02/15/2012 Agreement DANNYL. KOLHACE
CLERK OF THE CIRCUIT COURT
DATE: February 24, 2012
TO: Sheryl Graham, Director
Social Services Department
ATTN: Kim Wilkes Wean
Senior Grants Coordinator
FROM: Pamela G. Ilance D.C.
At the February 15, 2012, Board of County Commissioner's meeting the Board granted
approval and authorized execution of Item C9 the Low Income Home Energy Assistance
Program Federally Funded Subgrant Agreement Number 12EA-OF-11-54-01-019 between
Monroe County Board of County Commissioners (Community Services/Social Services) and the
State of Florida, Department of Economic Opportunity for the provision of funds to pay electric
bills for low income clients.
Enclosed are five duplicate originals, executed on behalf of Monroe County, for your
handling. Please be sure to return the fully executed "Monroe County Clerk" and "Monroe
County Finance Department"copies as soon as possible. Should you have any questions, please
do not hesitate to contact our office.
cc: County Attorney
Finance
File d/
Monroe County Clerk
4 STATE OF FLORIDA
DEPARTMENT OF ECONOMIC OPPORTUNITY
CFDA Number: 93.568
Contract Number: 12EA-O F-11-54-01-019
FEDERALLY-FUNDED SUBGRANT AGREEMENT
THIS AGREEMENT is entered into by the State of Florida, Department of Economic Opportunity,
with headquarters in Tallahassee,Florida(hereinafter referred to as the "Department"), and Monroe County
Board of County Commissioners(hereinafter referred to as the"Recipient").
THIS AGREEMENT IS ENTERED INTO BASED ON THE FOLLOWING REPRESENTATIONS:
A. The Recipient represents that it is fully qualified and eligible to receive these grant funds to
provide the services identified herein; and
B. The Department 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 below; and
C. The Department has statutory authority to disburse the funds under this Agreement.
THEREFORE,the Department and the Recipient agree to the following:
(1) SCOPE OF WORK
The Recipient shall perform the work in accordance with the Scope of Work,Attachment A, and
Budget Attachment I of this Agreement.
(2) INCORPORATION OF LAWS, RULES,REGULATIONS AND POLICIES
The Recipient and the Department shall be governed by applicable State and Federal laws,rules
and regulations, including those identified in Attachment B.
(3) PERIOD OF AGREEMENT
This Agreement shall begin upon execution by both parties or March 1, 2012 whichever is
earlier,and shall end March 31,2013, 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
agreed upon shall be valid only when in writing,signed by each of the parties,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
"Common Rule: Uniform Administrative Requirements for State and Local Governments" (53 Federal
Register 8034)or OMB Circular No. A-110(now 2 CFR 215), "Grants and Agreements with Institutions of
Higher Education, Hospitals, and Other Nonprofit Organizations," and either OMB Circular No. A-87,(now
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2 CFR 225), "Cost Principles for State and Local Governments," OMB Circular No.A-21, (now 2 CFR 220)
"Cost Principles for Educational Institutions," or OMB Circular No.A-122,(now 2 CFR 230) "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 to show its compliance with the terms of this
Agreement,and the compliance of all subcontractors or consultants paid from funds under this Agreement,
for a period of five years from the date the audit report is issued, and shall allow the Department or its
designee,the State Chief Financial Officer or the State Auditor General access to the records upon request.
The Recipient shall ensure that audit working papers are available to them upon request for a period of five
years from the date the audit report is issued, unless extended in writing by the Department. The five year
period may be extended for the following exceptions:
I. If any litigation, claim or audit is started before the five year period expires,and extends
beyond the five year period,the records shall be retained 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 it is acquired shall be retained for five years after final disposition.
3. Records relating to real property acquired shall be retained for five years after the
closing on the transfer of title.
(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 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
Department, its employees, and agents. "Reasonable" shall ordinarily 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 Department.
(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 reasonable times for inspection,review,or audit by state
personnel and other personnel authorized by the Department. "Reasonable" shall ordinarily mean normal
business hours of 8:00 a.m. to 5:00 p.m., local time, Monday through Friday.
(c) The Recipient shall provide the Department with the records, reports or financial statements
upon request for the purposes of auditing and monitoring the funds awarded under this Agreement.
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(d) If the Recipient is a State or local government or a non-profit organization as defined in
OMB Circular A-I 33, 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 Ito this Agreement shows the Federal
resources awarded through the Department by this Agreement. In determining the Federal awards expended
in its fiscal year,the Recipient shall consider all sources of Federal awards, including Federal resources
received from the Department. 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 for 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 chooses 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 funds.
(e) Send copies of reporting packages and any management letters issued by the auditor for
audits conducted in accordance with OMB Circular A-I33, as revised, and required by subparagraph(d)
above,when required by Section .320(d), OMB Circular A-133,as revised, by or on behalf of the Recipient
to the Department of Economic Opportunity at the following address:
Department of Economic Opportunity
Office of Audit Services
107 East Madison Street
MSC 130
Tallahassee,Florida 32399-4120
(also send an electronic copy to Ms. Ginny Helwig at: ginny.helwig(deo.myflorida.com)
Send the Single Audit reporting package and Form SF-SAC to the Federal Audit Clearinghouse by
submission online at
htta://harvestencensus.uov/fac/collect/ddeindex.html
And to any other Federal agencies and pass-through entities in accordance with Sections .320(e)and(f),
OMB CircularA-133, as revised.
(f) Pursuant to Section .320(f), OMB Circular A-133, as revised,the Recipient shall send 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 at the following addresses:
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Department of Economic Opportunity
Office of the Inspector General
107 East Madison Street
MSC 130
Tallahassee, Florida 32399-4120
And
Department of Economic Opportunity
Division of Community Development
Office of Housing and Community Development
Community Assistance Section
107 East Madison Street
MSC 400
Tallahassee, Florida 32399-4120
(g) By the date due, send any reports,management letter,or other information required to be
submitted to the Department pursuant to this Agreement 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 should state the date that the reporting package was delivered to the Recipient
when-submitting financial reporting packages to the Department for audits done in accordance with OMB
Circular A-133 or Chapters I0.550(local governmental entities)or 10.650(nonprofit and for-profit
organizations), Rules of the Auditor General,
(i) If the audit shows that all or any portion of the funds disbursed were not spent in accordance
with the conditions of this Agreement,the Recipient shall be held liable for reimbursement to the
Department of all funds not spent in accordance with these applicable regulations and Agreement provisions
within thirty days after the Department has notified the Recipient of such non-compliance.
(j) The Recipient shall have all audits completed by an independent certified public accountant
(IPA),either 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
received by the Department no later than nine months from the end of the Recipient's fiscal year.
(7) REPORTS
(a) The Recipient shall provide the Department with quarterly reports and 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 any other information requested by the Department.
(b) Quarterly reports are due to the Department no later than 21 days after the end of each
quarter of the program year and shall be sent each quarter until submission of the administrative close-out
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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 45 days after termination of this Agreement or 45 days after
completion of the activities contained in this Agreement, whichever first occurs.
(d) if a0 required reports and copies are not sent to the Department or are not completed in a
manner acceptable to the Department, the Department may withhold further payments until they are
completed or may take other action as stated in Paragraph(11)REMEDIES. "Acceptable to the
Department" means that the work product was completed in accordance with the Budget and Scope of Work.
(e) The Recipient shall provide additional program updates or information that may be required
by the Department. •
(f) The Recipient shall provide additional reports and information identified in
Attachment C.
(8) MONITORING The Recipient shall monitor its performance under this Agreement, as well as that of its
subcontractors and/or consultants who are paid from funds provided under this Agreement,to ensure that the
Scope of Work and other performance goals are being achieved. A review shall be done for each function
or activity in Attachment A to this Agreement, and reported in the quarterly report.
