09/22/1994 Contractsound do poultry COHMISSIONCRS
SOCC wally
Current contract expires September 300 191,44
Approval overtaken upon clearance from County AttOrasYg Risk'
uanc
MUOCXTSDt VOW 10 Oft
Appmovzo tcounty � anvil
vivittox DISMISS,
L.
misvospvfticoo Ageads Item ba
STANDARD, COMOACT BETWEEN
nroe
BOARD Of
«°. \Z Or rLAPAIDA
DEPARTMENT OHEALTH ARE ACHMUTATIVE SERVICES
I, general Provisiom
11 + Toderag Love and Itegulationst.
both parties ots"that : e CPW shallt
A. Cooply with theprovision* contained
hts .i .#Incorporated. . ..
o \� . a 2. w \ ..t \ \I/
111. Records, Reports and Audits.-
2
All appropriate CpHd amplaywas
Sggall report
(Or at Inaba ads sample perfect specified by the
dapartzont., and
In to* client Intormarl'oft SYStWeItHeAlch Management
6. Any othor state and county program specific
this contract.
during
Allow persons duly autharAzed by state or county, and
federal auditors., pursuant to 45 CIA# Part 74,#74(*)#
*X*Dlh* sold records and documents
retention yariod* and
Ell Include these aforamontimaod audit add �a
approvedrequirements In all
Purchasing Pr000dures'.0
both parties agree thatv *Ither determinism c9ocs"ry.'' Ebb
services as d*tallod In Attach"at 1 and Pperstud,
M or its subcontractor Or Assicbnae.
vategm3rOng Inforeations.
VIZ. Avolganants.a
in the event that the CPHU needs to scocura, a oubmuchhat
for an anount greater then Von (10) percent- of the volow for
this contract* both parties to this contract oust agree la
writing In, such & succontract prior to Its owevarion*
IS, payment for Services.&
A. The department agraccup
The county agrava:
X. The department and the county mutually agroe:
Termination
1.
delivery. The dapart.nont oa- the county shall be
two final authority so to the availability
funds, staffing and services shall be reduced
2. 'sarnimetion, for broach:
3. Termination at will:
This contract way be tormilwarod by elthor party
causes Sold notice shall be delivered by
certified nail, return receipt requested, or In
person with proof or delivery.
upon no less than thirty (30) days noticar# without
C. Notice and Contact:
Do Jawltication:
-Awv nare and Wroas of the
payront all be rade 1111:
fungi
CfAcial p3y*o to WnZN the
PubliC Health Unit TrUS1
F+ All terms and conditions inclulodt
DoNsto or COUNTY conxissicaus
SIGNED BY;
SIGNED ov
VAKC."
TITLZI
CASE:
STATE Or FLORIDA
orpomEur or HEALTH ADD
REHASILITATIVC SERVICES
SIGNED my:
I 7
ATCACHMENT
SPECIAL PROWSIOCS
1. County Public Health Unit Trust rund.-
A. That all funds to be expanded by the CUBU shall be
deposited In the County Public Health Unit Trust Fund
(CPHUTF) vaintalmod by rho state treasurer.
D. That all funds deposited in the County public: Health
Unit Trust Fund shall be oxtendod by the department
solely for services rendered by the CPHU as specified
In this cantrac'.. Nothing shall prohibit the rondering
of additional services not speciflod in this contract.
«A tr&Mmltta]Lbriny IV Sumbri8ir4.
activity&( </
¥.\ Contract cansgonenj « .
rlanCS
\ / « /
tqultgen0v� and
addinixtratores quarterly report to the county and the
oorch %, 19M... for And, report period October r
191A,,.. through June 30 Saptc-abor 1. for the report period occeper
4. Decanter to 19AL for the report Ported Iferopor to
Aa v
11. Connowleable disease service local
41
Primary cars reesO
C. collection <.2 us* of toong
Both parties agree *;
\< Proceeds from,. all fees aviiacted
of the CPHV, Whether for wavironsantal,
oensunicable di'veasea or prizary. 2\
shall only . . . . . .provided
\«..§w} . . . fund
Ill. Service Policie. and Standards.&
IS. fair \ Hearging Guidelines.-
Ths,
visible, to all clients either procedures or a poster
inforolog clients how they nay � \K~C)® contact .Susan ItIghts
Advocacy
12
: « : «.».<: ^l»
Both parties agreJ
A. The CPHV shallhow at least the following caplayme- #
\ .+ roaLlitiess
»h yn °tfoo &grew thats
all. Use of funds for LObbYLAS Prohibited, -
The CPUU sort** t
ccP1YWihhe provisSOftV. Of Sectio216-347, Florida tatuted, which prohlbits, the expenditure
of Contract funds for the purpose me lobbying the
leclolaturd, or a state agency,
Vttt-Nothod of paymonteo
2. VIC and other state funds appropolsted In 0 cost
rciaborsonent cat"ary (e.g. expense and apeclogj
shall be released on the basis my Invoices
documantlic; expenditures.
