Item C26C
UNTY So�MONROE
KEY WESTLORIDA 33040
(305)294-4641
District 4 Office:
9400 Overseas Highway
Florida Keys Marathon Airport
Suite 210
Marathon, FL 33050
Ph: 305 289-6000
Fx: 305 289-4610
Em: boccdis4@monroecounly-fl.gov
BOARD OF COUNTY COMMISSIONERS
Mayor Sylvia I Murphy, District 5
Mayor Pro Tern Danny Kolhage, District 1
Heather Carruthers, District 3
George Neugent, District 2
David Rice, District 4
Interoffice Memorandum
Date: April 11, 2014
To: Amy Heavilin, Clerk of the Court
From: Commissioner David Rice, District 4
Re: Notice of Voting Conflict
Per Florida Statute 112.3143, I hereby disclose by written memorandum that I will
abstain from the vote on certain issues that are brought before the Monroe County Board of
Commissioners with entities that I am involved with.
I will abstain from the vote on issues concerning the following entities: Guidance Care
Center, Inc., a private, not -for -profit entity, which receives some of its operational funding from
the County, as I am currently a member of the Board of Directors of the Care Center. I am also a
member of.the Board of the Historic Florida Keys Foundation, Inc.
At the April 16, 2014 BOCC meeting, I will abstain from the vote on item(s):
#C26: Approval of an amendment to the contract with
Guidance/Care Center, replacing Attachment D, which
concerns sub -contracted Baker Act transportation services.
J.
the Long Key Transfer Station and the other will be located at the
Cudjoe Transfer Station. VIEW
C. BULK APPROVALS — CONTINUED
19.
Approval to reject the second round of bids for the Wayfinding
Sign Program and notify FDOT to delete this project from their 5-
Year Work Program. VIEW
20.
Approval to negotiate a contract with Parsons Brinckerhoff, Inc.,
the highest ranked respondent, for construction engineering and
inspection (CEI) services for the No Name Key Bridge Repair
Project. If successful negotiations cannot be reached, approval to
negotiate a contract with the next highest ranked respondent until
successful negotiations are reached. VIEW
21.
Receipt of monthly report on change orders' reviewed by the
County Administrator's Office. VIEW
22.
Ratification of the contract for emergency repairs at Bayshore
Manor to SeaTech of the Florida Keys, Inc. in the amount of
$158,166.00. VIEW
23.
Approval of a 1st Amendment to Contract with William P. Horn
Architect, P.A. for professional services for major repair work at
the Senior Meal Site at Harvey Government Center. This project is
funded from the one -cent infrastructure tax. VIEW
24.
Approval of a Contract with Currie Sowards Aguila Architects for
professional services associated with the Freeman Justice Center
Acoustic Renovation. Funding for this project will come from
Fund 3-07 304 in the amount of $19,400.00. VIEW
25.
Approval of various resolutions for the transfer of funds and
resolutions for the receipt of unanticipated revenue VIEW
26.
'�`" .d'�
Approval of an amendment to the contract with u dance%Care
'Center re lacin Attachment D which concerns sub -contracted
p g
Baker Act transportation Services. VIEW
27. Approval to enter into an agreement between Academy Bus, LLC.
and Monroe County Board of County Commissioners, to provide
additional emergency transportation services to Monroe County
residents, guests, workforce and their appropriately caged or crated
pets during the evacuation, re-entry and recovery phase of an
emergency as determined by Monroe County Emergency
Management, and authorization for the County Administrator to
execute any other required documentation. VIEW
28. Approval to enter into an Employment Agreement/Contract
fulfilling the newly created Billing Specialist position, and
authorization for the County Administrator /Fire Chief to execute
all necessary documents. VIEW
29. Approval to release lien held by County's Health Insurance Plan in
return for $5,000 of insurance proceeds received by covered
employee. VIEW
4
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEMSUMMARY
Division: OMB
Ba€£k ltem: X. No ....._ Department-, Grants
St<aE i C:"asrataact 1P1aon 1..Aaaa.araa deLoaach-1-1<:arde x 4482
A E.NDA ITEM WORDING: Approval ofan aaeateraclar ent to the ccarataaact: yvith C:Ia€adance/CC'aa€a:
Center, wpl ac iaat,� Attachment D, which concerns staab..c ntazaa;:ted Baker Act transportation services,
ITEM i I Cl< C.;C C�ICOU . When the contract with Guidance/CareC:`ente was as proved the
Scxl=contraaa;t i ttaachaaarattt D) was not inc:icacled.
PRFVI(.')I.,JS RELEVANT BOCCI ACTION: The C has as vicaa€sly approved the agreement on
10/16r'`13-
C ONTR T/AGRE i CHANGES: Attachment D to include ga copy of the Stab -contract.
TiFFRECOMMENDATIONS: Approval
DIFFERENTIAL OFLOCAL PREFERENCE:
BUDGETED: Yes X--No
SOURCE OF FUNDS.
REVENUE PRODUCING- Yes __ No _ X AMOUNT `COUNT PER MONTII ....___-. Year ..