In addition to reviews of audits conducted in accordance with paragraph(6)above,monitoring
procedures may include,but not be limited to, on-site visits by Department staff, limited scope audits, and/or
other procedures. The Recipient agrees to comply and cooperate with any monitoring procedures/processes
deemed appropriate by the Department. In the event that 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 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 Florida Chief
Financial Officer or Auditor General. In addition,the Department 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 is solely responsible to parties it deals with in carrying out the terms of this Agreement,and
shall hold the Department harmless against all claims of whatever nature by third parties arising from the
work performance under this Agreement. For purposes of this Agreement, Recipient agrees that it is not an
employee or agent of the Department, but is an independent contractor.
(b) Any Recipient which is a state agency or subdivision, as defined in Section 768.28,Fla.
Stat. agrees to be fully responsible for its negligent or tortious acts or omissions which result in claims or
suits against the Department,and agrees to be liable for any damages proximately caused by the acts or
omissions to the extent set forth in Section 768.28,Fla. Stat. Nothing herein is intended to serve as a waiver
of sovereign immunity by any Recipient to which sovereign immunity applies. Nothing herein shall be
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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.
(10) DEFAULT
If any of the following events occur("Events of Default"),all obligations on the part of the
Department to make further payment of funds shall, if the Department elects,terminate and the Department
has the option to exercise any of its remedies set forth in Paragraph(11). However,the Department may
make payments or partial payments after any Events of Default without 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 Department is or becomes false or misleading in any respect,or if the Recipient fails to
keep or perform any of the obligations,terms or covenants in this Agreement or any previous agreement
with the Department and has not cured them in timely fashion, or is unable or unwilling to meet its
obligations under this Agreement;
(b) If material adverse changes occur in the financial condition of the Recipient at any time
during the term of this Agreement, and the Recipient fails to cure this adverse change within thirty days
from the date written notice is sent by the Department.
(c) If any reports required by this Agreement have not been submitted to the Department 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
If an Event of Default occurs,then the Department may, upon thirty calendar days written notice
to the Recipient and upon the Recipient's failure to cure within those thirty days,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 days prior
written notice of such termination. The notice shall be effective when placed in the United States, first class
mail,postage prepaid,by registered or certified mail-return receipt requested,to the address set forth in
paragraph (13)herein;
(b) Begin 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) Require that the Recipient refund to the Department any monies used for ineligible purposes
under the laws, rules and regulations governing the use of these funds.
(e) Exercise any corrective or remedial actions,to include but not be limited to:
I. request additional information from the Recipient to determine the reasons for or the
extent of non-compliance or lack of performance,
2. issue a written warning to advise that more serious measures may be taken if the
situation is not corrected,
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3. advise the Recipient to suspend,discontinue, or refrain from incurring costs for any
activities in question, or
4. require the Recipient to reimburse the Department for the amount of costs incurred for
any items determined to be ineligible;
(f) Exercise any other rights or remedies which may be otherwise available under law.
(g) Pursuing any of the above remedies will not keep the Department from pursuing any other
remedies in this Agreement or provided at law or in equity. If the Department waives any right or remedy in
this Agreement or fails to insist on strict performance by the Recipient, it will not affect,extend or waive
any other right or remedy of the Department, or affect the later exercise of the same right or remedy by the
Department for any other default by the Recipient.
(12) TERMINATION
(a) The Department may terminate this Agreement for cause with thirty days written notice.
Cause can include 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.
(b) The Department may terminate this Agreement for convenience or when it determines, in its
sole discretion,that continuing the Agreement would not produce beneficial results in line with the further
expenditure of funds,by providing the Recipient with thirty calendar days prior written notice.
(c) The parties may agree to terminate this Agreement for their mutual convenience through a
written amendment of this Agreement. The amendment shall state 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 receipt of the
termination notice will be disallowed. The Recipient shall not be relieved of liability to the Department
because of any breach of Agreement by the Recipient. The Department may,to the extent authorized by
law,withhold payments to the Recipient for the purpose of set-off until the exact amount of damages due the
Department 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:
Paula Lemmo,Community Program Manager
Department of Economic Opportunity
Division of Community Development
Office of Housing and Community Development
Community Assistance Section
107 East Madison Street
MSC 400
Tallahassee,Florida 32399-4120
Email: paula.lemmo@deo.myflorida.com
(c) The name and address of the Representative of the Recipient responsible for the
administration of this Agreement is stated in Attachment I, Recipient Information,of this Agreement.
(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 provided
as stated in (13)(a)above.
(14) SUBCONTRACTS
If the Recipient subcontracts any of the work required under this Agreement,a copy of the
unsigned subcontract must be forwarded to the Department for review and approval before it is executed 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(ii)the subcontractor shall hold the Department 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. The Recipient shall document in the quarterly report the
subcontractor's progress in performing its work under this Agreement.
For each subcontract,the Recipient shall provide a written statement to the Department 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.
(b)In the event of any inconsistencies or conflict between the language of this Agreement and
the attachments,the language of the attachments shall control,but only to the extent of the conflict or
inconsistency.
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Monroe County Board of County Commissioners
(c) This Agreement has the following attachments(check all that are applicable):
Z Exhibit 1 -Funding Sources
Z Attachment A—Scope of Work
Z Attachment B—Program Statutes and Regulations
N Attachment C—Reports
N Attachment D—Property Management and Procurement
N Attachment E—Statement of Assurances
N Attachment F—Special Conditions
N Attachment G—Warranties and Representations
N Attachment H—Certification Regarding Debarment
Z Attachment I— Recipient Information
N Attachment 1 —Budget Summary and Workplan
N Attachment K—Budget Detail
N Attachment L—Multi-County Fund Distribution
N Attachment M—Justification of Advance Payment
(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$181 340, subject to
the availability of funds and appropriate budget authority. The Recipient is authorized to incur costs in an
amount not to exceed$84 051 until further notification is received by the Department.As funds and budget
authority are available, changes to the costs the Recipient may incur will be accomplished by notice from the
Department to the Recipient, in the form of certified mail,return receipt requested,to the Recipient's contact
person identified in Attachment I,Recipient Information. The terms of the Agreement shall be considered to
have been modified to allow the Recipient to incur additional costs upon the Recipient's receipt of the
written notice from the Department.
(b) Any advance payment under this Agreement is subject to Section 216.181(16), FIa.Stat., and
is contingent upon the Recipient's acceptance of the rights of the Department 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. Any advance payment is also subject to federal OMB
Circulars A-87,A-I 10,A-122 and the Cash Management Improvement Act of 1990. If an advance payment
is requested below,the budget data on which the request is based and ajustification statement shall be
included in this Agreement as Attachment M. Attachment M will specify the amount of advance payment
needed and provide an explanation of the necessity for and proposed use of these funds.
(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 Scope of Work,Attachment A and Budget
Detail,Attachment K of this Agreement.
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If the necessary funds are not available to fund this Agreement as a result of action by the
United States Congress,the federal Office of Management and Budgeting,the State Chief Financial Officer,
or under subparagraph(19Xh)of this Agreement,all obligations on the part of the Department to make any
further payment of funds shall terminate,and the Recipient shall submit its closeout report within thirty days
of receiving notice from the Department.
(18) REPAYMENTS
All refunds or repayments to be made to the Department under this Agreement are to be made
payable to the order of"Department of Economic Opportunity"and mailed directly to the Department at the
following address:
Department of Economic Opportunity
Division of Community Development
Office of Housing and Community Development
Community Assistance Section
107 East Madison Street
MSC 400
Tallahassee,Florida 32399-4120
In accordance with Section 215.34(2), Fla. Stat., if a check or other draft is returned to the
Department for collection, Recipient shall pay to the Department a 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) MANDATED 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 later
submission or response to a Department request, or in any submission or response to fulfill the requirements
of this Agreement. All of said information, representations,and materials are incorporated by reference.
The inaccuracy of the submissions or any material changes shall, at the option of the Department and with
thirty days written notice to the Recipient, cause the termination of this Agreement and the release of the
Department 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 be in the Circuit Court of Leon County. If any provision of this
Agreement is in conflict with any applicable statute or rule, or is unenforceable,then the provision shall be
null and void to the extent of the conflict,and shall be severable,but shall not invalidate any other provision
of this Agreement.
