FY2012 10/19/2011DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE: October 31, 2011
TO: Lisa Tennyson
Grants Management
FROM: Isabel C. DeSantis, D.C. J"4y
At the BOCC meeting held on October 19, 2011 the Board approved the following:
Item CIO Heart of the Keys (Marathon Rec), in the amount of $30,400; Helpline,
Inc., in the amount of $5,000; Historic Florida Keys Foundation, in the amount of $28,500;
Hospice of the Florida Keys, Inc., in the amount of $126,000; Independence Cay Transitional
Housing, in the amount of $20,000; Keys Area Interdenominational Resources, in the amount of
$22,000; Literacy Volunteers of America - Monroe County, Inc., in the amount of $5,000;
Monroe Association for Retarded Citizens (MARC), in the amount of $153,000; Fonda, I n oun i
of the Arts, in the amount of $57,000; Rural Health
the amount of $327,600 - Children's dental services /$54,000; Southernmost Homeless
Assistance League, in the amount of $3,000; Star of the Sea Foundation, in the amount of
$44,000; Womankind, Inc., in the amount of $75,000; Upper Keys Pool, in the amount of
$180,000.
Attached are photocopies of the subject documents for your handling. Should you have
any questions, please feel free to contact my office.
cc: County Attorney
Finance
File
AGREEMENT
This Agreement is made and entered into this 19th day of October, 2011, between the BOARD
OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or
"County," and Star of the Sea Foundation, Inc., hereinafter referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not - for - profit corporation established to provide a certified food
pantry, prescription drug reimbursement assistance, one way bus tickets to enable persons in need to
leave the County and return home, redistribution of donated goods and clothing in Monroe County and
human service referrals.
WHEREAS, it is a legitimate public purpose to provide facilities and services related to the
provision of a food pantry, drug reimbursement assistance, transportation assistance to leave the
county, redistribution of donated goods and clothing and human service referrals.
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as
follows:
FUNDING
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and
satisfactorily performing and carrying out the duties of the Board as to providing facilities and services
related to provision of a food pantry, prescription drug reimbursement assistance, one way bus tickets,
redistribution of donated goods and clothing and human services referrals in Monroe County, Florida,
shall pay to the PROVIDER the sum of FORTY FOUR THOUSAND AND NO /100 DOLLARS ($44,000.00)
for fiscal year 2011 -2012.
2. TERM. This Agreement shall commence on October 1, 2011, and terminate September 30,
2012, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be made periodically, but no more frequently than monthly, as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's Finance
Office. The COUNTY shall only reimburse, subject to the funded amounts below, those reimbursable
expenses which are reviewed and approved as complying with Monroe County Code of Ordinances,
State laws and regulations and Attachment A - Expense Reimbursement Requirements. Evidence of
payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a notarized certification statement. An example of
a reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within thirty days after the termination date of this contract shown in Article 2 above.
After the Clerk of the Board examines and approves the request for reimbursement, the Board
shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the
aggregate sum shall not exceed the total amount shown in Article 1, above, during the term of this
agreement.
4. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level
sufficient to allow for continued reimbursement of expenditures for services specified herein, this
agreement may be terminated immediately at the option of the Board by written notice of termination
delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided
by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise
required by law.
S. CLAIMS FOR FEDERAL OR STATE AID. PROVIDER and County agree that each 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 each party prior to submission.
Contract - Star of the Sea Foundation FY122; page 1
6. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds
provided under this agreement, shall become the property of Monroe County and shall be accounted for
pursuant to statutory requirements.
RECORDKEEPING
7. RECORDS. PROVIDER 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 PROVIDER
pursuant to this Agreement were spent for purposes not authorized by this Agreement, the PROVIDER
shall repay the monies together with interest calculated pursuant to Sec. 55.03, FS, running from the
date the monies were paid to PROVIDER.
S. PUBLIC ACCESS. The County and PROVIDER 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
PROVIDER in conjunction with this Agreement; and the County shall have the right to unilaterally
cancel this Agreement upon violation of this provision by PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY
the following (items A -I must be provided prior to the payment of any invoices):
(a) IRS Letter of Determination indicating 501(c)(3) status;
(b) List of the Organization's Board of Directors of which there must be five or more; for each board
member please indicate when elected to serve and the length of term of service;
(c) Evidence of annual election of Officers and Directors;
(d) Unqualified audited financial statement from most recent fiscal year for all organizations that
expend $150,000 a year or more; if qualified, include a statement of deficiencies with corrective
actions recommended /taken;
(e) IRS Form 990 from most recent fiscal year for all organizations;
(f) Organization's Corporate Bylaws, which must include the organization's mission, board and
membership composition, and process for election of officers;
(g) Organization's Policies and Procedures Manual which must include hiring policies for all staff,
drug and alcohol free workplace provisions, and equal employment opportunity provisions;
(h) Specific description or list of services to be provided under this contract with this grant (see
Attachment C);
(i) Initial Performance Report describing services provided during the prior fiscal year. The
performance reports shall include statistical information regarding the types and frequencies of
services provided, a profile of clients (including residency) and numbers served, and outcomes
achieved.
