01/21/2015 Contract ORIGINAL
Contract No. KPZ27 Client Z Non-Client❑
CFDA No. 14.231
THIS GRANT AGREEMENT* is entered into between the Florida Department of Children and Families, hereinafter referred to as the
"Department"and Monroe County, hereinafter referred to as the"Provider. The Department and Provider agree as follows:
*If this document is denoted above as a GRANT AGREEMENT, the term "Contract" as it may appear hereinafter shall be construed to
mean "Grant"or"Grant Agreement"as the context may provide. Similarly, the term"Provider shall be construed to mean"Grantee"and
the term"Contract Manager"shall be construed to mean"Grant Manager."
1. ENGAGEMENT,TERM AND CONTRACT DOCUMENT.
1.1 Purpose and Contract Amount.
The Department is engaging the Provider for the purpose of providing Homeless Prevention and Rapid Re-Housing services to
eligible individuals and families,as further described in Section 2 hereof, payable as provided in Section 3 hereof, in an amount not to
exceed S76,598.00,
1.2 Effective and Ending Dates.
This Contract shall be effective on January 1, 2015 or the last date executed by a party, whichever is later. The service performance
period under this Contract shall commence on January 1, 2015 or the effective date of this Contract, whichever is later, and shall end at
midnight, Eastern time,on June 30, 2015, subject to the survival of terms provisions of Section 7.4 hereof.
® This Contract may not be renewed.
This Contract may be renewed in accordance with Section 26 of the PUR 1000 Form and, if renewed,costs for the renewal
may not be charged to this Contract.
❑ The renewal price(s) set forth in the bid, proposal, or reply are shown in Exhibit F , subject to negotiation at renewal
per section 287.057(13), Florida Statutes(F.S.). ❑ Not applicable.
1.3 Official Payee and Party Representatives.
a. The name, address, telephone number and e-mail address c. The name, address,telephone number and e-mail address of
of the Provider's official payee to whom the payment shall be the Contract Manager for the Department for this Contract are:
directed on behalf of the Provider are:
Name: Monroe County Name: Theresa Phelan
Address: 500 Whitehead Street Address: 1111 12'h Street
City: Key West State:FL Zip Code:33040 City: Key West State: FL Zip Code: 33040
Phone: 305.292.4500 Phone: 305.293.6350
ext: ext:
e-mail: _ e-mail:trixie_phelan@dcf.state.ff.us
b. The name of the contact person and address, telephone, d. The name, address, telephone number and e-mail of the
and e-mail address where the Provider's financial and Provider's representative responsible for administration of the
administrative records are maintained are: program under this Contract(and primary point of contact) are:
Name. Sheryl Graham Name: Sheryl Graham
Address: 1100 Simonton Street Address: 1100 Simonton Street _
City: Key West State:FL Zip Code:33040 City: Key West State:FL Zip Code:33040
Phone: 305-292-4500 Phone: 305-292.4500
ext: ext:
e-mail: graham-sheryl@monroecounty-fl.gov e-mail:graham•sheryl@monroecounty-fl.gov
Per section 402.7305(1)(a), F.S., the Department's Contract Manager is the primary point of contact through which all contracting
information flows between the Department and the Provider. Upon change of representatives(names. addresses, telephone numbers or
e-mail addresses)by either party, notice shall be provided in writing to the other party.
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1.4 Contract Document.
This Contract is composed of Sections 1 through 7 hereof, as well as Exhibits A through F and attachments 1 through 3 and any exhibits
referenced in said attachments, together with any documents incorporated by reference, which contain all the terms and conditions
agreed upon by the parties.
1.4.1 The definitions found in the Standard Contract Definitions, located at:
http://www.dcf.state.f.us/admin/contractsldocs/StandardContractTerms2014.pdf are incorporated into and made a part of this
Contract.Additional definitions may be forth in Exhibit A, Special Provisions.
1.4.2 The PUR 1000 Form (10/06 version)is hereby incorporated into and made a part of this Contract. Sections 1.d.,2-4, 6,6-13,
23, 27 and 31 of the PUR 1000 Form are not applicable to this Contract. In the event of any conflict between the PUR 1000 Form
and any other terms or conditions of this Contract, such other terms or conditions shall take precedence over the PUR 1000 Form.
1.4.3 The terms of Exhibit A, Special Provisions, supplement or modify the terms of Sections 1 through 7 hereof, as provided
therein.
1.4.4 In the event of a conflict between the provisions of the documents,the documents shall be interpreted in the following order of
precedence:
a. Exhibits A through F;
b. Any documents incorporated into any exhibit by reference;
c. This Standard Contract;
d. Any documents incorporated into this Contract by reference.
e. Attachments 1 through 3.
2. STATEMENT OF WORK.
The Provider shall perform all tasks and provide units of deliverables, including reports,findings, and drafts, as specified in this Contract.
Except for advances, if any, provided for in this Contract, these deliverables must be received and accepted by the Contract Manager in
writing prior to payment, subject to subsequent audit and review and to the satisfaction of the Department. The Department's
determination of acceptable services shall be conclusive. Department receipt of reports and other submissions by the Provider does not
constitute acceptance thereof, which occurs only through a separate and express act of the Contract Manager. Unless otherwise
provided in the procurement document, if any. or governing law, the Department reserves the right to increase or decrease the volume of
services and to add tasks that are incidental or complimentary to the original scope of services. Except where the method of payment is
prescribed by law, compensation under Section 3 will be equitably adjusted by the Department to the extent that it prescribes a fixed
price(previously called "fixed fee") payment method or does not provide a method of payment for added tasks.
2.1 Scope of Work.
The Scope of Work is described in Exhibit B.
2.2 Task List.
The Provider shall perform all tasks set forth in the Task List,found in Exhibit C, in the manner set forth therein.
2.3 Deliverables.
Deliverables shall be as described in Exhibit D.
2.4 Performance Measures.
2.4.1 Performance Measures for Acceptance of Deliverables. The performance measures for acceptance of deliverables are
set forth in Exhibit D, Section D-2.
2.4.2 Minimum Performance Measures. To avoid contract termination, Provider's performance must meet the minimum
performance standards set forth in Exhibit E, Minimum Performance Measures, Section E-1, regardless of any other performance
measures in this Contract. By execution of this Contract the Provider hereby acknowledges and agrees that its performance under
the Contract must meet these Minimum Performance Measures and that it will be bound by the conditions set forth therein. If the
Provider fails to meet these standards, the Department, at its exclusive option, may allow a reasonable period, not to exceed 6
months, for the Provider to correct performance deficiencies. If performance deficiencies are not resolved to the satisfaction of the
Department within the prescribed time, and if no extenuating circumstances can be documented by the Provider to the Department's
satisfaction, the Department must terminate the Contract. The Department has the sole authority to determine whether there are
extenuating or mitigating circumstances. The Provider further acknowledges and agrees that during any period in which the
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Provider fails to meet these standards, regardless of any additional time allowed to correct performance deficiencies, payment for
deliverables may be delayed or denied and financial consequences may apply.
3. PAYMENT,INVOICE AND RELATED TERMS.
The Department shall pay for services performed by the Provider during the service performance period of this Contract according to the
terms and conditions of this Contract in an amount not to exceed that set forth in Section 1.1 hereof, subject to the availability of funds
and satisfactory performance of all terms by the Provider. Except for advances, if any, provided for in this Contract, payment shall be
made only upon written acceptance of all services by the Department and shall remain subject to subsequent audit or review to confirm
contract compliance. The State of Florida's performance and obligation to pay under this Contract is contingent upon an annual
appropriation by the Legislature. Any costs or services paid for under any other contract or from any other source are not eligible for
payment under this Contract.
3.1 Method of Payment.
The Provider shall be paid in accordance with Exhibit F Method of Payment and Invoices.
3.2 Invoices.
3.2.1 Generally. The Provider shall submit bills for fees or other compensation for services or expenses in sufficient detail for
proper pm-audit and post-audit. Where itemized payment for travel expenses is permitted in this Contract,the Provider shall submit
bills for any travel expenses in accordance with section 112.061, F.S., or at such lower rates as may be provided in this Contract.
3.2.2 Final Invoice. The final invoice for payment shall be submitted to the Department no more than 45 days after the Contract
ends or is terminated. If the Provider fails to do so, all rights to payment are forfeited and the Department will not honor any
requests submitted after the aforesaid time period. Any payment due under the terms of this Contract may be withheld until
performance of services and all reports due from the Provider and necessary adjustments thereto, have been approved by the
Department.
3.3 Financial Consequences.
If the Provider fails to perform in accordance with this Contract or perform the minimum level of service required by this Contract, the
Department will apply financial consequences as provided for in Section 6.1 hereof. The parties agree that the penalties provided for
under Section 6.1 hereof constitute financial consequences under sections 287.058(1)(h) and 215.971(1)(c), F.S. The foregoing does
not limit additional financial consequences, which may include but are not limited to refusing payment, withholding payments until
deficiency is cured,tendering only partial payments,applying payment adjustments for additional financial consequences or for liquidated
damages to the extent that this Contract so provides, or termination of this Contract per Section 6.2.3 hereof and requisition of services
from an alternate source. Any payment made in reliance on the Provider's evidence of performance, which evidence is subsequently
determined to be erroneous, will be immediately due as an overpayment in accordance with Section 3.4 hereof, to the extent of such
error.
3.4 Overpayments and Offsets.
The Provider shall return to the Department any overpayments due to unearned funds or funds disallowed that were disbursed to the
Provider by the Department and any interest attributable to such funds. Should repayment not be made promptly upon discovery by the
Provider or its auditor or upon written notice by the Department, the Provider will be charged interest at the lawful rate of interest on the
outstanding balance until returned. Payments made for services subsequently determined by the Department to not be in full compliance
with contract requirements shall be deemed overpayments. The Department shall have the right at any time to offset or deduct from any
payment due under this or any other contract or agreement any amount due to the Department from the Provider under this or any other
contractor agreement.
3.5 MyFloridaMarketPlace Transaction Fee.
This Contract is exempt from the MyFloridaMarketPlace transaction fee.
4. GENERAL TERMS AND CONDITIONS GOVERNING PERFORMANCE.
4.1 Compliance with Statutes, Rules and Regulations.
In performing its obligations under this Contract, the Provider shall without exception be aware of and comply with all State and Federal
laws, rules and regulations relating to its performance under this Contract as they may be enacted or amended from time-to-time,
including but not limited to those described in Exhibit Al! as well as any court or administrative order,judgment, settlement or compliance
agreement involving the Department which by its nature affects the services provided under this Contract.
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4.2 Independent Contractor, Subcontracting and Assignments.
4.2.1 In performing its obligations under this Contract, the Provider shall at all times be acting in the capacity of an independent
contractor and not as an officer,employee,or agent of the State of Florida,except where the Provider is a State agency. Neither the
Provider nor any of its agents, employees, subcontractors or assignees shall represent to others that it is an agent of or has the
authority to bind the Department by virtue of this Contract, unless specifically authorized in writing to do so. This Contract does not
create any right in any individual to State retirement, leave benefits or any other benefits of State employees as a result of
performing the duties or obligations of this Contract.
4.2.2 The Provider shall take such actions as may be necessary to ensure that it and each subcontractor of the Provider will be
deemed to be an independent contractor and will not be considered or permitted to be an officer, employee, or agent of the State of
Florida. The Department will not furnish services of support (e.g., office space, office supplies, telephone service, secretarial or
clerical support) to the Provider, or its subcontractor or assignee, unless specifically agreed to by the Department in this Contract.
All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all
necessary insurance for the Provider, the Providers officers, employees, agents, subcontractors, or assignees shall be the sole
responsibility of the Provider and its subcontractors. The parties agree that no joint employment is intended and that, regardless of
any provision directing the manner of provision of services, the Provider and its subcontractors alone shall be responsible for the
supervision,control, hiring and firing, rates of pay and terms and conditions of employment of their own employees.
4.2.3 The Provider shall not assign its responsibilities under this Contract to another party, in whole or part, without prior written
approval of the Department, upon the Department's sole determination that such assignment will not adversely affect the public
interest. No payment shall be made under this Contract to any factor or other person who has been assigned or transferred the
right to receive payment in lieu of or on behalf of the Provider except upon full and faithful performance of the Provider's duties
hereunder.Any assignment or transfer occurring without prior approval of the Department shall be null and void. The Provider shall
not subcontract for any of the work contemplated under this Contract without prior written approval of the Department, which shall
not be unreasonably withheld.
4.2.4 The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under
this Contract to another governmental agency in the State of Florida or to a provider of the Department's selection, upon giving prior
written notice to the Provider. In the event of assignment by either party, this Contract shall remain binding upon the lawful
irracenrc_in interest of the Provider and the Department.
4.2.5 The Provider is responsible for all work performed and for all commodities produced pursuant to this Contract whether
actually furnished by the Provider or by its subcontractors. Any subcontracts shall be evidenced by a written document. The
Provider further agrees that the Department shall not be liable to the subcontractor in any way or for any reason relating to this
Contract.
4.2.6 The Provider shall include, in all subcontracts(at any tier)the substance of all clauses contained in this Contract that mention
or describe subcontract compliance, as well as all clauses applicable to that portion of the Provider's performance being performed
by or through the subcontract.
4.3 Provider Indemnity.
Section 19 of PUR 1000 Form shall apply per its terms, except that the phrase "arising from or relating to personal injury and damage to
real or personal tangible property" in the first paragraph is replaced with "arising out of or by reason of the execution of this Contract or
arising from or relating to any alleged act or omission by the Provider, its agents,employees, partners,or subcontractors in relation to this
agreement,"and the following additional terms will also apply:
__.4.3.1. If.the.Provider removes an infringing product because it is not reasonably able to modify that product or secure the
Department the right to continue to use that product,the Provider shall immediately replace that product with a non-infringing product
that the Department determines to be of equal or better functionality or be liable for the Department's cost in so doing.
4.3.2 Further,the Provider shall indemnify the Department for all costs and attorneys fees arising from or relating to Provider's claim
that a record contains trade secret information that is exempt from disclosure or the scope of the Provider's redaction of the record,
as provided for under Section 5.3. hereof, including litigation initiated by the Department.
The Providers inability to evaluate liability or its evaluation of liability shall not excuse its duty to defend and indemnify after receipt of
notice. Only an adjudication or judgment after the highest appeal is exhausted finding the Department negligent shall excuse the
Provider of performance under this provision, in which case the Department shall have no obligation to reimburse the Provider for the
cost of its defense. If the Provider is an agency or subdivision of the State, its obligation to indemnify, defend and hold harmless the
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Department shall be to the extent permitted by section 768.28, F.S. or other applicable law, and without waiving the limits of sovereign
immunity.
4.4 Insurance.
The Provider shall maintain continuous adequate liability insurance coverage during the existence of this Contract and any renewal(s)
and extension(s)thereof. With the exception of a State agency or subdivision as defined by subsection 768.28(2), F.S., by execution of
this Contract,the Provider accepts full responsibility for identifying and determining the type(s)and extent of liability insurance necessary
to provide reasonable financial protections for the Provider and the clients to be served under this Contract. Upon the execution of this
Contract, the Provider shall furnish the Department written verification supporting both the determination and existence of such insurance
coverage and shall furnish verification of renewal or replacement thereof prior to the expiration or cancellation. The Department reserves
the right to require additional insurance as specified in this Contract.