APPROVED Y: County O tt C)€MB/PurchaasiRisk Maaaaaa(gernent` 11
� m
DOCUMENTATION: UMENTATION: Itacla€clad
Revised �',109
Not Required —
AGENDA ITEM #
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract
Contract gift �.�_Uida �c�� tu,e Center r tfieetiare Date: 1.�?�i 111 _U
Expiration Date: J Q
Contract Purpose/Description: Provides fUnding for Baker Act transportation services an
r:r?Mrn;_:rrity transportation for the disadvantaged in Monrae County,
Contract Manager. Laura d Loach-Hartle 4482 Q IaLQrantq
(Name) (Ext.)) (Department)
for 3OCC rneetino can 04Ll!5114 gAID �1
CONTRACT COSTS
Total Dollar Value ofContract: �-Current Year Portion: 187.11.
Budgeted? dgeted? Yes[' No 0 Account Codes: 01-0CI3-53Q3LO-.j.4 010
Grant., (,._a0 i. 0:1-0 . - 3034m.-1,,,4�,�1._
County Match:
ADDITIONAL COSTS
stir sated Ongoing Costs: �_.�yr or:
(Not itaelr ded in dollar value above) keg• maintenance, utilities, janitorial, salaries,
etn.
Date In
Division Director
Risk Management .......� ;`
County Attorney �
CONTRACT tail'
Changes
Needed Reviewer
Yes ow
Yes[] Nor
Yeso a[�(
YesEl
r.)m i-or:n i evisea wii/qb mcp
Date Out
Baker/Marchman
Act
Transportation
GUIDANCE/CARE CENTER, INC,
300041 ST STREET, OCEAN
MARATHON, FL 33050
(v) 305/434-7660 / (f) 305/434-9040
October 16, 2013
Lee Connell
Elanjess LLC
P.O. Box 500218
Marathon, FL 33050
RE, LETTER OF AGREEMENT — Amendment I
Dear Mr, Connell:
The Guidance/Care Center, Inc. (G/CC) hereby e6ters into an agreement with Elanjess LLC to
provide coordination and transportation services for Baker Act/Marchman Act (BA/MA) clients
throughout Monroe County tolfrom Miami -Dade County as well as other destinations as
required.
GICC will supply Elanjess with two Ford Grown Victoria vehicles, meeting Elanjess
maintenance specifications-, one to be stationed in Key West at an Elanjess location and the
other in Marathon at GICC headquarters,
G/CC will pay for the fuel and maintenance of the two vehicles usedfor BA/MA transportation.
Elanjess will coordinate the maintenance for the Crown Victoria located in Key West. Invoices
for routine maintenance (labor and parts) on the Crown Victoria will be forwarded quarterly to
G/CC's Transportation Director for payment. Elanjess will not charge an extra fee for
coordinating the maintenance of the vehicle. Elanjess must obtain prior approval from the
G/CC Transportation Director to initiate major vehicle repairs. GICC will cot)rdinate the
maintenance for the Crown Victoria located in Marathon.
G/CC will maintain insurance on both of the vehicles. Elanjess will also be named as an
,,additional insured" for these two cars. Elanjess will report and document accidents involving
GICC vehicles and incidents involving clients to the proper authorities and immediately
thereafter contact G/CC. All Elanjess drivers operating G/CC vehicles will hold a minimum of
a Class E Florida Driver's License and be approved for GICC insurance coverage by the
Transportation Director. Upon execution of this agreement, Elanjess will fax to G/CC's
Transportation Director a current list of drivers - including a copy of the drivers license and
social security number for each driver - for approval to operate G/CC vehicles, Prior to adding
a driver, Elanjess will fax or email to G/CCI s Transportation Director or designee a copy of the
driver's license, social security number and signed "Request for Check of Driving Record" form
of the person. G/CC will initiate procedures to add the driver to G/CC vehicle insurance.
Elanjess cannot use the driver for BAIMA transports until it has received written notification
that the driver has been added to the G/CC insurance coverage
RYA:10105113
All drivers are required to have at minimum 3-year clean driving record. Additionally, Elanjess
will fax a copy of picture identification and social security number for each escort to GICC's
Transportation Director or designee. Elanjess cannot use the escort for BAIMA transports
until it has received written notification that the escort has been approved by G/CC. All BA/MA
approved drivers must read and sign the acknowledgement of reading and receiving
(Attachment 1) Transportation Protocol.
GICC will supply Elanjess with a cell phone. Elanjess will follow the transportation protocol
and complete the documentation provided as Attachment 1-3 herein -
The following fee structure is established for the period of the agreement:
Estimated
Elanjess
# Roundtrips*
Client Pickup Point
Client Dir Point
---ent
-- -
_-r
Pay n
Key West
Key West
$115
Marathon
Marathon
$115
450
Key West
Marathon
$145
Marathon f
Key West
$145
I Marathon
Key Largo
$145
Ke rat arch
Marathon
$145
40
Marathon
Miami -Dade County
$385
. ...
... Key Larao
Miami -Dade Counter
$3854
Key West
Miami -Dade County
$385
GICC Preauthorization Required for All Trips Below
*Approval for below fees will be granted only when
the Marathon BAWA vehicle
is engaged
with another BA/MA
trip that woUldprecludeanother
pickup within a reasonable
period of time.