(c) Any power of approval or disapproval granted to the Department under the terms of this
Agreement shall survive the term of this Agreement.
(d) This Agreement may be executed in any number of counterparts, any one of which may be
taken as an original.
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(e) The Recipient agrees to comply with the Americans With Disabilities Act(Public Law
101-336,42 U.S.C. Section 12101 et seq.)and the Florida Civil Rights and Fair Housing Acts(sections
760.01 —760.37,Florida Statutes),which prohibit discrimination by public and private entities on the basis
of disability in employment,public accommodations,transportation, state and local government services,
and telecommunications.
(0 A person or organization 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
$25,000.00 for a period of 36 months from the date of being placed on the convicted vendor list or on the
discriminatory vendor list.
(g) Any Recipient which is not a local government or state agency, and which receives funds
under this Agreement from the federal government, 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 3-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 19(g)2.of this
certification; and
4. have not within a 3-year period preceding this Agreement had one or more public
transactions(federal, state or local)terminated for cause or default.
If the Recipient is unable to certify to any of the statements in this certification,then the
Recipient shall attach an explanation to this Agreement.
In addition,the Recipient shall send to the Department (by email or by facsimile transmission)
the completed "Certification Regarding Debarment, Suspension,Ineligibility and Voluntary
Exclusion"(Attachment II)for each intended subcontractor which Recipient plans to fund under this
Agreement Such form must be received by the Department before the Recipient enters into a
contract with any subcontractor. .
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(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.
(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
(j) Any bills for travel expenses shall be submitted in accordance with Section 112.061, Fla.
Stat.
(k) The Department of Economic Opportunity reserves the right to unilaterally cancel this
Agreement if the Recipient refuses to allow public access to all documents,papers, letters, or other material
subject to the provisions of Chapter 119,Fla. Stat., which the Recipient created or received under this
Agreement.
(I) If the Recipient is allowed to temporarily invest any advances of funds under this
Agreement,any interest income shall either be returned to the Department 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 Department 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 of these meetings shall be publicly
noticed,open to the public,and the minutes of all the meetings shall be public records,available to the
public in accordance with Chapter 119, Fla. Stat.
(o) 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. I Oa, unless it would not be in the public interest or unreasonable in cost.
(20) LOBBYING PROHIBITION
(a) No funds or other resources received from the Department under 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
Recipient,to any person for influencing or attempting to influence an officer or employee of any agency,a
12
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 Recipient shall complete and submit
Standard Form-LLL, "Disclosure Form to Report Lobbying."
3. The Recipient shall require that this certification be included in the award documents for
all subawards(including subcontracts, subgrants, and contracts under grants, loans,and cooperative
agreements)and that all subrecipients shall certify and disclose.
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.
(21) COPYRIGHT, PATENT AND TRADEMARK
ANY AND ALL PATENT RIGHTS ACCRUING UNDER OR IN CONNECTION WITH
THEPERFORMANCE 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 has a pre-existing patentor 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 is developed in the course of or as a result of work or services
performed under this Agreement,or in any way connected with it,the Recipient shall refer the discovery or
invention to the Department for a determination whether the State of Florida will seek patent protection in its
name. Any patent rights accruing under or in connection with the performance of this Agreement are
reserved to the State of Florida. If any books,manuals,films, or other copyrightable material are produced,
the Recipient shall notify the Department. Any copyrights accruing under or in connection with the
performance under this Agreement are transferred by the Recipient to the State of Florida.
(c) Within thirty days of execution of this Agreement,the Recipient shall disclose all
intellectual properties relating 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
13
exists. The Department shall then,under Paragraph(b),have the right to all patents and copyrights which
accrue during performance of the Agreement.
(22) LEGAL AUTHORIZATION
The Recipient certifies that it has the legal authority to receive the funds under this Agreement
and that its governing body has authorized the execution and acceptance of this Agreement. The Recipient
also certifies that the undersigned person has the authority to legally execute and bind Recipient to the terms
of this Agreement.
(23) ASSURANCES
The Recipient shall comply with any Statement of Assurances incorporated as Attachment E.
14
0 0
Cr- N 1.J
L
- - _ STATE OF FLORIDA
c- r7 DEPARTMENT OF ECONOMIC OPPORTUNITY
C_- N
LL. c.. FEDERALLY FUNDED SUQGR.ANT AGREEMENT
L. SIGNATURE PAGE
IN WITNESS WHEREOF, the parties have executed this Agreement by their duly authorized
olticers on the day, month and year set forth below.
RECIPIENT STATE OF FLORIDA
DEPARTMENT OF ECONOMIC OPPORTUNITY
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
(Type Legal Name of Recipient)
BY: tT W '\‘. By: -4
Kim Wigington, Mayor Pro Tem
--EMMID-RICt-MAYOR Ken Reecy, Assistant Director
(Type Name and Title Here) Division of Community Development
Date: February 15, 2012 Date: 3-12-•IZ
59-6n00Ta9
Federal Identification Number
07187(215'1 MQp/C/E OUNTY RN
/,QPPR A
DGNS* Number YMt
r RCADO
a S '" AS ANT CO TY ATTOR EY
P M�u1 Date
n ' mu.:d\ n s''' .'c ' �.a 1I
EXHIBIT—1
THE FOLLOWING FEDERAL RESOURCES ARE AWARDED TO THE RECIPIENT UNDER
THIS AGREEMENT.
SEPARATELY LIST THE FOLLOWING INFORMATION FOR EACH FEDERAL PROGRAM FROM
WHICH THE RESOURCES AWARDED TO THE RECIPIENT ORIGINATE:
Federal Agency: U.S. Department of Health and Human Services
Catalog of Federal Domestic Assistance Title: Low Income Home Energy Assistance Program
Federal Award Identifier: G-1201 FLLIEA
Catalog of Federal Domestic Assistance#: 93.568
Recipient: Monroe County Board of County Commissioners
Contract# 12EA-OF-11-54-01-019
Award Amount: $181,340
THE FOLLOWING COMPLIANCE REQUIREMENTS APPLY TO THE FEDERAL RESOURCES
AWARDED UNDER THIS AGREEMENT:
Separately list each applicable compliance requirement(eligible activities, services, or commodities;
eligible recipients; etc.)and specify to which federal program each requirement applies:
—_Compliance Requirements
Program: Low Income Home Energy Assistance Program
1. Purposes resources must be used for:
The Recipient will use the LIHEAP funds to provide energy payment assistance to low income
consumers. These funds will be expended in accordance with the Scope of Work,Attachment A,
Program Statutes and Regulations, Attachment B,Budget Summary and Workplan, Attachment J,
and applicable OMB Circulars.
2. Eligibility requirements for recipients of the resources:
The Recipient will comply with applicable OMB Circulars and eligibility requirements as set forth
in U.S. Department of Health and Human Services regulations codified in: Title 45 of the Code
of Federal Regulations,Part 96—Block Grants,and Title 31 of the Code of Federal Regulations,
Part 205—Cash Management Improvement Act of 1990.
3. None of these funds will be used for research purposes.
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.
16
LIIIEAP
ATTACHMENT A
SCOPE OF WORK
The Recipient shall,or will ensure through subcontracts that subcontractors shall:
A. Program Requirements
(1) Conduct outreach activities designed to ensure that eligible households,especially households
with elderly or disabled individuals,young children and those with the highest percentage of their
income required to pay for their home energy are made aware of the assistance available under
this Agreement.
(2) Make home visits to home-bound clients,especially the elderly or disabled, for completion of the
program application or eligibility determination when other assistance is not adequate.
(3) The Recipient will make payments to those applicants with the "highest home energy needs and
lowest household income,"which will be determined by taking into account both the energy burden
and the unique situation of such households that results from having members of vulnerable
populations, including very young children,the disabled, and frail older individuals.
