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1st Amendment 07/18/2012 DANNY L. KOLHAGE CLERK OF THE CIRCUIT COURT DATE: August 8, 2012 TO: Christine Hurley, Director Growth Management Division ATTN: Mayra Tezanos Executive Assistant FROM: Pamela G. Hanc At the July 18, 2012, Board of County Commissioner's meeting, the Board granted approval and authorized execution of Item F1 Amendment No.1 to current Clean Vessel Act Agreement No. MV022 between the Florida Department of Environmental Protection (DEP) and Monroe County (County), which provides reimbursement funding for the County' mobile vessel pumpout program, extending the Agreement to September 9, 2013 and revising the scope of the Agreement. Enclosed are three duplicate originals of the above - mentioned, executed on behalf of Monroe County, for your handling. Please be sure to return the fully executed "Monroe County Clerk" as well as the "Monroe County Finance" originals as soon as possible. Should you have any questions, please feel free to contact our office. cc: County Attorney Finance File Monroe County Clerk DEP AGREEMENT NO. MV022 AMENDMENT NO. 1 THIS AGREEMENT as entered into on the 18 day of February, 2011, between the STATE OF FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION (hereinafter referred to as the "Department" or "DEP ") and the MONROE COUNTY BOARD OF COUTY COMMISIONERS (hereinafter referred to as the "Grantee" or "Recipient ") is hereby amended. WHEREAS, the Grantee has requested additional time for the installation of the pumpout to be completed; and, WHEREAS, the Grantee has requested and the Department has agreed that a time extension is necessary to complete the project; and, WHEREAS, other changes to the Agreement are necessary. NOW, THEREFORE, the parties hereto agree as follows: -- Paragraph 4 subparagraph A is hereby deleted in its entirety and replaced with the following: 4. A. This Agreement shall become effective upon execution by both parties and shall remain in effect for a period of five (5) years from the date of project completion in order for the Grantee to comply with the reporting requirements identified in paragraph 7 of this Agreement. It is understood and agreed that the Project shall be completed no later than September 9, 2013. The Grantee must make project facilities available to the boating public for a minimum of five (5) years after the completion date of the project established above. -- Paragraph 5 is hereby deleted in its entirety and replaced with the following: 5. A. As consideration for the services rendered by the Grantee under the terms of this Agreement, the Department shall pay the Grantee on a cost reimbursement basis up to a maximum of $96,528.33 towards the Total Project Cost as described in Attachment A -1, Revised Scope of Work and Conditions. This Agreement may be amended to provide for additional services if additional funding is made available by the U.S. Fish and Wildlife Service and/or the Florida Legislature. B. Prior written approval from the Department's Grant Manager shall be required for changes between approved task amounts that do not exceed 10% of the Total Project Budget. The DEP Grant Manager will transmit a copy of the written approval and revised budget to the DEP Procurement Office and the DEP Contracts Disbursements Office for inclusion in the Agreement file. Changes greater than 10% will require a formal amendment to the Agreement. C. The Grantee shall be reimbursed on a cost reimbursement basis for all eligible project costs upon the completion, submittal and approval of the deliverables identified in Attachment A -1, in accordance with the schedule therein. No travel expenses are authorized under the terms of this Agreement. i. Reimbursement shall be requested utilizing Attachment B, Grant Payment /Match Request Form. In conjunction with Attachment B, an itemized listing (by deliverable) of all expenditures claimed (including the dates of service). ii. The Chief Financial Officer requires detailed supporting documentation of all costs under a cost reimbursement agreement. In accordance with Attachment DEP Agreement No. MV022, Amendment No. 1, Page 1 of 5 • C, Contract Payment Requirements, the Grantee shall comply with the minimum requirements set forth therein. All bills for amounts due under this Agreement shall be submitted in detail sufficient for a proper pre -audit and post - audit thereof. iii. The Grantee shall submit a final invoice to the Department no later than September 23, 2013, to assure the availability of funds for final payment. The final invoice shall be accompanied by a completed and signed Project Completion Form to be provided by the Department, an Operational Plan as described in the Operations section of Attachment A of this Agreement, a copy of the operational log required under the Operations section of Attachment A, a photograph of the completed pumpout installation as well as a photograph of the pumpout logo sign and informational sign. iv. Each payment request submitted shall document all matching funds and/or match efforts (i.e. in -kind services) provided during the period covered by each request. The final payment will not be processed until the match requirement has been met.) Upon approval and payment of the