4.5 Notice of Legal Actions.
The Provider shall notify the Department of potential or actual legal actions taken against the Provider related to services provided
through this Contract or that may impact the Provider's ability to deliver the contractual services, or that may adversely impact the
Department. The Departments Contract Manager will be notified within 10 days of Provider becoming aware of such actions or potential
actions or from the day of the legal filing, whichever comes first.
4.6 Intellectual Property.
It is agreed that all intellectual property, inventions, written or electronically created materials, including manuals, presentations, films, or
other copyrightable materials, arising in relation to Provider's performance under this Contract, and the performance of all of its officers,
agents and subcontractors in relation to this Contract, are works for hire for the benefit of the Department, fully compensated for by the
contract amount, and that neither the Provider nor any of its officers, agents nor subcontractors may claim any interest in any intellectual
property rights accruing under or in connection with the performance of this Contract. It is specifically agreed that the Department shall
have exclusive rights to all data processing software falling within the terms of section 119.084, F.S., which arises or is developed in the
course of or as a result of work or services performed under this Contract, or in any way connected herewith. Notwithstanding the
foregoing provision, if the Provider is a university and a member of the State University System of Florida, then section 1004.23, F.S.,
shall apply.
4.6.1 If the Provider uses or delivers to the Department for its use or the use of its employees, agents or contractors, any design,
device, or materials covered by letters, patent, or copyright, it is mutually agreed and understood that, except as to those items
specifically listed in Exhibit A as having specific limitations, the compensation paid pursuant to this Contract includes all royalties or
costs arising from the use of such design, device, or materials in any way involved in the work contemplated by this Contract. For
purposes of this provision, the term "use' shall include use by the Provider during the term of this Contract and use by the
Department its employees,agents or contractors during the term of this Contract and perpetually thereafter.
4.6.2 All applicable subcontracts shall include a provision that the Federal awarding agency reserves all patent rights with respect
to any discovery or invention that arises or is developed in the course of or under the subcontract. Notwithstanding the foregoing
provision, if the Provider or one of its subcontractors is a university and a member of the State University System of Florida, then
section 1004.23, F.S.,shall apply, but the Department shall retain a perpetual,fully-paid, nonexclusive license for its use and the use
of its contractors of any resulting patented,copyrighted or trademarked work products.
4.7 Transition Activities.
Continuity of service is critical when service under this Contract ends and service commences under a new contract. Accordingly, when
service will continue through another provider upon the expiration or earlier termination of this Contract, the Provider shall, without
additional compensation, complete all actions necessary to smoothly transition service to the new provider. This includes but is not
limited to the transfer of relevant data and files, as well as property funded or provided pursuant to this Contract. The Provider shall be
required to support an orderly transition to the next provider no later than the expiration or earlier termination of this Contract and shall
support the requirements for transition as specified in a Department-approved Transition Plan, which shall be developed jointly with the
new provider in consultation with the Department.
4.8 Real Property.
Any State funds provided for the purchase of or improvements to real property are contingent upon the Provider granting to the State a
security interest in the property at least to the amount of the State funds provided for at least five(5) years from the date of purchase or
the completion of the improvements or as further required by law. As a condition of receipt of State funding for this purpose,the Provider
agrees that. if it disposes of the property before the Department's interest is vacated, the Provider will refund the proportionate share of
the State's initial investment, as adjusted by depreciation.
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4.9 Publicity.
Without limitation, the Provider and its employees, agents, and representatives will not, without prior Departmental written consent in
each instance, use in advertising, publicity or any other promotional endeavor any State mark,the name of the State's mark,the name of
the State or any State agency or affiliate or any officer or employee of the State,or any State program or service,or represent, directly or
indirectly, that any product or service provided by the Provider has been approved or endorsed by the State, or refer to the existence of
this Contract in press releases,advertising or materials distributed to the Provider's prospective customers.
4.10 Sponsorship.
As required by section 286.25, F.S., if the Provider is a non-governmental organization which sponsors a program financed wholly or in
part by State funds, including any funds obtained through this Contract, it shall, in publicizing, advertising, or describing the sponsorship
of the program state: "Sponsored by (Providers name) and the State of Florida, Department of Children and Families". If the
sponsorship reference is in written material,the words"State of Florida, Department of Children and Families"shall appear in at least the
same size letters or type as the name of the organization.
4.11 Employee Gifts.
The Provider agrees that it will not offer to give or give any gift to any Department employee during the service performance period of this
Contract and for a period of two years thereafter. In addition to any other remedies available to the Department, any violation of this
provision will result in referral of the Providers name and description of the violation of this term to the Department of Management
Services for the potential inclusion of the Providers name on the suspended vendors list for an appropriate period. The Provider will
ensure that its subcontractors, if any, comply with these provisions.
4.12 Mandatory Reporting Requirements.
The Provider and any subcontractor must comply with and inform its employees of the following mandatory reporting requirements. Each
employee of the Provider, and of any subcontractor, providing services in connection with this Contract who has any knowledge of a
reportable incident shall report such incident as follows: 1) reportable incidents that may involve an immediate or impending impact on
the health or safety of a client shall be immediately reported to the Contract Manager; and 2) other reportable incidents shall be reported
to the Department's Office of Inspector General by completing a Notification/Investigation Request (Form CF 1934) and emailing the
request to the Office of Inspector General at ig_complaints@dcf.state.fI.us. The Provider and subcontractor may also mail the completed
form to the Office of Inspector General, 1317 Winewood Boulevard, Building 5, 2nd Floor, Tallahassee, Florida, 32399-0700; or via fax at
(850)488-1428. A reportable incident is defined in CFOP 180-4, which can be obtained from the Contract Manager.
5. RECORDS, AUDITS AND DATA SECURITY.
5.1 Records, Retention, Audits, Inspections and Investigations.
5.1.1 The Provider shall establish and maintain books, records and documents (including electronic storage media) sufficient to
reflect all income and expenditures of funds provided by the Department under this Contract.
5.1.2 Retention of all client records, financial records, supporting documents, statistical records, and any other documents
(including electronic storage media) pertinent to this Contract shall be maintained by the Provider during the term of this Contract
and retained for a period of six (6) years after completion of the Contract or longer when required by law. In the event an audit is
required under this Contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or until
resolution of any audit findings or litigation based on the terms of this Contract, at no additional cost to the Department.
5.1.3 Upon demand, at no additional cost to the Department, the Provider will facilitate the duplication and transfer of any records
or documents during the term of this Contract and the required retention period in Section 5.1.2 hereof.
5.1.4 These records shall be made available at all reasonable times for inspection, review, copying, or audit by Federal. State, or
other personnel duly authorized by the Department.
5.1.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Department and Federal
auditors, pursuant to 45 Code of Federal Regulations(CFR) s. 92.36(1)(10), shall be allowed full access to and the right to examine
any of the Providers contracts and related records and documents, regardless of the form in which kept.
5.1.6 A financial and compliance audit shall be provided to the Department as specified in this Contract and in Attachment 1.
5.1.7 The Provider shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed
necessary by The Office of the Inspector General(section 20.055, F.S.).
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No record may be withheld nor may the Provider attempt to limit the scope of any of the foregoing inspections, reviews, copying,
transfers or audits based on any claim that any record is exempt from public inspection or is confidential, proprietary or trade secret
in nature; provided, however, that this provision does not limit any exemption to public inspection or copying to any such record.
5.2 Inspections and Corrective Action.
The Provider shall permit all persons who are duly authorized by the Department to inspect and copy any records, papers, documents,
facilities, goods and services of the Provider which are relevant to this Contract, and to interview any clients, employees and
subcontractor employees of the Provider to assure the Department of the satisfactory performance of the terms and conditions of this
Contract. Following such review, the Department will deliver to the Provider a written report of its findings, and may direct the
development, by the Provider,of a corrective action plan where appropriate. The Provider hereby agrees to timely correct all deficiencies
identified in the Department's written report. This provision will not limit the Department's termination rights under Section 6.2.3 hereof.
5.3 Provider's Confidential and Exempt Information.
5.3.1 By executing this Contract, the Provider acknowledges that, having been provided an opportunity to review all provisions
hereof, all provisions of this Contract not specifically identified in writing by the Provider prior to execution hereof as"confidential or
exempt" will be posted by the Department on the public website maintained by the Department of Financial Services pursuant to
section 215,985, F.S. The Provider agrees that, upon written request of the Department, it shall promptly provide to the Department
a written statement of the basis for the exemption applicable to each provision identified by the Provider as"confidential or exempt",
including the statutory citation to an exemption created or afforded by statute, and state with particularity the reasons for the
conclusion that the provision is exempt or confidential.
5.3.2 Any claim by Provider of trade secret (proprietary) confidentiality for any information contained in Providers documents
(reports, deliverables or workpapers, etc., in paper or electronic form) submitted to the Department in connection with this Contract
will be waived,unless the claimed confidential information is submitted in accordance with Section 5.3.2.a. hereof.
a. The Provider must cleady label any portion of the documents, data, or records submitted that it considers exempt from
public inspection or disclosure pursuant to Florida's Public Records Law as trade secret. The labeling will include a
justification citing specific statutes and facts that authorize exemption of the information from public disclosure. If
different exemptions are claimed to be applicable to different portions of the protected information, the Provider shall
include information correlating the nature of the claims to the particular protected information.
b. The Department, when required to comply with a public records request including documents submitted by the Provider,
may require the Provider to expeditiously submit redacted copies of documents marked as trade secret in accordance
with Section 5.3.2.a hereof. Accompanying the submission shall be an updated version of the justification under Section
5.3.2.a. hereof, correlated specifically to redacted information, either confirming that the statutory and factual basis
originally asserted remain unchanged or indicating any changes affecting the basis for the asserted exemption from
public inspection or disclosure. The redacted copy must exclude or obliterate only those exact portions that are claimed
to be trade secret. If the Provider fails to promptly submit a redacted copy, the Department is authorized to produce the
records sought without any redaction of proprietary or trade secret information.
The Provider shall be responsible for defending its claim that each and every portion of the redactions of trade secret information are
exempt from inspection and copying under Florida's Public Records Law.
5.4 Health Insurance Portability and Accountability Act.
L The Provider certifies that neither it nor its subcontractors will have access to, receive or provide Protected Health Information
within the meaning of the Health Insurance Portability and Accountability Act(42 U.S.C. s.1320d.) and the regulations promulgated
thereunder(45 CFR Parts 160, 162, and 164)incidental to performance of this Contract.
Z In compliance with 45 CFR s.164.504(e), the Provider shall comply with the provisions of Attachment 2 to this Contract,
governing the safeguarding, use and disclosure of Protected Health Information created, received, maintained, or transmitted by the
Provider or its subcontractors incidental to the Provider's performance of this Contract.
5.5 Confidential Client and Other Information. Except as provided in this Contract, the Provider shall not use or disclose but shall
protect and maintain the confidentiality of any client information and any other information made confidential by Florida law or Federal
laws or regulations that is obtained or accessed by the Provider or its subcontractors incidental to performance under this Contract.
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5.6 Data Security. The Provider shall comply with the following data security requirements whenever the Provider or its
subcontractors have access to Department data systems or maintain any client or other confidential information in electronic form:
5.6.1 An appropriately skilled individual shall be identified by the Provider to function as its Data Security Officer. The Data
Security Officer shall act as the liaison to the Departments security staff and will maintain an appropriate level of data security for
the information the Provider is collecting or using in the performance of this Contract. An appropriate level of security includes
approving and tracking all Provider employees that request or have access to any Departmental data system or information. The
Data Security Officer will ensure that user access to the data system or information has been removed from all terminated Provider
employees.
5.6.2 The Provider shall provide the latest Departmental security awareness training to its staff who have access to departmental
information.
5.6.3 All Provider employees who have access to Departmental information shall comply with, and be provided a copy of CFOP 50-
2, and shall sign the DCF Security Agreement form CF 0114 annually. A copy of CF 0114 may be obtained from the Contract
Manager.
5.6.4 The Provider shall make every effort to protect and avoid unauthorized release of any personal or confidential information by
ensuring both data and mobile storage devices are encrypted as prescribed in CFOP 50-2. If encryption of these devices is not
possible, then the Provider shall assure that unencrypted personal and confidential Departmental data will not be stored on
unencrypted storage devices.
5.6.5 The Provider agrees to notify the Contract Manager as soon as possible, but no later than five(5) business days following the
determination of any breach or potential breach of personal and confidential Departmental data.
5.6.6 The Provider shall at its own cost provide notice to affected parties no later than 45 days following the determination of any
potential breach of personal or confidential Departmental data as provided in section 817.5681, F.S. The Provider shall also at its
own cost implement measures deemed appropriate by the Department to avoid or mitigate potential injury to any person due to a
breach or potential breach of personal and confidential Departmental data.
The Provider shall cause each of its subcontractors having access to Department data systems or maintaining any client or other
confidential information in electronic form to comply with the provisions of this Section 5.6 and the term "Provider" shall be deemed to
mean the subcontractor for such purposes.
6. PENALTIES, TERMINATION AND DISPUTE RESOLUTION.
6.1 Financial Penalties for Failure to Take Corrective Action.
6.1.1 In accordance with the provisions of section 402.73(1), F.S., and Rule 65-29.001, F.A.C., corrective action plans may be
required for noncompliance, nonperformance, or unacceptable performance under this Contract. Penalties may be imposed for
failures to implement or to make acceptable progress on such corrective action plans.
6.1.2 The increments of penalty imposition that shall apply, unless the Department determines that extenuating circumstances
exist, shall be based upon the severity of the noncompliance, nonperformance, or unacceptable performance that generated the
need for corrective action plan. The penalty, if imposed, shall not exceed ten percent(10%)of the total contract payments during the
period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not
been made. Noncompliance that is determined to have a direct effect on client health and safety shall result in the imposition of a ten
percent(10%) penalty of the total contract payments during the period in which the corrective action plan has not been implemented
or in which acceptable progress toward implementation has not been made.
6.1.3 Noncompliance involving the provision of service not having a direct effect on client health and safety shall result in the
imposition of a five percent(5%) penalty. Noncompliance as a result of unacceptable performance of administrative tasks shall result
in the imposition of a two percent(2%) penalty.
6.1.4 The deadline for payment shall be as stated in the Order imposing the financial penalties. In the event of nonpayment the
Department may deduct the amount of the penalty from invoices submitted by the Provider.
6.2 Termination.
6.2.1 In accordance with Section 22 of PUR 1000 Form,this Contract may be terminated by the Department without cause upon no
less than thirty(30)calendar days notice in writing to the Provider unless a sooner time is mutually agreed upon in writing.
CF Integrated Contract 2014 8 Contract No. KPZ27
6.2.2 In the event funds for payment pursuant to this Contract become unavailable, the Department may terminate this Contract
upon no less than twenty-four(24) hours notice in writing to the Provider. The Department shall be the final authority as to the
availability and adequacy of funds.
6.2.3 In the event the Provider fails to fully comply with the terms and conditions of this Contract,the Department may terminate the
Contract upon no less than twenty-four (24) hours (excluding Saturday, Sunday, and Holidays) notice in writing to the Provider.
