2nd Modification 03/15/2017KEVIN MAW& CPA
MONROE COUNTY CLERK OF THE CIRCUIT COURT & COMY HOLLER
DATE: March 30, 2017
TO: Sheryl Graham, Director
Social Services
ATTN: Lourdes Francis, Ad inistrator
FROM: Pamela G. Hanco , C.
SUBJECT: Marchl5th BOCC Meeting
Enclosed are five (5) duplicate originals of Item C26, Modification No. 2 to the Federally -
funded reoccurring Low Income Home Energy Assistance Program Subgrant Agreement
#16EA-017-11-54-01-019 between the State of Florida, Department of Economic Opportunity
(DEO) and Monroe County BOCC/Monroe County Social Services for the contract period of
March 1, 2016 to March 31, 2017 in the amount of $204,849.00, for your handling.
Please be sure to return two duplicate originals once you have the fully executed copies back
from the state. Should you have any questions, please feel free to contact me at ext. 3130. Thank
you.
cc: County Attorney w/o document
Fin e
File
Fully
Executed
MODIFICATION NUMBER 2 OF AGREEMENT BETWEEN THE
FLORIDA DEPARTMENT OF ECONOMIC OPPORTUNITY
FY 2016 LOW INCOME HOME ENERGY ASSISTANCE PROGRAM AND
Monroe County
CFDA Number: 93.568 Agreement Number:lSEA-0E-11-54-01-019
FEDERALLY -FUNDED SUBGRANT AGREEMENT
THIS MODIFICATION Number 2 Is entered into by the State of Florida, Department of Economic
Opportunity, with headquarters in Tallahassee, Florida, hereinafter referred to as "DEO," and Monroe
County, hereinafter referred to as "Subreciplent" (each individually a "Party" and collectively "the Parties").
WHEREAS, Paragraph (4) of the Agreement provides that modification of the Agreement shall be in
writing executed by the Parties thereto; and
WHEREAS, DEO and Subrecipient have entered into the Agreement, pursuant to which DEO has
provided an Agreement of One Hundred Nlnetk-Nine Thousand Seven Hundred Forty Dollars and Zero
Cents ($199,740.00) to Subreciplent; and
WHEREAS, Fiscal Year 2015 carryover funds are available to increase the amount of funding granted
to Subrecipient; and
WHEREAS, additional funds have become available to increase the amount of the funding granted
to Subreciplent.
NOW, THEREFORE, in consideration of the mutual promises of the Parties contained herein, the
Parties agree as follows:
1. Subparagraph (5)(1), of AUDITS AND RECORDS, of the Agreement is hereby deleted in its entirety
and replaced with the following:
"(I) If an audit, monitoring visit, or other documentation or verifiable information shows that all or
any portion of the funds disbursed were not spent in accordance with the conditions of this Agreement or
applicable regulations, Subreciplent shall be held liable for reimbursement to DEC. Such reimbursement
shall be sent from Subreciplent to DEO within thirty calendar days after DEO has -notified Subreciplent of
such non-compliance."
2 . Paragraph (5), AUDITS AND RECORDS. of the Agreement is hereby modified to add subparagraph
(5)(n) as follows:
"(n) Subreciplent shall (1) maintain all funds provided under this Agreement in a separate bank
account or (ii) Subrecipient's accounting system shall have sufficient internal controls to separately track the
expenditure of all funds from this Agreement. There shall be no commingling of funds provided under this
Agreement with any other funds, projects, or programs; "commingling" of funds is distinguishable from
Page i
"blending" of funds specifically allowed by law. DEO may, in its sole discretion, disallow costs made with
commingled funds and require reimbursement for such costs as described herein above, in subparagraph
(S)(I) 0
3. Paragraph (6), INFORMATION RELEASE AND PUBLIC RECORDS REQUIREMENTS. of the Agreement is
hereby deleted in its entirety and replaced with the following:
"(6) INFORMATION RELEASE AND PUBLIC RECORDS REQUIREMENTS
(a) In addition to Subrecipient's responsibility to directly respond to each request it receives for
records made or received by Subrecipient in conjunction with this Agreement and to provide the applicable
public records in response to such request, Subrecipient shall notify DEO of the receipt and content of such
request by sending an e-mail to PRRequest@deo.myflorida.com within one (1) business day from receipt of
such request.