final invoice, any funds remaining under this Agreement will be unencumbered. D. For the purchase of goods or services costing more than $2,500 and less than $100,000 the Grantee shall obtain at least two written quotes. The quotes must be submitted to the Department for review and approval of the quote amount prior to the commencement of any work under this Agreement. Written quotes shall be for items that are alike in function, operation and purpose. An explanation must be provided whenever the Grantee proposes the use of a vendor quoting other than the lowest price. The Department has the right to reject all quotes and require additional documentation supporting the anticipated Project costs. The Department shall make no reimbursement from grant funds until this documentation has been provided and approved. Any purchase over $100,000 shall comply with the procurement requirements described in 43 CFR 12.76. E. The parties hereto understand and agree that this Agreement requires a cost sharing or match in the form of cash or third party in -kind, on the part of the Grantee. The match expended by the Grantee shall be at least 25% of the total amount actually expended on the Project. All cost sharing/match shall meet the federal requirements established in 43 CFR, Part 12 and OMB Circulars A -87 (2 CFR 225), A -122 (2 CFR 230) and A -21 (2 CFR 220). F. The Grantee may also be required to submit a cost allocation plan to the Department in support of its multipliers (overhead, indirect, general administrative costs, and fringe benefits) if applicable. State guidelines for allowable costs can be found in the Department of Financial Services' Reference Guide for State Expenditures at http: / /www.fldfs.com/aadir /reference %5Fguide and allowable costs for Federal Programs can be found under 48 CFR Part 31 and Appendix E of 45 CFR Part 74, at http: / /www. access.gpo.gov /nara/cfr/cfr- table - search.html and OMB Circulars A -87 (2 CFR 225), A -122 (2 CFR 230), A -21 (2 CFR 220); and administrative requirements can be found in OMB Circulars A -102 and A -110 (2 CFR 215) at http: / /www. whitehou se. gov /omb/ circulars /index.html #numerical. REMAINDER OF PAGE INTENTIALLY LEFT BLANK DEP Agreement No. MV022, Amendment No. 1, Page 2 of 5 G. Allowable costs will be determined in accordance with the cost principles applicable to the organization incurring the costs. For purposes of this Agreement, the following cost principles are incorporated by reference. Organization Type Applicable Cost Principles State, local or Indian tribal government. OMB Circular A -87 (2 CFR 225) Private non - profit organization other than OMB Circular A -122 (2 CFR 230) (1) an institution of higher education, (2) hospital, or (3) organization named in OMB Circular A -122 as not subject to that circular. Education Institutions OMB Circular A -21 (2 CFR 220) For- profit organization including an 48 CFR Part 31, Contract Cost Principles and organization named in OMB A -122 as not Procedures, or uniform cost accounting standards subject to that circular. that comply with cost principles acceptable to the federal agency. Hospital 45 CFR Subtitle A - Appendix E to Part 74- Principles for Determining Costs Applicable to Research and Development Under Grants and Contracts with Hospitals H. Any State agency or agency of a political subdivision of a State which is using appropriated Federal funds shall comply with the requirements set forth in Section 6002 of the Resource Conservation and Recovery Act (RCRA) (42 U.S.C. 6962). Regulations issued under RCRA Section 6002 apply to any acquisition of an item where the purchase price exceeds $10,000 or where the quantity of such items acquired in the course of the preceding fiscal year was $10,000 or more. RCRA Section 6002 requires that preference be given in procurement programs to the purchase of specific products containing recycled materials identified in guidelines developed by EPA. These guidelines are listed in 40 CFR 247. 1. The Grantee's accounting systems must ensure that these funds are not commingled with funds from other agencies. Funds from each agency must be accounted for separately. Grantees are prohibited from commingling funds on either a program -by- program or a project -by- project basis. Funds specifically budgeted and/or received for one project may not be used to support another project. Where a Grantee's, or subrecipient's, accounting system cannot comply with this requirement, the Grantee, or subrecipient, shall establish a system to provide adequate fund accountability for each project it has been awarded. 2. If the Department finds that these funds have been commingled, the Department shall have the right to demand a refund, either in whole or in part, of the funds provided to the Grantee under this Agreement for non - compliance with the material terms of this Agreement. The Grantee, upon such written notification from the Department shall refund, and shall forthwith pay to the Department, the amount of money demanded by the Department. Interest on any refund shall be calculated based on the prevailing rate used by the State Board of Administration. Interest shall be calculated from the date(s) the original payment(s) are received from the Department by the Grantee to the date repayment is made by the Grantee to the Department. 