider for 5ihre to coanply with the rogai<emeats of 7-1.1.1 CmWfi oco with American Recovery and Reirveslmect Ad of 2W9 (ARRA) which is attached b this oostracI as AftaebAMent A. all sdditinal docomeata . and oert*Scation regoiremaois miler ARRA and the FDOT Local Agency Program a AP) requirements. 5.10 The Comfy intends to pay for this oantrac - in wMie aria part with Federal fiords, the perties admowbdge that psymeet under tWs coatrac 'is contingent upon receipt of federal frodimg. 1..14 M lk Fed payment, c oadd tmg the enfim unpaid balance of the Contract Stan, shall be made by the Owner to the DaigolBm'ider when (1) the Caalrsct has been filly pm%cme I by the Da4pitSmIder eacapt for rho D=kWBuiWer•s reapoos.'br W b Work as provided is Sabpwagpo 12 22 of the General Cond6oas and to satisfy other recpirany, which neoessarrly survive final payment: and (2) a final Ca fiche for Payment has been issued by the Owner and 3) the DedgolBm'Ider has met all provision of the report®g n quh meob, taller the American Recovery and Reinvestment Act of 2009 and the FDOT LAP requ�mt ; sorb final payment shall be made by rho Owner not more than 20 days a8r= the bovance of the final Cerdficale for Payment 7_7,.7-I Will-.� .i_ 7.1 Where reaceoce is made in this Agreement to a provision of the General Conditions or anolhar Contract Document, the refne+mce refieis to that provision as amended or sapplemented by other provisions of the Ccut a Documents. 7.2 Payments shill be made accord -mg to the Florida Local Govemmemt Prompt Payme t Act Chyhter 21a Florida Suddes 73 Temporay SaTities and senicesr Nape for this project 7.4 Momoe CbuWs perfotmaU I and obliplioa b pay under this oaatrac' i< ooatiogmt Upon an amend appopriatioo by the Board of CoUsty Comumbsionem 7.5 IN I N c Rubles Criries By signing this Agreement, Design► adder raprments that the emmution of this Agre®ent will not vioiab the Public Fsadties Crime Act (Section 287.133, Florida Strir ks} Probation of i is J: '11 'a', a t'1 5 .- :Ikl ICI�IjPI DID :,:, C 1 r' 1 Ilill this section slsll result in termination of this Agreement and recovery of all monies paid hereto, and may rack in Iasmer , f om County's competitive procurement activities. In addition to do foregoing, DeignIBniWer fin represerts that there has Gem no ddermimtioo, based an an audit, that it or any doI , o - arc - haw committed an act defined by Section 297.133, Florida Statulm, as a "public entity crime" and that it has not been formally vatged with oommittag an act defied as a "public entity crime" regardless of the amount of money involved or whether subcontractor has been placed on the convicted vendor list DaaWyBmlder will promptly no* the County if it army oodraclor is font' charged with an act dalioad w a "public entity crime" or has been placed on the convicted vendor list. A person or al5liabe who has been placed an the convicted vendor He Wowing a conviction for public am ft crime may not submit a bid on a coatrsct bo provide any goods or services to a public amity, may not submit a bid an a contract with a public entity for the coosiroctim or mpair of a public bm7ding or public walk, may not submit bids on leases of red property b public a aft may not be awarded or perform work as Des*dBuildw, aappirec, toboaafracboy or consultant under a condrad wig cry pubic entity, and may not tratact business with any public entity in amners of the doeahold amount provided in Section 297.017, for CATEGORY TWO for a period of 36 mouths from the dale of being placed an the convicted vendor list 7.6 TLe Mowing items are part of this oonlaac* a) Mice of Room* Desiga/Bmlda doll meietain all boolor, truants, and documents directly pertinent b perfo>maooe mdor dais Agrnma t is wwr&mc widr generally socepbd accounting priocipies oo MY applied. Each party to this Agreement or toes suffio®d rep eseetsoves shall have reasonable and timely accessb s ch resod I of each ocher party to tots Agre®ert for public reoa I prposaa d aing the term of the Agmememt and for Clive years following the termination of this AgreemeaL If an sndbor aspioyed by the County or Ck& dereammes that monies paid to DedgwBuilder protestor to this Agreement wane spent for purposes not authorized by this Agreement, the Datigo(Bm7dw don repay the monies togathw with interest cdcdabed pot:uaat to Sec. 55A3; FS, munag fiom the date the monies were paid bo DesigniI uildw b) Govta7iq Law, Venues.11 1 1 1, Cads, and Fees: This Agreement shall be governed by and 000sI 'in acxordaoce with toa laws of the Shte of Florida applic" to coutrac- made sod b be peri'o ned eu&* in the Stele. In the event that cry apse of action or edminis native proceeding is iced for the enfadcemert or imerpaetation of this AgreemcK the Coady and DesigolBuMer agree that venire will He in the appropriates oomt or betbne toe appnvpniate a I inidtrati�ve body in Mourne Coady, Florida. c) Severab W. If say team, covenant, condition or pwidion of this Agreement (or the application thereof to arty we, or peon) doll be declared invalid or unm%roeable b any eadent by a court of oompabeat jurisdiction. the remaining tee, ovvenenfa, conditions and provisions of this Agreement, shall not be atbescied thereby, ad adli i i g term, covenant, 000dtim and provision of this Agreement AM be valid and doll be aa%ace" b the fallat eptmt pI-- by law unless the enforcement of the r+emsimirg terms, covamft, conditions and provisions of toffs Agreement would prevent the a000aplisLment of the origin talent of this Agreement. TLe Comfy and DesigdBadda agree to reform rhea Agreement b replace nay stricken provision. d) At/ariey's Fan said lids: Mo County and DosigalBm'{desr agree that in toes avert say apse of nation or administrative prooead'mg is imitided or defended by cry party relative to the enfnoemmt or imerpae... of this Agreamery toes provaTmg party shall be entitled to reasonable amorney's fees and court cold, as an award against the nun-previdling party, and dbalt include attorneys fees and counts cods in appellate prooeedngt. Mediation proceed V ioilmbd and ooeducled prunmot to *is Ag memmt shall be in accoadao 1 with the Florida R des of Civil Pmoedcre and =ad and c slomary procedures required by the crrcntit eoumtt of Moaroa County. e) Mbdkg The terms, coveuaofs, conditions, and provisions of this Apawand shall bind and inane to the beneIII of the County and DeagOBm7dw and their rapectivus legal representatives, successors, and assign. fl AST. Each ply represaft and vraito the odmr that the execution , delivery and pera ce of this Agreement have been duly sothorroed by all necessary Coady and Corporate actionas required by b;w. g) C3d= for Federal or Stab Aid: DaigniBoilder and County agree that auk shill be, and is, empowered b apply foes; seebk, and obtain federal and stale gmcb b fun 0 due purpose of this Agreement; podded th t an applications, rewa ts, grant peoposds, and fiaadmg soGehations shall be approved by each patty prior to submission. h) AdjmKd m of Dbpata or >Hagreemends: the Owner and DesignMuMer agree that all dispiwes and disagreement shall be atlempled b be resolved by mod and confer sessions between represeaudi s of each of doe parties. If the issue or issues are sM not reaaoived b the satida4im of the parties, then any party shall have the right to seek such relic£ or remedy as may be provided by this Agreement or by Florida law. Ibis Agtelsuea f is not subject lo arbitcatioo. i) Caaperaden: ooeedag is iu dented against either party rebtiag b the immatim. execution I®snce, or breach of this Agreement, Catty and DesigarBm'Ider agree b paaticip ft In, the moment mgnired by the other party, in all Im, Iamri a psuoesaes, medim and odor activities related to the sobshnce of this Agreement or provisim of the services under dds Agreemeat Coady and DesiBolBailder specifically agree tbst no party In, this Agreement shall be tegahed to enter ido any arbitrs6on pooeed'mgs related b this AgreememL J) Imhuntlesc C udy and DesigaIBander agree that there wig be no decrim�otioa against any person, and it is ampsesoly understood dot upon a ddennindion by a cram of cnmpelad jurisdiction that discximin lion has ooconed this Agreement salomaticagy terminates whhont any farthr action an the part of my party, eBective the dale of the coact ceder. Comfy or Design Bandar agree b comply with all Federal and Florida stables6 and as local oed'maoces, as app5able, r Id a b Tbese include but we sot limited tr. Tide VI of the Civil Rights Ad of 1964 (PL W352) wluc>h pacbibits discrimination an the basis of rat, color or notional or%* 2) Tift 17t of the Education Ameodm d of 1972, as amended (20 USC as.1681-168.3, and 1US- 1684 which 1 13 -s discrimination on the basis of sma, 3) Section 504 offloe RdW6fflbdm Ad of 1973, as amended (20 USC s 794) which probr'bbs dime — an the basis of t mffic@ ; 4) The Age Discrimination Act of 1975, as amended (42 USC as. 6101-6107) whirA peairibits ration on the bash of age; 5) The Drag Abuse Office and Treatment Act of 1972 (PL 92-255), as amawK reLting In noodiscrimisutim on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevemeoa. Treatment ad Rehabrilibbon Ad of 1970 (PL 91-616), as amended, relating to nondiscrimination an the basis of alcohol abase or Wbobolisor, 7) The Public Health Service Act of 19M as. 523 and 527 (42 USC as. 690dd-3 and 290ee-31 a amended, reWlog to confideatidity of alcohol and drug abuse patent rec n dr In Tide VM of the CM Rights Act of 1968 (42 USC s. at seq. as amended, g b nondiscrimination in the sale, rental or Smaociog of Ig; 9) The Americans with DisdxTdies Ad of 1990 (42 USC L MI Nftj as maybe amended fi+c n time In, time. resting to on the bomb of 6 1ft, 10) Moaroe County Code Chapter 13, Article VI, which I 'if -s dncriminotion an the bads of race, color, sir36 rerWon. no imW origin. ancestry, n=d arienbtioe. geader identity or crpteusion. fimnTW status a age. 11) Any odw He inprovadonsmanyFederalorstawdstates which may apply to the parties tots or the subject matter of, this Agreement. k) Cevenat of No Interest County and DesislBuilder covenant that nehher presently has soy interest, and shag not acquire my interest. which would conflict in say maooer or degree with its I>eDdscae under Ns Agreement, and stet only inlieeest of escln is to I A and receive benefits as recited in this Agreement 1) Cedes of ZMcs: County agrees do officers and employees of due County recognize and wM be required to comply with due standards of conduct for public officers and employees as delineated in Section 1 W13, Florida Sta news, reS M, g. but not limited to, solickstion or acceptance of gist, doing business with one's sgmry; unaolhori- - compensation; misuse of public pomilime, oonlSdmg employment or contractual ref tionsiup; and disclosure or use of cerbin in%®atioa. m) Ne The Comfy and DedigolBar1der waeaot the, in respect to MWK it has nnehher employed nor retsioe I any company or persoq oiler than a bona Ede employee worldos solely for 4 to solid or mecare this Agreement and stet it has not paid or agreed to .pay >uy pensoo, company, Capon . 9 ini ividaal, or firm, otbar than a bona fide employee wainag solely for it; any floW, common, perces. IR gift, or other cansidera- contingent upon or tea — g flan the acward or maiuog of this Agreement. For do bssa I or violation of tine provision. the DaoigmOuilder agrees that to County shall have the right to ienninift this Agreement without fidagy and, at ds dscaetioo, to offset fiem monies owed, or odmwise recover, the f m amount of such fee, commission. I, - P I Page, gift or consideration. n) Purbic Atom 11m Comity and Design/Builder dmH allow and permit neasanable access UN and inspection of; all documme ty papers, Wmis or other materials in its possession or under its caAtiol subject b the previsions of ampkr 119, Fbcids Stables, and made or racdvW by the County and DeaWBuilder is oogjunctim wdh this Agrommst; and the Comfy shill have the right b umilaftrany cancel this Agra meat upon violation of this provision by DesignOmWer o) Nw-Waver sf Laity: Nalw g the Povidow of Sea 76L22, Florida Strides the particip�2 of the County and the DesigolBuilder in this Agra me t and the acquisition of any commercial Gabinty o nNOMMce cum selpisauasoe eovmage, or local govmmneut liability imoraoce Pool eovenip shall not be deemed a waive of idy to the mrsad of Gablky coverages nor shall any contract emntesed in so by the County be regoirod to contain any provision for waiver P) ftif gees sand hommamider. All of the privileges and inmrundies fiam Nbitrty, epoemptions frrom hms, ardiaaoes, and roles and pensions and n 64 disability, wodmss' comPensubm and other bmafs which apply to the activity of of cem gpda, or employees of any Public agents or employees of the County, when pmii 1 g their respective functions; under this Agreement wiWm the temtorid Emits of the County shall apply to the acne duce and -tent In, the perbmiaoce of sacb ibactions and duties of socb o>Sioas, agents, voimntems, or employees outside the tm ikwW Gmib of the County. q) IIAW Obiipdm and 1Respa■niWiec Nan-Ddeption of Constitutional or Ststary Duties. This Apeenmt is not intended IN nor shall it be 000shrue I as. relieving soy pertickof g entity from any obligation or respomaft kp3wd upon the entity by law MOMpt b the esieat of actual and timely Iormanoe thereof by say pantidpatiag entity, in which one the Per%®asce may be oliaete I in mdsbcdm of the -1 Ogrtiea or rea1ooa0 My. Fwdmx this Agueemeat is not intended to, nor sbdl it be conshued as, as-1 1z1 g the deleptiaa of the constitutional or stadatory duties of the Cooaty Meet to the orient pe®d6ed by the Florida oonstitN&M, stnte ststtute, and case law. r) Ne&Baiamw by Nm4utim No person or entity ehdl be eoiitied b rely upon the toms or say of then, of this Ape®ent to enforce or athenpt fe eafarce espy third -Patty claim or edidemmt b or benefit of any $cr v or prosiam coateI lated hire®der, and the County and the DesigolBmldar agree that neither the Comity nor the Dm*ifflknM r or soy sneak officer, or amployee of either shall have the ndm ty to inform, counsel. or odirrwin imScate tbst any particular b&vWud or gioap of isdividu als, entity or entities bave eotitiem®b or l eneA under Ms Agreement separshe and apart, infariar to, or superior io them my ity in gmerd or for the purposes 000teapla' l in this Agiaenent s) Attrstutlaas: Design/BuMer agrees to eooewte such docanmb n the County may reasonably requh to hxhde a Public FA&y Crime Statement, an Stshment, and a DrWFree Workplace t) No Personal Ii MW. No oovmant or agreement contained I in shaD be deemed to be a covesat or arvement of may mew officer, agent or employee of Monroe County in his or her mdivAW opacity, and ao membeG oH'ioer, agmt or employee of Monroe Coady" be liable personally on thin Agreement or be sob, jea b my pmsand Gabi7rty er aowoob brft by reason of fine epmautioa of this Agreement. u) E:eeudm is Counterparts` This Agmam et may be execobed in say munI of eounharparb, each of whirl abdi be regarded n an signal, all of wbich taken b®eflw shall constitute one and the same mint and say of the pwfm bade may awcarhe this Agreement by singing my such eomdapart. v) Seances Headings: Section had'mgs bave been inserted in this Agreaneot as a matte of eeavenian cc of reference orb►, and it is agreed that sock section headings are not a part of this Agreemed and w➢Il not be used in the iolarpsepI " of any prevision ofthis Agheemeat W) Special Cwdlibms, if say are dats7ed in the Request for Proposal for uric Project a) Hold Harale s: The DeaWwBaiildar cevenats and agrees So iademdfy and boW harmless Monroe County Bead of County Commi mmers ficm any and all claims for bodily vWy Cmchuft desalt), I I b&y. and Ply damp (Jecluft prWaty o by Momm County) and other boom dm'm and aq en (mobdueg muno y's fees) which arse oat of; in connection with, or by resaca of services provided by the 122M SI'A AMMFM4CF O nERAM &vOg) 00500-7 DaignIBailder or may of its Sn6coallscloc>t - in wry tier• oolasiooed by dbe nq ftonce. arors, or od wr wrongful act or omiaioa of the DesiFa/BuBderor its Sab000ltac' (a) in nay tim drew eopivyees, or Numb - In the evalt an completion of the project (mclad'mg do work of odtas) is delayed or suspended as a result of the Design/Builder's Atse b I or maintain dx req dmd insurance, the Desiga/Buiilder dud indemnify the County from any and all i mmwd ©spaoses resulting from loch dairy. The first tun dodos (S10.00) of ra:nunera6on paid to fire DesignlBmlder is for the Womi8atim provided for above. The esdent of liabs'lst' y is in no way limited ti0. reduced, or k and by six insma me regWremeds ca�aine I elser%jum wiisin tiffs agreement. y) Caseeadw in the event that the Destmem'Wa dM be fo®d to be in say aspect of instrDabou, docimz nu o msooe, rep* or service. rho Coasay shah have the right fan tonfinde agreement after five drys wcitlm notification b the DestgnMailder. 7.7 Owmrddp of ft Project Doeaealse The docommts prepared by do DeaigalBuildea for this Project belong b the County and may be rep mdmxd and copied wMa t acimowledgameat or pion of the DaignJBm'Ida: 7.8 3aroeasass and Amlp w Thar Des4pvBmTdw shall not assign or subcontract its obligations under dds apeement. camp in writinig and with the prior written approval of do Board of County Commissioners, for Monroe County, wltidh approval sited be subject So such conditions and provisions as do Board may deem necearay. This pmmgtapb shun be iaonrpante I by refaeoce inb aray amm4poscut or subcontract and nay assignee or suibaosAra I nball comply wilh an ofdo proviaioos of this Apeesnaot. Subject b the provisions of d w ismedibety peoedog smraaee, each party be etc bands hwK is mcoesmm% aligns and legal represm dives b the otter and so ate ahsooeocn, sudgm and b*d representatives of star other Pudy- 79 1W tdrd Party Beseidasim Nothing oonfained harem shill create my:eladoomb ig contractual or otierwise, wi or any rigbtt in Senor of. nay third party. 7.10 Disdwaminged Dmb m Saterpdoe (DM Polity and Obigsf m The DetkolBm7der agrm b aomPly wih to provisions of FDOrs D%mdvmdmpd Budoeas Batrrpdw Program as outlined in the Cadfimdm contained in the RFP. The DeraDslB Aden wit coagtlefe and minute MOT form 275438-11B, DOS AMrnatve Action Plan, wbici is included as Atbdhmst B to this Agremoemt 7.11 FHWA Foes 1M: Farm 1273 is attached halo as Attathma t C and made a part ofthfa contract. The De:tgdBm'Idw will a I ball pmvidoas is FHWA Fcm IM. Section V. Stumments and Pryrolh on Page 5 ofFHWA Form 1273 is amended as follows: Thar dskmaK "except for projel:l-located on roadway: classified a:load roads or rural cotlecioas, which ere c mhpr, is deleted. 2. Paymb and Psyron Records Part d (1) is revised to read: that the payroll for the pgwfl period oottI - the information to I 1 11 d to be maintained under parapapi 2b of this Section V. with fie eoocgdm of fie eapiopaes' social seeoity wmbw and aftwo, wYef siaotd shot be snouted am payrais mbdt64 and that such h*m= m is ooaect and compte0e. Payroll statemeatr shall include an individodly i inu fyn s I for each employoa. 7.12 Be. A.a &= The DesigwBuildw agrees that it win comply wid< the retI iramae. of 49 U.S.0 Section 5323 6) ML Section 165 (a) of the Surface Transportation Assistance Act of 191Z as mm mded, but it may qoeft for an eaeeptioa to do requieoseo. porsuan'to Section 165 (b) (2) or (b) (4) of the Surface Transportation Assistance Act of 1982 and reguLtian in 49 CFR 661.7. 7.13 Fareip C d adw and Sappier Restriction: The Dea*mMM W dtan not abler WD nay subcontract under this coo><act U.S.1nms pied by the United idles Tirade Representative M or duel discriminate (2) For the supply of any I r I ' for use on the Fedad Public Woda project under this conaact that is produced or msmfimimed is a fim fta country included on the list of countries dust disabmivale against U.S. fims pebliahed by USTR anciodes `Bay Ammcad' provisions). 7.14 lnlie Agency SdwO traeBng b lrivale Sedw zadly Comtrad Pmddoa: in accordance with the provision of 23 CFR 635.1 Igo), No public agency dwH be pensitted to bid in , o 11 I'd or to earner into Sabooetracts with private Cooftaclom Al a of any of the stipulations 23 CFR 635.1Igo) shun be Saiictent pounds for temiontion of the Comract. 7.15 DadplBa l r Fareissd 6gd4ssw for Lod Owl in acoosdaooe with the provisions of 23 CFR 140 and 49 CFR Section 18.3 rho Des4WBm'Ida' win not po<clmw eQ*Bmmt for Coady Ownership• 7.16 Zgmkm ent Bstd Bates: in accordance with 23 CFR 63S120 and 48 CFR 31 the County WM pay standard egaipmed rental rates for the lot area who the Work is being conducted for reeled equipment. as needed dumq dw project 7.17 Local Mkft Prefts nee: the Comfy Win not Wade a Local loft Preference for this oaotract. 7.1a r tidy Owmd zgnip.aut is acoorrlaooe with the provision of 23 CM 635.106 puNcly owned eQmpnheet wM not be allawed to compete W ill privately owned equipment under talis aareemmt. 7.19 State h eMumm No requir ment wh7l be io posed: (a) To require due use afar provide a price di&aentid in favor of:ticles or n a mials produced wit6m due Stale, or oduawise to l lril restaict cr dsaimioale agamat rue um cf artidles or ma/aids slipped from or prepae 1. made or produced in my Stale, territory or possession of the Udled Stater or (b) To pr 1 a '-, restrict or odmwiw dial to agsiost the use of articles or materials of fflreign origin to aq g ea w es1ed than is p ie ®der policies of the Department of ltaoquatrmion a evidenced by rsqutremes. and procedures peeaaI>e I by to MWA Admioidrdw to carry out Such Policies. 720 Amman Recovery said Rdwvtilaant Act of 2Nl: SpecW provision SP00MI I MS is dsdhed hereto as Attsedahrt A and made a part of this oodract The DesigolBailder vA adhere to ell provisions of the smmpmvwm 721 9-1 go Credo Tine De sigalBuilder wM not receive credits for sdvareable malQiak. 722 Egnl Easglsynsant Onmtanily (ESO) Reqn1raftEft duo Coolractor Win adhere to due DOT EM regarieems - in acoordaooe wtil Fjoecutive Order I IM and as oared in the Etgad Fmploymeat gWwk Shy CatiBca6ca in Section Five ofthe RFP. Prior to due start of 000s<<hw i the Caalraclor win oomplela FDOT Firm 275 4 n-131Y.Ifaeatiaaa b FDOT of =O CNN= and F� 273-M-45, Record of &qm .iaary ad Office taesanndZffO Madtng er hWRvM=d Orimhdiaa, which are included a AtImcbmaest D to this Agreement. 723 Dnvis4W= Act: In accordance wifh rue Davia4b= Act the Cesbactor ad their SdhooadracI shad pay wudam employed dietary upon tie She of'the work no less than the lordly pmvas'Hng wages and f i ga bona to paid on projects of a similar cI Tie tameot pmv=Tmg wage rafts can be found at ZkdumdwMbnmeCmmiy- Wage Bate DoMm n,2" appis to s pn@uL Twnbm dam or Sugmmsim Ll The Combat may be -e ioaI I by the Owner as provided in Article 14 ofdw Gamal Cood dons. E2 The Work may be suspended by the Owner as provided in Article 14 of the General Conditions. Arddle Z Euaenerative of Centrod Documents 9.1 The Contract Dom, cwcpt for hiodificatim issued after execution of this Agreement, are enam ed as follows: 9.1.1 The Agreement is this owcuted Standard Form of Agreement between Owner and DesipSurlder. 9.12 The General Conditions are the Generd Conditions of the Contract for Design and Construction. 9.13 The Supplementary and other Conditions of the Contract are those contained in the Request for Proposal including but not Smiled to: a) Bidder's Technical Proposal b) Bid Price Proposal c) Schedule of Values d) Monroe Cody Certification Forms (Section Five of Request for Proposal). 9.1.4 The Addenda, if any, are as follows: Aft bid doeameats, Request: for Proposal and portions of Addenda relating to bidding requiresomb am pad of the Contract Documents. 9.1.5 Other docents, if any, forming part of the eoutrad Doca=ents are as folows: This Agreement is entered into as of the day and year Bast written above and is executed in at least four original copies of which one is hi be delivered to the Dedge/Builder, one each to the Director of Engineering Services and Architect for use in the administration of the Contract, and the remainder to the Owner (:a Art ,-DA40Y lam. KOLHAGE, Clerk Deputy Clerk Date 1—at (mil-) Attest 10%G MA C. ROURKE Titles M� OMMISSVI 4 DD 6736% :rojpr, `^r re ' d ,K Urodof xa BOARD OF COUNTY COMM SSIONSRS OF MONROE LINTY, A By COUNTY ATTORNEY PPRO E AS TO FORM: CHRISTTRE M. LIMBERT-BARROWS ASSISTANT COUNTY ATTORNEY Date 14aa,llll DFMG'N/BUIIAER some" t/yabara, UA END OF SECTION WM OV LAWS TO BE OBSERVZD. (RSV 3-31-" Ow" MMCLS 7-1(fto 60 and K) is expanded by die feiloF 7-111 CampI■ma wifi Amerkm Rewm7 and YdI ' Ad st28W. This project is object to the crimb and axWhim of the Amedcaa Recovery and Reiavestmeat Act (ARRA) of 2009 SW* die federal reporting reI . for the projecKs), rich m the monthly aopioyaat repot, for bath the eootraclor and sob 10 .or 4 Provide do required ndmmmdoa on fom(s) provided by the Department is the hmah aas indicated is the iwutracdom indods these reporting nequiire— in A sabooatrachL 7•LLL1 AmdwrIty sf duo Coarg! Ser Ganerai: SecKoa 902 of the ARRA of 2009 provides the U.S. Comptroller Geowd and hie i the aathodg. (1) to examine may records of the Contractor or any of its siubcontractors, or any Stale or Local ageoey admimelering sock ooetract, that dbacd7 Partin t, and involve transactions rebding toy the coatrad or asboontracg and (2) to ielecview my or eaipon) ee of the Cantractor or any of its snbooitredm, or of any State or Local gmmmeat apocT admia'dm ft the Codrau, regardbig suich traesactions. Accod5oly, the Camp wOw Gamd and his reprnenlatives d mH have the auWodtj and rights m provided under Section 902 of die ARRAwiti respect to this Contract, which is funded with funds made wadable under die ARRA. Section 902 fordia stoles that noddog in this Section daR bs io/ai - ' to limit or ruxtrict in nay wa, any eristinS �hodty of the Cooq*d ler Grand. 7-LLL2 Andmn* st do bspeefae Ge wmk Section 1515(a) of the ARRApwides sathoritj far nay repr<esemlives of the inspector Geoerd to examine nay records arinlavim my empioM or doers Watkins an this Cautrracr. The Cooftm* r is advised that repseseatalives aithe logiecto Gerard have the anhoritj to examine say record and hftw ew nay empkoyoe or of the Contractor, its sIaclor 1 or other firms working an this Contra L Section 1515(b) feather provides that coding in drill Section shA be inlapreled to limb or resaid in nay way my existing arthodty of an iaupector Gerad. AITACHMZNT B ascaam EQUALOPPORMaf OMM am Pvptdi EM AFFWJM7 E ACTION PLAN It is the poky of saodWdP#uwwds %VW4 se defined try 49 CFR Part 2C subpart D and irrW mentsd under Russ C u*W 14.78, FAC„ oppor'In 1 11, b participate as auboor*ackXa and suppbm on at contracts aM -- fin A by the Florida Deparbrerrt of Timmq - H, The mqukomerrfs of tads Chopber 141M FAC. staaN.appy tool oontrscfs mime talc between the Flaido Department d Tr=m port m and °" sysum% uz srdhoontracbrs w dtbr suppfers to aauearrar �" it WE atso be bound by >he regrieriislrrts'�1 Mule Clniplir 14-78 FAC. suucbmw Pmwrfsftn symums. LLC and rs subcontractors shot t" sM neossoM and reaoorrobi I deps In aooadarroe wNh Chopl er 14-78, FAC., b enrre the dsodvan pod brrafrnsesa have the npportu ft to rm jpale end perform work contracted vM the Fioride Deparlrnent of Trwwporb iion. sbmc-afar PVomn 3"ftrnm. L-C . and Ns subcontracbrs stud not dbcrirninale cn the basis d moe, color, retWorr, rrafiond ori8irr, dbWb y. sea, or ape in the adnridstrafion d cwntracts wNh the Dgmtr eri d Transpo Wom sbw a.d Pn.wr om ar t.U. LIAM . has dssi8rrstsd and appokied a t3aison Of AW to *Mlk*, .nM" , and mo dhM fhe DBE AlfcffM&A Action Man irrrpbnreridbrL The Lisbon 011icar wfa be reepm bie:Or ditsenrfrra9 this poky alabnlefi throrrphM* struelurd PrMwvatbn BYsbms. MC and b coriroled btu ra@=s. The staterrrent b posted on nolbe boards dthe Comperry. X X a54WIPM BWAL OPParmamr on+cE =M P¢2d3 stroea•W P'Ess'w@dw PLC wi ap "WIVsy result of kn Ila Company a Li ft da' Wop and msi�laI ffb Mirnntive Actions FW inoacoo� 1-1 with the re**wnwft of Rub Owpbr 14-78, F.A.C. The Lisbon Offberwi jwn pd wy rseponsbifiy for devaioping, nwkda di and nKxdk irg the Company's util>,M, of dkodrardaged suboanbVCt= in adCftn to the kft"lg speclic dutka: (1) The Liion Off w Ntal eWmwirrely solid bids from dfsedvartsped business auboontracka for ei Florida DepwbTwrt of Trarspordfion contracts; (2) The Liaison Oflioar wi aini al raoords, reports, and docurmerds r xOW by the Florida Deperkm t of Trar>lportaliorr. and ahel rtaidi such records fora period of not ksa than ttree years, or as directed by arty spaclic oordracI requisnrenb of the Florida DepubTd d of TrarmporbdbrL The Falb wig idivi" hes been des19a Limbos Oflbw with respormbfy for irmpkmerdng the ComperO adRrrnfirs action poparn 1n aocor *1 , P wlh the ragLdrwn ft of the Florida Department Tranaporfatiort. (Liaison OfNceft Nerve) (Your Camper" Name) (Your Car wmO Address) (Phase Number for Liaison OMM) (Erder FEIN or Tax Id Number) .011r•..=41,.'.97. :drawn Abraham Structural croup, Inc 7455 New Ridge Rd, Suite T Hanover, MD 21076 410-850-7000 - FEIN: 52 211 3986 In ceder io fommdmb a rsmb tic Affi nOm Adios Pbn, O&OCb"rProm Vaft" Systems, u.0 has id nditd the folowirp brown ba dw 1o; I fi l k abort by disadvantaged stuboordlac m , before dsscrbig ifs proposed affirms" adios methods: 1. Lack of grusN o dbadvarr pd subcordrac bm in our spedfic geographical areas of work 2 Lack of oerO n dMedrardaged suboonhackn who seek b perform Florida Department of Trumpor hdon work 3. Lack of' in pofornitg on Florida DWwbnerd of Tranapatedw cadracl:; 4. Lack of ra Ip a e when tegtussbd W bid; 5. LirdW orrrowiedge of Florida Department of Thwupodation plans and worm io prepare a bkL In view of the barters fo digdvardaged busitesses d bd above, ROM bathe poW of atrrcetrsr Pnssnrasoe arstonw LLC b Provide oppo kndy by utft rp the fold" ailrrod" sdion nmthods participalon th9 oontrads wlh thew Deparbnw t of TwwporteiiorL 1. Provide wrbw notice b al r m Mn DBE suboordradors in the 9sograpttical area where the work b to be s 1 P - I aci1 by the Corr*w r, 2. Advartbe in minody I c used media conger 6 subconlrad opporhxOn with the CompeW, 3. SeW pco "a s of work b be perk by DBEs In our n increase the flostltood of rtselkp cordract gook (indudnp. where eppopiela, breaking down contrails k0 ecormimicafy feasbie unb 10 feciilab DBE parf odbnr msaO-na eamaFPaRrrOarrdaMM mop v.Psas 4. Provide adequate I konadon about fibs plam p m pop "m n -• and sequin isim of the oonbacI not r mi l m nrg subeor*ackxs wdhout sound recess based on a Urororgh irrvesdpafion of their eapsbWAW S. W " regniemenb of perfahrance bonds where It In practical to do so; S. AfbwW pre bM nrsaffrgs held by the Fbrida Dspsrbnw t of Transportation to apprbe dhmkmnteged suboontrac m of opporbxrides wdh the Company; 7. Fodow up on ini ial soiclufflons of inlmast b DBE auboontrackxv to ddsn. ne with certainly whether the DBE compwy is lnlerasbd in the subcorbad opporbxrdy. stiveusai rj�ysdwn sysbr'N LLC understands dw this Rd of allmodws scion nheflhods is not edauedwe and wi inducts addibmW approaches after having eslabished familiarity wdh the disadvarrtapsd subconbucti g conarnshtty =vAW detenrriusd the stated appro- r-I s to be ineffective. H. On OOrhI A wdh specific DBE goals. S&ucbmw Prwwwafon systems, LLC WIN rra I every etbrt fo mast centred pools as stated by Witting Is aAirrrre" action rrredhods. On projedis with no :pectic pooh, the Company will. as an aopr a ioru of good fadh, seek lo totes DBE subconbactors where work is lo be St. r . traded. IV. RIMMM struchuac Preeervaden sysam., LLc shad keep and mebntain such rsconds as are nscessany to dden nk the Company's canrpli r m wdh ds DBE Affirmdfve Adios Plan. The Corrparry hull design ds record loeeping system to Incicdx 1. The mwf bw of DBE wAww lac tors end su RAwl used by the Company. idenniifyirg the terns of work, nhatsrials and services provided; 2. The aft ba and progress being made In obblrip DBE subcontractors dwough be ml and coma inly sources; 3. Docurnerrfafiodr cf d cod I A io inckide corraspondenoe. teiephodre cads, newspaper advertisemwnts. etc., to obtain DBE partldpatiotr on ill Fbrida Depa knw t of Trarapartodon projects: 4. The Company 9W a on ephl with Fkd& Dope kmd of Tramsportmdm% requkainw is egw rll g pryrasarin ft aobeorrlraAn a I Andleg DMs for omch on ids (sstlrade penlod) in whkh the amnapatriss have world. V. Ow agog= Structural Pme wwon Systems, LLC wi uW= the DBE Directory F Lib" lied by the Florida Deparbnent of Trarnpordiom The Company will disbfbuale Form Nunnber ZISW"1, Schedule A CwWcadw Form Ntsnber 1, to pcierttbl DBE oonbacic and asssht in their completion. ATrACEMEM C .t Ltiem. IL....................... ................................... 1 bL.. ........................ 3 V ...................s �'�� ... .... . 1A. Iltead dd ....... VIt.Cadiad ............... s VOL Fiha .��-yy-��..y............... Q X dClmwAlrAdi dt'idoail. .. whew CmbdAct ...................... f b. 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I mde r,y and othw aspects of �n 9s@+-a SMALOPPMO n MW Staffs of Florida Dspwbnw t of TransporWHO I EEO Officer NnMr-, ffnn This form is used by conb u*xs to corrnrunlcnte the appoinbrw of an EEO Mar and to provide EEO Offcer Coated data. The form is abo used to updebe that I fommtlon in the event of new appoirclses. name changes or corrfad:t dabs dsarpes. Refer to the EEO CormbucDon Contradd CompW=1Mortbook and the FDOT contract for oompin re program requirements and inskKftrrs. The contractor macs original of the completed form to FDOT Equal Opportunity Otfoe WS Suwannee Street-M 65 Talmho eee, Fl 32399-OM A copy of the form is returned to the coiwbw or upon completbn of processiq by FDOT Boot 1 Conbwtor Name — The name of the contractor. Boot 2 F® No. — The contractors Federal idon Nwnber Banc 3 = Hour Office Iflafling Address (Street) — The conttroWs home office abed address; if the bustiess' home office is outside of Florida, indkete the address of the Florida F�orne Office. Banc 4- Home Office MMIft Address (City, Slab, Zip) — The contractor's home office cry. state and zip collie; W the business' home office is outside of Florida, kdkzb the address of the Florida Home Office. Banc 5 Main Pfwne No. — Area code and phone number contractors main business phone Box 6 Fax Number No. — Area code and phone number contr cWs main fax Boot 7 Mot b Daft Changed? — Mark 'Yes' or 'No' to die if this is the company's initial submission of EEO Officer information; ff a new person has been appoitbd as EEO Officer, N the appointee of record had a name change, and if the appointee's contact data is being updated. figWWkEE0QMMIid@ Box 8 Name of EEO Officer— Fist narne, n kfie k*W and cast name of EEO Offfcer Boot 6 EEO Ofhaer's World Title — Job title If the EEO Offcer has other duties (e.g. Treasuer, Manager of Contract Services. etc) Box 10 work Address of EEO Officer (Stye" —Address of EEO Officers office Boot 11 Work Address of EEO Officer (City, Slab, apt — Address of EEO Officers offidx Boot 12 EEO Pfwrr Nunbw — Area code wd phone number for EEO Officer Banc 13 EEO Clffiar Fax Number — Area code and fax number for EEO Officer Banc 14 EEO 0Mcw ema8 address — EEO Officer Emsil address Banc 15 AppokOM OSkbf's Sig wh" — Sig wbxe of Company OMcbi responsible for EEO Officer Appoinkrw t Boot 16 Dab *Ior )WYmr) — Date appointing official signs this NWa tfon form Box 17 OAiah's Nn -a (prhrted) — Printed first none and fast name of person suing Box 15 Box 18 Offfclars TMfe (prkdoM — Printed title of person signing Box 15 (e.g. President, CEO. etc) This section Is ©ompieled by FDOT Box 19 Processed by — Fist and fast name of person processing the Notion Banc 20 Dab Processed — Date processing is corrnpieled TME ECORD OF SUPERVISORY AND OFFICE PERSONNEL EouK cFFamxrr EEO INIEET1NG OR RWIVDUAL ORIMATION 7. ZZO 'S CZKrUrICATION: IU sipntsas of sh C=gpWs ZZO Officer is ewdSmdm dinta• L divided oritdsn or was bdd wits wpw�bw� pesa�ael aad NYn i�voived is peesomd maum to addrsw sS mpwb of ow equal amplaymad. pr -dl7 (MO) o ftedum Tie major bpi= wM added aad n Biped atkaidance record was suds. to UTUN& . ZZO OFFICZR L MAJOR TOP" ADDZZS®: / FFO Poft and Affirmative Adin Plan BuDedu Boards / ldendEcatios off OBlim bWviaws by Stab and Federal npowNim -/ Egsol F.mpi"mest OpQott inkj and reanibrmt ✓ TrA ft ' l l -®hies / WNW Bad PAPV& / Complfsls / Utffiniun Busbmus BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: Administrator Bulk Item: Yes X No _ Department: Engineering Services Staff Contact Person/Phone #: Judy Clarke X4329_ AGENDA ITEM WORDING: Approval to use District One Transportation Impact Fees to reimburse Road and Bridge Fund 102 for eligible costs from the Key Deer Boulevard Roadway Improvement Project. ITEM BACKGROUND: A portion of the Key Deer Boulevard Roadway Improvement Project Scope of Work was eligible for funding by transportation impact fees. District One Impact Fees were not available when the project was constructed. An Impact Fee Reimbursement Report (attached) was prepared to document reimbursable costs. $475,000 of eligible costs will be reimbursed in the current fiscal year and the balance of the $791,439.50 will be reimbursed as District One Transportation Impact Fee Funds become available. PREVIOUS RELEVANT BOCC ACTION: The BOCC approved awarding the contract for construction of the Key Deer Boulevard Roadway Improvement Project at the December 2007 BOCC meeting. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval as recommended above. TOTAL COST: None INDIRECT COST: n/a BUDGETED: Yes No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: none SOURCE OF FUNDS: Fund 130 Transportation Impact Fees REVENUE PRODUCING: Yes _ No AMOUNT PER MONTH Year APPROVED BY: County Atty OMB/Purchasing Risk Management DOCUMENTATION: DISPOSITION: Included X Not Required AGENDA ITEM # Revised 7/09 Monroe County Board of County Commissioners Impact Fee Expenditure Request Section 1 - To be completed by requesting department Requestor: Judy Clarke Title: Director of Engineering Services Date: 11/04/2010 Facility type:_Road and paved pathway Project name Key Deer Boulevard Roadway Improvements Total Project Cost (capital only) $1,346,197.60 Description of project: Widen Key Deer Boulevard from US 1 to Watson Boulevard re -align road bed and construct a paved pathway on east side of road Impact fee district:_ District 1 Boundaries of Service Area:_Big Pine Key Boundaries within project's fee district: Yes _X_ No Type of project: Capital _X_ Operational Maintenance _ Project start date: _8/07 Useful life of project: 25 yrs_ (Must exceed 5 years to qualify as capital project) Project serves: Development that existed in 1986 _X_ started after 1986 projected beyond current year _X_ Would project have been needed to maintain level of service standards if no growth had occurred since 1986: Continued growth in Big Pine has increased traffic in the area Wider driving lanes with a paved pathway for cyclists and pedestrians will increase safety in the neighborhood Section 2 - Planning re 6w Reviewer: Title:y; Date:,�Z Project eligible for impact fee funding: Yes X No Fund: District: Partial Funding $: Full Funding $: County -Wide Municipality District 1 amount (Lower Keys) $791,439.50 District 2 amount (Middle Keys) District 3 amount (Upper Keys) Notes: Section 3 - Legal z review Reviewer: Title: eof4 ,0 Date: A C% Conc with planning review __jZ/Object to planning review _ Notes: Section 4 - OMB review Reviewer ���,�,n Title: Sr �,� � � /� , ,�� � , Date: << ` Y -/U Funds available: Yes _ No Transfer request prepared: 6ti V LA i f Gc IoLe y 75, 5 ?Y Agenda summary prepared? Yes _ No c/ Project code:_ Yes _ No _✓ Resolution prepared: Yes _ No 1/ Je /a- P,-e/q2,t&4 COr De,L.i5,2br7n, Date of BOCC action: T -�u�-t�►�c � j Y r I t Gt ✓ �c y� t b C,} r I i b b ► -V161 �� j �M b e- rfzm 2 Qva cc \-Dt-t, . OMB roan Revised 7, 2&98 Engineering Department MEMORANDUM To: Townsley Schwab, Planning Director Suzanne Hutboon, CountyAftw-ey Tina Boan, Budget Director From: Judy Clarke Date: November 4, 2010 Re: Key Deer Boulevard Road Improvement Project — Impact Fee Request Attached is an impact fee expenditure request for $791,439.50 District One impact fees to retroactively fund eligible portions of the Key Deer Boulevard Road Improvement Project. The money will reimburse the Road and Bridge Fund from which the project was funded. Please review it and if you do not have questions, please sign it and pass it on to the next individual. Call me at X4329 if you have questions. I have also attached a revised Impact Fee Reimbursement Report. Suzanne Hutton commented on the August 2010 version that she needed Planning Department to review the population information that determined the allowable percentage reimbursement for collector roads. Mitch Harvey in Planning performed this evaluation and determined that the allowable percentage should increase to 37.2% from 24.2%. This revised report reflects the change to the new percentage; Mitch's email explaining his determination is included in Appendix F with the Leitner memo. Penny Kipp informed me that the current budget has only $475,000 in District One Transportation Impact Fees. If possible I would like the request to be approved for the full amount requested with the understanding that the remaining amount would be reimbursed in future years as funds become available. By doing this the money will be available in Fund 102 where it is most needed to perform bridge repairs. I would like to have this request ready for the December 2010 agenda. Thank you. REVISED TRANSPORTATION IMPACT FEE PROPOSED REIMBURSEMENT FOR KEY DEER BOULEVARD ROADWAY IMPROVEMENT PROJECT PREPARED BY. Monroe County Engineering Department November, 2010 REVISED PROPOSED TRANSPORTATION IMPACT FEE REIMBURSEMENT FOR KEY DEER BOULEVARD ROADWAY IMPROVEMENT PROJECT Prepared by: Monroe County Engineering Department November, 2010 PURPOSE The purpose of this report is to identify amount of work in the Key Deer Boulevard Roadway Improvement Project that was eligible for transportation impact fee funding, but used other funding sources to pay for the work. FINDING The initial draft of this report was distributed in August 2010. Actual contract unit costs and quantities were used to determine the exact amount of impact fees to be applied to the project. The scope of construction performed dictated whether the project could be funded with one hundred percent impact fees or only a portion thereof. County Attorney indicated that this project meets the criteria for using transportation impact fees but questioned the percentage used to reimburse work on collector roads, which was taken from the 1994 "Leitner memo" that was included in the report as Appendix F. Planning Department staff reviewed population estimates and determined that the appropriate percentage was 37.2% as opposed to the 24.2% contained in the Leitner memo. Accordingly, the amount of eligible impact fee costs was recalculated using the updated percentage. The conclusion of our analysis revealed that $791,439.50 in expenditures should be reimbursed with transportation impact fees. Appendix A is a summary of the project and shows the proposed impact fee reimbursement the project. Appendices B through E contain supporting documentation used in the report. APPENDIX A — SUMMARY OF ELIGIBLE IMPACT FEE COSTS Appendix A summarizes the eligible impact fees for the project. Based on a legal opinion from impact fee attorney Martin L. Leitner, and an updated analysis of Monroe County population impact fees can pay 37.2% of the total cost for upgrading collector roads and 100.0% of bike path projects. (See Appendix F). These percentages are shown in Column 5. Column 6 calculates the eligible impact fee amount by multiplying the percentage by the eligible collector road total cost (Column 4). Any previously expended impact fees are recorded in Column 7 and then subtracted from the eligible amount (Column 6) to equal the proposed impact fee reimbursement (Column 8). Key Deer Boulevard is located in Transportation Impact Fee District one. U) H U) 0 LU w LL H Q a W J _m C� J LU LL O a cn U W a W Cl) O CD M Cfl CM 0 7 0 Lo 0 O 0 O 0 LA OWZ rno ti LO W LL LU Ln CA Cn O CO6Os�M d If y 1.- co U ct V Lo O N N CA N N r- r. P- W O O O O 0 0 0 0 O O O O r Q W O O O C LL 64 64 64 fi) W U a W Q a a r- 1` C00 OOOO (flM M �-- LOOOu? W W 1, 00 a0 LO 1- of O o of m � � LLti rn rn rn It IT ON LLO 0) N CA Q> W�Q O6q CV)64 ti ti 63 64) 0 0 0 0 WW N N O O Q r- 1,- W F� co co 0 r- _ � U W 4 U � W �a v o cD o N co CO T- * Q CV 6 Lo ti ~O N O 1l- Lo N N CA C) _ W ~ C4 N U') to CA 61D. co 61). 0 0 64 l 6H U ck: F- U p r y O c M U N W w C C a Q o C. ca c �._ ULumUw _ U Lis co N Q 00 O N N �- N Cl) U U U F F- > o cn co cn � tea` o00 U p M r 00 -0 0 0 0 0 a � 0 J J J o > >, 0 000� YF- E co Z) 7 Z) 0 JU)JU) cn H APPENDIX B — PROJECT TOTAL AND BALANCE COMPARISON Appendix B shows project totals, which were obtained from the Public Works Department and project expenditure balances obtained from the Finance Department. The difference was calculated by subtracting the Project Total from the Project Expenditures Balance with negative amounts in parenthesis. The account numbers charged for the project are listed in the final column. PROJECT CONSTRUCTION TOTAL AND BALANCE COMPARISON PROJECT DATE PROJECT CONSTRUCTION TOTAL PROJECT CONSTRUCTION EXPENDITURES FROM FINANCE DIFFERENCES ACCOUNT NUMBERS Key Deer Roadway Improvement Project 2005- 2008 $1,346,197.60 $1,346,197.60 $0.00 102 22506 560630 R04301 560630 I V IAL �7,34b,7`J/.bU� z�7,346,197.60t $0.001 APPENDIX C — INDIVIDUAL PROJECT COST Appendix C summarizes the project costs. The Project Number is the Account Number to which costs were charged. A brief description of the project scope of work is provided. The Project Cost Sheet is divided into the following sections: Engineering Cost by Monroe County Includes costs for Surveying, Design, and Inspection. Costs for the contracted projects were determined from the Project Audit Trail and Project Status reports from the Finance System. The percentage of costs allocated to Eligible Collector Road and Bicycle Path is based on the percentage of the direct cost items from construction costs (all items except for General Provisions and Maintenance of Traffic) allocated to each. 2. Construction Costs Shows actual construction costs obtained from the project schedule of values. Quantities and Unit Costs were determined from the bid sheet, pay requests, and approved change orders for contracted projects. The direct cost items were allocated between Eligible Collector Road and Bicycle Path categories based on actual work performed. 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O O U) N N N O U) 7 U) N cl? 0 0 0 O O O Cl) V O O O O O Co M O O O O O N 63 6. 6% 63 69 63 0) 6) 69 6. 63 64 'IT V' 'IT 6> N og� 64 O N 63 6) 63 00 _N N D� U) U) LO V' r O U7 N O NCO to 00 M O (D c- N *It V N M L, (n `O a E 0 co N c 0 _ CL E o E E m Z c o Y rn a- o. N E a� o `� E cn v> a c m E E m` E °o � 0) a 0 w f0 a 0 c' rn 0> E v CL L a�Ei n co Uu))_ c _ p a) 0 a .a .CL 'Q (n a s to Z Z Z m E a 0 �' O a o in 0 _0 00 0` a o m v> > E z 0 co a N iO iD iD 2°.° i0 iD °r ( i O J0 ) H O(M V U7 (D I-: CO 6 O N M V U) CD 1,� 00 Q) O N N N N N N N N M co co co M co M M m M� V V' LN x c a) Q Q El APPENDIX D — TIME CHARGE AND SALARY COSTS Appendix D summarizes the time charge and salary costs for the Monroe County Engineering Department. This information was obtained from the Finance System reports, copies of which are in Appendix E. All surveying, design work, administration, and inspections were completed 100% by in-house Engineering staff. U _z w w w _z 0 z w 0 O "- z D O U w w z E co O co CCOO co N -- D COO CNO Q O N f` d- �- V' N V' ti 611, O O 64 N c- m ti 64 69 69 64 CO m O O O 'ITC m C% CA N e— CV co m O t-- Cn co E (A — ~ Cn CO Cl) O � �- e- m 64 v O 64 64 69 69 N 0� !� CO Om0 Q O U m O U Cl) et co d' N 64 000 O 64 Go;� N CCU 63 63 64 0 0 o M o rn 69. 64 69 N 604 N a) E f» O U) vrnv�rn t .- CO N — ti f\ M C C 0 0 CO CCU (A 69m CD N 63 E!l 69 H9 N U) ry 0 0 0 0 0 LL LL LL LL LL jp O F C6 F w z w m s U) m O U J H O i— 10) 69 69 � CO Ww 2 O < O LU U) H m m O U C9 z w w w z_ a z w z O U w O w z O J H O h- 6 .164 co R x a c C n a Q APPENDIX E — WORKSHEETS Appendix E is a compilation of the project pay applications, change orders and salary charges (from Finance System) for the project. Nv r � Nc�.vIJCJ� ��v I�C- V) SC Z) APPENDIX F — TRANSPORTATION IMPACT FEE REIMBURSEMENT — LEGAL OPINION Appendix F is comprised of a 15-page legal opinion from Martin L. Leitner and Elizabeth A. Garvin, Legal Consultants, of the firm Freilich, Leitner & Carlisle. Questions 1 and 2 on page 1 address reimbursement. Responses, appearing on pages 10 through 13, state that reimbursement may occur in the amounts of 24.2% for roadway projects and 100% for bike path projects. Also enclosed is an email from Mr. Mitch Harvey of the Monroe County Planning Department that updates the population estimates as directed by County Attorney and revises the percentage for roadway projects to 37.2% Clarke -Judith From: Harvey -Mitch Sent: Friday, October 29, 2010 11:39 AM To: Clarke -Judith Cc: Schwab-Townsley Subject: FW: Population Esitmates and Impact Fees. Judy I hope this helps. Call me. Mitch Mitchell N. Harvey, AICP Comprehensive Planning Manager Monroe County Growth Management Marathon Government Center 2798 Overseas Hwy., Suite 410 Marathon, FL 33050 Phone: (305) 289-2514 Fax: (305) 289-2536 Email: Harvey-MitchC@monroecounty-fl.gov HELP US HELP YOU! Please take a moment to complete our Customer Satisfaction Survey: http://monroesurvey.virtualtownhall net/surve�php9accl4aelb Please note: Florida has a very broad public records law. Most written communications to or from the County regarding County business are public records available to the public and media upon request. Your e-mail communication maybe subject to public disclosure. From: Harvey -Mitch Sent: Friday, October 29, 2010 11:30 AM To: Schwab-Townsley Subject: Population Esitmates and Impact Fees. According to the Leitner Memorandum of 1994, the Monroe County Functional Population in 1992 was 98,963. According to the Fiskkind report titled Unincorporated Monroe County Population Projections (August 30 2010), the Monroe County Functional population in 2010 was 157,637. Based on this information, the projected new population is (1992-2010) is 58,674. This represents 37.2 % of total projected functional population in 2010. In accordance with page 9 of the Leitner Memorandum, the applicable new development share for each transportation project is now 37.2%, As stated in the Memorandum, "in order to determine the amount of impact fee revenues that could have been expended on transportation projects from 1986 to date, the County will have to calculate the total cost of each project then multiply 24.2 37.2% of total projected functional population in 2010." Let me know if you have any questions. Mitchell N. Harvey, AICP Comprehensive Planning Manager Monroe County Growth Management Marathon Government Center 2798 Overseas Hwy., Suite 410 Marathon, FL 33050 Phone: (305) 289-2514 Fax: (305) 289-2536 Email: Harvey-Mitch (c-)monroecounty-fl gov HELP US HELP YOU! Please take a moment to complete our Customer Satisfaction Survey: htAp://i-nonroesurvey.vii-tualtownhall.net/survey.php9acc14aelb Please note: Florida has a very broad public records law. Most written communications to or from the County regarding County business are public records available to the public and media upon request. Your e-mail communication may be subject to public disclosure. Please take a moment to complete our Customer Satisfaction Survey: htta://monroecofl.virttialtownhall.net/Pages/MonroeCoFL WebDoes/css Your feedback is important to us! Please note: Florida has a very broad public records law. Most written communications to or from the County regarding County business are public record, available to the public and media upon request. Your e-mail communication may be subject to public disclosure. CONFIDENTIAL: ATTORNEY -CLIENT PRIVILECED MEMORANDUM Freilich, Leitner & Carlisle Date: January 5, 1994 To: Mark Rosch, Acting Capital Improvements Coordinator, Lorenzo Aghemo, Planning Director, and David Koppel, Director of Engineering, Monroe County, Florida From: Martin L. Leitner and Elizabeth A. Garvin, Legal Consultants Subject: Transportation Facilities Impact Fees QUESTIONS PRESENTED 1. Whether Fair Share Transportation Impact Fees ("transportation impact fees") already collected by the County pursuant to § 9.5-491 of the Land Development Regulations of Monroe County ("LDR's") between 1986 and 1992 but not spent may be used to proportionately reimburse the County gas tax fund for gas tax fund monies expended on transportation improvement projects during the same time period that would have been eligible for transportation impact fee funding when undertaken? If so, what limitations, if any, would need to be applied to reimbursements (transfers of funds) from the transportation impact fee fund to the gas tax fund to ensure that applicable legal requirements are met? Are there restrictions on the specific projects or categories of projects that can be funded? Are there limitations on the amount of funding that can be allocated to each project due the extent, if any, to which the project is needed to correct an existing deficiency? 2. Whether "transportation impact fees" already collected by the County pursuant to § 9.5-491 of the LDR's between 1986 and 1992 but not spent can be used to 14237 1 r--t r-- rri .rT.7 n )may $, IM CONFIDENTIAL ATTORNEY -CLIENT PRIVILEGED proportionately reimburse the County gas tax fund for gas tax fund monies spent on bike paths during the same time period that may have been eligible for transportation impact fee funding when undertaken? 3. Whether it is necessary/desirable to use transportation impact fee funds collected from 1986 to 1992 or subsequently for the Card Sound Road Project, since the project has been fully funded with revenue bonds? 4. Whether the County can use transportation impact fee funds to match federal and/or state funding for improvement projects/upgrades on U.S. 1 in order to advance the priority of such projects despite the fact that (a) § 9.5-491 of the LDR's restricts the use of transportation impact fees to the "major road network system" in Monroe County? ("Major road network system" is not defined; however, there is express authorization for use of impact fee funds for projects outside of the district where collected on U.S. 1, Card Sound Road and C-905 in Key Largo.); and (b) Resolution No. 497-1992 establishing the schedule of transportation facilities impact fees restricts the use of the impact fees to "transportation improvement projects for collector roads, intersections of County roads with U.S. 1 and bike trails." DISCUSSION I. Reimbursement of the General Fund A. Introduction In 1986, Monroe County implemented a system to collect proportionate share transportation impact fees from new developments which created additional transportation demand on the Monroe County transportation system.' Fees collected pursuant to the regulations were earmarked for the funding of transportation ' "Fair Share Transportation Impact Fee," Monroe County Land Development ? Regulations, § 9.5-491 (1986). I 14237 2 January 5,1994 CONFIDENTIAL: ATTORNEY -CLIENT PRIVILEGED improvement projects to the "major road network system" in the County, including the upgrade of Card Sound Road. Based upon the then current estimate of the cost to upgrade Card Sound Road, as calculated by the transportation consulting firm under contract to the County, the County retained and accumulated a certain amount of the transportation impact fee funds collected specifically for the Card Sound Road project. When the project was opened for bids just a few months ago, it was discovered that the resulting bids were substantially lower than had been projected? As a result, the County has a substantial surplus of retained transportation impact fee revenues which have not been expended nor allocated to any specific transportation improvement project. B. Legal Basis The Fair Share Transportation Facilities Impact Fee program was designed to meet the rational nexus test required of all impact fees in Florida. This test was summarized in Hollywood, Inc. v. Broward County, 431 So.2d 606, 611-12 (Fla. 4th D.C.A. 1983): [T]he local government must demonstrate a reasonable connection, or rational nexus, between the need for additional capital facilities and the growth in population generated by the subdivision. In addition, the government must show a reasonable connection, or rational nexus, between the expenditure of the funds collected and the benefit accruing to [the development]. I The Card Sound Road improvement project was originally estimated to cost $9.6 million with the intent to fund one-half ($4.8 million) with revenue bonds and one-half ($4.8 million) with transportation impact fees. In January 1993, the County authorized the issuance of $4,585,000 in Card Sound Road and Bridge Improvement Revenue Bonds, Series 1993. When bids on the improvement project were opened in late 1993, it was discovered that the project costs had been substantially over -estimated and that the bids were, in fact, less than one-half of the originally estimated costs. The Board of County Commissioners has already awarded the construction contract to the low bidder at a cost of $3.1 million. 14237 3 January 5, 1994 CONFIDENTIAL: ATTORNEY -CLIENT PRMLEGED In the case of the transportation impact fees, the nexus between the additional population and the need for new transportation facilities was incorporated into the methodology used to determine the amount of the fee.' The nexus between the funds collected and the benefit accruing to the new development was reflected in the earmarking of the funds, pursuant to the adopting ordinance, to limit their use specifically to designated types of projects i.e., improvements to the major road network system, which were predetermined to benefit new development. Contractors & Builders Association v. City of Dunedin, 329 So.2d 314, 321 (Fla. 1976) (ordinance must "spell out necessary restrictions on the use of fees it authorizes to be collected"). Although not expressly stated in the Hollywood Inc. v. Broward County case, it is recognized that an attribute of the rational nexus or "reasonable relationship" test is that there is a reasonable connection between the time when the impact fees are collected and the time when they are expended on a project benefitting the development paying the fees. Despite this caveat, generally, once the impact fees are collected and properly earmarked by being placed in a segregated account or fund, expenditure of the funds is left to the discretion of the collecting governmental entity. Accordingly, the decision to spend the s See e.g.,Draft Transportation Facilities Impact Fee Report for Monroe County, Florida, submitted to the County on August 31, 1992 by Freilich, Leitner, Carlisle & Shortlidge. Although we do not have access to the methodology report prepared prior to the adoption of the Fair Share Transportation Impact Fee Ordinance in 1986, we f presume that it reflected a similar methodology and met this aspect of the rational nexus test. 14237 4 January 5, 1994 CONFIDENTIAL: ATTORNEY -CLIENT PRIVILEGED funds within the time period designated by the impact fee ordinance belongs to the County. Some commentators have expressed the view that impact fee funds must be spent within 5 to 6 years --the conventional capital improvements programming period --in order to meet the rational nexus test. This view has been reinforced by the fact that State impact fee enabling legislation in many states addresses this issue. For example, the Georgia legislation provides that funds must be refunded to the property owner if not encumbered within six (6) years. Ga. Code. Ann. § 36-71-9(1)(Supp. 1992). The Nevada legislation requires that impact fees must be refunded upon request of the property owner if construction is not initiated within five (5) years or fees are not expended within ten (10) years a Where no state legislation is in effect, greater discretion is left to the local government. However, based on a comprehensive review of state enabling legislation, the key to a legally valid time period may be more closely related to the size and scale of the capital improvements project (i.e., a major transportation, water, sewer or storm drainage project which takes many years for the conceptualization, programming, planning, design, engineering, land acquisition and construction, may require more time than a smaller, less expensive and less complex improvement project) and the time when the impact fee funds are "encumbered," rather than when they are expended. Leitner & Schoettle, A Survey of State Impact Fee Enabling Legislation, 25 LTRB. LAWYER 3 (Summer 1993) at 491-518. 14237 5 January 5, 1994 CONFIDENTIAL ATTORNEY -CLIENT PRMLECED One of the limitations on the usefulness of impact fees is that because they are dependent upon new development, the amount and timing of new development dictates the rapidity with which sufficient fees will be collected for particular improvement projects. If only some new development occurs in a particular area and fees are collected, but these are inadequate to fully fund the contemplated improvement, the local government must defer the improvement project, thereby triggering the issue of the time period between collection and expenditure of the impact fees; or supplement the impact fee funds with other County general funds; or refund the impact fees collected to date. While none of these options is perfect, supplementing the impact fee funds with County general funds is palatable if the general fund can subsequently be reimbursed when additional development occurs and impact fees are paid. Clearly, the payor of the impact fees has no complaint since he is being provided with the contemplated improvement within the specified time period and, therefore, receives benefit. C. Refund Provisions The Fair Share Transportation Impact Fee (§ 9.5-491(i)(3)(d) of the LDR's) specifies that fees collected shall be subject to refund if an application for a refund is made within one (1) year following the end of the sixth year from the date on which the fee was paid. This provision operates in effect as a statute of limitations within which refund applications must be made; however, it does not spell out, except by implication, when impact fee funds must be spent. Section 9.5-491(i)(3)(f) and (g) of the LDR's provides 14237 January 5, 1994 CONFIDENTIAL: ATTORNEY -CLIENT PRIVILEGED " that the refund application shall be approved if the Planning Director determines that the impact fees collected from the applicant for the refund have not been "spent or encumbered" within six (6) years from the date of the fee payment. (Note that the word "encumbered" is not defined.)' Since the fair share transportation impact fee ordinance was adopted on September 15, 1986, and the first fees were collected on October 1, 1986, a worst -case scenario would result from the failure of the County to expend or encumber any impact fee funds collected by October 1, 1992 (6 years from the earliest date on which any impact fee payment was made). A review of information provided by Melonie Bryan, Director, Office of Management and Budget of Monroe County' reveals that no transportation impact fee funds collected were expended in the five (5) FY's 1987-1991. In FY 1992, funds were expended in all transportation impact fee subdistricts with the exception of Key Colony Beach.' However, the amount of funds expended was very small compared with the impact fee revenues collected over the first six (6) fiscal years, 1987-1992, i.e., approximately $70,000 was expended in all subdistricts, although close to $7.5 million had been collected. ' We have had occasion in the past to define the word "encumber." See Memorandum titled " " (Freilich, Leitner & Carlisle, Date: ). 6 Summary of Impact Fees (Revenues, Expenditures, Balances) By Facility and By Impact Fee Subdistrict (where applicable), Effective September 30, 1993. ' Through September 30, 1993, no transportation impact fee funds have been expended by Key Colony Beach. I 14237 7 January 5, 1994 CONFIDENTIAL: ATTORNEY -CLIENT PRIVILEGED " approximately $70,000 was expended in all subdistricts, although close to $7.5 million had been collected. The principal reason for not expending impact fee revenues was to accumulate a sufficient amount to defray at least one-half of the estimated cost of the Card Sound Road and Bridge project, which was originally estimated to cost $9.6 million. In addition to Card Sound Road, the County initiated not less than 28 transportation improvement projectss utilizing constitutional gas tax? and county gas tax10 revenues between 1987 and 1993 which could have been funded, at least in part, with transportation impact fees. There are limitations on the use of constitutional gas tax and county gas tax funds but, if impact fee funds were used to supplement gas tax funds for projects undertaken between 1987 and 1993, it would have released a significant portion of the gas tax funds, which then could have been used for additional transportation improvement projects. Since impact fee funds could have been used in place of gas tax funds, it is essential to establish the total cost of each of the 28 transportation improvement projects and the percentage of the project costs that can legitimately be funded with impact fees, i.e., that percentage of the project cost attributable to new growth (versus that percentage s See 'Potential Reimbursement Projects Completed/Underway" provided to Freilich, Leitner & Carlisle by David Koppel, Director of Engineering, Monroe County, on November 24, 1993. ? Fla. Stats. §§ 206.41 and 206.47. to Fla. Stats. § 206.60. 14237 g January 5, 1994 CONFIDENTIAL ATTORNEY -CLIENT PRIVILEGED attributable to serving the needs of existing residents)." As noted in footnote 11, the applicable new development share of each transportation project is 24.2%. As noted in footnote 12, however, the applicable new development share for bike path projects is 100%. Thus, in order to determine the amount of impact fee revenues that could have been expended on transportation projects from 1986 to date, the County will have to calculate the total cost of each project and then multiply by 24.2% for transportation projects and by 100%" for bike path projects. The resulting amounts then also represent the amount of gas tax revenues that would be freed up for use on other eligible projects. " The methodology for development of a legally -valid impact fee ordinance must assure that improvement projects which are designed only in part to serve new growth demands and in part to serve existing development have costs proportionately allocated between the two. In Monroe County, the 1992 transportation impact fees relied on a methodology, which related then current County functional population (98,963) to projected future functional population in 2010 (130,574) (the comprehensive plan horizon date). Projected new population (1992-2010) (31,611) was determined to be 24.2% of total projected functional population in 2010 (while existing 1992 population was determined to be 75.8%). While this methodology was used in the 1992 transportation impact fee ordinance (not in the 1986 ordinance), the difference between the proportion in 1992 and 1986 is not considered to be significant. Moreover, the impact fee expenditures are being made now. 12 Bike path/trail projects undertaken after 1986 are 100% attributable to new development. The 1992 transportation impact fee methodology established that the County was providing 1.9 linear feet of bike paths per capita, which was established as the level of service standard. Therefore, there were no existing deficiencies and all additional bike paths would be needed to serve projected new growth. 14237 9 January 5, 1994 CONFIDENTIAL ATTORNEY -CLIENT PRMLECED D. Response to Question #1 Transportation impact fee revenues already collected pursuant to § 9.5-491 of the LDR's between 1986 and 1992 but not yet spent may be used to now reimburse the County gas tax fund for gas tax fund revenues expended during that time period on eligible projects provided that: (1) the amount of reimbursement shall be limited to 24.2% of the project costs for transportation projects, which represents the proportionate share attributable to new development projected to 2010 (the comprehensive plan horizon year); (2) the amount of reimbursement for bike path project costs shall be 100%. E. Response to Question #2 Transportation impact fee revenues already collected pursuant to § 9.5-491 of the LDR's between 1986 and 1992 but not yet spent may be used to now reimburse the County general fund for general fund revenues expended during that time period on eligible bike pathsltrails projects. Both § 9.5-491 of the LDR's and Resolution No. 497-92 list new bicycle paths as eligible improvement projects for use of impact fee revenues. See § 9.5-491(i)(3)(ix) with respect to the 1986 Fair Share Transportation Impact Fee Ordinance and Resolution No. 497-92 and Draft Transportation Facilities Impact Fee Report for Monroe County Florida 14237 10 January 5, 1994 CONFIDENTIAL: ATTORNEY -CLIENT PRIVILEGED (August 31, 1992) at pp. 5-6, 14-15 and 16. The methodology for calculating the "fair share" transportation impact fee in 1986 is not available, therefore, we do not know what level of service standard was used nor how much of the impact fee amount was for bike trails versus other transportation improvements. Fortunately, in 1992, the new transportation impact fee ordinance was based expressly on two (2) components which were independently calculated; one was bike trails (the other being all other transportation improvements). The calculation methodology established that the existing level of service in 1992 was 1.9 linear feet of bike -trail per capita. It then adopted that same level of service for projected growth anticipated between 1992 and 2010 so that the level of service would not be diminished over time. In this way, 100% of the costs could be legitimately and validly attributable to new growth. If the 1986 fair share transportation impact fee methodology could be reconstructed, it would be possible to determine the exact percentage of bike trail costs to be attributable to new growth between 1986 and 1992. In order to do this, the County would need to establish the number of miles of bike trails in 1986, the County functional population in 1986, the resulting level of service standard measured in linear feet of bike path per capita, the bike trail cost per linear foot, and the persons per household in 1986. If this information is available and the calculation can be done, it would establish the i percentage of bike trail costs attributable to new growth. Bike trail projects initiated i between 1986 and 1992 and funded with gas tax funds could then be identified and 14237 11 January 5, 1994 CONFIDENTIAL ATTORNEY -CLIENT PRIVILEGED appropriate reimbursement- could be made from the impact fee fund to .the County general fund. According to the project list forwarded by David Koppel, Director of Engineering (see footnote 8, supra), the following projects had bike trail components: 1989 Aviation Blvd. Bike Path (Marathon) 1990 U.S. 1 Bike Path (Plantation Key) 1990 Woods and Gardenia Bike Path (Plantation Key) 1992 Cross St. and 5th St. Bike Path .(Stock Island) 1992 Sugarloaf Blvd. Bike Path (Sugarloaf Key) 1993 Sombrero Blvd. Bike Path (Marathon) 1993 U.S. 1 - Marathon Bike Path (Marathon) Gas tax revenues may be used for bike paths and trails and were, in fact, fully used to fund 100% of the project costs, despite the fact that the projects are 100% attributable to demands generated by new development. Therefore, the County may and should reimburse the gas tax fund for 100% of the costs of the above -listed bike path projects out of accumulated but unspent and unencumbered transportation impact fee revenues. Moreover, the County should identify additional bike path projects in the current (1994) FY budget, in the 1995-1999 capital improvements program, and in the Monroe County Seven -Year Roadway/Bicycle Path Plan. The County should consider the following: (1) adding projects as needed in the 1995-1999 capital improvements program so as to maintain the 1.9 linear feet per capita standard based on development projections to 2010 and enabling all of such projects to be initiated by 1999; and (2) shifting (advancing) projects currently in the 1995-1999 capital improvements program to the current FY to the extent possible to immediately encumber the impact fee funds needed for such projects. 14237 12 January 5,1994 CONFIDENTIAL: ATTORNEY -CLIENT PRIVILEGED After identifying the -actual costs of the above -listed and described projects, we can determine the amount of the previously collected impact fee revenues which can be encumbered to avoid refunds. F. Response to Question #3 Because the Card Sound Road and Bridge project is primarily needed to serve hurricane evacuation demands resulting from new development, use of previously collected but expended transportation impact fee revenues to fund the project is permissible. The real question though is whether such reimbursement would be effective, i.e., will it allow the use of accumulated impact fee revenues to fund a portion of the cost of the project rather than toll receipts and then permit the transfer of the collected tolls to be used to reimburse the gas tax fund, or, better yet, the County general fund. If so, the County would gain $3.1 million plus (the cost of the Card Sound Road project) for the gas tax or general fund. However, the project is currently fully funded by revenue bonds backed by tolls and related project revenues, not by County general fund or gas tax or impact fee revenues. The key issue to be resolved in response to Question #3 is whether, pursuant to the Card Sound Road and Bridge Improvement Revenue Bonds, Series 1993, the toll revenues can be used for a purpose other than debt retirement assuming that the debt is retired by other revenues. Since we are not Bond Counsel, we have not attempted to answer this question; nor, to indicate any opinion as to whether such a change might 14237 13 January 5, 1994 CONFIDENTIAL: ATTORNEY -CLIENT PRMLECED affect the tax exempt status -of the bonds; nor to indicate an opinion abouta myriad of other potential legal issues associated with such a change. If the bonds have been authorized,13 but not issued and the project costs are now financed largely with accumulated impact fee revenues, can the County still collect tolls? Are there any restrictions imposed by the State or federal government on the ability of the County to utilize toll revenues for purposes other than operation and maintenance of the project? If possible, and subject to confirmation by Bond Counsel and other appropriate County consultants, staff and officials, we recommend that the proportionate share of the cost of the Card Sound Road and Bridge improvement project attributable to new development be funded by accumulated impact fee revenues and that toll and other revenues from the Card Sound Road and Bridge improvement project be placed in the County general fund. If the bonds have been authorized, but are now rescinded in light of the significant change in project costs, the County can fund the project 50% with accumulated impact fee revenues and 50% with accumulated gas tax revenues (including gas tax revenues freed -up by virtue of the use of impact fees for past and current transportation and bike path projects). The issue that is then raised is what the toll revenues would be used for if not for debt retirement. However, that issue is beyond the scope of this Memorandum (and the request by County staff). i 13 The bonds were authorized by a resolution adopted by the Board of County Commissioners on January 13, 1993, as amended and supplemented. See Bond Prospectus, p. 1. 14237 14 January 5, 1994 CONFIDENTIAL: ATTORNEY -CLIENT PRIVILEGED G. Response to Question #4 The County may use transportation impact fee revenues to match federal or state funding for improvement projects on U.S. 1 in order to advance the priority of such projects on State or federal capital program lists subject to the following: (1) the project is part of the "major road network system" as that term is used in § 9.5-491 of the LDR's; or (2) the project is part of an intersection improvement of any County road with U.S. 1 pursuant to Resolution No. 497-92. "Intersection improvement" may be subject to a broad interpretation to allow for the addition of, for example, left and right turn lanes on U.S. 1, medians, traffic signals, signage, landscaping, widenings, right-of- way acquisition, curb and gutter, sidewalks, drainage improvements, utility relocations, etc. However, "intersection improvement" would, presumably, be subject to some limitation related to distance from the intersection. And, more importantly, "intersection improvement" could not be considered expansive enough to include such things as the addition of a third travel lane for an extensive distance between intersections. If the County perceives that the use of impact fee funds for this purpose is important and desirable, consideration should be given to revising the current transportation impact fee calculation methodology, to amending Resolution No. 497-92, to amending the current FY 1994 County Annual Budget and FY 1995-1999 Capital Improvements Program and to revising the Seven Year Roadway/Bicycle Path Plan. 14237 15 January s, 1994 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: Administration Bulk Item: Yes X No _ Department: Project Management Staff Contact Person/Phone #: Jerry Barnett X4416 AGENDA ITEM WORDING: Approval of a First Amendment to Contract with William P. Horn Architect, P.A. for the Development of a Higg's Beach Park Master Plan. ITEM BACKGROUND: William P. Horn Architects is conducting an individual study for the purpose of developing a Higg's Beach Park Master Plan. The individual study is a contract issued under the Continuing Contract pursuant to Florida Statute 287.055(2) (g), and has an expiration date of December 12, 2010. This First Amendment extends the contract time by 90 days, from December 12, 2010 to March 12, 2011. PREVIOUS RELEVANT BOCC ACTION: On December 16, 2009 the BOCC approved a Continuing Contract with William P. Horn Architects, P.A. for Architectural/Engineering Services for projects in which construction costs do not exceed $2,000,000.00, or for study activity if the fee for professional services for each individual study does not exceed $200,000.00. On March 17, 2010 the BOCC approved a contract with William P. Horn, Architect P.A. to develop a Master Plan for the Higgs Beach Park, and on July 21, 2010 William P. Horn conducted a 10 minute presentation on the status and design of the Higgs Beach Park Master Plan during the BOCC meeting. CONTRACT/AGREEMENT CHANGES: Extend the contract time by 90 days, from December 12, 2010 to March 12, 2011. STAFF RECOMMENDATIONS: Approval as stated above. TOTAL COST: N/A INDIRECT COST: BUDGETED: Yes N/A No DIFFERENTIAL OF LOCAL PREFERENCE: N/A COST TO COUNTY: N/A SOURCE OF FUNDS: N/A REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year r� APPROVED BY: County Atty. chasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 7/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: William P. Horn Contract # Effective Date: 12/12/10 Expiration Date: 03/12/11 Contract Purpose/Description: Contract time extension of 90 days from 12/12/10 to 03/12/11 for the development of a Higgs Beach Park Master Plan Contract Manager: Ann Riger X4439 Facilities Devel/Stop #1 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 12/15/10 Agenda Deadline: 11/30/10 CONTRACT COSTS Total Dollar Value of Contract: $ 132,000.00 Current Year Portion: $ 87,750.00 Budgeted? Yes® No ❑ Account Codes: irn77050-530310-TH07662X-45%- Grant: $ N/A c�1-20502-530310- - -55% County Match: $ N/A - - - - ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) Da e 41 Division Director / X Risk Manag ment 0� J� �'` CONTRACT REVIEW Changes Needed evie er Yes❑ No� C Yes❑ No� O.M.B./Pu a��ng I 2- 4--10 Yes[-] Noo— County Attorney 0 Yes[-] No[2� Comments: OMB Form Revised 2/27/01 MCP #2 Date Out 11M1d FIRST AMENDMENT TO CONTRACT BETWEEN OWNER AND ARCHITECT/ENGINEER THIS FIRST AMENDMENT (herein after "AMENDMENT") to the CONTRACT BETWEEN OWNER AND ARCHITECT/ENGINEER ("CONTRACT") for the Higgs Beach Park Master Plan, entered into between MONROE COUNTY (the "Owner" or "County"), and WILLIAM P. HORN ARCHITECT, P.A. ("Architect/Engineer") is made and entered into this 15`h day of December 2010, in order to amend the CONTRACT, as follows: WITNESSETH WHEREAS, on the 16`h day of December, 2009, the parties entered into a continuing contract for projects in which the estimated construction costs of each individual project under the contract does not exceed Two Million Dollars ($2,000,000.00), or for study activity if the fee for professional services for each individual study under the contract does not exceed Two Hundred Thousand Dollars ($200,000.00); and WHEREAS, on the 171h day of March, 2010, the parties entered into a contract for an individual study for the purpose of developing a Higg's Beach Park Master Plan; and WHEREAS, in accordance to the contract of March 17, 2010 the contract expiration is two hundred and seventy days (270 days) from the contract date or December 12, 2010; now therefore IN CONSIDERATION of the mutual promises contained herein, the parties hereby agree as follows: 1. The contract time shall be extended by ninety days (90 days), from December 12, 2010 to March 12, 2011. 2. The remaining terms of the CONTRACT, not inconsistent herewith, shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Amendment on the date stated above. BALANCE OF PAGE INTENTIONALLY LEFT BLANK SIGNATURE PAGE TO FOLLOW Amend # 1 Execution by the Architect/Engineer must be by a person with authority to bind the entity. SIGNATURE OF THE PERSON EXECUTING THE DOCUMENT MUST BE NOTARIZED AND WITNESSED BY ANOTHER OFFICER OF THE ENTITY. Attest: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE By: COUNTY, FLORIDA Deputy Clerk By: Date: Mayor/Chairman (SEAL) ARCHITECT/ENG EER WILLIAM P. HORN CHITECT, P.A. Attest: By: Print Name: Title: Date: Or: Witness Print Na Witness Print Name:./4,4,u M ' )�; 6 r A STATE OF FLORIDA COUNTY OF IY By: Print Name: I�JIZ Z' hi'h �_/ �%'✓ Title: Date: `--zl ".._ On this _ " ''"-- day of AVUV , 2010, before me, the undersigned notary public, personally appeared f� known to me to be the person whose name is subscribed above or who produced -1 as identification, and acknowledged that he/she is the person who executed the above dment with Monroe County for Architect/Engineering services for the Higgs Beach Park Maser PI for the �urpo erein contained. ary Public Print Name My commission expires: _! /0 ' i 2 Amend #1 CONTRACT FOR PROFESSIONAL SERVICES BETWEEN OWNER AND ARCIIITECT/ENGINEER THIS CONTRACT FOR PROFESSIONAL SERVICES BETWEEN OWNER AND ARCHITECT/ENGINEER (the "Contract" or "Agreement') is made and entered into by Monroe County ("Owner" or "County'), a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, Florida 33040, its successors and assigns through the Monroe County Board Of County Commissioners ("BOCCI, and William P. Horn. Architect_ P.A. _ the ("Architect'j., whose address is 915 Eaton St. K9FL 33040. its successors and assigns. This contract shall be effective on the date of execution by the last party signatory to the contract. This contract is issued under a continuing contrad awarded to William P. Horn Architect, P.A. by Monroe County pursuant to Florida Statute 287.055(2) (g). The professional services required by this Contract are to be rendered for a project for study activity that the fee for professional services for each individual study under the contract does not exceed Two Hundred Thousand Dollars ($200,000.00). The professional services required by this contract will be for services in the form of developing a Higg's Beach Park Master Plan, commencing on the et%ctive date of this contract and ending 270 days from the commencement data An extension of time at no additional cost to the County, in the form of an amendment to this contract, may be granted only by BOCC approval. The tams and conditions of the Continuing Contract shall apply to this contract, unless expressly modified in the provisions of this contract. Where the tams of the Continuing Contract differ from the terms of this conM4 the terns of this contrad shall take precedence This contrad will contain a specific scope of worlL NOW, THEREFORE, in consideration of the mutual promises„ covenants and agreements stated herein, and for other good and valuable consideration, the sufficiency of which hereby acknowledged, the Owner and the Arehited agree: 1.1 REPRESENTATIONS AND WARRANTIES By executing this Contract, Architect makes the following express representations and warranties to the Owner. 1.1.1 The Architect is a professional qualified to act as the Architect for the Project and is licensed to practice Architecture/Engineering by all public entities having jurisdiction over the Architect/Engineer and the Project; 1.1.2 The Architect shall maintain all necessary licenses, permits or other authorizations necessary to act as Architect for the Project until the Architect's duties hereunder have been fully satisfied; 1.1.3 The Architect shall become familiar with the individual Project site and the local conditions under which the Project is to be designed 1.1.4 The Architect shall prepare all documents required by this Contract including, but not limited to, all contract Master Plans and Specifications, in such a manner that they shall be in conformity and comply with all applicable law, codes and regulations. The Architect wan -ants that the documents prepared as a part of this Contract will be adequate and sufficient to accomplish the purposes of the Project, therefore, eliminating any additional design costs due to missing or incorrect design elements in the contract documents; 1.1.5 The Architect assumes full responsibility to the extent allowed by law with regards to his performance and those directly under his employ as Architect of Record 1.1.6 The Architect's services shall be performed as expeditiously as is consistent with professional skill and care and the orderly progress of the Work. The Architect shall submit, for the Owner's and Monroe County Project Management Department's information, a schedule for the performance of the Architect's services which may be adjusted as the Project proceeds if approved by the Owner, and shall include allowances for periods of time required for the Owner's and Monroe County Project Management Department's review, and for approval of submission by authorities having jurisdiction over the Project. Time limits established by this schedule and approved by the Owner may not be exceeded by the Architect except for delay caused by events not within the control of the Architect or foreseeable by him. 1.1.7 In providing all services pursuant to this agreement, the Architect shall abide by all statutes, ordinances, rules and regulations pertaining to, or regulating such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the COUNTY to terminate this agreement immediately upon delivery of written notice of termination to the Architect. ARTICLE II SCOPE OF ARCHITECT/ENGINEER'S BASIC SERVICE 2.1 DEFINITION 2.1.1 Architect's Basic Services consist of those described in Paragraphs 2.2 through 2.3 and other services identified as part of Basic Services, and include normal, civil, structural, mechanical, and electrical engineering services as required for this project. 2.1.2 The Master Plan shall include, but shall not necessarily be limited to, plans and specifications that describe all systems, elements, details, components, materials, equipment, and other information necessary for the development and approval of the Master Plan. The Master Plan shall be accurate, coordinated and in all respects adequate for approval of the Development Plan and shall be in conformity, and comply, with all applicable law, codes, permits, and regulations. Products, equipment and materials specified for use shall be readily available unless written authorization to the contrary is given by the Owner. The Architect is not responsible for the development of Construction Drawings. 2.1.3 These services shall include, but not be limited to: Preparation and completion of the design program for space requirements and relationships, schematic design, design development, cost estimating during design and document preparation, preparation and submittal of approval applications, zoning applications, public presentations and presentations to the County Commission. Architect shall arrange his schedule in order to be available to perform the listed services for the project as requested by COUNTY and with the understanding that for any individual project the costs will not exceed the limits under F.S. 287.055 (2)(g). 2.2 PHASE ONE, SCHEMATIC DESIGN 2.2.1 The Architect shall review the County's program, schedule and budget furnished by the Owner to ascertain the requirements of the Project and shall arrive at a mutual understanding of such requirements with the Owner. 2.2.2 The Architect shall review with the Owner and Monroe County Project Management Department's proposed site use and improvements, required approvals, zoning, selection of materials, building systems and equipment; and method of Project delivery. 2.2.3 The Architect shall review with the Owner and Monroe County Project Management Department's alternative approaches to design of the Project. 2.2.4 Based on the mutually agreed -upon program, schedule and budget requirements, the Architect shall prepare, for approval by the Owner, Schematic Design Documents consisting of drawings and other documents illustrating the scale and relationship of Project components. 2.2.5 Upon completion of the Schematic Design Phase, the Architect shall provide drawings, outline specifications, estimate of anticipated cost in accordance with the schematic designs, and other documents for the Owner's approval and the Monroe County Project Management Department's information. 2.2.6 The Schematic Design must be approved in writing, by the Owner prior to Architect continuing to Phase Two of the Master Plan. 2.2.7 During the development of the Master Plan the Architect will plan, arrange and conduct Public Meetings and all other meetings as indicated in his proposal that is attached to and is part of this contract. Upon agreement between the County and the Architect (the total number of meetings shall remain the same) the number of meetings with individual committees, boards, staff, and etc. can be modified and scheduled as needed. The Architect shall provide for recording and distributing meeting minutes. The County will provide the spars for the Public Meetings and meetings with county staff and committees. Advertising for Public Meetings will be the County's responsibility. 2.2.8 The Architect shall take into consideration, for the development of the Master Plan, information acquired through meetings identified in 2.2.7 and shall review other Master Plans generated in the past regarding Higgs Beach Park. 2.2.9 The County, at its discretion, reserves the option to end the project with the completion of Phase One and not proceed to Phase Two. 'If the County chooses this option the Architect shall be paid for work completed on Phase One but will not receive any additional Rands unless instructed in writing to proceed with Phase Two. 2.3 PHASE TWO, DESIGN DEVELOPMENT DOCUMENTS AND APPROVALS 2.3.1 Upon completion of Phase One, and with written approval from the County, the Architect shall proceed to Phase Two and provide drawings, outline specifications and other documents for the Owner's approval and the Monroe County Project Management Department's information for submittal by the Architect to the City of Key West for development review and approval. The Architect shall provide an estimate of anticipated costs in accordance with Phase Two design documents. 2.3.2 The Phase One Documents must be approved in writing, by the Owner prior to Architect continuing to Phase Two. 23.3 The Architect shall provide all Drawings and Specifications required by the City of Key West's development Review Board for Development Approval and for the Owner's and the Monroe County Project Management Department's review. 4 2.3.4 The Architect shall submit to the City of Key West the above mentioned documents and information for obtaining Development Approval from the City of Key West. 2.3.5 The Architect's Development Approval documents (plans, specifications, etc.) will conform to all written codes and regulations of the federal government, county, state, municipalities, agencies and state departments, in effect at the date of this Agreement, and shall be of such completion as to receive all approvals when applied for. If approvals are denied, then the Architect will conform the documents in such manner to receive approvals upon such plans. Work required from the Architect to conform the documents to federal, state, city, county, or agency specifications and approval requirements to allow them to be approved shall be completed at no additional cost to the Owner. 23.6 Duties, responsibilities and limitations of authority of the Architect shall not be restricted, modified or extended without written agreement of the Owner and Architect. 23.7 The Architect shall make available to the Owner any personnel or consultants employed or retained by the Architect for the purpose of reviewing, studying, analyzing or investigating any claims, contentions, allegations, or legal actions relating to, or arising out of, the design of the project 2.3.8 The Architect shall without additional compensation, promptly correct any errors, omissions, deficiencies, or conflicts in the work product of the Architect or its consultants, or both. 3.1.1 The services described in this Article III are not included in Basic Services. They shall be paid for by the Owner as provided in this agreement as an addition to the compensation paid for the Basic Services but only if approved by the Owner before commencement, and as follows: A. Providing services of Architect for other than the previously listed consulting scope of Project provided as a part of Basic Services. B. Providing any other services not otherwise included in this Agreement or not customarily furnished in accordance with generally accepted consulting practice. 3.2 If Additional Services are required, such as those listed above, the Owner shall issue a letter requesting and describing the requested services to the Architect. The Architect shall respond with fee proposal based on hourly fees listed on Exhibit A to perform the requested services. Only after receiving an amendment to the Agreement and a notice to proceed from the Owner proceed with the Additional Services. 4.1 The Owner shall designate Monroe County Project Management Department to act on the Owner's behalf with respect to the Project. The Owner or Monroe County Project Management Department shall render decisions in a timely manner pertaining to documents submitted by the Architect in order to avoid unreasonable delay in the orderly and sequential progress of the Architect's services. However, the parties acknowledge that due to Monroe County Policy, Ordinances or State or Federal Statute there may be times when a decision must be made by the BOCC, in which case any delay shall not be attributed to Monroe County or its representative. 4.2 Prompt written notice shall be given by the Owner and Monroe County Project Management Department to the Architect if they become aware of any fault or defect in the Project or non-conformance with the Contract Documents. 4.3 The Owner shall furnish the required information and services and shall render approvals and decisions as expeditiously as necessary for the orderly progress of the Architect's services. 4.4 The Owner's review of any documents prepared by the Architect or its consultants shall be solely for the purpose of determining whether such documents are generally consistent with the Owner's criteria, as and ig modified No review of such documents shall relieve the Architect of responsibility for the accuracy, adequacy, fitness, suitability or coordination of its work product. 5.1 The Architect shall provide an Estimated Construction Cost for the total project. 6.1 The Architect covenants and agrees to indemnify and hold harmless Owner/Monroe County and Monroe County Board of County Commissioners from any and all claims for bodily injury, including death, personal injury, and property damage, including property owned by Monroe County, and any other losses, damages, and expenses, including attorney's fees, court costs and expenses, which arise out o4 in connection with, or by reason of services provided by the Architect or its Subcontractor(s), occasioned by the negligence, errors, or other wrongful act or omission of the Architect, their employees, or agents. 6.2 The first ten dollars (S 10.00) of remuneration paid to the Architect is for the indemnification provided for above. Should any claims be asserted against the County by virtue of any deficiency or ambiguity in the plans and specifications provided by the Architect, the Architect agrees and warrants that he shall hold the County harmless and shall indemnify him from all losses occurring thereby and shall further defend any claim or action on the County's behalf 6.3 In the event the completion of the project (to include the work of others) is delayed or suspended as a result of the Architect's failure to purchase or maintain the required insurance, the Architect shall indemnify County from any and all increased expenses resulting from such delays. Should any claims be asserted against County by virtue of any deficiencies or ambiguity in the plans and specifications provide by the Architect the Architect agrees and warrants that Architect hold the County harmless and shall indemnify it from all losses occurring thereby and shall further defend any claims or action on the County's behalf 6.4 The extent of liability is in no way limited to, reduced or lessened, by the insurance requirements contained elsewhere within the Agreement. 6.5 This indemnification shall survive the expiration or early termination of the Agreement. 7.1 PERSONNEL The Architect shall assign only qualified personnel to perform any service concerning the proJecL &I PAYMENT Payment shall be the agreed to lump sum and will be distributed on a monthly basis as described below. Additional services will be based on hourly rates to be approved by the County. Hourly rates are provided in Exhibit A and are subject to annual affirmation. Details ofpayment are as specified below. 8.1.1 The Architect shall submit monthly, unless otherwise agreed in writing by the Owner, an invoice to the Owner requesting payment for services properly rendered and reimbursable expenses due hereunder. The Architect's invoice shall describe with reasonable particularly the services rendered. For billing purposes, the project shall be divided into two portions, known as the Beach side and the Land side. The Architect shall identify that portion of work completed for the Beach side of the park and that portion of work completed for the Land side of the park separately. The boundary line between the two shall be the centerline of Atlantic Boulevard passing through the Park, The Architect's invoice shall be accompanied by such documentation or data, as required by the Owner, in support of expenses for which payment is sought. 7 S.1. LA - Phase One Fees Architectural, Planner, Civil, etc .................................. S45,000.00 Surveyor S 10.500.00 Phase One Total.........................................................S5S,500.00 8.1.1.B - Phase Two Fees Architectural, Planner, Landscape Design, Civil Engineering, Lighting Engineering, Studies and assessments. etc. S76.500.00 Phase Two Total ............................................... ... $76,500.00 S.1.l.0 - Total Contract Sum PhaseOne .......................................................... .S55,500.00 Phase Two $76,500.00 Total Contract Sum..............................................$132,000.00 At this time the number of buildings (new and/or to be renovated) is unknown. Therefore the above costs are based on design work for 4 (four) buildings. Additional buildings will be billed as stated below. Any additional work for Phase I or Phase II can be completed at a fixed fee (to be determined) or at the standard hourly rates listed in Exhibit A. The Total Contract Sum Is ......... $132,000.00 (one hundred thirty-two thousand dollars and no cents) 8.2 REIMBURSABLE EXPENSES All reimbursable expenses are included in the Total Contract Sum, however prior to incurring any additional expense written approval for that expense must be obtained in writing from the County. 83 BUDGET 83.1 The Architect may not be entitled to receive, and the County is not obligated to pay, any fees or expenses in excess of the amount budgeted for this Agreement in each fiscal year (October 1- September 30) by County's Board of County Commissioners. The budgeted amount may only be modified by an affirmative act of the County's Board of County Commissioners. 8.3.2 AVAILABILITY OF FUNDS. If funding cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified in this Contract the agreement may be terminated immediately at the option of the County by written notice of termination delivered to the Architect. The County shall not be obligated to pay for any services provided by the Architect after the Architect has received written notice of termination, unless otherwise required by law. 8.3.3 Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Board of County Commissioners and the approval of the Board members at the time of contract initiation and its duration. 9.1 APPLICABLE LAW This contract is governed by and construed in accordance with the laws of the State of Florida applicable to contracts made and performed entirely in the State. Venue for any mediation, dispute conferences or litigation arising under this contract must be in Monroe County, Florida. The Parties waive their rights to a trial by jury 10.1 OWNERSHIP OF THE PRELIMINARY DESIGN AND THE DESIGN DOCUMENTS 10.1 The Drawings, Specifications and other documents prepared by the Architect for this project are instruments of the Architect's service for use solely with respect to this project, and the Architect shall be deemed the author of these documents and shall retain all common law, statutory and other reserved rights, including reproducible copies, of the Architect's Drawings, Specifications and other documents shall not be used by the Owner on other projects except by agreement in writing and with appropriate compensation to the Architect 10.1.2 Submission or distribution of documents to meet official regulatory requirements or for similar purposes in connection with the project is not to be construed as publication in derogation of the Architect's reserved rights. 10.1.3 The Owner may utilize the documents as required for reference on any necessary future work on the site, and for constructing, using and maintaining the Project 11.1 SUCCESSORS AND ASSIGNS The Architect shall not assign its right hereunder, excepting its right to payment, nor shall it delegate any of its duties hereunder without the written consent of the Owner. The Owner and Architect, respectively, bind themselves, their partners, successors, assigns and legal representatives to the other party to this Agreement and to the partners, successors, assigns and legal representatives of such other party with respect to all covenants of this Agreement 9 ARTICLE XII NO THIRD PARTY BENEFICIARIES AND INDEPENDENT CONTRACTOR RELATIONSHIP 12.1 NO THIRD PARTY BENEFICIARIES Nothing contained herein shall create any relationship, contractual or otherwise, between the parties which creates or gives rise to any rights in favor of, any third party. 12.2 INDEPENDENT CONTRACTOR RELATIONSHIP The Architect is and shall be an independent contractor in the performance of all work, services, and activities under this Agreement and is not an employee, agent or servant of the County. The Architect shall exercise control over the means and manner in which it and its employees perform the work and in all respects the Architect's relationship and the relationship of its employees to the County shall be that of an independent contractor and not as employees or agents of the County. The Architect does not have the power or authority to bind the County in any promise, agreement or representation other than such power and authority that is specifically provided for in this Agreement. 13.1 INSURANCE 13.1.1 The Architect shall obtain insurance as specified and maintain the required insurance at all times that this Agreement is in effect. Professional Liability Insurance shall also be maintained as specified. In the event the completion of the project (to include the work of others) is delayed or suspended as a result of the Architect's failure to purchase or maintain the required insurance, the Architect shall indemnify the County from any and all increased expenses resulting from such delay. 13.1.2 The coverage provided herein shall be provided by an insurer with an A.M. Best Rating of VI or better, that is licensed to do business in the State of Florida and that has an agent for service of process within the State of Florida The insurance certificate shall contain an endorsement providing thirty (30) days notice to the County prior to any cancellation of said coverage. Said coverage shall be written by an insurer acceptable to the County and shall be in a form acceptable to the County. 13.1.3 Architect shall obtain and maintain the following policies: A. Workers' Compensation insurance as required by the State of Florida B. Employers Liability Insurance with limits of $100,000 per Accident, S500,000 Disease, policy limits, $100,000 Disease each employee. C. Comprehensive business automobile and vehicle liability insurance covering claims for injuries to members of the public and/or damages to property of others arising from use of motor vehicles, including onsite and offsite operations, and owned, hired or non -owned vehicles, with One Hundred 10 Thousand Dollars 0100,000.00) combined single limit and One Million Dollars (S1,000,000.00) annual aggregate. D. Commercial general liability covering claims for injuries to members of the public or damage to property of others arising out of any covered act or omission of the Architect or any of its employees, agents or subcontractors or subconsultants, including Premises and/or Operations, Independent Contractors; Broad Form Property Damage and a Contractual Liability Endorsement with Five Hundred Thousand Dollars ($500,000.00) per occurrence and annual aggregate. E. Professional liability insurance of Five Hundred Thousand Dollars ($500,000.00) per claim and One Million Dollars ($1,000,000.00) annual aggregate If the policy is a "claims made' policy, Architect shall maintain coverage or purchase a "tail" to cover claims made after completion of the project to cover the statutory time limits in Chapter 95 of the Florida Statutes. F. County shall be named as an additional insured with respect to Architect's liabilities hereunder in insurance coverage identified in Paragraphs C and D. G. Architect shall require its subconsultants to be adequately insured at least to the limits prescribed above, and to any increased limits of Architect if so required by County during the term of this Agreement; and subconsultants shall be required by contract to provide copies of insurance policies to the Architect. County will not pay for increased limits of insurance for subconsultants. H. Architect shall provide to the County certificates of insurance or a copy of all insurance policies including those naming the County as an additional insured by including any subsection thereunder. The County reserves the right to require a certified copy of such policies upon request. County reserves the right to require copies of insurance policies of subconsultants. 14.1 Either party hereto may terminate this contract prior to expiration upon giving seven (7) days written notice to the other in the event that such other party negligently or for any reason substantially fails to perform its material obligations set forth herein. No termination expenses shall be paid by the Owner after the date of notice of termination. 14.2 The Owner may terminate this Contract without cause by giving the other party sixty (60) days written notice of its intention to do so. Termination expenses shall include expenses available under the contract through the date on the notice of termination and shall not include any additional services required in order to stop performance of 11 services, unless agreed to in writing by the County and subject to audit for the purpose of verification. 15.1 This contract constitutes of the form of agreement, the exhibits that are attached and made a part of the contract, and the documents referred to in the form of agreement as a part of this contraa in the event any conflict between any of those contract documents, the one imposing the greater burden on the Architect will control. 15.2 A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the property to public entity, may not be awarded or perform work as a contrantor, 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 Section 287.017 of the Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. It �1t J[ i N R. 16.1 County and Architect agree that all disputes and disagreements shall fast be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If no resolution can be agreed upon within 30 days after the first meet and confer session, the issue or issues shall be submitted to mediation before a mediator mutually agreed to by the parties. The cost of mediation shall be shared equally. The parties agree that mediation is a condition precedent to the institution of legal or equitable proceedings by either party. Request for mediation shall be in writing and sent to the other party. The parties shall agree on a mediator to hear the dispute. 16.2 Mediation shall be held in Monroe County Florida in a location in Key West; the location may be moved only by mutual agreement of the parties. 16.3 Agreements reached in mediation shall be reduced to writing and signed by the representative of each party; however, agreements must be approved by the Board of County Commissioners to be enforceable. Agreements reached in mediation shall be enforceable as settlement agreements in any court having jurisdiction in Monroe County. 16.4 Nothing in this Agreement shall be construed to interfere with a subsequent order from any court of competent jurisdiction ordering the parties to enter into mediation after institution of legal or equitable proceedings. 12 16.5 Arbitration is specifically rejected by the parties as a method of settling disputes which arise under this agreement; neither of the parries shall be compelled by the other to arbitrate a dispute which may arise under this Agreement. 17.1 The following items are part of this contract: a) Architect shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the Agreement and for four years following the termination of this Agreement. If an auditor employed by the County or Clerk determines that monies paid to Architect pursuant to this Agreement were spent for purposes not authorized by this Agreement, the Architect shall repay the monies together with interest calculated pursuant to F.S. Sec. 55.03, running from the date the monies were paid to County. b) Governing Law, Venue, Interpretation, Costs, and Fees: This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to contracts made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the County and Architect agree that venue will lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida The Parties waive their rights to a trial by jury. The County and Architect agree that, in the event of conflicting interpretations of the terms or a tern of this Agreement by or between any of than the issue shall be submitted to mediation prior to the institution of any other administrative or legal proceeding, pursuant to Section XVI of this agreement. c) Severability. If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terns, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent pernutted by law unless the enforcement of the remaining terns, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The County and Architect agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. d) Attorney's Fees and Costs. The County and Architect agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party 13 shall be entitled to reasonable attorney's fees and court costs expenses, as an award against the non -prevailing party, and shall include attorney's fees and courts costs expenses in appellate proceedings. e) Binding Effect. The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the County and Architect and their respective legal representatives, successors, and assigns. t) Authority. Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law. Each party agrees that it has had ample opportunity to submit this Contract to legal counsel of its choice and enters into this agreement freely, voluntarily and with advise of counsel. g) Claims for Federal or State Aid. Architect and County agree that each shaU be, and is, empowered to apply for, seek, and obtain federal and state fiords to further the purpose of this Agreement; provided that all applications, requests, grant proposals, and fiinding solicitations shall be approved by each party prior to submission. h) Adjudication of Disputes or Disagreements. County and Architect agree that all disputes and disagreements shall be attempted to be resolved under Section XVI of this agreement. If no resolution can be agreed upon within 30 days after mediation, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida law. i) Cooperation. In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, County and Architect agree to participate; to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. County and Architect specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. j) Nondiscrimination. Architect and County agree that there will be no discrimination against any person, and it is expmsly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. Architect or County agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101-6107) which prohibits discrimination on the basis of 14 age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91- 616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patent records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s. 1201 Note), as maybe amended from time to time, relating to nondiscrimination on the basis of disability, 10) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. k) Covenant of No Interest. Architect and County covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and that only interest of each is to perform and receive benefits as, recited in this Agreement. 1) Code of Ethics. County agrees that officers and employees of the County recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, and the Monroe County Code of Ordinances, regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. m) No Solicitation/Payment. The Architect and County warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, the Architect agrees that the County shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the Rill amount of such fM commission, percentage, gift, or consideration. n) Public Access. The Architect and County shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the Architect and County in conjunction with this Agreement; and the Architect shall have the right to unilaterally cancel this Agreement upon violation of this provision by County. o) Non -Waiver of Immunity. Notwithstanding the provisions of Sec. 286.28, Florida Statutes, the participation of the Archited and the County in this Agreement and 15 the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract entered into by the County be required to contain any provision for waiver. . p) Privileges and Immunities. All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the County, when performing their respective functions under this Agreement within the territorial limits of the County shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the County. q) Legal Obligations and Responsibilities: Non -Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the County, except to the extent permitted by the Florida constitution, state statute, and case law. r) Non -Reliance by Non -Parties. No person or entity shall be entitled to rely upon the terns, or any of them, of this Agreement to enforce or attempt to enforce any third -party claim or entitlement to or benefit of any service or program contemplated hereunder, and the Architect and the County agree that neither the Architect nor the County or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. s) Attestations. Architect agrees to execute such documents as the County may reasonably require including a Public Entity Crime Statement, an Ethics Statement, and a Drug -Free Workplace Statement. t) No Personal Liability. No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. u) Americans with Disabilities Act of 1990 (ADA). The Architect will comply with all the requirements as imposed by the ADA, the regulations of the Federal government issued thereunder, and the assurance by the Architect pursuant thereto. 16 v) Disadvantaged Business Enterprise (DBE) Policy And Obligation. It is the policy of the County that DBE's, as defined in C.F.R. Part 26, as amended, shall have the opportunity to participate in the performance of contracts financed in whole or in part with County funds under this Agreement. The DBE requirements of applicable federal and state taws and regulations apply to this Agreement. The County and its Architect agree to ensure that DBE's have the opportunity to participate in the performance of the Agreement. In this regard, all recipients and contractors shall take all necessary and reasonable steps in accordance with applicable federal and state laws and regulations to ensure that DBE's have the opportunity to compete and perform contracts. The County and the Architect and subcontractors shall not discriminate on the basis of race, color, national origin or sex in the award and performance of contracts, entered pursuant to this Agreement. w) Execution in Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by singing any such counterpart. x) Section Headings. Section headings have been inserted in this Agreement as a matter of convenience of reference only, and it is agreed that such section headings anno a part of this Agreement and will not be used in the interpretation of any provision SS WHEREOF, each party caused this Agreement to be executed by its duly i l u rppresentative on the day and year first above written. BOARD OF COUNTY CO ISSIONERS -� rn o "*1 L. KO GE. Clerk - OF MONRqz COUN R A Bar. rn evayor/okirnme ;'PNA COUNTYATTORNZEY C�%�;w C:) APPROVED AS TO FO�tM: Date: MAR 17 2010 ' = m `� u : =may NATILEENE W. CAS, c ASSISTANT COUNTY ATTORNEY (INSERT N of Architect) -� N By: Print Name of 5orporajp Agent Date: 7/ W1TNJWVS T Architect' By: fttllrt� 1 ESS Sigpa5are Print WitnessName mom An Date: JLI F 09 M END OF AGREEMENT 17 SECTION FIVE INSURANCE REQUIREMENTS AND INDEMNIFICATION STATEMENT Workers' Compensation Employer's Liability General Liability Vehicle Liability Architects Errors and Omissions Liability Statutory Limits $100,000/$500,000/$100,000 $ 00,000 Combined Single Limit $100,000 Combined Single Limit per Occurrence/$1,000,000 Aggregate $500,000 per occurrence/ $1,000,000 Aggregate R-PiggIelf 0). mul 11. • Pi... Fil az 1 s : s 0. :wM_ ' :. 0l0 :..9I The ArehitecdConsultant covenants and agrees to indemnify, hold harmless and defend Monroe County, its commissioners, officers, employees, agents and servants from any and all claims for bodily injury, including death, personal injury, and property damage, including property owned by Monroe County, and any other losses, damages, and expenses of any kind, including attorney's fees, court costs and expenses, which arise out of, in connection with, or by reason of services provided by the Architect or Consultant or any of its Subcontractor(s) in any tier, occasioned by the negligence, errors, or other wrongful act or omission of the Architect/Consultant, including its Subcontractor(s) in any tier, their officers, employees, servants or agents. In the event that the completion of the project (to include the work of others) is delayed or suspended as a result of the Architect/Consuitant's failure to purchase or maintain the required insurance, the Architect/Consultant shall indemnify the County from any and all increased expenses resulting from such delay. Should any claims be asserted against the COUNTY by virtue of any deficiency or ambiguity in the plans and specifications provided by the Architect/Consultant, the Architect/Consultant agrees and warrants that Architect/Consultant shall hold the County harmless and shall indemnify it fiom all losses occurring thereby and shall further defend any claim or action on the County's behalf The first ten dollars (S 10.00) of remuneration paid to the Architect/Consultant is consideration for the indemnification provided for above. is The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. This indemnification shall survive the expiration or earlier termination of the Agreement RESPONDENT'S STATEMENT I understand the insurance that will be mandatory if awarded the'contract and will comply in full with all the requirements. J�Jlzzlvm �21 Avi Respondent Signature 19 l have reviewed the above requh anents with the Architect named below. ?be following dedctctibles appir to the cortesp mding policy. POLICY v-J 0 C le- (am p & I ccle— i(-e, DEDUCTIBLES V CQ Liabilitypolicim ace --Z/ Occu<renaeCW" Made Acld,zs�-- Insurance Agency signature 1 Print Name: C i��ti1 I The Fullers Ins. 1432 Kennedy Dr. Key West, FL 33040 20 SECTION SIX COUNTY RESPONSE FORMS RESPOND TO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS c% PURCHASING DEPARTMENT GATO BUILDING, ROOM 1-213 1100 SIMONTON STREET KEY WEST, FLORIDA 33040 I acknowledge receipt of Addenda No.(s) I have included: o no Response Form V V. / o Lobbying and Conflict of Int Clause v o Non -Collusion Affidavit o Drug Free Workplace Form :�Z ✓ o Respondent's Insurance and Inden ification Statement o Insurance Agent's Statement o Professional and Occupational Licenses_Ae—/ I have included a current copy of the following professional and occupational licenses: G lCUi-IK&Y (Check mark items above ,. as a rendnnder that they are included.) Mailing Address: 6/ S&M %0 -5 • Telephone:.3 Date: O Signed: f _ ., ._, _ Witness 421m- G✓/L L/,/1�h A!h/C� (seal} (Name) fi/L/NGJi6,7ifL (Title) 21 rrAWN bsAcir-MM LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO.010-19" MONROE COUNTY, FLORIDA ETHICS CLAUSE (Company) '004. " "... warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision the County may, in its discretion, terminate this Agreement without liability and may also, in its d' etion, deduct from the Agreement or purchase price, or otherwise recover, the amount of any fee, commission, percentage, gift, or consideration paid to t former County officer or employee". , (Sigiature) Date. 8 d STATE OF: rUR i DO COUNTY OF: / CIN!? CIF — Subscribed and sworn to (or affirmed) before me on A)! g jzo (date) by l/yi -/1i A /M Y ' nOaQ� personally known to me or has produced as identification. (type of AWtt NM "fty Po t - a" of Fla* *C*%wt ,0"njW t. A" ._ ca�NM • o01p1a 22 (name of affiant). She is My commission expires: DRUG -FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: (Name of Business) 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance Is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse In the workplace, the business's policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged In providing the commodities or contractual services that are under bid a copy of the statement specified In subsection (1). 4. in the statement specified In subsection (1), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nob contenders to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring In the workplace no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such Is available in the employee's community, or any employee who is so convicted. 8. Make a good faith effort to continue to maintain a dreg-fte workplace through Implementation of this section. As the person authorized to signp% statement I certify that this firm compiles fully with the above requirements. /' Respondent's Signature 23 NON -COLLUSION AFFIDAVIT I, GV/L��Oo01 9 � of the city of ak &6 i/ L according to law on my oath, and under penalty of perjury, depose and say that: 1. I am &AAL/wel L. of the firm of ��UAtb Ps IYaKA-1 ArzG,�O' the bidder making the Proposal for the project described in the Request for Qualifications for. DTI S Awol y and that I executed the said proposal with full authority to do so: 2. the prices in this bid have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor, 3. unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid opening, directly or indirectly, to any other bidder or to any competitor, and 4. no attempt has been made or will be made by the bidder to induce any other person, partnership or corpo tion to submit, or not to submit, a bid for the purpose of restricting eorr 'on; S. the statements contained i 's affidavit are true and correct, and made with full knowledge that M County relies upon the truth of the statements contained in this vit in awarding contracts for said project. Q D ( gnature of Respondent) (Date) STATE OF: 1%U�10,4 COUNTY OF: % V 041P a F PERSONALLY APPEARED BEFORE ME, the undersigned authority, _ i���19rt who, after first being sworn by me, (name of individual signing) affixed hi er signature in the space provided above on this ay of 0.L�• NOTARY PUBLIC My Commission Expires: AWIANOW NORM' � • �Mlr d t� �a 24 Ar co W r 0 Jamul L16 e r4 cc 0 A 3 W a a o 0 •N O H M 4 a1 e+f (� 1 Fri 5 o m j��co Q. 464) L--+ wUP U h� rn 2 elf y h n ao final co, • A � n O's ale r4maM .. � Sid 02 .4 > 1 �uuaou �o O �y 3 0 0 M i h.- cis � I 11 MEN ROUTING 0"k le I��I�O �" ' •:: N t �1 � — �N�t-t-- CY7Cic14c�.i'i,Qlt7t'_' 7AA WILLIAM R HORN ARCHITECT, P.A. Licens 915 EATON STREET. KEY WEST. FLORIDA 33040 PHONE:303-29h-Y302 FAX:30i-29h-1033 Date: 2/8/10 To: Jerry A. Barnett Director of Project Management Monroe County, Florida Re: Architectural Fee Proposal Higgs Beach Master Plan Key West, Florida Dear Mr. Barnett, This letter is to propose cost estimates for the work needed to be completed to create a master plan for the Higgs Beach Site. Work will be in two phases. Phase one will include the design and drawing of the master plan and all of the public meetings that are required to obtain input from the public, City of Key West and the County Commissioners. Phase two, if needed, will include all of the required work in order to obtain City of Key West Planning Board and City Commission approvals, including a development agreement. Phase one work will include obtaining a new survey of the site, creating an existing site plan with analysis of all existing conditions, including site and zoning analysis, 'existing building condition analysis and existing landscape and tree analysis. We will provide proposed site plan design options for review by all and finalize the options to create a master site plan with cost estimates for the new work. Meetings will include three public meetings in Key West, one meeting with the Higgs Beach Steering Committee, one public meeting with the City of Key West Commission, meeting with the City of Key West planner, two meetings with the Monroe County Commission and meetings with county staff as required We will finalize the whole process in a bound report. Costs for phase one is as follows: Master Site Plan Fee = $45,000.00 Surveyor Fee= $10,500.00 Phase two work, if needed, will include developing the master site plan to include all of the required items to go through the Planning Board approval process of the City of Key West and preparing a development agreement. Work will include filling out all of the applications and requirements, developing the site plan, landscape plan, civil drainage plan, lighting plan and coordination with all agencies. Work will also include designing and drawing plans and elevations of any building improvements or new buildings that are desired (includes a total of four buildings maximum). Meetings will include coordination meetings with the county staff and City of Key West staf& DRC meeting, Tree Commission meeting, Planning Board meeting and City Commission meeting. Costs for phase two is as follows: Fee— $76,500.00 Any additional work can be completed at a fixed fee (to be determined), or at our standard hourly rates as listed in the annual contract. Please call if u have any questions. We are looking forward to working with you on t,�s project. P. BORN ARCHITECT, P.A. William P. Horn, Principal, LEED AP OP ID: NF ACURDr CERTIFICATE 4F LIABILITY INSURANCE DATE (M►1ro�YYY) 11/15/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ins) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement A statement on this Certificate does not confer rights to the certificate holder in lieu of such endomeme s . PRODUCER 305-294-6677 The Fullers, Inc 305-292-4641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller NTACT NAME: PHONE Ed): ADD PRODUCER H0RPIW-1 INSURER(S) AFFORDING COVERAGE NAIC t INSURED William P Horn Architect PA INSURER A :First Community Insurance Co. 13990 Bill Horn 915 Eaton St Key West, FL 33M INSURERS: INSURERc; INSURER D INSURER E ; INSURER F; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LjIt TYPE OF INSURANCE POLICY NUMaER129%LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X Business Owners X 090004962995806 09/21/10 09/21/11 EACH OCCURRENCE S 1,000,00 DAMAGETO RENTED P = 60,00 MED EXP (Any are person) $ 5,00 PERSONAL d ADV INJURY S GENERAL AGGREGATE $ 2,000,00 GEW AGGREGATE LIMIT APPLIES PER X POLICY 7 PRO LOC PRODUCTS - COMP/OP AGG $ CSL S 1,000,00 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON4"ED AUTOS "19,1_1 .r _ COMBINED SINGLE LIMIT (Ea acddW) $ BODILY INJURY (Per Arson) $ BODILY INJURY (Per woklent) S PROPERTY DAMAGE (Pdlr ) _ $ r_1 _ UMBRELLA LIAe EXCESS LIAR CLAIMS -MADE ___T77 I ti s EACH OCCURRENCE S HOCCUR AGGREGATE S DEDUCTIBLE RETENTION S S WORKERS COMPENDATION AND EMPLOYERS LIABILITY IN ANY PROPRIETORIPARTNERIEXECUTIVE Y OFFICEMMEMBER EXCLUDE07 (Mende" in NH) II deso � under DESCRIPTION OF OP RATION be N / A WO STATU• OTH- E.L. EACH ACCIDENT $ E.L. DISEASE . EA EMPLOYE S EL DISEASE -POLICY LIMIT S PROPERTY DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attsdi ACORD 101, Additional Remarks Schedule, K more apace Is required) Certificate holder is an additional insured. MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY ty ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street Rm 268 AUTHORIZED REPRESENT Key West, FL 33040 Norman Fuller ©1988 2 CORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered maft of ACORD OP ID: NF A RD� CERTIFICATE OF LIABILITY INSURANCE UAT111115D/YYYY) 1/15/10 THIS CJFRTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s . PRODUCER PRODUCER 305-294-6677 The Fullers, Inc 305-292-4641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller -CONTACT- FAX PHONE Ax No: PRODU -H0RNWI1 INSU S AFFORDING COVERAGE NAIL INSURED William Horn 151 Key Haven Rd. Key West, FL 33"0 INSURERA:Pro rOSSive INSUIWA10: wsuaEa.c INSURER D : INSURER E : INSURER F t COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE NUMBER MINDDIYYYY) IMMIDDrrrYY1 LIMA -01LPOLICY GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 17 OCCUR EACH OCCURRENCE $ DAMAGE s owxre e $ MED EXP one ) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEML AGGREGATE LIMIT APPLIES PER: POLICY PRO- L0C PRODUCTS - COMP/OP AGG S S A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS x 02158316-7 05/29/10 ` O5/29111 COMBINED SINGLE LIMB (Es amKWd)BODILY i 1,000,00 INJURY (Per person) 3 BODILY M7JURY (Per eccideaq S X X PROPERTY DAMAGE (Per) $ X S s UMBRELLA LIARHCLAIMS-MADE E56 EXCLWB OCCUR EACH OCCURRENCE $ AGGREGATE i DEDUCTIBLE RETENTION IIIt i WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) M dssaibs under IPT ON OF PERATI below NIA - - N/C SCRYTATUTS1- OTH- ER E.L.EACH ACCIDENT S --- E.L DISEASE -FA EMPLQYE i E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (A�ttach ACORD 101, Additional Ranuwks Schadule, Ifnn more specs Is gWd) 2007 Chevrolet Tahoe C1501GNFC13027R283917. Certificate holder Is an additional insured. MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILT. BE DELIVERED IN ty ty ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street Rm 268 AUTHORIZED REPRESENTA Key West, FL 33040 Norman Fuller 01988- A ORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks Of A ORD nu....aa. acme unmmnAm 4 ACORD CERTIFICATE OF LIABILITY INSURANCE 8/20 O'"�` PRODUCae THIS CERTIFICATE IS f3SUED AS A MATTER OF INFORMATION ISU Suncoast Insurance Assoc P.O. Box 22668 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33622,2668 813 289-SM INSURERS AFFORDING COVERAGE NAIC S WHIM P. HOM, Architect, PA 915 Eaton Stree7 � W�� Key ••Day FL 33 0 A, Beazley insurance Company,Inc. 37540 INSURER a NNSLRtER a INSURER D: INSURER E: fr =F-TrrT3a THE POLICIES OF INSURANCE LISTED BELaW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY RECILRRU&NT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INIStRiANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF M>111AtANCE POLR'7 MAIB6t POUCYEFFECTME Lows GENERAL LIABILITY EACH OCCURRENCE $ RENTEDDAMAGE TO 1791 $ OOMMR 2CIAL GENERAL UABNlTY CLAM MADE ❑ OCCUR MED EXP VM or* person) $ PERSONAL A ADV INJURY s GENERALAGGREGATE $ GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS_- CO►IPIOP AGG ► POLICY ED PR(>- LAC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea OD -Wit) t BADLY BN.AIRY (P-P"-) _ ALL OAINED AUTOS SCHEDULED AUTOS BODILY MJURY (P- ) _ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per emidem) : GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ OTHERTHM EA ACC $ ANY AUTO $ AUTO ONLY: AGG EICE SSAAASHE.LA LUBLITY EACH OCCURRENCE $ OCCUR ❑ C LAM MADE AGGREGATE f _ s S oEDucneLE $ R rENTION $ WORKERS C01143 ATIDN AHD WC STATLL OTH- EACH ACCIDENT .. S famovow LJAeBM ANY PROPRlETORIPAR NERAD(ECUTNE E.L. DISEASE - EA EAMADYFE $ OFFICERIMEMOM EXCLUDED? U descr�e F-L DISEASE - POLICY LAST S A OTHER Prsofessiona[ VISV8010030i 0=0l10 0=0111 $1,000.000 per claim Liability $1,000,000 anni aggr. DESWUPTION OF OPERATIONS, LDCATIOW I V6BCLM I EXCLUSK M8 ADDED BY E DORSBMfT I SPECIAL PRD M"M Professlonal LlabMty Is clah. 9 made and reported. Project: Conch Kay, Big Pine & North Key Largo Fire Statlons Annual Contract for Architectmi Services Monroe county Board of county Commissioners Attn: Risk Mattnagernent 1100 Simonton Key West, FL 33040 LD ANY OF THE ABOVE DEGGMSED POLE BE CANCELLED SWORE TM EXPIRATION THratEm. THE mama miBuRER wILL E DEAvOR TO MAN. 3(jDAME vrwrrEN N=TD TIM CMWICATE HOL!" NAWM TO THE LEFT. BUT FAIWRE TO DO SO SHALL N£ NO EN JOATION OR LIAIMMY OF ANY KW UPON TM MBURBL, ITS AOBNTS OR ACORD 25 MM108)1 of 2 #S266185/M286181 KEB a ACORD CORPORATION 1968 �..�•r� OP ID: NF CERTIFICATE OF LIABILI INSURANCE °" 11n�°;0 ' THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT- If the car ilicate holder Is an ADDITIONAL INSURED, the po(ici►(les) must be endorsed. N SUBROGATION IS WAIVED, subject to the bans and condidons of the policy, certain Policies may require an wKlorasment. A sbd mw4 on eft certificate does not confer rights to the ceMflcats holder in lieu of such /ndorsement(s). PRODUCER 305-294-6677 r The Fullers, hx 306-292-4"1 F wo 1432 Kennedy Drive Key West, FL 33040 HORNW-1 Norman Fuller ..... - INSURED William P Rom Architect PA u+suitmA jechooloo Insurance Company Bill mom DISU Aa: 915 Eaton St. MOUNERC.- Key West, FL 33040 eb: IIIKIRER : nMKe AG! KQ'flRlf_ATGYII�i".I?' REVISION NLWBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED_ NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCHES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ow TYPE OF INSURANCE um In POJJ1CY NUMBER LYNAM GENERAL UAIN lTY COMMERCIAL GENERAL UABI.(IY CLAMSSMADE ❑ OCCUR EACH OCCURRENCE f amrMf a f� MED EXP wo S PERSONAL 8 ADV INJURY f GENERAL AGGREGATE s GENLAGGREGATE LIMIT APPLIES PER POLICY PRO. LAC PRODUCTS'COMPIOPAGO s i AUTONOSI.E L L49KI Y ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIED AUTOS) NON.owrIEDAuros COM OMED SINGLE UWT (Ea as dot) $ BODILY NAM (I* Pwxw) $ BODILY INJURY (Par aoddsrr) S PROPERTY DAMAfdL i s IMIB� LA LUAB EXCEU UAS OCCUR C EACH OCCURRENCE _ f AGGMEGATE s DEDUCTMLERETENTION S f s A COfPENSAIWN AM EMPLOYM W LIABILITY ANY PROPRIETOWARTNE�%EGUTTVE Y 1 M OFFH;eR MEMBER EXQAV� Y Iy�y M MN) � OPERATIONS NIA 184M � p� 01101N 1 STATIF X OTH EL EACH ACCIDENT $ 1,000, E.L. DISEASE - EA EfNPt f 1,000, E.L. DISEASE - POLICY umrr s 1,0w. _j 1H I; DESCRIPTION OF OPERAIIONS I LOCA7 0NS / YEFiCI[S IAash ACORD MBM, AddWm RaauM 8elnd�/a. N nwra apse b ram MONRCON SHOULD ANY OF THE ABOVE DESCRIED POLICIES BE CANCELLED NVORE THE b(PIPATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe Cotmty Board of County ACCORDANCE WMTH THE POLICY PROVISIONS. Commkokwwm 1100 Simonton Street Rm 268 AUTHOF iao REPREIIENTA Key West, FL 33040 Norntsh Fuller a 1N8- C TION. All rights reserved. ACORD 25 (20OW09) The ACORD name and logo are regWkwed mart EXHIBIT A Hourly Rates Monroe cf�Ujty 07 WILLIAM P. HORN ARCHITECT, RA"S�fAE:END W. 'Ena"1.'AA 0003040 V13 EATON STREET. KEY WEST. FLORIDA 33040 PHONE:305-296.8302 FAX:303-196.1033 Date: 11/20/09 To: Jerry Barnett Faeititda Development Coordinator Monroe County Res Hourly Rates Annual Contract Dear Mr. Barnett, Our 9tarxlard homey rates are as follows: P6Wpal Architect $195.00/hr '`chime $130.00/hr Intern Architect $100.00/hr Din $85.00/1,r SOuchual Engineer $1 S0.0&hr MEP En $123.00/hr Principal Civil En $150.00/hr Senior Civil & $120.0&br Civil Engineer $100.00/hr Planner $150.00/hr Please call if you have any questions, We am looking forward to working With you. , Sincerely P. HORN ARCHITECT, P.A. William P. Horn, Principal BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: Administration Bulk Item: Yes X No _ Department: Project Management Staff Contact Person/Phone #: Jegy Barnett X4416 AGENDA ITEM WORDING: Approval of Modification #4 to the State Funded Subgrant Agreement for the Design and Construction of the proposed Emergency Operations Center in Marathon. ITEM BACKGROUND: FEMA has now awarded (through the Florida Dept. of Emergency Management) and funded the Phase 2 (construction) Hazard Mitigation Grant for a new County Emergency Operations Center. To date, the total of state and federal funding to Monroe County is $1,099,513. Design of a new EOC in Marathon has been completed by Architects Design Group, Inc. Modification #4 provides partial funding for construction of those items of hardening of the facility above basic Florida Building codes. Additional funding will be required to initiate construction. Execution of this modification does not obligate the County to proceed but merely encumbers already promised FEMA money through August 18, 2011. After BOCC acceptance of this modification, we plan to request an extension of the performance time to correspond with the State grant's expiration date of June 2013 while we continue to seek other sources to fund the project*Monroe County's match to Modification #4 is 25%, or $571,435 which will be covered, when needed, by providing the land for the facility and in -kind services. PREVIOUS RELEVANT BOCC ACTION: On June 20, 2007, the BOCC approved to execute a Division of Emergency Management (DEM) State Funded Subgrant Agreement toward design and construction of a new County Emergency Management Operations Center (EOC) in Marathon. On January 16, 2008, the BOCC approved Modification #1 adding Federal (Hazard Mitigation Phase 1) funding to the Subgrant Agreement. On May 20, 2009, the BOCC approved Modification #2 extending the expiration date for federal funding from May 8, 2009 to December 7, 2009 and state funding from June 30, 2009 to June 30 2010, and on June 16, 2010 the BOCC approved Modification #3 extending the State Funding to June 30,2013. CONTRACT/AGREEMENT CHANGES: Additional Federal funding in the amount of $106,355 for the Design of the EOC, and $1,640,015 for Construction. Attachments A, B, and J are replaced with Revised Attachments A, B, and J. STAFF RECOMMENDATIONS: Approval as stated above. TOTAL COST: $2,285,742 INDIRECT COST: BUDGETED: Yes X No DIFFERENTIAL OF LOCAL PREFERENCE: N/A V -1--tj (/_(rd T>-- COST TO COUNTY: $571,435 SOURCE OF FUNDS: REVENUE PRODUCING: Yes X t OU T PER MONTH N/A Year APPROVED BY: County Atty B/P c asing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 7/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: State of Florida DEM Contract # 08-EC-30-11-54-01-039 Effective Date: 11/17/10 Expiration Date: 08/18/11 Contract Purpose/Description: Modification #4 to the State Funded Sub ant Agreement for the Design & Construction of a new EOC adding additional funding from FEMA Contract Manager: Ann Riger X4439 Facilities Devel/Sto #1 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 12/15/10 Agenda Deadline: 11/30/10 Total Dollar Value of Contract Budgeted? Yes® No ❑ Grant: $ 2,285,742 County Match: $ 571,435 CONTRACT COSTS $ 2,285,742 Current Year Portion: $ Unknown Account Codes: 26000-510310-560620-CP9902- ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. maintenance, Division Director Risk Manag ent 0.1VI.B./Purc asThg County Attorney Comments: CONTRACT REVIEW Changes Da4Nees Yesd Revi erdC Yes[E] t. \� �vl� Ll� (� Yes❑ No� r Yes❑ Yes❑ OMB Form Revised 2/27/01 MCP #2 etc. Date Out WA Contract Number: 08-EC-30-11-54-01-039 MODIFICATION # 4 TO SUBGRANT AGREEMENT This Modification is made and entered into by and between the State of Florida, Division of Emergency Management, ("the Division"), and Monroe County ("the Recipient") to modify the Division's Contract Number 08-EC-30-11-54-01-039, dated August 27, 2007 ("the Agreement"). WHEREAS, the Division and the Recipient have entered into the Agreement, pursuant to which the Division provided a sub -grant of $1,099,513, of this amount $1,029,547 in state funds and $69,966 in federal funds for Phase I; and WHEREAS, the Division now intends to provide additional funds to the Recipient of $106,355 in federal funds for Phase I; and WHEREAS, the Division now intends to provide additional funds to the Recipient of $1,640,015 in federal funds for Phase II, Construction; and WHEREAS, the state funds of $1,029,547 must be expended on or before June 30, 2013, and the additional federal funds of $1,746,370 must be expended on or before August 18, 2011; and WHEREAS, the Division and the Recipient desire to modify the Agreement by amending the Scope of Work, the Budget and by adding the appropriate federal attachments. NOW, THEREFORE, in consideration of the mutual promises of the parties contained herein, the parties agree as follows: 1. Paragraph 17 of the Agreement is hereby amended to increase the total funding under the Agreement to $2,845,883. 3. The Budget and Scope of Work, Attachment A, to this Agreement, is hereby deleted in its entirety, and the Budget and Scope of Work, Revised Attachment A -State and Revised Attachment A -Federal, to this Modification, which are attached hereto and incorporated herein by reference, are substituted in its place and stead. The revised Budget and Scope of Work, Attachment A -Federal, contains the additional provisions that apply to the added federal funding. 4. Attachment B of this Agreement is hereby deleted in its entirety, and the Revised Attachment B, Program Statutes and Regulations, which are attached hereto and incorporated herein by reference, are substituted in its place and stead. The Revised Attachment B Program Statutes and Regulations, contains the additional provisions that apply to the added federal funding. 5. Attachment J of this Agreement is hereby deleted in its entirety, and the Revised Attachment J, Statement of Assurances, which are attached hereto and incorporated herein by reference, are substituted in its place and stead. The Revised Attachment J, Statement of Assurances, contains the additional provisions that apply to the added federal funding. 6. All provisions not in conflict with this Modification remain in full force and effect, and are to be performed at the level specified in the Agreement. 7. All provisions of the Agreement being modified and any attachments thereto in conflict with this Modification shall be and are hereby changed to conform with this Modification, effective as of the date of the last execution of this Modification by both parties. IN WITNESS WHEREOF, the parties hereto have executed this document on the dates set out em-rs. RECIPIENT: MONROE COUNTY BY: NAME & TITLE: DATE: STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT BY: David Halstead, Director DATE: -V 2 Revised Attachment A State Budget and Scope of Work SCOPE OF WORK A. The Recipient shall construct a County Emergency Operations Center (EOC). Use of grant funds shall be consistent with Section 1(1), Ch. 2006-71, Laws of Florida. Grant funds shall not be used for land acquisition; purchase of equipment, furnishings, communications, or operational systems; or recurring expenditures. Eligible reimbursement costs include: Architectural and Engineering services and fees; site survey and soil testing; necessary permits and fees; civil and service utilities site work; construction of the building's substructure, superstructure, shell (exterior enclosure) and interior construction; special inspections; mechanical, plumbing, electrical, conveying and security systems; lightning protection; and redundant infrastructure systems (e.g., electric generator, uninterruptible power supply, potable water and wastewater systems, etc.). B. The Recipient shall in a timely manner prepare and submit a complete Hazard Mitigation Grant Program (HMGP) application, benefit -cost analysis, environmental review and such other documentation as necessary to determine eligibility and allowable costs under said grant program. C. The Recipient shall state in writing that for a period of not less than 15 years from the date of receipt of Certificate of Occupancy the EOC will be dedicated for emergency management purposes. The EOC shall remain demonstrably capable of being fully activated within one (1) hour of detection of an emergency; reference Rule Chapter 9G-6, Florida Administrative Code, "Emergency Management Capabilities Assessment Checklist." D. The EOC shall be constructed with sufficient space to house people and equipment for day-to- day and sustained continuous emergency operations, and capable of full staffing for the most extensive emergency anticipated. At a minimum, the designated EOC functional area(s), and essential shared -use area(s) if applicable, shall be designed for an emergency operations staff size of 62 persons per shift and a workspace floor area of 5,270 gross square feet. E. At a minimum, the EOC shall meet the hurricane hazard safety criteria established in Standards for Hurricane Evacuation Shelter Selection (ARC 4496). F. The EOC and essential ancillary structures and service equipment shall be designed to resist the effects of a major hurricane. The wind load design requirements shall be in accordance with the American Society of Civil Engineers (ASCE) Standard 7, Minimum Design Loads for Buildings and Other Structures. The minimum wind design criteria shall include: Design Wind Speed = 225 miles per hour (3 second gust) Wind Importance Factor, / = 1.00 Exposure Category = C Directionality Factor, Kd = 1.00 Internal Pressure Coefficient, GCpi = +/- 0.18 All components and cladding assemblies necessary to maintain a structurally enclosed condition and prevent rainwater intrusion shall be designed to meet the wind design criteria. Structural metal decking and cladding materials shall be 22 gauge or thicker. Roof cover waterproofing barriers shall meet the wind design criteria. Loose roof ballast shall not be used on the roof cover. Rooftop equipment shall be designed and installed to meet the wind design criteria. G. The EOC and essential ancillary structures and service equipment shall resist penetration by windborne debris impact. At a minimum, all exterior enclosure components, claddings and assemblies (i.e., walls, roofs, louvers, windows, doors, etc.) located within 60 feet in height above finish grade shall meet the hurricane windborne debris impact criteria specified in the Department of Energy's (DOE) Standard, Natural Phenomena Hazards Design and Evaluation Criteria, DOE-STD-1020-2002. That is, the building enclosure must resist penetration by a nominal 2"x4" lumber plank weighing 15 pounds propelled at 50 miles per hour (74 feet per second) striking end -on and normal to the assembly surface, or equivalent performance as approved by the Division. As applicable, impact test procedures shall be consistent with recognized state and national standards; such as, Test Standard for Determining Impact Resistance from Windborne Debris SSTD 12, American Society of Testing and Materials (ASTM) Standards ASTM E 1886 and ASTM E 1996, and Florida Building Code Testing Protocols TAS 201, TAS 202 and TAS 203. The impact test procedures may be modified as necessary to accommodate the required missile weight and velocity. H. The following information related to wind loads and flooding shall be shown on the construction drawings: 1. wind design per ASCE 7 with applicable year of revision; 2. design wind speed; 3. wind importance factor, l; 4. design wind exposure category; 5. wind directionality factor, Kd; 6. design internal pressure coefficient, GCpi; 7. design wind pressures in terms of pounds per square foot (psf) to be used for the design of exterior component and cladding materials not specifically designed by the principal licensed design professional; 8. windborne debris impact performance criteria; 9. finish floor elevation measured relative to the National Geodetic Vertical Datum (NGVD); and comparison reference of the finished floor elevation to the base flood elevation, or historical flood elevation if base flood elevation is not determined. I. The lowest floor for the EOC and essential ancillary structures and service equipment shall at a minimum be elevated above: Category 5 hurricane storm surge elevation plus 20 percent; the base flood elevation plus three (3) feet; the 500-year (0.2 percent annual chance) flood elevation (if determined) plus two (2) feet; the highest recorded flood elevation plus three (3) feet if the area is not in a mapped special flood hazard area; whichever is greater. The site (point maximum, one square mile) hydrologic design shall ensure that the EOC and essential ancillary structures and service equipment are not flooded due to a 24 hour, 37.0 inch rainfall event applied over a precedent 24 hour, 100-year rainfall event. J. Where secondary (emergency) roof drains or scuppers are required by the Florida Building Code —Plumbing, the secondary system shall be sized for a rainfall rate of eleven (11.0) inches per hour. K. The EOC shall be designated as a threshold building, and special structural inspections required. Special inspections shall be conducted in compliance with section 553.79, Florida Statutes and other applicable statutes, laws and rules. L. The EOC shall at a minimum be designed for 72 hours of self-contained continuous operation and shall not be solely reliant upon off -site services and utilities (e.g., water, natural gas fuel, electricity, etc.) M. Force protection and security measures shall be consistent with the guidance published in Florida's Homeland Security Comprehensive Assessment Model (HLSCAM), United States Air Force Installation Force Protection Guide, or other federal or state recognized best -practices guide(s) as approved by the Division. N. The Recipient shall provide an initial timeline and estimated reimbursement allocation schedule. Table SW-1, "Initial Timeline and Estimated Reimbursement Allocation Schedule" or other similar instrument as approved by the Division may be used. 4 0. During design and construction phases of the EOC project, the Recipient shall track and provide construction cost data for the designated EOC area as detailed in Table SW-2, "Cost Data for County Emergency Operations Center." PRODUCT ITEMS A. Per item I.N, Recipient shall prepare an initial timeline with key milestone activities/tasks schedule, including estimated start and end dates for each activity, and an estimate of state reimbursement request for each activity. Table SW-1 may be used to meet this product item. B. Per item I.C, Recipient shall submit a binding written statement that the EOC will be dedicated for a period of not less than15 years for emergency management purposes, and demonstrably capable of being fully activated within one (1) hour of detection of an emergency. C. The Recipient shall provide one (1) copy each of site survey, site master plan, spatial needs assessment, and schematic design plan or preliminary design drawings for review and comment by the Division. The spatial needs assessment and schematic design plan/preliminary design may be consolidated into one document. D. The Recipient shall provide one (1) set of substantially complete (approximately 70 percent) preliminary design construction drawings and specifications for the EOC and essential ancillary structures for review and comment by the Division. The construction drawings shall include site survey information, landscaping, civil, architectural, structural, mechanical, plumbing, and electrical drawings. E. The Recipient shall provide one (1) set of bid -ready construction drawings and specifications for the EOC and essential ancillary structures for review by the Division. The construction drawings shall include site survey information, landscaping, civil, architectural, structural, mechanical, plumbing, and electrical drawings and shall be certified by the applicable registered or licensed design professional(s) of record. F. The construction drawings shall demonstrate that the EOC will meet the hurricane hazard safety criteria of ARC 4496, and the wind load, windborne debris impact, flood and security design requirements set forth in items LE through I.M. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial of funds. G. Per item 1.6, Recipient shall submit a complete HMGP application, benefit -cost analysis, environmental review and such other documentation as necessary to determine eligibility and cost allowances under said grant program. The Recipient shall also provide two cost estimates prepared by one or more certified construction contractors that document the cost of constructing the facility to meet current building code wind and flood design requirements, and the cost premium of constructing the facility to the above -code wind and flood requirements set forth in items LE through I.J. H. Per item 1.0, the Recipient shall provide final project cost data. Table SW-2 shall be used to meet this product item. I. The Recipient shall provide the Division with copy(s) of pertinent construction permits, the threshold inspection final report, and the certificate of occupancy upon completion of the construction project. 5 III. SCHEDULE OF WORK A. By June 30, 2007, the Recipient shall provide the Division with Product Items A and B for review and approval. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial of funds. B. By September 30, 2007 and at least on a quarterly basis thereafter, Recipient shall report on progress in relation to the initial timeline, and submit Product Items C through H in a timely manner as accomplished. The Division shall be provided 30 calendar days to review and provide comments of product items pertaining to compliance with the scope -of -work. The Recipient shall also submit invoices for reimbursement for work accomplished in accordance with the Division approved cost reimbursement allocation schedule referenced in Product Item A. C. By a mutually agreed upon date, the Recipient shall provide the Division with Product Item F for review and approval. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial or reduction of funds at the sole discretion of the Division. D. By May 15, 2013, the Recipient shall provide final project cost estimate data as set forth in Table SW-2, certificate of occupancy, close-out documentation and final payment invoice. ly Table SW-1. Initial Timeline and Estimated Reimbursement Allocation Schedule Table SW-1. Initial Timeline and Estimated Reimbursement Allocation Schedule County Name: Monroe PROJECT PHASE Start Date End Date DEM Funds Other Funds Board Contract Approval Initial Payment of 20% in first quarter A&E Firm Selection Site Survey and Soil Testing Spatial Needs Assessment Preliminary Design, 70% complete Preliminary Design, 100% complete Regulatory Review Bid Document(s) Development & Award Notice to Proceed/Mobilization Construction Project Management & Special Inspections Construction 25% Complete Construction 50% Complete Construction 100% Complete Contingency Administrative Fees; maximum of 5% Sub -Totals $ TOTAL Estimated Project Cost A&E - Architectural and Engineering; DEM — Division of Emergency Management; FY - Fiscal Year Table SW-2. Cost Data for County Emergency Operations Center Table SW-2. Cost Data for County Emergency Operations Center County Name: Monroe NO. System/Component Description Estimated Cost A. SUBSTRUCTURE 1010 Foundation 1020 Slab -on -Grade 2010 Excavation 2020 Basement Walls 2030 Elevated Foundation B. SHELL ENVELOPE B10 Superstructure 1010 Floor Construction 1020 Roof Construction 1030 Structural Frame 1040 Load -Bearing Wall B20 Exterior Enclosure 2010 Exterior Walls 2011 Veneer/Cladding 2012 Louvers 2020 Exterior Windows 2030 Exterior Doors B30 Roofing 3010 Roof Coverings 3020 Roof Openings 3021 Soffits C. INTERIORS 1010 Partitions 1020 Interior Doors 1030 Fittings 2010 Stair Construction 3010 Wall Finishes 3020 Floor Finishes 3030 Ceiling Finishes D. SERVICES D10 Conveying 1010 Elevators & Lifts 1020 Escalators & Walks D20 Plumbing 2010 Plumbing Fixtures 2020 Domestic Water Distribution 2021 Back-up Potable Water System 2040 Rainwater Drainage D30 HVAC 3010 Energy Supply 3020 Heating System 3030 Cooling System 3050 Terminal & Package Units 3090 Other HVAC Sys. D40 Fire Protection 4010 Sprinkler Sys. 4020 Standpipe Sys. 4030 1 Other Sys. D50 Electrical 5010 Elec. Service & Distribution 5020 Lighting & Branch Wiring 5030 Communications & Security 5090 Other Elec. Sys. 5091 Generator Sys. 5092 UPS Sys. E. EQUIPMENT & FURNISHINGS 1010 Commercial Equip. 1020 Institutional Equip. 1030 Vehicular Equip. 1090 Other Equip. 1091 Audio/Video Equip. 1092 Special Telecom 1093 Information Tech. 1094 Geo. Info. Sys. F. SPECIAL CONSTRUCTION 1041 Generator Enclosure 1042 Comm. Tower 1043 Heli ad 1090 Other G. BUILDING SITEWORK 1010 Earthwork 1020 Roadway & Parkin 1030 Drainage & Flood Control 1040 Security Measures 1090 Other Sitework Revised Attachment A - Federal Budget and Scope of Work As a Hazard Mitigation Grant Program project, the Recipient, Monroe County, will provide protection needed for the above code hardening for the new construction of the Monroe County Emergency Operations Center (EOC) located at 10095 Overseas Highway, Marathon, Florida 33050. The entire shell and roof will be hardened beyond code against 225 mph winds and impact resistant windows will be installed. If deemed necessary, wind protection will be provided on any other openings such as skylights, vents, louvers, and exhaust fans. All construction and installations will be done in strict compliance with Florida Building Codes Specifications. All materials will be certified to meet the wind and impact standards of 225 mph wind loads. The local municipal or county building department will inspect and certify construction and installation according to the manufacturer specifications. The structure being mitigated at 10095 Overseas Highway, Marathon, Florida 33050 is located in a Special Flood Hazard Area (SFHA). The Title Holder must adhere to the following restrictions: • The Title holder must insure all structures that will not be demolished or relocated out of the SFHA to an amount at least equal to the project cost or to the maximum limit of coverage made available with respect to the particular property, whichever is less, through the National Flood Insurance Program (NFIP), a s authorized by 42 U.S.C. 4001 et seq., as long as the Title Holder holds title to the property as required by 42 U.S.C. 4012a. • The Title Holder must maintain all structures on the property in accordance with the flood plain management criteria set forth in Title 44 of the Code of Federal Regulations (CFR) Part 60.3 and City/County Ordinance as long as the Title Holder holds title to the property. • The Title Holder must notify subsequent purchasers that SFHA conditions are attached to the property. This will be accomplished by the Title Holder ensuring that the City/County will legally record with the county or appropriate jurisdiction's land records a notice that includes the name of the current Title holder (including book/page reference to record of current title if readily available), a legal description of the property, and a declaration that Federal Law requires flood insurance coverage during the life of the property. This is FEMA project 1609-153-R, funded under 1609-DR-FL. The Period of Performance for this project ends on August 18, 2011. Schedule of Work Construction Phase: 10 Months Total Period of Performance: 10 Months Line Item Budget* Project Cost Federal Share Non -Federal Share Additional Design Costs $ 141,806 $ 106,355 $ 35,451 Construction Materials and Supplies $2,143,936 $1,607,952 $ 535,984 Sub -total: $2,285,742 $1,714,307 $ 571,435 Administrative Cost: $ 0 $ 32,063 Total: $2,285,742 $1,746,370 $ 571,435 * Any line item amount in this Budget may be increased or decreased 10% or less without an amendment to this Agreement being required, so long as the overall amount of the funds obligated under this Agreement is not increased. 10 Fundina Summa Federal Share: $ 1,714,307 (75%) Local Share: $ 571,435 (25%) Total Project Cost: $2,285,742 (100%) Recipient Administrative Allowance up to $32,063 The materials and work funded pursuant to this Subgrant Agreement are intended to decrease the vulnerability of the building to property losses and are specifically not intended to provide for the safety of inhabitants before, during or after a natural man made disaster. The funding provided by the Division of Emergency Management under this subgrant shall compensate for the materials and labor for the installation of storm shutters and/or other hardening activities as a retrofit measure for the Recipient's building to reduce and/or mitigate the damage that might otherwise occur from severe weather or other hazards. The funding of this project by the Department does not confer or imply any warranty of use or suitability for the work performed pursuant to this agreement. The State of Florida disclaims all warranties with regard to this mitigation project, express or implied, including but not limited to, any implied warranties and/or conditions of satisfactory quality and fitness for a particular purpose, merchantability, or merchantable quality. This project has not been evaluated by the criteria contained in the standards of the Department of Homeland Security, Federal Emergency Management Agency (FEMA) guidance manual FEMA 361- Design and Construction for Community Shelter, and thus does not provide "near absolute protection." It is understood and agreed by the Department and the Recipient that the building may have vulnerabilities due to age, design and location which may result in damage to the building from wind events even after the installation of the mitigation measures funded under this Subgrant Agreement. It is further understood and agreed by the Department and the Recipient that the level of wind protection provided by the mitigation action, although meeting State standards and codes and enhancing the structural integrity of the building, does not ensure the safety of survival of building occupants. 11 Revised Attachment B Program Statutes and Regulations 1. Sections 215.555(7)(c) and 215.559, Florida Statutes 2. Chapter 252, Florida Statutes 3. Chapter 287, Florida Statutes 4. Chapter 119, Florida Statutes 5. Chapter 60A-1, Florida Administrative Code 6. Chapter 9G-19, Florida Administrative Code The parties to this Agreement and the Hazard Mitigation Grant Program (HMGP) are generally governed by the following statutes and regulations: (1) The Robert T. Stafford Disaster Relief and Emergency Assistance Act; (2) 44 CFR Parts 7, 9, 10, 13, 14, 17, 18, 25, 206, 220, and 221, and any other applicable FEMA policy memoranda and guidance documents; (3) State of Florida Administrative Plan for the Hazard Mitigation Grant Program; (4) Hazard Mitigation Long-term Recovery Guidance; and (5) All applicable laws and regulations delineated in Attachment C of this Agreement In addition to the above statues and regulations, the Recipient must comply with the following: The Recipient shall fully perform the approved hazard mitigation project, as described in the Application and Attachment A (Budget and Scope of Work) attached to this Agreement, in accordance with the approved scope of work indicated therein, the estimate of costs indicated therein, the allocation of funds indicated therein, and the terms and conditions of this Agreement. Recipient shall not deviate from the approved project and the terms and conditions of this Agreement. Recipient shall comply with any and all applicable codes and standards in performing work funded under this Agreement, and shall provide any appropriate maintenance and security for the project. Any development permit issued by, or development activity undertaken by, the Recipient and any land use permitted by or engaged in by the Recipient, shall be consistent with the local comprehensive plan and land development regulations prepared and adopted pursuant to Chapter 163, Part ll, Florida Statutes. Funds shall be expended for, and development activities and land uses authorized for, only those uses which are permitted under the comprehensive plan and land development regulations. The Recipient shall be responsible for ensuring that any development permit issued and any development activity or land use undertaken is, where applicable, also authorized by the Water Management District, the Florida Department of Environmental Protection, the Florida Department of Health, the Florida Game and Fish Commission, and any federal, state, or local environmental or land use permitting authority, where required. Recipient agrees that any repair or construction shall be in accordance with applicable standards of safety, decency, and sanitation, and in conformity with applicable codes, specifications and standards. Recipient will provide and maintain competent and adequate engineering supervision at the construction site to ensure that the completed work conforms with the approved plans and specifications and will furnish progress reports and such other information to HMGP as may be required. 12 If the hazard mitigation project described in Attachment A includes an acquisition or relocation project, then Recipient shall ensure that, as a condition of funding under this Agreement, the owner of the affected real property shall record in the public records of the county where it is located the following covenants and restrictions, which shall run with and apply to any property acquired, accepted, or from which a structure will be removed pursuant to the project: 1. The property will be dedicated and maintained in perpetuity for a use that is compatible with open space, recreational, or wetlands management practices; 2. No new structure will be erected on property other than: (a) a public facility that is open on all sides and functionally related to a designated open space; (b) a restroom; or 3. A structure that the Director of the Federal Emergency Management Agency approves in writing before the commencement of the construction of the structure; 4. After the date of the acquisition or relocation no application for disaster assistance for any purpose will be made to any Federal entity and no disaster assistance will be provided for the property by any Federal source; and 5. If any of these covenants and restrictions is violated by the owner or by some third party with the knowledge of the owner, fee simple title to the Property described herein shall be conveyed to the Board of Trustees of the Internal Improvement Trust Fund of the State of Florida without further notice to the owner, its successors and assigns, and the owner, its successors and assigns shall forfeit all right, title and interest in and to the property. HMGP Contract Manager will evaluate requests for cost overruns and submit to the Regional Director written determination of cost overrun eligibility. Cost overruns shall meet Federal regulations set forth in 44CFR 206.438(b). The National Environmental Policy Act (NEPA) stipulates that additions or amendments to a HMGP Recipient Scope of Work (SOW) shall be reviewed by all State and Federal agencies participating in the NEPA process. You are reminded that no construction may occur in this phase, that a full environmental review must be completed prior to funding Phase 11. As a reminder, the Recipient must obtain prior approval from the State, before implementing changes to the approved project Scope of Work (SOW). Per the Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments: 1. For construction projects, the grantee must "obtain prior written approval for any budget revision which result in a need for additional funds" (44 CFR 13 (c)); 2. A change in the scope of work must be approved by FEMA in advance regardless of the budget implications; and 3. The Recipient must notify the State as soon as significant developments become known, such as delays or adverse conditions that might raise costs or delay completion, or favorable conditions allowing lower cost or earlier completion. Any extensions of the period of performance must be submitted to FEMA 60 days prior to the project expiration date. 13 Revised Attachment J Statement of Assurances To the extent the following provisions apply to this Agreement, the Recipient certifies that: (a) It possesses legal authority to enter into this Agreement, and to cant' out the proposed program; (b) Its governing body has duly adopted or passed as an official act a resolution, motion or similar action authorizing the execution of the hazard mitigation agreement with the Division of Emergency Management (DEM), including all understandings and assurances contained in it, and directing and authorizing the Recipient's chief administrative officer or designee to act in connection with the application and to provide such additional information as may be required; (c) No member of or delegate to the Congress of the United States, and no Resident Commissioner, shall receive any share or part of this Agreement or any benefit. No member, officer, or employee of the Recipient or its designees or agents, no member of the governing body of the locality in which the program is situated, and no other public official of the locality or localities who exercises any functions or responsibilities with respect to the program during his tenure or for one year after, shall have any interest, direct or indirect, in any contract or subcontract, or the proceeds, for work be performed in connection with the program assisted under this Agreement. The Recipient shall incorporate, in all contracts or subcontracts a provision prohibiting any interest pursuant to the purpose state above; (d) All Recipient contracts for which the State Legislature is in any part a funding source, shall contain language to provide for termination with reasonable costs to be paid by the Recipient for eligible contract work completed prior to the date the notice of suspension of funding was received by the Recipient. Any cost incurred after a notice of suspension or termination is received by the Recipient may not be funded with funds provided under this Agreement unless previously approved in writing by the Division. All Recipient contracts shall contain provisions for termination for cause or convenience and shall provide for the method of payment in such event; (e) It will comply with: (1) Contract Work Hours and Safety Standards Act of 1962, 40 U.S.C. 327 et seq., requiring that mechanics and laborers (including watchmen and guards) employed on federally assisted contracts be paid wages of not less than one and one-half times their basic wage rates for all hours worked in excess of forty hours in a work week; and (2) Federal Fair Labor Standards Act, 29 U.S.C. Section 201 et seq., requiring that covered employees be paid at least the minimum prescribed wage, and also that they be paid one and one-half times their basic wage rates for all hours worked in excess of the prescribed work -week. (f) It will comply with: (1) Title VI of the Civil Rights Act of 1964 (P.L. 88-352), and the regulations issued pursuant thereto, which provides that no person in the United States shall on the grounds of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the Recipient receives Federal financial assistance and will immediately take any measures necessary to effectuate this assurance. If any real property or structure thereon is provided or improved with the aid of Federal financial assistance extended to the 14 Recipient, this assurance shall obligate the Recipient, or in the case of any transfer of such property, any transferee, for the period during which the real property or structure is used for a purpose for which the Federal financial assistance is extended, or for another purpose involving the provision of similar services or benefits; (2) Any prohibition against discrimination on the basis of age under the Age Discrimination Act of 1975, as amended (42 U.S.C.: 6101-6107) which prohibits discrimination on the basis of age or with respect to otherwise qualified handicapped individuals as provided in Section 504 of the Rehabilitation Act of 1973; (3) Executive Order 11246 as amended by Executive Orders 11375 and 12086, and the regulations issued pursuant thereto, which provide that no person shall be discriminated against on the basis of race, color, religion, sex or national origin in all phases of employment during the performance of federal or federally assisted construction contracts; affirmative action to insure fair treatment in employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff/termination, rates of pay or other forms of compensation; and election for training and apprenticeship; (g) It will establish safeguards to prohibit employees from using positions for a purpose that is or gives the appearance of being motivated by a desire for private gain for themselves or others, particularly those with whom they have family, business, or other ties pursuant to Section 112.313 and Section 112.3135, FS; (h) It will comply with the Anti -Kickback Act of 1986, 41 U.S.C. Section 51 which outlaws and prescribes penalties for "kickbacks" of wages in federally financed or assisted construction activities; (i) It will comply with the provisions of 18 USC 594, 598, 600-605 (further known as the Hatch Act) which limits the political activities of employees; Q) It will comply with the flood insurance purchase and other requirements of the Flood Disaster Protection Act of 1973 as amended, 42 USC 4002-4107, including requirements regarding the purchase of flood insurance in communities where such insurance is available as a condition for the receipt of any Federal financial assistance for construction or acquisition purposes for use in any area having special flood hazards. The phrase "Federal financial assistance" includes any form of loan, grant, guaranty, insurance payment, rebate, subsidy, disaster assistance loan or grant, or any other form of direct or indirect Federal assistance; (k) It will require every building or facility (other than a privately owned residential structure) designed, constructed, or altered with funds provided under this Agreement to comply with the "Uniform Federal Accessibility Standards," (AS) which is Appendix A to 41 CFR Section 101-19.6 for general type buildings and Appendix A to 24 CFR Part 40 for residential structures. The Recipient will be responsible for conducting inspections to ensure compliance with these specifications by the contractor; (1) It will, in connection with its performance of environmental assessments under the National Environmental Policy Act of 1969, comply with Section 106 of the National Historic Preservation Act of 1966 (U.S.C. 470), Executive Order 11593, 24 CFR Part 800, and the Preservation of Archaeological and Historical Data Act of 1966 (16 U.S.C. 469a-1, et seq.) by: (1) Consulting with the State Historic Preservation Office to identify properties listed in or eligible for inclusion in the National Register of Historic Places that are subject to adverse effects (see 36 CFR Section 800.8) by the proposed activity; and 15 (2) Complying with all requirements established by the State to avoid or mitigate adverse effects upon such properties. (3) Abiding by the terms and conditions of the "Programmatic Agreement Among the Federal Emergency Management Agency, the Florida State Historic Preservation Office, the Florida Division of Emergency Management and the Advisory Council on Historic Preservation, (PA)" which addresses roles and responsibilities of Federal and State entities in implementing Section 106 of the National Historic Preservation Act (NHPA), 16 U.S.C. 470f, and implementing regulations in 36 CFR part 800. (4) When any of Recipient's projects funded under this Agreement may affect a historic property, as defined in 36 CFR 800. (2)(e), the Federal Emergency Management Agency (FEMA) may require Recipient to review the eligible scope of work in consultation with the State Historic Preservation Office (SHPO) and suggest methods of repair or construction that will conform with the recommended approaches set out in the Secretary of Interior's Standards for Rehabilitation and Guidelines for Rehabilitating Historic Buildings 1992 (Standards), the Secretary of the Interior's Guidelines for Archeological Documentation (Guidelines) (48 Federal Register 44734-37), or any other applicable Secretary of Interior standards. If FEMA determines that the eligible scope of work will not conform with the Standards, Recipient agrees to participate in consultations to develop, and, after execution by all parties, to abide by, a written agreement that establishes mitigation and recondition measures, including but not limited to, impacts to archeological sites, and the salvage, storage, and reuse of any significant architectural features that may otherwise be demolished. (5) Recipient agrees to notify FEMA and the Division if any project funded under this Agreement will involve ground disturbing activities, including, but not limited to: subsurface disturbance; removal of trees; excavation for footings and foundations; and installation of utilities (such as water, sewer, storm drains, electrical, gas, leach lines and septic tanks) except where these activities are restricted solely to areas previously disturbed by the installation, replacement or maintenance of such utilities. FEMA will request the SHPO's opinion on the potential that archeological properties may be present and be affected by such activities. The SHPO will advise Recipient on any feasible steps to be accomplished to avoid any National Register eligible archeological property or will make recommendations for the development of a treatment plan for the recovery of archeological data from the property. If Recipient is unable to avoid the archeological property, develop, in consultation with the SHPO, a treatment plan consistent with the Guidelines and take into account the Advisory Council on Historic Preservation (Council) publication "Treatment of Archeological Properties". Recipient shall forward information regarding the treatment plan to FEMA, the SHPO and the Council for review. If the SHPO and the Council do not object within 15 calendar days of receipt of the treatment plan, FEMA may direct Recipient to implement the treatment plan. If either the Council or the SHPO object, Recipient shall not proceed with the project until the objection is resolved. (6) Recipient shall notify the Division and FEMA as soon as practicable: (a) of any changes in the approved scope of work for a National Register eligible or listed property; (b) of all changes to a project that may result in a supplemental DSR or modify an HMGP project for a National Register eligible or listed property; (c) if it appears that a project funded under this Agreement will affect a previously unidentified property that may be eligible for inclusion in the National Register or 16 affect a known historic property in an unanticipated manner. Recipient acknowledges that FEMA may require Recipient to stop construction in the vicinity of the discovery of a previously unidentified property that may be eligible for inclusion in the National Register or upon learning that construction may affect a known historic property in an unanticipated manner. Recipient further acknowledges that FEMA may require Recipient to take all reasonable measures to avoid or minimize harm to such property until FEMA concludes consultation with the SHPO. Recipient also acknowledges that FEMA will require, and Recipient shall comply with, modifications to the project scope of work necessary to implement recommendations to address the project and the property. (7) Recipient acknowledges that, unless FEMA specifically stipulates otherwise, it shall not receive funding for projects when, with intent to avoid the requirements of the PA or the NHPA, Recipient intentionally and significantly adversely affects a historic property, or having the legal power to prevent it, allowed such significant adverse affect to occur. (m) It will comply with 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; (n) It will comply with the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970, (42 U.S.C. 4521-45-94) relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (o) It will comply with 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; (p) It will comply with Lead -Based Paint Poison Prevention Act (42 U.S.C.: 4821 et seq.) which prohibits the use of lead based paint in construction of rehabilitation or residential structures; (q) It will comply with the Energy Policy and Conservation Act (P.L. 94-163; 42 U.S.C. 6201-6422), and the provisions of the state Energy Conservation Plan adopted pursuant thereto; (r) It will comply with the Laboratory Animal Welfare Act of 1966, 7 U.S.C. 2131-2159, pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by an award of assistance under this agreement; (s) It will comply with Title VIII of the Civil Rights Act of 1968, 42 U.S.C. 2000c and 42 3601-3619, as amended, relating to non-discrimination in the sale, rental, or financing of housing, and Title VI of the Civil Rights Act of 1964 (P.L. 88-352), which prohibits discrimination on the basis of race, color or nation origin; (t) It will comply with the Clean Air Act of 1955, as amended, 42 U.S.C. 7401-7642; (u) It will comply with the Clean Water Act of 1977, as amended, 42 U.S.C. 7419-7626; (v) It will comply with the Endangered Species Act of 1973, 16 U.S.C. 1531-1544; (w) It will comply with the Intergovernmental Personnel Act of 1970, 42 U.S.C. 4728-4763; (x) It will assist the awarding agency in assuring compliance with the National Historic Preservation Act of 1966, as amended, 16 U.S.C. 270; (y) It will comply with environmental standards which may be prescribed pursuant to the National Environmental Policy Act of 1969, 42 U.S.C. 4321-4347; 17 (z) It will assist the awarding agency in assuring compliance with the Preservation of Archeological and Historical Preservation Act of 1966, 16 U.S.C. 469a, et seq; (aa) It will comply with the Rehabilitation Act of 1973, Section 504, 29 U.S.C. 794, regarding non- discrimination; (bb) It will comply with the environmental standards which may be prescribed pursuant to the Safe Drinking Water Act of 1974, 42 U.S.C. 300f-300j, regarding the protection of underground water sources; (cc) It will comply with the requirements of Titles II and III of the Uniform Relocation Assistance and Property Acquisition Policies Act of 1970, 42 U.S.C. 4621-4638, which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs; (dd) It will comply with the Wild and Scenic Rivers Act of 1968, 16 U.S.C. 1271-1287, related to protecting components or potential components of the national wild and scenic rivers system; (ee) It will comply with the following Executive Orders: EO 11514 (NEPA); EO 11738 (violating facilities); EO 11988 (Floodplain Management); EO 11990 (Wetlands); and EO 12898 (Environmental Justice); (ff) It will comply with the Coastal Barrier Resources Act of 1977, 16 U.S.C. 3510; (gg) It will assure project consistency with the approved State program developed under the Coastal Zone Management Act of 1972, 16 U.S.C. 1451-1464; and (hh) It will comply with the Fish and Wildlife Coordination Act of 1958; 16 U.S.C. 661-666. (ii) With respect to demolition activities, it will: 1. Create and make available documentation sufficient to demonstrate that the Recipient and its demolition contractor have sufficient manpower and equipment to comply with the obligations as outlined in this Agreement. 2. Return the property to its natural state as though no improvements had ever been contained thereon. 3. Furnish documentation of all qualified personnel, licenses and all equipment necessary to inspect buildings located in Recipient's jurisdiction to detect the presence of asbestos and lead in accordance with requirements of the U.S. Environmental Protection Agency, the Florida Department of Environmental Protection and the County Health Department. 4. Provide documentation of the inspection results for each structure to indicate: a. Safety Hazards Present b. Health Hazards Present C. Hazardous Materials Present 5. Provide supervision over contractors or employees employed by Recipient to remove asbestos and lead from demolished or otherwise applicable structures. 6. Leave the demolished site clean, level and free of debris. 7. Notify the Division promptly of any unusual existing condition which hampers the contractors work. 18 8. Obtain all required permits. 9. Provide addresses and marked maps for each site where water wells and septic tanks are to be closed along with the number of wells and septic tanks located on each site. Provide documentation of closures. 10. Comply with mandatory standards and policies relating to energy efficiency which are contained in the State energy conservation plan issued in compliance with the Energy Policy and Conservation Act (Public Law 94-163). 11. Comply with all applicable standards, orders, or requirements issued under Section 112 and 306 of the Clean Air Act (42 U.S.C. 1857 (h), Section 508 of the Clean Water Act (33 U.S. 1368), Executive Order 11738, and the U.S. Environmental Protection Agency regulations (40 CFR Part 15 and 61). This clause shall be added to any subcontracts. 12. Provide documentation of public notices for demolition activities. FES Contract Number: 08-EC-30-11-54-01-039 MODIFICATION # 3 TO SUBGRANT AGREEMENT This Modification is made and entered into by and between the State of Florida, Division of Emergency Management, ("the Division"), and Monroe County ("the Recipient") to modify the Division's Contract Number 08-EC-30-11-54-01-039, dated August 27, 2007 ("the Agreement"). WHEREAS, the Division and the Recipient have entered into the Agreement, pursuant to which the Division provided a sub -grant of $1,099,513 of this amount $1,029,547 in state funds and $69,966 in federal funds for Phase I; and WHEREAS, the Agreement expires on June 30, 2010; and WHEREAS, the Division and the Recipient desire to modify the Agreement by extending certain dates; and WHEREAS, both parties wish to extend the time frame for the expenditure of the state funds until June 30, 2013; and WHEREAS, the Division and the Recipient desire to modify the Agreement by amending the Exhibit 1; and NOW, THEREFORE, in consideration of the mutual promises of the parties contained herein, the parties agree as follows: I. The Agreement is hereby extended through June 30, 2013. 2. The Exhibit 1 to this agreement, is herby deleted in its entirely, and the Revised Exhibit 1, which is attached hereto and incorporated herein by reference, is substituted in its place and stead. The Revised Exhibit 1 contains the amended federal language. 3. The Budget and Scope of Work, Attachment A, to this Agreement, is hereby amended to included the Revised Budget and Scope of Work, Revised Attachment A -State, to this Modification, which are attached hereto and incorporated herein by reference, are substituted in its place and stead. 4. All provisions not in conflict with this Modification remain in full force and effect, and are to be performed at the level specified in the Agreement. 5. All provisions of the Agreement being modified and any attachments thereto in conflict with this Modification shall be and are hereby changed to conform with this Modification, effective as of the date of the last execution of this Modification by both parties. IN WITNESS WHEREOF, the parties hereto have executed this document on the dates set out below. RE NA STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT BY:Ak Da dH (stead, Dir tce or ATE: & • l o 'HOVEDAS 1"0 FO: .� flIWVI'Cl10lttAAfYCf�iAIR 1iAT LEERIF W. (;;�cf�L > �y�1/ AS•_3!c'TIAAT COU'r `l A.TTO b +r' rmpin'y cLEP( REVISED EXHIBIT — 1 FEDERAL RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: NOTE, if the resources awarded to the recipient represent more than one Federal program, provide the same information shown below for each Federal program and show total Federal resources awarded. Federal Program: Federal Emergency Management Agency, Hazard Mitigation Grant Catalog of Federal Domestic Assistance Number: 97.039 Amount of Federal Funding: $69,966 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: NOTE.• if the resources awarded to the recipient represent more than one Federal program, list applicable compliance requirements for each Federal program in the same manner as shown below. Federal Program: List applicable compliance requirements as follows: 1. 1. Recipient is to use funding to perform the following eligible activities; include mitigation projects that will result in protection of public or private property from natural hazards. Eligible projects include, but are not limited to: • Acquisition of hazard prone properties • Retrofitting of existing buildings and facilities • Elevation of flood prone structures • Infrastructure protection measures • Storm water management improvements • Minor structural flood control projects • Relocation of structures from hazard prone areas • Retrofitting of existing buildings and facilities for shelters • Vegetative management/soil stabilization • Mitigation Planning Project • Other projects that reduce future disaster losses 2. Recipient is subject to all administrative and financial requirements as set forth in this Agreement, or will be in violation of the terms of the Agreement. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS: NOTE: If the resources awarded to the recipient for matchina represent more than one Federal oroaram provide the same information shown below for each Federal Program and show total State resources awarded for matching. SUBJECT TO SECTION 215.97, FLORIDA STATUTES: NOTE: If the resources awarded to the recipient represent more than one State proiect provide the same information shown below for each State oroiect and show total state financial assistance awarded that is subiect to Section 215.97, Florida Statutes. 3 State Project State of Florida - Division of Emergency Management CSFA # 52.010 $1,029,547 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: List applicable compliance requirements as follows: 1. First applicable compliance requirement (e.g., what services/purposes resources must be used for). 2. Second applicable compliance requirement (e.g., eligibility requirements for recipients of the resources). 3. Etc. State awarding agency may elect to use language that requires the recipient to comply with the requirements of applicable provisions of specific laws, rules, regulations, etc. NOTE Instead of listing the specific compliance requirements as shown above, in the example, the language may state that the recipient must comply with a specific law(s), rule(s), or regulation(s) that pertains to how the awarded resources must be used or how eligibility determinations are to be made. The State awarding agency, if practical, may want to attach a copy of the specific law, rule, or regulation referred to. NOTE: Section .400(d) of OMB Circular A-133, as revised, and Section 215.97(5)(a), Florida Statutes, require that the information about Federal Programs and State Projects included in Exhibit 1 be provided to the recipient. 4 Revised Attachment A State Budget and Scope of Work I. SCOPE OF WORK A. The Recipient shall construct a County Emergency Operations Center (EOC). Use of grant funds shall be consistent with Section 1(1), Ch. 2006-71, Laws of Florida. Grant funds shall not be used for land acquisition; purchase of equipment, furnishings, communications, or operational systems; or recurring expenditures. Eligible reimbursement costs include: Architectural and Engineering services and fees; site survey and soil testing; necessary permits and fees; civil and service utilities site work; construction of the building's substructure, superstructure, shell (exterior enclosure) and interior construction; special inspections; mechanical, plumbing, electrical, conveying and security systems; lightning protection; and redundant Infrastructure systems (e.g., electric generator, uninterruptible power supply, potable water and wastewater systems, etc.). B. The Recipient shall in a timely manner prepare and submit a complete Hazard Mitigation Grant Program (HMGP) application, benefit -cost analysis, environmental review and such other documentation as necessary to determine eligibility and allowable costs under said grant program. C. The Recipient shall state in writing that for a period of not less than 15 years from the date of receipt of Certificate of Occupancy the EOC will be dedicated for emergency management purposes. The EOC shall remain demonstrably capable of being fully activated within one (1) hour of detection of an emergency, reference Rule Chapter 9G-6, Florida Administrative Code, "Emergency Management Capabilities Assessment Checklist." D. The EOC shall be constructed with sufficient space to house people and equipment for day-to- day and sustained continuous emergency operations, and capable of full staffing for the most extensive emergency anticipated. At a minimum, the designated EOC functional area(s), and essential shared -use area(s) if applicable, shall be designed for an emergency operations staff size of 62 persons per shift and a workspace floor area of 5.270 gross square feet. E. At a minimum, the EOC shall meet the hurricane hazard safety criteria established in Standards for Hurricane Evacuation Shelter Selection (ARC 4496). F. The EOC and essential ancillary structures and service equipment shall be designed to resist the effects of a major hurricane. The wind load design requirements shall be in accordance with the American Society of Civil Engineers (ASCE) Standard 7, Minimum Design Loads for Buildings and Other Structures. The minimum wind design criteria shall include: Design Wind Speed = 225 miles per hour (3 second gust) Wind Importance Factor, / = 1.00 Exposure Category = C Directionality Factor, Kd = 1.00 Internal Pressure Coefficient, GCp, _ +/- 0.18 All components and cladding assemblies necessary to maintain a structurally enclosed condition and prevent rainwater Intrusion shall be designed to meet the wind design criteria. Structural metal decking and cladding materials shall be 22 gauge or thicker. Roof cover waterproofing barriers shall meet the wind design criteria. Loose roof ballast shall not be used on the roof cover. Rooftop equipment shall be designed and installed to meet the wind design criteria. 5 G. The EOC and essential ancillary structures and service equipment shall resist penetration by windbome debris impact. At a minimum, all exterior enclosure components, claddings and assemblies (i.e., walls, roofs, louvers, windows, doors, etc.) located within 60 feet in height above finish grade shall meet the hurricane windbome debris impact criteria specified in the Department of Energy's (DOE) Standard, Natural Phenomena Hazards Design and Evaluation Criteria, DOE-STD-1020-2002. That is, the building enclosure must resist penetration by a nominal 2"x4" lumber plank weighing 15 pounds propelled at 50 miles per hour (74 feet per second) striking end -on and normal to the assembly surface, or equivalent performance as approved by the Division. As applicable, impact test procedures shall be consistent with recognized state and national standards; such as, Test Standard for Determining Impact Resistance from Windborne Debris SSTD 12, American Society of Testing and Materials (ASTM) Standards ASTM E 1886 and ASTM E 1996, and Florida Building Code Testing Protocols TAS 201, TAS 202 and TAS 203. The impact test procedures may be modified as necessary to accommodate the required missile weight and velocity. H. The following information related to wind loads and flooding shall be shown on the construction drawings: 1. wind design per ASCE 7 with applicable year of revision; 2. design wind speed; 3. wind importance factor, 1, 4. design wind exposure category; 5. wind directionality factor, Kd; 6. design internal pressure coefficient, GCPi, 7. design wind pressures in terms of pounds per square foot (psf) to be used for the design of exterior component and cladding materials not specifically designed by the principal licensed design professional; 8. windborne debris impact performance criteria; 9. finish floor elevation measured relative to the National Geodetic Vertical Datum (NGVD); and comparison reference of the finished floor elevation to the base flood elevation, or historical flood elevation if base flood elevation is not determined. I. The lowest floor for the EOC and essential ancillary structures and service equipment shall at a minimum be elevated above: Category 5 hurricane storm surge elevation plus 20 percent; the base flood elevation plus three (3) feet; the 500-year (0.2 percent annual chance) flood elevation (if determined) plus two (2) feet; the highest recorded flood elevation plus three (3) feet if the area is not in a mapped special flood hazard area; whichever is greater. The site (point maximum, one square mile) hydrologic design shall ensure that the EOC and essential ancillary structures and service equipment are not flooded due to a 24 hour, 37.0 Inch rainfall event applied over a precedent 24 hour, 100-year rainfall event. J. Where secondary (emergency) roof drains or scuppers are required by the Florida Building Code —Plumbing, the secondary system shall be sized for a rainfall rate of eleven (11.0) inches per hour. K. The EOC shall be designated as a threshold building, and special structural Inspections required. Special Inspections shall be conducted In compliance with section 553.79, Florida Statutes and other applicable statutes, laws and rules. L. The EOC shall at a minimum be designed for 72 hours of self-contained continuous operation and shall not be solely reliant upon off -site services and utilities (e.g., water, natural gas fuel, electricity, etc.) M. Force protection and security measures shall be consistent with the guidance published in Florida's Homeland Security Comprehensive Assessment Model (HLSCAM), United States Air Force Installation Force Protection Guide, or other federal or state recognized best -practices guide(s) as approved by the Division. N. The Recipient shall provide an initial timeline and estimated reimbursement allocation schedule. Table SW-1, "Initial Timeline and Estimated Reimbursement Allocation Schedule" or other similar instrument as approved by the Division may be used. O. During design and construction phases of the EOC project, the Recipient shall track and provide construction cost data for the designated EOC area as detailed in Table SW-2, "Cost Data for County Emergency Operations Center." II. PRODUCT ITEMS A. Per item IN, Recipient shall prepare an initial timeline with key milestone activities/tasks schedule, including estimated start and end dates for each activity, and an estimate of state reimbursement request for each activity. Table SW-1 may be used to meet this product item. B. Per item I.C, Recipient shall submit a binding written statement that the EOC will be dedicated for a period of not less than15 years for emergency management purposes, and demonstrably capable of being fully activated within one (1) hour of detection of an emergency. C. The Recipient shall provide one (1) copy each of site survey, site master plan, spatial needs assessment, and schematic design plan or preliminary design drawings for review and comment by the Division. The spatial needs assessment and schematic design plan/preliminary design may be consolidated into one document. D. The Recipient shall provide one (1) set of substantially complete (approximately 70 percent) preliminary design construction drawings and specifications for the EOC and essential ancillary structures for review and comment by the Division. The construction drawings shall include site survey information, landscaping, civil, architectural, structural, mechanical, plumbing, and electrical drawings. E. The Recipient shall provide one (1) set of bid -ready construction drawings and specifications for the EOC and essential ancillary structures for review by the Division. The construction drawings shall Include site survey information, landscaping, civil, architectural, structural, mechanical, plumbing, and electrical drawings and shall be certified by the applicable registered or licensed design professional(s) of record. F. The construction drawings shall demonstrate that the EOC will meet the hurricane hazard safety criteria of ARC 4496, and the wind load, windbome debris impact, flood and security design requirements set forth in items LE through I.M. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial of funds. G. Per item 1.13, Recipient shall submit a complete HMGP application, benefit -cost analysis, environmental review and such other documentation as necessary to determine eligibility and cost allowances under said grant program. The Recipient shall also provide two cost estimates prepared by one or more certified construction contractors that document the cost of constructing the facility to meet current building code wind and flood design requirements, and the cost premium of constructing the facility to the above -code wind and flood requirements set forth In items LE through I.J. H. Per item 1.0, the Recipient shall provide final project cost data. Table SW-2 shall be used to meet this product item. 1. The Recipient shall provide the Division with copy(s) of pertinent construction permits, the threshold inspection final report, and the certificate of occupancy upon completion of the construction project. 7 III. SCHEDULE OF WORK A. By June 30, 2007, the Recipient shall provide the Division with Product Items A and B for review and approval. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial of funds. B. By September 30, 2007 and at least on a quarterly basis thereafter, Recipient shall report on progress in relation to the initial timeline, and submit Product Items C through H in a timely manner as accomplished. The Division shall be provided 30 calendar days to review and provide comments of product items pertaining to compliance with the scope -of -work. The Recipient shall also submit invoices for reimbursement for work accomplished in accordance with the Division approved cost reimbursement allocation schedule referenced in Product Item A. C. By a mutually agreed upon date, the Recipient shall provide the Division with Product Item F for review and approval. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial or reduction of funds at the sole discretion of the Division. D. By May 15, 2012, the Recipient shall provide final project cost estimate data as set forth in Table SW-2, certificate of occupancy, close-out documentation and final payment invoice. 8 Table SW-1. Initial Timeline and Estimated Reimbursement Allocation Schedule Table SW-1. Initial Timeline and Estimated Reimbursement Allocation Schedule County Name: Monroe PROJECT PHASE Start Date End Date DEM Funds Other Funds Board Contract Approval Initial Payment of 20% in first quarter A&E Firm Selection Site Survey and Soil Testing Spatial Needs Assessment Preliminary Design, 70% complete r1vnnm1aiy wwwyn, 100% complete Regulatory Review Bid Document(s) Development & Award Notice to Proceed/Mobi lizatior Construction Project Management & Special Inspections Construction 25% Complete Construction 50% Complete Construction 100% Complete Contingency Administrative Fees; maximum of 5% Sub -Totals TOTAL Estimated A&E - Architectural and Engineering; DEM — Division of Emergency Management; FY - Fiscal 9 Table SW-2. Cost Data for County Emergency Operations Center Table SW-2. Cost Data for County Emergency Operations Center County Name: Monroe NO. I System/Component Description Estimated Cost A. ISUBSTRUCTURE 1010 1 Foundation 1020 Slab -on -Grade 2010 Excavation 2020 9010 Basement Walls Fiaum+� PnsinA#I,.., 10 3050 Terminal & Package Units 3090 Other HVAC Sys. D40 Fire Protection 4010 Sprinkler Sys. 4020 Standpipe Sys. 4030 Other Sys. D50 Electrical 5010 Elec. Service & Distribution 5020 Lighting & Branch Wirin 5030 Communications & Security utner tiec. 5091 5092 UPS Sys. E. ( EQUIPMENT & FURNISHINGS 1010 Commercial Equip. 1020 Institutional Equip. 1030 Vehicular Equip. 1090 Other Equip. 1091 AudloMdeo Equip. 1092 Special Telecom 1093 Information Tech. 1094 Geo. Info. Sys. F. SPECIAL CONSTRUCTION 1041 Fbenerator Enclosure 1042 Comm. Tower 1043 Hellpad 1 1090 Other 11 Monroe_,o L Aty C 1e.rk's or► x a Contract Number: 08-EC-30-11-54-01.09 MODIFICATION # 2 TO STATE -FUNDED SUBGRANT AGREEMENI This Mcdification is made and entered into by and between the State of Florida, Division of Emergency Management, ("the Division"), and Monroe County ("the Recipient') to modify the Division's Contract Number 08-EC-30-11-54-01-039, dated August 27, 2007 ("the Agreement"). WHEREAS, the Division and the Recipient have entered into the Agreement, pursuant to which the Division has provided a sub grant of $1,099,513 of this grant $1,029,547.00 in state funds and $69,966.00 in federal funds to Recipient; and WHEREAS, the Agreement will expire on June 30, 2009; and WHEREAS, the Division and the Recipient desire to modify the Agreement by extending the term through June 30, 2010 and to modify the Agreement by amending the federal Budget and Scope of Work as set forth in the amended Revised Attachment A -Federal. WHEREAS, the state funds of $1,029,547.00 must be expended on or before June 30, 2010, and the federal funds of $69,966.00 must be expended on or before December 7, 2009; and NOW, THEREFORE, in consideration of the mutual promises of the parties contained herein, the parties agree as follows: 1. The Agreement is hereby extended through June 30, 2010. 2. The Revised Budget and Scope of Work, Attachment A Federal, as contained in Modification number 2 dated February 27, 2008, is hereby amended by the second Revised Budget and Scope of Work, Attachment A -Federal, to this Modification, which are attached hereto and incorporated herein by reference. The Revised Budget and Scope of Work, Attachment A -Federal, contains the additional provisions that apply only to the added federal funding. 3. Attachment A -Federal, the Recipient understands that Phase I is approved with the condition that no construction can begin until the results of the deliverables are reviewed, and Phase II activities are approved. Failure to comply with this condition could result in the loss of all funding for this project. 4. Final requests for reimbursement of state funds should be submitted no later than fifteen (15) days after the termination date of the contract. Any requests received after July 15, 2010 may, at the discretion of the Division, not be reimbursed from this Agreement. Reimbursement requests shall not be submitted by facsimile transmission. 5. However. availability of state funds after June 30 2009 is contingent upon legislative appropriation beyond June 30 2009 6. By May 15, 2010, the Recipient shall provide final project cost estimate data as set forth in Table SW-2, certificate of occupancy, close-out documentation and final payment invoice. 