Such notice may be issued without providing an opportunity for cure if it specifies the nature of the noncompliance and states that
provision for cure would adversely affect the interests of the State or is not permitted by law or regulation. Otherwise, notice of
termination will be issued after the Provider's failure to fully cure such noncompliance within the time specified in a written notice of
noncompliance issued by the Department specifying the nature of the noncompliance and the actions required to cure such
noncompliance. In addition, the Department may employ the default provisions in Rule 60A-1.006(3), F.A.C., but is not required to
do so in order to terminate the Contract. The Department's failure to demand performance of any provision of this Contract shall not
be deemed a waiver of such performance. The Department's waiver of any one breach of any provision of this Contract shall not be
deemed to be a waiver of any other breach and neither event shall be construed to be a modification of the terms and conditions of
this Contract. The provisions herein do not limit the Department's right to remedies at law or in equity.
6.2.4 Failure to have performed any contractual obligations under any other contract with the Department in a manner satisfactory
to the Department will be a sufficient cause for termination. To be terminated under this provision, the Provider must have: (1)
previously failed to satisfactorily perform in a contract with the Department, been notified by the Department of the unsatisfactory
performance, and failed to timely correct the unsatisfactory performance to the satisfaction of the Department, or(2) had a contract
terminated by the Department for cause. Termination shall be upon no less than twenty-four (24) hours notice in writing to the
Provider.
In the event of termination under Sections 6.2.1 or 6.2.2 hereof, the Provider will be compensated for any work satisfactorily completed
through the date of termination or an earlier date of suspension of work per Section 21 of the PUR 1000,
6.3 Dispute Resolution.
Any dispute concerning performance of this Contract or payment hereunder shall be decided by the Department's Contract Manager,
who shall reduce the decision to writing and provide a copy to the Provider. The decision shall be final and conclusive unless within
twenty-one(21)calendar days from the date of receipt of the Contract Manager's decision,the Provider delivers to the Contract Manager
a petition for alternative dispute resolution. After receipt of a petition for alternative dispute resolution the Department and the Provider
shall attempt to amicably resolve the dispute through negotiations. Timely delivery of a petition for alternative dispute resolution and
completion of the negotiation process shall be a condition precedent to any legal action by the Provider concerning this Contract. After
timely delivery of a petition for alternative dispute resolution, the parties may employ any dispute resolution procedures described in the
Attachment I or other attachment,or mutually agree to an altemative binding or nonbinding dispute resolution process,the terms of which
shall be reduced to writing and executed by both parties. Completion of such agreed process shall be deemed to satisfy the requirement
for completion of the negotiation process. This provision shall not limit the parties' rights of termination under Section 6.2 hereof.
All notices provided under Section 6 shall be in writing on paper, physically sent to the person identified in Section 1.3.d hereof by U.S.
Postal Service or any other delivery service that provides verification of delivery.or by hand delivery.
7. OTHER TERMS.
7.1 Governing Law and Venue.
This Contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in
accordance with Florida law, without regard to Florida provisions for conflict of laws. Courts of competent jurisdiction in Florida shall
have exclusive jurisdiction in any action regarding this Contract and venue shall be in Leon County, Florida. Unless otherwise provided in
any other provision or amendment hereof, any amendment, extension or renewal (when authorized) may be executed in counterparts as
provided in Section 46 of the PUR 1000 Form.
7.2 No Other Terms.
There are no provisions, terms, conditions, or obligations other than those contained herein, and this Contract shall supersede all
previous communications, representations, or agreements,either verbal or written between the parties.
7.3 Severability of Terms.
If any term or provision of this Contract is legally determined unlawful or unenforceable, the remainder of the Contract shall remain in full
force and effect and such term or provision shall be stricken.
CF Integrated Contract 2014 9 Contract No. KPZ27
7.4 Survival of Terms.
The parties agree that, unless a provision of this Contract, its attachments or incorporated documents expressly states otherwise as to
itself or a named provision, all provisions of this Contract concerning obligations of the Provider and remedies available to the
Department are intended to survive the "ending date" or an earlier termination of this Contract. The Provider's performance pursuant to
such surviving provisions shall be without further payment. as the contract payments received during the term of this Contract are
consideration for such performance.
7.5 Modifications.
Modifications of provisions of this Contract shall be valid only when they have been reduced to writing and duly signed by both parties.
The rate of payment and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of
payment when these have been established through the appropriations process and subsequently identified in the Departments
operating budget.
7.6 Most Favored Party Status.
The Provider represents and warrants that the prices and terms for its services under this Contract are no less favorable to the
Department than those for similar services under any existing contract with any other party. The Provider further agrees that, within 90
days of Provider entering into a contract or contract amendment or offering to any other party services similar to those under this
Contract under prices or terms more favorable than those provided in this Contract, the Provider will report such prices and terms to the
Department, which prices or terms shall be effective as an amendment to this Contract upon the Department's written acceptance
thereof. Should the Department discover such other prices or terms, the same shall be effective as an amendment to this Contract
retroactively to the earlier of the effective date of this Contract (for other contracts in effect as of that date) or the date they were first
contracted or offered to the other party (for subsequent contracts, amendments or offers) and any payment in excess of such pricing
shalt be deemed overpayments. Provider shall submit an affidavit no later than July 31st of each year during the term of this Contract
attesting that the Provider is in compliance with this provision, as required by section 216.0113, F.S.
7.7 Anticompetitive Agreements.
The Provider will not offer, enter into nor enforce any formal or informal agreement with any person, firm or entity under which the parties
agree to refrain from competing for any future service contract or limit in any manner the ability of either party to obtain employment by or
provide services to the Department or a provider of services to the Department.
7.8 Communications.
Except where otherwise provided in this Contract, communications between the parties regarding this Contract may be by any
commercially reasonable means. Where this Contract calls for communication in writing, such communication includes email, and
attachments thereto are deemed received when the email is received.
7.9 Accreditation.
The Department is committed to ensuring provision of the highest quality services to the persons we serve. Accordingly, the Department
has expectations that where accreditation is generally accepted nationwide as a clear indicator of quality service, the majority of the
Departments providers will either be accredited, have a plan to meet national accreditation standards, or will initiate a plan within a
reasonable period of time.
7.10 Transitioning Young Adults.
The Provider understands the Department's interest in assisting young adults aging out of the dependency system. The Department
encourages Provider participation with the local Community-Based Care Lead Agency Independent Living Program to offer gainful
employment to youth in foster care and young adults transitioning from the foster care system.
7.11 DEO and Workforce Florida.
The Provider understands that the Department, the Department of Economic Opportunity, and Workforce Florida, Inc., have jointly
implemented an initiative to empower recipients in the Temporary Assistance to Needy Families Program to enter and remain in gainful
employment. The Department encourages Provider participation with the Department of Economic Opportunity and Workforce Florida.
7.12 Purchases by Other Agencies.
The Department of Management Services may approve this Contract as an alternate contract source pursuant to Rule 60A-1.047, Florida
Administrative Code, if requested by another agency. Other State agencies may purchase from the resulting contract, provided that the
Department of Management Services has determined that the contract's use is cost-effective and in the best interest of the State. Upon
CF Integrated Contract 2014 10 Contract No. KPZ27
such approval, the Contractor may, at its discretion, sell these commodities or services to additional agencies, upon the terms and
conditions contained herein.
By signing this Contract, the parties agree that they have read and agree to the entire Contract, as described in Section 1.4
hereof.
IN WITNESS THEREOF, the parties hereto have caused this 48 page Contract to be executed by their undersigned officials as duly
authorized.
PROVIDER: Monroe County FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
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Name: Danny Kolhage Name: Bronwyn Stanford
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The parties agree that any future amendment(s)replacing this page will not affect the above execution.
STATE AGENCY 29 DIGIT FLAIR CODE: N/A
Federal Tax ID#(or SSN): 59-6000749 Provider Fiscal Year Ending Date: 09/30.
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CF Integrated Contract 2014 11 Contract No. KPZ27
EXHIBIT A—SPECIAL PROVISIONS
The following provisions supplement or modify the provisions of Sections 1 through 7, above, as provided herein:
SECTION 1: ENGAGEMENT,TERM AND CONTRACT DOCUMENT
A-1. Program or Service Specific Terms
A-1.1.Imminent Danger of Loss of Housing—A family who is about to lose their residence,or who face the loss of shelter due to financial
crisis or other crisis.
A-1.2 Region—The counties that comprise the geographical area of the Department of Children and Families.
A-1.3 Circuit—The counties that comprise the geographical area of the Department of Children and Families(formerly referred to as
Districts)which are aligned to match the local judicial court system.
A-1.4 CoC—Continuum of Care—A local planning body for a defined geographical area responsible for establishing and operating a
system to prevent and end homelessness for that area; provide funding efforts by nonprofits providers,and State and local governments
to quickly rehouse homeless individuals and families while minimizing the trauma and dislocation caused to homeless individuals,
families, and communities by homelessness; promote access to and effect utilization of mainstream programs by homeless individuals
and families; and optimize self-sufficiency among individuals and families experiencing homelessness.
A-1.5 CoC Plan—A community plan to organize and deliver housing and services to meet the specific needs of people who are
homeless as they move to stable housing and maximum self-sufficiency. It includes actions steps to end homelessness and prevent a
return to homelessness..
A-1.6 Department—The Department of Children and Families.
A-1.7 Grant Agreement—An agreement between the Department and a provider of goods or services for the delivery of services or
goods to eligible clients as defined in the agreement.
A-1.8 Grantee—The grant applicant that has been awarded funding for this 2014 Emergency Solutions Grant(ESG) program.
A-1.9 HUD—The federal Department of Housing and Urban Development that provides funding for the Emergency Solutions Grant
program,which includes Street Outreach. Emergency Shelter Facilities, and Homelessness Prevention and Rapid Re-housing sevices.
A-1.10 HMIS—The Homeless Management Information System is the information system designated by the Continuum of Care to
comply with the U.S. Department of Housing and Urban Development's data collection, management, and reporting standards as
referenced in 24 CFR 576.2 and used to collect client-level data and data on the provision of housing and services to homeless
individuals and families and persons at-risk of homelessness.
A-1.11 Homeless—An individual who lacks a fixed, regular and adequate nighttime residence or an individual who has a primary
nighttime residence that is:
A-1.11.1 A supervised publicly or privately operated shelter designed to provide temporary living accommodations, including welfare
hotels,congregate shelters,transitional housing for the mentally ill.
A-1.11.2 An institution that provides a temporary residence for individuals intended to be institutionalized.
A:1.11.3 A public or private place not designed for,or ordinarily used as, a regular sleeping accommodation for human beings.
Places that may include living on the street or under a bridge, in a park, bus terminal, railroad station, airport, abandoned building, or a
carltruck/vehicle.
A-1.12 Homeless Coalition(Coalition)—An agency/organization(either for profit or non-profit)established and operating pursuant to
section 420.623, Florida Statutes. The Coalition's mission is to plan,network,coordinate, and oversee the delivery of direct client
services to the homeless population in the local area.
A-1.13 Lead Agency—Of the homeless CoC Lead Agency means the agency designated by the CoC planning area in accordance with
section 420.624, Florida Statutes.
A-1.14 Minor Child(ren)—Means a child less than 18 years of age, or under the age of 19 if the child is a fulltime student in a secondary
school or at the equivalent level of vocational or technical training and does not include anyone who is married or divorced.
CF Integrated Contract 2014 12 Contract No. KPZ27
•
A-1.15 Office on Homelessness—The office created within the Department of Children and Families to provide interagency
coordination, and support to the Council on Homelessness, and other related coordination on issues relating to homelessness in
accordance with section 420.622, Florida Statutes.
A-1.16 Subgrantee—A local agency within the authorized homelessness CoC planning area that the Grantee subcontracts with to
provide services funded through this Grant Agreement.
SECTION 2: STATEMENT OF WORK.
There are no additional provisions to this section of the Standard Contract.
SECTION 3: PAYMENT, INVOICE AND RELATED TERMS
There are no additional provisions to this section of the Standard Contract.
SECTION 4:GENERAL TERMS AND CONDITIONS GOVERNING PERFORMANCE
A.4.1 Client Risk Prevention. In accordance with the client risk prevention system,the Grantee shall report those reportable situations
listed in CFOP 215-6 in the manner prescribed in CFOP 215-6. The Provider shall immediately report any knowledge or reasonable
suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-
free telephone number(1-800-96ABUSE). As required by Chapters 39 and 415, F.S.,this provision is binding upon both the Provider
and its employees.
SECTION 5: RECORDS,AUDITS AND DATA SECURITY
There are no additional provisions to this section of the Standard Contract.
SECTION 6: PENALTIES, TERMINATION AND DISPUTE RESOLUTION
6.1 Dispute Resolution: It is expected that the Recipient and the Department will agree to cooperate in resolving any differences
uuuLeuiiry performance or in interpreting the grant agreement.Within five(5)working days of the execution of a grant agreement for
services,each party shall designate one person to act as its representative for dispute resolution purposes, and shall notify the other
party of the person's name, business address and telephone number.Within five(5)working days from delivery to the designated
representative of the other party of a written request for dispute resolutions, the representatives will conduct a face-to-face meeting to
resolve the disagreement amicably. If the representatives are unable to reach a mutually satisfactory resolution,the representatives shall
make recommendations to the Secretary who has final authority to resolve the dispute. The parties reserve all their rights and remedies
under Florida Law.
SECTION 7: OTHER TERMS
There are no additional provisions to this section of the Standard Contract.
CF Integrated Contract 2014 13 Contract No. KPZ27
EXHIBIT Al-STATE AND FEDERAL LAWS, RULES AND REGULATIONS RELATING TO PERFORMANCE
As provided in Section 4.1 of this Contract, the Provider is required to comply with the following requirements, as applicable to its
performance under this Contract, as they may be enacted or amended from time to time, Provider acknowledges that it is independently
responsible for investigating and complying with all State and Federal laws, rules and regulations relating to its performance under this
Contract and that the below is only a sample of the State and Federal laws, rules and regulations that may govern its performance under
this Contract.
A1.1 Federal Law.
Al-1.1 If this Contract contains Federal Funds, the Provider shall comply with the provisions of Federal law and regulations
including, but not limited to,45 CFR, Parts 74 and 92, and other applicable regulations.
A1.1.2 If this Contract contains $10,000 or more of Federal Funds, the Provider shall comply with Executive Order 11246, Equal
Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor
regulation 41 CFR, Part 60 and 45 CFR, Part 92, if applicable.
Al-1.3 If this Contract contains over$100,000 of Federal Funds,the Provider shall comply with all applicable standards.orders,or
regulations issued under section 306 of the Clean Air Act, as amended (42 United States Code(U.S.C.) 7401 et seq.), section 508
of the Federal Water Pollution Control Act, as amended (33 U.S.C. 1251 et seq.), Executive Order 11738, as amended and where
applicable, and Environmental Protection Agency regulations (40 CFR, Part 30). The Provider shall report any violations of the
above to the Department.
Al-1.4 No Federal Funds received in connection with this Contract may be used by the Provider, or agent acting for the Provider,
or subcontractor to influence legislation or appropriations pending before the Congress or any State legislature. If this Contract
contains Federal funding in excess of$100,000, the Provider must, prior to contract execution,complete the Certification Regarding
Lobbying form, Attachment 3. If a Disclosure of Lobbying Activities form, Standard Form LLL, is required, it may be obtained from
the contract manager. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and
returned to the Contract Manager, prior to payment under this Contract.