3. In the event that the Grantee recovers costs, incurred under this Agreement and reimbursed by the Department, from another source(s), the Grantee shall reimburse the Department for all recovered funds originally provided under this Agreement. Interest on any refund shall be calculated based on the prevailing rate used by the State Board of Administration. Interest shall be calculated from DEP Agreement No. MV022, Amendment No. 1, Page 3 of 5 the date(s) the payment(s) are recovered by the Grantee to the date repayment is made to the Department by the Grantee. Paragraph 7 is hereby revised to add the following as subparagraph B: 7. B. The Grantee shall submit the following information to the Department on a quarterly basis: the gallons pumped, fees collected, vessels pumped, number of out of state vessels, and maintenance costs. This information shall be submitted to the Department on the form provided at: http: / /www.dep.state.fl.us/ cleanmarina /CVA /quarterlyjumpout.htm for a period of five (5) years following the Project completion date identified in paragraph 4.A. This form shall be submitted no later than fifteen (15) days following the last day of the reporting quarter beginning with the quarter during which the completion of the construction or installation of equipment occurred. - Paragraph 13 is hereby revised to add the following as subparagraph E: 13. E. The Grantee agrees to follow the affirmative steps identified in 43 C.F.R. 12 for its selection of subcontractors and retain records documenting compliance. - The following language is hereby added as Paragraph 30: Any notices between the parties shall be considered delivered when posted by Certified Mail, return receipt requested, or delivered in person to the Grant Managers at the addresses listed in Paragraphs 16 and 17. The following language is hereby added as Paragraph 31: A 3 x 4 foot sign of the International Pumpout Symbol shall be placed on a dock or on land, facing the waterway and easily visible to the boaters. Sign specifications can be found at the following link: http: / /wsfrprograms.fws.gov/ Subpages /ToolkitFiles /fasymb.pdf. In addition, informational signage stating fees, hours of operation, instructions, and operator name and telephone number shall be posted in a clearly visible location. The sign shall have posted emergency phone numbers for reporting service problems and shall include the following statement: "Funded in part by the U.S. Fish and Wildlife Service, Clean Vessel Act through the Florida Department of Environmental Protection." Attachment A, Scope of Work and Conditions, is hereby deleted in its entirety and replaced with Attachment A -1, Revised Scope of Work and Conditions, attached hereto and made a part of the Agreement. All references in the Agreement to Attachment A shall hereinafter refer to Attachment A -1, Revised Scope of Work and Conditions. Attachment B, Grant Payment/Match Request is hereby deleted in its entirety and replaced with Attachment B -1, Revised Grant Payment/Match Request, attached hereto and made a part of the Agreement. All references in the Agreement to Attachment B shall hereinafter refer to Attachment B -1, Revised Grant Payment/Match Request. Attachment E, Special Audit Requirements, Page 5 of 5 is hereby deleted in its entirety and replaced with Attachment E, Special Audit Requirements, Page 5 (Revised) of 5, attached hereto and made a part of the Agreement." In all other respects, the Agreement of which this is an Amendment, and attachments relative thereto, shall remain in full force and effect. DEP Agreement No. MV022, Amendment No. 1, Page 4 of 5 IN WITNESS WHEREOF, the parties have caused this Amendment to be duly executed the day and year last written below. MONROE COUNTY BOARD OF STATE OF FLORIDA DEPARTMENT OF COUNTY COMMISSIONERS ENVIRONMENTAL PROTECTION By: By: ..- *Title: Mayor David P. Rice Secretary or Designee Date: July 18, 2012 Date: Z 21 / Z T ( Brenda Leonard, DEP Grant Manager CE" TY ATTORNEY - MONROE COUNTY ATTORNEY PROVED AS FORM . 1� w►.�,�C O <� DEP Contracts Administrator Date: ' - °Z Y - Approved as to form and legality: (\fl AAA., DEP tkttorney *For Agreements with governmental boards /commissions: If someone other than the Chairman signs this Amendment, a resolution, statement or other document authorizing that person to sign the Amendment on behalf of the Grantee must accompany the Amendment. List of attachments /exhibits included as part of this Amendment: Specify Type Letter/Number Description (include number of pages) Attachment A -1 Revised Scope of Work and Conditions (5 Pages) Attachment B -1 Revised Grant Payment/ Match Request (1 Page) Attachment E Special Audit Requirements, Page 5 (Revised) of 5 (1 Page) 7 W 1t r rn r; CO • of p DEP Agreement No. MV022, Amendment No. 1, Page 5 of 5 ATTACHMENT A -1 Clean Vessel Act Grant Program Revised Scope of Work and Conditions FOR EQUIPMENT, INSTALLATION, OPERATIONS, MAINTENANCE & REPAIR, SEWAGE HAULING, AND SIGNAGE OF PUMPOUT STATION PURPOSE The purpose of the Clean Vessel Act Grant Program is to establish or restore pumpout facilities that are operational and accessible to the general boating public for the useful life of the