(4) The Recipient shall enter into a Memorandum of Understanding(MOU)with all
Weatherization Assistance Programs(WAP)in their service area. The Memorandum of
Understanding shall detail cooperative efforts and shall describe the actions that will be taken
by both parties to assure coordination,partnership and referrals. The Recipient,in coordination
widithe local WAP agency,shall develop a system by which LIHEAP recipients who have
received more than three LIHEAP benefits in the last 18 months and who are homeowners,are
referred to the WAP provider.
(5) Establish a Memorandum of Understanding(MOU)with service area Emergency Home Energy
Assistance for the Elderly Program(EHEAP)providers. The Agreement will ensure
coordination of services,avoid duplication of assistance, and increase the quality of services
provided to elderly participants. The agreements shall detail how LIHEAP and Emergency
Home Energy Assistance for the Elderly Program(EHEAP)records(for households with
elderly members)will be checked to avoid duplicate crisis assistance payments during the same
season.
(6) The Recipient will maintain a written policy and implement procedures to secure applicant's
social security number in order to protect their identity. At a minimum, this policy shall
address the handling of both paper and electronic records and files.
(7) Recipients serving multi-county areas must provide the Department with a description of how
direct client assistance funds will be allocated among the counties.The allocation methodology
must be based at least in part on the 150%of poverty population within each of the counties
served.This information must be reported in Attachment L to this Agreement.
17
(8) When LIHEAP funds are not available or are insufficient to meet the emergency home energy
needs of an applicant,the Recipient will assist the applicant to secure help through other
community resources.
(9) The Recipient shall agree to treat owners and renters equitably under the Agreement.
(10) The Recipient will develop and implement a written policy and procedure to assure that all
energy assistance payments are made to energy vendors comply with the requirements of
Attachment A, Section D of this agreement.
(11) The Recipient will define in a written policy what criteria and verification will be used to
determine if a household has a"home energy crisis"and is eligible for crisis assistance. The
policy must encourage households to seek assistance prior to incurring non-energy penalties
such as disconnect/reconnect fees,additional deposit, interest or late payment penalties.
(12) The Recipient will not charge applicants a fee or accept donations from an applicant to provide
LIHEAP benefits. This policy must be posted in a prominent place where it is visible to all
applicants and include the following language: No money,cash or checks,will be requested or
received from customers in a LIHEAP office. If an employee asks for money,report this to the
agency Executive Director or Department Head.
(13) The Recipient will be in a location and operate during hours available to clients.
(14) The Recipient will refund,with non-federal funds,to the Department,all funds incorrectly paid
on behalf of clients that cannot be collected from the client.
(15) The Recipient will have appropriate staff attend training sessions scheduled by the Department
to cover LIHEAP policies and procedures.
(16) The Recipient will furnish training for all staff members assigned responsibilities within the
program.
(17) The Recipient will take applications when it has a signed Agreement and adequate funding,and
continue taking applications until the Agreement expires or funds are exhausted,whichever
comes first.
(I8) The Recipient must have adequate procedures in place to ensure that LIHEAP funds are
appropriately budgeted and expended to sufficiently allow for energy assistance benefits in
both the heating and cooling seasons.
(19) The Recipient must comply with the Federal Financial Accountability and Transparancy Act
(FFATA). This includes securing a Dun and Bradstreet Numbering System(DUNS)number
(www.dnb.com)and maintaining an active and current profile in the Central Contractor Registration
(CCR)(www.ccr.gov).
•
18
B. Customer Services and Benefits
(1) Make LIHEAP home energy non-crisis assistance payments based on a state-provided payment
matrix and worksheet.The payment amount is based on the household's income level as
compared to the national poverty guidelines.This takes into account both gross income and
family size.
(2) The following maximum benefits will be available to eligible households:
(a)One non-crisis benefit per 12 month period;
(b)One summer home energy crisis benefit between April 1 and September 30 each year;and
(c)One winter home energy crisis benefit between October 1 and March 31 each year.
(3) Based on local need for LIHEAP services and other non-LIHEAP energy assistance resources in
their service area, the Subgrantee may limit crisis benefits to less than those stated in subsection (2)
above.
(4) Determine the correct amount of each crisis benefit based on the minimum necessary to resolve the -
crisis, but not more than the maximum set by the Department. The maximum crisis benefit for this
contract period is$600.00 per household per season.
(5) When the applicant is not in a life threatening situation,take actions that will resolve the
emergency within 48 hours of the application approval for a crisis benefit.
(6) When the applicant is in a life threatening situation,take actions that will resolve the
emergency situation within 18 hours of the application approval for a crisis benefit.
--(7) Make home energy payments within 30 days from the date the application is approved.
(8) The Recipient will,within 15 working days of receiving the client's application, furnish in
writing to all applicants a Notice of Approval which includes: the type and amount of
assistance;the name of the energy vendor to be paid on their behalf; and the next date when the
applicant will be eligible to apply for assistance.
(9) Recipients are required to have written applicant appeal procedures. Within 15 working days
of receiving the client's application,any applicant denied LIHEAP services must be provided a
written notice of the denial.At a minimum,the written Notice of Denial and Appeals shall
contain: the reason(s)for the denial;the appeal process; an explanation of under what
circumstances the client may reapply;what information or documentation is needed for the
person to reapply;the name and address to whom the re-application or appeal should be sent,and
the phone number of the Recipient. Appeal provisions must also be posted in a prominent
place within the office where it is on view for all applicants.
(10) The recipient will compare LIHEAP records and Emergency Home Energy Assistance for the
Elderly Program(CHEAP)records for households with elderly members to avoid duplicate
crisis assistance payments during the same eligibility period.
19
(11) The Recipient will be responsible for maintaining and implementing written policies and
procedures for determining the eligibility of the clients applying for the LIHEAP program.
Client eligibility shall be based on the following factors:
(a) The Recipient may only assist households who are or were residing in their LIHEAP service
area at the time the home energy costs were incurred.
(b) The client must complete an application and return all required information and verification to
the Recipient or subcontractor while funds remain available.
(c) The client must provide a fuel bill for home energy or provide other documentation verifying
an obligation to pay for home energy costs.
(d) The client must have a total gross household income of not more than 150%of the current
OMB federal poverty level for their household's size.
(e) For applicants receiving Supplimental Nutrition Assistance Program(SNAP)or Supplemental
Security Income(SSI), program qualification approvals or notifications may be used to
document household size and income. However,the household income eligibility and the
benefit levels are the same as other applicants.
(f) To receive crisis assistance,the applicant must have a verifiable home energy crisis.
(g) If the applicant lives in government subsidized housing,the Recipient must determine if all or
part of their utility costs are paid directly or indirectly by the government and take the
following actions:
---- 1. The applicant is not eligible for assistance if their home heating and cooling costs are totally
included in their rent and they have no obligation to pay any portion of the costs.
2. For Crisis Assistance Only: If the applicant receives an energy subsidy through Section 8 or
a Public Housing Authority,then the agency must subtract the amount of the subsidy
available to the applicant during the period covered by the utility bill from the allowable
LIHEAP crisis benefit calculated for the household.
3. The applicant is eligible for non-crisis,home energy assistance with no deductions at the
same level as other applicants.
(12) The client must not reside in a group living facility or a home where the cost of residency is at
least partially paid through any foster care or residential program administered by the state.
13)..The client must not be a student living in a dormitory.
C. Customer Records
The Recipient will maintain a separate client file for each LIHEAP client that includes at least
the following information:
(1) Client's name, address,sex, age;
(2) Names, ages and identification documentation of all household members;
(3) Documented Social Security Numbers for all household members(some exceptions may
apply and will be outlined by the Department);
20
(4) Income amount and method of verification for all household members;
(5) Income documentation to support eligibility;
(6) Statement of self-declaration of income if applicable;
(7) If the total household income is less than 50%of the current Federal Poverty Guidelines and
no one in the household is receiving SNAP assistance,include a signed statement of how
basic living expenses i.e.,food, shelter and transportation are being provided.