7. All provisions of the Agreement being modified and any attachments thereto in conflict with this Modification shall be and are hereby changed to conform with this Modification, effective as of the date of the last execution of this Modification by both parties. B. All provisir)ns not in conflict with this Modification remain in full force and effect, end are to be preformed at the level specified in the Agreement. IN WITNESS WHEREOF, the parties hereto have executed this document as of the dates set out herein. RECIPI M' ONROE C,OOUI BY: 'fit � le. NAME & TITLE: l,- -a-� DATE: TJ ad' V cl .. STATE OFAFLORIDA DIVISION PF EMERGENCY MANAGEMENT BY: Rub n D ,/ Imaguer, Interim Director for the sion of Emergency Management DATE: MEAL) DAMWL IroLMAcf*'LCRK �7l;FU7'Y C�,cr�.3C K MONROE COUNTY ATTORNEY PROV`r:p AS T FOR Nit'FILEEI:� V'd. CA.SSEL AS�,ISTAINT CoUNTT A TORNEY Date '�/�y" � Revised Attachment A - Federal Budget and Scope of Work As a Hazard Mitigation Grant Program project, the Recipient, Monroe County, will conduct a Phase 1 engineering feasibility study to identify modifications needed to wind retrofit the new Monroe County Emergency Operations Center, located at 9400 Overseas Highway, Marathon, Florida 33050, above the Florida Building Code or Miami -Dade Specifications. Phase I will provide funding for completion of design, surveying and permitting for this proposal. In order for Phase II to be considered for funding, Phase I deliverables must include a complete proposed budget and scope of work, along with engineering data from the study and engineering plans. Phase I of this project is approved with the condition that the above list of deliverables will be submitted for review and approval by the State and FEMA before Phase II is considered. No construction work may begin until Phase 11 deliverables are reviewed and approved by FEMA. Failure to comply with this condition can result in the loss of all funding for this project. The Period of Performance for this project ends on December 7, 2009. Schedule of Work State Contracting: 3 Months Request for A/E Proposal & Review: 3 Months Bidding of Design: 3 Months Engineering/Architectural Design: 6 Months Total Period of Performance: 15 Months Line Item Budaet* Project Cost Federal Share Local Share Survey, Engineering Design, Environmental Permitting: $ 89,700.00 $ 67,275.00 $ 22,425.00 Sub -total: $ 89,700.00 $ 67,275.00 $ 22,425.00 Administrative Cost: $ 0.00 $ 2,691.00 $ 0.00 Total: $ 89,700.00 $ 69,966.00 $ 22,425.00 * Any line item amount in this Budget may be increased or decreased 10% or less without an amendment to this Agreement being required, so long as the overall amount of the funds obligated under this Agreement is not increased. Funding Summary Federal Share: $67,275.00 (75%) Local Share: $22.425.00 (25%) Total Project Cost: $89,700.00 (100%) Recipient Administrative Allowance up to $2,691.00 3 The materials and work funded pursuant to this Subgrant Agreement ore intended to decrease the vulnerability of the building to property losses and are specifically not intended to provide for the safety of inhabitants before, during or after a natural man made disaster. The funding provided by the Division of Emergency Management under this subgrant shall compensate for the materials and labor for the installation of storm shutters and/or cther hardening activities as a retrofit measure for the Recipient's building to reduce andior mitigate the damage that might otherwise occur from severe weather or other hazards. The funding of this project by the Department does not confer or imply any warranty of use or suitability for the work performed pursuant to this agreement. The State of Florida disclaims all warranties with regard to this mitigation project, express or implied, including but not limited to, any implied warranties and/or conditions of satisfactory quality and fitness for a particular purpose, merchantability, or merchantable quality. This project has not been evaluated by the criteria contained in the standards of the Department of Homeland Security, Federal Emergency Management Agency (FEMA) guidance manual FEMA 361-Design and Construction for Community Shelter, and thus does not provide "near absolute protection." It is understood and agreed by the Department and the Recipient that the building may have vulnerabilities due to age, design and location which may result in damage to the building from wind events even after the installation of the mitigation measures funded under this Subgrant Agreement. !t Is further understood and agreed by the Department and the Recipient that the level of wind protection provided by the mitigation action, although meeting State standards and codes and enhancing the structural integrity of the building, does not ensure the safety of survival of building occupants. 4 i:fr =' v) c4i 1 Contract Number. 08-EC-30-11.5401-039 MODIFICATION #1 TO STATE -FUNDED SUBGRANT AGREEMENT This Modification is made and entered into by and between the State of Florida, Division of Emergency Management, ("the Division"), and Monroe County ("the Recipient@) to modify the Division's Contract Number 08-EC-30-11-54-01-039, dated August 27, 2007 ("the Agreement"). WHEREAS, the Division and the Recipient have entered into the Agreement, pursuant to which the Division has provided a subgrant of $1,029,547.00 in state funds to Recipient; and WHEREAS, the Division now intends to provide additional funds to the Recipient of $69,966.00 in federal funds; and WHEREAS, the state funds of $1,029,547.00 must be expended on or before June 30, 2009, and the federal funds of $69,966.00 must be expended on or before May 8, 2009; and WHEREAS, the Division and the Recipient desire to modify the Agreement by amending the Scope of Work, the Budget and by adding the appropriate federal attachments. NOW. THEREFORE, in consideration of the mutual promises of the parties contained herein, the parties agree as follows: 1. Paragraph 17 of the Agreement is hereby amended to increase the total funding under the Agreement to $1,099,513.00. 2. The Budget and Scope of Work, Attachment A, to this Agreement, is hereby deleted in its entirety, and the Revised Budget and Scope of Work, Revised Attachment A -State and Revised Attachment A -Federal, to this Modification, which are attached hereto and Incorporated herein by reference, are substituted In its place and stead. The revised Budget and Scope of Work, Attachment A -Federal, contains the additional provisions that apply to the added federal funding. 3. Attachment A -Federal, the Recipient understands that Phase I is approved with the condition that no construction can begin until the results of the deliverables are reviewed, and Phase U activities are approved. Failure to comply with this condition could result in the loss of all funding for this project. 4. Attachment E, Federal Audit Requirements, is attached hereto and incorporated herein by reference. Attachment E is required for compliance with federal standards. 5. Attachment F, Federal Recordkeeping, is attached hereto and incorporated herein by reference. Attachment F is required for compliance with federal standards. 6. Attachment G, Federal Standard Conditions, is attached hereto and incorporated herein by reference. Attachment G is required for compliance with federal standards. 7. Attachment H. Federal Lobbying Prohibition, Is attached hereto and incorporated herein by reference. Attachment H is required for compliance with federal standards. 8. Attachment 1, Federal Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion, is attached hereto and incorporated herein by reference. Attachment I is required for compliance with federal standards. 9. Attachment J, Federal Statement of Assurances, is attached hereto and incorporated herein by reference. Attachment J is required for compliance with federal standards. 10. All provisions not in conflict with this Modification remain in full force and effect, and are to be performed at the level specified in the Agreement. 11. All provisions of the Agreement being modified and any attachments thereto in conflict with this Modification shall be and are hereby changed to conform with this Modification, effective as of the date of the last execution of this Modification by both parties. IN WITNESS WHEREOF he parties hereto have executed this document as of the dates set out herein. RECIPIENT: MONRO CO Ty BY: NAME & TITLE: Mayy iarlr/"Sonny" McCoy DATE: January 16/2008 STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT BY: /---, W. Craig Fug'�a//te, Dlrecfir ` DATE: ��J, :, MONRQE COUNTY ATTORNEY PP qM. S TO FORM: 4HRI NIMBE T-BARROW$ A 1919 AUNTY ATTORNEY Dats 1 I1 /,2 a m S 2s N C17 N N 4LA iN Revised Attachment A State Budget and Scope of Work SCOPE OF WORK A. The Recipient shall construct a County Emergency Operations Center (EOC). Use of grant funds shall be consistent with Section 1(1), Ch. 2006-71, Laws of Florida. Grant funds shall not be used for land acquisition; purchase of equipment, furnishings, communications, or operational systems; or recurring expenditures. Eligible reimbursement costs include: Architectural and Engineering services and fees; site survey and soil testing; necessary permits and fees; civil and service utilities site work; construction of the building's substructure, superstructure, shell (exterior enclosure) and Interior construction; special inspections; mechanical, plumbing, electrical, conveying and security systems; lightning protection; and redundant infrastructure systems (e.g., electric generator, uninterruptible power supply, potable water and wastewater systems, etc.). 8. The Recipient shall in a timely manner prepare and submit a complete Hazard Mitigation Grant Program (HMGP) application, benefit -cost analysis, environmental review and such other documentation as necessary to determine eligibility and allowable costs under said grant program. C. The Recipient shall state in writing that for a period of not less than 15 years from the date of receipt of Certificate of Occupancy the EOC will be dedicated for emergency management purposes. The EOC shall remain demonstrably capable of being fully activated within one (1) hour of detection of an emergency; reference Rule Chapter 9G-6, Florida Administrative Code, "Emergency Management Capabilities Assessment Checklist." D. The EOC shall be constructed with sufficient space to house people and equipment for day -today and sustained continuous emergency operations, and capable of full staffing for the most extensive emergency anticipated. At a minimum, the designated EOC functional area(s), and essential shared -use area(s) if applicable, shall be designed for an emergency operations staff size of §2 persons per shift and a workspace floor area of 5.270 gross square feet E. At a minimum, the EOC shall meet the hurricane hazard safety criteria established in Standards for Hurricane Evacuation Shelter Selection (ARC 4496). F. The EOC and essential ancillary structures and service equipment shall be designed to with the American Society of Civil Engineers (ASCE) Standard 7, Minimum Design Loresist the effects of a major hurricane. The wind load design requirements shall be in ads for accordance Buildings and Other Structures. The minimum wind design criteria shah include: Design Wind Speed = 225 miles per hour (3 second gust) Wind Importance Factor, / = i.00 Exposure Category = C Directionality Factor, Kd - 1.00 Internal Pressure Coefficient, GCp, _ +/_ 0.18 All components and cladding assemblies necessary to maintain a structurally enclosed condition and prevent rainwater intrusion shall be designed to meet the wind Oesign criteria. Structural metal decking and cladding materials shall be 22 gauge or thicker. Rtoof cover waterproofing barriers shall meet the wind design criteria. Loose roof ballast shallmot be used on the roof cover. Rooftop equipment shall be designed and installed to meet the wind design criteria. G. The EOC and essential ancillary structures and service equipment shall resist penetration by windborne debris impact. At a minimum, all exterior enclosure components, claddings and assemblies (i.e., walls, roofs, louvers, windows, doors, etc.) located within 60 feet in height above finish grade shall meet the hurricane windborne debris impact criteria specified in the Department of Energy's (DOE) Standard, Natural Phenomena Hazards Design and Evaluation Criteria, DOE- STD-1020-2002. That is, the building enclosure must resist penetration by a nominal 2"x4" lumber plank weighing 15 pounds propelled at 50 miles per hour (74 feet per second) striking end -on and normal to the assembly surface, or equivalent performance as approved by the Division. As applicable, impact test procedures shall be consistent with recognized state and national standards; such as, Test Standard for Determining Impact Resistance from Wnndborne Debris SSTD 12, American Society of Testing and Materials (ASTM) Standards ASTM E 1886 and ASTM E 1996, and Florida Building Code Testing Protocols TAS 201, TAS 202 and TAS 203. The impact test procedures may be modified as necessary to accommodate the required missile weight and velocity. H. The following Information related to wind loads and flooding shall be shown on the construction drawings: 1. wind design per ASCE 7 with applicable year of revision; 2. design wind speed; 3. wind importance factor, I; 4. design wind exposure category; 5. wind directionality factor, Kd; 6. design internal pressure coefficient, GC,4 7. design wind pressures in terms of pounds per square foot (psf) to be used for the design of exterior component and cladding materials not specifically designed by the principal licensed design professional; 8. windborne debris impact performance criteria; 9. finish floor elevation measured relative to the National Geodetic Vertical Datum (NGVD); and comparison reference of the finished floor elevation to the base flood elevation, or historical flood elevation If base flood elevation is not determined. 1. The lowest floor for the EOC and essential ancillary structures and service equipment shall at a minimum be elevated above: Category 5 hurricane storm surge elevation plus 20 percent; the base flood elevation plus three (3) feet; the 500-year (0.2 percent annual chance) flood elevation (if determined) plus two (2) feet; the highest recorded flood elevation plus three (3) feet if the area is not in a mapped special flood hazard area; whichever is greater. The site (point maximum, one square mile) hydrologic design shall ensure that the EOC and essential ancillary structures and service equipment are not flooded due to a 24 hour, 37.0 inch rainfall event applied over a precedent 24 hour, 100-year rainfall event. J. Where secondary (emergency) roof drains or scuppers are required by the Florida Building Code —Plumbing, the secondary system shall be sized for a rainfall rate of eleven (11.0) inches per hour. K. The EOC shall be designated as a threshold building, and special structural inspections required. Special inspections shall be conducted In compliance with section 553.79, Florida Statutes and other applicable statutes, laws and rules. L. The EOC shall at a minimum be designed for 72 hours of self-contained continuous operation and shall not be solely reliant upon off -site services and utilities (e.g., water, natural gas fuel, electricity, etc.) M. Force protection and security measures shall be consistent with the guidance published in Florida's Homeland Security Comprehensive Assessment Model (HLSCAM), United States Air Force Installation Force Protection Guide, or other federal or state recognized best -practices guide(s) as approved by the Division. N. The Recipient shall provide an initial timeline and estimated reimbursement allocation schedule. Table SW-1, `Initial Timeline and Estimated Reimbursement Allocation Schedule" or other similar instrument as approved by the Division may be used. 4 O. During design and construction phases of the EOC project, the Recipient shall track and Provide construction cost data for the designated EOC area as detailed in Table SW-2, "Cost Data for County Emergency Operations Center." I1. PR09 TEItAS A. Per item IN, Recipient shall prepare an initial timeline with key milestone activities/tasks schedule, including estimated start and end dates for each activity, and an estimate of state reimbursement request for each activity. Table SW-1 may be used to meet this product item. B. Per item I-C, Recipient shall submit a binding written statement that the EOC will be dedicated for a period of not less than I S years for emergency management purposes, and demonstrably capable of being fully activated within one (1) hour of detection of an emergency. C. The Recipient shall provide one (1) copy each of site survey, site master plan, spatial needs assessment, and schematic design plan or preliminary design drawings for review and comment by the Division. The spatial needs assessment and schematic design plan/preliminary design may be consolidated into one document. D. The Recipient shall provide one (1) set of substantially complete (approximately 70 percent) preliminary design construction drawings and specificalons for the EOC and essential ancillary structures for review and comment by the Division. The construction drawings shall include site survey information, landscaping, civil, architectural, structural, mechanic, plumbing, and electrical drawings. E. The Recipient shall provide one (1) set of bid -ready construction drawings and specifications for the EOC and essential ancillary structures for review by the Division. The +ction drawings shall include site survey iMormation, landscaping, civil, architectural, constn structural, mechanical, plumbing, and electrical drawings and shag be certified by the applicable registered or licensed design professional(s) of record. F. The construction drawings shall demonstrate that the EOC will meet the hurricane hazard safety criteria of ARC 4496, and the wind load, windborne debris impact, flood and security design requirements set forth in items i.E through I.M. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial of funds. G. Per item 1.8, Recipient shall submit a complete HMGP application, benefit -cost analysis, environmental review and such other documentation as necessary to determine eligibility and cost allowances under said grant program. The Recipient shall afro provide two cost estimates prepared by one or more certified construction contractors that document the cost of constructing the facility to meet current building code wind and flood design requirements, and the cost premium of constructing the facility to the above -code wind and flood requirements set forth I items LE through I.J. n H. Per item 1.0, the Recipient shall provide final project cost data. Table SW-2 shall be used to meet this product item. 1. The Recipient shalt provide the Division with copy(s) of pertinent construction permits, the threshold inspection final report, and the certificate of occupancy upon completion of the construction project. •;. A. By June 30, 2007, the Recipient shall provide the Division with Product Items A and B for documentation by the Division, shall result in denial of funds. review and approval. Failure to supply the required documentation, or disapproval of this B. By September 30, 2007 and at least on a quarterly basis thereafter, Recipient shall report on progress in relation to the initial timeline, and submit Product Items C through H in a timely manner as accomplished. The Division shall be provided 30 calendar days to review and provide comments of product items pertaining to compliance with the scope -of -work. The Recipient shall also submit invoices for reimbursement for work accomplished in accordance with the Division approved cost reimbursement allocation schedule referenced in Product Item A- C. By a mutually agreed upon date, the Recipient shall provide the Division with Product Item F for review and approval. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial or reduction of funds at the sole discretion of the Division. D. By May 15, 2009, the Recipient shall provide final project cost estimate data as set forth in Table SW-2, certificate of occupancy, close-out documentation and final payment invoice. a Table SW-1. Initial Timeline and Estimated Reimbursement Allocation Schedule Table SW-2. Cost Data for County Emergency Operations Center Revised Attachment A - Federal Budget and Scope of Work As a Hazard Mitigation Grant Program project, the Recipient, Monroe County, will conduct a Phase 1 engineering feasibility study to identify modifications needed to wind retrofit the new Monroe County Emergency Operations Center, located at 9400 Overseas Highway, Marathon, Florida 33050, above the Florida Building Code or Miami -Dade Specifications. Phase I will provide funding for completion of design, surveying and permitting for this proposal. In order for Phase II to be considered for funding, Phase i deliverables mush include a complete proposed budget and scope of work, along with engineering data from the study and engineering plans. Phase 1 of this project is approved with the condition that the above list of deliverables will be submitted for review and approval by the State and FEMA before Phase II Is considered. No construction work may begin until Phase If deliverables are reviewed and approved by FEMA. Failure to comply with this condition can result in the loss of all funding for this project. The Period of Performance for this project ends on May 8, 2009. Schedule of Work State Contracting: Request for A/E Proposal & Review: Bidding of Design: Encineerina/Architect r aFnn Total Period of Performance: Line Item 9udaet• Survey, Engineering Design, Environmental Permitting: Sub -total: Aslministra ive Costa Total: Project Cost 3 Months 3 Months 3 Months 15 Months Federal Share local Share $ 89�--� 7 $$ 87 275�00 $22,42.5.00 ,�,4� $ 89�, 70�0 0�0 $ Z&Q1A $ — 42--45.�.0QQ ' Any line item amount in this Budget may be increased or decreased 10% or less without an amendment to this Agreement being requked, so long as the overall amount of the funds obligated under this Agreement is not increased. _ M ui,: 17A Federal Share: $67,275.00 (75%) Local Share: 4 5 Q0 (25%) Total Project Cost: $89,700.00 (100%) Recipient Administrative Allowance up to $2,691.00 The materials and work funded pursuant to this Subgrant Agreement are intended to decrease the vulnerability of the building to property losses and are specificAlly not intended to provide for the safety of inhabitants before, during or after a natural man made disaster. The funding provided by the Division of Emergency Management under this subgrant shall compensate for the materials and labor for the installation of storm shutters and/or other 10 hardening activities as a retrofit measure for the Recipient's building to reduce and/or mitigate the damage that might otherwise occur from severe weather or other hazards. The funding of this Project by the Department does not confer or imply any warranty of use or suitabitity for the work performed pursuant to this agreement The State of Florida disclaims all warranties with regard to this mitigation project, express or implied, including but not limited to, any implied warranties and/or conditions of satisfactory quality and fitness for a particular purpose, merchantability, or merchantable quality. This project has not been evaluated by the criteria contained in the standards of the Department of Homeland Security, Federal Emergency Management Agency (FEMA) guidance manual FEMA 361-Design and Construction for Community Shelter, and thus does not provide near absolute protection." It is understood and agreed by the Department and the Recipient that the building may have vulnerabilities due to age, design and location which may result in damage to the building from wind events even after the installation of the mitigation measures funded under this Subgrant Agreement It is further understood and agreed by the Department and the Recipient that the level of wind protection provided by the mitigation action, although meeting State standards and codes and enhancing the structural IntegrNy of the building, does not ensure the safety of survival of building occupants. 11 Attachment E Federal Audit Requirements If the Recipient is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised, and in the event that the Recipient expends $500,Ooo or more in Federal awards in its fiscal year, the Recipient must have a single or program -specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised. EXHIBIT i to this Agreement indicates Federal resources awarded through the Division by this Agreement. in determining the Federal awards expended in its fiscal year, the Recipient shall consider all sources of Federal awards. 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 Recipient conducted by the Auditor General In accordance with the provisions of OMB Circular A- 133, as revised, will meet the requirements of this paragraph. In connection with the audit requirements addressed In this Paragraph 6 (d) above, the Recipient shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C Of OMB Circular A-133, as revised. If the Recipient 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 Recipient 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 pail from Recipient resources obtained from other than Federal entitles). Copies of reporting packages for audits conducted in accordance with OMB Circular A- 133, as revised, and required by subparagraph (d) above shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the Recipient direc" of the following: to each Department of Community Affairs Office of Audit Services 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 [an electronic copy shall also be submitted to aurilla.parrish@dcs.stato.fi.usj and Division of Emergency Management Bureau of Policy and Financial Management 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections .320(dxl) 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 loth Street Jeffersonville, IN 47132 Other Federal agencies and pass -through entities in accordance with Sections .320 (e) and {fl OMB Circular A-133, as revised. 12 Pursuant to Section .320 (0, OMB Circular A-133, as revised, the Recipient shall submit a copy of the reporting package described in Section .320 (c), OMS Circular A-133, as revised, and any management letter issued by the auditor, to the following addresses: Department of Community Affairs Office of Audit Services 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 [an electronic copy shall also be submitted to aurills.parrish c@i dca.state.fl.usj and Division of Emergency Management Bureau of Policy and Financial Management 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2160 13 Attachment F Federall Recordkeeping As applicable, Recipient's performance under this Agreement shall be subject to the federal Common Rule: Uniform Administrative Requirements for State and Local Governments" (53 Federal Register 8034) or OMB Circular No. A-110, "Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Nonprofit Organizations," and either OMB Circular No. A- 87, "Cost Principles for State and Local Governments," OMB Circular No. A-21, "Cost Principles for Educational Institutions," or OMB Circular No. A-122, "Cost Principles for Nonprofit Organizations." If this Agreement is made with a commercial (for -profit) organization on a cost - reimbursement basis, the Recipient shall be subject to Federal Acquisition Regulations 31.2 and 931.2. 14 Attachment G Federal Standard Conditions With respect to any Recipient which is not a local government or state agency, and which receives funds under this Agreement from the federal government, by signing this Agreement, the Recipient certifies, to the best of its knowledge and belief, that it and its principals: 1. are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by a federal department or agency, 2. have not, within a five-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state focal) transaction or contract under public transor action; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. are not presently indicted or otherwise criminally or civilly charged by a governmental entity (federal, state or local) with commission df any offenses enumerated in paragraph 20(h)2. of this certification; and 4. have not within a five-year period preceding this Agreement had one or more public transactions (federal, state or local) terminated for cause or default. Where the Recipient is unable to certify to any of the statements in this certification, such Recipient shall attach an explanation to this Agreement. In addition, the Recipient shall submit to the Division (by email or by facsimile transmission) the completed "Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion' (Attachment K) for each prospective subcontractor which Recipient intends to fund under this Agreement. Such form must be received by the Division prior to the Recipient entering Into a contract with any prospective subcontractor. The State of Florida's performance and obligation to pay under this Agreement 1s contingent upon an annual appropriation by the Legislature, and subject to any modification in accordance with Chapter 216, Fla. Stat or the Florida Constitution. Unless Inconsistent with the public Interest or unreasonable in cost, all unmanufactured and manufactured articies, materials and supplies which are acquired for public use under this Agreement must have been produced in the United States as required under 41 U.S.C. 1 Oa. 15 Attachment H Federal Lobbying Prohibition The Recipient certifies, by its signature to this Agreement, that to the best of his or her knowledge and belief: 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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement. 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 of 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 on 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 subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subreciplents 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. 16 Attachment 1 Debarment, Suspension, I Contractor Covered Transactions (1) The prospective contractor of the Recipient, certifies, by submission of this document, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the Recipient's contractor is unable to certify to the above statement, the Prospective contractor shall attach an explanation to this form. CONTRACTOR: By: Signature Recipient's Name Name and Title Division Contract Number Street Address City, State, Zip Date 17 Attachment J Federal Statement of Assurances The Recipient hereby assures and certifies compliance with all Federal statutes, regulations, policies, guidelines and requirements, including OMB Circulars No. A-21, A-110, A-122, A-128, A- 87; E.O. 12372 and Uniform Administrative Requirements for Grants and Cooperative Agreements 28 CFR, Part 66, Common rule, that govern the application, acceptance and use of Federal funds for this federally -assisted project. Also the Applicant assures and certifies that: 1. It will comply with requirements of the provisions of the Uniform Relocation Assistance and Real Property Acquisitions Act of 1970 (P.L. 91-646) which provides for fair and equitable treatment of persons displaced as a result of Federal and federally -assisted programs. 2. It will comply with provisions of Federal law which limit certain political activities of employees of a State or local unit of government whose principal employment is In connection with an activity financed in whole or in part by Federal grants. (5 USC 1501, et seq.) 3. It will comply with the minimum wage and maximum hours provisions of the Federal Fair Labor Standards Act. 4. It will establish safeguards to prohibit employees from using their positions for a purpose that is or gives the appearance of being motivated by a desire for private gain for themselves or others, particularly those with whom they have family, business, or other ties. S. It will give the sponsoring agency or the Comptroller General, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the grant. 6. It will comply with all requirements imposed by the Federal sponsoring agency concerning special requirements of law, program requirements, and other administrative requirements. 7. It will insure that the facilities under its ownership, lease or supervision which shall be utilized in the accomplishment of the project are not listed on the Environmental Protection Agency's (EPA) list of Violating Facilities and that it will notify the Federal grantor agency of the receipt of any communication from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is under consideration for listing by the EPA. 8. It will comply with the flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973, Public Law 93-234, 87 Stat. 975, approved December 31, 1976, Section 102(a) requires, on and after March 2, 1975, the purchase of flood insurance in communities where such insurance is available as a condition for the receipt of any Federal financial assistance for construction or acquisition purposes for use in any area that has been identified by the Secretary of the Department of Housing and Urban Development as an area having special flood hazards. The phrase "Federal financial assistance" includes any form of loan, grant, guaranty, insurance payment, rebate, subsidy, disaster assistance loan or grant, or any other form of direct or indirect Federal assistance. 9. It will assist the Federal grantor agency in its compliance with Section 106 of the National Historic Preservation Act of 1986 as amended (16 USC 470), Executive Order 11593, and the Archeological and Historical Preservation Act of 19W (16 USC 5$9a-1 et seq.) by (a) consulting with the State Historic Preservation Officer on the conduct of Inv tigations, as necessary, to identify properties listed in or eligible for inclusion in the National egister of Historic Places that are subject to adverse effects (see 36 CFR Part 800.8) by the activity, and notifying the Federal grantor agency of the existence of any such properties and by (b):complying with all requirements 18 established by the Federal grantor agency to avoid or mitigate adverse effects upon such properties. 10. It will comply, and assure the compliance of all its subgrantees and contractors, with the applicable provisions of Title 1 of the Omnibus Crime Control and Safe Streets Act of 1968, as amended, the Juvenile Justice and Delinquency Prevention Act, or the Victims of Crime Act, as appropriate; the provisions of the current edition of the Office of Justice Programs Financial and Administrative Guide for Grants, M7100.1; and all other applicable Federal laws, orders, circulars, or regulations. 11. It will comply with the provisions of 28 CFR applicable to giants and cooperative agreements including Part 18, Administrative Review Procedure, Part 20, Criminal Justice Information Systems; Part 22, Confidentiality of Identifiable Research and Statistical Information; Part 23, Criminal Intelligence Systems Operating Policies; Part 30, Intergovernmental Review of Department of Justice Programs and Activities; Part 42, Nondiscriminadon/Equal Employment Opportunity Policies and Procedures; Part 61, Procedures for lImplementing the National Environmental Policy Act; Part 63, Floodplain Management anp Wetland Protection Procedures; and Federal laws or regulations applicable to Federal Assistance Programs. 12. It will comply, and all its contractors will comply, with the non-discrimination requirements of the Omnibus Crime Control and Safe Streets Act of 1968, as ainended, 42 USC 3789(d), or Victims of Crime Act (as appropriate); Title VI of the Civil Rights Act of 1964, as amended; Section 504 of the Rehabilitation Act of 1973, as amended; Subtitle A, Title iI of the Americans with Disabilities Act (ADA) (1990); Title IX of the Education Amendments of 1972; the Age Discrimination Act of 1975; Department of Justice Non -Discrimination Regulations, 28 CFR Part 42, Subparts C,D,E, and G; and Department of Justice regulations on disability discrimination, 28 CFR Part 35 and Part 39. 13. In the event a Federal or State court or Federal or State administrative agency makes a finding of discrimination after a due process hearing on the Grounds of race, color, religion, national origin, sex, or disability against a recipient of funds, the recipient will forward a copy of the finding to the Office for Civil Rights, Office of Justice Programs. 14. It will provide an Equal Employment Opportunity Program if required to maintain one, where the application is for $500,000 or more. 15, it will comply with the provisions of the Coastal Barrier Resources Act (P.L. 97-348) dated October 19, 1982 (16 USC 3501 et seq.) which prohibits the expenditure of most new Federal funds within the units of the Coastal Barrier Resources System, 16. DRUG -FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS) As required by the Drug -Free Workplace Act of 1988, and implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part 67 Sections 67.815 and 67.620. 19 Ls-EG-�i; ► 1 �ti •�i G:S�ti Contract Number: STATE -FUNDED SUBGRANT AGREEMENT THIS AGREEMENT is entered into by and between the State of Florida, Division of Emergency Management, with headquarters in Tallahassee, Florida (hereinafter referred to as the "Division"), and Monroe County, (hereinafter referred to as the "Recipient"). THIS AGREEMENT IS ENTERED INTO BASED ON THE FOLLOWING REPRESENTATIONS: A. WHEREAS, the Recipient represents that it is fully qualified and eligible to receive these grant funds to provide the services identified herein; and B. WHEREAS, the Division has received these grant funds from the State of Florida, and has the authority to subgrant these funds to the Recipient upon the terms and conditions hereinafter set forth; and C. WHEREAS, the Division has authority to disburse the funds under this Agreement pursuant to State Fiscal Year 2006 — 2007, Chapter 2006-71, Laws of Florida, Section b. The purpose of this act implements provisions relating to county emergency operations centers and designated alternate state emergency operations centers. NOW, THEREFORE, the Division and the Recipient do mutually agree as follows: (1) SCOPE OF WORK. The Recipient shall fully perform the obligations in accordance with the Budget and Scope of Work, Attachment A of this Agreement. (2) INCORPORATION OF kWg RULES REGULATIONS AND POLICIES IFS Both the Recipient and the Division shall be governed by applicable State and Federal laws, rules and regulations, including but not limited to those identified in Attachment B. (3) PERIOD OF AGR EMENT. This Agreement shall begin January 24, 2007, and shall end June 30, 2009, unless terminated earlier in accordance with the provisions of Paragraph (12) of this Agreement. (4) MODIFICATION OF CONTRACT Either party may request modification of the provisions of this Agreement. Changes which are mutually agreed upon shall be valid only when reduced to writing, duly signed by each of the parties hereto, and attached to the original of this Agreement. (5) RECORDKEEPING (a) The Recipient shall retain sufficient records demonstrating its compliance with the terms of this Agreement, and the compliance of all subcontractors or consultants to be paid from funds provided under this Agreement, for a period of five years from the date the audit report is issued, and shall allow the Division or its designee, the Chief Financial Officer, or Auditor General access to such records upon request. The Recipient shall ensure that audit working papers are made available to the Division or its designee, the Chief Financial Officer, or Auditor General upon request for a period of five years from the date the audit report is issued, unless extended in writing by the Department, with the following exceptions: 1. If any litigation, claim or audit is started before the expiration of the five year period and extends beyond the five year period, the records will be maintained until all litigation, claims or audit findings involving the records have been resolved. 2. Records for the disposition of non -expendable personal property valued at $5,000 or more at the time of acquisition shall be retained for five years after final disposition. 3. Records relating to real property acquisition shall be retained for five years after closing of title. (b) The Recipient shall maintain all records, for the Recipient and for all subcontractors or consultants to be paid from funds provided under this Agreement, including supporting documentation of all program costs, in a form sufficient to determine compliance with the requirements and objectives of the Budget and Scope of Work - Attachment A - and all other applicable laws and regulations. (c) The Recipient, its employees or agents, including all subcontractors or consultants to be paid from funds provided under this Agreement, shall allow access to its records at reasonable times to the Department, its employees, and agents. "Reasonable" shall be construed according to the circumstances but ordinarily shall mean during normal business hours of 8:00 a.m. to 5:00 p.m., local time, on Monday through Friday. "Agents" shall include, but not be limited to, auditors retained by the Division. I (6) At�DIT REQUIREMENTS (a) The Recipient agrees to maintain financial procedures and support documents, in accordance with generally accepted accounting principles, to account for the receipt and expenditure of funds under this Agreement. (b) These records shall be available at all reasonable times for inspection, review, or audit by state personnel and other personnel duly authorized by the Division. "Reasonable" shall be construed according to circumstances, but ordinarily shall mean normal business hours of 8:00 a.m. to 5:00 p.m., local time, Monday through Friday. (c) The Recipient shall also provide the Division with the records, reports or financial statements upon request for the purposes of auditing and monitoring the funds awarded under this Agreement. (d) If the Recipient is a nonstate entity as defined by Section 215.97, Fla. t, it shall comply with the following: Slat, In the event that the Recipient expends a total amount of State financial assistance equal to or in excess of $500,000 in any fiscal year of such Recipient, the Recipient must have a State single or project -specific audit for such fiscal year in accordance with Section 215.97, FI applicable rules of the Executive Office of the Governor and the Chief Financial Officer; and Chapters 10.550 (local government entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. EXHIBIT 1 to this Agreement indicates State financial assistance awarded through the Division by this Agreement. In determining the State financial assistance expended in its fiscal year, the Recipient shall consider all sources of State financial assistance, including State funds received from the Division, 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 this Paragraph 6(d) above, the Recipient shall ensure that the audit complies with the requirements of Section 215.97(7), Fla. Stat. This includes submission of a reporting package as defined by Section 215.97(2)(d), Fla. % . and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. If the Recipient expends less than $500,000 in State financial assistance in its fiscal year, an audit conducted in accordance with the provisions of Section 215.97, F_ la. Stat, is not required. In the event that the Recipient expends less than $500,000 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the 3 provisions of Section 215.97, Fla. tat, 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 Recipient's resources obtained from other than State entities). Additional information on the Florida Single Audit Act may be found at the following website: httq:. 'wwwr.Vate flus fsaa'statutes hfml. (e) Report Submission 1. The annual financial audit report shall include all management letters and the Recipient's response to all findings, including corrective actions to be taken. 2. The annual financial audit report shall include a schedule of financial assistance specifically identifying all Agreement and other revenue by sponsoring agency and Agreement number. 3. Copies of financial reporting packages required under this Paragraph 6 shall be submitted by or on behalf of the Recipient directl to each of the following: The Division of Community Affairs at each of the following addresses: Division of Community Affairs Office of Audit Services 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 (an electronic copy shall also be submitted to eurllls.parrlsh®dca.state.fl.usj and Division of Emergency Management Bureau of Policy and Budget 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 The Auditor General's Office at the following address: Auditor General's Office Room 401, Claude Pepper Building 111 West Madison Street Tallahassee, Florida 32399-1450 4. Any reports, management letter, or other information required to be submitted to the Division or the Department of Community Affairs 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. 5. Recipients, when submitting financial reporting packages to the Division or the Department of Community Affairs 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 Recipient in correspondence accompanying the reporting package. (f) In the event the audit shows that the entire funds disbursed hereunder, or any portion thereof, were not spent in accordance with the conditions of this Agreement, the Recipient shall be held liable for reimbursement to the Division of all funds not spent in accordance with these applicable regulations and Agreement provisions within thirty (30) days after the Division has notified the Recipient of such non-compliance. (9) The Recipient shall have all audits completed in accordance with Section 215.97, Fla. Sta. by an independent certified public accountant (IPA) who shall either be a certified public accountant or a public accountant licensed under Chapter 473, Fla. Stat. The IPA shall state that the audit complied with the applicable provisions noted above. The audit must be submitted to the Division no later than nine (9) months from the end of the Recipient's fiscal year. (7) REPORTS (a) At a minimum, the Recipient shall provide the Division with quarterly reports, and with a close-out report. These reports shall include the current status and progress by the Recipient and all subrecipients and subcontractors in completing the work described in the Scope of Work and the expenditure of funds under this Agreement, in addition to such other information as requested by the Division. (b) Quarterly reports are due to be received by the Division no later than 30 days after the end of each quarter of the program year and shall continue to be submitted each quarter until submission of the administrative close- out report. The ending dates for each quarter of the program year are March 31, June 30, September 30 and December 31. (c) The close-out report is due 60 days after termination of this Agreement or upon completion of the activities contained in this Agreement, whichever first occurs. (d) If all required reports and copies, prescribed above, are not sent to the Division or are not completed in a manner acceptable to the Division, the Division may withhold further payments until they are completed or may take such other action as set forth in Paragraph (11) REMEDIES. "Acceptable to the Division" means that the work product was completed in accordance with the Budget and Scope of Work. 5 the Division. (e) The Recipient shall provide such additional program updates or information as may be required by (8) MONITORING. The Recipient shall monitor its performance under this Agreement, as well as that of its subcontractors, subrecipients and consultants who are paid from funds provided under this Agreement, to ensure that time schedules are met, the Budget and Scope of Work is accomplished within the specified time periods, and other performance goals stated in this Agreement are achieved. Such review shall be made for each function or activity set forth in Attachment A to this Agreement, and reported in the quarterly report. In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised and Section 215.97, Fla. Stat. (see Paragraph (6) AUDIT REQUIREMENTS, above), monitoring procedures may include, but not be limited to, on -site visits by Division staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this Agreement, the Recipient agrees to comply and cooperate with all monitoring procedures/processes deemed appropriate by the Division. In the event that the Division determines that a limited scope audit of the Recipient is appropriate, the Recipient agrees to comply with any additional instructions provided by the Division to the Recipient regarding such audit. The Recipient further agrees to comply and cooperate with any inspections, reviews, investigations or audits deemed necessary by the Chief Financial Officer or Auditor General. In addition, the Division will monitor the performance and financial management by the Recipient throughout the contract term to ensure timely completion of all tasks. (9) LIABILITY. (a) Unless Recipient is a State agency or subdivision, as defined in Section 768.28, Fla. Stat., the Recipient shall be solely responsible to parties with whom it shall deal in carrying out the terms of this Agreement, and shall hold the Division harmless against all claims of whatever nature by third parties arising out of the performance of work under this agreement. For purposes of this Agreement, Recipient agrees that it is not an employee or agent of the Division, but is an independent contractor. (b) Any Recipient who is a state agency or subdivision, as defined in Section 768.28, Fla. Stat., agrees to be fully responsible to the extent provided by Section 768.28 Fla. Stat. for its negligent acts or omissions or tortious acts which result in claims or suits against the Division, and agrees to be liable for any damages proximately caused by said G acts or omissions. Nothing herein is intended to serve as a waiver of sovereign immunity by any Recipient to which sovereign immunity applies. Nothing herein shall be construed as consent by a state agency or subdivision of the State of Florida to be sued by third parties in any matter arising out of any contract. 00) DEFA_QLT. If any of the following events occur ("Events of Default"), all obligations on the part of the Division to make any further payment of funds hereunder shall, if the Division so elects, terminate and the Division may, at its option, exercise any of its remedies set forth in Paragraph (11), but the Division may make any payments or parts of payments after the happening of any Events of Default without thereby waiving the right to exercise such remedies, and without becoming liable to make any further payment: (a) If any warranty or representation made by the Recipient in this Agreement or any previous Agreement with the Division shall at any time be false or misleading in any respect, or if the Recipient shall fail to keep, observe or perform any of the obligations, terms or covenants contained in this Agreement or any previous agreement with the Division and has not cured such in timely fashion, or Is unable or unwilling to meet its obligations thereunder; (b) If any material adverse change shall occur in the financial condition of the Recipient at any time during the term of this Agreement, and the Recipient fails to cure said material adverse change within thirty (30) days from the time the date written notice is sent by the Division. (c) If any reports required by this Agreement have not been submitted to the Division or have been submitted with incorrect, incomplete or insufficient information; (d) If the Recipient has failed to perform and complete in timely fashion any of its obligations under this Agreement. 0 1) R DI Upon the happening of an Event of Default, then the Division may, at its option, upon thirty (30) calendar days prior written notice to the Recipient and upon the Recipient's failure to cure within said thirty (30) day period, exercise any one or more of the following remedies, either concurrently or consecutively: (a) Terminate this Agreement, provided that the Recipient is given at least thirty (30) days prior written notice of such termination. The notice shall be effective when placed in the United States mail, first class mail, postage prepaid, by registered or certified mail -return receipt requested, to the address set forth in Paragraph (13) herein; 7 (b) Commence an appropriate legal or equitable action to enforce performance of this Agreement: (c) Withhold or suspend payment of all or any part of a request for payment; (d) Exercise any corrective or remedial actions, to include but not be limited to: 1. requesting additional information from the Recipient to determine the reasons for or the extent of non-compliance or lack of performance, 2. issuing a written warning to advise that more serious measures may be taken if the situation is not corrected, 3. advising the Recipient to suspend, discontinue or refrain from incurring costs for any activities in question or 4. requiring the Recipient to reimburse the Division for the amount of costs incurred for any items determined to be ineligible; (e) Require that the Recipient return to the Division any funds which were used for ineligible purposes under the program laws, rules and regulations governing the use of funds under this program; (f) Exercise any other rights or remedies which may be otherwise available under law; (g) The pursuit of any one of the above remedies shall not preclude the Division from pursuing any other remedies contained herein or otherwise provided at law or in equity. No waiver by the Division of any right or remedy granted hereunder or failure to insist on strict performance by the Recipient shall affect or extend or act as a waiver of any other right or remedy of the Division hereunder, or affect the subsequent exercise of the same right or remedy by the Division for any further or subsequent default by the Recipient. (12) TERMINATION. (a) The Division may terminate this Agreement for cause upon thirty (30) days written notice. Cause shall include, but not be limited to, misuse of funds; fraud; lack of compliance with applicable rules, laws and regulations; failure to perform in a timely manner; and refusal by the Recipient to permit public access to any document, paper, letter, or other material subject to disclosure under Chapter 119, F a I . Stat., as amended. (b) The Division may terminate this Agreement for convenience or when it determines, in its sole discretion, that the continuation of the Agreement would not produce beneficial results commensurate with the further expenditure of funds, by providing the Recipient with thirty (30) calendar days prior written notice. (c) The parties may agree to terminate this Agreement for their mutual convenience as evidenced by written amendment of this Agreement. The amendment shall establish the effective date of the termination and the procedures for proper closeout of the Agreement. (d) In the event that this Agreement is terminated, the Recipient will not incur new obligations for the terminated portion of the Agreement after the Recipient has received the notification of termination. The Recipient will cancel as many outstanding obligations as possible. Costs incurred after the date of receipt of notice of the termination will be disallowed. Notwithstanding the above, the Recipient shall not be relieved of liability to the Division by virtue of any breach of Agreement by the Recipient. The Division may, to the extent authorized by law, withhold any payments to the Recipient for purpose of set-off until such time as the exact amount of damages due the Division from the Recipient is determined. 03) NOTICE AND CONTACT. (a) All notices provided under or pursuant to this Agreement shall be in writing, either by hand delivery, or first class, certified mail, return receipt requested, to the representative identified below at the address set forth below and said notification attached to the original of this Agreement. (b) The name and address of the Division contract manager for this Agreement is: Jenene Helms Division of Emergency Management Bureau of Policy and Budget 2555 Shumard Oak Boulevard Tallahassee, FL 32399-2100 Telephone: 850-413-9920 Fax: 850-488-7842 Email: ienen ?.helmsOem m lorida com (c) The name and address of the Representative of the Recipient responsible for the administration of this Agreement is: Dave Koppel, Engineer Monroe County 110 Simonton Street Key West, Florida 33040 Telephone: 305-292-4426 Fax: 305-295-4321 Email: Kopaet-Dave Ca'monroecounty fl pov (d) In the event that different representatives or addresses are designated by either party after execution of this Agreement, notice of the name, title and address of the new representative will be rendered as provided in (13)(a) above. 0 (14) SUBCONTRACTS If the Recipient subcontracts any or all of the work required under this Agreement, a copy of the unsigned subcontract must be forwarded to the Division for review and approval prior to execution of the subcontract by the Recipient. The Recipient agrees to include in the subcontract that (i) the subcontractor is bound by the terms of this Agreement, (ii) the subcontractor is bound by all applicable state and federal laws and regulations, and (iii) the subcontractor shall hold the Division and Recipient harmless against all claims of whatever nature arising out of the subcontractor's performance of work under this Agreement, to the extent allowed and required by law. Each subcontractor's progress in performing its work under this Agreement shall be documented in the quarterly report submitted by the Recipient. For each subcontract, the Recipient shall provide a written statement to the Division as to whether that subcontractor is a minority vendor, as defined in Section 288.703, Fla. Stat, 05) TERMS AND CONDITIONS This Agreement contains all the terms and conditions agreed upon by the parties. (16) ATTACHMENTS (a) All attachments to this Agreement are incorporated as if set out fully herein. (b) In the event of any inconsistencies or conflict between the language of this Agreement and the attachments hereto, the language of such attachments shall be controlling, but only to the extent of such conflict or inconsistency. (c) This Agreement has the following attachments: Exhibit i - Funding Sources Attachment A - Budget and Scope of Work Attachment B - Program Statutes and Regulations Attachment C - Justification of Advance Attachment D - Warranties and Representations (17) FUNDING/CONSIDERATION (a) This is a cost -reimbursement Agreement. The Recipient shall be reimbursed for costs incurred in the satisfactory performance of work hereunder in an amount not to exceed $1,029,547 subject to the availability of funds. 10 (b) Any advance payment under this Agreement is subject to Section 216.181(16), Fla. Stat., and is contingent upon the Recipient's acceptance of the rights of the Division under Paragraph (12)(b) of this Agreement. The amount which may be advanced may not exceed the expected cash needs of the Recipient within the first three (3) months of the contract term. If an advance payment is requested, the budget data on which the request is based and a justification statement shall be included in this Agreement as Attachment C. Attachment C will specify the amount of advance payment needed and provide an explanation of the necessity for and proposed use of these funds. No advance payment is requested. 2• An advance payment of $ is requested. (c) After the initial advance, if any, payment shall be made on a reimbursement basis as needed. The Recipient agrees to expend funds in accordance with the Budget and Scope of Work, Attachment A of this Agreement. ff the necessary funds are not available to fund this Agreement as a result of action by Congress, the state Legislature, the Office of the Chief Financial Officer or the Office of Management and Budgeting, all obligations on the part of the Division to make any further payment of funds hereunder shall terminate, and the Recipient shall submit its closeout report within thirty (30) days of receipt of notice from the Department. (18) REPAYMENTS All refunds or repayments to be made to the Division under this Agreement are to be made payable to the order of "Department of Community Affairs", and mailed directly to the Department at the following address: Department of Community Affairs Cashier Finance and Accounting 2555 Shumard Oak Boulevard Tallahassee FL 32399-2100 In accordance with Section 215.34(2), Fta. Stat., if a check or other draft is returned to the Division for collection, Recipient shall pay to the Division an additional service fee of Fifteen Dollars ($15.00) or Five Percent (5%) of the face amount of the returned check or draft, whichever is greater. (19) VENDOR PAYMENTS Pursuant to Section 215.422, Fla. $taL, the Division shall issue payments to vendors within 40 days after receipt of an acceptable invoice and receipt, inspection, and acceptance of goods and/or services provided in accordance with the terms and conditions of the Agreement. Failure to issue the warrant within 40 days shall result in the Division paying interest at a rate as established pursuant to Section 55.03(1) Fla. tat. The interest penalty shall be paid within 15 days after issuing the warrant. Vendors experiencing problems obtaining timely payment(s) from a state agency may receive assistance by contacting the Vendor Ombudsman at (850) 413-5516. (20) STANDARD CONDITIONS (a) The validity of this Agreement is subject to the truth and accuracy of all the information, representations, and materials submitted or provided by the Recipient in this Agreement, in any subsequent submission or response to Division request, or in any submission or response to fulfill the requirements of this Agreement, and such information, representations, and materials are incorporated by reference. The lack of accuracy thereof or any material changes shall, at the option of the Division and with thirty (30) days written notice to the Recipient, cause the termination of this Agreement and the release of the Division from all its obligations to the Recipient. (b) This Agreement shall be construed under the laws of the State of Florida, and venue for any actions arising out of this Agreement shall lie in Leon County. If any provision hereof is in conflict with any applicable statute or rule, or is otherwise unenforceable, then such provision shall be deemed null and void to the extent of such conflict, and shall be deemed severable, but shall not invalidate any other provision of this Agreement. (c) Any power of approval or disapproval granted to the Division under the terms of this Agreement shall survive the terms and life of this Agreement as a whole. (d) The Agreement may be executed in any number of counterparts, any one of which may be taken as an original. (e) The Recipient agrees to comply with the Americans With Disabilities Act (Public Law 101-336, 42 U.S.C. Section 12101 Of sea.), if applicable, which prohibits discrimination by public and private entities on the basis of disability in the areas of employment, public accommodations, transportation, State and local government services, and in telecommunications. (f) 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 on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, 12 or consultant under a contract with a public entity, and may not transact business with any public entity in excess of Category Two for a period of 36 months from the date of being placed on the convicted vendor list or on the discriminatory vendor list. (g) An entity or affiliate who has been placed on the discriminatory vendor list may not submit a bid on a contract to provide goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not award or perform work as a contractor, supplier, subcontractor, or consultant under contract with any public entity, and may not transact business with any public entity. (h) The State of Florida's performance and obligation to pay under this Agreement is contingent upon an annual appropriation by the Legislature, and subject to any modification in accordance with Chapter 216, FI . a Stat. or the Florida Constitution. (i) All bills for fees or other compensation for services or expenses shall be submitted in detail sufficient for a proper preaudit and postaudit thereof. 0) If otherwise allowed under this Agreement, all bills for any travel expenses shall be submitted in accordance with Section 112.061, Fla. Stat (k) The Division of Community Affairs reserves the right to unilaterally cancel this Agreement for refusal by the Recipient to allow public access to all documents, papers, letters or other material subject to the provisions of Chapter 119, Fla. tat., and made or received by the Recipient in conjunction with this Agreement. (1) If the Recipient is allowed to temporarily invest any advances of funds under this Agreement, any interest income shall either be returned to the Division or be applied against the Department's obligation to pay the contract amount. (m) The State of Florida will not intentionally award publicly -funded contracts to any contractor who knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324a(e) [Section 274A(e) of the Immigration and Nationality Act ("INA")]. The Division shall consider the employment by any contractor of unauthorized aliens a violation of Section 274A(e) of the INA. Such violation by the Recipient of the employment provisions contained in Section 274A(e) of the INA shall be grounds for unilateral cancellation of this Agreement by the Department. 13 (n) The Recipient is subject to Florida's Government in the Sunshine Law (Section 286.011. Fla. tat. ) with respect to the meetings of the Recipient's governing board or the meetings of any subcommittee making recommendations to the governing board. All such meetings shall be publicly noticed, open to the public, and the minutes of all such meetings shall be public records, available to the public in accordance with Chapter 119, Fla. tat. (21) STATE LOBBYING PROHIBITION. No funds or other resources received from the Division in connection with this Agreement may be used directly or indirectly to influence legislation or any other official action by the Florida Legislature or any state agency. (22) COPYRIGHT PATENT AND TRADEMARK ANY AND ALL PATENT RIGHTS ACCRUING UNDER OR IN CONNECTION WITH THE PERFORMANCE OF THIS AGREEMENT ARE HEREBY RESERVED TO THE STATE OF FLORIDA. ANY AND ALL COPYRIGHTS ACCRUING UNDER OR IN CONNECTION WITH THE PERFORMANCE OF THIS AGREEMENT ARE HEREBY TRANSFERRED BY THE RECIPIENT TO THE STATE OF FLORIDA. (a) If the Recipient brings to the performance of this Agreement a pre-existing patent or copyright, the Recipient shall retain all rights and entitlements to that pre-existing patent or copyright unless the Agreement provides otherwise. (b) If any discovery or invention arises or is developed in the course of or as a result of work or services performed under this Agreement, or in any way connected herewith, the Recipient shall refer the discovery or invention to the Division for a determination whether patent protection will be sought in the name of the State of Florida. Any and all patent rights accruing under or in connection with the performance of this Agreement are hereby reserved to the State of Florida. In the event that any books, manuals, films, or other copyrightable material are produced, the Recipient shall notify the Department. Any and all copyrights accruing under or in connection with the performance under this Agreement are hereby transferred by the Recipient to the State of Florida. (c) Within thirty (30) days of execution of this Agreement, the Recipient shall disclose all intellectual properties relevant to the performance of this Agreement which he or she knows or should know could give rise to a patent or copyright. The Recipient shall retain all rights and entitlements to any pre-existing intellectual property which is so disclosed. Failure to disclose will indicate that no such property exists. The Division shall then, under Paragraph (b), have the right to all patents and copyrights which accrue during performance of the Agreement. 14 (23) PROPERTY MANAGEMENT. (a) Title to equipment acquired by a Recipient with State funds shall vest in the Recipient, subject to conditions of this section. The Recipient must continue the operation, maintenance, repair and administration of any equipment or other personal property purchased under this Agreement in accordance with the purposes for which the funds were originally appropriated and for the period of time expressly specified in the Agreement or, failing to do so, the Recipient must return to the Division the subgrant funds used to purchase the property. (b) The Recipient shall not use equipment acquired with State funds to provide services to non -State outside organizations for a fee that is less than private companies charge for equivalent services, unless specifically authorized by Florida statute, for as long as the State retains an interest in the equipment. (c) The Recipient shall use the equipment in the project or program for which it was acquired as long as needed, whether or not the project or program continues to be supported by State funds and shall not encumber the property without approval of the Division. When no longer needed for the original project or program, the Recipient shall use the equipment in connection with its other State -sponsored activities, in the following order of priority: (i) Activities sponsored by the Division, then (ii) activities sponsored by other State agencies. (d) During the time that equipment is used on the project or program for which it was acquired, the Recipient shall make it available for use on other projects or programs if such other use will not interfere with the work on the project or program for which the equipment was originally acquired. First preference for such other use shall be given to other projects or programs sponsored by the Division; second preference shall be given to projects or programs sponsored by other State agencies. If the equipment is owned by the State of Florida, use on other activities not sponsored by the State of Florida shall be permissible if authorized by the Division. User charges shall be treated as program income. (e) When acquiring replacement equipment, the Recipient may use the equipment to be replaced as trade-in or sell the equipment and use the proceeds to offset the costs of the replacement equipment subject to the approval of the Division. 15 (f) The Recipient's property management standards for equipment acquired with State and State-owned equipment shall include all of the following. (1) Equipment records shall be maintained accurately and shall include the following information. (i) A description of the equipment. (ii) Manufacturer's serial number, model number, Federal stock number, national stock number, or other identification number. (III) Source of the equipment, including the award number. (iv) Whether title vests in the Recipient or the State of Florida. cost. (v) Acquisition date (or date received, if the equipment was furnished by the State of Florida) and NO Information from which one can calculate the percentage of State participation in the cost of the equipment (not applicable to equipment furnished by the State of Florida). (vii) Location and condition of the equipment and the date the information was reported. (viii) Unit acquisition cost. (ix) Ultimate disposition data, including date of disposal and s(ix) Ultimate disposition data, Including date of disposal and sales price or the method used to determine current fair market value where a Recipient compensates the Division for its share. (2) Equipment owned by the State of Florida shall be identified to indicate State ownership. (3) A physical inventory of equipment shall be taken and the results reconciled with the equipment records at least once every two years. Any differences between quantities determined by the physical inspection Recipient shall, in connection with the inventory, those shown in the accounting records shall be investigated to determine the causes of the difference. The , verify the existence, current utilization, and continued need for the equipment. (4) A control system shall be in effect to insure adequate safeguards to prevent loss, damage, or theft of the equipment. Any loss, damage, or theft of equipment shall be investigated and fully documented; if the equipment was owned by the State of Florida, the Recipient shall promptly notify the Division. (5) Adequate maintenance procedures shall be implemented to keep the equipment in good condition. (6) Where the Recipient is authorized or required to sell the equipment, proper sales procedures shall be established which provide for competition to the extent practicable and result in the highest possible return. (g) When the Recipient no longer needs the equipment, the equipment may be used for other activities in accordance with the following standards. For equipment with a current per unit fair market value of $5000 or more, the 16 Recipient may retain the equipment for other uses provided that compensation is made to the Division. The amount of compensation shall be computed by applying the percentage of State participation in the cost of the original project or program to the current fair market value of the equipment. If the Recipient has no need for the equipment, the Recipient shall request disposition instructions from the Division. The Division shall determine whether the equipment can be used to meet the Division's requirements. If no requirement exists within that agency, the availability of the equipment shall be reported to the Department of Management Services by the Division to determine whether a requirement for the equipment exists in other State agencies. The Division shall issue instructions to the Recipient no later than 120 calendar days after the Recipient's request and the following procedures shall govern. (1) If so instructed or if disposition instructions are not issued within 120 calendar days after the Recipient's request, the Recipient shall sell the equipment and reimburse the Federal awarding agency an amount computed by applying to the sales proceeds the percentage of Federal participation n the cost of the original project or program. However, the Recipient shall be permitted to deduct and retain from the State share $500 or ten percent of the proceeds, whichever is less, for the Recipient's selling and handling expenses. (2) If the Recipient is instructed to ship the equipment elsewhere, the Recipient shall be reimbursed by the State of Florida by an amount which is computed by applying the percentage of the Recipient's participation in the cost of the original project or program to the current fair market value of the equipment, plus any reasonable shipping or interim storage costs incurred. (3) If the Recipient is instructed to otherwise dispose of the equipment, the Recipient shall be reimbursed by the Division for such costs incurred in its disposition. (4) The Division may reserve the right to transfer the title to the State of Florida or to a third party named by the State when such third party is otherwise eligible under existing statutes. Such transfer shall be subject to the following standards. (i) The equipment shall be appropriately identified in the award or otherwise made known to the Recipient in writing. (10 The Division shall issue disposition instructions within 120 calendar days after receipt of a final inventory. The final inventory shall list all equipment acquired with grant funds and federally -owned equipment. If the Division fails to issue disposition instructions within the 120 calendar day period, the Recipient shall apply the standards of this section, as appropriate. (iii) When the Division exercises its right to take title, the equipment shall be subject to the provisions for State-owned equipment. (24) LEGAL AUTHORIZATION. The Recipient certifies with respect to this Agreement that it possesses the legal authority to receive the funds to be provided under this Agreement and that, if applicable, its governing body has authorized, by resolution or 17 otherwise, the execution and acceptance of this Agreement with all covenants and assurances contained herein. The Recipient also certifies that the undersigned possesses the authority to legally execute and bind Recipient to the terms of this Agreement. (25) ASSURANCE The Recipient shall comply with any Statement of Assurances. IN WITNESS WHEREOF, the parties hereto have caused this contract to be executed by their undersigned officials as duly authorized. Recinlent: Mon r ty Name and title: Mario DiGennaro, Mayor Date: June 20, 2007 SAMAS # STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT -r Name and Title: W_ _ �� c ,}!► �C �r Date: $ 18 MONROE COUNTY ATTORNEY APPROVED AS T FORM- ` !jATIL EENE • i------- W. CAS,:•FL ASSISTANT COUNTY ATTOA,vE� Date L c� EXHIBIT -1 STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: MATCHING RESc) ►RC :-S FOR FEDERAL PRRAMC- Federal Pr ram li t Fe ral en tal f F er I sti A is anc tit and num r - mo nt SUBJECT TO SECTION 215 97 FLORIDA STATUTES Florida Statutes "" " i rded thatis subi e 1 n- 1 State Project State of Florida - Division of Emergency Management CSFA # 52.010 $1,029,547 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: List applicable compliance requirements as follows. 1. First applicable compliance requirement (e.g., what services/purposes resources must be used for). 2• Second applicable compliance requirement (e.g., eligibility requirements for recipients of the resources). 3. Etc. State awarding agency may elect to use language that requires the recipient to comply with the requirements of applicable provisions of specific laws, rules, regulations, etc. NOTE. • Instead of listing the specific compliance requirements as shown above, in the example, the language may state that the recipient must comply regulation(s) that pertains to how the awarded resources must be used or how eligibility determinations with a iafic cre to be msader The State awarding agency, if practical, may want to attach a copy of the specific law, rule, or regulation referred to. NOTE: Section .400(d) of OMB Circular A-133, as revised, and Section 215.97(5)(a), Florida Statutes, require that the information about Federal Programs and State Projects included in Exhibit 1 be provided to the recipient. 19 Attachment A Budget and Scope of Work SCOPE OF WORK A. The Recipient shall construct a County Emergency Operations Center (EOC). Use of grant funds shall be consistent with Section 1(1), Ch. 2006-71, Laws of Florida. Grant funds shall not be used for land acquisition; purchase of equipment, furnishings, communications, or operational systems; or recurring expenditures. Eligible reimbursement costs include: Architectural and Engineering services and fees; site survey and soil testing; necessary permits and fees; civil and service utilities site work; construction of the building's substructure, superstructure, shell (exterior enclosure) and interior construction; special inspections; mechanical, plumbing, electrical, conveying and security systems; lightning protection; and redundant infrastructure systems (e.g., electric generator, uninterruptible power supply, potable water and wastewater systems, etc.). B. The Recipient shall in a timely manner prepare and submit a complete Hazard Mitigation Grant Program (HMGP) application, benefit -cost analysis, environmental review and such other documentation as necessary to determine eligibility and allowable costs under said grant program. C. The Recipient shall state in writing that for a period of not less than 15 years from the date of receipt of Certificate of Occupancy the EOC will be dedicated for emergency management purposes. The EOC shall remain demonstrably capable of being fully activated within one (1) hour of detection of an emergency; reference Rule Chapter 9G-6, Florida Administrative Code, "Emergency Management Capabilities Assessment Checklist." D. The EOC shall be constructed with sufficient space to house people and equipment for day-to-day and sustained continuous emergency operations, and capable of full staffing for the most extensive emergency anticipated. At a minimum, the designated EOC functional area(s), and essential shared -use area(s) if applicable, shall be designed for an emergency operations staff size of 62 persons per shift and a workspace floor area of 5.270 gross square feet. E. At a minimum, the EOC shall meet the hurricane hazard safety criteria established in Standards for Hurricane Evacuation She/ter Selection (ARC 4496). F. The EOC and essential ancillary structures and service equipment shall be designed to resist the effects of a major hurricane. The wind load design requirements shall be in accordance with the American Society of Civil Engineers (ASCE) Standard 7, Minimum Design Loads for Buildings and Other Structures. The minimum wind design criteria shall include: Design Wind Speed = 225 miles per hour (3 second gust) Wind Importance Factor, /= 1.00 Exposure Category = C Directionality Factor, Kd = 1.00 Internal Pressure Coefficient, GC,, _ +/- 0.18 All components and cladding assemblies necessary to maintain a structurally enclosed condition and prevent rainwater intrusion shall be designed to meet the wind design criteria. Structural metal decking and cladding materials shall be 22 gauge or thicker. Roof cover waterproofing barriers shall meet the wind design criteria. Loose roof ballast shall not be used on the roof cover. Rooftop equipment shall be designed and installed to meet the wind design criteria. G. The EOC and essential ancillary structures and service equipment shall resist penetration by windborne debris impact. At a minimum, all exterior enclosure components, claddings and assemblies (i.e., walls, roofs, louvers, windows, doors, etc.) located within 60 feet in height above finish grade shall meet the hurricane windborne debris impact criteria ,)o specified in the Department of Energy's (DOE) Standard, Natural Phenomena Hazards Design and Evaluation Criteria, DOE-STD-1020-2002. That is, the building enclosure must resist penetration by a nominal 2"x4" lumber plank weighing 15 pounds propelled at 50 miles per hour (74 feet per second) striking end -on and normal to the assembly surface, or equivalent performance as approved by the Division. As applicable, impact test procedures shall be consistent with recognized state and national standards; such as, Test Standard for Determining Impact Resistance from Windborne Debris SSTD 12, American Society of Testing and Materials (ASTM) Standards ASTM E 1886 and ASTM E 1996, and Florida Building Code Testing Protocols TAS 201, TAS 202 and TAS 203. The impact test procedures may be modified as necessary to accommodate the required missile weight and velocity. H. The following information related to wind loads and flooding shall be shown on the construction drawings: 1. wind design per ASCE 7 with applicable year of revision; 2. design wind speed; 3. wind importance factor, /; 4. design wind exposure category; 5. wind directionality factor, Kd, 6. design internal pressure coefficient, GCp,; 7, design wind pressures in terms of pounds per square foot (psf) to be used for the design of exterior component adding matials specifically designed by the principal licensed design professional; 8. windborne debris impact 1perfo mance triter at; 9. finish floor elevation measured relative to the National Geodetic Vertical Datum (NGVD); and comparison reference of the finished floor elevation to the base flood elevation, or historical flood elevation if base flood elevation is not determined. I. The lowest floor for the EOC and essential ancillary structures and service elevated above: Category 5 hurricane storm surge elevation plus 20 equipment shall at a minimum be base the 500-year (0.2 percent annual chance) flood elevation (if determined) plus two (2) feelt�e h ghtest ion recorded flood plus three (3) feet; elevation plus three (3) feet if the area is not in a mapped special flood hazard area; whichever is greater. The site (point maximum, one square mile) hydrologic design shall ensure that the EOC and essential ancillary structures and service equipment are not flooded due to a 24 hour, 37.0 inch rainfall event applied over a precedent 24 hour, 100-year rainfall event. J. Where secondary (emergency) roof drains or scuppers are required by the Florida Building Code —Plumbing, the secondary system shall be sized for a rainfall rate of eleven (11.0) inches per hour. K. The EOC shall be designated as a threshold building, and special structural inspections required. Special inspections shall be conducted in compliance with section 553.79, Florida Statutes and other applicable statutes, laws and rules. L. The EOC shall at a minimum be designed for 72 hours of self-contained continuous operation and shall not be solely reliant upon off -site services and utilities (e.g., water, natural gas fuel, electricity, etc.) M. Force protection and security measures shall be consistent with the guidance published in Florida's Homeland Security Comprehensive Assessment Model (HLSCAM), United States Air Force Installation Force Protection Guide, or other federal or state recognized best -practices guide(s) as approved by the Division. N. The Recipient shall provide an initial timeline and estimated reimbursement allocation schedule. Table SW-1, Initial Timeline and Estimated Reimbursement Allocation Schedule" or other similar instrument as approved by the Division may be used. O. During design and construction phases of the EOC project, the Recipient shall track and provide construction cost data for the designated EOC area as detailed in Table SW-2, "Cost Data for County Emergency Operations Center." ?1 I1. PRODUCT ITEMS A. Per item I.N, Recipient shall prepare an initial timeline with key milestone activities/tasks schedule, including estimated start and end dates for each activity, and an estimate of state reimbursement request for each activity. Table SW-1 may be used to meet this product item. B. Per item I.C, Recipient shall submit a binding written statement that the EOC will be dedicated for a period of not less than15 years for emergency management purposes, and demonstrably capable of being fully activated within one (1) hour of detection of an emergency. C. The Recipient shall provide one (1) copy each of site survey, site mAter plan, spatial needs assessment, and schematic design plan or preliminary design drawings for review and comment by the Division. The spatial needs assessment and schematic design plan/preliminary design may be consolidated into one document. D. The Recipient shall provide one (1) set of substantially complete (approximate) 70 desi construction drawings and specifications for the EOC and essential ancillary structures for review and rcomment by the n Division. The construction drawings shall include site survey Information, landscaping, civil, architectural, structural, mechanical, plumbing, and electrical drawings. E. The Recipient shall provide one (1) set of bid -ready construction drawings and specifications for the EOC and essential ancillary structures for review by the Division. The construction drawings shall include site survey information, landscaping, civil, architectural, structural, mechanical, plumbing, and electrical drawings and shall be certified by the applicable registered,or licensed design professional(s) of record. F. The construction drawings shall demonstrate that the EOC will meet the hurricane hazard safety criteria of ARC 4496, and the wind load, windborne debris impact, flood and security design requirements set forth in items LE through I.M. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial of funds. G. Per item LB, Recipient shall submit a complete HMGP application, benefit -cost analysis, environmental review and such other documentation as necessary to determine eligibility and cost allowances under said grant program. The Recipient shall also provide two cost estimates prepared by one or more certified construction contractors that document the cost of constructing the facility to meet current building code wind and flood design requirements, and the cost premium of constructing the facility to the above -code wind and flood requirements set forth in items LE through I.J. H. Per item 1.0, the Recipient shall provide final project cost data. Table SW-2 shall be used to meet this product item. 1. The Recipient shall provide the Division with copy(s) of pertinent construction permits, the threshold inspection final report, and the certificate of occupancy upon completion of the construction project. 22 III. SCHEDULE OF WORK A. By June 30, 2007, the Recipient shall provide the Division with Product Items A and B for review and approval. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial of funds. B. By September 30, 2007 and at least on a quarterly basis thereafter, Recipient shall report on progress in relation to the initial timeline, and submit Product Items C through H in a timely manner as accomplished. The Division shall be provided 30 calendar days to review and provide comments of product items pertaining to compliance with the scope -of - work. The Recipient shall also submit invoices for reimbursement for work accomplished in accordance with the Division approved cost reimbursement allocation schedule referenced in Product Item A. C. By a mutually agreed upon date, the Recipient shall provide the Division with Product Item F for review and approval. Failure to supply the required documentation, or disapproval of this documentation by the Division, shall result in denial or reduction of funds at the sole discretion of the Division. D. By May 15, 2009, the Recipient shall provide final project cost estimate data as set forth in Table SW-2, certificate of occupancy, close-out documentation and final payment invoice. 23 Table SW-1. Initial Timeline and Estimated Reimbursement Allocation Schedule Table SW-1. Initial Timeline and Estimated Reimbursement Allocation Schedule County Name: Monr�sg Date DEM Funds Other Funds Board Contract Approval Initial Payment of 20% in first quart( A&E Firm Selecti( Site Survey and S Testing Spatial Needs Assessment 70% corn fete Preliminary Design, 100% com fete R ulato Review Bid Document(s) Development & Award Notice to Proceed/Mobilizatior Construction Project Management & Special Inspections Construction 25% Complete Construction 50% ,ompfete ;onstruction 100% ;omplete ;ontingency administrative Fees; laximum of 5% A&E - Architectural and Engineering; DEM -Division of Emergency Management; FY - Fiscal Year 24 Table SW-2. Cost Data for County Emergency Operations Center 25 26 Attachment 8 Program Statutes and Regulations 1. Sections 215.555(7)(c) and 215.559, Florida Statutes 2. Chapter 252, Florida Statutes I Chapter 287, Florida Statutes 4. Chapter 119, Florida Statutes 5. Chapter 60A-1, Florida Administrative Code 6. Chapter 9G-19, Florida Administrative Code 27 Attachment C ZECIPIE111T: -M JUSTIFICATION OF ADVANCE PAYENT ndicate by checking one of the boxes below, if you are requesting an advance. If an advance payment is requested, budget data on vhich the request is based must be submitted. Any advance payment under this Agreement is subject to s. 216.181(16)(a) and (b), 'lorida Statutes. The amount which may be advanced shall not exceed the expected cash needs of the recipient within the initial hree months. f I NO ADVANCE REQUESTED No advance payment is requested. Payment will be solely on a reimbursement basis. No additional information is required. ADVANCE REQUEST WORKSHEET f J ADVANCE REQUESTED Advance payment of $ is requested. Balance of payments will be made on a reimbursement basis. These funds are needed to pay staff, award benefits to clients, duplicate forms and purchase start-up supplies and equipment. We would not be able to operate the program without this advance. If you are requesting an advance, complete the following worksheet (A) DESCRIPTION FFY 2002 1 INITIAL CONTRACT ALLOCATION 2 FIRST THREE MONTHF CT EXPENDITURES'AAVERAGE PERCENT EIN FIRST THREE MONTHS Divide lineh�t;r)es 1.First three monthneed only he provided for the years in which you information, call your consultant and they will assist you. MAXIMUM ADVAN F Al n 'ED CALULATION: Cell D3 X $ DEM Award (Do not Include any match) QUEST FOR WAIVER OF CALCULATED MAXIMUM (B) (C)—F—(D) FFY 2003 FFY 2004 Total an advance. If you do not have MAXIMUM ADVANCE J Recipient has no previous DEM contract history. Complete Estimated Expenses chart and Explanation of Circumstances below. J Recipient has exceptional circumstances that require an advance greater than the Maximum Advance calculated above. Complete estimated expenses chart and Explanation of Circumstances below. Attach additional pages if needed. 28 BUDGET CATEGORY 2004-2005 Anticipated Expenditures for First Three Nfonths of ADMINISTRATIVE COSTS Contract (Include Secondary Adminictrsti.... PROGRAM EXPENSES I TOTAL EXPENSES Explanation of Circumstances• 29 Attachment D Warranties and Representations Financial Manaoement Recipient's financial management system shall provide for the following: (1) Accurate, current and complete disclosure of the financial results of this (2) project or program Records that identify adequately the source and application of funds for all activities. These records shall contain information pertaining to grant awards, authorizations, obligations, unobligated balances, assets, outlays, income and interest. (3) Effective control over and accountability for all funds, property and other assets. Recipient shall adequately safeguard all such assets and assure that they are used solely for authorized purposes. (4) Comparison of expenditures with budget amounts for each Request For Payment. Whenever appropriate, financial information should be related to performance and unit cost data. (5) Written procedures for determining the reasonableness, allocability and allowability of costs in accordance with the provisions of the applicable cost principles and the terms and conditions of this grant. (6) Accounting records, including cost accounting records that are supported by source documentation. ii All procurement transactions shall be conducted in a manner to provide, to the maximum extent practical, open and free competition. The Recipient shall be alert to conflicts of interest as well as noncompetitive practices among contractors that eliminate unfair competitive advantage, contractors that develop or draft specifications, may restrict or eliminate competition or otherwise restrain trade. In order to ensure objective contractor performance and invitations for bids and/or requests for proposals shall be excluded from compet ng fr requirements,ch urements. Awards shallk, be made to the bidder or offeror whose bid or offer is responsive to the solicitation and is most advantageous to the Recipient, price, quality and other factors considered. Solicitations shall clearly set forth all requirements that the bidder or offeror shall fulfill in order for the bid or offer to be evaluated by the Recipient. Any and all bids or offers may be rejected when it is in the Recipient's interest to do so. �4des of condu t The Recipient shall maintain written standards of conduct governing the performance of its employees engaged in the award and administration of contracts. No employee, officer, or agent shall participate in the selection, award, or administration of a contract supported b Such a conflict would arise when the employee, lic officer, orrant ds if a agent anmember of parent conflict her immediate would mbi involved. partner, or an organization which employs or is about to employ any of the parties indicated herein, has a financial or other interest in the firm selected for an award. The officers, employees, and agents of the Recipient shalt neitherhis s her nor accept gratuities, favors, or anything of monetary value from contractors, or parties to subcontracts. The standaolici rdstof conduct shall provide for disciplinary actions to be applied for violations of such standards by officers, employees, or agents of the recipient. Business rs The Recipient shall have its offices open for business, with the entrance door open to the public, and at least one employee on site, from 30 Licensing and permitting All subcontractors or employees hired by the Recipient shall have all current licenses and permits required for all particular work for which they are hired by the Recipient. of the 31 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: Administration Bulk Item: Yes X No _ Department: Project Management Staff Contact Person/Phone #: Jerry Barnett AGENDA ITEM WORDING: Approval to issue a Request for Proposal (RFP) for a Design/Build contract for the mandatory sewer connections at the Marathon Courthouse, the Marathon Detention Center, and the Marathon Government Center. ITEM BACKGROUND: The Marathon Courthouse, Detention Center, and Government Center require a more complicated installation than the other County owned facilities in Marathon. There are many contractors already providing design services along with construction for commercial properties. A design/build contract will be less costly than separating the design from construction, and will include the design, permitting, and construction. Other Monroe County owned facilities in Marathon have a more straight forward installation procedure, and already have, or will have, a plan to connect to the central sewers when available. The estimated hook up deadline for these three facilities is June of 2011. PREVIOUS RELEVANT BOCC ACTION: N/A CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval as stated above, which will result in advertising costs to the County. TOTAL COST: App $900 advertising INDIRECT COST: BUDGETED: Yes X No _ DIFFERENTIAL OF LOCAL PREFERENCE: N/A COST TO COUNTY: App $900.00 SOURCE OF FUNDS: Fund 001 and 101 REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year _ APPROVED BY: County Atty_ '___/OMB/Purchasing Risk Manag ement DOCUMENTATION: Included DISPOSITION: Revised 7/09 Not Required X AGENDA ITEM # BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: County Administration Bulk Item: Yes X No _ Department: Project Management Staff Contact Person/Phone #: Jerry Barnett X4416 AGENDA ITEM WORDING: Receipt of monthly report on change orders reviewed by the County Administrator's Office. ITEM BACKGROUND: There were no change orders considered and approved by the County Administrator for the period beginning November 1, 2010 and ending November 30, 2010, and no change order requests denied by Project Management or Engineering Services. PREVIOUS RELEVANT BOCC ACTION: On September 9, 1998, Ordinance No. 026-1998 was adopted in order to provide that the County Administrator may approve separate, non -cumulative change orders for construction projects and professional service contracts in amounts not to exceed $25,000.00 or 5% of the original contract price, whichever is greater. The BOCC requested a monthly report of all change orders considered by the County Administrator. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: N/A TOTAL COST: N/A Andirect Costs BUDGETED: Yes N/A No _ DIFFERENTIAL OF LOCAL PREFERENCE: N/A COST TO COUNTY: N/A SOURCE OF FUNDS: N/A REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year APPROVED BY: County Atty _ OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 7/09 W 2 W Z a V W V M U. W ul oG 0 N z N G a Z 0 0 V W H m a W W 0 a 0 v O O M O ri 0 rl rl 0 v W IL W 1- 1w 0 U. W d' U G W ° °z 0 V Z O bi Q u H U 0 a 79 a. a O O O BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Bulls Item: Yes XX No Division: Airports Staff Contact Person: Peter Horton/Pedro Mercado AGENDA ITEM WORDING: Ratification and/or approval of exhibit "A" to the Kennedy Galleries lease. ITEM BACKGROUND: The County entered in to a 5 year lease with Kennedy Galleries for operation of a concession at the Key West International Airport. The lease included an exhibit showing the leased premises shown on an attachment to the lease marked as exhibit "A" however the back-up documentation submitted for approval of the lease omitted the aforementioned exhibit "A". This agenda item seeks to correct that omission PREVIOUS RELEVANT BOCC ACTION: Approved the original lease at the June 16, 2010 regular board meeting. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval TOTAL COST: N/A COST TO COUNTY: N/A BUDGETED: Yes No SOURCE OF FUNDS: N/A REVENUE PRODUCING: Yes XX No AMOUNT PER MONTH $1,250.00 per month plus 10% of annual gross revenue or $15,000, whichever is greater for the leasehold in the airport departure gate area. APPROVED BY: County Atty OMB/Purchasing Risk Management DOCUMENTATION: Included Not Required DISPOSITION: AGENDA ITEM # DANNYL. KOLHAGE CLERK OF THE CIRCUIT COURT DATE: November S, 2010 TO: Peter Horton, Director of Airports VIA: April Pearson FROM: Pamela G. Hanc 6ck, LC. At the June 16, 2010, Board of County Commissioners meeting, the Board granted approval and authorized execution of a Lease with Kennedy Galleries for retail space at Key West International Airport. This document was executed with Exhibit A; however, it was not part of the agenda back-up that went before the Board. I spoke with Pedro Mercado, Assistant County Attorney, about the exhibit since this item has been outstanding since June, due to an insurance issue. He gave me the permission to execute it with the exhibit and advised that this action will be ratified at the November or December BOCC meeting. Attached is an electroinic copy of the above -mentioned for your handling. Should you have any questions, please feel free to contact our office. cc: County Attorney Finance File LEASE AGREEMENT KENNEDY GALLERIES KEY WEST INTERNATIONAL AIRPORT THIS LEASE AGREEMENT is made and entered into on the 16th day of June, 2010, by and between MONROE COUNTY, a political subdivision of the State of Florida, hereinafter referred to as Lessor, and Kennedy Galleries hereinafter referred to as Lessee or Tenant; WHEREAS, the Lessor is the owner of the Key West International Airport, hereafter Airport, that has space available for an airport concession; and WHEREAS, Lessor desires to grant to Lessee the right to operate an airport concession at and from the Key West International Airport at Key West, Florida, and WHEREAS, the Lessee desires to enter into such a lease and represents to the Lessor that it is qualified to operate airport concession and has the financial resources to undertake such an operation; now, therefore IN CONSIDERATION of the premises and of mutual covenants and promises hereinafter contained, the parties hereto do hereby agree as follows: 1. Premises - Lessor hereby leases to Lessee the Airport area shown on Exhibit A, hereafter the premises, for use as an Airport Concession, hereafter also referred to as the operation. Exhibit A is attached to this agreement and incorporated by reference. 2. Term (a) This lease agreement will take effect on the 1 st day of June 2010, and will terminate on the 31 st day of May, 2015, unless terminated earlier under another paragraph of this agreement. (b) This lease may be renewed at the discretion of the Lessor for one (1) five year period. If the Lessee desires to renew this lease, Lessee must submit a written request to Lessor at least 90 days prior to the expiration of the initial term of this lease. 3. Rental and Fees (a) i. Lessee agrees to pay Lessor rent in the amount of $1,250.00 per month, including electricity, for retail concession spaces 124 — 127 and ii. In addition to the rent, Lessee agrees to pay Lessor 10% of the annual gross revenues, or a guaranteed minimum annual fee of $15,000, whichever is greater, generated by Lessee's operations at retail concession spaces 124 - 127. Rental payments are due by the 1st day of the month for which the rent is due. An annual rental payment adjustment shall be made in accordance with the percentage change in the Consumer Price Index for all urban consumers (CPI-U) for the most recent 12 months available or in accordance with the Airport's standard rates and charges as revised annually, whichever is greater. The increase will take effect on the anniversary month of the month when the operation opened for business. Annual gross revenues are determined on a calendar year basis. A calendar year shall run from January 1 Sc through December 31 sc inclusive. Payment of charges under this subparagraph shall be made in monthly installments. Lessee shall remit, at a minimum, 1/12 of the annual guaranteed minimum ($1250.00) on an arrears basis. Payment shall be made no later than the 251h day of the month payment is due, i.e. January payment by February 25, February by March 25, etc. In the event the total amount paid during any calendar year period is less than the greater of the fees set forth in 5a.ii, Lessee shall remit the difference by February 28 of the year subsequent to the calendar year for which the charge is due. iii. Rental and fees are subject to renegotiation if the total number of passengers serviced at KWIA fall below the total number of passengers served in calendar year 2008. (The total number of passengers served shall be the combined sum of the number of passengers arriving and number of passengers departing KWIA) (b) No rent payments are due under this agreement until the operation is open for business. If the operation opens on a date other than the first of the month, then the rent charge will be prorated as a percentage that the number of days in the month that the operation was in business represents to the months a whole. (c) Lessee must open the operation for business within 30 days of the effective date of this agreement. (d) At the end of this agreement (or any renewal), the Lessee's right to the premises, the use of Airport facilities, and any other right or privilege granted under this agreement ceases. All equipment, furnishings and other property of the Lessee at the premises must be removed by him. The Lessee must also restore the premises to its original condition, ordinary wear and tear and damage by causes beyond the control of the Lessee excepted. 4. Lessor's Right of Re -Entry - Notwithstanding anything set forth in paragraph 12 of this agreement, if the Lessee fails to pay any rents or fees due under this lease within 15 days after the Lessor notifies the Lessee in writing that the rent or charge is overdue, then the Lessor may, in its discretion, either immediately or later, re-enter the premises and repossess the premises and expel the Lessee and any persons claiming the premises by or through the Lessee, and remove any of the Lessee's effects without being guilty of trespass and without prejudice or waiver to any other available remedy the Lessor might have for the recovery of the rent or charges due from the Lessee. Upon the Lessor's re-entry, this lease will terminate. However, the Lessee's obligation to pay the rent or charges due will survive the termination. Overdue rent and charges will accrue interest beginning on the 16`h day after the Lessee was notified in writing by the Lessor that the renter charges were overdue. The interest rate will be that established by the Comptroller under Sec. 55.03, F.S., for the year in which the rent or charge first became overdue. 5. Lease Documents — The lease documents, of which this agreement is a part, consists of the lease documents, which are as follows: This agreement and any amendments executed by the parties hereafter, together with the RFP, the response to the RFP and all required insurance documentation. In the event of a discrepancy between the documents, precedence shall be determined by the order of the documents as just listed. 6. Merchandise Review, Audible Entertainment - The Lessee shall provide a list of all merchandise it intends to sell. The airport reserves the right to reject any items it finds inappropriate, objectionable or not in the best interests of the Airport. NO form of audible entertainment/announcement system will be permitted in the premises (retail spaces 124 — 127). Other forms of entertainment may be permitted with the written consent of the Airport Manager. When permitted, no sound source shall be permitted that is so loud that it emanates outside of the Lessee's concession space. 7. Federal, State and Local Law - The Lessee must comply with all the applicable requirements of the statutes, rules, ordinances, regulations, orders and policies of the federal and state governments and the County either in effect on the effective date of this lease or later adopted. 8. Subordination (a) This lease and all provisions hereof are subject and subordinate to the terms and conditions of the instruments and documents under which the Airport Owner acquired the subject property from the United States of America and shall be given only such effect as will not conflict or be inconsistent with the terms and conditions contained in the lease of such lands from the Airport Owner, and any existing or subsequent amendments thereto, and are subject to any ordinances, rules or regulations which have been, or may hereafter be adopted by the Owner pertaining to the Key West International Airport. (b) The leased premises and the Airport are subject to the terms of those certain Sponsor's Assurances made to guarantee the public use of the Airport as incident to grant agreements between the Lessor and the United States Of America. This lease and all provisions hereof shall be given only such effect as will not conflict or be inconsistent with the terms and conditions contained in those certain Sponsor Assurance's, and any existing or subsequent amendments thereto. (c) This lease shall be subject and subordinate to the provisions of any existing or future agreement between the Lessor and the United States relative to the operation or maintenance of the Airport, and execution of which has been or may be required by the provision of the Federal Airport Act of 1946, as amended, or any future act affecting the operation or maintenance of the Airport, provided, however, that Lessor shall, to the extent permitted by law, use its best efforts to cause any such agreement to include provisions protecting and preserving the rights of Lessee in and to the demised premises and improvements thereon, and to compensation for the taking thereof, and payment for interference therewith and for damage thereto, caused by such agreement or by actions of the Lessor or the United States pursuant thereto. 9. Rights Reserved - Notwithstanding anything herein contained that may be or appear to be, to the contrary, it is expressly understood and agreed that the rights granted under this agreement are nonexclusive and the LESSOR herein reserves the right to grant similar privileges to another LESSEE or other LESSEE on other parts of the airport. 10. Security Clearance/Cost - Lessee shall be solely responsible for the costs of, and the obtaining of, security clearances for the Lessee and any person(s) employed by Lessee. Notwithstanding anything set forth in paragraph 12 of this agreement, LESSEE's FAILURE TO OBTAIN OR MAINTAIN A SECURITY CLEARANCE SHALL BE DEEMED TO BE A BREACH OF THIS AGREEMENT AND THE COUNTY MAY IMMEDIATELY TERMINATE THIS LEASE. Before treating the Lessee in default and terminating the lease, the County need only provide the Lessee 24 hour notice by fax or overnight courier. The County may, but need not, provide Lessee with an opportunity to cure the default. 11. Lessee's Covenants (a) Lessee agrees to pay all assessments, taxes, including sales taxes, levied by any governmental body with the power to impose assessments or taxes. The Lessee must provide the Airport Manager with the sales tax records for each year on or before February 28 of the following year. (b) Lessee shall provide all items and equipment needed for the operation including, but not limited to: shelving, display cases, tables, chairs, refrigeration units, etc. Lessee's items and equipment must be removed from the premises when this lease terminates. Lessee has the right during the term hereof, at its own expense, at any time from time to time, to install, maintain, operate, repair and replace any and all trade fixtures and other personal property useful from time to time in connection with its operation on the Airport, all of which shall be and remain the property of Lessee and may be removed by Lessee prior to or within a reasonable time after expiration of the term of this agreement; provided, however, that Lessee shall repair any damage to the premises caused by such removal. The failure to remove trade fixtures or other personal property shall not constitute Lessee a hold -over, but all such property not removed within ten (10) days after Lessee receives a written demand for such removal shall be deemed abandoned and thereupon shall be the sole property of the Lessor. (c) The Lessee agrees to furnish good, prompt and efficient service to meet all demands for airport concession service at the Airport. The operation must be open for service 365 days per year consistent with flight schedules and will generally be 'h hour before the first daily scheduled flight and 'h hour following last scheduled daily DANNYL. KOLHAGE CLERK OF THE CIRCUIT COURT DATE: November S, 2010 TO: Peter Horton, Director of Airports VIA: April Pearson FROM: Pamela G. Hancock, D.C. At the June 16, 2010, Board of County Commissioners meeting, the Board granted approval and authorized execution of a Lease with Kennedy Galleries for retail space at Key West International Airport. This document was executed with Exhibit A; however, it was not part of the agenda back-up that went before the Board. I spoke with Pedro Mercado, Assistant County Attorney, about the exhibit since this item has been outstanding since June, due to an insurance issue. He gave me the permission to execute it with the exhibit and advised that this action will be ratified at the November or December BOCC meeting. Attached is an electroinic copy of the above -mentioned for your handling. Should you have any questions, please feel free to contact our office. cc: County Attorney Finance File flight from 6:00 A.M. to 7:00 P.M., as a minimum. The hours can be revised by mutual consent. (d) The Lessee shall provide an adequate number of covered metal waste containers at suitable locations, and must deposit all premises generated trash and waste in those containers for proper disposition of the waste at the place designated by the Lessor. (e) Lessee agrees that no signs, on premises advertising, or awnings may be erected by the Lessee on the premises or elsewhere at the Airport, unless they are approved by the Airport Manager in writing. No exterior architectural changes may be made without the consent in writing of the Airport Manager, whose consent will not be unreasonably withheld. (f) If any part of the premises exterior or interior is injured or damaged by any breaking or entering into the premises or by an attempt to break or enter the premises, the Lessee must promptly make all the necessary repairs at his expense to restore the premises to the condition immediately prior to the breaking or entering or the attempt to break or enter. (g) The Lessee is responsible for the maintenance of the premises, including the equipment and fixtures on the premises such as (but not limited to) plumbing, lighting, carpeting, planters, refrigeration equipment, electric wiring and fixtures, doors and walls. The Lessee must at his own cost make the repairs needed to preserve them in good condition. The repairs must equal or exceed the quality of the original work. However, the Lessor must maintain the premise air conditioning at its expense. The Lessee must also provide pest control for the premises at own expense. 11. Lessor's Covenants (a) Lessor will furnish the premises with back-up generator service should Keys Energy Services electric service fail. In the event both Keys Energy Services power and the back-up generator fail, the Lessor shall not be responsible or liable for any damage caused to Lessee as a result of the power outage. (b) The Lessor must operate, maintain and keep in good repair the Airport Terminal Building, and the Airport parking lots. The Lessor is not required to perform maintenance and make repairs to the Airport Terminal Building or parking lot caused by negligence of Lessee, its employees, or customers. If that happens, then it is the responsibility of the Lessee to make the repairs although, at the Lessor's option, the Lessor may perform the maintenance or repairs and charge the reasonable cost to Lessee. The Lessor may also abandon facilities that are no longer reasonably justified for the proper and adequate operation of the Airport. (c) The Lessor does not make any representations or warranties regarding the premises beyond those set forth in this agreement. The taking of possession of the premises by the Lessee is conclusive evidence that the premises and the Terminal Building were in good and satisfactory condition when the Lessee took possession. In no event will the Lessor be liable for any building construction defects whether in the premises or elsewhere in the Terminal Building. (d) In the event the premises are partially damaged by fire, explosion, the elements, the public enemy or other casualty, but not rendered untenable, then the premises will be repaired with due diligence by Lessor at the Lessor's cost and expense. If the damage is so extensive that the premises are rendered untenable but capable of being repaired within 30 days, then the premises will be repaired with due diligence by Lessor at the Lessor's cost and expense. The rent payable under this lease will be waived until the premises are fully restored. If the premises are completely destroyed or so damaged that the premises will be untenable for more than 30 days, the Lessor is under no obligation to repair and reconstruct the premises, and the rent must be paid only up to the time of the damage or destruction and then the obligation to pay rent ceases until the premises are fully restored. If within 30 days after the damage or destruction the Lessor fails to notify Lessee of the Lessor's intention to repair or reconstruct the damaged or destroyed premises, or to furnish a substantially equivalent facility, then the Lessee may give Lessor written notice of its intention to then cancel this agreement. 12. Default/Termination - Except as otherwise provided herein, the Lessor may cancel this agreement when, after giving the Lessee 30 days written notice that an act of default has occurred, the Lessee fails or cannot cure the following: (a) The appointment of a receiver of the Lessee's assets. (b) The divestiture of the Lessee's interest in the lease by court order or other operation of law. (c) The Lessee's abandonment of the operation. Failure to open the operation and keep it open during the business hours described in this agreement for seven (7) consecutive days shall constitute abandonment. (d) The failure of the Lessee to timely perform any of the obligations required of it under this agreement. No waiver of default by the Lessor of any of the obligations required of the Lessee under this agreement may be construed as a waiver of any subsequent default of any of the obligations that are required to be performed, kept or observed by the Lessee. The Lessor's waiver of an act of default by the Lessee is not a waiver of the right of the Lessor to later cancel this agreement because of the Lessee's failure to subsequently perform an obligation or obligations under this lease agreement. 13. Lessee's Right of Termination - If the Lessee is not in default of its obligation to pay the rent and the charges, then the Lessee may cancel this agreement when, after giving the Lessor 30 days written notice of an act of default, the Lessor fails or cannot cure any of the following: (a) The issue of a court order enjoining or in any way restraining the use of the Airport for Airport purposes if the order remains in effect for a period of at least 90 days. (b) The inability of the Lessee to use for 90 days or more the premises or the Airport because of a fire, explosion or other casualty or disaster, provided that the casualty event was not caused by negligent or intentional acts(s) of the Lessee. (c) The failure of the Lessor to timely perform the obligations required of it under this lease agreement. (d) The assumption by the United States Government or any authorized governmental agency of the operational control or use of the Airport and facilities, or any substantial part or parts, in a manner that substantially restricts Lessee for a period of at least 90 days, from conducting the operation. The Lessee's performance of obligations in this agreement when the Lessor is in default is not a waiver by the Lessee to later terminate this agreement because of a subsequent failure by Lessor to perform its obligations. 14. Insurance Requirements (a) Before entering the premises, the Lessee must obtain insurance in the amounts and according to the conditions described as follows: The Lessee will be responsible for all necessary insurance coverage which includes, at a minimum: Worker's Compensation - $100,000 Bodily Injury by Accident; $500,000 Bodily Injury by Disease, policy limits; $100,000 Bodily Injury by Disease, each employee Vehicle Liability - $100,000 combined single limit General Liability - $300,000 combined single limit Certificates of Insurance must be provided to Monroe County within fifteen days after award of proposal, with Monroe County BOCC listed as additionally insured on all except Workers Compensation. If the proper insurance forms are not received within the fifteen days, proposal may be awarded to the next selected respondent. The Lessee shall carry fire and extended coverage insurance, if obtainable, on all fixed improvements erected by Lessee on the demised premises to the full insurable value hereof, it being understood and agreed that for purposes hereof the term "full insurable value" shall be deemed to be that amount for which a prudent owner in like circumstances would insure similar property, but in no event an amount in excess of Lessee's original cost of constructing said fixed improvements. The Monroe County Board of County Commissioners will be included as "Additional Insured" on all policies, except workers compensation, issued to satisfy the above requirements. All forms of insurance required above shall be from insurers acceptable to the County. All insurance policies must specify that they are not subject to cancellation, non - renewal, material change, or reduction in coverage unless a minimum of thirty days prior notification is given to the County by the insurer. (b) The Lessee must keep in full force and effect the insurance described during the term of this agreement. If the insurance policies originally purchased that meet the requirements are canceled, terminated or reduced in coverage, then the Lessee must immediately substitute complying policies so that no gap in coverage occurs. (c) The insurance required of the Lessee in this paragraph is for the protection of the County, its property and employees, and the general public. The insurance requirement is not, however, for the protection of any specific member of the general public who might be injured because of an act or omission of the Lessee. The insurance requirements of this paragraph do not make any specific injured member of the general public a third party beneficiary under this agreement. Therefore, any failure by the County to enforce this paragraph, or evict the Lessee from the Airport if the Lessee becomes uninsured or underinsured, is not a breach of any duty or obligation owed to any specific member of the general public and cannot form the basis of any County liability to a specific member of the general public or his/her dependents, or estate or heirs. (d) Notwithstanding anything set forth in paragraph 12 of this agreement, the Lessor may treat the Lessee in default if the Lessee, after entering the premises but before beginning its operation, does not have the insurance required by subparagraph 14(a). Before the County may terminate the agreement in this situation, the County must give the Lessee a written notice of the default stating that, if the required insurance is not obtained within ten (10) days of the Lessee's receipt of notice, then the County will cancel this agreement. The County may treat the Lessee in default and cancel this agreement if the Lessee, after starting the operation, fails to keep in full force and effect the insurance required by subparagraph 14(a). Before treating the Lessee in default and terminating the agreement in this situation, the County need only provide the Lessee 24- hour notice by FAX or overnight courier. The County may, but need not, provide Lessee with an opportunity to cure the default. 15. Rights Reserved - Notwithstanding anything herein contained that may be, or appear to be, to the contrary, it is expressly understood and agreed that the rights granted under this agreement are nonexclusive and the Lessor herein reserves the right to grant similar privileges to another Lessee or other Lessees on other parts of the Airport. 16. Inspection and Maintenance of Premises by Lessor — Lessor and its authorized officers, employees, agents, contractors, subcontractors and other representatives shall have the right to enter upon the leased premises for the following purposes: a) to inspect the leased premises at reasonable intervals during regular business hours (or at any time in case of emergency) to determine whether Lessee has complied and is complying with the terms and conditions of this agreement with respect thereto; b) to perform essential maintenance, repair, relocation, or removal of existing underground and overhead wires, pipes, drains, cables and conduits now located on or across the leased premises, and to construct, maintain, repair, relocate, and remove such facilities in the future as necessary to carry out the Master Plan of development of the Airport; provided, however, that said work shall in no event unduly interfere with the operations of Lessee and, provided further, that the entire cost of such work, including but not limited to the cost of rebuilding, removing, relocating, protecting or otherwise modifying any fixed improvements at any time erected or installed in or upon the leased premises by Lessee, the Lessor or third parties, as a result of the exercise by the Lessor of its rights hereunder, and all damage to such fixed improvements caused thereby, shall be borne by the Lessor. 17. Assignment/Sublease - The Lessee may not assign this agreement, or any part of it, or sublease the premises, or any portion of the premises, without the written approval of the Lessor which shall not be unreasonably withheld. The terms of this Lease Agreement shall be binding on the heirs, executors, administrators, sub -lessees and assigns of Lessee. The change of the Lessee's status from an individual to a partnership or corporation is an assignment under this paragraph requiring the Lessor's approval. If the Lessee is approved to do business in the corporate form, any assignment of a controlling interest in the corporate stock is also an assignment under this paragraph that requires the Lessor's approval. All the obligations of this agreement will extend to the legal representatives, successors and assigns of the Lessee and Lessor. 18. Books, Records, Documents - Lessee shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the Agreement and for four years following the termination of this Agreement. An annual operating statement prepared by a C.P.A. must be provided to the Lessor on or before February 28 of the following year. 19. Hold Harmless - Notwithstanding any minimum insurance requirements prescribed elsewhere in this agreement, Lessee shall defend, indemnify and hold the County and the County's elected and appointed officers and employees harmless from and against (i) any claims, actions or causes of action, (ii) any litigation, administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption, and (iii) any costs or expenses (including, without limitation, costs of remediation and costs of additional security measures that the Federal Aviation Administration, the Transportation Security Administration or any other governmental agency requires by reason of, or in connection with a violation of any federal law or regulation, attorney's fees and costs, court costs, fines and penalties) that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with, (A) any activity of Lessee or any of its employees, agents, contractors or other invitees during the term of this lease, (B) the negligence or willful misconduct of Lessee or any of its employees, agents, contractors or other invitees, or (C) Lessee's default in respect of any of the obligations that it undertakes under the terms of this lease, except to the extent the claims, actions, causes of action, litigation, proceedings, costs or expenses arise from the intentional, or sole negligent acts, or negligent acts in part, or omissions of the County or any of its employees, agents, contractors or invitees (other than Lessee). Insofar as the claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this lease, this Section will survive the expiration of the term of this lease or any earlier termination of this lease. 20. Nondiscrimination - Lessee agrees that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the Court order. Lessor and Lessee agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VII of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975; as amended (42 USC ss. 6101-6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s. 1201 Note), as may be amended from time to time, relating to nondiscrimination based of disability; 10) Secs. 13-101, et seq., Monroe County Code, relating to discrimination based on race, color, sex, religion, disability, national origin, ancestry, sexual orientation, gender identify or expression, familial status or age; 11) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. 21. Severability - If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. Lessor and Lessee agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. 22. Binding Effect - The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of Lessor and Lessee and their respective legal representatives, successors, and assigns. 23. Authority - Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law. 24. Adjudication of Disputes or Disagreements - Lessor and Lessee agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If no resolution can be agreed upon within 30 days after the first meet and confer session, the issue or issues shall be discussed at a public meeting of the Board of County Commissioners. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement by Florida law. 25. Cooperation - In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, Lessor and Lessee agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. Lessor and Lessee specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. 26. Covenant of No Interest - Lessor and Lessee covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and the only interest of each is to perform and receive benefits as recited in this Agreement. 27. Code of Ethics - County agrees that officers and employees of the County recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. 28. No Solicitation/Payment - Lessor and Lessee warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of this provision, Lessee agrees that Lessor shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage, gift or consideration. 29. Non -Waiver of Immunity - Notwithstanding the provisions of Sec. 768.28, Florida Statues, the participation of the Lessor and the Lessee in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract entered into by the Lessor be required to contain any provision for waiver. 30. Privileges and Immunities - All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the Lessor, when performing their respective functions under this Agreement within the territorial limits of the Lessor shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the Lessor. 31. Legal Obligations and Responsibilities - Non -Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the Lessor, except to the extent permitted by the Florida Constitution, State Statute, and case law. 32. Non -Reliance by Non -Parties - No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third -party claim or entitlement to or benefit of any service or program contemplated hereunder, and the Lessor and Lessee agree that neither the Lessor nor Lessee or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. 33. Attestations - Lessee agrees to execute such documents as the Lessor may reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a Drug -Free Workplace Statement. 34. No Personal Liability - No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. 35. Execution in Counterparts - This Agreement may be executed in any number of counterparts, each of which shall be regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by signing any such counterpart. 36. Other Use - Lessee shall not use or permit the use of the demised premises or any part thereof for any purpose or use other than an authorized by this agreement. 37. Paragraph Headings - Paragraph headings herein are intended only to assist in reading identification and are not in limitation or enlargement of the content of any paragraph. 38. Notices - Any notice of other communication from either party to the other pursuant to this agreement is sufficiently given or communicated if sent by registered mail, with proper postage and registration fees prepaid, addressed to the party for whom intended, at the following addresses: For Lessor: For Lessee: Airports Director Key West International Airport Gary Lichtenstein 3491 S. Roosevelt Blvd. 34 Seaside Court South Key West, FL. 33050 Key West, Fl. 33040 or to such other address as the party being given such notice shall from time to time designate to the other by notice given in accordance herewith. 39. Governing Law, Venue, Interpretation - Governing Law, Venue, Interpretation, Costs, and Fees: This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to contracts made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the Lessor and Lessee agree that venue will lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. The Lessor and Lessee agree that, in the event of conflicting interpretations of the terms or a term of this Agreement by or between any of them the issue shall be submitted to mediation prior to the institution of any other administrative or legal proceeding. 40. Attorney's Fees and Costs - The Lessor and Lessee agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses, as an award against the non -prevailing party, and shall include attorney's fees, courts costs, investigative, and out-of-pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the circuit court of Monroe County. 41. AIRPORT SECURITY. a) General. The federal Transportation Security Administration is the federal agency primarily responsible for overseeing the security measures utilized by the airport owner pursuant to the relevant provisions of Chapter 49, United States Code, and regulations adopted under the authority of the Code, including but not limited to 49 CFR 1540, et seq. Violations of the statutes or regulations may result in severe civil monetary penalties being assessed against the airport operator. It is the intent of the airport operator that the burdens and consequences of any security violations imposed upon the airport operator as a result of actions by an airport tenant or the airport tenant's employees, agents, invitees, or licensees shall be borne by the airport tenant. b) Airport Tenant Defined. An airport tenant means any person, entity, organization, partnership, corporation, or other legal association that has an agreement with the airport operator to conduct business on airport property. The term also includes an airport tenant as defined in 49 CFR 1540.5. Each signatory to this Agreement, other than the airport operator, is an airport tenant. c) Airport Operator Defined. As used in this Agreement, airport operator means Monroe County, Florida, its elected and appointed officers, and its employees. d) Airport Property Defined. Airport property shall mean the property owned or leased by, or being lawfully used by, the airport operator for civil aviation and airport - related purposes. For purposes of this Agreement, airport property is the property generally referred to as the Key West Airport, the Marathon Airport, or both as may be set forth in this Agreement. e) Inspection Authority. The airport tenant agrees to allow Transportation Security Administration (TSA) authorized personnel, at any time or any place, to make inspections or tests, including copying records, to determine compliance of the airport operator or airport tenant with the applicable security requirements of Chapter 49, United States Code, and 49 CFR 1540, et seq. f) Airport Security Program. The airport tenant agrees to become familiar, to the extent permitted by the airport operator, with the Airport Security Program promulgated by the airport operator and approved by TSA, and also agrees to conform its' operations and business activities to the requirements of the Airport Security Program. g) Tenant Security Program. If permitted under TSA regulations, the airport tenant may voluntarily undertake to maintain an Airport Tenant Security Program as referred to in 49 CFR 1542.113. If the airport tenant voluntarily promulgates an Airport Tenant Security Program that is approved by TSA, such program, as may be amended and approved from time to time, shall be automatically incorporated into this Agreement. h) Breach of Agreement. Should TSA determine that the airport tenant or one or more of the airport tenant's employees, agents, invitees, or licensees has committed an act or omitted to act as required, and such act or omission is a violation which results in TSA imposing a civil penalty against the airport operator in accordance with TSA's Enforcement Sanction Guidance Policy, such determination and imposition of a civil penalty by TSA shall be considered a significant breach of this Agreement. (1). Minimum Violation. If the violation is the first or second violation attributed to the airport tenant and is a civil penalty "minimum violation" as provided for in TSA's Enforcement Sanction Guidance Policy, the airport tenant may cure the breach by paying to the airport operator the total costs incurred by the airport operator, including any fines or penalties imposed, in investigating, defending, mitigating, compromising, or taking of remedial measures as may be agreed to by TSA, to include but not be limited to reasonable attorney's fees and costs incurred in the investigation, defense, compromising, mitigation, or taking of remedial action measures. If the violation is a third violation, or there are multiple violations in excess of two violations, that is or are a civil penalty "minimum violation", the airport tenant shall pay to the airport operator the total costs incurred by the airport operator, including any fines or penalties imposed, in investigating, defending, compromising, mitigating, or taking of remedial measures as may be agreed to by TSA, to include but not be limited to reasonable attorney's fees and costs incurred in the investigation, defense, compromising, mitigation, or taking of remedial action measures; and, further, the airport operator shall have the right to unilaterally cancel this Agreement, such cancellation to be effective thirty calendar days after receipt by the airport tenant of written notice of cancellation of this Agreement by the airport operator. (2). Moderate Violation. If the violation is the first or second violation attributed to the airport tenant and is a civil penalty "moderate violation" as provided for in TSA's Enforcement Sanction Guidance Policy, the airport tenant may cure the breach by paying to the airport operator the total costs incurred by the airport operator, including any fines or penalties imposed, in investigating, defending, compromising, mitigating, or taking of remedial measures as may be agreed to by TSA, to include but not be limited to reasonable attorney's fees and costs incurred in the investigation, defense, compromising, mitigation, or taking of remedial action measures; and, further, the airport tenant may cause all of airport tenant's employees involved in the airport tenant's business operations on the airport property to undergo such security training as may be required by the airport operator. The total cost of the training shall be paid for by the airport tenant. If the violation is a third violation, or there are multiple violations in excess of two violations, that is or are a civil penalty "moderate violation", the airport tenant shall pay to the airport operator the total costs incurred by the airport operator, including any fines or penalties imposed, in investigating, defending, compromising, mitigating, or taking of remedial measures as may be agreed to by TSA, to include but not be limited to reasonable attorney's fees and costs incurred in the investigation, defense, compromising, mitigation, or taking of remedial action measures; and, further, the airport operator shall have the right to unilaterally cancel this Agreement, such cancellation to be effective thirty calendar days after receipt by the airport tenant of written notice of cancellation of this Agreement by the airport operator. (3). Maximum Violation. If the violation is the first violation attributed to the airport tenant and is a civil penalty "maximum violation" as provided for in TSA's Enforcement Sanction Guidance Policy, the airport tenant may cure the breach by paying to the airport operator the total costs incurred by the airport operator, including any fines and penalties imposed, in investigating, defending, compromising, mitigating, or taking of remedial measures as may be agreed to by TSA, to include but not be limited to reasonable attorney's fees and costs incurred in the investigation, defense, compromising, mitigation, or taking of remedial action measures; and, further, the airport tenant may cause all of airport tenant's employees involved in the airport tenant's business operations on the airport property to undergo such security training as may be required by the airport operator. The total cost of the training shall be paid for by the airport tenant. If the violation is a second violation, or there are multiple violations, that is or are a civil penalty "maximum violation", the airport tenant shall pay to the airport operator the total costs incurred by the airport operator, including any fines or penalties imposed, in investigating, defending, compromising, mitigating, or taking of remedial measures as may be agreed to by TSA, to include but not be limited to reasonable attorney's fees and costs incurred in the investigation, defense, compromising, mitigation, or taking of remedial action measures; and, further, the airport operator shall have the right to unilaterally cancel this Agreement, such cancellation to be effective thirty calendar days after receipt by the airport tenant of written notice of cancellation of this Agreement by the airport operator. (4). Mitigation of Breach. TSA has a policy of forgoing civil penalty actions when the airport operator detects violations, promptly discloses the violations to TSA, and takes prompt corrective action to ensure that the same or similar violations do not recur. This policy is known as the TSA Voluntary Disclosure Program Policy, and is designed to encourage compliance with TSA regulations, foster secure practices, and encourage the development of internal evaluation programs. The airport tenant agrees that upon detecting a violation the airport tenant will immediately report it to the airport operator. Should the TSA ultimately determine that the violation was committed by the airport tenant, or an employee, agent, invitee, or licensee of the airport tenant, but the violation should result in the issuance of a letter of correction in lieu of a civil penalty, then the airport tenant shall reimburse the airport operator the total costs incurred by the airport operator in investigating, defending, mitigating, or taking of remedial measures as may be agreed to by TSA, to include but not be limited to reasonable attorney's fees and costs incurred in the investigation, defense, mitigation, or taking of remedial action measures. A violation resulting in the issuance of a letter of correction shall not be considered to be a breach of this Agreement by the airport tenant. (5). Survival of Sub -Section. This sub -section h shall survive the cancellation or termination of this Agreement, and shall be in full force and effect. i) Hold Harmless; Indemnification; Defense; Release; Survival. Notwithstanding any minimum insurance requirements prescribed elsewhere in this Agreement, the airport tenant agrees to hold harmless, indemnify, defend and release the airport operator, and the airport operator's elected and appointed officers and employees, from any claims, actions, causes of action, litigation, administrative proceedings, appellate proceedings, or other proceedings relating to any and all types of injury, including death, loss, damage, fines, penalties, or business interruption of any nature whatsoever, of or to any person or property in connection with the use of the airport property under this Agreement, regardless of causation and including criminal acts of third parties; and especially including any and all fines, penalties, out of pocket expenses, attorney's fees and costs, and costs of remediation or additional security measures required to be implemented by any governmental agency (including but not limited to the Federal Aviation Administration and the Transportation Security Administration) resulting from a violation of any federal law or federal regulation. This sub -section shall survive the cancellation or termination of this Agreement. 42. Mutual Review - This agreement has been carefully reviewed by the Lessee and the Lessor. Therefore, this agreement is not to be construed against either party on the basis of authorship. 43. Final Understanding - This agreement is the parties' final mutual understanding. It replaces any earlier agreements or understandings, whether written or oral. This agreement cannot be modified or replaced except by another written and signed agreement. The Remainder of this page has been intentionally left blank. IN WITNESS WHEREOF, each party has caused this agreement to be executed by a duly authorized representative. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK ATTEST. By: _ 1%V Title: ►, k, J ' 0 O v W C LL Q W U- BOARD OF COUNTY COMMISSIONERS OF MONROE OUN LORIDA By V,-�#�/Chairman u 0 C: 0 m 0 CU c C: w ul m a) -j 11 %. v C14 � Page 1 of 1 Pam Hancock From: "Mercado -Pedro" <-294cb5@Mon roeCounty-FL.Gov> To: "Pam Hancock" < phan cock@ mon roe -clerk. com> Cc: "Pearson -April" <Pearson-April@monroecounty-fl.gov> Sent: Thursday, November 04, 2010 1:33 PM Subject: RE: Lease Agreement Kennedy Galleries Pam, sorry for the delay. The full fictitious name for Mr. Lichtenstein's business is Kennedy Studio Seaport Gallery. By some oversight we shortened it on the lease but the RFP proposal which is incorporated as part of the lease shows the full business name. Sunbiz lists the full name and the Seaport Gallery Inc. name and shows Mr. Lichtenstein as the owner. I am satisfied with the C01. Thanks From: Pam Hancock [mailto:phancock@monroe-clerk.com] Sent: Monday, November 01, 2010 10:40 AM To: Mercado -Pedro Cc: Pearson -April Subject: Lease Agreement Kennedy Galleries Good Morning Pedro, Wanted to remind you that I need a determination on the above -mentioned Lease. The attached certificates of insurance & waivers all refer to Seaport Gallery, Inc.; however, none of them refer to Kennedy Galleries. The only thing that ties the insurances & waivers to Kennedy Galleries is that Mr. Gary Lichtenstein's name is on the two waivers and in the Lease Agreement at Section 38. Please advise - thanks. Please take a moment to complete our Customer Satisfaction Survey: http://monroecofl.virtualtownhall.net/Pages/MonroeCoFL_WebDoes/css Your feedback is important to us! Please note: Florida has a very broad public records law. Most written communications to or from the County regarding County business are public record, available to the public and media upon request. Your e-mail communication may be subject to public disclosure. 11 /4/2010 AcoR& CERTIFICATE OF LIABILITY INSURANCE ATE D10/13/201 YY) THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Island insurance Agency, Inc. 3229 Hagler Ave;7112 CONTACT NAME: Phillips PHONE(305) 294-6666 FAX (305) 294-6668 A/C, No, AIC No ADDRESS islandinsurance@comcast.net PRODUCER CUSTOMER ID: Key West FL 33040 INSURER(S) AFFORDING COVERAGE NAIC IT INSURED INSURER A: MOUNT VERNON FIRE INS CO SEAPORT GALLERY, INC. dba INTERNATIONAL INSURER B: AIRPORT STORE 13EST OF KEY WEST INSURER C: 3491 S. RSVLT BLVD INSURER D: KEY WEST FL 33040 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMfDDIYYYY) (MmIDDryyyyj LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY [CLAIMS -MADE [OCCUR EACH OCCURRENCE $ 300,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 A CL2577792 07/15/2010 07/15/2011 PERSONALaADVINJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 600,000 j POLICY PROJ- LOC ECT AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ !. ALL OWNED AUTOS BODILY INJURY (Per accident) S SCHEDULED AUTOS - PROPERTY DAMAGE (Per accident) $ - j HIRED AUTOS �� V NON -OWNED AUTOS _ I �n 1 � 'CJRJ ✓ $ UMBRELLA LIAB I OCCUR I- EACH OCCURRENCE $ EXCESS LIAB '� CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ I $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N TORY LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE ---I OFRCERfMEMBER EXCLUDED NIA W9 E.L. DISEASE - EA $ - (Mandatory in NH) If yes, describe under E.L tI101T7� 5 ; - it .,`1I DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS f LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) O (T 1 1 RETAIL STORE LOCATEDAT: KEY WEST INTERNATIONAL AIRPORT, 3491 S. RSVLT BLVD, KEY WEST, FL. 33040 �I I I l' ****CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED***** CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY BOARD EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH OF COUNTY COMMISSIONERS c/o KWIA THE PO VISIONS. 3481 S. RSVLT BLVD AUTHORI KEY WEST FL. 33040 - 9 ACORD C RPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD Zoos Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, a specified in the CounWs Schedule of Insurance Requirements, be waived or modified on the fo contract, Contractor �lilc-) -Z� I � E Contract for. Address of Contractor `�S Phone: j�s� b� s- Scope of Work: Z,i Reason for Waiver: Policies Waiver will apply to: Signature of Contractor. Risk Management °ate County Administrator appeal: Approved: Not Approved: Date: Board of County Commissioners appal: Approved: Meeting Date: Administration Instruction 44709.6 Not Approved: 104 MONROE COUNTY, FLORIDA Request For Waiver Of Insurance Requirements It is requested that the insurance requirements, specified in the Countys Schedule of Insurance be waived or modified on the fol owing con°' Contractor a I / cs 04 Contract for: 1, Y l C Address of Contractor: Phone: Scope of Work Reason for Waiver: Policies Waiver will apply to: Signature of Contractor. Risk Management 1 u I Date �T ' County Administrator appeal: Approved: - Date: Board of County Commissioners appeal: Approved Meeting Date: Administration Instruction #4709.6 Not Approved Not Approved: Not Approved BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: Airports Bulk Item: Yes XX No Staff Contact Person: Peter Horton AGENDA ITEM WORDING: Approval of a contract and contract amendment with MBI-K2M Architecture, Inc., for Customs Terminal Security Enhancements at Key West International Airport. ITEM BACKGROUND: The Florida Department of Transportation awarded the airport a 100% grant to enhance security at Key West Airport. After discussion with the Department of Homeland Security, these improvements are recommended to improve security and safety. PREVIOUS RELEVANT BOCC ACTION: 12-16-2009 — approval of a continuing services contract with MBI-K2M for Architectural/Engineering Services; A2-17-2010 — approval of FDOT security grant CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approve TOTAL COST: _$45,700.00 BUDGETED: Yes XX No COST TO COUNTY (Airport): none SOURCE OF FUNDS: FDOT grant REVENUE PRODUCING: Yes No XX AMOUNT PER YEAR APPROVED BY: County Atty _ OMB/Purchasing Risk Management DOCUMENTATION: Included XX Not Required DISPOSITION: AGENDA ITEM #. Revised 2/05 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: MBI-K2M Architecture Inc. Effective Date: April 29, 2010 Expiration Date: December 16, 2013 Contract Purpose/Description: Security Enhancements for Customs Terminal at Key West International Airport. Contract Manager: Peter Horton # 5200 Airports - Stop # 5 (name) (Ext.) (Department/ Stop) for BOCC meeting on: December 15, 2010 Agenda Deadline: November 30, 2010 Total Dollar Value of Contract: $45,700.00 Budgeted? Yes Grant: Yes County Match: -0- (100%grant) Estimated Ongoing Costs: n/a (not included in dollar value above) Date In Airports Director Risk Management O.M.B./Purchasing County Attorney —/—/ Comments: CONTRACT COSTS Current Year Portion: $38,260.00 Account Codes: 630149-530490-GAKD122-530310 ADDITIONAL COSTS For: (eg. maintenance, utilities, janitorial, salaries, etc. CONTRACT REVIEW Changes Needed Yes No Peter Horton for Risk Management for OMB Reviewer County Attorney Date Out mbi I k2m ARCHITECTURE, INC. Date: April 27, 2010 1001 WHITEHEAD STREET KEY WEST, FLORIDA 33040 PHONE: 305,292.7722 FAX: 305.292.2162 PROF. REG. NO. AA26001059 DESIGN SERVICES AGREEMENT Client: Monroe County — Key West International Airport 3491 S. Roosevelt Boulevard Key West, Florida 33040 Attn: Mr. Peter Horton, Director of Airports — sent via email to horton-peter@monroecounty-fl.gov Design mbi I k2m Architecture, Inc. Professional: 1001 Whitehead Street, Suite 101 Key West, Florida 33040 Mr. Scott C. Maloney, R. A., Director Project: CUSTOMS TERMINAL SECURITY ENHANCEMENTS - KEY WEST INTERNATIONAL AIRPORT I. Scope of Services A. Design Professional shall provide architectural and engineering services for approval, permitting, and construction of security enhancements at the Customs Terminal at the Key West International Airport. Additionally, Design Professional shall provide design concepts for future expansion opportunities of the bus terminal and second floor storage areas. Refer to Appendix A for an expanded scope of work. II. Conditions A. This proposal remains valid for thirty days, after which time Design Professional reserves the right to modify or amend the Agreement. Terms and conditions contained in the Continuing Service Agreement between Client and Design Professional apply. III. Compensation A. For services described in Section IA, the Client agrees to pay a fixed fee of TWENTY-FOUR THOUSAND EIGHT -HUNDRED DOLLARS ($ 24,800) as required to complete the work, unless agreed to in writing by Client. B. In addition to compensation in Paragraph III (A), Client shall pay Design Professional for any and all reimbursable expenses. Reimbursable expenses are defined as the actual expenses increased by 10% incurred by the Design Professional in connection with the Project, such as expenses for: reproduction of reports, drawings, and specifications; renderings; and similar Project -related items. All additional consultants required for work will be billed at direct cost + 10%. C. Any items beyond those specifically outlined and described herein, are considered to be Additional Services and are chargeable at the standard hourly rate. D. The following is a listing of hourly rates assigned by staffing type for mbi I k2m Architecture, Inc. HOURLY RATES ARE SHOWN FOR PURPOSE OF AUTHORIZED ADDITIONAL WORK BEYOND THIS SCOPE OF WORK. RECEIVED KEY WEST I SOUTHWEST FLORIDA I CLEVELAND I HOUSTON IAPR19'F" AIRPORT GRANTS mbI I k2m ARCHITECTURE, INC. ARCHITECTURE Principal , Architect 1 $215,00 / hour Project Manager, Architect II $185.00 / hour Project Manager $120.00 / hour Construction Administration $120.00 / hour Draftsman 1 $ 95.00 / hour Draftsman 11 $ 70.00 / hour Administration $ 55.00 / hour 1001 WHITEHEAD STREET KEY WEST, FLORIDA 33040 PHONE:305.292.7722 FAX: 305.292.2162 PROF. REG, NO. AA26001059 DESIGN SERVICES AGREEMENT E. The Design Professional shall submit monthly invoices for services rendered. Payment of the invoice is due within 30 days after date on invoice. APPENDIX A The project will be broken into three tasks of work in accordance with the following: Task One: Security Enhancements • Front Entrance and Vestibule with Blast Proof Doors and Reception Counter • Rear Entrance Blast Proof Doors • Secure Holding Cell with Restroom compliant with current U.S. Department of Homeland Security standards • Secure Holding Cell compliant with current U.S. Department of Homeland Security standards • Sever Room compliant with current U.S. Department of Homeland Security standards • Blast Proof Exterior Windows • Interior Connection between Port Director's office and main terminal for security • Enhance 'Locals' waiting area at main arrival terminal Task Two: Bus Terminal Expansion Develop an addition design to the Southwest corner of the Customs Terminal, totaling approximately 700 s.f. and including: • Waiting area for fifteen persons • Office with reception counter • Restrooms Task Three: Customs Terminal Expansion Develop design concept to relocate second floor generator to new generator building adjacent to the Customs Terminal on the Northwest corner and utilize second floor as additional habitable space. Design will include: • Review life safety and egress at second floor • Provide interior stair / elevator connection to second floor as required KEY WEST I SOUTHWEST FLORIDA I CLEVELAND I HOUSTON I CHARLOTTE mb i I k2m ARCHITECTURE, INC. The following outlines an expanded Scope of Work (fee includes): Existing Conditions — Tasks One, Two, and Three Items Document existing building conditions. Deliverables include: Floor Plans Exterior Elevations 1001 WHITEHEAD STREET KEY WEST. FLORIDA 33040 PHONE: 305.292.7722 FAx: 30 5.292.2 162 PROF. REG. NO, AA26001059 DESIGN SERVICES AGREEMENT Schematic Design — Tasks One, Two, and Three Items Develop preliminary floor plans for review and approval by Key West International Airport / Customs Terminal staff, as required. Deliverables include: Floor Plans Design Development — Tasks One, Two, and Three Items Development of site plan, floor plans, ceiling plans, and building elevations by Key West International Airport / Customs Terminal staff, as required. Deliverables include: Site Plan Floor Plans Ceiling Plans Building Elevations Construction Cost Estimate Permitting Coordination Construction Documents — Task One Items Provide architectural and engineering drawings and specifications for building permit and construction along with coordination with Client and City. Deliverables include: Mechanical , Plumbing, Electrical Engineering as required Structural Engineering as required Architectural Code Review Demolition Package Site Plan Floor / Ceiling Plans Exterior Elevations Enlarged Plans / Interior Elevations as Required Interior and Exterior Details Specifications Interior Design — limited to basic finishes and materials consistent with building standard Construction Administration — Task One Items Q��� Review product submittals and respond to Contractor questions. KEY WEST I SOUTHWEST FLORIDA I CLEVELAND I HOUSTON I CHARLOTTE mbi I k2m ARCHITECTURE, INC. 1001 WHITEHEAD STREET KEY WEST, FLORIDA 33040 PHONE: 305.292.7722 FAX: 305.292.2162 PROF. REG, NO. AA26001059 DESIGN SERVICES AGREEMENT STIPULATION Upon signing this Design Services Agreement, it will be helpful and useful for the following documents to be made available to Design Professional: • U.S. Department of Homeland Security Design Standards (verbal approval from Phil DeMonch) • Existing architectural and/or engineering drawings ADDITIONAL SERVICES Additional services are those which arise as a result of unforeseen circumstances during the design of a project and which, therefore, cannot be included in the basic services agreement. Such additional services, when requested in writing by Client, shall be performed at an hourly rate per the Design Professional rates above. Additional Services are as defined in the AIA Document B101 — 2007 Edition — Standard Form of Agreement Between Owner and Architect, Article 4. Design Professional shall submit an estimated additional services cost for approval and authorization by Client in writing prior to proceeding. Design Professional owns and operates Spectrum Design Services which is a 7-person interior design firm that performs interior design and Agent Method purchasing services. Interiors Purchasing can be provided under a separate agreement. Design Professional has relationships with 3D computer and hand rendering companies. If renderings are required beyond they shall be billed as a reimbursable cost only when approved by Client prior to start of work. PROJECT BUDGETING In providing opinions of probable construction and / or FF&E cost, the Client understands that the Consultant has no control over the cost or availability of labor, equipment, furnishings, or materials, or over market conditions or the Contractor's / Manufacturer's method of pricing, and that the Consultant's opinion of probable construction and / or FF&E costs are made on the basis of the Consultant's professional judgment and experience. The Consultant makes no warranty, express or implied, that the bids or the negotiated cost of the Work will not vary from the Consultant's opinion of probable construction cost. SCHEDULE The Design Professional shall perform its services as expeditiously as is consistent with professional skill and care and the orderly progress of the Work. The following schedule is included as a guideline for the work required. Adjustments to the schedule may be required based on the date of the executed agreement. Design Professional cannot guarantee permit issuance within a given time frame due to permitting process in Key West, Florida. Anticipated Project Start Completion of Existing Conditions — Tasks One, Two, and Three Items Completion of Schematic Design — Tasks One, Two, and Three Items Client Approval of SD Completion of Design Development — Tasks One, Two, and Three Items Client Approval of DID Completion of Construction Documents — Task One Items Only KEY WEST I SOUTHWEST FLORIDA I CLEVELAND June 11, 2010 June 25, 2010 July 16, 2010 July 21, 2010 August 6, 2010 August 13, 2010 September 24, 2010 HOUSTON I CHARLOTTE mbi I k2m ARCHITECTURE, INC. 1001 WHITEHEAD STREET KEY WEST. FLORIDA 33040 PHONE: 305.292.7722 FAX: 305.292.2162 PROF. REG. NO. AA26001059 DESIGN SERVICES AGREEMENT This agreement represents the entire integrated agreement between Client and Design Professional and supercedes all prior negotiations, representations or agreement, whether written or oral. This agreement may be amended only in writing and signed by both Client and Design Professional. Please sign and return this proposal for the work to proceed. 4-2-5-fo Date a mbi ( k2m Architectuk, Inc - Scott C. Maloney, R.A., Director KEY WEST I SOUTHWEST FLORIDA I CLEVELAND I HOUSTON April 27, 2010 Date CHARLOTTE mbi I k2m ARCHITECTURE, INC. April 27, 2010 1001 WHITEHEAD STREET KEY WEST. FLORIDA 33040 PHONE: 305.292.7722 FAX: 305.292.2162 PROF. REG. NO. AA26001059 Key West International Airport 3491 S. Roosevelt Boulevard Key West, Florida 33040 Attn: Mr. Peter Horton, Director of Airports — sent via email to horton-peter@monroecounty-fl.gov RE: CUSTOMS TERMINAL SECURITY ENHANCEMENTS - KEY WEST INTERNATIONAL AIRPORT Dear Peter, Thank you for taking the time to meet with Anthony D. Samo last week to discuss the security enhancements and future expansion opportunities for the Customs Terminal at the Key West International Airport. Based on your conversation, we have broken the project into three task items to correspond with funding availability and current needs. Task One will focus on security enhancements, in cooperation with Port Director Phil DeMonch, and our Team will provide design, engineering, and construction administration services. Tasks Two and Three will be conceptual in nature to provide direction once future needs are realized and funding becomes available. The scope of services generally will include: Task One: Security Enhancements • Front Entrance and Vestibule with Blast Proof Doors and Reception Counter • Rear Entrance Blast Proof Doors • Secure Holding Cell with Restroom compliant with current U.S. Department of Homeland Security standards • Secure Holding Cell compliant with current U.S. Department of Homeland Security standards • Sever Room compliant with current U.S. Department of Homeland Security standards • Blast Proof Exterior Windows • Interior Connection between Port Director's office and main terminal for security • Enhance 'Locals' waiting area at main arrival terminal Task Two: Bus Terminal Expansion Develop an addition design to the Southwest corner of the Customs Terminal, totaling approximately 700 s.f. and including: • Waiting area for fifteen persons • Office with reception counter • Restrooms Task Three: Customs Terminal Expansion Develop design concept to relocate second floor generator to new generator building adjacent to the Customs Terminal on the Northwest corner and utilize second floor as additional habitable space. Design will include: • Review life safety and egress at second floor • Provide interior stair / elevator connection to second floor as required KEY WEST I SOUTHWEST FLORIDA I CLEVELAND I HOUSTON I CHARLOTTE 1001 WHITEHEAD STREET mbi k2m KEY WEST, FLORIDA 33040 PHONE: 305.292.7722 FAX: 305.292.2162 ARCHITECTURE, INC. PROF, REG. NO. AA26001059 mbi I k2m Architecture will provide conceptual design for Tasks Two and Three and be responsible for all design and engineering required to complete the work in Task One, Our Team will provide services and prepare design / Contract Documents in accordance with our Continuing Services Agreement to the County, which shall include the following information: • Cover Sheet — project name, code, general notes, system description, abbreviations, and location map • Demolition Plans • Site Plan • Floor and Ceiling Plans • Exterior Elevations • Enlarged Plans / Intedor Elevations as required • Interior and Exterior Details • Specifications • All engineering associated with structural, mechanical, electrical, and plumbing modifications • Assist County in bidding process • Completing a review of all submitted bids and assist County in awarding a contract • Shop Drawing Review as required by Architect / Engineering specifications • Respond to Requests for Information from Contractors • Punch List and Project Closeout Additionally mbi I k2m will submit to all governing agencies all required rights, permits, and approvals. The County will become the signatory on applications, permits, and utility agreements only when necessary. Our Team will provide cost estimating at the construction document phase in accordance with requirements for public projects, based on the estimated project budget of $125,000 for preliminary purposes. Again, thank you for this opportunity. Best Regards, k2m Qrchiterture, Inc. Scott C. Malon NC RB, LEED AP Director of Corn nv Cc: file KEY WEST I SOUTHWEST FLORIDA I CLEVELAND I HOUSTON I CHARLOTTE mbi I k2m ARCHITECTURE, INC. September 14, 2010 1001 WHITEHEAD STREET KEY WEST, FLORIDA 33040 PHONE:305.292.7722 FAX: 30S.292.2162 PROF. RED. NO. AA26001059 CONTRACT AMENDMENT Monroe County — Key West International Airport 3491 S. Roosevelt Boulevard Key West, Florida 33040 Attn: Mr. Peter Horton, Director of Airports — sent via email to horton-peter@monroecounty-fl.gov Re: Customs Terminal Security Enhancements — Key West International Airport Contract Amendment Number 1 MK-10049 Dear Mr. Horton, This letter is Amendment Number 1 to the Agreement ("Agreement") between mbi I k2m Architecture, Inc. ("Consultant") and Monroe County ("Client") for the performance of services in connection with security enhancements at the Customs Terminal at the Key West Intemal Airport ("Project"), dated April 27, 2010. The purpose of this letter is to request additional fee outside the original scope of work. This Amendment is effective as of the date of this letter. All other terms and conditions of the Agreement not previously amended or specifically modified by this Amendment remain in effect. Consultant and Client modify the Agreement as follows: The scope of work is herby modified to include the following in accordance with the Schematic Design review meeting on August 25, 2010 with the Department of Homeland Security • New computer room of approximately 180 s. f., located at the existing search room • Reconfiguring existing storage, detention room, and offices at the Southeast corner of the building for new detention, interview, and search rooms, office for workstations, and rover coordination center • Addition of second egress area for cleared passengers to depart to air side • Existing conditions analysis of affected area by design team • HVAC Engineering: o Modifications to existing HVAC systems for offices and vestibules; design for 100% outside air/exhaust system with negative pressure for hold rooms and detention room; design for 100% exhaust for interview room; design for separate HVAC system for computer room; HVAC system control modifications as required • Plumbing Engineering: o Modifications to existing sanitary waste and vent and domestic water systems for detention room; new detention type fixtures as required with electronic flush control in detention room and flush control curoff outside room; floor drain with tamper proof cover; eye wash and hand sink adjacent to detention room and search room; condensate drain piping for HVAC • Fire Protection Engineering: o Modifications to existing fire protection system as required for new floor plan; pop -down sprinkler heads in detention, hold, and interview rooms; FM 200 fire protection system for computer room X:1Jobs12010WK-10049 - Monroe - KwIA Customs Terminal SecurttylAdmin\Contracts\2010.09.14 Contract Amendment 1 - Customs Terminal.doc KEY WEST I SOUTHWEST FLORIDA I CLEVELAND I HOUSTON I CHARLOTTE mbi I k2m ARCHITECTURE, INC. 1001 WHITEHEAD STREET KEY WEST, FLORIDA 33040 PHONE: 305.292.7722 FAX: 305.292.2162 PROF. REG. NO. AA26001059 CONTRACT AMENDMENT • Electrical Engineering: o Modifications to lighting layout and circuiting as required for new floor plan; electrically powered equipment connections and circuiting; branch, power, and distribution wiring and raceway; connection of lighting to emergency power system for interview, detention, and holding rooms; dedicated power with UPS system for computer room; modifications to existing fire alarm system as required • Electronic Systems Engineering — extensions / modifications to existing: o Telephone distribution system (phone system /switch by Owner Operator); data systems distribution (electronics by Owner/ Operator); systems per CBP Airport Technical Design Standards 2006 • Security Systems Engineering — extensions / modifications to existing: o Duress system with keyed reset / disable control for interview, hold, and detention rooms; CCTV with microphone in interview room; CCTV in hold and detention rooms; IDS and alarm with UPS backup with keypad control inside computer room; telephone modem in computer room; server room to be designed in accordance with CBP and USDHS standards • Construction Administration Compensation for these modifications over and above the original agreement is proposed at a fixed fee of TWENTY THOUSAND NINE HUNDRED DOLLARS ($20,900.00) plus reimbursable expenses: • MPE, Fire Protection, Security, and Technology -existing conditions analysis field visit $2, 640 • MPE, Fire Protection, Security, and Technology - engineering and construction administration $14,300 Architectural - existing conditions analysis, design, coordination, and construction administration $3, 960 In addition to the fixed fee compensation noted above, Client shall pay Design Professional for any and all reimbursable expenses, including expenses for travel for consultants located outside Monroe County. The following is an estimate of anticipated reimbursable expenses for travel: • MPE, Fire Protection, Security, and Technology -existing conditions analysis field visit $600 • MPE, Fire Protection, Security, and Technology - construction administration field visit $600 At the request of Homeland Security, the following services can be provided: • MPE, Fire Protection, Security, and Technology - construction administration field visit $2,400 + reimbursable expenses The following project schedule modification is requested with this Amendment: Completion of Revised Schematic Design — Tasks I, II, and III 7 Days Homeland Security Review of Schematic Design (anticipated) 14 Days Completion of Design Development — Tasks I, II, and III 21 Days Existing Conditions Analysis 3 Days Homeland Security Review of Design Development (anticipated) 28 Days Completion of Construction Documents — Task 1 28 Days xalobs120101MK-10049 - Monroe - KWIA Customs Terminal SemdtylAdmin\Contracts12010.09.14 Contract Amendment 1 - Customs Terminal.doc KEY WEST I SOUTHWEST FLORIDA I CLEVELAND I HOUSTON I CHARLOTTE mbi I k2m ARCHITECTURE, INC. 1001 WHITEHEAD STREET KEY WEST, FLORIDA 33040 PHONE: 305.292.7722 FAX: 305.292.2162 PROF. REG. NO. AA26001059 CONTRACT AMENDMENT If the terms of this Amendment meet with your approval, please indicate by signing and returning one copy of this letter to us. If you have any questions, please do not hesitate to call. Thank you. Best Regards, mbi I k2m Architecture, Inc. n Scott C. Maloney, AIA, NCARB Director Authorization: Monroe County By:_ Title: Signature (signer represents that she or he is legally authorized to sign on behalf of client) Date X Uobs120101MK-10049 -Monroe - KWIA Customs Terminal SewdtylAdmin\Contracts12010.09.14 Contract Amendment 1 - Customs Terminal.doc KEY WEST I SOUTHWEST FLORIDA I CLEVELAND I HOUSTON I CHARLOTTE Pearson -April From: Horton -Peter Sent: Tuesday, September 14, 2010 3:52 PM To: Pearson -April Subject: FW: 10049 Customs FIS - Contract Amendment 1 - Expanded Scope per Homeland Security - FOR YOUR APPROVAL Attachments: 2010.09.14 Contract Amendment 1 - Customs Terminal.pdf; 2010.09.14 Contract Amendment 1 - Customs Terminal.pdf Follow Up Flag: Follow up Flag Status: Flagged From: Anthony Sarno [mailto:asarno@mbi-k2m.com] Sent: Tuesday, September 14, 2010 1:54 PM To: Horton -Peter Cc: Scott Maloney; Dee McKenzie Subject: 10049 Customs FIS - Contract Amendment 1 - Expanded Scope per Homeland Security - FOR YOUR APPROVAL Peter, Attached is Contract Amendment 1 for the Customs FIS project in response to the Homeland Security review and site meeting. Please return 1 signed copy to our office at your convenience. Thank you. Anthony D. Sarno, R.A., NCARB I Project Manager mbi I k2m Architecture, Inc. 1001 Whitehead Street, Key West, FL 33040 P 305.292.7722 F 305.292.2162 www.mbi-k2m.com I www.spectrumdesign.com Key West ( Southwest Florida ( Cleveland I Houston I Charlotte Finding Innovative Solutions in Sustainable Design This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity they are addressed. If you are NOT the intended recipient or the person responsible for delivering the e-mail to the intended recipient, be advised that you have received this e-mail in error and that any use, dissemination, forwarding, printing, or copy of this e-mail is strictly prohibited. If you have received this communication in error, kindly notify us immediately by e-mail reply to the originating address. Please take a moment to complete our Customer Satisfaction Survey: httu://monroecofl.virtualtownhall.net/Pates/MonroeCoFL WebDocs/css Your feedback is important to us! Please note: Florida has a very broad public records law. Most written communications to or from the County regarding County business are public record, available to the public and media upon request. Your e-mail communication may be subject to public disclosure. BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15 2010 Division: County Administrator Bulk Item: Yes Department: Airports Staff Contact Person/Phone #: Peter Horton. 809-5200 AGENDA ITEM WORDING: Approval of Purchase Service Order #09/10/40 with URS for Airport Noise Coordination — Part 150 Program, Phase 1 at the Key West International Airport. ITEM BACKGROUND: This project is funded 95% by the Federal Aviation Administration, with match from Airport Operating Funds. PREVIOUS RELEVANT BOCC ACTION: Approval to submit PFC Application 413, 3-21-2007. CONTRACT/AGREEMENT CHANGES: New agreement. STAFF RECOMMENDATION: Approval. TOTAL COST: $29,188.00 COST: NA DIFFERENTIAL OF LOCAL PREFERENCE: NA COST TO COUNTY: None COST TO AIRPORT: $1,459.00 COST TO PFC: None REVENUE PRODUCING: Yes APPROVED BY: County Attorney X DOCUMENTATION: Included X BUDGETED: Yes SOURCE OF FUNDS: FAA, operating No X AMOUNT PER YEAR: NA OMB/Purchasing %C Risk Management x Not Required DISPOSITION: AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: URS Effective Date: Execution Expiration Date: 127 days Contract Purpose/Description: PSO #09/10/40 for Noise Coordination — Part 150 Program Phase 1 at Key West International Airport, Contract Manager: Peter Horton # 5200 Airports - Stop # 5 (name) (Ext.) (Department/ Stop) for BOCC meeting on: December 15, 2010 Agenda Deadline: November 30, 2010 CONTRACT COSTS Total Dollar Value of Contract: $29,188.00 Current Year Portion: $29,188.00 Budgeted? Yes Account Codes: 406-636146-530490-GAKAP139 Grant: Yes - FAA County Match: operating ADDITIONAL COSTS Estimated Ongoing Costs: n/a For: (not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW ——� Changes Date In Needed Reviewer Date Out Airports Director 1L _ 10 Yes No f d Risk Manage ent C O.M.B./Purchasing �/ 1 / 1 1 /�/ �� ( ) (✓) r H rton - A0 or �sk Management tl /�/� / I / County Attorney _/_/_ ( ) ( ) �, or �t-f� ,orT"0 County Attorney Comments: DR �- 2 201 i� ; r r E_ PURCHASE / SERVICE ORDER FOR MONROE COUNTY To: URS Purchase Service Order No. 09/10-40 Re: PSA Agreement, Dated: 4-1-07 Resolution Project Name: Noise Coordination - Part J50 Program Phase i Description of Services: (See Attached Exhibit A Scope of Services) Multiple of Direct Salaries Lump Sum X Days to Complete 127 Reimbursable Expense Fee this Service Order $ 29 188.00 Payment for Services shall be in their entirety as per PSO. Prepared by: Reco by: Milford A. Reisert Date: / - 2 - /D Date: q-2-2- — 0 Accepted by: Carlos Garcia Date: ow OCT 04 2010 Approved by: Date: MO E COUNTY TO EY RO ED A PEDRO J. ERCADO NTY ATT ate �61 MMMINISTRATIVE ASSISTANT\AAA-RECEPTIONISTIPSO\09-10\PSO-09-10-40 LiT EXHIBIT A SCOPE OF SERVICES EXTENSION OF STAFF: AIRPORT NOISE PROGRAM COORDINATOR OCTOBER 2010 - JANUARY 2011 KEY WEST INTERNATIONAL AIRPORT This Scope of Services will describe tasks necessary for URS to assist the airport with duties previously performed by the Airport Noise Program Coordinator, including certain homeowner liaison tasks as described below. The PSO associated with this Scope of Services will cover services for a portion Fiscal Year 2011 (October 1, 2010 through January 31, 2011). URS will provide staff on an as -needed basis to answer inquiries from and provide information to the public, the media, the County, and the NIP Consultant Team, as appropriate. URS will act as the liaison between the Homeowners and the County. URS will prepare of the Agenda Package for the Ad -Hoc Committee meetings to be held on October 12 and December 7, 2010, in advance of these meetings. They will provide the agenda package to the County for posting on the website. URS will attend these meeting of the airport's Ad -Hoc Committee on Noise, and will also prepare minutes of these Ad -Hoc Committee meetings. URS will provide Homeowners with a telephone number, and monitor an answering machine connected to the local phone number. URS will maintain contact with Homeowners in all phases of the NIP to ensure homeowner satisfaction, answer questions, and assist in the resolution of any issues that arise during the NIP. URS will monitor the NIP Consultant Team during the Phase 7 construction period, which is scheduled to be concluded by December 2010. URS will make two visits during construction (October and December) to observe progress, ensure compliance with contract requirements, and monitor Homeowner satisfaction. URS will verify Homeowner satisfaction and document that the Homeowner has received their warranty manuals. The manuals will list the length of workmanship and product warranties, and the names and telephone numbers of whom to call should warranty service be required. URS will attend some of the post -modification noise measurements (tentatively scheduled for January 2011), and review the final report that documents acoustical improvements. D:\Key West\Scopes and Costs\Extension of Staff\Extension of Staff FY11.docx August 17, 2010 Created by wp_dwm co co C G r O 3 O 1- J tq U � o Cl i1 Oo m C 6 Z X W co N O w U N r R y U 09, U) oho o V- _ d o f. o co r rr i Lo ON U co .r «a 64 2 E -- .N aQ O 3 O co ti NFU 0 60� 2 6q CL d = L N a � O o o .. M o cl O L m O O 6q c c a = L N m 3 Co o 0 o +r 0 co L U d q- O V N CD M E? a R = — o g � o BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12/15/2010 Division: Community Services Bulk Item: Yes x No _ Department: Social Services/Transportation_ Staff Contact /Phone #: Sheryl Graham x4510 AGENDA ITEM WORDING: Approval of a contract between Monroe County and the Community Transportation Coordinator/Guidance C44e/Care Center Inc., of *he "piddle Keys for a contract period of 01/01/2011 through 12/31/2011. ITEM BACKGROUND: The contract is funded by the State Commission for the Transportation Disadvantaged allowing Monroe County Transit to be paid for providing contracted transit service to Monroe County's transportation disadvantaged, PREVIOUS RELEVANT BOCC ACTION: Contract approved 1/20/2010 CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval TOTAL COST: $0 INDIRECT COST: BUDGETED: Yes x No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: $0 SOURCE OF FUNDS: N/A REVENUE PRODUCING: Yes x No AMOUNT PER MONTH unknown Year unknown APPROVED BY: County Atty OMB/Purchasing Risk Management DOCUMENTATION: DISPOSITION: Revised 7/09 Included Not Required AGENDA ITEM # Meeting Date: 12/15/201`0 Division: CpMMumV Services Bulk Item: Yes X - No Department: Social Services/Transportation Staff' Contact /Phone : her I Graham x4510 AGENDA ITEM WORDING: Approval of a contract between Monroe County and the Community Transportation Coordinator/Guidance Clinic of the Middle Keys for a contract period. of 01 /01 /20 i 1 through 12/31/2011. ITEM BACKGROUND: The contract is funded by the State Commission for the Transportation Disadvantaged allowing Monroe County Transit to be paid for providing contracted transit service to Monroe County's transportation disadvantaged, PREVIOUS RELEVANT BOCC ACTION: Contract approved 1/20/2010 CONTRACT/AGREEMENT CHANGES: NIA STAFF RECOMMENDATIONS: Approval TOTAL COST: $0 INDIRECT COST: BUDGETED: Yes' x No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: $0 SOURCE OF FUNDS N/A REVENUE PRODUCING: Yes x No AMOUNT PER MONTH unknown Year unknown APPROVED BY: County Atty, © urchasing Risk Managemen �L�� DOCUMENTATION: Inclu ed Not Required DISPOSITION: AGENDA ITEM # Revised 7/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: CTC Contract # Effective Date: 01-01-2011 Expiration Date: 12-31-2011 Contract Purpose/Description: The agreement is ceded by the State of Florida Commission for the Transportation Disadvantaged paying for the services when contracted and provided by Monroe County Transit to Monroe Co!!pty's transportation disadvantaged elation segment. Contract Manager: Sheryl Graha 4510 Social Services/Stop #1 (Name) {Ext.) (Department/Stop #) for BOCC TEEti on 1211512010 A ends Deadline: 11130I10; CONTRACT COSTS Total Dollar Value of Contract: $ 0 Current Year Portion $ 0 Budgeted? Yeso No © Account Codes: — Grant: $ 0 - - County Match: 0 ADDITIONAL, COSTS Estimated Ongoing Costs: $ 0 Cyr For: (Not included in dollar value above) (e . maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date Out Date In Needed view ` Division Director /' YesO No Risk Manage ent Yes[] No 0 �Bt� .11'urc asio 1 ' — I QYesr No }10 County AttorneyYesEJ NpM Comments: Effective: 01 /01 /11 to 12/31 /11 STATE OF FLORIDA COMMISSION FOR THE TRANSPORTATION DISADVANTAGED STANDARD COORDINATION/OPERATOR CONTRACT THIS CONTRACT is entered into between the COMMUNITY TRANSPORTATION COORDINATOR, GUIDANCE/CARE CENTER, INC., designated pursuant to Chapter 427, F.S., to serve the transportation disadvantaged for the community that includes the entire area of MONROE County, and hereinafter referred to as the "Coordinator" andMONROE COUNTY BOARD OF COUNTY COMMISSIONERS,' hereinafter referred to as the "Agency/Operator". The terms and conditions of this Contract are effective January 1, 2011, and will continue through December 31, 2011. WHEREAS, the Coordinator is required, under Rule 41-2.011, F.A.C., when cost effective and efficient, to enter into contract with a transportation Agency/Operator to provide transportation services; and WHEREAS, transportation disadvantaged funds includes any local government, state or federal funds that are for the transportation of transportation disadvantaged; and WHEREAS, the Coordinator desires to contract with the Agency/Operator for the provision of transportation services for the transportation disadvantaged; and WHEREAS, the Coordinator believes it to be in the public interest to provide such transportation services through the Agency/Operator for the residents of the service area who are clients of the Agency/Operator; and WHEREAS, the Agency/Operator will provide the Coordinator the opportunity to develop a proposal for any new transportation services needed; and WHEREAS, the Agency/Operator, in an effort to coordinate available resources, will make available transportation services to the Coordinator. WHEREAS, this Contract allows for the provisions of transportation services be provided by the Agency/Operator, in accordance with Chapter 427, F.S., Rule 41-2, F.A.C., and the most current Community Transportation Coordinator policies. NOW, THEREFORE, in consideration of the mutual covenants, promises and representations herein, the parties agree as follows: THE AGENCY/OPERATOR SHALL: A. Provide services and vehicles according to the conditions specified in Attachment I. B. Coordinate available resources and make available transportation services to the Coordinator. Such services shall be provided in accordance with Attachment 1. This - 1 - contract currently excludes the coordination of Medicaid trips. A separate Medicaid transportation contract will be negotiated. C. Every three (3) months, submit to the Coordinator a Quarterly Year to Cate Operating Report (from the Annual Operating Report) detailing demographic, operational and financial data regarding coordination activities in the designated service area. The reported data will include information regarding all transportation provided by the Agency/Operator (including but not limited to CTC, Medicaid...) The report shall be prepared on forms provided by the Commission for the Transportation Disadvantaged, hereinafter Commission, and according to the instructions for the forms: D. Comply with audit and record keeping requirements by. 1. Utilizing the Commission recognized Chart of Accounts defined in the Transportation Accounting Consortium Model Uniform Accounting System for Rural and Specialized Transportation Providers (uniform accounting system) for all transportation disadvantaged accounting and reporting purposes. Agencies/Operators with existing and equivalent accounting systems are not required to adopt the Chart of Accounts in lieu of their existing Chart of Accounts but shall prepare all reports,invoices, and fiscal documents relating to the transportation disadvantaged functions and activities using the chart of accounts and accounting definitions as outlined in the above referenced manual. 2. Maintaining and filing with the Coordinator such progress, fiscal, inventory and other reports as the Coordinator may require during the period of this contract. 3. By reserving to the Coordinator, the right to conduct finance and compliance audits at anytime. Such audits conducted by the Coordinator will be at the expense of the Coordinator. E. Retain all financial records, supporting documents, statistical records, and any other documents pertinent to this Agreement for a period of five (5) years after termination of this Agreement. if an audit has been initiated and audit findings have not been resolved at the end of the five- (5) years, the records shall be retained until resolution of the audit findings. The Agency/Operator shall assure that these records shall be subject to inspection; review, or audit at all reasonable times by persons duly authorized by the Coordinator or Commission or this Agreement. The Commission and the Coordinator shall have full access to and the right to examine any of the records and documents during the retention period:' F. Comply with Safety Requirements by 1. Complying with Section 341.061, F.S., and Rule 14-90, F.A.C., concerning System Safety or complying with Chapter 234.051, F.S., regarding school bus safety requirements for those services provided through a school board; 2. Assuring compliance with local, state, and federal laws, and Commission policies relating to drug testing, and, -2- G H. 3. Complying with Coordinator's System Safety Program Plan {SSPP} for designated service area: Comply with Commission insurance requirements by maintaining at least minimum liability insurance coverage in the amount of $100,000'for any one person and $200,000 per occurrence at all times during the existence of this Contract. In the event of any cancellation or changes in the limits of liability in the insurance policy, the insurance agent or broker shall notify the Coordinator. The Agency/Operator shall furnish the Coordinator written verification of the existence of such insurance coverage prior to the execution of this Contract or proof of a self-insurance program operated by the Agency/Operator. School board vehicle insurance coverage shall be in accordance with Section 234.03, F.S. and 234.211, F.S. Safeguard informal i by not using treement for court of competent jurisdiction, writtc parent or guardian when authorized 1. Protect Civil Rights by: 1 Complying with Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, as amended. The Agency/Operator gives this assurance in consideration of and for the purpose of obtaining federal, grants, loans, contracts (except contracts of insurance or guaranty), property, discounts, or other federal financial assistance to programs or activities receiving or benefiting from federal financial assistance and agreeing to complete a Civil Rights Compliance Questionnaire if so required by the Coordinator: Agency/Operator shall also assure compliance with: a. Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d et seq., which prohibits discrimination on the basis of race, color, or national origin in programs and activities receiving or benefiting from federal financial assistance. b. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which prohibits discrimination on the basis of disability in programs and activities receiving or benefiting from federal financial assistance. C. Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. 161 et seq., which prohibits discrimination on the basis of sex in education programs and activities receiving or benefiting from federal financial assistance. d. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which prohibits discrimination on the basis of age in programs or activities receiving or benefiting from federal financial assistance. disclosing any information concerning a user of purpose not in conformity with the local, state and mited to 45 CFR, Part 205.50, except upon order of a consent of the recipient, or his/her responsible t law. -3- e. The Omnibus Budget Reconciliation Act of 1981, P.L. 97-35, which prohibits discrimination on the basis of sex and religion in programs and activities receiving or benefiting from federal financial assistance. f. All regulations, guidelines, and standards lawfully adopted under the above statutes. g. The Americans with Disabilities Act of 1990, as it may be amended from time to time. 2. Agreeing that compliance with this assurance constitutes a condition of continued receipt of or benefit from federal financial assistance, and that it is binding upon the Agency/Operator, its successors, subcontractors, transferees, and assignees for the period during which such assistance is provided. Assuring that operators, subcontractors, subgrantees, or others with whom the Coordinator 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 Agency/Operator agrees that the Coordinator may, at its discretion, seek a court order requiring compliance with the terms of this assurance or seek other appropriate judicial or administrative relief, to include assistance being terminated and further assistance being denied. J. The Agency/Operator, as a political sub -division of the State of Florida, as defined in Section 768.28, Florida Statutes, agrees to be fully responsible to the limits set forth in such statute for its own negligent acts or omissions, or intentional tortuous acts, which result in claims or suits against either the Agency/Operator or Coordinator, and agrees to be liable to the statutory limits for any damages proximately caused by said acts or omissions, or intentional tortuous acts. Nothing contained in this Section shall be construed to be a waiver by either party of any protections under sovereign immunity, Section 768.28 Florida Statutes, or any other similar provision of law. Nothing contained herein shall be construed to be a consent by either party to be sued by third parties in any matter arising out of this or any other Agreement. K Comply with all standards and performance requirements of the: The Commission for the Transportation Disadvantaged [Attachment 11 ]; 2. The local Coordinating Board approved Transportation Disadvantaged Service Plan and; 3. Any entities that purchase service. Failure • meet the '• or obligations set forth in this • and performance • established and monitored by the Coordinating Board in the approved Transportation Disadvantaged Service Plan shall be due cause for non�payment of reimbursement invoices until such deficiencies have been addressed or corrected to the satisfaction • the Coordinator. L. Provide Corrective Action. A corrective action notice is a written notice to the Agency/Operator that the Agency/Operator is in breach of certain provisions of this Contract and that correction is required. Any corrective action notice will specify a reasonable time for corrective action to be completed. The Agency/Operator agrees to implement the Corrective Action specified in the notice and provide written documentation to substantiate the implementation of the Corrective Action. M. All contracts, subcontracts, coordination contracts will be reviewed annually by the Coordinator and local Coordinating Board for conformance with the requirements of this Contract. N. Return to the Coordinator any overpayments due to unearned funds or funds disallowed pursuant to the terms of this Contract that were disbursed to the Agency/Operator by the Coordinator. The Agency/Operator shall return any overpayment within thirty (30) calendar days after either discovery by the Agency/Operator, or notification of the Agency/Operator by the Coordinator or entity purchasing transportation, whichever is earlier. In the event that the Coordinator first discovers an overpayment has been made, the Coordinator will notify the Agency/Operator by letter of such a finding. Should repayment not be made in a timely manner, the Coordinator or purchasing entity will charge interest after thirty (30) calendar days after the date of notification or discovery, or the Coordinator will deduct said amount from future invoices. O. In performing this Contract, the Agency/Operator shall not discriminate against any employee or applicant for employment because of race, age, disability, creed, color, sex or national origin. Such action shall include, but not be limited to, the following: employment upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Agency/Operator shall insert the foregoing provision modified only to show the particular contractual relationship in all its contracts in connection with the development of operation of the Contract, except contracts for the standard commercial supplies or raw materials, and shall require all such contractors to insert a similar provision in subcontracts relating to the performance of this Contract, except subcontracts for standard commercial supplies or raw materials. The Agency/Operator shall post, in conspicuous places available to employees and applicants for employment for Project work, notices setting forth the provisions of the nondiscrimination clause. P. By execution of this Contract, the Agency/Operator represents that it has not paid and, also, agrees not to pay, any bonus or commission for the purpose of obtaining an approval of its application for the financing hereunder. Funds disbursed to the Agency/Operator under this Contract shall not be expended for the purpose of lobbying the Legislature, the judicial branch, or a state agency. A. Recognize the Agency/Operator as described in Chapter 427, F.S., and Rule 41-2, F.A.C. B. Insure that entities with transportation disadvantaged funds will purchase Transportation Disadvantaged services through the coordinated system. -5- C. At a minimum, annually monitor the Agency/Operator for insurance, safety and reporting requirements, pursuant to Chapter 427, F.S., and Rule 41-2, F.A.C. The information contained in the AnnualOperating Report must be collected, at a minimum, quarterly from the Agency/Operator. THE OPERATOR AND COORDINATOR FURTHER AGREE: A. Nothing in the Contract shall require the Coordinator to observe or enforce compliance with any provision thereof, perform any other act or do any other thing; in contravention of any applicable state law. If any prevision of the Contract is found by a court of law to violate any , applicable state law, the purchasing entity will at once notify the Coordinator in writing in order that appropriate changes and modification may be made by the Coordinator and the Agency/Operator to the end that the Agency/Operator may proceed as soon as possible' with the provision of transportation services. B. If any part or provision of this Contract is held invalid; the remainder of this Contract shall be binding on the parties hereto. C. Termination Conditions: 1'. Termination at Will - This Contract may be terminated by either party upon no less than thirty (30) days notice, without cause. Said notice shall be delivered by certified mail, return receipt required, or in person with proof of delivery. 2. Termination due to Lack of Designation - In the event that the Coordinator so designated by the local Coordinating Board and approved by the Commission, loses its designation, this contract is terminated immediately upon notification to the Agency/Operator. Notice shall be delivered by certified mail, return receipt requested, or in person, with proof of delivery. Notice shall be effective upon receipt. 3. Termination due to Disapproval of Memorandum of Agreement -.In the event that the Commission does not accept and approve any contracted transportation rates listed within the Memorandum of Agreement, this Contract is terminated immediately upon notification to the Agency/Operator. ' Notice shall be delivered by certified mail, return receipt requested, or in person, with proof of delivery. Notice shall be effective upon receipt. 4. Termination due to Lack of Funds - In the event funds to finance this contract become unavailable, the Coordinator may terminate the contract with no less than twenty-four (24) hours written notice to the Agency/Operator. Notice shall be delivered by certified mail, return receipt requested, or in person, with proof of delivery. Notice shall be effective upon receipt. The Coordinator shall be the final authority as to the `availability of funds. 5. Termination for Breach - Unless the Agency/Operator's breach is; waived by the Coordinator in writing, the Coordinator may, by written notice to the Agency/Operator, terminate this Contract upon no less than twenty-four (24) hours notice. Notice shall be delivered by certified mail, return receipt requested, or in _s D. E. F. G. H. person with proof of delivery. Waiver by the Coordinator of breach of any provision 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 of this Contract, and shall not act as a waiver or estoppel to enforcement of any provision of this Contract. The provisions herein do not limit the Coordinator's right to remedies at law or to damages. 6. Upon receipt of a notice of termination of this Contract for any reason, the Agency/Operator shall cease service and prepare all final reports and documents required by the terms of this Contract. A final invoice shall be sent to the Coordinator within thirty (30) days after the termination of this Contract. 7. The Coordinator shall pay all bills within 7 days to the Agency/Operator after receipt of said payment by the CTID. Nonpayment to the Agency/Operator shall be a breach for which Agency/Operator may give 24-hour notice of termination of the contract. Renegotiations or Modifications of this Contract shall only be valid when they have been reduced to writing, duly approved by the Coordinator, and signed by both parties hereto. Agency/Operator shall assign no portion of this Contract without the prior written consent of the Coordinator. This Contract is the entire agreement between the parties. Attachments I and 11 are an integral part of the Contract and are hereby incorporated by reference into this Contract. All subsequent attachments are of an optional nature. Notice and Contact: The name and address of the contract manager for the Coordinator for this Contract is: Maureen Grynewicz Guidance/Care Center, Inc. 3000 41 st Street, Ocean Marathon, FL 33050 The representative/position of the Agency/Operator responsible for administration of the program under this contract is: Administrator, Transportation Monroe County Transportation 1100 Simonton Street Key West, Florida 33040 In the event that different representatives are designated by either party after execution of this Contract, notice of the name and address of the new representative will be rendered in writing to the other party and said notification attached to originals of this Contract. This contract and its attachments contain all the terms and conditions agreed upon by the parties hereto. -7- WITNESS WHEREOF, the parties hereto have caused these presents to be executed. AGENCY/OPERATOR: COMMUNITY TRANSPORTATION Monroe County Board of County Commissioners [ Agency/Operator Name ] Typed/Printed Name of Authorized Individual Title Date Signature COORDINATOR Guidance/Care Center [ Coordinator Name] Maureen Gryneicz Typed/Printed Name of Authorized Individual ME ATTACHMENT I AGENCY/OPERATOR CONTRACT SERVICE DESCRIPTION 1. The Agency/Operator will be able to provide: (type of service) Ambulatory and wheelchair service, paratransit 2. The Agency/Operator will be available to provide transportation (schedule) 3. Days Agency/Operator will not be able to provide services: Service will not be provided on Saturday and Sunday or County holidays 4. Vehicles Agency/Operator will use to transport all passengers (fleet list- if list does not fit in this section, please attach a separate sheet — please also include number of seats and Ic capacity)' 5. Vehicle/Equipment Standards Air Conditioning, first aid kit, fire extinguisher, warning triangles, 2 way radios 6. Driver Requirements License type depended on FL DOT requirements, 3 year clean driving record, CPR & First Aid, HIV training, Physicals, Defensive Driving, Drug Screening (see FAC 1-90 and requirements illustrated throughout contract) 7. Training Current CPR and First Aid certification, HIV/AIDS, Defensive Driving, Pre -employment and biennial driver physicals, ADA training (see FAC`41-90 and requirements illustrated throughout contract) 8. Reporting Requirements Quarterly Operating Reports, documenting all trips provided, Annual Review (conducted by CTC) -9- ATTACHMENT 11 The Commission for the Transportation Disadvantaged Standards and Performance Requirements Pursuant to Rule 41-2.006, Florida Administrative Code, the Community Transportation Coordinator and any Transportation Operator/Agency from whom service is purchased or arranged by the Community Transportation Coordinator shall adhere to Commission approved standards. These standards shall include: (a) Drug and alcohol testing for safety sensitive job positions within the coordinated system regarding pre -employment, randomization, post -accident, and reasonable suspicion as required by the Federal Highway Administration and the Federal Transit Administration; (b) An escort of a passenger and dependent children are to be transported as locally negotiated and identified in the local Transportation Disadvantaged Service Plan; (c) Child restraint devices shall be determined locally as to their use, responsibility, and cost of such device in the local Transportation Disadvantaged Service Plan; (d) Passenger property that can be carried by the passenger and/or driver in one trip and can be safely be stowed on the vehicle, shall be allowed to be transported with the passenger at no additional charge. Additional requirements may be negotiated for carrying and loading rider property beyond this amount. Passenger property does not include wheelchairs, child seats, stretchers, secured oxygen, personal assistive devices, or intravenous devices; (e) Vehicle transfer points shall provide shelter, security and safety of passengers; (f) A local toll free phone number for complaints or grievances shall be posted inside the vehicle. The local complaint process shall be outlined as a section in the local Transportation Disadvantaged Service Plan including, advising the dissatisfied person about the Commission's Ombudsman Program as a step within the process as approved by the Local Coordinating Board; (g) Out of service area trips shall be provided when determined locally and approved by the local Coordinating Board, except in instances where local ordinances prohibit such trips; (h) Interior of all vehicles shall be free from dirt, grime, oil, trash, torn upholstery, damaged or broken seats, protruding metal or other objects or materials which could soil items placed in the vehicle or provide discomfort for the passenger; (i) Billing requirements of the Community Transportation Coordinator to subcontractors shall be determined locally by the local Coordinating Board and provided in the local Transportation Disadvantaged Service Plan. All bills shall be paid within 15 calendar days to subcontractors, after receipt of said payment by the Community Transportation Coordinator, except in instances where the Community Transportation Coordinator is a non- governmental entity; -10- {j) Passenger/trip database must be maintained or accessible by the Community Transportation Coordinator on each rider being transported within the system; (k) Adequate seating for paratransit services shall be provided to each rider and escort, child, or personal care attendant, and no more passengers than the registered passenger seating capacity shall be scheduled or transported in a vehicle at any time. For transit services provided by transit vehicles, adequate seating or standing space will be provided to each rider and escort, child, or personal care attendant, and no more passengers than the registered passenger seating or standing capacity shall be scheduled or transported in a vehicle at any time; (1) Drivers for paratransit services, including > coordination contractors, shall be required to announce and identify themselves by name and company in a manner that is conducive to communications with the specific passenger, upon pickup of each rider, group of riders, or representative, guardian, or associate of the rider, except in situations where the driver regularly transports the rider on a recurring basis. Each driver must have photo identification that is in view of the passenger. Name patches, inscriptions or badges that affix to driver clothing are acceptable. For transit services, the driver photo identification shall be in a conspicuous location in the vehicle; (m) The paratransit driver shall provide the passenger with boarding assistance, if necessary or requested, to the seating portion of the vehicle. The boarding assistance shall include opening the vehicle door, fastening the seat belt or utilization of wheel chair securemen#' devices, storage of mobility asistive devices, and closing the vehicle door. In certain paratransit service categories, the driver may also be required to open and close doors to buildings, except in situations in which assistance in opening/closing building doors would not be safe for passengers remaining on the vehicle. Assisted access must be in a dignified manner. Drivers may not assist wheelchair up or down more than one step, unless it can be performed safely as determined by the passenger, guardian, and driver;' (n) All vehicles ordered or put into service after adoption of this section of the Rule, and providing service within the coordinated system, shall be equipped with two-way communications in good working order and be audible to the driver at all times to the base. All vehicles that are not equipped with two-way communications shall have two years to be in compliance' after the adoption date of this section of the Rule; (o) All vehicles ordered or put into service after the adoption of this section of the Rule, and providing service within the coordinated system, shall have working air conditioners and heaters in each vehicle. Vehicles that do not have a working air conditioner or heater will be scheduled for repair or replacement as soon as possible. All vehicles that are not equipped with an air conditioner shall have two years to be in compliance after the adoption date of this section of the Rule;` (p) First Aid shall be determined locally and provided in the local Transportation Disadvantaged Service Plan; and (q) Cardiopulmonary Resuscitation shall be determined locally and provided in the local Transportation Disadvantaged Service Plan. -11- BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12/15/2010 Division: Community Services Bulk Item: Yes x No _ Department: _Social Services Staff Contact /Phone #: Sheryl Graham x4510 AGENDA ITEM WORDING: Approval of an agreement between the Monroe County Community Transportation Coordinator/Guidance C44e/Care Center Inc., of *he "piddle Keys and Monroe County Board of County Commissioners for contract period of 01/01/2011 through 12/31/2011. ITEM BACKGROUND: This agreement is funded by Medicaid allocated by the State of Florida Commission for the Transportation Disadvantaged to the County's CTC to pay Monroe County Transit for providing Medicaid trips. PREVIOUS RELEVANT BOCC ACTION: Original agreement approved 9/19/2007; Amendment 41 approved 01/28/2009; Amendment 42 approved 12/16/2009 by BOCC. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval TOTAL COST: $0 INDIRECT COST: BUDGETED: Yes x No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: $0 SOURCE OF FUNDS: Medicaid REVENUE PRODUCING: Yes x No AMOUNT PER MONTH $5k-$7k Year $70,000.00 Max APPROVED BY: County Atty OMB/Purchasing Risk Management DOCUMENTATION: DISPOSITION: Revised 7/09 Included Not Required AGENDA ITEM # Meeting Date: 12/15/2010 Division: Co unity Services Bulk Item: Yes No Department: Social Services Staff Contact /Phone ##: Sheryl Graham x4510 AGENDA ITEM WORDING: Approval of an agreement between the Monroe County Community Transportation Coordinator/Guidance Clinic of the Middle Keys and Monroe County Board of County Commissioners for contract period of 01/01/2011 through 12/31/2011 ITEM BACKGROUND: This agreement is fimded by Medicaid allocated by the State of Florida Commission for the Transportation Disadvantaged to the County's CTC to pay Monroe County Transit for providing Medicaid trips. PREVIOUS .RELEVANT BOCC ACTION: Original agreement approved 9/19/2007; Amendment 1 approved 01/28/2009; Amendment #2 approved 12/16/2009 by BOCC. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval TOTAL COST: $0 INDIRECT COST: BUDGETED: Yes x No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: $0 SOURCE OF FUNDS: Medicaid REVENUE PRODUCING: Yes x No UNT PER MONTH $5k-$7k Year $70,000.00 Max APPROVED BY: County Atty chasing Risk Management DOCUMENTATION: IncluPed Not Required WISPOSITION: AGENDA ITEM 9 Revised 7/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY RY Contract with: CTC Contract # Effective Date: 01/01/2011 Expiration Date: 1/1/011 Contract se/Description: The Agreement with the State of Florida Commission for the Transportation Disadvantaged/CTC will allow Monroe County Transit payment for the transit services rendered to Monroe Count 's Medicaid;p2pulation for their medical pr s. Contract Manager: SherylGrahamn t,a4510 Social Services/Stop ## 3 (Name) (Ext.) (Departrnent'Stop #} for BOCC meetin on 12/15/2010 ALnda Deadline: 11/30/2010 CONTRACT COSTS Total Dollar Value of Contract: 0 Current Year Portion: 0 Budgeted?YesN No F1 Account Codes: N/A - Grant: $ 0 County Match: $ 0 - - ADDITIONAL COSTS Estimated Ongoing Costs: $ 0 /yr ` For: (I*iot included m dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date Out Needed evi er i Division Director 11744YesE01 N Risk; Manag ent '( Yes[ No P..1Cc. � 4� 0 AB./Pur+chagig j 3. W lU Yes ] No(� 11)�-j 1)0 County Attorney � lu Yeso NoR l Z Comments: OMB Form Revised 2/27/01 MCP #2 STATE OF FLORIDA COMMISSION FOR THE TRANSPORTATION DISADVANTAGED MEDICAID NON -EMERGENCY TRANSPORTATION (NET) PROGRAM SUBCONTRACTED TRANSPORTATION PROVIDER AGREEMENT AMENDMENT NO. 1 This amendment entered into on January 1, 2011, by and between the Guidance/Care Center, Inc., hereinafter called "Coordinator" and Monroe County Board of County Commissioners, hereinafter called "Subcontracted Transportation Provider". WITNESSETH: WHEREAS, the Coordinator and the Subcontracted Transportation Provider heretofore on January 1 2010, entered into an Agreement, hereinafter called the Original Agreement; WHEREAS, the Coordinator desires to participate in all eligible items of development for this project as outlined in the attached amended Exhibit B. WHEREAS, this amendment is necessitated by the amendment of the contract between the Coordinator, and the Commission for Transportation Disadvantaged. NOW, THEREFORE, THIS INDENTURE WITNE SETH; that for and in consideration of the mutual benefits to flow from each to the other, the parties hereto agree that the above described Agreement is to be amended as fellows: 1. Purpose of Agreement: The purpose of the agreement is not changed. 2. Accomplishment of the Agreement: The accomplishment of the agreement is not changed. 3. Expiration of Agreement: Paragraph 2, TERM of said agreement is amended to be December 31, 2011. 4. Amount: The reimbursement amount for this amendment has not changed. The Provider shall be paid up to a maximum amount of $70,000. The Provider shall submit monthly trip data in a format acceptable to the Coordinator. The Provider will be paid, after the Coordinator has received payment from the Commission in the amount of $3.00 per mile with a 5 mile minimum, $2.00 per mile for preauthorized out -of -County trips and $3.00 flat rate per client per mulitload for Medicaid eligible trips. 5.Exhibit B of said Agreement is replaced by Amended Exhibit B and is attached hereto and made a part hereof. EXCEPT as hereby modified, amended, or changed, all other terms of the Agreement dated January 1, 2010, shall remain in full force and effect. This amendment cannot be executed unless all previous amendments to this Agreement have been fully executed. AGREEMENT AMENDMENT DATE: January 1, 2011 ExHierr B AMENDMENT #1 METHOD OF COMPENSATION For the satisfactory performance of the services and the submittal of Encounter Data as outlined in Exhibit A, Scope of Services, the Subcontracted Transportation Provider payments shall be paid up to a maximum amount of $ZQOffl. The Provider shall submit monthly trip data in a format acceptable to the Coordinator. The Provider will be paid, after the Coordinator has received payment from the Commission in the amount of $3.00 per mile with a 5 mile minimum, $2.00 per mile for preauthorized out -of -County trips and $3.00 flat rate per client per mulitload for Medicaid eligible trips. The Subcontracted Transportation Provider shall submit invoices in a format acceptable to the Coordinator. The Subcontracted Transportation Provider will be paid after the Coordinator has received payment from the Commission. 1. Pr*ct cost The Subcontracted Transportation Provider shall request payment through submission of a propedy completed invoice to the Coordinator. Once the Coordinator has signed the invoice for approval, the Coordinator shall submit the approved invoice to the Commission for Transportation Disadvantaged. County: Monroe 2. Disbursement Schedule of Funds January 1, 2011 — December 31, 2011: not to exceed $70,000.00 In witness whereof, the parties hereto have caused these presents to be executed, the day and year first above written. Guidance/Care Center, Inc. Board of County Commissioners, Monroe County SIGIJATURE SIGNATURE Transportation Director TITLE DAfrE TITLE DATE Maureen Grynewicz PRINTED NAME PRINTEDNAME Mo E COUNTY RNEYW ov DAS PEDRO J. N ATT NEY ASSI t Dater 'I' G 1 1." a Meeting Date: 12/l 5-12/16/10 Division: Social Services Bulk Item: Yes X No Department: Bayshore Manor Staff Contact Person/Phone #: Sheryl Graham/4510 AGENDA ITEM WORDING: Approval of referral agreement between Alliance for Aging and Monroe County to enable respite clients to remain in the Aged and Disabled Adult (ADA) Waiver program. ITEM BACKGROUND: The Aged and Disabled Adult (ADA) Waiver program promotes the development of a coordinated service delivery system to meet the needs of aged or disabled adults who are at risk of premature institutionalization. Under this program, clients are referred to Bayshore Manor for daytime facility, respite. PREVIOUS RELEVANT BOCC ACTION: The Monroe County Hoard of County Commissioners authorized execution ofthe Aged and Disabled Adult (ADA) Waiver Referral Agreement between the Alliance for Aging, Inc. and Monroe County at a regular meeting of the Board held on December 15, 2004. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval TOTAL COST: N/A INDIRECT COST: DIFFERENTIAL OF LOCAL PREFERENCE: BUDGETED: COST TO COUNTY: N/A SOURCE OF FUNDS: REVENUE PRODUCING: Yes X No AMOUNT PER MONTH $1666.00 VEAR$20000.00 APPROVED BY: County Atty X OMB/Purchasing X Risk Management X DOCUMENTATION: Included X Not Required DISPOSITION: Revised 7/09 Mt` NROF COUNTY BOARD OFCOUNTY COMMISSIONERS CONTRACTSUMMARY Contract "'itb: Alliance for Ai,y1m)_ inc, Contract Effective Date: .Duly 1. 2004 Expiration Date: Ongoing Contract PurposeiDescription: __Ongoing To enable Monroc County Bayshore Manor to continue participation in the Aged and Disabled Adult (ADA) WaivIerPro�-,raln Contract M:lriager:�� t 4"-Y] Grallaln (Nallle) for BOCC meetirlt" ()It 12/15-12%16/10 4510 Social Services (Ext.) (Department/Mop #) Agenda Deadline: 110/10 CONTRACT COSTS Total Dolllm- Value ol'Contract: S 20,000.00 Current Year Portion: S N/A (estimate) Blldgeted? Y esEi No ❑ Account Codes: - Grant: County Match: S 'gone _ ADDITIONAL COSTS -- -- Estimated ()iwoln,, Costs: .$/ A/yr 1,or: N/A (Not inclu�e�i in dollar value l[xwel (eg. maintenance, utilities, CONTRACT REVII," C haII es DatYIII Needed DlVlslon Dlycctoi _ _.3 l eSE-1 No[71— R.Isk Manw-�c 1 nt Yes[] Now 1 O.M.I3.lI}ll] �hc sll�` Ca I Y esl( J No ti i.�f �`� (_'yp County Attori�,�-' Y�Y� YesC_j No r Comments: itorial, salaries, etc. Date Out OMB Form Rn isetl 2 27, t_) I MCI) t#2 HOME AND COMMUNITY BASED SERVICES AGED AND DISABLED ADULT (ADA) MEDICAID WAIVER REFERRAL AGREEMENT This Referral Agreement between the Alliance for Aqina. Inc., the Area Agency on Aging (AAA) f Planning and Service Area (PSA) 11 and _.Bayshore Manor t Service Provider, shall begin on July 1, 2004 or on the date the agreement has been signed by bo parties, whichever is later. This referral agreement is in effect for a period of time that is equal to t Medicaid waiver provider's enrollment period with the State of Florida's Medicaid fiscal agent and contingent upon an annual appropriation by the Legislature, One purpose of this agreement is promote the development of a coordinated service delivery system to meet the needs of the aged disabled adults who are at risk of premature institutionalization. Another purpose of this agreement is enable eligible elderly participants to receive home and community based services from qualifii providers with oversight of the quality of care by the Medicaid Waiver Specialist employed by the These services are authorized in order that the participant may remain in the least restrictive setting a avoid or delay premature nursing home placement. Services and care are to be furnished in a way th fosters the independence of each participant to facilitate aging in place. All parties agree that routines care provision and service delivery must be consumer driven to the maximum extent possible. All parti agree to and will treat each participant with dignity and respect. A. To maintain a climate of cooperation and consultation with and between agencies, in order to achieve maximum efficiency and effectiveness. B. To promote programs and activities designed to prevent the premature institutionalization of elders and disabled adults. C. To require the parties of this Agreement to provide technical assistance and consultation to each other on matters pertaining to actual service delivery and share appropriate assessment information and care plans so duplication may not occur. D. To establish an effective working relationship between the case management agency that is responsible for the development of care plans and authorization of services available under the waiver, the service provider that is responsible for the direct provision of those services to consumers served under the waiver program, and the AAA that is responsible for management and oversight of the waiver program. W. Under this Agreement, the Service Provider agrees to the following: A. TO accept referrals for the 1015c Horne and Community -Based Sen/imaS - ADA Medicaid Waiver from the enrolled case management agency. B. To provide quality service(s) to the waiver participant as specified in Section IV., Provision Of Gen/|ne/s\, subject to quality monitoring and/or observation by the case rO@naQ8nneOt agency and/or the AAA and/or the Department ofElder Affairs (the ''depart[nerd^) C. To provide only those services specifically outlined in the Plan Of Care and authorized by the enrolled case management agency. D. To attach documentation regarding the service provider's qualifications to this agreement; and to pr0viUe, as requeoted, any information regarding Medicaid Waiver billing, payment, or waiver participant information, to the case management agency or AAA. Provider rate - shall not exceed the approved negotiated rates that are at Or below the service provider's usual and customary ratesIf additional services are to be added tDthis @gneenlent, a written request to do so must be received by the AAA. If approved, an amendment rnUsd be prepared bythe AAA indicating the service(s) to be added. The necessary dDC;rDeOtati0O regarding provider qualifications for the additional services must be attached tOthe agreement. E. Tomaintain the waiver participant's confidentiality according to42CFR431 301 F. TO immediately report any changes in the waiver participant's condition to the case management agBOCV G. To maintain enrolled provider status by renewing applicable |icenSune' Qertificaton, contract and/or referral agreements and by maintaining all provider qualifications as contained in the Aged and Disabled Adult Medicaid Waiver under which services are provided. �. T- include its name and other appropriate information on a list of all enrolled providers which will be shown to consumers during development of an individualized plan of C@ns, understanding that the consumer reserves the right at all tinl8a to o choice Of enrolled providers. |. To immediately notify the case management agency of staffing shortfalls that will negatively impact provision of service to Medicaid Waiver consumers. J. To submit d@inn data for billing to the Medicaid fiscal agent after delivery of services has been accomplished. All services should be billed within 60 days after services have been provided or document reasons for delayed submission ofclaims. Such documentation shall be available for review by the area agency on agency or by the departnnent, upon request. K. To submit claims for billing to the Medicaid f|aoa| agent at the agency's contracted rate. L. To submit void Or adjustment o|ainoS no later than 45 days after either party has identified the error. The provider's refusal to adjust Or void erroneous d@iOne may result in termination of this agreement end/or referral to the department, and will be referred by the department to the Agency for Health Care Administration for appropriate action. K8. To develop and implement a policy to ensure that its ernp|oyees, board membens, and nnanaQennent, will avoid any conflict of interest or the appearance of conflict of interest when disbursing mrusing the funds described in this agreement. Aconflict ofinterest inc|udea, but is not limited to, receiving, or agreeing to receive, a direct Or indirect benefit. Or anything of value from a service provider, consumer, vendor. or any person wishing to benefit from the use or disbursement of funds. To avoid a conflict of interest' the service provider must ensure that all individuals make a diau|oSuns to the AAA of any relationship which may be @ conflict of interest, within thirty (30) days of an individua|'s original appointment or placement on a board. Or if the individual is serving as an incunnbent, within thirty (30) days of the COnnnnenCernent of the agreement. N. To adhere tothe federal waiver requirements and the pO|id8S and procedures outlined in the following manuals published bythe Agency for Health Care Administration: theAQed/DiS@b|ed Adult Waiver Guidelines and the Medicaid Provider Reimbursement Handbook (Non - Institutional 081). including any and all attachments urupdates. 0. If the Service Provider is enrolled as a home delivered meals vendor, the Area Agency will retain the services of registered dietitian to perform the following: 1 Conduct site inspections ofall catering facilities. These may heunannounced. 2 Monitor meal delivery times and temperatures. 3Review all menus submitted by the service provider and suggest changes as needed. 4. Work with the service provider to ensure that standardized recipes and computer -assisted nutritional analyses are carried out. P. The /\/\/\ may impose department -approved sanctions for non-compliance with the terms of this agreement. TotheexterdSetforthinF.S708.2O.dleSorvionPrnvd8ragreest0indennnifv'defand.and hold harmless the AAA. and all of the AAA's officers, 8gents, and 8Olp|VyeeS and the department and all of the department's officers, agents, and employees from any claim, loss, dannege. COSt, charge. or expense arising out of any @[tS. actions, neglect or omission, action in bad teith, or violation of federal or state |@vv by the service provider, its agents or employees, during the performance ofthis agreement. Nothing contained inthis section shall be construed to be a waiver by either party of any protections under sovereign immunity. section 708.28 Florida Gtotutea, or any other similar provision of law. � 1 Service Provider obligation to i0deDlDJ«' def8Dd, and pay for the defense Or. 6tthe AAA's and/or depodrnant'eoption, toparticipate and associate with the AAA and/or department in 'the defense and trial of any claim and any related settlement negotiations, shall be triggered bythe AAA's and/or department's notice ofclaim for indemnification to service provider. Service provider's inability to evaluate liability Orits evaluation nfliability shall not excuse service provider's or 'a duty to defend and indemnify the AAA and/or department, upon DOtiC8 by the AAA and/or department. Notice shall be given by registered or certified nnaii, return receipt requested Only an adjudication or judgment after the highest appeal is exhausted specifically finding the AAA and/or department solely negligent shall excuse performance of this provision by service providers and s. The SBn/ioe provider shall pay all costs and fees related to this obligation and its enforcement by the AAA and/or department. The AAA's or department's failure to notify the service provider Of a C|ainn shall not release service provider nfthe above duty todefend. 3. It is the intent and understanding of the parties that neither the S8rV|De p[Qvider, nor any of its employees are employees of the AAA or the department and shall not hold themselves out as employees or agents of the AAA or department without specific authorization from the AAA or, department. |tisthe further intent and understanding Ofthe parties that the AAA Dr department does not control the employment practices Ofthe service provider and shall not be liable for any wage and hOur, employment dischnOin8tioD. Orother labor and 8nlp|Dyrnent claims against the service provider. k Tofacilitate the onroUrnon1 of providers with the Medicaid Fiscal Agent, B. TO provide teohn|C8| assistance and training to Service Providers. C. Tonotify the case men8gerneniagency within 48hours Ofany approved service provider rate adius1rnen1 D. To regularly rnOniior the Service Providers in accordance with requirements specified by the department. E. To complete a new referral agreement signed by all parties when unit rate changes areapproved- IT.in accordance with the plan of care or service authorization: Service Unit Rate County/Region Served In the event this agreement is tenn/nated` the case management agency and the service provider agree to subrnit, at the time notice of mteni to terminate is de|ivened, a plan which identifies procedures to ensure services COIISLMiers will nut be interrupted or suspended by the termination, A. Termination atVViU B. Termination BeCaUse of Lack of Funds in the event funds to finance this agreement b8Conn8 un@vai|@b|e, the area agency may terminate this agreement upon no less than twenty-four (24) hours notice in vvnbng to the other party. Said notice shall be delivered by certified mail, return receipt /equested, or in person with proof of delivery. The area agency shall be the final authority as to the availability of funds. C. Termination for Breach Unless breach is waived by the area agency in writing, or the parties fail to cure the breach within the firne Specified by the area agenCy, the area agency may, by written notice to the parties, terminate the agreement upon no less than twenty-7our(24)hours notice. Said notice shall be delivered by certified nnaU, return receipt requested. or in person with proof ofdelivery. In witness whereof, the par -ties have caused this 3 page agreement to be executed by their Undersigned officials aeduly authorized. Area Agency on Aging Service provider n""'nnm° p"m"n=e PresidenUCEO _ «! I e, ooe d ate 4 U BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12/15/10 — 12/16/10 Division: CAD Bulk Item: Yes x No — Department: Social Services/NTutrition Staff Contact Person/Phone #: Ellen Caron X4522 AGENDA ITEM WORDING: Request approval of Amendment 001 to Contract US- 1151 between the Alliance for Aging, Inc. and Monroe County Board of County Commissioners for congregate and home delivered meals provided by the Monroe County Nutrition Program. ITEM BACKGROUND: This contract allows for reimbursement to the County for congregate and home delivered meals provided to clients of the Nutrition Program. The Alliance for Aging periodically adjusts the contract amount based on the official funding allocation published by the Department of Elder Affairs, as noted on Page I of the contract. PREVIOUS RELEVANT BOCC ACTION: Approval of Contract US - 1151 on October 20, 2010 CONTRACT/AGREEMENT CHANGES: Decreases the contract amount by $2,898 to $29,787. STAFF RECOMMENDATIONS: Approval TOTAL COST: $29,787 BUDGETED: Yes X—No — DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: $0 SOURCE OF FUNDS: Older Americans Act — USDA REVENUE PRODUCING: Yes — No X AMOUNT PER MONTH Year APPROVED BY: County Atty /Purchasing Risk Management DOCUMENTATION: Included x Not Required DISPOSITION: Revised 7/09 AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Alliance for Aging, Inc. Contract 4US - 1151 Effective Date: October 1, 2010 Expiration Date: September 30, 2011 Contract Purpose/Description: Reimburses the County for congregate and home delivered meals provided to the clients of the Monroe County Nutrition Program. Contract Manager: - Sheryl Graham 4510 Social Services/ Stop #1 (Name) (Ext.) (Department/Stop for BOCC meeting on December ]5,2010 Agenda Deadline: November 30, 2010 CONTRACT COSTS Total Dollar Value of Contract: $ 29,787 Current Year Portion: Budgeted? Yes® NoF-1 Account Codes: —I 25-6153110- Grant: $ 29,787 125-6153210- County Match: $ 0 125-6153111- 125-6153211- - ADDITIONAL COSTS Estimated Ongoing Costs: /yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date Out Da e I Needed Reviewer Division Director Yes❑ Nor�]- 61 Risk Management Yes❑ Noy[�/ OMB./Purc a"g 10 Yes❑ No County Attorney Yes❑ No'E Comments: OMB Form Revised 2/27/01 MCP A2 Amendment 001 CONTRACT US- 1151 THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to as the "Alliance", and Monroe County Board of Commissioners. The purpose of this amendment is to decrease the contract amount by $2,898, for a total contract of $ 29,787. Payments will be made based on availability of funds. This amendment shall begin on November 1, 2010 or the date it has been signed by both parties, whichever is later. All provisions in the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract are hereby amended to conform with this amendment. This amendment and all its attachments are hereby made a part of the contract. M IN WITNESS WHEREOF, the parties hereto have caused this 1-page amendment to be executed by their undersigned officials as duly authorized. NRO-Wrolu- SIGNED BY: NAME: TITLE: DATE: Monroe County Board of Commissioners. SIGNED BY: ALLIANCE FOR AGING, INC. NAME: Max B. Rothman, JD, LL.M. TITLE: President & CEO DATE: ON COUN AOVED A PEDR( JKU-ALJ-- 'ALu TT 2 �Sm IAN CID T-17YATTORNEY Contract Number US-1151 NUTRITION SERVICES INCENTIVE PROGRAM 2010-2011 CONTRACT THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the "Alliance", and Monroe County Board of Commissioners, hereinafter referred to as the "recipient The total amount and the reimbursement rate included in this initial contract are subject to change based on the official funding allocation and unit reimbursement rate is published by DOER. 1. Recipient Agrees: A. Services to be Provided: To plan, develop, and accomplish the services delineated, or otherwise cause the planning, development, and accomplishment of such services and activities, under the conditions specified and in the manner prescribed in Attachment I of this agreement. B. Requirements of Section 287, Florida Statutes: These requirements are herein incorporated by reference. C. Final Request for Payment: The Recipient must submit the final request for payment to the Alliance no more than 30 days after the contract ends or is terminated; if the Recipient fails to do so, all right to payment is forfeited, and the Alliance will not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from the Recipient, and necessary adjustments thereto, have been approved by the Alliance. D. Additional Reporting Requirements: 1. If the Alliance has sanctioned the recipient, while the sanctions are in effect the recipient shall provide to the Alliance, on a monthly basis, the recipient's financial statements that reflect the current, un-audited revenues and expenditures and the recipient's cash position as well as any other documentation that may be requested by the Alliance. 2. If the recipient is required to prepare a corrective action plan, supporting documentation as requested by the Alliance shall be provided. 11. The Alliance Agrees: A. Contract Amount: To pay for services according to the conditions of Attachment I in an amount not to exceed $32,685.00, subject to the availability of funds. Contract Number US-1 151 B. Obligation to Pay: The Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature and passed through the Department of Elder Affairs. C. Source of Funds: The costs of services paid under any other contract or from any other source are not eligible for reimbursement under this contract. The funds awarded to the recipient pursuant to this contract are in the state grants and aids appropriations and consist of the following: Program Title Year Funding CFDA# Fund Amounts Source Nutrition Services 20102011 OAA 10.570 $32,685.00 Incentive Program TOTAL FUNDS CONTAINED IN THIS CONTRACT: $32,685.00 Ill. Recipient and Alliance Mutually Agree: A. Effective Date: 1. This contract shall begin on October 1. 2010. 2. Delivery of services shall end on September 30, 2011. This contract shall end on Deember 31, 2011. See Attachment 1, Section III.E. B. Termination, Suspension, and/or Enforcement: The causes and remedies for termination or suspension of this contract shall follow the same procedures as outlined in Section 111.13. and Section III.C. of the Master Agreement. C. Recipient Responsibility: The provider agrees to comply with applicable parts of Rule Chapter 58C- 1, Florida Administrative Code promulgated for administration of Sections 430.201 through 430.207, Florida Statutes, and the Department of Elder Affairs 2010 Home and Community -Based Services Handbook. D. Notice, Contact, and Payee Information: 1. The name, address, and telephone number of the contract manager for the Alliance for this contract is: Max B. Rothman, JD, LL.M. President/CEO 760 W 107 th Avenue, Suite 214 Miami, FL 33156 Contract Number US-1151 2. The name, address, and telephone number of the representative of the recipient responsible for administration of the program under this contact is: Sheryl Graham GATO Building — 1100 Simonton Street Key West, FL 33040 (305) 292-4573 3. In the event different representatives are designated by either party after execution of this contract, notice of the name and address of the new representative will be rendered in writing to the other party and said notification attached to originals of this contract. 4. The name (recipient name as shown on page 1 of this contract) and mailing address of the official payee to whom the payment shall be made: Monroe County Board of Commissioners GATO Building — 1100 Simonton Street Key West, FL 33040 (305) 292-4573 E. Renegotiation or Modification: 1. Modifications or changes to the funding in this contract and corresponding services related to the increase or decrease, may be made in the form of a written Notice of Award Increase/Decrease signed by the Alliance's President and Director of Administration. The Board President or its Designee of the recipient shall sign the Notice of Award Increase/Decrease and return it to the Alliance within fourteen (14) days or sooner if requested by the Alliance. By signing Notice of Award Increase/Decrease, the Board President or its Designee of the recipient acknowledges the receipt of and agreement with the terms contained in the Notice. 2. Upon Receipt of a Notice of Award Increase/Decrease, the recipient shall update affected information in budget summaries, deliverable schedules, unit rate information contained in the unit cost methodology, or any other applicable financial information contained in the service provider application or required in this contract. This shall be done within ten working days of receipt of such notice. Contract Number US-1151 IN WITNESS THEREOF, the parties hereto have caused this 7-page contract to be executed by their undersigned officials as duly authorized. RECIPIENT: MONROE COUNTY BOARD OF COMMISSIONERS BOARD PRESIDENT OR AUTHORIZED DESIGNEE ALLIANCE FOR AGING, INC. SIGNE IGNED BY:� Max B. othm NAME: sy. a J. Murphy NAME: TITLE: Mayor/Chairman TITLE: President / CEO i DATE: October 20, 2010 DATE: OUNTY ATTORNI =D AS To/ fw PEUV ADNT COUN Y ATTORNEY FEDERAL ID NUMBER: 59-6000749 RECIPIENT FISCAL YEAR END DATE: 09/30 4 Contract Number US-1151 ATTACHMENT NUTRITION SERVICES INCENTIVE PROGRAM I. STATEMENT OF PURPOSE The Nutrition Services Incentive Program (NSIP) is authorized by Section 311 of the Older Americans Act of 2000, as amended. The NSIP is the new name for the former United States Department of Agriculture (USDA) cash or commodity program known as the Nutrition Program for the Elderly. NSIP provides reimbursement for the purchase of United States produced agricultural and other food commodities for use in nutrition projects operating under approved Older Americans Act Title I II contracts. II. SERVICES TO BE PROVIDED A. Services: Upon receipt of a prior authorization for services from Alliance staff, to provide the following services: The purchase of United States produced agricultural and other food commodities for use in nutrition projects operating under approved Title III contracts for nutrition services with the Recipient. Prior authorization for these services will be provided by the Alliance. B. Manner of Service Provision: The services will be provided in a manner consistent with and described in the recipient's service provider application update for federal fiscal year 2006 and the Department of Elder Affairs Home and Community -Based Services Handbook. In the event the handbook is revised, such revision will automatically be incorporated into the contract and the recipient will be given a copy of the revisions. III. METHOD OF PAYMENT A. This is a fixed rate contract. The Alliance shall make payment to the recipient for provision of services up to a maximum number of units of service and at the prospective rate stated below: Service to be Provided Units of Unit Rate Maximum Service Units Eligible Congregate and Home Delivered Meals 1 unit = 1 meal 0.68 48,066 The prospective rate is based on the estimated OAA grant award. 5 Contract Number US-1 151 B. All requests for reimbursement shall be in accordance with policy regarding reimbursable meals and Client Information Registration and Tracking System (CIRTS) policy regarding data entry for reimbursable meals. All requests for reimbursement shall include: 1. The request for reimbursement shall be submitted on DOEA Form 117, Request for Reimbursement, USDA Cash -In -Lieu of Commodities. 2. DOEA Form 118, PSA/Recipient Monthly Meals Report must be submitted with the request for reimbursement. A CIRTS report must be submitted with DOEA Forms 117 and 118 as supporting documentation for the total number of meals reported. The CIRTS report must match the number of meals reported on DOEA Form 118. 4. Duplication or replication of the DOEA forms 117 and 118 via data processing equipment is permissible but replication must include all data elements in the same format as included on the departmental forms. 5. The due date for the request for reimbursement and report(s) shall be no later than the 20th day of the month following the month being reported. C. Invoices will be in sufficient detail for a proper pre -audit and post -audit thereof. The recipient shall maintain documentation to support payment requests which shall be available to the Comptroller, the Department of Elder Affairs or the Alliance, upon request. D. Additional Reporting Conditions: This contract is for services provided during the 2011 Federal Fiscal Year beginning October 1, 2010 through September 30, 2011; however, the contract is in effect through January 31, 2011. The additional four months (October 1, 2011 through January 31, 2011) are to allow rates to be adjusted for the twelve-month service period. Retroactive rates will be based on the final OAA grant award divided by the total eligible meals reported in Florida. This contract shall automatically terminate after the final rate for the federal fiscal year has been established and the Department of Elder Affairs authorizes the release of final payments. 2. In the event that the final reimbursement rate is greater or less than the rate in Attachment 1, Section III.A., then this contract shall be 6 Contract Number US-1151 appropriately adjusted and the final rate shall be effective for the entire contract period upon notice from the department's contract manager. E. Any payment due by the Alliance under the terms of this contract may be withheld pending the receipt and approval by the Alliance of complete and accurate financial and programmatic reports due from the recipient and any adjustments thereto. IV. SPECIAL PROVISIONS A. State Laws and Regulation: 1. The recipient agrees to comply with applicable parts of Florida Statutes, Rule 58A-1, Florida administrative code and the Department of Elder Affairs Home and Community -Based Services Handbook. 2. The Alliance and recipient agree to provide services and implement the provisions of this contract in accordance with Federal, State, and Local laws, rules, regulations, and policies that pertain to the Nutrition Services Incentive Program cash payments and Older Americans Act. BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12-15-2010 Bulk Item: Yes No Division: _County Administrator Department: Social Services/In-Home Services Staff Contact Person/Phone #: Sheryl Graham/X45 10 AGENDA ITEM WORDING: Approval of Amendment #0001 to the Community Care for Disabled Adults (CCDA) Contract #KG-065 (7/1/10 — 6/30/11) between the Florida Department of Children & Families and the Monroe County Board of County Commissioners (Social Services/In-Home Services). ITEM BACKGROUND: Approval of this amendment will delete in their entirety pages 1-7 of the Standard Contract, dated 5/2010, and insert in lieu thereof and attach pages 1-7 of the Standard Contract, dated 6/2010 hereto. To hereby amend page 18, attachment I. Section B.5.a (2), page 22 Attachment I. Section C.l.c. and d. which will reduce said contract to $70,231.86 and reducing the county's match to $7,803.54. To delete in its entirety, page 23, Attachment I. Section D. paragraph 2. PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to the Community Care for Disabled Adults (CCDA) contract KG-065 on 6-16-10 CONTRACT/AGREEMENT CHANGES: To replace pages 1-7. Amend Attachment 1, Section B.5.a.(2), delete Page 23, Attachment 1, Section D. paragraph 2. To amend page 22, Attachment l,c. and d. which will reduce the contract by $11,501.14 to the total amount of the contract to $70,231.86. The county's match will also be reduced to $7,803.54 from $9,08 1.00. STAFF RECOMMENDATIONS: Approval TOTAL COST: $70,231.86 INDIRECT COST: --O--BUDGETED: Yes X No COST TO COUNTY: $7,803.54 required In -Kind Match SOURCE OF FUNDS: Ad Valorem Taxes REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year APPROVED BY: County Atty X— Irachasing X Risk Management —X— I DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 1/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Dept. of Children & Families Contract # CCDA Contract KG-065 Effective Date: July 1, 2010 Expiration Date: June 30, 2011 Contract Purpose/Description: Approval of Amendment #0001 to CCDA Contract #KG-065 will delete pages 1- 7 dated 5/2010 and replace them with pages 1-7 dated 6/2010. Amend page 18, attachment 1, Section B.5.a. (2). Delete page 23, Attachment 1. Section D. paragraph 2. Amend page 18, attachment 1. Section B.5.a. (2), page 22 Attachment 1. Section C.1.c. and d. to reduce the contract to $70,231.86 and reduce the county match to $7,803.54. Contract Manager: Sheryl Graham 4510 Social Services/Stop 1 (Name) (Ext.) (Department/Stop #) For BOCC meeting on 12/15/2010 Agenda Deadline: 11/30/2010 CONTRACT COSTS Total Dollar Value of Contract: $70,231.86 Budgeted? Yes X No Account Codes Grant:$70,231.86 (Fiscal Year) County Match: $7,803.54 (Required In -Kind Match) Current Year Portion: $ 125-6153710 - ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. Maintenan utilities, janitorial, salam CONTRACT REVIEW Changes Date Out Division Director Date In N evie r yes Risk Management O. .B./Purrlast g County Attorney Yes No,,/_ Yes I No) Yes No) Comments: OMB Form Revised 2/27/01 MCP #2 3 Contract #KG065 Amendment #0001 Date: 01/01/2011 THIS AMENDMENT, entered into between the State of Florida, Department of Children and Families, hereinafter referred to as the "department" and Monroe County, hereinafter referred to as the "provider," amends Contract #KG065. 1. Pages 1-7, Standard Contract, dated 05/2010, are hereby deleted in their entirety and pages 1-7, Standard Contract, dated 06/2010 are inserted in lieu thereof and attached hereto. 2. Pagel 8, Attachment 1, Section B. 5. a. (2) is hereby amended to read: (2) 20: # of qualified disabled adults (ages 18 — 59) provided case management. 3. Page 22, Attachment 1, Section C. 1. c. and d. are hereby amended to read: c. The department agrees to pay for the service units at the unit price(s) and limits listed below. FY 2010-2011 Service Service Unit Unit Price ;89 Service Allocation Case Management Hour $49 $10,133.49 Personal Care Hour $25.28 $13,898.00 Homemaking I Hour $21.79 1 $33,360.00 Home Delivered Meals I Meal $ 6.30 1 $12,840.37 d. The provider's dollar match for this contract is as follows: For Fiscal Year 2010-2011: $7,803.54 4. Page 23, Attachment 1, Section D. paragraph 2. is hereby deleted in its entirety. 5. Page 24, Attachment 1, Section D, paragraphs 3 through 7 are hereby renumbered paragraphs 2 through 6. This amendment shall begin on January 1, 2011 or the date on which the amendment has been signed by both parties, whichever is later. All provisions in the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract. Contract #KG065 Amendment #0001 Date: 01/01/2011 This amendment and all its attachments are hereby made a part of the contract. IN WITNESS THEREOF, the parties hereto have caused this nine (9) page amendment to be executed by their officials thereunto duly authorized. PROVIDER: PIAUPA.106 rlw& NAME: Sylvia Murphy TITLE.- Mayor FEDERAL ID NUMBER: 59-6000749 �1 "L0012-20ro'l ",1I I , SIGNED BY: NAME: Gilda Ferradaz TITLE: Circuit Administrator ASTOFORM , SUFFICIENCY COUNTY A ()h TE—DRO J, M V ISXAW�U�Y A �10RNE i I N w= Contract No. KG065 Client ® Non -Client ❑ CFDA No. FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES STANDARD CONTRACT THIS CONTRACT is entered into between the Florida Department of Children and Families, hereinafter referred to as the "department" and Monroe County, hereinafter referred to as the "provider", I, THE PROVIDER AGREES: A. Contract Document To provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, which constitute the contract document. B. Requirements of Section 287.058, Florida Statutes (F.S.) The provide shall provide units of deliverables, including reports, findings, and drafts, as specified in this contract. These deliverables must be received and accepted by the contract manager in writing prior to payment, The provider shall submit bills for fees or other compensation for services or expenses in sufficient detail for proper pre -audit and post -audit; where itemized payment for travel expenses are permitted in this contract, submit bills for any travel expenses in accordance with section 111061, F.S., or at such lower rates as may be provided in this contract. To allow public access to all documents, papers, letters, or other public records as defined in subsection 119.011(12), F.S. and as prescribed by subsection 119.07(1) F.S., made or received by the provider in conjunction with this contract except that public records which are made confidential by law must be protected from disclosure. It is expressly understood that the provider's failure to comply with this provision shall constitute an immediate breach of contract for which the department may unilaterally terminate the contract. C. Governing Law, Jurisdiction and Venue 1. State of Florida Law 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 Florida law, without regard to Florida provisions for conflict of laws. Courts of competent jurisdiction in Florida shall have exclusive jurisdiction in any action regarding this contract and venue shall be as provided in PUR 1000. (see Section I.BB) 2. Federal Law a. 1f this contract contains federal funds, the provider shall comply with the provisions of 45 Code of Federal Regulations (CFR), Part 74, 45 CFR, Part 92, and other applicable regulations. b. If this contract contains over S100,000 of federal funds, the provider shall comply with all applicable standards, orders, or regulations issued under section 306 of the Clean Air Act, as amended (42 United States Code (U.S.C.) 7401 et seq.), section 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, and Environmental Protection Agency regulations (40 CFR, Part 30). The provider shall report any violations of the above to the department. c. No federal funds received in connection with this contract may be used by the provider, or agent acting for the provider, or subcontractor to influence legislation or appropriations pending before the Congress or any State legislature. If this contract contains federal funding in excess of $100,000, the provider must, prior to contract execution, complete the Certification Regarding Lobbying form, Attachment N/A. If a Disclosure of Lobbying Activities form, Standard Form LLL, is required, it may be obtained from the contract manager. 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. d. Unauthorized aliens shall not be employed. The department shall consider the employment of unauthorized aliens a violation of section 274A(e) of the immigration and Nationality Act (8 U.S.C. 1324 a) and section 101 of the Immigration Reform and Control Act of 1986. Such violation shall be cause for unilateral cancellation of this contract by the department. e. If this contract contains $10,000 or more of federal funds, the provider 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, Part 60 and 45 CFR, Part 92, if applicable. f. If this contract contains federal funds and provides services to children up to age 18, the provider shall comply with the Pro -Children Act of 1994 (20 U.S.C. 6081). Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to S 1,000 for each violation or the imposition of an administrative compliance order on the responsible entity, or both. D. Audits, Inspections, Investigations, Records and Retention 1, The provider shall establish and maintain books, records and documents (including electronic storage media) sufficient to reflect all income and expenditures of funds provided by the department under this contract. 2. Retention of all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this contract shall be maintained by the provider 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 department. 3. Upon demand, at no additional cost to the department, the provider will facilitate the duplication and transfer of any records or documents during the required retention period in Section 1, Paragraph D. 2. 4, These records shall be made available at all reasonable times for inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the department. CF Standard Contract 06,2010 1 Contract # KG065 At all reasonable times for as long as records are maintained, persons duly authorized by the department and Federal auditors, pursuant to 45 CFR, section 9236(i)(10), shall be allowed full access to and the right to examine any of the provider's contracts and related records and documents, regardless of the form in which kept. 6. A financial and compliance audit shall be provided to the department as specified in this contract and in Attachment IL T The provider shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by The Office of the inspector General (section 20.055, F.S.). E. Monitoring by the Department The provider shall permit all persons who are duly authorized by the department to inspect and copy any records, papers, documents, facilities, goods and services of the provider which are relevant to this contract, and to interview any clients, employes and subcontractor employees of the provider to assure the department of the satisfactory performance of the terms and conditions of this contract. Following such review, the department will deliver to the provider a written report of its findings, and request for development, by the provider, of a corrective action plan where appropriate. The provider hereby agrees to timely correct all deficiencies identified in the corrective action plan. F. Indemnification I . The provider shall be fully liable for the actions of its agents, employees, partners, or subcontractors and shall fully indemnify, defend, and hold harmless the department and its officers, agents, and employees, from suits, actions, damages, and costs of every name and description, including attorneys' fees, arising from or relating to any alleged act or omission by the provider, its agents, employees, partners, or subcontractors, provided, however, that the provider shall not indemnify for that portion of any loss or damages proximately caused by the negligent act or omission of the department. Further, the provider shall, without exception, indemnify and save harmless the department and its employees from any liability of any nature or kind whatsoever, including attorneys fees, costs and expenses, arising out of, relating to or involving any claim associated with any trademark, copyrighted, patented, or unpatented invention, process, trade secret or intellectual property right, information technology used or accessed by the provider, or article manufactured or used by the provider, its officers, agents or subcontractors in the performance of this contract or delivered to the department for the use of the department, its employees, agents or contractors. The provider may, at its option and expense, procure for the department, its employees, agents or contractors, the right to continue use of, replace, or modify the product or article to render it non -infringing. If the provider is not reasonably able to modify or otherwise secure the department the right to continue using the product or article, the provider shall remove the product and refund the department the amounts paid in excess of a reasonable rental for past use. However, the department shall not be liable for any royalties. The provider has no liability when such claim is solely and exclusively due to the department's alteration of the product or article or the department's misuse or modification of the provider's products or the department's operation or use of vendor's products in a manner not contemplated by this contract. The provider shall provide prompt written notification to the department of any claim of copyright, patent or other infringement arising from the performance of this contract. Further, the provider shall protect, defend, and indemnify, including attorneys' fees and costs, the department for any and all claims and litigation (including litigation initiated by the department) arising from or relating to provider's claim that a document contains proprietary or trade secret information that is exempt from disclosure or the scope of the provider's redaction, as provided for under Section I.EE. 4. The provider's inability to evaluate liability or its evaluation of liability shall not excuse its duty to defend and indemnify after receipt of notice. Only an adjudication or judgment after the highest appeal is exhausted finding the department negligent shall excuse the provider of performance under this provision, in which case the department shall have no obligation to reimburse the provider for the cost of their defense. If the Provider is an agency or subdivision of the State, its obligation to indemnify, defend and hold harmless the department shall be to the extent permitted by law and without waiving the limits of sovereign immunity. G. Insurance Continuous adequate liability insurance coverage shall be maintained by the provider 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 provider accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the provider and the clients to be served under this contract. The limits of coverage under each policy maintained by the provider do not limit the provider's liability and obligations under this contract. Upon the execution of this contract, the provider shall furnish the department written verification supporting both the determination and existence of such insurance coverage. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida. The department reserves the right to require additional insurance as specified in this contract. H. Confidentiality of Client Information The provider shall not use or disclose any information concerning a recipient of services under this contract for any purpose prohibited by state or federal taw or regulations except with the written consent of a person legally authorized to give that consent or when authorized by law. Assignments and Subcontracts The provider shall not assign the responsibility for this contract to another party without prior written approval of the department, upon the department's sole determination that such assignment will not adversely affect the public interest. however, in no event may provider assign Or enter into any transaction having the effect of assigning or transferring any right to receive payment under this contract which right is not conditioned on full and faithful perfornance of provider's duties hereunder, Any sublicense, assignment, or transfer otherwise occurring without prior approval of the department shalt be null and void. The provider shall not subcontract for any of the work contemplated under this contract without prior written approval of the department, which shall not be unreasonably withheld. To the extent permitted by Florida Caw, and in compliance with Section l_F. of this Standard Contract, the provider is responsible for all work performed and for all commodities produced pursuant to this contract whether actually furnished by the provider or its subcontractors. Any subcontracts shall be evidenced by a written document. The provider further agrees that the department shall not be liable to the subcontractor in any way or for any reason. The provider, at its expense, will defend the department against such claims. CF Standard Contract 00 2010 2 Contract is KG065 The provider shall make payments to any subcontractor within seven (7) working days after receipt of full or partial payments from the department in accordance with section 287.0585, F.S., unless otherwise stated in the contract between the provider and subcontractor. Failure to pay within seven (7) working days will result in a penalty that shall be charged against the provider and paid by the provider to the subcontractor in the amount of one-half of one percent (.005) of the amount due per day from the expiration of the period allowed for payment_ Such penalty shall be in addition to actual payments owed and shall not exceed fifteen (15%) percent of the outstanding balance due. The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the provider. In the event the State of Florida approves transfer of the provider's obligations, the provider remains responsible for all work performed and all expenses incurred in connection with the contract. This contract shall remain binding upon the successors in interest of either the provider or the department The provider shall include, or cause to be included, in all subcontracts (at any tier) the substance of all clauses contained in this Standard Contract that mention or describe subcontract compliance. J. Return of Funds The provider shall return to the department any overpayments due to unearned funds or funds disallowed that were disbursed to the provider by the department and any interest attributable to such funds pursuant to the terms and conditions of this contract. In the event that the provider or its independent auditor discovers that an overpayment has been made, the provider shall repay said overpayment immediately without prior notification from the department. In the event that the department first discovers an overpayment has been made, the contract manager, on behalf of the department, will notify the provider by letter of such findings. Should repayment not be made forthwith, the provider will be charged interest at the lawful rate of interest on the outstanding balance after department notification or provider discovery. K. Client Risk Prevention and Incident Reporting If services to clients are to be provided under this contract, the provider and any subcontractors shall, in accordance with the client risk prevention system, report those reportable situations listed in CFOP 215-6 in the manner prescribed in CFOP 215-6 or circuit or region operating procedures. 2. The provider shall immediately report any 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 provider and its employees. L. Purchasing Articles which are the subject of or are required to carry out this contract shall be purchased 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 provider shall be deemed to be substituted for the department 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, 2. The provider shall 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 sections 403.7065, and 287.045, F.S. M. Civil Rights Requirements in accordance with Title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act of 1990, or the Florida Civil Rights Act of 1992, as applicable the provider shall not discriminate against any employee (or applicant for employment) in the performance of this contract because of race, color, religion, sex, national origin, disability, age, or marital status. Further, the provider agrees not to discriminate against any applicant, client, or employee in service delivery or benefits in connection with any of its programs and activities in accordance with 45 CFR 80, 83, 84, 90, and 91, Title VI of the Civil Rights Act of 1964, or the Florida Civil Rights Act of 1992, as applicable and CFOP 60-16. These requirements shall apply to all contractors, subcontractors, subgrantees or others with whom it arranges to provide services or benefits to clients or employees in connection with its programs and activities. 2. Complete the Civil Rights Compliance Checklist, CF Form 946 in accordance with CFOP 60-16 and 45 CFR 80, This is required of all providers that have fifteen (15) or more employees. Subcontractors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of 287.134, F.S. N. Independent Capacity of the Contractor 1. In performing its obligations under this contract, the provider shall at all times be acting in the capacity of an independent contractor and not as an officer, employee, or agent of the State of Florida, except where the provider is a state agency. 'neither the provider nor its agents, employees, subcontractors or assignees shall represent to others that it has the authority to bind the department unless specifically authorized in writing to do so. 2. This contract does not create any right to state retirement, leave benefits or any other benefits of state employees as a result of performing the duties or obligations of this contract. 3. The provider shall take such actions as may be necessary to ensure that each subcontractor of the provider will be deemed to be an independent contractor and will not be considered or permitted to be an agent, servant, joint venturer, or partner of the State of Florida. 4. The department will not furnish services of support (e.g., office space, office supplies, telephone service, secretarial or clerical support) to the provider, or its subcontractor or assignee, unless specifically agreed to by the department in this contract. 5. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the provider, the provider's officers, employees, agents, subcontractors, or assignees shall be the sole responsibility of the provider. CF Standard Contract 06i2010 3 Contract it KGO65 O. Sponsorship As required by section 286.25, F.S., ifthe provider 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 (provider's name) and the State of Florida, Department ofChildren and Families". if the sponsorship reference is in written material, the words "State of Florida, Department of Children and Families" shall appear in at least the same size letters or type as the name of the organization. P. Publicity Without limitation, the provider and its employees, agents, and representatives will not, without prior departmental written consent in each instance, use in advertising, publicity or any other promotional endeavor any State mark, the name of the State's mark, the name of the State or any State affiliate or any officer or employee of the State, or represent, directly or indirectly, that any product or service provided by the provider has been approved or endorsed by the State, or refer to the existence of this contract in press releases, advertising or materials distributed to the provider's prospective customers. Q. Final Invoice The final invoice for payment shall be submitted to the department no more than 45 days after the contract ends or is terminated. If the provider fails to do so, all rights to payment are forfeited and the department will 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 provider and necessary adjustments thereto, have been approved by the department. R. Use of Funds for Lobbying Prohibited The provider shall comply with the provisions of sections 11.062 and 216.347, F.S., which prohibit the expenditure of contract funds for the purpose of lobbying the Legislature, judicial branch, or a state agency. S. Public Entity Crime Pursuant to section 287.133, F.S., the following restrictions are placed on the ability of persons convicted of public entity crimes to transact business with the department. When a person or affiliate has been placed on the convicted vendor list following a conviction for a public entity crime, he/she 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 the 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 section 287.017, F.S., for CATEGORY TWO for a period of thirty-six (36) months from the date of being placed on the convicted vendor list. T. Gratuities The provider agrees that it will not offer to give or give any gift to any department employee. As part of the consideration for this contract, the parties intend that this provision will survive the contract for a period of two years. In addition to any other remedies available to the department, any violation of this provision will result in referral of the provider's name and description of the violation of this term to the Department of Management Services for the potential inclusion of the provider's name on the suspended vendors list for an appropriate period. The provider will ensure that its subcontractors, if any, comply with these provisions. U. Patents, Copyrights, and Royalties It is agreed that all intellectual property, inventions, written or electronically created materials, including manuals, presentations, films, or other copyrightable materials, arising in relation to provider's performance under this contract, and the performance of all of its officers, agents and subcontractors in relation to this contract, are works for hire for the benefit of the department, fully compensated for by the contract amount, and that neither the provider nor any of its officers, agents nor subcontractors may claim any interest in any intellectual property rights accruing under or in connection with the performance of this contract. It is specifically agreed that the department shall have exclusive rights to all data processing software falling within the terms of section 119.084, F.S., which arises or is developed in the course of or as a result of work or services performed under this contract, or in anyway connected herewith. Notwithstanding the foregoing provision, if the provider is a university and a member of the State University System of Florida, then section 1004.23, F.S., shall apply. 2. if the provider uses or delivers to the department for its use or the use of its employees, agents or contractors, any design, device, or materials covered by letters, patent, or copyright, it is mutually agreed and understood without exception that the compensation paid pursuant to this contract includes all royalties or costs arising from the use of such design, device, or materials in any way involved in the work contemplated by this contract. 3. All applicable subcontracts shall include a provision that the Federal awarding agency reserves all patent rights with respect to any discovery or invention that arises or is developed in the course of or under the subcontract. V. Construction or Renovation of Facilities Using State Funds Any state funds provided for the purchase of or improvements to real property are contingent upon the provider granting to the state a security interest in the property at least to the amount of the state funds provided for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law. As a condition of receipt of state funding for this purpose, the provider agrees that, if it disposes of the property before the department's interest is vacated, the provider will refund the proportionate share of the state's initial investment, as adjusted by depreciation. W. Information Security Obligations I . An appropriately skilled individual shall be identified by the provider to function as its Data Security Officer. The Data Security Officer shall act as the liaison to the department's security staff and will maintain an appropriate level of data security for the information the provider is collecting or using in the perfonnance of this contract. An appropriate level of security includes approving and tracking all provider employees that request or have access to any departmental data system or information. The Data Security Officer will ensure that user access to the data system or information has been removed from all terminated provider employees. 2. The provider shall provide the latest departmental security awareness training to its staff and subcontractors who have access to departmental information, CF Standard Contract 00,2010 4 Contract # KG065 3. All provider employees who have access to departmental information shall comply with, and be provided a copy of CFOP 50-2, and shall sign the DCF Security Agreement form CF 0 114 annually. A copy of CF 0 114 may be obtained from the contract manager. 4. The provider shall make every effort to protect and avoid urnmihorized release of any personal or confidential information by ensuring both data and storage devices are encrypted as prescribed in CFOP 50-2. If encryption of these devices is not possible, then the provider shall assure that unencrypted personal and confidential departmental data will not be stored on unencrypted storage devices, The provider shall require the same of all subcontractors. 5. The provider agrees to notify the contract manager as soon as possible, but no later than five (5) business days following the determination of any breach or potential breach of personal and confidential departmental data. The provider shall require the same notification requirements of all subcontractors. 6. The provider shall provide notice to affected parties no later than 45 days following the determination of any potential breach of personal or confidential departmental data provided in section 817,568 1, E.S. The provider shall require the same notification requirements of all subcontractors. X. Accreditation The department is committed to ensuring provision of the highest quality services to the persons we serve. Accordingly, the department has expectations that where accreditation is generally accepted nationwide as a clear indicator of quality service, the majority of the department's providers will either be accredited, have a plan to meet national accreditation standards, or will initiate a plan within a reasonable period of time. Y. Provider Employment Opportunities 1. Agency for Workforce Innovation and Workforce Florida: The provider understands that the department, the Agency for Workforce Innovation, and Workforce Florida, Inc., have jointly implemented an initiative to empower recipients in the Temporary Assistance to Needy Families Program to enter and remain in gainful employment. The department encourages provider participation with the Agency for Workforce Innovation and Workforce Florida. Transitioning Young Adults: The provider understands the department's Operation Full Employment initiative to assist young adults aging out of the dependency system. The department encourages provider participation with the local Community -Based Care Lead Agency Independent Living Program to offer gainful employment to youth in foster care and young adults transitioning from the foster care system. L Health Insurance Portability and Accountability Act The provider shall, where applicable, comply with the Health Insurance Portability and Accountability Act (42 U. S. C. 1320d.) as well as all regulations promulgated thereunder (45 CFR Paris 160, 162, and 164). AA. Emergency Preparedness I . If the tasks to be performed pursuant to this contract include the physical care or supervision of clients, the provider shall, within 30 days of the execution of this contract, submit to the contract manager an emergency preparedness plan which shall include provisions for records protection, alternative accommodations for clients in substitute care, supplies, and a recovery plan that will allow the provider to continue firrictioning in compliance with the executed contract in the event of an actual emergency. For the purpose of disaster planning, the term supervision includes the responsibility of the department, or its contracted agents to ensure the safety, permanency and well-being of a child who is under the jurisdiction of a dependency court. Children may remain in their homes, be placed in a non -licensed relative/non-relative home, or be placed in a licensed foster care setting. 1 The department agrees to respond in writing within 30 days of receipt of the plan accepting, rejecting, or requesting modifications. In the event of an emergency, the department may exercise oversight authority over such provider in order to assure implementation of agreed emergency relief provisions. An updated emergency preparedness plan shall be submitted by the provider no later than 12 months following the acceptance of an original plan or acceptance of an updated plan. The department agrees to respond in writing within 30 days of receipt of the updated plan, accepting, rejecting, or requesting modification to the plan. BB. PUR (Purchasing) 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 (including the department's Standard 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. CC. Notification of Legal Action The provider shall notify the department of legal actions taken against them or potential actions such as lawsuits, related to services provided through this contract or that may impact the provider's ability to deliver the contractual services, or adversely impact the department. The department's contract manager will be notified within 10 days of provider becoming aware of such actions or from the day of the legal filing, whichever comes first. DD. Whistleblower's Act Requirements In accordance with subsection 111.3 18", (2), F.S., the provider and its subcontractors shall not retaliate against an employee for reporting violations of law, rule, or regulation that creates substantial and specific danger to the public's health, safety, or welfare to an appropriate agency. Furthermore, agencies or independent contractors shall not retaliate against any person who discloses information to an appropriate agency alleging improper use of governmental office, gross waste of funds, or any other abuse or gross neglect of duty on the part of an agency, public officer, or employee. The provider and any subcontractor shall inform its employees that they and other persons may file a complaint with the Office ol'Chief Inspector General, Agency Inspector General, the Florida Commission on Human Relations or the Whistle -blower's Hotline number at 1-800-543-5353. CF Standard Contract 00 2010 5 Contract a KG065 EE. Proprietary or Trade Secret Information 1, Unless exempted bylaw, all public records are subject to public inspection and copying under Florida's Public Records Law, Chapter 119, F.S. Any claim by provider 017proprietary or trade secret confidentiality for any information contained in provider's documents (reports, deliverables or workpapers, etc., in paper or electronic form) submitted in connection with this contract will be waived, unless the claimed confidential information is submitted in accordance with paragraph 2 below, 2. The provider must clearly label any portion of the documents, data or records submitted that it considers exempt from public inspection or disclosure pursuant to Florida's Public Records Law as proprietary or trade secret. The labeling will include a justification citing specific statutes and facts that authorize exemption of the information from public disclosure. If different exemptions are claimed to be applicable to different portions of the protected information, the provider shall include information correlating the nature of the claims to the particular protected information. 3. The department, when required to comply with a public records request including documents submitted by the provider, may require the provider to expeditiously submit redacted copies of documents marked as confidential or trade secret in accordance with paragraph 2 above, Accompanying the submission shall be an updated version of the justification under paragraph 2, correlated specifically to redacted information. The redacted copy must exclude or obliterate only those exact portions that are claimed to be proprietary or trade secret. If the provider fails to promptly submit a redacted copy and updated justification in accordance with this paragraph, the department is authorized to produce the records sought without any redaction of proprietary or trade secret information. 4. The department is not obligated to agree with the provider's claim of exemption on the basis of proprietary or trade secret confidentiality and the provider shall be responsible for defending its claim that each and every portion of the redactions of proprietary or trade secret information are exempt from inspection and copying under Florida's Public Records Law. FF. Support to the Deaf or Hard -of -Hearing The provider and its subcontractors, where direct services are provided, shall comply with section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794, as implemented by 45 C.F.R. Part 84 (hereinafter referred to as Section 504), the Americans with Disabilities Act of 1990,42 U.S.C. 12131, as implemented by 28 C.F.R. Part 35 (hereinafter referred to as ADA), and the Children and Families Operating Instruction (CFOP) 60-10, Chapter 4, entitled "Auxiliary Aids and Services for the Deaf or Hard -of -Hearing." I. If the provider or any of its subcontractors employs 15 or more employees, the provider shall designate a Single -Point -of -Contact (one per firm) to ensure effective communication with deaf or hard -of -hearing customers or companions in accordance with Section 504, the ADA, and CFOP 60- 10, Chapter 4. The name and contact information for the provider's Single -Point -of -Contact shall be furnished to the department's Grant or Contract Manager within 14 calendar days of the effective date of this requirement. 2. The provider shall, within 30 days of the effective date of this requirement, contractually require that its subcontractors comply with section 504, the ADA, and CFOP 60-10, Chapter 4. A Single -Point -of -Contact shall be required for each subcontractor that employs 15 or more employees. This Single - Point -of -Contact will ensure effective communication with deaf or hard -of -hearing customers or companions in accordance with Section 504 and the ADA and coordinate activities and reports with the provider's Single -Point -of -Contact. 3. The Single -Point -of -Contact shall ensure that employees are aware of the requirements, roles& responsibilities, and contact points associated with compliance with Section 504, the ADA, and CFOP 60- 10, Chapter 4. Further, employees of providers and its subcontractors with 15 or more employees shall attest in writing that they are familiar with the requirements of Section 504, the ADA, and CFOP 60-10, Chapter 4. This attestation shall be maintained in the employee's personnel file. 4. The provider's Single -Point -of -Contact will ensure that conspicuous Notices which provide information about the availability of appropriate auxiliary aids and services at no -cost to the deaf or hard -of -hearing customers or companions are posted near where people enter or are admitted within the agent locations. Such Notices must be posted immediately by providers and subcontractors. The approved Notice can be downloaded through the Internet at: http:/,Iwww.dcf.state.fl.us/admin/ig/eivilrights.shtinl 5. The provider and its subcontractors shall document the customer's or companion's preferred method of communication and any requested auxiliary aids/services provided in the customer's record. Documentation, with supporting justification, must also be made if any request was not honored. The provider shall submit compliance reports monthly, by the 5 1b business day following the reporting month, to the department's Grant or Contract Manager. The provider shall distribute Customer Feedback forms to customers or companions, and provide assistance in completing the forms as requested by the customer or companion. 6. If customers or companions are referred to other agencies, the provider must ensure that the receiving agency is notified of the customer's or companion's preferred method ofcommunication and any auxiliary aids/service needs, H. THE DEPARTMENT AGREES: A. Contract Amount The department shall pay for contracted services according to the terms and conditions of this contract of an amount not to exceed S70,231.86, or the rate schedule, subject to the availability of funds. The State of Florida's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. B. Contract Payment Pursuant to section 215.422, F.S., the department has five (5) working days to inspect and approve goods and services, unless the bid specifications, purchase order, or this contract specify otherwise. With the exception of payments to health care providers for hospital, medical, or other health care services, if payment is not available within fortv (40) days, measured from the latter ofthe date a properly completed invoice is received by the department or the goods or services are received, inspected, and approved, a separate interest penalty set by the Chief Financial Officer pursuant to section 55.03, F.S., will be due and payable in addition to the invoice amount. Payments to health care providers for hospital, medical, or other health care services, shall be made not more than thirty-five (35) days from the date eligibility for payment is deten-nincd. Financial penalties will be calculated at the daily interest rate of.03333%. Invoices returned to a provider due to preparation Loors will result in a non -interest bearing payment delay. Interest penalties less than one ( I ) dollar will not be paid unless the provider requests payment. CF Standard Contract 06'20 10 6 Contract # KG065 C. Vendor Ombudsman A Vendor Ombudsman has been established within the Department of Financial Services. The duties of this office are found in section 215.422, F.S., which include disseminating information relative to prompt payment and assisting vendors in receiving their payments in a timely manner from a state agency. The Vendor Ombudsman may be contacted at (850) 413-5516. D. Notice Any notice that is required under this contract shall be in writing, and sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery. Said notice shall be sent to the representative of the provider responsible for administration of the program, to the designated address contained in this contract, III. THE PROVIDER AND DEPARTMENT MUTUALLY AGREE: A. Effective and Ending Dates This contract shall begin on July 1.2010, 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 Monroe County, Florida, on June 00. 2011. B. Financial Penalties for Failures to Comply with Requirement for Corrective Actions I . In accordance with the provisions of section 402.73(1), F.S., and Rule 65-29.001, F.A.C., corrective action plans may be required for noncompliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. 2. The increments of penalty imposition that shall apply, unless the department determines that extenuating circumstances exist, shall be based upon the severity of the noncompliance, nonperformance, or unacceptable performance that generated the need for corrective action plan. The penalty, if imposed, shall not exceed ten percent (10%) of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. Noncompliance that is determined to have a direct effect on client health and safety shall result in the imposition of a ten percent (10%) penalty of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. 3. Noncompliance involving the provision of service not having a direct effect on client health and safety shall result in the imposition of a five percent (5%) penalty. Noncompliance as a result of unacceptable performance of administrative tasks shall result in the imposition of a two percent (2%) penalty. 4. The deadline for payment shall be as stated in the Order imposing the financial penalties. In the event of nonpayment the department may deduct the amount of the penalty from invoices submitted by the provider. C. Termination 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 provider responsible for administration of the program. 2. In the event funds for payment pursuant to this contract become unavailable, the department may terminate this contract upon no less than twenty-four (24) hours notice in writing to the provider. Said notice shall be sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery. The department shall be the final authority as to the availability and adequacy of funds. in the event of termination of this contract, the provider will be compensated for any work satisfactorily completed. 3. This contract may be terminated for the provider's non-performance upon no less than twenty-four (24) hours notice in writing to the provider. If applicable, the department may employ the default provisions in Rule 60A-1.006(3), F.A.C. The department's failure to demand performance of any provision of this contract shall not be deemed a waiver of such performance. The department's waiver of any one breach of any provision of this contract shal I not be deemed to be a waiver of any other breach and neither event shall be construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the department's right to remedies at law or in equity. 4. Failure to have performed any contractual obligations with the department in a manner satisfactory to the department will be a sufficient cause for termination. To be terminated as a provider under this provision, the provider must have: (I ) previously failed to satisfactorily perform in a contract with the department, been notified by the department of the unsatisfactory performance, and failed to correct the unsatisfactory performance to the satisfaction of the department; or (2) had a contract terminated by the department for cause. D. Renegotiations or Modifications Modifications of 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 department's operating budget. CF Standard Contract 06!2010 1 1 Contract # KG065 Contract No. KG065 Client ® Non -Client ❑ CFDA No. FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES STANDARD CONTRACT THIS CONTRACT is entered into between the Florida Department of Children and Families, hereinafter referred to as the "department" and MONROE COUNTY, hereinafter referred to as the "provider". 1. THE PROVIDER AGREES: A. Contract Document To provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, which constitute the contract document. B. Requirements of Section 287.058, Florida Statutes (F.S.) The provider shall provide units of deliverables, including reports, findings, and drafts, as specified in this contract. These deliverables must he received and accepted by the contract manager in writing prior to payment. The provider shall submit bills for fees or other compensation for services or expenses in sufficient detail for proper pre -audit and post -audit, where itemized payment for travel expenses are permitted in this contract, submit bills for any travel expenses in accordance with section 1 12.061, F.S., or at such lower rates as may be provided in this contract. To allow public access to all documents, papers, letters, or other public records as defined in subsection 119.01 1(12), F.S. and as prescribed by subsection 1 19.01(1) F.S., made or received by the provider in conjunction with this contract except that public records which are made confidential by law must be protected from disclosure. It is expressly understood that the provider's failure to comply with this provision shall constitute an immediate breach of contract for which the department may unilaterally terminate the contract. C. Governing Law, Jurisdiction and Venue L State of Florida Law 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 Florida law, without regard to Florida provisions for conflict of laws. Courts of competent jurisdiction in Florida shall have exclusive jurisdiction in any action regarding this contract and venue shall he as provided in FUR 1000. (see Section I.BB) 2. Federal Law a. If this contract contains federal funds, the provider shall comply with the provisions of 45 Code of Federal Regulations (CFR), Part 74, 45 CFR, Part 92, and other applicable regulations. b. If this contract contains over $100,000 of federal funds, the provider shall comply with all applicable standards, orders, or regulations issued under section 306 of the Clean Air Act, as amended (42 United States Code (U.S.C.) 7401 et seq.), section 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, and Environmental Protection Agency regulations (40 CFR, Part 30). The provider shall report any violations of the above to the department. c. No federal funds received in connection with this contract may be used by the provider, or agent acting for the provider, or subcontractor to influence legislation or appropriations pending before the Congress or any State legislature. If this contract contains federal funding in excess of $100,000, the provider must, prior to contract execution, complete the Certification Regarding Lobbying form, Attachment NIA. If a Disclosure of Lobbying Activities form, Standard Form LLL, is required, it may be obtained from the contract manager. 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. it. Unauthorized aliens shall not he employed. The department shall consider the employment of unauthorized aliens a violation of section 274A(e) of the Immigration and Nationality Act (8 U.S.C. 1324 a) and section 101 of the Immigration Reform and Control Act of 1986, Such violation shall be cause for unilateral cancellation of this contract by the department. e. If this contract contains $10,000 or more of federal funds, the provider 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, Part 60 and 45 CFR, Part 92, if applicable. f if this contract contains federal funds and provides services to children up to age 18, the provider shall comply with the Pro -Children Act of 1994 (20 U.S.C. 6081). Failure to comply with the provisions of the law may result in the imposition ofa civil monetary penalty of up to $1,000 for each violation or the imposition of an administrative compliance order on the responsible entity, or both. D. Audits, Inspections, Investigations, Records and Retention 1. The provider shall establish and maintain books, records and documents (including electronic storage medial sufficient to reflect all income and expenditures of funds provided by the department under this contract. 2. Retention of all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this contract shall be maintained by the provider 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 department. 3. Upon demand, at no additional cost to the department, the provider will facilitate the duplication and transfer ofany records or documents during the required retention period in Section 1, Paragraph D. 2. 4. These records shall he made available at all reasonable times for inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the department. CF Standard Contract 05,2010 1 Contract # KG065 5. At all reasonable times for as long as records are maintained, persons duly authorized by the department and Federal auditors, pursuant to 45 CFR, section 42.36(i)(10), shall be allowed full access to and the right to examine any of the provider's contracts and related records and documents, regardless of the form in which kept. 6. A financial and compliance audit shalt be provided to the department as specified in this contract and in Attachment 11, The provider shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by The office of the Inspector General (section 20.055, ES.). E. Monitoring by the Department The provider shall permit all persons who are duly authorized by the department to inspect and copy any records, papers, documents, facilities, goods and services of the provider which are relevant to this contract, and to interview any clients, employees and subcontractor employees of the provider to assure the department of the satisfactory performance of the terns and conditions of this contract. Following such review, the department will deliver to the provider a written report of its Findings, and request for development, by the provider, of a corrective action plan where appropriate. The provider hereby agrees to timely correct all deficiencies identified in the corrective action plan. F. Indemnification 1. The provider shall be fully liable for the actions of its agents, employees, partners, or subcontractors and shall fully indemnify, defend, and hold harmless the department and its officers, agents, and employees, from suits, actions, damages, and costs of every name and description, including attorneys' fees, arising from or relating to any alleged act or omission by the provider, its agents, employees, partners, or subcontractors, provided, however, that the provider shall not indemnify for that portion of any loss or damages proximately caused by the negligent act or omission of the department. ?. Further, the provider shall, without exception, indemnify and save harmless the department and its employees from any liability of any nature or kind whatsoever, including attorneys fees, costs and expenses, arising out of, relating to or involving any claim associated with any trademark, copyrighted, patented, or unpatented invention, process, trade secret or intellectual property right, information technology used or accessed by the provider, or article manufactured or used by the provider, its officers, agents or subcontractors in the performance of this contract or delivered to the department for the use of the department, its employees, agents or contractors. The provider may, at its option and expense, procure for the department, its employees, agents or contractors, the right to continue use of, replace, or modify the product or article to render it non -infringing. If the provider is not reasonably able to modify or otherwise secure the department the right to continue using the product or article, the provider shall remove the product and refund the department the amounts paid in excess of a reasonable rental for past use. However, the department shall not be liable for any royalties. The provider has no liability when such claim is solely and exclusively due to the department's alteration of the product or article or the department's misuse or modification of the provider's products or the department's operation or use of vendor's products in a manner not contemplated by this contract. The provider shall provide prompt written notification to the department of any claim of copyright, patentor other infringement arising from the performance of this contract. 3. Further, the provider shall protect, defend, and indemnify, including attorneys' fees and costs, the department for any and all claims and litigation (including litigation initiated by the department) arising from or relating to provider's claim that a document contains proprietary or trade secret information that is exempt from disclosure or the scope of the provider's redaction, as provided for under Section LEE. 4. The provider's inability to evaluate liability or its evaluation of liability shall not excuse its duty to defend and indemnify after receipt of notice. only an adjudication or judgment after the highest appeal is exhausted finding the department negligent shall excuse the provider of performance under this provision, in which case the department shall have no obligation to reimburse the provider for the cost of their defense. If the Provider is an agency or subdivision of the State, its obligation to indemnify, defend and hold harmless the department shall be to the extent permitted by law and without waiving the limits of sovereign immunity. G. insurance Continuous adequate liability insurance coverage shall be maintained by the provider 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 provider accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the provider and the clients to be served under this contract. The limits of coverage under each policy maintained by the provider do not limit the provider's liability and obligations under this contract. Upon the execution of this contract, the provider shall famish the department written verification supporting both the determination and existence of such insurance coverage. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida. The department reserves the right to require additional insurance as specified in this contract. H. Confidentiality of Client information The provider 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, 1. Assignments and Subcontracts The provider shall not assign the responsibility for this contract to another party without prior written approval of the department, upon the department's sole determination that such assignment will not adversely affect the public interest, however, in no event may provider assign or enter into any transaction having the effect of assigning or transferring any right to receive payment under this contract which right is not conditioned on full and faithful performance of provider's duties hereunder. Any sublicense, assignment, or transfer otherwise occurring without prior approval of the department shall be null and void. The provider shall not -subcontract for any of the work contemplated under this contract without prior written approval of the department, which shall not he unreasonably withheld, 2. To the extent permitted by Florida Law, and in compliance with Section I.F. of this Standard Contract, the provider is responsible for all work performed and for all commodities produced pursuant to this contract whether actually furnished by the provider or its subcontractors, Any subcontracts shalt he evidenced by a written document. The provider further agrees that the department shall not be liable to the subcontractor in any way or for any reason_ The provider, at its expense, will defend the department against such claims. CF Standard Contract 052010 1 Contract # KG065 3. The provider shall make payments to any subcontractor within seven (7) working days after receipt of full or partial payments from the department in accordance with section 287,0585, F.S., unless otherwise stated in the contract between the provider and subcontractor. Failure to pay within seven (7) working days will result in a penalty that shall be charged against the provider and paid by the provider to the subcontractor in the amount of one-half of one percent (.005) of the amount due per day from the expiration of the period allowed for payment. Such penalty shall be in addition to actual payments owed and shall not exceed fifteen (f 5%) percent of the outstanding balance due. 4. The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the provider. In the event the State of Florida approves transfer of the provider's obligations, the provider remains responsible for all work performed and all expenses incurred in connection with the contract. This contract shall remain binding upon the successors in interest of either the provider or the department. 5. The provider shall include, or cause to be included, in all subcontracts (at any tier) the substance of all clauses contained in this Standard Contract that mention or describe subcontract compliance. J. Return of Funds The provider shall return to the department any overpayments due to unearned funds or funds disallowed that were disbursed to the provider by the department and any interest attributable to such funds pursuant to the terms and conditions of this contract. In the event that the provider or its independent auditor discovers that an overpayment has been made, the provider shall repay said overpayment immediately without prior notification from the department. In the event that the department fast discovers an overpayment has been made, the contract manager, on behalf of the department, will notify the provider by letter of such findings. Should repayment not be made forthwith, the provider will be charged interest at the lawful rate of interest on the outstanding balance after department notification or provider discovery. IC Client Risk Prevention and incident Reporting I . If services to clients are to be provided under this contract, the provider and any subcontractors shall, in accordance with the client risk prevention system, report those reportable situations listed in CFOP 215-6 in the manner prescribed in CFOP 215-6 or circuit or region operating procedures. 2. The provider shall immediately report any 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 (I-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon both the provider and its employees. L. Purchasing I . Articles which are the subject of or are required to carry out this contract shall be purchased 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 provider shall be deemed to be substituted for the department 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. 2. The provider shall 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 sections 403,7065, and 287.045, F.S. W Civil Rights Requirements I . in accordance with Title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act of 1990, or the Florida Civil Rights Act of 1992, as applicable the provider shall not discriminate against any employee (or applicant for employment) in the performance of this contract because of race, color, religion, sex, national origin, disability, age, or marital status. Further, the provider agrees not to discriminate against any applicant, client, or employee in service delivery or benefits in connection with any of its programs and activities in accordance with 45 CFR 80, 83, 84, 90, and 91, Title VI of the Civil Rights Act of 1964, or the Florida Civil Rights Act of 1992, as applicable and CFOP 60-16. These requirements shall apply to all contractors, subcontractors, subgrantees or others with whom it arranges to provide services or benefits to clients or employees in connection with its programs and activities. Complete the Civil Rights Compliance Checklist, CF Form 946 in accordance with CFOP 60-16 and 45 CFR 80. This is required of all providers that have fifteen (15) or more employees. Subcontractors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of 287.134, F.S. N. Independent Capacity of the Contractor I. In performing its obligations under this contract, the provider shall at all times be acting in the capacity of an independent contractor and not as an officer, employee, or agent of the State of Florida, except where the provider is a state agency. 'neither the provider nor its agents, employees, subcontractors or assignees shall represent to others that it has the authority to bind the department unless specifically authorized in writing to do so. 2. This contract does not create any right to state retirement, leave benefits or any other benefits of state employees as a result of performing the duties or obligations of this contract. 3. The provider shall take such actions as may be necessary to ensure that each subcontractor of the provider will be deemed to bean independent contractor and will not be considered or permitted to bean agent, servant, joint venturer. or partner of the State of Florida. 4. The department will not furnish services of support (e.g., office space, office supplies. telephone service, secretarial or clerical support) to the provider, or its subcontractor or assignee, unless specifically agreed to by the department in this contract. 5. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the provider, the provider's officers, employees, agents, subcontractors, or assignees shall be the sole responsibility of the provider. CF Standard Contract 051,2010 3 Contract # K, G065 O. Sponsorship As required by section 286.25, F.S., if the provider 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 (provider's name) and the State of Florida, Department of Children and Families". If the sponsorship reference is in written material, the words "State of Florida, Department of Children and Families" shall appear in at least the same size letters or type as the name of the organization. P. Publicity Without limitation, the provider and its employees, agents, and representatives will not, without prior departmental written consent in each instanceuse in advertising, publicity or any other promotional endeavor any State mark, the name of the State's mark, the name of the State or any State affiliate or any office , r or employee of the State, or represent, directly or indirectly, that any product or service provided by the provider has been approved or endorsed by the State, or refer to the existence of this contract in press releases, advertising or materials distributed to the provider's prospective customers. Q. Final Invoice The final invoice for payment shall be submitted to the department no more than 45 days after the contract ends or is terminated. if the provider fails to do so, all rights to payment are forfeited and the department will not honor any requests submitted after the aforesaid time period. Any payment due under the terms ofthis contract may be withheld until all reports due from the provider and necessary adjustments thereto, have been approved by the department. R. Use of Funds for Lobbying Prohibited The provider shall comply with the provisions of sections 11.062 and 216.347, F.S., which prohibit the expenditure of contract funds for the purpose of lobbying the Legislature, judicial branch, or a state agency. S. Public Entity Crime Pursuant to section 287.133, F.S., the following restrictions are placed on the ability of persons convicted of public entity crimes to transact business with the department. When a person or affiliate has been placed on the convicted vendor list following a conviction for a public entity crime, heJshe 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 the 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 he 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 section 287.017, F.S., for CATEGORY TWO for a period ofthitty-six (36) months from the date of being placed on the convicted vendor list. T. Gratuities The provider agrees that it will not offer to give or give any gift to any department employee. As part of the consideration for this contract, the parties intend that this provision will survive the contract for a period of two years. In addition to any other remedies available to the department, any violation of this provision will result in referral of the provider's name and description of the violation of this term to the Department of Management Services for the potential inclusion of the provider's name on the suspended vendors list for an appropriate period. The provider will ensure that its subcontractors, if any, comply with these provisions. U. Patents, Copyrights, and Royalties It is agreed that all intellectual property, inventions, written or electronically created materials, including manuals, presentations, films, or other copyrightable materials, arising in relation to provider's performance under this contract, and the performance of all of its officers, agents and subcontractors in relation to this contract, are works for hire for the benefit of the department, fully compensated for by the contract amount, and that neither the provider nor any of its officers, agents nor subcontractors may claim any interest in any intellectual property rights accruing under or in connection with the performance of this contract. it is specifically agreed that the department shall have exclusive rights to all data processing software falling within the terms of section 119.084, F.S., which arises or is developed in the course of or as a result of work or services performed under this contract, or in anyway connected herewith. Notwithstanding the foregoing provision, if the provider is a university and a member of the State University System of Florida, then section 1004.23, F.S., shall apply. 2. If the provider uses or delivers to the department for its use or the use of its employees, agents or contractors, any design, device, or materials covered by letters, patent, or copyright, it is mutually agreed and understood without exception that the compensation paid pursuant to this contract includes all royalties or costs arising from the use of such design, device, or materials in any way involved in the work contemplated by this contract. 3. All applicable subcontracts shall include a provision that the Federal awarding agency reserves all patent rights with respect to any discovery or invention that arises or is developed in the course of or under the subcontract. V. Construction or Renovation of Facilities Using State Funds Any state funds provided for the purchase of or improvements to real property are contingent upon the provider granting to the state a security interest in the property at least to the amount of the state funds provided for at least five (5) years from the date of purchase or the completion of the improvements or as further required bylaw. Asa condition of receipt of state funding for this purpose, the provider agrees that, if it disposes of the property before the department's interest is vacated, the provider will refund the proportionate share of the state's initial investment, as adjusted by depreciation. W. Information Security Obligations 1. An appropriately skilled individual shall be identified by the provider to function as its Data Security Officer. The Data Security Officer shall act as the liaison to the department's security staffand will maintain an appropriate level ofdata security for the information the provider is collecting or using in the performance of this contract. An appropriate level of security includes approving and tracking all provider employees that request or have access to any departmental data system or information. The Data Security Officer will ensure that user access to the data system or information has been removed from all terminated provider employees. 2. The provider shall provide the latest departmental security awareness training to its staff and subcontractors who have access to departmental information. CF Standard Contract 05t2010 4 Contract 9 KGO65 3. All provider employees who have access to departmental information shall comply with, and be provided a copy of CFOP 50-2, and shall sign the DCF Security Agreement form CF 01 14 annually. A copy ofCF 01 14 may be obtained from the contract manager. 4. The provider shall make every effort to protect and avoid unauthorized release of any personal or confidential information by ensuring both data and storage devices are encrypted as prescribed in CFOP 50-2, If encryption of these devices is not possible, then the provider shall assure that unencrypted personal and confidential departmental data will not be stored on unenerypted storage devices. The provider shall require the same of all subcontractors. 5. The provider agrees to notify the contract manager as soon as possible, but no later than five (5) business days following the determination ofany breach or potential breach of personal and confidential departmental data. The provider shall require the same notification requirements of all subcontractors. 6. The provider shall provide notice to affected parties no later than 45 days following the determination of any potential breach of personal or confidential departmental data provided in section 817,5681, F.S. The provider shall require the same notification requirements of ail subcontractors. X. Accreditation The department is committed to ensuring provision of the highest quality services to the persons we serve. Accordingly, the department has expectations that where accreditation is generally accepted nationwide as a clear indicator of quality service, the majority of the department's providers will either be accredited, have a plan to meet national accreditation standards, or will initiate a plan within a reasonable period of time. Y. Provider Employment Opportunities 1. Agency for Workforce Innovation and Workforce Florida: The provider understands that the department, the Agency for Workforce Innovation, and Workforce Florida, Inc., have jointly implemented an initiative to empower recipients in the Temporary Assistance to Needy Families Program to enter and remain in gainful employment. The department encourages provider participation with the Agency for Workforce Innovation and Workforce Florida. 2. Transitioning Young Adults: The provider understands the department's Operation Full Employment initiative to assist young adults aging out of the dependency system- The department encourages provider participation with the local Community -Based Care Lead Agency independent Living Program to offer gainful employment to youth in foster care and young adults transitioning from the foster care system. L Health Insurance Portability and Accountability Act The provider shall, where applicable, comply with the Health Insurance Portability and Accountability Act (42 U. S. C. 1320d.) as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164). AA. Emergency Preparedness 1. If the tasks to be performed pursuant to this contract include the physical care or supervision of clients, the provider shall, within 30 days of the execution of this contract, submit to the contract manager an emergency preparedness plan which shall include provisions for records protection, alternative accommodations for clients in substitute care, supplies, and a recovery plan that will allow the provider to continue functioning in compliance with the executed contract in the event of an actual emergency. For the purpose of disaster planning, the term supervision includes the responsibility of the department, or its contracted agents to ensure the safety, permanency and well-being of a child who is under the jurisdiction of a dependency court. Children may remain in their homes, be placed in a non -licensed relative/non-relative home, or be placed in a licensed foster care setting. 2. The department agrees to respond in writing within 30 days of receipt of the plan accepting, rejecting, or requesting modifications. In the event of an emergency, the department may exercise oversight authority over such provider in order to assure implementation of agreed emergency relief provisions. 3. An updated emergency preparedness plan shall be submitted by the provider no later than 12 months following the acceptance of an original plan or acceptance of an updated plan. The department agrees to respond in writing within 30 days of receipt of the updated plan, accepting, rejecting, or requesting modification to the plan. BB. PUR (Purchasing) 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 (including the department's Standard 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. CC. Notification of Legal Action The provider shall notify the department of legal actions taken against them or potential actions such as lawsuits, related to services provided through this contract or that may impact the provider's ability to deliver the contractual services, or adversely impact the department. The department's contract manager will be notified within 10 days of provider becoming aware of such actions or from the day of the legal filing, whichever comes first. DD. Whistleblower's Act Requirements In accordance with subsection 1 12.3187(2), F.S., the provider and its subcontractors shall not retaliate against an employee for reporting violations of law, rule, or regulation that creates substantial and specific danger to the public's health, safety, or welfare to an appropriate agency. Furthermore, agencies or independent contractors shall not retaliate against any person who discloses information to an appropriate agency alleging improper use of governmental office, gross waste of funds, or any other abuse or gross neglect cf duty on the part of an agency, public officer, or employee. The provider and any subcontractor shall inform its employees that they and other persons may file a complaint with the Office of Chief Inspector General, Agency inspector General, the Florida Commission on Human Relations or the Whistle -blower's Hotline number at 1-800-543-5353. CF Standard Contract 05,,2010 5 Contract # KG065 EE. Proprietary or Trade Secret information 1. Unless exempted bylaw, all public records are subject to public inspection and copying under Florida's Public Records Law, Chapter 119, F.S. Any claim by provider of proprietary or trade secret confidentiality for any information contained in provider's documents (reports, deliverables or workpapers, etc., in paper or electronic form) submitted in connection with this contract will be waived, unless the claimed confidential information is submitted in accordance with paragraph 2 below. 2. The provider must clearly label any portion of the documents, data or records submitted that it considers exempt from public inspection or disclosure pursuant to Florida's Public Records Law as proprietary or trade secret. The labeling will include a justification citing specific statutes and facts that authorize exemption of the information from public disclosure. If different exemptions are claimed to be applicable to different portions of the protected information, the provider shall include information correlating the nature of the claims to the particular protected information. 3. The department, when required to comply with a public records request including documents submitted by the provider, may require the provider to expeditiously submit redacted copies of documents marked as confidential or trade secret in accordance with paragraph 2 above. Accompanying the submission shall (ie an updated version of the justification under paragraph 2, correlated specifically to redacted information. The redacted copy must exclude or obliterate only those exact portions that are claimed to be proprietary or trade secret. If the provider fails to promptly submit a redacted copy and updated justification in accordance with this paragraph, the department is authorized to produce the records sought without any redaction of proprietary or trade secret information. 4. The department is not obligated to agree with the provider's claim of exemption on the basis of proprietary or trade secret confidentiality and the provider shall be responsible for defending its claim that each and every portion of the redactions of proprietary or trade secret information are exempt from inspection and copying under Florida's Public Records Law. FF. Support to the Deaf or Hard -of -Hearing The provider and its subcontractors, where direct services are provided, shall comply with section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794, as implemented by 45 C.F.R. Part 84 (hereinafter referred to as Section 504), the Americans with Disabilities Act of 1990, 42 U.S.C. 12131, as implemented by 28 C.F.R. Part 35 (hereinafter referred to as ADA), and the Children and Families Operating instruction (CFOP) 60-10, Chapter 4, entitled "Auxiliary Aids and Services For The Deaf and Hard -of -Hearing." 1. If the provider or any of its subcontractors employs 15 or more employees, the provider shall designate a Single -Point -of -Contact (one per firm) to ensure effective communication with deaf or hand -of -hearing customers or companions in accordance with Section 504, the ADA, and CFOP 60-10, Chapter 4. The name and contact information for the provider's Single -Point -of -Contact shall be firmished to the department's Grant or Contract Manager within 14 calendar days of the effective date of this requirement. 2. The provider shall, within 30 days of the effective date of this requirement, contractually require that its subcontractors comply with section 504, the ADA, and CFOP 60-10, Chapter 4. A Single -Point -of -Contact shall be required for each subcontractor that employs 15 or more employees. This Single - Point -of -Contact will ensure effective communication with deaf or hard -of -hearing customers or companions in accordance with Section 504 and the ADA and coordinate activities and reports with the provider's Single -Point -of -Contact. 3. The Single -Point -of -Contact shall ensure that employees are aware of the requirements, roles & responsibilities, and contact points associated with compliance with Section 504, the ADA, and CFOP 60-10, Chapter 4. Further, employees of providers and its subcontractors with 15 or more employees shall attest in writing that they are familiar with the requirements of Section 504, the ADA, and CFOP 60-10, Chapter 4. This attestation shall be maintained in the employee's personnel file. 4. The provider's Single -Point -of -Contact will ensure that conspicuous Notices which provide information about the availability ofappropriate auxiliary aids and services at no -cast to the deaf or hard -of -hearing customers or companions are posted near where people enter or are admitted within the agent locations. Such Notices must be posted immediately by providers and subcontractors. The approved Notice can be downloaded through the Internet at: http:,I/www.defstate,fl,us/admin/ig/eivibights.shtmi 5. The provider and its subcontractors shall document the customer's or companion's preferred method of communication and any requested auxiliary aids/services provided in the customer's record. Documentation, with supporting justification, must also be made if any request was not honored. The provider shalt submit compliance reports monthly, not later than the 15th day of each month, to the department's Grant or Contract Manager. The provider shall distribute Customer Feedback forms to customers or companions, and provide assistance in completing the forms as requested by the customer or companion. 6. if eustomers or companions are referred to other agencies, the provider must ensure that the receiving agency is notified of the customer's or companion's preferred method of communication and any auxiliary aids, service needs. iI. THE DEPARTMENT AGREES: A. Contract Amount The department shall pay for contracted services according to the terms and conditions of this contract of an amount not to exceed S8I,733.00 or the rate schedule, subject to the availability of funds. The State of Florida's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. R. Contract Payment Pursuant to section 215.422, F.S., the department has five (5) working days to inspect and approve goods and services, unless the bid specifications, purchase order, or this contract specify otherwise. With the exception of payments to healthcare providers for hospital, medical, or other health care services. if payment is not available within forty (40) days, measured from the latter of the date a properly completed invoice is received by the department or the goods or services are received, inspected, and approved, a separate interest penalty set by the Chief Financial Officer pursuant to section 55.03, F.S., will he due and payable in addition to the invoice amount. Payments to health care providers for hospital, medical, or other health care services, shall be made not snore than thirty-five (35) days from the date eligibility for payment is determined. Financial penalties will be calculated at the daily interest rate of-03333%, Invoices returned to a provider doe to preparation errors will result in a non -interest bearing payment delay. Inter-est penalties less than one I I I dollar will not be paid unless the provider requests payment_ CF Standard Contract 05/2010 6 Contract r# KG065 C. Vendor Ombudsman A Vendor Ombudsman has been established within the Department of Financial Services. The duties of this office are found in section 215.422, F.S., which include disseminating information relative to prompt payment and assisting vendors in receiving their payments in a timely manner from a state agency. The Vendor Ombudsman may be contacted at (850) 413-5516. D. Notice Any notice that is required under this contract shall be in writing, and sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery. Said notice shall be sent to the representative of the provider responsible for administration of the program, to the designated address contained in this contract. III. THE PROVIDER AND DEPARTMENT MUTUALLY AGREE: A. Effective and Ending Dates This contract shall begin on July 1, 2010, 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 Monroe County, Florida, on June 30, 201 I. B. Financial Penalties for Failures to Comply with Requirement for Corrective Actions 1. In accordance with the provisions of section 402.73(1), F.S., and Rule 65-29.001, F.A.C., corrective action plans maybe required for noncompliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. 2. The increments of penalty imposition that shalt apply, unless the department determines that extenuating circumstances exist, shall be based upon the severity of the noncompliance, nonperformance, or unacceptable performance that generated the need for corrective action plan. The penalty, if imposed, shall not exceed ten percent (10%) of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. Noncompliance that is determined to have a direct effect on client health and safety shall result in the imposition of a ten percent (10%) penalty of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. 3. Noncompliance involving the provision of service not having a direct effect on client health and safety shall result in the imposition of a five percent (5%) penalty. Noncompliance as a result of unacceptable performance of administrative tasks shall result in the imposition of a two percent (2%) penalty. 4. The deadline for payment shall be as stated in the Osier imposing the financial penalties. in the event of nonpayment the department may deduct the amount of the penalty from invoices submitted by the provider. C. Termination 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 provider responsible for administration of the program. 2. In the event fiords for payment pursuant to this contract become unavailable, the department may terminate this contract upon no less than twenty-four (24) hours notice in writing to the provider. Said notice shall be sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery. The department shall be the final authority as to the availability and adequacy of funds. In the event of termination of this contract, the provider will be compensated for any work satisfactorily completed. 3. This contract may he terminated for the provider's non-performance upon no less than twenty-four (24) hours notice in writing to the provider. If applicable, the department may employ the default provisions in Rule 60A-1.006(3), F.A.C. The department's failure to demand performance of any provision of this contract shall not be deemed a waiver of such performance. The department's waiver of anyone breach of any provision of this contract shall not be deemed to he a waiver of any other breach and neither event shall be construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the department's right to remedies at law or in equity. 4. Failure to have performed any contractual obligations with the department in a manner satisfactory to the department will be a sufficient cause for termination. To be terminated as a provider under this provision, the provider must have: (1) previously failed to satisfactorily perform in a contract with the department, been notified by the department of the unsatisfactory perfbrmance, and failed to correct the unsatisfactory performance to the satisfaction of the department; or (2) had a contract terminated by the department for cause. D. Renegotiations or Modifications 'Modifications ofpmvisions o£this contract shall be valid only when they have been reduced to writing and duly signed by both parties. The rate o€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 department's operating budget. CF Standard Contract 05/2010 7 Contract # KGO65 E. Official Payee and Representatives (Names, Addraxses, Telephone Numbers, and "mil addresses): 1. The provider name, as Mown on page i of this contract, and mailing 3. The name, address, telephone number and e-mail address of the conmsct manager address of the official payee to whom the payment sisals be made is: for the department for this contract is: :'dame: Monroe County Name: Theresa Phelan Address: 1 l00 Simonton Street Address: 1111 I2 Street City: Key West State:F ZipCode:33040 City: Key West State: FL Zip Cade: 33040 Phone 305-292-4510 Phone: 305-242-6810 ext: ext: e-mail: trixie Phelan{ardcfsrate.fl.us 2. The name of the contact person and street address where financial and 4. The names address, telephone number and c-mail of the representative of the administrative records are maintained is: 'Fame: provider responsible for administration of the program under this contract is: Sheryl Graham Name: Sheryi Graham Address: 1100 Simonton Streit Address: 1100 Simonton Street City: Key West State:FL Zip Code:33040 City: Key West State:FL Zip Code:33040 Phone: 305-292-4510 Phone: 305-2924510 ext: cxt: e-mail: graham -shay] atmonroecounty-fl.gov c-mail:grAhava-sheryL@montoecounty-fl.gov county-fl.gov 5. Upon change of representatives (names, addresses, telephone numbers and e-mail addresses) by either party, notice shall be provided in writing to the other party and the notification attached to the originals of this contract. F. All Terms and Conditions Included This contract and its attachments, I. U and ahibits A B G D & E 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 verbal or written between the parties. If any term or provision of this contract is legally determined unlawful or unenforceable, the remainder of the contract shall remain in full im= and affect and such term or provision shall be stricken. By signing this contract, the parties agree that they have read and agree to the entire contract, as described in Paragraph III. F. above. IN WITNESS THEREOF, the parties hereto have caused this 40 page contract to be executed by their tmdersigned officials as duly authorized. PROVIDER: MONROE COUNTY FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES Signature: Print, Type Nance: Sylvia J. Murphy Title: _ Monroe County May Date: Signature: Print/Type Name: Gilds P. Ferradaz Title: Circuit Administrator Date: STATE AGENCY 29 DIGIT FLAIR CODE: _ Federal Tax ID 4 (or SSN): 59-ti0074 Provider Fiscal Year Ending Date: 220. TO FORM FFICtENCY ro C vVV 4L COUNSEL DATE CF Standard Contract 05,'2010 8 Conract # KGO 07101/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program ATTACHMENT I A. Services to be Provided. 1. Definition of Terms a. Contract Terms Contract terms used in this document can be found in the Florida Department of Children and Families Operating Procedure (CFOP) 75-2, Glossary of Terms, which is incorporated herein by reference and can be obtained from the contract manager. b. Program or Service Specific Terms (1) Activities of Daily Living. Basic activities performed in the course of daily living, such as dressing, bathing, grooming, eating, using a commode or urinal, and ambulating around one's own home. (2) Client. Any person ages 18 through 59 having one (1) or more permanent physical or mental limitations that restrict the person's ability to perform normal activities of daily living, and impede the person's capacity to live independently or with relatives or friends without the provision of community -based services. (3) Medicaid Institutional Care Program (MICP). A program designs to provide primary, acute, and long-term care services at capltated federally matched rates to Medicaid recipients who are determined eligible for a nursing home level of care. (4) Nursing home. Any facility that provides nursing services as defined in Chapter 464, Florida Statutes, and which is licensed in accordance with Chapter 400, Florida Statutes. (5) Outcomes — Quantitative indicators that can be used by the department to objectively measure a provider's performance toward a stated goal. (6) Outputs — Process measures of the quantity of services delivered, clients served, or similar units completed. (7) Performance Measures - Quantitative indicators, outcomes and outputs, that can be used by the department to objectively measure a provider's performance. (8) Service Providers. Private, far -profit, nonprofit or local government agencies designated to provide coordination of care for eligible clients. PSNTAI # GA07 Monroe County 9 KG065 07/01/2008 Community Care for Disabled Adultsllaixed Price Adult Services Program Service Providers can be case management providers, direct service providers, or both. 2. General Description a. General Statement. The Community Care for Disabled Adults (CCDA) Program is designed to assist disabled adults, age eighteen (18) through fifty- nine (59), in utilizing available community and personal resources enabling them to remain in their own homes, and preventing their premature or inappropriate institutionalization. b. Authority. Sections 410.601-410.606, Florida Statutes, Chapter65C-2, Florida Administrative Code, and the annual appropriations act, with any proviso language or instructions to the department, constitute the legal basis for services to be delivered through the CCDA program. C. Scope of Service. Services will be targeted toward eligible adults in Monroe County. d. Major Program Goal. Under this contract, the CCDA program provides link to community -based services that are designed to prevent inappropriate institutionalization of disabled adults. 3. Clients to be Served. a. General Description Adults with disabilities, age eighteen (18) through fifty-nine (59), who are no longer eligible to receive children's services, and are too young to qualify for community and home -based services for the elderly, may be served under the provisions of this contract. b. Client Eligibility (1) Applicants must have one or more permanent physical or mental limitations, that restrict the ability to perform normal activities of daily living, as determined through the initial functional assessment and medical documentation of disability. Determination of a permanent disability must be established and evidenced in one of the following manners: (a) An applicant may present a check, award letter, or other proof showing receipt of Social Security Disability Income, or some other disability payment (e.g., Worker's Compensation); or (b) An applicant may present a written statement from a licensed physician, licensed nurse practitioner, or mental health professional, PSMAt #GA07 Monroe County t0 KG065 07101/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program which meets the Region's criteria for evidence of a disability. This written statement must, at a minimum, include the applicant's diagnosis, prognosis, a broad explanation of level of functioning, and the interpretation of need for services based on identified functional barriers caused by the applicant's disabling condition. (2) Applicants must have an individual income at or below the prevailing MICP eligibility standard in order to receive free CCDA services. (3) Applicants with incomes above the standard will be assessed a fee for a share of the costs, or may be required to provide volunteer services in lieu of payment. C. Client Determination (1) Clients will be assessed for eligibility determination, and prioritized for services by department case management staff, in accordance with subsection 410.604 (2), Florida Statutes. (2) The department will make the final determination of client eligibility. d. Contract Limits (1) The total annual cost estimated or actual, for an individual receiving CCDA services, shall not exceed the average, annual general revenue portion of a Medicaid nursing home bed within the Regional area. (2) Clients must not be receiving comparable services from any other entity. In order to prevent duplication of services, client files must contain documentation verifying that all comparable community services and funding sources have been explored and exhausted. (3) To the extent that funds are available, the provider will receive referrals for clients on whom the Human Service counselors have completed an Adult Services Screening for Consideration for Community Based Programs, Exhibit A. PSMAF # GA07 Monroe County it KC065 07/01/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program B. Manner of Service Provision 1. Service Tasks a. Task List (1) Service providers will ensure that appropriate community -based services are provided to clients in a manner designed to meet the client's changing needs, to assist the client in avoiding or reducing unnecessary dependence on the delivered service(s), and to increase the client's self-reliance. (2) The following tasks shall be performed under this contract: F]Adult Day Care X Case ❑Emergency Alert Management Response X Personal Care X Homemaker ❑Interpreter ❑Chore ❑Escort ❑Home Health Aide ❑Home Nursing ❑Transportation ❑Respite ❑Adult Day Health Care ❑Group Activity Therapy X Home Delivered Meals ❑Medical Therapeutic Services ❑Physical and Exams (3) Details of services to be provided under this contract and the negotiated parameters of those services include: Case Management to be performed by provider staff; Personal Care and Homemaker services to be performed by subcontracted vendor. Home Delivered Meals to be purchased through subcontract and then delivered by provider staff. (4) Each Regional CODA program must include case management services and at least one other community service. b. Task Limits The following task limits apply only to the services specified above. (1) Respite Care services may be provided for up to two hundred forty (240) hours per client per calendar year, depending upon individual need. The service may be extended to three hundred sixty (360) hours, as recommended by the case manager and approved by an immediate supervisor. Documentation of approval must be evident in the case narrative section of the case manager's file. PSMAI # GA07 Monroe County 12 KG065 07/0112008 Community Care for Disabled Adults/Fixed Price Adult Services Program (2) Personal Care services will not substitute for the care usually provided by a registered nurse, licensed practical nurse, therapist, or home health aide. The personal care aide will not change sterile dressings, irrigate body cavities, administer medications, or perform other activities prohibited by Chapter 59A-8, Florida Administrative Code. (3) Homemaker service time does not include time spent in transit to and from the client's place of residence except when providing shopping assistance, performing errands or other tasks on behalf of a client. (4) Several restrictions apply to persons providing Homemaker service activities. Persons providing services must not: (a) engage in work that is not specified in the referral from the case manager; (b) accept gifts from clients; (c) lend or borrow money or articles from clients; (d) handle client money, unless authorized in writing by a supervisor or case manager (documented in the personnel file) and unless bonded or insured by the employer; (e) transport clients, unless authorized in writing by a supervisor or case manager. (5) The parameters of service delivery, by type of service, are detailed in CFOP 140-8, Community Care for Disabled Adults Operating Procedures. (6) Region task limits, which exceed those in CFOP 140-8, Community Care for Disabled Adults Operating Procedures, and are distinctive to this contract, are listed here: None. 2. Staffing Requirements a. Staffing Levels (1) The provider will meet the minima staffing requirements for each service, as specified in CFOP 140-8, Community Care for Disabled Adults Operating Procedures. (2) The provider will notify the department, in writing, within thirty calendar (30) days whenever the provider is unable, or expects to be unable to PSMAI # GA07 Monroe County 13 KG065 07/01/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program provide the required quality or quantity of service due to staff turnovers or shortages. b. Professional Qualifications The provider will ensure that staff meets the professional qualifications for each service, as specified in CFOP 140-8, Community Care for Disabled Adults Operating Procedures. C. Staffing Changes The provider agrees to notify the department's contract manager within two (2) working days if a key administrative position (e.g., executive director) becomes vacant. Planned staffing changes that may affect service delivery, as stipulated in this contract, must be presented in writing to the contract manager for approval at least ten (10) working days prior to the implementation of the change. d. Subcontractors This contract allows the provider to subcontract for the provision of the following services under this contract: Personal Care, Homemaker and Home Delivered Meals. The provider may not subcontract services not listed. All subcontracting is subject to the provisions of Section I.I. of the Standard Contract. 3. Service Location and Equipment a. Service Delivery Location and Times (1) Services for this contract will be delivered at the following locations and times: SERVICE LOCATION TIMES Case Management Client's Home As needed Personal Care Client's Home As Needed Homemaker Client's Home As Needed Home Delivered deals Client's Home As Needed (2) CCDA services may be delivered in the client's home or on -site at a facility, as negotiated by the department and the provider. (3) Facilities delivering on -site services to clients shall pass an annual inspection by the local environmental health and fire authorities. PSMA[ # GA07 Monroe County 14 K6065 07,01/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program (4) Service providers will meet the minimum service location and time requirements as specified in CFOP 140-8, Community Care for Disabled Adults Operating Procedures. b. Changes in Location The provider must notify the department of changes in the location of service delivery. Once the service delivery location is agreed upon, any proposed change must be presented in writing to the contract manager for approval, ten (10) working days prior to implementation of that proposed change. In the event of an emergency, temporary changes in location may necessitate waiver of this designated standard by the Region's program office. Such a waiver will take into consideration the continuity, safety, and welfare of the department's clients, and is at the department's sole discretion. C. Equipment (1) if equipment is applicable to a specific provider's contract, the provider must submit an equipment listing (Exhibit N/A) to the department which lists the equipment. The equipment required to perform the contracted services must be negotiated by the department and the provider. To ensure uniformity, safety, and quality of service to clients, any requests for equipment change must be presented in writing to the contract manager for approval at least ten (10) days prior to any proposed change. (2) The provider must inventory all equipment acquired under this contract annually. The inventory list must be made available within seven (7) days upon receipt of written request by the contract manager. The provider must list the items of equipment on the equipment listing (Exhibit N/A), as applicable to the provider's contract for specific services. 4. Deliverables a. Service Units A service unit is an appropriate, distinct amount of given service, which may include, but is not limited to, an hour of direct service delivery; a meal, an episode of travel; or a twenty-four (24) hour period of Emergency Alert Response maintenance, as defined in CFOP 140-8, Community Care for Disabled Adults Operating Procedures. All service units, as well as their description and costs, are listed in CFOP 140-8, Community Care for Disabled Adults Operating Procedures. PSM At # GA07 Monroe County 15 KG065 07/01/2008 Community Care for disabled Adults/Fixed Price Adult Services Program b. Records and Documentation (1) Client Records (all clients) Providers shall maintain information on each client served by this contract, which includes the following: (a) documentation of the client by name or unique identifier; (b) current documentation of eligibility for services; (c) dates of service provision and delivery; (d) information documenting the client's need to receive services; (e) the number of service units provided; and (f) all other forms or records necessary for program operation and reporting, as set forth by the department. (2) Case Management Client records, Case management agency individual client files shall contain the following: (a) a completed client assessment (no more than one (1) year old); (b) a care plan (no more than one (1) year old); (c) a release of information form; (d) a copy of a completed Adult Services Information System (ASIS) form; (e) documentation of the client's age, disability, and income; (f) a completed and scored copy of the Adult Services Screening for Consideration for Community Based Services; and (g) a case narrative. (3) Providers must ensure that all client records accurately match the invoices submitted for payment. Records must cross reference to each invoice for payment. (4) Providers must maintain documentation necessary to facilitate monitoring and evaluation by the department. PSMA1 # GA07 Monroe County 16 KG065 07/01/2008 Community Care for Disabled Adults[Fixed Price Adult Services Program (5) The case management provider must maintain documentation in the client's file that all comparable community services and funding sources have been explored and exhausted before using CODA funding. C. Reports Report Title Reporting Report Date Number DCF Office addresses Frequency Due of copies to receive report due Monthly Monthly The 15'h of two Contract Cumulative month Manager Summary immediately & Report following the Program report period Office Reporting requirements for this contract include: (1) Exhibit B, Monthly Cumulative Summary Report. Regions will negotiate with the provider on specific submission requirement criteria for these reports. (2) In the event of early termination of this contract, the provider will submit the final Monthly Cumulative Summary Report within forty-five (45) days after the contract is terminated. (3) Acceptance of Reports. Where the contract requires the delivery of reports to the department, mere receipt by the department shall not be construed to mean or imply acceptance of those reports. It is specifically intended by the parties that acceptance in writing of required reports shall constitute a separate act. The department reserves the right to reject reports as incomplete, inadequate, or unacceptable according to the parameters set forth in the contract. The department, at its option, may allow additional time within which the provider may remedy the objections noted by the department or the opportunity to complete, make adequate, or acceptable, or declare the resulting contract to be in default. 5. Performance Specifications a. Performance Measures (1) Ninety eight percent (98%) of adults with disabilities receiving services will not be placed in a nursing home. PShlA1 # GA07 Nlonroe County 17 KG065 07/01/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program (2) 25: # of qualified disabled adults (ages 18-59) provided case management. (3) 3: # of qualified disabled adults (ages 18-59) in the CCDA and Aged and Disabled Adults (ADA) Medicaid Waiver Programs. b. Description of Performance Measurement Terms Placed:. The result of an assessment of an individual who is no longer able to remain in his present place of residence. (To place a client involves preparation for and follow up of moving a client into a more restrictive alternative living environment). C. Performance Evaluation Methodology Measuring Outcomes. The department will measure the outcomes found in paragraph B.S.a. above as follows: (1) The outcome measurement contained in paragraph B.S.a. (1) above will be calculated by dividing the total, fiscal year-to-date number of clients in the Community Care for Disabled Adults, Home Care for Disabled Adults, Cystic Fibrosis, and Medicaid waiver programs not transferred to a nursing home, by the total, fiscal year-to-date number of clients in the Community Care for Disabled Adults, Home Care for Disabled Adults, Cystic Fibrosis, and Medicaid wavier programs. (2) The outcome measurement contained in paragraph B.S.a. (2) above will be calculated by the total number of clients actively receiving case management from the Community Care for Disabled Adults, Home Care for Disabled Adults, Cystic Fibrosis, and Medicaid waiver programs. (3) The outcome measurement contained in paragraph B.S.a (3) above will be calculated by the total number of clients actively receiving daily living services from the Community Care for Disabled Adults and the Medicaid waiver programs. d. By execution of this contract the provider hereby acknowledges and agrees that its performance under the contract must meet the standards set forth above and will be bound by the conditions set forth in this contract. If the provider fails to meet these standards, the department, at its exclusive option, may allow up to six months for the provider to achieve compliance with the standards. If the department affords the provider an opportunity to achieve compliance and the provider fails to achieve compliance within the specified time frame, the department must cancel the contract in the absence of any extenuating or mitigating circumstances. The determination of the extenuating or mitigating circumstances is the exclusive determination of the department. PSMA1 # GA07 1lonrae Count y18 KG065 07/01/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program 6. Provider Responsibilities a. All Providers Unique Activities Health Insurance Portability and Accountability Act. If required by 45 CFR Parts 160, 162, and 164, the following provisions shall apply [45 CFR 164.504(e)(2)(ii)]: (1) The provider hereby agrees not to use or disclose protected health information (PHI) except as permitted or required by this contract, state or federal law. (2) The provider agrees to use appropriate safeguards to prevent use or disclosure of PHI other than as provided for by this contract or applicable law. (3) The provider agrees to report to the department any use or disclosure of the information not provided for by this contract or applicable law. (4) The provider hereby assures the department that if any PHI received from the department, or received by the provider on the department's behalf, is furnished to provider's subcontractors or agents in the performance of tasks required by this contract, that those subcontractors or agents must first have agreed to the same restrictions and conditions that apply to the provider with respect to such information. (5) The provider agrees to make PHI available in accordance with 45 C.F.R. 164.524. (6) The provider agrees to make PHI available for amendment and to incorporate any amendments to PHI in accordance with 45 C.F.R. 164.526. (7) The provider agrees to make available the information required to provide an accounting of disclosures in accordance with 45 C.F.R. 164.528. (8) The provider agrees to make its internal practices, books and records relating to the use and disclosure of PHI received from the department or created or received by the provider on behalf of the department available for purposes of determining the provider's compliance with these assurances. (9) The provider agrees that at the termination of this contract, if feasible and where not inconsistent with other provisions of this contract concerning record retention, it will return or destroy all PHI received from the PSMAI # GA07 Monroe County 19 KC065 07/01/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program department or received by the provider on behalf of the department, that the provider still maintains regardless of form. If not feasible, the protections of this contract are hereby extended to that PHI which may then be used only for such purposes as make the return or destruction infeasible. (10)A violation or breach of any of these assurances shall constitute a material breach of this contract. b. Direct Service Provider Unique Activities (1) The provider will be required to use volunteers to the fullest extent feasible in the provision of services and program operations. The provider is required to train, supervise, and appropriately support all volunteers with insurance coverage. (2) The provider will maintain an accurate and current active caseload list. (3) The provider will maintain a current monthly billing ledger of all provider claims submitted to the case management agency or Adult Services local office, including all corrected claims and adjustments to claims for services that were delivered to consumers being served through this contract. (4) The provider will notify the case management agency or Adult Services local office of all service terminations, service increase requests and monthly expenditure trends with regards to the terms of this contract. (5) The provider will explain to each individual requesting consideration for CCDA services that the program maintains a centralized Waiting List on which the individual will be placed according to his or her score received through an Adult Services Screening conducted by an Adult Services counselor. (6) The provider shall provide to individuals requesting services a contact name and phone number to the nearest Adult Services Region Office. C. Case Management Provider Unique Activities (1) The case management provider will accept all referrals through the Adult Services Regional Program Office. (2) The case management provider will complete ongoing face-to-face assessments on all pre-screened individuals referred by the Adult Services Regional Program Office for service consideration and program application, using the Adult Services Client Assessment, CF-AA 3019. PSMA1 # CA07 Monroe County 20 KG065 07/01/2008 Community Care for Disabled AdultsiFixed Price Adult Services Program (3) The case management provider will maintain an accurate and current active caseload list. (4) The CCDA case management provider will maintain a current monthly billing ledger of all provider claims submitted to the agency or the local Adult Services office, including all corrected claims and adjustments to claims for services that were delivered to consumers being served through this contract. (5) The CCDA case management agency will notify the local Adult Services office of all service terminations, service increase requests, Exhibit C, and monthly expenditure trends with regards to the terms of this contract. (6) The case management provider will explain to each individual requesting consideration for CCDA services that the program maintains a centralized Waiting List on which the individual will be placed according to his or her score received through an Adult Services Screening. (7) The case management provider shall provide to individuals requesting services a contact name and phone number to the nearest Adult Services Region Office. d. Coordination with Other Providers/Entities The case management provider must coordinate, as necessary, with the Agency for Persons with Disabilities, the Department of Children and Families, the Department of Education, the Department of Health, and the Florida Statewide Advocacy Council, to serve those clients who are eligible for services through two (2) or more service delivery continuums. 7. Departmental Responsibilities a. Department Obligations (1) The department will supply all new providers with a copy of the Community Care for Disabled Adults Operating Procedures, CFOP 140-8. (2) The department will provide CCDA technical assistance to the provider, relative to the negotiated terms of this contract and instructions for submission of required data. PSMAI # GA07 Monroe Countv 21 KG065 07/01/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program b. Department Determinations Should a dispute arise, the department will make the final determination as to whether the contract terms are being fulfilled according to the contract specifications. c. Monitoring Requirements The provider will be monitored in accordance with existing departmental procedures (CFOP 75-8). C. Method of Payment 1. Payment Clause a. This is a fixed price (unit cost) contract. The department shall pay the provider for the delivery of service units provided in accordance with the terms of this contract, subject to the availability of funds. b. The department shall make payments to the provider for the provision of services up to the maximum number of units of service at the rates shown below. c. The department agrees to pay for the service units at the unit price(s) and limits listed below. FY 2010-2011 Service Service Unit Unit Price Case Management Hour 549.89 Personal Care Hour $25.28 Homemakin Hour $21.79 Home Delivered Meals Meal $ 6.30 d. The provider's dollar match for this contract is as follows: For Fiscal Year 2010-2011: S9,08 1.00 e. Cash or in kind resources may be used to meet this match requirement. PS MA I A GA07 Monroe County 22 KG065 07f0112008 2. Invoice Requirements Community Care for Disabled Adults/Fixed Price Adult Services Program The provider shall request payment through submission of a properly completed :Monthly Request for Payment and Expenditure Report, Exhibit D, within 15 days following the end of the month for which payment is being requested. The provider shall submit to the contract manager an original Monthly Request for Payment and Expenditure Report, Exhibit D, and no copies, along with supporting documentation. Payment due under this contract will be withheld until the department has confirmed delivery of negotiated services. Payments may be authorized only for service units on the invoice which are in accordance with the above list and other terms and conditions of this contract. The service units for which payment is requested may not either by themselves, or cumulatively by totaling service units on previous invoices, exceed the total number of units authorized by this contract. 3. Supporting Documentation a. It is expressly understood by the provider that any payment due the provider under the terms of this contract may be withheld pending the receipt and approval by the department of all financial and program reports due from the provider as a part of this contract and any adjustments thereto. Requests for payment, which cannot be documented with supporting evidence, will be returned to the provider upon inspection by the department. b. The provider must maintain records documenting the total number of recipients and names (or unique identifiers) of recipients to whom services were provided and the dates the services were provided so that an audit trail documenting service provision can be maintained. D. Special Provisions 1. Fees a. The case management provider will collect fees for services provided according to Rule 65C-2.007, Florida Administrative Code. b. No fees shall be assessed other than those established by the department. Fees collected in compliance with the department directives will be reinvested in a manner prescribed by the department. 2. Florida Statewide advocacy Council The provider agrees to allow properly identified members of the Florida Statewide Advocacy Council access to the facility or agency and the right to communicate with PSMAI # GA07 Mourne County 23 KG065 07101t2008 Community Care for Disabled Adults/Fixed Price Adult Services Program any client being served, as well as staff or volunteers who serve them in accordance with subsections 402.165(8) (a) & (b), Florida Statutes. Members of the Florida Statewide Advocacy Council shall be free to examine all records pertaining to any case unless legal prohibition exists to prevent disclosure of those records. 3. Transportation Disadvantaged The provider agrees to comply with the provisions of Chapter 427, Florida Statutes, Part I, Transportation Services, and Chapter 41-2, F.A.C., Commission for the Transportation Disadvantaged, if public funds provided under this contract will be used to transport clients. 4. MyFloridaMarketPlace Transaction Fee This contract is exempt from the MyFloridaMarketPlace Transaction Fee in accordance with Chapter 60A-1.032(I) (e), Florida Administrative Code. 5. Incident Reporting The provider is required to document all reportable incidents, as defined in CFOP 215-6, Incident Reporting and Client Risk Prevention, which is incorporated herein by reference. For each critical incident occurring during the administration of its program, the provider must, within 24 hours of the incident, complete and submit an Incident Report (Exhibit E) to the contract manager for this contract. A copy of the incident report must also be placed in a central file marked "Confidential Incident Report". Dissemination of the report within the department will be the responsibility of the Department's contract manager. Incidents that threaten the health, safety or welfare of any person or that place any person in imminent danger must be reported immediately to the department contract manager by telephonic contact. The information contained in the incident report is confidential. The dissemination, distribution or copying of the report is strictly prohibited, unless authorized by the department. 6. Mandatory Reporting Requirements The provider and any subcontractor must comply with and inform its employees of the following mandatory reporting requirements. Each employee of the provider, and of any subcontractor, providing services in connection with this contract who has any knowledge of a reportable incident shall report such incident as follows: 1) reportable incidents that may involve an immediate or impending impact on the health or safety of a client shall be immediately reported to the contract manager; and 2) other reportable incidents shall be reported to the department's Office of Inspector General by completing a Notification/Investigation Request (form CF 1934) and emailing the PSMAI 4 CA07 Vlonroe County 24 KC065 07/01/2008 Community Care for Disabled Adults/Fixed Price Adult Services Program request to the Office of Inspector General at i gcompl ai nts(ddcf. state. fl. us. The provider and subcontractor may also mail the completed form to the Office of Inspector General, 1317 Winewood Boulevard, Building 5, 2'd Floor, Tallahassee, Florida, 32' )99-0700; or via fax at (850) 488-1428. A reportable incident is defined in CFOP 180-4, which can be obtained from the contract manager 7. Contract Term The department and the provider agree that this contract shall be for a one year term, at the provider's request. E. List of Exhibits I. Exhibit A, AS Screening for Consideration for Community -Based Programs 2. Exhibit B, CCDA Monthly Cumulative Summary Report 3. Exhibit C, Request for Approval of CCDA Care Plan Services Increase 4. Exhibit D, Monthly Request for Payment and Expenditure Report 5. Exhibit E, Incident Report PSNlAl 4 CA07 Monroe County 25 KC065 Exhibit A AS Screening for Consideration for Community -Based Programs PART I 1, Name: A. Date of Referral (Initial Contact): 2. Address: District/Region: 3. Phone: 4. Race: Gender: Age/DOB: 5. Marital Status: 6. Social Security Number: B. 17 Walk In 7 Phone 1-7 Other: C. Referral Source (include phone number): D. Relationship to Individual Being Referred: E. Is Individual Aware of Referral? ❑ Yes Fl No 7. Primary Language: 9. Medicare 0 Number: 8. Medicaid F Number: 10. Other Insurance: 11. Financial: (for Placement 12. Other Essential Person(s): physician, family member(s), POA, guardian, caregiver & Supportive Services only) (include address and phone number) $ (SSDI) $_(SSI) $ (Workers Comp) $ (Other) Emergency Contact (and phone): $ (Other) 13. Directions to Home (as needed): 14. Problem/Diagnosis: 15. How Long a Problem? 17. Services Requested: 18. Other Agencies Contacted for Help: 16. Urgency of Need: 19, AS Counselor's Signature: Date: 20. Disposition: [] Protective Intervention Placement 7, Protective Intervention Supportive Services F_7 Short -Term Case Mgmt. 17 Information & Referral L_! CCDA Application ❑ADA Medicaid Waiver Application 1'1'HCDA Application FICCDA Waiting List - Score - EfADA Medicaid Waiver Waiting List - Score _ E, HCDA Waiting List - Score 21. Due Process Pamphlet (CF/PI 140-43) Given/Mailed by: Date: 22. Given to Supervisor for Review by: Date: 23. Reviewed/Approved by: Date: 24. PART I sent to: Date: By: 25. Referred to AS Counselor/Case Manager: OF -AA 1022, POP 10i2005 Page 1 of 4 Y j Y FUNCTIONAL ASSESSMENT (ADLs AND IADLs) 26, Check sources of information used for FUNCTIONAL ASSESSMENT Section. I? Individual Requesting Services ❑ Other (specify): 27. Has individual requesting services had any ongoing problems with memory or confusion than seriously Interfere with daily living activities? Describe: Indicate name and phone number of physician/other who is treating individual for memory/confusion problem(s): (Address all questions to the individual requesting services if possible. The purpose of these questions Is to determine actual ability to do various activities. Sometimes, caregivers help the Individual with an item regardless of the person's ability. Ask enough questions to make sure the individual requesting services is telling you what he/she can or cannot do.) Response Definitions: No help: Individual can perform activity without assistance from another person. Some help: Needs physical help, reminders or supervision during part of the activity. Can't do it at all: Individual cannot complete activity without total physical assistance from another person. Total Score: Add numbers from "Some help" and "Can't do it at all" columns to points given in question #33, and put sum in Total Score boxes. ACTIVITIES OF DAILY LIVING (ADLs) (Read all choices before taking answer) Would you say that you need help from another person? (Does not include assistance from devices) 0 = No help 2 = Some help 3 = Can't do it at all Comments/Care Plan Implications: Include servirce I" 28. Dressing (includes getting out clothes and putting s r i su es a ument etc. them on and fastening them, and putting on shoes) 0 29. Bathing (includes running the water, taking the bath or shower and washing all parts of the body including 0 hair 30. Eating (includes eating, drinking from a cup and cutting foods) 0 31. Transferring (includes getting in and out of a bed or chair) 0 32. Tolleting (independently includes adjusting clothing, getting to and on the toilet, and cleaning one's self. If accidents occur and person manages alone, count it as independent. If reminders are needed to clean up, change diapers, or use the toilet this counts as some j help)I 33. BladdedBowel Control - Mow well can you control your bladder or bowel? — Never have accident (0) — Occasionally have accidents (2) Enter Score ( — Often have accidents (3) j — Always have accidents (4) ADL Total Score (Total possible score = 19) f Pege 2 of 4 INSTRUMENTAL ACTIVITES OF DAILY LIVING (IADLs) (Read all choices before taking answer) Would you say that you need help from another person? (Does not include assistance from devices) 0 = No help 1 = Some help 2 = Can't do it at all Comments/Care Plan Implications: (Include services. suDDlies. eouioment, etc.) 34. Transportation Ability (includes using local transportation, paratransit, or driving to places beyond 0 walking distance) 35. Prepare Meals (includes preparing meals for yourself including sandwiches, cooked meals and TV dinners) 0 36. Housekeeping (dusting, vacuuming, sweeping, laundry) 0 IADL Total Score (Total possible score = 6) SUPPORT AND SOCIAL RESOURCES OF INDIVIDUAL REQUESTING SERVICES (No Score for Questions 37-46) 37. Check source(s) of information used for this section. ❑ individual Requesting Services ❑ Other (specify): SERVICESMELP Yes No NOTES Do you receive ... 38. Personal Care Assistance (bathing, dressing, getting out of bed, toileting and eating) 39. Housekeeping (laundry, cleaning, meals, etc) 40. Transportation 41. ShoppinglErrands 42. Personal Finances (money management) 43. Services from a health professional such as an RN or Therapist? 44. Adult Day Care 45, Home delivered meals (Formal only) 46. Any other kind of help {Specify) Page 3 cf 4 28 PART III - SCORING MATRIX For items 1,2,3,4,5 and 6 in the scoring matrix below, enter the value (in parenthesis) following the question response which corresponds to the response obtained during the interview or through reviews. Example: If the answer was "yes" to the question "Is individual homebound?", a score of 1 point is placed on the line next to the answer line marked "Yes." For item 7, enter the score for ADLs and IADLs from the screening form. For item 8, subtract 40 points if the individual interested in HCDA or CCDA services appears eligible or is receiving comparable services from other programs. See the Adult Services Waiting List Policy for Community -Based Programs for a definition/description of "comparable services." Comments From Individual Requesting Services That May Result in Re -Adjustment of Score: Total Score: Add and subtract (as appropriate) the individual scores for each item to determine the total score and place the score in the box marked Total Score. Domain/Question Score 1. Is individual requesting services a victim and at high risk of abuse, neglect, or exploitation based on Protective investigator's report? 2. Is individual requesting services a victim and at intermediate risk of abuse, neglect, or exploitation based on Protective Investigator's Report? 3. Does individual live alone or is individual solely responsible for minor children (under the age of 12) in the home? 4. Is individual homebound? (See AS Screening for Consideration for Community -Based Programs INSTRUCTIONS for definition of homebound.) 5. Does individual have ongoing memory/confusion problems? 6. Is individual receiving SSI or SSD because of primary diagnosis of sensory impairment? 7. Functional Assessment: ADLs........................................... (ADLs......................................... 8. Support for Individual Requesting Services: Does individual currently receive help/services (formairnformal) in ADL or IADL deficit areas noted? For HCDA and CCDA Programs Only: Individual appears eligible or is receiving comparable services from other departmental programs, APD, or vocational rehabil- itation. (Does not include AS programs — see waiting list policy for definition of "comparable services.") Specify program(s) to which individual is being referred for eligibility determination and steps taken to refer individual to other program(s). Yes (4 pt.) Yes (2 pt.) Yes (1 pt.) Yes (1 pt) Yes (2 pt.) Yes (3 pt.) 0 (enter ADL total score) 0 (enter IADL total score) No help (4 pt.) Help is available but overall inadequate or changing, fragile or problematic (2 pt) Help is adequate overall in deficit areas (0 pt.) Minus 40 pt TOTAL SCORE CCDA ADA MW HCDA (Total Possible Score = -40 to +40) 0 Page 4 of 4 91 n- A 0 40 0) (A M R;u M mo "U El M < m 00-n --4 0 m 0 z 0 M 0 Z m cu m G) ;o 0 M'"r' T -4 0 -r M i: m© z 0 1 z -r 00 z a) 0 > CD m 0 0 30 cr 0 CD A CL, m () 0 0 m z G) 11 0 ;u CO m M m C/) a m m ;o m 0 --q 0 n 0 0 z 0 M m 11 0 ;u 0 C0 W r- m c Cl) 0 0 z C/) c m x C/) 0 0 0 z 4 X 0 m CA M X m "V 0 M q >"u 0 m z;o 0 m Z -0 C<0 > 50 -Ti 0 M 0> Z, z o m - 0 G) Z 0 z rT7 x 401 Exhibit C �"" Request for Approval of CCDA Care Plan Services Increase Lti Part I: Recipient Information Flame: Last name, first name, middle name or initial Date of birth: Social security number: MedicaidiMedicare Medical assistance number: Current Address: Address where services will be received: County: County: Status (Transfer/Existing): Describe reason for service funding increase. If individual is a transfer, indicate originating district/agency. An Adult Services client reassessment was completed on by and If individual is an existing consumer with your agency, respective revised care plan revisions made on indicate current monthly authorized units of service by by , to service type(s): reflect that this Recipient is justifiably in need of increased Service(s) based on (check all situations which apply): ❑ Failing Support System ❑ Decrease in Functional Capacity ❑ Rapidly Deteriorating Health Medicaid waiver eligibility date: Provider Information Agency name: Agency contact person: Agency address: Phone: Fax: E-mail address: Part Ii: Summary of Recipient's Presenting Situation. (Refer to form instructions for details about the type of information required here. Use the space below or include attachment.) Part III: Proposed New Service Request. (Please indicate the new care plan services being reouested and the corresoondino !o service start Service 31 KG065 Part IV: Specific Description of Proposed Now Service(s) As Tailored To Meet Recipient's Need. (Refer to the form instructions for details about the type of information required here. Use the space below or include attachment.) Part V: Cost Detail for Proposed New Care Plan Service(s). A. Attach a Cost Detail page for each service requested in Part 111. Each Cost Detail page should reflect the total annual cost of serving the consumer for that service type. Part VI: Care Plan Modification of Number of Service Units. The Budget Entity Team will not consider authorization to increase service unit quantity of an authorized service on a Recipient's care plan for any of the following documented reasons unless this section is accurately and fully completed. [To justify unit service rates, please present comparative information: unit rate quotes from a minimum of three other service agencies providing this same service within a ten mile radius; reasons for choosing this specific vendor, a statement attesting to the fact that selected vendor is a sole source provider of this service in this geographic area, etc. Attach information as necessary (e.g., agency administrative costs, your agency salary scale, etc.). Refer to the form instructions.] ❑ Failing support System: List proposed add -on number of monthly service units by service component with annualized service costs projected to safely maintain Recipient at home and to ameliorate this risk factor. ❑ Decrease in Functional Capacity: List proposed add -on number of monthly service units by service component with annualized service costs projected to safely maintain Recipient at home and to ameliorate this risk factor. ❑ Rapidly Deteriorating Health: List care plan add -on number of monthly service units by service component with annualized service costs projected to safely maintain Recipient at home and to ameliorate this risk factor. Part Vill. Signatures. (Please note: Final approval of all requests for Care Plan increases rest with the Budget Entity Team. Providers will raraiva an Awowt I attar frnm tht- RudriAt Fntitv Team for one of its members) when the Dian has been approved.) Provider Agency: (Signature indicates that the information presented in this Request for Care Plan Services Date: Increase and attachments are accurate and complete.) Recipient/Representative: (Signature indicates that the Recipient/Representative has reviewed the Request for Date: Care Plan Services Increase and attachments.) District/Regional Program Staff: (Signature indicates that the district/regionai program staff and provider have Date: agreed upon the services to be funded.) District/Regional Adult Services Program Director: (Signature indicates district/regional approval of the Service bate: Funding Plan.) 32 KG065 EXHIBIT D DEPARTMENT OF CHILDREN AND FAMILIES ADULT SERVICES OFFICE MONTHLY REQUEST FOR PAYMENT AND EXPENDITURE REPORT PROVIDER FED. ID # NAME AND MAILING ADDRESS OF PAYEE: CONTRACT AMNT.: REIMBURSEMENT YTD.: CONTRACT BALANCE: DATE: CONTRACT#: PERIOD OF SERVICE PROVISION: ��r►mc yr or-mvii c UN11 b/ AMOUNT PER UNIT/ TOTAL AMOUNT OR DESCRIPTION OF MATERIALS I QUANTITY EPISODE DUE TOTAL TOTAL MATCH REQUIRED PAYMENT FOR CONTRACT: REQUESTED THIS MNTH, YTD. LOCAL CASH MATCH t Florida Department of Children & Families LOCAL IN -KIND TOTAL DEDUCTIONS REMAINING MATCH BALANCE low SIGNITURE OF PREPARER DATE COMPLETED APPROVED BY TITLE *IF THIS INVOICE IS FOR A FIXED PRICE CONTRACT, THE REQUEST FOR PAYMENT WILL BE DETERMINED BY DIVIDING THE LENGTH OF THE CONTRACT INTO THE CONTRACTED AMOUNT (EX. S12,D0gALLOCAT1ONj DIVIDED SY 12 MONTHS f7HE LENGTH OF THE CONTRACT1,41.000 PAYMENT REQUEST) ON A COST REIMBURSEMENT CONTRACT THE PAYMENT REQUEST Wq_L BE THE MONTHLY REQUEST EXPENSE. DATE INV. RCD, APPROVED BY: ORG EO OBJ CHILDREN AND FAMILIES USE ONLY DATE DESC. AMNT OCA 33 KG065 Exhibit E Children & Families Circuit 11 & 16 INCIDENT REPORT CONFIDENTIAL WARNING: The information contained in this report is confidential. You are hereby notified that dissemination, distribution, or copying of this document is strictly prohibited, unless authorized by the Department of Children & Families. 1. IDENTIFYING INFORMATION Reporting Party Phone #: Date of Incident /_/ Time of Incident Reporting Party Name Specific Program: check all that apply ❑AMH ❑AS ❑ASA ❑CMH ❑CSA ❑DA ❑DC ❑DD ❑ ESS ❑ FS Please respond to one of the following as appropriate. a. Contract Provider Name b. Foster Home Name c. DS Home Name d. DCF Facility Name e. Other Name Did the incident occur in a licensed facility? ❑ Yes ❑ No ❑ Don't know. Specific location/address where incident occurred: 11. TYPE OF INCIDENT Check one box only. 1. Altercation: ❑Client/client ❑Client/staff ❑ Staff/staff 2. ❑ Client Death 3. ❑ Client Injury or Illness 4. ❑ Elopement/Runaway 5. ❑ Escape 6. ❑ Sexual Battery 7. ❑ Suicide Attempt 8. ❑ Other Incidents BMh Dab Rau Gender Client Employee Other —/_._f_ ____ — ❑ ❑ D 1 ❑ ❑ ❑ 34 KG065 Give Detailed Account - (Who, What, When, Where, Why, How) - Add Pages ACTIONV. CORRECTIVE • Immediate corrective action taken Is follow-up action needed? NO❑ YES❑ If yes, specify: 35 INDIVIDUALSit r EXTERNAL NOTIFICATION Agency Notified Person Contacted Status Datemme Called Copy Abuse Registry 1-800-962-2873 Name Report Accepted Yes ❑ No❑ ❑ ❑ ID# Agency for Health Care Administration Name: N/A Law Enforcement -Department Officer's Name Badge # Case # (if avail) N/A ❑ ❑ Parent/Guardiard Family Member Name Name: N/A El EJ Other (Please specify) Name: N/A ❑ ❑ Other (Please Specify) Name: N/A ❑ ❑ DCF (for providers only) 1 Name: N/A V11. REVIEW AND SIGNATURES NAME SIGNATURE TITLE PHONE # DATE REPORTING EMPLOYEE — — — SUPERVISOR DC1F INTERNAL NOTIFICATION ---- Individual/ enc Notified batsrnme Catt�d Copy Individual/ enc Notiified Dateffirrie Caned Copy Client Relations Employee Safety Program Regional Deputy Director ❑ ❑ H.R. Workers' Compensation ❑ ❑ Coordinator (amWdyea related incidents only) Program Supervisor Missing Children's Unit EJ El ❑ ❑ ❑ ❑ District Legal Counsel Contract Manager Others (Please specify) ❑ Public Information Officer 36 INCIDENT DEFINITIONS The definitions apply to DCF direct or contractual services/employees Altercation. A physical confrontation occurring between a client and employee or two more clients at the time services are being rendered, or when a client is in the physical custody of the department, which results in one or more clients or employees receiving medical treatment by a licensed health care professional. 2. Client Injury/Illness. A medical condition of a client requiring medical treatment by a licensed health care professional sustained or allegedly sustained due to an accident, act of abuse, neglect or other incident occurring while in the presence of an employee, in a Department of Children and Families or contracted facility or service center or who is in the physical custody of the department. 3. Client Death. Any person whose life terminates due to or alleged due to an accident, act of abuse, neglect or other incident occurring while in the presence of an employee, in a Department of Children and Families operated or contracted facility or service center, while in the physical custody of the department; or when a death review is required pursuant to CFOP 175-17,Child Death Review Procedures. 4. Escape. - The unauthorized absence as defined by statute, departmental operating procedure or manual of a client committed to, or securely detained in a Department of Children and Families mental health or developmental services forensic facility covered by Chapters 393, 394 or 916, FS. 5. Sexual Battery. An allegation of sexual battery by a client on a client, employee on a client, or client on an employee as evidenced by medical evidence or law enforcement involvement. 6. Suicide Attempt. An act which clearly reflects the physical attempt by a client to cause his or her own death while in the physical custody of the department or a departmental contracted or certified provider, which results in bodily injury requiring medical treatment by a licensed health care professional. 7. Other Incidents. An unusual occurrence or circumstance initiated by something other than natural causes or out of the ordinary such as a tornado, kidnapping, riot or hostage situation, which jeopardizes the health, safety and welfare of clients who are in the physical custody of the department. 37 ATTACHMENT II The administration of resources awarded by the Department of Children & Families to the provider may be subject to audits as described in this attachment. In addition to reviews of audits conducted in accordance with OMB Circular A-133 and Section 215.97, F.S., as revised, the department may monitor or conduct oversight reviews to evaluate compliance with contract, management and programmatic requirements. Such monitoring or other oversight procedures may include, but not be limited to, on -site visits by department staff, limited scope audits as defined by OMB Circular A-133, as revised, or other procedures. By entering into this agreement, the recipient agrees to comply and cooperate with any monitoring procedures deemed appropriate by the department. In the event the department determines that a limited scope audit of the recipient is appropriate, the recipient agrees to comply with any additional instructions provided by the department regarding such audit. The recipient further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the department's inspector general, the state's Chief Financial Officer or the Auditor General. AUDITS PART I: FEDERAL REQUIREMENTS This part is applicable if the recipient is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. In the event the recipient expends $500,000 or more in Federal awards during its fiscal year, the recipient must have a single or program -specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised. In determining the Federal awards expended during its fiscal year, the recipient shall consider all sources of Federal awards, including Federal resources received from the Department of Children & Families. The determination of amounts of Federal awards expended should be in accordance with guidelines established by OMB Circular A-133, as revised. An audit of the recipient 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 above audit requirements, the recipient shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised. The schedule of expenditures should disclose the expenditures by contract number for each contract with the department in effect during the audit period. The financial statements should disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and liabilities due the department shall be fully disclosed in the audit report package with reference to the specific contract number. Single Audit Information for Recipients of Recovery Act Funds: (a) To maximize the transparency and accountability of funds authorized under the American Recovery and Reinvestment Act of 2009 (Pub. L. 111-5) (Recovery Act) as required by Congress and in accordance with 2 CFR 215.21 `'Uniform Administrative Requirements for Grants and Agreements" and OMB Circular A- 102 Common Rules provisions, recipients agree to maintain records that identify adequately the source and application of Recovery Act funds. OMB Circular A-102 is available at http:!/www.whitehouse,govtomb/circulars/aIO2 at02,html. 38 KG065 (b) For recipients covered by the Single Audit Act Amendments of 1996 and OMB Circular A-133, "Audits of States, Local Governments, and Non -Profit Organizations," recipients agree to separately identify the expenditures for Federal awards under the Recovery Act on the Schedule of Expenditures of Federal Awards (SEFA) and the Data Collection Form (SF —SAC) required by OMB Circular A-133. OMB Circular A-133 is available at http:/iwww.whitehouse.gov/omb/cirqulars/aI33/aI33.html. This shall be accomplished by identifying expenditures for Federal awards madcunder the Recovery Act separately on the SEFA, and as separate rows under Item 9 of Part III on the SF —SAC by CFDA number, and inclusion of the prefix "ARRA-" in identifying the name of the Federal program on the SEFA and as the first characters in Item 9d of Part III on the SF —SAC. (c) Recipients agree to separately identify to each subrecipient, and document at the time ofsubaward and at the time of disbursement of funds, the Federal award number, CFDA number, and amount of Recovery Act funds. When a recipient awards Recovery Act funds for an existing program, the information furnished to subrecipients shall distinguish the subawards of incremental Recovery Act funds from regular subawards under the existing program. (d) Recipients agree to require their subrecipients to include on their SEFA information to specifically identify Recovery Act funding similar to the requirements for the recipient SEFA described above. This information is needed to allow the recipient to properly monitor subrecipient expenditure of ARRA funds as well as oversight by the Federal awarding agencies, Offices of inspector General and the Government Accountability Office. PART II: STATE REQUIREMENTS This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2), Florida Statutes. In the event the recipient expends $500,000 or more in state financial assistance during its fiscal year, the recipient must have a State single or project -specific audit conducted in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. In determining the state financial assistance expended during its fiscal year, the recipient shall consider all sources of state financial assistance, including state financial assistance received from the Department of Children & Families, 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 the preceding paragraph, the recipient 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 Chapters 10.550 or 10.650, Rules of the Auditor General. The schedule of expenditures should disclose the expenditures by contract number for each contract with the department in effect during the audit period. The financial statements should disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and liabilities due the department shall be fully disclosed in the audit report package with reference to the specific contract number. 39 KG065 PART III: REPORT SUBMISSION Any reports, management letters, or other information required to be submitted to the department pursuant to this agreement shall be submitted within 180 days after the end of the provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first, directl to each of the following unless otherwise required by Florida Statutes: A. Contract manager for this contract (2 copies) B. Department of Children & Families( 1 electronic copy and management letter, if issued) Office of the Inspector General Single Audit Unit Building 5, Room 237 1317 Winewood Boulevard Tallahassee, FL 32399-0700 Email address: side audit ,dcfstate.fl.us C. 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 recipient directly to the Federal Audit Clearinghouse using the Federal Audit Clearinghouse's Internet Data Entry System at: hgp://harvester.census.gov/fac/coIlect/ddeindex.htmI and other Federal agencies and pass -through entities in accordance with Sections .320(e) and (f), OMB Circular A-133, as revised. D. Copies of reporting packages required by Part II of this agreement shall be submitted by or on behalf of the recipient directly to the following address: Auditor General Local Government Audits/342 Claude Pepper Building, Room 401 111 West Madison Street Tallahassee, Florida 32399-1450 Email address: flaudgen—localgovt@aud.state.fl.us Providers, when submitting audit report packages to the department for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit or for -profit organizations), Rules of the Auditor General, should include, when available, correspondence from the auditor indicating the date the audit report package was delivered to them. When such correspondence is not available, the date that the audit report package was delivered by the auditor to the provider must be indicated in correspondence submitted to the department in accordance with Chapter 10.558(3) or Chapter 10.657(2), Rules of the Auditor General. The recipient shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued and shall allow the department or its designee, Chief Financial Officer or Auditor General access to such records upon request. The recipient shall ensure that audit working papers are made available to the department or its designee, Chief Financial Officer or Auditor General upon request for a period of three years from the date the audit report is issued, unless extended in writing by the department. 40 KG065 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15 2010 Bulk Item: Yes X No Division: Employee Services Department: Human Resources Staff Contact Person/Phone #Tanya Martinez X4459 AGENDA ITEM WORDING: Approval to advertise for Request for Proposals for Employment Physical Services. ITEM BACKGROUND: The County currently has a contracted physician in the lower and middle keys that perform employment physical services for county employees at the post -offer stage and during employment. PREVIOUS RELEVANT BOCC ACTION: The current contract was previously bid in 1994. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval Approx TOTAL COST: $800 INDIRECT COST: N/A — ____ _________BUDGETED: Yes X No _ DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: N/A SOURCE OF FUNDS: REVENUE PRODUCING: Yes No X —\ MOUNT PER MONTH Year APPROVED BY: County Atty (l�'� ur asin g Risk Management �.. DOCUMENTATION: Included Not Required DISPOSITION: AGENDA ITEM # Revised 7/09 MONROE COUNTY REQUEST FOR PROPOSALS FOR EMPLOYMENT PHYSICAL SERVICES BOARD OF COUNTY COMMISSIONERS Mayor, Heather Carruthers, District 1 Mayor Pro Tem, David Rice, District 4 George Neugent, District 2 Kim Wigington, District 3 Sylvia J. Murphy, District 5 CLERK OF THE CIRCUIT COURT EMPLOYEE SERVICES DIVISION Danny L. Kolhage Teresa E. Aguiar, Director DATE I of 42 NOTICE OF REQUEST FOR PROPOSALS Request for Proposals Employment Physical Services RFP-PER----PUR/CV The Board of County Commissioners of Monroe County, Florida, (hereinafter the County) hereby requests sealed proposals from applicants who wish to provide Employment Physical Services. Interested firms or individuals are requested to indicate their interest by submitting three (3) signed originals and three (3) complete copies (total = six (6)) of the proposal, in a sealed envelope clearly marked on the outside, with the Proposer's name and "EMPLOYMENT PHYSICALSERVICES", addressed to Monroe County Purchasing Department, 1100 Simonton Street, Room 1-213, Key West, FL 33040, which must be received on or before 3:00 P.M. local time on . Hand delivered Proposals may request a receipt. No proposals will be accepted after 3:00 P.M. Faxed or e-mailed proposals shall be automatically rejected. It is the sole responsibility of each Proposer to ensure its proposal is received in a timely fashion. Requirements for submission and the selection criteria may be requested from DemandStar by Onvia by calling 1-800-711-1712 or by going to the website www.demandstar.com or http://www.demandstar.com/supplier/bids/agency inc/bid list asp?f=search&mi 116478 The Public Record is available at the Purchasing Office, 1100 Simonton Street, Key West, Florida. All submissions must remain valid for a period of ninety (90) days from the date of the deadline for submission stated above. The Board will automatically reject the response of any person or affiliate who appears on the convicted vendor list prepared by the Department of Management Services, State of Florida, under Sec. 287.133(3) (d), Florida Statutes (1997). Monroe County declares that all or portions of the documents and work papers and other forms of deliverables pursuant to this request shall be subject to reuse by the County. Questions are to be directed, in writing, to: Ms. Tanya Martinez, Administrator, Human Resources, Employee Services Monroe County, 1100 Simonton Street, Suite 2-268, Key West, Florida 33040, or Facsimile (305) 292-4452. The Board reserves the right to reject any or all proposals, to waive informalities in the proposals and to re -advertise for proposals. The Board also reserves the right to separately accept or reject any item or items of a proposal, or portion of the work, and to award and/or negotiate a contract in the best interest of the County. It is possible that one or more Proposers will be chosen. 2 of 42 Interested firms or individuals will be evaluated and selected by a committee. The selection and recommendation will be presented to the Board of County Commissioners for final decision. If no contract can be negotiated with the first ranked Proposer, the Board reserves the right to negotiate with the next selected Proposer. Dated at Key West, this day of Monroe County Purchasing Department TENTATIVE SUBMISSION. RFVIFW ANvn rnn1TPA1-r AIA/ADr, 0t-�rmj - DATE ...v 'rr��w uVnCVIJLC ESCRIPTION for Request for Pro osals r Information Cut -Off Date SAddendum to RFP Issued with Requested n Proposal Submission Deadline, Proposal Date --Opening Review/Rankin Pro osals 3 of 42 TABLE OF CONTENTS NOTICE OF REQUEST FOR PROPOSALS SECTION ONE - Instruction to Proposers SECTION TWO - Draft Agreement EXHIBIT 1 - Scope of Services SECTION THREE - County Forms and Insurance Forms EXHIBIT 2 - Questionnaire ATTACHMENTS: A. Example employee Job Description B. Post -offer and Fit for Duty Physical Forms (4 pages) C. DOT Physical (9 pages) D. Respirator Physical "Part 1" (4 pages) Respirator Physical "Part 11" (6 pages) Respirator Policy "III" (12 pages) Respirator Fit Test Procedures "IV" E. NFPA Guidelines 2000 Edition — Firefighter Physical (33 pages) F. Firefighter Physical Forms (16 pages) SECTION ONE: INSTRUCTION TO PROPOSERS 1. OBJECTIVE OF THE REQUEST FOR PROPOSAL The Proposer awarded a contract shall provide Employment Physical Services and other related services as set out in the Scope of Services — Exhibit 1. The initial contract term will be for one (1) year beginning , or as soon thereafter as is possible and renewable at the County's option for two (2) additional consecutive year terms. 2. BACKGROUND INFORMATION Monroe County ("County") is a non -chartered county established under the Constitution and the laws of the State of Florida. The Clerk of the Circuit Court serves as the fiscal agent. The population of the County is estimated at approximately 75,000. The Board of County Commissioners, constituted as the governing body, has all the powers of a body corporate, including the powers to contract; to sue and be sued; to acquire, purchase, hold, lease and convey real estate and personal property; to borrow money and to generally exercise the powers of a public authority organized and existing for the purpose of providing community services to citizens within its territorial boundaries. In order to carry out this function, the County is empowered to levy taxes to pay the cost of operations. The Present Plans The County currently employs approximately 500 employees. All new hires receive a physical examination. Last year approximately: 88 received Urine Drug Screens; 10 received Alcohol Breathalyzer screens; 4 received PPD-TB inoculations; 4 received DOT physicals; 74 received 4 of 42 Post -offer employment physicals; 25 received Firefighter Physicals; 4 received Fitness for Duty Physicals; 23 received Stress Tests; 15 received Respirator Physicals. All other services being requested in this RFP were not performed by a contracted physician last year; however, they may need to be provided in the future. Random unannounced drug and alcohol screens are handled on a walk-in basis with the current contracted physicians. 3. SCOPE OF THE WORK TO BE PROVIDED BY PROPOSER The contractor is responsible for obtaining proper releases from the employee or prospective employee in order to discuss the results with Monroe County BOCC. The contractor will outline locations of exam and locations of all testing facilities. The County intends to contract with a minimum of one physician in the Lower, Middle and Upper Keys. All urine screens will conform to the standard chain of custody protocols mandated by state and federal regulations. The contractor will have an employee designated as coordinator or facilitator to assist in the communications with the Monroe County BOCC's primary contact personnel. Appointments for physicals will be available throughout the business hours of the facility. A testing facility must be available 24 hours a day, 7 days a week for post accident, random and reasonable suspicion alcohol and drug screening. Appointments will be seen by the contractor in a reasonable and timely fashion. The Medical Review Officer will be available for contact by the Monroe County BOCC or its employees to answer questions about the effect of prescribed drugs. The scope of work is included in Exhibit 1 of this document. 4. QUALIFICATIONS NECESSARY OF PROVIDER The firm must certify at least annually that all staff members, independent contractors, subcontracted work, if any, all service providers it uses, engages or manages, comply with Health Insurance Portability and Accountability Act (HIPAA) privacy and security rules. Physical examinations will be conducted by, or under the direct supervision, of a physician or medical doctor currently licensed and practicing general medicine in the State of Florida. The examining physician may employ assistants properly licensed and trained, as necessary, to perform laboratory tests and/or assist in all phases of the examination. X-rays will be interpreted by Board Certified Radiologist, EKG by Board Certified Cardiologist, and lab results by Board Certified Pathologist. Physicians should be Board Certified in Occupational Medicine. If the examinations are performed by a hospital, medical center, consortium or similar organization, a lead physician will be designated and assigned as the single point of contact for all medical matters relating to Monroe County BOCC personnel. The name of the physician along with appropriate procedures and policies for establishing and 5 of 42 maintaining effective communications with the Monroe County BOCC will be included in the RFP response. 5. PAYMENT TERMS • The contractor shall submit to the County an invoice with supporting documentation acceptable to the Clerk on a schedule as set forth in the contract. Acceptability to the Clerk is based on generally accepted accounting principles and such laws, rules and regulations as may govern the Clerk's disbursal of funds. • The contractor will submit such invoice monthly for services provided during the preceding month. • Upon receipt of the contractor's invoice in the proper form as stipulated above and upon acceptance by the Clerk, Monroe County will make payment in accordance with the Florida Local Prompt Payment Act, Section 218.70, and Florida Statutes. 6. EVALUATION CRITERIA Award shall be made to the responsible proposer whose proposal is determined to be the most advantageous to the County, taking into consideration the evaluation criteria set forth below: Ex erience and Qualifications 30 points Locations and Hours of O eration 30 points Abilit to provide all required services 30 points Cost of Services 5 points Location of firm (local preference if applicable: up to 5 additionalpoints) 5 points Total points earned are on a scale of 1 — 100 noints 1 = lowest 100 = highest 7. TERMINATION/NON-RENEWAL NOTICE Thirty (30) days written notice is required by the service provider for termination or non -renewal of the contract. 8. REQUEST FOR ADDITIONAL INFORMATION Request for additional information relating to the specifications of this Request for Proposals shall be submitted in writing directly to: Tanya Martinez, Human Resources Administrator Monroe County 1100 Simonton Street, Suite 2-268 Key West, FL 33040 Facsimile (305) 292-4564 All requests will be answered in the form of an addendum to the RFP, which will be issued - shortly thereafter and distributed to all interested Proposers. Oral requests will not be answered. 6 of 42 9. CONTENT OF SUBMISSION The proposal submitted in response to this Request for Proposals (RFP) shall be printed on 8- 1/2" x 11" white paper and bound; shall be clear and concise, tabulated, and provide the information requested herein. Statements submitted without the required information will not be considered. Responses shall be organized as indicated below. The Proposer should not withhold any information from the written response in anticipation of presenting the information orally or in a demonstration, since oral presentations or demonstrations may not be solicited. Each Proposer must submit adequate documentation to certify the Proposer's compliance with the County's requirements. Proposer should focus specifically on the information requested. Format. The response, at a minimum, shall include the following: A. Cove_ r Pag, e A cover page that states "EMPLOYMENT PHYSICAL SERVICES". The cover page should contain Proposer's name, address, telephone number, and the name of the Proposer's contact person. B. Tabbed Sections Tab 1. General Information (a) Introduction (b) Qualifications: This section should contain qualifications of personnel. Please submit resumes of key personnel who will be assigned to this contract. (c) A list of subcontractors, if any, that Proposer may hire along with a list and description of services the subcontractors will provide. (d) Other information: This section should address any other information necessary for a full understanding of your services. (e) Customer references (no more than three Florida government clients along with their telephone numbers, addresses, date of services and names of the persons who can be contacted to provide a reference. (Florida government clients will be preferred, and current clients will be preferred over former.) Tab 2. Relevant Experience The Proposer shall provide a list of similar contracts or agreements currently in force to include: Name and full address Telephone number of client contact Date of initiation and completion of contract Summary of the services and geographical area served Tab 3. Services, Approach and Availability of Service to County (a) The Proposer shall describe how he/she will accomplish the services defined herein. This shall include information on schedule and availability, staffing, whether sub- contractors are used, and any other relevant information explaining how the services will be accomplished. (b) The Proposer should identify any major issues of concern in providing the required services requested in this proposal. 7 of 42 (c) The Proposer should describe the delivery of individual services listed in the Scope of Services (Exhibit 1) in this RFP and how this will be accomplished. The Proposer should respond in detail and avoid a general overall response. Tab 4. Litigation Provide answers to the following questions regarding claims and suits: (a) Has the Proposer ever failed to complete work or provide the goods for which it has contracted? (If yes, provide details.) (b) Are there any judgments, claims, arbitration proceeding or suits pending or outstanding against the Proposer, or its officers or general partners? (If yes, provide details.) (c) Has the Proposer, within the last five (5) years, been a party to any lawsuit or arbitration with regard to a contract for services, goods or construction services similar to those requested in the RFP? (If yes, the Proposer shall provide a history of any past or pending claims and litigation in which the Proposer is involved as a result of the provision of the same or similar services which are requested or described herein.) (d) Has the Proposer ever initiated litigation against the county or been sued by the county in connection with a contract to provide services, goods or construction services? (If yes, provide details.) (e) Whether, within the last five (5) years, an officer, general partner, controlling shareholder or major creditor of the Proposer was an officer, general partner, controlling shareholder or major creditor of any other entity that failed to perform services or furnish goods similar to those sought in the request for bids. Tab 5. Other Information Proposer shall provide any additional information which will present evaluators with insight about the knowledge, skills and abilities of the Proposer. Tab 6. Forms and Licenses Proposer shall complete and execute the forms specified below and located in Section Three in this RFP, as well as copies of all professional and receipts for business tax and shall include them in this section, i.e. Tab 6: Forms Submission Response Form Lobbying and Conflict of Interest Ethics Clause Non -Collusion Affidavit Drug Free Workplace Form Proposer's Insurance and Indemnification Statement Insurance Agent's Statement Copy of current Licenses and diplomas for personnel Exhibit B — Questionnaire Any Proposer claiming a local preference as defined 2009 must complete the Local Preference Form and in Monroe County Ordinance 023- attach it to the Proposal. 8 of 42 10. COPIES OF RFP DOCUMENTS A. Only complete sets of RFP Documents will be issued and shall be used in preparing responses. The County does not assume any responsibility for errors or misinterpretations resulting from the use of incomplete sets. B. Complete sets of RFP Documents may be obtained in the manner and at the locations stated in the Notice of Request for Proposals. 11. STATEMENT OF PROPOSAL REQUIREMENTS See Notice of Request for Proposals. Interested firms or individuals are requested to indicate their interest by submitting three (3) signed originals and three (3) complete copies (total = six (6) )of the proposal, in a sealed envelope clearly marked on the outside with the Proposer's name and "EMPLOYMENT PHYSICAL SERVICES", addressed to Monroe County Purchasing Department, 1100 Simonton Street, Room 1-213, Key West, FL 33040, which must be received on or before 3:00 P.M. local time on . Hand delivered Proposals may request a receipt. No proposals will be accepted after 3:00 P.M. Faxed or e-mailed proposals shall be automatically rejected. It is the sole responsibility of each Proposer to ensure its proposal is received in a timely fashion. 12. DISQUALIFICATION OF PROPOSER A. NON -COLLUSION AFFIDAVIT: Any person submitting a proposal in response to this invitation must execute the enclosed NON -COLLUSION AFFIDAVIT. If it is discovered that collusion exists among the Proposers, the proposals of all participants in such collusion shall be rejected, and no participants in such collusion will be considered in future proposals for the same work. B. PUBLIC ENTITY CRIME: 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 proposal on a contract to provide any goods or services to a public entity, may not submit a proposal on a contract with a public entity for the construction or repair of a public building or public work, may not submit Proposals on leases or perform work as a contractor, supplier, subcontractor, or contractor under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. Category Two: $25,000.00 C. DRUG -FREE WORKPLACE FORM: Any person submitting a bid or proposal in response to this invitation must execute the enclosed DRUG -FREE WORKPLACE FORM and submit it with his/her proposal. Failure to complete this form in every detail and submit it with the bid or proposal may result in immediate disqualification of the bid or proposal. D. LOBBYING AND CONFLICT OF INTEREST ETHICS CLAUSE: Any person submitting a bid or proposal in response to this invitation must execute the 9 of 42 enclosed LOBBYING AND CONFLICT OF INTEREST CLAUSE and submit it with his/her bid or proposal. Failure to complete this form in every detail and submit it with the bid or proposal may result in immediate disqualification of the bid or proposal. 13. EXAMINATION OF RFP DOCUMENTS A. Each Proposer shall carefully examine the RFP and other contract documents, and inform himself/herself thoroughly regarding any and all conditions and requirements that may in any manner affect cost, progress, or performance of the work to be performed under the contract. Ignorance on the part of the Proposer shall in no way relieve him/her of the obligations and responsibilities assumed under the contract. B. Should a Proposer find discrepancies or ambiguities in, or omissions from, the specifications, or should he be in doubt as to their meaning, he shall at once notify the County. 14. INTERPRETATIONS, CLARIFICATIONS, AND ADDENDUM No oral interpretations will be made to any Proposer as to the meaning of the contract documents. Any inquiry or request for interpretation received by the Request for Information Cut -Off Date will be given consideration. All such changes or interpretation will be made in writing in the form of an addendum and, if issued, will be furnished to all known prospective Proposers prior to the established Proposal opening date. Each Proposer shall acknowledge receipt of such addenda in his/her Proposal. In case any Proposer fails to acknowledge receipt of such addenda or addendum, his/her response will nevertheless be construed as though it had been received and acknowledged and the submission of his/her response will constitute acknowledgment of the receipt of same. All addenda are a part of the contract documents and each Proposer will be bound by such addenda, whether or not received by him/her. It is the responsibility of each Proposer to verify that he/she has received all addenda issued before responses are opened. 15. GOVERNING LAWS AND REGULATIONS The Proposer is required to be familiar with and shall be responsible for complying with all federal, state, and local laws, ordinances, rules, professional license requirements and regulations that in any manner affect the work. Knowledge of business tax requirements and the responsibility for paying the tax in Monroe County and municipalities within Monroe County are the responsibility of the Proposer. 16. PREPARATION OF RESPONSES Signature of the Proposer: The Proposer must sign the response forms in the space provided for the signature. If the Proposer is an individual, the words "doing business as or "Sole Owner" must appear beneath such signature. In the case of a partnership, the signature of at least one of the partners must follow the firm name and the words "Member of the Firm" should be written beneath such signature. If the Proposer is a corporation, the title of the officer signing the Response on behalf of the corporation must be stated along with the Corporation Seal Stamp and evidence of his authority to sign the Response must be submitted. The Proposer shall state in the response the name and address of each person having an interest in the submitting entity. 10 of 42 17. MODIFICATION OF RESPONSES Written modification will be accepted from Proposers if addressed to the entity and address indicated in the Notice of Request for Proposals and received prior to Proposal due date and time. Modifications must be submitted in a sealed envelope clearly marked on the outside with the Proposer's name and "Modification to Proposal - Monroe County Proposal for"EMPLOYMENT PHYSICAL SERVICES". If sent by mail or by courier, the above - mentioned envelope shall be enclosed in another envelope addressed to the entity and address stated in the Notice of Request for Proposals. Faxed or e-mailed modifications shall be automatically rejected. 18. RESPONSIBILITY FOR RESPONSE The Proposer is solely responsible for all costs of preparing and submitting the response, regardless of whether a contract award is made by the County. 19. RECEIPT AND OPENING OF RESPONSES Responses will be received until the designated time and will be publicly opened. Proposers' names shall be read aloud at the appointed time and place stated in the Notice of Request for Proposals. Monroe County's representative authorized to open the responses will decide when the specified time has arrived and no responses received thereafter will be considered. No responsibility will be attached to anyone for the premature opening of a response not properly addressed and identified. Proposers or their authorized agents are invited to be present. 20. DETERMINATION OF SUCCESSFUL PROPOSER Award shall be made to the responsible proposer whose proposal is determined to be the most advantageous to the County, taking into consideration the evaluation criteria set forth below: Ex erience and Qualifications Location s and Hours of Operationpoints Abilit to rovide all required servicesCost of Services g30 Location of firm (local preference if applicable: up to 5 additionalpoints) Total points earned are on a scale of 1 — 100 Doints 1 = lowest 100 = highest The County reserves the right to reject any and all responses and to waive technical errors and irregularities as may be deemed best for the interests of the County. Responses that contain modifications are incomplete, unbalanced, conditional, obscure, or that contain additions not requested or irregularities of any kind, or that do not comply in every respect with the Instruction to Proposer and the contract documents, may be rejected at the option of the County. 21. AWARD OF CONTRACT A. The County reserves the right to award separate contracts for the services based on geographic area or other, and to waive any informality in any response, or to re -advertise for all or part of the work contemplated. It is possible that one or more Proposers will be chosen. 11 of 42 B. The County also reserves the right to reject the response of a Proposer who has previously failed to perform properly or to complete contracts of a similar nature on time. C. The recommendation of staff shall be presented to the Board of County Commissioners of Monroe County, Florida, for final selection and award of contract. D. The County reserves the right to reject all proposals. 22. CERTIFICATE OF INSURANCE AND INSURANCE REQUIREMENTS The Proposer shall be responsible for all necessary insurance coverage as indicated below. Certificates of Insurance must be provided to Monroe County within fifteen (15) days after award of contract, with Monroe County BOCC listed as additional insured as indicated. If the proper insurance forms are not received within the fifteen (15) day period, the contract may be awarded to the next selected Proposer. Policies shall be written by companies licensed to do business in the State of Florida and having an agent for service of process in the State of Florida. Companies shall have an A.M. Best rating of VI or better and a financial rating of A- from A.M. Best. The required insurance shall be maintained at all times while Proposer is providing service to County. Worker's Compensation Employers' Liability General Liability, including Professional Liability Statutory Limits $500,000 $300,000 combined single limit $1,000, 000 per occurrence and Aggregate Monroe County shall be named as an Additional insured on the General Liability policy. 23. INDEMNIFICATION The Proposer to whom a contract is awarded shall defend, indemnify and hold harmless the County as outlined below. The Proposer covenants and agrees to indemnify, hold harmless and defend Monroe County, its commissioners, officers, employees, agents and servants from any and all claims for bodily injury, including death, personal injury, and property damage, including damage to property owned by Monroe County, and any other losses, damages, and expenses of any kind, including attorney's fees, court costs and expenses, which arise out of, in connection with, or by reason of services provided by the Proposer or any of its Subcontractor(s), occasioned by the negligence, errors, or other wrongful act or omission of the Proposer, its Subcontractor(s), their officers, employees, servants or agents. In the event that the service is delayed or suspended as a result of the Vendor's failure to purchase or maintain the required insurance, the Vendor shall indemnify the County from any and all increased expenses resulting from such delay. The first ten dollars ($10.00) of remuneration paid to the Proposer is consideration for the indemnification provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. 24. EXECUTION OF CONTRACT The Proposer will be required to execute a contract with the County for the services provided for in this RFP. The Proposer with whom a contract is negotiated shall be required to return to the 12 of 42 County one (1) executed counterparts of the prescribed Contract together with the required certificates of insurance. A Draft of the contract is attached in Section Two. 13 of 42 SECTION TWO: DRAFT AGREEMENT These contract documents should be used only after consultation with counsel. The documents are not intended as legal advice appropriate to any specific situation, nor do they purport to address all issues which may arise between the contracting parties. The documents should be amended or supplemented where appropriate. MONROE COUNTY CONTRACTFOR EMPLOYMENT PHYSICAL SERVICES THIS AGREEMENT ("Agreement") is made and entered into this day of , by MONROE COUNTY ("COUNTY"), a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, Florida 33040 and ("CONTRACTOR"), whose address is Section 1. SCOPE OF SERVICES CONTRACTOR shall do, perform and carry out in a professional and proper manner certain duties as described in the Scope of Services — Exhibit 1 — which is attached hereto and made a part of this agreement. CONTRACTOR shall provide the scope of services in Exhibit 1 for COUNTY. CONTRACTOR warrants that it is authorized by law to engage in the performance of the activities herein described, subject to the terms and conditions set forth in these Agreement documents. The CONTRACTOR shall at all times exercise independent, professional judgment and shall assume professional responsibility for the services to be provided. Contractor shall provide services using the following standards, as a minimum requirement: A. The CONTRACTOR shall maintain adequate staffing levels to provide the services required under the Agreement resulting from this RFP process. B. The contractor is responsible for obtaining proper releases from the employee or prospective employee in order to discuss the results with Monroe County BOCC. C. The contractor will outline locations of exam and locations of all testing facilities. The County intends to contract with a minimum of one physician in the Lower, Middle and Upper Keys. D. All urine screens will conform with the standard chain of custody protocols mandated by state and federal regulations. E. The Contractor will have an employee designated as coordinator or facilitator to assist in the communications with the Monroe County BOCC's primary contact personnel. F. Appointments for physicals will be available throughout the business hours of the facility. G. A testing facility will be available 24 hours a day, 7 days a week for post accident, random and reasonable suspicion alcohol and drug screening. H. Appointments will be seen by the contractor in a reasonable and timely fashion. I. The Medical Review Officer will be available for contact by the Monroe County BOCC or its employees to answer questions about the effect of prescribed drugs. 