-- A1-1.5 If this Contract contains Federal Funds and provides services to children up to age 18, the Provider shall comply with the
Pro-Children Act of 1994 (20 U.S.C. 6081). Failure to comply with the provisions of the law may result in the imposition of a civil
monetary penalty of up to $1,000 for each violation or the imposition of an administrative compliance order on the responsible
entity, or both.
A1.1.6 Unauthorized aliens shall not be employed. Employment of unauthorized aliens shall be cause for unilateral cancellation of
this Contract by the Department for violation of section 274A(e)of the Immigration and Nationality Act(8 U.S.C. 1324 a)and section
101 of the Immigration Reform and Control Act of 1986. The Provider and its subcontractors will enroll in and use the E-verify
system established by the U.S. Department of Homeland Security to verify the employment eligibility of its employees and its
subcontractors' employees performing under this Contract. "Employee assigned to the contract" means all persons employed or
assigned (including subcontractors) by the Provider or a subcontractor during the contract term to perform work pursuant to this
contract within the United States and its territories.
A1•2 Civil Rights Requirements. In accordance with Title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act of
1990, or the Florida Civil Rights Act of 1992, as applicable the Provider shall not discriminate against any employee (or applicant for
employment) in the performance of this Contract because of race, color, religion, sex, national origin, disability, age, or marital status.
Further, the Provider agrees not to discriminate against any applicant, client, or employee in service delivery or benefits in connection
with any of its programs and activities in accordance with 45 CFR, Parts 80, 83, 84, 90, and 91, Title VI of the Civil Rights Act of 1964,or
the Florida Civil Rights Act of 1992, as applicable and CFOP 60-16. These requirements shall apply to all contractors, subcontractors,
subgrantees or others with whom it arranges to provide services or benefits to clients or employees in connection with its programs and
activities. If employing fifteen or more employees,the Provider shall complete the Civil Rights Compliance Checklist, CF Form 946 within
30 days of execution of this Contract and annually thereafter in accordance with CFOP 60-16 and 45 CFR, Part 80.
Al-3 Use of Funds for Lobbying Prohibited. The Provider shall comply with the provisions of sections 11.062 and 216.347, F.S., which
prohibit the expenditure of contract funds for the purpose of lobbying the Legislature,judicial branch, or a State agency.
A1.4 Public Entity Crime and Discriminatory Contractors. Pursuant to sections 287.133 and 287,134, F.S., the following restrictions
are placed on the ability of persons placed on the convicted vendor list or the discriminatory vendor list. When a person or affiliate has
CF Integrated Contract 2014 14 Contract No. KPZ27
been placed on the convicted vendor list following a conviction for a public entity crime, or an entity or affiliate has been placed on the
discriminatory vendor list, such person, entity or affiliate may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid,proposal,or reply on a contract with a public entity for the construction or the repair of a
public building or public work; may not submit bids, proposals,or replies on leases of real property to a public entity; may not be awarded
or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; and may not transact
business with any public entity: provided, however, that the prohibition on persons or affiliates placed on the convicted vendor shall be
limited to business in excess of the threshold amount provided in section 287.017, F.S., for CATEGORY TWO for a period of thirty-six
(36) months from the date of being placed on the convicted vendor list.
A1-5 Whistleblower's Act Requirements. In accordance with subsection 112.3187(2), F.S., the Provider and its subcontractors shall
not retaliate against an employee for reporting violations of law, rule, or regulation that creates substantial and specific danger to the
public's health, safety, or welfare to an appropriate agency. Furthermore, agencies or independent contractors shall not retaliate against
any person who discloses information to an appropriate agency alleging improper use of governmental office, gross waste of funds, or
any other abuse or gross neglect of duty on the part of an agency, public officer, or employee. The Provider and any subcontractor shall
inform its employees that they and other persons may file a complaint with the Office of Chief Inspector General, Agency Inspector
General,the Florida Commission on Human Relations or the Whistle-blower's Hotline number at 1-800-543-5353.
A1.6 Public Records.
A1.6.1 As required by section 287.058(1)(c), F.S., the Provider shall allow public access to all documents, papers, letters, or other
public records as defined in subsection 119,011(12), F.S. as prescribed by subsection 119.07(1) F.S., made or received by the
Provider in conjunction with this Contract except that public records which are made confidential by law must be protected from
disclosure. It is expressly understood that the Provider's failure to comply with this provision shall constitute an immediate breach
of contract for which the Department may unilaterally terminate this Contract.
A1.6.2 As required by section 119.0701, F.S., to the extent that the Provider is acting on behalf of the Department within the
meaning of section 119.011(2), F.S.,the Provider shall:
a. Keep and maintain public records that ordinarily and necessarily would be required by the Department in order to
perform the service.
b. Provide the public with access to public records on the same terms and conditions that the Department would provide
the records and at a cost that does not exceed the cost provided in Chapter 119, F.S., or as otherwise provided by law.
c. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are
not disclosed except as authorized by law.
d. Meet all requirements for retaining public records and transfer, at no cost, to the Department all public records in
possession of the Provider upon termination of the Contract and destroy any duplicate public records that are exempt
or confidential and exempt from public records disclosure requirements. All records stored electronically must be
provided to the Department in a format that is compatible with the information technology systems of the Department.
A1.7 Support to the Deaf or Hard-of-Hearing.
A1.7.1 Where direct services are provided, the Provider and its subcontractors shall comply with section 504 of the Rehabilitation
Act of 1973, 29 U.S.C. 794, as implemented by 45 CFR Part 84 (hereinafter referred to as Section 504), the Americans with
Disabilities Act of 1990, 42 U.S.C. 12131, as implemented by 28 CFR Part 35 (hereinafter referred to as ADA), and the Children
- ----and€ami4os Operating Procedure(CFOP)60-10, Chapter 4,entitled"Auxiliary Aids and Services for the Deaf or Hard-of-Hearing."
A1-7.2 If the Provider or any of its subcontractors employs 15 or more employees, the Provider shall designate a Single-Point-of-
Contact(one per firm)to ensure effective communication with deaf or hard-of-hearing customers or companions in accordance with
Section 504 of the ADA, and CFOP 60-10, Chapter 4. The Provider's Single-Point-of-Contact and that of its Subcontractors will
process the compliance data into the Departments HHS Compliance reporting Database by the 5" business day of the month,
covering the previous month's reporting, and forward confirmation of submission to the Contract Manager. The name and contact
information for the Provider's Single-Point-of-Contact shall be furnished to the Departments Grant or Contract Manager within 14
calendar days of the effective date of this requirement.
A1-7.3 The Provider shall, within 30 days of the effective date of this requirement, contractually require that its subcontractors
comply with Section 504,the ADA,and CFOP 60-10, Chapter 4. A Single-Point-of-Contact shall be required for each subcontractor
that employs 15 or more employees. This Single-Point-of-Contact will ensure effective communication with deaf or hard-of-hearing
CF Integrated Contract 2014 15 Contract No. KPZ27
customers or companions in accordance with Section 504 and the ADA and coordinate activities and reports with the Provider's
Single-Point-of-Contact.
A1.7.4 The Single-Point-of-Contact shall ensure that employees are aware of the requirements, roles & responsibilities, and
contact points associated with compliance with Section 504, the ADA, and CFOP 60-10, Chapter 4. Further, employees of
providers and their subcontractors with 15 or more employees shall attest in writing that they are familiar with the requirements of
Section 504,the ADA, and CFOP 60-10, Chapter 4. This attestation shall be maintained in the employee's personnel file.
A1•7.5 The Provider's Single-Point-of-Contact will ensure that conspicuous Notices which provide information about the availability
of appropriate auxiliary aids and services at no-cost to the deaf or hard-of-hearing customers or companions are posted near where
people enter or are admitted within the agent locations. Such Notices must be posted immediately by The Provider and its
subcontractors. The approved Notice can be downloaded through the Internet at: http:llwww.myfifamilies.comlabout-uslservices-
deaf-and-hard-hearingldcf-posters.
Al•7.6 The Provider and its subcontractors shall document the customer's or companion's preferred method of communication and
any requested auxiliary aids/services provided in the customer's record. Documentation, with supporting justification, must also be
made if any request was not honored. The Provider shall distribute Customer Feedback forms to customers or companions, and
provide assistance in completing the forms as requested by the customer or companion.
Al-7.7 If customers or companions are referred to other agencies,the Provider must ensure that the receiving agency is notified of
the customer's or companion's preferred method of communication and any auxiliary aids/service needs.
A1-7.8 The Department requires each contract/subcontract provider agency's direct service employees to complete Serving our
Customers who are Deaf or Hard-of-Hearing and sign the Attestation of Understanding. Direct service employees performing under
this Contract will also print their certificate of completion, attach it to their Attestation of Understanding, and maintain them in their
personnel file.
Al-8 Client and Other Confidential Information. State laws providing for the confidentiality of client and other information include but
are not limited to sections 39,0132, 39.00145, 39.202, 39,809, 39.908, 63.162,. 63.165, 383.412, 394.4615, 397.501, 409.821, 409.175,
410.037, 410.605, 414.295, 415.107, 415.295, 741.3165 and 916,107, F.S. Federal laws and regulations to the same effect include
section 471(a)(8) of the Social Security Act, section 106(b)(2)(A)(viii) of the Child Abuse Prevention and Treatment Act, 7 U.S.C.
§2020(e)(8), 42 U.S.C. §602 and 42 U.S.C. §1396a(a)(7) and 7 CFR §272.1(c). 42 CFR §§2.1-2.3, 42 CFR §431.300-30645 CFR
§400,27(a) and 45 CFR §205.50. A summary of Florida Statutes providing for confidentiality of this and other information are found in
Part II of the Attorney General's Government in the Sunshine Manual, as revised from time-to-time.
A1.9 PRIDE. Articles which are the subject of or are required to carry out this Contract shall be purchased from Prison Rehabilitative
Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in the same manner and under the procedures
set forth in subsections 946.515(2) and (4), F.S. For purposes of this Contract, the Provider shall be deemed to be substituted for the
Department insofar as dealings with PRIDE. This clause is not applicable to subcontractors unless otherwise required by law. An
abbreviated list of products/services available from PRIDE may be obtained by contacting PRIDE, (800)643-8459.
Al-10 Recycled Products. The Provider shall procure any recycled products or materials. which are the subject of or are required to
carry out this Contract, in accordance with the provisions of sections 403.7065, F.S.
Al-11 Scrutinized Companies. If this Contract is for an amount of$1 Million or more, the Department may terminate this Contract at
any time the Provider is found to have submitted a false certification under section 287.135, F.S., or has been placed on the Scrutinized
Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List.
A1-12 Federal funding Accountability and Transparency Act. The Provider will complete and sign the FFATA Certification of
Executive Compensation Reporting Requirements form (CF 1111 or successor) if this Contract includes $25,000 or more in Federal
Funds (as determined over its entire term). The Provider shall also report the total compensation of its five most highly paid executives if
it also receives in excess of 80%of its annual gross revenues from Federal Funds.
A1.13 Prompt Payment and Vendor Ombudsman. Pursuant to section 215.422, F.S., the Department has five (5) working days to
inspect and approve goods and services, unless the bid specifications, purchase order, or this Contract specify otherwise. Any amount
that is authorized for payment but is not available within forty (40) days, measured from the latter of the date a properly completed
invoice is received by the Department or the goods or services are received, inspected, and approved (or within 35 days after the date
eligibility for payment of a health care provider is determined), a separate interest penalty as described in section 215.422, F.S., will be
due and payable in addition to the amount authorized for payment. Interest penalties less than one(1)dollar will not be paid unless the
CF Integrated Contract 2014 16 Contract No. KPZ27
Provider requests payment. A Vendor Ombudsman has been established within the Department of Financial Services and may be
contacted at(850)413-5516.
A1.14 Timely Payment of Subcontractors. To the extent that a subcontract provides for payment after Provider's receipt of payment
from the Department, the Provider shall make payments to any subcontractor within 7 working days after receipt of full or partial
payments from the Department in accordance with section 287.0585, F.S., unless otherwise stated in the contract between the Provider
and subcontractor. Failure to pay within seven (7) working days will result in a penalty that shall be charged against the Provider and
paid by the Provider to the subcontractor in the amount of one-half of one percent(.005)of the amount due per day from the expiration of
the period allowed for payment. Such penalty shall be in addition to actual payments owed and shall not exceed fifteen(15%) percent of
the outstanding balance due.
AI•15 Employment Screening.
AI.15.1The Provider shah ensure that all staff utilized by the Provider and its subcontractors that are required by Florida law to be
screened in accordance with chapter 435, F.S., are of good moral character and meet the Level 2 Employment Screening
standards specified by sections 435.04, 110.1127, and subsection 39,001(2), F.S., as a condition of initial and continued
employment that shall include but not be limited to:
a. Employment history checks,
b. Fingerprinting for all criminal record checks,
c. Statewide criminal and juvenile delinquency records checks through the Florida Department of Law Enforcement
(FDLE)I
d. Federal criminal records checks from the Federal Bureau of Investigation via the Florida Department of Law
Enforcement', and
e. Security background investigation, which may include local criminal record checks through local law enforcement
agencies.
f. Attestation by each employee, subject to penalty of perjury, to meeting the requirements for qualifying for employment
pursuant to chapter 435 and agreeing to inform the employer immediately if arrested for any of the disqualifying
offenses while employed by the employer.
A1.15.2The Provider shall sign an affidavit each State fiscal year for the term of the contract stating that all required staff have been
screened or the Provider is awaiting the results of screening.
A1-16 Human Subject Research. The Provider shall comply with the requirements of CFOP 215-8 for any activity under this Contract
involving human subject research within the scope of 45 CFR, Part 46, and 42 U.S.C. section 289, et seq., and may not commence such
activity until review and approval by the Department's Human Protections Review Committee and a duly constituted Institutional Review
Board.
A1.17 Coordination of Contracted Services. Section 287.0575, F.S., mandates various duties and responsibilities for certain State
agencies and their contracted service providers, and requires the following Florida health and human services agencies to coordinate
their monitoring of contracted services: Department of Children and Families, Agency for Persons with Disabilities, Department of
Health, Department of Elderly Affairs, and Department of Veterans Affairs, where applicable.
In accordance with Section 287.0575(2), F.S.,each contract service provider that has more than one contract with one or more of the five
Florida health and human services agencies must provide a comprehensive list of their health and human services contracts to their
respective ConlraoLManager(s). The list must include the following information:
• Name of each contracting State agency and the applicable office or program issuing the contract.
• Identifying name and number of the contract.
• Starting and ending date of each contract.
• Amount of each contract.
• A brief description of the purpose of the contract and the types of services provided under each contract.
• Name and contact information of each Contract Manager.
See NIA for additional laws, rules and regulations affecting performance of this Contract.
CF Integrated Contract 2014 17 Contract No. KPZ27
EXHIBIT B- SCOPE OF WORK
B-1 Grant Agreement Terms
B-1.1 Grant agreement terms used in this document can be found in the Florida Department of Children and Families Glossary of
Grant and/or Contract agreement Terms,which is incorporated herein by reference and can be obtained from the grant
manager.
13-1.2 For the purposes of this agreement the term"grant"can be used interchangeably with the term "contract"and the term
"recipient'can be used interchangeably with the term"provider'.These terms will be subject to the terms and conditions of
this contract.