(8) Copies of approval or denial letters provided to the client;
(9) If preference is given due to a disability, documentation of disability income or physician's
statement.
(10) Documentation of client's obligation to pay the energy bill for the residence in which they
reside.
(11) All LIHEAP assistance applications must be signed by the client and by the Recipient's
representative and supervisory/edit staff.
D. Enemy Vendor Relations
The Recipient shall negotiate and maintain written agreements with home energy
suppliers which shall at a minimum include:
(1) The beginning and ending date of the agreement.
(2) The Vendor Agreement must include a process for identifying the Recipient's representatives
authorized to resolve a crisis situation and make a payment commitment on behalf of the
Recipeint.
(3) The Vendor Agreement must include a process for identifying the Vendor's representatives
authorized to resolve a crisis.
(4) A description of how energy payments will be made directly to the vendor on behalf of the
LIHEAP eligible customer. In cases where no vendor-Recipient agreement exists,the
payment shall be made to the client in the form of a two-party check made payable to the
client and vendor. This procedure shall be used only in rare special circumstances,according
to the Recipient's purchasing policies and only with written approval of the Recipient's
management.
(5) Assurances from the home energy supplier that no household receiving LIHEAP assistance
Will be treated adversely because of such assistance under applicable provisions of state law
or public regulatory requirements.
(6) Assurances from the home energy supplier that they will not discriminate,either in the cost of
goods supplied or the services provided,against the eligible household on whose behalf
payments are made.
(7) An understanding that only energy related elements of a utility bill are to be paid. No water
or sewage charges may be paid except if required by the energy vendor to resolving the crisis
21
and no other resources to pay that portion of the bill can be secured by the customer or
Recipient.
(8) A statement that the Recipient may not pay for charges that result from illegal activities such as a
bad check or meter tampering. A statement that the vendor is aware that those charges are the
responsibility of the customer.
(9) A statement that the vendor is aware that when the benefit amount does not pay for the complete
charges owed by a customer,that the customer is responsible for the remaining amount owed.
(I0) Details on how the vendor will assist the Recipient in verifying the LIHEAP applicant's account
information and in the case of crisis assistance make timely commitments to resolve the crisis. A
process should be in place to verify the current amount owned and'the amount necessary to
resolve the crisis situation.
(II) The Recipient's commitment to make payment to the vendor within 30 days of the day of the
Recipient's promise to pay.
(12) This agreement will be reviewed by both parties at least every 2 years.
(13) Vendor agreements must be signed by upper level management of both the Recipient and the
vendor who has authority to enter into such commitments.
(14) A description of when LIHEAP payments made to the vendor cannot be applied to the
client's account,the funds will be returned to the Recipient or with the Recipient's
approval applied to another eligible customer's account.
(15) The energy vendor,with the exception of municipal providers, must be in"active"status
with the State of Florida: http://sunbiz.orgjsearch.html and the vendor's name must be
checked on EPLS: https://www.epls.gov/. The business name on the vendor agreement
must match the legal business name on the State of Florida website.
•
22
LIHEAP
ATTACHMENT B
PROGRAM STATUTES AND REGULATIONS
A. INCORPORATION OF LAWS, RULES,REGULATIONS AND POLICIES
The applicable documents governing service provision regulations are in the Common Rule,45 CFR
Part 74 and 92,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,"and OMB Circular A-133, "Audits of States,Local Governments,and Non-Profit
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.Low-Income Home Energy Assistance Act of 1981 (Title XXVI of the Omnibus Budget
Reconciliation Act of 1981,Public Law 97-35)as amended. The following Federal Department of
Health and Human Services regulations codified in Title 45 of the Code of Federal Regulations are
also applicable under this Agreement.
1. Part 16—Procedures of the Departmental Grant Appeals Board;
2. Part 30-Claims Collection;
3. Part 80-Nondiscrimination under programs receiving Federal assistance through the
3. Department of Health and Human Services(HHS),Effectuation of Title VI of the Civil
Rights Act of 1964;
4. Part 81 -Practice and procedure for hearings under Part 80 of this Title;
5. Part 84— Nondiscrimination on the basis of handicap in programs and activities
receiving Federal financial assistance.
6. Part 86- Nondiscrimination on the basis of sex in education programs and activities
receiving Federal financial assistance.
7. Part 87—Equal Treatment for Faith Based Organizations;
8. Part 91 -Nondiscrimination on the Basis of Age in HHS programs or activities receiving
Federal Financial Assistance;
9. Part 93 -New restrictions on lobbying;
10. Part 96-Block Grants;
11. Part 100—Intergovernmental Review of Department of Health and Human Services
Programs and activities;
12. Executive Order 12549,Debarment and Suspension from Eligibility for Financial
Assistance(Non-procurement);
23
LHIEAP
ATTACHMENT B
PROGRAM STATUTES AND REGULATIONS
B. PROJECTS OR PROGRAMS FUNDED IN WHOLE OR PART WITH FEDERAL MONEY
The Recipient assures,as stated in Section 508 of Public Law 103-333,that all statements,
press releases,requests for proposals,bid solicitations and other documents describing projects or
programs funded in whole or in part with Federal money,all grantees receiving Federal funds,
including but not limited to State and local governments and recipients of Federal research
grants,shall clearly state:
(1) the percentage of the total costs of the program or project which will be financed with
Federal money,
(2) the dollar amount of Federal funds for the project or program, and
(3) percentage and dollar amount of the total costs of the project or program that will be
financed by non-governmental sources.
C. INTEREST FROM CASH ADVANCES
Recipients shall invest cash advances in compliance with section .21 (h)(2)(i)of the
Common Rule and section .22 of OMB Circular A-110 as revised. Recipients shall maintain
advances of Federal funds in interest-bearing accounts unless one of the following conditions
applies:
NON-PROFITS ONLY:
1. The Recipient or subcontractor receives less than$120,000 in total Federal awards per year.
2. The best reasonably available interest bearing account would not be expected to earn interest
in excess of$250 per year on all Federal cash balances.
3. The depository would require an average or minimum balance so high that it would not be
feasible within the expected Federal and non-Federal cash resource. Interest earned off cash
advances shall be reflected on the monthly financial status report and the close-out report.
LOCAL GOVERNMENTS ONLY:
Except for interest earned on advance of funds exempt under the inter-governmental Cooperation
Action(31 U.S.0 6501 et. seq.)and the Indian Self-Determination Act(23 U.S.C.450),grantees and
sub-grantees shall promptly,but at least quarterly,remit interest earned on advances to the Federal
agency. The grantee or sub-grantee may keep interest amounts up to$100 per year for
administrative expenses.
24
LIHEAP
ATTACTDYIENT B
PROGRAM STATUTES AND REGULATIONS
D. PROGRAM INCOME
The Recipient may reapply program income for eligible program projects or objectives.The amount
of program income and its disposition must be reported to the Department at the time of submission
of the final close-out report.
E. MODIFICATIONS
(1) The Department shall not be obligated to reimburse the Recipient for outlays in excess of the
funded amount of this Agreement unless and until the Department officially approves such
expenditures by executing a written modification to the original Agreement.
(2) The line item budget,as given in Attachment J of this Agreement and reported on the
monthly financial status reports, may not be altered without a written budget modification
submitted in accordance with the terms below:
(a) The Recipient must use a Department approved Modification package.
(b) Only unobligated funds may be transferred from one line item to another line item.
(c) The Recipient may transfer unobligated budgeted line items within a budget category
as long as the budget category subtotal remains the same. For the purpose of
transferring funds,the following are considered budget categories: Administrative
Expenses, Outreach Expenses and Direct Client Assistance.
(d) Each modified line item must meet all contractual minimum and maximum
percentage budget requirements.
(e) All requests for modifications to increase or decrease any line item must be submitted to
the Department for approval thirty(30)days prior to the anticipated implementation date.