14 of 42 J. The personnel shall not be employees of or have any contractual relationship with the County. To the extent that Contractor uses subcontractors or independent contractors, this Agreement specifically requires that subcontractors and independent contractors shall not be an employee of or have any contractual relationship with County. K. All personnel engaged in performing services under this Agreement shall be fully qualified, and, if required, to be authorized or permitted under State and local law to perform such services. Section 2. QUALIFICATIONS NECESSARY OF CONTRACTOR The CONTRACTOR must certify at least annually that all staff members, independent contractors, subcontracted work, if any, all service providers it uses, engages or manages, comply with Health Insurance Portability and Accountability Act (HIPAA) privacy and security rules. Physical examinations will be conducted by, or under the direct supervision, of a physician or medical doctor currently licensed and practicing general medicine in the State of Florida. The examining physician may employ assistants properly licensed and trained, as necessary, to perform laboratory tests and/or assist in all phases of the examination. X-rays will be interpreted by Board Certified Radiologist, EKG by Board Certified Cardiologist, and lab results by Board Certified Pathologist. Physicians should be Board Certified in Occupational Medicine. Section 3. COUNTY'S RESPONSIBILITIES 3.1 Provide all best available information as to the COUNTY'S requirements for the Scope of Services described in Exhibit 1 to this Agreement. 3.2 Designate in writing a person with authority to act on the COUNTY'S behalf on all matters concerning said services. Section 4. TERM OF AGREEMENT 4.1 The initial Agreement term will be for one (1) year beginning the day of 2010 and renewable at the County's option for two (2) additional consecutive one year terms. 4.2 The terms of this Agreement shall be from the effective date hereof and continue for a period of one year. This Agreement shall be automatically renewed for successive one- year periods until either party gives the other notice of cancellation in accordance with the terms set forth below. The Contractor must provide the Contractor with at least thirty (30) days notice of intent to terminate. If either party desires to modify this Agreement, it shall notify the other in writing at least thirty (30) days prior to the effective date of such modification. In the case of proposed modification the party receiving the notification of the proposed modification shall itself notify the other party within ten (10) days after receipt of notice of its agreement to the proposed modification. Failure to do so shall terminate this Agreement. 15 of 42 Section 5. COMPENSATION Compensation to CONTRACTOR is outlined in the Scope of Services — Exhibit 1. Section 6. PAYMENT TO CONTRACTOR 6.1 Payment will be made according to the Florida Local Government Prompt Payment Act. Any request for payment must be in a form satisfactory to the Clerk of Courts for Monroe County (Clerk). The request must describe in detail the services performed and the payment amount requested. The CONTRACTOR must submit invoices to the appropriate offices marked Human Resources. The respective office supervisor and the Administrator of Human Resources, who will review the request, note his/her approval on the request and forward it to the Clerk for payment. 6.2 Continuation of this Agreement is contingent upon annual appropriation by Monroe County Board of County Commissioners. Section 7. CONTRACT TERMINATION Either party may terminate this Agreement because of the failure of the other party to perform its obligations under the Agreement. COUNTY may terminate this Agreement with or without cause upon thirty (30) days notice to the CONTRACTOR. COUNTY shall pay CONTRACTOR for work performed through the date of termination. Section 8. CONTRACTOR'S ACCEPTANCE OF CONDITIONS A. CONTRACTOR hereby agrees that he has carefully examined the RFP, his response, and this Agreement and has made a determination that he/she has the personnel, equipment, and other requirements suitable to perform this work and assumes full responsibility therefore. The provisions of the Agreement shall control any inconsistent provisions contained in the specifications. All specifications have been read and carefully considered by CONTRACTOR, who understands the same and agrees to their sufficiency for the work to be done. Under no circumstances, conditions, or situations shall this Agreement be more strongly construed against COUNTY than against CONTRACTOR. B. Any ambiguity or uncertainty in the specifications shall be interpreted and construed by COUNTY, and its decision shall be final and binding upon all parties. C. The passing, approval, and/or acceptance by COUNTY of any of the services furnished by CONTRACTOR shall not operate as a waiver by COUNTY of strict compliance with the terms of this Agreement, and specifications covering the services. D. CONTRACTOR agrees that County Administrator or his designated representatives may visit CONTRACTOR'S facility (ies) periodically to conduct random evaluations of services during CONTRACTOR'S normal business hours. E. CONTRACTOR has, and shall maintain throughout the term of this Agreement, appropriate licenses and approvals required to conduct its business, and that it will at all times conduct its business activities in a reputable manner. Proof of such licenses and approvals shall be submitted to COUNTY upon request. Section 9. NOTICES Any notice required or permitted under this agreement shall be in writing and hand delivered or mailed, postage prepaid, to the other party by certified mail, returned receipt requested, to the following: 16 of 42 To the COUNTY: Employee Services Director 1100 Simonton Street, Suite 2-268 Key West, Florida 33040 To the CONTRACTOR: Section 10. RECORDS CONTRACTOR shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the agreement and for four years following the termination of this Agreement. If an auditor employed by the COUNTY or Clerk determines that monies paid to CONTRACTOR pursuant to this Agreement were spent for purposes not authorized by this Agreement, the CONTRACTOR shall repay the monies together with interest calculated pursuant to Section 55.03 of the Florida Statutes, running from the date the monies were paid to CONTRACTOR. Section 11. EMPLOYEES SUBJECT TO COUNTY ORDINANCE NOS. 010 AND 020-1990 The CONTRACTOR warrants that it has not employed, retained or otherwise had act on its behalf any former County officer or employee subject to the prohibition of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 020-1990. For breach or violation of this provision the COUNTY may, in its discretion, terminate this agreement without liability and may also, in its discretion, deduct from the agreement or purchase price, or otherwise recover the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. Section 12. CONVICTED VENDOR A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a Agreement with a public entity for the construction or repair of a public building or public work, may not perform work as a CONTRACTOR, supplier, subcontractor, or CONTRACTOR under Agreement with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017 of the Florida Statutes, for the Category Two for a period of 36 months from the date of being placed on the convicted vendor list. Section 13. GOVERNING LAW, VENUE, INTERPRETATION, COSTS AND FEES This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to Agreements made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the COUNTY and CONTRACTOR agree that 17 of 42 venue shall lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. Section 14. SEVERABILITY If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The COUNTY and CONTRACTOR agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. Section 15. ATTORNEY'S FEES AND COSTS The COUNTY and CONTRACTOR agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, and court costs, as an award against the non -prevailing party. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the Circuit Court of Monroe County. Section 16. BINDING EFFECT The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the COUNTY and CONTRACTOR and their respective legal representatives, successors, and assigns. Section 17. AUTHORITY Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law. Section 18. ADJUDICATION OF DISPUTES OR DISAGREEMENTS COUNTY and CONTRACTOR agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida law. This Agreement shall not be subject to arbitration. Section 19. COOPERATION In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, COUNTY and CONTRACTOR agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. COUNTY and CONTRACTOR 18 of 42 specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. Section 20. NONDISCRIMINATION COUNTY and CONTRACTOR agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. The parties agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VII of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination in employment on the basis of race, color, national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681- 1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of handicaps: 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101- 6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 29-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3) as amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC ss. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s. 1201), as may be amended from time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 13, Article VI, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; and 11) any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. Section 21. COVENANT OF NO INTEREST COUNTY and CONTRACTOR covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and that only interest of each is to perform and receive benefits as recited in this Agreement. Section 22. CODE OF ETHICS COUNTY agrees that officers and employees of the COUNTY recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. Section 23. NO SOLICITATION/PAYMENT The COUNTY and CONTRACTOR warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bonafide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, the CONTRACTOR 19 of 42 agrees that the COUNTY shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration. Section 24. PUBLIC ACCESS The COUNTY and CONTRACTOR shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the COUNTY and CONTRACTOR in conjunction with this Agreement; and the COUNTY shall have the right to unilaterally cancel this Agreement upon violation of this provision by CONTRACTOR. Section 25. NON -WAIVER OF IMMUNITY Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the COUNTY and the CONTRACTOR in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any Agreement entered into by the COUNTY be required to contain any provision for waiver. Section 26. PRIVILEGES AND IMMUNITIES All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the COUNTY, when performing their respective functions under this Agreement within the territorial limits of the COUNTY shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the COUNTY. Section 27. LEGAL OBLIGATIONS AND RESPONSIBILITIES Non -Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the COUNTY, except to the extent permitted by the Florida constitution, state statute, and case law. Section 28. NON -RELIANCE BY NON-PARTIES No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third -party claim or entitlement to or benefit of any service or program contemplated hereunder, and the COUNTY and the CONTRACTOR agree that neither the COUNTY nor the CONTRACTOR or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. 20 of 42 Section 29. ATTESTATIONS CONTRACTOR agrees to execute such documents as the COUNTY may reasonably require, including, but not being limited to, a Public Entity Crime Statement, an Ethics Statement, and a Drug -Free Workplace Statement, Lobbying and Conflict of Interest Clause, and Non -Collusion Agreement. Section 30. NO PERSONAL LIABILITY No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. Section 31. EXECUTION IN COUNTERPARTS This Agreement may be executed in any number of counterparts, each of which shall be regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by signing any such counterpart. Section 32. SECTION HEADINGS Section headings have been inserted in this Agreement as a matter of convenience of reference only, and it is agreed that such section headings are not a part of this Agreement and will not be used in the interpretation of any provision of this Agreement. Section 33. INSURANCE POLICIES 33.1 General Insurance Requirements for Other Contractors and Subcontractors. As a pre -requisite of the work governed, the CONTRACTOR shall obtain, at his/her own expense, insurance as specified in any attached schedules, which are made part of this contract. The CONTRACTOR will ensure that the insurance obtained will extend protection to all Subcontractors engaged by the CONTRACTOR. As an alternative, the CONTRACTOR may require all Subcontractors to obtain insurance consistent with the attached schedules; however CONTRACTOR is solely responsible to ensure that said insurance is obtained and shall submit proof of insurance to COUNTY. Failure to provide proof of insurance shall be grounds for termination of this Agreement. The CONTRACTOR will not be permitted to commence work governed by this contract until satisfactory evidence of the required insurance has been furnished to the COUNTY as specified below. Delays in the commencement of work, resulting from the failure of the CONTRACTOR to provide satisfactory evidence of the required insurance, shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work commenced on the specified date and time, except for the CONTRACTOR's failure to provide satisfactory evidence. The CONTRACTOR shall maintain the required insurance throughout the entire term of this contract and any extensions specified in the attached schedules. Failure to comply with this provision may result in the immediate suspension of all work until the required insurance has been reinstated or replaced and/or termination of this Agreement and for damages to the COUNTY. Delays in the completion of work resulting from the failure of the CONTRACTOR to maintain the required insurance shall not extend deadlines specified in this contract and any 21 of 42 penalties and failure to perform assessments shall be imposed as if the work had not been suspended, except for the CONTRACTOR's failure to maintain the required insurance. The CONTRACTOR shall provide, to the COUNTY, as satisfactory evidence of the required insurance, either: Certificate of Insurance or A Certified copy of the actual insurance policy. The County, at its sole option, has the right to request a certified copy of any or all insurance policies required by this contract. All insurance policies must specify that they are not subject to cancellation, non -renewal, material change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given to the County by the insurer. The acceptance and/or approval of the Contractor's insurance shall not be construed as relieving the Contractor from any liability or obligation assumed under this contract or imposed by law. The Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Insured" on general liability policies. 33.2 General Liability Insurance Requirements For Contract Between County And Contractor (Note: amounts of coverage are subject to change in final contract) Prior to the commencement of work governed by this contract, the CONTRACTOR shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: • Premises Operations • Bodily Injury Liability • Expanded Definition of Property Damage The minimum limits acceptable shall be: $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $100,000 per Person $300,000 per Occurrence $ 50,000 Property Damage An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this contract. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. 22 of 42 33.3 Workers' Compensation Insurance Requirements Prior to commencement of work governed by this contract, the CONTRACTOR shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes. In addition, the CONTRACTOR shall obtain Employers' Liability Insurance with limits of not less than: $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. 33.4 Professional Liability Requirements Recognizing that the work governed by this contract involves the furnishing of advise or services of a professional nature, the Contractor shall purchase and maintain, throughout the life of the contract, Professional Liability Insurance which will respond to damages resulting from any claim arising out of the performance of professional services or any error or omission of the Contractor arising out of work governed by this contract. The minimum limits of liability shall be: $1, 000,000 per occurrence and aggregate Section 34. INDEMNIFICATION The CONTRACTOR does hereby consent and agree to indemnify and hold harmless the COUNTY, its Mayor, the Board of County Commissioners, appointed Boards and Commissions, Officers, and the Employees, and any other agents, individually and collectively, from all fines, suits, claims, demands, actions, costs, obligations, attorneys fees, or liability of any kind arising out of the sole negligent actions of the CONTRACTOR or substantial and unnecessary delay caused by the willful nonperformance of the CONTRACTOR and shall be solely responsible and answerable for any and all accidents or injuries to persons or property arising out of its performance of this contract. The amount and type of insurance coverage requirements set forth hereunder shall in no way be construed as limiting the scope of indemnity set forth in this paragraph. Further the CONTRACTOR agrees to defend and pay all legal costs attendant to acts attributable to the sole negligent act of the CONTRACTOR. At all times and for all purposes hereunder, the CONTRACTOR is an independent contractor and not an employee of the Board of County Commissioners. No statement contained in this agreement shall be construed so as to find the CONTRACTOR or any of his/her employees, contractors, servants or agents to be employees of the Board of County Commissioners for Monroe County. As an independent contractor the CONTRACTOR shall provide independent, professional judgment and comply with all federal, state, and local statutes, ordinances, rules and regulations applicable to the services to be provided. The CONTRACTOR shall be responsible for the completeness and accuracy of its work, plan, supporting data, and other documents prepared or compiled under its obligation for this project, 23 of 42 and shall correct at its expense all significant errors or omissions therein which may be disclosed. The cost of the work necessary to correct those errors attributable to the CONTRACTOR and any damage incurred by the COUNTY as a result of additional costs caused by such errors shall be chargeable to the CONTRACTOR. This provision shall not apply to any maps, official records, contracts, or other data that may be provided by the COUNTY or other public or semi-public agencies. The CONTRACTOR agrees that no charges or claims for damages shall be made by it for any delays or hindrances attributable to the COUNTY during the progress of any portion of the services specified in this contract. Such delays or hindrances, if any, shall be compensated for by the COUNTY by an extension of time for a reasonable period for the CONTRACTOR to complete the work schedule. Such an agreement shall be made between the parties. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed on the day of 20 . (SEAL) Attest: DANNY L. KOLHAGE, CLERK OF MONROE COUNTY, FLORIDA By Deputy Clerk (CORPORATE SEAL) ATTEST: By BOARD OF COUNTY COMMISSIONERS by Mayor/Chairman (Name of Contractor) by_ Title: 24 of 42 EXHIBIT SCOPE OF SERVICES EMPLOYMENT PHYSICAL SERVICES The scope of services to be provided on an as needed basis by the Provider and may include, but not be limited to, the following. SERVICE DRUG SCREEN: When requested, a drug screen will be performed by the physician and (Collection, Lab, MRO will be either scheduled or done on a walk-in basis. review) 10 panel State A testing facility must be available 24 hours a day, 7 days a week Requirement for post accident, random, and reasonable suspicion drug screening. SCREEN: When requested, a drug screen will be performed by the physician and[DRUG Collection, Lab, MRO will be either scheduled or done on a walk-in basis. eview) 5 panel A testing facility must be available 24 hours a day, 7 days a week epartment of for a moving violation or an accident where a fatality occurs. Transportation Re uirement BLOOD ALCOHOL When requested, Blood Alcohol Screens will be performed by the (Collection, Lab, MRO physician and will be either scheduled or done on a walk-in basis. review) A testing facility must be available 24 hours a day, 7 days a week for post accident, random, and reasonable suspicion alcohol screening. BREATH ALCOHOL (if When requested, may be used for screening. If breath alcohol screen is available) positive, a blood screen will be performed. If Physician wishes to propose other means of screening method, please provide testing method explanation and accuracy. A testing facility must be available 24 hours a day, 7 days a week for post accident, random, and reasonable suspicion alcohol screening. PPD- TB screen When requested, a PPD-TB screen will be scheduled and performed by the physician during the facilities normal business hours. A PPD-TB screen will be performed with the new hire Firefighter __physical. HEPATITIS A When requested, a Hepatitis A inoculation will be scheduled and erformed by the physician during the facilities normal business hours. HEPATITIS B When requested, a Hepatitis B inoculation(s) will be scheduled and erformed by the physician during the facilities normal business hours. TYPHOID When requested, a Typhoid inoculation will be scheduled and performed -by the h sician during the facilities normal business hours. TETANUS When requested, a Tetanus inoculation will be scheduled and performed by the physician during the facilities normal business hours. DIPHTHERIA When requested, a Diphtheria inoculation will be scheduled and performed by the ,physician during the facilities normal business hours. 25 of 42 OT PHYSICAL: When requested, a DOT physical will be scheduled and performed by the SEE ATTACHMENT [employee physician during the facilities normal business hours. Includes exam and C" to be completed by physician review of employee health history and job description. and physician) The DOT physical is initially performed in conjunction with a post -offer physical. Thereafter, only a DOT physical is performed by the physician. Physician may also perform a urine drug screen if requested separately by Monroe County BOCC. POST -OFFER When requested, a post -offer physical will be scheduled and performed PHYSICAL: by the physician during the facilities normal business hours. Includes (SEE ATTACHMENT "B" exam and physician review of employee health history and job to be completed by description. employee and physician) Physician may also perform a urine drug screen if requested separately by Monroe County BOCC. FIREFIGHTER When requested, Firefighter physical will be scheduled and performed by PHYSICAL (SEE the physician during the facilities normal business hours. Includes exam ATTACHMENTS "F" to and physician review of employee health history and job description. be completed by employee Physician may also perform a urine drug screen if requested separately by and physician). Monroe County BOCC. FITNESS FOR DUTY When requested, a Fitness for Duty Physical may be requested at any PHYSICAL (SEE time by the employer in the employee's respective area of work. The ATTACHMENT "B" to be exam will be scheduled during the facilities normal business hours. completed by employee Includes physician review of employee health history, exam, review of and physician) job duties and medical records if necessary. Physician may also perform a urine drug screen if requested separately by Monroe County BOCC. RESPIRATOR When requested, a Respirator physical will be scheduled and performed PHYSICAL (SEE by the physician during the facilities normal business hours. Includes ATTACHMENTS "D" exam and physician review of employee health history and job PART I & II to be description. completed by employee Physician may also perform a urine drug screen if requested separately by andphysician) Monroe County BOCC. RESPIRATOR FIT Currently, the Safety Officer performs the fit test as outlined in the TEST (See Attachment "D attachment. IV" EKG Normally done in conjunction with the Firefi ter physical. CHEST X RAY Chest X Ray is normally done in conjunction with the New Hire Firefighter and Respirator physical if there is an issue with the EKG or s irometry results. SPIROMETRY Normally done in conjunction with the Respirator physical. All Firefighters and employees who use a respirator will have a Spirometry when hired. Normally done in conjunction with the appropriate physical. May be HEARING/AUDIOGRAM requested separately by Monroe County BOCC. STRESS TEST (SEE Normally done in conjunction with the new hire Firefighter physical. ATTACHMENT "E" for Performed thereafter for firefighters as needed and firefighters who are explanation of services to over 40 years old and older. be performed by __physician) 26 of 42 The Contractor shall retain all records pertaining to this contract for a period of four (4) years after the termination of this contract. The County, the Clerk, the State Auditor General, and agents thereof shall have access to Contractor's books, records, and documents required by this contract for the purposes of inspection or audit during normal business hours, at the Contractor's place(s) of business. 27 of 42 SECTION THREE: RESPONSE FORMS RESPOND TO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS C/o Purchasing Department 1100 Simonton Street GATO BUILDING, ROOM 1-213 1100 SIMONTON STREET KEY WEST, FLORIDA 33040 1 acknowledge receipt of Addenda No. (s) I have included • Lobbying and Conflict of Interest Clause ❑ • Non -Collusion Affidavit ❑ • Drug Free Workplace Form ❑ • Public Entity Crime Statement ❑ • Insurance Requirements ❑ • Local Preference Form (if applicable) ❑ In addition, I have included a current copy of the following professional and occupational licenses: List all charges for services, inclusive of all travel and other expenses (there will be no reimbursable expense items): (%,necK marK items above as reminder that they are included) Mailing Address: Signed: (Print Name) (Title) STATE OF: COUNTY OF: Telephone: Fax: Date: Witness: Subscribed and sworn to (or affirmed) before me on (date) by to me or has produced identification. (name of affiant). He/She is personally known (type of identification) as NOTARY PUBLIC My Commission Expires: 28 of 42 LOBBYING AND CONFLICT OF INTEREST CLAUSE ETHICS CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA (Company) "...warrants that he/it has not employed, retained or otherwise had act on his/her behalf any former County officer or employee in violation of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision the County may, in its discretion, terminate this Agreement without liability and may also, in its discretion, deduct from the Agreement or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee." STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on (date) by personally known to me or has produced (type of identification) as identification. (Signature) Date: (name of affiant). He/She is NOTARY PUBLIC My Commission Expires: 29 of 42 NON -COLLUSION AFFIDAVIT 1, of the city of according to law on my oath, and under penalty of perjury, depose and say that 1. I am of the firm of the bidder making the Proposal for the project described in the Request for Proposals for proposal with full authority to do so; and that I executed the said 2. The prices in this bid have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor; 3. Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid opening, directly or indirectly, to any other bidder or to any competitor; and 4. No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit, or not to submit, a bid for the purpose of restricting competition; and 5. The statements contained in this affidavit are true and correct, and made with full knowledge that Monroe County relies upon the truth of the statements contained in this affidavit in awarding contracts for said project. STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on (date) by personally known to me or has produced (type of identification) as identification. (Signature) Date: (name of affiant). He/She is NOTARY PUBLIC My Commission Expires: 30 of 42 DRUG -FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statutes Section 287.087 hereby certifies that: (Name of Business) 1. Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Informs employees about the dangers of drug abuse in the workplace, the business' policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notifies the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6. Makes a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. (Signature) Date: STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on (date) by to me or has produced (name of affiant). He/She is personally known (type of identification) as identification. NOTARY PUBLIC My Commission Expires: 31 of 42 PUBLIC ENTITY CRIME STATEMENT "A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or CONTRACTOR under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." I have read the above and state that neither (Respondent's name) nor any Affiliate has been placed on the convicted vendor list within the last 36 months. (Signature) Date: STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on (date) by (name of affiant). He/She is personally known to me or has produced (type of identification) as identification. NOTARY PUBLIC My Commission Expires: 32 of 42 MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION MANUAL Indemnification and Hold Harmless For Other Contractors and Subcontractors The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the Contractor or any of its Subcontractor(s) in any tier, occasioned by negligence, errors, or other wrongful act of omission of the Contractor or its Subcontractors in any tier, their employees, or agents. In the event the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractor's failure to purchase or maintain the required insurance, the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification Provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. 33 of 42 WORKERS' COMPENSATION INSURANCE REQUIREMENTS FOR EMPLOYMENT PHYSICAL SERVICES BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governed by this contract, the Contractor shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes. In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than: $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. If the Contractor has been approved by the Florida's Department of Labor, as an authorized self -insurer, the County shall recognize and honor the Contractor's status. The Contractor may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Contractor's Excess Insurance Program. If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required. In addition, the Contractor may be required to submit updated financial statements from the fund upon request from the County. 34 of 42 GENERAL LIABILITY INSURANCE REQUIREMENTS FOR EMPLOYMENT PHYSICAL SERVICES BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governed by this contract, the Contractor shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: • Premises Operations • Products and Completed Operations • Blanket Contractual Liability • Personal Injury Liability • Professional Liability • Expanded Definition of Property Damage The minimum limits acceptable shall be: 300 000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $ 100,000 _ per Person $ 300,000 per Occurrence $_ 50,000_ Property Damage An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this contract. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. 35 of 42 MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION MANUAL WAIVER OF INSURANCE REQUIREMENTS There will be times when it will be necessary, or in the best interest of the County, to deviate from the standard insurance requirements specified within this manual. Recognizing this potential and acting on the advice of the County Attorney, the Board of County Commissioners has granted authorization to Risk Management to waive and modify various insurance provisions. Specifically excluded from this authorization is the right to waive: • The County as being named as an Additional Insured — If a letter from the Insurance Company (not the Agent) is presented, stating that they are unable or unwilling to name the County as an Additional Insured, Risk Management has not been granted the authority to waive this provision. And • The Indemnification and Hold Harmless provisions Waiver of insurance provisions could expose the County to economic loss For this reason, every attempt should be made to obtain the standard insurance requirements. If a waiver or a modification is desired, a Request for Waiver of Insurance Requirement form should be completed and submitted for consideration with the proposal. After consideration by Risk Management and if approved, the form will be returned, to the County Attorney who will submit the Waiver with the other contract documents for execution by the Clerk of the Courts. Should Risk Management deny this Waiver Request, the other party may file an appeal with the County Administrator or the Board of County Commissioners, who retains the final decision - making authority. 36 of 42 MONROE COUNTY, FLORIDA Request for Waiver Of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract: Contractor: Contract for: Address of Contractor: Phone: Scope of Work: Reason for Waiver: Policies Waiver will apply to: Signature of Contractor: Approved Not Approved Risk Management: Date: County Administrator appeal: Approved Not Approved Date: Board of County Commissioners appeal: Approved Not Approved Meeting Date: BIDDER SIGNATURE 37 of 42 INSURANCE REQUIREMENTS FOR SUBMITTING PROPOSALS Worker's Compensation $ 100,000 Bodily Injury by Acc. $ 500,000 Bodily Inj. by Disease, policy Imts $ 100,000 Bodily Inj. by Disease, each emp. General Liability, including $ 300,000 Combined Single Limit Premises Operation Products and Completed Operations Blanket Contractual Liability Personal Injury Liability Expanded Definition of Property Damage Professional Liability Including errors and omissions $1, 000,000 per Occurrence and Aggregate The Monroe County Board of County Commissioners shall be named as Additional insured on general liability policy. 38 of 42 LOCAL PREFERENCE FORM A. Vendors claiming a local preference according to Ordinance 023-2009 must complete this form. Name of Bidder/Responder Date: 1. Does the vendor have a valid receipt for the business tax paid to the Monroe County Tax Collector dated at least one year prior to the notice or request for bid or proposal? (Please furnish copy. ) 2. Does the vendor have a physical business address located within Monroe County from which the vendor operates or performs business on a day to day basis that is a substantial component of the goods or services being offered to Monroe County? List Address: Telephone Number: B. Does the vendor/prime contractor intend to subcontract 50% or more of the goods, services or construction to local businesses meeting the criteria above as to licensing and location? If yes, please provide: 1. Copy of Receipt of the business tax paid to the Monroe County Tax Collector by the subcontractor dated at least one year prior to the notice or request for bid or proposal. 2. Subcontractor Address within Monroe County from which the subcontractor operates: Tel. Number Signature and Title of Authorized Signatory for Print Name: Bidder/Responder STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on (date) by (name of affiant). He/She is personally known to me or has produced (type of identification) as identification. NOTARY PUBLIC My Commission Expires: 39 of 42 EXHIBIT 2 QUESTIONNAIRE Organization Name: Primary Contact/Representative: Title: Address: City, State, Zip Code: Telephone Number: Fax Number: E-mail Address: Monroe County employs individuals throughout the Florida Keys. Please provide the locations of your facilities which will be providing the required services as outlined in number "4" below. The contractor will outline locations of exam facilities and locations of all testing facilities. The County intends to contract with a minimum of one physician in the Lower, Middle and Upper Keys. 2. A testing facility must be available 24 hours a day, 7 days a week for post accident, random and reasonable suspicion alcohol and drug screening. Are you able to provide this service? 3. Part of the requirements set forth by the State of Florida drug free workplace policy, which Monroe County has adopted, and the Department of Transportation, the County must have a qualified Medical Review Officer "MRO" perform drug screening services. The MRO receives lab reports from the laboratory (as governed by regulations); Reviews lab reports for integrity, authenticity, false negatives, and false positives; interprets lab results, including verification of lab positives; reports lab reports to the employer (as defined by rules and regulations). Are you qualified and/or able to provide this service? 4. Price SERVICE PROPOSED FEE DRUG SCREEN: (Collection, Lab, MRO review) 10 panel State Re uirement DRUG SCREEN: (Collection, Lab, MRO review) 5 panel Department of Transportation_ 40 of 42 Requirement BLOOD ALCOHOL (Collection, Lab, MRO review) BREATH ALCOHOL (if available) PPD- TB screen HEPATITIS A HEPATITIS B TYPHOID TETANUS DIPTHERIA DOT PHYSICAL POST -OFFER PHYSICAL FIREFIGHTER PHYSICAL *Proposed fee will not include EKG, Chest X-ray, Spirometry, Hearing/Audiogram, Stress Test or PPD- TB screen and will be priced separately by the Proposer. FITNESS FOR DUTY PHYSICAL RESPIRATOR PHYSICAL *Proposed fee will not include Chest X- ray or Spirometry and will be priced separately by the Proposer. RESPIRATOR FIT TEST *This test is currently performed by the Safety Officer. If the proposer is equipped to provide this test, please quote a fee. EKG CHEST X RAY SPIROMETRY HEARING/AUDIOGRAM STRESS TEST (Firefighters) All physical results will include: A. Written interpretation of test results in common terms and written explanation of the significance of each abnormality or written explanation of those results which are outside the normal range. B. Examining physician's written recommendation concerning future action on any condition considered outside the normal range. C. Written recommendation of specific reasonable accommodations in accordance with the ADA. 5. Monroe County will require a reasonable turnaround time in receipt of any drug or physical results provided by the contractor and/or subcontractors. If the contractor is unable to provide at least a 24 — 48 hour turnaround time to provide these results to the County, please provide an explanation along with the expected time frame to receive the results. 41 of 42 6. If the examinations are performed by a hospital, medical center, consortium or similar organization, please provide the name of the lead physician who will be designated and assigned as the single point of contact for all medical matters relating to Monroe County BOCC personnel along with providing the appropriate procedures and policies for establishing and maintaining effective communications with the Monroe County BOCC. 7. Will the Medical Review Officer be available for contact by the Monroe County BOCC or its employees to answer questions about the effect of prescribed drugs? 8. Provide any supplemental information you consider relevant or beneficial. The Representative stated below is the authorized agent of the Proposer and is authorized to bind the company upon acceptance by the County. Deviations from the requested program have been stated. Coverage(s) or services will be issued as proposed. Authorized Representative Print Name Firm Telephone Date Authorized Representative Signature 42 of 42 REQUEST FOR PROPOSALS EMPLOYMENT PHYSICAL SERVICES 2010 ATTACHMENT A ZONROE COUNTY JOB DESCRIPTION Position Title: MAINTENANCE WORKER Date: 12/29/98 Position Level: 3 _ FLSA Status: Nonexempt Class Code: 3-1 GENERAL DESCRIPTION Primary function is to perform general grounds maintenance duties in the upkeep of county property including parks and beaches. Assists in the general maintenance of buildings and grounds. KEY RESPONSIBILITES 1. Mows grass and trims trees.* 2. Picks up trash and empty trash.* 3. Moves furniture, boxes, etc. 4. Performs custodial duties at parks and beaches (cleans bathrooms, etc.). 5. Cleans up construction debris and work area.* 6. Digs trenches/holes in the grounds. 7. Performs basic repairs and maintenance of equipment and property. 8. Drives county vehicles transporting tools and equipment to worksite. * Indicates an "essential" 'ob function. The information on this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job. Position Title: MAINT WORKER I Class Code: 3-1 1 Position Level: 3 KEY JOB REQUIREMENTS Education: H.S. Diploma or GED required. Experience,- 1 to 2 years. Impact ofActions: Decisions and impact are limited to decisions and planning within a small work group or ro'ect team. Complexity: Routine: Work consists of routine tasks, processes, or operations. The incumbent selects and applies several clearly -prescribed, standard policies and procedures requiring little interpretation. Problems are solved by choosing between a few clear choices or discussing them with a supervisor. Decision Making.• Basic: Ongoing supervision is provided on an "as needed" basis. Some independent judgment is necessaryto select and apply the most a ro riate of available rocedures. Communication Requires regular contact within the department and with other departments, outside with Others: agencies and the general public, supply or seeking information. Managerial Skills: Involves no responsibility or authority for the direction of others. Working Conditions/ Work requires occasional physical exertion and/or muscular strain. Work involves Physical Effort.- several disagreeable elements and/or exposure to job hazards where there is some possibility of injury. On Call On call 24 hours pending disasters. Requirements.- Other.- Requires valid Florida Drivers License. On this date I have received a copy of my job description relating to my employment with Monroe County. Name: Signature: Date: REQUEST FOR PROPOSALS EMPLOYMENT PHYSICAL SERVICES 2010 ATTACHMENT B OF ATTACHED SH U 1 C V� [iINM MEDICAL RECORD I REPORT OF MEDICAL HISTORY Is In ormatlon Is for official and medically -confidential use only and will not be -released to unauthorized persons 1 NAME OF PATIENT (Lost, first, mtddle) �2. IDENTIFICATION NUMBER ' Position 4a. HOME STREET ADDRESS �Sneef or RFD: City or loan: State; and ZIP Code/ (5_ E�(AMINING FACILITY 1-- -- 6 4d. ZIP EXAMINATION 7. STATEMENT OF PATIENT'S PRESENT HEALTH AND MEDICATIONS CURRENTLY USED (Use addiftonel pages d necessary/ a. PRESENT HEALTH b. CURRENT MEDICATION REGULAR OR INTERM. c. ALLERGIES (Inc de Insect bites/stings and common foods/ d. HEIGHT e. — -- 8. PATIENT'S OCCUPATION ec one LaRIGHT HANDED EJ LEFT HANDED IU. 1'HJI/l11HHHN1 MH1]IC01 HISTnPV CHECK EACH ITEM YES NO DON'T KNOW CHECK EACH ITEM YES NO DON'T KNOW CHECK EACH ITEM YES NO DON'T KNOW Household contact with anyone with tuberculosis Shortness of breath Bone, joint or other deformity Pain or pressure in chest Loss of finger or toe Tuberculosis or positive TB test Chronic cough Painful or "trick' shoulder or elbow Blood in sputum or when coughing Palpitation or pounding heart Heart trouble Recurrenr back pain or any back injury Excessive bleeding after injury or dental work High or low blood pressure Cramps in your legs 'Trick' or locked knee Suicide attempt or plans Frequent indigestion Foot trouble Sleepwalking Stomach, liver or intestinal trouble Nerve Injury Wear corrective lenses Gall bladder trouble or gallstones Paralysis (including infantile) Eye surgery to correct vision Epilepsy or seizure Lack vision in either eye Jaundice or hepatitis Car, train, sea or air sickness Wear a hearing aid Broken bones Frequent trouble sleeping Stutter or stammer Adverse reaction to medication Depression or excessive worry Wear a brace or back support Skin diseases Loss of memory or amnesia Scarlet fever Tumor, growth, cyst, cancer Nervous trouble of any sort Rheumatic fever Hernla Periods of unconsciousness Swollen or painful Iomts Hemorrhoids or rectal disease Parent/sibling with diabetes, cancer, stroke or heart disease Frequent or severe headaches Frequent or painful urination D¢ziness or fainting spells Eye trouble Bed wetting since age 12 X ray or other radiation therapy I - Kidney stone or blood in untie Chemotherapy Hearing bss Sugar or albumin m urine Asbestos or toxic chemical exposure Recurrent ear infections Sexually transmitted diseases Chrornc or frequent colds !Recent gain or loss of weight { Pfate, pm or rod in any bone Severe tooth or gum trouble Eating disorder (anorexia bulimia, atal --` Easy fatigability Sinusitis Been told to cut down or criticized for alcohol use Ha fever or alley tic rhiniUs— y 9 _Head injury _ Arthritis, Rheumatism, or Bursitis Used illegal substances Asthma MqM 7Kdrn_nn_10, aoao { Thyroid trouble or goiter Used tobacco .� r'.r.-" r%J "n V.3 ;HtV b 961 Previous edition not usable Prescribed by ICMR/GSA FIRMR i41 CFRI 201-9 202-1 CHECK EACH ITEM YES NO DON'T DATE OF LAST MENSTRUAL DATE OF LAST PAP SMEAR DATE OF LAST MAMMO- KNOW PERIOD N/A N/A :GRAM N/A Treated for a female dmorder t1/ Change in menstrual pattern - -- - �^^• ^• o�.+��n —ut i U Hirsh i. LIS I EXPLANATION BY ITEM NUMBER. ITEM YES NO 12 Have you been refused employment or been unable to hold a job or stay in school because of: a. Sensitivity to chemicals, dust, sunlight, etc, b.lnabilrty to perform certain motions. c. Inability to assume certain positions. d.Other medical reasons lit yes, give reasons.) 13. Have you ever been treated for a mental condition? W yes, specify when, where, and give details.) 14. Have you ever been denied life msurancs7 Ilf yes, slat* mason and give details.) 15. Have you had, or have you been advised to have, any operation. lit yes, describe and give age at which occurred.) 7 a. Have you ever been a patient in any type of hospital? I/ yes, specify when, where, why, and name of doctor and complete address of hospital) 17. Have you consulted or been treated by clinics, physicians, healers, or other practitioners within the past 5 years for other than minor illnesses7 lit yes, give complete address of doctor, hospital, clinic, and details.) 7 a. Have you ever been rejected for military service because of physical, mental, or other reasons7 lit yes, give date and reason for rejection,) 19. Have you ever been discharged from military service because of physical, mental, or other reasons? lit yes, give date, reason, and type of discharge; whether honorable, other then honorable, for unfitness or unsuitability.) 20. Have you ever received, is there pending, or have you ever applied for pension or compensation for existing disability7 lit yes, specify what kind, granted by whom, end what amount, when, why,) 22, Have you ever been diagnosed with a learning disability? lit yes, give type, where, andhow diagnosed.) LIST ALL IMMUNIZAT certi y that I nave reviewed the foregoing information sup ie y me U t at it is true and compete to the best o my now a ge, au' onze any o the octors, hospitals, or clinics mentioned above to furnish the Government a complete transcript of my medical record for purposes of processing my application for this employment or service. 1 understand that falsification of information on Government forms is punishable by fine and/or imprisonment. 24a. TYPED OR PRINTED NAME OF EXAMINEE I 240. SIGNATURE 24c. DATE NOTE: HAND TO THE DOCTOR OR NURSE, OR IF MAILED MARK ENVELOPE "TO BE OPENED BY MEDICAL OFFICER ONLY". 25. PHYSICIAN'S SUMMARY AND ELABORATION OF ALL PERTINENT DATA (Physician shell comment on all positive answers in Items 7 through 17, Physician may develop by interview any additional medical history deemed important, and record any signdicient findings here.) D NAME OF PHYSICIAN OR EXAMINER DATE STANDARD FORM 93 (REV 6-96) BACK DATE OF EXAM MEDICAL RECORD REPORT OF MEDICAL EXAMINATION I 1 LAST NAME -FIRST NAME -MIDDLE NAME 2. IDENTIFICATION NUMBER 3. Position 4. HOME ADDRESS (Number, street or RFD, city or town, state and ZIP Cxte) 5. EMERGENCY CONTACT (Name and address of contad) 6. DATE OF BIRTH 7, AGE 8. SEX FEMALE MALE 9. RELATIONSHIP OF CONTACT 10 PLACE OF BIRTH 11, RACE El WHITE BLACK AMERICAN INDIAW HISPANIC HISPANIC ASIANIPACIFIC ALASKA NATIVE WHITE BLACK ISLANDER 12a. AGENCY 12b. ORGANIZATION UNIT 13. TOTAL YEARS GOVERNMENT SERVICE a. MILITARY b. CIVILIAN 14_ NAME OF EXAMINING FACILITY OR EXAMINER, AND ADDRESS 15. RATING OR SPECIALTY OF EXAMINER 16- PURPOSE OF EXAMINATION 7 /. ULINIGAL tVALUA I IUN NQR- MAL (Check each Rem In appropriate column, enter "NE" rfnot evaluated.) MAL MAL (Check each item In appropriate column, enter "NE" rf not evaluated.) MAL A. HEAD. FACE, NECK AND SCALP O. PROSTATE (Over 40orcOn"Itylndlcated) B. EARS - GENERAL (INTERNAL CANALS) (Auditory acuity under items 39 and 40) P. TESTICULAR R. ENDOCRINE SYSTEM C. DRUMS (Perforation) D. NOSE S. G-U SYSTEM E. SINUSES I T. UPPER EXTREMITIES (Strength, rangeofmotion) F. MOUTH AND THROAT U. FEET G. EYES - GENERAL (visualacurlyand mire lL urdar items 28, 29. and 36) V. LOWER EXTREMITIES (Except feet) (Strength, range ofmotion) H. OPTHALMOSCOPIC W. SPINE, OTHER MUSCULOSKELETAL I. PUPILS (Equality and reaction) X. IDENTIFYING BODY MARKS, SCARS, TATTOOS J. OCULAR MOTILITY (Associated parallel movements nystagmus) Y. SKIN, LYMPHATICS K. LUNGS AND CHEST Z. NEUROLOGIC (Equilibrium tests underitem41) L. HEART (Thrust, size, rhythm, sounds) AA. PSYCHIATRIC (Specify any personality deviation) M. VASCULAR SYSTEM (Varicosities, etc.) N. ABDOMEN AND VISCERA (Include hernia) - • -- _- .r ..... .,� -,., , t—.,,,,o,., „o,,, �,aue rr. wnunuv or nvm 4c at" us a nwnar sneers it necessary.) 18. DENTAL (Place approprrate symbols, shown In examples, above orbebwnumberof upperand rimer teeth.) REMARKS AND ADDITIONAL DENTAL Rr storable rvon Missng - Rev aced �� Fxed DEFECTS AND DISEASES Teeth reStOrat51® Teeth 3 2 3 Teeth 1 2 3 f 2 3 � t 2 _I paw 0 X X X Dentures x I Dentums R L 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 E G 32 31 H 30 29 28 27 26 25 24 23 22 21 20 19 18 17 F T T 19, TEST RESULTS (Copies of results are preferred as attachments) A URINALYSIS (1) SPECIFIC GRAVITY B CHEST X-RAY OR PPD (Place, data, Dlmnumberandmsuk) (2) URINE ALBUMIN (4) MICROSCOPIC A i�� �V (3) URINE SUGAR C SYPHILIS SEROLOGY (Speciry test used D EKG E_ BLOOD TYPE AND RH F OTHER TESTS and results) � � � N � � FACTOR gg 25 STANDARD FORM 88 (Rev 10-94) (EG) �_esrgned U-9 Pert — Pro, wN_1JD 0R..ran 97 Prescribed by GSA/IOMR FIRMR (41 CFR) 201-9 202-1 NAME MEASI NO. OF SHEETS ATTACHED 20 HEIGHT 21 WEIGHT 22, COLOR HAIR —rz i91, tutu v i riam riivUINGS 23. COLOR EYES 24 BUILD 25. TEMPERATURE 26 BLOOD PRESSURE (q� at heart leu9l) SLENDER MEDIUM HEAVY OBESE q SYS. SYS. C. 27. PULS E (Arm at heart k3 el) BITTING RECUM DIAS STANDING SYS A. SITTING B RECUMBENT C. STAN ING AN I D. AFTER EXERCISE E. 2 MINS. AFTER BENT DIAS. (SmMs.) DIAS (3 28. DISTANT VISION 29. REFRACTION RIGHT 20 CCORR. TO 201 BY S. 30 NEAR VISION LEFT 20l CORR TO 2(/ BY CX S, CORR.TO BY 31 NETEROPHORIA S d dstan�,*) r �� y AI CX CORR, TO BY ESO EXO R H. L H PRISM DIV. PRISM CONY. PC CT PD 32. ACCOMMODATION 33 COLOR VISION (rest used and resulq 34. DEPTH ERCEP O RIGHT LEFT (rest used and UNCORRECTED 35. FIELD OF VISION 36. NIGHT VISION (rest used and score) CORRECTED37. RIGHT LEFT RED LENS TEST - J1. 38. INTRAOCULAR TENSION 04 39. HEARING 40, AUDIOMETER RIGHT LEFT 41. PSYCHOLOGICAL AND PSYCHOMOTOR (rests RIGHT WN 115SV 115 250 ` 10W 20W 30W 4000 6000 8000 used and score) 256 512 1024 2048 289614096 6144 8192 i! LEFTWN N5SV /15 RIGH LEFT 42. NOTES (Continued)AND SIGNIFICANT OR INTERVAL FHSTORY (Use adddknal sheets B 43, SUMMARY OF DEFECTS AND DIAGNOSES (Llstdlagnoses with Item numhers) 44. RECOMMENDATIONS -FURTHER SPECIALIST EXAMINATfONS INDICATED (SpecJfy) 46_ EXAMINEE (Check) A. IS QUALIFIED FOR In accordance with attached job B 0 IS NOT QUALIFIED FOR description 47 IF NOT QUALIFIED, LIST DISQUALIFYING DEFECTS BY ITEM NI-ABER -'-- �v t yr rn YSICIAN — I rrcu vN WNINItU NAME OF PHYSICIAN vm rrtnvltUNAME OFDENTISTOR PHYSICIAN (Indicatewhi�M) 51 . TYPED OR PRINTED NAME OF REVIEWING OFFICER OR APPROVING A SIGNATURE SIGNATURE SIGNATURE 45A. PHYSICAL PROFILE L -! H 1 t I S 45B.PHYSICAL CATEGORY A B C E RD FORM 88 (Rev 10.k REQUEST FOR PROPOSALS EMPLOYMENT PHYSICAL SERVICES 2010 ATTACHMENT C 3C Cl O. w W °m 7 K d S" 3 A 3 C 00 ((DD (D (D A3 w 0 m = C w. O C 7 a3 �w :3-X y 7 A m c 0 (D c :5. 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O. m 7 "T) m m y m m (m/t n7�7cn �o mSF mmm 0 m'a o v�� mm m m��S o -°i oo^rn Vj ° 7 O y Q j o 3 m (� 7 m v 7 u6i (D(DzO vn(O � A nx m dmOO cyy •g Rm- 0m (D 2 m pN 7Q 7 3C-cr Ce cTN * O � =0 m( _t7 7On dmnm 3 c73 0 6 2 0m(DO(D 07 0 (dC0 - - Oqm r7mm < a p' 91 (D m (0 m 110 j �. j f1t m� (D` d 7Q. CD 0 d ail m C CD O m 0 C 0 210 2 C 7 0 m-W A 3�(0CD0m0) m � ASL a _� .7.. (0 y orm 7 0 m 0 f1t C 0' (0 >_- 0 m 0 O �• n y c� m n 3 y N m v-7i '~0 (D2w O fix? (pit O !/�! n0 -•in (o, (D j j �. (/i O (Q- ^' y 3 3 O t�/ 7 m= N m m(D d ((D O 010 �' ti, m (0 � ? n _n `� N d W or > o 0 0). � �� �r c3 (o 3- m ^ m O 0 n y � m.- EMPLOYMENT PHYSICAL SEKVK-t=b 2010 ATTACHMENT DI Res irafiar Medical Evaluation estio To the employer. Answers to questions in Set Lion I, and to dudstion 9 in Se( Lion 2 of Part A, do not require a medi( al examination. To the employee: Can you read,' (( he, k one): ................................................ Yes J No .................................................. Four employer must allow you to answer this questionnaire during normal working hours, or at a time and place that is convenient to you. To maintain your confidentiality, your employer or supervisor must not look at or review your answers, and your employer must tall yI>u how to deliver or sand this Lluestionnaire to the health card professional who will review it. The following information must IN- provided by every employed who has been sell( ted to use any type of respirator (please print). Name: Age (to nearest year): Height: feet _ inches Weight: lbs. Phone number where you can be reached by the health care person who reviews this (include area code): The best time to call you at this number. Has your employer told you how to contact the health care person who will review this (check one): ❑ Yes ❑ No Job Title: Sex (check one) ❑ Male ❑ Female Date: Check the type of respirator you will use (you can check more than one category): a. ❑ N, R, or P disposable respirator (filter -mask, non -cartridge type only). a. ❑ Other type (for example, half- or full-facepiece type, powered -air puri)ing,, supplied -air, self-contained breathing apparatus). Have you worna respirator. ❑ Yes ❑ No If "yes," what type(s): Part A — Section 2 (Mandatory) Questions 1 through 9 below must be answered by every employee who has been selected to use any type of respirator (please check "yes" or "no"). 1. Do you currently smoke tobacco, or have you smoked tobacco in the last month? ................................... 0 Yes ❑ No 2. Have you ever had any of the following conditions? a. Seizures (fits): ............................................................................................ 0 Yes ...................................................... b. Diabetes (sugar disease)................................................................................................................................. 0 Yes C. Allergic reactions that interfere with breathing: .................................... 0 Yes .................................................... d. Claustrophobia (fear of closed -in places): ................................................................................................... ❑ Yes e. Trouble smelling odors: ........ 0 Yes ............................................................ 3. Have you ever had any of the following pulmonary or lung problems? a. Asbestosis:...................................................................................... ........... ................................................. j Yes ..... b. Asthma: .................... .............. ................................................................ ..'J Yes ........................................................ c. Chronic bronchitis:......................................................................................................................... Yt s d. Emphysema: .................... .......................... -- ...... e. Pneumonia: . .... -- ........................ ............... f. Tuberculosis:.............................................................. t'. Silicosis:............................................................................... h. Pnoumothorax (collaosvd luntr): ..._.. . ........ i. Lung can( rr:................................................................ j. Broken ribs: ....... ...... ................. . k. \M ( hest Injurws or Surgvri(--;:... ........... _.._..._.__..... ........... .. I. 111y ether lunf; pr(411cm that you've kvn told ,Iikltlt: ................................................. ................ Ij Yes .......... ....... ........... ........... ............ ............ ..��Y(x; ...................... J YI-, Yds rJ No rJ No ❑ No C] No ❑ No J No 0 No J No 7 No J No .d No 7 No ............—......... -. j Yes 'J No Yes J No _........`jYes kNo _.... J Yes _j :No J No MI;A klEt dbW 1 vale NHy 8, 2= 4. Do you currently have any of the following symptoms of pulmonary or lung illness? a. Shortness of breath: ...... ...... ................................................. ...................... -- ............................. _J Yes b. Shortness of breath when walking fast on level ?,round or walking up a slight hill or incline:.......... J Yes �. Shortness of breath when walking with other people at an ordinary pace on level ground : ............. J Yes d. Have to stop for bn�ath when walking at your own pace on level ground: ........ - ....... ........ .......... J Yes e. Shortness of breath when washing or dro sing yourself : .................................... ...................................... ❑ Yes f. Shortn(-,s of breath that interferes with your job: ......... ..................................... — ........ ....... ... I ..... I ..... J Yes g. Coughing that produces phlegm (thick sputum):..................................................................................... ❑ Yes h. Coughing that wakes you early in the morning:......................................................................................... ❑ Yes i. Coughing that occurs mostly when you are lying down: ......................... -- ........................................... 0 Yes j. Coughing up blood in the last month: ................................................................................... ............ .....J Yes k. Wheezing:........................................................................................................................................................ ❑ Yogis I. Wheezing that interferes with your job: ....................................................................................................... J Yes m. Chest pain when you breathe deeply: ............................................................................... .......................... ❑ Yes n. Any other symptoms that you think may be related to lung problems: ................................................ ❑ Yes 5. Have you ever had any of the following cardiovascular or heart problems? a. Heart attack: .................................................................................................................................................... ❑ Yes b. Stroke: ............................................................................................................................................................... ❑ Yes c. Angina: .............................................................................................................................................................. O Yes d. Heart failure: ................................................................................................................................................... ❑ Yes e. Swelling in your legs or feet (not caused by walking): .............................................................................. 0 Yogis f. Heart arrhythmia (heart beating irregularly): ............................................................................................. 0 Yes g. High blood pressure: ........................................................................... .......................................................... ❑ Yes h. Any other heart problem that you've been told about: .................................................... ....................... ❑ Yes 6. Have you ever had any of the following cardiovascular or heart symptoms? a. Frequent pain or tightness in your chest: ..............................................................................................❑ YF•a b. Pain or tightness in your chest during physical activity: .......................................................................... ❑ Yes c. Pain or tightness in your chest that interferes with your job: ................................................................... ❑ Yes d. In the past two years, have you noticed your heart skipping or missing a beat: ................................... ❑ Yes e. Heartburn or indigestion that is not related to eating: ............................................................................... ❑ Yes f. Any other symptoms that you think may be related to heart or circulation problems: ...................... ❑ Yes 7. Do you currently take medication for any of the following problems? a. Breathing or lung problems: .......................................................................................................................... ❑ Yes b. Heart trouble: ................................................................................ .................................................................. ❑ Yes C. Blood pressure: ............................................................................................................................................... ❑ Yes d. Seizures (fits): ............ ................................................................................ .................................................... ❑ Yes S. If you've used a respirator, have you ever had any of the following problems? (If you've never used a aspirator go to (luestion 9) a. Eye irritation:... ...... ................ _ ..................................... ....................... __ ....... ....... b. Skin allergies or rashes: ....... ................... ............... .............. C. lnriety:......................................._...................................................................................................... d. t ;eneral weaklteess orfatigue:.................... .............................. ................ ........... ............ ........ ........... e. ether problem that interf -n-, w Ith Four respirator uue:....... ............ .................. ............................. J No J No J No "> No No ❑ No J No J No ❑ No ❑ No ❑ No ❑ No No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No �U No J No J No ..... 0 Yes J No ..—J Yes a No ..... ❑ Yos iJ No 7Yes -1No .—.,J YV% 'J No GJ MJ.7llG J MCA hst 86031 D& May 8. 20M 9. Would you like to talk to the health care professional who will review this questionnaire about your 111tisw•ers to this questionnaire:.......................................................................................................................................> Yes 7 No Qw-,lions Ill to 15 below must h i� answered by every employee who has been svIected to use either a full-facepicte r(-,pirator or a x�Lf-contained breathing apparatus (SCBA). For emptoycs�s who have been selected to use other types of n,%pirators, answering these questiows is voluntary. 10. Have you ever lost vision in either eye (temporarily or permanently): ........................................................J Yes J No 11. Do you currently have any of the following vision problems? a. Wear contact lenses: ............................................................................................................................ ........... J Yes D No b. Wear gla.-oses:.................................................................................................................................................... 0 Yes ❑ No C. Color blind: ....................................................................................................................................................... 0 Yes D No d. Other eye or vision problem: ......................................................................................................................... 0 Yc1s O No 12 Have you ever had an injury to your ears, including a broken ear drum: ................................................... 0 Yes D No 13. Do you currently have any of the following hearing problems? a. Difficulty hearing: ........................................................................................................................................... 0 Yes D No b. Wear a hearing aid: ......................................................................................................................................... 0 Yes D No c. Any other hearing or ear problem: ............................................................................................................... 0 Yes D No 14. Have you ever had a back injury: ........................................................................................................................ 0 Yes D No 15. Do you currently have any of the following musculoskeletal problems? a. Weakness in any of your arms, hands, legs, or feet: .................................................................................. 0 Yes 0 No b. Back pain: .......................................................................................................................................................... 0 Yes D No C. Difficulty fully moving your arms and legs: .............................................................................................. 0 Yes D No d. Pain or stiffness when you lean forward or backward at the waist: ....................................................... 0 Yes D No e. Difficulty fully moving your head up or down: ........................................................................................ 0 Yes D No f. Difficulty fully moving your head side to side: ......................................................................................... 0 Yes D No g. Difficulty bending at your knees: .................................................................................................................. 0 Yes D No h. Difficulty squatting to the ground: ............................................................................................... I ............... 0 Yes D No i. Climbing a flight of stairs or a ladder carrying more than 25 lbs.:........................................................... 0 Yes D No j. Any other muscle or skeletal problem that interferes with using a respirator :...................................... 0 Yes D No Part B wry of the following questions, and other questions not listed, may be added to the questionnaire at the disc retion of the health care professional who will review the questionnaire. 1. In your present job, are you working at high altitudes (over 5,000 feet) or in a place that has lower than normal amounts of oxygen: ................................. ................ .................... .................. ........... .......... J Yt-; J No or other sy mptoms when you're working under the-w conditions:...................._...................................................] Yes J No 2. At work or at home, have you ever been exposed to hazardous solvents, hazardous airborne chemicals gau'S, fumes, or lust), ur have Vou c ome into skin 1 (intact with ha/ardour, hemicals:.......... Yeti -1 No ............... Name Home Address Telephone Length of Employment RESPIRATOR USE PHYSICAL Age Sex Occupation I agree to the release of this information for State and Federal regulatory purposes to the extent provided by applicable laws. DATE EMPLOYER SIGNED ❑ Follow-up Medical Evaluation Physical Required. (Positive response — Question 1-8). ❑ Post -Offer Physical: Medical Evaluation Physical Required. 9. Would you like to talk to the health care professional who will review this questionnaire about your answersto this questionnaire: ............................................ ........................................... .... _ .......... ....................... Q uestionnaire:...............................................................................................................................J Yes �a No Questions 10 to 15 below must be a nswered by every employed- who has been,( !1,._ted to use either a full-facepiet n�spirator or a st�(f. ont rin<�i hreathint; apparatus (SCBA). For emplowt-s who have been select<�f to use other ty ons is volu Ps of respirators, arswering the-e qut- bntary. 10. Have you ever lost vision in either eye (temporarily or permanently): ............................... 0 Yes O Ito 11. Do you currently have anv of the following vision problems? a. Wear contact lenses : ......................................................... 0 Yes b. l Wear ...................................................... ....................... 0 No b........................................................... ................... ...... ....... ...................... .............................A Yes C. Color blind: .............. 0 No ................................................... ..........................................................................0 Yes d. Other eye or vision problem: ........................................................................................................................... roblem:...........................................................................................................................0 0 NO 0Yes 0 No tZ Have you ever had an injury to your ears, including a broken ear drum: ........................................................0 Yes 0 No 13. Do you currently have any of the following hearing problems? a. Difficulty hearing..............................................................................................................................................0 Yes b. Wear a hearing aid: .......................................................................................................................................... 0 No c. Any other hearing or ear problem: 0 Yes Q No Q Yes 0 No 14 Have you ever had a back injury: ........................................................................................................................... njury:...........................................................................................................................0 QYes 0 No 15. Do you currently have any of the following musculoskeletal problems? a. Weakness in any of your arms, hands, legs, or feet:.....................................................................................0 Yes b. Back pain: ............................................... . 0 No ..........................................................................................................0 Yes C. Difficulty fully moving your arms and legs: . .................................................................................. 0 No .............. 0 Yes d. Pain or stiffness when you lean forward or backward at the waist:...........................................................0 0 No Yes e. Difficulty fully moving your head up or down...........................................................................................0 0 No Yes f. Difficulty fully moving your head side to side: ..................................... 0 No ........................................................0 Yes 0 No g. Difficulty bending at your knees: .................................................................................................................... Q nees:....................................................................................................................0 Yes 0 No h. Difficulty squatting to the ground: ........................................................0 Yes 0 No ......................................................... i. Climbing a flight of stairs or a ladder carrying more than 25 lbs.:...............................................................0 Yes 0 No j. Any other muscle or skeletal problem that interferes with using a respirator...........................................0 Yes 0 No Part B Any of the following questions, and other questions not listed, may be added to the questionnaire at the discretion of the health care professional who will review the questionnaire. 1. In your present job, are you working at high altitudes (over5,000 feet) or in a place that has lower thannormal amounts of oxygen:....................................................................... ...........................................................0 Yes 0 No or other symptoms when you're working under these conditions: ........................................................................... Q Yes 0 No 2 At work or at home, have you ever been exposed to hazardous solvents, hazardous airborne chemicals (e.& gases, fumes, or dust), or have you come into skin contact with hazardous chemicals: .............................. Cj Yes 0 No 3. Have you ever worked with any of the materLds, orunder any of the conditions, listed below: a. Asbt-titos:............................................................................................................................................................0 h. Silica (e.g. in sandblasting): ...................... C. Tungsten/cobalt (c.�;. grinding; or welding this material): .............................................................FJ Yes ❑ No .............. d. Beryllium: ........................... .....:3 Yes 0 No e.Aluminum:........................................................................................................................................................ ] Yes O No f. Coal (tier example, mining): ............................................................. ....... _ ........ .................. ........................... Q Yes D No g.Iron:....................................... ...................J Ycs O No h. Tin: ........... ......................... ................................................�] Y,s ❑ No i. Dusty environments :..................................... 'J Yes D No ................................................................................................... j. Other hazardous exposures:...........................................................................................................................0 yes O No if "yes," des Ew these exposures: 4. List any second jobs or side businesses you have: 5. List your previous occupations: 6. List your current and previous hobbies. 7. Have you been in the military services?..................................................................................................................0 Yes O No If "yes," were you exposed to biological or chemical agents (either in training or combat): .................................. C] Yes O No S. Have you everworked on a ILAZ 1AT team?.......................................................................................................0 Yes O No 9.Other than medications for breathing and lung problems, heart trouble, blood pressure, and seizures mentioned earlier in this questionnaire, are you taking any other medications for any reason (including over-the-counter medications): .................................................................................................................... C] Yes O No If "yes," name the medications if you know them: A Will you be using any of the following items with your cespirator(s)? a. HEPA Filters: .................................................................................................................................................... C] ilters:....................................................................................................................................................0 Yes O No b. Canisters (for example, gas masks): ................................................................................................................ Q Yes O No c. Cartridges: ..............................................................................................................................................0 Yes O No 11. How often are you expected to use the cespirator(s)?: a. Escape only (no rLscue):....................................................................................................................................0 Yes O No b. Emergency rescue only: .................................................................................................................................... Q Yes O No c. Less than 5 hours per week.............................................................................................................................0 Yes O No d. Less than 2 hours per day: ................................................................................................................................ C] Yes O No e. 2 to 4 hours per day: .......................................................................................................................................... C] ay:..........................................................................................................................................0 Yes O No f. Over 4 hours per day: ....................................................................................................................................... C] ay:.......................................................................................................................................0 Yes O No 12. During the period you are using the respirator(s), is your work effort: a. Light (less than 2W kcal per hour):... ......................................................... Yes 0 No .......................... . If " y,-,," how long does this period last during the average shift: his. minx. Examples of a light work effort are sitting while writing typing, drafting, or performing light assembly work or sLmding while operating a dnli press (1-3 lbs.) or controlling machines. b. %federate OX) to -�50 kcal per hour): ...... our):......0 Yes O NO .................................................... .................................... If "yes," how long does this period last during theaverage shift: h grs, mins. EX,imples of moderate work effort are sitting while nulling or filirig; driving a truck or bus in urban traffic, standing while drilling nailing, performing assembly work, or transferring a moderate load (about 35 lbs.) at trunk level; walking on a level surface about 2 mph or down a 3-degree ),Trade about 3 mph; or pushing a wheelbarrow with a heavy load (about 1W lbs.) on a level surface. c. Heavy (above 350 kcal per hour): .................................................................❑ Yes ❑ No ................................................ . If "Yes," how long does this period last during the average shift hrs. mins. Examples of heavy work are lifting a heavy load (about 30 Ibs.) from the floor to your waist or shoulder, working on a loading dock; shoveling standing while bricklaying or chipping castings; walking up an 8-degree grade about 2 mph; climbing stairs with a heavy load (about 50 lhs.). 13. Will you be wearing protective clothing and/or equipment (other than the respirator] when you're usingyour respirator.......................................................................................................................................................❑Yes ❑ No "yes," describe this protective clothing and/or equipment 14. Will you be working under hot conditions (temperature exceeding 77PF):..................................................... ❑ Yes ❑ No 15. Will you be working under humid conditions: ................................................................................................... Q onditions:...................................................................................................❑ Yes ❑ No 17. Describe any special or hazardous conditions you might encounter when you're using your respirators) (for example, confined spaces, life -threatening gases): 18. Provide the following information, if you know it, for each toxic substance that you'll be exposed to when you're using your respirators): ti`ame of the first toxic substance: Estimated maximum exposure level per shift Duration of exposure per shift: Name of the second toxic substance: Estimated maximum exposure level per shift Duration of exposure per shift [Name of the third toxic substance: Estimated maximum exposure level per shift: Duration of exposure per shift: The name of other toxic substances that you'll be exposed to while using your respirator. 19. Describe any special responsibilities you'll have while using your respirator(s) that may affect the safety and well-being of others (for example, rescue, security): M-Airm-7xru uu4:n,tGUV PLHCP Follow-U employee Job Date of this follow - Reasons for follow-up Actions: Signed: Medical Examination Copy of recommendation given to employee? 1J Yes CI No Recommendations about employee use of the respirator: Limitations - Need for follow-up medical evaluations - Date signed: Date given: RESPIRATOR USE PFIYSICAL See Attached Job Description NAME AGE SEX HOME ADDRESS TELEPHONE OCCUPATION LENGTH OF EMPLOYMENT I agree to the release of this information for State and Federal regulatory purposes. DATE SIGNED CARDIO-PULMONARY EXAMINATION 1. HEIGHT WEIGHT 2. HEART: Murmers: Rate Rhythm Enlargement 3. LUNGS: Pulmonary Function Within Normal Limits Outside Normal Limits 4. PA CHEST X-RAY: Within Normal Limits Outside Normal Limits 5. RECOMMENDATIONS: It is my opinion that the above named patient is is not medically qualified to wear a Respirator in the performance of his/her duties. PHYSICIAN IvM rrwrvorAw EMPLOYMENT PHYSICAL SERVICES 2010 ATTACHMENT D III MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL 7. Use only safety type lathe dogs or those with flush set screws. 8. DO NOT HOLD emery cloth in your hand while polishing revolving work. Use a wood block or jig for this purpose. Only use files wi`ql handles. 9. When machine rods or bars that project beyond the head stock, enclose the projecting portion in a stationary pipe supported on a suitable stand. 10. The machining of irregularly shaped castings, crankshafts, and similar objects where the tool is not in contact with the work during the entire revolution of the chuck, IS EXTREMELY HAZARDOUS. The operator MUST BE CONSTANTLY ON THE ALERT to avoid being caught or struck by the work. 11. Do not knock chips off the tool or lean over the lathe to inspect the work while it is running. 10.17 PERSONAL PROTECTIVE EQUIPMENT A. Gloves: On operations where gloves are necessary, wear the proper type specified by your Supervisor. B. Hard Hats: Hard hats are provided by the County to protect your head against the danger of head injury from falling or flying objects, or from electrical shock and burns. Be sure your hat is in good condition and has a chin strap. There is no protection if the hard hat is knocked off. If an area is designated as "HARD HAT AREA" all persons entering these areas shall be required to wear a hard hat. C. Respirators POLICY It is the policy of Monroe County to protect its employees from hazardous atmospheres through a comprehensive program of recognition; evaluation; engineering, administrative and work practice controls; and personal protective equipment, including respirators. To the greatest extent feasible, hazard elimination and engineering and work practice controls shall be employed to control employee exposure to within allowable exposure limits. However, where these measures are not feasible or fully effective or are under development, Monroe County shall provide appropriate respirators to affected employees under this program. Monroe County is committed to full compliance with applicable federal and state regulations pertaining to employee respiratory protection. 10-59 MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL 2. PURPOSE The purpose of this program is to protect the health of Monroe County employees who may be exposed to hazardous atmospheres in the conduct of their work and to provide appropriate protection from these hazards, without creating new hazards. This program sets forth the County's practices for respirator use, provides information and guidance on the proper selection, use, and care of respirators, and contains requirements for establishing and maintaining a respirator program. 3. SCOPE This program applies to all Monroe County employees who need to wear a respirator to perform assigned duties. Examples of chemicals or operations that pose potential respiratory hazards and involve respirator use are Asbestos - Facilities Maintenance Dust — Facilities Maintenance & Roads & Bridges Spray Paint Operations — Fleet Management Immediate Danger to Life & Health (IDLH) — Fire Rescue Airborne/Bloodborne Pathogens — Fire Rescue Herbicides — Roads & Bridges, Airport Maintenance Household Waste — Solid Waste 4. ROLES AND RESPONSIBILITIES General Manager — Employee Services Director - Supports the Respiratory Protection Program and assigns a Respirator Administrator with responsibility and resources to administer the program. Respirator Administrator — Safety Officer - Has overall responsibility for the Respirator Protection Program including monitoring respiratory hazards, and conducting program evaluations. Has knowledge about respiratory protection and maintains an awareness of current regulatory requirements and good practices. Approves Respiratory Protection Programs for each operation that involves use of respirators. Approves training program for employees. 10-60 .k MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL Approves fit test procedures for employees Approves respirator makes and models for use. Performs employee exposure monitoring upon initial work in a potentially hazardous atmosphere and whenever work conditions change that may affect employee exposure. Performs employee exposure monitoring in accordance with Federal and State OSHA regulations Uses generally accepted sampling techniques and analytical methods, including generally accepted quality assurance and control measures. Reports all findings to the supervisor within five days of receipt of analytical results from the laboratory, at a minimum. Upon request, performs surveys and makes recommendations for hazard control. Respirator Technician - Supervisor Complete initial respirator training, refresher training and maintain records. In addition, complete any recommended respirator manufacturer training prior to servicing respirators and their components. Perform and document semi-annual inspections of each air purifying respirator and monthly inspections of each supplied air respirator issued by the employer or maintained in its inventory. Ensure that compressed breathing air cylinders are hydrostatically tested on schedule. Remove from service and tagout any defective respirator parts. Perform maintenance and repairs for respiratory protection equipment in accordance with the manufacturer's instructions. Maintain an inventory of respirators and associated parts and equipment in a clean, secure area. Issue respirators when so directed in writing, inspecting to confirm that the respirator or equipment is of the type specified in the respirator plan or program. Issue spectacle kits to employees who require corrective lenses with their respirators. Perform tests for compressed air quality and inspect breathing air compressors periodically 10-61 MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL Supervisors Initiate and approve a written Respiratory Protection Program for each operation that involves respirator use Complete the initial and respirator refresher training of the type attended by employees under their supervision Initiate safety briefings on respiratory protection issues at the start of each new project or task that involves respiratory hazards for affected employees under their supervision Ensure that any use of respirators by employees under their supervision is in accordance with this program and a written Respiratory Protection Program and Worksite-Specific Respiratory Protection Plan that has been approved by the Supervisor and the Respirator Administrator, or designee Record any complaints related to respirator usage, act promptly to investigate the complaints, correct any hazards, and get medical assistance, when indicated. Report first aid and medical treatment in accordance with Monroe County procedures. Report every respirator related incident to the Respirator Administrator before the end of the work shift Ensure that their employees have the requisite training, fit testing, and medical clearances before authorizing them to wear any respirators Prohibit any employee with lapsed or incomplete respirator clearances to work in hazardous atmospheres. Enforce any restrictions imposed by the occupational physician on individual employees, including the need for corrective lenses Physically check each respirator prior to its assignment to their employees to be sure that it is of the type specified in the written plan. Inform each affected employee of the results of exposure monitoring within one day of receiving such results and assure inclusion of all exposure reports in the County's recordkeeping system Monitor employee compliance with the respirator program requirements Employees Use respiratory protection in accordance with the instructions and training provide Immediately report any defects in the respiratory protection equipment and whenever there is a respirator malfunction, immediately evacuate to a safe area and report the malfunction 10-62 MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL Promptly report to the supervisor any symptoms of illness that may be related to respirator usage or exposure to hazardous atmospheres Report any health concerns related to respirator use or changes in health status to the occupational physician Wash their assigned reusable respirators at the end of each work shift when used and disinfect assigned respirators at least weekly Store respirators in accordance with instructions received Observe any restrictions placed on work activities by the occupational physician. Be clean shaven in all facial areas that seal to the respirator face piece. Allow no headpieces, Band-Aids or other items beneath a respirator seal or head -strap assembly. Inspect the respirator immediately before each use, in accordance with training provided. Perform a user seal, negative and positive respirator fit check each time a respirator is donned in accordance with training provided. 5. PERMISSIBLE PRACTICE Any respirator worn by a Monroe County employee on the job shall be issued by Monroe County under this program. Respirators shall be issued by Monroe County and worn by exposed employees whenever airborne contamination levels are not otherwise reduced to within the allowable limits. A written Respiratory Protection Program and Worksite-Specific Respiratory Protection Plan shall be prepared and approved by the Supervisor and the Respirator Administrator prior to any employee respirator use, including voluntary usage or emergency use. This plan shall identify the location and tasks, identify and quantitative the air contaminants or oxygen deficiency, specify the appropriate respirator, and specify any limitations, such as air monitoring, respirator cartridge change out frequency, etc. Each operation involving respirator use must have a signed and approved written plan. Upon an employee's request, an appropriate respirator shall be issued for voluntary use when exposure to contaminant levels is at or above 50 percent of allowable limits, but within allowable limits, or when exposed to nuisance dusts, molds, pollen, etc. Reasonable efforts should be made to reduce such exposures. 10-63 MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL Regardless of exposure level, employees who are exposed to any recognized carcinogen, mutagen or teratogen in the performance of their work assignments may request and receive an appropriate respirator for voluntary use and in addition, affected employees already assigned a respirator may request a respirator that provides a higher protection factor than the one provided by Monroe County for that work. The Monroe County Hazardous Material Emergency Response Plan required for chemical spills or releases, fire response, pathogen exposures, etc. shall include a Respiratory Protection Program and Worksite-Specific Respiratory Protection Plan whenever there is a reasonable potential for a respiratory hazard. The plan includes Monroe County's Fire Rescue, Public Works and Solid Waste response. At no time, however briefly, shall a Monroe County employee be exposed to contaminant levels that are more than three times the allowable 8-hour time - weighted average limits without respiratory protection No employee may work alone while wearing a respirator. Each respirator wearer shall have at least one employee assigned responsibility to perform periodic status checks throughout the duration of respirator use. When SCBAs are worn, at least one standby person, located outside of the hazardous atmosphere and equipped with an SCBA, shall be in constant attendance, ready to provide immediate assistance and to call for emergency help, if needed 6. Respiratory Protection Program and Worksite-Specific Respiratory Protection Plan Each operation that involves respirator use shall have a written Respiratory Protection Program and Worksite-Specific Respiratory Protection Plan that is approved and signed by the Supervisor and Respirator Administrator. This plan, which may be a part of a job hazard analysis, site safety plan, confined space entry permit or other document, shall contain an identification of the atmospheric hazard(s) and the respective measured or expected concentration(s) at each location or operation, the respective allowable concentration limits, the type of respirator(s) approved, monitoring requirements, emergency response procedures, and limitations, such as the frequency of respirator cartridge change -out. This document shall be updated annually and more frequently if conditions change. This document shall be available at the job location and shall be maintained for 30 years as an exposure record. 7. RECOGNITION AND EVALUATION OF AIRBORNE CONTAMINANTS A hazard assessment shall be initially performed in each workplace by the Supervisor or Respirator Administrator. Where the presence or potential presence of airborne 10-64 MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL contaminants is recognized or suspected the Respirator Administrator or other appointed evaluator shall perform evaluations to determine if allowable limits are exceeded or potentially exceeded. The results of the hazard assessment shall be communicated to the General Manager and affected supervisors and employees. For workplaces in which the hazard assessment produces no findings of potential exposures, Supervisors shall monitor the workplace and request a hazard assessment whenever materials or processes change. Whenever the hazard assessment identifies potential exposures to hazardous atmospheres, an annual reassessment shall be performed, unless a more frequent assessment is required by OSHA. In addition, the Supervisor is responsible for requesting a reassessment by the Respirator Administrator whenever materials or processes change. 8. EVALUATION OF AIRBORNE CONTAMINANT CONTROLS When hazardous atmospheres are recognized, elimination of the hazardous material or feasible engineering and work practice controls shall be instituted to reduce contaminant levels to within allowable limits. If such measures are not completely successful or if the condition is temporary, personal protective equipment, including respiratory protection shall be selected and worn. The Safety Officer shall reassess the workplace when controls are instituted to measure their effectiveness in reducing employee exposure to hazardous atmospheres. 9. SELECTION AND ISSUANCE OF RESPIRATORS Selection of the appropriate respirator shall be documented in the written Worksite-Specific Respiratory Protection Plan. If the atmosphere is uncharacterized, it must be assumed to be IDLH and a positive pressure SCBA or combination supplied -air respirator with SCBA must be worn. Respirator selection shall comply with OSHA requirements for specific substances, such as asbestos, lead, etc. At a minimum, the assigned protection factor of the selectee's respirator shall equal or exceed the hazard ratio. All respirators used by Monroe County employees shall be approved by NIOSH. No components shall be substituted, unless they are listed in the approval by NIOSH. Any change or modification to a respirator may void the respirator approval and may adversely affect its performance. Any restrictions or limitations recommended for a particular respirator by the respirator manufacturer shall be observed. The Supervisor shall inspect each respirator or component prior to issuance and shall assure that the respirator assembly is complete, sanitary and in good working order upon issuance. Atmosphere -supplying respirators shall be 10-65 MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL returned to the Supervisor at least monthly for periodic inspection and air purifying respirators shall be returned for periodic inspection at least semi- annually. A log shall be maintained of these periodic inspections. The Supervisor is responsible to ensure that each respirator user under the Supervisor's supervision is currently approved for respirator use, including medical, fit testing and training certifications. Employees with expired certifications shall not be permitted to work in hazardous atmospheres or to voluntarily wear a respirator until their lapsed requirements are updated. Each respirator must be inspected by its wearer immediately prior to each use, according to instructions provided in the respirator training. Any defects shall be reported to the Supervisor before entry into a hazardous atmosphere. A user seal check shall be performed by the wearer immediately prior to entering the hazardous atmosphere. Monroe County will provide an appropriate spectacle kit to each respirator wearer who requires corrective lenses and will pay for prescription safety lenses for the kit initially and as needed. Contact lenses shall be permitted if the employee's ophthalmologist or optometrist authorizes their use by the employee in hazardous atmospheres with negative pressure and positive pressure respirators in a written communication to Monroe County Employees who are issued a respirator are responsible for its maintenance, daily inspection and storage while the unit is in their control. 10. FIT TESTING Each respirator wearer shall be fit tested, using protocols approved by the Respirator Administrator. Frequency testing shall be performed if required by the Federal Code of Regulations for specific substances or if the wearer's facial contours change, such as by weight gain or loss, facial surgery, etc. On the occasion of each fit test, employees may choose their respirator from an array of face pieces from different manufacturers and sizes approved by the Respirator Administrator. Fit test certifications shall be prepared and signed by the person performing the fit test and must name the tested employee; the make, model and size of respirator fit tested; and the result of the fit test. A copy shall be provided to the Supervisor. Monroe County required fit tests, including reasonable employee time and travel costs, shall be paid for by Monroe County. A medical evaluation as described in Section 10.I7_.1 f must be performed before an employee is fit tested. 11. MEDICAL APPROVAL FOR RESPIRATOR USE 10-ss MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL Each respirator wearer shall be approved for respirator use by the County's designated physician before the employee is required to wear a respirator (including before being fit tested). The physician shall be provided a copy of the employee's duties, respirator types to be worn, and air contaminants, as well as any applicable OSHA standards governing the medical evaluation, such as the Respiratory Protection standard and applicable substance -specific standards in addition to the Respirator Medical Evaluation Questionnaire to be completed by the employee being examined. The questionnaire shall be filled out by the employee confidentially during the employee's normal working hours or at a time and place convenient to the employee - preferably in the Human Resource office location nearest to the employee's worksite location. The physician's approval shall be a written certification that lists the respirator types approved for use by the individual (i.e., negative pressure air purifying, powered air purifying, pressure demand SCBA) and any restrictions on the employee's use of respiratory protection, including the need for corrective lenses. The physician's certification shall not disclose any confidential medical information, but shall clearly list or describe any restrictions to be observed. Medical evaluations shall be performed by the County's designated physician and the cost of the respirator medical evaluation shall be budgeted and paid by employee's department including reasonable time and travel expenses of the employee. Payment for special medical diagnostic procedures needed to assess the ability of an employee to safely wear a respirator shall be approved in advance by the Respirator Program General Manager. No medical treatment costs shall be paid by the employee under this program. Medical records created under this program shall be handled in accordance with requirements for confidentiality, employee access and retention If it is found that an employee is not physically able to wear a respirator, arrangements must be made by the applicable Supervisor and Department Head to have the duties associated with a respirator be performed by another qualified employee within the department. 12. TRAINING Each respirator wearer, supervisor of a respirator wearer, respirator technician and Officer must be trained and updated as needed. Upon successful completion of respirator training, the instructor shall sign a certification that names the employee trained, the type(s) of respirator and the training date. A copy shall be provided to the supervisor. A record shall be maintained of the training topics covered. 10-67 MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL Monroe County approved respirator training shall be conducted by or paid for by Monroe County including the employee's reasonable time and travel to participate in such training. 13. DEFINITIONS Air purifying respirator (APR) — a type of respirator that removes specific contaminants from air by use of filters, cartridges or canisters by passing ambient air through the air -purifying element. APRs do not supply oxygen. Allowable limit — the maximum concentration of a substance in air that is permitted by regulation or voluntary standards to protect employee health. These concentrations may be expressed in terms of an 8-hour time -weighted average, a 15-minute short- term average or as an instantaneous upper ceiling limit. An example is the OSHA permissible exposure limits (PEL). Assigned protection factor — the level of respiratory protection expected to be provided by a given class of respirators to a properly fitted and trained user. This factor is assigned by OSHA in substance specific standards and by ANSI in the voluntary national standard, Z88.2. Atmosphere -supplying respirator — a type of respirator that supplies the user with breathing air from a source independent of the ambient atmosphere, and includes supplied -air respirators (SARs) and self-contained breathing apparatus (SCBA) units. Canister or cartridge — a container with a filter, sorbent or catalyst, or combination of these items, which removes specific contaminants from the air passed through the container. Demand respirator — an atmosphere -supplying respirator that admits breathing air to the face piece only when a negative pressure is created inside the face piece by inhalation. Dust mask — see filtering face piece. Emergency situation — any occurrence such as, but not limited to, equipment failure, rupture of containers, or failure of control equipment that may or does result in an uncontrolled significant release of an airborne contaminant. Employee exposure — exposure to a concentration of an airborne contaminant that would occur if the employee were not using respiratory protection. End -of -service -life indicator (ESLI) — a system that warns the respirator user of the approach of the end of adequate respiratory protection, for example, that the sorbent is approaching saturation or is no longer effective Escape -only respirator — a respirator intended to be used only for emergency exit. Filter or air -purifying element — a component used in respirators to remove solid or liquid aerosols from the inspired air. 10-68 MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL Filtering face piece (Dust mask) — a negative pressure particulate respirator with a filter as an integral part of the face piece or with the entire face piece composed of the filtering medium. Fit factor — a quantitative estimate of the fit of a particular respirator to a specific individual, and typically estimates the ratio of the concentration of a substance in ambient air to its concentration inside the respirator when worn. Fit test — use of a protocol to qualitatively or quantitatively evaluate the fit of a respirator on an individual. Hazardous atmospheres — an atmosphere that contains a contaminant(s) in excess of the allowable limit or contains less than 19.5 percent oxygen. Hazard ratio — a number calculated by dividing the actual air contaminant concentration by the allowable limit. Immediately dangerous to life and health (IDLH) — an atmosphere that poses an immediate threat to life would cause irreversible adverse health effect, or would impair an individual's ability to escape from a dangerous atmosphere. Loose -fitting face piece — a respiratory inlet covering that is designed to form a partial seal with the face. National Institute for Occupational Safety and Health (NIOSH) — a Federal institute responsible for conducting research and making recommendations for the prevention of work -related illnesses and injuries. It tests and issues approvals for respirators. Negative pressure respirator (tight fitting) — a respirator in which the air pressure inside the face piece is negative during inhalation with respect to the ambient air pressure outside the respirator Occupational Safety and Health Administration (OSHA) — the Federal or state agency with authority to issue and enforce workplace health and safety regulations. Oxygen deficient atmosphere — an atmosphere with oxygen content below 19.5 percent by volume. Physician or other licensed health care professional (PLHCP) — an individual whose legally permitted scope of practice (i.e., license, registration or certification) allows him or her to independently provide or be delegated the responsibility to provide some or all of the health care services required by this respirator program. Positive pressure respirator — a respirator in which the pressure inside the respiratory inlet covering exceeds the ambient air pressure outside the respirator. 10-69 MONROE COUNTY SAFETY POLICIES AND PROCEDURES MANUAL Powered air -purifying respirator (PAPR) — an air -purifying respirator that uses a blower to force the ambient air through air -purifying elements to the inlet covering. Pressure demand respirator — a positive pressure atmosphere -supplying respirator that admits breathing air to the face piece when the positive pressure is reduced inside the face piece by inhalation. Protection factor — a ratio calculated by dividing the air contaminant concentration outside a respirator by the concentration inside the respirator. This is measured in a quantitative fit test. Qualitative fit test (QLFT) — a pass/fail fit test to assess the adequacy of respirator fit that relies on the individual's response to the test agent. Quantitative fit test (QNFT) — an assessment of the adequacy of respirator fit by numerically measuring the amount of leakage into the respirator. Respiratory inlet covering — that portion of a respirator that forms the protective barrier between the user's respiratory tract and an air -purifying device or breathing air source or both. It may be a face piece, helmet, hood, suit or a mouthpiece respirator with nose clamp. Self-contained breathing apparatus (SCBA) — an atmosphere -supplying respirator for which the breathing air source is designed to be carried by the user. Service life — the period of time that a respirator, filter or sorbent or other respiratory equipment provides adequate protection to the wearer. Supplied -air respirator (SAR) or airline respirator — an atmosphere - supplying respirator for which the source of breathing air is not designed to be carried by the user. Tight -fitting face piece — a respiratory inlet covering that forms a seal with the face. User seal check — an action conducted by the respirator user to determine if the respirator is properly seated to the face D. Foot and Toe Protection The appropriate foot protection is required for work functions that include lifting heavy objects that may be dropped on the feet, electrical protection, piercing protection, chemical protection, fire protection and working in areas that are designated as high hazard areas and require foot protection i.e.; around fork lifts and rolling stock. 10-70 REQUE51 FOR NRUNU5AL5 EMPLOYMENT PHYSICAL SERVICES 2010 ATTACHMENT D IV Respirator Fit Testing The objective is to assure that any employee in Monroe County that is using a respirator has completed an annual fit testing to confirm that the respirator fits the individual securely and that the employee can don the equipment satisfactorily. These annual tests are based on standards and requirements of NFPA, NIOSH and OSHA. Before testing the employee must complete a respiratory questionnaire and be examined by a doctor that will determine if there any reasons why the employee cannot use a respirator. The type of testing we are doing at the present time is the Quantitative system. The equipment is manufactured by 3M. It consists of a hood and two different testing solutions, a sweet and a bitter. I use the bitter. At the beginning of the process the individual is tested to determine their level of sensitivity to the solution being used for the test. With a hood over their head they are given a nebulized mist of the diluted solution in a series of 10 shots into the hood. Once they have tasted the solution the number of shots that were provided is recorded and the hood is removed. The individual then dons the respirator they will be using in their line of work. I cannot help them in any way due to the fact I will not be there when they are using the equipment in their job and they must be able to don the equipment correctly. When the employee dons the equipment, (and performs a seal check under certain conditions) the hood is again placed over their head and the respirator and the actual test begins. The individual will be asked to perform a series of 7 exercises that emulate work conditions they might be exposed to. Prior to each exercise they are given the number of nebulized shots that were determined by the sensitivity test. During the testing, the solution, (Bitrex) is 100 times stronger than the solution used in the sensitivity test. Each exercise lasts about one minute. The 7 exercises are: 1. Normal breathing 2. Deep breathing 3. Turning their head left to right 4. Moving their head forward and back 5. Talking out loud 6. Bending at the waist 7. Normal breathing If at anytime during the test they taste the solution the test is stopped, the hood is removed and the respirator is refitted or replaced with a different size or style. Upon successful completion of the test, the employee signs the paperwork that provides the details of the testing and the type and size of the respirator. If the employee has never been respirator fit tested, I show them a video, produced by 3M that explains the testing process. HLOUEST FOR PROPOSALS EMPLOYMENT PHYSICAL SERVICES 2010 ATTACHMENT E 1582--1 yright Z 2000 NFPA, All Rights Reserved NFPA 1582 Standard on Medical Requirements for Fire Fighters and Information for Fire Department Physicians 2000 Edition This edition of NFPA 1582, Standard on Medical Requirements for Fire Fighters and Information for Fire Department Physicians, was prepared by the Technical Committee on Fire Service Occu- pational Medical and Health, and acted on by the National Fire Protection Association, Inc., at its November Meeting held November 14-17, 1999, in New Orleans, IA. It was issued by the Standards Council on January 14, 2000, with an effective date of February 11, 2000, and supersedes all previous editions. This edition of NFPA 1582 was approved as an American National Standard on February 11, 2000. Origin and Development of NFPA 1582 Ajoint task force of members representing both the Technical Committees on Fire Service Occupational Safety and Health and Fire Fighter Professional Qualifications began address- ing medical requirements for fire fighters in March 1988. A standing subcommittee on Med- ical/Physical Requirements for Fire Fighters was created under the Fire Service Occupational Safety and Health Committee in 1990 and was responsible for the development of NFPA 1582. This new document covered the medical requirements necessary for persons who perform fire -fighting tasks. Medical requirements that were previously contained in Section 2-2 of NFPA 1001, Standard forFire5ghterProfessional Qualifuations, applied only to the entry level. They were deleted from NFPA 1001. Legal opinion and federal laws show that requirements set for a position must apply to anyone who would be or is in that position. These medical requirements are therefore intended to apply to candidates as well as to current fire fighters. Two categories of medical conditions were created, Categories A and B. Category A repre- sented conditions that, if they exist in the candidate or current fire fighter, would not allow this person to perform fire -fighting operations. Category B conditions must be evaluated on a case -by -case basis so that the fire department physician can determine if the medical condi- tion in a particular candidate or current fire fighter would prevent that person from perform- ing fire -fighting operations. Medical evaluations, medical examinations, record keeping, and confidentiality were addressed in Chapter 2. Chapter 3 contained the actual medical conditions that comprise the requirements. Extensive advisory and informational material was developed in the appendixes to aid fire department administrators and fire department physicians. The committee completed its work inianuary 1992, and the first edition was presented to the Association membership at the 1992 Annual Meeting in New Orleans, Louisiana. The second edition of this standard reflected the numerous changes in medical technol- ogy that have impacted structural fire fighters. The technical committee was assisted by phy- sicians whose expertise covered the areas of emergency medicine; vision; haring; and cardiac, pulmonary, neurological, and metabolic conditions. The technical committee endeavored to update six critical areas and moved some of the previous Category A text to Category B. They then enhanced some of the Category A material that would prohibit an individual from being hired or to continue as a fire fighter. The com- mittee also added additional appendix text in the areas of ADA requirements, explanatory material for both fire department administrators and fire department physicians, and sample physician checklist forms. Additional explanatory material was added or enhanced to provide the user with addi- tional information regarding medical conditions whose categories were changed. These included a number of cardiac conditions, diabetic conditions, seizure disorders, asthma, and therapeutic anti -coagulation. 1582-2 MEDICAL REQUIREMENT'S FOR FIRE FIGHTERS A.ND INFOR-NU TION FOR FIRE DEPARTMENT PMSICLANS The 2000 edition of this standard reflects (1) the technical committee's recognition that medical technology is continually changing and (2) the committee's effort to incorporate F those medical technology changes within the standard. just as the committee recognizes med- ical technology advances, it is incumbenton the fire department to communicate with the fire S department physician changes in the essential function(i) the fire department performs. Conversely, the fire department physician must keep the fire department updated on the lat- est changes in the medical field. Fire department physicians are the primary users of NFPA 1382. Committee members feel that allowing the fire department physician more latitude in determination of a member's ability to perform essential functions will assist users in enforcing the standard. Therefore, the committee has changed the title of the standard to NFPA 1582, Standard on Medical Requin- F meets for Firs Fighters and Information for Fin Department Physicians. The topic of incident scene rehabilitation and accountability are included in this edition, since the fire department physician may provide guidance or assistance at the rehabilitation unit. In addition, specific areas concerning the following conditions were clarified or expanded; cardiac, vision, hearing, neurological, and metabolic. An appendix was added to this edition comparing the requirements of this standard with those of 29 CFR 1910.134, the OSFU respiratory protection regulation, There are many users of both documents, and this appendix clarifies the companion areas of each. 2M Efton COMMITTEE PERSONNEL 1582_3 Technical Committee on Fire Service Occupational Medical and Health Murrey E. Loftin, Chair Virginia Beach Fire Dept., VA (U] Rep. NFPA Fire Service Section David J. BarWo, U.S. Army Inst. of Surgical Research, TX (SE] Kimberly S. Bevins, Bio-Care, MI (SE] Paul "Shoo" Blake, City of Baytown Fire & Rescue Services. TX (E] Repp. Industrial Emergency Response Working Group Mary S. Bogucki, Yale University, CT (SE] Anthony L Clark, Kenton County Airport Board, OH (U] Thomas J. Cuff, Jr., Firemens Assn, of the State of New York. NY (UI Tammy DiAnda, Reno Fire Dept., NV (U] John F. Folan, Northside Medical Assoc., NY (SE] Richard D. Gerkin, Jr., Good Samaritan Hospital/Phoenix Fire Dept, AZ (E] Juan Gonzalez, Medtlex: The Exercise Science Inst., TX (RT] W. Larry Kenney, Penn State University, PA (RT] Rep. Landy Jacobs & Assoc. Sandra Kirkwood, Las Vegas Fire Dept, NV (U] Frank P. Mineo, New York City Fire Dept, NY (U] Gary L Neilson, Truckee Meadows Fire Protection District. NV (U] Rep. Fire Dept Safety Officers Assn. Alternates David W. Dodson, Loveland Fire Dept, CO [U] (AIL to G. L Neilson) 11Tclaael S. Gray, Virginia Beach Fire Dept., VA [U] (AIL to M. E. Loflin) Stephen N. Foley, NFPA Staff Liaison Deborah L Pritchett, Lawrence Township Fire Dept., IN (L] Rep. Indianapolis Metropolitan Professional Fire Fighters Union Gordon M. Sachs, IOCAD Emergency Services Group, PA (SE] Rep. Fairfield Community Fire Co., Inc. Daniel G. Samo, ENH - OMEGA, IL (SE] James Sewell, Seattle Fire Dept., WA (L] Rep. Int'I Assn. of Fire Chiefs Philip C. Stirdeburg, LaFarge Fire Dept, W1 (L] Rep. Nat'l Volunteer Fire Council Robert M. Stratman, West Metro Fire Protection District, CO (RT] Rep. Metropolitan State College of Denver Andy C. Teeter, Tulsa Fire Dept, OK (U] Rep. Inc'l Fire Service Training Assn. Kathy Tinios, Cooperative Personnel Services, CA (SE] Teresa Wann, Santa Ana College, CA [SE] Don N. Whittaker, Lockheed -Martin Idaho Technologies Co., ID (E] Decker Williams, Phoenix Fire Dept., AZ (E] Thomas R. Luby, New York City Fire Dept, NY [U] (AIL to F. P. Mineo) Brian V. Moore, Phoenix Fire Dept., AZ (E] (AIL to D. Williams) This list represents the membership at the time the Committee was balloted on the final text of this edition. Since that time, changes in the membership may have occurred. A key to classifications is found at the back of the document. NOTE: Membership on a committee shall not in and of itself constitute an endorsement of the Association or any document developed by the committee on which the member serves. Committee Scope: This Committee shall have primary responsibility for documents on occupational medi- cine and health in the working environment of the fire service. 2000 Edition 1582--4 htEDIC-XL REQUIREMENTS FOR FIRE FIGHTERS AND INFORMATION FOR FIRE DEPARTMENT PHN'SIC1,%-NS Contents Chapter 1 Administration ..................... 1582— 5 1-1 Scope ............................... 1582— 5 1-2 Purpose ............................. 1582— 5 1-3 Implementation ...................... 1582— 5 1-4 Definitions... --- ...... — .......... 1582— 5 Chapter 2 Medical Process .................... 1582— 6 2-1 Medical Evaluation Process ............. 1582— 6 2-2 Fire Department Roles, , . . . ... ........ 1582— 6 2-3 Preplacement Medical Evaluation........ 1582— 6 24 Periodic Medical Evaluation ............ 1582— 7 2-5 Return -to -Duty Medical Evaluation ....... 1582— 7 26 Medical Evaluation Records, Results, Reporting, and Confidentiality .......... 1582— 7 Chapter 3 Category A and Category B Medical Conditions ................. 1582— 8 3-1 Medical Conditions Affecting Ability to Perform ........................... 1582— 8 3-2 Head and Neck ....................... 1582— 8 3-3 Eyes and Vision ....................... 1582— 8 34 Ears and Hearing ..................... 1582— 8 3-5 Dental .............................. 1582— 8 3-6 Nose, Oropharynr, Trachea, Esophagus, and Larynx .......................... 1582— 8 3-7 Lungs and Chest Wall .................. 1582— 9 3-8 Heart and Vascular System ............. 1582— 9 3-9 Abdominal Organs and Gastrointestinal System .............................. 1582— 9 3-10 Genitourinary System .................. 1582— 9 3-11 Spine, Scapulae, Ribs, and Sacroiliac Joints ...................... 1582-10 3-12 Extremities .......................... 1582-10 3-13 Neurological Disorders ................ 1582-10 3-14 Skin ................................ 1582-10 3,15 Blood and Blood -Forming Organs ....... 1582-10 316 Endocrine and Metabolic Disorders ...... 1582-10 3-17 Systemic Diseases and Miscellaneous Conditions ........................... 1582-10 2000 Edition 3-18 Tumors and Malignant Diseases.......... 1582-10 3-19 Psychiatric Conditions .................. 1582-11 3-20 Chemicals, Drugs, and Medications....... 1582-11 Chapter 4 Infectious Disease Program ...........1582-11 4-1 Infection Control Program .............. 1582-11 4-2 Exposure Incidents ................ .... 1582-11 4-3 Tuberculosis. ......................... 1582-11 4-4 Immunizations ........................ 1582-11 Chapter 5 Incident Scene Rehabilitation and Medical Treatment ............. 1582-11 5-1 Incident Scene Rehabilitation ........... 1582-11 5-2 Incident Scene Safety and Health ........ 1582-11 5-3 Evaluation and Triage of Member Injuries ...................... 1582-11 5-4 Incident Scene Rehabilitation Tactical Level Management Component ............... 1582-11 Chapter 6 Referenced Publications ..............1582-12 Appendix A Explanatory Material .............. 1582-12 Appendix B Information for Fire Department Physicians .......................1582-21 Appendix C Essential Structural Fire -Fighting Functions ........................1582-26 Appendix D Guide for Fire Department ?administrators .................... 1582-26 Appendix E Sample Forms .................... 1582-33 Appendix F Referenced Publications ...........1582-33 Index.......................................1582-48 ,kDMINiSTRV"rION 1582- 5 NFPA 1582 Standard on Medical Requirements for Fire Fighters and Information for Fire Department Physicians 2000 Edition NOTICE: An viterisk (`) following the numberor letter des- ignating a paragraph indicates that explanatory material on die paragraph can be found in :Appendix A. Infonnaiion on referenced publications can be found in Chapter 6 and Appendix F. Chapter 1 Administration 1-1 Scope. 1-1.1 This standard shall contain medical requirements for members, including full-time or part-time employees and paid or unpaid volunteers. It also shall provide information for phy- sicians regarding other areas of fire department medicine, including infection control and fireground rehabilitation. 1-1.2 These requirements are applicable to public, governmen- tal, military, private, and industrial fire department organizations providing rescue, fire suppression, emergency medical services, hazardous materials mitigation, special operations, and other emergency services. 1-1.3 This standard shall not apply to industrial fire brigades that also can be known as emergency brigades, emergency response teams, fire teams, plant emergency organizations, or mine emergency response teams. 1-2 Purpose. 1-2.1 The purpose of this standard shall be to specify mini- mum medical requirements for candidates and current mem- bers. It also shall provide other information regarding fire department activities that assist the department physician in providing proper medical support for members. 1-2.2* The implementation of the medical requirements out- lined in this standard shall help ensure that candidates and current members are medically capable of performing their required duties and shall help to reduce the risk of occupa- tional injuries and illnesses. 1-2.3 Nothing herein shall be intended to restrict any jurisdic- tion from exceeding these minimum requirements. 1-3 Implementation. 1-3.1 For candidates, the medical requirements of this stan- dard shall be implemented when this standard is adopted by an authority having jurisdiction, on an effective date specified by the authority having jurisdiction. 1-3.2* When this standard is adopted by a jurisdiction, the authority having jurisdiction shall set a date or dates for cur- rent members to achieve compliance with the requirements of this standard and shall be permitted to establish a phase - in schedule for compliance with specific requirements of this standard in order to minimize personal and departmental disruption. 14 Definitions. 14.1* Approved. Acceptable to the authoriry having juris- diction. 14.2* Authority Having Jurisdiction. The organization, office, or individual responsible for approving equipment, materials, an installation. or a procedure. 14.3` Candidate. A person who has made application to commence performance as a member. 14.4 CategoryA Medical Condition. A medical condition that would preclude a person from performing as a member in a training or emergency operational environment by presenting a significant risk to the safety and healdi of the person or others. 14.5 Category B Medical Condition. A medical condition that. based on its severity or degree, could preclude a person from performing as a member in a training or emergency operational environment by presenting a significant risk to the safety and health of the person or others. 14.6 Drug. Any substance, chemical, over-the-counter medi- cation. or prescribed medication that could affect the perfor- mance of the member. 14.7 Essential Job Function. Task or assigned duty that is critical to successful performance of thejob. 14.8 Evaluation. See Medical Evaluation. 14.9 Exposure Incident. A specific eve, mouth, or other mucous membrane, non -intact skin, or parenteral contact with blood, body fluids, or other potentially infectious materi- als, or inhalation of airborne pathogens, ingestion of food - borne pathogens or toxins. 14.10 Fire Department Physician. The licensed doctor of medicine or osteopathy who has been designated by the fire department to provide professional expertise in the areas of occupational safety and health as they relate to emergency services. 14.11 Functional Capacity Evaluation. An assessment of the correlation between that individual's capabilities and the essential job functions. 14.12 Health and Fitness Coordinator. The person who, under the supervision of the fire department physician, has been desig- nated by the department to coordinate and be responsible for the health and fitness programs of the department. 14.13 Health and Safety Officer. The member of the fire department assigned and authorized by the fire chief as the manager of the safety and health program and who performs the duties and responsibilities specified in this standard. This individual can be the incident safety officer or that can also be a separate function. 14.14 Infection Control Officer. The person or persons within the fire department who'1re responsible for managing the department infection control program and for coordinat- ing efforts surrounding the investigation of an exposure. 14.15 Infection Control Program. The fire department's for- mal program relating to the control of infectious and commu- nicable disease hazards where employees, patients, or the general public could be exposed to blood, body fluids, or other potentially infectious materials in the fire department work environment. This program includes, but is not limited to, implementation of written policies and standard operating procedures regarding exposure follow-up measures, immuni- zations, members' health screening programs, and educa- tional programs. 2000 Edition 1582-6 MEDICAL REQUIRENIENTS FOR FIRE FIGHTERS .AND INFORNL\TION FOR FIRE DEP,ARrMENT PH,�SICI:. NS 14.16 Medical Evaluation. The analysis of information for the purpose of making a determination of medical certifica- tion. Medical evaluation can include a medical examination. 14.17 Medical Examination. An examination performed or directed by the fire department physician. 14.18 Medical Services, Emergency. The provision of treat- ment —such as first aid, cardiopulmonary resuscitation, basic life support, advanced life support, and other pre -hospital pro- cedures including ambulance transportation —to pauems. 14.19 Medically Certified- A determination by the fire depart- ment physician that the candidate or current member meets the medical requirements of this standard. 14.20* Member. A person involved in performing the duties and responsibilities of a fire department, under the auspices of the organization. A fire department member can be a full- time or part-time employee or a paid or unpaid volunteer, can occupy any position or rank within the fire department, and can engage in emergency operations. 14.20.1 Member, Current. A person who is already a mem- ber and whose duties require the performance of essential Fire -fighting functions. 14.21 Shall. Indicates a mandatory requirement. 14.22 Should. Indicates a recommendation or that which is advised but not required. 14.23 Standard. A document, the main text of which con- tains only mandatory provisions using the word "shall" to indi- cate requirements and which is in a Form generally suitable for mandatory reference by another standard or code or for adop- tion into law. Nonmandatory provisions shall be located in an appendix, Footnote, or fine -print note and are not to be con- sidered a part of the requirements of a standard. 14.24 Tactical Level Management Component (TLb1C). A management unit identified in the incident management sys- tem commonly known as "division," "group," or "sector." Chapter 2 Medical Process 2-1 Medical Evaluation Process. 2-1.1* The fire department shall establish and implement a medical evaluation process for candidates and current members. 2-1.2 The medical evaluation process shall include preplace- ment medical evaluations, periodic medical evaluations, and return -to -duty medical evaluations. 2-1.3 The fire department shall ensure that the medical eval- uation process and all medical evaluations meet all of the requirements of Section 2-1. 2-1.4 Each candidate or current member shall cooperate, par- ticipate, and comply with the medical evaluation process and shall provide complete and accurate information to the fire department physician. 2-1.5* Each candidate or current member shall report, on a timely basis, to the fire department physician any exposure or medical condition that could interfere with the ability of the individual to perform as a member. 2-1.6 The medical evaluation shall be at no cost to the candi- date, current member, or other member. 2000 Edition 2-2 Fire Department Roles- 2-2.1 The fire department shall have an officially designated physician who shall be responsible for guiding, directing, and advising the members with regard to their health, fitness, and suitability for duty as required by NFPA 1500, Standard on Fire Department Orcupational Safety and Health PmQram. 2-2.2* The fire department physician shall be a licensed doc- tor of medicine or osteopathy. 2-2.3* For the purpose of conducting medical evaluations, the fire department physician shall understand the physiolog- ical and psychological demands placed on members and shall understand the environmental conditions under which mem- bers must perform. The fire department shall provide the fire department physician with a currentjob description for all fire department positions and ranks. 2-2.4 The fire department shall require that the fire depart- ment health and safety officer and the health and fitness coor- dinator maintain a liaison with the fire department physician to ensure that the health maintenance process for the fire department is maintained. 2-2.5 Fire Department Physician Roles 2-2.5.1 The fire department physician shall evaluate the per- son to ascertain the presence of any medical conditions listed in this standard. 2-2.5.2 When medical evaluations are conducted by a physician other than the fire department physician, the evaluation shall be reviewed and approved by the fire department physician. 2-3* Preplacement Medical Evaluation. 2-3.1 The candidate shall be certified by the fire department physician as meeting the medical requirements of Chapter 3 of this standard prior to entering into a training program to become a member or performing in an emergency opera- tional environment as a member. 2-3,2 The candidate shall be evaluated according to the med- ical requirements of Chapter 3 of this standard to assess the effect of medical conditions on the candidate's ability to per- form as a member. 2-3,3 A candidate shall not be certified as meeting the medi- cal requirements of this standard if the fire department physi- cian determines that the candidate has any Category A medical condition as specified in Chapter 3 of this standard. 2-3.4* A candidate shall not be certified as meeting the med- ical requirements of this standard if the fire department phy- sician determines that the candidate has a Category S medical condition as specified in Chapter 3 of this standard that is of sufficient severity to prevent the candidate from performing, with or without reasonable accommodation, the essential functions of a member without posing a significant risk to the safety and health of the candidate or others. 2-3.4.1 The determination of whether a reasonable accom- modation shall be made by the authority having jurisdiction in conjunction with the fire department physician. 2-3.5 If the candidate presents with an acute medical problem or newly acquired chronic medical condition that interferes with the candidate's ability to perform the functions of a mem- ber, medical certification shall be postponed until that person ytEOt< �I PROCESS has recovered from this condition and presents to the Fire department for review. 24* Periodic Medical Evaluation. 24.1 The current member shall be certified annually, or at the request of either the fire department or the member, by the Fire department physician as meeting the medical require- ments of Chapter 3 ofthis standard in order to determine that member's medical ability to continue participating in a train- ing or emergency operational environment as a member. Any applicable OSHA standards, such as 29 CFR 1910.120. "Haz- ardous Waste Operations and Emergency Response." 29 (:FR 1910.134, "Respiratory Protection," 29 CM 1910,95. "Occupa- tional Noise Exposure," and 29 CFR 1910.1034), "Bloodborne Pathogens," shall be followed. 24.1.1 The components of the annual medical evaluation as specified in 24.1.2 shall be permitted to be performed by qualified personnel as authorized by the fire department physician. When other qualified personnel are used. the Fire department physician shall review the data gathered during the evaluation. 24.1.2 The annual medical evaluation shall consist of the fol- lowing (1) An interval medical history (2) An interval occupational history, including significant exposures (3) Height and weight (4) Blood pressure (5) Heart rate and rhythm 24.1.3* In addition to the annual medical evaluation, the fire department shall include a medical examination according to the following schedule: (1) Ages 29 and under —at least every 3 years (2) Ages 30 to 39 — at least every 2 years (3) Ages 40 and above — every year 214.1.4* The medical examination shall include examination of the following components: (1) Vital signs — namely, pulse, respiration, blood pressure, and, if indicated, temperature (2) Dermatological system 0) Ears, eyes, nose, mouth, throat (4) Cardiovascular system (5) Respiratory system (6) Gastrointestinal system (7) Genitourinary system (3) Endocrine and metabolic systems (9) Nlusculeskeletal system (10) Neurological system (11) Audiometry (12) Visual acuity and peripheral vision testing (13) Pulmonary function testing (14) Laboratory testing, if indicated (15) Diagnostic imaging, if indicated (16) Electrocardiography, if indicated 24.2 A current member shall not be certified as meeting the medical requirements of this standard if the fire department physician determines that the member has any Category A medical condition specified in Chapter 3 of this standard. 214.3* A current member shall not be certified as meeting the medical requirements of this standard if the fire department physician determines that the member has a Category B con- dition specified in Chapter 3 of this standard that is of sutfi- cient severity to prevent the member from perfo ming, with or Without reasonable accommodation, the essential functions of a member without posing a significant risk to the safety and health of the member or others. 24.3.1 The determination of reasonable :accommodation shall be made by the authority havingjurisdiction in conjunc- tion with the fire department physician. 9- 4.4 if the current member presents with an acute illness or recently acquired chronic medical condition, the evalua- tion shall be deferred until the member has recovered from the condition and presents to the fire department to return to duty. 2-5 Return -to -Duty Medical Evaluation. 2-5.1 * A current member who has been absent from duty for a medical condition of a nature or duration that could affect performance as a member shall be evaluated by the fire department physician before returning to duty. 2.5.2 The fire department physician shall not medically cer- tify the current member for return to duty if any Category A medical condition specified in Chapter 3 of this standard is present. 2-5.3* The fire department physician shall not medically cer- tify the current member for return to duty if any Category B medical condition specified in Chapter 3 of this standard is present that is determined to be severe enough to affect the member's performance as a member. The fire department physician, in conjunction with the authority having jurisdic- tion, shall take into account the member's current duty assign- ment and alternative duty assignments or other programs that would allow a member to gradually return to full duty. 2-5.4* The department shall provide guidance, opportunity, and encouragement to the member so as to expedite his safe return to full duty. 2-6 Medical Evaluation Records, Results, Reporting, and Confidentiality. 2-6.1 All medical information collected as part of a medical evaluation shall be considered confidential medical informa- tion and shall be released by the fire department physician only with the specific written consent of the candidate or cur- rent member. 2-6.2 The fire department physician shall report the results of the medical evaluation to the candidate or current member, including any medical condition(s) disclosed during the med- ical evaluation, and the recominendation as to whether the candidate or current member is medically certified to perform as a member. 2-6.3 The fire department physician shall inform the fire department fire chief or designee only as to whether or not the candidate or current member is medically certified to per- form as a member. The specific written consent of the candi- date or current member shall be required in order to release confidential medical information regarding this condition to the fire department. 2-6.4 All medical record keeping shall comply with the requirements of 29 C.FR 1910.20, "Medical Recordkeeping." 2000 Editon 1582 3 MEDICAL REQUIREMENTS FOR FIRE FIGHTERS ,AND INFOR`tATION FOR FIRE DEPARTMENT PI—MICIA S Chapter 3 Category A and Category B 3-4 Fars and Hearing. Medical Conditions 3-4.1 There shall be no Category A medical conditions. 3-1 Medical Conditions Affecting Ability to Perform. Cate- gory A and Category B medical conditions shall help the examiner understand the type of condition that could result in rejection or acceptance. The medical conditions listed are organized by organ system. In the corresponding Appendix A explanatory material, a diagnostic example is often included with the list. In addition, the rationale for the rejection is pre- sented in terms of the effect of the medical condition on the capability of the person to perform as a member. 3-2 Head and Neck. 3-2.1 Head. 3-2.1.1 There shall be no Category A medical conditions 3-2.1.2* Category B medical conditions shall include the fol- lowing: (1) Deformities of the skull such as depressions or exostoses (2) Deformities of the skull associated with evidence of dis- ease of the brain, spinal cord, or peripheral nerves (3) Loss or congenital absence of the bony substance of the skull (4) Any other head condition that results in a person not being able to perform as a member 3-2.2 Neck. 3-2.2.1 There shall be no Category A medical conditions 3-2.2.2* Category B medical conditions shall include the fol- lowing: (1) Thoracic outlet syndrome (2) Congenital cysts, chronic draining fistulas, or similar lesions (3) Contraction of neck muscles (4) Any other neck condition that results in a person not being able to perform as a member 3.3 Eyes and Vision. 3-3.1* CategoryA medical conditions shall include the fol- lowing: (a) Far visual acuity. Far visual acuity shall beat least 20/30 binocular, corrected with contact lenses or spectacles. Far visual acuity uncorrected shall be at least 20/ 100 binocular for wearers of hard contacts or spectacles. (b) Peripheral vision. Visual field performance without cor- rection shall be 140 degrees in the horizontal meridian in each eye. 3-3.2* Category B medical conditions shall include the fol- lowing- (1) Diseases of the eye such as retinal detachment, progres- sive retinopathy, or optic neuritis (2) Ophthalmological procedures such as radial keratotomy or repair of retinal detachment (3) Any other eye condition that results in a person not being able to perform as a member 2000 Edition 3-4.2* Category B medical conditions shall include the fol- lowing- (a) Hearing deficit in the pure tone thresholds in the unaided worst ear that is (1) Greater than 25 dB in three of the four frequencies a. 500 Hz b. 1000 Hz c. 2000 Hz d. 3000 Hz OR (2) Greater than 30 dB in any one of the three frequencies a. 500 Hz r b. 1000 Hz r c. 2000 Hz AND (3) In addition averages greater than 30 dB for the four fre- quencies a. 500 Hz b. 1000 Hz c. 2000 Hz d. 3000 Hz (b) Unequal hearing loss (c) Atresia, severe stenosis, or tumor of the auditory canal (d) Severe external otitis (e) Severe agenesis or traumatic deformity of the auricle (f) Severe mastoiditis or surgical deformity of the mastoid (g) Meniere's syndrome or labyrinthitis (h) Otitis media (i) Any other ear condition that results in a person not being able to perform as a member and results in a person being unable to pass a job•specific functional hearing task test or a hearing in noise test. 3-5 Dental. 3-5.1 There shall be no Category A medical conditions 3-5.2* Category B medical conditions shall include the fol- lowing: (1) Diseases of the jaws or associated tissues (2) Orthodontic appliances (3) Oral tissues, extensive loss (4) Relationship between the mandible and maxilla that pre- cludes satisfactory postorthodontic replacement or abil- ity to use protective equipment (5) Any other dental condition that results in a person not being able to perform as a member 3-6 Nose, Oropharynx, Trachea, Esophagus, and Larynx. 3-6.1* CategoryA medical conditions shall include the fol- lowing: (1) Tracheostomy (2) Aphonia 3-6.2* Category B medical conditions shall include the fol- lowing: (1) Congenital or acquired deformity (2) Allergic respiratory disorder I CATEGORY A AND GJLTECORY 6 MEDICAL, CONDITIONS 1582-9 (3) Sinusitis, recurrent (4) Dysphonia (5) Anosmia (6) Any other nose, oropharynx, trachea, esophagus, or lar- ynx condition that results in a person not being able to perform as a member or to communicate effectively 3-7 Lungs and Chest Wall. 3-7.1* Category A medical conditions shall include the fol- lowing: (1) Active hemoptysis (2) Empyema (3) Pulmonary hypertension (4) Active tuberculosis 3-7.2* Category B medical conditions shall include the fol- lowing: (1) Pulmonary resectional surgery, chest wall surgery, pneu- mothorax (2) Bronchial asthma or reactive airways disease (3) Fibrothotax, chest wall deformity, diaphragm abnormalities (4) Chronic obstructive airways disease (5) Hypoxemic disorders (6) Interstitial lung diseases (7) Pulmonary vascular diseases, pulmonary embolism (8) Bronchiectasis (9) Infectious diseases of the lung or pleural space (10) Any other pulmonary condition that results in a person not being able to perform as a member 3-8 Heart and Vascular System. 3-8.1 Heart. 3-8.1.1* Category A medical conditions shall include the fol- lowing- (1) Angina pectoris, current (2) Heart failure, current (3) Acute pericarditis, endocarditis, or myocarditis (4) Syncope, recurrent (5) Automatic implantable cardiac defibrillator M.1.2* Category B medical conditions shall include the fol- lowing- (1) Significant valvular lesions of the heart, including pros- thetic valves (2) Coronary artery disease, including history of myocardial infarction, coronary artery bypass surgery, or coronary angioplasty, and similar procedures (3) Atrial tachycardia, flutter, or fibrillation (4) Left bundle branch block, second- and third-degree atri- oventricular block (5) Ventricular tachycardia (6) Hypertrophy of the heart (7) Recurrent paroxysmal tachycardia (8) History of a congenital abnormality (9) Chronic pericarditis, endocarditis, or myocarditis (10) Cardiac pacemaker (11) Coronary artery vasospasm (12) Any other cardiac condition that results in a person not being able to perform as a member 3-8.2 Vascular System. 3-8.2.1 There shall be no Category A medical conditions. 3-8.2.2* Category B medical conditions shall include the fol- lowing- (1) Hypertension (2) Peripheral vascular disease such as Raynaud's phenome- non (3) Recurrent thrombophlebitis (4) Chronic Ivmphedema due to lymphadenopathy or severe venous valvular incompetency (5) Congenital or acquired lesions of the aorta or major ves- sels (6) Marked circulatory instability as indicated by orthostatic hypotension, persistent tachycardia, and severe periph- eral vasomotor disturbances (7) Aneurysm of the heart or major vessel (8) Any other vascular condition that results in a person not being able to perform as a member 3-9 Abdominal Organs and Gastrointestinal System. 3-9.1 There shall be no Category A conditions. 3-9.2* Category B medical conditions shall include the fol- lowing- (1) Cholecystitis (2) Gastritis (3) GI bleeding (4) Acute hepatitis (5) Hernia (6) Inflammatory bowel disease (7) Intestinal obstruction (8) Pancreatitis (9) Resection, bowel (10) Ulcer, gastrointestinal (11) Cirrhosis, hepatic or biliary (12) Chronic active hepatitis (13) Any other gastrointestinal condition that results in a per- son not being able to perform the duties of member 3-10 Genitourinary System. 3-10.1 Reproductive. 3-10.1.1 There shall be no Category A medical conditions. 3-10.1.2* Category B medical conditions shall include the fol- lowing- (1) Pregnancy, for its duration (2) Dysmenorrhea (3) Endometriosis, ovarian cysts, or other gynecologic con- ditions (4) Testicular or epididymal ma§s (5) Any other genital condition that results in a person not being able to perform as a member 3-10.2 Urinary System. 3-10.2.1 There shall be no Category A medical conditions. 3-10.2.2* Category B medical conditions shall include the fol- lowing: (1) Diseases of the kidney (2) Diseases of the ureter, bladder, or prostate (3) Any other urinary condition that results in a person not being able to perform as a member 2000 Edition 1582-10 MEDICS., REQUIREXIENTS FOR FIRE FIGHTERS AND INFORM "TION FOR FIRE DEPAIRT.IENT PM-w-L NS 3-11 Spine, Scapulae, Ribs, and Sacroiliac Joints, 3-11.1 There shall be no Category A medical conditions 3-11.2* Category B medical conditions shall include the fol- lowing: (1) Arthritis (2) Structural abnormality, fracture, or dislocation (3) Nucleus pulposus, herniation of, or history of laminec- tomy, discectomy or fusion (4) Ankylosing spondylitis (5) Anv other spinal condition that results in a person not being able to perform as a member 3-12 Extremities. 3-12.1 There shall be no Category A medical conditions. 3-12.2* Category B medical conditions shall include the fol- lowing: (1) Limitation of motion of a joint (2) Amputation or deformity of a joint or limb (3) Dislocation of a joint (4) joint reconstruction, ligamentous instability, or joint replacement (5) Chronic osteoarthritis or traumatic arthritis (6) Inflammatory arthritis (7) Any other extremity condition that results in a person not being able to perform as a member 3-13 Neurological Disorders. 3-13.1* Category A medical conditions shall include the fol- lowing: (1) Ataxias of heredo-degenerative type (2) Cerebral arteriosclerosis as evidenced by documented episodes of neurological impairment (3) Multiple sclerosis with activity or evidence of progression within previous three years (4) Progressive muscular dystrophy or atrophy (5) All epileptic conditions to include simple partial, complex partial, generalized, and psychomotor seizure disorders other than those with complete control during previous five years, normal neurological examination, and defini- tive statement from qualified neurological specialist. 3-13.2 If an epileptic member experiences a five-year seizure - free interval resulting from a change in the medical regimen, that individual shall not be cleared for return to fire -fighting duty until he or she has completed five years without a seizure on the new regimen. 3-13.3* Category B medical conditions shall include the fol- lowing: (1) Congenital malformations (2) Migraine (3) Clinical disorders with paresis, paralysis, dyscoordina- tion, deformity, abnormal motor activity, abnormality of sensation, or complaint of pain (4) Subarachnoid or intracerebral hemorrhage (5) Abnormalities from recent head injury such as severe cerebral contusion or concussion (6) Any other neurological condition that results in a person not being able to perform as a member 2OW Edition 3-14 Sldn. 3-14.1 There shall be no Category A medical conditions 3-14.2* Category B medical conditions shall include the fol- lowing: (1) Acne or inflammatory skin disease (2) Eczema (3) Any other dermatologic condition that results in the per- son not being able to perform as a member 3-15 Blood and Blood -Forming Organs. 3-15.1* Category A medical conditions shall inclttde the fol- lowing: (1) Hemorrhagic states requiring replacement therapy (2) Sickle cell disease (homozygous) 3-15-2* Category B medical conditions shall include the fol- lowing: (1) Anemia (2) Leukopenia (3) Polycythemia very (4) Splenomegaly (5) History of thromboembolic disease (6) Any other hematological condition that results in a per- son not being able to perform as a member 3-16 Endocrine and Metabolic Disorders. X3-16.1* Diabetes mellitus, which is treated with insulin or an oral hypoglycemic agent and where an individual has a history of one or more episodes of incapacitating hypoglycemia, shall be a Category A medical condition. 3-16.2* Category B medical conditions shall include the fol- lowing: (1) Diseases of the adrenal gland, pituitary gland, parathy- roid gland, or thyroid gland of clinical significance (2) Nutritional deficiency disease or metabolic disorder (3) Diabetes mellitus requiring treatment with insulin or oral hypoglycemic agent without a history of incapacitating hypoglycemia (4) Any other endocrine or metabolic condition that results in a person not being able to perform as a member 3-17 Systemic Diseases and Miscellaneous Conditions. 3-17.1 There shall be no Category A medical conditions. 3-17.2* Category B medical conditions shall include the fol- lowing- (1) Connective tissue disease, such as dermatomyositis, lupus erythematosus, scleroderma, and rheumatoid arthritis (2) Residuals from past thermal injury (3) Documented evidence of a predisposition to heat stress with recurrent episodes or resulting residual injury (4) Any other systemic condition that results in a person not being able to perform as a member 3-18 Tumors and Malignant Diseases. 3-18.1 There shall be no Category A medical conditions. 3-18.2* Category B medical conditions shall include the fol- lowing: (1) Malignant disease that is newly diagnosed, untreated, or currently being treated. t INCIDENT SCENE REILWILITATION .AND kfED1G\i. TREAT'NtENT 1582-1 1 a. Candidates shall be subject to the provisions of 2•3.5 of this standard. b. Current members shall be subject to the provisions of 24.4 of this standard. (2) Treated malignant disease that is evaluated on the basis of an individual's current physical condition and on the likelihood of the disease to recur or progress. (3) Anv other tumor or similar condition that results in a per- son not being able to perform as a member. 3-19 Psychiatric Conditions. 3-19.1 There shall be no Category A medical conditions 3-19.2* Category B medical conditions shall include the fol- lowing. (1) .-. history of psychiatric condition or substance abuse problem (2) Anv other psychiatric condition that results in a person not being able to perform as a member 3-19.3 Candidates and current members shall be evaluated based on the individual's current condition. 3-20 Chemicals, Drugs, and Medications. 3-20.1 There shall be no Category A medical conditions 3-20.2* Category B medical conditions shall include the use of the following- (1) Anticoagtilant agents (2) Cardiovascular agents (3) Narcotics (4) Sedative-hypnotics (5) Stimulants (6) Psychoactive agents (7) Steroids (8) Any other chemical, drug, or medication that results in a person not being able to perform as a member Chapter 4 Infectious Disease Program 4-1 Infection Control Program. 4-1.1 The fire department shall maintain infection control programs as delineated in NFPA 1581, Standard on Fire Depart- ment Infection Control Program 4-1.2 The fire department physician shall maintain a liaison with the infection control officer as specified in NFPA 1581. 4-2 Exposure Incidents. 4-2.1* All blood and/or body fluid exposures shall be reported immediately, and medical assessment shall be pro- vided within 2 hours of exposure. Medical assessment shall conform to current CDC guidelines. 4-2.2* All other exposure incidents shall be reported and assessment provided within 24 hours of exposure. 4-3 Tuberculosis. 4-3.1* The fire department shall provide a tuberculosis mon- itoring program that will test members at least annually and as indicated by CDC guidelines. Tuberculosis (TB) testing inter- vals shall conform to current CDC guidelines. 4-3.2* All members shall be evaluated according to current CDC guidelines following any tuberculosis exposure. These results shall be communicated to and reviewed by the fire department physician. 4-4* Immunizations. All members shall be immunized against infectious diseases as required by the authority having jurisdiction and by 29 C-FR 1910.1030 `Bloodborne Patho- gens.' The fire department physician shall ensure that all members are offered currently recommended immunizations. Chapter 5 Incident Scene Rehabilitation and Medical Treatment 5-1 Incident Scene Rehabilitation. 5-1.1* The fire department shall develop standard operating procedures that outline a systematic approach for the rehabil- itation of members operating at incidents. Provisions addressed in these procedures shall include medical evalua- tion and treatment, food and fluid replenishment, crew rota- tion, and relief from extreme climatic conditions. 5-1.2* The incident commander shall consider the circum- stances of each incident and initiate rest and rehabilitation of members in accordance with the fire department's standard operating procedures and with NFPA 1561, Standard on Emer- gency Services Incident Management System. 5-2 Incident Scene Safety and Health. 5-2.1 The incident safety officer shall ensure that the incident commander establishes an incident scene rehabilitation tacti- cal level management component during emergency opera- tions as required by NFPA 1521, Standard for Fin Department Safety officer. 5-2.2* Transport capable emergency medical services (EMS) shall be available in the incident scene rehabilitation tactical level management component for evaluation and treatment of members. Basic life support (BLS) shall be the minimum level of available care. Advanced life support (ALS) care is preferable where it is available. 5-3 Evaluation and Triage of Member Injuries. 5-3.1 In the event of an injury to a member during emergency operations, EMS personnel shall assess and treat the injury based on local EMS protocol and fire department standard operating procedures. 5-3.2* Protocols and procedures guiding EMS providers car- ing for ill or injured members during emergency operations shall be developed by the EMS Wdical director in collabora- tion with the fire department physician and chief. 5-4 Incident Scene Rehabilitation Tactical Level Management Component. 5-4.1 The rehabilitation tactical level management compo- nent shall be designated per department standard operat- ing procedures, such as large-scale incidents, long -duration incidents, or those associated with significant temperature extremes. 5-4.2 The rehabilitation tactical level management compo- nent shall be established in a safe environment away from the hazardous area of the incident. 2000 Edition 1582-12 NIEDU:Nt, REQUIREMENTS FOR FiRt: FiervFERS.v`:D iNFORMAT10N FOR FIRE DEP_iRTNIENT PFiYSiCl.vNy 54.3* The resources needed at the rehabilitation tactical level management component shall include an environment to limit temperature stress. medical equipment, and adequate medical staff. 54.4* Members shall be assigned to rehabilitation as pre- scribed by departmental standard operating procedures. Unusual circumstances, ouch as long -duration incidents, situa- dons requiring; heavy exertion, or severe weather extremes shall require an alteration in procedures. 54.5* Members arriving at rehabilitation shall be brieflv questioned by medical staff about any symptoms of dehydra- tion, heat stress, cold stress, physical exhaustion, and/or car- diopulmonary abnormalities. Any member having significant symptoms shall be moved to an area where assessment by advance life support personnel can be performed. 54.6 Members assigned to rehabilitation shall be encouraged to add;'remove clothing to regain normal body temperature, drink fluids (water, electrolyte replacement drinks), and rest. 54.7 No member shall be reassigned to return to dun- until medical evaluation and hydration has occurred for at least 10 minutes in rehabilitation and after being cleared by medical staff. 54.8 all members entering and leaving rehabilitation shall be properly assigned by the incident management system and be tracked through the personnel accountabilitysystem. Chapter 6 Referenced Publications 6-1 The following documents or portions thereof are refer- enced within this standard as mandatory requirements and shall be considered part of the requirements of this standard. The edition indicated for each referenced mandatory docu- ment is the current edition as of the date of the NFPA issuance of this standard. Some of these mandatory documents might also be referenced in this standard for specific informational purposes and, therefore, are also listed in Appendix F. 6-1.1 NFPA Publications. National Fire Protection Associa- tion, I Batterymarch Park, P.O. Box 9101, Quincy, ALA. 02269- 9101. NFPA 1500, Standard on Fire Department Occupational Safety and Health Program, 1997 edition. NFPA 1521, Standard for Fire Department Safety Officer, 1997 edition. NFPA 1561, Standard on Emergency Services Incident ,blanage- ment System, 2000 edition. NFPA 1581, Standard (m Fire Department Infection Control Pro- gram, 2000 edition. 6-1.2 U. S. Government Publications. C.S. Gnemment Print- ing Office, Washington, DC 20401. Title 29, Code of Federal Regulatimts, Part 1910.120, "Hazard- ous Waste Operations and Emergency Response," 1986, Title 29, Cade of Federal Regulations, Part 1910.134, "Respira- tory Protection," 1998. Title 29, Code of Federal Regulations, Part 1910.95, 'Occupa- tional Noise Exposure." 1980. Title 29. Cade of Federal Reg7ihatons. Part 1910.20, "Medical Recordkeeping," 1980. Title 29, Cade of Federal Regulations, Part 1910.1030, "Blood- borne Pathogens," 1995. 2000 Edition Appendix A Explanatory Material Appendix A is not a part of the requirements of this : TPA docu. meet but is included for informational purposes only. This appendix contains explanatory material, numbered to correspond with the appli. cable text paragraphs. A•1-2.2 There is a direct relationship between the medical requirements and the job description of members. The job description should include all essential job functions of mem. bers, both emergency and nonemergency. Members perform a variety of emergency operations including fire fighting, emergency medical care, hazardous materials mitigation, and special operations. Nonemergency duties can include, and are not limited to, training, station and vehicle maintenance, and physical fitness. Each fire department needs to identify and develop a written job description for members. appendix C. Essential Fire -Fighting Functions, provides an example of essentialjob functions for members. A-1-3.2 The specific determination of the authority having jurisdiction depends on the mechanism under which this stan- dard is adopted and enforced. Where this standard is adopted voluntarily by a particular fire department for its own use, the authority having jurisdiction should be the fire chief or the political entity that is responsible for the operation of the fire department. Where this standard is legally adopted and enforced by a body having regulatory authority over a fire department, such as federal, state, or local government or political subdivision, this body is responsible for making those determinations as the authority having jurisdiction. The com- pliance program should take into account the services the fire department is required to provide, the financial resources available to the fire department, the availability of personnel, the availability of trainers, and such other factors as will affect the fire department's ability to achieve compliance. A-14.1 Approved. The National Fire Protection Association does not approve, inspect, or certify any installations, proce- dures, equipment, or materials; nor does it approve or evalu- ate testing laboratories. In determining the acceptability of installations, procedures, equipment, or materials, the author- ity having jurisdiction may base acceptance on compliance with NFPA or other appropriate standards. In the absence of such standards, said authority may require evidence of proper installation, procedure, or use. The authority havingjurisdic- tion may also refer to the listings or labeling practices of an organization that is concerned with product evaluations and is thus in a position to determine compliance with appropriate standards for the current production of listed items. A-14.2 Authority Having Jurisdicdon. The phrase "authority having jurisdiction" is cued in NFPA documents in a broad manner, since jurisdictions and approval agencies vary, as do their responsibilities. Where public safety is primary, the authority having jurisdiction may be a federal, state, local, or other regional department or individual such as a fire chief; fire marshal; chief of a fire prevention bureau, labor depart- ment, or health department; building official; electrical inspector; or others having statutory authority. For insurance purposes, an insurance inspection department, rating bureau, or other insurance company representative may be the author- ity having jurisdiction. In many circumstances, the property owner or his or her designated agent assumes the role of the authority having jurisdiction; at government installations, the APPENDIX A 1582_13 commanding officer or departmental official mac be the A-2-3.3 See appendix D. Section D-1, Legal Considerations in mithoritv having jurisdiction. Applying the Standard. A-14.3 Candidate. In an employment context, the Ameri- cans with Disabilities act (discussed in further detail in Appen- dix D) requires that am, medical examination to be conducted take place after an offer of employment is made and prior to the commencement of duties. Therefore, in the emploo.-ment context, the definition of the term candidate;hould be applied so as to be consistent with that requirement. Volunteer members have been deemed to be employees in some states or jurisdictions. Volunteer fire departments should seek legal counsel as to their legal responsibilities in these matters. A-14.20 Member. See Appendix C, Essential Structural Fire- Fighung Functions. A-2-1.1 See Appendix D, Guide for Fire Department Adminis- trators. A-2-1.5 Exposures and medical conditions that should be reported if they can interfere with the ability of the individual to perform as a member include, but are not limited to, the followin-: A-2-3.4 Physical therapy, strength training, work hardenin;;, functional capacity evahtations, and alternate duty are all actin. ities that can be helpful. A-3-2.1.2 Category B medical conditions of the head include the following H (2) (3) (1) Exposures to hazardous materials or toxic substances (2) Exposure to infectious or contagious diseases (3) Illness or injury (4) Use of prescription or nonprescription drugs (5) Pregnancy (4) A-2-2.2 See Appendix D, Section D-2, Choosing a Fire Depart- ment Physician. A-2-2.3 See Appendix B. Information for Fire Department Physicians. Appendix C, Essential Structural Fire -Fighting Functions provides a generic description of job asks per- formed by members. A fire department needs to provide the fire department physician with ajob description of all posi- tions and ranks so that the fire department physician can understand the physical and mental demands placed upon all members regardless of position or rank. Appendix D, Guide for Fire Department Administrators, also provides guidance for ensuring that the fire department physician is provided with this information. A-2-3 See Appendix B, Section B-3, Guidance for Medical Evaluations. A 2-3.4 See Appendix D, Section D-1, Legal Considerations in Applying the Standard. A-24 See Appendix B, Section B-3, Guidance for Medical Evaluations. A-24.1.3 At the discretion of the fire department physician, an examination can be performed sooner than would be expected from the schedule given in 24.1.3. Current medical conditions and coronary risk factors could mandate more fre- quent medical examinations. A-24.1.4 See Appendix B, Guide for Fire Department Phy- sicians. A-24.3 See Appendix D, Section D- 1, Legal Considerations in Applying the Standard. A-2-5.1 X department should set protocols regarding length of time absent from duty and/or medical conditions that require the department physician to evaluate a member. Deformities of the skull. such as depressions or exos- toses, of a de-yree that interferes with the use of protec- tive equipment. Deformities of the skull can result in the member's inability to properly wear protective equipment. Deformities of the skull associated with evidence of dis- ease of the brain, spinal cord, or peripheral nerves. These deformities can result in the potential for sudden inca- pacitation, the inability to properly wear protective equipment, and the inability to communicate effectively due to orophanngeal dysfuncuon. Loss of or congenital absence of the bony substance of the skull (if associated with disease interfering with perfor- mance or ifappropriate protection cannot be provided for the area without interfering with protective equipment and vision). Loss of or congenital absence of the bony sub- stance of the skull can result in the inability to properly wear protective equipment and the inability to communi- cate effectively due to oropharyngeal dysfunction. Any other head condition that results in a person not being able to perform as a member. A-3-2.2.2 Category B medical conditions of the neck include the following: (1) Thoracic outlet syndrome (symptomatic). Thoracic out- let syndrome can result in frequent episodes of pain or inability to perform work. (2) Congenital cysts, chronic draining fistulas, or similar lesions (if lesions or underlying disease interferes with performance). Congenital cysts, chronic draining fistu- las, orsimilar lesions can result in the inability to properly wear protective equipment, and the inability to commu- nicate effectively due to oropharyngeal dysfunction. (3) Contraction of neck muscles (if it interferes with wearing of protective equipment or ability to perform duties). The contraction of neck muscles can result in the inabil- ity to properly wear protective equipment, and the inabil- ity to perform functions as a member due to limitation of flexibility. (4) Any other neck condition that results in a person not being able to perform as a member. A-3-3.1 Category A medical conditions of the eyes and vision include the following: (1) Far visual acuity. Far visual acuity is at least 20/30 binocu- lar, corrected with contact lenses or spectacles. Far visual acuity uncorrected is at least 20/100 binocular for wear- ers of hard contacts or spectacles. Successful long-term soft contact lens wearers (that is, six months without a problem) are not subject to the uncorrected standard - Inadequate far visual acuity can result in the failure to be able to read placards and street signs or to see and respond to imminently hazardous situations. (2) Peripheral vision. Visual field performance without correc- tion is 140 degrees in the horizontal meridian in each eye. (Members cannot have just monocular vision.) 20M Edition 1582-14 ME.DIC.AL RLQUIRENIENTS FOR FIRL FIG[ ITERS A -ND INFORN LION FOR FIRE DEPARTMENT PFRSICLtvS Monocular vision can result in sudden incapacitation when debris is lodged in one eye. Inadequate or compro- mised periplieral vision can result in the following: a. Failure to perform job duties and maintain visual con- tact with a partner b. Inability to maintain safety near moving objects c. Poor balance on uneven surfaces d. Unsuccessful performance in environments where visual cues are critical to personal safety A 3-3.2 Category B medical conditions of the eves and vision include the following: (2) (3) Diseases of the eve such as retinal detachment, progres- sive retinopathv, oroptic neuritis (severe or progressive)_ These diseases of the eye can result in the failure to read placards and street signs or to see and respond to immi- nently hazardous situations. Ophthalmological procedures such as radial keratot- omy and repair of retinal detachment. With retinal detachment, sufficient time (1-2 weeks for radial kera- tonomy and Lasik-rope surgeries, three months for reti- nal detachment) must have passed to allow stabilization of visual acuity and to ensure that there are no postsur- gical complications. These ophthalmological proce- dures may result in the failure to be able to read placards and street signs or to see and respond to imrni- nentiv hazardous situations. Any other eye condition that results in a person not being able to perform as a member. Persons with severe color vision loss will likely fail the acuity requirement. Formerly, color vision deficiency was listed as a Cate- gory B medical condition. However, it is felt that within most cases this condition will not affect the ability of a member to perform the essential functions of his or her job. The fire service physician should consider the color vision deficiency of the individual and consider the color vision requirements of the member's job and reach an individual determination. A-34.2 There are currently no hearing tests that will allow the fire department physician to accurately predict whether the fire fighter will adequately be able to perform essential job duties. Job -specific hearing tests should be individualized for each department and its specific job functions. The following list of hearing -specific tasks can assist to direct development of hearing protocols. (1) Understanding spoken commands, both over the radio and while wearing SCBA (2) Hearing alarm signals, including building evacuation, low air signal on the SCBA, and PASS alarms (3) Hearing and locating the source of calls for assistance from victims or other fire fighters All of the above tasks will need to be performed with rea- sonably simulated incident scene background noise and SCBA noise. The inability to hear sounds of low intensity or to distin- guish voice from background noise can lead to failure to respond to imminently hazardous situations. (Ste also B-4.5.) Category B medical conditions of hearing include the fol- lowing: (a) Unequal hearing can result in the inability to localize sounds, leading to failure in the ability to perform search and rescue and other localization tasks. 20W Edition (h) Severe external outls, that is, recurrent loss of hearing can result in the inability to hear sounds of low intensity or to distinguish voice from background noise, leading to failure to respond to imminently hazardous situations. (c) Severe agenesis or traumatic deformity of the auricle can result in the inability to properly wear protective equip- ment and the inability to hear sounds of low intensity or to dis- tinguish voice from background noise, leading to failure to respond to imminently hazardous situations. (d) Severe mastoiditis or surgical deformity of the mastoid can result in the inability to properly wear protective equip- ment and the inability to hear sounds of low intensity or to dis- tinguish voice from background noise, leading to failure to respond to imminently hazardous situations. (e) Meniere's syndrome or severe Iabviinthitis may result in the potential for sudden incapacitation and the inability to perform job functions due to limitations of balance. (f) Otitis media (chronic) can result in frequent episodes of pain or the inability to perform work and the inability to hear sounds of low intensity or to distinguish voice from back- ground noise, leading to failure to respond to imminently haz- ardous situations. (g) Any other ear condition that results in a person not being able to perform as a member can be classified as a Cat- egory B medical condition of hearing. A-3-5.2 Category B dental medical conditions include the fol- lowing: (1) Diseases of the jaws or associated tissues (those that are incapacitating or preclude ability to use protective equipment). Diseases of the jaws or associated tissues can result in the inability to properly wear protective equipment. (2) Orthodontic appliances (those that preclude the ability to use protective equipment). The wearing of orthodon- tic appliances can result fn the inability to properly wear protective equipment. (3) Oral tissues, extensive loss (that which precludes satisfac- tory postorthodontic replacement or ability to use pro- tective equipment). Extensive loss of oral tissues may result in the inability to properly wear protective equip- ment and the inability to communicate effectively due to oropharyngeal dysfunction. (4) Relationship between the mandible and manilla that pre- cludes satisfactory postorthodontic replacement or abil- ity to use protective equipment. This condition can result in the inability to properly wear protective equipment and the inability to communicate effectively due to oropharyngeal dysfunction. (5) Any other dental condition tPtat results in a person not being able to perform as a member. A-3-6.1 Category A medical conditions of the nose, orophar- ynx, trachea, esophagus, and larynx include the following: (1) Tracheostomy. A tracheostomy can result in the inability to properly wear protective equipment, the inability to perform job functions due to limitations of endurance, and the inability to communicate effectively due to oropharyngeal dysfunction. (2) Aphonia, regardless of cause. Aphonia can result in the inability to communicate effectively due to oropharyn- geal dysfunction. .APPENDIX A 1582-13 A-3-6-2 Category B medical conditions of the nose, orophar- ynx. trachea, esophagus. and larynx include the following: (1) Congenital or acquired deformity that interferes with the ability to use protective equipment. A congenital or acquired deformity can result in the inability to properly wear protective equipment. (2) .allergic respiratory disorder (uncontrolled). Allergic res- piratory disorder can result in frequent episodes of pain, the inabilia to perform work, and the inability to perform functions as a member due to limitations of endurance. (3) Sinusitis, recurrent (severe, requiring repeated hospital- izations or causing impairment). Recurrent sinusitis can result in frequent episodes of pain and the inability to perform work. (4) Dysphonia (severe). Severe dvsphonia can result in the inability to communicate effectively due to oropharvn- Beal dysfunction. (5) Any other nose, oropharynx, trachea, esophagus. or lar- ynx condition that results in a person not being able to perform as a member or to communicate effectively. A-3-7-1 Category A medical conditions of the lungs and chest wall include active hemoprysis, empyema, pulmonary hyper- tension, and active tuberculosis. These conditions can result in the inability to perform functions as a member due to limi- tations of endurance. A-3-7.2 Category B medical conditions of the lungs and chest wall include the following- (1) Pulmonary resectional surgery, chest wall surgery, pneu- mothorax (that is, history of recurrent spontaneous pneumothorax). These conditions can result in the inability to perform functions as a member due to limita- tions of strength or endurance and may result in the potential for sudden incapacitation. (2) Bronchial asthma or reactive airways disease (frequent medication use or symptoms caused by exposures to exer- tion, heat and cold, or products of combustion and other irritant inhalation). Bronchial asthma or reactive airways disease can result in frequent episodes of pain or the inability to perform work, the potential for sudden inca- pacitation, and the inability to perform functions as a member due to limitations of endurance. (3) Fibrothorax, chest wall deformity, diaphragm abnormali- ties. Fibrothorax, chest wall deformity, and diaphragm abnormalities can result in the inability to perform func- tions as a member due to limitations of endurance. (4) Chronic obstructive airways disease. Chronic obstructive airways disease can result in the inability to perform func- tions as a member due to limitations of endurance. (5) Hypoxemic disorders. Hypoxemic disorders can result in the inability to perform functions as a member due to limitations of endurance. (6) Interstitial lung diseases. Interstitial lung diseases can result in the inability to perform functions as a member due to limitations of endurance. (7) Pulmonary vascular diseases, pulmonary embolism. Pul- monary vascular diseases and pulmonary embolism can result in frequent episodes of pain and the inability to perform functions as a member due to limitations of endurance. (8) Bronchiectasis with significant residual impairment of pulmonary function or requiring frequent therapy. Bron- chiectasis can result in the inability to perform functions as a member due to limitations of endurance. (9) Infectious diseases of the lung or pleural space. (10) .any other pulmonary condition that results in a Person not being able to perform as a member. A-3-8-1-1 Category A medical conditions of the heart and vas- cular system include the following: (1) Angina pectoris, current. Angina pectoris can result in frequent episodes of pain or inability to perform work, progressive illness leading to functional impairment, and the potential for sudden incapacitation. (2) Heart failure, current. Heart failure can result in fre- quent episodes of pain or inability to perform work, pro- gressive illness leading to functional impairment, and the potential for sudden incapacitation. (3) Acute pericarditis, endocarditis, or myocarditis. These conditions can result in frequent episodes of pain or the inability to perform work. (4) Svncope, recurrent. Recurrent syncope can result in the potential for sudden incapacitation. (5) Automatic implantable cardiac defibrillator. An auto- matic implantable cardiac defibrillator can result in the potential for sudden incapacitation. A-3-8.1.2 Category B medical conditions of the heart and vas- cular system include the following: (1) Significant valvular lesions of the heart, including pros- thetic valves. Specific recommendations include the fol- lowing: a. Nlitral stenosis. Mitt -al stenosis is acceptable if in sinus rhythm and stenosis is mild, that is, valve area > 1.5 cm' or pulmonary artery systolic pressure < 35 mm Hg. b. Alitral insufficiency. Mural insufficiency is acceptable if in sinus rhythm with normal left ventricular size and function. c. Aortic stenosis, Aortic stenosis is acceptable if stenosis is mild, that is, mean aortic valvular pressure gradi- ent < 20 mm Hg. d. Aortic regurgitation. Aortic regurgitation is acceptable if left ventricular size is normal or slightly increased and systolic function is normal. e- Prosthetic valves. Prosthetic valves are acceptable unless full anticoagulation is in effect. (2) Coronary artery disease, including history of myocardial infarction, coronary artery bypass surgery, coronary angioplasty, and similar procedures. Persons at mildly increased risk for sudden incapacitation are acceptable for fire fighting. Mildly increased risk is defined by the presence of each of the following: a. Normal left ventricular ejection fraction b. Normal exercise tolerance, > 10 metabolic equivalents (METS) c. Absence of exercise4nduced ischemia by exercise testing d. Absence of exercise -induced complex ventricular arrhythmias e. Absence of hemodynamically significant stenosis on all major coronary arteries (�60 percent lumen diameter narrowing), or successful myocardial revascularization (3) Atrial tachycardia, flutter, or fibrillation (4) Left bundle branch, second- and third-degree atrioven- tricular block. These blocks will result in disqualification unless exercise can be performed with an adequate heart rate response. They can result in frequent episodes of pain, the inability to perform work, and have the poten- tial for sudden incapacitation, 2000 Edition 1582-16 NIEDICGAl- RrOUIREbIENTS FOR FIRE FIGIITER5 .-vND INFOR.NL\TION FOR FIRE DEPARTMENT ('I IISICLvNJ (3) Ventricular tachycardia. Ventricular tachycardia can result in the potential for sudden incapacitation and the inability to perform job functions due to limitations of strength or endurance. (6) Hypertrophy of the heart. Hypertrophy of the heart can result in the potential for sudden incapacitation and the inability to perform job functions due to limitations of endurance. (7) Recurrent paroxvsmal tachycardia. Recurrent paroxvs- mal tachycardia can result in the potential for sudden incapacitation and the inability to perform job functions due to limitations of strength or endurance. (3) History of a congenital abnormality that has been treated by surgery but with residual complications or that has not been treated by surgery, leaving residuals or complica- tions. A congenital abnormality can result in frequent episodes of pain or inability to perform work and the potential for sudden incapacitation. (9) Chronic pericarditis, endocarditis, or mvocarditis. These conditions can result in the inability to perform job func- tions due to limitations of endurance. (10) Cardiac pacemaker. If the person is pacernakerdepen- dent, then the risk for sudden failure due to trauma is not acceptable. Those with cardiac pacemakers can have the potential for sudden incapacitation- (11) Coronary artery vasospasm. Those with cardiac artery vasospasm can have the potential for sudden incapaci- tation. (12) Any other cardiac condition that results in a person not being able to perform as a member. A 3-8.2.2 Category S medical conditions of the vascular sys- tem include the following: (1) Hypertension that is uncontrolled, poorly controlled, or requires medication likely to interfere with the perfor- mance of duties- Acceptable hypertension is a blood pres- sure less than 180/100 and no target organ damage. Hypertension is a progressive illness leading to functional impairment with the potential for sudden incapacitation. (2) Peripheral vascular disease, such as Raynaud's phenome- non, that interferes with performance of duties or makes the individual likely to have significant risk of severe injury. Peripheral vascular disease can result in frequent episodes of pain or the inability to perform work and the inability to perform functions as a member due to limita- tions of endurance. (3) Recurrent thrombophlebitis- Recurrent thrombophlebi- Lis can result in frequent episodes of pain or the inability to perform work and the inability to perform functions as a member due to limitations of endurance. (4) Chronic lvmphedema due to lymphopathy or severe venous valvular incompetency. Chronic lymphedema can result in the inability to perform functions as a member due to limitations of endurance. (5) Congenital or acquired lesions of the aorta or major ves- sels, for example, syphilitic aortitis, demonstrable athero- sclerosis that interferes with circulation, and congenital acquired dilatation of the aorta. Congenital or acquired lesions of the aorta or major vessels can result in the potential for sudden incapacitation and the inability to perform job functions due to limitations of endurance. (6) Marked circulatory instability as indicated by orthostatic hypotension, persistent tachycardia, and severe periph- eral vasomotor disturbances. Marked circulatory instabil- ity can result in the inability to perform job functions due 2000 Edition to limitations of endurance and the inability to perform job functions due to limitations of balance. (7) ;aneurysm of the heart or major vessel, congenital or acquired. An aneurysm of the heart or major vessel can result in frequent episodes of pain, the inability to per- form work, and the potential for sudden incapacitation- (3) .Anv other vascular condition that results in a person not being able to perform as a member. A-3-9.2 Category 3 medical conditions of the abdominal organs and gastrointestinal ri5tem include the following: (1) Cholecvstitis (that which causes frequent pain due to stones or infection). Cholecystitis can result in frequent episodes of pain or the inability to perform work. (2) Gastritis (that which causes recurrent pain and impair- ment). Gastritis can result in frequent episodes of pain or the inability to perform work. (3) GI bleeding can cause fatigue, and or hemodynamic instability resulting in inability to perform work- (4) Acute hepatitis (until resolution of acute hepatitis as determined by clinical examination and appropriate lab- oratory testing). Acute hepatitis can result in frequent episodes of pain or the inability to perform work- (5) Hernia (unrepaired inguinal or abdominal hernia that could obstruct during duty). A hernia can result in the potential for sudden incapacitation. (6) Inflammatory bowel disease (that which causes disabling pain or diarrhea)- Inflammatory bowel disease can result in frequent episodes of pain or the inability to perform work. It is a progressive illness leading to functional impairment- (7) Intestinal obstruction (that is, recent obstruction with impairment). An intestinal obstruction can result in fre- quent episodes of pain, the inability to perform work, and the potential for sudden incapacitation. (8) Pancreatitis (that is, chronic or recurrent with impair- ment)- Pancreatitis can result in frequent episodes of pain or the inability to perform work. (9) Resection, bowel (if frequent diarrhea precludes perfor- mance of duty). A bowel resection can result in frequent episodes of pain or the inability to perform work. (10) Ulcer, gastrointestinal (where symptoms are uncon- trolled by drugs or surgery). A gastrointestinal ulcer can result in frequent episodes of pain or the inability to per- form work. (11) Cirrhosis, hepatic or biliary (that which is symptomatic or in danger of bleeding). Cirrhosis can result in frequent episodes of pain or the inability to perform work- (12) Chronic active hepatitis- Chronic, active hepatitis can result in frequent episodes of pain or the inability to per- form work. (13) Any other gastrointestinal condition that results in a per- son not being able to perform as a member. A-3-10.1.2 Category 3 medical conditions of the reproductive organs include the following: (1) Pregnancy. Pregnancy can result in frequent episodes of pain or the inability to perform work: progressive inabil- ity to perform work due to limitations of endurance, flex- ibility, or strength; and the inability to properly wear protective equipment. (See B-4.4, Reproductive-) (2) Dysmenorrhea that leads to recurrent incapacitation- Dysmenorrhea can result in frequent episodes of pain or the inability to perform work. ;APPENMX A 15S'2— t 7 (3) Endometriosis, ovarian cysts, or other gynecologic condi- tions (severe, leading to recurrent incapacitation). Endometriosis, ovarian cysts, and other gynecologic con- ditions can result in frequent episodes of pain or the inability to perform work. (4) Testicular or epididvmal mass (that which requires medi- cal evaluation). A testicular or epididymal mass can result in frequent episodes of pain or the inability to perform work. This is a progressive illness leading to functional impairment. (5) Anv other genital condition that results in a person not being able to perform as a member. A-3-10,2.2 Category B medical conditions of the urinary sys- tem include the following: (1) Diseases of the kidney requiring dialysis. Diseases of the kidney can result in frequent episodes of pain or the inability to perform work. Kidney disease is a progressive illness leading to functional impairment. (2) Diseases of the ureter, bladder, or prostate that require frequent or prolonged treatment. These diseases can result in frequent episodes of pain or the inability to per- form work. (3) Any other urinary condition that results in a person not being able to perform as a member. A-3-11.2 Category B medical conditions of the spine, scapu- lae, ribs, and sacroiliac joints include the following: (1) Arthritis that results in progressive impairment or limita- tion of movement. Arthritis is a progressive illness that leads to functional impairment. Arthritis can result in the inability to perform functions as a member due to limita- tions of endurance or flexibility. (2) Structural abnormality, fracture, or dislocation that is a progressive or recurrent impairment. These conditions are progressive illnesses leading to functional impair- ment. These illnesses can result in the inability to per- form functions as a member due to limitations of strength or flexibility. (3) Nucleus pulposus, herniation of, or history of laminec- tomy, discectomy, or fusion. These condiuons are pro- gressive illnesses leading to functional impairment and the inability to properly wear protective equipment. (4) Ankylosing spondylitis. This condition can result in the inability to perform functions as a member due to limita- tions of endurance or flexibility. (5) Any other spinal condition that results in a person not being able to perform as a member. A-3-12.2 Category B medical conditions of the extremities include the following: (1) Limitation of motion of ajoint of a degree to interfere with successful and safe performance of fire -fighting duties. The limitation of motion of a joint can result in the inability to perform functions as a member due to limitation of flexibility. (2) Amputation or deformity of ajoint or limb of a degree to interfere with successful and safe performance of fire- fighting duties. The amputation or deformity of ajoint or limb can result in the inability to perform functions as a member due to limitations of strength and/or balance. (3) Dislocation of ajoint. Recurrent dislocation of a joint or dislocation with residual limitation of motion of a degree to interfere with successful and safe performance of fire- fighting duties; successful surgery for recurrent shoulder dislocation, it' range of motion is intact, would not exclude a person. Dislocation of a joint can result in the inabilia- to perform functionsas a member due to limita- tions of strength or texihility. (4) Joint reconstruction, ligamentous instability, or joint replacement. In cases where recurrent or with residual limitation of motion of a degree to interfere with success- ful and safe performance of tire -fighting duties, sur�ery for a torn anterior cruciate ligament could disqualify if quadricep stren-Ch is not normal or if the knee is lax or develops pain or swelling when stressed. These condi- tions of the joint can result in the inability to perform functions as a member due to limitations of strength or flexibility. (3) Chronic osteoarthritis or traumatic arthritis (in cases where recurrent exacerbations leads to impairment). Chronic ostcoarthritis or traumatic arthritis can result in frequent episodes of pain, the inability to perform work, and the inability to perform functions as a member due to limitations of strength, endurance, or flexibility. (6) Inflammatory arthritis (in cases where it is severely recur- rent or a progressive illness or with deformity or limita- tion of range of motion of a degree to interfere with successful and safe performance of fire -fighting duties). Inflammatory arthritis can result in frequent episodes of pain, the inability to perform work, and the inability to perform functions as a member due to limitations of strength, endurance, or flexibility. (7) Any other extremity condition that results in a person not being able to perform as a member. A-3-13.1 Category A medical conditions of a neurological nature include the following: (a) Ataxias of the here do-dege nerative type. Ataxias of the heredo-degenerative n pe can result in the inability to perform functions as a member due to limitations of balance. (b) Cerebral arteriosclerosis as evidenced by documented episodes of neurological impairment- Cerebral arteriosclero- sis can result in the inability to perform functions as a member due to limitations of strength and/or balance. (c) Progressive multiple sclerosis or multiple sclerosis with evidence of progression within previous three years. Multiple sclerosis can result in the inability to perform functions as a member due to limitations of strength or flexibility. (d) Progressive muscular dystrophy or atrophy. This condi- tion can result in the inability to perform functions as a mem- ber due to limitations of strength and/or balance. (e) Epileptic conditions. After a provoked seizure, with the precipitant identified and alleviated, with subsequent normal CT or ',,fRl scan, normal EEG, normal neurological exam, free of recurrence without medication for one year, and with defin- itive statement from a qualified neurological specialist, a mem- ber can be cleared to return to duty. A-3-13.3 Category B medical conditions of a neurological nature include the following: (a) Congenital malformations (that is, severe vascular mal- formations that interfere with the ability to wear protective equipment). Congenital malformations can result in the inability to properly wear protective equipment- (b) Migraine (that is, recurrent, with impairment uncon- trolled). Migraines can result in frequent episodes of pain or the inability to perform work. 2000 Edition 158`_-ld N,fEDIC.\L REQUIREMENTS FOR FIRE FIG ITERS .\ND INFORMATIC) N FOR FIRE DEPARTMENT PITYSICL\NS (c) Clinical disorders with paresis, paralysis, dvscoordina- tion, deformity, abnormal motor activity, abnormality ofsensa- tion, or complaint of pain (progressive or severe). These disorders are progressive illnesses leading to functional impairment. Tliev can result in the inability to perform func- tions as a member due to limitations of strength, flexibility, or balance. (d) Subarachnoid or intracerebral hemorrhage, verified either clinically or by laboratory studies. except for those cor- rected with verification by laboratory studies and report of treating physician. Subarachnoid or intracerebral hemor- rhage is a progressive illness leading to functional impair- ment. This illness can result in the potential for sudden incapacitation. (e) Abnormalities from recent head injury, such as severe cerebral contusion or concussion. The abnormalities can result in the potential for sudden incapacitation. (f) Any other neurological condition that results in a per- son not being able to perform as a member. A-3-14.2 Category B medical conditions of the skin include the following: (a) Acne or inflammatory skin disease (if condition pre- cludes good fit of protective equipment, such as SCBA face piece, or prevents shaving). Acne or inflammatory skin disease can result in the inability to properly wear protective equipmenL (b) Eczema (if broken skin results in impairment from infections or pain or interferes with seal between skin and per- sonal protective equipment). Eczema can result in frequent episodes of pain or the inability to perform work. (c) Any other dermatologic condition that results in the person not being able to perform as a member. r13-15,1 Category A medical conditions of blood and blood - forming organs includes the following: (a) Hemorrhagic states requiring replacement therapy (for example, von Willebrand's disease, thromboeytopenia, hemophilia). These hemorrhagic states can result in frequent episodes of pain or the inability to perform work. (b) Sickle cell disease (homozygous). Sickle cell disease can result in frequent episodes of pain or the inability to per- form work and the potential for sudden incapacitation. A4-15,2 Category B medical conditions of blood and blood - forming organs include the following: (a) Anemia (in cases that require regular transfusions). Anemia can result in frequent episodes of pain or the inability to perform work. Anemia is a progressive illness leading to functional impairment. (b) Leukopenia (where chronic and indicative of serious illness). Leukopenia is a progressive illness leading to func- tional impairment. (c) Polyeythemia very (where severe, requiring treat- ment). Polycythemia vera can result in frequent episodes of pain or the inability to perform work and the potential for sud- den incapacitation. (d) Splenomegaly (where the spleen is susceptible to rup- ture from blunt trauma). Splenomegaly can result in the potential for sudden incapacitation. (e) History of thromboembolic disease (that is, more than one episode or an underlying condition). A history of thromboembolic disease can result in the potential for sud- den incapacitation. 2000 Edition (f) Any other hematological condition that results in a person not being able to perform as a member. A-3-16.1 Category A medical conditions of endocrine and metabolic disorders include diabetes mellitus that is treated with insulin or an oral hypoglycemic agent and that includes a history of one or more episodes of incapacitating hvpoglyce- mia. Diabetes mellitus can result in the potential for sudden incapacitation. A-3-16.2 Category B medical conditions of endocrine and metabolic disorders includes the following: (a) Diseases of the adrenal ;land, pituitary gland, paratliv- roid gland, or thyroid gland of clinical significance (that is, symptomatic and poorly controlled). These diseases can result in frequent episodes of pain, the inability to perform work, and the potential for sudden incapacitation. (b) Nutritional deficiency disease or metabolic disorder (where clinically significant and not correctable by replace- ment therapy or other medication). Nutritional deficiency dis- ease or metabolic disorder can result in frequent episodes of pain or the inability to perform work. (c) Diabetes mellitus requiring treatment with insulin or oral hypoglycemic agent. Diabetes mellitus can result in epi- sodes of pain or inability to perform work. It is a progressive illness leading to functional impairment and can result in the potential for sudden incapacitation. (d) Any other endocrine or metabolic condition that results in a person not being able to perform as a member. A-3-17.2 Category B medical conditions of systemic diseases and miscellaneous conditions include the following: (a) Connective tissue disease, such as dermatomyositis, lupus erythematosus, scleroderma, and rheumatoid arthri- tis (where manifested by systemic impairment or limitations of motion) . These connective tissue diseases are progressive illnesses leading to functional impairment and the inability to function as a member due to limitations of strength or flexibility. (b) Residuals from past thermal injury (for example, frost- bite resulting in significant symptomatic discomfort). Residu- als from past thermal injury may result in the inability to perform functions as a member due to limitations of strength, endurance, or flexibility. (c) Documented evidence of a predisposition to heat stress with recurrent episodes or resulting residual injury. A predisposition to heat stress can result in the potential for sud- den incapacitation and the inability to perform functions as a member due to limitations of endurance. (d) Any other systemic condition that results in a person not being able to perform as a member. r13-18.2 Category B medical conditions of tumors and malig- nant diseases can include the following. (a) The medical evaluation of any person with malignant disease that is newly diagnosed, untreated, or currently being treated will be deferred. Any person with treated malignant disease should be evalu- ated based on that person's current physical condition and on the likelihood of that person's disease to recur or progress. (b) Any other tumor or similar condition that results in a person not being able to perform as a member. APPENDIX A 1582-19 A 3-19.2 Category B medical conditions of a psychiatric nature include the following: (a) Any person with a history of a psychiatric condition or substance abuse problem should be evaluated based on that person's current condition. Psychiatric conditions and sub- stance abuse problems can result in frequent episodes of pain or the inability to perform work and the potential for sudden incapacitation. These conditions are progressive illnesses lead- ing to functional impairment. (b) Anv other psychiatric condition that results in a per on not being able to perform as a member. A-3-20.2 Category B medical conditions concerning chemi- cals, drugs, and medications include the following: (a) Anticoagulant agents such as coumadin can be permit- ted if the anticoagttlated state is controlled such that the pro - thrombin time or INR has been in the therapeutic range on a stable medical regimen for at least one month and that no other coexisting conditions would either contribute to a bleeding diathesis or by themselves preclude certification for full duty. Anticoagulant agents can result in frequent episodes of pain or the inability to perform work, as well as the potential for sudden incapacitation. (b) Cardiovascular agents (for example, antihypertensives) can result in frequent episodes of pain or the inability to per- form work, as well as the potential for sudden incapacitation. (c) The use of narcotics can result in frequent episodes of pain or the inability to perform work, as well as the potential for sudden incapacitation. (d) The use of sedative-hypnotics can result in frequent episodes of pain or the inability to perform work, as well as the potential for sudden incapacitation. (e) The use of stimulants can result in frequent episodes of pain or the inability to perform work, as well as the potential for sudden incapacitation. (f) The use of psychoactive agents can result in frequent episodes of pain or the inability to perform work, as well as the potential for sudden incapacitation. (g) The use of steroids can result in frequent episodes of pain or the.inability to perform work. (h) Any other chemical, drug, or medication that results in a person not being able to perform as a member is included in this group. A4-2.1 Physicians who care for members need to be familiar and keep up-to-date with the most current recommendations for post -exposure prophylaxis (PEP) for bloodborne patho- gen (BBP) exposures. Also there should be a written protocol for dealing with members who present with BBP exposures. This should be based on the following elements: (1) Fact sheet that explains in lay language the risks of infec- tion, the various prophylactic and therapeutic options, the testing and follow-up that will be needed and recom- mendations for personal behavior (i.e., safe sex, blood donation, and so forth) following an exposure. (2) Classification table to determine the exposure type and recommendation for prophylaxis. Current recommenda- tions of U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and Public Health Services. (3) Listing of testing to be done on exposed member, includ- ing the following a. HIV b. Hepatitis B surface Antibody (HBsAb), if not previ- ously known to be positive c. Hepatitis B surface Antigen (HBsAg), if not previously known to be positive HBsAb d. Hepatitis C Antibody (HCAb) e. If HIV prophylaxis is to be given, the following tests should be done: 1. CBC 2. Glucose, renal and hepatic chemical function 3. Pregnancy test for females (4) Listing of testina to be done on source patient, including the following: a. HIV b. HBsAg c. HCAb (5) If source is available, interview for HIV, HepB, and HepC risk/status. (6) Determination of risk and need for PEP (7) Member counseling regarding PEP medication(s) and side effects of treatment. A printed fact sheet should be available for the member to review. (8) If PEP prophylaxis is to be given, it should be done as soon as possible after the incident, preferably within 2 hours. (9) Members on prophylaxis need to be followed (preferably by an ID specialist) for the duration of their treatment. (10) Assessment of tetanus status and administration of dT booster, if appropriate (11) Assess HepB status a. If previously immunized with a positive post -immuni- zation titer, no further treatment is needed. b. If previously immunized, titer was negative, and source is HBsAg positive or high risk, give Hepatitis B Immune Globulin (HBIG) as soon as possible — pref- erably within 24 hours — and a dose of Hepatitis B vaccine. c. If previously immunized and titer is unknown, draw titer. 1. If titer is positive, no further treatment is needed. 