(b) Subrecipient shall keep and maintain public records required by DEO to perform
Subrecipient's responsibilities -hereunder. Subrecipient shall, upon request from DEO's custodian of public
records, provide DEO with a copy of the requested records or allow the records to be inspected or copied
within a reasonable time at a cost that does not exceed the cost provided by chapter 119, F.S., or as
otherwise provided by law. Subrecipient shall allow public access to all documents, papers, letters or other
materials made or received by Subrecipient in conjunction with this Agreement, unless the records are
exempt from section 24(a) of Article 1 of the State Constitution and section 119.07(1), F.S. For records made
or received by Subrecipient in conjunction .with this Agreement, Subrecipient shall respond to requests to
Inspect or copy such records in accordance with chapter 119, F.S.
(c) This Agreement may be terminated by DEO for refusal by Subrecipient to comply with
Florida's public records laws or to allow public access to any public record made or received by Subrecipient
In conjunction with this Agreement.
(d) if, for purposes of this Agreement, Subrecipient is a "contractor" as defined in section
119.0701(i)(a), F.S. ("Subrecipient-contractor"), Subrecipient-contractor shall transfer to DEO, at no cost to
DEO, all public records upon completion, including termination of this Agreement, or keep and maintain
public records required by DEO to perform the service. if Subrecipient-contractor transfers all public records
to DEO upon completion of the contract, the contractor shall destroy any duplicate public records that are
exempt or confidential and exempt from public records disclosure requirements. If Subrecipient-contractor
keeps and maintains public records upon completion of the contract, Subrecipient-contractor shall meet all
applicable requirements for retaining public records. All records stored electronically must be provided to
DEO, upon request from DEO's custodian of public records, in a format that is compatible with the
information technology systems of DEO.
_. _ Page 2
(e) If DEO does not possess a record requested through a public records request, DEO shall
notify Subrecipient-contractor of the request as soon as practicable, and Subrecipient-contractor must
provide the records to DEO or allow the records to be inspected or copied within a reasonable time. If
Subrecipient-contractor does not comply with DEO's request for records, DEO shall enforce the provisions
set forth in this Agreement. A Subrecipient-contractor who fails to provide public records to DEO within a
reasonable time may be subject to penalties under section 119.10, F.S.
(f) Subrecipient shall notify DEO verbally within 24 chronological hours and In writing within
72 chronological hours if any data In Subrecipient's possession related to this Agreement Is subpoenaed or
Improperly used, copied, or removed (except in the ordinary course of business) by anyone except an
authorized representative of DEO. Subrecipient shall cooperate with DEO, in taking all steps as DEO deems
advisable, to prevent misuse, regain possession, or otherwise protect the State's rights and the data
subject's privacy.
(g) Subrecipient acknowledges that DEO is subject to the provisions of chapter 119, F.S.,
relating to public records and that reports, invoices, and other documents Subrecipient submits to DEO
under this Agreement constitute public records under Florida Statutes. Subrecipient shall cooperate with
DEO regarding DEO's efforts to comply with the requirements of chapter 119, F.S.
(h) if Subrecipient submits records to DEO that are confidential and exempt from public
disclosure as trade secrets or proprietary confidential business Information, such records should be
identified as such by Subrecipient prior to submittal to DEO. Failure to identify the Legal basis for each
exemption from the requirements of chapter 119, F.S., prior to submittal of the record to DEO serves as
Subreciplent's waiver of a claim of exemption. Subrecipient shall ensure that public records that are exempt
or confidential and exempt from public records disclosure requirements are not disclosed except as
authorized by law for the duration of the Agreement term and following completion of the Agreement if
Subrecipient does not transfer the records to DEO upon completion, including termination, of the
Agreement.
(1) IF SUBRECIPIENT-CONTRACTOR HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE SUBRECIPIENT-
CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS
AGREEMENT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS by telephone at 850-
245-7140, via e-mail at PRReguest@deo.myfiorida.com, or by mail at Department
-- Page 3 _ _ -
of Economic Opportunity, Public Records Coordinator, 107 East Madison Street,
Caldwell Building, Tallahassee, Florida 32399-4128.
0) To the extent allowable bylaw, Subrecipient shall be fully liable for the actions of its agents,
employees, partners, contractors, and subcontractors and shall fully Indemnify, defend, and hold harmless
the State and DEO, and their officers, agents, and employees from suits, actions, damages, and costs of
every name and description, including attorneys' fees, arising from or relating to public record requests or
public record law violation(s) alleged to be caused In whole or in part by Subrecipient, its agents, employees,
partners, contractors, or subcontractors, provided, however, that Subrecipient does not indemnify for that
portion of any costs or damages proximately caused by the negligent act or omission of the State or DEO.