Failure to meet this time frame may result in reimbursement delays.
(f) A letter of explanation and a completed modification package(Budget Summary and
Workplan, Administrative and Outreach Budget Detail(if applicable)and Multi-County
Fund Distribution (if applicable)signed by the Recipient must be submitted to the
Department and approved prior to the submission of a financial status report in which the
changes are implemented.
(g) Upon approval,the Recipient's budget detail will be revised in the Department's
electronic payment system.
(h) None of the budget transfers may violate this Agreement or OMB Circulars
A-1 10,Common Rule,A-121 or A-87. The budget revision(s)will be reviewed by the
Department for compliance with these circulars.
25
LIHEAP
ATTACHMENT B
PROGRAM STATUTES AND REGULATIONS
F. BONDING
(1) Non-Profit Organizations: The Recipient agrees to purchase a blanket fidelity bond covering
all officers, employees and agents of the Recipient holding a position of trust and authorized
to handle funds received or disbursed under this Agreement. Individual bonds apart from the
blanket bond are not acceptable. The amount of the bond must cover each officer, employee
and agent up to an amount equal to at least one-half of the total LIHEAP agreement amount.
(2) Local Governments:The Recipient agrees to purchase a fidelity bond in accordance with
Section 113.07,Fla. Stat.The fidelity bond must cover all officers,employees and agents of
the Recipient holding a position of trust and authorized to handle funds received or disbursed
under this Agreement.
G. OTHER PROVISIONS
(I) The Recipient must budget a minimum of twenty-five(25)percent of the total Agreement
funds for Home Energy Assistance.
(2) The Recipient must budget a minimum of two(2)percent of the total Agreement funds for
Weather Related/Supply Shortage emergency assistance. These funds must be held in this
budget line item category until December 15 of the program year for use in response to a
possible disaster. These funds will only be used during state or federal emergencies declared
by the President,the Governor or the Secretary of the Department as he/she deems necessary.
In the event of an emergency being officially declared,if the Recipient or the Department
fords that two percent of the budget is not sufficient to meet the emergency,the Recipient
may draw on other Agreement categories, up to fifty percent(50%)of the total Agreement
budget, without additional written authorization. After December 15, if no emergency has
been declared,the Recipient may allocate these funds to the crisis or the home energy
category of the program without additional written authorization from the Department. When
funds are distributed for a weather-related/supply shortage emergency,the Department will
provide binding directives as to the allowable expenditures of the funds. The Recipient will
comply with these directives or agree that these funds will remain with the Department.
(2) In addition to the record keeping and audit requirements contained in Sections(5)and (6)of
this Agreement,the books,records,and documents required under this Agreement must also
be available for copying and mechanical reproduction on or off the premises of the
Recipient.
26
LHEAP
ATTACHMENT B
PROGRAM STATUTES AND REGULATIONS
(4) If the U.S. Department of Health and Human Services initiates a hearing regarding the
expenditure of funds provided under this Agreement,the Recipient shall cooperate with,and
upon written request,participate with the Department in the hearing.
(5) All records, including supporting documentation of all program costs,shall be sufficient to
determine compliance with the requirements and objectives of the Scope of Work,
Attachment A,and all other applicable laws and regulations.
•
27
ATTACHMENT C
REPORTS
1. Annual reports
(a) Within 45 days after the end of the Agreement the Recipient shall submit a LIHEAP Close-out
Report,including the LIHEAP Final Financial Report,a refund check for any unspent funds,and
the LIHEAP Final Program Report.
(b) Agencies that are below the$500,000 threshold of all Federal awards in its fiscal year and thus
are exempt from the federal single audit act requirements, shall submit with their contract proposal
a copy of their most recent IRS From 990.
2. Ouarterly Reports-For each county the Recipient serves,the LIHEAP Household Quarterly
Program Report must be provided to the Department no later than twenty-one(21)calendar days
following the end of the quarter. For the purposes of this contract,the ending dates of the quarters
are June 30, September 30,December 31 and March 31.
3. Monthly reports- The LIHEAP Monthly Financial Status Report must be provided to the
Department by no later than the twenty-first(21'day)of each month following the end of the reporting
month in which funds were expended.
4. Cost Allocation Plans
2 CFR Part 215, Subpart C, Section 215.21(6)requires that Recipients have written financial
management systems procedures for determining the reasonableness,allocability,and allowability of
costs in accordance with the provisions of the applicable federal cost principles and terms and
conditions of the award. To document this,Recipients must submit copies of their written Cost
Allocation Plans to the Department with their contract proposal.
5. Upon reasonable notice,the Recipient shall provide such additional program updates or information
as may be required by the Department, including supporting or source documentation for any reports
identified above in this section.
The reports shall be submitted to:
Ms. Hilda Frazier,Manager
Florida Department of Economic Opportunity
Division of Community Development
Office of Housing and Community Development
Community Assistance Section
107 East Madison Street -MSC 400
Tallahassee, FL 32399-4120
Fax: (850)488-2488
28
LIHEAP
ATTACHMENT D
PROPERTY MANAGEMENT AND PROCUREMENT
A. All such property purchased under this Agreement shall be inventoried annually and an
inventory report shall be made available to the Department upon request.
B. All property purchased under this Agreement shall be listed on the property records of the
Recipient. Said listing shall include a description of the property,model number,
manufacturer's serial number, funding source, information needed to calculate the federal
and/or state share,date of acquisition,unit cost,property inventory number and information on
the location, use and condition,transfer,replacement or disposition of the property.
C. Title(Ownership)to all nonexpendable property acquired with funds from this Agreement shall
be vested in the Department upon completion or termination of the Agreement.
D. The Recipient agrees to comply with Section 507 of Public Law 103-333.As stated in
this section, it is the sense of Congress that,to the extent practicable,all equipment and
products purchased with funds made available in this Act should be American made.
29
LIHEAP
ATTACHMENT E
STATEMENT OF ASSURANCES
A. Interest of Certain Federal Officials
No member of or delegate to the Congress of the United States,and no Resident Commissioner,shall
be admitted to any share of part of this Agreement or to any benefit to arise from the same.
B. Interest of Members. Officers, or Employees of Recipient.Members of Local Governing Body,or
Other Public Officials.
No member,officer,or employee of the Recipient, or its delegates or agents,no member of the
governing body of the locality in which the program is situated, and no other public official of such
locality or localities who exercises any functions or responsibilities with respect to the program
during his tenure or for one year thereafter,shall have any interest,direct or indirect,in any contract
or subcontract, or the proceeds thereof, for work to be performed in connection with the program
assisted under this Agreement. The Recipient shall incorporate or cause to be incorporated in all such
Agreements,a provision prohibiting such interest pursuant to the purposes of this subsection.No
board member,officer or employee will be permitted to receive any remuneration or gift in any
amount. Board members may receive travel expenses in accordance with s. 112.061, Florida Statutes.
C. Nepotism
The Recipient agrees to abide by the provisions of s. 112.3135,Ha. Stat. pertaining to nepotism in their
performance under this Agreement
D. LIHEAP Assurances
The Recipient hereby assures and certifies as a condition of receipt of Low Income Home Energy
Assistance Program funds,that it and its subcontractors will comply with the applicable
requirements of Federal and State laws,rules, regulations,and guidelines.As part of its
acceptance and use of LIHEAP funds,the Recipient assures and certifies that:
(1) The Recipient possesses the legal authority to administer the program as approved by
the Recipient's governing body,including all assurances contained herein.
(2) The Recipient possesses the sound controls and fund accounting procedures necessary to
adequately safeguard the assets of the agency,check the accuracy and reliability of
accounting data,promote operating efficiency and maintain compliance with prescribed
management policies of the agency.
(3) The Recipient will permit and cooperate with Federal and State investigations designed
to evaluate compliance with the law.
30
LIHEAP
ATTACHMENT E
STATEMENT OF ASSURANCES
(4) The Recipient will give the Department,the Auditor General or any authorized
representatives,complete access to examine all records,books,papers or documents
related to all program operations of the grant, including those of any sub-contractor.