facilities. The purpose of these conditions is to ensure compliance with 50 CFR Part 85, Subpart D - Conditions on Use /Acceptance of Funds, for the Agreement period, including the five (5) year reporting period extending beyond the date of equipment installation or construction completion, if applicable. These conditions cover pumpout facilities and equipment purchased with Clean Vessel Act Grant funds. This is a cost reimbursement Agreement with matching requirement based on the amount actually paid by the Department to the Grantee. The Department agrees to pay the Grantee, on a cost reimbursement basis, a grant award in an amount not to exceed $96,528.33 for satisfactory completion of the project outlined herein and the Grantee agrees to undertake the project as described and submitted by the Grantee in the Grant Application, CVA 10 -575, and provide a minimum 25% non - federal matching funds. The project is located at the Murray E. Nelson Government Center, 102050 Overseas Highway, Key Largo, Florida 33037. CONDITIONS OF THE PROJECT AGREEMENT Project Reimbursement 1. Match documentation shall be provided in accordance with instructions and on Attachment B, Grant Payment/Match Request Form. Any credit for the match by the Grantee shall be based on forms completed and documented to the satisfaction of the Department. 2. Grantee invoices must be accompanied by all required deliverables as identified in this Attachment and all documentation as outlined in Paragraphs 5.B. through 5.E. of the Agreement. The Department shall have thirty (30) days to review and approve all invoices and deliverables. Upon review and approval of the required deliverables, the Grant Payment/Match Request Form and required documents, the Department will process the request for payment. 3. The final request shall be accompanied by a completed and signed Pumpout Project Certification of Completion Form which is provided by the Clean Vessel Act Grant Program as part of the grant award package mailed to Grantee, a copy of the Pumpout Station Operational Plan, a copy of the Pumpout Log, and photographs of the installed pumpout project including required signage. Project Requirements 1. The Grantee shall obtain all required permits and approvals prior to commencement of the project. A grant award is not an indication of permitability of a project. A Site Visit/Permit Verification Form, completed by the Department District Office shall be on file with the Department Grant Manager before invoices will be processed for payment. 2. Pumpout facilities will be designed and operated in accordance with state and local health regulations. 3. Each pumpout facility or dump station funded under this Agreement shall be open and available to the recreational boating public. Each pumpout facility, pumpout vessel, or dump station shall be operated, maintained, and continue to be reasonably accessible to all recreational vessels for the full five year period as described and set forth in Paragraph 4.A. of the Agreement. DEP 55 -240 (4/12) DEP Agreement No. MV022, Attachment A -1, Page 1 of 5 4. The Grantee will conduct operations of the pumpout facility, pumpout vessel, or dump stations under a Pumpout Station Operational Plan that specifies hours of operation, maintenance principles, methods in determining volume of material pumped including the use of flow meters as may be necessary, informational/educational materials on pumpout operation and assurances that the pumpout facility, pumpout vessel, or dump station will be used solely for the collection of recreational boat sewage. Pumpout vessels are to be used solely for the collection and hauling of recreational boat sewage. This plan will be submitted to the Department with the Pumpout Project Certification of Completion. 5. The location of each pumpout facility, pumpout vessel, or dump station will be continually identified through informational markers using the International Pumpout Symbol on a sign of at least three feet by four feet (3 x 4') in size. Any informational markers should be located on a dock or on land clearly visible from the waterway. Any informational markers located in the waters of the state shall be with prior approval of the Florida Fish and Wildlife Conservation Commission as required by permitting procedures established by Florida Statutes and the Florida Administrative Code. 6. Informational placards stating fees, hours of operations, instructions, and operator name and telephone number shall be posted in a clearly visible location at the pumpout location. The placard shall have posted emergency phone numbers for reporting service problems and shall include the following statement: Funded in part by the U. S. Fish and Wildlife Service, Clean Vessel Act and through the Florida Department of Environmental Protection. 7. Pumpout facilities, pumpout vessels, or dump station services will be provided free of charge or for a fee not to exceed $5 per vessel. Fees greater than $5 requires prior written cost justification approval by the Department. If fees are collected, such proceeds shall be accounted for, and used by the operator exclusively to defray operation and maintenance costs of the pumpout equipment and associated materials. An accounting of all fees collected will be provided with the quarterly log described below. 