IX- ZmbOrWtQrY and Philemacy Support.,,
The department acireen, to supply laboratory and p
support services for the SUCH ot least at to& I*Vgl«provided
In the prior state fiscal year It funds are availoolo.
Z. toorganclax.-
$*to portion 09TOW, to tho mutant of rMAir respoettva
C*B"rfts,, that th*Y MMY assist each other In Dicting public
health *bergamot*$.
x1a opcovarchipe.
not too Statt of 1plorldat popartment of Health and
Robabilhative, services.w if coc sponsorship roperecon,la,
In writton naterial, the worso& e
'*St&t* at Vlorldc,,'
Department at Health and RObbbilicatimS*rvle*ss shall
M
appear in the sane size lattees or typo as the name at the
Xtk. Indicate In the waaco below the Income alLuIbIlity limit for
comprehensive primary care ellonta.
XIII.Progrom specific Reporting Requirements:
specific Information not, *callable through CISJRMC be SAM
must be supplied by Completing the following:
hlspecify In the space below the wininun number at
clients who will receive con repeoviva primary met*
service& (clients registered fe Program Component 99
who ill receive services during this contract period).
C. Complete the planned really Plawnivat bQ4194b, t
an the following page, for this °ei,
blue county resso.
1
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AITTACKNEirr 11
PLANNED FUNDING: I EXPENDITURES
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ATIACHME!"IT III
CIVIL RIGHTS CEATIFICATE
Che applicant assures that it will CQZPIY Ulth&
all r"u1stiessip qvide1lboo and ftAnd&r(j3lawfully
adopted under the ab6V* st&tUt*f,
".0
ATTACHMENT IV
STATE FEE SCRECULF.So BY SERVICE
Laskim.firancusima=
A1DS,j Btu, Alternate Site Tatting
Ito, Z11111ARX—SAM
Im
mm
$20 (optional)
catinstoo
Annual Revenue
accvwlrq To The
9mm.21RULLDWA
34
IM
III
STATE FEE SCHEDULESi
ENVIRONMENTAL HEALTH:
A. ONSITE SEWAGE DISPOSAL WAS) PROGRAM To*
HIM
includes a *S research foe to be collected until September Got isock
transferred to headquarters using revenve object code 001201,
Includes a $$ surcharge collocted; by the N pursuant-0*04tvuotton
permit Issuance to be transferred to b*adquarters to, provido- ,,
4
STATE FEE SCHEDULESo Y SERVIAC
'oPUBLIC SWSKNZIIC POOLS JUIV o
ThINC PLACES roe
up to (and is
Here thanJS&GOO.
maximum rea is charged by has chous and to% at that to* is transterred
to headquarters and should be coded Ed:
Planning and valuation Trust fund
1
Annual Permitag
S Spaces and par GPM* OUR)
D. "IMMM LABOR CAP"
Annual "rattat
Facilities with S-50
Facilities With 54-240
BE
Annual Permit*:
Meant 9 Office Generating less
than.55
Stelospoation (after the fir
Late 25
Mobile treatment usable* 25
mm
IBM
ATTACHMENT IV JCONTIOUCO1
Swart, CEO SCHEDUZZA by SERVICE
C. FOOD INTABLISUNCEIT's ?a*
aOAS that Is transcorrowd, to bv&dqUSrS*mmmS1pvov1d4�
Includes a $10 Surpamw
training, contract Act *Biological so
technical emblatao0s, using revenue object cod* 0011120
In* $10 surcharge *tests be Coded tot
.;° Off
object Code m 002132a state Program w 0402000004P at 0 XV
42) InCludOx � I "Banat
k"
the cost of poschosing and providing malattrance an
used for,this, prvgVas Using revenue object code Col,210'
The $a surchAr9d; should be Coded tot
a 00
object mode a III
38
ATTACHMENT IV (COUTIMUCO)
STATE TEE SCHEDULZSt MY SCAVICE,
H. TANNING VACILITTES Its
Annual PICS1,003
W us SSS per per facility to
Movies
the first sic ...