(5) The Recipient will comply with non-discrimination provisions,in accordance with Florida
Statutes; Section 677 of P.L.97-35; Titles VI and VII of the Civil Rights Act of 1964;and 45
C.F.R.Parts 84,86 and 90.
(6) The Recipient will comply with section 680 of Public Law 97-35, as amended, which
prohibits use of LIHEAP funds for purchase or improvement of land, or the purchase,
construction, or permanent improvement of any building or other facility.
(7) The LIHEAP application and all its attachments, including budget data, are true and correct.
(8) The Recipient will prohibit any political activities in accordance with Section 678F(b)
of 42 USC 9918,as amended.
(9) Administration of this program has been approved by the Recipient's governing body
by official action,and the officer who signs it is duly authorized to sign this
Agreement.
(10) The Recipient agrees to comply with Public Law 103-227,Part C,Environmental
Tobacco Smoke,also known as the Pro-Children Act of 1994(Act).This Act requires
that smoking not be permitted in any portion of any indoor facility owned or leased or
contracted for by an entity and used routinely or regularly for the provision of health, day
care,education,or library services to children under the age of 18, if the services are
funded by Federal programs either directly or through States or local governments.
Federal programs include grants, cooperative agreements, loans or loan guarantees,and
contracts.The law does not apply to children's services provided in private residences,
facilities funded solely by Medicare or Medicaid funds, and portions of facilities used for
inpatient drug and alcohol treatment. The Recipient further agrees that the above
language will be included in any subawards which contain provisions for children's
services and that all subrecipients shall certify compliance accordingly.Failure to
comply with the provisions of this law may result in the imposition of a civil monetary
penalty of up to$1,000 per day.
(I 1) The Recipient will have a published and publicized local outreach office number when
the outreach office is open a minimum of 40 hours per week,or toll-free telephone
number.
31
LIIIEAP
ATTACHMENT F
SPECIAL CONDITIONS
A. The Recipient and its subrecipients shall comply with the following special conditions:
NONE
B. Failure of the Recipient or its subrecipients to comply with the special conditions under this
Agreement shall be cause for the immediate suspension of payments,and may be cause for the
immediate termination of this Agreement.
32
LIHEAP
ATTACHMENT G
WARRANTIES AND REPRESENTATIONS
Financial Management
Recipient's financial management system must include the following:
(I) Accurate,current and complete disclosure of the financial results of this project or program.
(2) Records that identify the source and use of funds for all activities.These records shall contain
information pertaining to grant awards,authorizations,obligations, un-obligated balances,assets,
outlays, income and interest.
(3) Effective control over and accountability for all funds,property and other assets. Recipient shall
safeguard all 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 whether costs are allowed and reasonable under the provisions of
the applicable OMB cost principles and the terms and conditions of this Agreement.
(6) Cost accounting records that are supported by backup documentation.
Competition
All procurement transactions shall be done in a manner to provide 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 excellent 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,considering the price,quality
and other factors. Solicitations shall clearly set forth all requirements that the bidder or offeror must
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.
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
33
LIHEAP
ATTACHMENT G
WARRANTIES AND REPRESENTATIONS
about to employ any of the parties indicated,has a financial or other interest in the fum 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 the 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 CJ:00 A 111 to 5:00 pm
Licensing and Permitting
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.
•
34
LIHEAP
ATTACHMENT H
CERTIFICATION REGARDING
DEBARMENT,SUSPENSION,INELIGIBILITY
AND VOLUNTARY EXCLUSION
(1) The prospective subcontractor of the Recipient, N fpllcn.ble.
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 subcontractor is unable to certify to the above statement,the prospective
subcontractor shall attach an explanation to this form.
SUBCONTRACTOR:
Kok. Applicable_
By:
Signature Recipient's Name
Name and Title DEO Contract Number
Street Address
City, State,Zip
Date
35
ATTACHMENT I
RECIPIENT INFORMATION
FEDERAL YEAR: 2012 CONTRACT
T PERIOD: Date of Signing through March 31,2013
FOR DEO USE ONLY: RECEIVED '2,Ia1I)0. REVISION(S)
Instructions: Complete the blanks highlighted in yellow. For item II,put an"X"in whichever highlighted box applies to your agency.
I. DEO CONTRACT NUMBER: 12EA-OF-11-54-01-019 CONTRACT AMOUNT: 181,340.00
TOTAL DIRECT CLIENT ASSISTANCE: 141,038.00 LEVERAGE AMOUNT(If applicable): g,T'-:
II. RECIPIENT CATEGORY: D Non-Profit ❑X Local Government 0 State Agency
III. COUNTY(IES)TO BE SERVED WITH THESE FUNDS: MONROE
IV. GENERAL ADMINISTRATIVE INFORMATION
a. Recipient: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS County Location: FLORIDA
b. Executive Director or Chief Administrator: SHERYL GRAHAM
c. Address: 1100 SIMONTON STREET SUITE 2-257 City: KEY WEST ,FL Zipcode: 33040
Telephone: (305)292-4510 Fax: (305)295-4359
Cell: Email: graham-shervl@monroecountv-fl.aov
d. Mailing Address: 1100 SIMONTON STREET SUITE 2-257 City: KEY WEST ,FL Zipcode: 33040
-e. Chief Elected Official(for local governments)or President/Chairman of the Board(for corporations):
Name: DAVID RICE Title: MAYOR
Enter home or business address,telephone numbers and email other than the Recipients
Address: 9400 OVERSEAS HWY,11210 City: MARATHON ,FL Zipcode: 33050
Telephone: (305)289-6000 Fax: Email:
f. Official to Receive State Warrant:
Name: DANNY KOLHAGE Title: CLERK OF THE COURT
Address: 500 WHITEHEAD STREET City: KEY WEST ,FL Zipcode: 33040
g. Recipient Contacts
1. Program: Name: SHERYL GRAHAM Title: SOCIAL SERVICES DIRECTOR
Address:1100 SIMONTON STREET SUITE 2-257 City: KEY WEST ,FL Zipcode: 33040
Telephone: (305)292-4510 Fax: (305)295-4359
Cell:
2. Fiscal: Name: DANNY KOLHAGE Title: CLERK OF THE COURT
Address: 500 WHITEHEAD STREET City: KEY WEST ,FL Zipcode: 33040
Telephone: (305)292-3560 Fax: (305)295-3660
Cell:
h. Person(s)authorized to sign reports: SHERYL GRAHAM,KIM WEAN
i. Agency's FEID Number: 59-6000749 I. Agencys DUNS Number: 73878757
V. AUDIT DUE DATE: Audit(s)are due by the end of the Ninth month following the end of the acencv's fiscal year.
Recipient Fiscal Year: October 1,2011 thru September 30,2012 Audit Due to DEO: June 30,2013
38
ATTACHMENT J
BUDGET SUMMARY AND WORKPLAN
RECIPIENT: S1ONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT: 12EA-OF-11-54-01-019
Instructions: Enter the appropriate figures in the boxes highlighted in yellow only.
I. BUDGET SUMMARY
LIHEAP FUNDS ONLY BUDGETED AMOUNT
l on
1 LIHEAP FUNDS (No Leveraging Funds) 181,340.00 HINT:ecci LIHEAP Feet u ert.C nrac Amount.
waMsheet under I.Contract Amount.
ADMINISTRATIVE EXPENSES
Salaries including Fringe,Rent,Uhldies.Travel.Other (Total cannot exceed 8.5%of Line it-
2 15,413.00
Maximum Administrative Expense: IS15,113.90
OUTREACH EXPENSES
Salaries including Fringe,Rent,Utilities,Travel,Other(Total cannot exceed 15%of the dilterence
3 between Line 1&Line 2 (Line 1 minus Line 2 times.15))' 24,889.00
Maximum Outreach Expense: 1524,889.05
DIRECT CLIENT ASSISTANCE
Home Energy Assistance (Must be at least 25%of Line 1.)