8. The pumpout facility operator shall maintain a pumpout log to be submitted to the Department no later than fifteen (15) days of each calendar quarter following the quarter during which completion of construction or installation of equipment occurred. The log shall document use of the equipment by number of pumpout services events, gallons pumped, number of out of state vessels pumped, fees charged, and maintenance, labor, or other operational costs incurred. Volume of sewage handled must be determined as described in the approved pumpout station operational plan. 9. The Grantee shall provide marine sanitation and pumpout information for boat owners and training for pumpout operators. These services may be provided through such methods as informational materials, on- site instruction or audio - visual methods by the marina owner /operator, equipment vendors, harbormaster or local government personnel. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK DEP 55 -240 (4/12) DEP Agreement No. MV022, Attachment A -1, Page 2 of 5 TASKS /DELIVERABLES FOR PROJECT REIMBURSEMENT The following is a schedule of tasks /deliverables and budget detail for the completion of the tasks required to complete this project. Prior written approval from the Department's Grant Manager shall be required for changes between approved task amounts that do not exceed 10% of the total project budget amount of this Agreement. The DEP Grant Manager will transmit a copy of the written approval and revised budget to the DEP Procurement Office and the DEP Contracts Disbursements Office for inclusion in the Agreement file. Changes greater than 10% will require a formal amendment to the Agreement. No reimbursement will be made that exceeds the grant award amount. An increase in funding or a completion date extension will require a formal written amendment to this Agreement. Task 1. Equipment Purchase: The Grantee will purchase authorized pumpout or waste receptacle equipment and costs related to equipment and parts. Deliverable: Dated photograph of pumpout equipment purchased and a copy of paid invoice and delivery receipt. Performance Standard: Documentation will be reviewed to verify authorized equipment has been purchased. Financial Consequence: Failure to meet the performance standard above will result in the rejection of the invoice for reimbursement and/or denial of match claim. Task Timeline: After agreement execution and before project completion date of September 9, 2013. Budget: Allowable costs for this task are for equipment. Note: Payment can be requested upon submission and review and approval of the deliverable identified above. Task 2. Equipment Installation: The Grantee will be responsible for ensuring proper installation of the equipment purchased. This includes materials and labor for installing plumbing and electrical service for pumpout equipment. Deliverable: Dated photographs of installed pumpout equipment and written certification from the Grantee that the equipment is operating properly. Written certification can be in the form of an email or letter. Performance Standard: Dated photographs of installed equipment and certification statement will be reviewed to ensure equipment has been installed. Financial Consequence: Failure to meet the performance standard above will result in the rejection of the invoice for reimbursement and/or denial of match claim. Task Timeline: After agreement execution, receipt of any required permits, and prior to project completion date of September 9, 2013. Budget: Allowable costs for this task are for the installation of the pumpout (contractual services). Note: Payment can be requested upon submission and review and approval of the deliverable identified above. Task 3. Operations of Equipment: The Grantee is responsible for ensuring that the pumpout equipment, pumpout vessel or dump station operate according to the Pumpout Station Operational Plan. Deliverable: Copy of Pumpout Station Operational Plan and list of employee names, hourly rate, # of hours worked, totals, and a copy of the quarterly pumpout report. Performance Standard: Pumpout Station Operational Plan and quarterly pumpout report will be reviewed to confirm that the Clean Vessel Act Program requirements are met. Financial Consequence: Failure to meet the performance standard above will result in the rejection of the invoice for reimbursement and/or denial of match claim. Task Timeline: After agreement execution and prior project completion date of September 9, 2013. Budget: Allowable costs for this task are for daily operations of pumpout equipment (salaries and fringe benefits). Note: Payment can be requested upon submission and review and approval of the deliverable identified above. Task 4. Maintenance and Repair: The Grantee is responsible for maintaining the pumpout according to manufacturer's specifications and providing any necessary repairs. This includes costs related to purchase of equipment, parts, and labor associated with the repair of pumpout facilities. Includes replacement pumps, engines and parts valued over $1,000.00. DEP 55 -240 (4/12) DEP Agreement No. MV022, Attachment A -1, Page 3 of 5 Deliverable: List of maintenance or repairs made