DEO, in its sole discretion, has the right, but the not obligation, to enforce this indemnification provision
(k) DEO does not endorse any Subrecipient, commodity, or service. No public disclosure or
news release pertaining to this Agreement shall be made without the prior written approval of DEO.
Subrecipient is prohibited from using Agreement information, or DEO customers in sales brochures or other
promotions, including press releases, unless prior written approval is obtained from DEO."
4. Subparagraph (14)(b), NOTICE AND CONTACT, is hereby deleted in its entirety and replaced with the
following:
"b) The name and address of DEO's Grant Manager for this Agreement is:
Gerald Durbin, Grant Manager
Department of Economic Opportunity
Division of Community Development
Bureau of Community Assistance
107 East Madison Street, MSC 400
Tallahassee, Florida 32399-4120
Email: gerald.durbin@deo.myfiorida.com
Phone: 850-717-84S8"
S. Subparagraph (18)(a), FUNDING/CONSIDERATION, is hereby deleted in its entirety and replaced
with the following:
"(a)This Is a cost -reimbursement agreement. Subrecipient shall be reimbursed for costs
incurred in the satisfactory performance of work hereunder in an amount not to exceed Two Hundred Four
Thousand Eight Hundred Forty -Nine Dollars and Zero Cents ($204,849.00), subject to the availability of
funds and appropriate budget authority.
This revised agreement amount includes:
_ Page 4 _ _ _
1. $199,740.00 Current LIHEAP Allocation (FY 2016)
2. $5,109.00 Base Increase and Carryover
3. $204,849.00 Total Modified LIHEAP Allocation"
6. Exhibit 1-A, Funding Sources, of the Agreement is hereby deleted in its entirety and is replaced by
the revised Exhibit 1-A, Funding Sources, which is attached hereto and Incorporated herein by reference.
7. Exhibit 3, Subreciplent Federal Awards Agreements Checklist, of the Agreement is hereby deleted
in Its entirety.
8. Attachment I, Recipient Information, is hereby deleted in Its entirety and is replaced by the revised
Attachment I, Subreciplent Information, which is attached hereto and incorporated herein by reference.
9. Attachment J, Budget Summary and Workplan, is hereby deleted in Its entirety and is replaced by
the revised Attachment, Budget Summary and Workpian, which is attached hereto and incorporated herein
by reference.
10. Attachment K, Budget Detail, is hereby deleted in its entirety and is replaced by the revised
Attachment K, Budget Detail, which is attached hereto and incorporated herein by reference.
11. Attachment L, Multi -County Fund Distribution, is hereby deleted in its entirety and Is replaced by
the revised Attachment L, Multi -County Fund Distribution, which is attached hereto and Incorporated herein
by reference.
12. Except as specifically modified herein, all provisions of the Agreement, including any Attachments
or Exhibits thereto, remain In full force and effect.
The remainder of this page is Intentionally left blank.
Page 5
STATE OF FLORIDA
DEPARTMENT OF ECONOMIC OPPORTUNITY
FEDERALLY FUNDED SUBGRANT AGREEMENT MODIFICATION
SIGNATURE PAGE
IN WITNESS WHEREOF, the Parties have duly executed and delivered this Modification as of the date
set forth below.
SUBRECIPIENT
a e to nj,, Ma L
(Print�ameind Title Here)
Date: � � I_�i S, 2° -7
59-6000749
Federal Identification Number
73 76757
DUNS Number
16EA-0E-11-54-01-019
Agreement Number
STATE OF FLORIDA
DEPARTMENT OF ECONOMIC OPPORTUNITY
By:
�u,lierii5, Director
Division of Community Development
Date: / 417
Approved as to form and legal
sufficiency, subject only to full and
proper execution by the Parties.