Estimated
Car Client Pickup
Elanjess
# Roundtrips
Location Point
Client Drop-off Paint
Payment
5
Key West Marathon & North
Marathon
$145
5
Marathon Key West
Marathon
$145
2
Key West Marathon & North
Key Largo
$225
-----------3
Key West Marathon & North
Miami -Dade Cq"unll
$385
GICC Preauthorization
Estimated
If Roundtrips* Client - Pic ' kup Point
Key Largo
Marathon
-Key West
Key _targo
Marathon
---- ------- -1 ---- --- Key West,
for All Trips Below
Elanjess
Client Drop-off Point Pavrr
Avon Park (Area)
$770
Avon Park (Area)
$770
AVQPPark (Areay
$770
Up -State (McClenny Area)
s1,200
Up -State (McClenny Area)
$1,200
UP -State (McClenny Area)
$1.200
Timely payment for services rendered is ensured by adherence to the following invoicing
procedures:
Rv,sd: 10105,113
-2-
• Elanjess will submit two staitementslinvoices per month; one covering the trips made
from the first through the fifteenth and one covering trips rnade from the sixteenth
through the end of the month. Elanjess will send statements/invoices to G/CC within 5
business days after the end of the billing period.
• Elanjess will include required documentation with each statement/invoice.
• Elanjess statements/invoices for BA/MA trips will be submitted to the attention of G/CC
Inpatient Unit Coordinator.
• G/CC's Inpatient Unit Coordinator will review statement/invoice, mediate any
discrepancies with Elanjess, and,forward approved invoice to G/CC Finance
Department, r
• Elanjess will submit vehicle maintenance bills for the KW car quarterly to the Director of
Transportation.
• G/CC will mail payment to Elanjess within 7 working days (Finance Department) upon
receipt of statement/invoice by the Inpatient Unit Coordinator.
't
The agreement can be cancelled by either party with 30 days written notice.
G/CC d Eq. atdlje e ter into this agreement including Attachments 1-3 by affixing signatures
belo
Frank Rabbito Date
gare
Sr, VP, WesIcarllorida, GCC
_car
_,-Et',1�6jes—s LLC
Andy Lee Connell
General Operations Manager / CFO
Co -Signer (print name/title)
--Date
ate
Attachments:
1, G/CC Transportation Protocol
2, GICC Transportation Record and Payment Authorization Sheet
3. Statement
I
Rvsd:10105113
0
ATTACHMENT 1
A. Client Related Rules:
1 Confidentially of a client and client related information shall be maintained at all
times.
2. Each client shall be treated with respect and dignity at all times.
1 No information with client information shall leave the clinic unless part of a client
transfer packet to a designated facility. (No driver/escort shall maintain a personal
copy of the Transportation Record and Payment Authorization Sheet.)
4, Client transportation within Monroe County may be conducted with a driver and an
escort.
5. Client transportation outside of Monroe County must be made with one driver and
one escort.
6. A client must be observed for any unusual behaviors including hurting self/others or
sudden medical conditions. Report/respond to conditions immediately to the Nurse
on Duty.
7. At the time of pick up for a Baker Act or Marchman Act client, a driver must obtain
the original Baker Act or Marchman Act paper work from the Pick Up facility. If the
original paper work is not available the driver must immediately report this
information to the G/CC Nurse on Duty for further instructions.
8. A female client requires a female escort or a female driver.
9. A parent is not allowed to travel in the Baker Act vehicle with a Baker Act or
Marchman Act minor.
• When a parent or other responsible party reports he/she plans to follow the
Baker Act vehicle, the Baker Act driver advises the parent/party that our
primary responsibility is to the child and ensuring the safety of the child
therefore following our vehicle as a method of direction is not encouraged.
10. Only one client may be transported at a time in the Baker Act vehicle.
11. Drivers, Escorts and Clients are not to smoke in the car at any time.
12. Clients are not to be placed in handcuffs or any type of restraints for any reason by a
driver or escort — or to be placed in the vehicle by others (i.e. Law Enforcement) in
handcuffs or any type of restraints
11 A client's movement is not to be impeded with any physical restraint unless directed
by a nurse/MD/law enforcement officer.
14. If a client is violent during transport and poses a threat to safety, stop the vehicle and
call 911, than notify the Nurse on Duty of the situation at (305) 434-7660 ext. 31123
15. A client shall not be left alone in the vehicle during the trip for any reason.
16. A client shall be under the observation of the driver or escort at all times during the
transport.
17. Client is encouraged to use restroom facilities prior to departure. If the trip is
generated from Key West and a stop is required, the G/CC may be used for that
purpose.
Rvsd: 12/13
18. A client may not use aluminum/metal cans. Items for drinking shall be provided only
in a plastic container.
19. Clients may not have any metal utensils, glass or other hard products such as
pencils or pens.
20. A client may not shop during a stop. All efforts should be made to avoid stops. If a
stop is required, it should be short and without delay.
21. If a client must use a public facility, the client must be escorted to the restroom and
the driver must remain outside the restroom door until the client leaves the restroom.
The driver will remain in conversation with client while the client is in the restroom.
B. Coordination of Transportation Rules:
1 Transportation arrangements for Baker Act and Marchman Act clients are under the
direction of the Unit Nurse on Duty/G/CC per contractual arrangement Elanjess LLC.
No other agency is authorized to contact Elanjess directly for transportation.
2. Final decision for a driver to transport is made by the nurse on duty. The nurse may
request a BAL be conducted or send a drivers/escort home if he/she has a concern.