2. If titer is negative and source is HBsAg positive or high risk, then give Hepatitis B Immune Globulin (HBIG) as soon as possible — preferably within 24 hours — and a dose of Hepatitis B vaccine. d. If previously immunized with negative titer and revac- cinated with a negative titer, give HBIG immediately and a second dose 1 month later. e. If never immunized, give HBIG and begin Hepatitis B vaccine series. (12) Follow-up instructions should include the following: a. Adverse events and side effects of PEP b. Signs and symptoms of retroviral illness (fever, aden- opathy, rash) c. Appointments for follow-up blood work, including the following: 1. HIV at 6 weeks, 3 months, and 6 months 2. HBsAb and/or HCAb at 6 weeks, 3 months, and 6 months, if source is HepB and/or HepC positive 3. Every other week CBC, renal and liver function, if receiving PEP 20M Edition 1532-20 \[ED[C A\L R:OUIREMENTS FOR FIRE FIGHTERS AND INFORNLATION FOR FIRE DEP.NI'TMENT PI RSICE\NS A-1-2.2 Post -exposure prophylaxis may also be indicated for the following diseases: (1) Diphtheria (2) Hepatitis A (3) Meningitis (4) Pert ssis (5) Rabies (6) Varicella Zoster A-4-3.1 An annual TB program should include the following: (1) Documentation of a two-step purified protein derivative (PPD) prior to this PPD or a 0-mm PPD within the past I near. (2) Placement of PPD and reading by a trained, designated reader within 43 hours to 72 hours of placement. `lem- bers with a history of positive PPD should fill out a ques- tionnaire. (3) PPD results should be documented in millimeters (mm). A test with no skin reaction should be recorded as 0 mm. (4) A PPD skin test will be considered positive if the following conditions are present. a. Greater than 5 mm in someone who is immunosttp- pressed b. Greater than 10 mm in someone with a normal immune system who is at risk for conversion due to an exposure c. Greater than 10 mm increase from previous reading (5) If PPD is positive (conversion), the following steps should be taken: a. Fill out questionnaire b. Obtain chest x-ray c. Evaluate for active disease d. Evaluate for preventative therapy (6) If active disease is diagnosed, the member has to be removed from any duty until she/he has been deter- mined to be noninfectious. This will occur when ade- quate therapy has been instituted, the cough has resolved, and 3 consecutive sputum smears for acid -fast bacillus (AFB) on different days are negative. A4-3.2 In the event of an exposure to TB, the following steps should be taken: (1), Member should receive a PPD within 14 days of expo- sure. Members with a history of positive PPD should fill out a TB questionnaire. (2) Repeat PPD or questionnaire should be done 6 weeks to 12 weeks after the first. (3) If PPD is positive (conversion) or questionnaire is posi- tive, proceed as per (5) and (6) of A-4-3.1. A4-4 29 CFR 1910.1030 requires that members be offered Hep- atitis B immunization at no cost to the member. Members who choose to decline the offerof this immunization are required to sign a written declination. The declination becomes part of a member's confidential health data base as specified in Section 8-4 of NFPA 1500, Standard an Fire Department Occupational.Safeiy and Health Program. 4lembers are allowed to recant at any time and receive offered immunizations. A-5-1.1 Having a preplanned rehabilitation program that is applicable to most incident types is essential for the health and safety of members. This program should outline an ongoing rehabilitation for simple or short -duration incidents as well as a process to transition into the rehabilitation needs of a large 2000 Edthon or long -duration incident. Medical evaluation and treatment in the on -scene rehabilitation area should be conducted according to emergency medical service (ENIS) protocols developed by the fire department in consultation with the fire department physician and the EMS medical director. If advanced life support (ALS) personnel are available, this level of ENIS care is preferred. A-5-1.2 Weather factors during emergency incidents can impact severeh on the safety and health of members, who are operating during extremes of heat or cold. Where these fac- tors combine with long -duration incidents or situations that require heavy exertion. the risks to members increase rapidly. The fire department should develop procedures, in consulta- tion with the fire department physician, to provide relief from adverse climatic conditions. The following are typical rehabilitation considerations for operations during hot weather extremes: (1) Moving fatigued or unassigned members away from the hazardous area of the incident (2) Removing personal protective equipment (3) Ensuring that personnel are out of direct sunlight (4) Ensuring that there is adequate air movement over per- sonnel, either naturally or mechanically (5) Providing members with fluid replenishment, especially water (6) Providing medical evaluation for personnel showing signs or symptoms of heat exhaustion or heat stroke The following are typical rehabilitation considerations for operations during cold weather extremes: (1) Moving fatigued or unassigned members away from the hazardous area of the incident (2) Providing shelter from wind and temperature extremes (3) Providing members with fluid replenishment, especially water (4) Providing medical evaluation for members showing signs or symptoms of frostbite, hypothermia, or other cold - related injury A-5-2.2 The assignment of an ambulance or other support crew to the rehabilitation function is essential during long - duration or heavy -exertion incident operations. This crew can assist with rehabilitation functions as well as be available to provide immediate basic life support needs for members. Advanced life support (paramedic) level of evaluation and treatment has to be available quickly, however, to ensure the proper level of care. The medical staff has to have an assigned medical director. This can be an on -scene physician such as a fire department physician, a remote physician at a base hospital, or a central medical direction facility. A-5-3.2 For major incidents or escalating incidents, medical control can be established by the fire department physician or medical director at the incident scene. Burn Injury. When a member suffers a burn injury, he or she should be evaluated as to the extent of injury. First -degree burns can be treated on scene, and the member may continue duty. Second-degree burns should be evaluated by a physician familiar with burns, such as an emergency department physi- cian, a member of a burn unit, or a fire department physician. Second-degree burns and higher are conditions that demand that the member be removed from emergency response duty. After the burns have healed to the extent that there is minimal risk for entry into the member's body of body fluids and chem- APPENM Q icals encountered during regular duties, he or she can return to full duty. The American Burn Association has criteria for referral to a burn center. Thev are second- and third-degree burns with characteristics as follows: (1) Exceeding 20 percent body surface area (BSA) (2) Exceeding 10 percent BSA for age under 10 or over 50 (3) Anv third-degree burn over 5 percent BSA (4) Involving hands, feet, face, perineum, genitalia, or major joints (5) Circumferential involving extremities or chest (6) Caused by contact with chemicals, electricity, or lightning (7) Coupled with smoke inhalation injury (9) Associated with multiple trauma (9) Involving patients with pre-existing sigmificant medical illness ,blusculoskeWal Sprains. Strains and sprains are among the mostcommon member injuries. When they occur during peri- ods when circulating catecholamines are high, such as on the fireground, the injured member might underestimate the severity of the injury. Under such conditions, he or she might continue working and worsen the injury. Evaluation of these type of injuries on the fireground can be difficult. The injury might worsen with time due to swelling, muscle spasm, and increased pain perception after the emer- gency call is over. Any acute injury that leads to swelling or results in more than a trivial limitation of motion should prob- ably be evaluated by a physician. .Smoke Inhalation. Smoke inhalation is fortunately becoming less common, due to the use of self-eontained breathing appa- ratus. A member with smoke inhalation should be treated with 100 percent oxygen and transported to an emergency depart- ment. Burns involving greater than 15 percent of body surface area, facial burns, singed hair, and airway soot are associated with more severe airway burns. Lower airway injury can be associated with carbonaceous sputum, wheezing, vales, rhon- chi, and chest pain. Pulmonary function tests can reveal a decrease in forced expiratory volume in one second (FEVl). A chest radiograph may disclose infiltrates or atelectasis. Hypoxemia may be seen on arterial blood gas analysis. A nor- mal chest radiograph and normal arterial blood gas results do not, however, rule out significant smoke inhalation injury. Endotracheal intubation should be performed if there is central nervous system, stridor, hypoxemia (PO., less than 60), hypercarbia (PCO2 greater than 50), full -thickness burns of the face or neck, airway or pulmonary edema, or inability to handle secretions. Positive end -expiratory pressure (PEEP) should be used if hypoxemia persists despite incubation and administration of 100 percent oxygen. Inhaled beta-agonists and anticholinergics can be used for bronchospasm. Systemic corticosteroids are not recommended for pneumonitis or pul- monary edema. Antibiotics may be needed if sputum gram stain and culture with fever and leukocytosis suggest the pres- ence of a bacterial pneumonia. Down Member. Certainly the scenario involving the discovery of an unconscious member is one that is difficult to manage given the psychological responses of all involved. Of course, the first priority is the safe removal of the victim from the haz- ardous area. Then the Airway, Bleeding, Cardiac (ABCs) are carried out and a secondary surrey performed. Transport to a hospital should be expedited. Any unconscious member should be treated with 100 per- cent oxygen, since carbon monoxide poisoning is common and cyanide poisoning possible as secondary effects of smoke inhalation. At the emergency department, the victim should have an arterial carboxvhemogLobin determined and should be evaluated for possible cyanide toxicity. If cvanide poisoning is suspected, treatment with a cyanide antidote kit should be initiated. Since inducing methemoglobinemia in a patient with an elevated carboxyhemoglobin level mac further impair oxygen delivery, only sodium thiosulfate should be given ini- tially. If treatment with hyperbaric oxv;en is started, nitrites may be used. A-54.3 Items that can assist in limiting temperature stress in cold environments include heat, blankets, and protection from the wind. For hot weather, items should include adequate shade, tans, air-conditioning, and misting systems. Food and hydration needs include water and oral fluids, food, broth. and Emit. Also, for hydration, a 50i50 mixture of water and an electrolyte replacement drink can be provided. Medical equipment should include blood pressure cuffs, stethoscopes. oxygen, cardiac monitors, thermometers, and intravenous fluid and supplies. A-5-4.4 The incident commander should consider the cir- cumstances of each incident and make suitable provisions for rest and rehabilitation of members operating at the incident scene. For example, when members consume air from two SCBA air cylinders (two -cylinder rule), they should be assigned to rehab. A-5-4.5 The measurement of the pttlse rate has been used by some fire departments in assessing members during rehabilita- tion. A persistently elevated pulse could be a sign of excessive stress on the body due to dehydration, heat stress, exhaustion, or cardiopulmonary disease. The use of a pulse rate has not been studied in a manner that allows strict medical protocol to be recommended. The pulse rate combined with the remain- der of the clinical evaluation of the member may be used to determine if the member can return to operations. Appendix B Information for Fire Department Physicians This appendix is not a part of the requirements of this ATPA dat- ument but is included for informational purposes only. B-1 Occupational Safety and Health Problems for Members. B-1.1 General. Fire fighting and emergency response are very difficultjobs. People in thesejobs perform functions that are physically and psychologically very demanding. These functions are often performed under very difficult conditions. (.See Appendix C.) B-1.2 Physical Load. Studies have shown that fire -fighting functions require working at near maximal heart rates for pro- longed periods of time. Heavy protective equipment (includ- ing respirators) and the heat from the fire contribute to this physical load. B-1.3 Toxic Substances. Members and emergency response personnel also are exposed to many toxic substances during their work. Carbon monoxide is the most common contami- nant; studies have shown individual exposures that are as high as 5000 ppm during actual fires. Other significant exposures common during fires include cyanide, acrolein, hydrogen chloride, nitrogen dioxide, and benzene. The burning of plas- tics and other synthetic materials can expose members to other toxic materials, such as isocyanates and nitrosamines. Hazardous materials incidents can involve exposures to many 2000 Edition 1582-22 MLDfC.LL REQUIRE�MENT5 FOR FIRE FIGHTERS .AND tNFOR%LV LION FOR FIRE DEPARTMENT PI RSICLVNS other toxic materials. .4tthough the use of respirators helps to reduce exposures_ mechanical, environmental, and behav- ioral factors can limit their use during all phases of a tire. The available health data on members are limited. While the protection for members has improved over the last several years, exposures might be changing due to the introduction of more synthetic materials. Given the delay between exposure and onset. (that is, latency) of manv• occupational illnesses, current or past health studies of members might not reflect future health risks. These limitations should be recognized when reviewing the available studies. B-1-4 Increased Risk of Injury and Disease. Available data indicate that members have increased risk for injuries, pul- monary disease, cardiovascular disease, cancer, and noise - induced hearing loss. The increased risk for injuries is expected. given the demands and circumstances of this work. Fatalities and serious injuries from burns or other fire -scene hazards can occur. The risk for respiratory disease occurs due to the respira- tory damage caused by many of the components of fire smoke (for example, particulate, acrolein, nitrogen oxides, and so on.) Acute reductions in pulmonary function and even hypox- emia are not uncommon after fires, even in asymptomatic members. Permanent damage from smoke inhalation has also been repotted. Studies of chronic pulmonary changes from Fire fighting have not had consistent results. Some follow-up studies have shown a greater rate of decline in pulmonary function among members over time, while others have not been able to detect this change. Increased use of protective equipment and job selection factors (ill members transferring to other duties) could account for these inconsistent findings. The strenuous work demands of fire fighting combined with exposures to carbon monoxide and other toxic sub- stances can increase the risk for cardiovascular disease among members. Acute respiratory changes also can stress the cardiovascular system. This increased cardiovascular dis- ease risk has been documented even in some mortality stud- ies, despite the job selection factors that tend to mask any increase when compared to the general population. Other studies have not detected this risk. Certainly, the combina- tion' of the physical stress of fire fighting and exposures for a person with preexisting coronary heart disease would be expected to increase the risk of a myocardial infarction or other acute event. However, the degree of this acute risk and whether fire fighting also contributes to the development of coronary heart disease is uncertain. Increased cancer risk for members has been found in sev- eral recent studies. While not totally consistent, these studies generally show an increased risk of brain cancer, (gastrointes- tinal cancers) colon cancer, prostate cancer, lymphoma, and leukemia among members in many different parts of the world. Increased incidence of other cancer sites has also been shown in some studies. Several studies are currently under way to further evaluate this risk. Noise -induced hearing loss has now been documented in several studies of members. Members might also be at risk from other specific exposures including infectious diseases and liver, kidney, or neurological damage from exposure to specific chemicals. 2000 Edition B-2 Guidance for Medical Evaluations. B-2.1 Preplacement and Baseline Medical Evaluations. Preplacement medical evaluations assess an individual's health status before assignment to a position. The purpose of the evaluation is to ascertain whether the individual has any health condition that prevents him or her from performing the job. including the ability to wear protective equipment required for the job. The evaluation should also identify any health problems that could be substantially ati-r averted by the physical demands and working conditions. Baseline medical information concerning the applicant's health status can then be compared to subsequent evaluation results for the purpose of determining whether the individual has any significant health trends that can be occupationally related. Two npes of information are essential for a medical Pre - placement evaluation of those performing member duties. First, the physician must understand the working conditions and physical demands of this occupation. Appendix C pro- vicies a list of the environmental factors encountered in fire fighting and emergency response. The physician also should obtain additional information from the fire department regarding specific job duties and task lists (if the fire depart- ment has conducted a validation study or job analysis) and should be familiar with the organization of the fire depart- ment. For the evaluation of some medical conditions, the phy- sician will need to obtain further information about specific job duties in order to make a determination. This might require on -site inspections and consultation with fire depart- ment personnel, Second, the physician needs to have accurate information about the person's disease or medical condition, the func- tional limitations associated with that condition, and an understanding of how physical demands and working condi- tions would impact on that condition. An accurate diagnosis is often the key factor in determining the person's capability. For example, different skin diseases can have similar clinical appearances but can markedly differ in their response to envi- ronmental exposures. The physician should also recognize that individual variability can exist between persons with the same clinical condition. Upon completion of the examination, the physician should infonn the authority having jurisdiction whether the applicant is medically qualified to perform as a member. B-2.2 Periodic Medical Evaluations. The periodic medical evaluation is designed to evaluate the person's continued abil- ity to perfonn his or her duties and to detect any other signif- icant changes in the condition of his or her health. The latter includes possible job -related changes or abnormalities. Every year, each member will be medically evaluated by the Fire department physician. This medical evaluation includes an update on the member's medical history, including any sig- nificant changes, a brief review of symptoms, and a report on any significant job -related exposures experienced during the past year. Height, weight, visual acuity, and blood pressure are measured'and recorded. The extent of the medical evaluation and additional testing will depend on the member's medical condition. A more thorough evaluation, including a medical examina- tion, is conducted on a periodic basis. For individuals less than 30 years of age, the medical evaluation and examination is conducted at least every three years; for those 30 to 39 years of age, at least every two years; and for those 40 years of age or over, every year. This evaluation should include an updated APPENDIX e 1582-23 medical and interval history, complete physical examination, vision testing, audiometry, pulmonary function testing, and a CBC, urinalysis, glucose. BUN, creaunine, liver function tests, and lipid profile. The use of chest x-rays in surveillance activities in the absence of significant exposures, symptoms, or medical find- ings has not been shown to reduce respiratory or other health impairment. Therefore, only preplacement chest x-rays are recommended. No firm guidelines for stress elecrrocardiography in asyTmp- tomauc individuals have been developed. There have been problems with false -positive results from this testing, especially in younger age groups and in women. In those with one or more risk factors for coronary artery disease, there is probably justitication for performing the testing. As well, stress tests are more important in those whose work deals with public safety. Stress tests can be performed using a treadmill, bicycle, or stair climber, as long as the protocol being used gradually increases in workload metabolic equivalent of resting energy. expenditure (METS). A submaximal test, with the endpoint being the attainment of 85 percent of predicted maximal heart rate (P[v1HR), may be performed. Additional informa- tion gained by performing a maximal symptom -limited test might not be worth the addidonal time, effort, cost, and risk. A reasonable approach is to start periodic treadmill testing on members at age 40. In those with one or more coronary artery disease risk factors (premature family history (less than age 55), hypertension, diabetes mellitus, cigarette smoking, and hypercholesterolemia (total cholesterol greater than 210 or HDL cholesterol less than 35)], tesdngshould be started by age 35. The frequency of testing should increase with age, but at the minimum the test should be done at least every two years. Testing can also be done as indicated for those with symptoms suggestive of coronary artery disease, as reported in their yearly medical histories or interim reports. Conversely, it is known that even maximal stress testing fre- quently misses cardiac abnormalities seen during actual fire- fighting duties. B-2.3 Content of the Medical Evaluation. B-2.3.1 Medical and Occupational History. The medical his- tory should cover the person's known health problems, such as major illnesses, surgeries, medication use, allergies, and so forth. Symptom review is also important for detecting early signs of illness. In addition, a comprehensive medical history should include a personal health history, a family health his- tory, a health habit history, an immunization history, and a reproductive history. An occupational history should also be obtained to collect information about the person's past occu- pational and environmental exposures. B-2.3.2 Medical Examination. The medical examination includes the following organ systems and tests: (1) Vital signs, such as pulse, respiration, blood pressure, and, if indicated, temperature (2) Dermatological (3) Ears, eyes, nose, mouth, throat (4) Cardiovascular (5) Respiratory (6) Gastrointestinal (7) Cenitourinary (8) Endocrine and metabolic (9) *,Ytusculoskeletal (10) Neurological (I 1) Audiometry (12) Visual acuity and peripheral vision testing (13) Pulmonary function testing (14) Laboratory testing, if indicated (15) Diagnostic imaging, if indicated (I6) Electrocardiography, if indicated B-2.3.2.1 Laboratory Tests. CBC. biochemical test battery, urinalysis, glucose. BUN, creaunine, liver function test-,, and lipid profile, should be conducted for detecting specific ill- nesses as well as developing a baseline for later comparison. B-2.3.2.2 X—rays. A baseline chest s-r-ay can be helpful for individuals with a history of respiratory health problems or symptoms. For others, it can be useful for later comparison. B-2.3.2.3 Pulmonary Function Testing. Pulmonary function testing can be helpful for individuals with a history of respira- tory health problems and as a baseline for later comparison. A baseline test should be administered by an experienced per- son. Only a spirogram that is technically acceptable and dem- onstrates the best efforts by an individual should be used to calculate the forced vital capacity (FVC) and forced expiratory volume in one second (FEVl). B-2.3.2.4 Audiometry. Audiograms should be performed in an ANSI -approved soundproof booth (,VNSI S3,1, Afaximum PermissibL- Ambient Noise Levels for Audiometric Teat Rooms) with equipment calibrated to AINSI standards (AINSI 53.6, Specifica- tion for Audiometers). If a booth is unavailable, the test room sound pressure levels should not exceed those specified in the federal OSHA. noise regulations (29 CFR 1910.95). B-2.3.2.5 Electrocardiography. Baseline electrocardiography should be conducted. (Periodic resting electrocardiograms have not been shown to be useful, but may be reasonable as a member's age increases.) B-2.4 Reporting the Results of the Medical Evaluation. All individuals participating in a medical evaluation should be informed ahead of time about the purpose of the medical evaluation and the content of the exam. The results of any medical evaluation are considered to be confidential medi- cal information, subject to customary patient -physician con- fidentiality restrictions. Under most circumstances, results and recommendations arising from the evaluation should be expressed in general terms without specific diagnostic infor- mation. In cases where more specific information is needed in order to make a decision on the status of a candidate or member, a specific consent form releasing that information should be obtained from the candidate or member. Blanket or general "release of medical information" forms should not be used. In most cases, a simple statement like one of the following will suffice: (a) Based on the results of the preplacement medical eval- uation of December 10, 1996, jane Doe is (or is NOT) medi- cally certified to engage in training and emergency operations for Anytown Fire Department- (b) Based on the results of the preplacement medical eval- uation of December 10, 1996, John Doe is NOT medically cer- tified to engage in training and emergency operations for Anytown Fire Deparunent. He has been advised of the medical reasons for this recommendation and of the policies and pro- cedures available to him if he disagrees with the results of the medical evaluation. 2OW Edition 1382—: 4 '.ILD[c:.vL REQEiRE-NIENTS FOR FiRE FIGHTERS .A`ID INFORM.vTiON FOR FiFLL- DEPART.NILNT PI WiICI.ANS B-2.5 Second Opinions. Fire department policies and proce- dures should allow fora medical second opinion when a candi- date or member disagrees with the results or recommendations of a medical examination conducted by the fire department physician or when the fire department physician is uncertain about the limitations or prognosis of the individual's condition. Often other physicians will not be familiar with the duties and demands of fire fighting and emergency response. When possi- ble, the fire department physician should help educate the other physician about how the individual's condition could affect or be affected by fire fighting. If there is still disagreement about the condition or placement recommendation, a third physician (acceptable to both the fire department and the can- didate) can be consulted. B-2.6 Musculoskeletal System. Some of the injuries or prob- lems encountered in this system will need functional capacity evaluation to determine fitness for duty. Physical therapy pro- viders often design tests for employers to determine ability- to perform tasks similar to those required as part of their essen- tial job functions. These tests should be based on direct mea- surements of the actual job functions. These functional capacity evaluations can be especially useful when a member has been cleared for full duty by a physician who is not familiar with the essential job functions of a member. B-3 Specific Medical Conditions. B-3.1 Diabetes Mellitus. The major concern for diabetic members is the risk of becoming hypoglycemic during fire - ground operations or other emergency responses. Both exog- enous insulin and oral hypoglycemic agents can be associated with episodes of hypoglycemia that can rapidly progress from impaired judgment to unconsciousness. The most reliable predictor of hypoglycemia is a history of it. In one study of insulin -dependent adolescents conducted at theJoslin Clinic (BhaLia and Wolfsdorf 1991), all 196 patients experienced hypoglycemia at least once during the two-year observation period. Of these, 15 percent were classified as severe, based on loss of consciousness, seizure, or the clinical need for thera- peutic glucagon or intravenous glucose. It was particularly concerning that 24 percent of hypoglycemic episodes detected by blood glucose monitoring were inapparent to the patients. The probable causes of hypoglycemia were identified in 71 percent of cases, and the most common were strenuous exercise and skipped meals or snacks. Both of these precipi- tants are likely to occur in emergency responders, especially fire service personnel. In addition to accelerating glucose uti- lization, strenuous exercise increases insulin sensitivity (Wasserman and Sinman 1994). With the tighter glycemic control that is now known to decrease and delay onset of dia- betic complications, there is a concomitantly increased likeli- hood of exercise -induced hypoglycemia (Wasserman and Sinman 1994). Insulin is clearly associated with a much higher risk of symptomatic hypoglycemia than are oral agents. In the absence of a history of incapacitating hypoglycemic episodes, and with close medical monitoring, there is probably no rea- son to exclude members who are taking oral hypoglycemic agents, as long as they have stable weights, diets, and renal function. Although the Americans with Disabilities Act (Public Law 101-336 1990) does not appear to require each diabetic patient to be evaluated for fitness for duty individually, there is some case law that disallowed blanket exclusion of insulin - dependent diabetics from public safety positions (Fire & Police Personnel Reporter 1994). The Federal Aviation 2000 Edition Administration (14 GFR67.1316 1995) does not grant medical certificates to diabetics treated with insulin and severely limits those on oral hypoglycemic agents. B-3.2 Asthma and Reactive Airways Disease. The diagnosis of asthma and related airway hvperactivity disorders is often confounded by definitional issues. For the purposes of member certification, a variety of airwav disorders that meet the following criteria can be included. Pothma is a chronic inflammatory disorder of the airways. In suscepti- ble individuals, this inflammation causes symptoms that are usually associated with widespread but variable airflow obstruction that is often reversible, either spontaneously or with treatment, and causes an associated increase in airway responsiveness to a variety of stimuli. Since asthma is a highly prevalent disease, a number of member applicants will require special evaluation. Combus- tion products, exercise, and cold air are all potent provokers of an asthma attack. Some of these exposures are unavoidable, even with SCBA use. If a candidate has a diagnosis or symp- toms consistent with an asthma -like disease, many factors will need to be considered. An asthma attack during a suppression activity could harm the member, his fellow members, or a member of the public. The following factors can be used to help in certification: (1) Persistence of airway obstruction between attacks (as measured by spirometry) (2) Need and frequency of steroid and bronchodilator use (frequent bronchodilator use suggests persistent airway hyperactivity) (3) Usual type of triggers in the applicant (allergic, infec- tious, exercise -induced, etc.) (4) History of hospitalization, emergency room, or urgent treatment (5) Length of time between attacks (6) Nocturnal symptoms and other estimates of airway insta- bility Moderate asthma or worse could disqualify an individual for member duties. Unknown factors such as the suppression of airway hyperactivity with anti-inflammatory medications to reduce the possibility of a sudden or severe attack are under investigation and could modify current suggestions. B-3.3 Heart Disease. The medical conditions relating to the cardiovascular system have been reviewed since the previous edition (1997) of this document. The task forces at the Bethesda Conference published recommendations for ath- letes competing with cardiovascular disease in the, fournal of the American College of Cardiology, in October 1994. The analysis used by the task force has relevance to the evaluation of mem- bers with cardiovascular disease. Eire -fighting activities have a high static component (i.e., inducing predominantly an increase in blood pressure) and a moderate to high dynamic component (i.e., inducing predominantly an increase in heart rate). Sports with a similar set of demands include wrestling, body building, and boxing. Recommendations made by the task force with respect to athletic activities that have these physical demands (high static, moderate dynamic) have been followed in this document. B-3.4 Reproductive. Exposures in the fire -fighting environ- ment can cause adverse reproductive effects for both males and females. Medical evidence exists to indicate that chemical exposure, heat, noise, and physical exertion can affect various endpoints of reproductive health including fertility, fetal loss, APPENDIX B 1582-25 and growth parameters of the offspring. All candidates and members should be educated about these risks .and about the need to take appropriate steps to limit dacir exposures. Vso, there could be some situations where a male or female member is attenipting to conceive a child and is having difficulty. In these situations, where a complete medical evalil- ation has not identified another cause for this infertility, tem- porary assignment on a voluntary basis to alternative duav or a leave of absence should be considered. Medical evidence exists that certain toxic substances or con- ditions that are present in the fire -fighting environment are dangerous to the saleov and well-being of the fetus. Therefore, it is important to educate all members about these risks and the reasons for recommending that pregnant members restrict their fire -suppression activities. For example. there is good evi- dence that the fetus is especiallvsensitive to carbon monoxide, a known significant component of fine smoke. Although die use of SCBA is assumed to be protective, sometimes Such equipment is not used throughout a fire suppression or haz- ardous materials incident The use of such equipment also increases other fetal stressors, such as exertion and heat. Other concerns are those involving physical work. Prolonged stand- ing, heavy lifting, and exposures to temperature extremes and humidity have been related to an increase of preterm and low birth weight infants. Because the fetus should be protected from these exposures at the earliest possible time, the member who might be pregnant should obtain early pregnancy testing. Recognizing potential risks to the fetus from the fire -fighting environment is a relatively recent event, and many members might not be aware of these risks. Based on a recent U.S. Supreme Court decision (Interna- tional Union et al. v. Johnson Controls, Inc., 59 U.S.L.W. 4209, March 20, 1991), the ability to perform as a member is to be the basis for the medical certification without consideration of health risks to the fetus. However, the pregnant member should be counseled on the potential risks to her fetus due to her exposures during fire -fighting duties. Any member who becomes pregnant should be offered the opportunity at any time during the pregnancy to be voluntar- ily removed from fire -fighting duties and from other duties involving the hazards or physical stress that might endanger the fetus. If practical, the member should be offered voluntary reassignment to an alternative position. At such time as the pregnant member can no longer be medically certified as being capable of performing fire -fighting duties, the member should be reassigned to other duties- At such time as the mem- ber is no longer pregnant, the member should be reinstated to the position held prior to being pregnant. Nursing mem- bers should also be advised about the potential exposures to their infants. B-3.5 Noise -Induced Hearing Loss. This category can pose difficulties because a high percentage of current members have noise -induced hearing loss due to their exposures as members. Implementation of hearing conservation programs and programs to reduce noise exposures should lead to a decrease in the prevalence of this condition in the future. B-3.6 Seizures and Epilepsy. It is important to di56nguLih between a history of seizures and epilepsy. As much as 10 per- cent of the population will experience at least one seizure in a lifetime, whereas less than 1 percent of the population qualifies for a diagnosis of epilepsy (Hauser and HesdortTer 1990). Many conditions producing seizures in the pediatric age group are known to remit prior to adulthood, and many adults sustain a reactive ieizmc that c:ai he ar.thhuted to a reversihlc, underly- ing precipitui. These circumstances do not necessarily repre- sen t an ongoing risk of sudden, unpredictable incapacitation ,> f a member. If a member Iias a single scizure. a clear precipitant not associated with central nervous system damage is identified and eliminated. and die individual has no recurrence over the ensuing year, then he or slie is prohahly not more likely to have .another seizure than the rest of the general population (Spen- cer 1995). Most fire department physicians will want a qualiticd neuvologist to verify that an individual with a history of seizures does not, in fact, have epilepsy. Epilepsy is dia,moicd by the presence of "unprovoked, recurrent seizures — paroxysmal disorders of the central ner- vous svitem characterized by an abnormal cerebral neuronal discharge with or without loss of consciousness' (Cascino 1994). Treatment of patients with epilepsy is onlvvariabh suc- cessful, with roughly 40 percent of patients attaining remission on antv,conulsant therapy (Hauser and Hesdorffer 1990; Spencer 1995). Remission is defined as five years without recurrence of seizure activity (.-nnegers. Hauser, and Elve- back 1979). Further complicating the fimess-forducy issue is the fact that only 50 percent of patients who achieve remission do so without toxic side effects of the anti-convulsant dnig (Cascino 1994). Partial, simple epilepsy, or recurrent seizures that do not impair consciousness, are felt to be a disqualifying condition because of the uncertainty regarding how much of the brain might be involved, and the risk of propagation to other regions of the brain, particularly in the highly epileptogenic environment of the fireground (Spencer 1995). This standard is somewhat more liberal than that promul- gated by the Federal ,aviation Administration of the U.S. Department of Transportation for aircraft pilots (14 CFR 67.1316 1995). All epileptics, regardless of therapeutic success are denied first-, second-, or third-class medical certificates, except under the provisions of 14 CFR67.19. "Special Issue of Medical Certificates." B4 References. Annegers, J. F., W. A. Hauser, and L. R. Elveback. 1979. "Remission of Seizures and Relapse in Patients with Epilepsy," Epilepsia 20:729. Bhatia, V., andJ. L WollsdorF. 1991. "Severe Hypoglycemia in Youth with Insulin -Dependent Diabetes Mellitus: Fre- quency and Causative Factors." Pediatrics, 88:1187. Brunacini, Alan. Firegnnand Command. National Fire Protec- tion Association, 1985. Cascino. G. D. 1994. Epilepsy: Contemporary Perspectives on Evahaatfort and Treatment, Mayo Clinic Proceedings 69:1199, "Emergency Incident Rehabilitation," United States Fire Administration (FA#112). Fire & Police Personnel Reporter„iNovember 1994, p. 169. Hauser, W. A., and D. C. Hesdortfer. 1990. "Epilepsy: Fre- quency. Causes and Consequences." New York: Demos. National Fire Incident Reporting System (NFIRS) data base. NFPA 1521, Standard for Firr Department .Safety Officer, 1997 edition. Public Law 101-336. 1990, Title I — Emplo}Ynent. Spencer, S., Personal Communication, 1995. (Spencer is professor of neurology and director of the Clinical Epilepsy and Electrophysiologic Monitoring Services at Yale University School of Medicine.) Title 14, Cate for Federal Regulations. Part 1910.1000, Sub- parts 13-16. Asir Contaminants." 2GW Edition 1582-26 tIEDIG\L REQUE-ENIE:vTS FOR FIRL F[GHTERS.AUD IVFOR.MAT[ON FOR FIRE DE[,.ARr%[EVT PMi S[Cl,A. S -Toxic smoke inhalation: Cyanide poisoning in fire vic- tims.- Jones, J. et al., .American journal of Emergency Medicine 5:317. 1987. Wasserman. D. H.. and B. Sinman. 1991. "Exercise in Indi- viduals with 1DDL1," Diabetic. Care, 17:9" k. Appendix C Essential Structural Fire -Fighting Functions This appendix is not a part of the requirements of this NTP.A dt)c- umrnt but is rnclnded for informational purposes only. C-1 The medical requirements in this standard were based on in-depth consideration of essential structural fire -fighting functions. These essential functions are what members are ex- pected to perform at emergency incidents and are derived from the performance objectives stated in NFPA 1001, Stan- dard far Fire Fighter Professional Qualifications. Essential functions are performed in and affected by the following environmental factors: (1) Operating both as a member of a team and indepen- dendv at incidents of uncertain duration (2) Spending extensive time outside exposed to the elements (3) Tolerating extreme fluctuations in temperature while per- forming duties; fire fighters are required to perform phys- ically demanding work in hot (up to 4007), humid (up to 100 percent) atmospheres while wearing equipment that significantly impairs body -cooling mechanisms. (4) Experiencing frequent transition from hot to cold and from humid to dry atmospheres (5) Working in wet, icy, or muddy areas (6) Performing a variety of tasks on slippery, hazardous sur- faces such as on rooftops or from ladders (7) Working in areas where sustaining traumatic or thermal injuries is possible (8) Facing exposure to carcinogenic dusts such as asbestos, toxic substances such as hydrogen cyanide, acids, carbon monoxide, or organic solvents, either through inhalation or skin contact (9) Facing exposure to infectious agents such as Hepatitis B or HIV (10) Wearing personal protective equipment that weighs approximately 50 lb while performing fire-ffighting tasks (I 1) Performing physically demanding work while wearing pos- itive -pressure breathing equipment with 1.5 in. of water column resistance to exhalation at a flow of 40 L/min (12) Performing complex tasks during life -threatening emergencies (13) Working for long periods of time, requiring sustained physical activity and intense concentration (14) Facing lifeor-death decisions during emergency conditions (15) Being exposed to grotesque sights and smells associated with major trauma and burn victims (16) Making rapid transitions from rest to near -maximal exer- tion without warm-up periods (17) Operating in environments of high noise, poor visibility, limited mobility; at heights; and in enclosed or confined spaces (18) Using manual and power tools in the performance of duties (19) Relying on senses of sight, hearing, smell, and touch to help determine the nature of the emergency, to maintain personal safety, and to make critical decisions in a con- fused, chaotic, and potentially life -threatening environ- ment throughout the duration of the operation 2000 Edition Appendix D Guide for Fire Department administrators This appendix is not a pan of the requirrmentr of this N7PA itor• ument but is included for inf�rmational purposes only. D-1 Legal Considerations in Applying the Standard. The con- sideration of an application or continued employment of a mem- ber based on medical or physical performance e•.aivationa involves a determination that is not without legal implications. To this end, prior to makin7 an adverse employment decision bled on the foregoing standard, the authority with jurisdiction might wish to consult with counsel. D-l.I Individuals with Handicaps or Disabilities. The Reha- bilitation Act of 1973, as amended. 29 U.S.C. 791 et seq., and implementing regulations, prohibit discrimination against those with handicaps or disabilities under any program receiv- ing financial assistance from the federal government. The .americans with Disabilities Act of 1990, 42 U.S.C. � 12 10 1, et seq., also prohibits employment discrimination by certain pri- vate employers against individuals with disabilities. In addition, many states have enacted legislation prohibiting discrimination against those with handicaps or disabilities. These laws prevent the exclusion, denial of benefits, refusal to hire or promote, or other discriminatory conduct against an individual based on a handicap or disability, where the individual involved can, with or without reasonable accommodation, perform the essential functions of the job without creating undue hardship on the employer or program involved. Application of this standard should be undertaken with these issues in mind. The medical requirements of the 1997 edition of this stan- dard were initially developed and found to bejob-related by a subcommittee comprised of medical doctors, physiological specialists, and fire service professionals, as processed through the NFPA consensus standards -making system. Changes for the current edition have been proposed by a task group com- prised of similar expertise. The standard provides, to the extent feasible, that decisions concerning candidates and cur- rent members with medical ailments, handicaps, ordisabilides be made after case -by -case medical evaluations. Thus, most medical conditions have been assigned to Category B. The medical requirements in this edition of the standard were revised based on the essential functions contained in Appendix C. It is recognized that some fire -fighting functions and tasks can vary from location to location due to differences in department size, functional and organizational differences, geography, level of urbanization, equipment utilized, and other factors. Therefore, it is the responsibility of each individ- ual fire department to document, through job analysis, that the essential functions performed in the local jurisdicLion are substantially similar to those contained in Appendix C. There are a wide variety ofjob apalytic techniques available to document the essential functions of the job of a member. However, at a minimum, any method utilized should be cur- rent, in writing, and meet the provisions of the Americans with Disabilities Act (29 CFR 1630.2(n) (3) ]Job descriptions should focus on critical and important work behaviors and specific tasks and functions. The frequency and/orduration of task per- formance, and the consequences of failure to perform the task should be specified The working conditions and environmen- tal hazards in which the work is performed should be described. The job description should be made available to the fire service physician for use during the preplacement medical examination for the individual determination of the medical suitability of applicants for member. APPENDIX D 1582—`_'7 D-1,2 Anti -Discrimination Laws. Finally, users of this stan- dard should be aware that, while courts are likely to give con- siderable weight to the existence of a nationally recognized standard such as `lFP:k 1582, Standard on Medical Requirrmencs for Fire Fghters and Information for Fin Department Phvsidans (e.g_ Miller a Sioux Gateway Fire Department, 497 N.W, 21d 838 (1993), reliance on the standard alone could be insufficient to withstand a challenge under the anti -discrimination laws. Even in the case of Category A medical conditions, courts can cull require additional expert evidence concerning an individ- ual candidate's or member's inability to perform the essential functions of the job. Until the courts provide further guidance in this developing area of law, some uncertainty as to the degree and nature of the evidence required to establish com- pliance with the anti -discrimination laws will remain. 134.3 Individuals Who Are Members of Protected Classes (Race, Sex, Color, Religion, or National Origin). Title VII of the Civil Rights _act of 1964, as amended, 42 U.S.C. 2000e, and implementing regulations by the Equal Employment Opporno- nity Commission (EEOC) prohibit discrimination in employ- ment on the basis of race, sex, color, religion, or national origin (i.e., protected classes), Under Title VII, an "employer" is defined, generally, to mean a person with "15 or more employ- ees for each working day in each of 20 or more calendar weeks in the current or preceding calendar year." (42 U.S.C. 2000e) Several federal jurisdictions have held that unpaid volunteers are not considered to be "employees" under Title VII. Additionally, many states, cities, and localities have adopted similar legislation. Generally, physical performance or other requirements that result in "adverse impact" on mem- bers of a protected class (e.g., on the basis of gender) are required to be validated through a study in accordance with EEOC guidelines, if such requirements are to be relied on in making employment decisions. Under EEOC guidelines, a study validating employment standards in one jurisdiction can be transportable to another jurisdiction (and therefore used in lieu of conducting a separate study). However, specific pre- conditions must be met in this regard, and the authority hav- ing jurisdiction should seek the advice of counsel before relying on a transported validation study. D-1.4 Pregnancy and Reproductive. Federal regulations, as well as many court decisions, including the U.S. Supreme Court's decision in International Union, et al. v. Johnson Contmlr, Inc. (499 U.S. 187, 111 S.Cr- 1196 (1991)1, have interpreted the requirements of Title VII with respect to pregnancy and reproduction. The authority having jurisdiction should seek the advice of counsel in resolving specific questions concern- ing these requirements as well as other requirements that can be imposed by state or local laws. D-2 Choosing a Fire Department Physician. Several factors should be considered in choosing a fire department physician. There are relatively few physicians with formal residency train- ing and certification in occupational medicine. The fire depart- ment physician needs to be qualified to provide professional expertise in the areas of occupational safety and health as these areas relate to emergency services. For the purpose of conduct- ing medical evaluations, the fire department physician needs to understand the physiological and psychological demands placed on members and needs to understand the environmen- tal conditions under which members have to perform. Therefore, physicians with specialties other than occupa- tional need to be considered, as well as the physician's back- ground and experience. Knowledge of occupational medicine and experience with occupational health programs, obviously, would be helpful. The physician has to be committed to meeting the require- ments of the program, including appropriate record keeping. His or her willingness to work with the department to contin- ually improve the program is also important. Finally, his or her concern and interest in the program and in the individuals in the department is vital. There are many options for obtaining phvsician services. (a) Physicians could be paid on a service basis or through a contractual arrangement. (b) For volunteer departments, local physicians could be willing to volunteer their services for the program, with addi- tional member arrangements for payment of laboratory test- ing, x-rays, and so forth. (c) Some departments could utilize a local health care facility for medical care. However, in that case, the department should be sure to have one individual physician responsible for the program, record keeping, and so forth. (d) In some cases, it could be possible to have the medical examination by the fire department physician, while some of the associated costs could be defrayed by the member's own health insurance. For example, the health insurance prodder could allow the member to have a yearly physical, normally performed by the member's personal physician. The health care insurance provider could allow that physical to be per- formed by the fire department physician with some degree of reimbursement. D63 Coordinating the Medical Evaluation Program. An indi- vidual from within the department should be assigned the responsibility for managing the health and fitness program, including the coordination and scheduling of evaluations and examinations. This person should also act as liaison between the department and the physician to make sure that each has the information necessary for decisions about placement, scheduling appointments, and so forth. Confidentiality of all medical data is critical to the success of the program. Members need to feel assured that the infor- mation provided to the physician will not be inappropriately shared. No fire department supervisor or manager should have access to medical records without the express written consent of the member. There are occasions, however, when specific medical information is needed to make a decision about placement, return to work, and so forth, and a fire department manager must have more medical information for decision making. In that situation, written medical consent should be obtained from the individual to release the specific information necessary for that decision. Budgetary constraints can affect the medical program. Therefore, it is important that components of the program be prioritized such that essential elements are not lost. With addi- tional funding, other programs or testing can be added to enhance the program. D4 Table D-4 represents a comparison between NFPA 1582 and OSHA 29 CFR 1910.134, 2000 Edition 1582-28 MEDICAL REQU(RLMENTS FOR FtRL FIG[ (TERS AND tNFORMA MON FOR FtRL DEPART',(ENT P! nStC[ .NS Table D-i Comparison of OSHA 29 CFR, Parts 1910.134, "Medical Requirements" and NFPA 1582, Standard on Nfedical Rr.,,,i.rr is fnr Fire Fighters and Information for Fire Department Physicians, 2000 Edition NFPA 1582 OSHA 1910.134 2-1 Medical Evaluation Process. The employer must establish and implement those elements of the written respiratory pro- 2-1.1 * The fire department shall establish and implement a medical evalua- tection program necessary to ensure that any employee using a respirator voluntarily is med- tiun process for candidates and current members. ically able to use that respirator, and that the respirator is cleaned, stored, and maintained so that its use does not present a hazard to the user. Exception: Employers are not required to include in a written respiratory protection pro- gram those employees whose only use of respi- rators involves the voluntary use of filtering face pieces (dust masks). Appendix D-3 Coordinating the Medical Evaluation Program. An individual from the department should be assigned the responsibility for man- (3) The employer shall designate a program administrator who is qualified by appropriate within aging the health and fitness program, including the coordination and scheduling of evaluations and examinations. This person should also act as training or experience that is commensurate with the complexity of the program to admin- liaison between the department and the physician to make sure that each ister or oversee the respiratory protection pro - and conduct the required evaluations of has the information necessary for decisions about placement, scheduling gram appointments, and so forth. the program effectiveness. Confidentiality of all medical data is critical to the success of the program. Members must feel assured that the information provided to the physician will not be inappropriately shared. No fire department supervisor or man- ager should have access to medical records without the express written con- sent of the member. There are occasions when specific medical information is needed to make a decision about placement, return to work, and so forth, and a fire department manager must have more medical information. In that situation, written medical consent should be obtained from the individ- ual to release the specific information necessary for that decision. Budgetary constraints can affect the medical program. Therefore, it is important that components of the program be prioritized such that men- lost. With funding, other or test- ial elements are not additional programs ing can be added to enhance the program. 2-1.2 The medical evaluation process shall include preplacement medical medical evalu- (1) General, The employer shall provide a medical evaluation to determine the evaluations, periodic medical evaluations, and return-to-dury employee's ability to use a respirator, before ations. the employee is fit tested or required to use the respirator in the workplace. The employer may discontinue an employee's medical evalu- ations when the employee is no longer required to use a respirator. (S)ieet I of 5) 2000 Edition :vPPENDIX D 1582-29 Table D4 Comparison of OSHA 29 CFP, Parts 1910.134, "Medical Requirements" and NFPA 1582, Standard on Aledical Rvmiirements for Fire Fighters and Information for Fire Department Physicians, 2000 Edition (Continued) NFPA 1582 OSHA 1910.134 2-1.3 The fire department shall ensure that the medical evaluation process (3) Follow-up medical examination. and all medical evaluations meet all of the requirements of Section 2-1. (i) The employer shall ensure that afollow-up medical examination is prodded for an employee who gives a positive response to any question among questions 1 through 8 in Sec- tion 2, Part A of Appendix C or whose initial medical examination demonstrates the need I for follow-up medical examinations. (ii) The follow-up medical examination shall include anv medical tests, consultations, or diagnostic procedures that the physician or licensed health care professional (PLHCP) deems necessary to make a final determina- rion. 2-1.4 Each candidate or current fire fighter shall cooperate, participate, and (7) Additional medical evaluations. At a mini - comply with the medical evaluation process and shall provide complete and mum, the emplover shall provide additional accurate information to the fire department physician. medical evaluations that comply with the requirements of this section if 2-1.5" Each candidate or current fire fighter shall, on a timely basis, report to the fire department physician any exposure or medical condition that (i) An employee reports medical signs or could interfere with the ability of the individual to perform as a fire fighter. symptoms that are related to ability to use a respirator; 24.1.1 The components of the annual medical evaluation specified in 24.1.2 of this section shall be permitted to be performed by qualified per- sonnel as authorized by the fire department physician. When other quali- fied personnel are used, the fire department physician shall review the data gathered during the evaluation. (ii) A PLHCP, supervisor, or the respirator pto- grain administrator informs the employer that an employee needs to be re-evaluated; (iii) Information from the respiratory protec- tion program, including observations made during fit testing and program evaluation, indicates a need for employee re-evaluation; or (iv) A change occurs in workplace conditions (e.g., physical work effort, protective clothing, temperature) that may result in a substantial increase in the physiological burden placed on an employee. . (Shut 2 of 5) 20W Edition 1582-30 MEDICAL REQUIREMENTS FOR FIRE FIGHTERS AND INFORNUTION FOR FIRE DEMRTMENT PHISICIANS Table D4 Comparison of OSHA 29 CM Parts 1910.134, "Medical Requirements" and NFPA 1582, Standard on Medical Reauirtments for Fire Fiehters and Information for Fire Department Physicians, 2000 Edition (Continued) NFPA 1582 2-2 Fire Department Roles. OSHA 1910.134 (2) Medical evaluation procedures. 2.2.1 The fire department shall have an officially designated physician who (i) The employer shall identify a physician or other licensed health care professional shall be responsible for guiding, directing, and advising the members with *XFPA ( PLHCP) to perform medical questionnaire regard to their health, fitness, and suitability for duty as required by or an initial medical examination that obtains 1500, Standard an Fire Department Occupational Safety and Health Program. the same information as the medical question- naire. 2-2.2 The fire department physician shall be a licensed doctor of medicine or osteopathy. D-2 Choosing a Fire Department Physician. Several factors should be consid- ered in choosing a fire department physician. There are relatively few physi- cians with formal residency training and certification in occupational medicine. The fire department physician shall be qualified to provide pro- fessional expertise in the areas of occupational safety and health as they relate to emergency services. For the purpose of conducting medical evalua- tions, the fire department physician shall understand the physiological and psychological demands placed on fire fighters and shall understand the environmental conditions under which fire fighters must perform. Therefore, physicians with other specialties need to be considered. The background and experience of the physician should be considered. Knowl- edge of occupational medicine and experience with occupational health programs obviously would be helpful. The physician must be committed to meeting the requirements of the pro- gram including appropriate record keeping. His/her willingness to work with the department to continually improve the program is also important. Finally, his/her concern and interest in the program and in the individuals in the department is vital. There are many options for obtaining physician services. They could be paid on a service basis or through a contractual arrangement. For volunteer departments, local physicians might be willing to volunteer their services for the program with additional arrangements to pay for laboratory testing, x- rays, and so forth. Some departments might want to utilize a local health care facility for their care. However, in that case, the department should be sure to have one individual physician responsible for the program, record keeping, and so forth. In some cases it could be possible to have the medical examination by the fire department physician, while some of the associated costs could be defrayed by the fire fighter's own health insurance. For exam- ple, the health insurance provider might allow the fire fighter to have a yearly physical, normally performed by the fire fighter's personal physician. The health care insurance provider can allow that physical to be performed by the fire department physician with some degree of reimbursement. 2000 Edition (ii) The medical evaluation shall obtain the information requested by the questionnaire in Sections I and 2, Part A of Appendix C of this section. (Sheet 3 of 5) APPENDIX D 1582-31 Table D-4 Comparison of OSHA 29 CFR, Parts 1910.134, "Medical Requirements" and NFPA 1582, Standard on Medical far Fire Fighters and Information for Fire Department Physicians, 2000 Edition (Continued) NYPA 1582 2-2.3* For the purpose of conducting medical evaluations. the fire depart- ment physician shall understand the physiological and psychological demands placed on members and shall understand the environmental con- ditions under which members must perform. The fire department shall pro- vide the fire department physician with a current job description for all fire department positions and ranks. B-1 Occupational Safety and Health Problems for Fire Fighters. Fire fighting and emergency response are very difficultjobs. People in these jobs per- form functions that are physically and psychologically very demanding. These functions are often performed under very difficult conditions. (See .appendix C.) Studies have shown that fire -fighting functions require work- ing at near maximal heart rates for prolonged periods of time. Heavy pro- tective equipment (including respirators) and the heat from the fire contribute to this physical load. Fire fighters and emergency response personnel also are exposed to many toxic substances during their work. Carbon monoxide is the most common contaminant; studies have shown individual exposures as high as 5000 ppm in actual fires. Other significant exposures common in fires include cya- nide, acrolein, hydrogen chloride, nitrogen dioxide, and benzene. The burning of plastics and other synthetic materials can expose fire fighters to other toxic materials such as isocyanates and nitrosamines. Hazardous mate rials incidents can involve exposures to many other toxic materials. While the use of respirators helps to reduce exposures, mechanical, environmen- tal, and behavioral factors can limit their use during all phases of a fire. OSHA 1910.134 (e) Medical evaluation. Using a respirator may place a physiological burden on employees that varies with the type of respirator worn, the job and the workplace conditions in which the respirator is used, and the medical status of the employee. Accordingly, this paragraph specifies the minimum requirements for medi- cal evaluation that employers must implement to determine the employee's ability to use a respirator. (5) Supplemental information for the PLHCP. (i) The following information must be pro- vided to the PLHCP before the PLHCP makes a recommendation concerning an employee's ability to use a respirator. (A) The type and weight of the respirator to be used by the employee; (B) The duration and frequency of respirator use (including use for rescue and escape); (C) The expected physical work effort; (D) Additional protective clothing and equip- ment to be worn; and (E) Temperature and humidity extremes that be encountered. (ii) Any supplemental information provided previously to the PLHCP regarding an employee need not be provided for subse- quent medical evaluation if the information and the PLHCP remain the same, (iii) The employer shall provide the PLHCP with a copy of the written respiratory protec- tion program and a copy of this section. Note to paragraph (e)(5)(iii): When the employer replaces a PLHCP, the employer must ensure that the new PLHCP obtains this information, either by rovfding the docu- ments directly to the PLHCP or having the documents transferred from the former PLHCP to the new PLHCP. However, OSHA does not expect employers to have emplovees medically re-evaluated solely because a new PLHCP has been selected. (Sleet 4 of 5) MW Edition 1582-32 MEDtCkL REQUIREMENTS FOR FIRE FtGHTERS.AND tNFORAMON FOR FIRE DEP.ART\.[ENT PT SICLINs Table D-4 Comparison of OSHA 29 CM Parts 1910.134, "Medical Requirements" and NFPA 1582, Standard on Stedical Requirements for Fire Fighters and Information for Fire Department Physicians, 2000 Edition (Continued) NFPA 1582 24.1 The current member shall be certified annually, or at the request of either the fire department or the member, by the fire department physician as meeting the medical requirements of Chapter 3 of this standard in order to determine that member's medical ability to continue participating in a ❑raining or emergency operational environment as a member_ Any applica- ble OSHA standards, such as 29 CFR 1910.120, "Hazardous Waste Opera- tions and Emergency Response," 29 CFR 1910.134, "Respiratory Protection," 29 CFR 1910.95, "Occupational Noise Exposure," and 29 CFR 1910.1030, "Bloodbome Pathogens," shall be followed. 2000 Edition OSHA 1910.134 (6) Medical determination. In determining the employee's ability to use a respirator, the employer shall; (i) Obtain a written recommendation regard- ing the empployee's ability to use the respirator from the PLHCP. The recommendation shall provide only the following information: (A) Any limitations on respirator use related to the medical condition of the employee, or relating to the workplace conditions in which the respirator will be used, including whether or not the employee is medically able to use the respirator.; (B) The need, if any, for follow-up medical evaluations; and (C) A statement that the PLHCP has provided the employee with a copy of the PLHCP's writ- ten recommendation, (ii) If the respirator is negative a pressure res- pirator and the PLHCP finds a medical condi- tion that may place the employee's health at increased risk if the respirator is used, the employer shall provide a PAPR if the PLHCP's medical evaluation finds that the employee can use such a respirator, if a subsequent med- ical evaluation finds that the employee is med- ically able to use a negative pressure respirator, then the employer is no longer required to provide a PAPR. (4) Administration of the medical question- naire and examinations. (i) The medical questionnaire and examina- tions shall be administered confidentially dur- in� the employee's normal working hours or at a ume and place convenient to the employee. The medical questionnaire shall be adminis- tered in a manner that ensures that the employee understands its content. (ii) The employer shall provide the employee with an opportunity to discuss the question- naire and the examination results with the PLHCP. (Shm s of 5) APPENDIX F 1582-33 Appendix E Sample Forms This appendix is not a Part of the requirements of this PYTRA doc- ument but is included for informational purposes only. E•1 Physical Exam Summary. The fire department physician can report results of the periodic medical evaluation, which is designed to evaluate a member's continued ability to perform his or her duties and to detect any significant changes in the condition of his or her health, on a form like the Physical Exam Summary. (See Figure E-I.) E-2 Medical Examination Report. The fire department physi- cian can record information from the medical examination on a form like the Medical Examination Report (See Figure E-2.) Appendix F Referenced Publications F-1 The following documents or portions thereof are refer- enced within this standard for informational purposes only and are thus not considered part of the requirements of this standard unless also listed in Chapter 6. The edition indicated here for each reference is the current edition as of the date of the NFPA issuance of this standard. F-1.1 NFPA Publications. National Fire Protection Associa- tion, 1 Batterymarch Park, P.O. Box 9101, Quincy, NU 02269- 9101. NFPA 1001, Standard for Fire Fighter Professional Qual fica_ bons, 1997 edition. F-1.2 ANSI Publications. American National Standards Insti- tute, Inc., 11 West 42nd Street, 13th floor, New York, NY 10036. ANSI S3.1, lldaximum Permissible Ambient �Voue Levels for,iudi- ometrie Test Room. 1991 edition. ANSI 53.6, Specification for Audiometers, 1996 edition. 2000 Edition EMPLOYMENT PHYSICAL SERVICES 2010 ATTACHMENT F 1562-34 JIEDIC L REQUIREMENTS FOR FIRE FIGHTERS AND INFOR-NLITION FOR FIRE DEPARTMENT PMSICLvNS FIGURE &I Form for Fire department physician's report. Physical Exam Summary Employer. Employee's Name: Position Title: Date of Exam: Examining Physician: Components Performed Within Normal Limits Abnormal, Able to Perform Job Tasks Abnormal, Unable to Perform Job Tasks Significant Changes Noted from Previous Exam (if applicable) ❑ Physical exam ❑ Audiogram ❑ Pulmonary function ❑ Treadmill stress ❑ EKG- 12lead ❑ Chest x-ray ❑ Mammogram ❑ Pelvic/Pap ❑ Laboratory tests ❑ Other Explanation of Abnormal Results/Significant Changes: ❑ Medically cleared to perform job tasks ❑ Denied medical clearance for current job tasks NFPA Physical Exam Summary III of 21 2000 Edition APPENDIX F t58^.-35 FIGURE E-I (Continued'_) H of P.I.: MrJNis. is a v.o. Fire Fighter Police Officer with the department. The purpose of this annual physical is to establish fitness for the continuation of those duties. He/she has enjoyed good health. MrJ'Lvirs. voiced the following questions: Medical History Surgical History Medications _ D.M_ — Orthopedic _ HTN — ENT — CVD — Optho _ Asthma — Other Allergies Social History ROS — Smoke GI — PPD — Hematochezia — Quit — Stool caliber Bowel -habits. Exercise Alcohol G.U. — Amount — Stones — Frequency — Hematuria CV — Chest pain SOB Resp — Cough — Wheezes SOB FH Physical Audio _ DM Insert physical here — HFHL — HTN — Speech range _ CVD Vision EKGfrMT Blood — Near — RR H/H — Far — Target WBC — Corrected — Interp Glu — Stage achieved Choi Stool OB HDL Positive Pulm — Ratip — Negative FVC Risk % Pred UA LFTs _ Blom FEVt SGOT — Protein % Pred SGPT — Glucose GGT Other NFPA "skat Exam Summary (2 of 21 2000 Edwn 1582-36 MEDICAL REQUIREMENTS FOR FIRE FIGHTERS AND INFORiti MON FOR FIRE DEPARTMENT PMSICLkNS FIGURE E-2 Medical examination report Form. 1. NAME (Last) Medical Examination (First) (Middle) 2. SEX 3. DATE OF EXAMINATION 4. PLANT OR DIVISION 5. SOC. SEC. OR EMPLOYEE NO. 6. OCCUPATION 7. DATE LAST EXAMINATION 8, REASON FOR PRESENT EXAMINATION ❑ PRE -PLACEMENT ❑ D.O.T. ❑ SURVEILLANCE ❑ IMMIGRATION ❑ F.LT. 9. TEMP. 10. PULSE I1. BLOOD PRESSURE 12. HEIGHT FT IN. 13. WEIGHT 14. TITMUS SNELLING 15. VISION DISTANT UNCORRECTED CORRECTED 16. COLOR VISION (Use Code)* RE 20/ BOTH LE 20/ RE 20/ BOTH LE 20/ NEAR RE 20/ BOTH LE 20/ RE 20/ BOTH LE 20/ 17. PERIPHERAL Clinical Evaluation Area Examined * Use Code Remarks (Describe all "Code Is" in detail) 18. Head and neck 19. Thyroid --------------------------------- Lymph nodes -------------------- 20. Eyes ---------------------------------- Fundi -------------------- 21. Ears 22. Nose and sinuses 23. Mouth and throat 24. Teeth 25. Chest and lungs --------------------------------- Breast -------------------- 26. Heart 27. Abdomen 28. Inguinal, e.g., hernia 29. Genitalia * Code: 0 — Within normal limits I — Significantly abnormal X — Not examined NFPA Msdlcal Eaaminstion Form 0 of 12) 2000 Edition APPENDIX F 1582-37 FIGURE E-2 (Continued.) 30. Pelvis 31. Anus and rectum --------------------------------- Prostate ------------------------ Proctoscopic ---------------- �( -----t_ �--------- 32. Spine 33. Skin 34. Arms --------------------------------- Hands -------------------- 35. Legs -------------------------------------------------------- Feet 36. Peripheral -Vascular 37. Neurologic 38. Emotional status 39. Other 40. Urine dip: Glucose: Albumin: S.G.: Heme: Leukocyte -Esterase: Other- 4 1. Flex k 42. Step test 10 43. Body fat 1 WIC 44. PFT 45. Audio 46. Chest x-ray (use 0, 1, or X) 47. EKG (use 0, 1, or X) and specify test used 48. Hemojcult 49. Back oval. 50. Tetanus ll� 51. PPD 52. Stress test Code: 0 — Within normal limits i —Significantly abnormal X — Not examined NFPA M"Cai Examination Form (2 of 12) 2000 Edidon 1582-38 MEDICAL REQUIREMENTS FOR FIRE FIGHTERS AND INFORMATION FOR FIRE DEPARTMENT PHYSICUNS FIGURE E-2 (Continued.) 53. other x-ray or laboratory findings 54. Physician's summary, remarks, and diagnoses, including"recommendations made to patient (include code numbers for diagnoses and conditions found) 55. Recommendations/Restrictions 56. R.N. signature ❑ 57. Physician's signature 58. Patient's signature 59. Work qualification: 60. Contact person: 61. Date: 62. Initial: Code: 0 — Within normal limits 1 —Significantly abnormal X — Not examined NFPA NodkAi Examinauon Form(3 o112) 2000 Edition APPENDIX F 1582-39 FIGURE E-2 (Continued) Health History Yes No it "Yes," Give Details. Have You Had Any Surgeries/Operations: On your back, arm, leg. or knee? ❑ ❑ To treat a hernia? ❑ ❑ Varicose veins? ❑ ❑ Other operations? ❑ ❑ Have you ever been hospitalized? ❑ ❑ Allergy — Have You Ever Had or Do You Currently Have: Serious allergy? ❑ ❑ Bad reaction to any medication? ❑ ❑ Advised not to take any medication (e.g., aspirin)? ❑ ❑ Skin — Have You Ever Had or Do You Currently Have: Hives/eczema or rash? ❑ ❑ Chronic skin problems (e.g., cuts slow to ❑ ❑ heal)? Excessive skin dryness? ❑ ❑ Problems with "easy bruising"? ❑ ❑ Chemical or jewelry rash/sensitivity? ❑ ❑ Neuro — Have You Ever Had or Do You Currently Have: A psychiatric or emotional problem? ❑ ❑ Numbness/weakness/paralysis? ❑ ❑ Dizziness or fainting spells? ❑ ❑ Severe/frequent or migraine headaches? ❑ ❑ Head injury, concussion, or skull fracture? ❑ ❑ Neurological disorders? ❑ ❑ Seizures or blackouts? ❑ ❑ Stroke? ❑ ❑ Eyes/Ears — Have You Ever Had or Do You Currently Have: Hearing loss? ❑ ❑ Frequent ear infections? ❑ ❑ NFPA M"csi E"mina8on Fwm (4 of 12) 2000 Edtlnn 1582-40 MEDICAL REQUIREMENTS FOR FIRE FIGHTERS AND INFOR_Nt!\TION FOR FIRE DEPARTMENT PH61CL-A.vS FIGURE 112 (Continued.) Health History Yes No If "Yes," Give Details. Ringing in ears? Other ear problems? Glaucoma or cataracts? Red eyes? Eye injury/vision loss? Other eye problems (e.g., strain from VDT use)? Glasses/contacts? Date of last vision screen? Head/Neck — Have You Ever Had or Do You Currently Have: Date of last dental exam: Recent problems with teeth/dentures? Frequent mouth ulcers/infections? Sinus or hay fever? Frequent sore throats? Frequent nose bleeds? Trouble with thyroid (e.g., taking thyroid medication)? Problem requiring radiation treatment to the neck area? Lungs — Have You Ever Had or Do You Currently Have: Asthma or wheezing? Coughed up any blood? Shortness of breath without apparent reason? TB or a positive skin test for TB? Pneumonia or pleurisy? Do you cough every day, especially in the morning? Pain or tightness in chest? More than three episodes of bronchitis in one year? Ever smoked tobacco in any form? ❑ ❑ How long: Yrs. Packs per day: When quit: Had a chest x-ray? ❑ Last time: NFPA Modlul EnminsCon Forth (S of 1;4 1 2000 Edition I �7 _ APPENDIX F 1582-41 FIGURE E-2 (Continued.) Health History Yes No If "Yes," Give Details. Heart — Have You Ever Had or Do You Currently Have: Rheumatic fever or heart murmur? ❑ ❑ Heart disease? ❑ ❑ Treated for heart condition? ❑ ❑ Unusually cold or bluish -colored hands ❑ ❑ or feet? High blood pressure. If "Yes," how is it ❑ ❑ 0 Medicine 0 Diet 0 Exercise treated? Do you have a history of elevated cholesterol? ❑ ❑ Anemia or any blood disease? ❑ ❑ Phlebitis, varicose veins, or blood clots/ ❑ ❑- poor circulation? Chest pain with activity? ❑ ❑ GI — Have You Ever Had or Do You Currently Have: Ulcers? ❑ ❑ Hiatal hernia? ❑ ❑ Indigestion, pain, or unusual burning in stomach? ❑ ❑ Vomiting of blood? ❑ ❑ Bloody/tarry bowel movements? ❑ ❑ Colitis or nervous stomach? ❑ ❑ Yellow jaundice or hepatitis? ❑ ❑ Problems with your pancreas? ❑ ❑ Gallbladder disease? ❑ ❑ Kidneys — Have You Ever Had or Do You Currently Have: Bladder or kidney infections? ❑ ❑ Kidney stones? ❑ ❑ _ Burning or discomfort on urination, or frequent urination? ❑ ❑ _ Hernia? ❑ ❑ _ Blood in urine? ❑ ❑ NFPA Mod" E"minotion Form (6 of 12) 2000 Edition 1582-42 MEDICAL REQUIREMENTS FOR FIRE FIGHTERS AND INFORIMATION FOR FIRE DEPARTNIENT PHYSICIANS FIGURE E-2 (Continued) Health History Yes No it "Yes," Give Details. I Miscellaneous — Have You Ever Had or Do You Currently Have: Diabetes or sugar in your blood or urine? ❑ ❑ Cancer of any kind? ❑ ❑ Muscle -Skeletal — Have You Ever Had or Do You Currently Have: Arthritis, rheumatism, neck, back, or spine injury or disease? ❑ ❑ Been treated for a back problem? ❑ ❑ Recurrent stiffness or back pain? ❑ ❑ Bursitis, tendonitis? ❑ ❑ Recurrent pulled muscles or sprains? ❑ ❑ -- Hand or wrist injury or problem? ❑ ❑ Hip or knee injury or problem? ❑ ❑ Ankle or foot injury or problem? ❑ ❑ Frostbite? ❑ ❑ Job requiring heavy lifting or standing, or sitting for long periods of time? ❑ ❑ Any broken bones? ❑ ❑ For Females Only — Have You Ever Had or Do You Currently Have: Menstrual irregularities? ❑ ❑ Recurrent problems of the female organs? ❑ ❑ Breast masses or lumps? ❑ ❑ Do you practice monthly breast self -exam? ❑ ❑ Have you ever had a mammogram? ❑ ❑ Date of last pap smear. ❑ ❑ For Males Only — Have You Ever Had or Do You Currently Have: Prostate or testicular problems? ❑ ❑ Breast tendemess, swelling, or lumps? ❑ ❑ Do you practice monthly testicular self -exam? ❑ ❑ NFPA IM"C*1 Uarn/nftlon Forth (7 0l t2) 2000 Edition 0 APPENDIX F 1582-43 nGLPRE E•2 (Con6—d.) Health History General Lifestyle I. Check the Hower that best describes you.) O Poor O Fair O Good O Excellent General health O 0-24% O 25-49% O 50-74% O 75-100% %b Seatbelt use O Low O Moderate O High Daily stress Average hours sleep O 6 hours or less O 7-8 hours O 8 hours or more Average meals daily O 1 meal 0 2 meals 0 3 or more 'Number of eggs per week O 0--1 O 2 O 3 or more Average number red meat meals per week O 0-1 O 2-3 O 3 or more Average number of alcoholic beverages/beers O 0-5 O 6-14 O 15 or more per week Yes No- If "Yes," Give Details. Do you exercise three times per week? ❑ ❑ 30-40 minutes each time? ❑ ❑ Identify types of exercise. Are you more than 30% above your ideal ❑ ❑ weight? Have you received a tetanus booster in the ❑ ❑ last 10 years? Have you been immunized against hepatitis B? ❑ ❑ Year immunized: Do you take any prescription medication? ❑ ❑ Do you take nonprescription medication (or drug) basis? ❑ ❑ over-the-counter on a regular General Lifestyle II. Do you participate in a workplace wellness/ ❑ ❑ help promotion program? Which of the following would you like to see offered and would you participate in? ❑ ❑ Cholesterol screen ❑ ❑ Blood pressure screen ❑ ❑ Weight loss ❑ ❑ Nutrition program ❑ ❑ Stress management ❑ ❑ Smoking cessation ❑ ❑ CPR NFPA medtcai Examination Form (a of 12) 200o E(jdon 1582-44 MEMCA L REQUIREMENTS FOR FIRE FIGHTERS UND (NFOR.NLMON FOR FIRE DEPARTMENT PHYS(CL\NS FIGURE E-2 (Continued) Health History Yes No It "Yes," Give Details. Blood drive a a Health risk appraisal a a Self -directed exercise a a Health education program a a Women's health a a Work History I. Have you ever: Been restricted in your work or given "light because health or injury? a a duty" of your Left a job because of health problems? a a Been injured on the job and treated by a doctor? a a Received compensation for an industrial injury or illness? a a Are you receiving any health care treatment (e.g., physical therapy, chiropractic, a a acupuncture, medical, etc.)? Been hospitalized in the last five years? Have you had any illness or injury that we have not asked you about? a a Work History II: Do you have hobbies, such as furniture refin- ishing, painting, hunting, shooting, or model building? a a Do you moonlight or have a second job? 11 a a Work History III, Exposures — Have You Ever Worked Around the Following. Chemical plant? a a Coke oven? a a Construction? ❑ ❑ Cotton, flax, or hemp mill? a a Electronics plant? Farm? a a Foundry? a a NFPA Medical Exurninadon Form (9 of 12) 2000 Editlon APPENDIX F 1582-45 FIGURE E-2 (Continued.) Health History Yes No It "Yes," Give Details. Hazardous waste industry? ❑ ❑ Hospital? ❑ ❑ Lumber mill? ❑ ❑ Metal production? ❑ ❑ Mine? ❑ ❑ Nuclear industry? ❑ ❑ Paper mill? ❑ ❑ Pharmaceutical? ❑ ❑ Plastic production? ❑ ❑ Pottery mill? ❑ ❑ — Refinery? ❑ ❑ Rubber processing plant? ❑ ❑ Sand pit or quarry? ❑ ❑ Service station? ❑ ❑ Shipyard? ❑ ❑ Smelter? ❑ ❑ Have You Ever Worked Wlth or Been Exposed To: Aldrin? ❑ ❑ Arsenic? ❑ ❑ Asbestos? ❑ ❑ j3enzene? ❑ ❑ Benzidine? ❑ ❑ Beryllium? ❑ ❑ BIS chlormethyl ether? ❑ ❑ Cadmium? ❑ ❑ Carbon disulfide? ❑ ❑ Carbon tetrachloride? ❑ ❑ Chlorine? ❑ ❑ Chlorodane? ❑ ❑ Chloroform? ❑ ❑ NFPA Madloai E"minaHon Form (10 0112) 2000 Edition 1582-46 MEDICAL REQUIREMENTS FOR FIRE FIGHTERS AND INFORMATION FOR FIRE DEPARTMENT PHYWLANS FIGURE E-2 (Continued.) Health History Yes No it "Yes," Give Details. Chloroprene? ❑ ❑ Chromates? ❑ ❑ Chromic acid mist? ❑ ❑ Cutting oils? ❑ ❑ DDT? ❑ ❑ Dieldrin? ❑ ❑ Dioxin? ❑ ❑ Dust, coal? ❑ ❑ Dust, sandblasting? ❑ ❑ Dust, other? ❑ ❑ Ethyl dibromide? ❑ ❑ Ethylene oxide? ❑ ❑ Extreme heat or cold? ❑ ❑ Heptachlor? ❑ ❑ Hexachlorobenzene? ❑ ❑ Isocyanates (TDI, MDI)? ❑ ❑ Loud or continuous noise? ❑ ❑ Mercury? ❑ ❑ Methylene chloride? ❑ ❑ Microwaves, lasers? ❑ ❑ Nickel? ❑ ❑ PCBs? ❑ ❑ Pesticides, herbicides? ❑ ❑ Phenois? ❑ ❑ Phosgene? ❑ ❑ Plastics? ❑ ❑ Radioactive materials? ❑ ❑ Roofing materials? ❑ ❑ Rubber? ❑ ❑ Silica? ❑ ❑ NFPA M*dcal E"transtion form (I I of 12) 2M Edition APPENDIX F 1582-47 FIGURE &2 (Continued.) Health History Yes No n "Yes," Give Details. Solvents/degreasers? ❑ ❑ Soots and tars? ❑ ❑ Spray painting? ❑ ❑ TRUPER chloroethylene? ❑ ❑ Vinyl chloride? ❑ ❑ List any toxins/chemicals/biological hazards you might currently be exposed to: Work History IV. Jobs — Start with the Most Recent: Date (Year to Year) Company Position Any Work Hazards I certify that the above information is true and complete to the best of my knowledge. I hereby give permission to release work -related information to the proper authorities of my employer or the company for which I am a job applicant. Date: Signature: Examiner: NFPA Modt" Exumi ud" Form (12 of 12) 1 2WO EMOM 1582-48 'vIEDICAt. REQUIREMENTS FOR FIRE FIGHTERS AND INFORMATION FOR FIRE DEPARTMENT PWSICLANS Index t2000 National Fire Protection Association. All Rights Reserved. The copyright in this index is separate and distinct from the copyright in the document that it indexes. The licensing provisions set forth for the document are not applicable to this index. This index may not be reproduced in whole or in part by any means without the express written per- mission of the National Fire Protection Association, Inc. _A_ Abdominal organs ................................. 3-9, A•3-9.2 Administrators, guide for fire department ................ App. D Advanced life support (AIS) ................ 5.2.2, A•51.1, A•5-2.2 Antidiscrimination laws ................................. D•1.2 Approved (definition) ................... 1 .... 1 . 1 .1.4.11 A•14.1 Asthma.................... ....... .......... .......... B-3.2 Audiometry ........................................ B-2.3.2.4 Authority having jurisdiction (definition) ............. I-4.2, A•1-4.2 _B_ Basic life support (BLS)...........................5.2.2, A•5-2.2 Blood and blood -forming organs .................. ..3-15, A 3-15 Blood exposures .................................. -2.1,A-4-2.1 Bloodborne pathogen exposures, post -exposure prophylaids for..............................AA-2.1 Body fluid exposures ............................ A-2.1, A-4-2.1 Burn injury ..... .................................. ...A•5-3.2 •C_ Cancerrisk ........................................... B-1.4 Candidates Definition....................................1-4.3, A•1-4.3 Medical evaluation ...............2-1, 2.3, A•2.1.1, A•2.1.5, A•2.3 Category A medical condition ............. see Medical conditions Category B medical condition .............see Medical conditions Chemicals ..................................... 3-20, A 3.20.2 Chestwall .........................................3.7, A•3-7 Confidentiality, medical evaluations ......................... 2.6 -D- Dental.......................................... 3.5, A•3-5.2 Diabetes mellitus ....................................... B-3.1 Disabled persons ......................... I .......... I.ID•1.1 Downmember ....................................... ............................ Drugs ......................................... 3-20, A•3-20.2 Definition .......................................... 1-4.6 _E- Ears............................................ 34, A•34.2 Electrocardiography ............................ B-2.2, B-2.3.2.5 Emergency medical services (EMS) .............. 5-2.2, 5-3, A•5-1.1 A•5-2.2, A•5-3.2 Definition ......................................... 1-4.18 Endocrine disorders ... ......... ................... 3-16, A•3-16 Epilepsy.............................................. B-3.6 Esophagus.........................................3-6,A-" Essential job functions (structural fire -fighting) .......... App. C Definition .......................................... 1-4.7 Evaluations .................. see Functional capacity evaluation; Medical evaluations Exposure incidents ...................... ............ 4-2, A-4-2 Definition .......................................... 1-4.9 Extremities ..................... ............... 3-12,A•3-12.2 Eyes...... ............ ...... .... ... ........ ..... ..3-3, A•3.3 2000 Edition _F_ Fire department Guide for administrators.............................App. D Members .................................... see Members Fire department physician ..... 2.2. A•2.2; see aLto Medical evaluations Choosing ................................ 2.2.2, A•2.2.2. D•2 Definition ........................ .................. 1-4.10 Immunizations, responsibility for ......................... 4-4 Incident scene treatment, role in ......... 5.3.2, A•5-1.1 to A•5-1.2 A•5-3.2 Infection disease control, role in ................. 4-1.2, A-4-2.1 Information for .................................... App. B Record keeping and reports of ........................... 2.6 Functional capacity evaluation ......................... ...B-2.6 Definition ........ .................................. 1-4.11 •G- Gastrointestinal systems ............................3A, A•3-9.2 Genitourinary systems...................3-10, A•3-10. ".4, D•1.4 _H_ Head.........................................3.2.1, A•3-2.1.2 Health and fitness coordinator............................2-2.4 Definition..........................................1-4.12 Health and safety officer.................................2.2.4 Definition..........................................IA13 Hearing ....................... 3-4, A•34.2, B-1.4, B-2.3.2.4, B-3.5 Heart ..... MA, AM.1, B-1.2, B-1.4, B-2.1 to B-2.2, B-2.3.2.5, B-3.3 Hepatitis B immunizations .............................. A-4-4 •I_ Immunizations ......................................". A-" Implementation of standard .........................1.3, A•1.3.2 Incident commander ........................ 5-1.2, 52.1, A44.4 Incident safety officer...................................5-2.1 Incident scene rehabilitation and medical treatment ....Chap. S. A•5 Infection control officer.................................4-1.2 Definition .......................................... 1-4.14 Infection control program (infectious and communicable disease control) ..........................Chap. 4, A-4 Definition..........................................1-4.15 _I,_ Laboratory tests.....................................B Larynx......... ................... ............... 3-6,A-" Legal considerations ..................................... D•1 Lungs .... t .......................... 3.7, A•3-7, B_2.3.2.3, B-3.2 •M. Malignant diseases .......... ..................... 3-18, A 3-18.2 Medical conditions Category A ............. Chap. 3, A•3; see also specific body party and conditions Definition.........................................1.4.4 INDEX 1582--49 Category B ................... Chap 3. A-3; see aLra specific body parts and conditions Definition ........................................ 1-4.5 Specific............................................. B-3 Medical evaluations Content of ......... .............. ................... B-2.3 Coordination of program ............................... D-3 Definition ........... ............... ............... 1-4.16 Guidance for ......................................... B-2 Incident scene .................................. 5-3, A-5-3.2 OSHA 1910.134 compared ........................ Table D4 Periodic .............................. 2-1.2, 2-4, A-24, B-2.2 Preplacement and base line .............. 2-1.2. 2-3, A-2-3, B-2A Process ................................. 2-1, A-2-1.1. A-2-1.5 results, reporting, and confidentiality .........2-6, B-2.4 -Records, Sample forms, medical examinations ................ App. E Return-todury.............. 2-1.2, 2-5, A-2-5.1, A 2-5.3 to A-2-5.4 Tactical level management component (Tl_MQ ........... 5-4.5 5-4.7, A-5-4.5 Medical examinations ......... _ ...... see aLsa Medical evaluations Components of .................................... B-2.3.2 Definition ......................................... 1-4.17 Sample forms ..................................... App. E Medical histo B-2.3.1 Medical process ...... . ........................... Chap. 2, A-2 Medical services, emergency ..................... seeEmergency medical services (EMS) Medically certified Definition ......................... ................ 1-4-19 Periodic medical evaluation .........................2-4, A-2-4 Preplacement medical evaluation ....................2-3, A 2-3 Reports .............................. ........ 2-6.2 to 2-6.3 Return-todury medical evaluation ......... 2-5.2 to 2-5.3, A-2-5.3 Medications .................................... 3-20, A-3-20.2 Members Current Definition ...... . .... ...........................1-4.20.1 Medical evaluations ............2-1, 2-4, Pt 2-1.1, A 2-1.5. A 2-4 Definition .............................. . ...1-4.20, A 1-4.20 Down............................................ A-5-3.2 " Incident scene rehabilitation and medical treatment ....................... Chap. 5, A-5 Infection control program ....................... Chap. 4, A-4 Occupational safety and health problems .......... B-1. Table D-4 Metabolic disorders ..... .......................... 3-16, A-3-16 Musculoskeletal system ..................... . ..... A-5-3.2. B-2.6 _N. Neck......................................... 3 2_2, A-3.2.2.2 Neurological disorders .......... I ..................3.13, A-3-13 Nose........... ................ ................ ...3-6.A-" -O- Occupational history ................................. B-2.3.1 Occupadotw Safety and Health Administration (OSHA) 1910.134 comparison ............... Table D 4 Occupational safety and health probleau............ B-1. Table D-4 Oropharynx........................................3-6.A-" -P- Personnd accountability system ...... ..................... 5-}.8 Physical load, of fire -fighting functions .................... B-1.2 physidm . .... ... . ......... . ..... see Fire department physician Post -exposure prophylaxis ................. .... A-4-2.1 to A-4-2.2 Pregnancy ....................................... B-3.4, DI -IA Protected classes ...................................... D-1.3 Psychiatric conditions ........................... 3-19, A-3-19.2 Pulmonary function testing ................... ........ B-2.3.2.3 Purpose of standard .............................. 1-2. A-1-2.2 -R- Reactive airways disease ................................ B-3.2 Referenced publications .................... Chap. 6, 114, App. F Reports and records Exposure incidents ................... 4-2, 4-3.2, A-4.2, A-4-3.2 Immunization records ................................ A-" Medical evaluations .................................... 2.6 Sample forms, medical examinations. . ... ......... . _. . App. E Reproductive system ............... 3-10.1, A-3-10.1.2, B-3.4. D-1.4 Respiratory disease risk .................... B-1.4, B-2.3.2.3, B-3.2 Ribs .......................................... 3-11, A-3.11.2 Risk, increased........................................ B-1.4 -S- Sacradiac joints ................................ 3-11, A-3-11.2 Sample forms ................................... App. E Scapulae ...................................... 3-11, A-3-11.2 Scope of standard ....................................... 1-1 Second opinions. . ..................................... B-2.5 Seizures B-3.6 .............................................. Shall (definition) ............................... .......1-4.21 Should (definition) .................................... 1-4.22 Skin_ _........................................ 3-14, A-3-14.2 Smoke inhalation ..................................... A-5-3.2 Spine ......................................... 3-11, A-3.11.2 Standard (definition) ...................... I ............ 1-4.23 Stress testing ................. . ................. . ...... B-2.2 Systemic diseases ............. . ................. 3-16, A-3-17.2 -T Tactical level management component (TLMC) ............... 5-4 A-514.3 to A-5-4.5 Definition..........................................1-4.24 Toxic substances ............. I .............. B-1.3, B-1.4, B-3.4 Trachea.............................. I ....... .....3-6.A-" Triage, incident scene ............................. 5.3, A-5-3.2 Tuberculosis ....................................... 4.3, A-4-3 Tumors......................................... 3.18, A-3-18.2 _U. Urinary system .............................. 3-10.2, A-3.10.2.2 -Y- Vascular system ......................... 3-8.2. A M, B-1.4. B-3.3 Vision............................................ 3-3. A-3-3 -X- X-rays ......................... B-2.2. B-2.3.2.2 200o Edition Cou/W OARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: Employee Services Bulk Item: Yes X No — Department: Risk Management Staff Contact Person/Phone#:Maria L. Slavik X3178 AGENDA ITEM WORDING: Approval to accept Agreement from Asset Works Appraisal for Real and Personal Property. ITEM BACKGROUND: Proposal from Asset Works Appraisal for Real and Personal Property was approved at the November 17, 2010 BOCC meeting. PREVIOUS REVELANT BOCC ACTION: N/A CONTRACT/AGREEMENT CHANGES: None STAFF RECOMMENDATIONS: Approval to accept Agreement from Asset Works Appraisal for Real and Personal Property. TOTAL COST: $10,360 INDIRECT COST: BUDGETED: Yes X No COST TO COUNTY: 10 360 SOURCE OF FUNDS: Ad Valorem REVENUE PRODUCING: Yes (_ No X AMOUNT PER MONTH Year U` APPROVED BY: County Atty O chasing Risk Management'& — DOCUMENTATION: DISPOSITION: Revised 2/27/01 Included X To Follow Not Required AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Asset Works Appraisal Contract # Effective Date: 12/01/2010 Expiration Date: Contract Purpose/Description: A raisal of Real and Personal Property Contract Manager: Maria Slavik 3178 Risk Management #7 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 12/15/10 Agenda Deadline: 11-30-10 CONTRACT COSTS Total Dollar Value of Contract: $ $10,360 Current Year Portion: $ Budgeted? Yes® No ❑ Account Codes: 503-08502-530-450- Grant: $ _ County Match: $ ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (e . maintenance, utilities, janitorial, salaries, etc. CONTRACT REVIEW Change: Date In Needed Division Director t! Yes❑ No Risk Manaent�,� �0 Yes❑ No OLL O.M.B./Purc sing )I'3o-10 Yes❑ No County Attorney Cj'-3o "V1 d Yes[:] Noj Comments: Date Out I/hdll� -30 -t it- 3a-?o"d C UNTYMONROE KEY WEST FLOR►DA 33040 (305)2"-4641 vice of me (~dv Qv"seg 111112d Street, Suite #4CS Peet 694w Sax 1026 Neg `tDeot, 5X 33041-1026 (305) 292-3470 MEMORANDUM TO: Danny L. Kolhage, Clerk of the Court FROM: Kathy M. Peters, County Attorney's Office RE: AGENDA ITEM F-3: BOCC 11/17/2010 DATE: November 18, 2010 MayorHe&W CarTuthers, District Mayor Pro Tem David Rice, District 4 DistrictSytvia Murphy, Enclosed please find two (2) originally executed copies of the Professional Appraisal Agreement that correlates with the above -referenced agenda item approved by the BOCC on 10/20/10 and received by this office on 11/18/10 for processing. F. BULK APPROVALS 3. Approval to accept proposal from Asset Works Appraisal for Real and Personal Property. KMP/ Enclosures: Two (2) originally executed copies of the Professional Appraisal Agreement Maria, The agreement did not go before the Board for approval. The item was only to accept the proposal; therefore, it should go back before the Board to grant approval for execution of the Agreement. Thanks, Pam cc: CAY C UNITYMONROE KEY WEST FLORIDA 33040 (305)294-4641 Office of the Employee Services Division Director The Historic Gato Cigar Factory 1100 Simonton Street, Suite 268 v Key West, FL :330to N (305) 292--1.158 —Phone R (305) 292-456t - Fax TO: Board of County Commissioners FROM: Teresa E. Aguiar, Employee Services Directo DATE: November 30, 2010 BOARD OF COUNTY COMMISSIONERS Mayor Heather Carruthers, District 3 Mayor Pro Tem David Rice, District 4 Kim Wigington, District 1 George Neugent, District 2 Sylvia J. Murphy, District 5 SUBJ: Approval of Agreement with Asset Works for Appraisal of Property This item requests approval to accept the agreement from Asset Works Appraisal in the amount of $8,360. The last appraisal was performed by Marshall & Stevens Incorporated on September 23, 2005. We will use the information obtained from the appraisal for establishing values to be insured under our Property insurance program. To ensure the County is purchasing proper limits on its Property Insurance, appraisals must be performed periodically. Six proposals were received and Asset Works was the lowest bidder at $8,360. If during the appraisal we learn of a structure that was not included (for whatever reason) on the original schedule, Asset Works will charge the County an additional $135 to appraise each additional property. This is why it is also recommended that the Board approve an additional $2,000 to make the total request $10,360. Once the initial appraisal is done, Asset Works also proposed a fee of $995 to provide annual updates to its appraisal if requested by the County. If after the initial appraisal, the County wanted Asset Works to appraise additional structures, they would charge a minimum fee of $2,700 to appraise one (1) additional structure and $135 for each additional structure. However, it is not expected that this scenario would come into play. It is therefore recommended that the BOCC approve this Agenda Item in the amount of $10,360. If you have any questions, please do not hesitate to contact me. It 9 PROFESSIONAL APPRAISAL AGREEMENT TYIS A REEMENT ("Agreement') is made and entered into this/ day of ,2010, by and between Monroe County , a political subdivision of the State of Florida ("County "), and Asset Works Appraisal , a corporation duly licensed to operate in the State of Florida ("Appraiser"), whose mailing address is 4955 Steubenville Pike, Ste. 401, Pittsburgh, PA 15205. Section 1. Scope of Services 1.01 The Appraiser is to inspect and appraise the parcel(s) of property or perform the other appraisal services as outlined in Attachment A, and perform all necessary services required under this Agreement to complete the appraisal project. 1.02 All appraisal services shall be conducted and provided in conformance with the most recent edition of the Uniform Standards of Professional Appraisal Practice (USPAP) promulgated by the Appraisal Foundation. 1.03 All appraisals shall follow accepted principles and techniques which are a part of good appraisal practice. 1.04 The Date of Valuation of the Appraisal Report shall be the date of the Appraiser's last inspection of the subject property and shall be dated no more than thirty (30) calendar days prior to receipt of the Appraisal Report by the County. 1.05 All Appraisal Reports furnished by an Appraiser, pursuant to this Agreement, shall become the sole property of the County and may be subject to disclosure by the County under Chapter 119, Florida Statutes. The Appraiser agrees not to engage in any business transactions involving the property which is the subject of the appraisal for a period of one year following the final acceptance by the County of work performed pursuant to the Notice to Proceed referenced in Attachment A. 1.06 The Appraiser agrees that Michael Borello will be responsible for actively supervising all appraisal and other services provided under the terms of this Agreement. The County, in its sole discretion, must approve or disapprove any change to this designated individual. If, in its sole discretion, the County declines to approve the substitute, then this Agreement may be determined by the County. 1.07 The Appraiser will furnish the County with the reports specified in Attachment A. Section 2. Responsibilities of the County 2.01 The County shall make available to the Appraiser any pertinent information available to the County, including title information, property maps, site plans, and engineering studies. Page 1 of 20 f V Section 3. Compensation 3.01 Compensation to Appraiser shall be $8,360 for the appraisal of an estimated 88 Individual Structures Listed on the Property Schedule. The appraiser fees are contingent based on the total number of buildings appraised. 3.02 Payment will be made according to the Florida Local Government Prompt Payment Act. Any request for payment must be in a form satisfactory to the Clerk of Courts for Monroe County (Clerk). The request must describe in detail the services performed and the payment amount requested. The Appraiser must submit invoices to the appropriate offices marked Group Insurance. The respective office supervisor and the Director of Employee Services, who will review the request, note his/her approval on the request and forward it to the Clerk for payment. 3.03 Continuation of this Agreement more than twelve months from the effective date shown above is contingent upon annual appropriation by Monroe County Board of County Commissioners. Section 4. Contract Termination Either party may terminate this Agreement because of the failure of the other party to perform its obligations under the Agreement. County may terminate this Agreement with or without cause upon thirty (30) days notice to the Appraiser. County shall pay Appraiser for work performed through the date of termination. Section 5. Notices Any notice required or permitted under this agreement shall be in writing and hand delivered or mailed, postage prepaid, to the other party by certified mail, returned receipt requested, to the following: To the County: Risk Management Administrator 1100 Simonton Street, Suite 2-268 Key West, Florida 33040 To the Appraiser: Asset Works, Inc. 4955 Steubenville Pike, Ste. 401 Pittsburgh, PA 15205 Section 6. Records Appraiser shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the agreement and for four years following the termination of this Agreement. If an auditor employed by the County or Clerk determines that monies paid to Appraiser pursuant to this Agreement were spent for purposes not authorized by this Agreement, the Appraiser Page 2 of 20 t V shall repay the monies together with interest calculated pursuant to Section 55.03 of the Florida Statutes, running from the date the monies were paid to Appraiser. The County and Appraiser shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and the County shall have the right to unilaterally cancel this Agreement upon violation of this provision by Appraiser. Section 7 Monroe County Ordinances 010 and 020-1990 The Appraiser warrants that it has not employed, retained or otherwise had act on its behalf any former County officer or employee subject to the prohibition of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 020-1990. For breach or violation of this provision the County may, in its discretion, terminate this agreement without liability and may also, in its discretion, deduct from the agreement or purchase price, or otherwise recover the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. Section 8. Convicted Vendor A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a Agreement with a public entity for the construction or repair of a public building or public work, may not perform work as a Appraiser, supplier, subcontractor, or Appraiser under Agreement with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017 of the Florida Statutes, for the Category Two for a period of 36 months from the date of being placed on the convicted vendor list. Section 9. Governing Law and Venue This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to Agreements made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the County and Appraiser agree that venue shall lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. Section 9. Severability If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The County and Appraiser Page 3 of 20 agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. Section 10. Attorney's Fees and Costs The County and Appraiser agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, and court costs, as an award against the non -prevailing party. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the Circuit Court of Monroe County. Section 11. Binding Effect The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the County and Appraiser and their respective legal representatives, successors, and assigns. Section 12. Authority Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law. Section 13. Adjudication of Disputes County and Appraiser agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida law. This Agreement shall not be subject to arbitration. Section 14. Cooperation In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, County and Appraiser agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. County and Appraiser specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. Section 15. Nondiscrimination County and Appraiser agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. The parties agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VII of the Civil Rights Act of 1964 (PL 88-352) which prohibits Page 4 of 20 discrimination in employment on the basis of race, color, national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685- 1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of handicaps: 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101-6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 29-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3) as amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC ss. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s. 1201), as may be amended from time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 13, Article VI, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; and 11) any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. Section 16. Florida Code of Ethics County agrees that officers and employees of the County recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. Section 17. No Solicitation The County and Appraiser each warrant that, as to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, the Appraiser agrees that the County shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration. Page 5 of 20 in Section 18. Non -Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the County , except to the extent permitted by the Florida constitution, state statute, and case law. Section 19. Attestations Appraiser agrees to execute such documents as the County may reasonably require, including, but not being limited to, a Public Entity Crime Statement, an Ethics Statement, and a Drug -Free Workplace Statement, Lobbying and Conflict of Interest Clause, and Non -Collusion Agreement. Section 20. No Personal Liability. No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. Section 21. Execution in Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by signing any such counterpart. Section 22. Insurance Policies As a pre -requisite of the work governed, the Appraiser shall obtain, at his/her own expense, the insurance specified in the Request for Proposal issued in connection with this Agreement, the terms and conditions of which are incorporated herein by reference. Section 23. Indemnification The Appraiser shall defend, indemnify and hold harmless the County, its commissioners, officers, employees, agents and servants from any and all claims for bodily injury, including death, personal injury, and property damage, including damage to property owned by Monroe County, and any other losses, damages, and expenses of any kind, including attorney's fees, court costs and expenses, which arise out of, in connection with, or by reason of services provided by the Appraiser, occasioned by the negligence, errors, or other wrongful act or omission of the Appraiser, its officers, employees, or agents. In the event that the service is delayed or suspended as a result of the Appraiser's failure to purchase or maintain the required insurance, the Appraiser shall indemnify the County from any and all increased expenses resulting from such delay. Page 6 of 20 The first ten dollars ($10.00) of remuneration paid to the Appraiser are consideration for the indemnification provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. The Appraiser shall be responsible for the completeness and accuracy of its work, plan, supporting data, and other documents prepared or compiled under its obligation for this project, and shall correct at its expense all significant errors or omissions therein which may be disclosed. The cost of the work necessary to correct those errors attributable to the Appraiser and any damage incurred by the County as a result of additional costs caused by such errors shall be chargeable to the Appraiser. This provision shall not apply to any maps, official records, contracts, or other data that may be provided by the County or other public or semi-public agencies. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed on the day of 20_. (SEAL) BOARD OF COUNTYCOMMISSIONERS OF MONROE COUNTY, FLORIDA Attest: DANNY L. KOLHAGE, CLERK Deputy Clerk by Mayor/Chairman (CORPORATE SEAL) Asset Works Appraisal By By Print Name: /-t c --e I '/�:! .ello Title: vP , ,4?P,.`s4 / 'MO OE COUNTY ATTORNEY A RO D AS O O YNTHEA LL ASSES NT COUNTY ATTORNEY Date /1— "5— „I' 610 Page 7 of 20 Attachment A Page 8 of 20 Monroe County Proposal for Appraisal of Real and Personal Property Offered by: AssetWORKS APPRAISAL Property Appraisal Services Proposal for: The Monroe County BOCC September 24, 2010 Monroe County Purchasing Office Monroe County BOCC 1100 Simonton Street, Room 1-213 Key West, FL 33040 AssetWORKS APPRAISAL RE: Appraisal Services Proposal in Response to RFP-RSK-271-94-20100PUR/CV AsssetWorks Appraisal, formerly MAXIMUS Asset Services, is pleased to submit our comprehensive property appraisal proposal. The services being proposed focus on valuation, proof of loss, updating and risk assessment. We understand client satisfaction is our number one priority. All appraisal reports are certified and are in compliance with the reporting requirements set forth by the Uniform Standards of Professional Appraisal Practice ("USPAP"). With our proven expertise and experience, we are uniquely qualified to provide property appraisals to achieve the goal of accurate insurance placement and to act as a system for proof of loss substantiation in the event of a catastrophe. AssetWorks Appraisal has successfully completed property appraisal engagements for risk pools and public entities across the nation. The undersigned will be your primary point of contact. If I can be of any assistance, please contact me directly at 877-809-0600 or shaun.callahan@assetworks.com. Respectfully submitted, Shaun M. Callahan Vice President AssetWorks Appraisal 2 Property Appraisal Services Proposal for: AssetWORKS The Monroe County BOCC APPRAISAL 1. EXECUTIVE SUMMARY C0N5J_ELLNFlON AssetWorks, Inc. is a wholly owned subsidiary of Constellation Software, Inc. SOFT i%ARE Constellation Software, Inc. is an international provider of market -leading FNC. software and services to a variety of industries, across both public and private sectors. The company was founded in 1995 and has a large, diverse customer base of 16,000 customers, operating in over 30 countries around the world. Constellation is an extremely healthy organization, with consolidated revenues exceeding US$240 million. AssetWorks, Inc. (formerly MAXIMUS Asset Solutions) was recently purchased by Constellation Software, Inc. with transaction being closed in September 30, 2008. AS s e t1 A /Op K C+ �7 AssetWorks, Inc. is an industry —leading provider of technology and V V , \ f\ consulting solutions for asset and infrastructure intensive organizations in government, education, utilities, telecommunications, transportation, healthcare and the commercial sector. Our suite of Enterprise Asset Management (EAM) software solutions and professional consulting services enable organizations to improve maintenance practices, streamline operations, and improve accountability for mission -critical capital and infrastructure assets. Our Federal Tax ID is 46-0521049 incorporated in Delaware. Leveraging the latest Internet, e-commerce, and mobile computing technologies, our software and industry leading expertise help our customers maximize resource utilization, improve service delivery, and achieve substantial and measurable cost savings. Whether you are doing more with fewer resources, or managing more assets with the same amount of resources, AssetWorks provides a complete solution. AssetWorks Appraisal offers asset management solutions that As s e t WOR K S embrace all aspects of capital asset and real property tracking, APPRAISAL valuation and reporting. Our innovative solutions help organizations to vastly improve GASB34/35 compliance, generate detailed financial reports, carry out depreciation and capitalization modeling, track property disposal, generate property insurance reports, and much more. 1.1 CONFIDENCE IN HIGH QUALITY AssetWorks has identified 'quality' as being the primary focus in all projects. Quality work results in a highly satisfied client and has been the basis of our success. Systems in place lead to shorter study periods, reliable data, minimized rework and a more useful reporting tool. The five stages of quality control include: ■ Project Design & Implementation Plan — Project Director ■ Daily Data Review — Project Manager ■ Finalized Data Review — Regional Manager ■ Preliminary Reports Review — Client ■ Data Integrity Review — ISG Processor 3 Property Appraisal Services Proposal for: AssetWORKS The Monroe County BOCC APPRAISAL Our aggressive quality control regime is led by a corporate philosophy of "Quality First, Profitability Second". Annual client surveys along with the partnerships with long-term clients have taught that this is never to be overlooked. 1.2 VALUE-ADDED SOFTWARE & TECHNOLOGY AssetWorks internally designed and built the AssetMaxx system, a web -based application enabling clients to track, access and maintain their asset/property data. Insurance and accounting reporting is made possible for the client through this system. Template reports and Ad -Hoc reports provide for flexibility and a customized aspect to AssetMaxx. Annual perpetuation of data saves time and money for our clients and makes the annual reporting process a much simpler task. The increased reliance on modern information technology (versus manual processes) was a core component of the reengineering of our practice. 1.3 STRONG & STABLE FINANCIAL PARTNER It is important to have confidence in the commitments made to you and AssetWorks has the strength and stability to guarantee. Our group has been successful since 1989 performing the same services. This is a high integrity, public company that is a part of the Toronto Stock Exchange. Open books and open disclosure along with strong finances provide for an environment of quality, honesty and commitment. 4 Property Appraisal Services Proposal for: AssetWORKS The Monroe County BOCC APPRAISAL 2. RELEVANT EXPERIENCE You can confidently select AssetWorks Appraisal (formerly MAXIMUS Asset Services) as a partner to conduct your on -site appraisal service for the following reasons: • We have been in the business of property appraisals for 20 years and have the reputation of being the "best of class" provider. We are already a trusted partner with several government entities in Florida and entities across the United States who have employed our appraisal services in year past. • We have successfully provided property valuation and appraisal services for more than 5,000 entities across the United States, Europe, and Puerto Rico. • Within the past 5 years alone, AssetWorks has provided insurance appraisal services to more than 300 individual public entities in the State of Florida. 5 Property Appraisal Services Proposal for: The Monroe County BOCC 3. PAST PERFORMANCE ON SIMILAR PROJECTS Our relevant client references are as follows: City of Key West, FL Sandra Barroso P.O. Box 1409 Key West, FL 33041-1409 305-809-3811 AssetWORKS APPRAISAL sbarroso()keyewestcity.com Scope: AssetWorks recently completed an appraisal of city -owned buildings in July of 2010. The fieldwork portion of the project was started on June 28, 2010 and preliminary reports were delivered on July 26, 2010. Charlotte County, FL Janine Hewitt 18500 Murdock Circle, Room 344 Port Charlotte, FL 33948 941-743-1244 Janine.hedtt @charlottefl.com Scope: AssetWorks successfully appraised all owned buildings in 2006. Since 2006, AssetWorks has provided the County with value trending services and on -site appraisals to updated values and conduct appraisals of newly constructed/acquired structures as recently as 2010. City of Sunrise, FL Bill Mason 4747 N. Nob Hill Road, Suite 6 Sunrise, FL 33351 954-572-2496 bmason aa)cityofsunrise. org Scope: AssetWorks successfully appraised all owned buildings in 2007 and has provided value update services through 2009. on Property Appraisal Services Proposal for: The Monroe County BOCC City of Lakeland, FL Karen Lukhaub 520 N. Lake Parker Avenue Lakeland, FL 33803 863-834-6799 AssetWORKS APPRAISAL Karen. lukh aub(o)lakelandgov. net Scope: AssetWorks successfully appraised all owned buildings in 2006. Since 2006, AssetWorks has provided the City with value trending services and on -site appraisals to updated values and conduct appraisals of newly constructed/acquired structures as recently as 2010. Preferred Government Insurance Trust (PGIT), FL Kurt Heyman 615 Crescent Executive Court, Suite 600 Lake Mary, FL 32746 321-832-1455 kheyman(a publicrisk.com Scope: Between 2008 and 2010, AssetWorks successfully completed a 3 phase appraisal project that included the appraisal of all PGIT members. The appraisals consisted of over 8,000 individual appraisals for 274 members. 7 Property Appraisal Services Proposal for: ASSetWORKS The Monroe County BOCC APPRAISAL 4. PROJECT APPROACH 4.1 PROJECT SCOPE The scope of this project is focused on the inventory and valuation of owned -structures and contents. The resulting data will provide current insurable values, adequate proof -of -loss documentation and the basis for insurance premiums. Project `Kickoff Meeting Our project team will hold a comprehensive project -planning meeting with your representatives in advance to the start of the fieldwork. We advise that members of the administrative staff or other directly involved personnel attend this meeting. Topics of discussion include confirmation of project scope and time frames, the physical appraisal schedule, accessibility to buildings, contact person at each building or location, and availability and use of original purchase records, assignment of database code numbers and associated descriptions for locations and buildings. This meeting lays the foundation for the methods and procedures used during the onsite fieldwork. Client Staff Expectations AssetWorks believes that clients retain our services with the expectation that AssetWorks staff, as paid professionals and consultants, will perform the necessary tasks in a high quality manner to successfully complete the project on time. We do, of course, view our clients as active participants and anticipate their assistance with the following: ■ Pre -Project Planning and Announcement — AssetWorks will identify key items to have prepared for the project kickoff meeting. We ask that you prepare a memo for staff members to announce the project and give the general purpose and time frame. ■ Availability of Existing Building Records — AssetWorks will utilize existing records, as provided by the District. Blueprints, for example, can aid in calculating square foot area. ■ Access to All Sites — AssetWorks appraisers will be granted access to all sites and buildings based on a mutually agreed upon appraisal schedule. Project `Closeout' Meeting Upon completion of the on -site investigation, the AssetWorks project manager will conduct a final closeout meeting with your staff. The focus is to ensure that all sites and properties have been accounted for and to answer any questions that you might have. This is also the time at which your staff should ensure that they have transferred all client supplied data to the project manager. Later delivery of data could delay final report processing. Property Appraisal Services Proposal for: The Monroe County BOCC 4.2 APPRAISAL SERVICES & PROCEDURES GENERAL BUILDINGS & STRUCTURES AssetWORKs APPRAISAL The buildings/structures subject to our survey will be carefully inspected and measured. Professional AssetWorks appraisers will independently calculate the square foot area of each building appraised through the review of "as -built" blueprints or physically measuring each building. Building photographs will be prepared for each structure to become part of our proof -of -loss documentation, in addition to assisting with the valuation efforts. A description for each building will be developed and recorded, depicting construction type and materials utilized. Primary Construction, Occupancy, Protection, and Exposure (COPE) data includes: a) Occupancy b) Constructiol c) Frame Type d) Number of e) Condition f) Roof Shape g) Roof Pitch h) Roof Strappl i) Roof Type j) Exterior Wal k) Year Built 1) Foundation/f m) Square Footage n) Ceiling o) Partitions/Interior Walls p) Updates (Roof/Bldg) Yr. q) Heating/Cooling Systems r) Flooring s) Electrical/Plumbing t) Elevators u) Identify Protection Systems v) Additional Features w) GPS Coordinates x) Flood Zone Classifications During the office valuation portion of the engagement, property exclusions (those items not typically covered by an insurance policy) will be segregated to properly report the site preparation and excavation, footings and foundations, and a portion of plumbing costs (below grade). Construction/ISO Classirications In addition to the analysis of individual building components, construction classes will also be recorded. ISO classes 1-6, as defined by the Commercial Fire Rating Schedule (CFRS) are defined in terms of the Marshall and Swift construction classes as follows: ISO Class M&S Class Description 1 D Frame/Combustible 2 C Joisted Masonry 3 S Noncombustible 4 C Masonry Noncombustible 5 A Modified Fire Resistive 6 B Fire Resistive E Property Appraisal Services Proposal for: AS S e t WOR K S The Monroe County BOCC APPRAISAL SPECIALIZED BUILDINGS & STRUCTURES Water/Sewer Treatment Facilities AssetWorks' approach to valuing water/sewer treatment facilities are performed on an itemized building and/or process basis. The fieldwork should begin with a meeting between the project team and the plant manager or other delegate. The following is verified: ■ Available blueprints/site map/processing summary info ■ Plant accessibility and available working time ■ Chaperone requirements and other safety requirements Additional information on specific structures/equipment does not necessarily need to be discussed at the initial meeting but at minimum would be obtained prior to the conclusion of fieldwork. This would include: ■ Plant design capacity — measured in "million gallon capacity per day treated" MGD ■ Plant original construction date ■ Plant addition dates ■ Drawings for original and additional (architectural drawings) ■ Plant flow diagram (used to establish numbering scheme) ■ Any "contractors cost breakdowns" for construction (original or additions) ■ Area to work from and be able to utilize drawings Ideally, the plant walk-through will be done after the plan review since the availability of blueprints or other information will determine which structures need to be physically measured. The plans may also provide info on the construction classification and other building features and processing equipment. Process Piping (underground) is typically excluded from property schedules for insurance purposes, however, should the Client elect to include piping as an individual land improvement entry, we can comply. Common processes and structures analyzed and included are: ■ Headworks (Influent Pump Station) ■ Clarifiers (Primary, Intermediate, Secondary) ■ Aeration Tanks/Ponds/Basins ■ Gravity Thicken ers/Dewatering Buildings / Belt Presses ■ Digesters ■ Filters (Trickling, Biological, UV... etc.) ■ Sludge Drying Beds/Lagoons/Incinerators ■ Laboratories ■ Ozone Structures ■ Chlorine Contact Structures ■ Blower Buildings ■ Pump Stations / Equipment Galleries 10 Property Appraisal Services Proposal for: The Monroe County BOCC AssetWORKS APPRAISAL Historical Properties & Reproduction Cost Historical properties are addressed on two levels, starting with the identification of subject properties. This is to be completed by either obtaining a list of these properties from the Client or extracting buildings meeting a defined age requirement, with the Client subsequently identifying which of those are to be appraised with a reproduction cost as a historical property. The second level is the actual appraisal itself. In order to perform a historical property appraisal, components of the subject building must be identified and appraised individually, building a segregated cost approach to determine valuations on material that is like -kind as well as function. Specialty attributes are taken into consideration and valued in terms of reproduction as it relates to the subject building. The valuations for historical properties are often complex and may be performed by a senior valuations expert from data recorded onsite by our project team. Swimming Pools Outdoor swimming pools are included in our onsite inspections and typically all in - ground concrete structures with pumps, filters, and chlorination equipment. If pools are included for insurance purposes, costing breakdowns will be discussed in order to determine what percentage used is 80% (the other 20% representing equipment). The equipment may be included in the cost of the pool or included in the content value of the building they are located. Large slides should be listed separately as additional features. Other types of pools include wave, diving and wading pools. *Key details are recorded for theses specialty structures for valuations, as follows: ■ Electrical Substation Equipment o Substation Capacity o Circuit Breaker Quantity, Type, Capacity o Transformers, Quantity, Type, Capacity o Structures (Control, Dead -Man, Other) o Control Panel Details o Accessory Equipment Details ■ Reservoirs & Water Containment Structures o Type (co ncrete/steel/above-ground/in-ground) o Capacity o Construction Date & Cost ■ Pump Houses, Lift Stations, Wells, etc. o Structure type, size/depth, services, & features o Itemized equipment (type, capacity) Property Appraisal Services Proposal for: As s e tWOR K S The Monroe County BOCC APPRAISAL VALUATION OF BUILDING CONTENTS "MODELING APPROACH" Content values will be included based on the "modeling approach" that was developed to meet the valuation needs of risk pools and public entities without the need for a detailed inventory. AssetWorks utilizes computer models of more than 100 building types and their contents based on data gathered from thousands of appraisals over the past several years. A field inspection of each building will be conducted in conjunction with the building inspection. We will estimate the value of contents in a particular building by taking the square foot equipment value of a like facility and applying it to the calculated area of the building. We can adjust the equipment value to account for variations above or below the average value of equipment present at each facility. The adjustments are made based on a physical walk-through of each building. The "modeling approach" is unique in that a reliable replacement cost estimate of a building's contents can be generated without performing a lengthy and costly inventory. VALUATION OF INSURABLE LAND IMPROVEMENTS / PROPERTY -IN -THE -OPEN (PITO) AssetWorks will individually identify and value various insurable land improvements at each of your locations. These assets include, but are not limited to signs, exterior lighting, fencing, flag poles, benches, trash receptacles, etc... AssetWorks can provide an individual value for each asset or an aggregate value per site with a brief description of the assets included. VALUATION METHODOLOGY Our investigation of each property will follow generally accepted appraisal techniques and valuations in accordance with the Uniform Standards of Professional Appraisal Practice (USPAP). This includes the use of various research sources to develop the cost conclusions for each building. Sources include price lists, trade journals, industry publications, technical and pricing subscription services, engineering manuals and inquiries with local contractors as well as direct cost research. It is an ongoing task to not only identify but continuously substantiate values. Multiple sources of value exist, but to rely on one can be dangerous as they all have positive points to pull from. Example sources of construction cost information include: ■ Direct cost information from recent projects ■ Inquiries with local contractors and architects ■ US Department of Labor — Bureau of Labor Statistics ■ Marshall and Swift 1 Boeckh ■ RS Means Construction Cost Index ■ Reed Construction Data ■ Producer Price Index 12 Property Appraisal Services Proposal for: The Monroe County BOCC AssetWORKS APPRAISAL The offsite valuation portion of the project entails the research and calculations necessary to formulate replacement costs, reproduction costs, and insurance exclusions, defined as follows: Replacement Cost New is the amount required to reproduce property in like utility and function, in accordance with current market prices for materials, labor, equipment, contractor's overhead, profit and fees, but with no provisions for overtime or bonuses for labor and premiums for material or equipment, based upon replacing the entire property at one time. Cost of Reproduction New (Historical Properties) may or may not be applicable for this project but if encountered, is the amount required to reproduce a duplicate or replica of the entire property at one time in like kind and materials, in accordance with current market prices for materials, labor and manufactured equipment, contractor's overhead, profit, and fees, but with no provisions for overtime, bonuses for labor, or premiums for material. Insurance Exclusion is a provision in an insurance contract describing property, or types of property, that are not covered by an insurance policy. Based upon a review of current District policy specifics, we can identify those items specifically excluded under terms of the policy. The insurance exclusion amount is deducted from replacement cost to arrive at an insurable value, specific to each structure. Insurable Value is the Replacement Cost New less the Insurance Exclusions PROJECT SCHEDULE & PROPOSED TIMELINE AssetWorks' automated approach and depth of experienced staff qualify us to complete all phases of this project in a timely fashion. Upon receipt of your authorization, AssetWorks will arrange a mutually agreeable schedule for the project planning meeting and our on -site inspection. AssetWorks will complete all appraisals and deliver final reports within 60 days from the time the project is awarded. 13 Property Appraisal Services Proposal for: AssetWORKS The Monroe County BOCC APPRAISAL 4.3 DELIVERABLES Preliminary electronic reports will be provided as well as hard -copy final reports. CERTIFICATION LETTER Certified appraisal reports are bound in an easy -to -read format. AssetWorks will provide a set of insurance summary and insurance detail reports. The certified appraisal report will include the Letter of Certification, which will: a) Identify the property appraised b) State the purpose of the appraisal c) Specify the appraisal date d) Define the level of value sought and the premise of value employed e) Describe the nature of the property included in and excluded from the appraisal f) Discuss the appraisal investigation g) Indicate the factual data considered h) Present the conclusions of value i) Outline the qualifying and limiting conditions j) Include the signature of an authorized officer of the company PRELIMINARY REPORTS Electronic Data File AssetWorks will provide you with an electronic data file in Microsoft Excel format. This data file will include all building features, COPE data, and values that are displayed on our building detail report. The data will be provided to you in a format that can be sorted and edited by you to populate and update your current statement of values. Draft Summary and detail reports will be sent via email in .pdf format for review. Our clients have two weeks from the point of issuance to determine acceptability of the final data. Upon acceptance, AssetWorks will then prepare and deliver final reports in electronic and hard -copy format. 14 Property Appraisal Services Proposal for: The Monroe County BOCC FINAL REPORTS Insurance Summary Report - Summary of values by location, this AssetWORKS APPRAISAL Sample Summary Report Sample Value Comparison Report I m7P2o08 SOY SAMPLE City of Aurora As of: IW3112006 to%uranoe Burn -y by Buiidinp - fOV Comparison P.O.: 1 BatMdr a LTetwnpti0n Cod* Add-%. R*ptao*rment Cost R*ptaoemertt R*pN-nt % Less Eaotnsi- Cost - sov Cost Differ*na* Chang* Entft: AUR CITY OF ALWORA sit*: O01 CITY HALL 1.01 C " MALL B."i.9 302,600 t38,8T7 t63.a?3 b4.00 x 21420 MAIN STREET NE Cortt*nf% 103,872 103.672 O O.00 x AURORA. OR 07CW Property In the Op*n 3,200 O 3.200 1CFO-00 x Nob"CAD: VARIOUS CRM Y OEPARTEINCES POLICE OEPAFTMEM LAND VAPROVEMEW: W A . COLJL CFV WIBERS CONCRETE PAVEUIEW - 642 SF a S3,200 Sit. tofu for Dal Building 302,600 138.877 163.623 5-4.00 x ConferMt 103.872 103.872 O O_0D x Property In th* Open 3.200 O 3.200 100-00 x site: 005 WATER RESERVCWt 5.02 WATER TANK Bv411014a0 232700 138,677 93,823 40.31 x 14582 OTTAWAY ROAD NE Contents O 0 O AURORA. OR 97002 Property in the OP.. 4,6W O 0.00 x No*s: tDAAA4ETER s 41-W6 hEIGW-28.4T, CAPACITY a 294D00 GAL. SERIAL *BO40154 4,600 10000 x BOOSTER PLOUIP STATION AT THE SAME STFE, Gil£, C ENIEiATOR A, RAXSM OIESE P6�L TAW 04EXT TO PU&V STATION_ LAND p4PRCKEMEW: CfiAA44-NK FENCRid WJBARBM WIRE - 288LF AT ICE FfOH 9400O Sit totat for 005: E36."A p 232,700 138,877 93,823 40,31 x Cont*nfs O O O 0,00 x Propesty in Op- Op 4A00 O 4.600 100.00 x Sit*: 006 PUBLIC RESTWOOM 6.01 R2%TRO0#A 8LR.CTIN3 B."I.O 116,160 127,883 -11,723 -10.09 x SECX *A3 STET NE Contra% 7,649 7,549 O G 00 x AURORA. OR 97002 Prep*rty in the Open O 0 0 0.00 x site totaf far 0": BuNdinp t16,160 127.883 -11,723 -t0.00 x Con nb 7.649 7,849 O 0 00 x Proparty fn the Op*n O O O ODO % 15 Property Appraisal Services Proposal for: AS S e t WOR K S The Monroe County BOCC APPRAISAL Insurance Detail Report — Provides detail information on a per building basis. This report includes, but is not limited to the following: 1) Site Name 2) Building Name 3) Building Address 4) Occupancy and/or function of facility or building 5) Construction/ISO Classification 6) Year Built 7) Square Feet 8) Narrative Description 9) COPE Data (Primary & Secondary) 10) Replacement Cost New 11) Exclusion Amount 12) Content Value Sample Insurance Detail Report 041171 DB0 Eottly: tit SAMPLE RISK POOL Vie: 0M DEMONSTRATION ELEMENTARY SCHOOL tt ikOng: 01 ELLMENIAFtY SCHOOL 200ANY STREET ANY CITY, US 00000 Department M 2"APPPIAISAL, Year Sulic 2000 Year AcguttetL 20DO- Nbr. of Stones: 1square Footage: 95 S Basem"t: NO A dslftnovatitms: NO Occupancy, SES SCHOOL - ELEMENTARY Frame Type,. ST ST'EEL ISO cum A, MASONRY NON COMBUSTMLE GPS Latltudv °57 86 77N' Ps Longitude; 081 "• 4,34OW' flood zorte., X Fire Protection: INTRUSION SYSI'EM f IRE ALARM - MANUAL FIRE ALARM - AUTOMATIC SPRINKLER SYSTEM (1 % G1E E 6%qL NQ C"ARAGTEM TI S Exterior'Walic DECORATIVE C>CNCRE."`1E BLOCK, BRICK ON MASONRY Roofing,: % METAL - MEDIUM PITCH, 101% MEMBRANE . FLAT Foundation' CONCRETE SLAB ON GROUND, CCNCRE-E FOOTING FOUNDATION Floor Finish: CARPETNG,VINYL Getling Flnlsh: ACOUSTICAL DRYWALL Parlltions: CONCRETE BLOCK, DR Y'A1F4LLjG UCS Servlcw Feldurew ELECTRICAL BVILT^NS @CABINETS, LOCKERS, BOOKCASES) PLtUM8INc COVERED ENTRANCE WAY HE.k TINGJ',AR CONDITIONING (HEAT PUMP, COVERED'WALKWA' UNIT HEATERS BACKUP GENERATOR A..R COND TtONING= UNIT EY E WOR SECURITY r CGH SING SEC URITY CAMERA SYS-EM Note ROOF REPT.AC'EIC 2004 AVE.RAGf. WALLA HI, IGH" - 14' ROOF STRAPS • YES PERMETER ETER §'S!ALL LENGTH - 2,886 LF Total Insurable Replacetnent Cosa.. 13.313, 798, 12514, G+BB. 14.123 Property Appraisal Services Proposal for: AssetWORKS The Monroe County BOCC APPRAISAL 5. PERSONNEL QUALIFICATIONS AssetWorks is a corporation and the core of our success is our dedicated and qualified personnel. Our asset services professional staff is compromised of consultants possessing backgrounds in a wide range of specialties, including architecture, engineering, construction estimating, accounting, real estate, finance, and business management. Members of our staff maintain affiliations with various professional associations focusing on the American Society of Appraisers (ASA). AssetWorks has a unique combination of highly skilled professionals and cutting edge technology that allows us to assess, execute, and support each client's specific valuation requirements in a professional, timely, and cost effective manner. AssetWorks proposes the following appraisal team to the Monroe County BOCC: Professional Affiliations USPAP — Uniform Standards of Professional Appraisal Practice Certification Property Focus Machinery & Technical Specialties Buildings & Structures Land & Improvements Valuations Focus Replacement Cost New Reproduction Cost New Fair Market Value Historical Costs for GASB 34/35 JUSTIN DEEM Project Manager Pittsburgh, PA Mr. Deem is a regional manager and senior appraiser with AssetWorks, Inc. He has been serving our clients since 2003 and his tenure with AssetWorks has included the execution of various insurance appraisal projects and asset inventory studies for risk pools, states, municipalities, school districts, and several other public sector entities. He is responsible for the management of staff and quality control of projects managed in the east/southeast region of the United States. Mr. Deem possesses technical expertise in the procedures and methodologies used to value machinery and equipment, buildings and building services, infrastructure, land improvements, and land parcels. He possesses a practical knowledge and understanding of Generally Accepted Accounting Principles (GAAP); Government Accounting, Auditing, and Financial Reporting (GAAFR); Governmental Accounting Standards Board Statement 34 (GASB 34); and various other audit concerns related to capital asset reporting. Mr. Wilderspin is also experienced in providing insurance replacement and proof -of -loss information to our clients to assist in addressing their insurance reporting needs. A sampling of projects Mr. Deem has managed or worked on includes: • South Carolina School Boards Insurance Trust, SC • New Hampshire Public Risk Management Exchange (PRIMEX) • Atlanta Public Schools, GA • Detroit Public Schools, MI • Preferred Government Insurance Trust, FL • City of Atlantic Beach, FL • Muncie Community Schools, IN • Etc... 17 Property Appraisal Services Proposal for: The Monroe County BOCC Professional Affiliations USPAP — Uniform Standards of Professional Appraisal Practice Certification Property Focus Machinery & Technical Specialties Buildings & Structures Land & Improvements Valuations Focus Replacement Cost New Reproduction Cost New Fair Market Value Historical Costs for GASB 34/35 AssetWORKS APPRAISAL CHRISTAIN GUTIERREZ Data and Report Processing Miami, FL Chris Gutierrez has been an integral part of the AssetWorks group since 2001. He is responsible for the management and oversight of the Information Services Group. These responsibilities include software project management, data processing, data conversions, appraisal report compilation, software development, software support, project planning, and quality control. Mr. Gutierrez also served as a staff appraiser for two years. As a staff appraiser, he possesses a practical knowledge and understanding of Generally Accepted Accounting Principles (GAAP); Government Accounting, Auditing, and Financial Reporting (GAAFR); Governmental Accounting Standards Board Statement 34 (GASB 34); and various other audit concerns related to capital asset reporting. 18 Property Appraisal Services Proposal for: ASSetWORKS The Monroe County BOCC APPRAISAL 6. OPTIONAL SERVICES Along with our standard Insurance Appraisal Services, AssetWorks is please to introduce you to our optional services. These provide additional valuations, underwriting data, and methods of perpetuation to manage and update appraised values and data established as a result of our initial study. These services include: 6.1 BUILDING DIAGRAMS If desired, AssetWorks can provide a one dimensional drawing of each structure that illustrates the exterior footprint of the building can be provide with each building appraisal. 6.2 ANNUAL UPDATE SERVICE (TRENDING OF INSURABLE VALUES & APPRAISAL OF NEWLY CONSTRUCTED/ACQUIRED STRUCTURES) AssetWorks will apply detailed trend factors to the existing buildings, contents, and other related values for the purpose of updating each building's insurable values. The trend factors used are developed based on a variety of factors including the Consumer Price Index, the Marshall & Swift Valuation Guide, the Handy -Whitman Index, and the increase/decrease in the cost of materials, technology equipment advancement, etc. After the trending is complete, AssetWorks will provide a complete set of updated insurance reports. AssetWorks is also proposing to provide the County with annual on -site appraisals of newly constructed/acquired structures. AssetWorks will follow the same policies and procedures as described in this proposal for the appraisal of new buildings. These building will be added to the database of existing buildings and will be included with the updated reports on an annual basis. 6.3 ADDITIONAL / SECONDARY COPE DATA COLLECTION Due to the fact that data modeling continues to be a major influence on the pricing of retailer's property programs, basic COPE data is not enough to guarantee the best pricing. Many retailers are adding secondary data to their submissions in order to get favorable underwriting evaluations. Secondary COPE Data — GENERAL ■ Distance to Nearest Fire Hydrant 0 Year of Last Plumbing Upgrade ■ Distance to Nearest Fire Department 0 Year of Last HVAC Upgrade ■ Distance to Nearest Ocean/Gulf 0 Year of Last Roof Replacement ■ Year of Last Electrical Upgrade 19 Property Appraisal Services Proposal for: The Monroe County BOCC Secondary COPE Data — WIND ■ Cladding Type ■ Wind Resistance — Windows ■ Roof Framing Type ■ Roof Geometry ■ Architectural Elements ■ Mechanical & Electrical Systems (Ground Level Only) Secondary COPE Data — EARTHQUAKE ■ Setbacks & Overhangs ■ Cladding Type ■ Ornamentation ■ Pounding AssetWORKS APPRAISAL ■ Mechanical & Electrical Systems (Building Side Only) ■ External Ornamentation ■ Wind Resistance — Doors ■ Roof Parapets ■ Roof Covering ■ Flood Protection ■ Roof Age ■ Tank ■ Shape Configuration ■ Building Exterior See "Attachment A" of the Proposal for a Detailed Description of Each Secondary Wind and Earthquake Characteristic Listed Above. 6.4 ASSETMA)0(TM WEB -BASED PROPERTY MANAGEMENT SYSTEM Easy asset maintenance and overall system navigation are the cornerstones of the AssetMAXX design. AssetMAXX has a general look and feel that users are accustomed to when using the web. We are pleased to offer AssetMAXX, a web -based program allowing users to securely maintain, collect, and retrieve data over the World Wide Web. AssetMAXX allows for the tracking and updating of real property structures for insurance reporting and insurance placement purposes. AssetMAXX is the most comprehensive and flexible property management tool available in the property tracking industry. Because AssetMAXX is a web -based solution, it provides users with significant advantages over traditional client -server or stand-alone software: ■ With AssetMAXX, users access the application via the internet (Dial -up or Network). ■ AssetMAXX Avoids the need for the large initial capital outlay generally associated with software purchases. ■ Users 'rent" the applicaton and access it over the web, eliminating the added internal need for costly hardware and lime consuming maintenance. ■ Application and data are housed on AssetWorks' hardware at the AssetWorks' data center in Wayne, PA. This ensures that the system is always optimally configured. AssetMAXX encompasses all areas of capital asset and real property tracking and reporting to include: ■ Fast, reliable and easy access to data ■ Secure server location and administration 20 Property Appraisal Services Proposal for: The Monroe County BOCC AssetWORKS APPRAISAL ■ Secure authentication, data encryption and user log for accountability ■ Supports unlimited number of users ■ Multiple levels of security and access permissions ■ Digital photo interface ■ Both standard and ad hoc reporting features ■ Multiple user defined fields ■ Data import and export capabilities The AssetMAXX pricing schedule is subscription based. Users pay a fixed monthly/annual fee, which provides them with access to their database. The monthly fee includes: ■ 24 hour access to AssetMAXX ■ All license and maintenance fees ■ Unlimited help desk support ■ Automated trending of values ■ All system maintenance (database administration, network maintenance, etc...) TRY THE ON-LINE DEMOI @ www.assetmaxx.com 21 Property Appraisal Services Proposal for: The Monroe County BOCC 7. LITIGATION AssetWORKS APPRAISAL (a) Has the Proposer ever failed to complete work or provide the services for which it has contracted? (If yes, provide details.) NO (b) Are there any judgments, claims, arbitration proceeding or suits pending or outstanding against the Proposer, or its officers or general partners? (If yes, provide details.) NO (c) Has the Proposer, within the last five (5) years, been a party to any lawsuit or arbitration with regard to a contract for services, goods or construction services similar to those requested in the RFP? (If yes, the Proposer shall provide a history of any past or pending claims and litigation in which the Proposer is involved as a result of the provision of the same or similar services which are requested or described herein.) NO (d) Has the Proposer ever initiated litigation against the county or been sued by the county in connection with a contract to provide services, goods or construction services? (If yes, provide details.) NO (e) Whether, within the last five (5) years, an officer, general partner, controlling shareholder or major creditor of the Proposer was an officer, general partner, controlling shareholder or major creditor of any other entity that failed to perform services or furnish goods similar to those sought in the request for proposals. NO 22 Property Appraisal Services Proposal for: The Monroe County BOCC 8. COUNTY FORMS SEE FOLLOWING PAGES AssetWORKS APPRAISAL 23 Property Appraisal Services Proposal for: The Monroe County BOCC 9. PROJECT FEES AssetWORKS APPRAISAL All professional fees outlined below are in US Dollars and include out-of-pocket expenses. All appraisal fees are contingent based on the total number of buildings appraised. The TOTAL investment is as follows: Standard AssetWorks Appraisal $95 per building o Appraisal of Buildings/Structures o Primary COPE Data (Includes GPS Coordinates) o Value Comparison Reports o Modeling of Building Contents o Classification of Flood Zones o Valuation of Insurable Land Improvements/PITO Estimated Cost for the Appraisal of an Estimated 88 Individual Structures Listed on the Current Property Schedule Provided by the City $8,360 Optional Services 1001 here ■ Building Diagrams $10 per bldg ■ Annual Update Service — Value Trending $995 per year ■ Annual Update Service — Apprasial of New Buildings $135 per building $2,700 minimum fee ■ Collection of Secondary COPE Data — General Available Upon Request ■ Collection of Secondary COPE Data — Wind Available Upon Request • Collection of Secondary COPE Data — Earthquake Available Upon Request ■ AssetMAXX (1 year subscription) 1 Year FREE Trial (Includes 1 user & 1 "view only" account) $1,500 per year (future) RESPECTFULLY OFFERED BY AssetWORKS APPRAISAL - I I-- �_� �_ �a /�_ Shaun M. Callahan Vice President September 24, 2010 ACCEPTED BY: Monroe County BOCC Signature Name Title Date 24 Property Appraisal Services Proposal for: The Monroe County BOCC 10. TERMS & CONDITIONS AssetWORKS APPRAISAL AssetWorks standard terms and conditions are as follows. Upon award of the project, AssetWorks will work with the County to establish a mutually agreeable set of contract terms and conditions. 1) AssetWorks shall provide guidance to the CUSTOMER in determining the data required for purposes of the contemplated services. The CUSTOMER further agrees to provide all data specifically requested, including documentation and information to AssetWorks in a timely manner. AssetWorks shall assume without incurring liability therefore, that all data so provided is correct and complete. 2) In the event that the CUSTOMER provides additional an/or corrected data, documentation and information at a later date, AssetWorks' efforts with respect to such additional and/or corrected data, documentation and information shall be deemed additional services and compensated in addition to the fees set forth herein based on applicable hours, professional fees and expenses. 3) The CUSTOMER acknowledges project completion upon delivery of final reports. Final report delivery occurs only upon either acceptance of the preliminary reports data by the CUSTOMER or upon the passing of the two -week (10 business days) period of time after preliminary report delivery, whichever comes first. 4) The fees proposed in this contract are valid for a period of 90 days. 5) To the extent a claim is not covered by the required insurance, each party agrees that each party's total liability for any and all damages whatsoever arising out of or in any way related to this Agreement from any cause, including but not limited to negligence, errors, omissions, strict liability, breach of contract or breach of warranty shall not, in the aggregate, exceed the total amount of this Agreement. To the extent a claim is covered by the required insurance, each party's total liability will be limited to the amount of required insurance. 6) CUSTOMER and AssetWorks shall each retain ownership of, and all right, title and interest in and to, their respective pre-existing Intellectual Property, and no license therein, whether express or implied, is granted by this Agreement or as a result of the Services performed hereunder. To the extent the parties wish to grant to the other rights or interests in pre-existing Intellectual Property, separate license agreements on mutually acceptable terms will be executed. 25 t N Monroe County Property Worksheet Static tnformation Code Occupancy !tame Address City State ZrD Construction Year # of Square t5 Built Stories Footage Class Fire Station #9 Big Cow BCt Ambulance Station 28 Emerald Rd. Key FL 33040 masorify NC 1991 1 6,440 4 Big Pine Bpi Fire Station #13 390 Key Geer Blvd_ Key FL 33043 Concrete 2009 unknown 8,189 unknown Senior Citizen Big Pine BP2 CenterlAARP Bldg 380 Key Deer Blvd_ Key FL 33043 wood 1970 1 1,750 1 213 Key Deer Blvd., Big Pine BP5 Library #11 & 412 Key FL 33043 steelfconcrete 1984 1 3,600 4 Catch Cot Fire Station 10 Conch Ave Key FL 33050 JM 1970 1 1 3,451 2 Sheriffs Sub Cudjoe CJ3 StatiorVAmtwtance 20950 Overseas Hwy Key FL 33050 JM 1989 1 2,430 2 Islamorad 101 Library 2331 Overseas Hwy a FL 33036 fire resistive 1937 1 6,696 6 KOt Library 101485 Overseas Hwy Key Largo FL 33081 masonry NC 1989 1 12,077 4 Aviation Sheriffs office Monroe Cty Sheriffs moo Office 10100 Overseas Hwy Marathon FL 33050 Metal 2004 1.5 21,210 M01 Sub-GourthousetOifices 3117 Overseas l fwy_ Marathon FL 33050 JM 1976 1 4,008 2 SherRts Sub- M02 StationlOf{ces 3103 Overseas . Marathon FL 330501 JM 1973 1 6 990 2 M05 Library 3251 Overseas Hwy, Marathon FL 33050 JM 1984 1 7,028 2 M06 Senior Citizen Center 33rd Street- Gulf Marathon FL 33050 frame 1979 1 1,783 1 M07 Health Department 1 3333 Overseas Hwy, Marathon FL 33050 masonry NC 1997 1 4 9% 4 Marathon Airport I M10 Complex 9480 Overseas Hwy. Marathon FL 33050 masonry NC 1 1964 1 40,145 1 4 To include Terminal Building, Air Chiller Building, various T Hangs, DAV Hall, aerator Building, blast Disposal Plant, Sheriffs Hanger and Antique Aircraft Hancw M11 Public Works Offices 10600 Aviation Blvd_ Marathon FL 33050 JM 1976 1 1,800 2 Fleet Maintenance M12 Facility 10600 Aviation Blvd. Marathon FL 33050 masonry NC 1995 2 8 500 4 Government Center M17 Annex 490 63rd Street Marathon FL 33050 masonry NC 1970 1 10,074 4 Marathon Gov. M20 Center/EOC 2790 Overseas Hwy. Marathon FL 33050 masonry NC 1993 2 23,250 4 bKtg owned by state No construction is Cade Sheriff Dispatch Center 2796 Overseas Hwy. Maranon FL 33050 needed M22 Detention Facility 3981 Ocean Terrace Marathon FIL 1 33050 masonry NC 19W 1 7,303 4 Sheriffs Special 6 Coco Plum Rd. M99 Operations (Leased) MarathonI FL 1 33050 waodtcoterete 1 1970 2 1 5,270 Static Information is based on best available information. Proposers will be required to develop their own Static Information ant incorporate it in their final report Monroe County Property Worksheet IStatic Infaff"allo" I AR -a Q —cc 51414.1 Litz Tion =Year t'q I S(Lu4 e BUIR Slooles Fo4,) t pjLe las s Governmental CtrJCoodtmse Plantation Key Sbenfrs Station (PfeviousiY known as the Old Plantation Pot Mariners Hosvitat) 50 HOpoint Rd, Key FL 33070 1 masonry NC 1977 2 21,988 4 Spotswood Bldg- Sheriffs Sub-Stawn, Facilities, Maintenance, Growth mgmt & Plantation P02 Roads/Bridaes 88770 O"rsas Hwy, Ke FL 1 33070 JM 1959 1 1 5.182 2 Plantation P05 Public Works Offices 103 Key Heights Dr, Key FL im 1960 1 2,437 2 County Offices/Eilts f33O7(0 Bldg,- Plantation Key Courthouse & Monroe 68800 - 88820 US Hwy. Plantation PIG CtV Public Works #1 Key FL 33070 w0od1concrete steel 1987 2 1 8.400 2 Plantation Pit Detention Facility 53 Highpoint Rd. Key FL 33070 masonry NC 1990 1 5,500 4 Stock SO4 Bayshore Manor 5200 College Rd, [stand FL 33040 frame 1947 1 8,066 1 stock 809 Detention Facility 5501 ColRd. Wand FL 33040 fire resistive 1994 3 183,500 6 Stock 311 Sheriff Admin, Bldg, 5525 College Rd. Island FL 330401 fire resistive 1996 3 29.660 6 170WI Highway #1 T01 Health Clinic (Rear) Tavernier FL 33040 NC 1937 1 2,590 3 Plantation Key Fleet Maintenance - Storage & Equipment for Road Dept. (old motel, plan to P17 sell it) _ 186 Key Hetahts Dr Tavernier FL Fire & Ambulance T03 station 151 Marine Ave, Tavernier FL 1 33040 masonry NC 1970 1 1 6,711 4 W01 Courthouse 500 Whitehead St, Key West FL 1 33040 Wckiconcrete/iM 1890 2 19135 2 W02 AnneyiCourtrooms 510 Whitehead St, Key West FL 33040 fire resistive 1968 4 60,215 6 W()5 Lighthouse Museum 938'Nhttehead St, Key West FL 33040 frame 1928 1 2,950 1 Justice Bldg./Record W09 Stmage 530 Whitehead St Key West —West FL 33040 JM 1987 3 27,400 2 W10 Library 700 Ftem#ng St- Key FL 33040 im 1968 1 13,137 2 Senior CAL -en Nutrition W Wil Center 1200 Truman Ave. Key West FL 33040 NC 1954 1 4,100 3 Harvey Govemment YV14 Center 1200 Truman Ave, Key West FL 33040 im 1914 2 _ 26,850 2 Static Information is based on best available information. proposers will be required to develop their own Static Information ant, incorporate it in their final report 4� )r Monroe County Property Worksheet Static Information Code Occupancy Name Address City State 6Q Construction Year # of Square iS—f. Built Stories Footage Class Governmental CtriCourihouse, Plantation Key Sheriffs Station tprevtoustj known as the Old Plantation P01 Mariners itat 50 HOpoint Rd_ Key FL 33070 masonry NC 1977 2 21,988 4 Spotswood Bldg- Sherffs Sub -Station, Facilities, Maintenance, Growth Mgmt & Plantation P02 Roads/Bridqes 88770 Oversas Hwy. Key FL 33070 Jed 1959 1 5,182 2 Plantation P05 Public Works Offices 103 Key Heights Dr, Key FL 33070 JM 1960 1 2,437 2 County CMiceslEtlis Bldg.; Plantation Key Courthouse R Monroe 88800 - 98820 US Hticy. Plantation PIO Cty Public Woks #1 Key FL 33070 woodfconcrete steel 1987 2 8.400 2 Plantation P11 Detention Facility 53 Highpoint Rd, Key FL 33070 masonry NC 1990 1 5,500 1 4 Stock 904 Bayshore Manor 5200 College Rd. Island FL 33040 frame 1947 1 8,066 1 S09 Detention Facility 5501 College Rd. Stock Island FL 33040 fire resistive 1994 3 183.500 6 S11 SheeffAdmin, Bldg_ 5525 Col Rd. Stock Island FL 33040 fire resistive 19% 3 1 29,660 6 170901 Highway #1 T01 Heath Chnic (Rear) Tavernier FL 33040 NC 1937 1 2,590 3 Plantation Key Fleet Maintenance - Storage & Equipment for Road Dept- (oki motel, plan to Piz sell it) 186 Key Ha his Dr Tavernier F! Fire & Ambulance T03 station 151 Marine Ave. Tavernier FL 33040 masonry NC 1970 1 6,711 4 Iwo Courthouse Whitehead St. Key West FL 33040 brtckleoncrete/JM 1890 2 19135 2 W02 ArmextCourtrooms 510 Whitehead St. Key West FL 33040 fire resistive 1968 4 60.215 6 W05 se Museum 938 Whitehead 5L Key West FL 33040 frame 1928 1 2,950 1 Justice BldgJRecord W09 Stor e 530 Whitehead St Key West FL 1 33040 JM 1987 1 3 27,400 2 W10 Library 700 Flefritrig St Key West FL 33040 JM 1968 1 13,137 2 Senior Citizen Nutrition W11 Center 1200 Truman Ave. Key West FL 33040 NC 1954 1 4,100 3 Harvey Government W14 I Center I 1200 Truman Ave. Key West FL 33040 JM 1914 2 26.950 2 Static Information is based on best available information. Proposers will be required to develop their own Static Information anc incorporate it in their final report b AW d {Monroe County Property Worksheet Static Information Code occupancy Name Address LAY State I DR Construction Year # of ware I SO Footage Built Stories Class Airport Terminal & 3491 - 3493 S. W16 supportingstFucturds Roosevelt Blvd_ Key West FL I 33M40 masons NC 1957 2 23,761 4 To include arrival terminal, departure terminal, annex, Ong fire house, (used for storage & admin offices), 2 generatof logs, bag make up butksing, VCB fire station teen center, tax collbldg, historical hunker & nawlational P runway slunage & equipment -- CO Issuers wdh maieff qirnnnsion in 2009 Arnold Airport Terminal 3491 - 3493 S_ W16 Annex Roosevelt Blvd_ I Key West I FL 33040 1 masonry NC 1996 2 13,335 4 3491 - 3493 S_ W16 Tax Collectors office Roosevelt Blvd. Key West FL 33040 many NC 1968 1 2,592 3491 - 3493 S. W16 Boys & Giris Club Roosevelt Blvd. Key West FL 33040 masonry NC 1971 1 4,540 County Garage - Monroe Cty Public W'23 Works 3583 S. Roosevelt Blvd. Key West FL 33044 1 masonry NC 1 1984 1 2 820 4 Gato Building & W24 Generator 1100 Simonton St Key West FL 33040 fire resistive 1916 2 42,556 6 Pigeon PK1 Section Gang Quarter Pigeon Key Island Key FL .im 1909 1 2,869 Assistant Bridge Tenef Pigeon PK2 House Peon Kev Island Key FL JM 1912 1 904 Assistant Paint Pigeon PK3 Foreman's House Pigeon Key Island Key FL ,iM 1912 1 850 Pigeon PK4 Bridge Worhers Dorm Pigeon Key Island Key FL JM 1912 1 1,364 Pigeon PK5 B Tenders House eon K Island KeyFL JNI 1912 1 1 79fi Bridge Foreman's Pigeon PK6 house Pigeon Key island Key FL 4M t912 1 81# Pgeon PK7 Honeymoon Cottage Pigeon Key Island Key FL JM 1951 1 24T Pigeon PK8 Negro Quarters Pigeon Key Isiand Key Ft JM 1912 1 470 Pigeon PK9 Generator Building Pigeon Key Istand Key FL JM 1912 1 470 geon PiKey PK10 Garage Building Pigeon Key Island I FL JM 1951 1 750 Pigeon PK11 Restroorn Building Peon Key Island Key FL JM 1912 1 300 Dweginq 601 Sands Rd_ Key FL 33043 CBS 1978 1 1 883 Government & Cultural UK-K14 102050 Overseas Hwy Key West FL 33040 fire resistive 2007 2 Freeman Justice Bill 302 FlemingSt KeyWest FL 33040 fire resistive 2007 3 ILK-W42 County C7ffices %639 Overseas Maranon FL 33050 fire resistive 2008 1 8 648 TBD East Martesio - CAtdiel 3501 S- Roosevelt Blvd Key West FL 33040 Static Information is based on best available information. Proposers will be required to develop their own Static Information arc incorporate it in their final report N Monroe County Property Worksheet Static Information Code Occupancy Name Address City State Dp Construction Year Suitt 1f of stories Square ISO Class f2Ltage TBD East MarteHo - Baftery 3501 S_ Roosevelt Blvd Key West EL 330At? TBD Station 6180 2nd Ave. Key 'Nest EL 33040 Static Information is based on best available information_ Proposers will be required to develop their own Static information ant incorporate it in their final report BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: Employee Services Bulk Item: Yes X No _ Department: Employee Benefits Staff Contact Person/Phone #: Maria Fernandez -Gonzalez/ Ext. 4448 AGENDA ITEM WORDING: Approval of Amendment #2 to the Monroe County Group Health Plan. In light of the adoption of the Patient Protection and Affordable Care Act ("PPACA") the Plan must be amended in certain particulars. ITEM BACKGROUND: PPACA requires plans to amend certain particulars effective January 1, 2011. Amendment #2 amends the plan to meet those requirements. PREVIOUS RELEVANT BOCC ACTION: BOCC approved amended Plan Document effective January 1, 2010 at the March 17, 2010 meeting; Amendment #1 was BOCC approved at July 21, 2010 meeting. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval Less than 1% TOTAL COST: _of wdicai costs_INDIRECT COST: N/A BUDGETED: Yes X No DIFFERENTIAL OF LOCAL PREFERENCE: N COST TO COUNTY: N/A SOURCE OF FUNDS: REVENUE PRODUCING: Yes _ No X AMOUNT PER MONTH Year APPROVED BY: County Atty B/ asing Risk Management R�P' DOCUMENTATION: Included Not Required DISPOSITION: Revised 7/09 AGENDA ITEM # C UNTYMONROE KEY WEST FLORIDA 33040 (305)294-4641 Office of the Employee Services Division Director The Historic Gato Cigar Factory 1100 Simonton Street, Suite 268 Key West, F1, 33040 aa (:300) 292--1-1)8 — Phone (305) 292-4561 - Fax " ~ - `Ay TO: Board of County Commissioners FROM: Teresa Aguiar, Direct o Employee Services V), DATE: November 23, 2010 SUBJ: Group Health Plan Document Amendment #2 BOARD OF COUNTY COMMISSIONERS Mayor Heather Carruthers, District 3 Mayor Pro Tem David Rice, District 4 Kim Wigington, District 1 George Neugent, District 2 Sylvia 1. Murphy, District 5 This item requests approval to amend the Group Employee Health Plan Document to become effective January 1, 2011. The Plan is the sole document used in determining the benefits of eligible Covered Persons under the Health Insurance Plan. The current Plan document became effective January 1, 2010. Amendment #1 was approved at the July 2 1 " meeting and became effective August 1, 2010. Due to the adoption of the Patient Protection and Affordable Care Act (PPACA), the Plan must be amended as follows: • The Plan is prohibited from levying lifetime limits on coverage. The amendment therefore revises the current limit of S 1,000,000 to unlimited. We will be soliciting providers for excess insurance in the next few months. 0 The Plan is prohibited from excluding coverage for pre-existing conditions for children (those under the age of 19). b Children aged 19 to 26, who meet the eligibility requirements, will be able to remain covered under their parent's health insurance plan. The Plan is also being revised so that there is no lifetime maximum benefit on Autism Disorders. This is a requirement and falls under the current Mental Health Parity Act. If you have any questions, please do not hesitate to contact me at X4458. Monroe County Board of County Commissioners Group Health Plan Document Amendment #2 WHEREAS, the Monroe County Board of County Commissioners ("Plan Sponsor") sponsors the Monroe County Group Health Plan ("Plan") effective January 1, 2010; and WHEREAS, the Plan Sponsor reserves the right to amend the Plan at any time; and WHEREAS, in light of the adoption of the Patient Protection and Affordable Care Act ("PPACA"), the Plan must be amended in certain particulars; and NOW, THEREFORE, pursuant to the Plan amendment provisions, the Plan shall be amended effective January 1, 2011 as follows: Page 1-2: The "Accumulated Total Lifetime Maximum Benefit" line item of Section 1 C of the Plan is amended to read as follows: "Accumulated Total Lifetime Maximum Benefit Per Covered Participant (includes medical care services & pharmaceuticals) .................. Unlimited 2. Page 1-2: The "Autism Spectrum Disorder" line item of Section 1 C of the Plan is amended to read as follows: "Autism Spectrum Disorder Per Covered Plan Participant Per Calendar Year ...... ....... $36,000" 3. Page 4-1: The Introduction section of Section 4 of the Plan is amended to read as follows: "Introduction Covered Plan Participants when initially enrolled in the Plan will be subject to a Pre- existing Condition exclusionary period, except for the following properly -enrolled individuals: newborn or adopted dependents; and individuals under the age of 19. A Covered Plan Participant with Creditable Coverage in effect for a continuous period of 12 months or longer prior to initial enrollment will not be subject to a Pre-existing Condition exclusionary period." 4. Page 7-3: The Exclusion under the "Autism" section of Section 7 of the Plan is amended to read as follows: "Exclusion — The plan will not pay for Covered Services which exceed the annual maximum for Autism Spectrum Disorder listed in the Schedule of Benefits." 5. Page 9-2: Paragraph 3a of the "Eligibility Requirements for Dependent(s)" subsection of Section 9 of the Plan is amended to read as follows: "a. is under the age of 26 or is still within the Calendar Year in which he or she reaches age 26 and who is not eligible to enroll in an eligible employer -sponsored health plan other than a grandfathered health plan of a parent; or" 6. Page 11-1: Paragraph 2 of the "Termination of a Covered Dependent's Coverage" subsection of Section 11 is amended to read as follows: "2. on the date the Covered Dependent's coverage terminates for any reason; a. As further clarification for purposes of this subsection, a Covered Dependent child who has reached the end of the Calendar Year in which he or she becomes 26, but who has not reached the end of the Calendar Year in which the Covered Dependent child becomes 30 will lose coverage if the Covered Dependent child incurs any of the following: i. marriage; ii. no longer resides in Florida or is no longer a full-time or part-time student; iii. obtains a dependent (e.g., through birth or adoption); iv. obtains other coverage; or V. on the date of termination of the Covered Employee's coverage. " PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the day of , 2010. SEAL: Attest: ME Mayor Mayor Pro Tem Commissioner Commissioner Commissioner Deputy Clerk BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Mayor/Chairperson MON9, JqE COUNTY ATTORNEY AP OV AST R 'NTH!A L. HALL ASSIST T COU � TY ATTORNEY ,jW, � Date ' c2Ejlp BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division: _Employee Services Bulk Item: Yes X No _ Department: Human Resources Staff Contact Person/Phone #Tanya Martinez X4459 AGENDA ITEM WORDING: Approval to piggyback on a competitively bid contract between Monroe County Sheriff and Key West Urgent Care to provide employment post -offer physicals. ITEM BACKGROUND: The County plans to advertise for a Request for Proposal for all services; however, at this time, we need to piggyback onto this contract until a contract is awarded with a Provider(s) and approved by the BOCC. PREVIOUS RELEVANT BOCC ACTION: N/A CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval Approximately TOTAL COST: $500.00 INDIRECT COST: BUDGETED: Yes X No DIFFERENTIAL OF LOCAL PREFERENCE: N/A COST TO COUNTY: N/A SOURCE OF FUNDS: REVENUE PRODUCING: Yes _ No X AMOUNT PER MONTH Year APPROVED BY: County Atty *Xrchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: Revised 7/ 09 AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Key West Urgent Care Contract # Effective Date: December 15, 2010 Expiration Date: September 30, 2013 Contract Purpose/Description: Provider to render employment physical services Contract Manager: Tanya Martinez 4459 Emp Services/Human Res #1 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 12/15/10 Agenda Deadline: 11-30-10 Total Dollar Value of Contract Budgeted? Yes® No ❑ Grant: $ County Match: $ Estimated Ongoing Costs: $_ (Not included in dollar value above CONTRACT COSTS $ $500.00 Current Year Portion: $ Account Codes: 001-06500-510-316- ADDITIONAL COSTS /yr For: utilities etc. CONTRACT REVIEW Changes Date Out Division Director Date In IV,29_10 . Needed Reviewer Yes❑ NoN_ t j . q. LJ Risk Management 1 O.M.B./Purc asl ig 'ate D 1---Zq- tD Yes[:] No _ Yes❑ No _ (� L) County Attorney (' ?�1' t� Yes[:] Not �' Zq' I 0 Comments: UMIJ corm Kevised l/Z-//U 1 MCP #1 AGREEMENT MONROE COUNTY CONTRACTFOR EMPLOYMENT PHYSICAL SERVICES EXHIBIT 1 Scope of Services Attachment A 2010 Contract for Medical Services (4 pages) Attachment B Written Permission from Monroe County Sheriff's office Attachment C Written Permission from Key West Urgent Care, Inc. Attachment D Report of Medical History to be reviewed by Physician Attachment E Report of Medical Examination to be completed by Physician THIS AGREEMENT ("Agreement") is made and entered into this 15th day of December, by MONROE COUNTY ("COUNTY"), a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, Florida 33040 and Key West Urgent Care ("CONTRACTOR"), whose address is 1501 Government Road, Key West, FL 33040. Section 1. SCOPE OF SERVICES CONTRACTOR shall do, perform and carry out in a professional and proper manner certain duties as described in the Scope of Services — Exhibit 1 — which is attached hereto and made a part of this agreement. CONTRACTOR shall provide the scope of services in Exhibit Al for COUNTY. CONTRACTOR warrants that it is authorized by law to engage in the performance of the activities herein described, subject to the terms and conditions set forth in these Agreement documents. The CONTRACTOR shall at all times exercise independent, professional judgment and shall assume professional responsibility for the services to be provided. Contractor shall provide services using the following standards, as a minimum requirement: A. The CONTRACTOR shall maintain adequate staffing levels to provide the services required under the Agreement. B. The personnel shall not be employees of or have any contractual relationship with the County. To the extent that Contractor uses subcontractors or independent contractors, this Agreement specifically requires that subcontractors and independent contractors shall not be an employee of or have any contractual relationship with County. C. All personnel engaged in performing services under this Agreement shall be fully qualified, and, if required, to be authorized or permitted under State and local law to perform such services. Section 2. QUALIFICATIONS NECESSARY OF CONTRACTOR The CONTRACTOR must provide an adequate staff of experienced personnel, capable of and devoted to the successful accomplishment of work to be performed under any contract with the County. Section 3. COUNTY'S RESPONSIBILITIES 3.1 Provide all best available information as to the COUNTY'S requirements for the Scope of Services described in Exhibit 1 to this Agreement. 3.2 Designate in writing a person with authority to act on the COUNTY'S behalf on all matters concerning said services. Section 4. TERM OF AGREEMENT 4.1 The initial Agreement term will be effective December 15, 2010 until September 30, 2013. 4.2 This Agreement shall be in effect until the expiration date or until either party gives the other notice of cancellation in accordance with the terms set forth below. Section 5. COMPENSATION Compensation to CONTRACTOR will be in the amount of $50 per employment physical. Section 6. PAYMENT TO CONTRACTOR 6.1 Payment will be made according to the Florida Local Government Prompt Payment Act. Any request for payment must be in a form satisfactory to the Clerk of Courts for Monroe County (Clerk). The request must describe in detail the services performed and the payment amount requested. The CONTRACTOR must submit invoices to the appropriate offices marked Group Insurance. The respective office supervisor and the Director of Employee Services, who will review the request, note his/her approval on the request and forward it to the Clerk for payment. 6.2 Continuation of this Agreement is contingent upon annual appropriation by Monroe County Board of County Commissioners. Section 7. CONTRACT TERMINATION Either party may terminate this Agreement because of the failure of the other party to perform its obligations under the Agreement. COUNTY may terminate this Agreement with or without cause upon thirty (30) days notice to the CONTRACTOR. COUNTY shall pay CONTRACTOR for work performed through the date of termination. Section 8. CONTRACTOR'S ACCEPTANCE OF CONDITIONS A. CONTRACTOR hereby agrees that he/she has the personnel, equipment, and other requirements suitable to perform this work and assumes full responsibility therefore. B. The passing, approval, and/or acceptance by COUNTY of any of the services furnished by CONTRACTOR shall not operate as a waiver by COUNTY of strict compliance with the terms of this Agreement, and specifications covering the services. C. CONTRACTOR agrees that County Administrator or his designated representatives may visit CONTRACTOR'S facility (ies) periodically to conduct random evaluations of services during CONTRACTOR'S normal business hours. D. CONTRACTOR has, and shall maintain throughout the term of this Agreement, appropriate licenses and approvals required to conduct its business, and that it will at all times conduct its business activities in a reputable manner. Proof of such licenses and approvals shall be submitted to COUNTY upon request. Section 9. NOTICES Any notice required or permitted under this agreement shall be in writing and hand delivered or mailed, postage prepaid, to the other party by certified mail, returned receipt requested, to the following: To the COUNTY: Employee Services Director 1100 Simonton Street, Suite 2-268 Key West, Florida 33040 To the CONTRACTOR: Dr. John Ray VanTuyl, MD Key West Urgent Care 1501 Government Road Key West, FL 33040 Section 10. RECORDS CONTRACTOR shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the agreement and for four years following the termination of this Agreement. If an auditor employed by the COUNTY or Clerk determines that monies paid to CONTRACTOR pursuant to this Agreement were spent for purposes not authorized by this Agreement, the CONTRACTOR shall repay the monies together with interest calculated pursuant to Section 55.03 of the Florida Statutes, running from the date the monies were paid to CONTRACTOR. Section 11. EMPLOYEES SUBJECT TO COUNTY ORDINANCE NOS. 010 AND 020-1990 The CONTRACTOR warrants that it has not employed, retained or otherwise had act on its behalf any former County officer or employee subject to the prohibition of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 020-1990. For breach or violation of this provision the COUNTY may, in its discretion, terminate this agreement without liability and may also, in its discretion, deduct from the agreement or purchase price, or otherwise recover the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. Section 12. CONVICTED VENDOR A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a Agreement with a public entity for the construction or repair of a public building or public work, may not perform work as a CONTRACTOR, supplier, subcontractor, or CONTRACTOR under Agreement with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017 of the Florida Statutes, for the Category Two for a period of 36 months from the date of being placed on the convicted vendor list. Section 13. GOVERNING LAW, VENUE, INTERPRETATION, COSTS AND FEES This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to Agreements made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the COUNTY and CONTRACTOR agree that venue shall lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. Section 14. SEVERABILITY If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The COUNTY and CONTRACTOR agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. Section 15. ATTORNEY'S FEES AND COSTS The COUNTY and CONTRACTOR agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, and court costs, as an award against the non -prevailing party. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the Circuit Court of Monroe County. Section 16. BINDING EFFECT The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the COUNTY and CONTRACTOR and their respective legal representatives, successors, and assigns. Section 17. AUTHORITY Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law. Section 18. ADJUDICATION OF DISPUTES OR DISAGREEMENTS COUNTY and CONTRACTOR agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida law. This Agreement shall not be subject to arbitration. Section 19. COOPERATION In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, COUNTY and CONTRACTOR agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. COUNTY and CONTRACTOR specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. Section 20. NONDISCRIMINATION COUNTY and CONTRACTOR agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. The parties agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VII of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination in employment on the basis of race, color, national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681- 1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of handicaps: 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101- 6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 29-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3) as amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC ss. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s. 1201), as may be amended from time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 13, Article VI, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; and 11) any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. Section 21. COVENANT OF NO INTEREST COUNTY and CONTRACTOR covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and that only interest of each is to perform and receive benefits as recited in this Agreement. Section 22. CODE OF ETHICS COUNTY agrees that officers and employees of the COUNTY recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. Section 23. NO SOLICITATION/PAYMENT The COUNTY and CONTRACTOR warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bonafide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, the CONTRACTOR agrees that the COUNTY shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration. Section 24. PUBLIC ACCESS The COUNTY and CONTRACTOR shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the COUNTY and CONTRACTOR in conjunction with this Agreement; and the COUNTY shall have the right to unilaterally cancel this Agreement upon violation of this provision by CONTRACTOR. Section 25. NON -WAIVER OF IMMUNITY Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the COUNTY and the CONTRACTOR in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any Agreement entered into by the COUNTY be required to contain any provision for waiver. Section 26. PRIVILEGES AND IMMUNITIES All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the COUNTY, when performing their respective functions under this Agreement within the territorial limits of the COUNTY shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the COUNTY. Section 27. LEGAL OBLIGATIONS AND RESPONSIBILITIES Non -Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the COUNTY, except to the extent permitted by the Florida constitution, state statute, and case law. Section 28. NON -RELIANCE BY NON-PARTIES No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third -party claim or entitlement to or benefit of any service or program contemplated hereunder, and the COUNTY and the CONTRACTOR agree that neither the COUNTY nor the CONTRACTOR or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. Section 29. ATTESTATIONS CONTRACTOR agrees to execute such documents as the COUNTY may reasonably require, including, but not being limited to, a Public Entity Crime Statement, an Ethics Statement, and a Drug -Free Workplace Statement, Lobbying and Conflict of Interest Clause, and Non -Collusion Agreement. Section 30. NO PERSONAL LIABILITY No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. Section 31. EXECUTION IN COUNTERPARTS This Agreement may be executed in any number of counterparts, each of which shall be regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by signing any such counterpart. Section 32. SECTION HEADINGS Section headings have been inserted in this Agreement as a matter of convenience of reference only, and it is agreed that such section headings are not a part of this Agreement and will not be used in the interpretation of any provision of this Agreement. Section 33. INSURANCE POLICIES 33.1 General Insurance Requirements for Other Contractors and Subcontractors. As a pre -requisite of the work governed, the CONTRACTOR shall obtain, at his/her own expense, insurance as specified in any attached schedules, which are made part of this contract. The CONTRACTOR will ensure that the insurance obtained will extend protection to all Subcontractors engaged by the CONTRACTOR. As an alternative, the CONTRACTOR may require all Subcontractors to obtain insurance consistent with the attached schedules; however CONTRACTOR is solely responsible to ensure that said insurance is obtained and shall submit proof of insurance to COUNTY. Failure to provide proof of insurance shall be grounds for termination of this Agreement. The CONTRACTOR will not be permitted to commence work governed by this contract until satisfactory evidence of the required insurance has been furnished to the COUNTY as specified below. Delays in the commencement of work, resulting from the failure of the CONTRACTOR to provide satisfactory evidence of the required insurance, shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work commenced on the specified date and time, except for the CONTRACTOR's failure to provide satisfactory evidence. The CONTRACTOR shall maintain the required insurance throughout the entire term of this contract and any extensions specified in the attached schedules. Failure to comply with this provision may result in the immediate suspension of all work until the required insurance has been reinstated or replaced and/or termination of this Agreement and for damages to the COUNTY. Delays in the completion of work resulting from the failure of the CONTRACTOR to maintain the required insurance shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work had not been suspended, except for the CONTRACTOR's failure to maintain the required insurance. The CONTRACTOR shall provide, to the COUNTY, as satisfactory evidence of the required insurance, either: • Certificate of Insurance or • A Certified copy of the actual insurance policy. The County, at its sole option, has the right to request a certified copy of any or all insurance policies required by this contract. All insurance policies must specify that they are not subject to cancellation, non -renewal, material change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given to the County by the insurer. The acceptance and/or approval of the Contractor's insurance shall not be construed as relieving the Contractor from any liability or obligation assumed under this contract or imposed by law. The Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Insured" on general liability and vehicle liability policies. 33.2 General Liability Insurance Requirements For Contract Between County And Contractor Prior to the commencement of work governed by this contract, the CONTRACTOR shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: • Premises Operations • Bodily Injury Liability • Expanded Definition of Property Damage The minimum limits acceptable shall be: $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $100,000 per Person $300,000 per Occurrence $ 50,000 Property Damage An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this contract. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. 33.3 Workers' Compensation Insurance Requirements Prior to commencement of work governed by this contract, the CONTRACTOR shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes. In addition, the CONTRACTOR shall obtain Employers' Liability Insurance with limits of not less than: $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. 33.4 Professional Liability Requirements Recognizing that the work governed by this contract involves the furnishing of advise or services of a professional nature, the Contractor shall purchase and maintain, throughout the life of the contract, Professional Liability Insurance which will respond to damages resulting from any claim arising out of the performance of professional services or any error or omission of the Contractor arising out of work governed by this contract. The minimum limits of liability shall be: $1,000,000 per occurrence and aggregate Section 34. INDEMNIFICATION The CONTRACTOR does hereby consent and agree to indemnify and hold harmless the COUNTY, its Mayor, the Board of County Commissioners, appointed Boards and Commissions, Officers, and the Employees, and any other agents, individually and collectively, from all fines, suits, claims, demands, actions, costs, obligations, attorneys fees, or liability of any kind arising out of the sole negligent actions of the CONTRACTOR or substantial and unnecessary delay caused by the willful nonperformance of the CONTRACTOR and shall be solely responsible and answerable for any and all accidents or injuries to persons or property arising out of its performance of this contract. The amount and type of insurance coverage requirements set forth hereunder shall in no way be construed as limiting the scope of indemnity set forth in this paragraph. Further the CONTRACTOR agrees to defend and pay all legal costs attendant to acts attributable to the sole negligent act of the CONTRACTOR. At all times and for all purposes hereunder, the CONTRACTOR is an independent contractor and not an employee of the Board of County Commissioners. No statement contained in this agreement shall be construed so as to find the CONTRACTOR or any of his/her employees, contractors, servants or agents to be employees of the Board of County Commissioners for Monroe County. As an independent contractor the CONTRACTOR shall provide independent, professional judgment and comply with all federal, state, and local statutes, ordinances, rules and regulations applicable to the services to be provided. The CONTRACTOR shall be responsible for the completeness and accuracy of its work, plan, supporting data, and other documents prepared or compiled under its obligation for this project, and shall correct at its expense all significant errors or omissions therein which may be disclosed. The cost of the work necessary to correct those errors attributable to the CONTRACTOR and any damage incurred by the COUNTY as a result of additional costs caused by such errors shall be chargeable to the CONTRACTOR. This provision shall not apply to any maps, official records, contracts, or other data that may be provided by the COUNTY or other public or semi-public agencies. The CONTRACTOR agrees that no charges or claims for damages shall be made by it for any delays or hindrances attributable to the COUNTY during the progress of any portion of the services specified in this contract. Such delays or hindrances, if any, shall be compensated for by the COUNTY by an extension of time for a reasonable period for the CONTRACTOR to complete the work schedule. Such an agreement shall be made between the parties. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed on the day of 20_ (SEAL) Attest: DANNY L. KOLHAGE, CLERK OF MONROE COUNTY, FLORIDA By Deputy Clerk (CORPORATE SEAL) ATTEST: By 715 rr A txvrt - U - - 20 � 0 BOARD OF COUNTY COMMISSIONERS by Mayor/Chairman KEY WEST URGENT CARE b G TOle, EXHIBIT 1 SCOPE OF SERVICES SPECIFICATIONS The services are to be provided on an as needed basis during the normal business hours of the Contractor. The Contractor shall provide post -offer physicals at the rate of $50 per physical. The forms to be reviewed and completed by the Contractor are attached to this agreement (Attachments D and E). LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE (Company) "...warrants that he/it has not employed, retained or otherwise had act on his/her behalf any former County officer or employee in violation of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision the County may, in its discretion, terminate this Agreement without liability and may also, in its discretion, deduct from the Agreement or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee." STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on (date) by personally known to me or has produced (type of identification) as identification. (Signature) Date: (name of affiant). He/She is NOTARY PUBLIC My Commission Expires: NON -COLLUSION AFFIDAVIT I, of the city of my oath, and under penalty of perjury, depose and say that according to law on I am of the firm of the bidder making the Proposal for the project described in the Request for Proposals for and that I executed the said proposal with full authority to do so; 2. The prices in this bid have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor; 3. Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid opening, directly or indirectly, to any other bidder or to any competitor; and 4. No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit, or not to submit, a bid for the purpose of restricting competition; and 5. The statements contained in this affidavit are true and correct, and made with full knowledge that Monroe County relies upon the truth of the statements contained in this affidavit in awarding contracts for said project. (Signature) STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on (date) by personally known to me or has produced (type of identification) as identification. Date: (name of affiant). He/She is NOTARY PUBLIC My Commission Expires: DRUG -FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statutes Section 287.087 hereby certifies that: (Name of Business) 1. Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Informs employees about the dangers of drug abuse in the workplace, the business' policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notifies the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6. Makes a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on to me or has produced (Signature) Date: (date) by (name of affiant). He/She is personally known (type of identification) as identification. NOTARY PUBLIC My Commission Expires: PUBLIC ENTITY CRIME STATEMENT "A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or CONTRACTOR under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." I have read the above and state that neither (Respondent's name) nor any Affiliate has been placed on the convicted vendor list within the last 36 months. STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on (date) by or has produced identification) as identification. (Signature) Date: name of affiant). He/She is personally known to me (type of NOTARY PUBLIC My Commission Expires: MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION MANUAL Indemnification and Hold Harmless For Other Contractors and Subcontractors The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the Contractor or any of its Subcontractor(s) in any tier, occasioned by negligence, errors, or other wrongful act of omission of the Contractor or its Subcontractors in any tier, their employees, or agents. In the event the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractor's failure to purchase or maintain the required insurance, the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. WORKERS' COMPENSATION INSURANCE REQUIREMENTS FOR EMPLOYMENT PHYSICAL SERVICES BETWEEN MONROE COUNTY, FLORIDA AND KEY WEST URGENT CARE Prior to the commencement of work governed by this contract, the Contractor shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes. In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than: $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. If the Contractor has been approved by the Florida's Department of Labor, as an authorized self -insurer, the County shall recognize and honor the Contractor's status. The Contractor may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Contractor's Excess Insurance Program. If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required. In addition, the Contractor may be required to submit updated financial statements from the fund upon request from the County. GENERAL LIABILITY INSURANCE REQUIREMENTS FOR EMPLOYMENT PHYSICAL SERVICES BETWEEN MONROE COUNTY, FLORIDA AND KEY WEST URGENT CARE Prior to the commencement of work governed by this contract, the Contractor shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: • Premises Operations • Products and Completed Operations • Blanket Contractual Liability • Personal Injury Liability • Professional Liability • Expanded Definition of Property Damage The minimum limits acceptable shall be: 300 000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $ 100,000 _ per Person $ 300,000 per Occurrence $_ 50,000 Property Damage An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this contract. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION MANUAL WAIVER OF INSURANCE REQUIREMENTS There will be times when it will be necessary, or in the best interest of the County, to deviate from the standard insurance requirements specified within this manual. Recognizing this potential and acting on the advice of the County Attorney, the Board of County Commissioners has granted authorization to Risk Management to waive and modify various insurance provisions. Specifically excluded from this authorization is the right to waive: • The County as being named as an Additional Insured — If a letter from the Insurance Company (not the Agent) is presented, stating that they are unable or unwilling to name the County as an Additional Insured, Risk Management has not been granted the authority to waive this provision. • The Indemnification and Hold Harmless provisions Waiver of insurance provisions could expose the County to economic loss. For this reason, every attempt should be made to obtain the standard insurance requirements. If a waiver or a modification is desired, a Request for Waiver of Insurance Requirement form should be completed and submitted for consideration with the proposal. After consideration by Risk Management and if approved, the form will be returned, to the County Attorney who will submit the Waiver with the other contract documents for execution by the Clerk of the Courts. Should Risk Management deny this Waiver Request, the other party may file an appeal with the County Administrator or the Board of County Commissioners, who retains the final decision - making authority. MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract: Contractor: Contract for: Address of Contractor: Phone: Scope of Work: Reason for Waiver: Policies Waiver will apply to: Signature of Contractor: Approved Not Approved Risk Management: Date: County Administrator appeal: Approved Not Approved Date: Board of County Commissioners appeal: Approved Not Approved Meeting Date: BIDDER SIGNATURE INSURANCE REQUIREMENTS Worker's Compensation $ 100,000 Bodily Injury by Acc. $ 500,000 Bodily Inj. by Disease, policy Imts $ 100,000 Bodily Inj. by Disease, each emp. General Liability, including $ 300,000 Combined Single Limit Premises Operation Products and Completed Operations Blanket Contractual Liability Personal Injury Liability Expanded Definition of Property Damage Professional Liability $250,000 per Occurrence and Including errors and omissions $750,000 Aggregate The Monroe County Board of County Commissioners shall be named as Additional insured on general liability policy. CONTRACT FOR EMPLOYMENT PHYSICAL SERVICES KW URGENT CARE 2010 ATTACHMENT 2010 Contract for Medical Services RECT NEAP 3 0 2010, Monroe County Sheriff's Office and Key West Urgent Care 1-Purpose: The Monroe Country, the State of Florida, requires medical efrvices for is ffice ernSlOo"e ),apolitical subdivision of a Florida corporation doing business as Key West Urgent CaresisKey West a fled a Urgent Care, to provide those services to MCSO. This Contract states the terms al the agreement lling between the parties. 2-Parties: The parties to this Contract are MCSO and Key West Urgent Car. mailing address and points of contact for the parties are: g e The Donna Moore, Executive Director of Human Resources Monroe County Sheriffs Office 5525 College Road Key West, Florida 33040 Telephone: (305) 292 7044 Facsimile: (305) 292 7159 Dr. John Ray VanTuyl, MD Key West Urgent Care IS e j -- 4�Governrnent Road Key West, FL 33040 Q U Telephone: 305-295-7550 Facsimile: VVV EIN: 3-Term: The term of this Contract begins the day when both parties have signed it It ends September 30, 2013. 4-Early Termination for Conveni Contract for any reason after ence of the parties: Either party may terminate providing sixty (60) days advance written noticeate this other party to the 5-Services and Fees: A list of the services Key West Urgent Care agrees to the fees MCSO agrees to pay for each service, provide, and is contained on the attached titled "Medical Services Provided by Key West Urgent Care and Fees for Service 6-Invoicing And Payment: Key West Urgent Care will submit invoices and MCSO on a monthly basis. be paid by Page 1 o f 1 7-Representations of Key West Urgent Care A -Audit trail: Key West Urgent Care agrees to m records sufficient to permaintain and make available it a proper audit of its performance of this Contract. B-Debarment: Key West Urgent Care represents that it has never had a contract bid or proposal rejected, suspended, or cancelled due to any allegation of a fail comply with y , failure to p y th an federal state or local government law or regulation regarding competitive bidding or auditing or accounting standards. C-Insurance: Key West Urgent Care represents that all physicians providin services under this contract are covered by medical malpractice insurance in amounts s sufficient for hospital admission in the State of Florida. Certificates of insurance for Key West Urgent Care and each medical professional are attached to this Contra by reference made a part hereof. Key West Urgent Care will main ct and malpractice coverage during the term of this Contract Key West I gen Care mu provide written notice to MCSO of any change of coverage, terms, or carrier. st 8-Indemnification: Key West Urgent Care agrees to hold harmless, indemni an defend the Monroe County Sheriffs Office, Sheriff Robert P Pe fY d is predecessors and successors in office, and each and every one of his deputies employees, and attorneys from any and all loss, damage, 1 of the provision of services pursuant to this Contract c aura or judgment arising out 9-Prohibition Against Assignment: Neither party shall assign all or any portion of duties or rights under this Contract without the prior written consent of r the other party. 10-Independent Status: Key West Urgent Care is an independent contra Neither t nor any of its personnel are employees or agents of MCSO. Neither Key WesUrgent Care nor its personnel will make any statement or representation on behalf of MCSO. 16-Paragraph Headings Not Dis ositive: The Paragraphs and other subdivisions of this Contracctear agree headin or ease o erefer gs given the are not dispositive in the interpretation of Contract language. ence only and 17-No Presumption Against Drafter: The parties agree that this Contract has bee n freely negotiated by both parties, and tha in t, any dispute over the meaning, interpretation, validity, or enforceability of this Contract or any of its terms or Provisions, there shall be no presumption whatsoever against either part, b virtue their having drafted this Contract or any portion thereof y of Page 2 of 2 J! 18-Goverillg Law and Venue: This Contract shall be construed, interpreted, governed by the laws of the State of Florida. Venue for any litigation ng nsi outd of this Contract will be in Monroe County, Florida. 19-Entire Agreement: This Contract expresses the complete and final and the parties hereto, that any and all negotiations and representations not girded herein of n or referred to herein are hereby abrogated and that this Contract cannot be changed, modified or varied except by a written instrument signedIncluded herein by all parties hereto. Theare no private" or "side agreements." Z0-Authority of Signatories: The persons sung this Contract re resent authority to bind their principles its terms. P that they UNDERSTOOD AND AGREED TO THI,�;& DAY OF X�CL KEY WEST URGENT CARE , 2010. MC ROE COUN / FF'S OFFICE Authorized represe tive r" Au orized representative Printed name and title Witnesses as to Key West U Page 3 of 3 Printed name and title -Medical Services Provided & Fees for Service Physical ----" --- __ � Key West Urgent Care - _ _ _ EKG $50 - -- --- TB Test _ __ _ _ S50 _ - ___--"_"----- Urinalysis 530 -- Complete Blood Count (CRC) i 540 Comprehensive Metabolic Panel (CMP) Drug Test (10 Panel) $40 -- - ---- ___ _. $50 Drug Test Collection only I --------- -- - --1 $20 -- - --- -- — 1 Hep BVaccination — $155 each injection (3) *Fitness for Duty $90/no charge if done with *Consultation with Sheriff - --- ____physical Designee *Stress Test -- ----- -- - ----- ---- *SPlrometry (Respirator test) $50 "Range of Motion Tert - -- "- "- --- --- 'Audlogram—_-------- ------ S15 [*Hep B Surface Antibody —� - --- - ---- *If Applicable Total Cost _ Annual Physicals $220 $270 - --- �aa CONTRACT FOR EMPLOYMENT PHYSICAL SERVICES KW URGENT CARE 2010 ATTACHMENT B Sherif SUBSTATIONS Freeman Substation 20950 Overseas Hwy. Cudjoe Key, FL 33042 (305)745-3184 FAX (305) 745-3761 Marathon Substation 3103 Overseas Hwy. Marathon. FL 33050 (305) 289-2430 FAX (305) 289-2497 Islamorada Substation 87000 Overseas Hwy, Islamorada, FL 33036 (305)853-7021 FAX (305) 853-9372 Roth Building 50 High Point Roa Tavernier. FL 33070 (305)853-3211 FAX (305) 853-3205 DETENTION CENTERS Key West Det. Center 5501 College Road Key West, FL 33040 (305) 293-7300 FAX (305) 293-7353 Marathon Det. Facility 3981 Ocean Terrace Marathon, FL 33050 (305)289-2420 FAX (305) 289-2424 Plantation Det. Facility 53 High Point Road Plantation Key, FL 33070 (305) 853-3266 FAX (305) 853-3270 October 26, 2010 31 onroe County Sheriffs office Robert T. Teryam, Sheriff 5525 (ofrege Fwad ?,ey TL'est, 'Florida .33040 (305) 292-7000 TAX (305) 292-7o70 1-800-27.3-CO,^ ttrarur. kysso. net Dr. John Ray VanTuyle Attention: Jante VanTuyle — Officer Manager Key West Urgent Care 1501 Government Road Key West, FL 33040 RE: Monroe County Board of County Commissioners Dear Mrs. VanTuyle: Please be advised that the Monroe County Sheriff's Office (MCSO) is authorizing the Board of County Commissioners (BOCC) to utilize the services outlined in the MCSO contract with Key West Urgent Care. The Monroe County Sheriffs Office will not be responsible for payment for services rendered to BOCC employees and/or applicants. Billing for services for BOCC employee and/or applicants should be sent to: Board of County Commissioners Teresa Aguiar, Employee Services Director 1100 Simonton Street — Room 2-268 Key West, FL 33040 Please contact me if you have any questions or require additional information at (305) 2927044. SPECIAL OPERATIONS a -P.O. Box 500975 Marathon, FL 33050(305)289-2410 FAX (305) 289-2498 AVIATION DIVISIONMoore, Executive Director 10100 Overseas Hwy, Marathon. FL 33050 (305) 289-2777 FAX (305) 289-2776 cc: Teresa Aguiar, Employee Services Director COMMUNICATIONS 2796 Overseas Hwy. Marathon, FL 33050 (305) 289-2351 ( = t t t t FAX (305) 289-2493 Sziun_nRx in v_ ACRe&btlm CoNGtiMioo CONTRACT FOR EMPLOYMENT PHYSICAL SERVICES KW URGENT CARE 2010 ATTACHMENT C Aguiar-Teresa From: Janet Van Tuyl 0lv_kwuc@bellsouth.net] Sent: Monday, November 08, 2010 1:57 PM To: Aguiar-Teresa Subject: RE: Physicals Teresa, We are happy to perform physicals for the BOCC under the same contract as agreed to with the MCSO. The attached physical will be completed with the exception of #18 (we will be able to remark on any dental disease or defect),# I 9A(4),B,C,D,E,F, #29,#30, #31, #32, #34, #36, #37, #38, #41. These portions were not agreed to with the MCSO or were not requested by the BOCC. This physical will be done for $50 each. If a urine drug screen is required it will be an additional $50 each. Let me know if this needs to be changed in any way. Thank you for your business, Janet Van Tuyl Key West Urgent Care, Inc. Wk S � 1501 Government Roads � Key West, FL 33040�� Phone: 305-295-7550 y t Fax: 305-296-3010 Y ✓" Email: ilv kwuc(d/;bellsouth.net --- On Mon, 11/8/10, Aguiar-Teresa<Aguiar-Teresa(&NonroeCounty-FL.Gov> wrote: From: Aguiar-Teresa<Aguiar-Teresa�MonroeCounty-FL.Gov> Subject: RE: Physicals To: "'Janet Van Tuyl"' <jlv_kwucC(�bellsouth.net> Date: Monday, November 8, 2010, 12:31 PM Hello Janet: I'm going to give your office a call as well in case you don't get this email. I can't do 9am in the morning. I have to take my father for an 8:30 appt that I just was informed of. If you can do the afternoon of Tuesday or anytime Wednesday that would be great. Sorry about that. Please let me know. From: Janet Van Tuyl [mailto:jlv_kwuc@bellsouth.net] Sent. Thursday, November 04, 2010 10:57 AM To. Aguiar-Teresa Subject: Physicals Teresa, Please give me a call when you get back in the office regarding the BOCC physicals. I have questions regarding what you want to do about the chest xrays, vision tests, audiometry, and lab tests. Thank you, Janet Van Tuyl Key West Urgent Care, Inc. 1501 Government Road Key West, FL 33040 Phone: 305-295-7550 Fax: 305-296-3010 Email: jlv kwuc(i-pbelIsouth. net Please take a moment to complete our Customer Satisfaction Survey: http://monroecofl.virtualtownhall.net/Pages/MonroeCoFL WebDocs/css Your feedback is important to us! Please note: Florida has a very broad public records law. Most written communications to or from the County regarding County business are public record, available to the public and media upon request. Your e-mail communication may be subject to public disclosure. CONTRACT FOR EMPLOYMENT PHYSICAL SERVICES KW URGENT CARE 2010 ATTACHMENT A MEDICAL RECORD I REPORT OF MEDICAL HISTORY NM: This inf rmation Is for official -and medically.confidential use only and will not be re eased to unauthorized persons 1 NAME OF PATIENT Vast, lirst, mrdd/el 2. IDENTIFICATION NUMBER - Position 4a. HOME STREET ADDRESS Street w RFD; City or Town. State; and ZIP Code/ 5. EXAMINING FACILITY 6. PURPOSE OF EXAMINATION 7. STATEMENT OF PATIENT'S PRESENT HEALTH AND MEDICATIONS CURRENTLY USED /Use additional pages if necessary/ a. PRESENT HEALTH b. CURRENT MEDICATION REGULAR OR INTERM. c. ALLERGIES (Include Insect bites/stings and common foods) d. HEIGHT e. 8. PATIENT'S OCCUPATION YUU ec. one 11 RIGHT HANDED LEFT HANDED 1 U. PAS I /CUHHtN I MtL)lUAL 111b I UtiY CHECK EACH 11EM YES NO DON'T KNOW CHECK EACH ITEM YES NO DON'T KNOW CHECK EACH ITEM YES NO DON'T KNOW Household contact with anyone with tuberculosis Shortness of breath Bone, joint or other deformity Pain or pressure in chest Loss of finger or toe Tuberculosis or positive TB test Chronic cough Painful or 'trick' shoulder or elbow Blood in sputum or when coughing Palpitation or pounding heart Heart trouble Recurrenr back pain or any back injury — Excessive bleeding after injury or denial work High or low blood pressure Cramps in your legs 'Trick' or locked knee Suicide attempt or plans Frequent indigestion Foot trouble Sleepwalking Stomach, liver or intestinal trouble Nerve Injury Wear corrective lenses Gall bladder trouble or gallstones Paralysis (including infantile) Eye surgery to correct vision Epilepsy or seizure Lack vision in either eye Jaundice or hepatitis Car, train, sea or air sickness Wear a hearing aid Broken bones Frequent trouble sleeping Stutter or stammer Adverse reaction to medication Depression or excessive worry Wear a brace or back support Skin diseases Loss of memory or amnesia Scarlet fever Tumor, growth, cyst, cancer Nervous trouble of any sort Rheumatic fever Hernia Periods of unconsciousness Swollen or painful joints Hemorrhoids or rectal disease parent/sibling with diabetes, cancer, stroke or heart disease Frequent or severe headaches Frequent or painful urination Dizziness or fainting spells Bed wetting since age 12 X-ray or other radiation therapy Eye trouble Kidney stone or blood in urine Chemotherapy Hearing loss Sugar or albumin in unno Asbestos or toxic chemical exposure Recurrent ear infections Sexually transmitted diseases Chronic or frequent colds Recent gain or loss of weight Plate, pin or rod in any bone Severe tooth or gum trouble I Eating disorder ;anorexia bulimia. i etc -I _ _ Arthritis, Rheumatism, or Bursitis _ _ Easy fatigability Sfnusrtis Been told to cut down or criticized for alcohol use Hay fever or allergic rhinais _ Head injury { Used illegal substances Asthma ', Thyroid trouble or goiter Used tobacco NSN 7540-00-181-6368 or1 -.1 - 1nc1 o wr Previous edition not usable Prescribed by ICMR/GSA FIRMR (41 CFRI 201-9 202-1 11 . FEMALES ONLY CHECK EACH ITEM YES NO DON'T KNOW DATE OF LAST MENSTRUAL PERIOD N/A GATE OF LAST PAP SMEAR N/A JDATE OF LAST MAMMO- GRAM N/A Treated for a female disorder N Change in menstrual pattern N/ LHtCK EACH IIEM. IF -Yto EXPLAIN IN BLANK SPACE IO RIGH I. LISI EXPLANATION BY If EM NUMBER, ITEM 12. Have you been refused employment or been unable to hold a job or stay in school because of: a. Sensitivity to chemicals, dust, sunlight, etc. b. Inability to perform certain motions. c. Inability to assume certain positions. d.Other medical reasons (If yes, give reasons./ 13, Have you ever been treated for a mental condition? (If yes, specify when, where, and give details-) 14. Have you ever been denied Ufa Insurance/ (If yes, state reason and give details./ 15. Have you had, or have you been advised to have, any operation. (If yes, describe and give age at which occurred./ 16. Have you ever been a patient in any type of hospital (If yes, specify when, where, why, and name of doctor and complete address of hospital) 17, Have you consulted or been treated by clinics, physicians, healers, or other practitioners within the past 5 years for other than minor illnesses? (If yes, give complete address of doctor, hospital, clinic, and details./ 18. Have you ever been rejected for militaryservice because of physical, mental, or other reasons? Of yes, give date and reason for rejection./ 19. Have you ever been discharged from military service because of physical, mental, or other reasons? (If yes, give date, reason, and type of discharge; whether honorable, other than honorable, for unfitness or unsultability.l 20. Have you over received, is there pending, or have you ever applied for pension or compensation for existing disability? //f yes, specify what kind, granted by whom, and what amount, when, why,/ 22. Have you ever been diagnosed with a learning disability? pf yes, give type, where, and how diagnosed./ 23 LIST ALL IMMUNIZATIONS RECEIVED certify that I have reviewed the foregoing information supplied y me and that It Is true and compete to the best of my knowledge. I authorize any of the octors, osprta s, or clinics mentioned above to furnish the Government a complete transcript of my medical record for purposes of processing my application for this employment or service. I understand that falsHication of information on Government forms is punishable by fine and/or imprisonment. 