Office of the General Counsel
Department of Economic Opportunity
Ql
CD
FY 2016 LIHEAP AGREEMENT
EXHIBIT 1-A
FUNDING SOURCES
FEDERAL RESOURCES AWARDED TO THE SUBREGPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE
FOLLOWING:
Subreciplent's DUNS Registered Name: Monroe, County of
Subrecipient's DUNS Number. 073876757
Federal Award Identification Number: G-1601FLLIEA
Federal Award Date: October 22, 2015
Subaward Period of Performance Start and End March 1, 2016 —March 31, 2017
Date:
Federal award project description, as required to
be responsive to the Federal Funding
Accountability and Transparency Act (FFATA);
Federal Awarding Agency:
Pass -Through Entity:
Contact Information for Awarding Official of Pass -
Through Entity:
Home energy assistance to low income households
U.S. Department of Health and Human Services;
Florida Department of Economic Opportunity
Contact: Hillary A. Ryan, 85D-717-8433
Catalog of Federal Domestic Assistance Number: 93.568
Catalog of Federal Domestic Assistance Title:
Research and Development:
Indirect Cost Rate, If applicable:
Low Income Home Energy Assistance Programs
No
N/A
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS
AGREEMENT ARE AS FOLLOWS:
Federal Program:
1. Subrecipient shall use the LIHEAP funds to provide energy payment assistance to eligible clients
with low income. These funds will be expended in accordance with applicable law and the terms of
this Agreement, including, but not limited to, all attachments to this Agreement, the applicable
OMB Uniform Guidance, and the FFY 2016 LIHEAP State Plan.
2. Subrecipient shall comply with applicable OMB Uniform Guidance and eligibility requirements as
set forth in the U.S. Department of Health and Human Services regulations codified in title 45 of
the Code of Federal Regulations, part 75 and part 96
STATE RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE
FOLLOWING:
N/A
Page 7
MATCHING RESOURCES FOR FEDERAL PROGRAMS:
Federal Program: N/A
SUBJECT TO SECTION 215.97, FLORIDA STATUTES:
State Project: N/A
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
AGREEMENT ARE AS FOLLOWS:
N/A
NOTE: Title 45 C.F.R. § 75.352 and section 215.97(5), Florida Statutes, require that the information about
Federal Programs and State Projects included in Exhibit 1 be provided to Subrecipient.
The remainder of this page is intentionally left blank.
Page 0
FY 2016 LiHEAP AGREEMENT
ATTACHMENT I
As modified by Modifkation [21 to Agreement 16EA-OF-11-54-01-019
SUBRECIPIENT INFORMATION
FEDERAL FISCAL YEAR: 2026 AGREEMENT PERIOD: March 1, 2016 through March 31, 2017
Instructions: Complete the blanks highlighted in yellow. For item III, put an °X" In whichever highlighted box applies to your agency.
E SUBRECIPIENT: MONROE, COUNTY OF AGREEMENT #:
II. Agreement Amount: $204,849.00
III. SUBRECIPIENT CATEGORY, DNon-Profit
IV. COUNTY(IES) TO BE SERVED WITH THESE FUNDS:
MONROE
V. GENERAL ADMINISTRATIVE INFORMATION
a. Subrecipient County Location: MONROE
16EA-0E-11-54-01-019
Total Direct Client Assistance: $159,322.00
Ix'Local Government r Cttate Agency
b. Executive Director or Chief Administrator:
SHERYL GRAHAM
Address: 1100 SIMONTON ST 2-257
City:
KEY WEST , FL Zipcode: 33040
Telephone: (305)2924510
Fax:
(305)295-4359
Cell:
Email:
graham-sheryl0monroec oun>Jr-fl.00v
Mailing address If different from above
Mailing Address:
City:
, FL Zipcode:
c. Chief Elected Official for Local Governmarts, or President/Chair of the Board for Nonprofits:
Name: GEORGE NEUGENT
Title:
MAYOR
Address*: 25 SHIPS WAY
City:
BIG PINE KEY , FL Zipcode: 33043
Telephone: (305)872-1678 Fax:
Email: boccdis2 monroacounty-fl.00v
' Enter home or business address, telephone numbers and enroll other than the Subreciplent's
d. Official to Receive State Warrant:
Name: KEVIN MADOK Title: CLERK OF THE COURTS
Address: 500 WHiTEHEAD STREET City: KEY WEST , FL Zipcode: 33040
e. Subreciplent Contacts:
1. Proaram: Name: SHERYL GRAHAM
Address. 1100 SIMONTON ST. 2-257
Telephone: (305)292-4510
Cell:
Title: SR. DIRECTOR, SOCIAL SERVICES
City: KEY WEST , FL Zipcode: 33040
Fax: (305)295-4359
Email: graham-sher ly 0monroecounbtfl.aov
2. Fiscal: Name:
KIM WILKES WEAN
Title:
COMPLIANCE MANAGER
Address:
2100 SIMONTON ST. 2-190
City:
KEY WEST , FL Zipcode: 33040
Telephone:
(305)292-4588
Fax:
Cell:
Email:
wilkes-kjmQmgnM2ggU0ty-fl.gpv
f. Person(s) authorized to sign reports:
Name:
SHERYL GRAHAM
Title:
SR. DIRECTOR, SOCIAL SERVICES
Name:
KIM WILKES WEAN
Title:
COMPLIANCE MANAGER
Name:
S. SubrecIplent's FEID Number.
VI. SUBRECIPIENT FISCAL YEAR:
Title:
59-6000749 h. Subneciplent's DUNS Number. 073876757
OCTOBER 1 thru
Month/Day
SEPTEMBER 30
Month/Day
SUBRECIPIENT: MONROE, COUNTY OF
AGREEMENT 16EA-OF-11-54-01-019
16
r
FY 2016 UNEAP AGREEMENT
ATTACHMENT J
As moddhrd by Afodj(IcWkn [2] to Agmrem nt 16EA-0F11-34-01-019
BUDGET SUMMARY AND WORKPLAN
LIILAP FUNDS ONLY
1 LIHEAP FUNDS
S'/RA7iV81DMISES (f:erf 2D oearrot exxaed d.9X of CeN 1D•J
mAdmielstra0veftwases., $IY,412.17
2 Salaries IMI. Fringe, Remo Utilales, Travel, Other
ICHOMISES (W 3DcarwW cw ed apiDmkws au2Dtfinea ls)
of oubwolft Expenses: $28,115.55j
3 Salaries Ind. Fringe, Rent, Utilities, Travel, Other
CUENTASSWANCE
Home Energy Assistance
4 CeH 4D must be at least 25% of Cdl 10
Minimum Home Energy.
5 Crisis Assistance
Weather Related / Supply Shortage / Disaster
6
(Previously budgeted funds should be moved to Una 4 or 5)
7 Subtotal Direct Client Assistance
(Line 4+Una 5 + Line 6)
8 BRAND TOTALS
SEMW IL• WilIIaPUN
TOTAL
Lent Approved Adjohtteatsto ANIII DED
Bw1Aet Approved Budget BUDGET
Araoutk B+C
199,740.00 5,109.00 i 204,i49.00
16,977.00 43S.00 ! 17AILOO
27,395.00 720.00 t 28,11S.00
75,000.00
9,000.00
84,000.00
76368.00
(1,046.00) i
75,32200
4,000.00
(4,000.00) `
f
moo
155,368 00 I
3,9S4A0
3S9,32200
Last Approved Amended Estimated
Type of Assistance Estimated Number of Number of Households
Households
Stammer Home Energy j 125 l 105
winter Nome Energy 125 C 175
Summer Crisis 165 192
whttarcrm 173 k ise
weather Ra is I Q-
TOTAL 603 d60
Estimated Cost Per
Notisehoi&O
300.00
300.00 I'
181.00
i zis:ao
p4p'
Amended Estimated
Expenditures"•
t 31,5110
52,500 00
34,7S2.00
4"W-00
1�,36+RL0
• if less than 8.S% of Una 1 Is budgeted for Administrative Expenses, the maximum allowed for Outreach Expenses may be increased. The total Administrative Expenses
plus the total Outreach Expenses may not exceed the sum of the original maximum allowed for these items.
Total of Line 2 plus Una 3 may not exceed:
$4S 527.72
mou Ant budgeted
Una 2 + Una 3 -
$45,527.00
" Estimated Cost per Household must be Leased on the agencys historic average cost.
*'* Estimated Expenditues gIm In the Workptan mustegree with the corresponding values on Lines 4-7.