to the equipment and copy of maintenance /repair receipts. Performance Standard: Documentation will be reviewed to confirm that the necessary maintenance and/or repair was completed. Financial Consequence: Failure to meet the performance standard above will result in the rejection of the invoice for reimbursement and/or denial of match claim. Task Timeline: After agreement execution and prior project completion date of September 9, 2013. Budget: Allowable costs for this task are for required maintenance and repairs (contractual services). Note: Payment can be requested upon submission and review and approval of the deliverable identified above. Task 5. Sewage hauling: The Grantee is responsible for hiring a licensed contractor to haul recreational boater sewage collected from a permitted holding tank to a permitted wastewater treatment facility or sewage transfer station. Deliverable: Documentation from the sewage hauler showing gallons of sewage hauled and documentation from the permitted facility accepting the waste. Performance Standard: Documentation will be reviewed to verify that the sewage hauled agrees with the documentation from the receiving facility. Financial Consequence: Failure to meet the performance standard above will result in the rejection of the invoice for reimbursement and/or denial of match claim. Task Timeline: After agreement execution and prior project completion date of September 9, 2013. Budget: Allowable costs for this task are for sewage hauling (contractual services). Note: Payment for this task may be requested upon each completion of a sewage hauling and submission and review and approval of the deliverable identified above. Task 6. Pumpout Signage: The Grantee will install the signage required in paragraph 4 of this attachment under Project Requirements. Deliverable: Photographs of the installed signage showing the pumpout logo sign, equipment instructional sign and Pumpout information sign with accrediting information. Performance Standard: Photographs will be reviewed to ensure signage requirements are met. Financial Consequence: Failure to meet the performance standard above will result in the rejection of the invoice for reimbursement and/or denial of match claim. Task Timeline: After agreement execution and prior project completion date of September 9, 2013. Budget: Allowable costs for this task are for signage costs (miscellaneous). Note: Payment can be requested upon submission and review and approval of the deliverable identified above. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK DEP 55 -240 (4/12) DEP Agreement No. MV022, Attachment A -1, Page 4 of 5 Approved Tasks/Deliverables and Amounts Tasks Deliverables Total Project Amount (100 %) 1. Equipment Purchase Dated photograph of pumpout equipment $28,681.77 purchased and a copy of paid invoice and delivery receipt. 2. Equipment Installation Dated photographs of installed pumpout $3,290.00 equipment and written certification from the Grantee that the equipment is operating properly. Written certification can be in the form of an email or letter. 3. Operations of Equipment Copy of Pumpout Station Operational Plan and $52,931.42 list of employee names, hourly rate, # of hours worked, totals, and a copy of the quarterly pumpout report. 4. Maintenance and Repair List of maintenance or repairs made to the $23,196.34 equipment and copy of maintenance /repair receipts. 5. Sewage Hauling Documentation from the sewage hauler $20,104.91 showing gallons of sewage hauled and documentation from the permitted facility accepting the waste. 6.Pumpout Signage Photographs of the installed signage showing $500.00 the pumpout logo sign, equipment instructional sign and Pumpout information sign with accrediting information. Total Project Amount 100% $128,704.44 Total Grant Award Amount 75% $96,528.33 Total Match Amount 25% $32,176.11 REMAINDER OF PAGE INTENTIALLY LEFT BLANK DEP 55 -240 (4/12) DEP Agreement No. MV022, Attachment A -1, Page 5 of 5 ATTACHMENT B -1 REVISED GRANT PAYMENT/MATCH REQUEST Monroe County Board of County Commissioners MV022 CVA 10 -575 DEP Program: Clean Vessel Act Grant Program If Department payment is being requested, an invoice on your letterhead must accompany this form. TOTAL PROJECT (100 %) of costs Permitting $N /A Construction $N /A Renovation $N /A Equipment Purchase Equipment Installation Operations Maintenance and Repair Sewage Hauling Pumpout Signage Education and Instructional $N /A Materials TOTAL PROJECT $ 25% Grantee match $ 75% reimbursable to Grantee $ I attest that documentation has been and will be maintained as required by this Agreement to support the amounts reported above and is available for audit upon request. I attest that all expenditures prior to this request have been made and are true and accurate and are only for the purposes as described in Clean Vessel Act Grant Project Agreement No. MV022_ I further attest, that Monroe County Board of County Commissioners has complied with the terms and conditions of this Agreement. Grantee's Project Manager Date DEP 55 -240 (5/09) DEP Agreement No. MV022, Attachment B -1, Page 1 of 1 O 0 0 Q -0 a � i o O O F� + V . — • 0 N a) •— 0 + U + ... 0 r , " 0 'O on ° s.. cal C '-" O. 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