1 "A driver shall not be permitted or required to drive more than 12 hours in any one
24-hour period, or drive after having been on duty for 16 hours in any one 24-
hour period. "
4, All trips will be made within the approved fee structure.
5. All trips will be made using the closest vehicle and the shortest distance unless
preauthorization is obtained from the Unit Nurse on Duty at the G/CC.
6. Clients may be picked up at only approved locations. The G/CC Nurse on Duty will
communicate the pick up location. Approved locations will include:
Hospitals, Detention Facility
Mental Health Clinics, Anchor Away
With a G/CC staff member
Or otherwise authorized by the G/CC IP Unit Coordinator
7. At Depoo: Call security with phone located on the first floor.
8. At G/CC: Use the telephone call box next to the elevator.
9, At G/CC, staff members shall place the client in the vehicle for departure and will
assist the client from the vehicle at time of arrival.
10. The facility responsible for the departing client for a trip longer than 2 hours shall
provide a brown bag snack. All minors shall be supplied with a snack for any trip
over hour.
11. When a driver reports a client is too dangerous to transport, the nurse on duty shall
work with the Sheriffs department to transport the client the client to the nearest
emergency room.
12. If a client absconds at time of or during transport, immediately report the information
to the G/CC Nurse on Duty. Do not go after the client.
13. Neither Drivers nor Escorts are permitted to physically restrain a client. G/CC offers
a verbal de-escalation training that all Elanjess drivers are encouraged to attend.
14. "Jail Hold" clients from the Monroe County Detention Facility shall be picked up from
the Sallyport area only. To access the Sallyport area, the driver must drive the car
within 1 foot of the Sallyport entrance. If the door does not open, the escort must use
Rvsd: 12/13
-2-
the speaker mounted on the wall next to the Sallyport entrance to request entrance.
Once inside, Detention Facility staff will bring the client to the car. When the client is
inside the car and the doors are locked, the Sallyport area exit doors will open.
15. The driver/escort must determine from the Pick Up facility if the client has been
searched and encourage staff to conduct a search prior to transport. If the client is
not searched prior to transport, the driver must communicate this information to the
Duty Staff Member prior to opening the client door at the Designation point.
16. Driver/escort MUST respond to the pick up point within a maximum time -frame of
I hour and 15 minutes.
C. Reimbursement related rules
1. All cancelled and otherwise diverted trips will be reported on the Transportation
Record and Payment Authorization Sheet.
2. Transportation Record and Payment Authorization Sheets and a Statement of
services rendered will be faxed to the IP Unit Coordinator on the first and sixteenth
of each month.
1 G/CC does not reimburse Elanjess for cancelled trips. Compensation to the
drivers/escorts for cancelled trips is at the discretion of Elanjess.
4. If the driver arrives without the original Baker or Marchman Act paperwork, Elanjess
will obtain the paper work without charge to the G/CC.
I acknowledge I have received and read the above BA/MA Transportation Protocol.
Driver/Escort Signature
Rvsd: 12/13
Date
ATTACHMENT 2
GUIDANCE/CARE CENTER
300041 ST ST. Ocean
Marathon, FL 33050
Voice 305-434-7660 • Fax 305-434-9040
TRANSPORTATION RECORD AND PAYMENT AUTHORIZATION SHEET
Transportation Type: ❑ Baker Act ❑ Marchman Act
Date: Client Name: DOB:
Time Called: Time of Pick Up:
Time of Drop Off: Time van returned to Duty:
Vehicle: KW vehicle Mar vehicle
19EMEJAMME
(Where did you pick up the Client: Facility Name/City)
Authorized Staff Signature at Pick Up Facility:
Time:
0 1 H V.T Me,
(Where did you take the Client: Facility Name/City)
Authorized Staff Signature at Designation Facility:
Timm
(Staff member accepting client)
Escort Name:
Beginning Miles: Pick Up Miles:
Drop Off Miles: Ending Miles:
FOR G/CC USE ONLY:
Amount to be paid:
Unit Director Signature:
\\westcare.local\Files\FL-GCC\Management\Senior Management\Transportation\Baker Act\2013-2014\Aftachement 2.doc RVSD0912
Statement
Elanjess LLC
800 Catherine St.
Kev West. Florifv-3M4f)t
Guidance/Care Center
3000 41't St. Ocean
Marathon, FL 33050
Re: Baker Act and Marchman Act transportation
The following is a break down for trips from
Ire
Date Name Pick Up Cost Vehicle
1 2 3
Designation 2 3
TOTAL
Elanjess LLC Representative Signature
G/CC Finance Director or Designee Signature
\\westeare.local\Files\FL-GCC\Management\Senior Management\TransportationNBaker Act\2013-2014\Atchmnt 3 - Statement for Elanjes.doc
Rvsd: 10/10
This Agreement is made and entered into this 16m day of October, 2013 between the
BOARD OFCOUNTY COMMISSIONERS DFMDNROEC(}UNTY,FLORIDA, hereinafter
'referred \mms
^Boond"wr"Counb/,~and the Guidance/Care Center, hereinafter referred to as "Provider."