B-1.3 The definitions contained in the U.S. Department of Housing and Urban Development Interim Regulations published
December 5, 2011, as amended and the 24 CFR Part 576 shall govern the Department's grant awards. Copies of these
federal regulations are available by contacting the grant manager identified in the Department contact section.Grantees are
directed to review the definition of homelessness in Section 576,2 of the federal regulations published in the December 5,
2011 Interim Rule.
B-2 Scope of Service: Services shall be provided in Monroe County, in accordance with the Provider's response to the Department's
Emergency Solutions Grant solicitation LPZ12.
B-3 Program Requirements
B-3.1 The Emergency Solutions Grant(ESG) is a federal grant program from the U.S. Department of Housing and Urban
Development, and the federal regulations published for the grant program contained in 24 CFR Part 576,as amended, shall
govern the awards made by the Department of Children and Families, herein after referred to as the Department.
B-3.2 In addition to the definitions contained in 24 CFR, Part 576 as amended,the Provider must also comply with other federal
laws and regulations, including the following:
Participate fully in the Homeless management Information System(HMIS). HMIS requirements are outlined in the Interim
Rule published December 5, 2011 as amended. Accordingly,only Providers who commit to participate in HMIS will be
eligible for the Emergency Solutions Grant funding. Section 605 of the Violence Against Women Act of 2005 amended the
McKinney-Vet Homeless Assistance Act to prohibit victim service providers from entering personally identifiable information
into an HMIS database. This law applies to Providers receiving Violence Against Women Act and/or Family Violence
Prevention and Service Act funding. Domestic violence service providers are not required to participate in HMIS, but shall
provide aggregate service data on persons and outcomes achieved. [See HUD Notice issued March 16, 2007, published in
the Federal Register]
B-3.3 The Provider shall be aware of and comply with regulations and requirements set forth in Part 24. Code of Federal
Regulations(C.F.R.)§ 576.23, Emergency Solutions Grant Program: Stewart B. McKinney Homeless Assistance Act.
Organizations that are religious or faith based are eligible,on the same basis as any other organization,to participate in the
Emergency Solutions Grants program. Neither the Federal government nor a state or local government receiving funds
-- under Emergency Solutions Grants programs shall discriminate against an organization on the basis of the organizations
religious character or affiliation. Provisions set forth generally require that when services are funded under the ESG
program the services will be provided in a way that is tree from religious influences and in accordance with the following
principles:
B-3.3.1 An organization that participates in the Emergency Solutions Grants program shall not, in providing assistance,
discriminate against a program beneficiary or prospective program beneficiary on the basis of religion or religious
belief.
8-3.3.2 The organization will provide grant services in a way that is free from religious influences and will not engage in
inherently religious activities,such as worship, religious services, instruction, counseling,or proselytization as part
of the programs or services funded under the grant. If an organization conducts such activities, the activities must
CF Integrated Contract 2014 18 Contract No. KPZ27
• be offered separately, in a time or location,from the programs or services funded under the grant, and
participation must be voluntary for the beneficiaries of the programs or services funded by the grant.
B•3.3.3 The organization will not discriminate against any employee or applicant for employment on the basis of religion
and will not limit employment or give preference on the basis of religion.
B-3.3.4 The organization will not limit services provided to,or give preference to any person seeking services based on
religion.
B•3.4 There are additional federal and state assurances and certifications that the Provider must comply with, including all
ordinances, codes, and statutes relating to building, health,fire, safety, sanitation,zoning and the environment, as well
habitability standards for all housing units occupied by assisted participants.
B-3.5 The Emergency Solutions Grant requires matching funds. The Provider is required by federal regulations under HUD's
December 5,2011 Interim Rule, as amended,and the 24 CFR, Part 576 to match the Emergency Solutions Grant with an
equal amount of funds from other sources.A Provider may use in-kind services,or other public or private cash sources to
meet the dollar for dollar match requirement. Matching funds must be provided after the date of the grant agreement's
execution. Funds used to match previous Emergency Solutions Grants or any other grant may not be used to match the
grant award made under this solicitation.
B-3.6 Provider may use any of the following as matching funding:
B-3.6.1 Cash;
B•3.6.2 Value of fair rental value of any donated material or building;
B-3.6.3 Value of any lease on a building;
8-3.6.4 Salary paid to staff to carry out the program of the provider;or
B-3.6.5 Value of the time and services contributed by volunteers to carry out the program of the Provider
based on the value at rates consistent with those paid for similar work in the provider's organization
(24 CFR, Section 576.201 (e)).
B•3.7 The Department will reimburse the Provider for eligible expenditures, based upon actual program expenses incurred Song
with supporting documentation as determined by the Department or the Department of Financial Services.There will be no
advance payments under this grant agreement. The supporting documentation must be submitted along with copies of
invoices in order for payment to be processed.
B•3.8 Administrative Costs. Recipients may use up to 4.5%of its Emergency Solutions Grant for costs related to the planning
and execution of ESG activities. Eligible costs include:
B-3.8.1 Costs of overall program management,coordination,or oversight(including staff salaries for program
administration activities)
B•3.B.2 Training on ESG requirements and costs of attending HUD sponsored training
B-3,8.3 Costs associated with conducting Environmental Reviews conducted under 24 CFR Part 576.407
B-3.9 Authority: For federal regulations governing the Emergency Solutions Grant Program see the HUD web site to view or
print regulations at:
https alwww.onecpd.infolresourcel19271hearthesg-prog ram-and-consolidated-plan-conform ing-amend menu/
B•4 Major Contract Goals
B-4.1 Facilities: This clause does not apply to this contract.
CF Integrated Contract 2014 19 Contract No. KPZ27
B•4.2 Prevention and Re-housing:
B•4.2.1 The objectives of homeless prevention is to assist individuals and families who are at imminent risk, or at risk,of
homelessness, meaning those who qualify under the homeless definition or those who qualify as at risk of
homelessness with short and medium term rental assistance and housing relocation and stabilization services to
1)prevent persons from becoming homeless in a shelter or an unsheltered situation,or 2)to help such persons
regain stability in their current housing or other permanent housing. Individuals and families must have incomes
below 30"%Annual Median Income(AMI).
B-4.2.2 The objectives of rapid re-housing is to assist individuals and families who are literally homeless, meaning those
who qualify under paragraph 1 of the definition of homeless with short and medium term rental assistance and
housing relocation and stabilization services to 1)help homeless persons living on the streets or in an emergency
shelter transition as quickly as possible into permanent housing, and then 2)help such persons achieve stability in
that housing.
B-4.3 Street Outreach: This clause does not apply to this contract.
8-5 Service Area/Locations/Times
B-5.1 Service Location -Services will be provided at:
Monroe County Social Services
1100 Simonton Street
Key West, Florida 33040
B•5.2 Service Times: Services for Prevention(Rapid Re-housing contracts wilt be made available to those seeking assistance
within normal business hours. Monday-Friday, 8 am until 5 pm and those deemed necessary by the Provider to meet the
needs of clients seeking service. Any change in service time shall not require an amendment to this grant, but will require
the Provider requesting written approval from the Department prior to the time change.
B-5.3 Changes in Location: The service delivery location shall not be changed without prior written approval from the contract
manager.
B•6 Clients to be Served-General Description:
B•6.1 Facilities: •This clause does not apply to this contract.
B•6.2 Prevention
Homeless Prevention serves extremely low income individuals and families,whose household income is below 30%AMI, at
risk of becoming homeless and moving into an emergency shelter or place not meant for human habitation. (Exhibit B1).
B-6.3 Rapid Re-Housing
Rapid Re-Housing serves individuals or families who are literally homeless, currently living in an emergency shelter or
place not meant for human habitation. (Exhibit 81).
B-6.4 Outreach: This clause does not apply to this contract.
8.7 Client Eligibility: Client eligibility for services shall be determined by the Provider in accordance with 24 CFR Part 576 as
amended in HUD December 5, 2011 Interim Rule;the guidelines outlined in the providers written standards and procedures as
approved by the Department prior to execution of this grant as incorporated by reference herein; and by the criteria for defining
homeless under the Homeless Definition established by HUD.
8-8 Client Determination: In the event of any disputes regarding the eligibility of clients,the determination made by the Department
is final and binding on all parties. Provider is directed to review the definition of homelessness in Section 576.2 of the federal
regulations published in the December 5, 2011 Interim Rule,
CF Integrated Contract 2014 20 Contract No. KPZ27
B-9 Equipment: It is the responsibility of the Provider to supply at its own expense,any equipment(aside form equipment purchased
with funds from this grant agreement)necessary to provide services under this grant agreement.All equipment acquired under
this grant agreement will be inventoried annually.
B•10 Contract Limits: This grant agreement is limited to funding from January 1, 2015 or the date of grant execution,whichever is
later,to and including June 30th, 2015. Funding is limited to no more than $76,598.00 for the grant period and must be met with a
dollar for dollar match requirement according to 24 CFR, Part 576 and HUD's December 5. 2011 Interim Rule as amended. There
is no provision for renewal or extension of this grant agreement.
CF Integrated Contract 2014 21 Contract No.KPZ27
EXHIBIT B1
WO
MN Li rpi; •• . . Homeless Definition
I Individuals defined as Homeless under the following categories are eligible for -
assistance in SO.
• Category 1-Literally Homeless
ic
• Category 0-Fleeing/Attempting to Flee DV(where the II dividu a Or family
to
ist alto meets the Cieria for Category ii
w SO projects have the following additional limitations on eligibility within Category
as
cj 1:
N • Individuals and families must be living on the streets for other places not
meant for human habitation)and be unwilling o unable to access services
In emergency shelter
Zm , Individuals and Families defined as Homeless under the following categories are
W tto 5 eligible for assistance in FS protectsas
z 2
O • Category 1-Literally Homeless
O • Category 2-Imminent Risk of Homeless
•
Gr% • Category 3-Homeless Under Other Federal Statutes
O U`r E • Category 4-Fleeing/Attempting to Flee DV
V yr
y o Individuals defined az Homeless under the following categories are eligible'or
CO assistance in RRH projeats:
04
r •a.� Categoryl-Literally Homeless
• Category 4-Fleeing/Attempting to Flee DV(where the individual or family
m v cc also meets the criteria for Category 11
lso
su• e m Individuals and Families defined as Homeless under the fol lowng categories are
wW eligible for assistance in HP projects:
• Category 2-Imminent Risk of Homeless
o
- • Category 3-Homeless Under Other Federal Statutes
• Category e-Reefing/Attempting to Flee DV
es
Individuals and Families who are defined as At Risk of Homelessness are eligible for
Eat asOst a nee in HP rojects.
r
HP projects have the following additional limitations on eligibi ity with homeless
E and at risk of homelesso
z
• Must only serve individuals and families that have an annual income
below 30%of AMI
CF Integrated Contract 2014 22 Contract No. KPZ27
EXHIBIT C-TASK LIST
The Provider shall perform all functions necessary for the proper delivery of services including,but not limited to,the
following:
C-1 Service Tasks
C•1.1 The Provider shall comply with the Program/Project Narrative as described in the Provider's response to Grant Application
LPZ12, within the limits of the approved Budget(Exhibit C1), Budget Narrative(Exhibit C2)and the Task Limits contained
herein.
C-1.2 Task List: Provider must develop written standards and procedures for providing assistance in accordance with
provisions set forth in HUD's December 5, 2011 Interim Rule. These standard policies and procedures must be
approved by the Department prior to grant execution and are incorporated by reference herein. Standards must meet
these criteria:
C-1.2.1 Standard policies and procedures for evaluating individuals'and families'eligibility for assistance under the
Emergency Solutions Grant: Minimum Standards: Must be(1)consistent with the definition of homeless and at-
risk homeless set forth in 24 CFR 576.2; and(2)the record keeping requirements set forth in CFR 576.500 (b-e).
C-1.2.2 Standard policies and procedures for coordination among homeless service providers, as well as mainstream
service and housing providers: Minimum Standards: Standard shall encompass all providers and programs listed
in Sections 576.400(b)and (c)of the HUD December 5, 2011 Interim Rule.
C-1.2.3 Continuum of Care Centralized or Coordinated Assessment System: The Department shall require all grant
Providers to submit a certification from the designed continuum of care lead agency that the Provider is using the
assessment system. If the continuum of care has not yet developed such a coordinated assessment system in
accordance with HUD's December 5,2011 Interim Rules requirement,the continuum lead agency shall provide
written documentation of this. Victim service providers may choose not to use the continuum's coordinated
assessment system. If so,the victim service provider shall document this decision in writing.
C-1.2.4 Outreach: This clause does not apply to this contract.
C-1.2.5 Shelter Facilities:This clause does not apply to this contract.
C-1.2.6 Prevention and Re-Housing
C-1.2.6.1 Policies and procedures for determining and prioritizing which eligible families and individuals will
receive homeless prevention assistance or rapid re-housing aid. Departments Priority: Families with
children shall be given preference under the Departments award for both prevention and rapid re-
housing,to the maximum extent possible.
C•1.2.6.2 Standards for determining the share of rent and utility costs that each eligible participant must pay, if
any,while receiving either homeless prevention or rapid re-housing aid.
C-1.2.6.3 Standards for determining how long a particular participant will be provided with rental assistance,
and whether and how the amount of assistance may be adjusted over time.
C-1.2.6.4 Standards for determining the type, amount and duration of housing stabilization and/or rapid re-
housing assistance andlor relocation services to be provided to an eligible participant, including
limits, if any,on the amount of homeless prevention or rapid re-housing assistance that a participant
may receive. The standards shall set forth the maximum amount of assistance,the maximum months
of assistance possible, and maximum number of times a participant may receive assistance.
CF Integrated Contract 2014 23 Contract No. KPZ27
C-1.2.7 HMIS(Homeless Management Information System)
C-1.2.7.1 Recipients must enter data on all persons served and all activities assisted under ESG into the
applicable community-wide Continuum of Care HMIS or comparable database.Activities funded by
ESG must comply with HUD's standards on participation,data collections and reporting under local
HMIS(See 24 CFR Part 576.107). Victim service providers must not enter data into an HMIS but
must use a comparable database. Information in the comparable data must not be entered directly
into or provided to an HMIS. Eligible costs include*:
a. Hardware equipment and software costs
b. Staff salaries for operating HMIS
c. Training and overhead (participation fees charged by the lead agencies)
C-1.2.7.2 `Activities funded under this component must comply with HUD's standards on participation, data
collection and reporting under a local HMIS in HUD's December 5, 2011 Interim Rule as amended.
C-2 Administrative Tasks
C-2.1 Staffing:
C-2.1.1 The Provider will maintain sufficient and appropriate staff to deliver the proposed services reflected in the grant
agreement.The Provider shall maintain an adequate administrative organizational structure and support staff to
conduct its contractual responsibility, including intake and evaluation of applications for assistance and case
management of client's receiving assistance. This grant will partially support the salaries of two Case Managers
and one administrative position.
C-2.1.2 The Provider shall replace any employee,whose continual presence would be detrimental to the success of the
project, as may be determined by the Department.
C-2.2 Professional Qualifications: Minimum professional qualifications for staff shall be determined by the Provider.The
position descriptions as described in the Provider's application submitted in response to the grant applications shall remain
in place until written approval for any changes is obtained from the Department.