24a. TYPED OR PRINTED NAME OF EXAMINEE 124b. SIGNATURE 124r. OATF NOTE: HAND TO THE DOCTOR OR NURSE, OR IF MAILED MARK ENVELOPE "TO BE OPENED BY MEDICAL OFFICER ONLY". 25. PHYSICIAN'S SUMMARY AND ELABORATION OF ALL PERTINENT OATH (Physician shall comment on all positive answers in Items 7 through 11. Physician may develop by interview any additional medical history deemed Important, and record any srgndiciant findings here./ 26a. TYPED OR PRINTED NAME OF PHYSICIAN OR EXAMINER 126b. SIGNATURE 26c GATE STANDARD FORM 93 IREV, 6-96I BACK CONTRACT FOR EMPLOYMENT PHYSICAL SERVICES KW URGENT CARE 2010 ATTACHMENT E DATE OF EXAM MEDICAL RECORD REPORT OF MEDICAL EXAMINATION I 1 . LAST NAME - FIRST NAME - MIDDLE NAME 2. IDENTIFICATION NUMBER 3. posit ion 4. HCME ADDRESS (Number, sbeetorRFD, city ortown, state andZlP Co(je) 5, EMERGENCY CONTACT (Name and address ofcontad) 6. DATE OF BIRTH 7. AGE 8. SEX 9. RELATIONSHIP OF CONTACT FEMALE MALE 10 PLACE OF BIRTH 11. RACE AMERICAN INDIAN/ HISPANIC HISPANIC HISPAASIAN/PACIFlC WHITE BLACK gLASKq NATIVE WHITE BLACK ISLANDER 12a. AGENCY 12b. ORGANIZATION UNIT 13. TOTAL YEARS GOVERNMENT SERVICE a. MILITARY b, CIVILIAN 14_ NAME OF EXAMINING FACILITY OR EXAMINER, AND ADDRESS 15. RATING OR SPECIALTY OF EXAMINER 16, PURPOSE OF EXAMINATION MAL (Check each item In appropriate column, enter *NE` if not evaluated.) M MAI. (Check each item In appropriate column, enter *NE'ff M evaluated.) MAL A. HEAD, FACE, NECK AND SCALP O. PROSTATE (Over40 or clinically indicated) B. EARS - GENERAL (INTERNAL CANALS) (Auditory acuity under Items 39 and 40) P. TESTICULAR R. ENDOCRINE SYSTEM C. DRUMS (Perforation) D, NOSE S. G-U SYSTEM E. SINUSES T. UPPER EXTREMITIES (Strength, rangeotmotion) F. MOUTH AND THROAT U. FEET G. EYES - GENERAL rvt ual acwtyand refractor under rtenv 28, 29, and 36) V. LOWER EXTREMITIES (Except feet) (Strength, range ofmotion) H. OPTHALMOSCOPIC W. SPINE, OTHER MUSCULOSKELETAL 1. PUPILS (Equalftyandreaction) X. IDENTIFYING BODY MARKS, SCARS, TATTOOS J. OCULAR MOTILITY (Associated parallel movements nystagmus) Y. SKIN, LYMPHATICS K. LUNGS AND CHEST Z. NEUROLOGIC (Equilibrium tests under Rem 41) L. HEART (Thrust, size, rh)thm, sounds) AA. PSYCHIATRIC (Speciryany personaklydeviatkm) M. VASCULAR SYSTEM (Varicosities, etc.) N. ABDOMEN AND VISCERA (include hernia) NU I t 5: (uescnoe every dunwrrewny nr ueoan. —1-1 I,o.1.1,o,,. „o„ 18, DENTAL (place appropriate symbols, shown In exampiewabie]sabove or below number of upper and ewer teem.) � ReTedh 1 ^Teeth -��i 40 'j2 31 30 rest�hfe -N Xi 35 Da�e t��3i-34i—� Dentwes /t R L 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 E G 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 F T H T REMARKS AND ADDITIONAL DEFECTS AND DISEASES 19. TEST RESULTS (Copies of results are preferred as attachments) A URINALYSIS (1) SPECIFIC GRAVITY B CHEST X-RAY OR PPD (Place, date, fllm number and resuft) (2) URINE ALBUMIN (4) MICROSCOPIC wo 0 (3) URINE SUGAR D C SYPHILIS SEROLOGY (Specify test used EKG E. BLOOD TYPE AND RH F OTHER TESTS and results) FACTOR NO �� �d 8& 126 ['e"nad u,mp Perform Pro, WTistDOR ,ten 97 STANDARD FORM 88 (Rev 10-94) (EG) Prescribed by GSA/ICMR FIRMR (41 CFR) 201.9 202.1 t MEASUREMENTS AND OTHER FI NO. OF SHEETS ATTACHED 20 HEIGHT 21 WEIGHT 172.2-,735LORHWAIR j23,COLOREYE_S_T_24 25. TEMPERATURE SLENDER MEDIUM HEAVY OBESE 26- BLOOD PRESSURE (Aim atheari ieN3l) 27. PULSE (Aim at heart klv"I) A SYS. B. RECUM SYS. C STANDING SYS. A. SITTING 8 RECUMBENT C. STANDING EXERCISE E, 2 MINS. AFTER DIA$ DIAS SITTING BENT OIAS, (5 m�s.) (3mins) jD,ArTER 28, DISTANT VISION 29. REFRACTION 30 NEAR VISION RIGNT 201 CORR. TO 201 BY S. CX CORR, TO BY LEFT 201 CORR TO 201 BY S, CX CORR. TO BY I V U ESO EXO R H. L H PRISM DIV PRISM CONV. PC P O CT 32 ACCOMMOOATION tS1Q 33 COLOR VISION (Test used and resin) 34. DEPTH PERC P ON UNCORRECTED RIGHT LEFT (Test used and scare) CORRECTED 35. FIELD OF VISION 36. NIGHT VISION (Test usedandsowe) 37. RED LENS TEST 38- INTRAOCULAR TENSION RIGHT LEFT N D ^ I O RIGHT LEFT 39, HEARING 40, AUDIOMETER 41. PSYCHOLOGICAL AND PSYCHOMOTOR (Tests used and scare) RIGHTVWV i15SV 15 250 500 1000 2000 3000 ! 4000 6000 8000 �4 256 512 1024 2048 2896 4096 6144 8192 LEFT wN 115SV f15 RICH LEFT 42. NOTES (Continued) AND SIGNIFICANT OR INTERVAL HISTORY (Use additkinal sheets d necessary 43. SUMMARY OF DEFECTS AND DIAGNOSES (List diagnoses with Item numbers) 44. RECOMMENDATIONS -FURTHER SPECIALIST EXAMINATIONS INDICATED (SpAc ify) 45A. PHYSICAL PROFIT F P U L H E S 46. EXAMINEE (Check) A. IS QUALIFIED FOR In accordance with attached job B ISNOTOUALIFIEOFOR description 458. PHYSICAL CATEGORY 47. IF NOT QUALIFIED, LIST DISQUALIFYING DEFECTS BY ITEM NUMBER A B C E 48. TYPED OR PRINTED NAME OF PHYSICIAN SIGNATURE 49_ TYPED OR PRINTED NAME OF PHYSICIAN SIGNATURE 50 TYPED OR PRINTED NAME OFOENTIST OR PHYSICIAN (indicate which) SIGNATURE 51, TYPED OR PRINTED NAME Of REVIEVNNG A NG OFFICER OR APPROVIUTHORI SIGNATURE a I ANUAKU tVKM 53 (Rev, 10-94) t3ACK BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December IS 2010 Division: Employee Services Bulk Item: Yes X No — Department: Human Resources Staff Contact Person/Phone #Tanya Martinez X4459 AGENDA ITEM WORDING: Approval of changes to the Monroe County Personnel Policies and Procedure Manual as recommended by the Policies and Procedures Board. ITEM BACKGROUND: Monroe County Code Section 2-214 established a seven -member Personnel Policies and Procedures Board. The members: 3 members elected by the Employee Relations Committee, 1 supervisor, 1 middle manager, 1 Division Director and the Director of Human Resources. This Board is tasked with reviewing all proposed changes from the employees prior to presentation to the Board of County Commissioners. PREVIOUS RELEVANT BOCC ACTION: Last revision to the policy was November 18, 2009. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval Addl Approx. TOTAL COST: $1,550.00 INDIRECT COST: _None BUDGETED: Yes No _ DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: N/A SOURCE OF FUNDS: REVENUE PRODUCING: Yes _ No X AMOUNT PER MONTH Year APPROVED BY: County Atty t B/P ur asing Risk Manag ement DOCUMENTATION: Included Not Required DISPOSITION: AGENDA ITEM # Revised 7/09 C UNTYMONROE KEY WEST FLORIDA 33040 (305) 294 - 4641 Office of the Employee Services Division Director The historic Gato Cigar Factory 1100 Simonton Street, Suite 268 Key West, FL :3:30tA (305) 292--1-1,58 — Phone (305) 292--r-)61- Fax BOARD OF COUNTY COMMISSIONERS Mayor Heather Carruthers, District 3 Mayor Pro Tem David Rice, District 4 Kim Wigington, District 1 George Neugent, District 2 Sylvia 3. Murphy, District 5 TO: Board of County Commissioners DATE: November 29, 2010 FROM: Teresa E. Aguiar, Employee Services Direc )�� SUBJ: Personnel Policies and Procedures revisions This item requests approval of the revisions approved by the Personnel Policies and Procedures Board. In accordance with Monroe County Code Section 2-214, this Board, made up of 3 members elected by the Employee Relations Committee, one supervisor, one middle manager, one Division Director and the Human Resources Director. They are tasked with reviewing all proposed changes from the employees prior to presentation to the BOCC for approval. The Board met on three different occasions this year and has approved these changes for your review and final approval. Recap of Significant changes to the Personnel Policies & Procedures Manual Board of County Commissioner Meeting — December 15 2010 Changes of a housekeeping nature (spelling, grammar, consistency, capitalization, rearrangement of items for clarifications, updating current source number of Ordinances and regulations and title changes) are not considered significant. 1.01 B (Page 9) Career Service — A correction to this section deleting "full time". This is not a requirement under the Career Service Council Act. 1.01 C (Page 9) Contract Employee — A correction to this section deleting "prior to" and replacing with "after". A contract employee cannot attain career service status, therefore h/she could not have had a probationary period while being employed under a contract. 2.03 B (page 14) Substitute Employee — A clarification so that it is understood that a substitute employee employed for more than 12 months would attain career service status. 2.15 (page 22) Years of Service Program — Clarification of the current responsibilities of Human Resources and the departments. Currently an employee reaching 35 years of service is not recognized under this Program. The addition was made so that an employee would be recognized with a $1,500 award and an engraved Lucite Desk clock (under the price of $50). The recognition of a 35 year employee is recommended to be Effective August 1, 2010 so that an employee already reaching this milestone can be recognized under this Page 1 of 2 Page 2 of 2 1 1/29/10 PPP changes BOCC meeting 12-15-10 Program. The PPP Board decided to make a recommendation in the near future to recognize a 40 year employee 10.01 D (page 62 & 63) Addition of wording "reduction in pay". This action is also currently appealable under the Career Service Council Act. Correction made to reflect the current number of the reference to the Administrative Instruction. Section 15.01 B & C was also discussed and approved to be changed, however it is being addressed under a Resolution (which will include additional changes) to be presented to the Board by the County Attorney for further consideration. If you have any questions on this item, please do not hesitate to contact me at X4458. rt�,xbVNNEL POLICIES & PROCEDURES MANUAL Table of Contents Sections Pages Preamble, .......... 2-3 :fission, Vision and Value Statements............ Introduction .................. .. ........... 1. General Policies .................. .............................. ............... 9-12 2. Employment Policies...................................... ............ 3. Classification plan. . ............ 4. Pay Plan........................................................................2 5-3 0 5. Hours of Work.................................................................3 1-3 3 6. Holidays.................................................................... ....34-35 7. Leave with Pay.................................................................3 6-40 8. Leave of Absence ..... .................. ....................................... 41-53 9• Standards of Employment, Disciplinary ructions & Appeals. .... , * ....... 54-60 10. Employee Complaint/Grievance Procedure ......................... • ......61-62 11. Separations. ............. .................... 12. Soliciting........................................................................64 13. Employee Performance Evaluations.........................................65 14. Employee Insurance Coverage....... 15. Travel............................................................................7 0 16. Appearance.....................................................................71 17. Violence in the Workplace ............................... ............... .......72-73 18. Children in the Work Environment........... , 19• Cash %lanagement Procedures ................................. 20. Fire alarm Procedures ............. . . . . . 1 of 77 PREAMBLE i\DMINISTRATION CODE OF ETHIC'S An employee in the public service must always demonstrate the highest standards of personal integrity, truthfulness, honesty and fortitude in all public activities in order to inspire public confidence and trust in public institutions. Perceptions of others are critical to the reputation of an individual or a public agency. Nothing is more important to public administrators than the public's opinion about their honesty, truthfulness and personal integrity. It overshadows competence as the premier value sought by citizens in their public officials and employees. Any individual or collective compromise with respect to these character traits can damage the ability of an agency to perform its tasks or accomplish its mission. The reputation of the administrator may be tarnished. Effectiveness may be impaired. A career or careers may be destroyed. The best insurance against loss of public confidence is adherence to the highest standards of integrity, honesty, truthfulness and fortitude. Public administrators are obliged to develop civic virtues because of the public responsibilities they have sought and obtained. Respect for the truth, for fairly dealing with others, for sensitivity to rights and responsibilities of citizens and for the public good must be generated and carefully nurtured and matured. If one is responsible for the performance of others, the reasons for the importance of integrity must be shared with them. They must be held to high ethical standards and taught the moral as well as the financial responsibility for the public funds under their care. If one is responsible only for his or her performance, then he or she must not compromise honesty and integrity for advancement, honors, or personal gain. We must strive to be discreet, respectful of proper authority and our appointed or elected superiors, and sensitive to the expectations and the values of the public we serve. We must practice the Golden Rule: doing to and for others what we would have done to and for us in similar circumstances. One should be modest about his or her talents, letting the work speak for itself and be generous in their praises of the good work of our peers and associates. We must be ever mindful to guard the Public Purse as if it were our own. No matter whether an official or an employee, by our own example, we should give testimony to our regard for the rights of others, acknowledging their legitimate responsibilities and not trespassing upon them. We must concede gracefully, quickly and publicly when we have erred and be fair and sensitive to those who have not fared well in their dealings with our agencies and their applications of the law, regulations, or administrative procedures. The only gains one should seek from public employment are salaries, fringe benefits, respect and recognition for work. One's personal gains may also include the infinite pleasure of doing a good job, helping the public, and achieving career goals. No elected or appointed public servant should borrow or accept gifts from the staff or any corporation which buys services from, or sells to, or is regulated by his or her governmental agency. If one's work brings him or her in frequent contact with firms supplying the government, he or she must be sure to pay his or her own expenses. 2 of 77 Public property, funds and power should never be directed toward personal or political gain. We must make it clear by our own actions that we will not tolerate any use of public funds to benefit one's self, family or friends. And finally, we must serve the public with respect, concern, courtesy and responsiveness, recognizing that service to the public is beyond service to oneself. END 3 of 77 70 J'A i le Li mp mnyrro The mission of Monroe County is to provide outstanding public service responsive to the needs of our citizens, our unique community, and our environment. VISIQN STATEMENT Utopia in the Florida Keys - Working and learning, together to -maintain the diverse community by pre serving the natural resources and habitat that makes us a unique and preferred place to live and visit! YULE UATEMENTS- - We Believe in the Highest of.Eth cal Behavior as -we Sail the Seven "C"'s. Competence _— knowledge. We encourage a competent workforce through continuing education and training: Knowedge adds value to the services we provide and increases employee and citizen satisfaction. Creative -- new ideas. We are open to new ideas. We believe in taking fresh approaches to overcome challenges while striving to add value to the services we provide to our community: Committed. - career as a calling to public service. We believe that service togoveis the ,highest career calling. --A professional attitude imposes a pledge of excellent performance with a commitment to the organization. Concern7 fiscal responsibility. We believe fiscal responsibility_ demonstrates out respect for the citizens whose- taxes support our organization,. Fiscat responsibility recognizes that most problems cannot be solved by money alone; however, take seriously our task to safeguard the public trust. Care — positive and supportive work environment. We provide a positive work environment_: for our employees_ by recognizing their needs and allowing a balance with their professional and personal lives. We treat everyone with respect. We are compassionate and responsive to the needs of all citizens. Communication .— exchange of ideas: We believe that two. way communications amongst our organization, our employees, and our citizens is essential. We encourage feedback and the sharing of ideas. By working together, we can share information and improve our services through open government: Cont_ inu�ty — fairness, equality and sustaitiability. We believe in fairness = and equality and place emphasis on truth and honesty in all of our actions: Through the use of strategic planning we ensure the continuity and sustainability of County services and programs. _ W 4 of 77 INTRODUCTION INTENT It shall be the intent of the Board of County Commissioners and other grants, agencies or elected officials who so request to adopt these policies and procedures that: A. The employees of Monroe County are productive persons who perform useful County functions. B. There shall be no employees on the County payroll for whom there is no employment need. C. All officials and employees shall comply with and assist in carrying out the personnel program. D. All appointments to the County Service are to be made in accordance with the rules, regulations and procedures established and adopted by the Board of County Commissioners. E. These Policies and Procedures generally cover the information concerning the policies, regulations and benefits for the employees of Monroe County. These Policies and Procedures and the representations made in them do not constitute any form of employment contract or guarantee. If an employee seeks information which is not covered in these Policies and Procedures, or if an employee wishes clarification of any policy or procedure, he or she should check with his or her Supervisor and/or Department Head. The County, of course, may change its Policies and Procedures with regard to matters covered herein and such changes may not be reflected in these Policies and Procedures at the time the employee reads them. Existing policy as determined from time to time by the County Administrator or the Board of County Commissioners shall supersede any written information previously distributed to employees. F. In accordance with Ordinance #038-1988, the Board of County Commissioners established a Personnel Policies and Procedures Review Board whereby any employee may submit proposed changes to the Monroe County Personnel Policies and Procedures to the Human Resources office at any time. Proposed changes will be discussed by the Review Board and recommendations will be made to the County Administrator who will review said recommendations for his approval. If there are any recommendations that do not meet with the approval of the Administrator, those changes will again be reconsidered by the Review Board. If approved, said changes will be presented to the Board of Commissioners for a final decision. If there is one or more proposed changes on which the Review Board and the Administrator cannot agree, the final decision will be made by the Board of Commissioners. These changes will be adopted by resolution. Forms for proposed changes may be obtained in the Human Resources office. SCOPE For the purpose of expediency, these policies may refer to either the male or female gender, or both with no intent to discriminate. All policies apply to both genders. The personnel policies, regulations and procedures as adopted shall apply to all personnel in the County Service falling under the jurisdiction of the Board of County Commissioners and any other agency grant, board or department which so requests. Any action which these procedures authorize to be taken at a particular level of authorization may be initiated or taken by anyone in a position of higher authority, within the chain of command. 5 of 77 THE COUNTY SERVICE The County Service shall consist of all existing positions and any positions hereinafter created in the County with the following exemptions: A. The Board of County Commissioners and any positions which are exempt under Chapter 69-1321, Section 3, Laws of Florida. B. Other elected officials. C- Members of Boards, Committees and Commissions, unless they are also County employees. D. Persons employed in a professional capacity on a contractual, fee or retainer basis or hired to perform specific services, as defined herein, including but not limited to investigations or inquiries on behalf of the County Commissioners, or a committee thereof, or other elected officials. E. Volunteers. HUNL-kN RESOURCES It is the responsibility of the County Administrator to render service to the County government in the fields of personnel management and employee relations, and to ensure uniform, fair and efficient personnel administration. In this regard, the County Administrator shall establish and oversee the administration of a Human Resources office, through the Division of Employee Services. In addition to the duties imposed by personnel policies and regulations, it is the responsibility of the County Administrator, through the Human Resources office, to: A. Apply and carry out personnel policies and regulations as adopted by the Board of County Commissioners. B. Foster and develop programs for the improvement of employee effectiveness and morale. C. Conduct evaluations and studies to determine the effectiveness of the personnel program, and periodically submit a report of findings and recommendations to the Board of County Commissioners. D. Ensure that all personnel have been employed in accordance with the provisions of personnel policies and procedures. E. Maintain a classification plan for all employees in the County Service. F. Maintain a pay plan for all employees in the County Service. G. Develop and admituster tests and examinations as deemed necessary to determine the fitness and abilities of applicants for jobs in the County Service, and promotional opportunities. H. Prepare, or have prepared, and submit to the Board of County Commissioners, corrected, revised or additional personnel policies and procedures for their approval. I. Perform any other lawful acts considered necessary to carry- out the purpose and provisions of the personnel policies and procedures. J. Perform interviewing, background investigations and otherwise pre -qualifying candidates for County employment. 6 of 77 K. Prepare any County Affirmative Action Plan. L. Recruit qualified applicants to fill departmental vacancies. M. Perform induction of all newly -hired personnel including completion of required personnel and payroll forms, arranging physical examinations and providing employee orientation. N. Provide staff support to the Board of County Commissioners in regard to personnel matters. O. Administer B.O.C.C. adopted drug and alcohol programs. RECORDS OF HUMAN RESOURCES The efficient administration of the County's Human Resources office depends on accurate information about the County and each of its employees. In order to keep personnel records up to date, employees must notify their Supervisor and the Human Resources office immediately of any change of name, address, telephone number, whom to contact in case of emergency, insurance beneficiaries, dependents eligible for family coverage of insurance, information for income tax withholding, driving status and other similar information. The County respects the privacy of its employees' rights and, in this regard, will keep all information in its personnel files confidential -- to the extent permitted under Florida law. All requests from sources outside the County for personnel information concerning applicants for employment, current employees, and former employees shall be directed to the Human Resources Office. The Human Resources office will release information to outsiders in accordance with the standards as set forth in Administrative Instruction 4901 RISK MANAGEMENT - SAFETY/LOSS CONTROI A. RISK MANAGEMENT It is the responsibility of the County Administrator to protect the County from financial loss due to public liability exposures and/or property damage. This may be accomplished by either the utilization of fully insured or self -insured programs or policy contracts, as approved by the Board of County Commissioners. The Risk Management office will maintain all insurance policies, property schedules, etc., and will properly distribute all insurance premiums to the budgetary units. The County Administrator will institute recognized risk management techniques, with the cooperation of all Division and Department Heads, the County Attorney's office, and Constitutional Officers (where applicable), to further identify potential exposures, recommending to the County Commission the best course of action to properly protect the interests of Monroe County. INSURANCE A. EMPLOYEE BENEFITS (Group Insurance and Workers Compensation) The County Administrator will oversee all employee benefit programs, including, but not limited to Life Insurance and Health Insurance for Board employees, as well as Constitutional Officer employees (if participated in by those entities). All enrollment records, claim files and the proper distribution of expenses will be assigned to Employee Benefits, with final approval of program types and levels of benefits remaining with the Board of County Commissioners. 7 of 77 B. SELF -FUNDED PROGRAMS Where the Board of County Commissioners has determined that the use of a self -funded program is in its best interest, it will be the County administrators responsibility to oversee the Administration of said programs. Any proposed change to the self -funded health insurance program that would constitute a material reduction in benefits or change in cost to current employees and retirees that will be presented to the Board of County COMMIssioners will be preceded by a two week written notice to the affected employees and retirees. C. MONROE COUNTY ACCIDENT REVIEW BOARD In accordance with the Monroe County Safety Policies and Procedures, and County administrator Instructions, the Monroe County Safety/Accident Board functions to prevent accidents through review of accident incidents reported to the Human Resource Office, and recommends safety -related policies and procedures to the County Safety Office. This Board also serves as the Safety advisory Committee, and functions under the guidelines as set down in the administrative Instructions for the function and by-laws of the committee D. ADIyIINISTRITIVE INSTRUCTION SYSTEM The County Administrator will establish a standardized administrative instruction system for initiating, preparing, controlling, monitorilig and promulgating all Monroe County Administrative Policies and Procedures by way of rules and guidelines, which clarify those adopted Monroe County administrative Policies and Procedures, These administrative Instructions shall only be further detailing, by instructions or rules, of those Policies and Procedures provided in this manual, where, for ministerial purposes, policy clarifications are particularly applicable. Where conflict may occur, the Board of County Commissioners reserves the authority of final determination as to ministerial function. This system will be structured according to Monroe County Administration Instruction 1000, issued February 2, 1989, but may be deleted, changed, revised or altered at any time by the County Administrator. Reference to these Administrative Instructions will be made throughout these policies. All employees will be responsible for being familiar with and complying with these instructions. Division and Department Heads will be responsible for appropriate dissemination of these instructions. All references to Administrative Instruction should be construed to mean most current revision. Suffix numbers change with revisions_ 8 of 77 GF,NERAL POLICIES SECTION 1 1.01 CAREER SERVICE A. DEFINITION In accordance with Chapter 69-1321 Laws of Florida, as amended, employees designated in this Act, having at least one (1) year of continuous satisfactory service, shall be considered career service employees, except as set forth in these policies and procedures. B. APPLICATION FOR CAREER SERVICE Approximately one month prior to the employee's anniversary date, except as provided for in Section 2.04 herein, the Human Resources office will provide the Department Head with notice to evaluate the employee in accordance with Administrative Instruction 4003. The evaluation form shall be forwarded to the Human Resources office and placed in the employee's personnel file. (See Section 2.04.) If a positive recommendation is made to retain the employee by the appropriate Department/Division Director and approved by the County Administrator, the employee will be eligible for Career Service upon completion of one (1) year of continuous, satisfactory,, 6 employment. "Temporary employees who transfer to or are hired in a regular County position must serve a 12-month probationary period in the County position before being eligible for Career Service. C. CONTRACT EMPLOYEE The County Commission may waive, at its option, the necessity for the probationary service of a contract employee wafter the commencement of to employment by the County into a regular position under the Career Service rules. In no event, however, may the County waive such probationary requirement unless the affected employee has served at least one (1) year in the capacity for which the probation has been waived. 1.02 POLITICAL ACTIVITY A. No employee shall use any promise, reward or threat to encourage or coerce any person to support or contribute to any political issue, candidate or party. B. No employee shall use his official authority as an employee to influence or attempt to influence, coerce or attempt to coerce a political body or to in any way interfere with any nomination or election of any person to any public office. C. Nothing will prohibit any employee from expressing his opinion on any candidate, on issues, or from participating in any political campaign during his off -duty hours. D. Nothing herein contained shall affect the right of the employees to hold membership in, and support, a political party, to vote as they choose, to express opinions on all political subjects and candidates, to maintain political neutrality, and to attend political meetings during off -duty hours- 9 of 77 E. Employees shall at all times comply with all provisions of Section 104.31, Florida Statutes, which is generally stated in part in 1.02 (A) & (B) above, any may be amended from time to time. 1.03 OUTSIDE EMPLOYMENT A. Full-time employees are not restricted from engaging in other employment during their off -duty hours. However, County employment must be considered the primary employment. Employees shall not, directly or indirectly, engage in any outside employment or financial interest which may conflict, in the County's opinion, with the best interests of the County or interfere with the employee's ability to perform the assigned County job. Examples include, but are not limited to, outside employment which: 1) Prevents the employee from being available for work beyond normal working hours, such as emergencies or peak work periods, when such availability is a regular part of the employee's job; 2) Is conducted during the employee's work hours; 3) Utilizes County telephones, computers, supplies, or any other resources, facilities, or equipment; 4) May reasonably be perceived by members of the public as a conflict of interest or otherwise discredits public service. B. Employees shall not be instructed or allowed to perform work for private individuals or other governmental agencies as part of his/her County employment except in those instances where such work is part of contract arrangements entered into by the Board of County Commissioners with such private individuals or government agencies, or in those cases where under prior Board of County Commission policy, the employee is to give service in an emergency situation. 1.04 USE OF COUNTY PROPERTY PROCEDURES OR FACILITIES Equipment, facilities, vehicles, property, or any resource or procedure of the County shall not be used by any employee, or use of same authorized for anyone by an employee for any reason or purpose beyond that deemed de minimis use by the Internal Revenue Service Code for anything other than County business. The use of same for personal gain or use may be cause for termination. See Administrative Instruction 1004 for additional information concerning use of County vehicles. 1.05 CODE OF ETHICS A. 2kll employees must be aware of, and comply with, Section 112:311 (6) Florida Statutes which currently provides in part: "It is declared to be the policy of the state that public officers and employees, state and local, are agents of the people and hold their positions for the benefit of the public. They are bound to uphold the Constitution of the United States and the State Constitution and to perform efficiently and faithfully their duties under the laws of the federal, state, and local governments. Such officers and employees are bound to observe, in their official acts, the highest standards of ethics consistent with this code and the advisory opinions rendered with respect hereto regardless of personal considerations, recognizing that promoting the public interest and maintaining the respect of the people in their government must be of foremost concern." B. Employees may not, either directly or indirectly, use their official position with the County or information obtained in connection with their employment for private gain, for themselves or others. C. Employees shall not accept any gift, favor or service from any member of the public, including but not limited to Christmas and/or birthday gifts. D. No employee shall make any false statement, certification or recommendation of any employment under any provision of these policies, or in any manner, commit or attempt to commit any fraud preventing the impartial execution of the provisions of these policies, with regard to employment, promotion or transfer. 10 of 77 E. Conflict of interest rules shall be in accordance with the established laws of the State of Florida. No County employee shall transact any business in his or her official capacity with any business entity of which that employee is an officer, agent or member, or in which he or she holds a material interest. If an employee is uncertain as to whether he or she may be in violation of this policy, clarification may be obtained from the Human Resources office. The County Administrator may at any time, require a statement of disclosure from any employee if he has reason to believe that said employee may be in violation of this policy. The Human Resources office will be responsible for investigating any alleged incident of conflict of interest and when needed, the County's legal counsel will interpret Florida Statute 112.311-112.326. If a violation of this policy- is found, appropriate disciplinary action may be initiated. F. Employees shall not conduct personal business while in County uniform while on duty Employees shall not consume alcoholic beverages while on duty, nor on off -duty hours while in uniform. G. Employees shall not consume or be under the influence of alcoholic beverages while on duty or in County uniform, nor shall they use, be under the influence of, consume or possess illegal substances while on duty, in County uniform or on County property at any time. It is the intent of Monroe County to create and maintain a drug -free workplace for Monroe County employees, in accordance with the Drug -Free Workplace Act of 1988. (See Monroe County Administrative Instruction 4703.) H. Any violation of the provisions of this policy shall be subject to review and appropriate disciplinary action. If the employee has any doubt as to the application of the policy as it relates to his or her position, the possible violations should be discussed with the Department Head or his or her designee, who shall either approve or forbid the activity, or refer the question to the Human Resources Office. The County Administrator, Division and Department Heads, their Deputies and other employees holding positions of high public trust and/or authority will be held to higher disciplinary and ethical standards than other employees. 1.06 DISCLOSURE OF INFORNLATION/RECORDS Information of a sensitive or confidential nature which is obtained in the course of official duties shall not be released by any employee other than by those charged with this responsibility as part of their official duties. All county offices shall comply with any request for records and/or information and appropriately disclose such in accordance with the standards as set forth in Administrative Instruction 4903. 1.07 RESTRICTION OF EMPLOYMENT OF RELATIVES Restrictions on employment of relatives shall be in accordance with Florida Statute 112.3135 (2) (a) as amended, which currently reads, "A public official may not appoint, employ, promote, or advance, or advocate for appointment, employment, promotion, or advancement, in or to a position in the agency in which he is serving or over which he exercises jurisdiction or control, any individual who is a relative of the public official." The definition of relative will be in accordance with Florida Statute 112.3135(1) (d) and will include Domestic Partner. Nothing set forth herein shall prohibit the employment of more than one (1) member of the same family. '`lie Human Resources Office will be responsible to investigate any alleged incident of nepotism. Upon investigation if it is found that a potential conflict or that a relationship exists that could be interpreted as such, action may be taken so that the situation no longer exists. When needed, the 11 of 77 County's legal advisor will furnish current information to the Human Resources office on Florida Statute 116.111. Where a State or Local statute regarding nepotism exists which is more restrictive than this policy, the eligible applicant should follow the State and Local statute in lieu of this policy. Definition: Domestic Partner' - "Domestic Partners" are two adults who have chosen to share one mother's lives in a committed family relationship of mutual caring. Two individuals are considered to be Domestic Partners if: (1) they consider themselves to be members of each other's immediate family; (2) they agree to be jointly responsible for each other's basic living expenses: (3) neither of them is married or a member of another Domestic Partnership; (4) they are not blood related in a way that would prevent them from being married to each other under the laws of Florida; (5) each is at least of the legal age and competency required by Florida Law to enter into a marriage or other binding contract; (6) they each sign of Declaration of Domestic Partnership as provided in for Section 14.03 (7) they reside at the same residence. 1.08 VOLUNTEERS Monroe County recognizes the importance of work performed by volunteers. The Department Head will be responsible for obtaining authorization through the Human Resources office before allowing work to be performed by anyone on a volunteer basis. Volunteers will not, under any circumstances, be considered County employees, but will be responsible for following proper procedures and schedules as outlined by the Department Head. (See Section 8.01 I regarding voluntary Emergency Response Team for County employees.) 1.09 VETERANS PREFERENCE IN INITIAL EMPLOYMENT If no qualified applicant is selected in-house after a seven (7) calendar day posting period, available positions will then be offered to the general public, unless in-house and general public notice are authorized by the Director of Human Resources concurrently. Eligible veterans and spouses of veterans will receive preference in initial employment with the exception of those positions which are exempt pursuant to Florida's Preference Law {Chapter 295 Florida Statutes (1987)}. ' Resolution 081-1998 12 of 77 EMPLOYMENT POLICIES SECTION 2 2.01 APPOINTING AUTHORITY The Board of County Commissioners shall be the appointing authority for the County Administrator and County Attorney. All other positions under the jurisdiction of the Board of County Commissioners shall be employed and supervised by the County Administrator. Employment of Division and Department Heads will require the confirmation of the Board of County Commissioners. The County Administrator will be responsible for: A. Approval of all changes in employee status ensuring that all changes are in accordance with the Personnel Policies and Procedures and the Pay/Classification Plan. B. Ensuring that all positions in all Divisions have been fairly and equally evaluated, rated and classified in accordance with Personnel Policies and Procedures and the Pay/Classification Plan. 2.02 POSITION CONTROI A. All positions in the County Service are established and maintained through a budget each fiscal year, in accordance with procedures provided by the Board of County Commissioners. B. The establishment of new or additional positions can only be authorized by the Board of County Commissioners and the County Administrator, subject to adequate justification of need and availability of funds. C. Personnel to fill approved new positions shall be appointed after the position has been evaluated, classified and assigned a pay grade. 2.03 TYPES OF EMPLOYMENT A. Original employment is subject to budgetary restrictions. When a person is initially employed in a position in County Service, he shall be employed in at least one of the following types of original employment status: 1. Full -Time Regular Employee 2. Substitute Employee 3. Temporary Employee 4. Emergency Temporary Employee 5. Part -Time Employee 6. Trainee 7. Contract Participation in the Social Security program and the Florida State Retirement System will be in accordance with the rules and regulations governing said programs. Any employee paid on an hourly basis will not be eligible for fringe benefits. B. Definitions of types of original employment: 13 of 77 1. Full -Time Regular Employee a. Full -Time Regular employment will be made to a classification for regularly budgeted County positions, working 25 hours or more per week. b. A Full -Time Regular employee shall be eligible for all County fringe benefits as set forth in these policies. c. Ali employee serving in a full-time regular position shall be eligible for career seryas described 1S1 Section 1.01. ice status 2. Substitute Employee a. Substitute employment may be made to fill positions for which leaves of absences are granted to a regular employee. b. Substitute employment shall be only for a period of time for which the regular employee is granted leave. c. A substitute employee shall not be eligible for County fringe benefits. d. A substitute employee shall be exempt from career service status if employedfor less than one continuous year. I Temporary Employee a. Temporary employment may be made when the work of a department requires the services of one or more employees on a seasonal or intermittent basis, or in a position not classified as a regular County position. b. An employee shall not be allowed to serve on temporary employment of more than 12 consecutive months or, in the case of intermittent employment, for more than 1,040 hours during any 12-month period, except as set forth below. c. A temporary employee shall not be eligible for County benefits or paid holidays, except as stated in V below. d. A temporary employee shall be exempt from career service status. C. All employees who are employed under special grants/projects shall be temporary employees throughout the duration of the grant/project. Such employees shall at no time be considered regular employees of the County, and shall only have the rights of temporary employees as set forth in these policies and procedures, except as might be specifically set forth in the special grant or project requirements. Grant employees, who do not qualify as temporary employees, are entitled to the same benefits as a regular employee except for Career Service status, and any benefit not eligible for reimbursement under the grant funding for the position. 4. Emergency Temporary Employee a. Emergency temporary employment may be made when a short-term emergency exists. 14 of 77 b. Emergency temporary employment may be made without regard to the person's training or experience. c. No person shall be given one or more emergency employments for more than three (3) calendar months. d. An Emergency Temporary Employee shall not be eligible for County fringe benefits. e. An employee hired on an emergency basis shall be exempt from career service status. 5. Part -Time Employee An employee is to be considered part-time if the employee works less than twenty-five (25) hours per week. The salaried part-time employee who works at least twenty (20) hours per week will accrue vacation and sick leave according to scheduled work hours. Anyone working less than twenty (20) hours per week will not accrue sick or annual leave. 6. Trainee Employee An employee appointed to fill an established position on a regular full-time or part-time basis shall be given trainee status when qualified applicants are not available for the position and the employee does not meet the minimum training and experience requirements for the position. (Refer to Section 4.07.) 7. Contract Employee Anyone whose employment is project specific will be a contract employee. Said employee(s) will not attain Career Service Status. Each proposed contract will be submitted by the County Administrator to the Board of Commissioners for approval_ 2.04 PROBATIONARY PERIOD A. The standard probationary period for new employees will be twelve (12) months from the date the employee begins working as a regular employee for the County. If at any time during the probationary period it is determined that the employee does not meet performance standards, the employee may be terminated without recourse. The County Administrator, or a designee, shall either: (1) approve, in writing, retention of the employee, at which time the employee shall be granted career service status: or (2) decide that the probationary period will be extended for no longer than an additional 90 days if the employee has not met performance standards : or (3) in the event the County shall fail to approve the employees' retention the employee shall automatically be separated from employment with the County, said separation being absolutely final, with no rights of appeal to any authority, including the grievance procedure contained herein. "Temporary employees, Federal or State Grant employees as well as employees originally hired under the CETA Program will retain their original date of hire if transferred to or hired in a regular County position for use in procedures governing fringe benefits and evaluation purposes, when applicable_ Said employee must then serve the standard 12-month probationary period, before becoming eligible for career service status. B. During the probationary period, the Department Head or duly -appointed representative must observe the employee's work habits, attitude and attendance to see if continued employment in the job is desirable. 15 of 77 C. In the event an employee receives a promotion through the promotional opportunty process, said employee will serve a 90 day probationary period, or the remainder of their original probationary period, whichever is greater. If during this probationary period the employee does not meet performance standards, he or she may be terminated without right of appeal if recommended by the Department Head and the Division Director and approved by the Adininistrator, but will be able to apply for another County position after through the promotional opportunity system for 1 year, which time he or she must wait until'a desired position is open to the public. D. Any employee whose position evolves into accepting additional or different duties and/or responsibilities within the same department may be reclassified to another pay grade and/or title upon recommendation of the Department Head and Division Director and approved by the Administrator but will not serve an additional probationary period. (See Section 3.04 and 3.05.) 2.05 DEFINITION OF SERVICE A. Creditable Service shall be defined as service during which the employee was on the payroll of the County, or on approved leave of absence without pay. B. An employee's continuous service date shall be established as the most recent date of hire and may not precede the date of actual job performance. C_ Authorized leaves of absence to the extent provided in Section 8 of these policies shall not be considered a break in service effective at the end of the employee's regular shift on the last day of work. D. If an employee has a break of service of 48 hours or more, he/she cannot be reinstated to his/her former employment status. If he/she is selected for County employment after such a break in service, he/she must begin as a new employee in all respects, except for Retirement Benefits which are governed by Florida Statutes. E. Any unauthorized leave without pay for three consecutive work days or more may be considered a break in service, and may result in termination. 2.06 MEDICAL EXAMINATIONS A. In order to maintain a vigorous and healthy work force the County shall require post offer medical examinations by a physician designated by the County. B_ The County Administrator may require that an employee submit to a physical and/or psychiatric examination by a physician or other qualified practitioner at any time during their employment, which may include blood and/or urine testing for drug or alcohol usage. Charges for same will be the responsibility of the County. Grant Programs will provide funding for medical examinations for their employees in their respective budgets C. Should an examination result in disclosure of inability to meet the required =* urnum standards of the specific occupation, the results of the examination shall be reviewed by the Human Resources office and the employee's Department Head and/or Division Director. Findings and recommendations shall be forwarded to the County Administrator for final disposition. Payment of any expense uicurred by the applicant/emplovee other than the initial examination required by the County will be the responsibility of the applicant/employ ee. 16 of 77 D An employee determined to be physically or mentally unfit to continue working in his/her current classification may be terminated, but may apply through the promotional opportunity system for any available Position for which said employee is determined to be qualified as well as physically and mentally fit t' perform all required duties of the position. Said employee will have promotional o ortunit5� g p Ills/her termination date. pp rights for one year after E. If a Department Head has reasonable suspicion that an employee is under the influence of, or using alcoholic or illegal substances, that Department Head may require that said employee be examined b physician who may include blood and/or urine testing. y 2.07 BASIS FOR CHANGE OF STATUS Selection of applicants for new hire and in-house promotion shall be based on the applicant's ability to perform the job as outlined in the job description of the position being filled. Zhe job description shall identify the specific knowledge, skills, and abilities necessary for the successful performance of the duties of the position. An evaluation of the applicant's knowledge, skills, and abilities as reflected in education, experience, licensure or certification as outlined on the employment application shall be compared to the required minimum qualifications of the position. All applicants who appear to possess the required minimum qualifications shall be evaluated according to uniform and consistently applied selection techniques established by Personnel Policies and Procedures. These selection techniques shall be designed to provide maximum validity reliability, and objectivity and result in selection from among the applicants who are most qualified for the position. In determining change of status as a result of demotion, recall from layoff or transfer, job performance shall be the sole criterion. Job performance being equal, length of continuous service shall be the criterion. 2.08 SELECTION PROCESS All interviews whether for new hire or in-house promotion must follow the interview procedures outlined administrative Instruction 4705. m 2.09 TRANSFERS A. The County Administrator may, at any time, transfer an employee from one area to another and/or from one position to another when lie determines that it is in the best interest of the operation of the County to do so. Transfers will be made by the County Administrator based upon a recommendation Department Head and Division Director, on by the B. Employees will be notified in writing of the County Administrator's decision to transfer them. Em to gees who claim that a transfer is made arbitrarily and capriciously or that it is being recommended for disci linary reasons may appeal a transfer decision pursuant to Section 10 (Employee Complaint/Grievance Procedure). 2.10. EMPLOYEE TRAINING jobThe County may require any employee to attend any and all training deemed necessary to perform his or her duties adequately and safely. Prior to employment with I'�fonroe County, it is the applicant's responsibility to provide proof of completion of said training requirements. Once employed, any certification training deemed necessary for continued employment is to be paid by the individual with reimbursement made after successful completion. See 2.11, item A. 17 of 77 2.11 EDUCATIONAL ASSISTANCE PROGRAM A. EDUCATION kL ASSIS F--1NCE POI ICY` The County may provide financial assistance to County employees for educational courses which are applicable to the employee's field of work, or of such nature and quality to directly contribute to the employee's value and potential growth in the County service. Employees required to maintain training and certification requirements as a condition of employment are also eligible for this program. In the case of a degree -seeking student; although attainment of said degree may provide job enhancement for the employee, courses taken in the pursuit of the degree must have some relation to County employment. B. ELIGIBILITY An employee will be considered eligible for participation in the Educational Assistance Program if he has been a full-time employee of the County for one year or more, and is so recommended by the Supervisor and Department Head. An exception may be made for those employees referred to in Ordinance No. 008-1987, as approved by the Board of Commissioners. C. APPLICATIONS An Employee must submit the completed Request for Educational Assistance Form to the immediate Supervisor and Department Head for approval prior to the employee enrolling in the course. The Department Head shall review the employee's eligibility to participate in the Educational Assistance Program and shall be responsible for the administration of the program. Upon enrollment in the course, the employee shall submit to the Department Head the enrollment receipt and textbook receipt. Upon completion of the course, the employee shall submit to the Department Head the proof of successful completion. The tuition and textbook receipts, the Audit Slip or Purchase Order and the proof of successful completion will be sent to the Finance Department for processing. A copy of all the documentation will be sent to the Human Resources office and placed in the employee's personnel file. D. TIME OFF FROM WORK Qualified employees may be permitted time off from work with pay to attend educational training classes or seminars which are related to their job duties but which are not available during non- working hours, if approved by the applicable Department Head and/or Division Director. Allowable time off will be restricted to a maximum of 160 hours in any calendar year unless specifically otherwise approved by the County Adrninistrator. See Florida Statutes 112.063 18 of 77 Employees are attending this training on a volunteer basis and time allowed for attending such training does not constitute hours worked for the purpose of computing required overtime payments. E. REIMBURSEMENT 1. Upon the successful completion of approved courses, the employee will be eligible for reimbursement of tuition, textbooks, online access fees, distance learning fees, and lab fees. The employee must present a certification of successful course completion and a paid receipt for tuition, textbooks, online access fees, distance learning fees, and lab fees to the Department. Requests for reimbursement must be made within sixty days after completion of the course. 2. Textbook reimbursement allowance is limited to $125 per course. The employee is responsible for paying any difference. 3. Reimbursement for tuition will be made only to employees who are on the active payroll when payment is due. 4. Where tuition is covered under benefits from the Veterans Administration or a philanthropic source, qualified employees may participate only in the "time off from work" feature of the program. 5. Reimbursement under the Educational Assistance Program constitutes income to the employee. The County must withhold taxes from this income and report to government agencies in the same manner. 6. Employees must provide their own transportation to and from training. 7. Refunds shall be limited subject to the availability of funds and the number of participants in the program. 8. This program may be amended or terminated at any time, however, such amendment or termination will not affect any courses of study previously approved. F. CONDITIONS OF REIMBURSEMENT Employees who obtain reimbursement for any educational assistance program shall remain with the County at least one (1) year after completion of courses, otherwise any reimbursement which was made by the County to the employee shall be refunded to the County, if the employee terminates within less than one (1) year from date of completion of educational assistance courses. Further funding to the County shall be accomplished by deducting all reimbursement due from the employee's final paycheck. 2.12 EMPLOYEE SAFE l It is the responsibility of the County to promote and pursue a safe and healthy environment for all employees. Monroe County has a viable safety program administered and enforced by the Monroe County Safety Administrator according to the Safety Policies and Procedures adopted by the Board of County Commissioners. 19 of 77 Employees will observe all safety rules and regulations established by the State of Florida and County Government. Division Directors, Department Heads and Supervisors are responsible for the observance of those rules within their jurisdiction. Failure to comply may result in disciplinary action. 2.13 PROMOTIONAI OPPOR:1 UNITIFS Al It is the policy of the Board of County Commissioners to consider qualified County employees for promotional opportunities before applicants from the general public are considered. An employee must remain in his or her respective position for a period of at least six (6) months before transferring to another position through the Promotional Opportunity system. If it is thought to be in the best interest of the County to waive this rule, prior approval of the appropriate Division Director(s) and the County Administrator must be obtained. Please review Section 2.04 Probationary Period. Promotional Opportunities will be posted on bulletin boards throughout the County system for seven (7) calendar days. B. An eligible employee wishing to apply for a promotional position will complete the Promotional Opportunity Application Form within the seven (7) day period (date of posting is day one (1)) and submit it to the Human Resources office. The Human Resources office will review these completed forms and forward all in-house applications to the Department with the vacancy for consideration. C. During the seven (7) days the position is posted, any qualified County applicant is to be given preference in the vacant position. All Promotional Opportunity applications must be reviewed by the department with the vacancy. It is the responsibility of the hiring department to review in-house applications and conduct interviews for qualified County applicants. Any qualified employee filing a Promotional Opportunity within the required seven (7) day period is to be considered a priority. In the event the Promotional Opportunity is not received within the seven (7) day period, the in-house employee shall lose preferential treatment. D. Eligible veterans and spouses of veterans will receive preference in initial employment pursuant to Florida's Veterans' Preference Law {Chapter 295, Florida Statutes}, with the exception of those positions which are exempt under said law. 2.14 EQUAL OPPORTUNITY POLICY A. The County is firmly committed to equal employment opportunity, and does not discriminate in any employment -related decisions on the basis of race, color, religion, national origin, sex, age, disability or other similar factors that are not job -related. The County's policy of equality of opportunity applies to all organizational levels of the County and to all job classifications. It is the responsibility of each Division Director, Department Head and Supervisor to give the County's non-discrimination policy full support through leadership, and by personal example. In addition, it is the duty of each employee to help maintain a work environment which is conducive to, and which reflects, the County's commitment to equal employment opportunity. B. All personnel actions shall be based solely on ability and fitness of the individual. C. The Human Resources office shall see that information about job opportunities is readily available to all employees and citizens of the County, and a continuing program shall be conducted to make the Equal Employment policies known to all citizens of the County. 20 of 77 D. In this capacity, the Human Resources office will be responsible for anticipating problems, formulating solutions, presenting complete analysis of alternatives and recommended corrective actions and coordinating the recommended actions with Division Directors, Department Heads and employees. In the implementation of this policy, the County will aggressively seek personnel for all job levels within the organization through upgrading and recruitment from minority group members and women. This policy is specifically included and will be a continuing and essential component of the Personnel Policies and Procedures. E. Harassment of any kind is prohibited and will not be tolerated This policy applies to all employees (including Division Directors, department heads and supervisors), agents and third -parties such as contractors, vendors, suppliers, and other visitors to County buildings or workplaces. A violation of this policy will subject an employee (including Division Directors, department heads or supervisors) to disciplinary action, up to and including termination of employment. A violation of this policy by any third party will result in appropriate action, which may result in the person(s) being barred from the County premises. Harassment is defined as verbal or physical conduct which: 1. Denigrates or shows hostility or aversion toward an individual because of his or her race, color, religion, gender, national origin, age, veteran status, marital status, familial status, sexual orientation/preference, or disability/handicap, or that of his or her relatives, friends or associates. 2. Has the purpose or effect of creating an intimidating, hostile or offensive working environment; 3. Has the purpose or effect of unreasonably interfering with an individual's work performance or; 4. Otherwise adversely affects an individual's employment opportunities. Prohibited harassing conduct includes, but is not limited to, epithets, slurs, jokes, negative stereotyping, or threatening, intimidating or hostile acts that relate to race, color, religion, gender, age, national origin, veteran status, marital status, familial status, sexual orientation/preference, or disability/handicap. Prohibited harassing conduct includes written or graphic material that is placed on walls, bulletin boards or elsewhere on the premises or that is circulated in the workplace. The above policy includes, but is not limited to, sexual harassment. Sexual harassment is defined as: 1. Unwelcome sexual advances; 2. Requests for sexual favors; 3. Verbal or physical conduct of a sexual or otherwise offensive nature, particularly where: a. submission to such conduct is made, explicitly or implicitly, a term or condition of employment; b. submission to or rejection of such conduct is used as a basis for decisions affecting an individual's employment; or c. such conduct has the purpose or effect of creating an intimidating, hostile or offensive working environment. 4. Sexually offensive jokes, innuendoes, and other sexually oriented statements or behavior. If you experience or observe any prohibited harassment by any person (including Division Directors, department heads, supervisors, employees or third -parties), you are required to promptly report the incident to a Department Head, the Human Resources Director or to the County Administrator. (We encourage you to put such a complaint in writing). Your complaint will be immediately investigated and kept confidential to the extent possible. Individuals who make complaints have an obligation to assist and cooperate with the County's investigation. If the County determines that an employee (including Division Director, Department Head, or supervisor) or third -party has harassed another individual, appropriate remedial action will be taken against the offender, up 21 of 77 to and including termination. If the harassment involves a third party such as a contractor, vendor, supplier, or other visitors to County buildings or the workplace, that person may be barred from the premises. The County prohibits any forth of retaliation against an employee or third party for lodging a bona fide complaint under this policy or for assisting in the investigation of a claim of harassment. F. If one believes that the County has violated the equal opportunity policy, as stated in this section, he/she should submit a written complaint to the EEO Coordinator. The EEO Coordinator shall investigate the complaint and respond to the complaint. 2.15 EMPLOYEE RECOGNITION A - EMPLOYEE OF THE MONTH/YEAR PROGRAM Monroe County has established an Employee Service Award which is designed to recognize employees who demonstrate superior performance and dedication to their work which is above and beyond the call of duty. (See Monroe County Administrative Instruction Series 4000.) The employee selected for the month shall be awarded a $100 United States Savings Bond and an appreciation plaque. The employee of the year shall receive a 4° o increase, and an appreciation plaque. B - YEARS OF SERVICE PROGRAM Mon -roe County has established a program to recognize County employees who have been in the County Service for Five, Ten, Fifteen, Twenty, Twenty-five, aid Thirty and Thirty-five years. Grant and part-time employees will be eligible for the years -of -service program. At the employee's anniversary date, or as soon thereafter as is feasible, the Human Resources office will send Division Directors a list of employees that are eligible for a years of service award that month alon with a template letter for recognizing the employee and notifyng the Payroll office Each Division will be responsible for completing and providing a letter of recognition to the employee along with providing a copy to Human Resources to be placed in the employee's personnel file, noting the years of service and the award that will be given Payment of the award will be distributed as outlined below and will be included in the employee's paycheck A letter to the Payroll Department will be completed by the Division informing Payroll what the amount of the award shallbe and a copy of the letter provided to Human Resources to be placed in the employee's personnel file It is the Division's responsibility to discuss the presentation opportunity with the employee and together come to a decision as to whether the employee would like to be recognized at the BOCC meeting..If the employee chooses to be recognized at the BOCC meeting, the Division must coordinate with the Human Resources office regarding the appropriate award as outlined below, and with the County Administrator's office to ensure that said recognition is placed on the meeting agenda Whenever possible, this presentation will take place at the BOCC meeting in the employee's location use a letter to be phteed in the employee's personnel file noting the years of serviee and most dehver tThe following will be provided; in a lump sum payment, to the employee: a - For 5 years of service, a decorative pin and a $100.00 award; b - For 10 years of service, a decorative pin and a $175.00 award and recognition at the BOCC fleeting; c - For 15 years of service, a decorative pin and a $200.00 award and recognition at the BOCC Meeting; d - For 20 years of service, a decorative pin and a $350.00 award and recognition at the BOCC Meeting; e - For 25 years of service, a decorative pin and a $500.00 award and recognition at the BOCC Meeting; f - For 30 years of service, a decorative pin and a $1,000.00 award and recognition at the BOCC Meeting. 22 477 Effective August 1, 2010• g — For 35 years of service an engraved Lucite desk clock and a $1,500 00 award and recognition at the BOCC meefing. 23 of 77 CLASSIFICATION PI-kN SECTION 3 3.01 CLASSIFICATION PLAN A. SCOPE The Classification Plan provides for a systematic and equitable arrangement of job classes and provides for a complete inventory of all County positions. The purpose of the plan is to group various positions into related classes based upon the range of duties, responsibilities and level of work performed. B. COMPOSITION OF THE CLASSIFICATION PLAN The Classification Plan comprises written job descriptions for each class of work included in the County service. Job descriptions are intended to be a general outline of job duties performed by employees in a particular job. They are used as a guide in recruiting and examining candidates for employment, in determining the lines of promotion and developing training programs, as guidelines in determining salary relationships and in providing uniform job terminology to convey the same meaning to all concerned. Job descriptions may be changed from time to time by the County. This change may expand or reduce the job duties of any job classification. Employees will be given as much advance notice of a change in their jobs as is practicable. The job descriptions are maintained by the Human Resources office and should be reviewed and updated annually, or whenever a change occurs in the duties of any position. Each job description will be approved by the Department Head, the Division Director, and the County Administrator. Each employee will receive a copy of his or her respective job description at the time of his or her employment, and any time there is a change in his or her job description. 3.02 POSITION AUDIT PROCEDURE The County Administrator is charged with the responsibility of initiating position audits of any or all County service positions at any time. Other position audits may be initiated by written request to the County Administrator from the Department Head or the Division Director in which the specific position is located, or the incumbent of the position to be audited. All requests must be approved by the Division Director. Position information will be gained through completion of a Position Information Questionnaire (PIQ by the incumbent or by the Supervisor of the position if the position is vacant, and through field studies of the position, which may include a personal visit with the position incumbent by a representative of the Human Resources office. The applicable Department and Division Director should review and make recommendations to the County Administrator through the Human Resources office on all proposed new positions, changes, and position descriptions. 3.03 DETERMINATION OF CI-NSSES A. The Human Resources office upon certification of funds and findings that the proposed class or classes are needed, shall propose new or revised classes of work as well as the abolition of existing or obsolete classes, to the County Administrator for appropriate action. 24 of 77 B. Whenever an employee's position is abolished under this section, said employee shall have first consideration for a position in a similar classification that may arise in the County service for a period of one year. However, if that employee refuses an offer for a similar position or, if that employee within the one-year period elects to take any position in the County service, said employee shaU be removed from preferential consideration. 3.04 ALLOCATION AND RFCI-,ISSIFICATION OF POSITIONS A. The Human Resources office, after having determined the content of the positions and having received the certification of funds and findings that the proposed class or classes are needed, shaU propose new or revised classes of work as well as the abolition of existing or obsolete classes, to the County zdministrator for appropriate action. Recommendations for changes may be made by the Division Director, who must submit sufficient documentation for the change, including assurance(s) that the respective departmental budget contains sufficient funds. B. An employee may be reclassified to a different tide and/or pay grade at any time the County Administrator deems appropriate, after receiving good and sufficient documentation. A temporary reclassification does not constitute a promotion or demotion. A change in tide and/or pay grade which results from an evolution into a reduction of duties and/or responsibilities does not constitute a demotion. 3.05 STATUS OF AN INCUMBENT IN A RECLASSIFIED POSITION When the incumbent of a position, through diligent application of work, is officially assigned more difficult and significant additional responsibilities and duties so that it appears as if the position warrants reclassification to a higher class, the Human Resources office shall perform a field study of the present duties and responsibilities of the position. If it is determined after recommendation by the Department Head, Division Director and Human Resources that the position should be reclassified, the County Administrator may require that the incumbent undergo a prescribed test of fitness, depending on the conditions of the reclassification and the nature of the position to be reclassified before approval. A revised job description will be submitted by the Department Head for approval by the Division Director and the County Adrninistrator which includes the additional duties of the position. An employee reclassified in this manner will not serve an additional probationary period as a result of this reclassification. 3.06 POSITTION CONTROL All positions are established and maintained through a budget each fiscal year in accordance with established budget and accounting procedures. The establishment of a new or additional position can only be based on adequate justification of need and the availability of funds. Such additions must be approved by the County Administrator and the Board of County Commissioners. The provisions herein do not relate to the Pay Plan, but to position statuses created by need and necessity only. The Division of Employee Services shall maintain a position control system in the office of Human Resources. Important: All additions, revisions, reclassifications or other personnel actions having a financial impact on the County shall be reviewed by the Human Resources office and the Division of Budget and Finance and approved by the Countv Administrator. 25 477 PAY PII-1N SECTION 4 4.01 Pt RPOSE The Pay Plan is designed to provide a fair and equitable method for payment of employees in the County service. It also establishes a set of rules and a uniform system of administration. 4.02 ESTABLISHMENT OF THE PAY PLAN The Pay Plan shall be directly related to the Classification Plan and is the basis for payment of employees in the County service. This plan shall be established with consideration being given to the following factors: A. Relative difficulty and responsibilities existing between various classes of work. B. Prevailing wage scales, for similar types of work, found in public and private industry in the local labor market. C. Availability of qualified personnel. D. Economic conditions found in the area. E. Fiscal policies of the Board of County Commissioners. 4.03 AMENDMENTS The County Administrator shall make amendments to the Pay Plan when, in his discretion, economic conditions, labor supplies, or other considerations indicate a need for such action. Division Directors may recommend to the County Administrator possible amendments to the Pay Plan by providing sufficient justification to make an evaluation of the causes and conditions requiring the change within the confines of their respective departmental budget. 4.04 PAY PLAN REVISIONS The Board of County Commissioners must approve the County Administrator's recommended Plan of Compensation and subsequent revisions for approval and adoption. 4.05 ADMINISTRATION The Human Resources office, in conjunction with the Division of Budget and Finance, shall have the responsibility for the day to day administration of the compensation plan. Approval of all hiring rates and other payroll changes shall require approval of the County Administrator in accordance with these personnel policies. 4.06 APPLICATION OF THE PAY PLAN All employees shall be employed and paid in accordance with the rates and policies established by the Pay Plan for the specific job classification under consideration, unless otherwise stipulated in these policies. 26 of77 4.07 STARTING RATES A. The minimum salary established for a position is considered the normal appointment rate for new employees. B. Appointments below or above the minimum salary may be authorized in the following situations: 1. In the event an applicant does not meet the minimum qualifications, but is expected to obtain said qualifications within 6 months, the hiring authority may request appointment as a "trainee". In such cases, the employee should be hired at an appropriate rate below the minimum starting salary. 2. If the applicant's training, experience or other qualifications are substantially above those required for the position, the County Administrator may approve employment at a rate above the minimum established for the class. The need to make appointments in excess of the minimum shall require documentation and specific approval from the County Administrator. 4.08 SALARY RANGES PROGRESSIONS INCREASES No salary adjustment shall be approved unless there is availability of funds, and must be recommended in writing by the Division Director and approved by the County Administrator. A. An employee may receive a salary increase by means of a promotion, reclassification or pay range adjustment. An employee reclassified, transferred or hired through promotional opportunity of one pay grade level or higher shall receive the greater of the minimum salary of the pay range or a 5% salary increase. An increase above 5% shall require justification in accordance with Section 4.07 B (2). In no case shall the employee's salary be above the maximum pay range. B. There are no provisions in the County Pay Plan for automatic salary advancements, as all increases are to be based on availability of funds, work performance, and other pertinent factors as evaluated by the employee's Supervisor and/or Department Head, and approved by the Division Director and County Administrator. C. All requests for salary increases shall be processed through the Human Resources office and the Division of Budget and Finance for review and determination of compliance with the County policies and procedures and budgetary control. D. ?MERIT INCREASES 1. A merit increase is a salary increase within the same pay grade, awarded for outstanding County Service. 2. Merit increases are not automatic. 3. The amount of merit increase an employee receives, if any shall be determined by the availability of funds, and the system/procedures proposed by the County Administrator and adopted by the Board of County Cominissioners each fiscal year. A11 salary adjustments must be approved byIthe County Administrator. 27 of 77 4. An employee shall be eligible for consideration for a merit increase during the budget preparation period after completion of their initial probation period. Unless otherwise approved by the Board of Count receive a Merit Increase on their Anniversary Date (s e Section 4.09sC� ch fiscal year, an employee will 5. New employees hired below the minimum rate would be eligible for consideration six months from the date they are adjusted into the minimum rate. G. Once an employee has reached the maximum salary amount of the pay grade in which his or her Position is classified, the merit increase will be awarded as a one time lump sum payment on the employee's anniversary date (unless otherwise approved by the Board of County Comn-,issioners each fiscal year), unless said position is reclassified to a higher pay grade (See Section 3 regarding reclassifications). Nevertheless, the employee will still be evaluated in accordance with the County evaluation system. All employees are expected to maintain a satisfactory or above performance level. Failure to do so will result in appropriate disciplinary action. 7. The foregoing reflects the current procedure, however the County reserves the right to change or eliminate the procedure whenever necessary. NOTE: Time spent on a leave of absence without pay in excess of thirty days shall be deducted from the employee's length of service record when determining the time required for advancement eligibility. E. COST OF LIVING INCREASES The decision whether to or when to grant a cost of living allowance, as well as the decisi amount of such increase (if any) will be made in the sole and exclusion of the ve discretion of the Board of County Commissioners. F. RECRUITMENT AND RETENTION INCREASES Retention Salary Increase This provision is intended to provide consideration of critical and/or unusual administration problems. A retention salary increase may be approved, at the County Adm the following provisions: inistrator's sole discretion, in accordance with A. If the employee has received a documented bona fide job offer with an employer other than the County and the retention increase is a counter offer to retain the employee in their current position (job offers from other Monroe County BOCC offices, Property Appraiser, Clerk of the Circuit Court, Supervisor of Elections, Tax Collector, Sheriff or other office that reports to the Board of County Commissioners will not be deemed a bona fide Job offer with an employer other than the County under this provision). B. Retention salary increase decisions are not grievable through the County's grievance procedure unless it is alleged that such a decision was made based upon unlawful discrimination. C. To be eligible for retention increase consideration, the affected employee inust: 1. currently be employed by the County in a carer service status position; 2. have been continuously employed in their current position for at least one calendar year prior to the date the bona fide job offer was made; 28 of 77 3. have received at least a "Meets Expectations" rating on their most recent performance evaluation, must currently be performing at an acceptable level, and may not have been issued a written warning within the previous twelve (12) months; and 4. not have received a retention increase with the past twenty-four (24) calendar months from the date the increase request is submitted to Human Resources. D. The County Administrator has sole authority to determine amount offered as a retention increase within the range of 0% to 25°,0 of the affected employee's salary. The County Administrator increases as single or multiple salary adjustments; however, if multiple lry lments may are made rove tfo cone retention increase, the total of those salary adjustments may not exceed 25% of the affected employee's salary. E. The retention salary increase must not place the employee above the maximum for their current pay range. F. Retention increases recommended under this provision are subject to the availability of funds. Procedure: To request a retention increase, the respective Department Head shall submit a retention increase request package to his/her Division Director and obtain his/her approval pri Office. Increase request packages will or to submitting the request to the Human Resources include, at a minimum, the following documentation: I • A cover memo addressed to the County Administrator with the written recommendation approved by the department head and division director. 2. If the employee has another job offer: (a) Validity of the job offer, preferably a copy of the written job offer; (b) The respective division's independent verification of the job offer; (c) Whether the job offer is comparable to the one the employee currently holds with the County. 3. A detail of the training costs that Monroe County (24) months; incurred on the employee's behalf over the past twenty-four 4. summation of the employee's satisfactory job performance (that the employee to perform at least at a "Meets Expectations" level and that he/she has not be naissued a w n i performed avarning continues within the previous twelve months); 5. that the division's recommended increase, if approved, would not place the employee above the maximum for their current pay range; 6. salary comparison of other employees within the division; 7. recruitment and retention conditions in critical areas as may be demonstrated by (a) high turnover; (b) declined job offers; or (c) copies of resignation letters from previous employees. 8. Importance of the position in relation to the Action Plans of the department and division. The Human Resources office will review the request and make a recommendation to the County Administrator. Certification Incentive Sala Increase This provision is intended to provide an incentive for employees to obtain certifications beyond their current minimum job requirements which will enhance the knowledge in their current positi department as well as the County. on and add value to the A. Certification incentive salary increase decisions are not grievance through the County's grievance procedure unless it is alleged that such a decision was made based upon unlawful discrimination. B. To be eligible for a certification incentive salary increase consideration, the affected employee must: a. currently be employed by the County in a career service status position; b. have been continuously employed with the County for at least one calendar year pri registration of the certification; or to the date of 29 of 77 c. have received at least a "Meets Expectations" rating on their most recent performance evaluation, must currently be performing at an acceptable level, and may not have been issued a written warning within the previous twelve (12) months; and d. not exceed two certifications per calendar year (renewal of a certification will not net anv additional increase in pay). C. $1,500 will be added to the affected employee's salary. D. The certification incentive salary increase must not place the employee above the maximum of their current pay range. In the event the employee reaches the maximum of their current pay range, the salary increase will be awarded as a one time lump sum payment. E. Certification incentive salary increases recommended under this provision are subject to the availability of funds. The Human Resources office will review the request and make a recommendation to the County Administrator. Procedure: To request a certification incentive salary increase, the respective employee shall complete the Certification Incentive form and obtain approvals prior to registering in the certification course or program. I. The employee shall complete the form and submit it to the Department Head and Division Director for their approval of the recommendation. 2. The Employee Services Director will review the request and shall approve or deny the request. 3. Human Resources will officially notify the employee of the approval (or denial). 4. Upon satisfactory completion of the certification program, the employee shall provide sufficient proof to Human Resources. Human Resources will prepare and process the PAF form to be effective on the date of certification. 4.09 DATE OF HIRE PAYROLL CHANGES ANNIVERSARY DATES & EMPLOYMENT STATUS CHANGES A. DATE OF HIRE The date an employee first begins work for the County shall be his/her date of hire, and shall be used in relation to the procedures governing fringe benefits and evaluations when applicable. Any break in employment of 48 hours or more will create the need for a new date of hire if that employee returns to County Service. B. CHANGES IN FMPI OYTIENT STATUS A promotion can occur when an employee is moved from a position in one class to another position in a different class which has a higher maximum salary. Any employee may be recommended for demotion by the Department Head with the approval of the Division Director and the County Administrator for cause. A demoted employee may not be paid more than the maximum rate established for the new pay grade. An employee moved into another position in the same job classification or to a different position with the same pay range may not be eligible for a salary increase at the time of transfer. 30 of 77 C. ANNIVERSARY DATES An employee's anniversary date is effective one year from a promotion, reclassification, or transfer which also resulted in an increase in salary. D. OTHER When a temporary employee attains the status of regular employee in the same position, his anniversary date will be his date of hire for evaluation purposes. Leave accrual and benefits will be implemented in accordance with current rules and regulations governing same. 4.10 TEMPORARY - HIGHER CLASSIFICATION An employee may be assigned to work in a higher classification up to one year, unless otherwise determined by the County Administrator. An employee required working in a higher classification 30 consecutive working days or less may be required to do so at no increase in pay. If the employee is required to work beyond this period, he or she should be given a temporary transfer to the higher classification and be paid the appropriate rate for the higher classification retroactively applied to day one he or she served ill such higher classification and every consecutive working day thereafter. At the conclusion of the assignment, pay shall revert to the authorized rate established for his regular position. Any such temporary increase granted shall not affect the employee's eligibility for normal salary advancement. 4.11 WAGES DUE DECEASED EMPLOYEE In the case of the death of an employee for whom an estate is not raised, any wages, travel expenses or similar amounts due the employee shall be paid by the County in accordance with the Florida Statute 222,15. An employee who does not have living parents, spouse, or children shall have the right to designate a beneficiary in writing. 4.12 BUDGET LIMITATIONS The County Administrator must administer these Policies and Procedures within the amounts which are contained in the budget as established by the Board of County Commissioners. Accordingly, all employees are hereby placed on notice that the payment of salaries and the granting of salary increases is always subject to the availability of funds. 4.13 COMPENSATION FOR EXECUTIVE ASSISTANT TO THE MAYOR When an employee becomes the mayor's aide, said employee will be awarded a 40% salary increase for the length of time he/she holds the position of Executive Assistant to the mayor. Said employee will acknowledge by signature on form entitled "Monroe County Employment Agreement Executive Assistant to the Mayor" that he/she understands and agrees that this additional compensation will be withdrawn if and when the commissioner is no longer Mayor. 31 of77 HOURS OF WORK SEC"FION 5 5.01 WORK DAYS AND WORK WEEK A. No County Department may operate on less than a 37 1/2 hour normal work week, nor more than a 40 hour normal work week (exclusive of lunch breaks), unless authorized in advance in writing by the County Admuiistrator. B. The work week shall start at 12:01 a.m. Sunday and end at 12:00 midnight Saturday, unless otherwise approved by the County Administrator. C. Effective May 1, 1991, all newly hired regular full-time employees will be required to work 40 hours per week unless the authorized job posting states otherwise, or unless otherwise determined by the County Admuustrator. When an employee changes his or her position through the Promotional Opportunity system he/she will be required to work forty (40) hours per week, unless otherwise posted. D. All full-time employees are required to be present on their assigned jobs for the total hours in their work week, unless absence from duty is authorized by the appropriate authority in accordance with these personnel policies. E. Part -tune employees are required to be present on their assigned jobs for the total number of hours for which compensations are being received, unless absence from duty is authorized by the appropriate authority in accordance with these personnel policies. F. All absences shall be properly recorded and charged. G. Nothing herein shall constitute a guaranteed minimum number of working hours per week. H. Alternative work schedules (e.g. four 10 hour days) are implemented at the discretion of the Division Director for operations and sections that can utilize manpower and equipment in a more productive manner with the longer day. I. Flextime Program — In departments where operations permit a flexible schedule, department heads may authorize a flexible schedule under the following provisions: L While maintaining sufficient staffing during normal office hours (defined as Monday — Friday, 8 am through 5 pm, staff may choose the following: (1) Continue working normal working hours; (2) work 4 ten hour days (no earlier than 7 a.m. — no later than 7 p.m.); (3) work 4 nine hour days and one four hour day; (4) work 5 eight hour days and use only '/z hour for lunch and arrive a half-hour later or leave a half-hour earlier; or (5) such other arrangement as are mutually agreeable with employee, supervisor, and Division Director. 2. During weeks with holidays as detailed in Section 6 of Personnel Polices and Procedures (or as otherwise granted by the BOCC), the employee will be granted time for the holiday (if not worked) for what the employee would have normally worked for that day. 3. In situations where there are multiple requests for the same schedule that leaves the department understaffed, the schedules will be rotated on the basis of seniority with the most senior county employee getting their first choice for one month and the next most senior county employee getting their schedule of choice during month two and so forth. 32 477 4. Immediate supervisor, Department Head or Division Director has the right to cancel an employee's participation in the Flex Time Program due to hardship issues or abuse of the policy. 5.02 OVERTIME WORK FOR NOVEXE__MP I' NON -EMERGENCY RESPONSE EMPLOYEES Overtime is generally an unbudgeted expense, and should be approved prior to time worked. A. STATEMENT OF POLICY I. Overtime, whether compensated with cash or time off, must be approved by the Department Head or other appropriate authority as stated in Administrative Instruction #1003 Series. The employment and work program of each Department should be arranged so as to eliminate the necessity of overtime work except in emergency situations. 2. Overtime is defined as work assigned and actually worked by any employee beyond the normal scheduled work week. 3. Employees who work more than their normally scheduled hours will be paid at their straight -time rate of pay for all hours worked up to and including forty (40) hours in a work week. Hours worked in excess of forty (40) hours in a work week will be compensated as provided below. 4. Employees who work in excess of forty (40) hours in any work week will be paid overtime at one and one-half times their regular rate of pay for all hours worked over forty (40), or will be granted time off (compensatory time) in lieu of overtime if the employee consents in writing. 5. Compensatory time, if offered by the County, will be governed by the following conditions: a. Must be authorized by the appropriate Department Head or other appropriate authority as defined in A. 1. above and the employee must consent in writing to compensatory time in lieu of time and a half monetary compensation; b. One and one-half hours of compensatory time will be granted for each hour of overtime worked; c. Compensatory time may be "banked"; however, the maximum balance is 240 hours. When an employee has accrued the maximum of 240 hours compensatory time, any additional overtime hours worked {i.e., over forty (40)1 will automatically be paid at the time and one- half rate; d. An employee's reasonable request to utilize accrued compensatory time will be considered; however, the County reserves the right to exercise control of the use of time off based on work load and scheduling but only if such work load and scheduling constitutes an undue burden on the County. Paying overtime to another employee to accommodate an employee's compensatory time request is not an undue burden. e. Upon terinination of employment, an employee will be paid for all unused authorized compensatory time at a rate of compensation not less than: (I) the average regular rate received by the employee during the last three years, or (ii) the final regular rate received by the employee, whichever is higher. 33 of 77 5.03 OVERTIME WORK FOR EMERGENCY RESPONSE EMPLOYEES Overtime for Firefighters is outlined in the negotiated IAFF Union Contract. 5.04 OVERTIME WORK FOR EXEMPT EMPLOYEES It is the general policy of Monroe County not to compensate for overtime those employees classified as exempt', from the Fair Labor Standards act. However the County Administrator in his sole discretion may approve compensation for overtime, either in compensatory time or pay, for an exempt employee who has been required to work unusually large amounts of overtime, such as during a disaster, etc. 5.05 MEzkL ,AND REST PERIODS Employees classified as regular full time will receive a total of one hour for meal/rest period per work shift, the time and sequence of which will be determined by the Supervisor and approved by the Department Head. If it is necessary for the non-exempt employee to work without a meal/rest period he/she will be otherwise compensated for that time. All other employees will receive meal or rest periods in an amount and time deemed appropriate by their Supervisor. Meal and rest periods shall be scheduled by the Department Head consistent with the effective operation of the department and may be rescheduled whenever necessary. 34 of77 HOLIDAYS SECTION 6 6.01 OFFICLIL HOLIDAYS The following are holidays which shall be observed by all County offices in which functions can be discontinued without adversely affecting required services to the public: New Years Day Presidents Day Martin Luther King's Birthday Good Friday Memorial Day Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Day Thanksgiving Friday Christmas Day In addition to the above -designated holidays, the Board of Commissioners, in its sole discretion, may grant other special holidays during the course of a year to some, or all, County employees. 6.02 ELIGIBILITY All salaried employees on the active payroll on the date of the holiday shall be eligible for holiday pay at their regular rate of pay. Hourly employees shall not be eligible for holiday pay. Employees must be working or on approved leave with pay the entire day before and the day after a holiday to be compensated for said holiday. 6.03 WORK DURING HOLIDAYS Each employee shall observe all holidays designated in this Section, provided that the work load of the department is, in the discretion of the County Administrator, such that the employee's work load cannot be discontinued without causing a hardship to the County_ In the event that the work load in any department does not permit the observance of any designated holiday, all employees required to work on said designated holiday, or if holiday falls on employees designated day off, may be granted another day's leave in lieu of the holiday or paid for the work performed on the holiday, as determined by the Department Head and/or Division Director. 6.04 HOLIDAYS FALLING ON WEEKENDS OR WHEN COUNTY FACILITIES ARE NORNL1LLY CLOSED Unless otherwise specified by the Board of County Commissioners - when a holiday falls on a Saturday, the preceding Friday shall be observed as a holiday - when a holiday falls on a Sunday, the following Monday shall be observed as a holiday. For County facilities normally open on Saturdays and Sundays, when a holiday falls on a Saturday or Sunday, those facilities will observe the holiday on the actual holiday in lieu of the normally scheduled County Holiday. For County facilities normally closed on Sundays and Mondays, when a holiday falls on a Sunday or Monday, those facilities will observe the holiday on the following 'Tuesday. 35 of 77 6.05 HOLIDAY DURING PAID LEAVE Employees on annual or sick leave during periods when designated holidays occur, shall not have the day of the holiday charged against their accrued leave. 6.06 OBSERVANCE OF RELIGIOUS HOLIDAYS Employees who choose to observe other "holidays" for religious or other reasons must do so by utilizmg annual leave pursuant to Section 7. 36 of 77 LEAVE WITH PAY SECTION 7 7.01 ANNUAL LEAVE A. ELIGIBILITY AN salaried employees with regular status working 20 hours or more per week shall earn and accrue annual leave with pay. Hourly employees will not accrue annual leave. B. ACCRUAL Annual leave for regular, employees shall be earned in accordance with the following table: Years of Hours of Leave Earned Continuous During Each Calendar Service ------------------- Month --------------------------------- 40 HPW 1 through 3 years 4 hours per bi-weekly pay period (13 working days per year) 4 through 10 years 5 hours per bi-weekly pay period (16 1 /4 working days per year) 11 through 15 years 6 hours per bi-weekly pay period (19 1 /2 working days per year) 16 through termination of employment 7 hours per bi-weekly pay period (22 3/4 working days per year) Hours of Leave Earned During Each Calendar Month ----------------- 37 1/2 HPW .3.75 hours per bi-weekly pay period (13 working days per year) 4.75 hours per bi-weekly pay period (16.5 working days per year) 5.75 hours per bi-weekly pay period (19.9 working days per year) 6.75 hours per bi weekly pay period (23.4 working days per year) Monroe County currently has a bi-weekly pay period system commencing at 12:00 a.m. Sunday, ending two Saturdays later at 11:59 p.m. There are 26 pay periods per year. Annual leave for employees working less than 40 hours per week, but more than 20 hours per week will be prorated according to the hours worked. When there has been a break in employment of 48 hours or more, the employee, upon reinstatement or re-employment, will begin earning annual leave as a new employee. 37 of77 Employees who are on leave without pay status for more than 8 hours during a pay period will not accrue annual leave for that pay period. C. 1. Annual leave may be used on a payday -to- payday basis as it is earned according to scheduling requirements and may be accumulated up to 40 working days with a maximum of 320 hours. 'try time earned in excess of this amount as of April 1" of each year will be rolled over to the employee's Sick Leave balance. Individual employees are responsible for monitoring their own leave balance. It is an employee's personal responsibility to request and schedule leave in order to avoid the roll over of hours. 2. All annual leave must be approved in advance by the applicable Department Head, Division Director and/or the County Administrator depending on the position held by the requesting employee. The employee shall till out his Leave Request Form and submit it to the Department Head, who has the right to deny an employee's request for annual leave, if granting such leave at that time would be detrimental to County operations. Upon such denial, the employee may request the leave at another time. The Department Head is responsible for verifying that the employee does have sufficient accrued leave to cover the period of absence, and should return the leave request to the employee indicating approval or denial, within seven (7) days of receipt of the request, unless a valid reason is given to the employee for the delay. D. ANNUAL LEAVE PAY UPON SEP'tRATION If the payment of annual leave is approved by the County, computing said leave pay will be based on the employee's regular rate of pay and terms of separation. E. RESTRICTIONS Annual leave may be used for any purpose; however, it is a privilege incident to County service and is not a right, and may only be used by the employee if taken prior to termination for cause or in accordance with these policies, with the following restrictions: 1. Annual leave may not be taken until accrued in accordance with these rules. 2. Employees will not accrue annual leave during a leave of absence without pay, a suspension or when the employee is otherwise in a non-paying status. 3. Section 11.01-Resignations. 4. Employees who leave the County service without proper notice or who are terminated for just cause may be denied payment of accrued annual leave. 7.02 SICK LEAVE A. ELIGIBILITY All salaried employees with regular status working 20 hours or more per week shall have the p i ilege of accruing sick leave in accordance with these policies. Hourly employees will not accrue sick leave. Employees shall not be eligible to use sick leave until they have been in the Countv service for 90 days, unless recommended by the Department Head and approved by the Division Director. Verification of illness be a physician may be required. 38 of 77 B. ACCRUAL OF SICK LEAVE - AN regular, full-time employees will accrue 4 hours sick leave per pay period. There will be no limit of the amount of sick leave that can be accrued. Sick leave for employees working less than 40 hours per week, but at least twenty (20) hours per week will be prorated according to the hours worked. When there has been a break in service of 48 hours or more, the employee upon reinstatement or re- employment will begin accruing sick leave as a new employee. Employees who are on leave without pay for more than 8 hours during a pay period will not accrue sick leave for that pay period. C. USE OF SICK LEAVE 1. Sick leave shall be used only with the approval of the applicable Department Head, Division Director or County Administrator and shall not be authorized prior to the time it is earned and credited to the employee except in cases of prearranged medical appointments, surgery or other health -related matters. 2. Sick leave shall be authorized only in the event of: a. The employee's personal illness, injury or exposure to a contagious disease which would endanger others. b. Illness or injury of a husband, wife, domestic partner, father, mother, legal guardian, son or daughter (including adopted or foster child). c. The employee's personal appointments with a practitioner when it is not possible to arrange such appointments for off -duty hours, but not to exceed the extent of time required to complete such appointments. d. Prearranged surgery or other health -related matters. D. Monroe County has established a Sick Leave Pool for eligible full-time employees designed to aid the employee suffering from an extended illness or injury (See Administrative Instruction 4702 for rules and enrollment procedures). 7.03 MEDICAL, JUSTIFICATION A. Sick leave is a privilege, and not a benefit. In fact, use of sick time actually causes a hardship on the County. The County must, therefore, ensure that employees utilizing sick leave are complying with Section 7.02 of these policies and procedures. Employees must meet the following conditions in order to be granted sick leave with pay: (1) Notify lus/her immediate Supervisor as soon as the emplo�,ee learns that he/she will be unable to report to work in accordance with individual department policy. The employee shall call in to his/her immediate Supervisor at least one (1) time on each consecutive shift thereafter, that the employee will miss work because of sick leave. 39 of 77 (2) File a written report (after returning to work) explaining the nature of the illness when required, by her Supervisor or Department Head. (3) permit medical examination, nursing visit or any County inquiry (telephone call, visit to the employee's house, etc.) deemed appropriate by the County to document the illness of the employee or family member. The Department Head is responsible for following up on sick leave use and for ensuring that there is no sick leave abuse. The Department Head may require any employee to bring in a note from his or her personal physician for absences of three (3) consecutive working days or more. However, if a Department Head reasonably suspects that an employee is abusing sick leave, said Department Head may require that any use of sick leave by the employee for herself or family member be justified by a note from a physician. Further, in the event that a Department Head is unsatisfied with the initial doctor's note, he may require the employee or family member to be examined by a County - designated physician at the County's expense. B. If it is determined that the employee is unfit to continue working, the Department Head may require the employee to use any part of his accrued sick leave, compensatory time or annual leave and may thereafter require the employee to take such leave without pay as is medically determined sufficient to restore him to normal health, however, this will in no way prevent the County from separating him from employment if the absence would be of such duration as to pose a hardship on the operations of the Department. C. The Department Head may require, at any time, an employee to present medical evidence that he is physically or mentally fit to work and/or the Department Head may require an employee to be examined by a County -designated physician or psychiatrist, at the County's expense. 7.04 NOTIFICATION OF ABSENCE (SEE 7.03 A) If absent for three consecutive work days without reporting to the Supervisor a reason sufficient to justify the absence, the employee may be removed from the payroll as having voluntarily resigned without notice. The Supervisor is to notify the Department Head. Any unauthorized absence may be cause for disciplinary action, up to and including termination. 7.05 FUNERAL LEAVF A. All employees covered under this policy shall be granted up to two working days off with pay in order to attend a funeral of a member of the employee's immediate family. The immediate family shall be construed to mean one of the following: Husband, Wife, father, mother, son, daughter, sister, brother, uncle, aunt, first cousin, nephew, niece, domestic partner, domestic partner's father and mother, legal guardian, grandparent or in-laws father-in-law, mother-in-law, son-in-law, daughter-it-1-law, brother-in-law, sister-in-law, stepfather, stepmother, stepson, stepdaughter, stepbrother, stepsister, half brother, half sister . Additional time off (over and above the two working days herein provided) may be approved by the Department Head, and charged to sick or annual leave. Additionally, the County may require proof of death of a family member before making payment for leave. 7.06 HOLIDAYS DURING SICIL LFAVF Holidays occurring while an employee is on sick leave shall not be charged against the employee's sick leave balance. 40 of 77 7.07 PAYMENT OF UNUSED SICK LEAVE A. An employee who terminates with less than five (5) years continuous service shall not be paid for any unused sick leave credits. B. Employees with varying years of continuous service shall, upon separation, from the County in good standing, death or retirement, receive incentive sick leave pay as follows: 5 to 10 years of service - 1 /4 of all accrued sick leave, with a maximum of 30 days. 10 to 15 years of service - 1 /2 of all accrued sick leave, with a maximum of 90 days. 15 years or more - 1/2 of all accrued sick leave, with a maximum of 120 days. C. The payments made as terminal pay for unused sick leave, whether paid as salary or otherwise, shall not be used in the calculation of average final compensation for retirement. D. Employees who leave the County service without proper notice or who are terminated for just cause may be denied payment of accrued sick leave. 7.08 TRANSFER OF LEAVE An employee who resigns from any entity or organization to accept a position with the county will not be credited with hours of unused sick or annual leave which was accrued while employed by that entity or organization. 41 of 77 LEAVE OF zkBSENCE SECTION 8 8.01 ADMINISTRATIVE LEAVE Administrative leave is leave with pay that is not charged to the employee's sick or annual leave. A. JURY DUTY AND COURT LEAVE AVF 1. A full-time employee who is summoned to jury duty by a city, the County (Monroe), the State of Florida, or the Federal Government or subpoenaed to appear in court as a witness in a criminal or civil action arising from his or her county employment shall be granted time off with pay for the time actually spent on jury duty or in the court appearance. Fees paid by the court will be retained by the employee unless otherwise determined by the County Administrator. As conditions precedent to receiving time off with pay for jury duty or court appearance of the aforesaid nature, the employee must: a. Notify his/her Department Head of the summons or subpoena immediately upon receipt, produce the summons or subpoena to his/her Department Head upon request, and provide the Department Head with an estimate of the duration of the absence; b. Report to the Department Head immediately upon the conclusion or continuance of such jury duty or court appearance; c. Report status of jury duty to supervisor or designee on a daily basis. 2. Any employee on jury duty as specified above, and who is released or excused from jury duty during normal working hours, will immediately contact his or her supervisor in order to determine whether the employee will be required to report back to work. Employees who work a 24 hour shift, will contact their Department Head (or designee) when released from jury duty. If the Department Head (or designee) determines that the employee could not effectively complete his or her work shift, the employee may be granted time off with pay for the remainder of the shift. 3. The County, in its discretion, may reschedule the working hours and days of work of an employee employed on other than a full-time basis who is summoned to jury duty or subpoenaed to appear in court as a witness by a city, the County (Monroe), the State of Florida, or the Federal Government in a criminal or civil action arising from his or her county employment. If, in the County's judgment, it is not feasible or practical to schedule the employee's hours of work around such, the County shall grant the employee time off with pay for the time actually spent on jury duty or in the court appearance. As conditions precedent to receiving time off with pay for jury duty or court appearance of the aforesaid nature, the employee must abide by the provisions contained above in Section 8.01 A-1, (a) and (b). 4. If any employee is subpoenaed as a witness other than in the specific circumstances described above, the County will grant the employee leave without pay to the extent that the Department Head so approves. 5. Notwithstanding any of the provisions of Section 8.01-,k above, no employee shall receive pay from the County where the employee is a plaintiff, claimant, or witness against the County in a matter contrary to the County's interests. 42 of 77 6. Any employee subpoenaed or otherwise requested to be a participant ill any legal matter related to County business must inform the County Attorney's office as soon as possible after receiving said notification_ B. ELECTIONS An employee who is a properly registered voter and who lives at such distance from his assigned work locations as to preclude his voting outside of working hours may be authorized by the Department Head to have a maximum of two hours of leave with pay for this purpose. An employee shall not be granted administrative leave to work at the polls during elections. C. MEETINGS In cases where it is deemed by the Division Director to be beneficial to the County, an employee may be granted leave with pay to attend such professional meetings or conferences as may contribute to the effectiveness of his employment (See Section 15 -Travel - for reimbursement procedures). D. EXAMINATIONS An employee may be granted leave with pay while taking examinations before a Federal, State or County agency, provided such examinations are pertinent to his County employment, if approved by the Department Head and the Division Director. E. I✓IILITARY LEAVE — In accordance with F S 115 I. Military Training - Employees who are reserve enlisted personnel in the United States military or naval service or members of the National Guard will be granted leave with full pay during days which they are engaged in military or naval training. Leave shall not exceed 17 working days in any one annual period (beginning October 1 and ending September 30 of the following year). Additional time shall be without pay and shall be granted without loss of time or efficiency rating. The employee will not be required to use annual leave or similar leave (comp time) in lieu of LWOP. Does not include Armory Drills or Multiple Training Assemblies, 2. Militaryy Service - Employees who are enlisted personnel in the National Guard or a reserve of the U.S. Armed Forces will be granted leave to perform active military service for the first 30 days with full pay. Paid leave shall also include the period during which a person in military service is absent from duty on account of sickness, wounds, leave, or other lawful cause. Period of active military service shall begin with the date of entering upon active military service and shall terminate with death or a date 30 days immediately next succeeding the date of release or discharge from active military service, or upon return from active military service, whichever shall occur first. Military earnings will be retained by the employee. 3. Examinations for NlllltM Service - Any employee who is ordered by the Selective Service Board to appear for a physical examuiation for induction into the military service shall be granted leave with pay- for this purpose. 43 of 77 4. Re --employment — National Guard Members — A member of the National Guard who returns to work after serving on state active duty will maintain seniority and other benefits as outlined in F.S. 250.482. F. USERRA — Uniformed Service Employment and Reemployment Rights Acts of 1994. Does not apply to "fate"military dirty or,governor call-ups of National Guard ,Vfovber.f. Please r%r to `E?"above for lea»e polity. In addition to "E" above: USERR1� covers employees who are: Active or reserve: Army, Navy, Marine Corps, Air Force, Coast Guard, Army National Guard, or Air National Guard, Commissioned Corps of the Public Health Service, and Any other category designated by the President in time of war or emergency. In addition, protects former and retired members and applicants for future service with a uniformed service. USERR-L does not include temporary employees unless employment is for a brief period with no reasonable expectation of continuance for a significant period of time. USERRA covers voluntary and involuntary. For purposes of military leave covered by USERRA — "Service" is defined as: Active duty, active duty for training, initial active duty for training, inactive duty training, full-time National Guard duty, absence for examination to determine fitness for any of the above forms of duty and funeral honors duty by National Guard or Reserve. Employees will receive up to 5 years military leave of absence (which includes reemployment rights). Types of service that do not count against an employee's five-year maximum includes: Inactive duty training (drills), annual training, involuntary recall to or retention on active duty, voluntary or involuntary active duty in support of war, national emergency, certain operational missions, or additional training requirements determined and certified in writing by the Service Secretary, and considered to be necessary for professional development or for completion of skill training or retraining. Certain specific exceptions will continue to protect beyond the five-year time period: Service required to complete an initial period of obligated service: Six --year active duty stint as an enlistee with the U.S. Navy's nuclear power program; Service from which a person, through no fault of the person, is unable to obtain a release within the five --year limit; Required training for reservists and National Guardsmen; Service under an involuntary order to, or to be retained on, active duty during domestic emergency or national security related situations; Service under an order to, or to remain on, active duty (other than for training) because of a war or national emergency declared by the President or Congress; Active duty (other than for traitung) by volunteers supporting "operational missions" for which selected reservists have been ordered to active duty without their consent; Service by volunteers who are ordered to active duty in support of a critical mission or requirement in times other than war or national emergency and when no involuntary call-up is in effect; and Federal service by members of the National Guard called into action by the President to suppress an insurrection, repel an invasion, or to execute the Laws of the United States. 1. BENEFITS WHILE ON LEAVE — Beginning on the 31" day and beyond, there will be no health insurance coverage. Employees will be offered coverage under COBRA,. 44 of 77 2. RE-ENIPLOYMENT (Military time served must be satisfactory. Must not be `less than honorable conditions".) A returning employee's notification of intent to return to work must be made promptly following completion of military service. Service of 1 — 30 days: the beginning of the next regularly scheduled work period on the first full day following completion of service and expiration of an 8-hour rest period following safe transportation home. Service 31-180 days: application for reinstatement must be submitted no later than 14 days after completion of military duty. Service of 181 or more days: application for reinstatement must be submitted no later than 90 days after completion of military duty. The deadline for reinstatement may be extended for employees who are convalescing due to a disability incurred during service. The employee must report back to work as soon as possible. Failure to report (unless through no fault of the employee) will be handled in accordance with the County's policies. Returning employee's pension plan accruals and vesting will continue as though no break in service had occurred except in limited situations (regarding health benefits as defused under the Act). Upon re-employment, the employee has 3 times the length of service (not to exceed 5 years) to make payments to any contributory plan and the County will fund any resulting obligation of the plan within the same time). When re-employed, the health insurance coverage will start from day 1 and there will be no waiting period. G. ADMINISTRATIVE LEAVE FOR RE-EXAMINATION OR TREATMENT BY VETERANS ADMINISTRATION WITH RESPECT TO SERVICE -CONNECTED DISABILITY — In accordance with F.S. 110-119. Any employee of the County who has been rated by the Veterans Administration to have incurred a service -connected disability and has been scheduled by the Veterans Administration to be re-examined or treated for the disability shall be granted administrative leave for such examination or treatment without loss of pay or benefits. In no event shall the paid leave under this section exceed six (6) calendar days a year. A leave request should be submitted to the Department Head for said leave as far in advance as possible. H. BLOOD DRIVES Employees will be granted leave with pay to donate blood during the County's organized Blood Drives. I. E-,AIERGENCY RESPONSE VOLUNTEFRS 45 of 77 1. Any employee who is a documented member of an Emergency Response Team will not be charged annual or sick leave, or be required to use accrued compensatory tune when called to respond to a legitimate emergency. The County reserves the right to require documentation that an emergency did in fact exist. 2. Any employee who is a member of an Emergency Response Team should inform the County at the time of employment interview or if already employed by the County, upon becoming a member of such a Team. Failure to do so could result in disciplinary action. J. MENTORING PROGRAM Pursuant to Resolution 100-2000, county employees may mentor a child in the Monroe County School District for up to one hour per week (not to exceed five hours per calendar month). Leave will be granted after taking into consideration the impact on such leave on the employee's work unit. If an employee is granted administrative leave under this section and does not use the administrative leave as authorized in this section, the employee shall not accrue or be paid for such unused leave. 8.02 DISABILITY LEAVE - WORKERS COMPENSATION A. ELIGIBILITY An employee, who sustains a County Service -connected disability which prevents the employee from carrying out his regular duties or any other duties as assigned, shall be entitled to disability leave within the guidelines of this Section. B. DEFINITIONS 1. Date of Disability - The date on which the disability began, or the last day of duty following injury, whichever is later. 2. Service -Connected Disability - A physical condition, resulting from accident or injury in the line of duty, which prevents an employee from performing his regular duties or any other duties as assigned. C. DISABILITY DETERI''VIINATION Determinations of the existence and service connection of a disability shall be made in accordance with the Florida State Workers Compensation Act which provides that the employer is responsible for furnishing employees, who have incurred service -connected disabilities, with such remedial treatment, care and attendance under the direction and supervision of a qualified physician, surgeon or other recognized practitioner. The County reserves the right under the provisions of this Section to speciIry fy the physician or surgeon or recognized practitioner to handle any and all service -connected disability cases. Disability determination shall be made based on: 1. All facts in the service history of the case. 2. The findings of the medical examiner assigned by the Workers Compensation carrier. 3. Such evidence as the employee may submit, at his own expense, of the service connection of his disability. 46 of 77 4. Other relevant evidence submitted to the medical examiner. 5. There shall be no presumption that any disability is service -connected, unless such a presumption exists as a matter of law. 6 Any condition which is self-inflicted or caused by another person for reasons personal to the employee and not because of his employment shall not be considered as disability under this provision. D. WORIfE:RS COhIPENSATION CLAIMS 1. It is the responsibility of the employee to report any and all job related injuries to his or her immediate Supervisor as soon after the injury occurs as possible. All Notice of Injury must be reported to Worker's Compensation office. It is the responsibility of the Supervisor to file a Notice of Injury Form and Supervisor's Report with the Employee Benefits Section, as soon as possible. A fine of $500 will be assessed against the County by the State of Florida for a claim that is not filed on a timely basis. The Notice of Injury Form must be complete. 2. An employee who sustains a job -related injury resulting in disability- that is compensable under the Workers Compensation Law, Chapter 440, Florida Statutes, shall have a seven (7) calendar day waiting period before Workers Compensation Benefit payments begin. During this waiting period, an employee may elect to use sick leave, annual leave, or documented compensatory time to receive normal salary. 3. Time spent obtaining medical treatment after seven (7) day waiting period related to the workers compensation injury will be paid for by the employing department and will not be charged against the employee's sick, annual or other accrued hours. The employee shall obtain the "Authorization for Treatment Evaluation" form from the Worker's Compensation Office and have the physician complete and forward to the workers' compensation office so that the employee not be charged sick/annual hours. 4. If disability continues into the eight (8th) calendar day, normal Workers Compensation payments would begin at a rate of 66 2/3% of the employees gross salary, computed on their average weekly wage for 13 weeks prior to the date of injury, in accordance with the Workers Compensation Law. 5. If disability continues into the twenty-first (21st) calendar day, the employee will receive Workers Compensation benefits retroactive to the date of injury, at the same rate discussed in #2, in accordance with the Workers Compensation Law. Any sick leave, annual leave, or compensatory time used by the employee for this seven (7) day period will be replaced on the books, based percentage wise on Workers Compensation Benefits paid. 6. After seven (7) calendar days, the disabled employee will continue to receive Workers Compensation benefit payments every two weeks until their physician releases them to return to work. 7. If requested by the employee, a review of the case will be made by a committee composed of a representative of the Human Resources and/or Employee Benefits offices and the 47 of 77 employee's Department Head, and a written recommendation may be made to the County Administrator that the employee be allowed to use annual leave, sick leave and/or approved compensatory time in an amount necessary to receive a salary amount that will supplement their Workers Compensation payments up to the total net salary received prior to the disability. In no case shall the employee's salary and Workers Compensation benefits combined exceed the amount of their regular salary payments. If the Workers Compensation absence is designated as FMLA leave, the employee will not be allowed to use annual leave, sick leave and/or approved compensatory time to supplement leave, in accordance with Department of Labor rules. 8. The disabled employee will continue to accrue both sick leave and annual leave during the period of disability. 9_ An employee placed on light -duty by his or her physician, may enroll in the Light -Duty Program as written in Administrative Instruction 8002. 10. When an employee on Workers Compensation can no longer perform his/her normal job duties, he/she may be separated from employment, if approved by the County Administrator, in accordance with the laws of the State of Florida governing Workers Compensation and these policies and procedures. 8.03 PREGNANCY, MATERNITY AND CHILD CARE LEAVE A. PREGNANCY 1. An employee who knows in advance that he/she intends to request Maternity or Child Care leave shall notify, in writing, their Department Head or Supervisor at least thirty (30) days prior to the requested time of leave. Eligible employees shall submit a "Family and Medical Leave Act Leave Request" form (see Section 8.05) 2. An employee whose duties may be considered hazardous enough to cause the employee to become medically disabled anytime during the pregnancy will be required to furnish medical evidence of her fitness to continue in the performance of her duties beyond that time. A Department Head may request this determination at any time he/she deems necessary for the health or welfare of the employee. 3. A pregnant employee may continue her employment as long as she is able to properly perform the required duties of the job, and these duties are stated in writing by her physician to be non -hazardous to the employee and the unborn infant. B. MATERNITY LEAVE 1. Disabilities arising out of pregnancy, childbirth and recovery there from, shall be treated the same as other temporary, non -job -connected disabilities in terms of eligibility for use of sick leave, annual leave, or leave of absence. 2. 11 regular employee who has completed the standard probationary period may request a maternity leave of absence without pay for childbirth, recovery and child -rearing following birth of up to six (6) months after all accrued sick and annual leave has been used. Such approval is subject to scheduling and work load requirements. The County reserves the right to require employee(s) to return to work 48 477 when it is no longer medically necessary to be away from their job, if work load and scheduling requirements require the employee's return in accordance with the Family and Medical Leave Act. 3. Any such leave must be requested in advance and approved by the applicable Department Head and the Division Director, who may approve the length of said leave based on workload, scheduling and the employee's physical ability to return to work. 4. An employee approved for maternity leave shall be eligible to return to work at any time during the leave of absence upon presentation of medical certification indicating that she is able to satisfactorily perform her original duties. 5. An employee returning from an approved maternity leave of absence shall resume her duties in the position held prior to childbirth or a similar position with like pay. 6. An employee who fails to return from an approved maternity leave of absence shall be considered to have abandoned her position and shall be terminated from the County Service, unless proper resignation procedures are followed. C. CHILD CURE LEAVE Child Care Leave is an absence available to eligible employees under the Family Medical Leave Act for up to 12 weeks (see Section 8.05). 8.04 LEAVE OF ABSENCE WITHOUT PAY A. EDUCATIONAL LEAVE 1. An employee with at least twelve (12) months of satisfactory service may be granted leave of absence without pay for the purpose of furthering his/her education, if it is determined by the County Administrator, in his discretion, that such education will be of clearly foreseeable benefit to the County. 2. Leaves of this type shall not normally exceed twelve (12) months; however, the Division Director may approve an extension of such leave if an individual case is justified and approved by the County Administrator. B. PERSONAL LEAVE 1. If recommended by the Department Head and the Division Director, an employee with at least twelve (12) months of satisfactory service may, be granted leave without pay for reasons other than those stated in the previous paragraphs for a period not exceeding six (6) months; provided the County Administrator deems such leave to be justified, and not detrimental to the operations of the Department. C. SCHEDULING AND APPROVAL OF LEAVE AVF OF ABSENCE WITHOUT PAY All leave of absence without pay must be approved in advance. The employee shall fill out the Leave Request Form and submit it to the Department Head for approval. The Department Head will submit the approved form to the Division Director for approval. . A completed copy of the Leave Request Form will be forwarded to the Payroll Department along with the Employee's Time Sheet whenever possible and a copy placed in the employee's official personnel tile. 49 477 2. Leave without pay is not intended as a convenience for the employee but rather to help the employee in cases where an emergency exists after all available time has been used. In cases of short term absences (except as noted in K04 A & B) where the employee has no leave available, such leaves may be processed without the prior approval of the County A' dministrator. D. LEAVE OF ABSFNCF - GENERAI PROVISIONS 1. RETURN FROM LEAVE OFABSENCE An employee returning from approved leave shall be entitled to employment in the same Department and the same or equivalent classification wherein employed when said leave began, provided the employee is physically capable of performing the required duties, and that there is such a vacant and budgeted position available. 2. EFFECTIVE DATE Leave of absence shall be effective the first date of approved absence and shall continue through the last date of approved absence. 3. LIMITATIONS ON LEAVE WITHOUT PAY a. Fringe Benefits - An employee shall not earn benefits while on leave without pay status. This would include, but not necessarily be limited to, sick, vacation and holiday leave. b. Wage Increases - The time during which an employee is on leave without pay may not count toward eligibility for wage increases. Nor may an employee receive any wage increases while on leave without pay; unless special approval is obtained from the County Administrator. c. Employees on an approved leave of absence without pay that is covered under the Family and Medical Leave Act will not lose the benefits that the employee earned or was entitled to before using FMLA leave. E. INSURANCE COVERAGE WHILE ON LEAVE OF ABSENCE 1. The County will continue to maintain group insurance benefits for employees while on approved paid leave status. 2. Employee Coverage - In most cases the County will not maintain Group/Health insurance benefits for employees on leave without pay status, except in the case of debilitating/catastrophic illness, of the employee or member of the immediate family for which the care of that family member is the responsibility of the employee. In accordance with 8.04 (C), the Division Director shall approve the absence and communicate with the Employee Benefits Committee. The Employee Benefits Committee is comprised of the County Administrator, the Employee Services Director and the Sr. Administrator, Benefits. The Committee will review each case to determine whether employee coverage should be maintained as verified by a physician, up to six (6) months. Employees covered under the Family and Medical Leave Act will be granted up to 12 weeks of insurance benefits as stated in Section 8.05. 50 of 77 If leave extends beyond the maximum allowed period of six months and is on a non -paid status, said mium payments for themselves in order to continue health employee must make monthly pre insurance coverage. Failure to make payment(s) on a timely basis will result in termination of coverage. 3. Dependent Coverage - Monroe County employees elect dependent coverage under a group plan at their own expense. Monroe County uses the bi-weekly payroll deduction system for payment of dependent coverage premiums for employees. However, if for any reason an employee is not due to receive a paycheck in an amount sufficient to deduct said premium, that employee is responsible for making the premium payments to the Employee Benefits Section in accordance with their payment schedule. As long as an employee is in good standing, as in the case of approved leave without pay status, he or she may make premium payments and coverage will remain in effect. Failure to make payments on a timely basis may result in termination of coverage. 4. Extension of Group Insurance benefits will be awarded in accordance with the Consolidated Omnibus Budget Reconciliation Act (COBRA), effective October 1, 1986. Information regarding this Act is available in the Employee Benefits Section. 8.05 FAMILY AND MEDICAL LEAVE OF ABSENCE (FMI -k) (FAMILY AND MEDICAL LEAVE ACT OF 1993. A family leave of absence, and/or medical leave of absence, is an approved absence available to eligible employees. An eligible employee is entitled to 12 weeks of leave per calendar year Qanuary — December) (#1, 2, 3, 5) or a combined total of 26 weeks of leave (for #4)-during the calendar year to care for: I)- The employee's newborn child or child placed with the employee for adoption or foster care (leave must conclude within 12 months of placement and may be taken by either parent); 2)- The employee's spouse, child or parent with a serious health condition, or 3)- An employee's own serious health condition. 4)-For the spouse, child, parent, or next of kin of a member of the Armed Forces, including a member of the National Guard or Reserves, who is undergoing medical treatment, recuperation, or therapy, is otherwise in outpatient status, or is otherwise on the temporary disability retired fist, for serious injury or illness. 5)-For the spouse, child, or parent, is on active duty, or because of notification of an impending call or order to active duty in support of a contingency operation. If the employee is requesting FMLtk qualifying leave, all accrued sick and annual leave must be taken first. Paid leave so taken will be counted against the employee's total FMLA leave entitlement. The employee will be notified that paid leave will be counted as FTNILA leave within five (5) business days of making that determination. The notice will be confirmed in writing to the employee on or before the following payday. A. ELIGIBILITY To be eligible, an individual must have been employed at Monroe County: - For at least 12 months, and - For at least 1,250 hours of service during the 12 month period immediately preceding the leave. Subsequent eligibility will be determined by looking back to the beginning of that calendar year from the first day of a new FNH 1� leave period which is requested by the employee. FMIA leave may not exceed twelve weeks during the 51 of 77 calendar year or a combined total of 26 weeks. An eligible employee shall be entitled to a combined total of 26 work weeks of leave for family, medical and/or service member leave. Husbands and wives working for the same employer are only granted a combined 12 weeks of leave; however, both spouses may each take 12 weeks to care for a child with a serious health condition. The determination of whether an employee meets the minimum service and hour requirements of the FMLA must be made by ?Monroe County as of the date the leave commences, and ?Monroe County will advise the employee whether he or she is eligible with five (5) business days after making a determination of eligibility. B. PROCEDURES A "Request for Fainily and Medical Leave of Absence" form should be completed by the employee as part of the notice and reporting requirements. The employee shall notify the Department Supervisor of the need for leave either verbally or by completing the FMLA form. (In any event, the employee shall fill out a Leave Request Form in accordance with the County's Policies and Procedures in order to request leave.) After completing the form in detail and signing it, the employee or Supervisor must submit it to Human Resources for approval. Notification shall be given at least thirty (30) days in advance of the effective date of the requested leave if the need for leave is foreseeable. The "Certification of Health Care Provider" form must be completed and signed by the health care provider. Failure to have the form completed may result in a delay for the approval of leave. C. BzkSIC REGULATIONS AND CONDITIONS OF LEAVE 1. Monroe County will require the employee to fill out a request for Family and Medical Leave of Absence form that included the "Certification of Health Care Provider" form supporting the need for leave due to a serious health condition affecting the employee or employee's spouse, child, or parent or next of kin in the case of service member family leave. 2. Monroe County may, at its own expense, require a second medical opinion and periodic re -certification. If the first and second medial opinions vary, Monroe County may, at its own expense, require the binding opinion of a third healthcare provider, approved jointly by Monroe County and the employee. 3. If medically necessary, such leave may be taken intermittently or on a reduced work schedule. If FMI.A leave is for both birth and care or placement for adoption or foster care, use of intermittent leave is subject to approval. The decision to grant leave or to temporarily transfer the employee on this basis rests solely with the County Administrator based on a medical certification provided with the Family Medical Leave of Absence Form. 4. When husband and wife are both employed by Monroe County, together they are entitled to a total aggregate of twelve weeks of Family Leave or a combined total of 26 weeks for service member leave. 5. Employees requesting FMLA qualifying leave will be required to substitute paid vacation and sick leave for all or party of any (otherwise) unpaid FMLA leave. 6. While on any unpaid part of an FMLr1 qualifying leave, no time will be accrued by the employee. Upon return to work, leave will accrue based upon established policy. D. DESIGNATION OF LEAVE Monroe County shall designate an employee's absence toward the employee's 12-week FMLA entitlement as soon as it is known that the employee's absence qualifies as FMI z\ leave. Monroe County will notify the employee that 52 of 77 his/her leave will be designated as FMLA leave witlln five (5) business days. The notification to the employee can be oral, but will be confirmed in writing no later than the next regular payday. Injuries entitling employees to workers' compensation frequently qualifies as serious health conditions for purposes of F-1%I11-k leave eligibility. Monroe County shall count an employee's workers' compensation absence toward the employee's 12-week FMI.A entitlement as stated above. If it is found that the absence does not qualify under the FMLA, Monroe County will withdraw the designation with written notice to the employee. E. EMPLOYEE NOTICE AND RETORTING REQUIREMENTS 1. When FMLA quahf ,l ng leave is foreseeable, an employee must give Monroe County thirty (30) days advance notice. 2. When such leave is not foreseeable, an employee must give notice as soon as practicable. According to the FNILA regulations, "as soon as practicable" means within one or two working days of learning of the need for leave, except in extraordinary circumstances. 3. If an employee fails to satisfy the thirty (30) day notice without reasonable excuse, Monroe County may, at its discretion, postpone the leave until the notice requirement is satisfied. 4. The employee may be required to submit periodic reports during FNILA leave regarding the employee's leave status and intent to return to work. This requirement may be satisfied by he employee's personally telephoning his or her immediate supervisor. F. HEALTH BENEFITS DURI_NG LEAVE OF ABSENCE, 1. Monroe County will continue group health coverage for an employee on leave at the same level and under the same conditions that existed while he or she was working. The employee must pay the dependent coverage premium for any unpaid leave. Payment for dependent coverage must be received in the Group Insurance Office every payday in order to continue coverage. Failure to pay dependent coverage during this unpaid leave will result in termination of coverage. 2. In the event that the employee does not return to work at Monroe County following FINILA leave, the employee can be required to reimburse Monroe County for health insurance premiums paid to continue the employee's health coverage during FMLA leave, unless the employee is unable to return to work due to a continuation, recurrence, or onset of a serious health condition that would entitle the employee to FMLA leave or other circumstances beyond the employee's control. Questions regarding the FNILA should be addressed to the Human Resources office 8.06 DOMESTIC OR SEXUAL VIOLENCE LEAVE Definitions: "Domestic Violence" means any assault, aggravated assault, battery, aggravated battery, sexual assault, sexual battery stalking, aggravated stalking, kidnapping, false imprisonment, or any criminal offense resulting in physical injury or death of one family or household member by another family or household member. "Sexual Violence" is sexual battery, or lewd or lascivious acts committed on, or in the presence, of, someone under the age of 16; or luring or enticing a child; or sexual performance by a child; or any other forcible felony involving a sexual act, regardless of whether criminal charges were filed, reduced or dismissed. 53 of 77 Employees are permitted to request and take leave in connection with domestic or sexual violence under certain circumstances. This applies to employees who have been employed for 3 or more months. Eligible employees can take up to 3 working days of leave in any 12 month period if the employee, or family or household member of the employee, is the victim of domestic or sexual violence. Employees shall use annual or sick leave when available to cover this leave. This leave applies if the employee is: -Seeking an injunction for protection against domestic violence or an injunction for protection in cases of repeated violence, dating violence or sexual violence; -Obtaining medical care or mental health counseling, or both, for the employee or family or household member to address physical or psychological injuries resulting from the act of domestic or sexual violence; -Obtaining the services from a victim -services organization, including, but not limited to, a domestic or sexual violence shelter or program or a rape crises center as a result of a domestic or sexual violence act; -Making the employee's home secure from the perpetrator of the domestic or sexual violence or to seek new housing to escape the perpetrator; or -Seeking legal assistance in addressing issues arising from the domestic or sexual violence or attending and preparing for court -related proceedings arising from the domestic or sexual violence. Except in cases of imminent danger to the health or safety of the employee, family or household member, employees seeking such leave must provide their employer with appropriate advance notice of the leave as required by policy (see Section 7.01 C(2) and 7.02 C) along with sufficient documentation of the domestic or sexual violence act as required by the employer. All information relating to the employee's leave for domestic or sexual violence must be kept confidential. 54 477 STANDARDS OF EMPLOYMENT, DISCIPLINARY ACTION AND APPEALS SECTION 9 9.01 INTENTION It is the intention of the Board of County Commissioners that effective supervision and employee relations will avoid most matters which necessitate disciplinary action. The purpose of rules and disciplinary action for violating such rules is not intended to restrict the rights of anyone; but to ensure the rights of all, and secure cooperation and orderliness throughout the County Service. For minor, non -serious offenses, whenever possible, the administration of discipline will be characterized as constructive, corrective and progressive. 9.02 RESPONSIBILITY FOR ADMINISTRATION It shall be the responsibility of the County Admuustrator, in cooperation with Division Directors and the Board of County Commissioners to assure that disciplinary action is fair and consistent throughout the County Service. 9.03 STANDARDS OF EMPLOYMENT For the protection of Monroe County government and each employee, the following rules for personnel conduct have been established. The list includes, but is not limited to, reasons which may require disciplinary action, up to discharge. -1 violation of any reasonable standard of employment, whether or not specifically listed herein, will result in appropriate disciplinary action, which may include discharge for the first offense, depending upon the seriousness of the offense. A. Willful or repeated violations of County, State or Federal law or of these policies and procedures. B. Insubordination - Refusal to respond to authority's reasonable request(s) or instruction. C. Misconduct - Behavior not conforming to prevailing standards - Misconduct may include, but is not limited to the following: Fighting or inflicting bodily harm on another person, gambling, dangerous horseplay, being under the influence or possession of illegal drugs or alcoholic beverages, immoral behavior, smoking in restricted areas, any violent act or language which adversely affects morale, production, or maintenance of discipline. Rudeness or acts of disrespect to members of the public, supervisors, or other employees; on duty or off duty. Employees shall not consume or be under the influence of alcoholic beverages, while on duty or in County uniform, nor shall they use or be under the influence of, consume or possess illegal substances while on duty, in County uniform or on County property at any time. D. Criminal, dishonest, infamous or notoriously disgraceful conduct adversely affecting the employer/employee relationship (on duty or off duty). E. Conviction of (or a plea of nolo contendere in connection with) a felony or gross misdemeanor, or conviction of a misdemeanor or ordinance violation involving moral turpitude. F. Theft or pilfering - Possessing, unauthorized use of, taking, removing, destroying or tampering with County property without proper authorization. 55 of 77 G. Fraud or Dishonesty - Falsification of County documents or records or failure to give complete information for personnel records. Intentionally making false statement either oral or written about the County, other employees, supervision, oneself or work situations. H. Absenteeism or Abuse of Sick Leave - Habitual or excessive absence from work, or failure to return to work promptly upon expiration of leave or vacation. Excessive absences, even if caused by a legitimate illness, seriously impairs the County's operations, and such absences may be grounds for separation. I. "Tardiness - Failure to report to assigned work station on or before the scheduled starting time. J. Leaving Assigned Work Area - Except for emergency reasons or with the Supervisor's approval, employees are not to leave their assigned work area. K. Misuse of Time - Sleeping or other acts of inattention or neglect of duty. Unauthorized sale of articles or services, distribution or posting of literature, canvassing, polling or petitioning. L. Abuse of County Policies and Procedures - Misuse or abuse of established County policies such as vacation, leave of absence, excused absence, sick leave, or any rule, regulation, policy or procedure_ M. Safety Violations - Unauthorized possession and/or use of weapons, ammunition or explosives. Failure to observe County and general safety practices and regulations_ Neglect in the safety of others or the committing of unsafe acts in the use and care of County property or equipment. N. Illegal driving - Driving private or County vehicle while on County business when not possessing a valid Florida and County driver's permit or liability insurance, in accordance with the Monroe County Safety Policies. O. Malicious or Negligent Destruction of Property - Willful or malicious destruction of County property. Damage of property- by failing to use proper equipment, care and good judgment. P. Incompetence or Inefficiency - Inability or failure to perform work of an acceptable standard after a reasonable trial and training period. Q. Discrimination 111 Employment - Discriminating against an employee or an applicant for employment because of race, color, national origin, sex, religion, creed, sexual preference, handicap or age as defined in State and Federal laws. R. Acceptance of unauthorized compensation. S. Misfeasance - The doing of a lawful act ii1 an unlawful or improper manner so that there is an infringement on the rights of another. T. Smoking — Smoking of tobacco products is prohibited in all ;Monroe County owned or occupied public facilities (buildings), vehicles, elevators, meeting rooms, hallways, corridors, lobbies, water fountain areas, stairwells and entryways. 9.04 DISCIPLIN_1RY ACTIONS Disciplinary actions are a means of calling employees to accountability for some act of commission or omission which is regarded as injurious to the employer/employee relationship. The act could be relatively 56 477 minor, or quite serious. Serious acts may warrant immediate discharge, even for the first offense. All employees should be made aware that a system of discipline exists for the benefit of all, and will be administered without favor for the sake of orderliness and proper compliance with reasonable rules and regulations pertaining to conduct and the performance of work. When it is necessary that disciplinary action be taken, the degree of action shall be based on the following considerations: 1. There can be no mechanical formula for the application of discipline. Each instance of misconduct or deficiency must be viewed and judged individually. For most lesser or first minor offenses, oral or written reprimand shall be appropriate discipline. 2. When applicable, discipline for employees who commit multiple non serious offenses of a like or different nature shall be more progressively stringent until the employee corrects the deficiency, or failing this, discharge is considered to be necessary. 3. Department, Division Directors, the County Administrator, their Deputies and others occupying positions of high trust and authority will be held to higher disciplinary and ethical standards than that of other employees. Therefore the rules of progressive discipline for violations of Personnel Policies and Procedures, and/or State and Federal Statutes may not be applicable. 4. Disciplinary actions shall be severe enough to constitute a reasonable attempt to bring about correction. 5. Acceptable disciplinary actions shall be oral warning, written warning, written reprimand, suspension (with or without pay), discharge, and in some cases demotion, depending on the offense. 6. Discharge for continued commitment of non serious, minor offenses shall be resorted to only when sufficient other efforts to bring about correction have failed, or when the offense is sufficiently serious in and of itself to warrant termination. 7. In determining the appropriate disciplinary action to be imposed against an employee, the County Administrator will consider, at a minimum, the following factors: a. The seriousness and circumstances of the particular offense. b. The past record of the employee and his length of service. c. The lapse of time since the employee last received a disciplinary action. d. The County's practice in similar cases. 9.05 AUTHORIZATION FOR DISCIPLINARY ACTION A. All written reprimands, suspensions and recommendations for suspension or discharge actions must be approved by the Department Head and the Division Director and the letter concerning the action must be forwarded immediately to the Human Resources office for review, and then approved by the County administrator or his designee. B. In case of a recommendation for discharge, the employee may be suspended pending approval of discharge by the County Administrator. 57 477 C. Disciplinary actions applied to Department Heads or Division Directors may be initiated by the County Administrator. 9.06 ORAL WARN ING An oral warning is given to an employee to take recognition of a violation of County policy, rule, regulation, standard or of an unsatisfactory habit, practice or act which, if repeated or continued, will subject the employee to a more severe disciplinary action. The oral warning should be noted in writing, a copy of the notation placed in the employee's official personnel file, specifying the nature of the warning and the date given. 9.07 WRITTEN REPRIMAND A letter of reprimand constitutes formal action against an employee for more serious types of violation of County rules or standards of employment, or where less stringent actions have not been successful in correcting a deficiency. The letter of reprimand must identify the offense or deficiency and the correction required. A letter of reprimand can be used to impose restrictions on an employee, such as attendance, conduct or special procedures to be followed. Restrictions so imposed shall be reviewed periodically and be removed, modified, or continued with a follow-up letter. A copy of all letters should be placed in the employee's official personnel file within 15 days of writing, whenever possible. 9.08 DEMOTION Whenever it becomes apparent that an employee can no longer efficiently perform any or all of the duties and responsibilities of his or her position, or when it is otherwise deemed to be in the best interest of the County, an employee may be demoted. A demoted employee shall be notified by the County Administrator or his designee at the time of demotion of the specific reason for the action and correction expected, if any. Such notification shall be given the employee in writing. A copy of the notification will be placed in the employee's official personnel file along with a written report on all appropriate information concerning the action. An employee may be reclassified to a different title and/or pay grade at any time the County Administrator deems appropriate. A temporary reclassification does not constitute a demotion, nor does a change in title and/or pay grade which results from an evolution into a reduction of duties and/or responsibilities. 9.09 SUSPENSION 1. An employee may be suspended with or without pay by the Department Head and/or Division Director with the approval of the County Administrator. The employee must be notified in writing of the suspension period and citing the reason for the suspension. 2. An employee may be verbally suspended with or without pay by a Supervisor for the balance of a work shift, or a longer period of time if needed until the Department Head or appropriate authority can be contacted, if the employee's conduct impairs normal working operations. The Supervisor must then report the incident to the Department Head, who with the approval of the Division Director must either concur with, or cancel the action, in writing, to the employee citing the reason for the suspension, and corrective action expected. Additional time of suspension may be recommended by the Department Head with the approval of the Division Director and the County Administrator at that time. A copy of 58 of 77 the suspension notification will be placed in the employee's official personnel file along with a written report containing all appropriate information concerning the action. 9.10 DISCHARGE Discharge is appropriate for first offenses of serious misconduct as well as repeated offenses of less serious misconduct. Sufficient documentation must be present to merit recommendation by the Department Head and the Division Director to the County Administrator for discharge of any employee. 9.11 PROCEDURE FOR IMPOSING DISCIPLINE 1. This procedure shall apply in cases where an employee may be subject to suspension, demotion or termination. Furthermore, this procedure shall not necessarily apply to contract employees, probationary employees, temporary employees or grant employees. 2. When the County receives information that an employee has engaged in certain conduct which could warrant disciplinary action (other than a verbal warning or written reprimand, which may be issued by the appropriate Supervisor) the employee will be advised, in writing, that disciplinary action could possibly be imposed against him/her. 3. The employee will be provided with a written statement of the charges including sufficient facts and reasons therefore as will enable the employee to provide an explanation and/or defense. An employee against whom disciplinary charges have been made will remain in pay status until such time as the County Administrator renders his decision pursuant to paragraph 6(e), below. However, nothing herein shall preclude the County Administrator, or other authorized personnel, from imposing immediate disciplinary action, without advance notice, where it is believed by the person taking that action that giving such notice would result in damage to the property of the County, would be detrimental to the interests of the County or would result in injury to the employee, a fellow employee, or the general public. In such circumstances, said employee will be given reasons for such action after it takes effect and thereafter will be entitled to utilize the hearing procedure set forth in the following paragraphs. 4. The hearing shall be informal and shall not be in the nature of an evidentiary hearing. The employee may bring an attorney or qualified representative to assist or advise him, but discovery, cross-examination, and similar legal procedures are generally not permissible. An employee who wants to engage in discovery, cross- examination, or other legal procedures must make an advance written application to the hearing officer. The hearing officer's decision is final. 5. The informal hearing will be conducted before a hearing officer who shall be: a. A Division Director or the County Administrator where the employee charged is a Department Head; b. The County Administrator or his designee where the employee charged is a Division Director; or c. A Division/Department Head or a designee where the employee charged is an employee holding Career Service Status and to whom section A and B above do not apply. d. The County Administrator may serve as hearing officer whenever he/she sees a need to do so. 6. The hearing will be informal and will be conducted as follows: 59 of 77 a. At least two working days prior to the hearing date, the employee shall provide the individual conducting the hearing with a list of any witnesses or documents which the employee wishes to offer at the hearing. b. The employee may be accompanied by legal counsel of his/her choice. If the employee intends to be represented by counsel at said hearing, notice of such must be provided to the hearing officer as far in advance of the hearing as possible. The hearing officer may, reschedule the hearing if necessary. c. During the hearing, the hearing officer will orally review the charges with the employee. The employee shall have the right to respond to the charge(s) made against him/her, either orally and/or in writing. The employee may present documentation to the hearing officer and may, if appropriate, be permitted to call witnesses in support of his/her case. d. The hearing officer may consider any available documentation and may discuss the charges with any witness he/she deems appropriate. The hearing officer shall decide what evidence -- either in the form of witness testimony or documents -- may be introduced. Cumulative or irrelevant evidence will not be permitted. e. The hearing officer shall render a final written decision within ten (10) calendar days after the hearing. In the event of extenuating circumstances, the final written decision may be extended beyond the ten (10) calendar days upon mutual agreement of the Hearing Officer and employee. Such an agreement shall be provided in writing from the hearing officer to the employee in order to officially document the agreement. The final decision shall advise the employee of whatever action, if any, the hearing officer is recommending to be taken against the employee. The hearing officer's recommendation will be forwarded to the County Administrator (through the appropriate Department and Division Director, if applicable). Disciplinary action (except for verbal warning and written reprimand, which may be issued by the appropriate Supervisor) becomes final when approved by the County Administrator. 7. Employees who are suspended without pay, discharged, given a reduction in pay or a demotion (as defined herein) may appeal said disciplinary actions only to the Career Service Council as provided in Section 9.15. Other forms of discipline may be appealed pursuant to Section 10, 8. During the period between the first notice and the effective date of the action, the employee shall be expected to perform his usual duties without disrupting fellow employees, or other persons, or the agency's activities. If, however, it is deemed highly desirable or necessary that the employee not continue to perform the same duties in the same location during this period, the County may temporarily assign the employee to other duties. 9.12 POSSESSION OF WEAPON OR FIREARM' It is the policy of Monroe County that no employee shall carry or otherwise possess a weapon while on duty or in uniform, including firearms. If the performance of job duties requires the use or possession of a weapon or firearm, prior approval from the County Administrator must be obtained. 9.13 INDICTMENTS PROSECUTIONS ARRESTS s See Florida Statutes 790.251 60 of 77 It is the responsibility of Monroe County to maintain a proper workforce. Employees who are arrested, indicted by a Grand Jury, or on whom information has been filed by a prosecuting official, shall be given a pre -determination hearing to determine the effect said action and/or circumstances surrounding said actions have on his or her employment with the County, which may result in disciplinary action. If the employee is tried and found guilty and the conviction is not reversed he or she may be terminated from his or her position in the County Service. 9.14 FAILURE; TO COOPERATE IN A TC) B-REL UED INVESTIGATION L As a condition of employment, any County employee may be required, upon due notice, to cooperate with respect to any job -related hearing or investigation scheduled by the County, or any person, commission, board or body authorized to act on its behalf. This duty of cooperation also extends to any "outside" agency, body or court of law with respect to any job -related matters. 2. Any employee who refuses to appear at any such hearing or inquiry, or who having appeared fails to answer questions related to the performance of their official job duties will be considered to have resigned from their employment with the County. 9.15 APPEALS A Career Service employee who has been suspended without pay, discharged, given a reduction in pay or a demotion (as defined herein) shall have only the right to appeal said action to the Career Service Council by filing a petition with said Council within thirty (30) days following such suspension, discharge, reduction in pay, or demotion. Failure to file a timely appeal shall result in the forfeiture of all right to challenge/grieve the discipline. There shall be no appeals to the Board of County Commissioners and/or the County Administrator. 61 of 77 EMPLOYEE COMPLAINT/GRIEVANCE PROCEDURE SECTION 10 10.01 COMPLAINT/GRIEVANCES In the event an employee believes that the rules contained in this manual have been misapplied/violated, he/ she must utilize the following procedure, except in the cases of suspension, reduction in pay, demotion or termination - See 10.01 F. Failure of the grieving employee to follow the time limits will automatically result in a final and binding denial of the grievance. If the County does not follow the time limits, the appropriate County official will be deemed to have denied the grievance and it may proceed to the next step. A. Step 1: The aggrieved employee shall present his/her grievance orally or in writing to his or her Supervisor within fifteen (15) working days of the incident to be grieved. Discussion will be informal for the purpose of resolving differences in the simplest and most direct manner_ The immediate Supervisor shall consult with the Department Head, reach a decision, and communicate that decision orally or in writing to the aggrieved employee within ten (10) working days from the date the grievance was presented to him or her. Supervisors are not empowered to make policy decisions. B. -Step 2: If the grievance is not resolved in Step 1, the employee shall reduce the grievance in writing, sign it and present it to the Supervisor. The Supervisor shall attempt to resolve the issue(s) concerning the alleged grievance within ten (10) working days of the receipt of the written grievance. Should the grievance still not be resolved at this point, it shall be presented to the Department Head for review. The Department Head shall confer with the immediate Supervisor and they shall attempt to obtain the facts concerning the alleged grievance, and within ten (10) working days of receipt of the written grievance, answer the employee in writing or schedule a meeting with the employee. If a meeting is held, the Department Head shall notify the aggrieved employee in writing of his or her decision, no later than ten (10) working days after the meeting. The meeting may be rescheduled by the Department Head for a valid reason. C. Step I If the response from the Department Head is not satisfactory, the employee may present the grievance form to the Division Director, who may confer with anyone he/she deems appropriate to obtain the facts concerning the alleged grievance, and within ten (10) working days of receipt of the grievance, schedule a meeting with the employee. The Division Director shall notify the aggrieved employee in writing of his/her, decision no later than ten (10) working days after the meeting. D. Step 4: If the response from the Division Director is not satisfactory, the employee may bring the grievance form to the Human Resources office, for review before the Employee Grievance Council. This Council will provide an additional avenue for the employee to pursue in the processing of appropriate complaints or grievances. By the establishment of the Employee Grievance Council, the employee whose problem is not resolved by the Division Director , may have the opportunity appear before this Council of peers and present his/her case. The Employee Grievance Council is empowered to call all necessary witnesses before them and to subsequently make their recommendations concerning disposition aetions to the County Administrator. The decision of the Council is not binding; final determination will be made by the County Administrator. (Please refer to Monroe County Administrative Instniction54714 for rules and procedures governing the Council.) The County Administrator shall furnish a copy of his decision to the aggrieved employee within fifteen (15) working days of receipt of the Councils recommendation(s). E. Any complaint/grievance involving matters that pertain to the Personnel; Policvies and Procedures may be addressed in writing to the Employee Grievance Council, (via the Human Resources office) who will forward to the Council to determine whether the matter is appropriate to be considered by the Council. If 62 of 77 deemed appropriate by a majority of Council members, the Human Resources office will schedule the airing of the Grievance at the earliest convenience. The Council is empowered to call all necessary witnesses and make a recommendation concerting disposition to the County Administrator whose decision is final. F. This Procedure does not apply to an individual who has been suspended, discharged, redueed received a reduction in pay or demoted. Such individuals shall appeal in accordance to Section 9.15 hereof. G. If an employee does not answer to a Department Head and/or a Division Director, the Human Resources office will assist the employee in moving through the appropriate steps of this grievance procedure. H. The by-laws governing the establishment and operation of the Employee Grievance Council may be reviewed in Administrative Instruction IW5 4714. I. If the grievant feels the issue has not been satisfactorily resolved, the employee may appeal to the County Administrator. 63 477 SEPARATIONS SECTION 11 11.01 RESIGNATIONS r1 resignation is defined as an action whereby an employee voluntarily leaves the County Service with or without the giving of notice and/or as any employee conduct which is stated herein to constitute a resignation. An employee wishing to leave the County Service in good standing shall file with the Department Head a written letter of resignation stating the date and reasons for leaving, 14 calendar days prior to the effective date of resignation. Failure to comply with this requirement may be cause for denying such employees re-employment rights and payment of unused leave. Unauthorized absences of three (3) days or more may be considered a resignation. 11.02 LAYOFFS Should it become necessary to abolish a position or reduce the number of County employees because of lack of work, shortage of funds, re -organized and transferred functions to an existing County employee, or for other legitimate reasons, the County Administrator/Board of County Commissioners may lay off as many employees as required, after two weeks notice. There shall be no appeal except the internal grievance proceedings. No regular employee shall be laid off while there are temporary or probationary employees serving in the same class in the same department. Such laid off employees shall be given priority of re -hire, in the event the position(s) is/are re-established, based on seniority and previous performance evaluations, for a period of time to their length of continuous service, but not to exceed one year. Such employees will also be eligible for promotional opportunity privileges for a period of one year after date of lay-off. 11.03 RETIREMENT Employee benefits upon retirement will be based upon the regulations of the State and County Government, Employees Retirement System Law, Social Security Act, and any other provisions which may be in effect at the time of retirement. 11.04 DISCHARGES A discharge occurs when an employee has been involuntarily separated from County Service, usually for cause. Employees discharged for disciplinary reasons may not be eligible for re -hire and may lose all seniority and reinstatement privileges. 11.05 EXIT INTERVIEWS It is the desire of the County to determine why good employees leave the County Service. An exit interview program has been established for the purpose of determining the causes and possible solutions of turnover among County personnel. If an employee wishes, he or she may request an exit interview with Employee Services by contacting the Human Resources office.The Employee Services Division Director or County Administrator may also request an interview with an employee who has made known his or her intention to leave the County Service. The information obtained during the interview will be used solely for the purpose of identifying or solving problem areas and will not become part of the employee's personnel record unless authorized in writing by the employee. 64 of 77 SOLICII`ING SECI`ION 12 12.01 SOLICITING 1. No employee shall be permitted to solicit any other employee during working time. Working time means the time when either employee (solicitor or solicitee) is on duty and not on an authorized break or meal period. 2. No employee shall be permitted to distribute leaflets, notices or other materials, or pass petitions during working or non -working time in work areas. Such distribution can take place only in non -work areas and during non working time. 3. No non -employee shall be permitted to enter County premises or property at any time for the purpose of soliciting employees or distributing or posting any written, printed or other material except in those areas customarily open to the public or vendors. 4. Limited exceptions to the above rules may occur but only upon application to and approval by the County Administrator. 5. It is intended that the above rules shall be interpreted and applied in accordance with applicable law. 65 of 77 EMPLOYEE PERFOR-'LLANCE EVALUATIONS SECTION 13 13.01 POLICY All Departments shall evaluate the performance of all employees on an impartial basis using standard evaluation forms and the Employee Performance Appraisal Handbook provided in Administrative Instruction 4003. 13.02 PURPOSE Employee performance evaluations shall be used for, but not limited to, the following purposes: A. To inform the employee of strong and weak points in his performance, as well as training needs and improvements expected. B. To recognize the employee's potential for promotion. C. To determine the employee's eligibility for merit salary advancements. D. To provide a record of past performance. E. To assist in determining the order of layoffs and reinstatements. 13.03 PROCEDURES A. Each employee shall have his performance evaluated on a periodic basis as outlined in the Performance Appraisal Handbook 1. All performance evaluations shall be made by the employee's immediate Supervisor (with input from anyone deemed appropriate by the Supervisor) and reviewed by a higher level Supervisor whenever possible. The immediate Supervisors final evaluation shall not be changed by higher level Supervisors; however, reviewing Supervisors shall certify that they reviewed the rating and may attach any written comments they deem appropriate concerning the evaluation. 2. Department Head may authorize an evaluation at any time he or she deems appropriate. 3.The original, completed evaluation form, as well as any written material from the Supervisor, the Department Head, or the employee, shall be placed in the employee's official Personnel File. B. If an employee receives a below satisfactory rating in any category, the immediate Supervisor shall work with the employee in an effort to assist him/her in improving job performance. Such employees, if retained by the department, shall have their performance re-evaluated in the category(s) which do not meet performance standards. 66 477 EMPLOYEE INSURANCE COVERAGE SECTION 14 14.01 COVERAGE All full-time, regular employees are covered by life and accidental death and dismemberment insurance paid for by the County. The amount of such insurance is determined by the Board of County Commissioners. Group hospitalization insurance coverage for full-time employees is paid for by the County at a rate approved by the Board of Commissioners. Dependent coverage will be available for those eligible at group rates, paid for by the employee. The County may change its benefit program at any time, for example, by adjusting benefits, changing employee contributions, changing deductibles, and/or selecting other insurance carriers. 14.02 DEFINITIONS A. Domestic Partners. "Domestic Partners" are two adults who have chosen to share one another's lives in a committed family relationship of mutual caring. Two individuals are considered to be Domestic Partners if: 1. they consider themselves to be members of each others immediate family; 2. they agree to be jointly responsible for each other's basic living expenses; 3. neither of them is married or a member of another Domestic Partnership; 4. they are not blood related in a way that would prevent them from being married to each other under the laws of Florida; 5. each is at least of the legal age and competency required by Florida law to enter into a marriage or other biding contract; 6. they must each sign a Declaration of Domestic Partnership as provided for in Section 14.03; 7. they both reside at the same residence. B. Joint Responsibility for Basic Living Expenses. "Basic living expenses" means basic food and shelter. "Joint responsibility" means that each partner agrees to provide for the other's basic living expenses while the domestic partnership is in effect if the partner is unable to provide for him or herself. It does not mean that the partners must contribute equally or jointly to basic living expenses. C. Competent to Contract. "Competent to Contract" means the two partners are mentally competent to contract. D. Domestic Partnership. "Domestic Partnership" means the entity formed by two individuals who have met the criteria listed above and file a Declaration of Domestic Partnership as described below. E. Declaration of Domestic Partnership. "Declaration of Domestic Partnership" or "DDP" is a form provided by the Human Resources Director. By signing it, two people swear under penalty of perjury that they meet the requirements of the definition of domestic partnership when they sign the statement. The form shall require each partner to provide a mailing address. F. Dependent. "Dependent" means an individual who lives within the household of a domestic partnership and is: 1. 3 biological child or adopted child of a domestic partner; or `Resolution 081-1998 67 of 77 2. A dependent as defined under County employee benefit plan document. 3. A ward of a domestic partner as determined in a guardianship proceeding. G. Employee means an employee of the Board of County Commissioners, the constitutional officers or the Mosquito Control Board, except where the context is otherwise. 14.03 ESTABLISHING A DOMESTIC PARTNERSHIP A. An employee and his/her domestic partner as set out in Section 14.02 are eligible to declare a Declaration of Domestic Partnership (hereafter DDP) in the presence of the Human Resources Director, or the employee partner may present a signed and notarized DDP to the Human Resources Director. The DDP shall include the name and date of birth of each of the domestic partners, the address of their common household, and the names and dates of birth of any dependents of the domestic partnership, and shall be signed, under the pain and penalties of perjury, by both domestic partners and witnessed (two) and notarized. B. As further evidence of two individuals being involved in a domestic partnership, to of the following documents must be presented along with the DDP to the Human Resources Director: 1. A lease, deed or mortgage indicating that both parties are joint responsible; 2. Driver's licenses for both partners showing the same address; 3. Passports for both partners showing the same address; 4. Verification of a joint bank account (savings or checking) 5. Credit cards with the same account numbers in both names; 6. Joint wills; 7. Powers of attorney; or S. Joint title indicating that both partners own a vehicle. C. An individual cannot become a member of a domestic partnership until at least six months after any other domestic partnership of which she or he was a member has ended and a notice that the partnership has ended was given as provided for in Section 14.04. This does not apply if their domestic partners deceased. D. Domestic partners may amend the DDP to add or delete dependents or change the household address. Amendments tot he DDP shall be executed in the same manner as the declaration of a domestic partnership. 14.04 TERMINATION OF A DOMESTIC PARTNERSHIP A. A domestic partnership is terminated when: 1. one of the partners dies; 2. one of the partners marries; or 3. a domestic partner files a termination statement with the Human Resources Director. A domestic partnership may be terminated by a domestic partner who files with the Human Resources Director by hand or by certified mail, a termination statement. The person filing the termination statement must declare under pain and penalties of perjury that the domestic partnership is terminated and that a copy of the termination statement has been mailed by certified mail to the other domestic partner at this or her last know address. The person filing the termination staternent must include on such statement the address to which the copy was mailed. B. The termination of a domestic partnership shall be effective unmediately upon the death of a domestic partner. The voluntary termination of a domestic partnership by a partner shall be effective thirty (30) days after the receipt of a termination statement by the Human Resources Director. If the termination statement is withdrawn before the effective date, the domestic partner shall give notice of the withdrawal, by certified mail, to the other domestic partner. 68 477 C. If a domestic partnership is terminated by the death of a domestic partner, there shall be no required waiting period prior to filing another domestic partnership. If a domestic partnership is terminated by one or both domestic partners, neither domestic partner may file another domestic partnership until six (6) months have elapsed from effective termination. D. It is the obligation of the employee domestic partner to notify the Human Resources Director of the termination of a domestic partnership as soon as possible after it occurs. 14.05 HUMAN RESOURCES DIRECTOR RECORDS A. The Human Resources Director will keep a record of all employees DDPs, Amendments and Termination Statements. The records will be maintained so that DDPs, Amendments and Termination Statements will be filed to which they apply. B. The Human Resources Director shall identify on the DDP what type of documents was presented for further verification of the domestic partnership. C. Upon determination by the Human Resources Director that the DDP is complete and that further evidence of the domestic partnership has been presented as provided in Section 14.03 (B); the Human Resources Director shall provide the employee with a copy of the DDP. The employee/domestic partner shall become eligible to elect domestic partnership health and other employee fringe benefits as provided in Section 14.06. It will be the employee's responsibility to notify the Employee Benefits Section of their intent to enroll the domestic partner and/or any eligible dependents under the Monroe County Employee Benefit Plan. Domestic partner/dependents enrolled in the Monroe County Employee Benefit Plan are subject to the same rules and provision applicable to covered spouses/dependents. D. The Human Resources Director shall provide forms to employees requesting them. E. The Human Resources Director shall allow public access to domestic partnership records to the same extend and in the same manner as any other public record. 14.06 EMPLOYMENT BENEFITS A. The County shall provide the same health and other employment fringe benefits to employees with domestic partners as to employees with spouses. As used in this section, "employees" refers to active and retired employees of Monroe County that are eligible for benefits pursuant to state law, County Ordinances, County employment policies, and collective bargaining agreements. B. The County shall provide health insurance and benefit coverage to an employee's domestic partner as it does to an employee's spouse, and to the dependent's of an employee's domestic partnership as it does to an employee's child(ren). An employee may opt to decline health insurance coverage for her or his domestic partner, without foregoing the right to obtain health insurance coverage or her or his domestic partner during a future open enrollment period. C. Upon termination of a domestic partnership by an employee, the non -employee domestic partner health insurance and benefits lapses. If the employee domestic partner leaves employment with the County, the health and benefit package of the non -employee domestic partner shall lapse on the date that the former employee's insurance lapses. D. Upon termination of a domestic partnership by the death of an employee, the sun iving domestic partner's health insurance and benefits coverage shall lapse as it would for the spouse of a married employee, upon the death of such employee. E. Board of County Commissioner employees shall be granted a leave of absence, with pay, for the death of a domestic partner or family member of a domestic partner to the same extent as for a spouse or family member of a spouse. Use of the term "in-law" in employee handbooks shall include the relatives of a domestic partner. 69 477 F. Board of County Commissioner employees shall be granted sick leave to care for a domestic partner to the same extent permitted to care for a spouse, and to care for a dependent of a domestic partnership to the same extent permitted to care for a child. G. Board of County Commissioner employees shall be entitled to take parental leave to take care of a child born to his/her domestic partner or a newly adopted child to the same extent as a married person. 14.07 LIMITATION OF LLABILITIES -A. Nothing in this ordinance shall be interpreted to contravene the general laws of this state. B. Nothing contained in this Ordinance shall be construed to impose liability upon a domestic partner for the health or health expenses of his or her domestic partner. 14.08 FORMS A. The Human Resources Director shall distribute copies of the following forms to those individuals who request them: 1. Declaration of Domestic Partnership 2. Domestic Partnership Information Sheet 3. Amendment to Declaration of Domestic Partnership 4. Termination Statement of Domestic Partnership. 70 of 77 TRAVEL SECTION 15 15.01 TRAVEL It shall be the policy of the Board of County Commissioners to reimburse all employees, Board members and other Department personnel for all authorized travel. Said reimbursement shall be made in the following manner: A. In County overnight travel will require the approval of the Department Head. Out of County travel will require the prior approval of the applicable Division Director or County Administrator. If travel is to any county contiguous to Monroe County or if the travel can be completed within one workday, not requiring overnight lodging, prior approval of the next -highest supervisory level can be obtained. B. Private use of individual vehicles for county business shall be reimbursed for travel mileage in accordance with Monroe County Code. C. Employees who use their personal vehicles for approved County travel shall be reimbursed in accordance with the information reflected on the reverse side of Form #C676. These employees should be aware that they may be subject to periodic odometer audit(s), and that the employee's personal auto insurance is primary payer in case of an accident while or County business. D. Individuals shall be entitled to per diem while on official travel in accordance with provisions contained in Monroe County Code, except the Board may authorize the reimbursement of actual expenditures where documented evidence is provided justifying actual expenses incurred. E. The County Administrator shall authorize reimbursement for lease, rental cars and/or aircraft where it is deemed by the County Administrator to be the most advantageous to the County. Employees are to waive all insurance on rental car contracts, and no reimbursement for insurance costs shall be authorized under this section. F. All requests for travel reimbursement shall be submitted in writing on State of Florida Voucher for Reimbursement of Travel Expenses which shall give date(s) of travel, purpose, all applicable receipts, and amount due the traveler. Advance payment for travel must be requested by submitting voucher form for approval by the applicable Division Director or County Administrator. G. Travel shall be the most economical and practicable method available. 71 of 77 APPEARANCE SECTION 16 16.01 APPEARx1NCE AND PROPER ATFIRE All County employees should strive to be as neat and clean in appearance as possible. Proper attire conducive to carrying out the functions of their respective positions should be worn by all employees. The Department Head will be responsible to insure that the appearance of his or her employees properly represents Monroe County in relation to their positions. Proper clothing and equipment needed to insure employee safety is required to be utilized at all times in accordance with the Monroe County Safety Policies. 72 477 VIOLENCE IN THE WORKPLACE SECTION 17 17.01 The purpose of this policy is to provide a safe environment for conducting County business for employees, visitors, clients, and customers by prohibiting, preventitig, and taking action in response to work - related acts of violence. 17.02 Defm'tions: 17.03 Procedures: For the purpose of this policy, acts of violence include, but are not limited to: 1. verbal abuse, assault, threatening or obscene language or behavior, or 2. aggressive, harmful, dangerous, or violent physical actions, or 3. actions which endanger county employees, directly or incidentally, or 4. improper or dangerous use or display of any weapon or object used as a weapon. For the purpose of this policy, work -related acts include, but are not limited to, those which: 1. take place on County premises and affect county property, employees or representatives, or 2. involve one or more County employees or representatives, acting in their official County capacity, or 3. may occur off of County premises, but are related to County business, or 4. may occur outside of normal working hours, but are related to County business or 5. involve the use of County equipment, vehicles, communications equipment (phones, radio, FAY, etc.). A. The County will take prompt remedial action against any employee, visitor, client, or customer who engages in any behavior prohibited by this policy. B. The County will establish security measures, to the extent practical, to ensure that County facilities are safe and secure against actions prohibited by this policy. C. Employees, supervisors, etc. will take reasonable immediate action to protect victims of violent actions from further harm. Actions which will increase any danger should be avoided. When necessary, local law enforcement agencies must be notified as soon as possible. D. After any imminent danger or threat has been dealt with, an employee, manager, supervisor, etc. has a duty to notify their immediate supervisor, Safety Administrator Risk Manager, or other appropriate person of any incident or activity which is in violation of this policy. Reports made pursuant to this policy will be held in confidence to the extent possible. The County will not tolerate any form of retaliation against anyone who makes a report under this policy. 73 of 77 E. The Human Resources office shall be notified of any prohibited acts by the affected employee, their supervisor, or other appropriate person, as mentioned in the preceding paragraph. Personnel shall determine the extent of remedial and disciplinary action to be taken, In making this determination, Human Resources may consult with employees, supervisors, safety or risk management representatives, law enforcement officials, etc. Disciplinary action taken against employees who violate this policy will be carried out in accordance with Monroe County Personnel Policies and Procedures. 74 of 77 CHILDREN IN THE WORK ENVIRONMENT SECTION 18 I. The Purpose of this section is to establish the policy of the Administration concerning Monroe County employees bringing children into the County work environment during normal working hours. A. It is the policy of this I\dministration that County employees shall not routinely bring children into the County work environment during the applicable employee's normal working hours. B. It is recognized that circumstances may arise wherein an employee's option with regard to caring for their dependent children may be restricted for any number of reasons. Generally, it would be expected that the employee would utilize vacation or sick leave, as appropriate, to resolve said matters. However, on the rare occasion where there are no other alternatives, and/or the work requirements are such that the employee's presence is mandatory, the Division Director or Department head may grant a special exception. C. A Division Director or Department head may grant a special exception ul response to unusual or emergency circumstances which would, for a very limited, specific period of time, permit an employee to bring children into the environment. The applicable Division Director or Department head shall then formally authorize said special exception in writing by completing the "Children in the Work Place Form" and routing the original to the Human Resources Department via the appropriate Division Director and the County Administrator, prior to the day the child is expected to be present. D. It is incumbent upon all Division Directors/Department Heads to insure that permitting children in the work environment is a rare exception and not the rule and that the special exception provisions provided above are not to be abused. E. The parent(s) shall be responsible for the proper behavior of the child while in the workplace. F. Children are not permitted in County vehicles at any time. G. Children are totally barred from certain high -risk jobs and work locations (such as construction sites). H. The County Administrator has the authority to waive the policy for special events (such as Daughter/Son At -Work Days. 75 of 77 CASH �IANA(3EMFNT PROCEDURES SECTION 19 To establish a standardized cash management procedure that will eliminate the risk of loss or misappropriation of funds. 1. All Divisions/Departments will have in effect a policy for all cash funds received to be deposited as quickly as possible, but in any event, not later than three (3) business days from receipt. 2. Check vouchers should be date stamped. In cases where there is no voucher attached, paperwork corresponding to the transaction should indicate the date of the check's receipt. 3. Advise OMB of the appropriate employees in each Division/Department who will be responsible for the cash deposits of the policy. 4. Division Directors and Department Heads are responsible for periodically reviewing the cash management procedure with their departments to ensure efficiency and compliance with this policy. 76 of 77 FIRE ALARM PROCEDURES SECTION 20 The purpose of this instruction is to establish the procedure for building occupants to adhere to when fire alarm systems located within County facilities annunciate. The definition of annunciate is to announce the alarm system. 1. When a fire alarm system located in a County Facility annunciate, building occupants are to turn off all electrical equipment that will not delay their exit; and shall immediately evacuate the building, reporting to their designated assembly area in accordance with posted fire evacuation plans located throughout County Facilities. 2. Emphasis shall be placed on orderly evacuation under proper discipline, rather than on speed. 3. Once in the assembly area, each Office Representative will account for their personnel. 4. All personnel will remain in the designated assembly area, well clear of the building, until released by the Fire Department and/or a representative from the Monroe County Public Works, Facilities Maintenance Department. 5. Constitutional Officers, Division Directors, and Department Heads are to ensure that all employees under their purview familiarize themselves with this policy and Reference A — Monroe County Safety Policies and Procedures Manual, along with the designated assembly area. 6. Constitutional Officers, Division Directors, Department Heads, and Monroe County Safety Administrator are to ensure evacuation routes are posted on bulletin boards throughout County Facilities, to include an assembly area for each office to report to, in the event of a fire evacuation. 7. Constitutional Officers, Division Directors, and Department Heads shall assign one person from each office the responsibility of accounting for each employee that works in their office, in the event of a fire evacuation. 77 of 77 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12-15-2010 Bulk Item: Yes X No Division: _County Administrator Department: Social Services/In-Home Services Staff Contact Person/Phone #: Sheryl GrahamlX4510 AGENDA ITEM WORDING: Approval of the Community Living Program (CLP) Contract CLP- MCSS-1 between the Alliance for Aging, Inc. (Area Agency on Aging for Miami -Dade and Monroe Counties) and the Monroe County Board of County Commissioners (Social Services/In-Home Services) for fiscal period 12/1/10 to 12/31/10. ITEM BACKGROUND: Approval of the CLP Contract #CLP-MCSS-1 will allow In -Home Services to perform short term, cost effective, interventions, to individuals at high risk of nursing home placement or hospital re -admission. PREVIOUS RELEVANT BOCC ACTION: None CONTRACT/AGREEMENT CHANGES: None STAFF RECOMMENDATIONS: Approval TOTAL COST: $15,000.00 INDIRECT COST: -0- BUDGETED: Yes X No COST TO COUNTY: $1,500.00 (10% Cash Match Required) SOURCE OF FUNDS: Ad -Valorem Taxes And $1,500.00 (10% In -Kind Match) REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year APPROVED BY: County Atty TI � OMB/Purchasing X Risk Management _X_ DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 1/09 CONTRACT SUMMARY Contract with: Alliance For Aging, Inc. Contract CLP # CLP-MCSS-1 Effective Date: 12/1/2010 Expiration Date: 12/31/2010 Contract Purpose/Description: Approval of the Community Living Program (CLP) Contract CLP-MCSS-1 will allow Monroe County In -Home Services to perform short term, cost effective, interventions, to individuals at high risk of nursing home placement or hospital re -admission. Contract Manager: Sheryl Graham 4510 Community Services/Stop I (Name) (Ext.) (Department/Stop #) For BOCC meeting on 12/15/10 Agenda Deadline: 11/30/10 CONTRACT COSTS Total Dollar Value of Contract: (extension) $15,000.00 Current Year Portion: $ Budgeted? Yes X No Account Codes: 125-6153010- Grant: $ 15,000.00 County Match: $1,500.00 (10% Cash Match Required $1,500.00 10% hi -Kind Match Total 20% Match ADDITIONAL COSTS Estimated Ongoing Costs: For: (Not included in dollar value above) (eg. Maintenance, utilities, janitorial, sala CONTRACT REVIEW Changes Changes Date Out Division Director Daye' �n Ne Ye a No0 Revi4er Risk Man ent Yes No 'V I -f I L� e O.M.B./Purchasing I Yes County Attorney -Z Yes "4 Comments: OMB Form Revised 2/27/01 MCP #2 0 December 2010 Contract CLP- MCSS I ALLIANCE FOR AGING, INC. STANDARD CONTRACTOLDER AMERICANS ACT PROGRAM TITLE HI-B COMMUNITY LIVING PROGRAM THIS CONTRACT is entered into between the Alliance for AOmz, Inc., hereinafter referred to as the "AAA," and Monroe County Social Services hereinafter referred to as the "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 AAA has established through the Area Plan on Aging 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 AAA. NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the mutual covenants and conditions hereinafter set forth, the Parties agree as follows: 1. Purpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, which constitute the contract document. 1.1 Definitions DOEA means the Florida Department of Elder Affairs. AAA means the Alliance for Aging, Inc. PSA means the Planning and Service Area corresponding to Miami -Dade and Monroe Counties. 2. Incorporation of Documents within the Contract The contract will incorporate the provider's application in response to the 2010 Community Living Program Invitation to Negotiate (ITN), attachments, proposal(s), state plan(s), grant agreements, relevant department handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the Proposal(s) or other general materials not specific to this contract document and identified attachments. 3. Term of Contract This contract shall begin on December 1 2010 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 Miami, Florida, on December 31 2010. 4. Contract Amount The department agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $15,000.00, 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)(f), F.S., the AAA 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 AAA and the availability of funds. 1196 December 2010 Contract CLP- MOSS I 6. Compliance with Federal Law 6.1. If this contract contains federal funds the following shall apply: 6.1.1 The provider shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 6.1.2 If this contract contains federal funds and is over $100,000.00, the contractor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The contractor shall report any violations of the above to the AAA. 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 II. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Contract Manager, prior to payment under this contract. 