WHEREAS, the PROVIDER is a not -for -profit corporation established to provide
transportation services iothe citizens ofMonroe County, and
WHEREAS, it is a legitimate public purpose to provide transportation services to the
residents of Monroe County, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein it is agreed
as follows�
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board, shall reimburse the
PROVIDER for providing transportation services as billed by the PROVIDER for clients qualifying
for such services under applicable state and federal regulations and eligibility determination
procedures. The cost shall not exceed a total reimbursement of ONE HUNDRED EIGHTY SEVEN
THOUSAND ONE HUNDRED FIFTY ONE DOLLARS (�187,1�1.00), during fiscal year �0l4
payable asfoUows: ` '
a) the sum of ONE HUNDRED FORTY SIX THOUSAND DOLLARS ($146,000.00) for Baker Act
transportation services pursuant to F5 394; and
b) the sunn of FORTY ONE THOUSAND ONE HUNDRED FIFTY ONE DOLLARS ($41 51 OO) for
Community Transportation Coordinator- related transportation services to residents o' -Mo'''noe
County,
2. TERM. This Agreement shall commence onOctober 1 2013 and terminate Bep1ernber
30, 2014, un|ess earlier terminated pursuant to other provisions
'herein,
'
3. PAYMENT. Payment for Baker Act and Marchnnan Act transportation services shall be
made according to the rate schedule set forth in AttachrnentD, subject bothe rnox|rnunn amounts
set forth in Paragraph 1. a. above. Billing Summary Forms, certified monthly financial and service
load reports will be made available to the Board to validate the delivery nfservices under this
coniract. The monthly financial report is due in the office of the Clerk of the Board no later than
the 15th day of the following month. After the Clerk of the Board pre -audits the certified
— » , report, Board shall reimburse the Provider for its monthly expenses'However' the total of saidnonth|y payments in the aggregate sunshall not exceed thetotal Article 1
'obuve, during the term of this agreement. To preserve client confidentiality required �y law,copies of individual client bills and records shall not be available to the uoonU for reimbursementPurPoees but shall be made available onlyunder controlled conditions to qualified auditors foraudit purPuses. The nrganizaUon\s Dnm| invoice must be received within thirty days after the
termination date ofthis contract shown in Article 2 above.
Payment will he made periodically, but no more frequently than nnonth|y, as hereinafter
sothzrth� Reimbursement requests will be submitted to the Board via the Oerk's'Finance Ofh er
The County shall only reimburse, subject to the funded amounts be|ow, those reirnbursace'
expenses which are reviewed and approved as complying with Monroe County Code of
u�
Ordinances, State laws and regulations and Attachment A - E
Requirements, Evidence of payment by the PROVIDER shall be in Expense Reimbursement
the formof a letter,
summarizing the expenses, with supporting documentation attached. he letter should contain '
Guidance Cafe Center -Tranopp*atiom'8ake ActandC7DFY/4;pa0e/
notarized certification StaternenL. An example of reimbursement request cover letter is included
as Attachment B. The onganization's final invoice must be received within thirty days after the
termination dote nfthis contract shown in Article 2 above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
paynnents in the aggregate sunn shall not exceed the kztal amount shown in Article 1, above/
during the term ufthis agreement,
4. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at e
level Sufficient to allow for continued reimbursement ofexpenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by vvrii&sn notice of
termination delivered to the PROVIDER. The Board shall not beobligated to pay for ally services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
ternninat|un, unless otherwise required by law.
S. CLAIMS FOR FEDERAL OR STATE AID. PROVIDER and County agree that each shall
be, and is, empowered to apply for, seek, and obtain federal and state funds to further the
purpose of this Agreement; provided that all applications, requests, grant proposals, and funding
solicitations shall be approved by each party prior to submission,
6. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
aCCOunted for pursuant to statutory requirannents.
RECORDKEEPING
7. RECORDS, PROVIDER shall maintain all books, records, and documents directly
pertinent to performance under this Agreement in accordance with generally accepted accounting
principles consistently applied. Each party tothis Agreement ortheir authorized representatives
shall have reasonable and Urne|y access to such records of each other party to this Agreement for
public records purposes during the term of the Agreement and for four years following the
termination of this Agreernmnt, If on auditor employed by the County or Clerk determines that
monies paid to PROVIDER pursuant tothis Agreement were spent for purposes not authorized by
this Agreement, the PROVIDER shall repay the monies together with interest calculated pursuant
to Sec. 55.03, FS, running from the date the monies were paid to PROVIDER.
8. PUBLIC ACCESS. The County and PROVIDER shall allow and permit reasonable
access to, and inspection of, all documents, papers, letters nrother materials in its possession or
under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received
by the County and PROVIDER in conjunction with this Agreement; and the County shall have the
right to unilaterally cancel this Agreement upon violation of this provision by PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES, The PROVIDER must furnish to the
COUNTY the [o||nvving (items A -I must be provided prior to the payment of any invoices):
(a) IRS Letter ofDetermination indicating 501(c)(3) status;
(b) List of the 0vganizaUon's Board of Directors ofwhich there must be five or more; for each
board member please indicate when elected to serve and the length of term of service;
(o) Evidence of annual election
of Officers and Directors; '
(d) Unqualified audited financial statement from most recent fiscal year for all organizations
that expend $150,000 a year or more; if qualified, include a statement of deficiencies with
corrective actions reconnnoended/taken;
(e) IRS Form 990 from most recent fiscal year for all organizations;
(f) Qrgan|zaLiom's Corporate Bylaws, which must include the organization's mission, board
and membership composition, and process for election of officers;
Guidance Care Center -Transportation: Baker Act edC0*Y/4; page
(g) OnQanizaUon's Policies and Procedures Manual which must include hiring policies for all
staff, drug and alcohol free workplace provisions, and equal employment opportunity
provisions;
(h) S peciMc description or list of services to be provided under this contract with this grant
(eaeAttachment C);
(i) Annual Performance Report describing services rendered during the most recently
completed grant period (to be furnished within 30 days after the contract end date.) The
performance report shall include statistical information regarding the types and
frequencies of services provided, a profile of clients (including residency) and numbersserved,andmutcornesachiev8d;
(j) Cooperation with County monitoring visits that the County may request during the contract
year; and
(k) OLher reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may request during the
contract year.