(j) Final Performance Report describing services rendered during the current grant period (to be
furnished within 30 days after the contract end date.) The performance reports shall include
statistical information regarding the types and frequencies of services provided, a profile of
clients (including residency) and numbers served, and outcomes achieved.
(k) Cooperation with County monitoring visits that the County may request during the contract
year; and
(1) Other reasonable reports and information related to compliance with applicable laws, contract
provisions and the scope of services that the County may request during the contract year.
RESPONSIBILITIES
10. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and agrees
with the Board to substantially and satisfactorily perform and provide the services outlined in
Attachment C to residents of Monroe County, Florida.
Contract - Star of the Sea Foundation FYI 22; page 2
11. ATTORNEY'S FEES AND COSTS. The County and PROVIDER 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.
12. BINDING EFFECT. The terms, covenants, conditions, and provisions of this Agreement
shall bind and inure to the benefit of the County and PROVIDER and their respective legal
representatives, successors, and assigns.
13. 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.
14. NO SOLICITATION/ PAYMENT. The County and PROVIDER 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 PROVIDER 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.
15. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement contained in
this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors,
servants or agents to be employees of the Board.
COMPLIANCE ISSUES
16. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the
provision of 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 Board to terminate this contract immediately upon delivery of written notice of
termination to the PROVIDER.
17. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that
all professionals have current and appropriate professional licenses and professional liability insurance
coverage. Funding by the Board is contingent upon retention of appropriate local, state and /or federal
certification and /or licensure of the PROVIDER'S program and staff.
18. NON - DISCRIMINATION. County and PROVIDER 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. County or
PROVIDER 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
Contract - Star of the Sea Foundation FY122; page 3
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 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.
AMENDMENTS, CHANGES, AND DISPUTES
19. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and /or
reimbursement of services shall be accomplished by an amendment, which must be approved in writing
by the COUNTY.
20. ADJUDICATION OF DISPUTES OR DISAGREEMENTS. County and PROVIDER 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.
21. 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
PROVIDER 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 PROVIDER specifically agree that no party to this
Agreement shall be required to enter into any arbitration proceedings related to this Agreement.
ASSURANCES
22. COVENANT OF NO INTEREST. County and PROVIDER 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.
23. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and
with the prior written approval of the Board, which approval shall be subject to such conditions and
provisions as the Board may deem necessary. This agreement shall be incorporated by reference into
any assignment and any assignee shall comply with all of the provisions herein. Unless expressly
provided for therein, such approval shall in no manner or event be deemed to impose any obligation
upon the Board in addition to the total agreed upon reimbursement amount for the services of the
PROVIDER.
24. NON - WAIVER OF IMMUNITY. Notwithstanding the provisions of Sec. 768.28, Florida
Statutes, the participation of the County and the PROVIDER 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.
25. ATTESTATIONS. PROVIDER agrees to execute such documents as the County may
reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a Drug -Free
Workplace Statement.
Contract - Star of the Sea Foundation FYI 22; page 4
26. 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.
INDEMNITY ISSUES
27. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER 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 PROVIDER occasioned by the
negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or
volunteers.
28. 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.
29. 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.
30. 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.
31. NON - RELIANCE BY NON - PARTIES. No person or entity shall be entitled to rely upon the
terms 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 PROVIDER agree
that neither the County nor the PROVIDER 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.
GENERAL
32. 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.
33. NOTICE. Any notice required or permitted under this agreement shall be in writing and
hand - delivered or mailed, postage pre -paid, by certified mail, return receipt requested, to the other
party as follows:
For Board:
Grants Administrator and Monroe County Attorney
1100 Simonton Street PO Box 1026
Contract - Star of the Sea Foundation FYI 22; page 5
Key West, FL 33040
For PROVIDER
Erica Hughes Sterling, President
Star of the Sea Foundation, Inc.
5640 Maloney Avenue
Key West, FL 33040
305 - 292 -3013
305- 292 -3014 FAX
Key West, FL 33041
34. 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 PROVIDER agree that venue will lie in
the appropriate court or before the appropriate administrative body in Monroe County, Florida.
The County and PROVIDER 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.
35. NON - WAIVER. Any waiver of any breach of covenants herein contained to be kept and
performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not
operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the
same conditions or covenants or otherwise.
36. 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 PROVIDER
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.
37. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties
hereto with respect to the subject matter hereof and supersedes any and all prior agreements with
respect to such subject matter between the PROVIDER and the Board.
[THIS SPACE INTENTIONALLY LEFT BLANK WITH SIGNATORY PAGE TO FOLLOW]
Contract - Star of the Sea Foundation FYI 22; page 6
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the
day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
D
BOARD OF COUNTY COMMISSIONERS
OF MONR C TY, FLORIDA
l� 6
By
Mayor /Chairman
Witness
Witness
Star of the Sea Foundation, Inc. /
(Federal ID No. 13 (2
S
I� President
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Contract - Star of the Sea Foundation FYI 22; page 7
ATTACHMENT A
Expense Reimbursement Requirements
This document is intended to provide basic guidelines to Human Service and Community-Based
Organizations, county travelers, and contractual parties who have reimbursable expenses associated
with Monroe County business. These guidelines, as they relate to travel, are from the Monroe County
Code of Ordinances and State laws and regulations.