C-2.3 Subcontracting: This grant agreement allows the Provider to subcontract only for services described in the Provider's
response to Grant Application LPZ12 that are described as being in need of subcontracting. All subcontracting is subject to
the provisions of Section 4 of the Standard Contract Agreement and must be approved prior by the Department.The
Provider may not subcontract services not listed in their response to Grant Application LPZ12.
C-2.4 Records and Documentation
C-2.4.1 To the extent that information is utilized in the performance of the resulting grant agreement or generated as a
result of it, and to the extent that information meets the definition of"public record"as defined in subsection
119.011(1), F.S.,said information is hereby declared to be and is hereby recognized by the parties to be a public
record and absent a provision of law or administrative rule or regulation requiring otherwise, shall be made
available for inspection and copying by any interested person upon request as provided in Chapter 119, F.S.,or
otherwise. It is expressly understood that the Provider's refusal to comply with Chapter 119., F.S., shall constitute
an immediate breach of the resulting grant agreement, which entitles the Department to unilaterally cancel the
grant agreement. The Provider is required to notify the Department in writing of requests made for public records.
C-2.4.2 All documents pertaining to the program shall be retained by the Provider for a period of six(6)years after the
termination of the grant agreement, or longer as may be required by any renewal or extension of the grant
agreement. During the record retention period, the Provider agrees to provide all documents required to be
retained upon demand by the Department.
CF Integrated Contract 2014 24 Contract No. KPZ27
C-2.4.3 The Provider agrees to maintain the confidentiality of all records required by law or administrative rule to be
protected from disclosure. The Provider further agrees to hold the Department harmless from any claim or damage
including reasonable attorneys fees and costs of any fine or penalty imposed as a result of improper disclosure by
the Provider of confidential records may be maintained manually or electronically.
C•2.5 Reports(programmatic and to support payment): - Refer to Exhibit D, Section D-7.
C-3 Standard Contract Requirements. Provider will perform all acts required by Sections 4, 5 and 7 of the Standard Contract.
CF Integrated Contract 2014 25 Contract No. KPZ27
EXHIBIT Cl
APPROVED BUDGET
Emergency Solutions Grant
Prevention and Re-Housing
Eligible Activity Grant $
1. Rapid Re-Housing
A. Rental Assistance $28,000.00
B. Housing Relocation and Stabilization
i. Financial Assistance Costs $15,000.00
ii Services Costs $ 980.00
2. Homeless Prevention
A. Rental Assistance $22,500.00
B. Housing Relocation and Stabilization
i. Financial Assistance Costs $ 3,000.00
ii Services Costs $ 620.00
3. HMIS
A. Cost of contributing data to HMIS for CoC $ 3,200.00
B. HMIS Lead Agency Costs for hosting and
maintaining system
C. Victim Services provider costs for comparable
database
4. Administrative Costs [Cap 4.5%]
A. Local government $ 3,298.00
B. Private non-profit organization
TOTAL BUDGET $76,598.00
CF Integrated Contract 2014 26 Contract No. KPZ27
EXHIBIT C2
Budget Narrative
Rapid Re-Housing
• Rental Assistance-short term(up to three months of rent)and medium-term(more than three months) rental assistance and
payment of rental arrears in a one-time payment for up to six months of rent in arrears provided to households eligible for rapid
rehousing assistance.
• Financial assistance costs-rental application fee, security deposits, last month's rent, utility deposits, utility payments and
moving costs
Homeless Prevention
• Rental assistance-short term (up to three months of rent)and medium-term (more than three months)rental assistance and
payment of rental arrears in a one-time payment for up to six months of rent in arrears provided to households eligible for
homeless prevention assistance.
• Financial assistance costs-rental application fee,security deposits, last month's rent, utility deposits, utility payments and
moving costs.
HMIS
• Cost of contributing data to HMIS for CoC
Administrative cost-
• Local Government-This line item includes the cost of managing oversight, accounting reporting and the annual financial audit
costs associated with the grant.
CF Integrated Contract 2014 27 Contract No. KPZ27
EXHIBIT D-DELIVERABLES
Recipient is required to meet these deliverables as part of compliance for funding received under the Emergency Solutions
Grant:
D-1 Emergency Shelters:This clause does not apply to this contract.
D-2 Prevention and Re-housing
D-2.1 A unit of service is one month of Prevention and Rapid Re-Housing services provided to eligible clients.A client may be an
individual or household: however, households with children are to receive priority for services.A minimum of 2 households will be
served each month for the term of the grant as documented in the monthly and year to date client activity report(Exhibit D1).
Services include providing intake,eligibility determination, case management and the provision of rental or utility assistance.
D-2.2, The Provider shall input service data monthly into the Homeless Management System(HMIS)on all activity conducted with
ESG funds.
D-3 Street Outreach: This clause does not apply to this contract.
D-4 In addition to the above,the Provider shall submit quarterly HMIS Consolidated Annual Performance and Evaluation Reports
(CAPER)on all activity conducted with ESG funds as indicated on the reports; and
D-5 Submit monthly invoice(Exhibit D1)for reimbursement with the required documentation to include but not limited to for ESG
' services provided during the covered period.
D-6----Submit-the HUD Annual Performance Report(APR)on all activity conducted with ESG funds as indicated on the reports
D-7 The Recipient shall maintain and submit to the Department the following reports.
Report Title Reporting Report Due Date Number DCF Office to receive
Frequency of Copies reports)
Invoice(Exhibit D1) Monthly 201^of each month 1 Grant Manager
following service, or next
business day if Saturday,
Sunday or holiday
1 I
Match Report(Exhibit D1) Monthly with invoice 20th of each month 1 each Grant Manager and Office
following service, or next ! on Homelessness
business day if Saturday,
Sunday or holiday
Client Activity Report(Exhibit D1) Monthly with invoice 2001 of each month 1 Grant Manager
•
(#of clients served following service,or next
monthly and year to date) business day if Saturday,
Sunday or holiday
HMIS CAPER/APR Performance Quarterly with 20'h of month following the 1 each Grant Manager and Office
1 Report invoice end of December, March on Homelessness
and June
HUD Annual Performance Report Annually July 15(for grant period I 1 each Grant Manager and Office
ending 06/30/2015) on Homelessness
CF Integrated Contract 2014 28 Contract No. KPZ27
D-8 The Provider shall submit the required reports listed in the above chart to the Grant Manager at the following address:
Florida Department of Children and Families
Attention: Theresa Phelan, Contract Manager
1111 12v Street
Key West, FL 33040
D-9 And where indicated to the State Office on Homelessness at the following address:
Department of Children and Families
State Office on Homelessness
1317 Winewood Blvd, Building 3, Room 201
Tallahassee, FL 32399-0700
D-10 Where the grant requires the delivery of reports to the Department, mere receipt by the Department shall not be construed to
mean or imply acceptance of those reports. It is specifically intended by the parties that acceptance of required reports shall
constitute a separate act.
D-11 The Department or the Department of Financial Services reserves the right to reject reports as incomplete, inadequate,or
unacceptable according to the parameters set forth in the grant agreement or the Department of Financial Services Reference
Guide for State Expenditures(Exhibit 02). The Department,at its option, may allow additional time within which the Provider may
remedy the objections noted by the Department, or the Department may, after having given the Provider a reasonable opportunity
to complete,make adequate or acceptable, and declare this grant agreement to be in default.
O•f2 On-a-monthly basis,the Provider will report the matching expenditure dollars and in-kind contributions with the monthly
performance reports submitted to the Grant Manager and Office on Homelessness. In-kind contributions may be evaluated and
counted as all or part of the match. In addition,the Provider shall report match with invoices submitted for reimbursement for the
corresponding month of service to the grant manager for approval. The report will be due not later than fifteen(15)calendar days
following the end of the month to the grant manager.Grant Managers may require additional reports regarding and substantiating
claimed match as deemed necessary, and will request these from the Provider if needed.
CF Integrated Contract 2014 29 Contract No. KPZ27
EXHIBIT D1
MONTHLY INVOICE, PERFORMANCE& MATCH REPORTING
MONTHLY REPORT OF DISBURSEMENT•INVOICE
2014 Federal Emergency Solutions Grant Program
Provider: Monroe County ESG Contract# KPZ27
Address: 500 Whitehead Street
Key West,FL 33040
FEID: 59.6000149 Department of Children and Family Count(ies)
served: Monroe
Telephone: 305.292.4500 Grant Year: FY2014-2015
Reporting Period: OCA: ESG15
Amount Total Budget
Line Items Approved
this Expenditures Remaining
9 Invoice to Date
RAPID RE-HOUSING(790064)
Rental Assistance $28,000.00
Housing Relocation and Stabilization
Financial Assistance Costs $15,000.00
' Services Cost $ 980t$22,500.00
00
HOMELESS PREVENTION (790067) _' Rental Assistance �g R-- -Housing Relocation and Stabilization3°"'Financial Assistance Costs ��Services Costs 1j�[,�+_Ei CA
HMIS(790066) �j "'�Cost of contributing data to HMIS for Continuum of Care HMIS Lead Agency Costs for hosting and maintaining system *
Victim Services provider costs for comparable database
ADMINISTRATION COSTS(Cap 4.5%)(790065)
1 Local Government : $3,298.00
Private Non-profit Organization
�� A. TOTAL $76,598.00 I
/hereby certify that the above report is a true, accurate and correct reflection of the activities of this period;and that these
expenditures reported are made only for items that are allowable and directly relate to the purposes of this referenced contract.
Signature of Provider Agency Official Title of Provider Agency Official
CLIENT ACTIVITY REPORT FY14/15
CF Integrated Contract 2014 30 Contract No. KPZ27
Provider Name:
GRANT It KPZ27
Served Life to Date
Rapid
Number Rapid Prevention Rehousing
Number Prevention Rehousing Clients Persons Persons
Month&Year Clients Served Served* Served Served
Jul 2014
Aug 2014
Sep 2014
Oct 2014
Nov 2014
Dec2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
June 2015
Total 0 0 0 0
Number of households with children served for
Reporting month**
KK e4 $Jb it, R
*Clients may be individuals or households
** Households with children shall be prioritized for services
Monthly Match Report:
Source of Match Amount Cash Amount In-Kind
Total both cash and in-kind:
Comments Regarding Match:
Note: DCF reserves the right to revise this format without amending the grant agreement
CF Integrated Contract 2014 31 Contract No. KPZ27
EXHIBIT D2
Department of Financial Services � s�� .
.5 � s
r3Ai10=
.,ova .+ '� � ', . 'mt - Jr ✓ r .,
Reference -y A
.� a
Guide „at
41
For State •
_ : '" •
4
Expenditures
Division of Accounting and Auditing
Bureau of Auditing r
200 East Gaines Street .
Tallahassee,Florida 32399-0355
CF Integrated Contract 2014 32 Contract No. KPZ27
EXHIBIT D2
The following requirements apply to all invoices submitted for payment.
1. An invoice submitted for payment must be a legible copy. The original invoice is maintained by the agency. If an
agency is filing a copy of the invoice as its original, it must contain the statement "original invoice not available,
agency records show that this obligation has not been previously paid"with the signature of the person certifying
the statement. Thermo fax copies, because of their temporary nature, shall not be filed as the original at the
agency. It should be copied on a standard photocopy machine.
2. Invoices for commodities must clearly reflect a description of the item or items, number of units and cost per unit.
Numerical code descriptions alone will not be accepted.
3. Invoices for services must also clearly reflect the specific deliverables that must be provided and accepted prior to
payment.
i. Invoices for fixed unit rate agreements must show the number of units and cost per unit.
ii. Invoices for agreements paid out on a reimbursement basis or a fixed rate for a specific time
period, e.g. quarterly, monthly, etc., must identify the deliverables provided or be supported by
documentation (such as a progress report) that clearly reflects the deliverables provided during the
invoice period. Documentation must evidence that the minimum performance standards were met.
4. No balances for prior purchases will be paid unless supported by an invoice.
5. A statement will not be paid unless it can be clearly shown that the vendor intended it to be used as on invoice that
meets all invoice requirements.
6. All invoices shall be processed in accordance with s. 215.422, F.S., and the rules set forth in Rule 691-24, F.A.C.
7. Invoices that are split payments require information showing the distribution of charges between funds for such
invoice and a cross-reference of the statewide document numbers for all related vouchers.
8. Invoices and other supporting documentation included in a voucher must be grouped by vendor and arranged in
the same order as the vendors are listed on the voucher schedule. If the voucher includes multiple invoices from
the same vendor, the voucher must include a calculator tape or other evidence showing that the total of the
invoices is equal to the amount shown on the voucher schedule.
9. Acronyms and non-standard abbreviations for programs or organizational units within an agency should not be
used in the supporting documentation unless an explanation is also included.
CF Integrated Contract 2014 33 Contract No. KPZ27
PA YME T PROCESS/ 4GRE EMT. Ts FOR SERVICES
These payment processing requirements apply to agreements for services provided by vendors and recipients/sub-
recipients.
Agencies are required to complete and submit a Contract Summary Form with each payment for agreements for services
(including payments to recipients/sub-recipients). The Contract Summary Form information will be used by the Bureau of
Auditing to pre-audit the invoice so the form must be complete and reflect specific information from the agreement.
Information should clearly identify the specific deliverables including the minimum performance requirements and the
payment criteria(compensation)for each deliverable. This information may be included on an attachment if there is
insufficient space on the form.
The Summary Form is available on the Department of Financial Services website at
www.myfloridacfo.com/aadir/summary csa.htm.
In addition to the requirements listed in "Invoices"and "Payment Processing,"agreements for services require additional
documentation based on the method of payment.
Agencies must submit an itemized invoice by expenditure category(salaries, travel, expenses, etc.). Each agency is required
to maintain detailed supporting documentation and to make it available for audit purposes. By submission of the payment
request, the agency is certifying that the detailed documentation to support each item on the itemized invoice is on file at
the agency and is available for audit.
Supporting documentation shall be maintained in support of expenditure payment requests for cost reimbursement
contracts as provided in Comptroller's Memorandum No. 04 (1996-97). Documentation for each amount for which
reimbursement is being claimed must indicate that the item has been paid. Check numbers maybe provided in lieu of
copies of actual checks. Each piece of documentation should clearly reflect the dates of service. Only expenditures for
categories in the approved agreement budget may be reimbursed. These expenditures must be allowable(pursuant to
lowland directly related to the services being provided.
Types and examples of supporting documentation for cost reimbursement agreements:
Salaries:A payroll register or similar documentation should be maintained. The payroll register should show gross salary
charges,fringe benefits, other deductions and net pay. If an individual for whom reimbursement is being claimed is paid
by the hour, a document reflecting the hours worked times the rate of pay will be acceptable.
Fringe benefits:Fringe benefits should be supported by invoices showing the amount paid on behalf of the employee, e.g.,
insurance premiums paid. If the contract specifically states that fringe benefits will be based on a specified percentage
rather than the actual cost of fringe benefits, then the calculation for the fringe benefits amount must be shown.
Exception: Governmental entities are not required to provide check numbers or copies of checks for fringe benefits.
Travel:Reimbursement for travel must be in accordance with s. 112.061, F.S., which includes submission of the claim on
the approved state travel voucher.
Other direct costs:Reimbursement will be made based on paid invoices/receipts. If nonexpendable property is purchased
using state funds, the contract should include a provision for the transfer of the property to the State when services are
terminated. Documentation must be provided to show compliance with DMS Rule 60A-1.017, F.A.C., regarding the
requirements for contracts which include services and that provide for the contractor to purchase tangible personal
property as defined ins. 273.02, F.S.,for subsequent transfer to the State.