RESPONSIBILITIES
10. The Provider, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in rendering counsel in the matter of mental health and guidance to the citizens of the
Monroe County, Florida, The Provider shall provide Baker Act transportation services in
ozrnp||mnce with Florida Statutes Chapter 394. Baker Act and Marchrnan Act transportation
services which are covered under this agreement may be subcontracted, but one subject to the
rates set forth in Attachment D, and the limitations above. The subcontractor shall be subject to
all of the conditions of this contract, including but not limited to insurance and hold -harmless
requirements, as is the Provider.
11. ACCESS TO FUELING FACILITIES, The County shall provide access to the
Provider's vehicles at all County fueling facilities, The County shall grant the Provider license for
the use of the real property and its improvements for each fueling site.
The Provider agrees that only those individuals authorized by the County to use the fueling
sites designated in this agreement shall have twenty-four hour access tosaid sites,and that they
shall either be maintained open or access otherwise provided to them by a uniforrnkey oyshano on
such atwenty-four hour basis.
The County shall bill the Provider for fueling and other related services and materials
utilized by the Provider at the fueling sites within the County!s immediate control and as
previously set forth in this agreement. Said billing by the County to the Provider shall include an
administrative surcharge, as adopted by the Monroe County Board of County Commissioners
annually, for processing, servicing, and handling, The Provider shall reimburse the County within
thirty (38) days of the date of issuance of the bill,
Access bothe Fuel Sentry System shall be provided by an electronic memory electronic key, which
shall be issued by the County to all authorized designated users of the fueling sites,' and as
contemplated by this Agreement, For purposes of uniformity, the Monroe County
" Fleet
Management Department shall be responsible for establishing a uniform o|ast i k ''`'
use by both the County and the Provider under this agreennent and shall establish
eysystennfor
puiicies and procedures hzridenti�caUon, contro|' and diytribuU`onu f a ey|| k an� n«a|ntain
s|ssued.
12. ATTORNEYS FEES AND COSTS. The County and PROVIDER agree that in the event
any cause of action or administrative proceeding is initiated or defended by any party relative to
the enforcement or interpretation of this Agreement, the prevailing party asha|| be entitled to
reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses, as an award
Guidance CamCene/-Transportatim:Bakw ActandC7DFY/4:page3
against the non -prevailing party, and shall include aLborney\sfees, courts costs, investigative, and
out -Of -pocket expenses in appellate proceedinQs. Mediation proceedings initiated and conducted
pursuantbo this Agreement shall be in accordance with the Florida Rules of Civil Procedure and
uSua| and customary procedures required bythe circuit court ofMonroe County.
13. BINDING EFFECT. The terms, covenants, conditions and provisions of this
Agreement shall bind and inure to the benefit of the County and PROVIDER and their respective
legal representatives, successors, and assigns.
14. CODE OF ETHICS. County agrees that officers and employees of the County
recognize and will be required to comply with the standards of conduct for public officers and
employees as delineated in Section 112.313, Florida Statutes, regarding,but not limited Lo
solicitation or, acceptance of gifts; doing business with one's agency; unauthorized compensation;
rniSuse of public position, conflicting employment or contractual relationship; and disclosure o/
'
use of certain information.
'r'
IS. NO SOLZCITATIO[0/PAYMENlF. The County and PROVIDER warrant that, in respect
to itself, it has neither employed nor retained any company or person other than ` bona fide
employee working solely for it, to solicit or secure this Agreement and
that it has not paid or
agreed to pay any person cornpany, corporation, individual, h - ''
employee working solely `r it any ' e commission, L«r firm, other than a bona fide
.~ , fee, � , percentage, g|Mr or other consideration
cnnUngenL upon or resulting fnzrn be award or making f this
'
violation of the provision the pRDy��ER rna ng o a Agreement. For the breach or
this Agreement without provision,
anu at its
that the County shall have the right to bernn|n�ba
. u, discretion, to offset from monies owed or otherwise
recover, the full annmuntofSuch fee, commission, percentage, gift, or consideration,
16. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board No statement
contained in this agreement shall be construed so as to find the PROVIDER
employees, contractors, servants oragents tobeennp|oyeeso[the Board.
or any of its
COMPLIANCE ISSUES
17. COMPLIANCE WITH LAW. In providing all services pursuant tothis agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted Any
violation of said statutes, ordinances, rules and regulations shall constitute n material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
IS. PROFESSIONAL RESPONSIBILITY AND LICENSINGThe PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional | liability
insurance coverage. Funding by the Board is contingent upon reten'`i~�n ofa�propri��� 'v�a|ty
and/or federal certification and/or |icensure of the PROVIDER'S ' sLace
proAnxnn and staff.