antiInside
IRE
COURTY FEZ SCHEOULESo OF SERVICE
Estimated
Accruing To The
OMLIduLimAd
To S2wDMMILLJQLU=
3 07,222
E
Iff at
Monroe County Public Health Unit
Fing Schedule
coaaaaae go State Price Phis IS
Clinic Sirvicom
weagam powes f specim"'Colledmon)
Igloo
327,60
PAP Stator
$$is$
$433
ploe"W7 Ttit
4470
SIOS
Tdifts (POO k*"
"M
020
X. $too
TOM
124.16
"evatme
"lit
Li2o$
TWAY S"
13.71'
vAfh"
$1032
04*vem
u.it
camompone" C4*vn
RHOPM
comoseec"Fam
w6wp owdawn Vor bduu UW4
$4011
Modkad" SW Vkmdft
k"Taow
$1410
Mobiddotob
Pt&FOCUW
im
Tww*ow2sonvudm
sm
EW250atatkUM
Saw
Er)Oomydoi.
F"PCW
411,310
xm
"SSW"
FM*PhmninG vwm Von
~AfAod vtmt SSW
&V*V%a V#Vao uw
*Now" smw sm�*
umupdoomopogo suit
Ted Loom (AM C- $ad** Lino
vnodow
Page 40-A
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Atileabdunt
rr
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r
laced Grow IL 04
$1553
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$2160
61070
slowtoo.,1
. 731
CWVM'
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Data
$24s
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sjffitftuiatasat�
sum
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PAST 19 Or Sal"
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ATTACHMENT V1
CLASSIFICATION WHO NODDED Or EXPENTEAS WARNING 30 THE
COUNTY PUSLIC HNALTS UNIT WHO AR9 PAID By THE
COURT& My LCVZL Or SERVICts Ir APPISCASLC
*pggtial payment by couRty, rates
sm
11
ATTACHMENTVII
FACIUMS UTIUZED BY THE CPHU
.1mak Do" LAW"A oonpd
tm. MWWWCO&WY
PtAfet4o"LM S" W&K r*vw
HAS - Mowoo COWIr
pkbh"wAhunk
HM-14"Mcaft
HAS-AMSPMAN"
CAMW
Fkwxm4RSwW6
cmwmdmy"bd&
Fdg*Wft CAWN
13OGtwvwvu"
TwAWN.fUd" MMWC*M"
lWo"w&s"(jOwal MCkqob&d&&
Mmaom%Fufwo Pdw*Pnpwom
MAW "Mrookm
WWKmwWrO"
Kvvwm%nvd&
mm
mod"Cowdy
IML&wwPpUsKwp
"Oftsfawom
ely4dKwwea
%q%%Wrbmb
Whose *no PAWS man 00-4CkwOMOlomwVtmd to
Societe* lot OO&AWOM*m oo$TmmnAw am
evhwwqw ,°rawksoftoodempapig
ATTACHMcur In
SPECIFIC
Ito
COMPLIANCE WITH THE PROVISIONS
1. ally Transa,itted
In MRS" 130-220 R
Program
Womonts
regarding Wts Health Office
$10 Program toulow end approval
of if
Dental Health
Monthly reporting on MRMSIN
Fors, IvOS.
I* special Supplemental rood
or an for Wasone Infants
documentation2.
sarvice
monthly financial to SO
and ChLldr*n.
as Specified In MRSK 250,24
Mary
requirosents,
sm
61
ON
ON
ON
AT,r)iCUHZlrr IX forantinuod)
trounization
CPHV Program
chronic disease program
chvironmental wealth
to. weres Program
it, school Health sovvLces
Requirements as 0 Pitied In NWRMS
150-3 and BRAN 30-Os
Requirements me spealtled in t"h
Reference Guide to CHIP Rod HGO
torso Identiflod, in K=RR Iso-sland,
Roqult*m*ots At specified , An ixwnms
so -IN
ME