6.1.4 That if this contract contains $10,000.00 or more of federal funds, 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 That 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 That a contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards shall not be made to parties listed on the government -wide Excluded 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 will 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 AAA shall consider the employment of unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324 a) and the Immigration Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation shall be cause for unilateral cancellation of this contract by the AAA. 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 AAA in writing within thirty (30) days of receiving the IRS notice of revocation. 7. Compliance with State Law 7.1 That this contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 7.2 Requirements of s. 287.058, F.S. as amended. 2/96 December 2010 Contract CLP- MCSS 1 7.2.1 The contractor will 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. 215971, F.S. (1) and (2). 7.2.2 The contractor will submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre -audit and post -audit. 7.2.3 If itemized payment for travel expenses is permitted in this contract, the contractor will 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 will 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 shall constitute an immediate breach of contract for which the AAA may unilaterally terminate the contract. 7.3 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 will 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. 8. Backgoround Screening 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, shall pass a Level 11 criminal background screening in accordance with the requirements of s. 430.0402 and ch. 435, F.S., as amended. These provisions shall apply to employees, subcontractors, consultants, direct service providers and volunteers. Consequently, any commitment for employment, purchase of services, or volunteer program participation shall be contingent upon the passing of a Level II background check. The background screening shall include employment history checks as provided in s. 435.03(l), 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, 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 and 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, should provide for notice of the grievance procedure and an opportunity for review of the subcontractor's determination(s). 10. Audits, Inspections, Investigations, Public Records and Retention 10.1 To establish and maintain books, records and documents (including electronic storage media) sufficient to reflect all income and expenditures of funds provided by the AAA under this contract. 3/96 December 2010 Contract CLP- MCSS 1 10.2 To 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 AAA. 10.3 Upon demand, at no additional cost to the AAA, the contractor will facilitate the duplication and transfer of any records or documents during the required retention period in Paragraph 10.2. 10.4 To assure that the records described in Paragraph 10 shall be subject at all reasonable times to inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the AAA. 10.5 At all reasonable times for as long as records are maintained, persons duly authorized by the AAA, DOEA and Federal auditors, pursuant to 45 CFR 92.36(i)(10), shall 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 To provide a financial and compliance audit to the AAA as specified in this contract and in ATTACHMENT III and to ensure that all related party transactions are disclosed to the auditor. 10.7 To comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S. tl. Nondiscrimination -Civil Rights Compliance 11A The contractor will execute assurances in ATTACHMENT VI that it will not discriminate against any person in the provision of services or benefits under this contract or in employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance with state and federal law and regulations. The 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 The contractor will retain, on file, during the term of this agreement a timely, complete and accurate Civil Rights Compliance Checklist (ATTACHMENT B). 11.3 The contractor agrees to establish procedures pursuant to federal law to handle complaints of discrimination involving services or benefits through this contract. These procedures shall include notifying clients, employees, and participants of the right to file a complaint with the appropriate federal or state entity. 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 AAA 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 will provide services in the manner described in ATTACHMENT I. 4196 December 2010 Contract CLP- MCSS I 13. Monitoring by the AAA The contractor will permit persons duly authorized by the AAA 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 AAA of the satisfactory performance of the terms and conditions of this contract. Following such review, the AAA will deliver to the contractor a written report of its findings and request for development, by the contractor, a corrective action plan where appropriate. The contractor hereby agrees to timely correct all deficiencies identified in the corrective action plan. 14. Coordinated Monitoring with Other Agencies If the contractor receives funding from one or more of the State of Florida other human service agencies, in addition to the 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 coordinator, the contractor shall comply and cooperate with all monitors, inspectors, and/or investigators. 15. Indemnification The contractor shall indemnify, save, defend, and hold harmless the AAA and its agents and employees from any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the execution of this agreement or performance of the services provided for herein. It is understood and agreed that the provider is not required to indemnify the AAA for claims, demands, actions or causes of action arising solely out of the AAA's negligence. 15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contracts executed between the DOEA and state agencies or subdivisions defined in s. 768.28(2), F.S. 16. Insurance and Bonding 16.1 To provide continuous adequate liability insurance coverage during the existence of this contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or subdivision as defined by subsection 768.28(2), F.S., the 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 AAA has the most current written verification of insurance coverage throughout the term of this contract. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida. The AAA reserves the right to require additional insurance as specified in this contract. 16.2 Throughout the term of this agreement, the contractor agrees to 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 Portability and Accountability Act 5/96 December 2010 Contract CLP- MCSS I Where applicable, the contractor will 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 Reporting 19.1 The contractor shall notify the AAA 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 To immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number (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) Reporting (NIA) 21. Bankruptcy Notification If, at any time during the term of this contract, the contractor, its assignees, subcontractors or affiliates files a claim for bankruptcy, the contractor must immediately notify the AAA Within ten (10) days after notification, the contractor must also provide the following information to the AAA: (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., Northern District of Florida, Tallahassee Division); and, (4) the name, address, and telephone number of the bankruptcy attorney. 22. Sponsorship 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), The Alliance for Aging, and the State of Florida, Department of Elder Affairs." If the sponsorship reference is in written material, the words "Alliance for Aging" and "State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or type as the name of the organization. 22.2 The contractor shall not use the words "Alliance for Aging" or "The State of Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless, specific authorization has been obtained by the AAA prior to use. 23. Assignments 23.1 The contractor shall not assign the rights and responsibilities under this Contract without the prior written approval of the AAA, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring without prior written approval of the AAA will constitute a material breach of the contract. 23.2 The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the 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 AAA. 6/96 December 2010 Contract CLP- MCSS 1 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 AAA deems necessary. The contractor further agrees that the AAA shall not be liable to the subcontractor in any way or for any reason. The contractor, at its expense, will defend the AAA against any such claims. 24.2 The contractor shall promptly pay any subcontractors upon receipt of payment from the department or other sponsoring 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 Capacity of Contractor It is the intent and understanding of the parties that the contractor, or any of its subcontractors, are independent contractors and are not employees of the AAA and shall not hold themselves out as employees or agents of the AAA without specific authorization from the AAA. It is the further intent and understanding of the parties that the AAA does not control the employment practices of the contractor and shall 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 shall be the sole responsibility of the contractor. 26. Payment Payments will be made to the contractor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the contractor. The AAA's 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 AAA's fiscal 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 will return to the AAA any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the contractor by the AAA. 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 AAA. In the event that the AAA first discovers an overpayment has been made, the Contract Manager, on behalf of the AAA, will notify the contractor by letter of such findings. Should repayment not be made forthwith, the contractor will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after AAA notification or contractor discovery. 28. Data Integriity and Safeguarding Information The contractor shall insure 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 must be routinely backed up to insure recovery from losses or outages of the computer system. The security over the backed -up data is to be as stringent as the protection required of the primary systems. The contractor shall insure all subcontractors maintain written procedures for computer system back up and recovery. The contractor shall complete and sign ATTACHMENT IV prior to the execution of this contract. 7/96 December 2010 Contract CLP- MCSS I 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 will establish safeguards to prohibit employees, board members, management and subcontractors from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain. No employee, officer or agent of the 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 AAA 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., the following restrictions are placed on the ability of persons convicted of public entity crimes to transact business with the AAA. 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. 32. Purchasing 32.1 To procure any recycled products or materials, which are the subject of or are required to carry out this contract, in accordance with the provisions of s. 403.7065, F.S. 33. Patents, Copyrights, Royalties If any discovery, invention or copyrightable material is developed or produced 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 AAA 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) I and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the contract. 8/96 December 2010 Contract CLP- NICSS 1 33.1 If the primary purpose of this contract is the creation of intellectual property, the state shall retain an unencumbered right to use such property, notwithstanding any agreement made pursuant to Paragraph 33. 34. Emeraency Preparedness and Continuity 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 AAA of emergency provisions. 34.2 In the event, a situation results in a cessation of services by a subcontractor, the contractor will 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. 36. Use of State Funds to Purchase or Improve Real Property Any state funds provided for the purchase of or improvements to real property are contingent upon the contractor or political subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by law. 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 Consequences 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 AAA 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 shall not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the AAA. 39. No Waiver of Sovereign Immunity Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which sovereign immunity may be applicable. 40. Venue If any dispute arises out of this contract, the venue of such legal recourse will be Leon County, Florida. 41. Entire Contract This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or representations shall be valid or binding upon the AAA or the contractor unless expressly contained herein or by a written amendment to this contract signed by both parties. 9/96 December 2010 Contract CLP- MCSS I 42. Force Maieure Neither party shall be liable for any delays or failures in performance due to circumstances beyond its control, provided the party experiencing the force majeure condition provides immediate written notification to the other 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: Appropriations The parties agree that the AAA's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature to DOEA. 45. Addition/Deletion The parties agree that the AAA reserves the right to add or to delete any of the services required under this contract when deemed to be in the PSA'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 AAA to exercise or enforce any of its rights under this contract shall not constitute or be deemed a waiver of the AAA's right thereafter to enforce those rights, nor shall any single or partial exercise of any such right preclude any other or further exercise thereof or the exercise of any other right. 47. Compliance The contractor agrees to 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 AAA. 48. Final Invoice The contractor shall submit the final invoice for payment to the AAA as specified in Paragraph 3.3.4. (date for final request for payment) of ATTACHMENT I. If the contractor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the AAA may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from the contractor and necessary adjustments thereto have been approved by the AAA. 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 AAA'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. December 2010 Contract CLP- MCSS I 50.2 In the event funds for payment pursuant to this contract become unavailable, the AAA 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 AAA shall 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 AAA 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 AAA's or the contractor's rights to remedies at law or in equity. 50.4 Failure to have performed any contractual obligations with the AAA in a manner satisfactory to the AAA 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 AAA, been notified by the AAA of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction of the AAA; or (2) had a contract terminated by the AAA for cause. 51. Official Payee and Representatives (Names, Addresses, and Telephone Numbers): The contractor name, as shown on page 1 of this Monroe County Board of County Commissioners/In-Home a. contract, and mailing address of the official payee to Services Program whom the payment shall be made is: 1100 Simonton Street Rm 2-257 Key West, FL 33040 The name of the contact person and street address Sheryl Graham, Director, Monroe County Social Services b. where financial and administrative records are 1100 Simonton Street, Rm. 2-257 maintained is: Key West, FL 33040 305-292-4510 The name, address, and telephone number of the Sheryl Graham, Director, Monroe County Social Services C. representative of the contractor responsible for 1100 Simonton Street, Rm. 2-257 administration of the program under this contract is: Key West, FL 33040 305-292-4510 The section and location within the AAA where Anthony Coombs, Associate Vice President d. Requests for Payment and Receipt and Expenditure 760 NW 107th Avenue, Suite 201 and 214 forms are to be mailed is: Miami, Florida 33172 e The name, address, and telephone number of the Maria Scotto 760 NW 107"' Ave. #214 Contract Manager for the AAA for this contract is: Miami, FL 33174 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. 11/96 December 2010 Contract CLP- MCSS I 52. All Terms and Conditions Included This contract and its Attachments, I — X, A, B, E, F, G and 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. 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 63 page contract, to be executed by their undersigned officials as Z:1 duly authorized. Contractor: SIGNED BY: NAME: TITLE: DATE: ALLIANCE FOR AGING, INC. SIGNED BY: NAME: MAX B. ROTHMAN, JD, LL.M. TITLE: PRESIDENT AND CEO DA 12/96 December 2010 ATTACHMENT ATTACHMENT I ATTACHMENT 11 ATTACHMENT III, EXHIBIT 1 ATTACHMENT III, EXHIBIT 2 ATTACHMENT III, EXHIBIT 3 ATTACHMENT IV ATTACHMENT V ATTACHMENT VI ATTACHMENT VII ATTACHMENT VIII ATTACHMENT IX ATTACHMENT X, EXHIBIT 1 ATTACHMENT X, EXHIBIT 2 ATTACHMENT X, EXHIBIT 3 ATTACHMENT A ATTACHMENT B ATTACHMENT E ATTACHMENT F, EXHIBIT I ATTACHMENT F, EXHIBIT 2 ATTCHMENT G ATTACHMENT H INDEX TO CONTRACT ATTACHMENTS ATTACHMENT DESCRIPTION STATEMENT OF WORK CERTIFICATION REGARDING LOBBYING FINANCIAL COMPLIANCE AUDIT ATTACHMENT Contract CLP- MCSS I PAGE 15-25 27 29-32 FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT AUDIT RELATIONSHIP DETERMINATION & FISCAL COMPLIANCE REQUIREMENTS CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION ASSURANCES — NON -CONSTRUCTION PROGRAMS OLDER AMERICANS ACT PROGRAM BUDGET SUMMARY OLDER AMERICANS ACT CONTRACT REPORT CALENDAR REQUEST FOR PAYMENT RECEIPTS AND EXPENDITURES, TITLE III ADMINISTRATION RECEIPTS AND EXPENDITURES, TITLE IIIB, IIIC 1, AND IIIC2 RECEIPTS AND EXPENDITURES, TITLE IIIE DEPARTMENT OF ELDER AFFAIRS' PROGRAMS & SERVICES HANDBOOK (ON CD) DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE CHECKLIST AND INSTRUCTIONS DEPARTMENT OF ELDER AFFAIRS' COMPUTER USE AND SOCIAL MEDIA POLICY (ON CD) DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY II INSTRUCTIONS: DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY II CLP PROGRAMS PROTOCOLS SERVICE PROVIDER APPLICATION 33 35 37 39 41-42 43 45 47 49-51 53-55 57-59 61 63-68 69 71 73 75-84 85-96 13196 December 2010 Contract CLP- MOSS i 14/96 December 2010 Contract CLP- MCSS I ALLIANCE FOR AGING, INC. STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS ADL — Activities of Daily Living APS — Adult Protective Services AIRS — Alliance of Information & Referral Systems ADA — Americans with Disabilities Act AAA — Area Agency on Aging APCL — Assessed Priority Consumer List CIRTS — Client Information and Registration Tracking System FLAIRS — Florida Alliance of Information and Referral Services I&R — Information and Referral IADL — Instrumental Activities of Daily Living MOA — Memorandum of Agreement MOU — Memorandum of Understanding OAA — Older Americans Act PSAs — Planning and Service Areas WebDB — Web -based Database System 1.1.2 PROGRAM SPECIFIC TERMS ATTACHMENT I ADI (Alzheimer's Disease Initiative) — Services targeted to individuals with Alzheimer's Disease or a similar memory disorder, including respite, assessment, caregiver training, and other community -based services. These services are funded through a specific state appropriation. ADRC or ARC (Aging and Disability Resource Centers or Aging Resource Centers) — The not -for -profit entity which is the single entry point for the aging service system within each established region of the state. APS (Adult Protective Services) High Risk — The designation of an elder who needs immediate protection from further abuse, neglect or exploitation, which can be accomplished completely or in part through the provision of home and community -based services. Area Plan: A plan developed by the area agency on aging outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and department instructions. Area Plan Update: A revision to the area plan wherein the area agency on aging enters OAA specific data in the web -based database system (WebDB). An update may also include other revisions to the area plan as instructed by the department. Caregiver or Support System — For this project, the caregiver or support system is one or more persons whom the elder can depend on to provide care or to organize the provision of needed care. Care Plan Review Team — For purposes of this project, a team of staff designated by the CLP staff, which reviews the client's situation and makes recommendations concerning continuation of services after the initial short term grant -funded crisis -resolving period. However in no case will services be continued on a long term basis under this program. CCE (Community Care for the Elderly) — Services offered to functionally impaired older persons to enable them to 15f96 December 2010 Contract CLP- MCSS I live in the least restrictive environment, including adult day care, consumable medical supplies, home delivered meals, homemaker, personal care, respite, and other community -based services. These services are funded through a specific state appropriation. CIRTS (Client Information and Registration Tracking System) — The database of the Department of Elder Affairs used by the aging network to manage client assessment data, register clients for services, plan client services and maintain program waiting lists. Lead agency provider assessors also use CIRTS to evaluate client eligibility for Medicaid services and to develop recommendations for client placement. CDC (Consumer Directed Care) — A service option that gives elders, or their representatives, the opportunity to manage the elder's service delivery, including decisions about which services will be provided, by whom and how often. With the assistance of a consultant, an elder develops a budget plan that identifies needed goods and services and authorizes the elder to hire workers, who may be family members or friends, and select vendors to help with daily care needs. A fiscal/employer agent (F/EA) pays the workers and vendors according to the rates on the budget plan. The F/EA also pays the required federal and state taxes and files the necessary tax forms. Community Living Program — "Community Living Program" is a grant to the state of Florida from the federal Administration on Aging. For persons meeting the project's functional and financial eligibility criteria, the grant provides crisis -resolving in -home services to address their immediate and temporary needs as they leave a hospital or rehabilitation center or after a short-term nursing home stay. Without these services, the person would be at high risk of either nursing home placement or continued stay in a nursing home. This program also manages consumer directed care services provided to veterans. Cost Sharing — Payment by an individual for a portion of the monthly cost of the services he/she receives, based on the individual's income and assets, and determined by the total monthly cost of the planned services. Crisis -Resolving Services — Time -limited community -based services provided to address a client's immediate short- term care needs. Possible services include, but are not limited to: ease management, personal care, homemaker, transportation, meals. For the purposes of this program, a crisis is an episode that has a high probability of creating a nursing home long term placement or a re -hospitalization. Examples of such crisis include caregiving situations, i.e. a caregiver hospitalization that would cause the nursing home placement of the care recipient; it also includes hospital/rehab discharges that have a high likelihood of recidivism or further patient deterioration where a permanent nursing home placement is a likely sequel. Financial Eligibility —To be financially eligible to receive services, other than assessment and referral, under this project, the individual must not be eligible for Medicaid under the Institutional Care Program (ICP) rules. Frail: When an older individual is unable to perform at least two activities of daily living (ADL) without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. Lead Agency —A Community Care for the Elderly (CCE) designated agency. Lead agencies provide services under the CCE and ADI programs. In addition lead agencies handle APS cases in accordance with a DOEA established protocol. Lead Service Provider —A provider of Older American Act Services that also provides case management under this project. The Case manager from the service provider will follow-up with those project participants referred by the CLP staff to facilitate the provision of services during the grant period and to help plan for the person's needs after the grant period. OAA IIIB, IIID, IIIE (Older Americans Act Titles) — Title IIIB provides supportive services to assist elders to live independently in their community. Title IIID provides disease -prevention and health -promotion services at senior centers or alternative sites. Title IIIE provides services through the National Family Caregiver Support Program to assist families caring for frail older members, and to assist grandparents or older relatives who are caregivers for children who are under 19 or are disabled. 16/96 December 2010 Contract CLP- MOSS I Private Pay — Payment of the complete cost of services by an individual with sufficient income and assets to be over the financial standards for receipt of state or grant funded services. Referring Entity — An entity providing referrals to the single entry point. These include case management agencies, hospitals, rehabilitation centers, home health agencies, physician assisted home based programs, and nursing homes. Individuals referred should appear to meet the eligibility criteria for this project. Self -declared — For purposes of initial financial eligibility for the project, the individual's declaration of income and assets will not require verification. SEP (Single Entry Point) —The CLP staff for the area where the individual is receiving services is the single entry point into the aging service system. Spend down to Medicaid — The use of personal resources to pay for services prior to the individual's resources being reduced to the level of Medicaid eligibility. Triage — The activity performed by CLP staff to prioritize an individual for service based on the criteria established for publicly funded programs because he/she does not meet the eligibility criteria for this project. Veterans Administration Consumer Directed Care —A capitated consumer directed care program sponsored by the Veterans Administration and operated through the Community Living Program. Also, see Consumer Directed Care definition above. 1.2 Alliance for Aging Mission The Alliance For Aging Inc. mission id to promote and advocate for the optimal quality of life for older adults and their families. 1.2.1 DOEA Mission Statement The department's mission is to foster an optimal quality of life for elder Floridians. The department's vision and shared values are to foster a social, economic and intellectual environment for all ages, and especially those age 60 and older, where all can enjoy Florida's unparalleled amenities in order to thrive and prosper. Area agencies, lead agencies and local service providers as partners and stakeholders in Florida's aging services network are expected to support the department's mission, vision, and program priorities. 1.2.2 Older Americans Act Program Mission Statement The Older Americans Act (OAA) Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 1.3 GENERAL DESCRIPTION 1.31 General Statement The goals of Community Living Program Phase 11, for PSA I are to reduce overall Medicaid long term care expenditures, develop co -pay and financially sustainable systems —within the context of the Older Americans Act network of AAA and providers, and to increase consumer choice and self -direction. 1.3.2 Authority The relevant references authority governing the OAA program are: (1) Older Americans Act of 2006, as amended; (2) Rule 58A-1, Florida Administrative Code; and am December 2010 Contract CLP- MCSS I (3) Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and 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 providing services in accordance with the CLP Program Protocols contained in ATTACHMENT G and its response to the 2010 CLP program ITN contained in ATTACHMENT H. The services shall be provided in a manner consistent with and described in the current contractor's area plan update and the current Department of Elder Affairs Programs and Services Handbook (ATTACHMENT A). 1.3.4 Major Program Goals The goals of Community Living Program Phase II, for PSA 11 are to reduce overall Medicaid long term care expenditures, develop co -pay and financially sustainable systems —within the context of the Older Americans Act network of AAA and providers, and to increase consumer choice and self -direction. To achieve these goals PSA 11 will focus its efforts in providing consumers with the means to resolve events that have been identified as "critical pathways" to institutional long term care. Some of these "critical pathways" include sudden caregiver burnout, depression, malnutrition/dehydration and lack of proper follow up with home and community based services following hospital/rehab discharges. PSA 11 will also manage a Veterans Administration Consumer Directed Care. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility Client Identification 1. Individual is at least 60 years old. 2. Individual is a resident of Miami -Dade or Monroe Counties. 3. Financially uneligible for Medicaid and functionally impaired. 4. Has Medicare or private health insurance. 5. Individual is not receiving hospice services. Individual or careeiver is in need of crisis resolving services and/or short term care, to avoid readmission to a hospital/rehab facility or a nursing home placement which could lead to spend down to Medicaid. Services are not geared to resolve a long term care need, but to address a critical short term need that if left unresolved would precipitate a nursing home placement or re -hospitalization zn 1.4.1.1 OAA Title III, General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitated long-term care program. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need, with particular attention to low- income older individuals, including those that are low-income minorities, have limited English proficiency, and older individuals residing in rural areas. 18/96 December 2010 Contract CLP- MOSS I SECTION II — MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program, the contractor shall ensure that the protocols contained in ATTACHMENT G and the response to the 2010 CLP program ITN contained in ATTACHMENT H 2.1.3.1 Supportive Services Supportive services include a variety of community -based and home -delivered services that support the quality of life for older individuals by helping them remain independent and productive. Services include the following: (1) Adult Day Care/Adult Day Health Care; (17) Legal Assistance; (2) Caregiver Training/Support; (18) Material Aid; (3) Case Aid/Case Management; (10) Occupational Therapy; (4) Chore Services; (20) Outreach; (5) Companionship; (21) Personal Care; (6) Counseling (Gerontological and Mental (22) Physical Therapy; Health); (7) Education/Training; (23) Recreation; (8) Emergency Alert Response; (24) Referral/Assistance; (9) Escort; (25) Respite Services; (10) Health Support; (26) Screening/Assessment; (11) Home Health Aid; (27) Shopping Assistance; (12) Homemaker; (28) Skilled Nursing; (13) Housing Improvement; (29) Specialized Medical Equipment, Services, and (14) Information; Supplies (15) Intake; (30) Speech Therapy; (16) Interpreter/Translating; (31) Telephone Reassurance; and (32) Transportation 2.1.4 Use of Volunteers to Expand the Provision of Available Services The contractor shall make use of trained volunteers in providing direct services delivered to older individuals and individuals with disabilities needing such services. If possible, the contractor shall work in coordination with organizations that have experience in providing training, placement, and stipends for volunteers or participants (such as organizations carrying out Federal service programs administered by the Corporation for National and Community Service). in community service settings. 2.1.5 Monitoring the Performance of Subcontractors The contractor shall conduct at least one monitoring per year of each subcontractor. The contractor shall perform fiscal, administrative and programmatic monitoring of each subcontractors to ensure contractual compliance, fiscal accountability, programmatic performance, and compliance with applicable state and federal laws and regulations. 19/96 December 2010 Contract CLP- MCSS I 2.1.5.1 Use of Subcontractors If this contract involves the use of a subcontractor or third party, then the contractor shall not delay the implementation of its agreement with the subcontractor. If any 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 AAA's Contract Manager and the AAA's Chief Financial Officer in writing of such delay. The contractor shall not permit a subcontractor to perform services related to this agreement without having a binding subcontractor agreement executed. In accordance with Paragraph 24.1 of the Standard Agreement, the AAA will not be responsible or liable for any obligations or claims resulting from such action. 2.2 SERVICE LOCATION AND EQUIPMENT 2.2.1 Service Times The contractor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its subcontractors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 Equipment 2.3.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable, tangible personal property of a nonconsumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at least one year; and hardback bound books not circulated to students or the general public, with a value or cost of $250.00 or more [for state funds]. 2.3.2 Contractors and sub -contractors 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. The property records must be maintained on file and shall be provided to the AAA upon request. 2.3.3 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); (7) Location and condition of the equipment and the date the information was reported; (8) Unit acquisition cost; and 20196 December 2010 Contract CLP- MCSS I (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. 2.3.4 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 DOEA 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 sub -contractors (not included in a cost methodology), is subject to the conditions of Chapter 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 AAA, or purchased with funds provided through this contract without first obtaining the approval of the AAA's Contract Manager. When disposing of property or equipment the contractor must submit a written request for disposition instructions to the respective Contract Manager. The request should include a brief description of the property, purchase price, funding source, percentage of state or federal participation, acquisition date and condition of the property. The request should also indicate the contractor's proposed disposition (i.e., transfer or donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc.). 2.3.6 The AAA's 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). 2.3.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but excludes movable machinery and equipment. Real property may not be purchased with state or federal funds through agreements covered under this contract without the prior approval of the DOEA. 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 a fixed capital outlay grants and aids appropriation and therefore are subject to the provisions of s. 216.348, F. S. 2.3.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior to disposal to ensure no confidential information remains. 21 /96 December 2010 2.4 DELIVERABLES Contract CLP- MCSS I 2.4.1 Service Unit The contractor shall provide the services described in the contract in accordance with ATTACHMENTS A, G and H. 2.5 REPORTS The contractor is responsible for responding in a timely fashion to additional routine and/or special requests for information and reports required by the AAA. 2.5.1 Service Costs Reports The contractors shall submit to the AAA semi-annual service cost reports, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.6.1 Each contractor and subcontractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The contractor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with subcontractors. These policies and procedures shall be made available to the AAA upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The contractor shall timely submit to the AAA all reports described in ATTACHMENT I, Paragraph 2.5 REPORTS; (2) The contractor shall timely submit to the AAA all information described in ATTACHMENT I, Paragraph 2.6 RECORDS AND DOCUMENTATION; (3) The contractor shall ensure services in this contract are in accordance with ATTACHMENT A. 2.7.3 Monitoring and Evaluation Methodology The AAA 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, and/or an on -site visit. The AAA's determination of acceptable performance shall be conclusive. The contractor agrees to cooperate with the AAA in monitoring the progress of completion of the service tasks and deliverables. 2.7.4 Remedies -Nonconforming Services The contractor shall ensure that all participants served under this agreement are eligible for the program, and that all monthly and/or quarterly performance reports and financial records are maintained for each reporting period and submitted as stipulated in Paragraphs 1.4 - 1.4.2 and 2.1- 2.1.6. Any nonconforming program services, performance reports or financial records not meeting the aforementioned requirements shall not be eligible for reimbursement under this program. The costs associated with enrolling, training, reporting and/or managing the program shall be borne solely by the contractor. The AAA requires immediate notice of any significant and/or systemic infractions that compromise the contractor's ability to provide participant services, to achieve programmatic performance or to provide sound financial management of the program. 2.8 CONTRACTOR'S FINANCIAL OBLIGATIONS 22/96 December 2010 Contract CLP- MCSS I 2.8.1 Matching, Level of Effort, and Earmarking Requirements The contractor will fulfill a match requirement of at least 10 percent of the cost for all services funded through this contract (i.e. 90 cents of grant funds must be matched with 10 cents from the contractor.) The subcontractor's match will be made in the form of cash and/or in -kind resources. Match must be reported by title each month. At the end of the contract period, all OAA funds must be properly matched. The provider must comply with the "value added" provisions contained in Appendix 2.8.2 Consumer Contributions (1) The contractor assures compliance with Section 315 of the Older Americans Act as amended in 2006. in regard to consumer contributions; (2) Voluntary contributions are not to be used for cost sharing or matching; (3) Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; and (4) Voluntary contributions are to be used only to expand services. 2.8.3 Use of Service Dollars The contractor is expected to spend all federal, state and other funds provided by the AAA for the purpose specified in the contract. The contractor must manage the service dollars in such a manner so as to avoid having a wait list and a surplus of funds at the end of the contract period, for each program managed by the contractor. If the AAA determines that the contractor is not spending service funds accordingly, the AAA may transfer funds to other providers during the contract period and/or adjust subsequent funding allocations accordingly, as allowable under state and federal law. 2.8.4 Title III Funds The contractor assures compliance with Section 306 of the Older Americans Act, as amended in 2006, that funds received under Title III will not be used to pay any part of a cost (including an administrative cost) incurred by the contractor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.9 AAA RESPONSIBILITIES 2.9.1 Program Guidance and Technical Assistance The AAA will provide to the contractor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the contractor. 2.9.2 Contract Monitoring The AAA shall, at its own discretion, conduct monitoring concerning any aspect of the contractor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this contract includes advances, cost reimbursement for administration costs, and fixed rate for services. The contractor shall ensure fixed rates for services include only those costs that are in accordance with all applicable state and federal statutes and regulations and are based on audited historical costs in instances where an independent audit is required. The contractor shall consolidate all requests for payment from subcontractors and expenditure reports that support requests for payment and shall submit to the AAA on forms 106A (ATTACHMENT IX), 105AA (ATTACHMENT X-EXHIBIT 1), 105AS (ATTACHMENT X-EXHIBIT 2), and 105AE (ATTACHMENT X-EXHIBIT 3). 23/96 December 2010 Contract CLP- MCSS I 3.1.1 The contractor agrees to implement the distribution of funds as detailed in ATTACHMENT VII, Budget Summary. An amendment is required to change the total amount of the contract. 3.2 Advance Payments 3.2.1 The contractor may request up to two months of advances at the start of the contract period, if available, to cover program administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount of funds released to the AAA by the State of Florida ("budget release"). The contractor shall provide the AAA's Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. 3.2.2 The contractor's requests for advance require the approval of the AAA's Contract Manager. If sufficient budget is available, the AAA will issue approved advance payments after January 1, 2011. 3.2.3 Requests for the first through the twelfth months shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests, if available is shown on ATTACHMENT VIII of this contract. 3.2.4 All advanced payments made to the contractor shall be recouped in accordance with the Reporting Schedule, ATTACHMENT VIII of this contract. 3.2.5 Interest earned on advances must be identified separately by source of funds, state or federal. Contractors shall maintain advances of federal funds in interest bearing accounts unless otherwise excepted in accordance with 45 CFR 74.22(k). Earned interest must be returned to the AAA at the end of each quarter. 3.3 Invoice Submittal and Requests for Payment All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA forms 106A (ATTACHMENT IX) , 105AA (ATTACHMENT X-EXHIBIT 1), 105AS (ATTACHMENT X- EXHIBIT 2), and 105AE (ATTACHMENT X-EXHIBIT 3). 3.3.1 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests (when available) and invoices is ATTACHMENT VIII to this contract. 3.3.2 Any payment due by the AAA under the terms of this contract may be withheld pending the receipt and approval of all financial and programmatic reports due from the contractor and any adjustments thereto, including any disallowance not resolved as outlined in Paragraph 26 of this contract. 3.3.3 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in ATTACHMENT VII, Budget Summary. Any changes in the amounts of federal or general revenue funds identified on the Budget Summary form require a contract amendment. 3.3.4 Date for Final Request for Payment The final request for payment will be due to the AAA no later than February 14, 2011. 3.4 Documentation for Payment The contractor shall maintain documentation to support payment requests that shall be available to the AAA or authorized individuals, such as Department of Financial Services, upon request. 3.4.1 The contractor must enter all required data per the department's CIRTS Policy Guidelines for clients and services in 24196 December 2010 Contract CLP- MCSS I the CIRTS database. Data must be entered into CIRTS before the contractors submit their request for payment and expenditure reports. 3.4.2 The contractor run monthly CIRTS reports and verify that client and service data in CIRTS is accurate. This report must be submitted to the AAA with the monthly request for payment and expenditure report and must be reviewed by the AAA before the contractor's request can be approved by the AAA. 25/96 December 2010 Contract CLP- MCSS I December 2010 Contract CLP- MCSS I CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: ATTACHMENT II (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 sub -contractors 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 $10,000.00 and not more than $100,000.00 for each such failure. Signature Date Name of Authorized Individual Application or Agreement Number Name and Address of Organization DOEA Form 103 (Revised Nov 2002) 27196 December 2010 Contract CLP- MCSS I 28196 December 2010 Contract CLP- MCSS I FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT III The administration of resources awarded by the Department of Elder Affairs or the Alliance for Aging to the provider may be subject to audits and/or monitoring by the Department of Elder Affairs or the Alliance for Aging, as described in this section. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A- 133, as revised, and Section 21597, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by the department 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 the Department of Elder Affairs or the Alliance for Aging. In the event the Department of Elder Affairs or the Alliance for Aging determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Department of Elder Affairs or the Alliance for Aging to the provider regarding such audit. The provider further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial Officer (CFO) or Auditor General. AUDITS PART I: FEDERALLY FUNDED This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. In the event that the provider expends $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 the Department of Elder Affairs or the Alliance for Aging by this agreement. In determining the Federal awards expended in its fiscal year, the provider shall consider all sources of Federal awards, including Federal resources received from the Department of Elder Affairs or the Alliance for Aging. 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 Department of Elder Affairs or the Alliance for Aging shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Department of Elder Affairs or the Alliance for Aging shall be fully disclosed in the audit report with reference to the Department of Elder Affairs or the Alliance for Aging 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 29/96 December 2010 Contract CLP- NICSS I awards shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs or the Alliance for Aging 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 project -specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for- profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded through the Department of Elder Affairs or the Alliance for Aging 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 Department of Elder Affairs or the Alliance for Aging, 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 21597(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 21597, 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 Department of Elder Affairs or the Alliance for Aging shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Department of Elder Affairs or the Alliance for Aging shall be fully disclosed in the audit report with reference to the Department of Elder Affairs or the Alliance for Aging agreement involved. If not otherwise disclosed as required by Rule 69I-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs or the Alliance for Aging in effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after the provider's fiscal year end for local governmental entities. Non-profit or for - profit organizations are required to be submitted within 45 days after delivery of the audit report, but no Later than 9 months after the provider's fiscal year end. Notwithstanding the applicability of this portion, the Department of Elder Affairs or the Alliance for Aging retains all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the provider directly to each of the following: The Alliance for Aging, Inc 30196 December 2010 Contract CLP- MCSS I Alliance for Aging, Inc. Attn: Horacio Soberon 760 NW 107t" Ave. Miami, FL 33172 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 IOt" Street Jeffersonville, IN 47132 Other Federal agencies and pass -through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. Pursuant to Sections .320(f), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the Department of Elder Affairs at each of the following addresses: Department of Elder Affairs Attn: Beverly Friedberg 4040 Esplanade Way Office 325B Tallahassee, FL 32399-7000 Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on behalf of the provider directly to each of the following: The Alliance for Aging, Inc. at each of the following addresses: Alliance for Aging, Inc. Attn: Horacio Soberon 760 NW 1071" Ave. Miami, FL 33172 The Department of Elder Affairs at each of the following addresses Department of Elder Affairs Attn: Beverly Friedberg 4040 Esplanade Way Office 325B Tallahassee, FL 32399-7000 The Auditor General's Office at the following address: State of Florida Auditor General Claude Pepper Building, Room 574 111 West Madison Street Tallahassee, Florida 32399-1450 Any reports, management letter, or other information required to be submitted to the Department of Elder Affairs pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-133, Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General, as applicable. Providers, when submitting financial reporting packages to the Department of Elder Affairs for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit 31196 December 2010 Contract CLP- MCSS I organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the provider in correspondence accompanying the reporting package. PART IV: RECORD RETENTION The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued, and shall allow the Department of Elder Affairs or its designee, the CFO or Auditor General access to such records upon request. The provider shall ensure that audit working papers are made available to the Department of Elder Affairs, 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 the Department of Elder Affairs. 32196 December 2010 Contract CLP- MCSS I ATTACHMENT III EXHIBIT I 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT Older Americans Act Administration U.S. Health and Human Services 93.044 $15,000 Title 111B — Support Services TOTAL FEDERAL AWARD $15,000 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 33196 December 2010 Contract CLP- MCSS I 34/96 December 2010 Contract CLP- MCSS I PART I: AUDIT RELATIONSHIP DETERMINATION 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 I 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 department 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-1 10 — 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 35/96 December 2010 Contract CLP- MCSS 1 36196 December 2010 Contract CLP- MCSS 1 ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE 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 sub -contractors 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, sub-contractor(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 sub-contractor(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 sub -contractors 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). Name and Address of Contractor Signature Title Date Name of Authorized Signer (Revised June 2008) 37/96 December 2010 Contract CLP- MCSS I 38/96 December 2010 Contract CLP- MOSS 1 ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective contractor certifies, by signing this certification, neither it nor its principals are 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 prospective contractor is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this certification. Signature Title (Certification signature should be same as Contract signature.) Date Agency/Organization Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered 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 department 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 department 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) 39/96 December 2010 Contract CLP- MOSS 1 40196 December 2010 Contract CLP- MCSS I ASSURANCES —NON -CONSTRUCTION PROGRAMS ATTACHMENT VI Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non -Federal share of project cost) to ensure proper planning, management, and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C., 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C., 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C., 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (t) 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 11 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. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328). which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C., 276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C..874) and the Contract Work Hours and Safety Standards Act (40 U.S.C.. 327-333). regarding labor standards for federally assisted construction subagreements. 41I96 December 2010 Contract CLP- MCSS I 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10.000.00 or more. it. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 1 1514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C._ 1451 et seq.); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C., 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523). and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C., 1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C., 469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C..2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C., 4801 et seq.), which prohibits the use of lead- based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, Audits of States, Local Governments, and Non -Profit Organizations. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED 42196 December 2010 Contract CLP- MCSS I ATTACHMENT VII BUDGET SUMMARY Service(s) to be Provided Service Unit Rate Maximum Units of Service* Maximum Dollars* HOMEMAKER $22.04 TBD TBD PERSONAL CARE $25.87 TBD TBD CASE MANAGEMENT $38.03 TBD TBD Total Contract I I *The number of units of service will be determined by the AAA authorizing individual care plans for each CLP program participant. The total contract amount will not be exceeded. 43/96 December 2010 Contract CLP- MOSS I 44/9b December 2010 Contract CLP- MCSS 1 CONTRACT REPORT CALENDAR ADVANCE BASIS CONTRACT ATTACHMENT Vill Report Number Based On Submit to the Alliance On This Date 1 December Expenditure Report January 5, 2011 2 Final Expenditure and Request for Payment February 14, 2011 3 Closeout Report February 28, 2011 Note #I: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Department, payment is to accompany the report. 45l96 December 2010 Contract CLP- MCSS 1 46/96 December 2010 Contract CLP- MCSS 1 ATTACHMENT IX REQUEST FOR PAYMENT OLDER AMERICANS ACT PROVIDER NAME, ADDRESS, PHONE AND FED ID NUMBER TYPE OF REPORT: THIS REQUEST PERIOD: Advance Report # Reimbursement Agreement # ...PSI Agreement Period CERTIFICATION: I hereby certify to the best of my knowledge that this request conforms with the terms and the purposes set forth in the above agreement. Prepared By: Date: _ Approved By Date: PART A: (1) (2) (3) (4) (7) (6) BUDGET SUMMARY ADMIN. III B IIIC1 IIIC2 Title IIIE TOTAL I. Approved Agreement Amount. 0.00 0.00 0.00 0.00 0.00 0.00 2. Previous Funds RECEIVED for Agreement period. 0.00 0.00 0.00 0.00 0.00 0.00 3. Agreement Balance 0.00 0.00 0.00 0.00 0.00 0.00 4. Previous Funds REQUESTED and Not Received. 0.00 0.00 0.00 0.00 0.00 0.00 5. Agreement Balance 0.00 0.00 0.00 0.00 0.00 0.00 PART B: FUNDS REQUESTED 1. 1st-2nd Months Request Only 0.00 0.00 0.00 0.00 0.00 0.00 2. Net Expenditures For Month 0.00 0.00 0.00 0.00 0.00 0,00 3. Additional Cash Needs (Attach Doc.) 0.00 0.00 0.00 0.00 0.00 0,00 4. Total 0.00 0.00 0.00 0.00 0.00 0.00 PART C: NET FUNDS REQUESTED: 1. Less: Over -Advance 0.00 0.00 0.00 0.00 0.00 0.00 2. Agreement Funds are Hereby Requested For 0.00 0.00 0.00 0.00 0.00 0.00 IDOEA FORM 106A revised 5110 47/96 December 2010 Contract CLP- MCSS I 48/96 December 2010 Contract CLP- MCSS 1 ATTACHMENT X EXHIBIT 1 49196 December 2010 Contract CLP- MCSS I BLANK PAGE 50196 December 2010 Contract CLP- MCSS 1 RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source: THIS REPORT PERIOD FROM: TO: CONTRACT Title III Admin. PERIOD: CONTRACT # REPORT # PSA# CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : Approved by : Date: PART A: BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0,00 $0.00 $0.00 2. State Funds $0.00 $0.00 $0.00 3. Program Income $0.00 $0.00 $0.00 4. Cash Match (CCE, HCE and Other) $0.00 $0.00 $0.00 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 6. Local In -Kind Match $0.00 $0.00 $0.00 7. TOTAL RECEIPTS $0.00 $0.00 $0.00 PART B : EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget 1. Administrative Services $0.00 $0.00 $0.00 2. Travel $0.00 $0.00 $0.00 3. TOTAL EXPENDITURES $0.00 $0.00 $0.00 PART C : OTHER EXPENDITURES (Far tracking purposes only) 1. Match: CCE / GR $0.00 $0.00 $0.00 HCE / GR $0.00 $0.00 $0.00 Other and In -Kind $0.00 $0.00 $0.00 2. Local Match $0.00 $0.00 $0.00 3. TOTAL $0.00 $0.00 $0.00 PART D : Other Revenue and Expenditures II, Addition Cost Alternative Program Income III. Interest 1. Program Income (PI): 1. Approved Budget $ 1. Earned on GR Advance $ a.OAA Unbudgeted PI Receipts YTD 2. Received YTD $ 2. Return of GR Advance $ $ 3. Expenditures $ 3. Other Earned $ 51196 December 2010 Contract CLP- MCSS 1 52196 December 2010 Contract CLP- MCSS I ATTACHMENT X EXHIBIT 2 53196 December 2010 Contract CLP- MCSS I BLANK PAGE 54/96 December 2010 Contract CLP- MCSS I RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source : THIS REPORT PERIOD FROM: TO: IIIB IIIC1 CONTRACT IIIC2 PERIOD: CONTRACT# REPORT# PSA# CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : Approved by : Date PART A: BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0.00 $0.00 % 2. State Funds $0.00 $0.00 $0.00 % 3. Program Income $0.00 $0.00 $0.00 % 4. Local Cash Match (GCE, HCE and Other) $0.00 $0.00 $0.00 % 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 % 6. Local In -Kind Match $0.00 $0.00 $0.00 % 7. TOTAL RECEIPTS $0.00 $0.00 $0.00 % PART B : EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget 1. Meals / Meal Agreements $0.00 $0.00 $0.00 % 2. Service Subcontractor $0.00 $0.00 $0.00 % 3. Other $0.00 $0.00 $0.00 % 4. Indirect Cost $0.00 $0.00 $0.00 % 5. TOTAL EXPENDITURES $0.00 $0.00 $0.00 % PART C : OTHER EXPENDITURES (For Tracking Purposes only) 1. Match a. Other and In -Kind $0.00 $0.00 $0.00 % b. Local Match $0.00 $0.00 $0.00 °% 2. USDA Cash Received $0.00 $0.00 $0.00 % 3. TOTAL OTHER $0.00 $0.00 $0.00 % PART D : OTHER REVENUE AND EXPENDITURES 2. Addition Cost Alternative Program Income 3. Interest 1. Program Income (PI) a. Approved Budget $ a. Earned on GR Advances $ a. OAA Unbudgeted PI Receipts YTD b. Received YTD $ b. Return of GR Advance $ c. Expenditures $ c. Other Earned $ DOEA FORM 105as revised 11/09 55/96 December 2010 Contract CLP- MCSS 1 BLANK PAGE 56/96 December 2010 Contract CLP- MCSS 1 REMAINDER OF PAGE BLANK ATTACHMENT X EXHIBIT 3 57196 December 2010 Contract CLP- MCSS I BLANK PAGE • December 2010 Contract CLP- MOSS I RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source THIS REPORT PERIOD FROM: TO: CONTRACT Title III E PERIOD: CONTRACT # REPORT# P �' , A4' CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for forth in the contract. purposes set Prepared by Date Approved by Date PART A: BUDGETED INCOME/ RECEIPTS 1 Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0,00 $0.00 % 2. State Funds $0.00 $0.00 $0.00 % 3. Program Income $0.00 $0.00 $0.00 % 4. Local Cash Match $0.00 $0.00 $0.00 % 5. SUBTOTAL: CASH RECEIPTS $om $0.00 $0.00 % 6. Local In -Kind Match $0.00 $0.00 $0.00 % 7. TOTAL RECEIPTS $0-00 $0.00 $0.00 % PART B: EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget A: Direct Services 1. Personnel $om $0.00 $0.00 % 2. Travel $0.00 $0_00 $0.00 % 3. Building Space $0.00 $0.00 $0.00 % 4. Communication / Utilities $0.00 $0.00 $0.00 % 5. Printing / Supplies $0.00 $0.00 $0.00 % 6. Equipment $0.00 $0.00 $0.00 % 7. Other $0.00 $0.00 $0.00 % B Agreement Services 8. Services Subcontracted $0.00 $0,00 $om % 9. TOTAL EXPENDITURES $0-00 $0,00 $0.00 % 10. DEDUCTIONS a. Total Local Match $0.00 $0.00 $0.00 % b. Program Income Used $0.00 $0.00 $0.00 % c. TOTAL DEDUCTIONS $0.00 $0,00 $0.00 % 11. NET EXPENDITURES $0-00 $0-00 $0.00 % PART C: EXPENDITURES ANALYSIS 2. Units of Services Year to Date 3. Number of People Served Year to Date A. Expenditures by Services Year to Date: 1. Information.......... _........ $000 ... ........... ... $0.W ... _ .... ..... 0.00 2. Assistance... ..... __ ........ $0-00 ... ... .......... $0.00 ............ ....... _0.00 3. Counseling.....-.. .... ... $000 ...... ...... 0.00 a- Respite.........._.._..._.... $000 ........ I ...... 1. $0 00 _ ... �W 5. Supplemental Services..... $000 .................. $000 ........................ 0.00 6. TOTAL..... ..... _ ... _ ......... $000 Part B Line 11, column 3 should be equal to this total. PART D - GRANDPARENT SERVICES (reported by Federal Fiscal Year) FFY _ $ FFY_ $ FFY_ $ Match $ Match $ Match $ DOEA FORM 105AE revised 12`OS 59/96 December 2010 Contract CLP- MCSS 1 60l96 December 2010 Contract CLP- MOSS I Department of Elder Affairs Programs & Services Handbook, provided on CD. Also, available at the Department's Intranet site under, "Publications". ATTACHMENT A 61/96 December 2010 Contract CLP- MCSS i 62196 December 2010 Contract CLP- MOSS I 1.11 f-AN :go] a awe]*.] I by-ffls] 42LI �R�� 11 iiii 1 1111, firlila III ATTACHMENT B CIVIL RIGHTS COMPLIANCE CHECKLIST Program/Facility Name County AAA/Contractor Address Completed By City, State, Zip Code Date Telephone PART 1. READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU IN THE COMPLETION OF THIS FORM. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: 2. POPULATION OF AREA SERVED. Source of data: Total # I % White I % Black I % Hispanic % Other % Female 3. STAFF CURRENTLY EMPLOYED. Effective date: Total # I % White I % Black I % Hispanic % Other % Female % Disabled 4. CLIENTS CURRENTLY ENROLLED OR REGISTERED Effective date: Total # I % White I % Black I % Hispanic I % Other % Female % Disabled % Over 40 5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE. Total # I % White I % Black I % Hispanic % Other % Female % Disabled PART 11. USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 6. Is an Assurance of Compliance on file with DOEA? If NA or NO, explain. NA YES NO ❑ ❑ ❑ 7. Compare the staff composition to the population. Is staff representative of the population? NA YES NO If NA or NO, explain. ❑ ❑ EJ 8. Compare the client composition to the population. Are race and sex characteristics representative NA YES NO of the Population? If NA or NO, explain, El 0 D 9. Are eligibility requirements for services applied to clients and applicants without regard to NA YES NO race, color, national origin, sex, age, religion or disability? If NA or NO, explain. ❑ D ❑ Dcccmhor2A|0 10' Are all benefits, services and facilities available Voapplicants and participants inanequally effective manner regardless of race, sex, color, age, national origin, religion ordisability? |fNAorNO, explain. mx YES NO [l [� [� .� `� `� 11. For in -patient aorvicuu, are room assignments made without regard to raoo, color, national origin or disability? If NA or NO, explain. NA YES NO �� �� �l '� `� `� 12. {othe program/facility accessible tonon-English speaking clients? KNAorNO, explain. 13. Are employees, applicants and participants informed oftheir protection against discrimination? If yes, how? Verbal R Written 0 Poster R /fNAorNO, explain. 14. Give the number and current otskua of any discrimination complaints regarding oen/ioou or employment filed against theprognam/feoi|ity. 15. Is the program/facility physically noowooib/u to mobi|iiy, huar/ng, and sight -impaired individuals? /f NA or NO, explain. NA YES NO PART Ill. THE FOLLOWING QUESTIONS APPLY T0PROGRAMS AND FACILITIES WITH 15 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. h4/96 I December 2010 Contract CLP- MCSS 17. Is there and established grievance procedure that incorporates due process in the resolution of complaints? If NO, explain. YES NO El El 18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain. YES NO U 0 19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? If NO, explain. 20. Are auxiliary aids available to assure accessibility of services to hearing and sight impaired individuals? If NO, explain. YES NO F-1 El 0 0 PART IV. FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000 OR MORE. 21. Do you have a written affirmative action plan? If NO, explain. YES NO 1-1 1:1 65196 Deccrober2UlO Contract CLy-MCSSl AAA USE ONLY Reviewed By In Compliance: YES NO* 0 Program Office *Notice of Corrective Action Sent Date Telephone Response Due On -Site 0 Desk Review o Response Received DDEAForm 101ARevised May 2OO8Page 2of2 57 December 2010 Contract CLP- NICSS I INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST ATTACHMENT B 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. 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.) 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? 3. 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 67/96 December 2010 Contract CLP- MCSS I 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). 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: With the assistance of a disabled individual/organization, evaluate current practices and policies which do not comply with Section 504. Modify policies and practices that do not meet Section 504 requirements. Take remedial steps to eliminate any discrimination that has been identified. Maintain self -evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been followed.), 45 CFR 84.6. 17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b). 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply with Section 504.45 CFR 84.7 (a). 19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads, and other appropriate written communication, 45 CFR 84.8 (a). 20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide equally effective services, (45 CFR 84.52 (d). 21. Programs/facilities with 50 or more employees and $50,000 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. 68/96 December 2010 Contract CLP- MCSS I Department's Computer Use Policy and its Social Media Policy, provided on CD. 69/96 ATTACHMENT E December 2010 Contract CLP- MCSS I 70/96 December 20I0 Contract CLP- MCSS I PROGRAM: TYPE OF SERVICE: DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess Of Category II CONTRACT PERIOD: ATTACHMENT F EXHIBIT 1 1 2 Column 3 Column 4 Column 5 6° 7 8 (to be completed by the contractor) (to be completed by the DOER Contract Manager Budget Line Item Amount % Allocated Allowable Reasonable Necessary Category Budget Category to this Agreement a. Salaries b. Fringe Benefits c O C. Equipment d. Telephone & Utilities e. Travel = f. Printing & Supplies g. Other (Please list or attach details) Q h. Allocated Cost/Overhead TOTAL Client Services (Attach v details) L TOTAL V, CERTIFICATION (to be signed by DOEA Contract Manager) I certify that the cost for each line item budget category has been evaluated and determined to be allowable, reasonable, and necessary as required by Section 216.3475 Florida Statutes. Marne Title' Signature Date 7 I /96 December 20 10 Contract CLP- MCSS I 72/96 December 2010 Contract CLP- MCSS I ATTACHMENT F EXHIBIT 2 INSTRUCTIONS: COST ANALYSIS FOR NON-COMPETIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY II The purpose of the ATTACHMENT F, Exhibit 1, is to document that costs in non -competitively procured contracts in excess of $35,000 are allowable, reasonable and necessary. This form is required to be submitted by the contractor to the contract manager within 30 days of the contract execution date. Upon receipt of the form, the DOEA contract manager will: 1. Evaluate each separate line item to determine whether the cost is allowable, reasonable and necessary. a. To be allowable, a cost must be allowable pursuant to state and federal expenditure laws, rules and regulations and authorized by the agreement between the state and the contractor. b. To be reasonable, a cost must be evaluated to determine that the amount does not exceed what a prudent person would incur given the specific circumstances. c. To be necessary, a cost must be essential to the successful completion of the program. d. Allocated costs/overhead should be evaluated to determine that the rate is reasonable. 2. Place the Cost Analysis for Non -Competitively Procured Agreements in Excess of Category // form in the official file for this contract at the Department of Elder Affairs. (1) In accordance with the following instructions, the contractor must complete COLUMNS 3, 4 AND 5 of the DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess Of Category II worksheet (ATTACHMENT F, EXHIBIT 1) for the original contract and any amendment that affects the amount of compensation and/or the level of services provided. (2) Definition of Administrative Costs — a. Salaries/Wages: Are the charges to directly hire someone and put them on payroll. b. Fringe Benefits: Are the costs of health insurance, Social Security, Medicare, unemployment and other benefits paid on behalf of each employee. If fringe benefits will be based on a specified percentage, rather than the actual cost of fringe benefits, then the calculation for the fringe benefits amount must be shown. c. Equipment: Equipment means an article of nonexpendable, tangible personal property generally having a useful life of more than one year and an acquisition cost that equals or exceeds the lesser of the established capitalization level of $5,000 (federal funds) or $1,000 or hardback bound books not circulated, with a value of $250.00 or more (state funds). d. Telephone and Utilities: Are items such as utilities and telephone service costs. e. Travel: Are those that are necessary, reasonable and allowable for carrying out the project. Travel must be in accordance with Section 112.061, Florida Statutes, which includes submission of the claim on the approved State travel voucher or electronic means and at the authorized meal, per diem and state mileage reimbursement rates. f. Printing and Supplies: Are items such as office supplies, postage, and printing. g. Other Costs or Miscellaneous: Please explain/justify. Support documentation for other direct costs may include copies of published rates, copies of expense vouchers, and/or invoices. Support documentation for other costs or fees may include copies of published catalog prices, or copies of expense vouchers. h. Allocated Costs or Overhead: The contractor should attach a copy of the computation schedule supporting the allocated cost rate. Support documentation for allocated costs may be a federally - negotiated allocated cost rate agreement. If the contractor does not have a rate agreement, (1) sufficient information should be attached indicating how the rate used was determined and (2) if the rate was accepted and paid previously by either a federal agency or agency of the State of Florida, documentation to that affect should be provided. (3) Client Service costs should be documented via Area Agency on Aging Area Plans, Unit Cost information input into WebDB, or some other form of documentation to support the cost analysis. (4) The allocation to the agreement will be calculated based on the cost by line item cost divided by the total agreement amount. 73/96 December 2010 Contract CLP- MCSS I 74/96 December 2010 Contract CLP- MCSS I ATTACHMENT G COMMUNITY LIVING PROGRAM PROTOCOLS Program Overview The goals of Community Living Program Phase II, for PSA 11 are to reduce overall Medicaid long term care expenditures, develop co -pay and financially sustainable systems —within the context of the Older Americans Act network of AAA and providers, and to increase consumer choice and self -direction. To achieve these goals PSA 11 will focus its efforts in providing consumers with the means to resolve events that have been identified as "critical pathways" to institutional long term care. Some of these "critical pathways" include sudden caregiver burnout, depression, malnutrition/dehydration and lack of proper follow up with home and community based services following hospital/rehab discharges. PSA 11 will also manage a Veterans Administration Consumer Directed Care. In particular, PSA 11 will provide short term, cost effective, interventions, to individuals at high risk of nursing home placement or hospital re -admission, using a Holistic Social Work model utilizing a motivational empowerment case management approach focus on monitoring client follow-up in the community with medical needs, nutritional needs, mental health, home care needs, and recreational needs in order to reduce re -admission and nursing home placements. A Case Manager will utilize an interdisciplinary managed team approach whose major role is to coordinate community based services to enable the client's independence and prevent premature or unnecessary institutionalization. The proposed model has three characteristics: Timely, short term sponsored interventions using Older Americans Act services, intensive case management and, the possibility of long term continuation of services on a cost -shared basis at the consumer's choice. Acronyms and Derinitions ADI (Alzheimer's Disease Initiative) — Services targeted to individuals with Alzheimer's Disease or a similar memory disorder, including respite, assessment, caregiver training, and other community -based services. ADRC or ARC (Aging and Disability Resource Centers or Aging Resource Centers) — The not -far -profit entity which is the single entry point for the aging service system within each established region of the state. APS (Adult Protective Services) High Risk — The designation of an elder who needs immediate protection from further abuse, neglect or exploitation, which can be accomplished completely or in part through the provision of home and community -based services. 75/96 December 2010 Contract CLP- MCSS I Caregiver or Support System — For this project, the caregiver or support system is one or more persons whom the elder can depend on to provide care or to organize the provision of needed care. Care Plan - A comprehensive listing of all services, including Medicare, CCE, OAA, county, etc. that address the client's physical, mental, and home care needs to resolve the crisis condition(s), and accomplish the client's personal goals. The Lead Service Provider would coordinate all services and evaluate their outcomes in conjunction with the client. Care Plan Review Team — For purposes of this project, a team of staff designated by the CLP staff, which reviews the client's situation and makes recommendations concerning continuation of services after the initial short term grant -funded crisis -resolving period. However in no case will services be continued on a long term basis under this program. CCE (Community Care for the Elderly) — Services offered to functionally impaired older persons to enable them to live in the least restrictive environment, including adult day care, consumable medical supplies, home delivered meals, homemaker, personal care, respite, and other community -based services. CIRTS (Client Information and Registration Tracking System) — The database of the Department of Elder Affairs used by the aging network to manage client assessment data, register clients for services, plan client services and maintain program waiting lists. Lead agency provider assessors also use CIRTS to evaluate client eligibility for Medicaid services and to develop recommendations for client placement. CDC (Consumer Directed Care) — A service option that gives elders, or their representatives, the opportunity to manage the elder's service delivery, including decisions about which services will be provided, by whom and how often. With the assistance of a consultant, an elder develops a budget plan that identifies needed goods and services and authorizes the elder to hire workers, who may be family members or friends, and select vendors to help with daily care needs. A fiscal/employer agent (FfEA) pays the workers and vendors according to the rates on the budget plan. The F/EA also pays the required federal and state taxes and files the necessary tax forms. Community Living Program — "Community Living Program" is a grant to the state of Florida from the federal Administration on Aging. For persons meeting the project's functional and financial eligibility criteria, the grant provides crisis -resolving in -home services to address their immediate and temporary needs as they leave a hospital or rehabilitation center or after a short-term nursing home stay. Without these services, the person would be at high risk of either nursing home placement or continued stay in a nursing home. This program also manages consumer directed care services provided to veterans. 76196 December 2010 Contract CLP- MCSS I Cost Sharing — Payment by an individual for a portion of the monthly cost of the services he/she receives, based on the individual's income and assets, and determined by the total monthly cost of the planned services. Crisis -Resolving Services — Time -limited community -based services provided to address a client's immediate short-term care needs. Possible services include, but are not limited to: case management, personal care, homemaker, transportation, meals. For the purposes of this program, a crisis is an episode that has a high probability of creating a nursing home long term placement or a re -hospitalization. Examples of such crisis include caregiving situations, i.e. a caregiver hospitalization that would cause the nursing home placement of the care recipient; it also includes hospital/rehab discharges that have a high likelihood of recidivism or further patient deterioration where a permanent nursing home placement is a likely sequel. Functional Eligibility — The priority rank of 4 or higher (priority score of > 40) is based on the 701A or 701B assessment tool; with an option for imminent risk designation in accordance, to the DOEA policy. APS High Risk Referrals (priority rank 8) are not eligible. Financial Eligibility: • For a single person, the gross monthly income must be a minimum of $700 and a maximum of $4,100. The assets, excluding primary residence and vehicle, must be valued at a minimum of $25,000 with a maximum cap of $179,999. -_For a couple, the gross monthly income must be a minimum of $900 and a maximum of $5,500. The assets, excluding primary residence and vehicle, must be valued at a minimum of $25,000 with a maximum cap of $249,999. Imminent Risk - "In designating an individual imminent risk, the case manager must document in the client file how the client's situation meets all three of the criteria listed in the 3d) contract language: 1. The client's mental or physical condition has deteriorated to the degree that self care is not possible, 2. There is no capable caregiver, and 3. Institutional placement will occur within 72 hours." Lead Agency —A Community Care for the Elderly (CCE) designated agency. Lead agencies provide services under the CCE and ADI programs. In addition lead agencies handle APS cases in accordance with a DOEA established protocol. Lead Service Provider —A provider of Older American Act Services that also provides case management under this project. The Case manager from the service provider will follow-up with those project participants referred by the CLP staff to facilitate the provision of services during the grant period and to help plan for the person's needs after the grant period. 77/96 December 2010 Contract CLP- MCSS I OAA IIIB, IIID, IIIE (Older Americans Act Titles) — Title IIIB provides supportive services to assist elders to live independently in their community. Title IIID provides disease -prevention and health -promotion services at senior centers or alternative sites. Title IIIE provides services through the National Family Caregiver Support Program to assist families caring for frail older members, and to assist grandparents or older relatives who are caregivers for children who are under 19 or are disabled. Private Pay — Payment of the complete cost of services by an individual with sufficient income and assets to be over the financial standards for receipt of state or grant funded services. Referring Entity — An entity providing referrals to the single entry point. These include case management agencies, hospitals, rehabilitation centers, home health agencies, physician assisted home based programs, and nursing homes. Individuals referred should appear to meet the eligibility criteria for this project. Self -declared — For purposes of initial financial eligibility for the project, the individual's declaration of income and assets will not require verification. SEP (Single Entry Point) — The CLP staff for the area where the individual is receiving services is the single entry point into the aging service system. Spend down to Medicaid — The use of personal resources to pay for services prior to the individual's resources being reduced to the level of Medicaid eligibility. Triage — The activity performed by CLP staff to prioritize an individual for service based on the criteria established for publicly funded programs because he/she does not meet the eligibility criteria for this project. Protocols Client Identification 1. The referring entity will use the following criteria to identify potentially appropriate project participants: 2. Individual is at least 60 years old. 3. Individual is a resident of Miami -Dade or Monroe Counties. 4. Financially and functionally eligible. 5. Has Medicare or private health insurance. 6. Individual is not receiving hospice services. 7. Individual or caregiver is in need of crisis resolving services and/or short term care, to 78/96 December 2010 Contract CLP- MOSS I avoid readmission to a hospital/rehab facility or a nursing home placement. 8. Not currently receiving any DOEA sponsored services. Client Referral The referring entity will make client referrals to the single entry point (SEP). 1. Each referring entity will designate a Community Living Program contact to make referrals. 2. The SEP will designate an appointed staff to receive referrals. 3. At the referring entity, staff will complete the Referral Checklist and the designated Community Living Program, contact will transmit the Referral to the SEP. o For individuals in a hospital or nursing home, the referral will be completed 24 to 48 hours prior to discharge, excluding weekends or holidays. Individuals in the community may be referred to the project during any time deemed to be in crisis or in need of short term intervention to avoid readmission and or nursing home placement. o SEP will work with the discharge planner, in the case of a facility discharge, to identify emergency services that wrap -around other benefits for which the client may be eligible, such as Medicare home health benefits, to authorize services prior to discharge and in -home assessment. o The SEP designated staff will confirm receipt of the referral to the referring entity and log in and assign the case for screening and intake on the date received. 4. To conclude the referral process from a hospital or nursing home, the referring entity will transmit a copy of the discharge summary to the SEP staff. Client Screening (Functional and Financial Eligibility) Within 24 hours of receiving the referral, the SEP designated staff will determine client eligibility for project participation. 2. The SEP staff will conduct a CIRTS record check to determine if the individual is currently enrolled in CCE, ADI, or is a high risk APS referral. If such is the case, the SEP staff will refer to the individual's case management agency of record for follow up The lead agency will recommend crisis resolving services, if needed, to supplement the existing care plan. If the individual appears eligible for project participation, then the SEP staff will authorize the lead agency to update the 701B. 79196 December 2010 Contract CLP- MCSS I If the client is not enrolled in CCE, ADI, or any other case managed program, or is not a high risk APS referral and is in need of a short term care intervention, then the SEP designated staff will determine client eligibility for project participation. Screening must take place within 48 hours from the time the referral was received by the SEP. 3. Individuals scoring as priority levels 4 or 5 on the CLP screen, that also meet self -declared income and asset criteria will be eligible for referral to the Lead Service Provider. Individuals that score less than a priority level 4 will be eligible if there are demonstrable circumstances that put such individual at high risk of nursing home placement or re -hospitalization. These cases will be approved based on their particulars by the SEP on an exception basis. The SEP staff will notify the referring entity of the eligibility of the individual or, if applicable, the reasons for denying eligibility, in accordance to DOER criteria. 4. If the individual does not appear eligible for project participation, then the SEP staff will triage the individual to the ARC/ADRC for follow-up options counseling to provide assistance with referrals to other OAA programs and services which may aid in their situation. Lead Service Provider Responsibilities: Initial Client Assessment (701 13): • The Case manager (CM) will have contact, within 24 firs of referral, with client and/or caregiver to introduce services and program. The CM will reach out to individuals referred by the SEP to assess the situation. • The Case manager (CM) will provide information, including brochures and pamphlets regarding the project. The Case manager (CM) will begin discussing cost sharing, private pay, and consumer directed care service options should services be needed beyond the short term crisis resolving intervention. The financial worksheet will be completed. • The Case Manager will conduct the comprehensive assessment in the client's home, or medical facility within 72 hours of referral using form 70113, in this latter instance, the CM will review the hospital discharge paperwork. The Lead Service Provider will enter data in CIRTS within the week of the assessment. • The Case manager (CM) will develop a care plan with the client and or caregiver/support system, based on the assessment, and will initiate in -home crisis resolving services within 72 hours of receipt of referral. • The Case manager (CM) will inform the client that the Department of Elder Affairs has contracted an 80/96 December 2010 Contract CLP- MCSS I evaluator that will be calling to conduct a five-minute survey about the quality and effectiveness of the services the client receives as part of the "Community Living Program" program. The case manager should assure the client that services will not be affected in any way whether the client participates or not in the survey or by how the client answers any of the questions. The case manager should report to the SEP staff if the client requests not to be surveyed. • The Case manager (CM) will maintain a client file, including: care plan, financial worksheet, referral information, assessments, a summary of each contact with or on behalf of the client and caregiver, project forms, and any other related information collected on behalf of the client/caregiver or required by the program. Enrollment Authorization: • The SEP staff will authorize enrollment of the individual in the project. • The SEP staff will refer the individual to the CLP lead agency provider for Case Management and crisis resolving services. • If after initial enrollment the client is determined to be ineligible for financial reasons, the individual will continue to receive the services being provided up to the crisis -resolving service period. o The CLP lead service provider will notify the SEP. o The SEP staff will contact the individual. o Transition will be made as possible to other appropriate programs. o The SEP staff will notify the CLP lead agency provider of the action to take regarding termination from the project. On -Going Case Management Responsibilities: The Case manager (CM) will conduct on -going service coordination of home and community based services and hospital, nursing home or rehabilitation center if applicable. The Case manager will verify the information and coordinate services as needed. Client contact service is as follows: Throughout the grant period, the Case manager (CM) will discuss the following with the client and caregiver issues pertaining to the client's medical needs, nutritional needs, mental health needs, home care needs, recreational needs: 81 /96 December 2010 Contract CLP- MCSS I Medication management issues: The Case manager will encourage client and care giver to address medication management issues with primary physician. 2. Medical management: The Case manager will review primary physician appointments and encourage client and family to maintain appointments accordingly. Encourage client and care giver to follow-up with medical needs. 3. Nutrition management: The Case manager (CM) will make referrals for nutrition counseling and meals programs, if needed. It will encourage client and caregiver to follow the instructions of the nutritionist conduct referrals as needed. 4. Mental Health: The Case manager (CM) will monitor good mental health practice and encourage appropriate follow-up as needed for mental health need and conduct referrals and placement of services as needed. 5. Home Care needs: The Case manager (CM) will assess and monitor home care needs and conduct referrals and placement of services as needed 6. Recreational needs: The Case manager (CM) will assess and monitor recreational needs and encourage good recreational practices for both client and caregiver. CM will conduct referrals for services as needed. The Case Manager will document the review in the client's case notes _Satisfaction with services delivered during 45-day crisis resolving service period 2. What services is the client receiving? 3. Are specific services adequately addressing the client's needs? 4. What are additional needs? How are those additional needs being addressed? Periodic Follow-up One week after initiating services, the Case manager will visit the client to ascertain services planned are being delivered and client needs are being met. 2. Two weeks after service initiation, the case manager will conduct telephone contact with the client to determine if services are addressing the client's needs. 3. Four weeks after service initiation the case manager will conduct telephone contact with the client to determine if services are addressing the client's needs. 82196 December 2010 Contract CLP- MCSS I 4. No less than 5 days prior to the end of project participation, the CLP Lead agency provider case manager will conduct a face to face contact with the client and caregiver to review the care plan and determine the individual's continued need of crisis -resolving services. The timing of this contact will be at the discretion of the Case manager prior to the discharge determination date. Termination of Services The Case manager will advise the SEP staff of the following: o The crisis is resolved and the client may be terminated from the project. o The client is not stabilized and continues to need crisis resolving services. _Detail will be provided as to the recommended services, frequency and duration. o The crisis is resolved, but the client will need on -going in -home services. Detail will be provided as to the recommended services, frequency and duration. Also whether client is continuing with co -pays and consumer directed care. Method of service delivery after crisis -resolving service period ends ■ The client has an option of continuing to receive services in a traditional manner (agency ordered and delivered) continuing with a co -pay, subject to provider funding availability. (The share of cost is stated on the care plan.) ■ The client has an option of participating in consumer directed care (consumer determines service provision), as a private pay client, however the provider will charge the consumer rates that are not higher than the lowest rates the provider receives from the Alliance. The client can afford the cost of private pay services. Funding Options: The SEP staff must ensure the availability of OAA dollars to serve individuals at high risk of nursing home placement and spend down to Medicaid by implementing assessment and screening tools, as well as care planning and case management for Title IIIB funding. Title IIID and Title IIIE funds should be considered for the provision of services such as medication management and caregiver support services. The Alzheimer's disease Demonstration Grant funding should be coordinated as appropriate to expand services to clients in Miami -Dade County. This will include individuals with Alzheimer's disease or Related Disorders, who are 83/96 December 2010 Contract CLP- MCSS I not eligible for Medicaid but are at imminent risk of nursing home placement and spend down, to remain in the community and avoid or delay nursing home placement. CIRTS Data Entry• Screening data for each referral based on the CLP Screening tool or 701A or similar instrument will be entered into CIRTS. The Lead Service Provider will enter 701B assessment data promptly entered into CIRTS. All clients authorized for CLP services will be enrolled in CIRTS under the CLP program enrollment code. For all services received by CLP clients, the case management agency will report the service units and unit cost data in CIRTS. • All services will be reported as client specific, including non -registered OAA services. •_ All services funded with CLP grant funds will be reported under the appropriate CLP service code. • All services funded with other program funds (OAA, CCE, etc.) will be reported using the appropriate program's service code. 84196 December 2010 Contract CLP- MCSS I ATTACHMENT H SERVICE PROVIDER APPLICATION MM December 2010 Contract CLP-MCSS I INVITATION TO NEGOTIATE COMMUNITY LIVING PROGRAM OLDER AMERICANS ACT TITLE III-B SUBMITTED BY: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS SOCIAL SERVICES IN -HOME SERVICES PROGRAM SYLVIA J. MURPHY, MAYOR, MONROE COUNTY HISTORIC GATO BUILDING 1100 SIMONTON STREET RM. 2-257 KEY WEST, FL 33040 PHONE: (305) 292-4510 FAX: (305) 295-4359 86196 December 2010 Contract CLP-MCSS I IMPLEMENTATION OF SERVICES STATEMENT OF READINESS L k Deputy County Administrator do hereby stipulate and Dee Frederick agree that Monroe County Social Services/In-Home Services is ready to implement the services mentioned in this Invitation to Negotiate (ITN) Date: 87/96 December 2010 Contract CLP-MCSS I i MR11110 0XIII Submitted by: Monroe County In -Home Services (MCIHS) Monroe County Board of County Commissioners Monroe County Social Services 1100 Simonton Street 2-257 Key West, FL 33040 305-292-4510 (phone) Sylvia 3. Murphy, Mayor, Monroe County — Chief Executive Officer Monroe County In -Home Services (MCIHS), a department within Monroe County Social Services (MCSS), is well-equipped to handle service interventions for the short-term high risk individual. Due to our extensive reach throughout all of Monroe County, there are no areas that cannot be served. MCIHS is able to provide any manner of services throughout the entirety of Monroe County. For example, MCIHS already provides value-added services (via a number of non DOEA sources) such as, case management, homemaking, personal care, in -home respite, facility -based respite, nutrition services for in -home and congregate clients, prescription assistance, pauper burials, transportation assistance, shelter, energy cost assistance, weatherization services, and many more. The funding for the Community Living Program will allow MOBS to provide the following short-term services to the ARC referred high -risk individuals: homemaking, personal care, and case management. MCIHS employs County staff, as well as subcontracted staff, that are strategically positioned throughout all areas of Monroe County. In addition to all of the aforementioned services which are considered value-added services, for the Community Living Program, we are able to perfoun the following direct In -Horne Services: Homemaking - which will allow clients to receive specific home management services such as general housekeeping, laundry, assistance with budgeting and paying bills, shopping assistance, meal preparation, etc. Personal Care — which will allow clients to receive assistance with 88/96 December 2010 Contract CLP-MOSS I eating, dressing, personal hygiene, and other significant activities of daily living. Case Management Monroe County has qualified and experienced Case Managers. Our Case Managers are able to assist clients in identifying physical and emotional needs and problems through an interview and assessment process. Case Managers are able to discuss and develop a care plan for services for these short-term clients to remove them from being high risk. Our Case Managers are "gatekeepers" in the community care system and have vast knowledge in the different resources available in our community. Monroe County's Case Managers have many years of experience and are fully able to coordinate and link clients and caregivers with appropriate resources in the health care and delivery systems regardless of the agency or organization offering the services, to meet the client's needs. Case Managers are able to monitor all services and referrals to ensure they are having a positive impact on the problems that have caused the client to become high risk. Respite Care -- as a value.added service _will provide relief or rest for a primary caregiver from the constant, continued supervision and care of a functionally impaired, high risk older person by providing care for the person in the home for a pre -determined period of time. Overall Coordination Monroe County Case Managers are able to coordinate all community resources for high risk clients via a community care service that comprises health and community resources. As part of a government agency MCIHS has access to a myriad of social service programs available within our own offices, such as funding for prescription drugs and the others referenced on page 1. If a consumer needed medication and could not afford it, MCSS would be able to pay for that medication. This is just one example of the many value-added services that MCSS already has in place. Another example would be the Monroe County Disability Council which is sponsored and staffed by the Monroe County Board of County 89196 December 2010 Contract CLP-MOSS I Commissioners (BOCC). The Social Services Department has long been the liaison for the BOCC with this advisory council. At present time one of our Case Manager Supervisors is Liaison and Secretary/Treasurer. The Council seeks to improve access, to. services for all residents of our community. As a governmental agency, the BOCC provides additional funding to Social Services organizations (outside of the County structure) following the counsel of the Human Services Advisory Council (HSAB). The HSAB reviews applications and makes funding recommendations for programs in the following service categories: primary and behavioral health care, core services, and quality of life services. The recommendations of HSAB are presented to the BOCC for approval. Once approved, the BOCC enters into contracts funding over 25 non -governmental, agencies that offer essential services for consumers. As contractors for the BOCC, these agencies are willing and able partners with the MCIHS Case Managers and Social Services staff to help meet the needs of consumers within the County. Monroe County Transit (MCT), a program within the Social Services Department, is a partner with In -Home Services providers. The MCT vehicle fleet is 100 percent accessible to the physically disabled and provides door-to-door transportation for anyone who is transportation disadvantaged throughout the entire length and breadth of the Keys. MCT coordinates closely with the local Community Transportation Coordinator and Medicaid Transportation Coordinator — the Guidance Care Center. All local transit providers are members of the Local Coordinating Board, including the City of Key West that provides bus routes in Key West and Stock Island and the Lower Keys Shuttle that operates a fixed route from Marathon to Key West. Monroe County is an equal financial partner with the Cities of Key West and Marathon in the operation of the Lower Keys Shuttle. MCIHS Case Managers actively coordinate with available transportation providers throughout the communities of the Keys to ensure that access to needed NWO December 2010 Contract CLP-MCSS I services is available. Since MOBS is integrated into the Social Services department, Case Managers work closely with Community Support Services (CSS) for Consumable Supplies (value-added service). The Case Managers also work very closely with the health care providers in the Keys and CSS to provide a link to ensure individuals who are low income receive the supplies they need. This requires the involvement of local physicians, hospitals, physical therapy centers, etc. Further, Case Managers in Monroe County continuously monitor the quality, appropriateness, and cost of services that are delivered to consumers to ensm that the most appropriate and cost-effective service is being received. Referrals are often made for value-added services to the Helpline of the Florida Keys for clients who need Telephone Reassurance. This service is designed to allow staff to check on the consumer daily and if needed call to remind them to take their medication. Caregiver Support is also offered through Helpline and they hold support groups throughout the Florida Keys for any caregiver in need. Often caregivers are in crisis and this gives them an opportunity to discuss their situation and obtain some advice and assistance relative to their loved one. MCSS currently provides Homeless Prevention and Rapid Re -Housing Program (HP"). This grant is funded by the American Recovery and Reinvestment Act of 2009, through the Department of Homelessness/DCF and assists eligible Monroe County households with the prevention of homelessness. The intent of this funding is to help persons who can remain stably housed AFTER the temporary housing assistance ends. It generally provides rent for 3 months or less. Like the Community Living Program, HPRP is not a long-teini assistance program. MCSS also operates the Weatherization Assistance Program (WAP). This grant through DCA provides Energy Reducing Services to low income families to reduce energy cost, conserve energy, increase comfort in the home and improve safety and health standards. Some of the services that 91 /96 December 2010 Contract CLP-MCSS I are offered under this grant are threshold repairs, window and door replacement, insulation, and installation of smoke/fire/carbon monoxide detectors, etc. The Low Income Dome Energy Assistance Program (LIHEAP) is another service we are able to provide through the DCA. This grant assists low income households to receive financial assistance in paying for the cooling and heating of their homes. As Visiting Nurse Association (VNA) currently sub -contracts with MCIHS for the provision of direct services to our clients, we have developed a close alliance with them and are able to make referrals to them for services outside of direct services. One of the services that we often refer to VNA for is Bereavement Counseling. Often consumers are very distraught after losing a loved one, such as a spouse, and are in dire need of professional services. VNA offers this service with licensed counselors free of charge. Along with VNA, Case Managers also refer for counseling services to the Guidance Care Center and the Care Center for Mental Health, Inc. (CCMII). These agencies have on staff a licensed mental health counselor (PhD), and a certified addiction professional (MSW). A wide range of Gerontological Counseling Services are also available to clients who are referred to these agencies. Service Coordination/Assessment Coordination with the AAA - As Monroe County's Lead Agency for over the past three decades, MCIHS is able to ensure the coordination of services and is able to coordinate all aspects of the grant with the AAA. Monroe County has a close relationship with the Aging Resource Center (ARC) and is able to receive and coordinate all referrals for them. MCIHS are also able to work innovatively, since the Case Managers have a long-standing relationship with the local hospitals Discharge Planners. Staff are able to give these planners the ARC's contact information and they call the ARC when a high risk consumer is going to be released from the hospital. Throughout Monroe County, these referrals will lead to 92196 December 2010 Contract CLP-MOSS I intake and assessment. Intake and Assessment begins when a potential consumer, caregiver, family member, friend, neighbor, or public or private agency seeks assistance for an individual by contacting the Alliance for Aging's ARC. MCIHS employs ten staff members who have been trained and certified to take referrals and administer the DOEA Assessment Forms in accordance with the DOEA Assessment Instructions (701A, 701B, 701C) Manual. Training and certification was completed for MCIHS staff by the AAA in Miami during August 2007 and August 2008 and staff continue to receive updated information and training as needed. MCIHS staff members conduct all assessments in accordance with the instructions for completion as indicated in the aforementioned training sessions and the DOEA Assessment Instructions (701A, 701B, 701C) Manual. The ARC determines when persons are approved for services from MCIHS and will send the referrals accordingly. After the referral is received, MCIHS conducts a home visit with the consumer in order to perform a comprehensive assessment (701B) and develop a care plan in accordance with the DOEA. Referrals from the ARC for high risk individuals who are at imminent risk of institutional placement, such as individuals awaiting hospital or emergency room discharge, will be served immediately. Case Managers have the capability after administering the assessment (701B) to communicate with other agencies to ensure that all needs for the consumer are adequately addressed and keep the individual from staying high -risk. This is due to the fact that MCIHS enjoys a high level of coordination and commitment from community partners countywide. The success of MCIHS as well as the high level of countywide coordination and service linkage is due in a large part to the exceptional working relationship MOBS has maintained throughout the community for over three decades. Program Success and Reporting Requirements and familiarity with reporting requirements and service descriptions -As previously mentioned, MCIHS employs ten staff 93l96 December 2010 Contract CLP-MOSS I members who have been trained and certified to administer the DOEA Assessment Forms in accordance with the DOEA Assessment Instructions (701A, 701B, 701C) Manual. Two MCIHS administrative staff members are responsible for the upkeep and maintenance of the CIRTS data entry. Both staff members are full trained on the CIRTS application. While one clerical staff member serves as the primary CIRTS data entry worker, the other administrative staff member serves as a backup, thus ensuring that CIRTS data entry is completed timely. Monthly, quarterly, and annual reporting requirements are fulfilled by a full time Sr. Grants Coordinator employed by MCSS. The Sr. Grants Coordinator maintains a chart of reports including due dates, submission requirements, standards for completion, etc. Additionally, the Sr. Grants Coordinator reviews and coordinates all reporting with the Director of Social Services. This ensures that multiple staff members are aware of each report, progress being made on the report, when it is due, and what the requirements for completion are. The Sr. Grants Coordinator maintains electronic copies and printed copies of each report. Working papers and substantiating backup documentation are maintained in the printed copy files and stored in locked filing cabinets, inside locked offices, in a secure building. Daily backups of electronic data occur through routine Monroe County Technical Services operations. Since Monroe County implemented the position of Sr. Grants Coordinator, all reports have been submitted timely and accuracy and continuity has been ensured. Further, there is now one central person that the Alliance for Aging can contact if there are questions about reporting. Monroe County's staff is very familiar with the Service Descriptions as identified in the DOEA Handbook issued July 2010 as Monroe County being a CCE Lead Agency for the past 30 years. Additional Services/Resources at no charge to the Alliance for Aging - As previously mentioned, MCIHS is a department within the MCSS. MCSS offers a wide array of services to 94l96 December 2010 Contract CLP-MCSS I help Monroe County's citizens and MCIFIS has full access to all services and funds. Some of these services include but are not limited to the services outlined under Overall Coordination starting on page 2. Self-sustaining program when it is at the end of its Pilot Monroe County is certain it will be able to self -sustain the program when it is at the end of its pilot time allotment. All of the aforementioned services are able to be provided, on a limited basis, through our Case Managers, the MCSS, and all non DOEA funding. While some of these services are paid for with grants from DCF and DCA, many of these services are paid for through General Funds (County tax dollars) and is provided annually from Monroe County. Once the Community Living Program pilot ends our Case Managers will continue referring and coordinating services (as mentioned above) between the clients and other entities to provide the needed services for our citizens. Monroe County In -Home Services Technical Capacitv to provide the proposed service intervention - MCIIIS Case Managers have the knowledge, educational background, experience, and skills to coordinate the most beneficial and least restrictive services and community resources for consumers throughout the community. Along with experience and training in the In -Home Services field, our Case Managers have many years and extensive training in the Social Services field. Several of our Case Managers have worked for DCF or other governmental or private agencies before working for Monroe County and have a background and wide ranging knowledge services and procedures. With this knowledge, Monroe County Case Managers are proficient in helping individuals with Medicaid applications along with assisting them with their applications for Food Stamps online. Monroe County's Case Managers have a minimum of 5 years experience in the Social Services field and as much as 26 years field experience. Along with the Case Managers extensive experience, MCIHS has been a 95196 December 2010 Contract CLP-MOSS I CCE lead agency for over 30 years and we have the knowledge and technical ability to submit all data and reporting into the CIRTS system, the knowledge of required reports, and the flexibility to handle requirements set forth by the DOEA and the Alliance for Aging. Statement of Readiness — MCIHS is fully ready to implement services within the Community Living Program immediately. All of the services that we are proposing here are currently being performed by existing staff. We have the necessary infrastructure and financial resources necessary to begin serving referred clients immediately. Unit Rate — MCIHS has the commitment of the BOCC to meet the 10% cash match requirement as set forth in the ITN. In addition, MCIHS has the capacity to offer an additional 10 o in -kind match via our existing infrastructure (office and congregate meal site space). The combination of these two sources of funds will equate to an overall 20% match. Value-added services are outlined and documented in this response, as well as the office and congregate meal site space which are documented on the Unit Cost Methodology. 96196 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12-15-2010 Bulk Item: Yes X No _ Division: County Administrator. Department: Social Services/In-Home Services_ Staff Contact Person/Phone #: Sheryl Graham/X4510 AGENDA ITEM WORDING: Approval of the Community Living Program (CLP) Contract CLP- MCSS-II between the Alliance for Aging, Inc. (Area Agency on Aging for Miami -Dade and Monroe Counties) and the Monroe County Board of County Commissioners (Social Services/In-Home Services) for fiscal period 1/l/11 to 12/31/11. ITEM BACKGROUND: Approval of the CLP Contract #CLP-MCSS-II will allow In -Home Services to perform short term, cost effective, interventions, to individuals at high risk of nursing home placement or hospital re -admission. PREVIOUS RELEVANT BOCC ACTION: None CONTRACT/AGREEMENT CHANGES: None STAFF RECOMMENDATIONS: Approval TOTAL COST: $15,000.00 INDIRECT COST: _-0-_BUDGETED: Yes X No COST TO COUNTY: $1,500.00 (10% Cash Match Required) SOURCE OF FUNDS: Ad -Valorem Taxes And $1,500.00 (10% In -Kind Match) REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year. APPROVED BY: County Atty X OMB/Purchasing X Risk Management _X DOCUMENTATION: DISPOSITION: Revised 1/09 Included X Not Required AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Alliance For Aging, Inc. Contract CLP # CLP-MCSS-II Effective Date: 1/1/2011 Expiration Date: 12/31/2011 Contract Purpose/Description: Approval of the Community Living Program (CLP) Contract CLP-MCSS-11 will allow Monroe County In -Home Services to perform short term, cost effective, interventions, to individuals at high risk of nursing home placement or hospital re -admission. Contract Manager: Sheryl Graham 4510 Community Services/Stop 1 (Name) (Ext.) (Department/Stop #) For BOCC meeting on 12/15/10 Agenda Deadline: 11/30/10 CONTRACT COSTS Total Dollar Value of Contract: (extension) $15,000.00 Current Year Portion: $ Budgeted? Yes X No Account Codes: _125_-_6153011_-_ Grant: $ 15,000.00 - - County Match: $1,500.00 (10% Cash Match Required - -_ $1,500.00 10% In -Kind Match Total 20% Match - - ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. Maintenan uti CONTRACT REVIEW Changes Date Out Da Ne 4eview Division Director j� 70 Yes, No Risk Mana e ent �" es No O.M.B./Purc asing �'�j� ``Cy Yeses County Attorney Avi Yes Comments: OMB Form Revised 2/27/01 MCP #2 January 2011 Contract CLP- MCSS II ALLIANCE FOR AGING, INC. STANDARD CONTRACTOLDER AMERICANS ACT PROGRAM TITLE III-B COMMUNITY LIVING PROGRAM THIS CONTRACT is entered into between the Alliance for Aging I�hereinafter referred to as the "AAA," and Monroe County Social Services hereinafter referred to as the "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 AAA has established through the Area Plan on Aging 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 AAA. NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the mutual covenants and conditions hereinafter set forth, the Parties agree as follows: 1. Purpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, which constitute the contract document. 1.1 Definitions DOEA means the Florida Department of Elder Affairs. AAA means the Alliance for Aging, Inc. PSA means the Planning and Service Area corresponding to Miami -Dade and Monroe Counties. 2. Incorporation of Documents within the Contract The contract will incorporate the provider's application in response to the 2010 Community Living Program Invitation to Negotiate (ITN), attachments, proposal(s), state plan(s), grant agreements, relevant department handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the Proposal(s) or other general materials not specific to this contract document and identified attachments. 3. Term of Contract This contract shall begin on January 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 Miami, Florida, on December 31, 2011. 4. Contract Amount The department agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed 15 000.00, 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)(f), F.S., the AAA 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 AAA and the availability of funds. 1/96 January 2011 Contract CLP- MCSS II 6. Compliance with Federal Law 6.1. If this contract contains federal funds the following shall apply: 6.1.1 The provider shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 6.1.2 If this contract contains federal funds and is over $100,000.00, the contractor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The contractor shall report any violations of the above to the AAA. 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 II. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Contract Manager, prior to payment under this contract. 6.1.4 That if this contract contains $10,000.00 or more of federal funds, 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 That 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 That a contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards shall not be made to parties listed on the government -wide Excluded 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 will 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 AAA shall consider the employment of unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324 a) and the Immigration Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation shall be cause for unilateral cancellation of this contract by the AAA. 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 AAA in writing within thirty (30) days of receiving the IRS notice of revocation. 7. Compliance with State Law 7.1 That this contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 7.2 Requirements of s. 287.058, F.S. as amended. 2/96 January 2011 Contract CLP- MCSS II 7.2.1 The contractor will 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 will submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre -audit and post -audit. 7.2.3 If itemized payment for travel expenses is permitted in this contract, the contractor will 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 will 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 shall constitute an immediate breach of contract for which the AAA may unilaterally terminate the contract. 7.3 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 will 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. 8. Background Screening 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, shall 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 shall apply to employees, subcontractors, consultants, direct service providers and volunteers. Consequently, any commitment for employment, purchase of services, or volunteer program participation shall be contingent upon the passing of a Level II background check. The background screening shall 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, 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 and 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, should provide for notice of the grievance procedure and an opportunity for review of the subcontractor's determination(s). 10. Audits, Inspections. Investigations. Public Records and Retention 10.1 To establish and maintain books, records and documents (including electronic storage media) sufficient to reflect all income and expenditures of funds provided by the AAA under this contract. 3/96 January 2011 Contract CLP- MCSS II 10.2 To 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 AAA. 10.3 Upon demand, at no additional cost to the AAA, the contractor will facilitate the duplication and transfer of any records or documents during the required retention period in Paragraph 10.2. 10.4 To assure that the records described in Paragraph 10 shall be subject at all reasonable times to inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the AAA. 10.5 At all reasonable times for as long as records are maintained, persons duly authorized by the AAA, DOEA and Federal auditors, pursuant to 45 CFR 92.36(i)(10), shall 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 To provide a financial and compliance audit to the AAA as specified in this contract and in ATTACHMENT III and to ensure that all related party transactions are disclosed to the auditor. 10.7 To comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S. 11. Nondiscrimination -Civil Rights Compliance 11.1 The contractor will execute assurances in ATTACHMENT VI that it will not discriminate against any person in the provision of services or benefits under this contract or in employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance with state and federal law and regulations. The 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 The contractor will retain, on file, during the term of this agreement a timely, complete and accurate Civil Rights Compliance Checklist (ATTACHMENT B). 11.3 The contractor agrees to establish procedures pursuant to federal law to handle complaints of discrimination involving services or benefits through this contract. These procedures shall include notifying clients, employees, and participants of the right to file a complaint with the appropriate federal or state entity. 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 AAA 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 will provide services in the manner described in ATTACHMENT I. 4/96 January 2011 Contract CLP- MCSS II 13. Monitoring by the AAA The contractor will permit persons duly authorized by the AAA 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 AAA of the satisfactory performance of the terms and conditions of this contract. Following such review, the AAA will deliver to the contractor a written report of its findings and request for development, by the contractor, a corrective action plan where appropriate. The contractor hereby agrees to timely correct all deficiencies identified in the corrective action plan. 14. Coordinated Monitoring with Other Agencies If the contractor receives funding from one or more of the State of Florida other human service agencies, in addition to the 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 coordinator, the contractor shall comply and cooperate with all monitors, inspectors, and/or investigators. 15. Indemnification The contractor shall indemnify, save, defend, and hold harmless the AAA and its agents and employees from any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the execution of this agreement or performance of the services provided for herein. It is understood and agreed that the provider is not required to indemnify the AAA for claims, demands, actions or causes of action arising solely out of the AAA's negligence. 15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contracts executed between the DOEA and state agencies or subdivisions defined in s. 768.28(2), F.S. 16. Insurance and Bonding 16.1 To provide continuous adequate liability insurance coverage during the existence of this contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or subdivision as defined by subsection 768.28(2), F.S., the 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 AAA has the most current written verification of insurance coverage throughout the term of this contract. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida. The AAA reserves the right to require additional insurance as specified in this contract. 16.2 Throughout the term of this agreement, the contractor agrees to 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 Portability and Accountability Act 5/96 January 2011 Contract CLP- MCSS II Where applicable, the contractor will 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 Reporting 19.1 The contractor shall notify the AAA 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 To immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number (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) Reporting (N/A) The contractor shall notify the AAA 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 If, at any time during the term of this contract, the contractor, its assignees, subcontractors or affiliates filoR a claim for bankruptcy, the contractor must immediately notify the AAA Within ten (10) days after notification, the contractor must also provide the following information to the AAA: (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., Northern District of Florida, Tallahassee Division); and, (4) the name, address, and telephone number of the bankruptcy attorney. 22. Sponsorship 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), The Alliance for Aging, and the State of Florida, Department of Elder Affairs." If the sponsorship reference is in written material, the words "Alliance for Aging" and "State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or type as the name of the organization. 22.2 The contractor shall not use the words "Alliance for Aging" or "The State of Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless, specific authorization has been obtained by the AAA prior to use. 23. Assignments 23.1 The contractor shall not assign the rights and responsibilities under this Contract without the prior written approval of the AAA, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring without prior written approval of the AAA will constitute a material breach of the contract. 23.2 The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the January 2011 Contract CLP- MCSS II 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 AAA. 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 AAA deems necessary. The contractor further agrees that the AAA shall not be liable to the subcontractor in any way or for any reason. The contractor, at its expense, will defend the AAA against any such claims. 24.2 The contractor shall promptly pay any subcontractors upon receipt of payment from the department or other sponsoring 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 Capacity of Contractor It is the intent and understanding of the parties that the contractor, or any of its subcontractors, are independent contractors and are not employees of the AAA and shall not hold themselves out as employees or agents of the AAA without specific authorization from the AAA. It is the further intent and understanding of the parties that the AAA does not control the employment practices of the contractor and shall 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 shall be the sole responsibility of the contractor. 26. Payment Payments will be made to the contractor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the contractor. The AAA's 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 AAA's fiscal 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 will return to the AAA any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the contractor by the AAA. 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 AAA. In the event that the AAA first discovers an overpayment has been made, the Contract Manager, on behalf of the AAA, will notify the contractor by letter of such findings. Should repayment not be made forthwith, the contractor will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after AAA notification or contractor discovery. 28. Data Integrity and Safeguarding Information The contractor shall insure 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 7/96 January 2011 Contract CLP- MCSS II information processing capabilities. All data and software must be routinely backed up to insure recovery from losses or outages of the computer system. The security over the backed -up data is to be as stringent as the protection required of the primary systems. The contractor shall insure all subcontractors maintain written procedures for computer system back up 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 will establish safeguards to prohibit employees, board members, management and subcontractors from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain. No employee, officer or agent of the 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 AAA 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., the following restrictions are placed on the ability of persons convicted of public entity crimes to transact business with the AAA. 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. 32. Purchasing 32.1 To procure any recycled products or materials, which are the subject of or are required to carry out this contract, in accordance with the provisions of s. 403.7065, F.S. 33. Patents, Copyrights, Royalties If any discovery, invention or copyrightable material is developed or produced 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 AAA to be referred to the Department of State. Any and all patent rights or copyrights accruing under this contract are hereby January 2011 Contract CLP- MCSS II 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 shall retain an unencumbered right to use such property, notwithstanding any agreement made pursuant to Paragraph 33. 34. Emergency Preparedness and Continuity 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 AAA of emergency provisions. 34.2 In the event, a situation results in a cessation of services by a subcontractor, the contractor will 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. 36. Use of State Funds to Purchase or Improve Real Property Any state funds provided for the purchase of or improvements to real property are contingent upon the contractor or political subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by law. 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 Consequences 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 AAA 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 shall not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the AAA. 39. No Waiver of Sovereign Immunity Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which sovereign immunity may be applicable. 40. Venue If any dispute arises out of this contract, the venue of such legal recourse will be Leon County, Florida. 9/96 January 2011 Contract CLP- MCSS II 41. Entire Contract This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or representations shall be valid or binding upon the AAA or the contractor unless expressly contained herein or by a written amendment to this contract signed by both parties. 42. Force Ma_ieure Neither party shall be liable for any delays or failures in performance due to circumstances beyond its control, provided the party experiencing the force majeure condition provides immediate written notification to the other 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: Appropriations The parties agree that the AAA's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature to DOEA. 45. Addition/Deletion The parties agree that the AAA reserves the right to add or to delete any of the services required under this contract when deemed to be in the PSA'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 AAA to exercise or enforce any of its rights under this contract shall not constitute or be deemed a waiver of the AAA's right thereafter to enforce those rights, nor shall any single or partial exercise of any such right preclude any other or further exercise thereof or the exercise of any other right. 47. Compliance The contractor agrees to 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 AAA. 48. Final Invoice The contractor shall submit the final invoice for payment to the AAA as specified in Paragraph 3.3.4. (date for final request for payment) of ATTACHMENT I. If the contractor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the AAA may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from the contractor and necessary adjustments thereto have been approved by the AAA. 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 AAA'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 10/96 January 2011 Contract CLP- MCSS II 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. 50.2 In the event funds for payment pursuant to this contract become unavailable, the AAA 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 AAA shall 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 AAA 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 AAA's or the contractor's rights to remedies at law or in equity. 50.4 Failure to have performed any contractual obligations with the AAA in a manner satisfactory to the AAA 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 AAA, been notified by the AAA of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction of the AAA; or (2) had a contract terminated by the AAA for cause. 51. Official Payee and Representatives (Names, Addresses, and Telephone Numbers): The contractor name, as shown on page 1 of this Monroe County Board of County Commissioners/In-Home a. contract, and mailing address of the official payee to Services Program whom the payment shall be made is: 1100 Simonton Street Rm 2-257 Key West, FL 33040 The name of the contact person and street address Sheryl Graham, Director, Monroe County Social Services b. where financial and administrative records are 1100 Simonton Street, Rm. 2-257 maintained is: Key West, FL 33040 305-292-4510 The name, address, and telephone number of the Sheryl Graham, Director, Monroe County Social Services C. representative of the contractor responsible for 1100 Simonton Street, Rm. 2-257 administration of the program under this contract is: Key West, FL 33040 305-292-4510 The section and location within the AAA where Anthony Coombs, Associate Vice President d• Requests for Payment and Receipt and Expenditure 760 NW 107th Avenue, Suite 201 and 214 forms are to be mailed is: Miami, Florida 33172 e. The name, address, and telephone number of the Maria Scotto 760 NW 107th Ave. #214 Contract Manager for the AAA for this contract is: Miami, FL 33174 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. 11/96 January 2011 Contract CLP- MCSS II 52. All Terms and Conditions Included This contract and its Attachments, I — X, A, B, E, F, G and 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. 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 63 page contract, to be executed by their undersigned officials as duly authorized. Contractor: ALLIANCE FOR AGING, INC. SIGNED BY: SIGNED BY: NAME: NAME: MAX B. ROTHMAN, JD, LL.M. TITLE: TITLE: PRESIDENT AND CEO DATE: DATE: 12/96 January 2011 Contract CLP- MCSS II ATTACHMENT ATTACHMENTI FEN aWN'Torm Orl gifts11 ATTACHMENT III, EXHIBIT 1 ATTACHMENT III, EXHIBIT 2 INDEX TO CONTRACT ATTACHMENTS ATTACHMENT DESCRIPTION STATEMENT OF WORK [aim .%Y_I0[4w.,NI[$]e1 C1g0ty..1117Qk[" 000: 11,61 f1 FINANCIAL COMPLIANCE AUDIT ATTACHMENT FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT ATTACHMENT III, AUDIT RELATIONSHIP DETERMINATION & FISCAL COMPLIANCE EXHIBIT 3 REQUIREMENTS ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION ATTACHMENT VI ASSURANCES - NON -CONSTRUCTION PROGRAMS ATTACHMENT VII ATTACHMENT VIII ATTACHMENT IX ATTACHMENT X, EXHIBIT 1 ATTACHMENT X, EXHIBIT 2 ATTACHMENT X, EXHIBIT 3 ATTACHMENT A ATTACHMENT B ATTACHMENT E ATTACHMENT F, EXHIBIT 1 ATTACHMENT F, EXHIBIT 2 ATTCHMENT G ATTACHMENT H OLDER AMERICANS ACT PROGRAM BUDGET SUMMARY OLDER AMERICANS ACT CONTRACT REPORT CALENDAR REQUEST FOR PAYMENT RECEIPTS AND EXPENDITURES, TITLE III ADMINISTRATION RECEIPTS AND EXPENDITURES, TITLE IIIB, IIIC1, AND IIIC2 RECEIPTS AND EXPENDITURES, TITLE IIIE DEPARTMENT OF ELDER AFFAIRS' PROGRAMS & SERVICES HANDBOOK (ON CD) DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE CHECKLIST AND INSTRUCTIONS DEPARTMENT OF ELDER AFFAIRS' COMPUTER USE AND SOCIAL MEDIA POLICY (ON CD) DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY II INSTRUCTIONS: DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY II CLP PROGRAMS PROTOCOLS SERVICE PROVIDER APPLICATION PAGE 15-25 27 29-32 33 35 37 39 41-42 43 45 47 49-51 53-55 57-59 61 63-68 69 71 73 75-84 85-96 13/96 January 2011 Contract CLP- MCSS II 14/96 January 2011 Contract CLP- MCSS II ATTACHMENT I ALLIANCE FOR AGING, INC. STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS ADL — Activities of Daily Living APS — Adult Protective Services AIRS — Alliance of Information & Referral Systems ADA — Americans with Disabilities Act AAA — Area Agency on Aging APCL — Assessed Priority Consumer List CIRTS — Client Information and Registration Tracking System FLAIRS — Florida Alliance of Information and Referral Services I&R — Information and Referral IADL — Instrumental Activities of Daily Living MOA — Memorandum of Agreement MOU — Memorandum of Understanding OAA — Older Americans Act PSAs — Planning and Service Areas WebDB — Web -based Database System 1.1.2 PROGRAM SPECIFIC TERMS ADI (Alzheimer's Disease Initiative) — Services targeted to individuals with Alzheimer's Disease or a similar memory disorder, including respite, assessment, caregiver training, and other community -based services. These services are funded through a specific state appropriation. ADRC or ARC (Aging and Disability Resource Centers or Aging Resource Centers) — The not -for -profit entity which is the single entry point for the aging service system within each established region of the state. APS (Adult Protective Services) High Risk — The designation of an elder who needs immediate protection from further abuse, neglect or exploitation, which can be accomplished completely or in part through the provision of home and community -based services. Area Plan: A plan developed by the area agency on aging outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and department instructions. Area Plan Update: A revision to the area plan wherein the area agency on aging enters OAA specific data in the web -based database system (WebDB). An update may also include other revisions to the area plan as instructed by the department. Caregiver or Support System — For this project, the caregiver or support system is one or more persons whom the elder can depend on to provide care or to organize the provision of needed care. Care Plan Review Team — For purposes of this project, a team of staff designated by the CLP staff, which reviews the client's situation and makes recommendations concerning continuation of services after the initial short term grant -funded crisis -resolving period. However in no case will services be continued on a long term basis under this program. 15/96 January 2011 Contract CLP- MCSS II CCE (Community Care for the Elderly) — Services offered to functionally impaired older persons to enable them tc live in the least restrictive environment, including adult day care, consumable medical supplies, home delivered meals, homemaker, personal care, respite, and other community -based services. These services are funded through a specific state appropriation. CIRTS (Client Information and Registration Tracking System) — The database of the Department of Elder Affairs used by the aging network to manage client assessment data, register clients for services, plan client services and maintain program waiting lists. Lead agency provider assessors also use CIRTS to evaluate client eligibility for Medicaid services and to develop recommendations for client placement. CDC (Consumer Directed Care) — A service option that gives elders, or their representatives, the opportunity to manage the elder's service delivery, including decisions about which services will be provided, by whom and how often. With the assistance of a consultant, an elder develops a budget plan that identifies needed goods and services and authorizes the elder to hire workers, who may be family members or friends, and select vendors to help with daily care needs. A fiscal/employer agent (F/EA) pays the workers and vendors according to the rates on the budget plan. The F/EA also pays the required federal and state taxes and files the necessary tax forms. Community Living Program — "Community Living Program" is a grant to the state of Florida from the federal Administration on Aging. For persons meeting the project's functional and financial eligibility criteria, the grant provides crisis -resolving in -home services to address their immediate and temporary needs as they leave a hospital or rehabilitation center or after a short-term nursing home stay. Without these services, the person would be at high risk of either nursing home placement or continued stay in a nursing home. This program also manages consumer directed care services provided to veterans. Cost Sharing — Payment by an individual for a portion of the monthly cost of the services he/she receives, based on the individual's income and assets, and determined by the total monthly cost of the planned services. Crisis -Resolving Services — Time -limited community -based services provided to address a client's immediate short- term care needs. Possible services include, but are not limited to: case management, personal care, homemaker, transportation, meals. For the purposes of this program, a crisis is an episode that has a high probability of creating a nursing home longterm placement or a re -hospitalization. Examples of such crisis include caregiving situations, i.e. a caregiver hospitalization that would cause the nursing home placement of the care recipient; it also includes hospital/rehab discharges that have a high likelihood of recidivism or further patient deterioration where a permanent nursing home placement is a likely sequel. Financial Eligibility —To be financially eligible to receive services, other than assessment and referral, under this project, the individual must not be eligible for Medicaid under the Institutional Care Program (ICP) rules. Frail: When an older individual is unable to perform at least two activities of daily living (ADL) without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. Lead Agency —A Community Care for the Elderly (CCE) designated agency. Lead agencies provide services under the CCE and ADI programs. In addition lead agencies handle APS cases in accordance with a DOEA established protocol. Lead Service Provider —A provider of Older American Act Services that also provides case management under this project. The Case manager from the service provider will follow-up with those project participants referred by the CLP staff to facilitate the provision of services during the grant period and to help plan for the person's needs after the grant period. OAA IIIB, IIID, IIIE (Older Americans Act Titles) — Title IIIB provides supportive services to assist elders to live independently in their community. Title IIID provides disease -prevention and health -promotion services at senior centers or alternative sites. Title IIIE provides services through the National Family Caregiver Support Program to assist families caring for frail older members, and to assist grandparents or older relatives who are caregivers for 16/96 January 2011 Contract CLP- MCSS II children who are under 19 or are disabled. Private Pay — Payment of the complete cost of services by an individual with sufficient income and assets to be over the financial standards for receipt of state or grant funded services. Referring Entity — An entity providing referrals to the single entry point. These include case management agencies, hospitals, rehabilitation centers, home health agencies, physician assisted home based programs, and nursing homes. Individuals referred should appear to meet the eligibility criteria for this project. Self -declared — For purposes of initial financial eligibility for the project, the individual's declaration of income and assets will not require verification. SEP (Single Entry Point) — The CLP staff for the area where the individual is receiving services is the single entry point into the aging service system. Spend down to Medicaid — The use of personal resources to pay for services prior to the individual's resources being reduced to the level of Medicaid eligibility. Triage — The activity performed by CLP staff to prioritize an individual for service based on the criteria established for publicly funded programs because he/she does not meet the eligibility criteria for this project. Veterans Administration Consumer Directed Care —A capitated consumer directed care program sponsored by the Veterans Administration and operated through the Community Living Program. Also, see Consumer Directed Care definition above. 1.2 Alliance for Aging Mission The Alliance For Aging Inc. mission id to promote and advocate for the optimal quality of life for older adults and their families. 1.2.1 DOEA Mission Statement The department's mission is to foster an optimal quality of life for elder Floridians. The department's vision and shared values are to foster a social, economic and intellectual environment for all ages, and especially those age 60 and older, where all can enjoy Florida's unparalleled amenities in order to thrive and prosper. Area agencies, lead agencies and local service providers as partners and stakeholders in Florida's aging services network are expected to support the department's mission, vision, and program priorities. 1.2.2 Older Americans Act Program Mission Statement The Older Americans Act (OAA) Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 1.3 GENERAL DESCRIPTION 1.3.1 General Statement The goals of Community Living Program Phase II, for PSA 11 are to reduce overall Medicaid long term care expenditures, develop co -pay and financially sustainable systems —within the context of the Older Americans Act network of AAA and providers, and to increase consumer choice and self -direction. 1.3.2 Authority The relevant references authority governing the OAA program are: (1) Older Americans Act of 2006, as amended; 17/96 January 2011 Contract CLP- MCSS II (2) Rule 58A-1, Florida Administrative Code; and (3) Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and 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 providing services in accordance with the CLP Program Protocols contained in ATTACHMENT G and its response to the 2010 CLP program ITN contained in ATTACHMENT H. The services shall be provided in a manner consistent with and described in the current contractor's area plan update and the current Department of Elder Affairs Programs and Services Handbook (ATTACHMENT A). 1.3.4 Major Program Goals The goals of Community Living Program Phase II, for PSA 11 are to reduce overall Medicaid long term care expenditures, develop co -pay and financially sustainable systems —within the context of the Older Americans Act network of AAA and providers, and to increase consumer choice and self -direction. To achieve these goals PSA 11 will focus its efforts in providing consumers with the means to resolve events that have been identified as "critical pathways" to institutional long term care. Some of these "critical pathways" include sudden caregiver burnout, depression, malnutrition/dehydration and lack of proper follow up with home and community based services following'hospital/rehab discharges. PSA 11 will also manage a Veterans Administration Consumer Directed Care. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility Client Identification 1. Individual is at least 60 years old. 2. Individual is a resident of Miami -Dade or Monroe Counties. 3. Financially uneligible for Medicaid and functionally impaired. 4. Has Medicare or private health insurance. 5. Individual is not receiving hospice services. Individual or caregiver is in need of crisis resolving services and/or short term care, to avoid readmission to a hospital/rehab facility or a nursing home placement which could lead to spend down to Medicaid. Services are not geared to resolve a long term care need, but to address a critical short term need that if left unresolved would precipitate a nursing home placement or re -hospitalization 1.4.1.1 OAA Title III, General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitated long-term care program. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need, with particular attention to low- 18/96 January 2011 Contract CLP- MCSS II income older individuals, including those that are low-income minorities, have limited English proficiency, and older individuals residing in rural areas. SECTION II — MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program, the contractor shall ensure that the protocols contained in ATTACHMENT G and the response to the 2010 CLP program ITN contained in ATTACHMENT H 2.1.3.1 Supportive Services Supportive services include a variety of community -based and home -delivered services that support the quality of life for older individuals by helping them remain independent and productive. Services include the following: (1) Adult Day Care/Adult Day Health Care; (17) Legal Assistance; (2) Caregiver Training/Support; (18) Material Aid; (3) Case Aid/Case Management; (10) Occupational Therapy; (4) Chore Services; (20) Outreach; (5) Companionship; (21) Personal Care; (6) Counseling (Gerontological and Mental (22) Physical Therapy; Health); (7) Education/Training; (23) Recreation; (8) Emergency Alert Response; (24) Referral/Assistance; (9) Escort; (25) Respite Services; (10) Health Support; (26) Screening/Assessment; (11) Home Health Aid; (27) Shopping Assistance; (12) Homemaker; (28) Skilled Nursing; (13) Housing Improvement; (29) Specialized Medical Equipment, Services, and (14) Information; Supplies (15) Intake; (30) Speech Therapy; (16) Interpreter/Translating; (31) Telephone Reassurance; and (32) Transportation 2.1.4 Use of Volunteers to Expand the Provision of Available Services The contractor shall make use of trained volunteers in providing direct services delivered to older individuals and individuals with disabilities needing such services. If possible, the contractor shall work in coordination with organizations that have experience in providing training, placement, and stipends for volunteers or participants (such as organizations carrying out Federal service programs administered by the Corporation for National and Community Service), in community service settings. 2.1.5 Monitoring the Performance of Subcontractors The contractor shall conduct at least one monitoring per year of each subcontractor. The contractor shall perform fiscal, administrative and programmatic monitoring of each subcontractors to ensure contractual compliance, fiscal 19/96 January 2011 Contract CLP- MCSS II accountability, programmatic performance, and compliance with applicable state and federal laws and regulations. 2.1.5.1 Use of Subcontractors If this contract involves the use of a subcontractor or third party, then the contractor shall not delay the implementation of its agreement with the subcontractor. If any 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 AAA's Contract Manager and the AAA's Chief Financial Officer in writing of such delay. The contractor shall not permit a subcontractor to perform services related to this agreement without having a binding subcontractor agreement executed. In accordance with Paragraph 24.1 of the Standard Agreement, the AAA will not be responsible or liable for any obligations or claims resulting from such action. 2.2 SERVICE LOCATION AND EQUIPMENT 2.2.1 Service Times The contractor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its subcontractors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 Equipment 2.3.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable, tangible personal property of a nonconsumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at least one year; and hardback bound books not circulated to students or the general public, with a value or cost of $250.00 or more [for state funds]. 2.3.2 Contractors and sub -contractors 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. The property records must be maintained on file and shall be provided to the AAA upon request. 2.3.3 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); (7) Location and condition of the equipment and the date the information was reported; 20/96 January 2011 Contract CLP- MCSS II (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. 2.3.4 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 DOEA 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 sub -contractors (not included in a cost methodology), is subject to the conditions of Chapter 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 AAA, or purchased with funds provided through this contract without first obtaining the approval of the AAA's Contract Manager. When disposing of property or equipment the contractor must submit a written request for disposition instructions to the respective Contract Manager. The request should include a brief description of the property, purchase price, funding source, percentage of state or federal participation, acquisition date and condition of the property. The request should also indicate the contractor's proposed disposition (i.e., transfer or donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc.). 2.3.6 The AAA's 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). 2.3.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but excludes movable machinery and equipment. Real property may not be purchased with state or federal funds through agreements covered under this contract without the prior approval of the DOEA. 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 a fixed capital outlay grants and aids appropriation and therefore are subject to the provisions of s. 216.348, F. S. 2.3.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior to disposal to ensure no confidential information remains. 21/96 January 2011 Contract CLP- MCSS II 2.4 DELIVERABLES 2.4.1 Service Unit The contractor shall provide the services described in the contract in accordance with ATTACHMENTS A, G and H. 2.5 REPORTS The contractor is responsible for responding in a timely fashion to additional routine and/or special requests for information and reports required by the AAA. 2.5.1 Service Costs Reports The contractors shall submit to the AAA semi-annual service cost reports, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.6.1 Each contractor and subcontractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The contractor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with subcontractors. These policies and procedures shall be made available to the AAA upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The contractor shall timely submit to the AAA all reports described in ATTACHMENT I, Paragraph 2.5 REPORTS; (2) The contractor shall timely submit to the AAA all information described in ATTACHMENT I, Paragraph 2.6 RECORDS AND DOCUMENTATION; (3) The contractor shall ensure services in this contract are in accordance with ATTACHMENT A. 2.7.3 Monitoring and Evaluation Methodology The AAA 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, and/or an on -site visit. The AAA's determination of acceptable performance shall be conclusive. The contractor agrees to cooperate with the AAA in monitoring the progress of completion of the service tasks and deliverables. 2.7.4 Remedies -Nonconforming Services The contractor shall ensure that all participants served under this agreement are eligible for the program, and that all monthly and/or quarterly performance reports and financial records are maintained for each reporting period and submitted as stipulated in Paragraphs 1.4 - 1.4.2 and 2.1- 2.1.6. Any nonconforming program services, performance reports or financial records not meeting the aforementioned requirements shall not be eligible for reimbursement under this program. The costs associated with enrolling, training, reporting and/or managing the program shall be borne solely by the contractor. The AAA requires immediate notice of any significant and/or systemic infractions that compromise the contractor's ability to provide participant services, to achieve programmatic performance or to provide sound financial management of the program. 2.8 CONTRACTOR'S FINANCIAL OBLIGATIONS 22/96 January 2011 Contract CLP- MCSS II 2.8.1 Matching, Level of Effort, and Earmarking Requirements The contractor will fulfill a match requirement of at least 10 percent of the cost for all services funded through this contract (i.e. 90 cents of grant funds must be matched with 10 cents from the contractor.) The subcontractor's match will be made in the form of cash and/or in -kind resources. Match must be reported by title each month. At the end of the contract period, all OAA funds must be properly matched. The provider must comply with the "value added" provisions contained in Appendix 2.8.2 Consumer Contributions (1) The contractor assures compliance with Section 315 of the Older Americans Act as amended in 2006, in regard to consumer contributions; (2) Voluntary contributions are not to be used for cost sharing or matching; (3) Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; and (4) Voluntary contributions are to be used only to expand services. 2.8.3 Use of Service Dollars The contractor is expected to spend all federal, state and other funds provided by the AAA for the purpose specified in the contract. The contractor must manage the service dollars in such a manner so as to avoid having a wait list and a surplus of funds at the end of the contract period, for each program managed by the contractor. If the AAA determines that the contractor is not spending service funds accordingly, the AAA may transfer funds to other providers during the contract period and/or adjust subsequent funding allocations accordingly, as allowable under state and federal law. 2.8.4 Title III Funds The contractor assures compliance with Section 306 of the Older Americans Act, as amended in 2006, that funds received under Title III will not be used to pay any part of a cost (including an administrative cost) incurred by the contractor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.9 AAA RESPONSIBILITIES 2.9.1 Program Guidance and Technical Assistance The AAA will provide to the contractor guidance and fulfillment of the contract by the contractor. technical assistance as needed to ensure the successful 2.9.2 Contract Monitoring The AAA shall, at its own discretion, conduct monitoring concerning any aspect of the contractor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this contract includes advances, cost reimbursement for administration costs, and fixed rate for services. The contractor shall ensure fixed rates for services include only those costs that are in accordance with all applicable state and federal statutes and regulations and are based on audited historical costs in instances where an independent audit is required. The contractor shall consolidate all requests for payment from subcontractors and expenditure reports that support requests for payment and shall submit to the AAA on forms 106A (ATTACHMENT IX), 105AA (ATTACHMENT X-EXHIBIT 1), 105AS (ATTACHMENT X-EXHIBIT 2), and 105AE (ATTACHMENT X-EXHIBIT 3). 23/96 January 2011 Contract CLP- MCSS II 3.1.1 The contractor agrees to implement the distribution of funds as detailed in ATTACHMENT VII, Budget Summary. An amendment is required to change the total amount of the contract. 3.2 Advance Payments 3.2.1 The contractor may request up to two months of advances at the start of the contract period, if available, to cover program administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount of funds released to the AAA by the State of Florida ("budget release"). The contractor shall provide the AAA's Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. 3.2.2 The contractor's requests for advance require the approval of the AAA's Contract Manager. If sufficient budget is available, the AAA will issue approved advance payments after January 1, 2011. 3.2.3 Requests for the first through the twelfth months shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests, if available is shown on ATTACHMENT VIII of this contract. 3.2.4 All advanced payments made to the contractor shall be recouped in accordance with the Reporting Schedule, ATTACHMENT VIII of this contract. 3.2.5 Interest earned on advances must be identified separately by source of funds, state or federal. Contractors shall maintain advances of federal funds in interest bearing accounts unless otherwise excepted in accordance with 45 CFR 74.22(k). Earned interest must be returned to the AAA at the end of each quarter. 3.3 Invoice Submittal and Requests for Payment All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA forms 106A (ATTACHMENT IX) , 105AA (ATTACHMENT X-EXHIBIT 1), 105AS (ATTACHMENT X- EXHIBIT 2), and 105AE (ATTACHMENT X-EXHIBIT 3). 3.3.1 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests (when available) and invoices is ATTACHMENT VIII to this contract. 3.3.2 Any payment due by the AAA under the terms of this contract may be withheld pending the receipt and approval of all financial and programmatic reports due from the contractor and any adjustments thereto, including any disallowance not resolved as outlined in Paragraph 26 of this contract. 3.3.3 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in ATTACHMENT VII, Budget Summary. Any changes in the amounts of federal or general revenue funds identified on the Budget Summary form require a contract amendment. 3.3.4 Date for Final Request for Payment The final request for payment will be due to the AAA no later than February 14, 2012. 3.4 Documentation for Payment The contractor shall maintain documentation to support payment requests that shall be available to the AAA or authorized individuals, such as Department of Financial Services, upon request. 3.4.1 The contractor must enter all required data per the department's CIRTS Policy Guidelines for clients and services in 24/96 January 2011 Contract CLP- MCSS II the CIRTS database. Data must be entered into CIRTS before the contractors submit their request for payment and expenditure reports. 3.4.2 The contractor run monthly CIRTS reports and verify that client and service data in CIRTS is accurate. This report must be submitted to the AAA with the monthly request for payment and expenditure report and must be reviewed by the AAA before the contractor's request can be approved by the AAA. 25/96 January 2011 Contract CLP- MCSS II January 2011 Contract CLP- MCSS II ATTACHMENT II 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 sub -contractors 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 $10,000.00 and not more than $100,000.00 for each such failure. Signature Date Name of Authorized Individual Application or Agreement Number Name and Address of Organization DOEA Form 103 (Revised Nov 2002) 27/96 January 2011 Contract CLP- MCSS II 28/96 January 2011 Contract CLP- MCSS II FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT III EXHIBIT 1 The administration of resources awarded by the Department of Elder Affairs or the Alliance for Aging to the provider may be subject to audits and/or monitoring by the Department of Elder Affairs or the Alliance for Aging, 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 department 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 the Department of Elder Affairs or the Alliance for Aging. In the event the Department of Elder Affairs or the Alliance for Aging determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Department of Elder Affairs or the Alliance for Aging to the provider regarding such audit. The provider further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial Officer (CFO) or Auditor General. AUDITS PART I: FEDERALLY FUNDED This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. In the event that the provider expends $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 the Department of Elder Affairs or the Alliance for Aging by this agreement. In determining the Federal awards expended in its fiscal year, the provider shall consider all sources of Federal awards, including Federal resources received from the Department of Elder Affairs or the Alliance for Aging. 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 1, 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 Department of Elder Affairs or the Alliance for Aging shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Department of Elder Affairs or the Alliance for Aging shall be fully disclosed in the audit report with reference to the Department of Elder Affairs or the Alliance for Aging 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 9=91 January 2011 Contract CLP- MCSS II awards shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs or the Alliance for Aging 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 project -specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for- profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded through the Department of Elder Affairs or the Alliance for Aging 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 Department of Elder Affairs or the Alliance for Aging, 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 Department of Elder Affairs or the Alliance for Aging shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Department of Elder Affairs or the Alliance for Aging shall be fully disclosed in the audit report with reference to the Department of Elder Affairs or the Alliance for Aging agreement involved. If not otherwise disclosed as required by Rule 69I-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs or the Alliance for Aging in effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after the provider's fiscal year end for local governmental entities. Non-profit or for - profit organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the provider's fiscal year end. Notwithstanding the applicability of this portion, the Department of Elder Affairs or the Alliance for Aging retains all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the provider directly to each of the following: The Alliance for Aging, Inc.: 30/96 January 2011 Contract CLP- MCSS II Alliance for Aging, Inc. Attn: Horacio Soberon 760 NW 1071h Ave. Miami, FL 33172 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 loth Street Jeffersonville, IN 47132 Other Federal agencies and pass -through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. Pursuant to Sections .320(f), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the Department of Elder Affairs at each of the following addresses: Department of Elder Affairs Attn: Beverly Friedberg 4040 Esplanade Way Office 325B Tallahassee, FL 32399-7000 Additionally, copies of financial reporting packages required by Part H of this agreement shall be submitted by or on behalf of the provider directly to each of the following: The Alliance for Aging, Inc. at each of the following addresses: Alliance for Aging, Inc. Attn: Horacio Soberon 760 NW 1071h Ave. Miami, FL 33172 The Department of Elder Affairs at each of the following addresses Department of Elder Affairs Attn: Beverly Friedberg 4040 Esplanade Way Office 325B Tallahassee, FL 32399-7000 The Auditor General's Office at the following address: State of Florida Auditor General Claude Pepper Building, Room 574 111 West Madison Street Tallahassee, Florida 32399-1450 Any reports, management letter, or other information required to be submitted to the Department of Elder Affairs pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-133, Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General, as applicable. Providers, when submitting financial reporting packages to the Department of Elder Affairs for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit 31/96 January 2011 Contract CLP- MCSS II organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the provider in correspondence accompanying the reporting package. PART IV: RECORD RETENTION The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued, and shall allow the Department of Elder Affairs or its designee, the CFO or Auditor General access to such records upon request. The provider shall ensure that audit working papers are made available to the Department of Elder Affairs, 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 the Department of Elder Affairs. 32/96 January 2011 Contract CLP- MCSS II ATTACHMENT III EXHIBIT 2 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT Older Americans Act Administration U.S. Health and Human Services 93.044 $15,000 Title IIIB — Support Services TOTAL FEDERAL AWARD $15,000 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 33/96 January 2011 Contract CLP- MCSS II 34/96 January 2011 Contract CLP- MCSS II ATTACHMENT III EXHIBIT 3 PART I: AUDIT RELATIONSHIP DETERMINATION 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 department 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 35/96 January 2011 Contract CLP- MCSS II 36/96 January 2011 Contract CLP- MCSS II ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE 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 sub -contractors 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, sub-contractor(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 sub-contractor(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 sub -contractors 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). Name and Address of Contractor Signature Title Date Name of Authorized Signer (Revised June 2008) 37/96 January 2011 Contract CLP- MCSS II 3 8/96 January 2011 Contract CLP- MCSS II ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective contractor certifies, by signing this certification, neither it nor its principals are 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 prospective contractor is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this certification. Signature Title (Certification signature should be same as Contract signature.) Date Agency/Organization Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered 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 department 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 department 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) 39/96 January 2011 Contract CLP- MCSS II January 2011 Contract CLP- MCSS II ATTACHMENT VI ASSURANCES —NON -CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non -Federal share of project cost) to ensure proper planning, management, and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C..4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C., 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C., 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C._ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g). 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C., 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C.. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C..1501-1508 and 7324-7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C., 276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C..874) and the Contract Work Hours and Safety Standards Act (40 U.S.C., 327-333), regarding labor standards for federally assisted construction subagreements. 41/96 January 2011 Contract CLP- MCSS II 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or more. 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 1996 and OMB Circular No. A-133, Audits of States, Local Governments, and Non -Profit Organizations. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED 42/96 January 2011 Contract CLP- MCSS II ATTACHMENT VII BUDGET SUMMARY Service(s) to be Provided Service Unit Rate Maximum Units of Service* Maximum Dollars* HOMEMAKER $22.04 TBD TBD PERSONAL CARE $25.87 TBD TBD CASE MANAGEMENT $38.03 TBD TBD Total Contract I$15,000 *The number of units of service will be determined by the AAA authorizing individual care plans for each CLP program participant. The total contract amount will not be exceeded. 43/96 January 2011 Contract CLP- MCSS II 44/96 January 2011 Contract CLP- MCSS II ATTACHMENT VIII CONTRACT REPORT CALENDAR ADVANCE BASIS CONTRACT Report Number Based On Submit to the Alliance On This Date 1 January Advance* January 1, 2011 2 February Advance* January 1, 2011 3 January Expenditure Report February 5, 2011 4 February Expenditure Report March 5, 2011 5 March Expenditure Report April 5, 2011 6 April Expenditure Report May 5, 2011 7 May Expenditure Report June 5, 2011 8 June Expenditure Report July 5, 2011 9 July Expenditure Report August 5, 2011 10 August Expenditure Report September 5, 2011 11 September Expenditure Report October 5, 2011 12 October Expenditure Report** November 5, 2011 13 November Expenditure Report December 5, 2011 14 December Expenditure Report January 5, 2012 15 Final Expenditure and Request for Payment February 14, 2012 16 Closeout Report February 28, 2012 Legend: * Advance based on projected cash need. * * Recoupment of advance due with this report. Note # 1: Report #1 for Advance Basis Agreements cannot be submitted to the Department of Financial Services (DFS) prior to January 1 or until the agreement with the Department has been executed and a copy sent to DFS. Actual submission of the vouchers to DFS is dependent on the accuracy of the expenditure report. Note # 2: All advance payments made to the contractor shall be returned to the Department by the submission date of report #12. The adjustment shall be recorded in Part C, 1 of the report (ATTACHMENT IX). Note #3: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Department, payment is to accompany the report. 45/96 January 2011 Contract CLP- MCSS II 46/96 January 2011 Contract CLP- MCSS II ATTACHMENT IX _ ..... REQUEST FOR PAYMENT OLDER AMERICANS ACT PROVIDER NAME, ADDRESS, PHONE AND FED ID NUMBER TYPE OF REPORT: THIS REQUEST PERIOD: Advance Report # Reimbursement Agreement # Agreement Period: PSA : CERTIFICATION: I hereby certify to the best of my knowledge that this request conforms with the terms and the purposes set forth in the above agreement. Prepared By: Date: Approved By: Date: PART A: (1) (2) (3) (4) (7) (6) BUDGET SUMMARY ADMIN. III B IIICi IIIC2 Title IIIE TOTAL I. Approved Agreement Amount. 0.00 0.00 0.00 0.00 0.00 0.00 2. Previous Funds RECEIVED for Agreement period. 0.00 0.00 0.00 0.00 0.00 0.00 3. Agreement Balance 0.00 0.00 0.00 0.00 0.00 0.00 4. Previous Funds REQUESTED and Not Received. 0.00 0.00 0.00 0.00 0.00 0.00 5. Agreement Balance 0.00 0.00 0.00 0.00 0.00 0.00 PART B: FUNDS REQUESTED 1. 1st-2nd Months _ _ Request Only 0.00 0.00 0.00 0.00 0.00 0.00 2. Net Expenditures For Month 0.00 0.00 0.00 0.00 0.00 0.00' 3. Additional Cash Needs (Attach Doc.) 0.00 0.00 0.00 0.00 0.00 0.00 4. Total 0.00 0.00 0.00 0.00 0.00 0.00 PART C: NET FUNDS REQUESTED: 1. Less: Over -Advance 0.00 0.00 0.00 0.00 0.00 0.00 2. Agreement Funds are Hereby Requested For 0.00 0.00 0.00 0.00 0.00 0.00 DOEA FORM 106A revised 5/10 47/96 January 2011 Contract CLP- MCSS I1 O, January 2011 Contract CLP- MCSS II ATTACHMENT X EXHIBIT 1 49/96 January 2011 Contract CLP- MCSS II BLANK PAGE 50/96 January 2011 Contract CLP- MCSS II RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source : THIS REPORT PERIOD FROM: TO: CONTRACT Title III Admin. PERIOD: CONTRACT # REPORT # PSA# CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : Approved by : Date PART A: BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0.00 $0.00 % 2. State Funds $0.00 $0.00 $0.00 % 3. Program Income $0.00 $0.00 $0.00 % 4. Cash Match (CCE, HCE and Other) $0.00 $0.00 $0.00 % 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 % 6. Local In -Kind Match $0.00 $0.00 $0.00 % 7. TOTAL RECEIPTS $0.00 $0.00 $0.00 % PART B : EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget 1. Administrative Services $0.00 $0.00 $0.00 % 2. Travel $0.00 $0.00 $0.00 % 3. TOTAL EXPENDITURES $0.00 $0.00 $0.00 % PART C : OTHER EXPENDITURES (For tracking purposes only) 1. Match: CCE / GR $0.00 $0.00 $0.00 HCE / GR $0.00 $0.00 $0.00 Other and In -Kind $0.00 $0.00 $0.00 2. Local Match $0.00 $0.00 $0.00 3. TOTAL $0.00 $0.00 $0.00 PART D : Other Revenue and Expenditures II. Addition Cost Alternative Program Income III. Interest 1. Program Income (PI): 1. Approved Budget $ 1. Earned on GR Advance $ a.OAA Unbudgeted PI Receipts YTD 2. Received YTD $ 2. Return of GR Advance $ $ 3. Expenditures $ 3. Other Earned $ DOEA FORM 105aa revised 10/08 51/96 January 2011 Contract CLP- MCSS II 52/96 January 2011 Contract CLP- MCSS II ATTACHMENT X EXHIBIT 2 53/96 January 2011 Contract CLP- MCSS II BLANK PAGE 54/96 January 2011 Contract CLP- MCSS II RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source : THIS REPORT PERIOD FROM: TO: IIIB IIIC1 CONTRACT IIIC2 PERIOD: CONTRACT # REPORT # PSA# CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : Approved by : Date PART A : BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0.00 $0.00 % 2. State Funds $0.00 $0.00 $0.00 % 3. Program Income $0.00 $0.00 $0.00 % 4. Local Cash Match (CCE, HCE and Other) $0.00 $0.00 $0.00 % 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 % 6. Local In -Kind Match $0.00 $0.00 $0.00 % 7. TOTAL RECEIPTS $0.00 $0.00 $0.00 % PART B : EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget 1. Meals / Meal Agreements $0.00 $0.00 $0.00 % 2. Service Subcontractor $0.00 $0.00 $0.00 % 3. Other $0.00 $0.00 $0.00 4. Indirect Cost $0.00 $0.00 $0.00 % 5. TOTAL EXPENDITURES $0.00 $0.00 $0.00 % PART C : OTHER EXPENDITURES (For Tracking Purposes only) 1. Match a. Other and In -Kind $0.00 $0.00 $0.00 % b. Local Match $0.00 $0.00 $0.00 % 2. USDA Cash Received $0.00 $0.00 $0.00 3. TOTAL OTHER $0.00 $0.00 $0.00 % PART D : OTHER REVENUE AND EXPENDITURES 2. Addition Cost Alternative Program Income 3. Interest 1. Program Income (PI) a. Approved Budget $ a. Earned on GR Advances $ a. OAA Unbudgeted PI Receipts YTD b. Received YTD $ b. Return of GR Advance $ c. Expenditures $ c. Other Earned $ DOEA FORM 105as revised 11/09 55/96 January 2011 Contract CLP- MCSS II BLANK PAGE 56/96 January 2011 Contract CLP- MCSS II REMAINDER OF PAGE BLANK ATTACHMENT X EXHIBIT 3 57/96 January 2011 Contract CLP- MCSS II BLANK PAGE 58/96 January 2011 Contract CLP- MCSS II RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source : THIS REPORT PERIOD FROM: TO: CONTRACT Title III E PERIOD: CONTRACT# REPORT# PSA# CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : Approved by : Date PART A : BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0.00 $0.00 2. State Funds $0.00 $0.00 $0.00 3. Program Income $0.00 $0.00 $0.00 4. Local Cash Match $0.00 $0.00 $0.00 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 6. Local In -Kind Match $0.00 $0.00 $0.00 7. TOTAL RECEIPTS $0.00 $0.00 $0.00 PART B : EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget A : Direct Services 1. Personnel $0.00 $0.00 $0.00 2. Travel $0.00 $0.00 $0.00 3. Building Space $0.00 $0.00 $0.00 4. Communication / Utilities $0.00 $0.00 $0.00 5. Printing / Supplies $0.00 $0.00 $0.00 6. Equipment $0.00 $0.00 $0.00 7.Other $0.00 $0.00 $0.00 B : Agreement Services 8. Services Subcontracted $0.00 $0.00 $0.00 9. TOTAL EXPENDITURES $0.00 $0.00 $0.00 10. DEDUCTIONS a. Total Local Match $0.00 $0.00 $0.00 b. Program Income Used $0.00 $0.00 $0.00 c. TOTAL DEDUCTIONS $0.00 $0.00 $0.00 11. NET EXPENDITURES $0.00 $0.00 $0.00 PARTC : EXPENDITURES ANALYSIS 2. Units of Services Year to Date 3. Number of People Served Year to Date A. Expenditures by Seances Year to Date: 1. Information ..................... 0.00 ........................ $0.00 .......................... 0.00 2. Assistance ..................... $0.00 ........................ $0.00 ..........................0.00 3. Counseling ..................... $0.00 .......... I............. $0.00 ..........................0.00 4. Respite ......................... $0.00 ........................ $0.00 ..........................0.00 5. Supplemental Seances..... $0.00 ........................ $0.00 ..........................0.00 6. TOTAL .......................... $0.00 Part B Line 11, column 3 should be equal to this total. PART D : GRANDPARENT SERVICES (reported by Federal Fiscal Year) IFFY $ FFY $ FFY $ Match $ Match $ Match $ DOEA FORM 105AE revised 12/08 59/96 January 2011 Contract CLP- MCSS II 60/96 January 2011 Contract CLP- MCSS II Department of Elder Affairs Programs & Services Handbook, provided on CD. Also, available at the Department's Intranet site under, "Publications". ATTACHMENT A 61/96 January 2011 Contract CLP- MCSS II 62/96 January 2011 Contract CLP- MCSS II STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS ATTACHMENT B CIVIL RIGHTS COMPLIANCE CHECKLIST Program/Facility Name County AAA/Contractor Address Completed By City, State, Zip Code Date Telephone PART I. READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU IN THE COMPLETION OF THIS FORM. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: 2. POPULATION OF AREA SERVED. Source of data: Total # % White % Black % Hispanic % Other % Female 3. STAFF CURRENTLY EMPLOYED. Effective date: Total # % White % Black % Hispanic % Other % Female % Disabled 4. CLIENTS CURRENTLY ENROLLED OR REGISTERED Effective date: Total # % White % Black % Hispanic % Other % Female % Disabled % Over 40 5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE. Total # % White % Black % Hispanic % Other % Female % Disabled PART II. USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 6. Is an Assurance of Compliance on file with DOEA? If NA or NO, explain. NA YES NO ❑ ❑ ❑ 7. Compare the staff composition to the population. Is staff representative of the population? NA YES NO If NA or NO, explain. ❑ ❑ ❑ 8. Compare the client composition to the population. Are race and sex characteristics representative NA YES NO of the Population? If NA or NO, explain. ❑ ❑ ❑ 9. Are eligibility requirements for services applied to clients and applicants without regard to NA YES NO race, color, national origin, sex, age, religion or disability? If NA or NO, explain. ❑ ❑ ❑ January 2011 Contract CLP- MCSS II 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 NA or NO, explain. NA YES NO ❑ ❑ ❑ 11. For in -patient services, are room assignments made without regard to race, color, national origin or disability? If NA or NO, explain. NA YES NO ❑ ❑ ❑ 12. Is the program/facility accessible to non-English speaking clients? If NA or NO, explain. 13. Are employees, applicants and participants informed of their protection against discrimination? If yes, how? Verbal ❑ Written ❑ Poster ❑ If NA or NO, explain. 14. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility. 15. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals? If NA or NO, explain. NA YES NO ❑ ❑ ❑ PART III. THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 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. .R •N January 2011 Contract CLP- MCSS II 17. Is there and 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 u❑ 19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? If NO, explain. 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 OR MORE. 21. Do you have a written affirmative action plan? If NO, explain. YES NO ❑ ❑ G '61 January 2011 Contract CLP- MCSS II AAA USE ONLY Reviewed By In Compliance: YES ❑ NO* ❑ Program Office 'Notice of Corrective Action Sent Date Telephone Response Due _/_/_ On -Site ❑ Desk Review ❑ Response Received DOEA Form 101-A, Revised May 2008 Page 2 of 2 6YA 66/96 January 2011 Contract CLP- MCSS II ATTACHMENT B 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.) Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of your summary. 4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list their percent by race, sex and disability. Include the date that enrollment was counted. 5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no advisory or governing board, leave this section blank. 6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the contract language for 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 67/96 January 2011 Contract CLP- MCSS II 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). 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: With the assistance of a disabled individual/organization, evaluate current practices and policies which do not comply with Section 504. Modify policies and practices that do not meet Section 504 requirements. Take remedial steps to eliminate any discrimination that has been identified. Maintain self -evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been followed.), 45 CFR 84.6. 17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b). 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply with Section 504.45 CFR 84.7 (a). 19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads, and other appropriate written communication, 45 CFR 84.8 (a). 20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide equally effective services, (45 CFR 84.52 (d). 21. Programs/facilities with 50 or more employees and $50,000 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. 68/96 January 2011 Contract CLP- MCSS II Department's Computer Use Policy and its Social Media Policy, provided on CD. 69/96 ATTACHMENT E January 2011 Contract CLP- MCSS II 70/96 January 2011 Contract CLP- MCSS II ATTACHMENT F EXHIBIT 1 DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess Of Category II PROGRAM: CONTRACT PERIO TYPE OF SERVICE: a. Salaries b. Fringe Benefits c o C. Equipment cc d. Telephone & Utilities N .� e. Travel f. Printing & Supplies g. Other (Please list or attach details) Q h. Allocated Cost/Overhead TOTAL Client Services (Attach details) v TOTAL L N 71/96 January 2011 Contract CLP- MCSS II 72/96 January 2011 Contract CLP- MCSS II ATTACHMENT F EXHIBIT 2 INSTRUCTIONS: COST ANALYSIS FOR NON-COMPETIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY II The purpose of the ATTACHMENT F, Exhibit 1, is to document that costs in non -competitively procured contracts in excess of $35,000 are allowable, reasonable and necessary. This form is required to be submitted by the contractor to the contract manager within 30 days of the contract execution date. Upon receipt of the form, the DOEA contract manager will: 1. Evaluate each separate line item to determine whether the cost is allowable, reasonable and necessary. a. To be allowable, a cost must be allowable pursuant to state and federal expenditure laws, rules and regulations and authorized by the agreement between the state and the contractor. b. To be reasonable, a cost must be evaluated to determine that the amount does not exceed what a prudent person would incur given the specific circumstances. c. To be necessary, a cost must be essential to the successful completion of the program. d. Allocated costs/overhead should be evaluated to determine that the rate is reasonable. 2. Place the Cost Analysis for Non -Competitively Procured Agreements in Excess of Category/1 form in the official file for this contract at the Department of Elder Affairs. (1) In accordance with the following instructions, the contractor must complete COLUMNS 3, 4 AND 5 of the DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess Of Category II worksheet (ATTACHMENT F, EXHIBIT 1) for the original contract and any amendment that affects the amount of compensation and/or the level of services provided. (2) Definition of Administrative Costs — a. Salaries/Wages: Are the charges to directly hire someone and put them on payroll. b. Fringe Benefits: Are the costs of health insurance, Social Security, Medicare, unemployment and other benefits paid on behalf of each employee. If fringe benefits will be based on a specified percentage, rather than the actual cost of fringe benefits, then the calculation for the fringe benefits amount must be shown. c. Equipment: Equipment means an article of nonexpendable, tangible personal property generally having a useful life of more than one year and an acquisition cost that equals or exceeds the lesser of the established capitalization level of $5,000 (federal funds) or $1,000 or hardback bound books not circulated, with a value of $250.00 or more (state funds). d. Telephone and Utilities: Are items such as utilities and telephone service costs. e. Travel: Are those that are necessary, reasonable and allowable for carrying out the project. Travel must be in accordance with Section 112.061, Florida Statutes, which includes submission of the claim on the approved State travel voucher or electronic means and at the authorized meal, per diem and state mileage reimbursement rates. f. Printing and Supplies: Are items such as office supplies, postage, and printing. g. Other Costs or Miscellaneous: Please explain/justify. Support documentation for other direct costs may include copies of published rates, copies of expense vouchers, and/or invoices. Support documentation for other costs or fees may include copies of published catalog prices, or copies of expense vouchers. h. Allocated Costs or Overhead: The contractor should attach a copy of the computation schedule supporting the allocated cost rate. Support documentation. for allocated costs may be a federally - negotiated allocated cost rate agreement. If the contractor does not have a rate agreement, (1) sufficient information should be attached indicating how the rate used was determined and (2) if the rate was accepted and paid previously by either a federal agency or agency of the State of Florida, documentation to that affect should be provided. (3) Client Service costs should be documented via Area Agency on Aging Area Plans, Unit Cost information input into WebDB, or some other form of documentation to support the cost analysis. (4) The allocation to the agreement will be calculated based on the cost by line item cost divided by the total agreement amount. 73/96 January 2011 Contract CLP- MCSS II 74/96 January 2011 Contract CLP- MCSS II ATTACHMENT G COMMUNITY LIVING PROGRAM PROTOCOLS Program Overview The goals of Community Living Program Phase II, for PSA 11 are to reduce overall Medicaid long term care expenditures, develop co -pay and financially sustainable systems —within the context of the Older Americans Act network of AAA and providers, and to increase consumer choice and self -direction. To achieve these goals PSA 11 will focus its efforts in providing consumers with the means to resolve events that have been identified as "critical pathways" to institutional long term care. Some of these "critical pathways" include sudden caregiver burnout, depression, malnutrition/dehydration and lack of proper follow up with home and community based services following hospital/rehab discharges. PSA 11 will also manage a Veterans Administration Consumer Directed Care. In particular, PSA 11 will provide short term, cost effective, interventions, to individuals at high risk of nursing home placement or hospital re -admission, using a Holistic Social Work model utilizing a motivational empowerment case management approach focus on monitoring client follow-up in the community with medical needs, nutritional needs, mental health, home care needs, and recreational needs in order to reduce re -admission and nursing home placements. A Case Manager will utilize an interdisciplinary managed team approach whose major role is to coordinate community based services to enable the client's independence and prevent premature or unnecessary institutionalization. The proposed model has three characteristics: Timely, short term sponsored interventions using Older Americans Act services, intensive case management and, the possibility of long term continuation of services on a cost -shared basis at the consumer's choice. Acronyms and Definitions ADI (Alzheimer's Disease Initiative) — Services targeted to individuals with Alzheimer's Disease or a similar memory disorder, including respite, assessment, caregiver training, and other community -based services. ADRC or ARC (Aging and Disability Resource Centers or Aging Resource Centers) — The not -for -profit entity which is the single entry point for the aging service system within each established region of the state. APS (Adult Protective Services) High Risk — The designation of an elder who needs immediate protection from further abuse, neglect or exploitation, which can be accomplished completely or in part through the provision of home and community -based services. 75/96 January 2011 Contract CLP- MCSS II Caregiver or Support System — For this project, the caregiver or support system is one or more persons whom the elder can depend on to provide care or to organize the provision of needed care. Care Plan - A comprehensive listing of all services, including Medicare, CCE, OAA, county, etc. that address the client's physical, mental, and home care needs to resolve the crisis condition(s), and accomplish the client's personal goals. The Lead Service Provider would coordinate all services and evaluate their outcomes in conjunction with the client. Care Plan Review Team — For purposes of this project, a team of staff designated by the CLP staff, which reviews the client's situation and makes recommendations concerning continuation of services after the initial short term grant -funded crisis -resolving period. However in no case will services be continued on a long term basis under this program. CCE (Community Care for the Elderly) — Services offered to functionally impaired older persons to enable them to live in the least restrictive environment, including adult day care, consumable medical supplies, home delivered meals, homemaker, personal care, respite, and other community -based services. CIRTS (Client Information and Registration Tracking System) — The database of the Department of Elder Affairs used by the aging network to manage client assessment data, register clients for services, plan client services and maintain program waiting lists. Lead agency provider assessors also use CIRTS to evaluate client eligibility for Medicaid services and to develop recommendations for client placement. CDC (Consumer Directed Care) — A service option that gives elders, or their representatives, the opportunity to manage the elder's service delivery, including decisions about which services will be provided, by whom and how often. With the assistance of a consultant, an elder develops a budget plan that identifies needed goods and services and authorizes the elder to hire workers, who may be family members or friends, and select vendors to help with daily care needs. A fiscal/employer agent (F/EA) pays the workers and vendors according to the rates on the budget plan. The F/EA also pays the required federal and state taxes and files the necessary tax forms. Community Living Program — "Community Living Program" is a grant to the state of Florida from the federal Administration on Aging. For persons meeting the project's functional and financial eligibility criteria, the grant provides crisis -resolving in -home services to address their immediate and temporary needs as they leave a hospital or rehabilitation center or after a short-term nursing home stay. Without these services, the person would be at high risk of either nursing home placement or continued stay in a nursing home. This program also manages consumer directed care services provided to veterans. 76/96 January 2011 Contract CLP- MCSS II Cost Sharing — Payment by an individual for a portion of the monthly cost of the services he/she receives, based on the individual's income and assets, and determined by the total monthly cost of the planned services. Crisis -Resolving Services — Time -limited community -based services provided to address a client's immediate short-term care needs. Possible services include, but are not limited to: case management, personal care, homemaker, transportation, meals. For the purposes of this program, a crisis is an episode that has a high probability of creating a nursing home long term placement or a re -hospitalization. Examples of such crisis include caregiving situations, i.e. a caregiver hospitalization that would cause the nursing home placement of the care recipient; it also includes hospital/rehab discharges that have a high likelihood of recidivism or further patient deterioration where a permanent nursing home placement is a likely sequel. Functional Eligibility — The priority rank of 4 or higher (priority score of > 40) is based on the 701A or 701B assessment tool; with an option for imminent risk designation in accordance, to the DOEA policy. APS High Risk Referrals (priority rank 8) are not eligible. Financial Eligibility: • For a single person, the gross monthly income must be a minimum of $700 and a maximum of $4,100. The assets, excluding primary residence and vehicle, must be valued at a minimum of $25,000 with a maximum cap of $179,999. For a couple, the gross monthly income must be a minimum of $900 and a maximum of $5,500. The assets, excluding primary residence and vehicle, must be valued at a minimum of $25,000 with a maximum cap of $249,999. Imminent Risk - "In designating an individual imminent risk, the case manager must document in the client file how the client's situation meets all three of the criteria listed in the 3d) contract language: 1. The client's mental or physical condition has deteriorated to the degree that self care is not possible, 2. There is no capable caregiver, and 3. Institutional placement will occur within 72 hours." Lead Agency —A Community Care for the Elderly (CCE) designated agency. Lead agencies provide services under the CCE and ADI programs. In addition lead agencies handle APS cases in accordance with a DOEA established protocol. Lead Service Provider —A provider of Older American Act Services that also provides case management under this project. The Case manager from the service provider will follow-up with those project participants referred by the CLP staff to facilitate the provision of services during the grant period and to help plan for the person's needs after the grant period. 77/96 January 2011 Contract CLP- MCSS II OAA IIIB, IIID, IIIE (Older Americans Act Titles) — Title IIIB provides supportive services to assist elders to live independently in their community. Title IIID provides disease -prevention and health -promotion services at senior centers or alternative sites. Title IIIE provides services through the National Family Caregiver Support Program to assist families caring for frail older members, and to assist grandparents or older relatives who are caregivers for children who are under 19 or are disabled. Private Pay — Payment of the complete cost of services by an individual with sufficient income and assets to be over the financial standards for receipt of state or grant funded services. Referring Entity — An entity providing referrals to the single entry point. These include case management agencies, hospitals, rehabilitation centers, home health agencies, physician assisted home based programs, and nursing homes. Individuals referred should appear to meet the eligibility criteria for this project. Self -declared — For purposes of initial financial eligibility for the project, the individual's declaration of income and assets will not require verification. SEP (Single Entry Point) — The CLP staff for the area where the individual is receiving services is the single entry point into the aging service system. Spend down to Medicaid — The use of personal resources to pay for services prior to the individual's resources being reduced to the level of Medicaid eligibility. Triage — The activity performed by CLP staff to prioritize an individual for service based on the criteria established for publicly funded programs because he/she does not meet the eligibility criteria for this project. Protocols Client Identification 1. The referring entity will use the following criteria to identify potentially appropriate project participants: 2. Individual is at least 60 years old. 3. Individual is a resident of Miami -Dade or Monroe Counties. 4. Financially and functionally eligible. 5. Has Medicare or private health insurance. 6. Individual is not receiving hospice services. 7. Individual or caregiver is in need of crisis resolving services and/or short term care, to 78/96 January 2011 Contract CLP- MCSS II avoid readmission to a hospital/rehab facility or a nursing home placement. 8. Not currently receiving any DOEA sponsored services. Client Referral The referring entity will make client referrals to the single entry point (SEP). 1. Each referring entity will designate a Community Living Program contact to make referrals. 2. The SEP will designate an appointed staff to receive referrals. 3. At the referring entity, staff will complete the Referral Checklist and the designated Community Living Program, contact will transmit the Referral to the SEP. o For individuals in a hospital or nursing home, the referral will be completed 24 to 48 hours prior to discharge, excluding weekends or holidays. Individuals in the community may be referred to the project during any time deemed to be in crisis or in need of short term intervention to avoid readmission and or nursing home placement. o SEP will work with the discharge planner, in the case of a facility discharge, to identify emergency services that wrap -around other benefits for which the client may be eligible, such as Medicare home health benefits, to authorize services prior to discharge and in -home assessment. o The SEP designated staff will confirm receipt of the referral to the referring entity and log in and assign the case for screening and intake on the date received. 4. To conclude the referral process from a hospital or nursing home, the referring entity will transmit a copy of the discharge summary to the SEP staff. Client Screening (Functional and Financial Eligibility) 1. Within 24 hours of receiving the referral, the SEP designated staff will determine client eligibility for project participation. 2. The SEP staff will conduct a CIRTS record check to determine if the individual is currently enrolled in CCE, ADI, or is a high risk APS referral. If such is the case, the SEP staff will refer to the individual's case management agency of record for follow up The lead agency will recommend crisis resolving services, if needed, to supplement the existing care plan. If the individual appears eligible for project participation, then the SEP staff will authorize the lead agency to update the 701B. 79/96 January 2011 Contract CLP- MCSS II If the client is not enrolled in CCE, ADI, or any other case managed program, or is not a high risk APS referral and is in need of a short term care intervention, then the SEP designated staff will determine client eligibility for project participation. Screening must take place within 48 hours from the time the referral was received by the SEP. 3. Individuals scoring as priority levels 4 or 5 on the CLP screen, that also meet self -declared income and asset criteria will be eligible for referral to the Lead Service Provider. Individuals that score less than a priority level 4 will be eligible if there are demonstrable circumstances that put such individual at high risk of nursing home placement or re -hospitalization. These cases will be approved based on their particulars by the SEP on an exception basis. The SEP staff will notify the referring entity of the eligibility of the individual or, if applicable, the reasons for denying eligibility, in accordance to DOEA criteria. 4. If the individual does not appear eligible for project participation, then the SEP staff will triage the individual to the ARC/ADRC for follow-up options counseling to provide assistance with referrals to other OAA programs and services which may aid in their situation. Lead Service Provider Responsibilities: Initial Client Assessment (701 B): • The Case manager (CM) will have contact, within 24 hrs of referral, with client and/or caregiver to introduce services and program. The CM will reach out to individuals referred by the SEP to assess the situation. • The Case manager (CM) will provide information, including brochures and pamphlets regarding the project. The Case manager (CM) will begin discussing cost sharing, private pay, and consumer directed care service options should services be needed beyond the short term crisis resolving intervention. The financial worksheet will be completed. • The Case Manager will conduct the comprehensive assessment in the client's home, or medical facility within 72 hours of referral using form 701B, in this latter instance, the CM will review the hospital discharge paperwork. The Lead Service Provider will enter data in CIRTS within the week of the assessment. • The Case manager (CM) will develop a care plan with the client and or caregiver/support system, based on the assessment, and will initiate in -home crisis resolving services within 72 hours of receipt of referral. • The Case manager (CM) will inform the client that the Department of Elder Affairs has contracted an January 2011 Contract CLP- MCSS II evaluator that will be calling to conduct a five-minute survey about the quality and effectiveness of the services the client receives as part of the "Community Living Program" program. The case manager should assure the client that services will not be affected in any way whether the client participates or not in the survey or by how the client answers any of the questions. The case manager should report to the SEP staff if the client requests not to be surveyed. • The Case manager (CM) will maintain a client file, including: care plan, financial worksheet, referral information, assessments, a summary of each contact with or on behalf of the client and caregiver, project forms, and any other related information collected on behalf of the client/caregiver or required by the program. Enrollment Authorization: • The SEP staff will authorize enrollment of the individual in the project. • The SEP staff will refer the individual to the CLP lead agency provider for Case Management and crisis resolving services. • If after initial enrollment the client is determined to be ineligible for financial reasons, the individual will continue to receive the services being provided up to the crisis -resolving service period. o The CLP lead service provider will notify the SEP. o The SEP staff will contact the individual. o Transition will be made as possible to other appropriate programs. o The SEP staff will notify the CLP lead agency provider of the action to take regarding termination from the project. On -Going Case Management Responsibilities: The Case manager (CM) will conduct on -going service coordination of home and community based services and hospital, nursing home or rehabilitation center if applicable. The Case manager will verify the information and coordinate services as needed. Client contact service is as follows: Throughout the grant period, the Case manager (CM) will discuss the following with the client and caregiver issues pertaining to the client's medical needs, nutritional needs, mental health needs, home care needs, recreational needs: 81/96 January 2011 Contract CLP- MCSS II Medication management issues: The Case manager will encourage client and care giver to address medication management issues with primary physician. 2. Medical management: The Case manager will review primary physician appointments and encourage client and family to maintain appointments accordingly. Encourage client and care giver to follow-up with medical needs. 3. Nutrition management: The Case manager (CM) will make referrals for nutrition counseling and meals programs, if needed. It will encourage client and caregiver to follow the instructions of the nutritionist conduct referrals as needed. 4. Mental Health: The Case manager (CM) will monitor good mental health practice and encourage appropriate follow-up as needed for mental health need and conduct referrals and placement of services as needed. 5. Home Care needs: The Case manager (CM) will assess and monitor home care needs and conduct referrals and placement of services as needed 6. Recreational needs: The Case manager (CM) will assess and monitor recreational needs and encourage good recreational practices for both client and caregiver. CM will conduct referrals for services as needed. _The Case Manager will document the review in the client's case notes 1. Satisfaction with services delivered during 45-day crisis resolving service period 2. What services is the client receiving? 3. Are specific services adequately addressing the client's needs? 4. What are additional needs? 5. How are those additional needs being addressed? Periodic Follow-up 1. One week after initiating services, the Case manager will visit the client to ascertain services planned are being delivered and client needs are being met. 2. Two weeks after service initiation, the case manager will conduct telephone contact with the client to determine if services are addressing the client's needs. 3. Four weeks after service initiation the case manager will conduct telephone contact with the client to determine if services are addressing the client's needs. 