19. NON- DISCRIMINATION. County and PROVIDER agree that there will be no
discrimination against any person, and itisexpressly understood that upon a determination by
courc or competent jurisdiction that discrimination has occurred, this Agreement automatically
terminates without any further action on the part of any party, effective the date of the court
urder. Cuunty or PROVIDER agree to comply with all Federal and Florida statutes, and all local
u
ordinances, as applicable, relating to nondiscrimination. These include but a t | it d to:
Title VI of the Civil Rights Act of 1964 (PL 88-352) which prohibits
discrinninreinooxnhe basis 1)
race, color or national origin; 2) Title IX of the Education A ~^� ��v// // � c �»/ �r
USC ss' 1681 1503, and 1`85-1686) which prohibits discrimination
»f 1�7�' as amended (�q
Section 504 of the Rehabilitation Act 1973 s o cnnn/n�Uon on the basis o[ sex; 3)
discrimination on the basis of
4) Th ' as amended (20 U�C s' �94), which prohibits
/ P�� ' � Age Discrimination Act of 1975, as amended (42
Guidamwe Care Center -Transportatron:Baker Act and CrDFY/4; page 4
UBCss. 6101'6107) which prohibits discrimination on the basis 8fage; S)The Drug Abuse Office
and Treatment Act of1972 (PL92'2S5), as amended, relating to nondiscrimination on the basis
of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (PL91-61G), as amended, relating to nondiscrimination on the basis of
alcohol abuse or, alcoholism; 7)The Public Health Service Act of 1912, ss. 523 and 527 (42 USC
ss. 690dd-3 and 290en'3), as amended, relating to confidentiality of alcohol and drug abuse
patient records; B} llUe VlIT of the Civil Rights Act of 1968 (42 U5C s, e{ seq.), as amended,
relating to nondiscr|nnination in the sale, rental or financing of housing; 9) The Americans with
Disabilities Act of199O (42 USCs. 1201 Note), aamaybe amended from time totime, relating to
nondiscrimination on the basis of disability; 10) Any other nondiscrimination provisions in any
Federal or state statutes which may apply to the pa/ties to, or the subject matter of, this
Agreement,
20. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reirnbunaennent of services shall be accomplished by an amendment, which must be
approved in writing bythe COUNTY.
21. ADJUDICATION OF DISPUTES OR DISAGREEMENTS. County and PROVIDER
agree that all disputes and disagreements shall be attempted to be resolved by meet and confer
sessions between representatives of each of the pa/ties. If no resolution can be agreed upon
within 30 days after the first meet and confer session, the issue or issues shall be discussed at a
public meeting of the Board of County Cornnnissionens. If the issue or issues are still not resolved
to the satisfaction of the parties, [hen any party shall have the right to seek such relief or remedy
as may be provided bythis Agreement orby Florida law.
22. COOPERATION. In the event any administrative or legal proceeding /s instituted
against either party relating to the formation, execution, performance, or breach of this
Agreement, County and PROVIDER agree to participate, tothe extent required bythe other party
in all proceedings, hearings, processes, meetings, and other activities related kzthe substance o'
this Agreement or provision of the services under this Agreement, County and PROVIDER
"
specifically agree that no party tothis Agreement shall be required Loenter into any arbitration
proceedings related to this Agreement,
23. COVENANT OF NO INTEREST. County and PROVIDER covenant that neither
presently has any interest, and shall not acquire any interest, which would conflict in any manner
or degree with its performance under this Agreement, and that only interest of each is to perform
and receive benefits as recited inthis Agreement,
24. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in vvhbng
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions hene|n. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services ofthe PROVIDER.
25. NON -WAIVER OF IMMUNITY. Notwithstanding the provisions of Sec76828
Florida Statutes, the participation of the County and the PROVIDER in this Agreement and the
`
acquisition of any commercial liability insurance coverage, self-insurance coverage,ur local
"
government liability insurance pool coverage shall not be deemed o waiver ofirnnnu`the
ity to
extent of liability coverage, nor shall any contract entered into by the County be required to
contain any provision for waiver,
8uidam�C,.,iroCenter -TranspurtationBaker Act and QTDFY/�page 5
26' ATTESTATIONS. PROVIDER agrees toexecute such docunneoLsosthe County may
reasonably require, to include a Public Entity Crime Statement, on Ethics Statement, and a Drug -
Free VVurkp|aceStatement,
27. AUTHORITY. Each party represents and warrants to the other that the execution
delivery and performance ofthis Agnaennent have been duly authorized by all necessary County
and corporate action, as required by law.
`'
INDEMNITY ISSUES
2& INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees
to indernn|fy and hold harmless Monroe County Board of County Commissioners fnonn any and all
dairns for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, orvo|unteers.