In-house charges:Charges which may be of an internal nature (e.g., postage, copies, etc.)may be reimbursed based on a
CF Integrated Contract 2014 34 Contract No. KPZ27
usage log which shows the units times the rate being charged. The rates must be reasonable.
Indirect costs:If the contract specifies that indirect costs will be paid based on a specified rate, then the calculation should
be shown.
Contracts between state agencies may submit alternative documentation to substantiate the reimbursement request that
may be in the form of FLAIR reports or other detailed reports.
Additionally, the invoice or submitted documentation must evidence the completion of all tasks required to be performed
for the deliverable and must show that the provider met the minimum performance standards established in the
agreement.
Above references taken from pages 30-31 and 41-42 of the Department of Financial Services, Reference Guide on State
Expenditures.
CF Integrated Contract 2014 35 Contract No. KPZ27
•
EXHIBIT E—MINIMUM PERFORMANCE MEASURES
E-1 Minimum Performance Measures
E-1.1 The Recipient shall maintain comprehensive client files containing all required documentation to support service provision
and make these available to the Department upon request.
E•1.2 Performance measures are proposed to be used jointly by the Department and the Continuum of Care planning lead
agency to assess the performance of the Department's funded Providers under the 2014 Emergency Solutions Grant.The
Provider will be required to provide copies of the Department required reports to the lead agency at the same time the
report is due to the Department.
E-1.3 Performance Measures are:
E-1.3.1 A reduction of 5 households with children who are homeless in the Continuum of Care(CoC) area.
E•1.3.2 At least 35%of the participants served remain permanently housed six(6) months following the last date
assistance was provided under the grant.
E-2 Performance Evaluation Methodology
E-2.1 Performance measure 1 above shall be calculated as follows:
#of homeless households with children in the CoC as of 07/01/2014
#of homeless households with children in the CoC as of 06/30/2015
E-2.2 Performance measure 2 above shall be calculated as follows:
#of participants served remaining permanently housed 6 months following last assistance
Total number of clients served during the reporting period
E•2.3 Compliance with the above will be determined by the Department by reviewing related HMIS data, as follows:
E•2.3.1 ESG CAPER Report will document compliance with Performance Measure 1: and
E-2.3.2 HUD APR Report will document compliance with Performance Measure 2,
E-3 Performance Standards Statement: By execution of this grant the Provider hereby acknowledges and agrees that its
performance under the grant must meet the standards set forth above and will be bound by the conditions set forth in this grant. If
the Provider fails to meet these standards, the Department,at its exclusive option, may allow up to six(6)months for the Provider
to achieve compliance with the standards. If performance deficiencies are not resolved to the satisfaction of the Department within
the prescribed time, and if no extenuating circumstances can be documented by the Provider to the Departments satisfaction,the
Department must cancel the grant with the Provider. The determination of the extenuating or mitigating circumstances is the
exclusive determination of the Department.
CF Integrated Contract 2014 36 Contract No. KPZ27
•
EXHIBIT F- METHOD OF PAYMENT
F-1 Cost Reimbursement
F-1.1 Costs associated with carrying out services under this grant agreement will first be paid by the Provider. The Provider will
submit invoices for eligible costs to the Department for reimbursement in accordance with the Department of Financial
Services Reference Guide For State Expenditures which is incorporated by reference. A copy can be requested upon
request to the grant manager or located at the Florida Department of Financial Services website.
F-1.2 This is a cost reimbursement grant.The Department shall reimburse the Provider for allowable expenditures incurred
pursuant to the terms of this grant agreement for a total dollar amount not to exceed $76,598.00, subject to the availability
of funds, and the Provider's required match of 100 percent.This project is funded by an Emergency Solutions Grant for the
homeless from the U.S. Department of Housing and Urban Development.
F-1.3 The Provider shall request reimbursement on a monthly basis through a submission of a properly completed Invoice
(Exhibit D1), not later than fifteen(15)days following the end of the month for which reimbursement is being requested.
Charges on the invoice must have supporting documentation attached. Payment shall be contingent upon receiving and
accepting the invoice and all required reports and supporting documentation submitted to the grant manager.
F-1A Payment may be authorized only for allowable expenditures on the Invoice which are in accordance with the limits specified
in the approved Budget(Exhibit C1)and approved Budget Narrative (Exhibit C2), as submitted to the Department of
Children and Families for the Emergency Solutions Grant Program and its applicable program component.
F-1.5 If no services are due to be invoiced from the preceding month,the Provider shall submit a written document to the
Department indicating this information within fifteen(15)days following the end of the month.
F-2 Financial Consequences
F-2.1 This grant agreement shall have financial consequences related to failure of the Recipient to perform under the terms of the
grant agreement and pursuant to Chapter 2013-154, Laws of Florida and section 215.971(1)(c), FS. The Recipient shall be
penalized 2%of the last invoice total to be reimbursed or the last invoice that has been reimbursed by the Department. The
Recipient shall make payable to the Department the amount of the penalty within 30 days after being notified in writing by
the grant manager. If the Recipient fails to reimburse the Department,the Department has the right to refuse to gran any
new grant agreement or contract awarded through the Department for any services, until said reimbursement is received.
F-3 Supporting Documentation Requirements: Documentation of all expenses incurred under a cost reimbursement grant must
accompany the propedy completed invoice. In addition to the documentation required in Exhibit D2, documentation also includes,
but is not limited to the following.
F-3.1 Professional Service Fees on a time/rate basis. The invoice must include a general statement of the services
being provided.The time period covered by the invoice, as well as the hourly rate limes the number of hours
worked, must be stated. Supporting documentation must be included detailing the hours represented on the
invoice. Such documentation should include timesheets or a time log and copies of canceled payroll checks or
payroll register. The State's Chief Financial Officer(CFO) reserves the right to require further documentation on an
as needed basis.
F•3.2 Postage and Reproduction Expenses. Purchases made from outside vendors must be supported by paid invoices
or receipts. Purchases for all in-house postage(e.g., postage meter)and reproduction expenses must be
supported by usage logs or similar documents.
F-3.3 Expenses. Receipts are required for all expenses incurred(e.g.,office supplies, printing, long distance telephone
calls,etc.)
F-3.4 Travel. For all travel expenses, a Department travel voucher, Form DFS-AA-15(State of Florida Voucher for
Reimbursement of Traveling Expenses)must be submitted. Original receipts for expenses incurred during officially
CF Integrated Contract 2014 37 Contract No. KPZ27
authorized travel(items such as car rental and air transportation, parking and lodging,tolls and fares)are required
for reimbursement. Subsection 287.058(1)(b), F.S., requires that bills for any travel expense shall be sub mitted in
accordance with s. 112.061, F.S.,governing payments by the state for traveling expenses. CFOP 40-1 (Official
Travel of DCF Employees and Non-Employees)provides further explanation, clarification and instruction regarding
the reimbursement of traveling expenses necessarily incurred during the performance of official state business.
ESG funds may be used for travel when such travel is to HUD sponsored training.
F-4 Budget Changes. The Recipient must submit to the Department a written request for budget changes and obtain written
approval before a change is implemented.Such changes between categories may be allowed if the following conditions are
met:
F•4.1 There is no change in the scope or objectives of the grant agreement.
F 4.2 The changes do not increase or decrease the original dollar amount in the total budget.
F-4.3 There is another category in the budget from which funds can be shifted.
F-4.4 The changes do not involve establishing a new category or totally eliminating a category.
F-4.5 Budget changes which do not meet the above conditions will require a propedy executed grant
agreement amendment,signed by the Recipient and the Department on or before the effective date for
implementation of the specified change.
F•5 Service Delivery Documentation: The Recipient must maintain records documenting the total number of clients and names
(or unique identifiers)of clients to whom services were provided and the date(s)on which services were provided so that an
audit trail documenting service provision is available.Any payment requested under the terms of this grant agreement may be
withheld until the evaluation and reports due from the Recipient,and adjustments thereto have been received and approved by
the Department.
F-6 Match Requirements: Pursuant to Title 24, Part 576.51,Code of the Federal Regulations, a match of 100%is required on the
part of the Recipient. The match requirement may be satisfied by an in-kind match subject to the following provisions:
F•6.1 The value of materials used to improve/remodel,the fair market rental value of the space being utilized for the
period and/or the lease expense paid by the organization or donated to the organization at fair market value.
Volunteer services and donated professional services are to be valued at their actual fair market value within
the community. For the purposes of the Emergency Solutions Grants Program,suitable match may be defined
as any and all current or proposed Recipient expenditures on behalf of the homeless shelter,so long as they
are not other Emergency Solutions Grant funds or funds being concurrently used as match for other grants
and projects, Eligible match includes the value of goods and services,buildings and land,equipment,
furnishings, supplies, staff,administrative support,volunteer manpower,donations,grants,cash,
contributions, and rent, utility, insurance and maintenance expenditures. The match is to be dollar for dollar.
Funds used for Emergency Shelter Grants match may not be concurrently utilized as match for other grants or
funding sources. Recipient funds used to match previous Emergency Shelter Grants or Emergency Solutions
Grants may not be used to match a subsequent Emergency Solutions Grant.
F•6.2 There must be specific documentation as to the amount and source of all matching contributions.
F-6.3 Matching funds must be provided after the date of the grant agreement is executed.
F-7 If any compensation under this contract is based on Provider costs, in order to be recognized for such purposes, all such costs
must be of a type authorized by the contract, allowable in nature under Federal standards and State law, reasonable in amount
and prudently incurred in the performance of services under this contract. Additionally,cost reimbursement remains subject to
any contract terms relating to performance and other conditions affecting compensation. Except as otherwise provided in this
contract, to the extent that administrative, overhead or similar costs are recognized for purposes of compensation, such costs
are limited to recurring costs normally and prudently incurred in the ordinary course of business in the delivery of services under
this contract and will not include extraordinary costs or costs resulting from or relating to uninsured loss, litigation or
CF Integrated Contract 2014 38 Contract No. KPZ27
nonrecurring events, regardless of cause. Furthermore, recovery of any cost is barred by the indemnity provisions of this
contract to the extent resulting from any imprudent or negligent act or omission of the Provider, its agents, employees or
subcontractors.
CF Integrated Contract 2014 39 Contract No. KPZ27
ATTACHMENT I
The administration of resources awarded by the Department of Children& Families to the provider may be
subject to audits as described in this attachment.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-I33 and Section 215.97.
F.S., as revised, the department may monitor or conduct oversight reviews to evaluate compliance with
contract, management and programmatic requirements. Such monitoring or other oversight procedures
may include,but not be limited to.on-site visits by department staff, limited scope audits as defined by
OMB Circular A-133,as revised,or other procedures. By entering into this agreement, the recipient agrees
to comply and cooperate with any monitoring procedures deemed appropriate by the department. In the
event the department determines that a limited scope audit of the recipient is appropriate,the recipient
agrees to comply with any additional instructions provided by the department regarding such audit. The
recipient further agrees to comply and cooperate with any inspections,reviews, investigations.or audits
deemed necessary by the department's inspector general,the states Chief Financial Officer or the Auditor
General.
AUDITS
PART I: FEDERAL REQUIREMENTS
This part is applicable if the recipient is a State or local government or a non-profit organization as defined
in OMB Circular A-133.as revised.
In the event the recipient expends S500,000 or more in Federal awards during its fiscal year,the recipient
must have a single or program-specific audit conducted in accordance with the provisions of OMB Circular
A-133, as revised. The recipient agrees to provide a copy of the single audit to the Department's Single
Audit Unit and its contract manager. In the event the recipient expends less than S500.000 in Federal
awards during its fiscal year,the recipient agrees to provide certification to the Department's Single Audit
Unit and its contract manager that a single audit was not required. In determining the Federal awards
expended during its fiscal year.the recipient shall consider all sources of Federal awards, including Federal
resources received from the Department of Children& Families, Federal government(direct),other state
agencies, and other non-state entities. The determination of amounts of Federal awards expended should be
in accordance with guidelines established by OMB Circular A-133.as revised. An audit of the recipient
conducted by the Auditor General in accordance with the provisions of OMB Circular A-133,as revised.
will meet the requirements of this part. In connection with the above audit requirements,the recipient shall
fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-
133, as revised.
The schedule of expenditures should disclose the expenditures by contract number for each contract with
the department in effect during the audit period. The financial statements should disclose whether or not
the matching requirement was met for each applicable contract. All questioned costs and liabilities due the
department shall be fully disclosed in the audit report package with reference to the specific contract
number.
Single Audit Information for Recipients of Recovery Act Funds:
(a)To maximize the transparency and accountability of funds authorized under the American Recovery and
Reinvestment Act of 2009(Pub. L. III-5)(Recovery Act)as required by Congress and in accordance with
2 CFR 215.21 "Uniform Administrative Requirements for Grants and Agreements'. and OMB Circular A—
CFI 120(12'1412011) 40 Grant agreement xKPZ27
102 Common Rules provisions, recipients agree to maintain records that identify adequately the source and
application of Recovery Act funds. OMB Circular A 102 is available at
http://www.whitehouse.gov.'omb/circulars/a102/a 102.html.
(b)For recipients covered by the Single Audit Act Amendments of 1996 and OMB Circular A—I33,
"Audits of States, Local Governments,and Non-Profit Organizations," recipients agree to separately
identify the expenditures for Federal awards under the Recovery Act on the Schedule of Expenditures of
Federal Awards(SEFA)and the Data Collection Form(SF—SAC)required by OMB Circular A-133. OMB
Circular A-133 is available at http7/www.whitehouse.govrombicirculars/a133/a133.html. This shall be
accomplished by identifying expenditures for Federal awards made under the Recovery Act separately on
the SEFA. and as separate rows under Item 9 of Part III on the SF—SAC by CFDA number. and inclusion of
the prefix "ARRA-" in identifying the name of the Federal program on the SEFA and
as the first characters in Item 9d of Part III on the SF—SAC.
(c) Recipients agree to separately identify to each subrecipient,and document at the time of subaward and
at the time of disbursement of funds, the Federal award number. CFDA number, and amount of Recovery
Act funds. When a recipient awards Recovery Act funds for an existing program,the information furnished
to subrecipients shall distinguish the subawards of incremental Recovery Act funds from
regular subawards under the existing program.
(d) Recipients agree to require their subrecipients to include on their SEFA information to specifically
identify Recovery Act funding similar to the requirements for the recipient SEFA described above. This
information is needed to allow the recipient to properly monitor subrecipient expenditure of ARRA funds
as well as oversight by the Federal awarding agencies.Offices of Inspector General and the Government
Accountability Office.
PART II: STATE REQUIREMENTS
This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2), Florida Statutes.
In the event the recipient expends$500,000 or more in state financial assistance during its fiscal year. the
recipient must have a State single or project-specific audit conducted in accordance with Section 215.97,
Florida Statutes: applicable rules of the Department of Financial Services; and Chapters 10.550(local
governmental entities)or 10.650(nonprofit and for-profit organizations). Rules of the Auditor General.The
recipient agrees to provide a copy of the single audit to the Department's Single Audit Unit and its contract
manager. In the event the recipient expends less than 5500,000 in State financial assistance during its fiscal
year.the recipient agrees to provide certification to the Department's Single Audit Unit and its contract
manager that a single audit was not required. In determining the state financial assistance expended
during its fiscal year.the recipient shall consider all sources of state financial assistance, including state
financial assistance received from the Department of Children& Families. other state agencies,and other
nonstate entities. State financial assistance does not include Federal director pass-through awards and
resources received by a nonstate entity for Federal program matching requirements.