FY 2016 LIHEAP AGREEMENT
ATTACHMENT K
As modl/hed by Mod0cat/on 121 to Agreement 16E4-oF11-5"1-019
ADMINISTRATIVE AND OUTREACH EXPENSE BUDGET DETAIL (Lines 2-3 of Attachmant J)
$LJBRECIPIENT: MONROE, COUNTY OF
AGREEMENT* 16EA-OF-11-54-01-019
Mstructlons: On aim form bek%, enter the detaf! of the figures listed on the Budget Summwy. ymore space is needed, copy this fora
copy ft fo►m to another tab and name the am WW'Budget DetaN 2, -'Budget Deto112,' etc
Une
Item
Number
Expencilture Detail
(Round all line items to dollars. Do not use cents and decimals in totals. Totals must agree with Attachment J)
LIHEAP FUNDS
2
ADMINISTRATIVE EXPENSES:
SALARY: SR. DIRECTOR
6,774.00
5%UHEAP,15%CCE, 20%MCT, 4%C1, 4%C2, 32%GENERAL REVENUE, 20% WAP
104 HOURS X $65.13/HR LOADED WITH FRINGE
SALARY: COMPLIANCE MANAGER
4,234.00
5% LIHEAP, 15% CCE, 5% MCT, 5% ADI, 5% C1, 5% C2, 50% GENERAL REVENUE, 5% WAP, 5% CCDA
104 HOURS X $40.71/HR LOADED WITH FRINGE
MLSC OTHER:
5,754.00
1) PHONE, POSTAGE $454.00
2) PRINTING AND BINDING SUPPLIES $800.00
3) OFFICE SUPPLIES $1000.00 (xerox paper, pens, clipboards, staples, file folders)
4) OPERATING SUPPLIES $1A00.00 (2 office chairs, calculator, 2 file cabinets)
5) MAINTENANCE AGREEMENT $2,500.00
(annual fee for maintaining Internal data client tracking system)
TRAVEL: 1 COMPLIANCE MANAGER TO THE ANNUAL STATEWIDE TRAINING (AIFARE, MEALS, PER DIEM)
650.00
2
TOTAL ADMINISTRATIVE EXPENSES:
17Al2.00
3
OUTREACH EXPENSES:
SALARY: FULL TIME CASE MANAGER (INTAKE, ELIGIBILITY, PROCESS CASES)
9,394.00
15% LIHEAP, 85%GENERAL REVENUE
322 HRS X $30.11/HR LOADED WITH FRINGE
SALARY: TWO STAFF ASSISTANTS (INTAKE, ELIGIBILITY) $8253.D0 X 2 EMPLOYEES
16,506.00
20%LIHEAP, 90%GENERAL REVENUE
416 HRS X $19.84/HR LOADED WITH FRINGE
TRAVEL: 1500 X .445/PER MILE (ESTIMATED LOCAL MILEAGE)
668.00
TRAVEL:1 CASE MANAGER SUPERVISOR TO ATTEND ANNUAL STATEWIDE TRAINING (AIRFARE, MEALS, PER DIEM)
647.00
OTHER: CONSUMABLE OFFICE SUPPLIES
500.00
POSTAGE MAIL OUTS
400.00
3
TOTAL OUTREACH EXPENSES
28,115.00
DIRECT CLIENT ASSISTANCE:
4
HOME ENERGY
84,000.00
s
CRISIS
75,322.00
6
WEATHER
0.00
7
TOTAL CLIENT ASSISTANCE
155,3noo
8
TOTAL LIHEAP BUDGET
204,949.00
FY 2016 LIHEAP AGREEMENT
ATTACHMENT L
As modified by Modification [2] to Agreement 16E4-OF-11-54-01-019
MULTI -COUNTY FUND DISTRIBUTION
SUBRECIPIENT: MONROE, COUNTY OF
Number of Counties to be Served with this agreement:
AGREEMENT #: 16EA-OF-11-54-01-019
If the Recipient will serve more than one county with this agreement, complete the form below. Describe how you will equitably allocate
LIHEAP resources to each of the counties you serve. This plan must be in part based on the 150% poverty population of each county.
Instructions: Enter appropriate data only in the cells below that are highlighted in yellow. Percentages will automatically populate when the
total direct cllent assistance amount and all three columns for each county are filled in.
Poverty Population Data Souce: Provide the U. S. Census data source for the 150% of poverty population used including the year of the data.
If any other data or factors are used in allocating the funds, describe and give the source.
Data Source and NA
Description:
Distribution Table (see Instructions Tabs for assistance
COUNTY
Budgeted Direct Client
150% POVERTY
POPULATION
this table)
COUNTY'S % OF
POVERTY POPULATION
IN SERVICE AREA
TOTAL DIRECT CLIENT
ASSISTANCE
S159.322.00
COUNTY ALLOCATION
0
$0.00
0..��—_
$0.06
_
Q
— —
$0.00 j
o
u
_... $0.00 : l
$0.00
ii
$0.00 i
li
. -50;00 -_-
0
' $o.66
0 1 0%
* Total County Allocation must be equal to Total Direct Client Assistance (Attachment J, Budget Summary
% OF AGENCY'S DIRECT
CLIENT ASSISTANCE
DOLLARS ALLOCATED TO
THIS COUNTY
Line
0.00%i