A cover letter (see Attachment B) summarizing the major line items on the reimbursable expense
request needs to also contain the following notarized certified statement:
"I certify that the above checks have been submitted to the vendors as noted and that the
attached expenses are accurate and in agreement with the records of this organization. Furthermore,
these expenses are in compliance with this organization's contract with the Monroe County Board of
County Commissioners and will not be submitted for reimbursement to any other funding source."
Invoices should be billed to the contracting agency. Third party payments will not be considered for
reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract. This
document should not be considered all- inclusive. The Clerk's Finance Department reserves the right to
review reimbursement requests on an individual basis. Any questions regarding these guidelines
should be directed to 305 -292 -3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter - company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are attached
and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a
Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours
worked, withholding information and paid payroll taxes, check number and check amount. If a Payroll
Journal is not provided, the following information must be provided: pay period, check amount, check
number, date, payee, support for applicable paid payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement. For
overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable
expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The log
must define the date, number of copies made, source document, purpose, and recipient. A reasonable
fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the
finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the number
called, and the reason for sending the fax.
Contract - Star of the Sea Foundation FYI 22; page 8
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel and Meal Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel reimbursement requests must be submitted and will be paid in accordance with
Monroe County Code of Ordinances and State laws and regulations. Credit card statements are not
acceptable documentation for reimbursement. If attending a conference or meeting a copy of the
agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline
ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires
the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed
if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for
a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the
destination. Airport parking during a business trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be
registered and paid for by traveler. The County will only reimburse the actual room and related bed
tax. Room service, movies, and personal telephone calls are not allowable expenses.
Mileage reimbursement shall be at the rate established by ARTICLE XXVI, TRAVEL, PER DIEM, MEALS,
AND MILEAGE POLICY of the Monroe County Code of Ordinances. An odometer reading must be
included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office
to a point of departure. For example, driving from one's home to the airport for a business trip is not a
reimbursable expense.
Meal reimbursement shall be at the rates established by ARTICLE XXVI, TRAVEL, PER DIEM, MEALS,
AND MILEAGE POLICY of the Monroe County Code of Ordinances. Meal guidelines state that travel must
begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch
reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement.
Non - allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically included
in the contract), entertainment expenses, fundraising, non - sufficient check charges, penalties and fines.
Contract - Star of the Sea Foundation FYI 22; page 9
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name for the time period of
to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending 05/28/01 XXX.XX
(A) Total $ X X�X X.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D -C) $ X,XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that the expenses are
accurate and in agreement with the records of this organization. Furthermore, these expenses are in
compliance with this organization's contract with the Monroe County Board of County Commissioners
and will not be submitted for reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this
personally known to me.
Notary Public
day of
200_ by
who is
Notary Stamp
Contract - Star of the Sea Foundation FYI 22; page 10
ATTACHMENT C
Services to be provided:
(Insert a description of your organization including a list of the services that will be provided by your
organization under this contract.)
Certified food pantry , prescription drug reimbursement assistance, food recovery and distribution.
Contract - Star of the Sea Foundation FY122; page 11
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 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, for CATEGORY TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
Contract - Star of the Sea Foundation FY122; page 12
SWORN STATEMENT UNDER ORDINANCE NO. 10 -1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
�Ijq warrants that he /it has not employed, retained or
otherwise had act do his /its behalVany former County officer or employee in violation of Section 2 of
Ordinance No. 10 -1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-
1990. For breach or violation of this provision the County may, in its discretion, terminate this contract
without liability and may also, in its discretion, deduct from the contract 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.
(signature)
Date: �V' 2,
STATE OF 1' LO tt Q
COUNTY OF ft J l-
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
r✓(l (,a �Jq� s � � t �� -P who, after first being sworn by me, affixed his / her_
signature (name of individual signing) in the space provided above on this day of
L2° �V , 20 jj—.
NOTARY PUBLIC
My commission expires: .,ayP. PATRICIA GAE GANISTER
_ Notary Public • State of Florida
• i My Comm. Expires Sep 20.2011
':'+ r Commission EE 16813
OMB -MCP FORM #4 ' .1;;;;.•••`'� #r 8 ondedThrouphNationalNotaryAm.
Contract - Star of the Sea Foundation FY122; page 13
DRUG -FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that:
6Y) I Oc
(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'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. 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 statemenL I certify that this firm complies fully with the above
requirements.
STATE OF F (L( r7�
(Signature of Respo ent)
COUNTY OF Mo P U CS
[) 1 1 - 1- 210 1
Date
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
e( I C.C.S t - + —_ -. who, after first being sworn by me, (name of individual
signing) affixed is /her signaturk in the space provided above on this
*'- day of o G 1✓ , 20H.
NOTARY PUBLIC
My commission expires:
Eaw l t PATRICIA GAE GANISTER
U..." Notary Public - Slate of Florida
y Comm. Expires Sep 20, 2014
Commission # EE 16873
onded Through National Notary Assn.
Contract - Star of the Sea Foundation FYI 22; page 14