4 25%Minimum Calculation: I545,335.00 45,500.00
5 Crisis Assistance 91,688.00
6 Weather Related/Supply Shortage/Disaster (Must be at least 2%of line 1.) 3,850.00
2%Minimum Calculation: 1E3,626.80
7 TOTAL DIRECT CLd,t,.T n.F5iSTANCE (Lines 4+5+6) 141,038.00
LEVERAGING FUNDS ONLY BUDGETED AMOUNT
8 LEVERAGE FUNDS
9 Home Energy Assistance
10 Crisis Assistance
11 TOTAL LEVERAGING(Lines 8 v 9)
12 GRAND TOTAL ALL EXPENSES(Lines 2+3+7+10) 181,340.00
II. DIRECT CLIENT ASSISTANCE PLAN
Estimated If of Estimated Estimated
Type of Assistance Benefits to Cost Per Expenditures"
be Provided Benefit (Col.2 x Col.3)
Home Energy 182 250.00 45,500.00
Crisis 259 354.01 91,688.59
Weather Related/Supply Shortage 14 275.00 3,850.00
Leveraging-Home Energy
Leveraging-Crisis
TOTAL 141,038.59
•If less than 8.5%of Line 1 is budgeted for Mmniatratve Expenses,the Recipient may increase the Outreach Expenses.The total Adrninsvatr,e Ewrenses
plus the total Outreach Expenses may not exceed the sum of the original maximum allowed for each of these line earns.
Total of Lite 2 plus Line 3 may not exceed: 1340.302.95 'Line 2+Line 3= 1840.302.00
"Estimated Expenditues given in the Assistance Plan.must agree with the corresponding values on Lines 4.7.
37
ATTACHMENT K
ADMINISTRATIVE AND OUTREACH EXPENSE BUDGET DETAIL(Lines 2-3)
Recipient: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Contract: 12EA-0E-1154-01-019
Instructions: On the form below,enter the detail of the figures listed on the Budget Summary. If more space is needed,copy this form
copy this form to another tab and name the new tabs'Budget Detail f', 'Budget Detail 2',etc.
Line Expenditure Detail LIHEAP
Kern FUNDS
No (Round up line items to dollars. Do not use cents and decimals in totals.)
2 ADMINISTRATIVE EXPENSES:
salary:Director
5%LIHEAP,15%CCE,20%MCT,4%C1,4%C2,22%GENERAL REVENUE,30%WAP
105 HRS X$40.64MR LOADED WITH FRINGE 4,267.00
salary:Sr.Grants Coordinator
10%LIHEAP,40%CCE,5%MCT,5%ADI,5%CCDA,5%C1,5%C2,25%GENERAL REVENUE
208 HRS X$32.65MR LOADED WITH FRINGE 6,791.00
MISC-OTHER:
1)PHONE,POSTAGE,FREIGHT- 250
2)PRINTING AND BINDING SUPPLIES- 355
3)OFFICE SUPPLIES 500
4)OPERATING SUPPLIES 250
5)RENTAUCOPIER 500
6)MAINTENANCE AGREEMENT 2500 4,355.00
(annual fee for maintaining internal data client tracking system)
TOTAL ADMINISTRATIVE EXPENSES 15.413.00
3 OUTREACH EXPENSES
salary:FULL TIME CASE MANAGER(INTAKE,ELIGIBILITY)
20%LIHEAP, 80%GENERAL REVENUE
400 FIRS X$30.129-1R LOADED WITH FRINGE 12,098.00
salary:STAFF ASSISTANTS(TWO INTAKE,ELIGIBILITY)
15%LIHEAP, 85%GENERAL REVENUE
312 FIRS X$19.84/HR LOADED WITH FRINGE 12,380.00
TRAVEL:1036 MILES X$.445/PER MILE 461.00
TOTAL OUTREACH EXPENSES 24,889.00
38
ATTACHMENT L
MULTI-COUNTY FUND DISTRIBUTION
Agency:MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, Contract: 12EA-DF-11-54-01-019
Number of Counties to be Served with this agreement:
If the Recipient will serve more than one county with the this agreement,complete the form below. Describe
how you will equitably allocate LIHEAP resources to each of the counties you serve. This plan must be in part
based on the 150%poverty population of each county.
Instructions: Enter appropriate data only in the cells below that are highlighted in yellow. Percentages will
automatically populate when the total direct client assistance amount and all three columns for each county
Poverty Population Data Sauce: Provide the U.S.Census data source for the 150%of poverty population
used including the year of the data. If any other data or factors are used in allocating the funds,describe and
give the source.
u o
2fi
rR 00g
9 d
a"
TOTAL DIRECT %OF AGENCY'S
COUNTY'S% CLIENT DIRECT CLIENT
COUNTY 150%POVERTY OF POVERTY ASSISTANCE ASSISTANCE
POPULATION" POPULATION IN S141,038.00 DOLLARS
SERVICE AREA COUNTY ALLOCATED TO
ALLOCATION THIS COUNTY
MONROE 191.038.00 100.0%
Total Budgeted Direct 0 0% 141,038.00 100.0%
Client Assistance*
• Allocation must be equal to Attachment J,Budget Summary and Workplan.Line T.
39
ATTACHMENT M
JUSTIFICATION OF ADVANCE PAYMENT
RECIPIENT: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT NUMBER: 12EA-0E-11-54-01-019
Any advance payment under this Agreement is subject to s.216.181 (16)(a)(b), Florida Statutes and Attachment D,Section D of this Agreement.
The Recipient shall invest cash advances In compliance with section.21(h)(2)(I)of the Common Rule,section.22 of OMB Circular A-f f0
as revised and Attachment B,subsection D of this Agreement. Check the applicable box below(check only one).
ONO ADVANCE REQUESTED OADVANCE REQUESTED
No advance payment is being requested. Advance payment of is requested. Balance of payments will
Payment will be made solely on a be made on a reimbursement basis. These funds are needed to pay staff,award
reimbursement basis. No additional benefits to clients,duplicate forms and purchase start-up supplies and equipment.
information is required. We would not be able to operate the program without this advance.
ADVANCE REQUEST WORKSHEET If an advance is requested,complete the following worksheet by filling in the cells highlighted in yellow.
DESCRIPTION (A) (B) (C) (0)
FFY 2009 FFY 2010 FFY 2011 Total
1 INITIAL CONTRACT ALLOCATION 0.00 0.00 0.00 0.00
2 FIRST TWO MONTHS OF CONTRACT 0.00 0.00 0.00 0.00
_EXPENDITURES
3 AVERAGE PERCENT EXPENDED IN FIRST #DIV/01 #DIV/01 4DIV/01 #DIV/01
TWO MONTHS(Divide line 2 by line 1)
The first two months in which expenditures were reported need to be provided for the years you received a LIHEAP contract. If you do not
have this information,call your financial specialist and they will assist you.
The Recipient may request an amount up to the historical percent of expenditures for the first 2 months of the agreement OR 17%of the
award,whichever Is g$g.
HISTORICAL PERCENT FOR FIRST 2 MONTHS: #DIV/01 x $ 181,340.00 = #DIV/01
Cell D3 LIHEAP Award Historical Advance
17%CALCULATION: 181,340.00 x 0.17 = 30,827.80
LIHEAP Award Percent of Award Maximum Advance
REQUEST FOR WAIVER OF CALCULATED MAXIMUM Check the applicable statement,then complete the Estimated Expenses Chart.
ORecipient has no previous history with LIHEAP contracts. Recipient has exceptional circumstances that require an advance greater
than average first two months expenditures of the previous three years.
ESTIMATED EXPENSES FOR FIRST TWO MONTHS
ANTICIPATED EXPLANATION OF CIRCUMSTANCES
BUDGET EXPENDITURES
CATEGORY FOR FIRST2
MONTHS
Administrative
Outreach
Direct Assistance
Total Expenses 0
40