In connection with the audit requirements addressed in the preceding paragraph,the recipient shall ensure
that the audit complies with the requirements of Section 215.97(8), Florida Statutes. This includes
submission of a financial reporting package as defined by Section 215.97(2). Florida Statutes,and Chapters
10550 or 10.650. Rules of the Auditor General.
The schedule of expenditures should disclose the expenditures by contract number for each contract with
the department in effect during the audit period. The financial statements should disclose whether or not
the matching requirement was met for each applicable contract. All questioned costs and liabilities due the
department shall be fully disclosed in the audit report package with reference to the specific contract
number.
CFI 120 (12/1-42011) 41 Grant agreement 4KPZ27
PART III: REPORT SUBMISSION
Any reports. management letters, or other information required to be submitted to the department pursuant
to this agreement shall be submitted within 180 days after the end of the provider's fiscal year or within 30
days of the recipient's receipt of the audit report,whichever occurs first,directly to each of the following
unless otherwise required by Florida Statutes:
A. Contract manager for this contract(I copy)
B. Department of Children& Families( I electronic copy and management letter, if issued)
Office of the Inspector General
Single Audit Unit
Building 5.Room 237
1317 Winewood Boulevard
Tallahassee, FI.32399-0700
Email address: sin..le audit indcfyate,tl-us
C. Reporting packages for audits conducted in accordance with OMB Circular A-133,as revised,and
required by Part 1 of this agreement shall be submitted, when required by Section.320(d).OMB
Circular A-133. as revised,by or on behalf of the recipient directly to the Federal Audit Clearinghouse
using the Federal Audit Clearinghouse's Internet Data Entry System at:
Iulp. harstster.census.nov lac collect ddemde‘.html
and other Federal agencies and pass-through entities in accordance with Sections.320(e)and(f).
OMB Circular A-133,as revised.
D. Copies of reporting packages required by Pan II of this agreement shall be submitted by or on behalf
of the recipient directly to the following address:
Auditor General
Local Government Auditsl342
Claude Pepper Building.Room 401
III West Madison Street
Tallahassee, Florida 32399-1450
Email address: Ilaudgen_localgovtr aud.statetlus
Providers, when submitting audit report packages to the department for audits done in accordance with
OMB Circular A-133 or Chapters 10.550(local governmental entities)or 10.650(nonprofit or for-profit
organizations), Rules of the Auditor General, should include, when available,correspondence from the
auditor indicating the date the audit report package was delivered to them. When such correspondence is
not available,the date that the audit report package was delivered by the auditor to the provider must be
indicated in correspondence submitted to the department in accordance with Chapter 10.558(3)or Chapter
+0:637(2), Rules of the Auditor General.
PART IV: RECORD RETENTION
The recipient shall retain sufficient records demonstrating its compliance with the terms of this agreement
for a period of six years from the date the audit report is issued and shall allow the department or its
designee. Chief Financial Officer or Auditor General access to such records upon request. The recipient
shall ensure that audit working papers are made available to the department or its designee.Chief Financial
Officer or Auditor General upon request for a period of three years from the date the audit report is issued,
unless extended in writing by the department.
CF 1120(12(14,2011) 42 Grant agreement 4KPZ27
ATTACHMENT 2
This Attachment contains the terms and conditions governing the Provider's access to and use
of Protected Health Information and provides the permissible uses and disclosures of protected
health information by the Provider, also called "Business Associate."
Section 1. Definitions
1.1 Catch-all definitions:
The following terms used in this Attachment shall have the same meaning as those
terms in the HIPAA Rules: Breach, Data Aggregation, Designated Record Set,
Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy
Practices, Protected Health Information, Required by Law, Security Incident,
Subcontractor, Unsecured Protected Health Information, and Use.
1.2 Specific definitions:
1.2.1 "Business Associate" shall generally have the same meaning as the term
"business associate" at 45 CFR 160.103, and for purposes of this Attachment
shall specifically refer to the Provider.
1.2.2 "Covered Entity" shall generally have the same meaning as the term "covered
entity" at 45 CFR 160.103, and for purposes of this Attachment shall refer to
the Department.
1.2.3. "HIPAA Rules" shall mean the Privacy, Security, Breach Notification, and
- - - - Enforcement Rules at 45 CFR Part 160 and Part 164.
1.2.4. "Subcontractor" shall generally have the same meaning as the term
"subcontractor" at 45 CFR § 160.103 and is defined as an individual to whom a
business associate delegates a function , activity, service , other than in the
capacity of a member of the workforce of such business associate.
Section 2. Obligations and Activities of Business Associate
2.1 Business Associate agrees to:
2.1.1 Not use or disclose protected health information other than as permitted or
required by this Attachment or as required by law:
2.1.2 Use appropriate administrative safeguards as set forth at 45 CFR § 164.308,
physical safeguards as set forth at 45 CFR § 164.310, and technical
safeguards as set forth at 45 CFR § 164.312: including, policies and
----- - procedures regarding the protection of PHI and/or ePHI set forth at 45 CFR §
164.316 and the provisions of training on such policies and procedures to
applicable employees, independent contractors, and volunteers, that
reasonably and appropriately protect the confidentiality, integrity, and
availability of the PHI and/or ePHI that the Provider creates, receives,
maintains or transmits on behalf of the Department;
2.1.3 Acknowledge that (a) the foregoing safeguards, policies and procedures
requirements shall apply to the Business Associate in the same manner that
such requirements apply to the Department, and (b) the Business Associate's
and their Subcontractors are directly liable under the civil and criminal
October 2014 43 Grant Agreement KPZ27
enforcement provisions set forth at Section 13404 of the HITECH Act and
section 45 CFR § 164.500 and 164.502(E) of the Privacy Rule (42 U.S.C.
1320d-5 and 1320d-6), as amended, for failure to comply with the safeguards,
policies and procedures requirements and any guidance issued by the
Secretary of Health and Human Services with respect to such requirements;
2.1.4 Report to covered entity any use or disclosure of protected health information
not provided for by this Attachment of which it becomes aware, including
breaches of unsecured protected health information as required at 45 CFR
164.410, and any security incident of which it becomes aware;
2.1.5 Notify the Department's Security Officer, Privacy Officer and the Contract
Manager as soon as possible, but no later than five (5) business days following
the determination of any breach or potential breach of personal and confidential
departmental data;
2.1.6 Notify the Privacy Officer and Contract Manager within (24) hours of notification
by the US Department of Health and Human Services of any investigations,
compliance reviews or inquiries by the US Department of Health and Human
Services concerning violations of HIPAA(Privacy, Security Breach).
2.1.7 Provide any additional information requested by the Department for purposes
of investigating and responding to a breach,
2.1.8 Provide at Business Associate's own cost notice to affected parties no later
than 45 days following the determination of any potential breach of personal or
confidential departmental data as provided in section 817,5681, F.S.;
2.1.9 Implement at Business Associate's own cost measures deemed appropriate by
the Department to avoid or mitigate potential injury to any person due to a
breach or potential breach of personal and confidential departmental data;
2.1.10 Take immediate steps to limit or avoid the recurrence of any security breach
and take any other action pertaining to such unauthorized access or disclosure
required by applicable federal and state laws and regulations regardless of any
actions taken by the Department ;
2.1.11 In accordance with 45 CFR 164.502(e)(1)(ii) and 164.308(b)(2), if applicable,
ensure that any subcontractors that create, receive, maintain, or transmit
protected health information on behalf of the business associate agree to the
same restrictions, conditions, and requirements that apply to the business
associate with respect to such information. Business Associate's must attain
satisfactory assurance in the form of a written contract or other written
agreement with their business associate's or subcontractor's that meets the
applicable requirements of 164.504(e)(2) that the Business Associate or
Subcontractor will appropriately safeguard the information. For prior contracts
or other arrangements, the provider shall provide written certification that its
implementation complies with the terms of 45 CFR 164.532(d);
2.1.12 Make available protected health information in a designated record set to
covered entity as necessary to satisfy covered entity's obligations under 45
CFR 164.524;
2.1.13 Make any amendment(s) to protected health information in a designated record
set as directed or agreed to by the covered entity pursuant to 45 CFR 164.526,
or take other measures as necessary to satisfy covered entity's obligations
under 45 CFR 164.526;
2.1.14 Maintain and make available the information required to provide an accounting
of disclosures to the covered entity as necessary to satisfy covered entity's
obligations under 45 CFR 164.528;
October 2014 44 Grant Agreement KPZ27
2.1.15 To the extent the business associate is to carry out one or more of covered
entity's obligation(s) under Subpart E of 45 CFR Part 164, comply with the
requirements of Subpart E that apply to the covered entity in the performance
of such obligation(s); and
2.1.16 Make its internal practices, books, and records available to the Secretary of the
U.S. Department of Health and Human Services for purposes of determining
compliance with the HIPAA Rules.
Section 3. Permitted Uses and Disclosures by Business Associate
3.1 The Business associate may only use or disclose protected health information covered
under this Attachment as listed below:
3.1.1 The Business Associate may use and disclose the Department's PHI and/or
ePHI received or created by Business Associate (or its agents and
subcontractors) in performing its obligations pursuant to this Attachment.
3.1.2 The Business Associate may use the Department's PHI and/or ePHI received
or created by Business Associate (or its agents and subcontractors) for archival
purposes.
3.1.3 The Business Associate may use PHI and/or ePHI created or received in its
capacity as a Business Associate of the Department for the proper
management and administration of the Business Associate, if such use is
necessary (a) for the proper management and administration of Business
Associate or (b) to carry out the legal responsibilities of Business Associate.
3.1.4 The Business Associate may disclose PHI and/or ePHI created or received in
its capacity as a Business Associate of the Department for the proper
management and administration of the Business Associate if (a) the disclosure
is required by law or (b) the Business Associate (1) obtains reasonable
assurances from the person to whom the PHI and/or ePHI is disclosed that it
will be held confidentially and used or further disclosed only as required by law
or for the purpose for which it was disclosed to the person and (2) the person
agrees to notify the Business Associate of any instances of which it becomes
aware in which the confidentiality and security of the PHI and/or ePHI has been
breached.
3.1.5 The Business Associate may aggregate the PHI and/or ePHI created or
received pursuant this Attachment with the PHI and/or ePHI of other covered
entities that Business Associate has in its possession through its capacity as a
Business Associate of such covered entities for the purpose of providing the
Department of Children and Families with data analyses relating to the health
care operations of the Department (as defined in 45 C.F.R. §164.501).
3.1.6 The Business Associate may de-identify any and all PHI and/or ePHI received
or created pursuant to this Attachment, provided that the de-identification
process conforms to the requirements of 45 CFR § 164.514(b).
3.1.7 Follow guidance in the HIPAA Rule regarding marketing, fundraising and
research located at Sections 45 CFR § 164.501, 45 CFR § 164.508 and 45
CFR § 164.514.
October 2014 45 Grant Agreement KPZ27
Section 4. Provisions for Covered Entity to Inform Business Associate of Privacy
Practices and Restrictions
4.1 Covered entity shall notify business associate of any limitation(s) in the notice of privacy
practices of covered entity under 45 CFR 164.520, to the extent that such limitation may
affect business associate's use or disclosure of protected health information.
4.2 Covered entity shall notify business associate of any changes in, or revocation of, the
permission by an individual to use or disclose his or her protected health information, to
the extent that such changes may affect business associate's use or disclosure of
protected health information.
4.3 Covered entity shall notify business associate of any restriction on the use or disclosure
of protected health information that covered entity has agreed to or is required to abide
by under 45 CFR 164.522, to the extent that such restriction may affect business
associate's use or disclosure of protected health information.
Section 5. Termination
5.1 Termination for Cause
5.1.1 Upon the Departments knowledge of a material breach by the Business
Associate, the Department shall either:
5.1.1.1 Provide an opportunity for the Business Associate to cure the breach
or end the violation and terminate the Agreement or discontinue
access to PHI if the Business Associate does not cure the breach or
end the violation within the time specified by the Department of
Children and Families;
5.1.1.2 Immediately terminate this Agreement or discontinue access to PHI if
the Business Associate has breached a material term of this
Attachment and does not end the violation; or
5.1.1.3 If neither termination nor cure is feasible, the Department shall report
the violation to the Secretary of the Department of Health and Human
Services.
5.2 Obligations of Business Associate Upon Termination
5.2.1 Upon termination of this Attachment for any reason, business associate, with
respect to protected health information received from covered entity, or
created, maintained, or received by business associate on behalf of covered
entity. shall:
5.2.1.1 Retain only that protected health information which is necessary for
Business Associate to continue its proper management and
administration or to carry out its legal responsibilities;
5.2.1.2 Return to covered entity, or other entity as specified by the
Department or, if permission is granted by the Department, destroy
the remaining protected health information that the Business
Associate still maintains in any form;
5.2.1.3 Continue to use appropriate safeguards and comply with Subpart C of
45 CFR Part 164 with respect to electronic protected health
October 2014 46 Grant Agreement KPZ27
information to prevent use or disclosure of the protected health
information, other than as provided for in this Section, for as long as
Business Associate retains the protected health information;
5.2.1.4 Not use or disclose the protected health information retained by
Business Associate other than for the purposes for which such
protected health information was retained and subject to the same
conditions set out at paragraphs 3.1.3 and 3.1.4 above under
"Permitted Uses and Disclosures By Business Associate which
applied prior to termination; and
5.2.1.5 Return to covered entity, or other entity as specified by the
Department or, if permission is granted by the Department, destroy
the protected health information retained by business associate when
it is no longer needed by business associate for its proper
management and administration or to carry out its legal
responsibilities.
5.2.1.6 The obligations of business associate under this Section shall survive
the termination of this Attachment.
Section 6. Miscellaneous
6.1 A regulatory reference in this Attachment to a section in the HIPAA Rules means the
section as in effect or as amended.
6.2 The Parties agree to take such action as is necessary to amend this Attachment from
time to time as is necessary for compliance with the requirements of the HIPAA Rules
and any other applicable law.
6.3 Any ambiguity in this Attachment shall be interpreted to permit compliance with the
HIPAA Rules.
October 2014 47 Grant Agreement KPZ27
Attachment 3
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or an employee
of any agency, a member of congress, an officer or employee of congress, or an employee of
a member of congress in connection with the awarding of any federal contract, the making of
any federal grant, the making of any federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any
federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person
for influencing or attempting to influence an officer or employee of any agency, a member of
congress, an officer or employee of congress, or an employee of a member of congress in
connection with this federal contract, grant, loan, or cooperative agreement, the undersigned
shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in
accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, and contracts
under grants, loans and cooperative agreements) and that all subrecipients shall certify and
disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making
or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who
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.
/ ?LC;2 12I Ic 114'
Signature Date
Roman Gastesi- County Administrator KPZ27
Name of Authorized Individual Application or Contract Number
MONROE COUNTY BOCC/SOCIAL SERVICES
Name of Organization
1100 SIMONTON STREET, SUITE 2-257, KEY WEST, FLORIDA 33040-6627
Address of Organization CF 1123, PDF 03/96 Page 43