82/96 January 2011 Contract CLP- MCSS II 4. No less than 5 days prior to the end of project participation, the CLP Lead agency provider case manager will conduct a face to face contact with the client and caregiver to review the care plan and determine the individual's continued need of crisis -resolving services. The timing of this contact will be at the discretion of the Case manager prior to the discharge determination date. Termination of Services The Case manager will advise the SEP staff of the following: o The crisis is resolved and the client may be terminated from the project. o The client is not stabilized and continues to need crisis resolving services. Detail will be provided as to the recommended services, frequency and duration. o The crisis is resolved, but the client will need on -going in -home services. Detail will be provided as to the recommended services, frequency and duration. Also whether client is continuing with co -pays and consumer directed care. Method of service delivery after crisis -resolving service period ends ■ The client has an option of continuing to receive services in a traditional manner (agency ordered and delivered) continuing with a co -pay, subject to provider funding availability. (The share of cost is stated on the care plan.) ■ The client has an option of participating in consumer directed care (consumer determines service provision), as a private pay client, however the provider will charge the consumer rates that are not higher than the lowest rates the provider receives from the Alliance. ■ The client can afford the cost of private pay services. Funding Options: The SEP staff must ensure the availability of OAA dollars to serve individuals at high risk of nursing home placement and spend down to Medicaid by implementing assessment and screening tools, as well as care planning and case management for Title IIIB funding. Title IIID and Title IIIE funds should be considered for the provision of services such as medication management and caregiver support services. The Alzheimer's disease Demonstration Grant funding should be coordinated as appropriate to expand services to clients in Miami -Dade County. This will include individuals with Alzheimer's disease or Related Disorders, who are January 2011 Contract CLP- MCSS II not eligible for Medicaid but are at imminent risk of nursing home placement and spend down, to remain in the community and avoid or delay nursing home placement. CIRTS Data Entry: Screening data for each referral based on the CLP Screening tool or 701A or similar instrument will be entered into CIRTS. The Lead Service Provider will enter 701B assessment data promptly entered into CIRTS. All clients authorized for CLP services will be enrolled in CIRTS under the CLP program enrollment code. For all services received by CLP clients, the case management agency will report the service units and unit cost data in CIRTS. • All services will be reported as client specific, including non -registered OAA services. •_ All services funded with CLP grant funds will be reported under the appropriate CLP service code. • All services funded with other program funds (OAA, CCE, etc.) will be reported using the appropriate program's service code. January 2011 Contract CLP- MCSS II ATTACHMENT H SERVICE PROVIDER APPLICATION 85/96 December 2010 Contract CLP-MCSS I INVITATION TO NEGOTIATE COMMUNITY LIVING PROGRAM OLDER AMERICANS ACT TITLE III-B SUBMITTED BY: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS SOCIAL SERVICES IN -HOME SERVICES PROGRAM SYLVIA J. MURPHY, MAYOR, MONROE COUNTY HISTORIC GATO BUILDING 1100 SIMONTON STREET RM. 2-257 KEY WEST, FL 33040 PHONE: (305) 292-4510 FAX: (305) 295-4359 :. •. December 2010 Contract CLP-MCSS I IMPLEMENTATION OF SERVICES STATEMENT OF READINESS cC , Deputy County Administrator do hereby stipulate and 4 Debe rederick agree that Monroe County Social Services/In-Home Services is ready to implement the services mentioned in this Invitation to Negotiate (ITN) Date: 87/96 December 2010 Contract CLP-MCSS I COMMUNITY LIVING PROGRAM — INVITATION TO NEGOTIATE Submitted by: Monroe County In -Home Services (MCIHS) Monroe County Board of County Commissioners Monroe County Social Services 1100 Simonton Street 2-257 Key West, FL 33040 305-292-4510 (phone) Sylvia J. Murphy, Mayor, Monroe County — Chief Executive Officer Monroe County In -Home Services (MCIHS), a department within Monroe County Social Services (MCSS), is well-equipped to handle service interventions for the short-term high risk individual. Due to our extensive reach throughout all of Monroe County, there are no areas that cannot be served. MCIHS is able to provide any manner of services throughout the entirety of Monroe County. For example, MCIHS already provides value-added services (via a number of non DOEA sources) such as, case management, homemaking, personal care, in -home respite, facility -based respite, nutrition services for in -home and congregate clients, prescription assistance, pauper burials, transportation assistance, shelter, energy cost assistance, weatherization services, and many more. The funding for the Community Living Program will allow MOBS to provide the following short-term services to the ARC referred high -risk individuals: homemaking, personal care, and case management. MCIHS employs County staff, as well as subcontracted staff, that are strategically positioned throughout all areas of Monroe County. In addition to all of the aforementioned services which are considered value-added services, for the Community Living Program, we are able to perfoun the following direct In -Horne Services: Homemaking - which will allow clients to receive specific home management services such as general housekeeping, laundry, assistance with budgeting and paying bills, shopping assistance, meal preparation, etc. Personal Care — which will allow clients to receive assistance with December 2010 Contract CLP-MCSS I eating, dressing, personal hygiene, and other significant activities of daily living. Case Management - Monroe County has qualified and experienced Case Managers. Our Case Managers are able to assist clients in identifying physical and emotional needs and problems through an interview and assessment process. Case Managers are able to discuss and develop a care plan for services for these short-term clients to remove them from being high risk. Our Case Managers are "gatekeepers" in the community care system and have vast knowledge in the different resources available in our community. Monroe County's Case Managers have many years of experience and are fully able to coordinate and link clients and caregivers with appropriate resources in the health care and delivery systems regardless of the agency or organization offering the services, to meet the client's needs. Case Managers are able to monitor all services and referrals to ensure they are having a positive impact on the problems that have caused the client to become high risk. Respite Care -- as a value-added service — will provide relief or rest for a primary caregiver from the constant, continued supervision and care of a functionally impaired, high risk older person by providing care for the person in the home for a pre -determined period of time. Overall Coordination. Monroe County Case Managers are able to coordinate all community resources for high risk clients via a community care service that comprises health and community resources. As part of a government agency MCIHS has access to a myriad of social service programs available within our own offices, such as funding for prescription drugs and the others referenced on page 1. If a consumer needed medication and could not afford it, MCSS would be able to pay for that medication. This is just one example of the many value-added services that MCSS already has in place. Another example would be the Monroe County Disability Council which is sponsored and staffed by the Monroe County Board of County December 2010 Contract CLP-MCSS I Commissioners (BOCC). The Social Services Department has long been the liaison for the BOCC with this advisory council. At present time one of our Case Manager Supervisors is Liaison and Secretary/Treasurer. The Council seeks to improve access, to. services for all residents of our community. As a governmental agency, the BOCC provides additional funding to Social Services organizations (outside of the County structure) following the counsel of the Human Services Advisory Council (HSAB). The HSAB reviews applications and makes funding recommendations for programs in the following service categories: primary and behavioral health care, core services, and quality of life services. The recommendations of HSAB are presented to the BOCC for approval. Once approved, the BOCC enters into contracts funding over 25 non -governmental, agencies that offer essential services for consumers. As contractors for the BOCC, these agencies are willing and able partners with the MCIHS Case Managers and Social Services staff to help meet the needs of consumers within the County. Monroe County Transit (MCT), a program within the Social Services Department, is a partner with In -Home Services providers. The MCT vehicle fleet is 100 percent accessible to the physically disabled and provides door-to-door transportation for anyone who is transportation disadvantaged throughout the entire length and breadth of the Keys. MCT coordinates closely with the local Community Transportation Coordinator and Medicaid Transportation Coordinator — the Guidance Care Center. All local transit providers are members of the Local Coordinating Board, including the City of Key West that provides bus routes in Key West and Stock Island and the Lower Keys Shuttle that operates a fixed route from Marathon to Key West. Monroe County is an equal financial partner with the Cities of Key West and Marathon in the operation of the Lower Keys Shuttle. MCIHS Case Managers actively coordinate with available transportation providers throughout the communities of the Keys to ensure that access to needed 90/96 December 2010 Contract CLP-MCSS I services is available. Since MOBS is integrated into the Social Services department, Case Managers work closely with Community Support Services (CSS) for Consumable Supplies (value-added service). The Case Managers also work very closely with the health care providers in the Keys and CSS to provide a link to ensure individuals who are low income receive the supplies they need. This requires the involvement of local physicians, hospitals, physical therapy centers, etc. Further, Case Managers in Monroe County continuously monitor the quality, appropriateness, and cost of services that are delivered to consumers to ensm that the most appropriate and cost-effective service is being received. Referrals are often made for value-added services to the Helpline of the Florida Keys for clients who need Telephone Reassurance. This service is designed to allow staff to check on the consumer daily and if needed call to remind them to take their medication. Caregiver Support is also offered through Helpline and they hold support groups throughout the Florida Keys for any caregiver in need. Often caregivers are in crisis and this gives them an opportunity to discuss their situation and obtain some advice and assistance relative to their loved one. MCSS currently provides Homeless Prevention and Rapid Re -Housing Program (HPRP). This grant is funded by the American Recovery and Reinvestment Act of 2009, through the Department of Homelessness/DCF and assists eligible Monroe County households with the prevention of homelessness. The intent of this funding is to help persons who can remain stably housed AFTER the temporary housing assistance ends. It generally provides rent for 3 months or less. Like the Community Living Program, HPRP is not a long-teini assistance program. MCSS also operates the Weatherization Assistance Program (WAP). This grant through DCA provides Energy Reducing Services to low income families to reduce energy cost, conserve energy, increase comfort in the home and improve safety and health standards. Some of the services that i! • December 2010 Contract CLP-MCSS I are offered under this grant are threshold repairs, window and door replacement, insulation, and installation of smoke/fire/carbon monoxide detectors, etc. The Low Income Home Energy Assistance Program (LIHEAP) is another service we are able to provide through the DCA. This grant assists low income households to receive financial assistance in paying for the cooling and heating of their homes. As Visiting Nurse Association (VNA) currently sub -contracts with MCIHS for the provision of direct services to our clients, we have developed a close alliance with them and are able to make referrals to them for services outside of direct services. One of the services that we often refer to VNA for is Bereavement Counseling. Often consumers are very distraught after losing a loved one, such as a spouse, and are in dire need of professional services. VNA offers this service with licensed counselors free of charge. Along with VNA, Case Managers also refer for counseling services to the Guidance Care Center and the Care Center for Mental Health, Inc. (CCMII). These agencies have on staff a licensed mental health counselor (PhD), and a certified addiction professional (MSW). A wide range of Gerontological Counseling Services are also available to clients who are referred to these agencies. Service Coordination/Assessment, Coordination with the AAA - As Monroe County's Lead Agency for over the past three decades, MCIHS is able to ensure the coordination of services and is able to coordinate all aspects of the grant with the AAA. Monroe County has a close relationship with the Aging Resource Center (ARC) and is able to receive and coordinate all referrals for them. MCIHS are also able to work innovatively, since the Case Managers have a long-standing relationship with the local hospitals Discharge Planners. Staff are able to give these planners the ARC's contact information and they call the ARC when a high risk consumer is going to be released from the hospital. Throughout Monroe County, these referrals will lead to 92/96 December 2010 Contract CLP-MCSS I intake and assessment. Intake and Assessment begins when a potential consumer, caregiver, family member, friend, neighbor, or public or private agency seeks assistance for an individual by contacting the Alliance for Aging's ARC. MCIHS employs ten staff members who have been trained and certified to take referrals and administer the DOEA Assessment Forms in accordance with the DOEA Assessment Instructions (701A, 701B, 701C) Manual. Training and certification was completed for MCIHS staff by the AAA in Miami during August 2007 and August 2008 and staff continue to receive updated information and training as needed. MCIHS staff members conduct all assessments in accordance with the instructions for completion as indicated in the aforementioned training sessions and the DOEA Assessment Instructions (701A, 701B, 701C) Manual. The ARC determines when persons are approved for services from MCIHS and will send the referrals accordingly. After the referral is received, MCIHS conducts a home visit with the consumer in order to perform a comprehensive assessment (701B) and develop a care plan in accordance with the DOEA. Referrals from the ARC for high risk individuals who are at imminent risk of institutional placement, such as individuals awaiting hospital or emergency room discharge, will be served immediately. Case Managers have the capability after administering the assessment (701B) to communicate with other agencies to ensure that all needs for the consumer are adequately addressed and keep the individual from staying high -risk. This is due to the fact that MCIHS enjoys a high level of coordination and commitment from community partners countywide. The success of MCIHS as well as the high level of countywide coordination and service linkage is due in a large part to the exceptional working relationship MOBS has maintained throughout the community for over three decades. Program Success and Reporting Requirements and familiarity with reporting requirements and service descriptions -As previously mentioned, MCIHS employs ten staff 93/96 December 2010 Contract CLP-MCSS I members who have been trained and certified to administer the DOEA Assessment Forms in accordance with the DOEA Assessment Instructions (701A, 701B, 701C) Manual. Two MCIHS administrative staff members are responsible for the upkeep and maintenance of the CIRTS data entry. Both staff members are full trained on the CIRTS application. While one clerical staff member serves as the primary CIRTS data entry worker, the other administrative staff member serves as a backup, thus ensuring that CIRTS data entry is completed timely. Monthly, quarterly, and annual reporting requirements are fulfilled by a full time Sr. Grants Coordinator employed by MCSS. The Sr. Grants Coordinator maintains a chart of reports including due dates, submission requirements, standards for completion, etc. Additionally, the Sr. Grants Coordinator reviews and coordinates all reporting with the Director of Social Services. This ensures that multiple staff members are aware of each report, progress being made on the report, when it is due, and what the requirements for completion are. The Sr. Grants Coordinator maintains electronic copies and printed copies of each report. Working papers and substantiating backup documentation are maintained in the printed copy files and stored in locked filing cabinets, inside locked offices, in a secure building. Daily backups of electronic data occur through routine Monroe County Technical Services operations. Since Monroe County implemented the position of Sr. Grants Coordinator, all reports have been submitted timely and accuracy and continuity has been ensured. Further, there is now one central person that the Alliance for Aging can contact if there are questions about reporting. Monroe County's staff is very familiar with the Service Descriptions as identified in the DOEA Handbook issued July 2010 as Monroe County being a CCE Lead Agency for the past 30 years. Additional Services/Resources at no charge to the Alliance for Aging - As previously mentioned, MCIHS is a department within the MCSS. MCSS offers a wide array of services to 94/96 December 2010 Contract CLP-MCSS I help Monroe County's citizens and MCIFIS has full access to all services and funds. Some of these services include but are not limited to the services outlined under Overall Coordination starting on page 2. Self-sustaining program when it is at the end of its pilot --Monroe County is certain it will be able to self -sustain the program when it is at the end of its pilot time allotment. All of the aforementioned services are able to be provided, on a limited basis, through our Case Managers, the MCSS, and all non DOEA funding. While some of these services are paid for with grants from DCF and DCA, many of these services are paid for through General Funds (County tax dollars) and is provided annually from Monroe County. Once the Community Living Program pilot ends our Case Managers will continue referring and coordinating services (as mentioned above) between the clients and other entities to provide the needed services for our citizens. Monroe County In -Home Services Technical Capacity to provide the proposed service intervention - MCIIIS Case Managers have the knowledge, educational background, experience, and skills to coordinate the most beneficial and least restrictive services and community resources for consumers throughout the community. Along with experience and training in the In -Home Services field, our Case Managers have many years and extensive training in the Social Services field. Several of our Case Managers have worked for DCF or other governmental or private agencies before working for Monroe County and have a background and wide ranging knowledge services and procedures. With this knowledge, Monroe County Case Managers are proficient in helping individuals with Medicaid applications along with assisting them with their applications for Food Stamps online. Monroe County's Case Managers have a minimum of 5 years experience in the Social Services field and as much as 26 years field experience. Along with the Case Managers extensive experience, MCIHS has been a 95/96 December 2010 Contract CLP-MCSS I CCE lead agency for over 30 years and we have the knowledge and technical ability to submit all data and reporting into the CIRTS system, the knowledge of required reports, and the flexibility to handle requirements set forth by the DOEA and the Alliance for Aging. Statement of Readiness — MCIHS is fully ready to implement services within the Community Living Program immediately. All of the services that we are proposing here are currently being performed by existing staff. We have the necessary infrastructure and financial resources necessary to begin serving referred clients immediately. Unit Rate — MCIHS has the commitment of the BOCC to meet the 10% cash match requirement as set forth in the ITN. In addition, MCIHS has the capacity to offer an additional 10 o in -kind match via our existing infrastructure (office and congregate meal site space). The combination of these two sources of funds will equate to an overall 20% match. Value-added services are outlined and documented in this response, as well as the office and congregate meal site space which are documented on the Unit Cost Methodology. 96/96 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12/15/10 Division: TECHNICAL SERVICES Bulk Item: Yes X No _ Department: TECHNICAL SERVICES Staff Contact Person/Phone #: Lisa Druckemiller , 295-5100 AGENDA ITEM WORDING: Approval to enter into a "MASTER SERVICES AGREEMENT — ORDER ATTACHMENT FOR CSA SERVICES" # FL10-0443-01, with AT&T which includes an additional speed of 1 Gb/s to our existing Metro Ethernet wide area network agreement. ITEM BACKGROUND: Monroe County has an existing contract with AT&T for a wide area network service call Metro Ethernet. This service connects our larger offices together throughout the Keys. We can purchase bandwidth at each office in the following increments 4 Mb/s, 10 Mb/s and 100 Mb/s. This order attachment adds 1000 Mb/s to that list. This additional bandwidth will give us room to grow our network to be able to handle additional applications and services as our reliance on email, the internet and our data network continues to grow. PREVIOUS RELEVANT BOCC ACTION: Approval on May 16, 2007 of Bellsouth Master Contract Service Arrangements for Metro Ethernet CPG-21553 to Master Service Agreement FL03-F871-00 CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval. TOTAL COST:$ 0.00 BUDGETED: Yes X No COST TO COUNTY: $0.00 SOURCE OF FUNDS: Primarily Advalorem REVENUE PRODUCING: Yes No AMOUNT PER MONTH Year APPROVED BY: County Atty Purchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: Revised 11/06 AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: AT&T Contract # FL10-0443-02 Effective Date: 12/15/10 Expiration Date: 03/21/11 Contract Purpose/Description: AT&T Agreement to add the option of purchasing 1 Gb/s bandwidth to the existing Metro Ethernet A reement under our Master Services Agreement FL03-F871-00 Contract Manager: Lisa Druckemiller 5100 Technical Services 5-B (Name) (Ext.) (Department/Stop #) for BOCC meeting on 12/15/10 Agenda Deadline: 11/30/10 CONTRACT COSTS Total Dollar Value of Contract: $ 0 Current Year Portion: $ 3 Budgeted? Yes® No ❑ Account Codes: 001-05002-530-340- Grant: $ - - - - County Match: $ - - - ADDITIONAL COSTS Estimated Ongoing Costs: $0/yr For: Additional bandwidth option for ME of included in dollar value above e . maintenance, utilities, janitorial, salaries, etc. CONTRACT REVIEW Chang D e In Neede Division Director IX I /d Yes❑ N Risk Manage ent� Yes❑ N PLL O.M.B./Purc sing \\ ` 310 Yes❑ N Date Out County Attorney 12410 YesR NoN1 0U'&QVW-a1,U LiMkA 11 Comments: OMB Form Revised 2/27/01 MCP #2 m Addendum Agreement Case Number FL10-0443-01 MASTER SERVICES AGREEMENT - ORDER ATTACHMENT FOR CSA SERVICES This Order Attachment Agreement is Made Pursuant to the Master Services Agreement No. FL03-F871-00. This Agreement is entered into pursuant to Tariff Section A5 of the General Subscriber Services Tariff. Offer Expiration: This offer shall expire on: 12/31/2010. Customer's Billing Address: Monroe County, by and through its Board of County Commissioners, a political subdivision of the State of Florida 1200 Truman Ave Key West, FL 33040- Page 1 of 6 AT&T and Customer Confidential Information 46251 aW Addendum Agreement Case Number FL10-0443-01 Option 1 of 1 Estimated service interval following acceptance date: Negotiable weeks. THE UNDERSIGNED PARTIES, BellSouth Telecommunications, Inc. d/b/a AT&T Florida, ("Company") and Monroe County, by and through its Board of County Commissioners ("Customer" or "Subscriber"), hereby agree, as acknowledged by their appropriate signatures as set out below, to amend and change Contract Service Arrangement (CSA) Agreement FL07-2033-01. This Addendum Agreement is based upon the following terms and conditions as well as any Attachment(s) affixed and the appropriate lawfully filed and approved tariffs which are by this reference incorporated herein. Subscriber acknowledges that Subscriber has read and understands this Agreement and agrees to be bound by its terms and conditions. Subscriber further agrees that this Agreement, and any orders, constitute the complete and exclusive statement of the Agreement between the parties, superseding all proposals, representations, and/or prior agreements, oral or written, between the parties relating to the subject matter of the Agreement. Acceptance of any order by Company is subject to Company credit and other approvals. Following order acceptance, if it is determined that: (i) the initial credit approval was based on inaccurate or incomplete information; or (ii) the customer's creditworthiness has significantly decreased, Company in its sole discretion reserves the right to cancel the order without liability or suspend the Order until accurate and appropriate credit approval requirements are established and accepted by Customer. This Agreement is not binding upon Company until executed by an authorized employee, partner, or agent of Subscriber and Company. This Agreement may not be modified, amended, or superseded other than by a written instrument executed by both parties, approved by the appropriate Company organization, and incorporated into Company's mechanized system. The undersigned warrant and represent that they have the authority to bind Subscriber and Company to this Agreement. Page 2 of 6 AT&T and Customer Confidential Information ate Addendum Agreement Case Number FL10-0443-01 Option 1 of 1 IN WITNESS WHEREOF, the Parties hereto have caused this Order Attachment to be executed by their respective duly authorized representatives on the date indicated below. Accepted by: Subscriber: Monroe County, by and through its Board of County Commissioners, a political subdivision of the State of Florida By: Authorized Signature Printed Name: Title: Date: Company: BellSouth Telecommunications, Inc. d/b/a AT&T Florida By: Authorized Signature Printed Name: Title: Date: M0NR0E OCR€ N'TY ATT017N1FY PPROV D '4135 TO FORM: CHRISTINE Nil. L!;N6BERT-BARROWS ASSISTANT C QUINITY ATTORNEY Date f I Page 3 of 6 AT&T and Customer Confidential Information aw Addendum Agreement Case Number FL10-0443-01 Option 1 of 1 Service description: This Addendum Agreement adds an additional speed to the Customer's existing BellSouth® Metro Ethernet service. All terms and conditions of Contract Service Arrangement Agreement FL07-2033-01 apply to this Addendum Agreement unless modified herein. Page 4 of 6 AT&T and Customer Confidential Information aw Addendum Agreement RATES AND CHARGES Rate Elements BellSouth® Metro Ethernet Service, 1000 Mbps Premium Connection, per connection, Fixed (Addendum to FL07-2033-01. Add rate element.) Case Number FL10-0443-01 Option 1 of 1 Non- Monthly Rate USOC Recurring Page 5 of 6 AT&T and Customer Confidential Information $.00 $3,860.00 MTEPT aw Addendum Agreement RATES AND CHARGES NOTES: Case Number FL10-0443-01 Option 1 of 1 The `NOTES' Section of the `RATES AND CHARGES' PAGES OF Contract Service Arrangement Agreement FL07-2033- 01 is replaced in its entirety with the following: 1. Metro Ethernet service is location specific. If facilities do not exist, special construction charges may apply. 2. These rates and charges are only valid if the Customer is served from a central office equipped for Metro Ethernet service, or can be extended to a central office equipped for Metro Ethernet service. 3. The following nonrecurring charges will not apply upon installation. However, if all or any part of the service is disconnected prior to the expiration of the selected term, then Customer will pay full nonrecurring charges that were waived at installation as identified below in addition to applicable termination liability charges. USOC Description Nonrecurring Charge CNMSC CNM Security Card $ 200.00 each CNMSE CNM Service Establishment Charge $ 250.00 each MTEP1 Metro Ethernet Service, 4 Mb s Premium Connection, Fixed $1,000.00 each MTEP3 Metro Ethernet Service, 10 Mb s Premium Connection, Fixed $1,000.00 each MTEP6 Metro Ethernet Service, 100 Mb s Premium Connection, Fixed $1,500.00 each MTEPT Metro Ethernet Service, 1000 Mbps Premium Connection, Fixed $1,750.00 each Furthermore, upon Customer's request to disconnect all service prior to the expiration of the selected term, Customer will be charged a one-time Contract Preparation Charge in the amount of $423.00. There are no other additions, deletions or changes to the above referenced Contract Service Arrangement Agreement included in this Addendum Agreement. All other terms and conditions as previously agreed and acknowledged remain unchanged and in full force. All trademarks and service marks contained herein are owned by AT&T Intellectual Property and/or AT&T affiliated companies. END OF ARRANGEMENT AGREEMENT OPTION 1 Page 6 of 6 AT&T and Customer Confidential Information Technical Services December 15, 2010 Item Background BellSouth/AT&T has provided Technical Services with an addendum to our existing agreement for wide area network service known as Metro Ethernet Currently, Monroe County is able to order bandwidth for interconnecting our offices at rates of 4 Mb/s, 10 Mb/s and 100 Mb/s. This addendum to our existing agreement will add 1000 Mb/s to this list of available bandwidths. This will allow for future growth if our bandwidth requirements continue to expand. At present we do not have any plans to increase the bandwidth but we can say that our facilities in Key West and Marathon may be good candidates for increases in the future. New Pricing Schedule Below please find the monthly leasing costs of bandwidth under our current agreement with the addition of the new option: Speed Cost per Month New 4 Mb/s $590.00 N 10 Mb/s $810.00 N 100 Mb/s $1,620.00 N 1000 Mb/s $3,860.00 Y Staff Recommendation Technical Services recommends that the Monroe County Board of County Commissioners approve this addendum to our current Master Service Agreement with BellSouth/AT&T. BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2010 Division:EmMency Services Bulk Item: Yes X No _ Department: Emergency Management Staff Contact Person/Phone # Jose Tezanos / 305-289-6325 AGENDA ITEM WORDING: Approval to rescind FY07 State Homeland Security Grant Program (SHSGP) Agreement Number 08-DS-60-11-54-01-343 Modification #2, and approval of Federally - Funded Subgrant Agreement contract number 11DS-52-11-54-01 in the amount of $57,834.92 with no county match required; entered into between the State of Florida, Division of Emergency Management (FDEM) and Monroe County Emergency and authorization for the County Administrator to execute any other required documentation in relation to the application process. ITEM BACKGROUND: FDEM had awarded Monroe County an original agreement in the amount of $97,411.00 to provide planning, training and exercise under the Homeland Security Grant Program. The period of this grant began April 21, 2007 through April 30, 2010. On April 21, 2010 the Board approved Modification #1 to extend this grant to June 30, 2010, and on August 18, 2010 the Board approved Modification #2 to extend this grant to December 31, 2010 to allow vendor additional time to complete their task. On November 2, 2010 we received an email from FDEM (see attached copy) advising correct State Department of Financial Services requirements to Reinstate and Extend sub -grant agreements which have expired. If an agreement has expired, the correct procedure is to unencumbered the old agreement and execute a new agreement for the balance. PREVIOUS RELEVANT BOARD ACTION: On December 19, 2007 the Board approved SHSGP agreement 08-DS-60-11-54-01-343; on April 21, 2010 the Board approved Modification #1 to extend this grant to June 30, 2010, and on August 18, 2010 the Board approved Modification #2 to extend to December 31, 2010. CONTRACT/AGREEMENT CHANGES: New SHSGP Agreement Number 11DS-52-11-54-01 to replace unencumbered portion of SHSGP Agreement 08-DS-60-11-54-01-343 STAFF RECOMMENDATIONS: It is appropriate to accept this State funded subgrant agreement. A revenue cost center is requested from OMB. TOTAL COST: 57,834.92 INDIRECT COST: BUDGETED: Yes No X DIFFERENTIAL OF LOCAL PREFERENCE: N/A COST TO COUNTY: $ 0.00 SOURCE OF FUNDS:_. _ Grant REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year APPROVED BY: County AX rchasing X Risk Management X� DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 7/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: State of Florida DEM Contract #1 l-DS 52-11-54-01- Effective Date: June 30, 2010 Expiration Date: December 30, 2011 Contract Purpose/Description: Approval to rescind FY07 State Homeland Security Grant Program SHSGP Agreement Number 08-DS-60-11-54-01-343 Modification #2, and approval ofFederally-Funded Sub ant Agreement contract number 11DS-52-11-54-01 in the amount of $57,834.92 with no county match required; entered into between the State of Florida, Division of Emergency Management FDE and Monroe County Emergency. A revenue cost center is requested from OMB. Contract Manager: Jose Tezanos 6325 14 (Name) (Ext.) (Department/Stop #) for BOCC meeting on Dec 15, 2010 Agenda Deadline: Nov 30, 2010 Total Dollar Value of Contract Budgeted? Yes❑ No Grant: $ 57,834.92 County Match: $ 0 CONTRACT COSTS $ 57,834.92 Current Year Portion: $ Account Codes: GE- - - - ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included m dollar value above) (eg. maintenance. 57.834.92 etc. CONTRACT REVIEW Division Director Date In it "3°' 1 0 Changes Needed er Yes[-] No[o '"' Date Out I -30 1 0 Risk Man ement ' -P O.M.B./Purcha�ng 11 1 10 County Attorney 1 0 Yes❑ No Yes❑ N Yes❑ No[�/ L6, f f Comments: LyAgn rorm i e,msea LIL /tul mL r *L Contract Number: 11DS-52-11-54-01- CFDA Number: 97.067 FEDERALLY -FUNDED SUBGRANT AGREEMENT THIS AGREEMENT is entered into by and between the State of Florida, Division of Emergency Management, with headquarters in Tallahassee, Florida (hereinafter referred to as the "Division"), and Monroe County Emergency Management, (hereinafter referred to as the "Recipient"). THIS AGREEMENT IS ENTERED INTO BASED ON THE FOLLOWING REPRESENTATIONS: A. WHEREAS, the Recipient represents that it is fully qualified and eligible to receive these grant funds to provide the services identified herein; and B. WHEREAS, the Division has received these grant funds from the State of Florida, and has the authority to subgrant these funds to the Recipient upon the terms and conditions hereinafter set forth; and C. WHEREAS, the Division has authority pursuant to Florida law to disburse the funds under this Agreement. NOW, THEREFORE, the Division and the Recipient do mutually agree as follows: (1) SCOPE OF WORK. The Recipient shall fully perform the obligations in accordance with the Budget and Scope of Work, Attachment A of this Agreement. (2) INCORPORATION OF LAWS RULES REGULATIONS AND POLICIES Both the Recipient and the Division shall be governed by applicable State and Federal laws, rules and regulations, including but not limited to those identified in Attachment B. (3) PERIOD OF AGREEMENT. This Agreement shall begin June 30, 2010 and shall end December 31 2010, unless terminated earlier in accordance with the provisions of Paragraph (12) of this Agreement. (4) MODIFICATION OF CONTRACT Either party may request modification of the provisions of this Agreement. Changes which are mutually agreed upon shall be valid only when reduced to writing, duly signed by each of the parties hereto, and attached to the original of this Agreement. (5) RECORDKEEPING (a) As applicable, Recipient's performance under this Agreement shall be subject to the federal ACommon Rule: Uniform Administrative Requirements for State and Local Governments" (53 Federal Register 8034) or OMB Circular No. A-110, "Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Nonprofit Organizations," and either OMB Circular No. A-87, "Cost Principles for State and Local Governments," OMB Circular No. A-21, "Cost Principles for Educational Institutions," or OMB Circular No. A-122, "Cost Principles for Nonprofit Organizations." If this Agreement is made with a commercial (for -profit) organization on a cost -reimbursement basis, the Recipient shall be subject to Federal Acquisition Regulations 31.2 and 931.2. (b) The Recipient shall retain sufficient records demonstrating its compliance with the terms of this Agreement, and the compliance of all subcontractors or consultants to be paid from funds provided under this Agreement, for a period of five years from the date the audit report is issued, and shall allow the Division or its designee, Chief Financial Officer, or Auditor General access to such records upon request. The Recipient shall ensure that audit working papers are made available to the Division designee, Chief Financial Officer, or Auditor General upon request for a period of five years from the date the audit report is issued, unless extended in writing by the Division with the following exceptions: 1. If any litigation, claim or audit is started before the expiration of the five year period and extends beyond the five year period, the records will be maintained until all litigation, claims or audit findings involving the records have been resolved. 2. Records for the disposition of non -expendable personal property valued at $5,000 or more at the time of acquisition shall be retained for five years after final disposition. 3. Records relating to real property acquisition shall be retained for five years after the closing on the transfer of title. 2 (c) The Recipient shall maintain all records for the Recipient and for all subcontractors or consultants to be paid from funds provided under this Agreement, including supporting documentation of all program costs, in a form sufficient to determine compliance with the requirements and objectives of the Budget and Scope of Work - Attachment A - and all other applicable laws and regulations. (d) The Recipient, its employees or agents, including all subcontractors or consultants to be paid from funds provided under this Agreement, shall allow access to its records at reasonable times to the Division, its employees, and agents. 'Reasonable" shall be construed according to the circumstances but ordinarily shall mean during normal business hours of 8:00 a.m. to 5:00 p.m., local time, on Monday through Friday. "Agents" shall include, but not be limited to, auditors retained by the Division. (6) AUDIT REQUIREMENTS (a) The Recipient agrees to maintain financial procedures and support documents, in accordance with generally accepted accounting principles, to account for the receipt and expenditure of funds under this Agreement. (b) These records shall be available at all reasonable times for inspection, review, or audit by state personnel and other personnel duly authorized by the Division. 'Reasonable" shall be construed according to circumstances, but ordinarily shall mean normal business hours of 8:00 a.m. to 5:00 p.m., local time, Monday through Friday. (c) The Recipient shall also provide the Department and/or the Division with.tbe records, reports or financial statements upon request for the purposes of auditing and monitoring the funds awarded under this Agreement. (d) If the Recipient is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised, and in the event that the Recipient expends $500,000 or more in Federal awards in its fiscal year, the Recipient 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 the Division by this Agreement. In determining the Federal awards expended in its fiscal year, the Recipient shall consider all sources of Federal awards. 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 Recipient conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the requirements of this paragraph. In connection with the audit requirements addressed in this Paragraph 6 (d) above, the Recipient shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised. If the Recipient 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 Recipient 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 Recipient resources obtained from other than Federal entities). (e) Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by subparagraph (d) above shall be submitted, when required by Section 320 (d), OMB Circular A-133, as revised, by or on behalf of the Recipient directly to each of the following: Department of Community Affairs Office of Audit Services 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 an electronic copy shall also be submitted to aurilla.parrish@dca.state.fl.us and Division of Emergency Management Bureau of Response 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 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 10th Street Jeffersonville, IN 47132 4 Other Federal agencies and pass -through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. (f) Pursuant to Section .320 (f), OMB Circular A-133, as revised, the Recipient shall submit a copy of the reporting package described in Section .320 (c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the following addresses: Department of Community Affairs Office of Audit Services 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 an electronic copy shall also be submitted to aurilla.parrish@dca.state.fl.us and Division of Emergency Management Bureau of Response 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 (g) Any reports, management letter, or other information required to be submitted to the Department and the Division 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. (h) Recipients, when submitting financial reporting packages to the Department and the Division 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 Recipient in correspondence accompanying the reporting package. (i) In the event the audit shows that the entire funds disbursed hereunder, or any portion thereof, were not spent in accordance with the conditions of this Agreement, the Recipient shall be held liable for reimbursement to the Division of all funds not spent in accordance with these applicable regulations and Agreement provisions within thirty (30) days after the Department or the Division has notified the Recipient of such non-compliance. 0) The Recipient shall have all audits completed by an independent certified public accountant (IPA) who shall either be a certified public accountant or a public accountant licensed under Chapter 473, Fla. Stat. The IPA shall state that the audit complied with the applicable provisions noted above. The audit must be submitted to the Department and the Division no later than nine (9) months from the end of the Recipient's fiscal year. (7) REPORTS (a) At a minimum, the Recipient shall provide the Division with quarterly reports, and with a close-out report. These reports shall include the current status and progress by the Recipient and all subrecipients and subcontractors in completing the work described in the Scope of Work and the expenditure of funds under this Agreement, in addition to such other information as requested by the Division. (b) Quarterly reports are due to be received by the Division no later than 30 days after the end of each quarter of the program year and shall continue to be submitted each quarter until submission of the administrative close-out report. The ending dates for each quarter of the program year are March 31, June 30, September 30 and December 31. (c) The close-out report is due 60 days after termination of this Agreement or upon completion of the activities contained in this Agreement, whichever first occurs. (d) If all required reports and copies, prescribed above, are not sent to the Division or are not completed in a manner acceptable to the Division, the Division may withhold further payments until they are completed or may take such other action as set forth in Paragraph (11) REMEDIES. "Acceptable to the Division" means that the work product was completed in accordance with the Budget and Scope of Work, Attachment A. (e) The Recipient shall provide such additional program updates, reports or information as may be required by the Division. (8) MONITORING. The Recipient shall monitor its performance under this Agreement, as well as that of its subcontractors, subrecipients and consultants who are paid from funds provided under this Agreement, to ensure that time schedules are met, the Budget and Scope of Work, Attachment A is accomplished within the specified time periods, and other performance goals stated in this Agreement are achieved. Such mo review shall be made for each function or activity set forth in the Budget and Scope of Work, Attachment A to this Agreement, and reported in the quarterly report. In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised and Section 215.97, Fla. Stat. (see Paragraph (6) AUDIT REQUIREMENTS, above ), monitoring procedures may include, but not be limited to, on -site visits by Division staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this Agreement, the Recipient agrees to comply and cooperate with all monitoring procedures/processes deemed appropriate by the Division. In the event that the Division determines that a limited scope audit of the Recipient is appropriate, the Recipient agrees to comply with any additional instructions provided by the Division to the Recipient regarding such audit. The Recipient further agrees to comply and cooperate with any inspections, reviews, investigations or audits deemed necessary by the Comptroller or Auditor General. In addition, the Division will monitor the performance and financial management by the Recipient throughout the contract term to ensure timely completion of all tasks. (9) LIABILITY (a) Unless Recipient is a State agency or subdivision, as defined in Section 768.28, Fla. Stat., the Recipient shall be solely responsible to parties with whom it shall deal in carrying out the terms of this agreement, and shall hold the Division harmless against all claims of whatever nature by third parties arising out of the performance of work under this agreement. For purposes of this agreement, Recipient agrees that it is not an employee or agent of the Division, but is an independent contractor. (b) Any Recipient who is a state agency or subdivision, as defined in Section 768.28, Fla. Stat., agrees to be fully responsible to the extent provided by Section 768.28 Fla. Stat. for its negligent acts or omissions or tortious acts which result in claims or suits against the Division, and agrees to be liable for any damages proximately caused by said acts or omissions. Nothing herein is intended to serve as a waiver of sovereign immunity by any Recipient to which sovereign immunity applies. Nothing herein shall be construed as consent by a state agency or subdivision of the State of Florida to be sued by third parties in any matter arising out of any contract. 7 (10) DEFAULT. If any of the following events occur ("Events of Default"), all obligations on the part of the Division to make any further payment of funds hereunder shall, if the Division so elects, terminate and the Division may, at its option, exercise any of its remedies set forth in Paragraph (11), but the Division may make any payments or parts of payments after the happening of any Events of Default without thereby waiving the right to exercise such remedies, and without becoming liable to make any further payment: (a) If any warranty or representation made by the Recipient in this Agreement or any previous Agreement with the Division shall at any time be false or misleading in any respect, or if the Recipient shall fail to keep, observe or perform any of the obligations, terms or covenants contained in this Agreement or any previous agreement with the Division and has not cured such in timely fashion, or is unable or unwilling to meet its obligations thereunder; (b) If any material adverse change shall occur in the financial condition of the Recipient at any time during the term of this Agreement, and the Recipient fails to cure said material adverse change within thirty (30) days from the time the date written notice is sent by the Division. (c) If any reports required by this Agreement have not been submitted to the Division or have been submitted with incorrect, incomplete or insufficient information; (d) If the Recipient has failed to perform and complete in timely fashion any of its obligations under this Agreement. (11) REMEDIES. Upon the happening of an Event of Default, then the Division may, at its option, upon thirty (30) calendar days prior written notice to the Recipient and upon the Recipient's failure to cure within said thirty (30) day period, exercise any one or more of the following remedies, either concurrently or consecutively: (a) Terminate this Agreement, provided that the Recipient is given at least thirty (30) days prior written notice of such termination. The notice shall be effective when placed in the United States mail, first class mail, postage prepaid, by registered or certified mail -return receipt requested, to the address set forth in paragraph (13) herein; Agreement; (b) Commence an appropriate legal or equitable action to enforce performance of this (c) Withhold or suspend payment of all or any part of a request for payment; (d) Exercise any corrective or remedial actions, to include but not be limited to: 1. requesting additional information from the Recipient to determine the reasons for or the extent of non-compliance or lack of performance, 2. issuing a written warning to advise that more serious measures may be taken if the situation is not corrected, 3. advising the Recipient to suspend, discontinue or refrain from incurring costs for any activities in question or 4. requiring the Recipient to reimburse the Division for the amount of costs incurred for any items determined to be ineligible; (e) Require that the Recipient return to the Division any funds which were used for ineligible purposes under the program laws, rules and regulations governing the use of funds under this program. (f) Exercise any other rights or remedies which may be otherwise available under law. (g) The pursuit of any one of the above remedies shall not preclude the Division from pursuing any other remedies contained herein or otherwise provided at law or in equity. No waiver by the Division of any right or remedy granted hereunder or failure to insist on strict performance by the Recipient shall affect or extend or act as a waiver of any other right or remedy of the Division hereunder, or affect the subsequent exercise of the same right or remedy by the Division for any further or subsequent default by the Recipient. (12) TERMINATION. (a) The Division may terminate this Agreement for cause upon thirty (30) days written notice. Cause shall include, but not be limited to, misuse of funds; fraud; lack of compliance with applicable rules, laws and regulations; failure to perform in a timely manner; and refusal by the Recipient to permit public access to any document, paper, letter, or other material subject to disclosure under Chapter 119, Fla. Stat., as amended. I (b) The Division may terminate this Agreement for convenience or when it determines, in its sole discretion, that the continuation of the Agreement would not produce beneficial results commensurate with the further expenditure of funds, by providing the Recipient with thirty (30) calendar days prior written notice. (c) The parties may agree to terminate this Agreement for their mutual convenience as evidenced by written amendment of this Agreement. The amendment shall establish the effective date of the termination and the procedures for proper closeout of the Agreement. (d) In the event that this Agreement is terminated, the Recipient will not incur new obligations for the terminated portion of the Agreement after the Recipient has received the notification of termination. The Recipient will cancel as many outstanding obligations as possible. Costs incurred after the date of receipt of notice of the termination will be disallowed. Notwithstanding the above, the Recipient shall not be relieved of liability to the Division by virtue of any breach of Agreement by the Recipient. The Division may, to the extent authorized by law, withhold any payments to the Recipient for purpose of set-off until such time as the exact amount of damages due the Division from the Recipient is determined. (13) NOTICE AND CONTACT. (a) All notices provided under or pursuant to this Agreement shall be in writing, either by hand delivery, or first class, certified mail, return receipt requested, to the representative identified below at the address set forth below and said notification attached to the original of this Agreement., , (b) The name and address of the Division contract manager for this Agreement is: Carolyn Washington, Community Assistance Consultant Division of Emergency Management Bureau of Finance Grants Section 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 Telephone: (850) 410-1271 Fax: (850) 488-7842 Email: carolvn.washington(a)_em.myflorida.com 10 (c) The name and address of the Representative of the Recipient responsible for the administration of this Agreement is: Telephone: Fax: Email: (d) In the event that different representatives or addresses are designated by either party after execution of this Agreement, notice of the name, title and address of the new representative will be rendered as provided in (13)(a) above. (14) SUBCONTRACTS If the Recipient subcontracts any or all of the work required under this Agreement, a copy of the unsigned subcontract must be forwarded to the Division for review and approval prior to execution of the subcontract by the Recipient. The Recipient agrees to include in the subcontract that (i) the subcontractor is bound by the terms of this Agreement, (ii) the subcontractor is bound by all applicable state and federal laws and regulations, and (iii) the subcontractor shall hold the Division and Recipient harmless against all claims of whatever nature arising out of the subcontractor's performance of work under this Agreement, to the extent allowed and required by law. Each subcontractor's progress in performing its work under this Agreement shall be documented in the quarterly report submitted by the Recipient. For each subcontract, the Recipient shall provide a written statement to the Division as to whether that subcontractor is a minority vendor, as defined in Section 288.703, Fla. Stat.. (15) TERMS AND CONDITIONS This Agreement contains all the terms and conditions agreed upon by the parties. (16) ATTACHMENTS (a) All attachments to this Agreement are incorporated as if set out fully herein. (b) In the event of any inconsistencies or conflict between the language of this Agreement and the attachments hereto, the language of such attachments shall be controlling, but only to the extent of such conflict or inconsistency. (c) This Agreement has the following attachments: Exhibit 1 - Funding Sources 11 Attachment A — Budget and Scope of Work Attachment B — Program Statutes and Regulations Attachment C — Justification of Advance Attachment D — Warranties and Representations Attachment E — Certification Regarding Debarment Attachment F — Assurances (17) FUNDING/CONSIDERATION (a) This is a cost -reimbursement Agreement. The Recipient shall be reimbursed for costs incurred in the satisfactory performance of work hereunder in an amount not to exceed $57,834.92 subject to the availability of funds. (b) Any advance payment under this Agreement is subject to Section 216.181(16), Fla.Stat., and is contingent upon the Recipient's acceptance of the rights of the Division under Paragraph (12)(b) of this Agreement. The amount which maybe advanced may not exceed the expected cash needs of the Recipient within the first three (3) months of the contract term. For a federally funded contract, any advance payment is also subject to federal OMB Circulars A-87, A-110, A-122 and the Cash Management Improvement Act of 1990. If an advance payment is requested, the budget data on which the request is based and a justification statement shall be included in this Agreement as Attachment C. Attachment C will specify the amount of advance payment needed and provide an explanation of the necessity for and proposed use of these funds. No advance payment is requested. 2. An advance payment of $ is requested. (c) After the initial advance, if any, payment shall be made on a reimbursement basis as needed. The Recipient agrees to expend funds in accordance with the Budget and Scope of Work, Attachment A of this Agreement. If the necessary funds are not available to fund this Agreement as a result of action by Congress, the State Legislature, the Office of the Chief Financial Officer, the State Office of Planning and Budgeting or the Federal Office of Management and Budgeting, all obligations on the part of the Division to make 12 any further payment of funds hereunder shall terminate, and the Recipient shall submit its closeout report within thirty (30) days of receipt of notice from the Division. (18) REPAYMENTS All refunds or repayments to be made to the Division under this Agreement are to be made payable to the order of "Department of Community Affairs", and mailed directly to the Department at the following address: Department of Community Affairs Cashier Finance and Accounting 2555 Shumard Oak Boulevard Tallahassee FL 32399-2100 In accordance with Section 215.34(2), Fla. Stat., if a check or other draft is returned to the Division for collection, Recipient shall pay to the Division an additional service fee of Fifteen Dollars ($15.00) or Five Percent (5%) of the face amount of the returned check or draft, whichever is greater. (19) VENDOR PAYMENTS. Pursuant to Section 215.422, Fla. Stat., the Division shall issue payments to vendors within 40 days after receipt of an acceptable invoice and receipt, inspection, and acceptance of goods and/or services provided in accordance with the terms and conditions of the Agreement. Failure to issue the warrant within 40 days shall result in the Division paying interest at a rate as established pursuant to Section 55.03(1) Fla. Stat. The interest penalty shall be paid within 15 days after issuing the warrant. Vendors experiencing problems obtaining timely payment(s) from a state agency may receive assistance by contacting the Vendor Ombudsman at (850) 413-5516. (20) STANDARD CONDITIONS (a) The validity of this Agreement is subject to the truth and accuracy of all the information, representations, and materials submitted or provided by the Recipient in this Agreement, in any subsequent submission or response to Division request, or in any submission or response to fulfill the 13 requirements of this Agreement, and such information, representations and materials are incorporated by reference. The lack of accuracy thereof or any material changes shall, at the option of the Division and with thirty (30) days written notice to the Recipient, cause the termination of this Agreement and the release of the Division from all its obligations to the Recipient. (b) This Agreement shall be construed under the laws of the State of Florida, and venue for any actions arising out of this Agreement shall lie in the Circuit Court of Leon County. If any provision hereof is in conflict with any applicable statute or rule, or is otherwise unenforceable, then such provision shall be deemed null and void to the extent of such conflict, and shall be deemed severable, but shall not invalidate any other provision of this Agreement. (c) Any power of approval or disapproval granted to the Division under the terms of this Agreement shall survive the terms and life of this Agreement as a whole. (d) The Agreement may be executed in any number of counterparts, any one of which may be taken as an original. (e) The Recipient agrees to comply with the Americans With Disabilities Act (Public Law 101-336, 42 U.S.C. Section 12101 et seg.), if applicable, which prohibits discrimination by public and private entities on the basis of disability in the areas of employment, public accommodations, transportation, State and local government services, and in telecommunications. (f) A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime or on the discriminatory vendor list may not submit a bid on,a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids 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 a public entity, and may not transact business with any public entity in excess of Category Two for a period of 36 months from the date of being placed on the convicted vendor list or on the discriminatory vendor list. 14 (g) With respect to any Recipient which is not a local government or state agency, and which receives funds under this Agreement from the federal government, by signing this Agreement, the Recipient certifies, to the best of its knowledge and belief, that it and its principals: 1. are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by a federal department or agency; 2. have not, within a five-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. are not presently indicted or otherwise criminally or civilly charged by a governmental entity (federal, state or local) with commission of any offenses enumerated in paragraph 20(h)2. of this certification; and 4. have not within a five-year period preceding this Agreement had one or more public transactions (federal, state or local) terminated for cause or default. Where the Recipient is unable to certify to any of the statements in this certification, such Recipient shall attach an explanation to this Agreement. In addition, the Recipient shall submit to the Division (by email or by facsimile transmission) the completed "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion" (Attachment D) for each prospective subcontractor which Recipient intends to fund under this Agreement. Such form must be received by the Division prior to the Recipient entering into a contract with any prospective subcontractor. (h) The State of Florida's performance and obligation to pay under this Agreement is contingent upon an annual appropriation by the Legislature, and subject to any modification in accordance with Chapter 216, Fla. Stat. or the Florida Constitution. 15 (i) All bills for fees or other compensation for services or expenses shall be submitted in detail sufficient for a proper preaudit and postaudit thereof. Q) If otherwise allowed under this Agreement, all bills for any travel expenses shall be submitted in accordance with Section 112.061, Fla. Stat. (k) The Division reserves the right to unilaterally cancel this Agreement for refusal by the Recipient to allow public access to all documents, papers, letters or other material subject to the provisions of Chapter 119, Fla. Stat., and made or received by the Recipient in conjunction with this Agreement. (1) If the Recipient is allowed to temporarily invest any advances of funds under this Agreement, any interest income shall either be returned to the Division or be applied against the Division's obligation to pay the contract amount. (m) The State of Florida will not intentionally award publicly -funded contracts to any contractor who knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324a(e) [Section 274A(e) of the Immigration and Nationality Act ("INA")]. The Division shall consider the employment by any contractor of unauthorized aliens a violation of Section 274A(e) of the INA. Such violation by the Recipient of the employment provisions contained in Section 274A(e) of the INA shall be grounds for unilateral cancellation of this Agreement by the Department. (n) The Recipient is subject to Florida's Government in the Sunshine Law.(Section 286.011, Fla. Stat.) with respect to the meetings of the Recipient's governing board or the meetings of any subcommittee making recommendations to the governing board. All such meetings shall be publicly noticed, open to the public, and the minutes of all such meetings shall be public records, available to the public in accordance with Chapter 119, Fla. Stat. (o) Unless inconsistent with the public interest or unreasonable in cost, all unmanufactured and manufactured articles, materials and supplies which are acquired for public use under this Agreement must have been produced in the United States as required under 41 U.S.C. 10a. 16 (21) LOBBYING PROHIBITION (a) No funds or other resources received from the Division in connection with this Agreement may be used directly or indirectly to influence legislation or any other official action by the Florida Legislature or any state agency. (b) The Recipient certifies, by its signature to this Agreement, that to the best of his or her knowledge and belief: 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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement. 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 subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients 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 17 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. (22) COPYRIGHT PATENT AND TRADEMARK ANY AND ALL PATENT RIGHTS ACCRUING UNDER OR IN CONNECTION WITH THE PERFORMANCE OF THIS AGREEMENT ARE HEREBY RESERVED TO THE STATE OF FLORIDA. ANY AND ALL COPYRIGHTS ACCRUING UNDER OR IN CONNECTION WITH THE PERFORMANCE OF THIS AGREEMENT ARE HEREBY TRANSFERRED BY THE RECIPIENT TO THE STATE OF FLORIDA. (a) If the Recipient brings to the performance of this Agreement a pre-existing patent or copyright, the Recipient shall retain all rights and entitlements to that pre-existing patent or copyright unless the Agreement provides otherwise. (b) If any discovery or invention arises or is developed in the course of or as a result of work or services performed under this Agreement, or in any way connected herewith, the Recipient shall refer the discovery or invention to the Division for a determination whether patent protection will be sought in the name of the State of Florida. Any and all patent rights accruing under or in connection with the performance of this Agreement are hereby reserved to the State of Florida. In the event that any books, manuals, films, or other copyrightable material are produced, the Recipient shall notify the Division. Any and all copyrights accruing under or in connection with the performance under this Agreement are hereby transferred by the Recipient to the State of Florida. (c) Within thirty (30) days of execution of this Agreement, the Recipient shall disclose all intellectual properties relevant to the performance of this Agreement which he or she knows or should know could give rise to a patent or copyright. The Recipient shall retain all rights and entitlements to any pre-existing intellectual property which is so disclosed. Failure to disclose will indicate that no such property exists. The Division shall then, under Paragraph (b), have the right to all patents and copyrights which accrue during performance of the Agreement. (23) LEGAL AUTHORIZATION. The Recipient certifies with respect to this Agreement that it possesses the legal authority to receive the funds to be provided under this Agreement and that, if applicable, its governing body has authorized, by resolution or otherwise, the execution and acceptance of this Agreement with all covenants and assurances contained herein. The Recipient also certifies that the undersigned possesses the authority to legally execute and bind Recipient to the terms of this Agreement. (24) ASSURANCES. Attachment G. The Recipient shall comply with any Statement of Assurances incorporated as 19 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their undersigned officials as duly authorized. RECIPIENT: MONROE COUNTY EMERGENCY MANAGEMENT BY: Name and title: Date: SAMAS # STATE OF FLORIDA FID# DIVISION OF EMERGENCY MANAGEMENT As Name and Title: David Halstead, Director Date: 20 MON,J�OE COUNTY ATTORNEY APPROVED A SJTO/FOFY: YNTHiA L. HALL ASSIS NT COUNTY ATTORNEY 'date /Fg' wo EXHIBIT 1 FEDERAL RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: NOTE: If the resources awarded to the recipient represent more than one Federal program, provide the same information shown below for each Federal program and show total Federal resources awarded. Federal Program (list Federal agency, Catalog of Federal Domestic Assistance title and number) — CFDA #97.067 $57,834.92 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: NOTE: If the resources awarded to the recipient represent more than one Federal program, list applicable compliance requirements for each Federal program in the same manner as shown below. Federal Program: List applicable compliance requirements as follows: 1. Recipient is to use funding to perform the following eligible activities as identified in the United States Department of Homeland Security, Federal Emergency Management Agency, and National Preparedness Directorate Fiscal Year 2007-08 State Homeland Security Grant Program (SHSGP), consistent with the Department of Homeland Security State Strategy. 2. Recipient is subject to all administrative and financial requirements as set forth in this Agreement, or will be in violation of the terms of the Agreement. NOTE: Instead of listing the specific compliance requirements as shown above, the State awarding agency may elect to use language that requires the recipient to comply with the requirements of applicable provisions of specific laws, rules, regulations, etc. For example, for Federal Program 1, the language may state that the recipient must comply with a specific law(s), rule(s), or regulation(s) that pertains to how the awarded resources must be used or how eligibility determinations are to be made. The State awarding agency, if practical, may want to attach a copy of the specific law, rule, or regulation referred to. NOTE: Section .400(d) of OMB Circular A-133, as revised, and Section 215.97(5)(a), Florida Statutes, require that the information about Federal Programs and State Projects included in Exhibit 1 be provided to the recipient. 21 Attachment A Budget and Scope of Work Proposed Program Budget Below is a general budget which outlines eligible categories and their allocation under this award. The Recipient is to utilize the "Proposed Program Budget" as a guide for completing the "Budget Detail Worksheet" below. No more than 3% of the total award may be expended on Management and Administration costs by the Recipient. .4- At the discretion of the Recipient, funds allocated to Management and Administration (as described in the "Proposed Program Budget") may be put towards Programmatic costs instead. ,4. The transfer of funds between planning, training, exercises and management & administration is permitted, for this contract only, whereas management & administration costs do not exceed 3% of the Recipient's total award. 22 Budget Detail Worksheet The Recipient is required to provide a completed budget detail worksheet, to the Division, which accounts for the total award for issue 10 as described in the "Proposed Program Budget". If any changes need to be made to the "Budget Detail Worksheet", after the execution of this contract, contact the contract manager listed in this contract via email or letter. 211 ia,; i RAOs, .-: a, a t r 8�, >�.— r { Public Education/Outreach Develop and implement homeland security support programs and adopt ongoing DHS national initiatives Develop and enhance plans and protocols Develop or conduct assessments Establish, enhance, or evaluate Citizen Corps -related volunteer programs Hiring of full or part-time staff or contractors/consultants to assist with planning activities (not for the purpose of hiring public safety personnel fulfilling traditional public safety duties) Conferences to facilitate planning activities Materials required to conduct planning activities Travel/per diem related to planning activities Overtime and backfill costs — Payment of overtime expenses will be for work performed by award (SAA) or sub -award employees in excess of the established work week (usually 40 hours) related to the planning activities for the development and implementation of the programs under HSGP. Overtime and backfill funding for emergency preparedness and response personnel attending G&T-sponsored and approved training classes and technical assistance programs. Grantees may also use G&T grant funds to cover overtime and backfill expenses for part-time and volunteer emergency response personnel participating in G&T training. Training Workshops and Conferences - Grant funds may be used to plan and conduct training workshops or conferences to include costs related to planning, meeting space and other meeting costs, facilitation costs, materials and supplies, travel, and training plan development. Full or Part -Time Staff or Contractors/Consultants - Full or part-time staff may be hired to support training -related activities. Payment of salaries and fringe benefits must be in accordance with the policies of the state or local unit(s) of government and have the approval of the state or the awarding agency, whichever is applicable. The services of contractors/oonsultants may also be procured by the state in the design, development, conduct, and evaluation of CBRNE training. The applicant's formal written procurement policy or the Federal Acquisition Regulations (FAR) must be followed. 23 Travel - Travel costs (i.e., airfare, mileage, per diem, hotel, etc.) are allowable as expenses by employees who are on travel status for official business related to the planning and conduct of the training project(s) or for attending ODP-sponsored courses. These costs must be in accordance with state law as highlighted in the OJP Financial Guide. States must also follow state regulations regarding travel. If a state or territory does not have a travel policy they must follow federal guidelines and rates, as explained in the OJP Financial Guide. For further information on federal law pertaining to travel costs please refer to http://www.ojp.usdoj.gov/FinGuide. Supplies - Supplies are items that are expended or consumed during the course of the planning and conduct of the training project(s) (e.g., copying paper, gloves, tape, and non -sterile masks). Tuition for higher education Other Items - These costs include the rental of space/locations for planning and conducting training, badges, etc. A complete list of G&T approved courses may be found at www.ojp.usdoj.gov/o((dp/docs/Eligible Federal Courses.pdf � � A' 3s..,.?. Exercise Planning Workshop - Grant funds may be used to plan and conduct an Exercise Planning Workshop to include costs related to planning, meeting space and other meeting costs, facilitation costs, materials and supplies, travel and exercise plan development. Full or Part -Time Staff or Contractors/Consultants - Full or part-time staff may be hired to support exercise -related activities. Payment of salaries and fringe benefits must be in accordance with the policies of the state or local unit(s) of government and have the approval of the state or the awarding agency, whichever is applicable. The services of contractors/consultants may also be procured to support the design, development, conduct and evaluation of CBRNE exercises. The applicant's formal written procurement policy or the Federal Acquisition Regulations (FAR) must be followed. Overtime and backfiil costs — Overtime and backfill costs associated with the design, development and conduct of CBRNE exercises are allowable expenses. Grantees may also use G&T grant funds to cover overtime and backfill expenses for part-time and volunteer emergency response personnel participating in G&T exercises. Implementation of HSEEP (Homeland Security Exercise and Evaluation Program Travel - Travel costs (i.e., airfare, mileage, per diem, hotel, etc.) are allowable as expenses by employees who are on travel status for official business related to the planning and conduct of the exercise project(s). These costs must be in accordance with state law as highlighted in the OJP Financial Guide. States must also follow state regulations regarding travel. If a state or territory does not have a travel policy they must follow federal guidelines and rates, as explained in the OJP Financial Guide. For further information on federal law pertaining to travel costs please refer to http://www.ojp.usdoj.gov/FinGuide. Supplies - Supplies are items that are expended or consumed during the course of the planning and conduct of the exercise project(s) (e.g., copying paper, gloves, tape, non -sterile masks, and disposable protective equipment). 24 Other Items - These costs include the rental of space/locations for exercise planning and conduct, exercise signs, badges, etc. The scenarios used in SHSGP funded exercises must be terrorism -related and based on the State Homeland Security Strategy and plans. Acceptable scenarios for exercises include: chemical, biological, radiological, nuclear, explosive, cyber and agricultural. A state or local jurisdiction that conducts an exercise using SHSGP funds must follow the HSEEP doctrine and protocols located at http.//www.oip.usdoi..qov/odp/exercises.htm#hseep. l«.•—• I\rt t,s }...... � r1 1 c{ ,1,� ysli�,�� ��{�p1 ri ttFrl kt,,,1-�t Hiring of full-time or part-time staff or contractors/consultants: 4. To assist with the management of the FY 2007 SHSGP 4- To assist with design, requirements and the implementation of the FY 2007 SHSGP 4- To assist with the implementation and administration of the State Homeland Security Strategy, as it may relate to the FY 2007 SHSGP Hiring of full-time or part-time staff or contractors/consultants and expenses related to: 4 HSGP pre -application submission management activities and application requirements. -41 Meeting compliance with reporting/data collection requirements, including data calls. Development of operating plans for information collection and processing necessary to respond to DHS/ODP data calls. Overtime and backfill costs — Overtime expenses are defined as the result of personnel who worked over and above their normal scheduled daily or weekly worked time in the performance of G&T — approved activities. Backfill Costs also called "Overtime as Backfill" are defined as expenses from the result of personnel who are working overtime in order to perform the duties of other personnel who are temporarily assigned to G&T — approved activities outside their core responsibilities. Neither overtime nor backfill expenses are the result of an increase of Full — Time Equivalent (FTEs) employees. These costs are allowed only to the extent the payment for such services is in accordance with the policies of the state or unit(s) of local government and has the approval of the state or the awarding agency, whichever is applicable. In no case is dual compensation allowable. That is, an employee of a unit of government may not receive compensation from their unit or agency of government AND from an award for a single period of time (e.g., 1:00 pm to 5:00 pm), even though such work may benefit both activities. Fringe benefits on overtime hours are limited to Federal Insurance Contributions Act (FICA), Workers' Compensation and Unemployment -Compensation. Travel expenses Meeting -related expenses (For a complete list of allowable meeting - related expenses, please review the OJP Financial Guide at hftp://www.ojp.usdoj.gov/FinGuide). Acquisition of authorized office equipment, including personal computers, laptop computers, printers, LCD projectors, and other equipment or software which may be required to support the implementation of the homeland security strategy. The following are allowable only within the contract period: 1 Recurring fees/charges associated with certain equipment, such as cell phones, faxes, etc. ,iLeasing and/or renting of space for newly hired personnel to administer programs within FY 2007 SHSGP. TOTAL 25 Scope of Work Funding is provided to perform eligible activities as identified in the Office for Domestic Preparedness Fiscal Year 2007 State Homeland Security Grant Program (SHSGP), consistent with the Department of Homeland Security, National Preparedness Directorate. Eligible activities are outlined in the Scope of Work for each category below: Categories and Eligible Activities Issue 10. Planning, Training and Exercises for Local and Regional Efforts FY 2007 SHSGP, Issue 10, allowable costs are divided into the following categories: planning, training and exercises. In addition, management and administration costs are also allowable. Management and administration costs may not exceed 3% of the Recipient's total award. A. Planning Developing and implementing homeland security support programs and adopting DHS national initiatives including but not limited to the following: • Costs associated with implementing the National Preparedness Goal and Guidance • Costs associated with implementing and adopting NIMS • Costs associated with complying with the requirements for the National Preparedness System (NPS) that includes jurisdictional review of the Target Capabilities List (TCL) • Costs associated with modifying existing incident management and EOPs to ensure proper alignment with the NRP coordinating structures, processes, and • Establishing or enhancing mutual aid agreements • Developing communications and interoperability protocols and solutions • Conducting local, regional, and tribal program implementation meetings • Developing or updating resource inventory assets in accordance to typed resource definitions issued by the NIC • Designing state and local geospatial data systems • Developing related critical infrastructure terrorism prevention activities including: • Planning to enhance security during heightened alerts, during terrorist incidents, and/or during mitigation and recovery • Public information/education: printed and electronic materials, public service announcements, seminars/town hall meetings, web postings coordinated through local Citizen Corps Councils • Citizen Corps activities in communities surrounding critical infrastructure sites, including Neighborhood Watch, VIPS, and other opportunities for citizen participation • Evaluating CIP security equipment and/or personnel requirements to protect and secure sites • CIP cost assessments, including resources (financial, personnel, etc.) required for security enhancements/deployments. Developing related terrorism prevention activities including, including but not limited to the following: • Planning to enhance security during heightened alerts, during terrorist incidents, and/or during mitigation and recovery. • Multi -discipline preparation across first responder community, including EMS for 26 • response to catastrophic events and acts of terrorism. • Public information/education: printed and electronic materials, public service announcements, seminars/town hall meetings, web postings coordinated through local Citizen Corps Councils. • Citizen Corps volunteer programs and other activities to strengthen citizen participation. • Conducting public education campaigns, including promoting individual, family and business emergency preparedness; promoting the Ready campaign; and/or creating State, regional or local emergency preparedness efforts that build upon the Ready campaign. • Evaluating CIP security equipment and/or personnel requirements to protect and secure sites. • CIP cost assessments, including resources (e.g., financial, personnel) required for security enhancements/deployments. Developing and enhancing plans and protocols, including but not limited to: • Developing or enhancing EOPs and operating procedures. • Developing terrorism prevention/deterrence plans. • Developing plans, procedures, and requirements for the management of infrastructure and resources related to HSGP and implementation of State or Urban Area Homeland Security Strategies. • Developing or enhancing border security plans. • Developing or enhancing cyber security plans. • Developing or enhancing cyber risk mitigation plans. • Developing or enhancing agriculture/food security risk mitigation, response, and recovery plans. • Developing public/private sector partnership emergency response, assessment, and resource sharing plans. • Developing or updating local or regional communications plans. • Developing plans to support and assist special needs jurisdictions, such as port authorities and rail and mass transit agencies. • Developing or enhancing continuity of operations and continuity of government Plans. • Developing or enhancing existing catastrophic incident response and recovery plans to include and integrate Federal assets provided under the NRP. • Developing or enhancing evacuation plans. • Developing or enhancing citizen surge capacity. Developing or conducting assessments, including but not limited to: • Conducting point vulnerability assessments at critical infrastructure sites/key assets and develop remediation/security plans. • Conducting cyber risk and vulnerability assessments. • Conducting assessments and exercising existing catastrophic incident response and recovery plans and capabilities to identify critical gaps that cannot be met by existing local and State resources. • Activities that directly support the identification of specific catastrophic incident priority response and recovery projected needs across disciplines (e.g. law enforcement, fire, EMS, public health, behavioral health, public works, agriculture, information technology, and citizen preparedness). • Activities that directly support the identification of pre -designated temporary housing sites. 27 E. Training Funds may be used to enhance the capabilities of State and local emergency preparedness and response personnel through development of a State homeland security training program. Allowable training -related costs include: 1. Establishment of support for, conduct of, and attendance at preparedness training programs within existing training academies/institutions, universities, or junior colleges. Preparedness training programs are defined as those programs related to prevention, protection, response, and or recovery from natural, technical, or manmade catastrophic incidents, supporting one or more Target Capabilities in alignment with national priorities as stated in the Goal. Examples of such programs include but are not limited to CBRNE terrorism, critical infrastructure protection, cyber security, and citizen preparedness. 2. Overtime and backfill costs associated with attendance at G&T-sponsored and approved training classes and technical assistance programs. SHSP may also be used for training citizens in awareness, prevention, protection, response, recovery skills. Reimbursement Requirements. In order to be reimbursed the following steps must be completed: • Submit invoices for all costs • Requests for backfill must be accompanied by proof of payment to the payee • Requests for overtime must be accompanied by timesheets indicating the extra hours worked and proof of payment to the payee • Submit copies of the sign in sheets from the training C. Exercises Funds may be used to design, develop, conduct, and evaluate exercises that: • Provide homeland security preparedness personnel and volunteers a venue to practice prevention, protection, response, and recovery activities. • Evaluate prevention and response plans, policy, procedures, and protocols, including NIMS and NRP. • Assess the readiness of jurisdictions to prevent and respond to terrorist attacks. • Encourage coordination with surrounding jurisdictions in prevention, protection, response, and recovery activities. • Implementation of HSEEP, including developing and maintaining a self-sustaining State Homeland Security Exercise and Evaluation Program that is modeled on the national HSEEP. Exercises conducted with ODP support (grant funds or direct support) must be managed and executed in accordance with the Homeland Security Exercise and Evaluation Program (HSEEP). HSEEP Volumes 1-III contains guidance and recommendations for designing, developing, conducting, and evaluating exercises. HSEEP Volumes 1-III can be found at ODP's website at http://www.ojp.usdoj.gov/odp/exercises.htm. Volume IV, which contains sample exercise materials and documents, can be found on ODP's Secure Portal at https://odp.esportals.com or http://www.11is.gov. Exercise Scenarios. The scenarios used in SHSGP-funded exercises include catastrophic events, provided that they also build capabilities that relate to terrorism and based on the State or Urban Area Homeland Security Strategy and plans. Acceptable scenarios for exercises include: chemical, biological, radiological, nuclear, explosive, cyber and agricultural. Grantees that need further clarification on scenarios should consult with their State Exercise Manager for assistance and/or approval. Fifteen all - hazards National Planning Scenarios, including 12 terrorism scenarios, have been 28 developed, and will be made available for use in national, federal, state, and local homeland security preparedness activities (See HSPD-8: National Preparedness on page 49). Citizen participation in exercises is encouraged to include backfilling non- professional tasks for first responders deployed on exercise, administrative and logistical assistance with exercise implementation, and providing simulated victims, press, and members of the public. Citizen participation in exercises should be coordinated with local Citizen Corps Council(s). If a state or urban area will be hosting an upcoming special event (e.g., Superbowl, G-8 Summit, etc.), or they anticipate that they will apply to be a venue for a future Top Officials (TOPOFF) exercise, they should plan to use SHSP or UASI funding to fund training and exercise activities in preparation for that event. All tabletop exercises (TTXs), drills, functional exercises (FEs), and full-scale exercises (FSEs) will be evaluated and performance based. An After Action Report (AAR) and Improvement Plan will be prepared and submitted to the State following every TTX, drill, FE, and FSE. AAR/IPs must be provided to the State within 30 days following completion of each exercise (see HSEEP Volume II, Appendix A). All tabletop exercises (TTXs), drills, functional exercises (FEs), and full-scale exercises (FSEs) will be evaluated and performance based. An After Action Report (AAR) and Improvement Plan will be prepared and submitted to the State following every TTX, drill, FE, and FSE. AAR/lPs must be provided to the State within 45 days following completion of each exercise (see HSEEP Volume II, Appendix A). Reimbursement Requirements. In order to be reimbursed the following steps must be completed: • All exercises must be posted on the National Exercise Schedule on the HSEEP web site https:Hhseep.dhs.gov/toolkit.htm . They must be approved by the Exercise Administrative Authority for the state before they will be eligible for reimbursement. • Submit invoices for all costs • Requests for backfill must be accompanied by proof of payment to the payee • Requests for overtime must be accompanied by timesheets indicating the extra hours worked and proof of payment to the payee • Submit an Exercise Plan or Situation Manual along with completed After Action Report with Improvement Plan • Submit copies of the sign in sheets from the exercise D. Management and Administration - no more than 3% of each sub -recipient's total award may be expended on Management and Administration costs by the sub -recipients. Hiring of full-time or part-time staff or contractors/consultants: • To assist with the management of the FY 2007 SHSGP • To assist with design, requirements and the implementation of the FY 2007 SHSGP • To assist with the implementation and administration of the State Homeland Security Strategy, as it may relate to the FY 2007 SHSGP Hiring of full-time or part-time staff or contractors/consultants and expenses related to: • Meeting compliance reporting/data collection requirements, including data calls Development of operating plans for information collection and processing necessary to respond to DHS/ODP data calls 29 Overtime and backfill costs - Overtime expenses are defined as the result of personnel who worked over and above their normal scheduled daily or weekly worked time in the performance of G&T — approved activities. Backfill Costs also called "Overtime as Backfill" are defined as expenses from the result of personnel who are working overtime in order to perform the duties of other personnel who are temporarily assigned to G&T — approved activities outside their core responsibilities. Neither overtime nor backfill expenses are the result of an increase of Full — Time Equivalent (FTEs) employees. These costs are allowed only to the extent the payment for such services is in accordance with the policies of the state or unit(s) of local government and has the approval of the state or the awarding agency, whichever is applicable. In no case is dual compensation allowable. That is, an employee of a unit of government may not receive compensation from their unit or agency of government AND from an award for a single period of time (e.g., 1:00 pm to 5:00 pm), even though such work may benefit both activities. Fringe benefits on overtime hours are limited to Federal Insurance Contributions Act (FICA), Workers' Compensation and Unemployment Compensation. Travel expenses Meeting -related expenses (For a complete list of allowable meeting -related expenses, please review the OJP Financial Guide at http://www.oip.usdoi.gov/FinGuide). Acquisition of authorized office equipment, including: • Personal computers • Laptop computers • Printers • LCD projectors, and • Other equipment or software which may be required to support the implementation of the homeland security strategy The following are allowable only within the period of performance of the contract: • Recurring fees/charges associated with certain equipment, such as cell phones, faxes, etc. • Leasing and/or renting of space for newly hired personnel to administer programs within the FY 2007 SHSGP E. Unauthorized Expenditures • Expenditures for items such as general -use software (word processing, spreadsheet, graphics, etc.) • General -use computers and related equipment • General -use vehicles • Licensing fees • Weapons systems and ammunition • Construction or renovation of facilities that would have been reasonably necessary due to non -terrorist threats • Activities unrelated to the completion and implementation of the SHSGP • Other items not in accordance with the Authorized Equipment List or previously listed as allowable costs • Recurring Costs • Funding may not be used to supplant ongoing, routine public safety activities of state and local emergency responders, and may not be used to hire staff for operational activities or backfill 30 F. Overtime and Backfill Guidance Overtime: Expenses incurred by those personnel who, as a result of G&T-approved activities, are performing over and above their normal, scheduled work hours or work week. Backfill (also called Overtime as Backfill): Expenses incurred by those personnel who are working over and above their normal, scheduled work hours, or work week, in order to perform the duties of other personnel who are temporarily assigned to G&T-approved activities outside their core responsibilities. The OJP OC does not distinguish between Overtime and Overtime as Backfill — they are both viewed as overtime regardless of whether the individual has performed more hours in their normally assigned place of duty or if the overtime accrued as a result of being re -assigned to a different place of duty. Overtime and backfill do not result in an increase of full-time employees (FTEs). National Preparedness Initiatives Urban Areas are strongly encouraged to pay close attention to the language in these sections in order to stay abreast of initiatives being highlighted by DHS and to comply with associated program requirements. A. National Incident Management System (NIMS) NIMS provides a consistent nationwide approach for federal, state, territorial, tribal, and local governments to work effectively and efficiently together to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size or complexity. Since FY 2007 is a critical year for initial NIMS adoption, the Recipient should start now by prioritizing FY 2007 preparedness assistance (in accordance with the eligibility and allowable uses of the grant) to facilitate its implementation. Minimum FY 2007 NIMS Compliance Requirements • Incorporating NIMS into existing training programs and exercises; • Completion of the NIMCAST tool • Ensuring that federal preparedness funding supports NIMS implementation (in accordance with the eligibility and allowable uses of the grants); Incorporating NIMS into emergency operations planning; • Promotion of mutual aid agreements; and, • Institutionalizing the use of the Incident Command System (ICS). 2. Local units of government should support NIMS implementation by: • Having relevant personnel complete the NIMS Awareness Course: These independent study courses are available on-line and will take between forty-five minutes to three hours to complete. The course is available on the Emergency Management Institute web page at: http://training.fema.gov • Formally recognizing NIMS and adopting NIMS principles and policies. The NIC will provide sample language and templates to assist in formally adopting NIMS through legislative and/or executive/administrative means. Establish a NIMS baseline by determining which NIMS requirements are already satisfied. The NIC is developing a web -based self -assessment system, the NIMS Capability Assessment Support Tool (NIMCAST) to evaluate their incident response and management capabilities. The NIC is currently piloting the NIMCAST with a limited number of states. Upon completion of the pilot, the NIC will provide all potential future users with voluntary access to the system. 31 FY 2007 Requirements In order for the State to receive FY 2007 preparedness funding, the compliance requirements described above must be met. Additional information about NIMS compliance and resources for achieving compliance will be forthcoming from the NIC. The NIC web page, http://www.fema.gov/nims, will be updated regularly with NIMS information and implementation guidance. Note: All FY 2007 Homeland Security Grant Program Grant Guidance can be found at http://www.ojp.usdo4.gov/odp/docs/fy2007hsgp.pdf B. National Preparedness System (NPS) The NPS provides a tool to assist jurisdictions, agencies, and organizations at all levels to plan for, assess, and track capabilities in a shared environment. It integrates various efforts to provide the comprehensive picture of preparedness and progress toward achieving the Goal. Recipients are responsible for/and required to report data into this developing system. C. Monitoring: Florida Division of Emergency Management US Department of Homeland Security Grants Program Grant Monitoring Process Florida has enhanced the state and local capability and capacity to prevent, prepare and respond to terrorist threats since 1999 through various funding sources including federal grant funds. As the steward of the State Homeland Security Grant Program funds, projects and equipment the Florida Division of Emergency Management (FDEM) has a responsibility to track and monitor the status of the grant activity and items purchased. The monitoring process detailed in this document is designed to assess a recipient agency's compliance with applicable state and federal guidelines. The FDEM is responsible for monitoring the programmatic and capability portion of the grant to include equipment procurement and compliance with applicable SHSGP grant guidance. Monitoring is accomplished utilizing various methods including desk monitoring and site visits. There are two primary areas reviewed during monitoring activities - financial and programmatic/capability. Financial monitoring is the review of records associated with the purchase and disposition of property, projects and contracts. Capability review is the observation of equipment purchased, protocols and other associated records. Various levels of financial and programmatic review may be accomplished during this process. Desk monitoring is defined as the review of projects, financial activity and technical assistance between the program office and the applicant via e-mail and telephone. Site visits are defined as actual visits to the recipient agency's location by a team or members of the FDEM or their designee, to actually observe records, procedures and equipment. Frequency of annual monitoring activity: Each year the FDEM will identify up to 50% of sub grantees for site visit monitoring. Examples of areas that may be examined include: Status of equipment purchases Status of training for purchased equipment Status and number of response trainings conducted to include number trained 32 Status and number of exercises Status of planning activity Anticipated projected completion Specific difficulties completing the project. Agency NIMS compliance documentation In certain circumstances, the FDEM may be requested to provide additional monitoring/information if the activity, or lack there of, on the part of the specific recipient has generated questions from the region, the sponsoring state agency or the FDEM leadership. The method of gathering this information will be determined on a case -by -case basis. Desk monitoring is an on -going process. Agency recipients will be required to participate in desk top monitoring on an annual basis and as determined by the SAA. The agency recipients will compete and submit the desk top monitoring within 30 calendar days of receipt. This contact will provide an opportunity to identify the need for technical assistance (TA) and/or a site visit if the SAA determines that a recipient is having difficulty completing their project. As difficulties/deficiencies are identified, the respective region or sponsoring agency will be notified by the program office via email. Information will include the grant recipient agency name, year and project description and the nature of the issue in question. Many of the issues that arise may be resolved at the regional or sponsoring agency level. Issues that require further TA will be referred to the FDEM for assistance. Examples of TA include but are not limited to: ➢ Equipment selection or available vendors ➢ Eligibility of items or services ➢ Coordination and partnership with other agencies within or outside the region or discipline. Site Visits Site visits will be conducted by the FDEM or their designated personnel. Site visits will be scheduled in advanced with the recipient agency POC designated in the grant agreement. Monitoring questionnaires will be provided in advance of the visit The FDEM will also conduct coordinated financial and grant file monitoring. These monitoring visits will be coordinated with the capability review visits. Subject matter experts from other agencies within the region or state may be called upon to assist in the form of a peer review as needed. All findings related to the capability review will be documented and maintained within the FDEM. Site Visit Protocol The following outlines the monitoring protocol for the FDEM: The site visits will begin with those grantees that are currently spending or have completed spending for that federal fiscal year (IFFY). Site visits may be combined when geographically convenient. There is a site visit checklist to assist in the completion of all required tasks. Site Visit Preparation A letter will be sent to recipient agency POC stating the purpose of the site visit and sent at least 30 calendar days before the planned arrival date. FDEM personnel will call within the next 10 calendar days to schedule an appointment to review the grantee's program. The physical location of any equipment located at an alternate site should be confirmed with a representative from that location and the address should be documented in the grantee folder before the site visit. 33 The appointment should be confirmed with the grantee in writing (email is acceptable) and documented in the grantee folder. Any personnel from the FDEM attending the site visit will review the grantee's corresponding folder(s) before the visit. Prior to the visit, individual roles will be identified for the site visit. Copies of applicable documents will be made and distributed to the site visit team at a minimum of five (5) calendar days before the visit. A reminder e-mail should be sent to all team members and the recipient POC one business day in advance of the site visit. Site Visit Once FDEM personnel have arrived at the site, an orientation conference will be conducted. During this time, the purpose of the site visit and the items FDEM intends to examine will be identified. If financial monitoring visit will be conducted, they will then explain their objectives and will proceed to perform the financial review. FDEM personnel will review all files and supporting documentation. Once the supporting documentation has been reviewed, a tour/visual/spot inspection of equipment will be conducted. Each item should be visually inspected whenever possible. Bigger items (computers, response vehicles, etc.) should have an asset decal (information/serial number) placed in a prominent location on each piece of equipment as per recipient agency requirements. The serial number should correspond with the appropriate receipt to confirm purchase. Photographs should be taken of the equipment (large capitol expenditures in excess of $1,000. per item). If an item is not available (being used during time of the site visit), the appropriate documentation must be provided to account for that particular piece of equipment. Once the tour/visual/spot inspection of equipment has been completed, the FDEM personnel will then conduct an exit conference with the grantee to review the findings. Other programmatic issues can be discussed at this time, such as missing quarterly reports, payment voucher/reimbursement, equipment, questions, etc. Post Site Visit FDEM personnel will review the site visit worksheet as a team and receive notes from the Financial Review Team, if applicable. Within 30 calendar days of the site visit, a monitoring report will be generated and sent to the grantee explaining any issues and corrective actions required or recommendations. The grantee will submit a Corrective Action Plan within a timeframe as determined by the SAA. The Site Visit Worksheet, report and photographs will then be included in the grantee's file along with any documents distributed at the site visit by the grantee. 34 111. Reporting Requirements A. Quarterly Programmatic Reportin The Quarterly Programmatic Report is due within 30 days after the end of the reporting periods (March 31, June 30, September 30 and December 31) for the life of this contract. If a report(s) is delinquent, future financial reimbursements will be withheld until the Recipient's reporting is current. Programmatic Reporting Schedule Reporting Period Report due to DEM no later than January 1 through March 31 Aril 30 April 1 through June 30 July 31 July 1 through September 30 October 31 October 1 through December 31 January 31 Programmatic Reporting: Information to Report On After the end of each reporting period, for the life of the contract, the Division will provide a Biannual Strategy and Implementation Report worksheet to the Recipient Point of Contact listed in this contract. This worksheet will contain all of the information that the Recipient needs to report on. The Recipient is to complete this worksheet in its entirety and email the finished product to the programmatic contact listed below. The first worksheet will be available after the July 1 — September 30, 2007 reporting period. B. Reimbursement Requests: A request for reimbursement may be sent to your contract manager for review and approval at anytime during the contract period. The Recipient should include the category's corresponding line item number in the "Detail of Claims"form. This number can be found in the "Proposed Program Budget". A line item number is to be included for every dollar amount listed in the "Detail of Claims" form. C. Close-out Programmatic Reporting: The Close-out Report is due to the Florida Division of Emergency Management no later than 60 days after the contract is either completed or the contract has expired. IV. Programmatic Point of Contact Contractual Point of Contact Programmatic Point of Contact Carolyn Washington Tara Walters FDEM FDEM 2555 Shumard Oak Blvd. 2555 Shumard Oak Blvd. Tallahassee, FL 32399-2100 Tallahassee, FL 32399-2100 (850) 410-1271 (850) 410-1391 carolyn.washington@em.mAorida.com Tara.walters(a)em.myflorida.com 35 V. Contractual Responsibilities The FDEM shall determine eligibility of projects and approve changes in scope of work. The FDEM shall administer the financial processes. 36 Attachment B Program Statutes and Regulations 1) 53 Federal Register 8034 2) Federal Acquisition Regulations 31.2 and 031.2 3) Section 1352, Title 31, US Code 4) OMB Circulars A-21, A-87, A-110, A-122 5) Chapter 473, Florida Statutes 6) Chapter 215, Florida Statutes 7) Section 768.28, Florida Statutes 8) Chapter 119, Florida Statutes 9) Section 216.181(6), Florida Statutes 10) Cash Management Improvement Act Of 1990 11) American with Disabilities Act 12) Section 112.061, Florida Statutes 13) Immigration and Nationality Act 14) Section 286.011, Florida Statutes 15) E.O. 12372 and Uniform Administrative Requirements for Grants and Cooperative Agreements 28 CFR, Part 66, Common rule, 16) Uniform Relocation Assistance and Real Property Acquisitions Act of 1970 17) Section 102(a) of the Flood Disaster Protection Act of 1973, Public Law 93-234, 87 Stat. 975 18) Section 106 of the National Historic Preservation Act of 1966 as amended (16 USC 470), Executive Order 11593 19) Archeological and Historical Preservation Act of 1966 (16 USC 569a-1 et seq.) 20) Title I of the Omnibus Crime Control and Safe Streets Act of 1968, 21) Juvenile Justice and Delinquency Prevention Act, or the Victims of Crime Act 22) 28 CFR applicable to grants and cooperative agreements 23) Omnibus Crime Control and Safe Streets Act of 1968, as amended, 24) 42 USC 3789(d), or Victims of Crime Act (as appropriate); 25) Title VI of the Civil Rights Act of 1964, as amended; 26) Section 504 of the Rehabilitation Act of 1973, as amended; 27) Subtitle A, Title II of the Americans with Disabilities Act (ADA) (1990); 28) Title IX of the Education Amendments of 1972; 29) the Age Discrimination Act of 1975; Department of Justice Non -Discrimination Regulations, 30) 28 CFR Part 42, Subparts C,D,E, and G 31) Department of Justice regulations on disability discrimination, 28 CFR Part 35 and Part 39. 32) Federal Acquisition Regulations 31.2 and 931.2 37 Attachment C JUSTIFICATION OF ADVANCE PAYMENT RECIPIENT: Indicate by checking one of the boxes below, if you are requesting an advance. If an advance payment is requested, budget data on which the request is based must be submitted. Any advance payment under this Agreement is subject to s. 216.181(16), Fla. Stat. The amount which may be advanced shall not exceed the expected cash needs of the recipient w Tin the initial three months. [ ] NO ADVANCE REQUESTED No advance payment is requested. Payment will be solely on a reimbursement basis. No additional information is required. ADVANCE REQUEST WORKSHEET [ I ADVANCE REQUESTED Advance payment of $ is requested. Balance of payments will be made on a reimbursement basis. These funds are needed to pay staff, award benefits to clients, duplicate forms and purchase start-up supplies and equipment. We would not be able to operate the program without this advance. If you are requesting an advance, complete the following worksheet (A) (13) (C) (D) FFY FFY FFY Total 2004-2005 2005-2006 2006-2007 DESCRIPTION 1 INITIAL CONTRACT ALLOCATION 2 FIRST THREE MONTHS CONTRACT EXPENDITURES' 3 AVERAGE PERCENT EXPENDED IN FIRST THREE MONTHS Divide line 2 by line 1. ' First three months expenditures need only be provided for the years in which you requested an advance. if you do not have this information, call your consultant and they will assist you. MAXIMUM ADVANCE ALLOWED CALULATION: X $ Cell D3 DEM Award MAXIMUM (Do not include any match) ADVANCE REQUEST FOR WAIVER OF CALCULATED MAXIMUM [ ] Recipient has no previous DCA/DEM contract history. Complete Estimated Expenses chart and Explanation of Circumstances below. [ ] Recipient has exceptional circumstances that require an advance greater than the Maximum Advance calculated above. Complete estimated expenses chart and Explanation of Circumstances below. Attach additional pages if needed. ESTIMATED EXPENSES BUDGET CATEGORY 2006-2007 Anticipated Expenditures for First Three Months of Contract ADMINISTRATIVE COSTS Include Sec ndary Administration.) PROGRAM EXPENSES TOTAL EXPENSES Explanation of Circumstances: 39 Attachment D Warranties and Representations Financial Management Recipient's financial management system shall provide for the following: (1) Accurate, current and complete disclosure of the financial results of this project or program (2) Records that identify adequately the source and application of funds for all activities. These records shall contain information pertaining to grant awards, authorizations, obligations, unobligated balances, assets, outlays, income and interest. (3) Effective control over and accountability for all funds, property and other assets. Recipient shall adequately safeguard all such assets and assure that they are used solely for authorized purposes. (4) Comparison of expenditures with budget amounts for each Request For Payment. Whenever appropriate, financial information should be related to performance and unit cost data. (5) Written procedures for determining the reasonableness, allocability and allowability of costs in accordance with the provisions of the applicable cost principles and the terms and conditions of this grant. (6) Accounting records, including cost accounting records that are supported by source documentation. Competition. All procurement transactions shall be conducted in a manner to provide, to the maximum extent practical, open and free competition. The Recipient shall be alert to conflicts of interest as well as noncompetitive practices among contractors that may restrict or eliminate competition or otherwise restrain trade. In order to ensure objective contractor performance and eliminate unfair competitive advantage, contractors that develop or draft specifications, requirements, statements of work, invitations for bids and/or requests for proposals shall be excluded from competing for such procurements. Awards shall be made to the bidder or offeror whose bid or offer is responsive to the solicitation and is most advantageous to the Recipient, price, quality and other factors considered. Solicitations shall clearly set forth all requirements that the bidder or offeror shall fulfill in order for the bid or offer to be evaluated by the Recipient. Any and all bids or offers may be rejected when it is in the Recipient's interest to do so. .o Codes of conduct. The Recipient shall maintain written standards of conduct governing the performance of its employees engaged in the award and administration of contracts. No employee, officer, or agent shall participate in the selection, award, or administration of a contract supported by public grant funds if a real or apparent conflict of interest would be involved. Such a conflict would arise when the employee, officer, or agent, any member of his or her immediate family, his or her partner, or an organization which employs or is about to employ any of the parties indicated herein, has a financial or other interest in the firm selected for an award. The officers, employees, and agents of the Recipient shall neither solicit nor accept gratuities, favors, or anything of monetary value from contractors, or parties to subcontracts. The standards of conduct shall provide for disciplinary actions to be applied for violations of such standards by officers, employees, or agents of the recipient. Business Hours The Recipient shall have its offices open for business, with the entrance door open to the public, and at least one employee on site, from 8:00 AM to 5:00 PM. Monday through Friday. Licensina and Permittina All subcontractors or employees hired by the Recipient shall have all current licenses and permits required for all of the particular work for which they are hired by the Recipient. 41 Attachment E Contractor Covered Transactions (1) The prospective contractor of the Recipient, , certifies, by submission of this document, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the Recipient's contractor is unable to certify to the above statement, the prospective contractor shall attach an explanation to this form. CONTRACTOR: By: Signature Recipient's Name Name and Title Division Contract Number Street Address City, State, Zip Date 42 Attachment F Statement of Assurances The Recipient hereby assures and certifies compliance with all Federal statutes, regulations, policies, guidelines and requirements, including OMB Circulars No. A-21, A-110, A-122, A-128, A-87; E.O. 12372 and Uniform Administrative Requirements for Grants and Cooperative Agreements 28 CFR, Part 66, Common rule, that govern the application, acceptance and use of Federal funds for this federally -assisted project. Also the Applicant assures and certifies that: 1. It will comply with requirements of the provisions of the Uniform Relocation Assistance and Real Property Acquisitions Act of 1970 (P.L. 91-646) which provides for fair and equitable treatment of persons displaced as a result of Federal and federally -assisted programs. 2. It will comply with provisions of Federal law which limit certain political activities of employees of a State or local unit of government whose principal employment is in connection with an activity financed in whole or in part by Federal grants. (5 USC 1501, et seq.) 3. It will comply with the minimum wage and maximum hours provisions of the Federal Fair Labor Standards Act. 4. It will establish safeguards to prohibit employees from using their positions for a purpose that is or gives the appearance of being motivated by a desire for private gain for themselves or others, particularly those with whom they have family, business, or other ties. 5. It will give the sponsoring agency or the Comptroller General, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the grant. 6. It will comply with all requirements imposed by the Federal sponsoring agency concerning special requirements of law, program requirements, and other administrative requirements. 7. It will insure that the facilities under its ownership, lease or supervision which shall be utilized in the accomplishment of the project are not listed on the Environmental Protection Agency's (EPA) list of Violating Facilities and that it will notify the Federal grantor agency of the receipt of any communication from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is under consideration for listing by the EPA. 8. It will comply with the flood insurance purchase requirements of Section 102(a) of the Flood'Disaster Protection Act of 1973, Public Law 93-234, 87 Stat. 975, approved December 31, 1976, Section 102(a) requires, on and after March 2, 1975, the purchase of flood insurance in communities where such insurance is available as a condition for the receipt of any Federal financial assistance for construction or acquisition purposes for use in any area that has been identified by the Secretary of the Department of Housing and Urban Development as an area having special flood hazards. The phrase "Federal financial assistance" includes any form of loan, grant, guaranty, insurance payment, rebate, subsidy, disaster assistance loan or grant, or any other form of direct or indirect Federal assistance. 9. It will assist the Federal grantor agency in its compliance with Section 106 of the National Historic Preservation Act of 1966 as amended (16 USC 470), Executive Order 11593, and the Archeological and Historical Preservation Act of 1966 (16 USC 569a-1 et seq.) by (a) consulting with the State Historic Preservation Officer on the conduct of Investigations, as necessary, to identify properties listed in or eligible for inclusion in the National Register of Historic Places that are subject to adverse effects (see 36 CFR Part 800.8) by the activity, and notifying the Federal grantor agency of the existence of any such properties and by (b) complying with all requirements established by the Federal grantor agency to avoid or mitigate adverse effects upon such properties. 43 10. It will comply, and assure the compliance of all its subgrantees and contractors, with the applicable provisions of Title I of the Omnibus Crime Control and Safe Streets Act of 1968, as amended, the Juvenile Justice and Delinquency Prevention Act, or the Victims of Crime Act, as appropriate; the provisions of the current edition of the Office of Justice Programs Financial and Administrative Guide for Grants, M7100.1; and all other applicable Federal laws, orders, circulars, or regulations. 11. It will comply with the provisions of 28 CFR applicable to grants and cooperative agreements including Part 18, Administrative Review Procedure; Part 20, Criminal Justice Information Systems; Part 22, Confidentiality of Identifiable Research and Statistical Information; Part 23, Criminal Intelligence Systems Operating Policies; Part 30, Intergovernmental Review of Department of Justice Programs and Activities; Part 42, Nondiscrimination/Equal Employment Opportunity Policies and Procedures; Part 61, Procedures for Implementing the National Environmental Policy Act; Part 63, Floodplain Management and Wetland Protection Procedures; and Federal laws or regulations applicable to Federal Assistance Programs. 12. It will comply, and all its contractors will comply, with the non-discrimination requirements of the Omnibus Crime Control and Safe Streets Act of 1968, as amended, 42 USC 3789(d), or Victims of Crime Act (as appropriate); Title VI of the Civil Rights Act of 1964, as amended; Section 504 of the Rehabilitation Act of 1973, as amended; Subtitle A, Title II of the Americans with Disabilities Act (ADA) (1990); Title IX of the Education Amendments of 1972; the Age Discrimination Act of 1975; Department of Justice Non -Discrimination Regulations, 28 CFR Part 42, Subparts C,D,E, and G; and Department of Justice regulations on disability discrimination, 28 CFR Part 35 and Part 39. 13. In the event a Federal or State court or Federal or State administrative agency makes a finding of discrimination after a due process hearing on the Grounds of race, color, religion, national origin, sex, or disability against a recipient of funds, the recipient will forward a copy of the finding to the Office for Civil Rights, Office of Justice Programs. 14. It will provide an Equal Employment Opportunity Program if required to maintain one, where the application is for $500,000 or more. 15. It will comply with the provisions of the Coastal Barrier Resources Act (P.L. 97-348) dated October 19, 1982 (16 USC 3501 et seq.) which prohibits the expenditure of most new Federal funds within the units of the Coastal Barrier Resources System. 16. DRUG -FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS) As required by the Drug - Free Workplace Act of 1988, and implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part 67 Sections 67.615 and 67.620. BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: December 15, 2009 Division: Deputy County Administrator Bulk Item: Yes X No _ Department: Library Staff Contact Person/Phone #: Norma Kula / x7349 AGENDA ITEM WORDING: Approval to close the Libraries at 1:00 p.m. on Christmas Eve. ITEM BACKGROUND: Other County offices will be closed for the Christmas holiday on Friday, December 24. Since the usual Library Saturday hours will be their Christmas holiday, they are scheduled to be open all day on Christmas Eve. Library staff and administration are requesting unanimously that they be allowed to take four hours of vacation time so that the Libraries might be closed at 1:00 p.m. on Christmas Eve, which is usually a less busy time. This will not give them any extra holiday time, and schedules will be rearranged to ensure that all regular services and programs will be available for the morning half -day. PREVIOUS RELEVANT BOCC ACTION: CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval TOTAL COST:--00-- INDIRECT COST: N/A BUDGETED: Yes X No DIFFERENTIAL OF LOCAL PREFERENCE: N/A COST TO COUNTY: --00-- SOURCE OF FUNDS: N/A REVENUE PRODUCING: Yes No AMOUNT PER Year APPROVED BY: County Atty OMB/Purchasing Risk Management DOCUMENTATION: Included Not Required X_ DISPOSITION: Revised 7/09 AGENDA ITEM # BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 12-15-2010 Bulk Item: Yes X No Division: _County Administrator Department: Social Services/In-Home Services Staff Contact Person/Phone #: Sheryl Graham/X4510 AGENDA ITEM WORDING: Approval of the Older Americans Act (OAA) Contract AA-1129 between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County Board of County Commissioners (Social Services/Nutrition and In -Home Services programs) for fiscal year 1/1/11 to 12/31/11. ITEM BACKGROUND: Approval of the Older Americans Act (OAA) Contract will continue to provide Respite Services, Congregate Meal Services and Home Delivered Meals to Monroe Counties elderly and needy citizens. This contract must be approved by December 15, 2010 or these services to the elderly will cease as of January 1, 2011 PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to Older American's Act (OAA) contract #AA-1029 on 12-16-2009 CONTRACT/AGREEMENT CHANGES: None STAFF RECOMMENDATIONS: Approval of this contract at this time will allow services to Monroe County's elderly and needy population to continue. If this contract is not approved by 12-15-2010, all services will cease on 1-1-2011. TOTAL COST: $420,992.00 INDIRECT COST: _-0-_BUDGETED: Yes X No COST TO COUNTY: Approx. $42,099.20 (In -Kind Match) SOURCE OF FUNDS: In -Kind (Space) REVENUE PRODUCING: Yes fNo X_ AMOUNT PER MONTH Year APPROVED BY: County Att X OMB/Purchasing X Risk Management X DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # 613, Revised 1/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Alliance For Aging, Inc. Contract # AA_ 1129 Effective Date: 1/l/2011 Expiration Date: 12/31 /2011 Contract Purpose/Description: Approval of the OAA Contract #AA-1 129,(1/1/11-12/31 / 11) between the Alliance for Aging, Inc. (Area Agency on Aging for Miami -Dade and Monroe Counties) and the Monroe County Board of County Commissioners (Community Services/Nutrition and In -Home Services programs) will enable Monroe County to continue providing Respite and Nutritional Services to Monroe County's elderly and needy population under the Older Americans Act. Contract must be approved by 12-15-10 or services will cease as of 1-1-11 Contract Manager: Sheryl Graham 4510 ,,- Community Services/Stop 1 (Name) W'� (Ext.) (Department/Stop #) For BOCC meeting 12/15/10 Agenda Deadline: 11/30/10 CONTRACT COSTS Total Dollar Value of Contract: (extension) $420,992.00 Current Year Portion: $ Budgeted? Yes X No Account Codes: 125-_6153111_ _ Grant: $ 420,992.00 _125_-_6153211_ County Match: S42,099.20 (In -Kind Match) _125_-6153411 Estimated Ongoiing Costs: $ / ADDITIONAL COSTS (Not included in dollar value above) N For: (e . Maintenance, utilities, janitorial, salaries, etc) Division Director Risk Manage nt 1 O-M.B./Purcf6sing County Attorney Comments: Date In 'C4_1 I (-,I I C, OMB Form Revised 2/27/01 MCP #2 CONTRACT REVIEW Changes Needed Yes ( No Yes Nq) Yes Yes No Date Out ' 1 i 1 , l Z iu i� _ v January 2011 ALLIANCE FOR AGING, INC. STANDARD CONTRACT Contract AA-1129 OLDER AMERICANS ACT PROGRAM TITLE III THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the "AAA," and Monroe County Social Services. hereinafter referred to as the "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 AAA has established through the Area Plan on Aging 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 AAA. NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the mutual covenants and conditions hereinafter set forth, the Parties agree as follows: 1. Purpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, which constitute the contract document. 1.1 Definitions DOEA means the Florida Department of Elder Affairs. AAA means the Alliance for Aging, Inc. PSA means the Planning and Service Area corresponding to Miami -Dade and Monroe Counties. 2. Incorporation of Documents within the Contract The contract will incorporate the provider's application in response to the 2009 OAA RFP, attachments, proposal(s), state plan(s), grant agreements, relevant department handbooks, the Alliance for Aging Policies and Procedures manuals or desk books, as an integral part of the contract, and 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 January I, 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 Miami, Florida, on December 31. 2011. 4. Contract Amount The department agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $420,992.00, 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)(f), F.S., the AAA may renew the contract for a period not to exceed three years. 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 AAA and the availability of funds. 1 /71 January 2011 Contract AA-1129 6. Compliance with Federal Law 6.1. If this contract contains federal funds the following shall apply: 6.1.1 The provider shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 6.1.2 If this contract contains federal funds and is over $100,000.00, the contractor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The contractor shall report any violations of the above to the AAA. 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 II. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Contract Manager, prior to payment under this contract. 6.1.4 That if this contract contains $10,000.00 or more of federal funds, 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 That 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 That a contract award with an amount expected to equal or exceed $25,000,00 and certain other contract awards shall not be made to parties listed on the government -wide Excluded 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 will 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 AAA shall consider the employment of unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324 a) and the Immigration Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation shall be cause for unilateral cancellation of this contract by the AAA. 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 AAA in writing within thirty (30) days of receiving the IRS notice of revocation. 7. Compliance with State Law 7.1 That this contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 7.2 Requirements of s. 287.058, F.S. as amended. 2/71 January 2011 Contract AA-1129 7.2.1 The contractor will 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 will submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre -audit and post -audit. 7.2.3 If itemized payment for travel expenses is permitted in this contract, the contractor will 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 will allow public access to all documents, papers, letters, or other public records as defined in subsection 119.01 l(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 shall constitute an immediate breach of contract for which the AAA may unilaterally terminate the contract. 7.3 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 will 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. 8. Background Screening 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, shall 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 shall apply to employees, subcontractors, consultants, direct service providers and volunteers. Consequently, any commitment for employment, purchase of services, or volunteer program participation shall be contingent upon the passing of a Level II background check. The background screening shall include employment history checks as provided in s. 435.03(1), F.S., and both local and national criminal record checks coordinated ithrough 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, 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 and 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, should provide for notice of the grievance procedure and an opportunity for review of the subcontractor's determination(s). 10. Audits, Inspections, Investigations, Public Records and Retention 10.1 To establish and maintain books, records and documents (including electronic storage media) sufficient to reflect all income and expenditures of funds provided by the AAA under this contract. 3/71 January 2011 Contract AA-1129 10.2 To 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 AAA. 10.3 Upon demand, at no additional cost to the AAA, the contractor will facilitate the duplication and transfer of any records or documents during the required retention period in Paragraph 10.2. 10.4 To assure that the records described in Paragraph 10 shall be subject at all reasonable times to inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the AAA. 10.5 At all reasonable times for as long as records are maintained, persons duly authorized by the AAA, DOEA and Federal auditors, pursuant to 45 CFR 92.36(i)(10), shall 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 To provide a. financial and compliance audit to the AAA as specified in this contract and in ATTACHMENT III and to ensure that all related party transactions are disclosed to the auditor. 10.7 To comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S. 11. Nondiscrimination -Civil Rights Compliance 11.1 The contractor will execute assurances in ATTACHMENT VI that it will not discriminate against any person in the provision of services or benefits under this contract or in employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance with state and federal law and regulations. The 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 The contractor will retain, on file, during the term of this agreement a timely, complete and accurate Civil Rights Compliance Checklist (ATTACHMENT B). 11.3 The contractor agrees to establish procedures pursuant to federal law to handle complaints of discrimination involving services or benefits through this contract. These procedures shall include notifying clients, employees, and participants of the right to file a complaint with the appropriate federal or state entity. 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 AAA 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 will provide services in the manner described in ATTACHMENT I. 4/71 January 2011 Contract AA-1129 13. Monitorina by the AAA The contractor will permit persons duly authorized by the AAA 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 AAA of the satisfactory performance of the terms and conditions of this contract. Following such review, the AAA will deliver to the contractor a written report of its findings and request for development, by the contractor, a corrective action plan where appropriate. The contractor hereby agrees to timely correct all deficiencies identified in the corrective action plan. 14. Coordinated Ntonitorina with Other Aeencies If the contractor receives funding from one or more of the State of Florida other human service agencies, in addition to 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 coordinator, the contractor shall comply and cooperate with all monitors, inspectors, and/or investigators. 15. Indemnification The contractor shall indemnify, save, defend, and hold harmless the AAA and its agents and employees from any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the execution of this agreement or performance of the services provided for herein. It is understood and agreed that the provider is not required to indemnify the AAA for claims, demands, actions or causes of action arising solely out of the AAA's negligence. 15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contracts executed between the DOEA and state agencies or subdivisions defined in s. 768.28(2), F.S. 16. Insurance and Bondine 16.1 To provide continuous adequate liability insurance coverage during the existence of this contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or subdivision as defined by subsection 768.28(2), F.S., the 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 AAA has the most current written verification of insurance coverage throughout the term of this contract. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida. The AAA reserves the fright to require additional insurance as specified in this contract. 16.2 Throughout the term of this agreement, the contractor agrees to 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 Portability and Accountability Act Where applicable, the contractor will 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). 5/71 January 2011 19. Incident Reporting Contract AA-1129 19.1 The contractor shall notify the AAA 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 To immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number (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) Reporting The contractor shall notify the AAA 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 If, at any time during the term of this contract, the contractor, its assignees, subcontractors or affiliates files a claim for bankruptcy, the contractor must immediately notify the AAA Within ten (10) days after notification, the contractor roust also provide the following information to the AAA: (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., Northern District of Florida, Tallahassee Division); and, (4) the name, address, and telephone number of the bankruptcy attorney. 22. Sponsorship 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), The Alliance for Aging, and the State of Florida, Department of Elder Affairs." If the sponsorship reference is in written material, the words "Alliance for Aging" and "State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or type as the name of the organization. 22.2 The contractor shall not use the words "Alliance for Aging" or "The State of Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless, specific authorization has been obtained by the AAA prior to use. 23. Assignments 23.1 The contractor shall not assign the rights and responsibilities under this Contract without the prior written approval of the AAA, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring without prior written approval of the AAA will constitute a material breach of the contract. 23.2 The Alliance shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under this contract to agency, upon giving prior written notice to the contractor. In the event the State of Florida approves transfer of the Alliance's obligations, the contractor remains responsible for all work performed and all expenses incurred in connection with the contract. 6/71 January 2011 Contract AA-1129 23.3 This contract shall remain binding upon the successors in interest of either the contractor or the AAA. 24. Subcontracits 24.1 The contractor is responsible for all work performed and for all commodities produced pursuant to this contract and the service provider application in response to the 2009 OAA RFP, 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 AAA deems necessary. The contractor further agrees that the AAA shall not be liable to the subcontractor in any way or for any reason. The contractor, at its expense, will defend the AAA against any such claims. 24.2 The contractor shall promptly pay any subcontractors upon receipt of payment from the department or other sponsoring 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 Capacity of Contractor It is the intent and understanding of the parties that the contractor, or any of its subcontractors, are independent contractors and are not employees of the AAA and shall not hold themselves out as employees or agents of the AAA without specific authorization from the AAA. It is the further intent and understanding of the parties that the AAA does not control the employment practices of the contractor and shall 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 shall be the sole responsibility of the contractor. 26. Payment Payments will be made to the contractor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the contractor. The AAA's 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 AAA's fiscal 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. 27. Return of Funds The contractor will return to the AAA any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the contractor by the AAA. 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 AAA. In the event that the AAA first discovers an overpayment has been made, the Contract Manager, on behalf of the AAA, will notify the contractor by letter of such findings. Should repayment not be made forthwith, the contractor will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after AAA notification or contractor discovery. 28. Data Integrity and Safeguarding Information The contractor shall insure 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 must be routinely backed up to insure recovery from losses or outages of the computer system. The security over the backed -up data is to be as stringent as the protection required of the primary systems. The contractor shall insure all subcontractors maintain written procedures for computer system back up and recovery. The contractor shall complete and sign ATTACHMENT IV prior to the execution of this contract. 7/71 January 2011 29. Computer Use and Social Media Policy Contract AA-1129 30. Conflict of Interest The contractor will establish safeguards to prohibit employees, board members, management and subcontractors from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain. No employee, officer or agent of the 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 AAA 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., the following restrictions are placed on the ability of persons convicted of public entity crimes to transact business with the AAA. 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. 32. Purchasing 32.1 To procure any recycled products or materials, which are the subject of or are required to carry out this contract, in accordance with the provisions of s. 403.7065, F.S. 33. Patents, Copyrights. Royalties If any discovery, invention or copyrightable material is developed or produced 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 AAA 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) I 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 shall retain an unencumbered right to use such property, notwithstanding any agreement made pursuant to Paragraph 33. 34. Emergeney Preparedness and Continuity 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 8/71 January 2011 Contract AA-1129 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 AAA of emergency provisions. 34.2 In the event., a situation results in a cessation of services by a subcontractor, the contractor will 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. 36. Use of State Funds to Purchase or Improve Real Property Any state funds provided for the purchase of or improvements to real property are contingent upon the contractor or political subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by law. 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 Consequences 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 AAA 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 shall not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the AAA. 39. No Waiver of Sovereign Immunity Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which sovereign immunity may be applicable. 40. Venue If any dispute arises out of this contract, the venue of such legal recourse will be Miami -Dade County, Florida. 41. Entire Contract This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or representations shall be valid or binding upon the AAA or the contractor unless expressly contained herein or by a written amendment to this contract signed by both parties. 42. Force Maieure Neither party shall be liable for any delays or failures in performance due to circumstances beyond its control, provided the party experiencing the force majeure condition provides immediate written notification to the other party and takes all reasonable efforts to cure the condition. 43. Severability Clause 9/71 January 2011 Contract AA-1129 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: Appropriations The parties agree that the AAA's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature to DOEA. 45. Addition/Deletion The parties agree that the AAA reserves the right to add or to delete any of the services required under this contract when deemed to be in the PSA'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 AAA to exercise or enforce any of its rights under this contract shall not constitute or be deemed a waiver of the AAA's right thereafter to enforce those rights, nor shall any single or partial exercise of any such right preclude any other or further exercise thereof or the exercise of any other right. 47. Compliance The contractor agrees to 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 AAA. 48. Final Invoice The contractor shall submit the final invoice for payment to the AAA as specified in Paragraph 3.3.4. (date for final request for payment) of ATTACHMENT I. If the contractor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the AAA may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from the contractor and necessary adjustments thereto have been approved by the AAA. 49. Reneeotiations 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 AAA'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. 50.2 In the event funds for payment pursuant to this contract become unavailable, the AAA 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 AAA shall 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 AAA may employ the default provisions in Rule 60A-1.006(3), F.A.C. Waiver of 10/71 January 2011 Contract AA-1129 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 AAA's or the contractor's rights to remedies at law or in equity. 50.4 Failure to have performed any contractual obligations with the AAA in a manner satisfactory to the AAA will be a sufficient cause for termination. To be terminated as a contractor under this provision, the contractor must have ( I ) previously failed to satisfactorily perform in a contract with the AAA, been notified by the AAA of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction of the AAA; or (2) had a contract terminated by the AAA for cause. 51. Official Payee and Representatives (Names, Addresses, and Telephone Numbers): The contractor name, as shown on page I of this Monroe County Board of County Commissioners Nutrition a. contract, and mailing address of the official payee to and In -Home Services Programs whom the payment shall be made is: 1 100 Simonton Street Rm 2-257 Key West, FL 33040 The name of the contact person and street address Sheryl Graham, Director, Monroe County Social Services b. where financial and administrative records are 1 100 Simonton Street, Rm. 2-257 maintained is: Key West, FL 33040 305-292-4510 C. The name, address, and telephone number of the Sheryl Graham, Director, Monroe County Social Services representative of the contractor responsible for 1100 Simonton Street, Rm. 2-257 administration of the program under this contract is: Key West, FL 33040 305-292-4510 d. The section and location within the AAA where Anthony Coombs, Associate Vice President Requests for Payment and Receipt and Expenditure 760 NW 107th Avenue, Suite 201 and 214 forms are to be mailed is: Miami, Florida 33172 e. The name, address, and telephone number of the AAA Contract Manager (MARIA SCOTTO) Contract Manager for the AAA for this contract is: 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. 11/71 January 2011 Contract AA-1 129 52. All Terms and Conditions Included This contract and its Attachments, I — X, A, B, D, E and F, 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. 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 63 page contract, to be executed by their undersigned officials as duly authorized. Contractor Monroe County Social Services. SIGNED BY: NAME: Heather Carruthers TITLE: Mayor DATE: 12-15-2010 ALLIANCE FOR AGING, INC. SIGNED BY: NAME: MAX B. ROTHMAN TITLE: PRESIDENT AND CEO DATE: TY ATTORNEY 12/71 January 2011 ATTACHMENT ATTACHMENT I ATTACHMENT II ATTACHMENT III ATTACHMENT III EXHIBIT 1 ATTACHMENT III EXHIBIT 2 ATTACHMENT IV ATTACHMENT V GYIil110t41HuWel011 ATTACHMENT VII ATTACHMENT VIII ATTACHMENT IX ATTACHMENT X, EXHIBIT 2 ATTACHMENT X, EXHIBIT 3 ATTACHMENT A ATTACHMENT B ATTACHMENT F, EXHIBIT I ATTACHMENT F, EXHIBIT 2 ATTACHMENT G INDEX TO CONTRACT ATTACHMENTS ATTACHMENT DESCRIPTION STATEMENT OF WORK CERTIFICATION REGARDING LOBBYING Contract AA-1129 PAGE 15-27 29 FINANCIAL COMPLIANCE AUDIT ATTACHMENT FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT AUDIT REPLATIONSHIP DETERMINATION CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS ASSURANCES - NON -CONSTRUCTION PROGRAMS CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE OLDER AMERICANS ACT CONTRACT REPORT CALENDAR REQUEST FOR PAYMENT RECEIPTS AND EXPENDITURES, TITLE IIIB, IIIC 1, AND IIIC2 RECEIPTS AND EXPENDITURES, TITLE IIIE DEPARTMENT OF ELDER AFFAIRS' PROGRAMS & SERVICES HANDBOOK (ON CD) DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE CHECKLIST AND INSTRUCTIONS DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY II INSTRUCTIONS: DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY II ARC POLICY AND PROCEDURES FOR OUTSOURCED FUNCTIONS 31-33 35 37 39 41 43-44 45 47 49 51 53 55 57-62 63 65 67-71 13/71 January 2011 Contract AA-1129 14/71 January 2011 ALLIANCE FOR AGING, INC. STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS ADL — Activities of Daily Living APS — Adult Protective Services AIRS — Alliance of Information & Referral Systems ADA — Americans with Disabilities Act AAA — Area Agency on Aging APCL — Assessed Priority Consumer List CIRTS — Client Information and Registration Tracking System FLAIRS -- Florida Alliance of Information and Referral Services I&R — Information and Referral IADL — Instrumental Activities of Daily Living MOA — Memorandum of Agreement MOU — Memorandum of Understanding OAA — Older Americans Act PSAs — Planning and Service Areas WebDB — Web -based Database System Contract AA-1129 ATTACHMENT I 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 Older Americans Act and department instructions. Area Plan Update: A revision to the area plan wherein the area agency on aging enters OAA specific data in the web -based database system (WebDB). An update may also include other revisions to the area plan as instructed by the department. Child: Art individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual, who is an informal provider of in -home and community care to an older individual. Frail: When an older individual is unable to perform at least two activities of daily living (ADL) without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. Grandparent: A grandparent or step -grandparent of a child, or a relative of a child by blood, marriage or adoption and who lives with the child; is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling to serve as the primary caregiver of the child; and has a legal relationship to the child, such as legal custody or guardianship, or is raising the child informally. 15/71 January 2011 Contract AA-1129 1.2 Alliance for Aging Mission The Alliance For Aging Inc. mission id to promote and advocate for the optimal quality of life for older adults and their families. 1.2.1 DOEA Mission Statement The department's mission is to foster an optimal quality of life for elder Floridians. The department's vision and shared values are to foster a social, economic and intellectual environment for all ages, and especially those age 60 and older, where all can enjoy Florida's unparalleled amenities in order to thrive and prosper. Area agencies, lead agencies and local service providers as partners and stakeholders in Florida's aging services network are expected to support the department's mission, vision, and program priorities. 1.2.2 Older Americans Act Program Mission Statement The Older Americans Act (OAA) Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 1.3 GENERAL DESCRIPTION 1.3.1 General Statement The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self -care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: (1) Older Americans Act of 2006, as amended; (2) Rule 58A-1, Florida Administrative Code; and (3) Sectiean 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and 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 activities listed in this Appendix, Sections I and II and Appendix G, and shall be delivered in keeping with the in Provider Service Application in response to the 2009 OAA RFP. The services shall be provided in a manner consistent with and described in the current Department of Elder Affairs Programs and Services Handbook (ATTACHMENT A). 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. l 6/71 January 2011 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility (Title III Programs) Contract AA- 1129 1.4.1.1 OAA Title III, General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitated long-term care program. 1.4.1.2 OAA Title IIIB, Supportive Services (1) Individuals age 60 or older; and (2) Information and Referral/Assistance services are provided to individuals regardless of age. 1.4.1.3 OAA Titles IIIC1 and C2, Nutrition Services, General General factors that should be considered in establishing priority for Nutrition Services, both Cl and C2, include those older persons who: (1) Cannot afford to eat adequately; (2) Lack the skills or knowledge to select and prepare nourishing and well-balanced meals; (3) Have limited mobility which may impair their capacity to shop and cook for themselves; or (4) Have a disabling illness or physical condition requiring nutritional support or have been screened at a high nutritional risk. 1.4.1.3.1 OAA Title IIIC1, Congregate Nutrition Services In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I, Paragraph 1.4.1.3 individuals must be mobile, not homebound and physically, mentally and medically able to attend a congregate nutrition program. Individuals eligible to receive congregate meals include: (1) Individuals age 60 or older; and (2) Any spouse (regardless of age) who attends the dining center with his/her eligible spouse; (3) Persons with a disability, regardless of age, who reside in a housing facility occupied primarily by older individuals where congregate nutrition services are provided; (4) Disabled persons who reside at home with and accompany an eligible person to the dining center; and (5) Volunteers, regardless of age, who provide essential services on a regular basis during meal hours. 1.4.1.3.2 OAA Title HIC2, Home Delivered Nutrition Services In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I, Paragraph 1.4.1.3, individuals must be homebound and physically, mentally or medically unable to attend a congregate nutrition program. Individuals eligible to receive home delivered meals include: (1) Individuals age 60 or older who are homebound by reason of illness, disability or isolation; (2) The 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 disabilities, regardless of age, who reside at home with eligible individuals and are dependent on them for care; and (4) Persons at nutritional risk who have physical, emotional or behavioral conditions, which would make their presence at the congregate site inappropriate; and persons at nutritional risk who are socially or otherwise isolated and unable to attend a congregate nutrition site. 1.4.1.4 OAA Title! IIIE, Caregiver Support Services l 7/71 January 2011 (1) Family caregivers of individuals age 60 or older; Contract AA-1129 (2) Grandparents (age 55 or older) or older individuals (age 55 or older) who are relative caregivers; (3) Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and (4) For respite and supplemental services, a family caregiver must be providing care for an older individual who meets the definition of the term "frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need, with particular attention to low- income older individuals, including those that are low-income minorities, have limited English proficiency, and older individuals residing in rural areas. SECTION II — MANNER OF SERVICE PROVISION 2.1 SERVICE; TASKS In order to achieve the goals of the OAA program, the contractor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Targeting and screening of service delivery for new clients; (3) Delivery of services to eligible clients; (4) Use of volunteers to expand the provision of available services; (5) Monitoring the performance of its subcontractors; and (6) Information and Referral/Assistance Access Services (Elder Helplines). 2.1.1 Client Eligibility Determination as listed in ATTACHMENT I, Paragraph 1.4. 2.1.2 Targeting and Screening of Service Delivery for New Clients The contractor shall develop and implement policies and procedures consistent with OAA targeting and screening criteria. 2.1.3 Delivery of Services to Eligible Clients The contractor shall provide a continuum of services that meets the diverse needs of elders and their caregivers. The contractor shall perform and report performance of the following services in accordance with ATTACHMENT A. The services funded pursuant to this contract are in accordance with the OAA, Title III, sections 321, 331, 336, and 373 as follows: (1) Section 321, Title IIIB Supportive Services; (2) Section 331, Title IIIC1 Congregate Nutrition Services; (3) Section 336, Title IIIC2 Home Delivered Nutrition Services; 14) Section 373, Title IIIE Caregiver Support Services; and (5) Sections 321 and 373 — Information and Referral/Assistance Access Services (Elder Helplines) 18/71 January 2011 Contract AA-1129 2.1.3.1 Supportive Services Supportive, services include a variety of community -based and home -delivered services that support the quality of life for older individuals by helping them remain independent and productive. Services include the following: (1) Adult Day Care/Adult Day Health Care; (8) Legal Assistance; (2) Caregiver Training/Support; (9) Material Aid; (3) Case Aid/Case Management; (10) Occupational Therapy; (4) Chore Services; (11) Outreach; (5) Companionship; (12) Personal Care; (6) Counseling (Gerontological and Mental (13) Physical Therapy; Health); (7) Education/Training; (14) Recreation; (15) Emergency Alert Response; (24) Referral/Assistance; (16) Escort; (25) Respite Services; (17) Health Support; (26) Screening/Assessment; (18) Home Health Aid; (27) Shopping Assistance; (19) Homemaker; (28) Skilled Nursing; (20) Housing Improvement; (29) Specialized Medical Equipment, Services, and (21) Information; Supplies (22) Intake; (30) Speech Therapy; (23) Interpreter/Translating; (31) Telephone Reassurance; and (32) Transportation 2.1.3.2 Congregate Nutrition Services Nutrition services are provided in congregate settings and are designed to reduce hunger and food insecurity, promote socialization and the health and well being of older individuals by assisting them to gain access to nutrition and other disease prevention and health promotion services. Services include: (1) Congregate meals; (2) Congregate meals screening; (3) Nutrition education and nutrition counseling; and (4) Outreach. 2.1.3.3 Home Delivered Nutrition Services In -home nutrition services are provided to reduce hunger and food insecurity; promote socialization and the health and well being of older individuals by assisting such individuals to gain access to nutrition and other disease prevention and health promotion services. Services include: (1) Home delivered meals; (2) Nutrition education and counseling; and (3) Outreach. 2.1.3.4 Caregiver Support Services (IIIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and 19/71 January 2011 Contract AA-1129 responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling (Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction (Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Referral/Assistance; (10) Respite Services; (11) Screening/Assessment; and (12) Transportation. 2.1.3.5 Caregiver Support Supplemental Services (HIES Program): At least 10 percent, but no more than 20 percent, of the total Title IIIE funds shall be used to provide supplemental support services. The following services are provided to complement the care provided by caregivers. (1) Chore! Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.1.3.6 Caregiver Support Grandparent Services (IIIEG Program): At least 5 percent, but no more than 10 percent, of the total Title IIIE funds shall be used to provide support services to grandparents and older individuals who are relative caregivers. Services for grandparents or older individuals who are relative caregivers designed to help meet their caregiving obligations include: (1) Caregiver Training/Support; (7) Outreach; (2) Child Day Care; (8) Referral/Assistance; (3) Counseling (Gerontological and Mental (9) Screen ing/Assessment; Health); (10) Sitter; and (4) Education/Training; (11) Transportation (5) Information; (6) Legal Assistance; 2.1.4 Use of Volunteers to Expand the Provision of Available Services The contractor shall make use of trained volunteers in providing direct services delivered to older individuals and individuals with disabilities needing such services. If possible, the contractor shall work in coordination with organizations that have experience in providing training, placement, and stipends for volunteers or participants (such as organizations carrying out Federal service programs administered by the Corporation for National and Community Service), in community service settings. 20/71 January 2011 Contract AA-1129 2.1.5 Monitoring the Performance of Subcontractors The contractor shall conduct at least one monitoring per year of each subcontractor. The contractor shall perform fiscal, administrative and programmatic monitoring of each subcontractors to ensure contractual compliance, fiscal accountability, programmatic performance, and compliance with applicable state and federal laws and regulations. 2.1.5.1 Use of Subcontractors If this contract involves the use of a subcontractor or third party, then the contractor shall not delay the implementation of its agreement with the subcontractor. If any 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 AAA's Contract Manager and the AAA's Chief Financial Officer in writing of such delay. The contractor shall not permit a subcontractor to perform services related to this agreement without having a binding subcontractor agreement executed. In accordance with Paragraph 24.1 of the Standard Agreement, the AAA will not be responsible or liable for any obligations or claims resulting from such action. 2.2 SERVICE. LOCATION AND EQUIPMENT 2.2.1 Service Times The contractor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its subcontractors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 Equipment 2.3.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable, tangible personal property of a nonconsumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at least one year; and hardback bound books not circulated to students or the general public, with a value or cost of $250.00 or more [for state funds]. 2.3.2 Contractors and sub -contractors 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 -I 10) 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. The property records must be maintained on file and shall be provided to the AAA upon request. 2.3.3 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 21/71 January 2011 Contract AA-1129 (not applicable to equipment furnished by the Federal Government); (7) 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. 2.3.4 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 DOEA 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-1 10), 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 sub -contractors (not included in a cost methodology), is subject to the conditions of Chapter 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 AAA, or purchased with funds provided through this contract without first obtaining the approval of the AAA's Contract Manager. When disposing of property or equipment the contractor must submit a written request for disposition instructions to the respective Contract Manager. The request should include a brief description of the property, purchase price, funding source, percentage of state or federal participation, acquisition date and condition of the property. The request should also indicate the contractor's proposed disposition (i.e., transfer or donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc.). 2.3.6 The AAA's 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 -I 10). 2.3.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but excludes movable machinery and equipment. Real property may not be purchased with state or federal funds through agreements covered under this contract without the prior approval of the DOEA. 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 a fixed capital outlay grants and aids appropriation and therefore are subject to the provisions of s. 216.348, F. S. 2.3.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior to disposal to ensure no confidential information remains. 22/71 January 2011 2.4 2.4.1 2.5 2.5.1 DELIVERABLES Contract AA-1129 Service Unit The contractor shall provide the services described in the contract in accordance with ATTACHMENT A. The chart below lists the services that can be performed and the unit of measurement. Adult Day Care/Adult Day Health Care Caregiver Training/Support Case Aid/Case Management Child Day Care Chore Services Companionship Congregate Meals Screening Counseling Services Escort Financial Risk Reduction Services Health Support Home Health Aide Homemaker Housing Improvement Intake Emergency Alert Response Interpreter/Translating Legal Assistance Medication Management Mental Health Counseling/Screening Nutrition Counseling Occupational Therapy Personal Care Physical Therapy Recreation Respite Services Screening/Assessment Sitter Skilled Nursing Services Speech Therapy Education/Training Information Material Aid Nutrition Education Outreach Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort Shopping Assistance Transportation Congregate and Home Delivered Meals Hour Day Episode One -Way Trip Meal REPORTS The contractor is responsible for responding in a timely fashion to additional routine and/or special requests for information and reports required by the AAA. Service Costs Reports The contractors shall submit to the AAA serni-annual service cost reports, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 23/71 January 2011 Contract AA-1129 2.5.2 Surplus/Deficit Report The contractor will submit a consolidated surplus/deficit report in a format provided by the AAA to the AAA's Contract Manager by the 15th of each month. This report is for all agreements and/or contracts between the contractor and the AAA. The report shall include the following: (1) A list of all subcontractors and their current status regarding surplus/deficit; (2) The contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by the AAA 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. (7) Number of contacts including walk-ins, calls, emails or faxes as related to outsourced ARC functions. 2.5.3 DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess of Category II In compliance with State of Florida Chief Financial Officer Memorandum No. 03 (released June 29, 2010), the contractor will submit a completed DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess of Category I1' identified as Attachment F, Exhibit 1 within 30 days of contract execution. Instructions for completing the form are identified as Attachment F, Exhibit 2. 2.6 RECORDS AND DOCUMENTATION The contractor will ensure the accurate collection and maintenance of client and service information on a monthly basis from the CIRTS or any such system designated by the AAA. Maintenance includes valid exports and backups of all data and systems according to AAA standards. 2.6.1 Each contractor and subcontractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The contractor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with subcontractors. These policies and procedures shall be made available to the AAA upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The contractor shall timely submit to the AAA all reports described in ATTACHMENT I, Paragraph 2.5 REPORTS; (2) The contractor shall timely submit to the AAA all information described in ATTACHMENT I, Paragraph 2.6 RECORDS AND DOCUMENTATION; (3) The contractor shall ensure services in this contract are in accordance with ATTACHMENT A. 2.7.2 The performance of the contractor in providing the services described in this contract shall be measured by the current Area Plan strategies for the following criteria: (1) Percent of most frail elders who remain at home or in the community instead of going into a nursing home; (2) Percent of Adult Protective Services (APS) referrals who are in need of immediate services to prevent further harm who are served within 72 hours; 24/71 January 2011 Contract AA- 1129 (3) Avenge monthly savings per consumer for home and community -based care versus nursing home care for comparable client groups; (4) Percent of elders assessed with high or moderate risk environments who improved their environment score; (5) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved; (6) Percent of new service recipients whose ADL assessment score has been maintained or improved; (7) Percent of new service recipients whose IADL assessment score has been maintained or improved; (8) Percent of family and family -assisted caregivers who self -report they are very likely to provide care; (9) Percent of caregivers whose ability to continue to provide care is maintained or improved after one year of service intervention (as determined by the caregiver and the assessor); and (10) Percent of customers who are at imminent risk of nursing home placement who are served with community based services. (11) Any other outcome measures as listed in the Provider's Service Application in response to the 2009 OAA RFP. 2.7.3 Monitoring and Evaluation Methodology The AAA 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, and/or an on -site visit. The AAA's determination of acceptable performance shall be conclusive. The contractor agrees to cooperate with the AAA in monitoring the progress of completion of the service tasks and deliverables. 2.7.4 Remedies -Nonconforming Services The contractor shall ensure that all participants served under this agreement are eligible for the program, and that all monthly and/or quarterly performance reports and financial records are maintained for each reporting period and submitted as stipulated in Paragraphs 1.4 - 1.4.2 and 2.1 - 2.1.6. Any nonconforming program services, performance reports or financial records not meeting the aforementioned requirements shall not be eligible for reimbursement under this program. The costs associated with enrolling, training, reporting and/or managing the program shall be borne solely by the contractor. The AAA requires immediate notice of any significant and/or systemic infractions that compromise the contractor's ability to provide participant services, to achieve programmatic performance or to provide sound financial management of the program. 2.8 CONTRACTOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,, Level of Effort, and Earmarking Requirements The contractor will fulfill a match requirement of at least 10 percent of the cost for all services funded through this contract (i.e. 90 cents of grant funds must be matched with 10 cents from the contractor.) The subcontractor's match will be made in the form of cash and/or in -kind resources. Match must be reported by title each month. At the end of the contract period, all OAA funds must be properly matched. 2.8.2 Consumer Contributions (1) The contractor assures compliance with Section 315 of the Older Americans Act as amended in 2006, in regard to consumer contributions; (2) Voluntary contributions are not to be used for cost sharing or matching; (3) Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; and (4) Voluntary contributions are to be used only to expand services. 2.8.3 Use of Service Dollars The contractor is expected to spend all federal, state and other funds provided by the AAA for the purpose specified 25/71 January 2011 Contract AA-1129 in the contract. The contractor must manage the service dollars in such a manner so as to avoid having a wait list and a surplus of funds at the end of the contract period, for each program managed by the contractor. If the AAA determines that the contractor is not spending service funds accordingly, the AAA may transfer funds to other providers during the contract period and/or adjust subsequent funding allocations accordingly, as allowable under state and federal law. 2.8.4 Title III Funds The contractor assures compliance with Section 306 of the Older Americans Act, as amended in 2006, that funds received under Title III will not be used to pay any part of a cost (including an administrative cost) incurred by the contractor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.9 AAA RESPONSIBILITIES 2.9.1 Program Guidance and Technical Assistance The AAA will provide to the contractor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the contractor. 2.9.2 Contract Monitoring The AAA shall, at its own discretion, conduct monitoring concerning any aspect of the contractor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this contract includes advances, cost reimbursement for administration costs, and fixed rate for services. The contractor shall ensure fixed rates for services include only those costs that are in accordance with all applicable state and federal statutes and regulations and are based on audited historical costs in instances where an independent audit is required. The contractor shall consolidate all requests for payment from subcontractors and expenditure reports that support requests for payment and shall submit to the AAA on forms 106A (ATTACHMENT IX), 105AA (ATTACHMENT X-EXHIBIT 1), 105AS (ATTACHMENT X-EXHIBIT 2), and 105AE (ATTACHMENT X-EXHIBIT 3). 3.1.1 The contractor agrees to implement the distribution of funds as detailed in ATTACHMENT VII, Budget Summary„ An amendment is required to change any amount, unit cost, or number of units by service. 3.2 Advance Payments 3.2.1 The contractor may request up to two months of advances at the start of the contract period, if available, to cover program administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount of funds released to the AAA by the State of Florida ("budget release"). The contractor shall provide the AAA's Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. 3.2.2 The contractor's requests for advance require the approval of the AAA's Contract Manager. If sufficient budget is available, the AAA will issue approved advance payments after January 1, 2011. 3.2.3 Requests for the first through the twelfth months shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests, if available is shown on ATTACHMENT VIII of this contract. 26/71 January 2011 Contract AA-1129 3.2.4 All advanced payments made to the contractor shall be recouped in accordance with the Reporting Schedule, ATTACHMENT VIII of this contract. 3.2.5 Interest earned on advances must be identified separately by source of funds, state or federal. Contractors shall maintain advances of federal funds in interest bearing accounts unless otherwise excepted in accordance with 45 CFR 74.22(k). Earned interest must be returned to the AAA at the end of each quarter. 3.3 Invoice Submittal and Requests for Payment All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA forms 106A (ATTACHMENT IX) , 105AA (ATTACHMENT X-EXHIBIT 1), 105AS (ATTACHMENT X- EXHIBIT 2), and 105AE (ATTACHMENT X-EXHIBIT 3). 3.3.1 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests (when available) and invoices is ATTACHMENT VIII to this contract. 3.3.2 Any payment due by the AAA under the terms of this contract may be withheld pending the receipt and approval of all financial and programmatic reports due from the contractor and any adjustments thereto, including any disallowance not resolved as outlined in Paragraph 26 of this contract. 3.3.3 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in ATTACHMENT VII, Budget Summary. Any changes in the amounts of federal or general revenue funds identified on the Budget Summary form require a contract amendment. 3.3.3.1 Monthly review of the Receipt and Expenditure Report and the Request for Payment Form by the Alliance will focus on: a. Line item comparison of year-to-date expenditures with the budget to monitor rate of expenditures. b. Allowable total reimbursement, on a service by service level, does not exceed budgeted/contractual amount. (No unilateral modified spending authority.) C. Validation of service units reported against CIRTS. d. Validation of service units reported against the Area Plan on Aging, fiscal module contract data housed in WebDB. 3.3.4 Date for Final Request for Payment The final request for payment will be due to the AAA no later than March 1, 2012. 3.4 Documentation for Payment The contractor shall maintain documentation to support payment requests that shall be available to the AAA or authorized individuals, such as Department of Financial Services, upon request. 3.4.1 The contractor must enter all required data per the department's CIRTS Policy Guidelines for clients and services in the CIRTS database. Data must be entered into CIRTS before the contractors submit their request for payment and expenditure reports. 3.4.2 The contractor run monthly CIRTS reports and verify that client and service data in CIRTS is accurate. This report must be submitted to the AAA with the monthly request for payment and expenditure report and must be reviewed by the AAA before the contractor's request can be approved by the AAA. 27/71 January 2011 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: Contract AA-1129 ATTACHMENT II (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 sub -contractors 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 $10,000.00 and not more than $100,000.00 for each such failure. Signature Date Name of Authorized Individual Application or Agreement Number Name and Address of Organization DOEA Form 103 (Revised Nov 2002) 29/71 January 2011 FINANCIAL AND COMPLIANCE AUDIT Contract AA-1129 ATTACHMENT III The administration of resources awarded by the Department of Elder Affairs or the Alliance for Aging to the provider may be subject to audits and/or monitoring by the Department of Elder Affairs or the Alliance for Aging, 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 department 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 the Department of Elder Affairs or the Alliance for Aging. In the event the Department of Elder Affairs or the Alliance for Aging determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Department of Elder Affairs or the Alliance for Aging to the provider regarding such audit. The provider further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial Officer (CFO) or Auditor General. AUDITS PART I: FEDERALLY FUNDED This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. In the event that the provider expends $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 l to this agreement indicates Federal resources awarded through the Department of Elder Affairs or the Alliance for Aging by this agreement. In determining the Federal awards expended in its fiscal year, the provider shall consider all sources of Federal awards, including Federal resources received from the Department of Elder Affairs or the Alliance for Aging. 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 Department of Elder Affairs or the Alliance for Aging shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Department of Elder Affairs or the Alliance for Aging shall be fully disclosed in the audit report with reference to the Department of Elder Affairs or the Alliance for Aging agreement involved. If not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A-133, as revised, the schedule of expenditures of Federal awards shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs or the Alliance for Aging 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. 31/71 January 2011 Contract AA-1129 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 project -specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for- profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded through the Department of Elder Affairs or the Alliance for Aging 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 Department of Elder Affairs or the Alliance for Aging, 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 Department of Elder Affairs or the Alliance for Aging shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Department of Elder Affairs or the Alliance for Aging shall be fully disclosed in the audit report with reference to the Department of Elder Affairs or the Alliance for Aging agreement involved. If not otherwise disclosed as required by Rule 69I-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs or the Alliance for Aging 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 acre required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the provider's fiscal year end. Notwithstanding the applicability of this portion, the Department of Elder Affairs or the Alliance for Aging retains all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the provider directly to each of the following: The Alliance for Aging, Inc.: Alliance for Aging, Inc. Attn: Horacio Soberon 760 NW 1071' Ave. Miami, FL 33172 32/71 January 2011 Contract AA-1129 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 101h Street Jeffersonville, IN 47132 Other Federal agencies and pass -through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. Pursuant to Sections .320(f), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the Department of Elder Affairs at each of the following addresses: Department of Elder Affairs Attn: Beverly Friedberg 4040 Esplanade Way Office 325B Tallahassee, FL 32399-7000 Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on behalf of the provider directly to each of the following: The Alliance for Aging, Inc. at each of the following addresses: Alliance for Aging, Inc. Attn: Horacio Soberon 760 NW 1071h Ave. Miami, FL 33172 The Department of Elder Affairs at each of the following addresses Department of Elder Affairs Attn: Beverly Friedberg 4040 Esplanade Way Office 325B Tallahassee, FL 32399-7000 The Auditor General's Office at the following address: State of Florida Auditor General Claude Pepper Building, Room 574 111 West Madison Street Tallahassee, Florida 32399-1450 Any reports, management letter, or other information required to be submitted to the Department of Elder Affairs pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-133, Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General, as applicable. Providers, when submitting financial reporting packages to the Department of Elder Affairs 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. 33/71 January 2011 PART IV: RECORD RETENTION Contract AA-1129 The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued, and shall allow the Department of Elder Affairs or its designee, the CFO or Auditor General access to such records upon request. The provider shall ensure that audit working papers are made available to the Department of Elder Affairs, 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 the Department of Elder Affairs. 34/71 January 2011 Contract AA-1129 ATTACHMENT III EXHIBIT 1 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT Older Americans Act Administration U.S. Health and Human Services 93.044 $0.00 Title IIIB — Support Services Older Americans Act Administration U.S. Health and Human Services 93.045 $142,6(X).00 Title IIIC I — Congregate Meals Older Americans Act Administration U.S. Health and Human Services 93.045 $210,832.00 Title III C2 — Home Delivered Meals Older Americans Act Administration U.S. Health and Human Services 93.052 $67,560.00 Title III E — Caregiver Support Services TOTAL FEDERAL AWARD $420,992.00 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 35/71 January 2011 PART I: AUDIT RELATIONSHIP DETERMINATION Contract AA-1129 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 I 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 department 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 -I 10 — 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 titscal 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 I. 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, rues 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 37/71 January 2011 Contract AA-1129 ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE 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 sub -contractors 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, sub-contractor(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 sub-contractor(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 sub -contractors 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 -I 10). Name and Address of Contractor Signature Title Date Name of Authorized Signer (Revised June'008) 39/71 January 2011 Contract AA-1129 40/71 January 2011 Contract AA-1129 ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective contractor certifies, by signing this certification, neither it nor its principals are 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 prospective contractor is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this certification. Signature Date Title Agency/Organization (Certification signature should be same as Contract signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered 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 department 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 department 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. i Revised June 2W 41/71 January 2011 ASSURANCES —NON -CONSTRUCTION PROGRAMS Contract AA-1129 ATTACHMENT VI Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLEThO rOKM I 1 tih uUM-h yr MAINAv,ENMiN i Ai'Nu nuo"r, I, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, ;you will be notified. 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non -Federal share of project cost) to ensure proper planning, management, and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C.,4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C.. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C., 794), which prohibits discrimination on the basis of handicaps: (d) the Age Discrimination Act of 1975, as amended (42 U.S.C.. 6101-6107), which prohibits discrimination on the basis of age: (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse, (t) 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 (j) 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. 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. 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.'_76c 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. 43/71 January 2011 Contract AA-1129 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or more. 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) 1 1514, (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in tloodplains 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- I et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C..2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C.,4801 et seq.), which prohibits the use of lead- based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, Audits of States, Local Governments, and Non -Profit Organizations. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL I TITLE APPLICANT ORGANIZATION I DATE SUBMITTED 44/71 January 2011 Contract AA-1129 ATTACHMENT VII BUDGET SUMMARY WEBDB SUMMARY FOR THE AGENCY Service(s) to be Provided Service Unit Rate Maximum Units of Service Maximum Dollars Congregate Meals C 1 $9.56 $134,816 Congregate Screening C 1 $20.00 $5,241 Nutrition Counseling Cl $47.50 $1,906 Nutrition Education C 1 $63.58 $637 Home Delivered Meals C2 $6.13 $204,629 Screening & Assessment C2 $25.00 $5,841 Nutrition Education C2 $63.67 $362 In Home Respite 3E $23.08 $19,230 Facility Respite 3E $10.34 $48,330 Total Contract $420,992 45/71 January 2011 Contract AA-1129 ATTACHMENT VIII CONTRACT REPORT CALENDAR ADVANCE BASIS CONTRACT Report Number Based On Submit to AAA On This Date 1 January Advance* January 1 2 February Advance* January 1 3 January Expenditure Report February 5 4 February Expenditure Report March 5 5 March Expenditure Report April 5 6 April Expenditure Report May 5 7 May Expenditure Report June 5 8 June Expenditure Report July 5 9** July Expenditure Report** August 5 10** August Expenditure Report** September 5 11 September Expenditure Report October 5 12 October Expenditure Report November 5 13 November Expenditure Report December 5 14 December Expenditure Report January 5 15 Final Expenditure and Request for Payment February 14 16 Close Out Report February 28 Legend: * Advance based on projected cash need. * 1` Recoupment of advance due with this report. Note # 1: Report #1 for Advance Basis Agreements cannot be submitted to the Department of Financial Services (DFS) prior to January 1 or until the agreement with the Department has been executed and a copy sent to DFS. Actual submission of the vouchers to DFS is dependent on the accuracy of the expenditure report. Note # 2: Pill advance payments made to the contractor shall be returned to the Department by the submission date of report #9. The adjustment shall be recorded in Part C, 1 of the report (.ATTACHMENT IX). Note #3: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Department, payment is to accompany the report. 47/71 January 2011 Contract AA-1129 ATTACHNIENT IX REQUEST FOR PAYMENT OLDER AMERICANS ACT PROVIDER NAME, ADDRESS, PHONE AND FED ID NUMBER TYPE OF REPORT: THIS REQUEST PERIOD: Advance Report # Reimbursement Agreement # Agreement Period: PSA: CERTIFICATION: I hereby certify to the best of my knowledge that this request conforms with the terms and the purposes set forth in the above agreement. Prepared By: Date: Approved By: Date: PART A: (1) (2) (3) (4) (7) (6) BUDGET SUMMARY ADMIN. III B IIICt IIIC2 Title IIIE TOTAL I. Approved Agreement Amount. 0.00 0.00 0.00 0.00 0.00 0.00 2. Previous Funds RECEIVED for Agreement period. 0.00 0.00 0.00 0.00 0.00 0.00 3. Agreement Balance 0.00 0.00 0.00 0.00 0.00 0.00 4. Previous Funds REQUESTED and Not Received. 0.00 0.00 0.00 0.00 0.00 0.00 5. Agreement Balance 0.00 0.00 0.00 0.00 0.00 0.00 PART B: FUNDS REQUESTED 1. 1st-2nd Months Request Only 0.00 0.00 0.00 0.00 0.00 0.00 2. Net Expenditures For Month 0.00 0.00 0.00 0.00 0.00 0.00 3. Additional Cash Needs (Attach Doc.) 0.00 0.00 0.00 0.00 0.00 0.00 4. Total 0.00 0.00 0.00 0.00 0.00 0.00 PART C: NET FUNDS REQUESTED: 1. Less: Over -Advance 0.00 0.00 0.00 0.00 0.00 0.00 2. Agreement Funds are Hereby Requested For 0.00 0.00 0.00 0.00 0.00 0.00 DOER FORM 106A revised 5/10 49/71 January 2011 Contract AA- 1129 ATTACHMENT X EXHIBIT-2 RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source : THIS REPORT PERIOD FROM: TO: IIIB IIIC1 CONTRACT IIIC2 PERIOD: CONTRACT # REPORT # PSA# CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : Approved by : Date PARTA : BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0.00 $0.00 2. State Funds $0.00 $0.00 $0.00 /e 3. Program Income $0.00 $0.00 $0.00 i 4. Local Cash Match (CCE, HCE and Other) $0.00 $0.00 $0.00 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 !, 6. Local In -Kind Match $0.00 $0.00 $0.00 % 7, TOTAL RECEIPTS $0.00 $0.00 $0.00 PART B : EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget 1. Meals / Meal Agreements $0.00 $0.00 $0.00 2. Service Subcontractor $0.00 $0,00 $0.00 i, 3. Other $0.00 $0.00 $0.00 % 4.. Indirect Cost $0.00 $0.00 $0.00 5. TOTAL EXPENDITURES $0.00 $0.00 $0.00 PART C : OTHER EXPENDITURES (For Tracking Purposes only) 1. Match a. Other and In -Kind $0,00 $0.00 $0.00 % b. Local Match $0.00 $0.00 $0.00 2. USDA Cash Received $0.00 $0.00 $0.00 3. TOTAL OTHER $0.00 $0.00 $0.00 '6 PART D : OTHER REVENUE AND EXPENDITURES 2. Addition Cost Alternative Program Income 3. Interest 1. Program Income (PI) a. Approved Budget $ a. Earned on GR Advances $_ a. OAA Unbudgeted PI Receipts YTD b. Received YTD $ b. Return of GR Advance $ _ c. Expenditures $ c. Other Earned $ DOEA FORM 105as revised 11/09 51/71 January 2011 Contract AA-1129 ATTACHMENT X EXHIBIT 3 RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source : THIS REPORT PERIOD FROM: TO: CONTRACT Title III E PERIOD: CONTRACT# REPORT# PSA# CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : Approved by : Date PART A: BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal =ands $0.00 $0.00 $0.00 % 2. State Funds $0.00 $0.00 $0.00 % 3. Program Income $0.00 $0.00 $0.00 4. Local Cash Match $0.00 $0.00 $0.00 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 6. Local In -Kind Match $0.00 $0.00 $0.00 7. TOTAL RECEIPTS $0.00 $0.00 $0.00 PART B : E:XPENDETURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget A: Direct Services 1. Personnel $0.00 $0.00 $0.00 2. Travel $0.00 $0.00 $0.00 3. Building Space $0.00 $0.00 $0.00 % 4. Communication / Utilities $0.00 $0.00 $0.00 % 5. Printing / Supplies $0.00 $0.00 $0.00 6. Equipment $0.00 $0.00 $0.00 7.Other $0.00 $0.00 $0.00 % B : Agreement Services 8. Services Subcontracted $0.00 $0.00 $0.00 9. TOTAL EXPENDITURES $0.00 $0.00 $0.00 % 10. DEDUCTIONS a. Total Local Match $0.00 $0.00 $0.00 b. Program Income Used $0.00 $0.00 $0.00 % c. TOTAL DEDUCTIONS $0.00 $0.00 $0.00 % 11. NET EXPENDITURES $0.00 $0.00 $0.00 % PART C : E!XPENDITURES ANALYSIS 2. Units of Services Year to Date 3. Number of People Served Year to Date A. Expenditures by Services Year to Date: 1. Information ..................... $0.00 $0.00 .......................... 0.00 2. Assistance ..................... $0.00 ....................... $0.00 ... I ..... I .... ............ 3. Counseling .... __._....... .._....0 00 4. Respite ................. _...... $0.00 ..................... $0.00 .......... _... _ 0.00 5. Supplemental Services..... 0.00 ........................ $0.00 .......I..................0.00 6. TOTAI ........................... $0.00 Part B Line 11, column 3 should be equal to this total. PART D : GRANDPARENT SERVICES (reported by Federal Fiscal Year) FFY $ FFY_ $ FFY_ $ Match $ Match $ _ Match $ DOEA FORM 105AE revised 12'08 53/71 January 2011 Department of Elder Affairs Programs & Services Handbook, provided on CD. Also, available at the Department's Intranet site under, "Publications". Contract AA-1129 ATTACHMENT A 55/71 January 2011 STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS Contract AA-1129 ATTACHMENT B CIVIL RIGHTS COMPLIANCE CHECKLIST Program/Facility Name County AAA/Contractor Address Completed By City, State, Zip Code Date Telephone PART I. READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU IN THE COMPLETION OF THIS FORM. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: 2. POPULATION OF AREA SERVED. Source of data: Total # % White % Black % Hispanic % Other % Female 3. STAFF CURRENTLY EMPLOYED. Effective date: I Total # I % White I % Black I % Hispanic I % Other I % Female I % Disabled 4. CLIENTS CURRENTLY ENROLLED OR REGISTERED Effective date: Total # I % White I % Black I % Hispanic I % Other % Female % Disabled % Over 40 5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE. Total # % White T% Black % Hispanic % Other % Female % Disabled PART II. USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 6. Is an Assurance of Compliance on file with DOEA? If NA or NO, explain. NA YES NO ❑ ❑ ❑ 7. Compare the staff composition to the population. Is staff representative of the population? NA YES NO If NA or NO, explain. ❑ ❑ ❑ 8. Compare the client composition to the population. Are race and sex characteristics representative NA YES NO of the Population, If NA or NO, explain. ❑ ❑ ❑ 9. Are eligibility requirements for services applied to clients and applicants without regard to NA YES NO race, color, national origin, sex, age, religion or disability? If NA or NO, explain. ❑ ❑ ❑ 57/71 January 2011 Contract AA-1129 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 NA or NO, explain. NA YES NO ❑ ❑ ❑ 11. For in -patient services, are room assignments made without regard to race, color, national origin or disability? If NA or NO, explain. NA YES NO ❑ ❑ ❑ 12. Is the program/facility accessible to non-English speaking clients? If NA or NO, explain. 13. Are employees, applicants and participants informed of their protection against discrimination? If yes, how? Verbal ❑ Written ❑ Poster ❑ If NA or NO, explain. 14. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility. 15. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals? If NA or NO, explain. NA YES NO M PART Ill. THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 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. 17. Is there and established grievance procedure that incorporates due process in the resolution of complaints? If NO, explain. YES NO 58/71 January 2011 ❑ ❑ 18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain. Contract AA-1129 YES NO u❑ 19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? If NO, explain. 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 OR MORE. 21. Do you have a written affirmative action plan? If NO, explain. YES NO ❑ ❑ 59/71 January 2011 Contract AA-1129 AAA USE ONLY Reviewed By In Compliance: YES ❑ NO" ❑ Program Office 'Notice of Corrective Action Sent Date Telephone Response Due _/_/_ On -Site ❑ Desk Review ❑ Response Received DOEA Form 101-A, Revised May 2008 Page 2 of 2 57 60/71 January 2011 Contract AA-1129 ATTACHMENT B INSTRIUCTIONS 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. 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). 1 I . 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 61/71 January 2011 Contract AA-1129 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). 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: With the assistance of a disabled individual/organization, evaluate current practices and policies which do not comply with Section 504. Modify policies and practices that do not meet Section 504 requirements. Take remedial steps to eliminate any discrimination that has been identified. Maintain seilf-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been followed.), 45 CFR 84.6. 17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b). 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply with Section 504.45 CFR 84.7 (a). 19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads, and other appropriate written communication, 45 CFR 84.8 (a). 20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide equally effective services, (45 CFR 84.52 (d). 21. Programs/facilities with 50 or more employees and $50,000 in federal contracts must develop, implement and maintain a written affirmative action compliance program in accordance with Executive Order 1 1246.41 CFR 60 and Title VI of the Civil Rights Act of 1964, as amended. 62/71 January 2011 Contract AA-1129 ATTACHNIENT F EXHIBIT 1 PROGRAM: TYPE OF SERVICE: DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess Of Category 11 CONTRACT PERIOD: 1 2 Column 3 Column 4 Column 5 B 7 1 8 (to be completed by the contractor) (to be completed by the DOEA Contract Manager Budget Line Item Amount % Allocated Allowable Reasonable Necessary Category Budget Category to this Agreement a. Salaries b. Fringe Benefits C o C. Equipment i d. Telephone & Utilities N_ e. Travel = f. Printing & Supplies -gyp g. Other (Please list or attach details) Q h. Allocated Cost/Overhead TOTAL Client Services (Attach d) details) v TOTAL N CERTIFICATION (to be signed by DOEA Contract Manager) I certify that the cost for each line item budget category has been evaluated and determined to be allowable, reasonable, and necessary as required by Section 216.3475, Florida Statutes. Name Title Signature Date 63/71 January 2011 Contract AA-1129 ATTACHMENT F EXHIBIT 2 INSTRUCTIONS: COST ANALYSIS FOR NON-COMPETIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY II The purpose of the ATTACHMENT F, Exhibit 1, is to document that costs in non -competitively procured contracts in excess of $35,000 are allowable, reasonable and necessary. This form is required to be submitted by the contractor to the contract manager within 30 days of the contract execution date. Upon receipt of the form, the DOEA contract manager will: 1. Evaluate each separate line item to determine whether the cost is allowable, reasonable and necessary. a. To be allowable, a cost must be allowable pursuant to state and federal expenditure laws, rules and regulations and authorized by the agreement between the state and the contractor. b. To be reasonable, a cost must be evaluated to determine that the amount does not exceed what a prudent person would incur given the specific circumstances. c. To be necessary, a cost must be essential to the successful completion of the program. d. Allocated costs/overhead should be evaluated to determine that the rate is reasonable. 2. Place the Cost Analysis for Non -Competitively Procured Agreements in Excess of Category // form in the official file for this contract at the Department of Elder Affairs. (1) In accordance with the following instructions, the contractor must complete COLUMNS 3, 4 AND 5 of the DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess Of Category II worksheet (ATTACHMENT F, EXHIBIT 1) for the original contract and any amendment that affects the amount of compensation and/or the level of services provided. (2) Definition of Administrative Costs — a. Salaries/Wages: Are the charges to directly hire someone and put them on payroll. b. Fringe Benefits: Are the costs of health insurance, Social Security, Medicare, unemployment and other benefits paid on behalf of each employee. If fringe benefits will be based on a specified percentage, rather than the actual cost of fringe benefits, then the calculation for the fringe benefits amount must be shown. c. Equipment: Equipment means an article of nonexpendable, tangible personal property generally having a useful life of more than one year and an acquisition cost that equals or exceeds the lesser of the established capitalization level of $5,000 (federal funds) or $1,000 or hardback bound books not circulated, with a value of $250.00 or more (state funds). d. Telephone and Utilities: Are items such as utilities and telephone service costs. e. Travel: Are those that are necessary, reasonable and allowable for carrying out the project. Travel must be in accordance with Section 112.061, Florida Statutes, which includes submission of the claim on the approved State travel voucher or electronic means and at the authorized meal, per diem and state mileage reimbursement rates. f. Printing and Supplies: Are items such as office supplies, postage, and printing. g. Other Costs or Miscellaneous: Please explain/justify. Support documentation for other direct costs may include copies of published rates, copies of expense vouchers, and/or invoices. Support documentation for other costs or fees may include copies of published catalog prices, or copies of expense vouchers. h. Allocated Costs or Overhead: The contractor should attach a copy of the computation schedule supporting the allocated cost rate. Support documentation for allocated costs may be a federally -negotiated allocated cost rate agreement. If the contractor does not have a rate agreement, ( I ) sufficient information should be attached indicating how the rate used was determined and (2) if the rate was accepted and paid previously by either a federal agency or agency of the State of Florida, documentation to that affect should be provided. (3) Client Service costs should be documented via Area Agency on Aging Area Plans, Unit Cost information input into WebDB, or some other form of documentation to support the cost analysis. (4) The allocation to the agreement will be calculated based on the cost by line item cost divided by the total agreement amount. 64/71 January 2011 Contract AA-1129 ATTACHMENT G Alliance for Aging, Inc. Aging Resource Center/Elder Helpline Policy and Procedure for Outsourced function - Screening Objective: To ensure that a comprehensive list of clients in need of services is maintained in CIRTS by appropriate funding source and that the ARC is thereby able to effectively gauge the level of elder service need in Miami -Dade and Monroe COLmtles. Policy: To obtain necessary information from clients in order to assist in determining level of need and eligibility for DOEA funded services Procedure: l . ARC Contracted Providers will collect information from callers and conduct a 701A assessment. Alternatively, if a 701 B assessment already exists or is provided from another source (i.e. CARES) the information from the 701 B can be utilized. 2. Based on the information provided via the 701A(B) assessment, the ARC Contracted Provider will make a determination as to the services that the caller is in need of receiving (see Contract Amendment APCL). 3. The ARC Contracted Provider will determine the appropriate funding source(s) that provides the needed services (see Contract Amendment APCL). 4. If the caller is in need of a service(s) that is not provided by the ARC Contracted Provider, the ARC Contracted Provider will refer caller to the ARC Elder Helpline utilizing the ARC Referral Form and/or to an ARC Contracted Provider that provides the needed service. 5. The caller will be provided with general information regarding the ARC as well as the ARC Elder Helpline contact number. 6. The caller will be informed of the services and funding sources that they are being placed on the wait list for in CIRTS. 7. ARC Contracted Provider will create a client record in CIRTS (if there is no existing record) and enter the services needed for the caller by funding source and service. [If there is an existing record in CIRTS, the appropriate fields will be updated]. If the ARC Contracted Provider determines that the caller may qualify for more than one funding source, ARC Contracted Provider is encouraged to enter the appropriate information under multiple funding sources. [If there is an existing client record in C]RTS, the client record in CIRTS will be updated with appropriate informationl. 9. ARC Contracted Provider will inform caller that they will receive a follow-up call (or home visit in case of active client) to check on their status based on DOEA Wait List Reassessment Standards and encourage caller to contact the ARC Elder Helpline with any questions. 65/71 January 2011 Alliance for Aging, Inc. Aging Resource Center/Elder Helpline Policy and Procedure for Outsourced function - Triage Contract AA-1129 Objective: To ensure that clients in need of DOEA funded services receive services based on the highest level of need, first, as funding becomes available. Policy: To assist clients in obtaining DOEA funded services as funding becomes available, based on level of need as determined by a CIRTS priority score. Procedure: 1. ARC Contracted Provider will conduct periodic follow-up calls (or home visit in case of active client) to check on client status based on DOEA Wait List Reassessment Standards. 2. Based on the information provided via the 701A(B) assessment, the ARC Contracted Provider will update the client information in CIRTS specifically as it pertains to level of need for services by funding source The ARC Contracted Provider will ensure that the CIRTS prioritization score is accurately maintained, according to DOEA Standards. 4. If the caller is in need of a service(s) that is not provided by the ARC Contracted Provider, the ARC Contracted Provider will refer caller to the ARC Elder Helpline utilizing the ARC Referral Form and/or to an ARC Contracted Provider that provides the needed service. 5. The caller will be informed of the services and funding sources that they remain on the wait list for and/or have been removed from the wait list for. 6. ARC Contracted Provider will advise client of any change in their CIRTS priority score based on the updated information. 7. ARC Contracted Provider will remind client of the ARC Elder Help Line contact number and to contact the ARC Elder Help Line with any questions or concerns. 8. As funding becomes available, ARC Contracted Provider will run CIRTS Prioritization Report and activate clients according to DOEA Standards (refer to ARC Client Activation Policies and Procedures). The Contracted Provider will apply targeting criteria, as appropriate, to prioritized clients to ensure activations meet programmatic requirements. 67/71 January 2011 Alliance for Aging, Inc. Aging Resource Center/Elder Helpline Policy and Procedure for Activation From Wait List — Clients/Services Contract AA-1129 Objective: To ensure that elders in need of DOEA funded services in Miami -Dade and Monroe Counties and on the CIRTS wait list begin to receive services as funding becomes available. Policy: ARC will wort: with ARC Contracted Providers to ensure that clients waiting for DOEA funded services begin to receive those services as funding becomes available. Procedure: 1. ARC Contracted Provider will activate clients on CIRTS wait list based on DOEA prioritization polices and funding availability. 2. ARC Contracted Provider will update CIRTS status by funding source and service for any services being activated for the client using appropriate CIRTS codes. 3. Client may be left on wait list of a different funding source than the one being activated if ARC Contracted Provider determines that it is appropriate. 4. Client may also be left on wait list in CIRTS if they are being activated by the ARC Contracted Provider under a temporary non--DOEA funding source and ARC Contracted Provider determines that the clients need will persist after the temporary funding source is exhausted. 5. ARC Contracted Provider will inform the client of any services/funding source that they are being activated for as well as those services and funding sources that they will continue to be wait listed for. 6. ARC Contracted Provider will inform client to contact the ARC Elder Helpline if they have any questions or concerns regarding the status of any of their services. 69/71 January 2011 Alliance for Aging, Inc. Aging Resource Center/Elder Helpline Policy and Procedure for Termination From Wait List — Clients/Services Contract AA-1129 Objective: To ensure that the comprehensive list of clients in need of services in CIRTS is appropriately maintained by funding source and that the ARC is thereby able to effectively gauge the current level of elder service need in Miami -Dade and Monroe Counties. Policy: ARC will maintain an accurate and current list of clients in need of elder services in Miami -Dade and Monroe Counties with the assistance of the ARC Contracted Providers. Procedure: 1. ARC Contracted Provider will re -screen clients which the ARC Contracted Provider initially placed on the CIRTS wait list for services based on DOEA Reassessment Standards. 2. The re -screening may be in the form of a phone screening or a home visit depending on the clients status (i.e. active/pending) 3. ARC Contracted Provider will determine if the client is no longer in need (or eligible) for any of the services they were wait listed for. 4. ARC Contracted Provider will terminate the client from the wait list (entirely or by specific service) using the appropriate CIRTS termination code for any services or funding source for which the client is determined to no longer be eligible for or no longer in need of. 5. ARC Contracted Provider will inform the client of any services/funding source that they are being removed from the wait list for. 6. ARC Contracted Provider will inform client of their ability to be re -added to the wait list if their level of need should change. 7. ARC Contracted Provider will inform client to contact the ARC Elder Helpline if they have any questions or concerns regarding their wait list status. 8. Reference DOEA Notice of Instruction: Assessed Priority Consumer List#:062906-1-I-OVCS as applicable. 71/71