29. PRIVILEGES AND IMMUNITIES. All of the privileges and immunities from Uabi|ity,
exernb
�ona from laws, ordinances, and rules and pensions and relief, disability, workers'
compensation, and other benefits which apply to the activity of officers, agents, or employees of
any public agents or employees of the County, when performing their respective functions under
this Agreement within the territorial limits of the County shall apply to the same degree and
extent to the performance of such functions and duties of such officers, agents, volunteersor
employees outside the territorial limits of the County. '
30~ NO PERSONAL LIABILITY. No covenant oragreement contained herein shall be
deemed to he a covenant or agreement of any member, officer, agent or employee of Monroe
County in his or her individual capacity, and no member, officer, agent oremployee of Monroe
County shall be liable personally on this Agreement or be subject to any personal liability or
accountability byreason ofthe execution ofthis Agreement.
31. LEGAL OBLIGATIONS AND RESPONSIBILITIES: Non -Delegation of Constitutional
or Statutory Dubes. This Agreement is not intended to, nor shall it be construed as,relieving any
participating entity from any oNigat|onornsspons|biUimposedLy imposed upon the entity b' |awexoaptto
the extent of actual and timely performance thereof by any participating entity, in which case the
performance may be offered in satisfaction of the obligation or responsibility,
ty Further, this
Agreement is not intended to, nor shall it be construed as, authorizing the delegation ° oo `f the
constitutional or statutory duties of the County, except to the extent permitted by the Florida
consUtuLiun, state statute, and case law.
32. NON -RELIANCE BY NON-PARTIES. No person or entity shall be entitled to rely
upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third -
party claim or entitlement to or benefit of any service or program contemplated hereunder, and
��
the County and the PROVIDER agree that neither the County nor the PROVIDER or any agent,
officer, or employee nfeither shall have the authority to inform, counsel, or otherwise indicate any particular individuol or group of individuals, entity or entities, enL|t|ee'/c= or
^uc �
benefits under this Agreement separate and apart, inferior to, or superior entitlements
to the connrnuni
general orfor the purposes contemplated in this Agreement.
community /n
GENERAL
33. EXECUTION IN COUNTERPARTS. This Agreement may be executed in any number
of counterparts, each of which shall be regarded as an original, all of which taken together shall
GuidanoeCbre Center -Tranv000aNm�Baker Act and C7DpY/4;page 6
constitute one and the sanne instrument and any of the parties hereto may execute this
Agreement by signing any such counterpart.
34. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand -delivered or mailed, postage pre -paid, by certified mail, return receipt requested, to the
other party asfollows:
E_0L_D_0gLd:
Grants Administrator and
11OOSimonton Street
Key West, FL33040
Frank Rabbito,Senior Vice President
Guidance/Care Center Inc,
1205 Fmurth Street
Key West, Florida 33040
UTC
PO Box 1026
Key West, FL 33041
35. GOVERNING LAW, VENUE, INTERPRETATION/ COSTS'AND FEESThis
Agreement shall be governed by and construed in accordance with the laws of ���he ~' ~ Florida
app}icob|e to contracts made and to be performed entirely in the 5bote. -
In the event that any cause of action or administrative proceeding is instituted for the
ennorcernent or interpretation of this Agreement, the County and PROVIDER agree that venue will
||e in the appropriate court or before the appropriate administrative body in Monroe County,
The County and PROVIDER agree that, in the event of conflicting interpretations of the
terms or term of this Agreement by or between any of them the issue shall be submitted to
rnediodon prior to the institution of any other administrative or legal proceeding.
36. NON -WAIVER. Any waiver ofany breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and
shall not operate to bar or prevent the Board from declaring o forfeiture for any succeeding
breach, either ofthe same conditions or covenants or otherwise,
37. SEVERABILITY. If any term, covenant, condition or provision of this Agreement (or
the application thereof to any circumstance or person) shall be declared invalid or unenforceable
to any extent by a court of competent jurisdiction, the remaining terms, covenants conditionsond provisions of this Agreement, shall not be affected thereby; and each remaining ~ term
covenant, condition and provision of this Agreement shall be valid and shall be enforceableh
^e
�o �.
fullest extent permitted by law unless the enforcement of the remaining tcrons covenants,
conditions and provisions of this Agreement would prevent the accomplishment � ~~the original
intent of this Agreement. The County and PROVIDER agree to reform the Agreement to replace
"
any stricken provision with n valid provision that comes as close as possible to the intent of
stricken provision. v/�
38. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
[THIS SPACE INTENTIONALLY LEFT BLANK WITH SIGNATORY PAGE TO FOLLOW1
GuidanueCaTe Center -Tranppoxabon Baker Act and C7D FY/4;page 7
N WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
my, and year first written above,
BOARD OF COUNTY COMMISSIONERS
HEAVILIN, CLERK OF MONROE COUNTY, FLORIDA
By
Deputy Clerk Mayor/Chairman
GUIDANCE/CARE CENTER
(Federal ID No.
Witness
Witness By (5 Dir tor, O�L reac A�v�y&_
Guidance/Care Center
MONROE COUNTY ATTORNEY
.1,APPROVED AS TO FORM:
urlril,') I INt M - LIMBERT-BARROWS
ASSISTANT COUNTYATTORNEY
Date
Guidance Care Center -Transportation: Baker Act and CTD FY14,- page 8
ATTACHMENT A
Expense Reimbursement Requirements
This dwcunnent is intended to provide basic guidelines Lo Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate LVtravel, are from Florida Statute 112.061.
Acover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
°I certify that the above checks have been submitted to the vendors as noted and
that the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are incompliance with this onganizotion'scontract with the
Monroe Cuunty Board of County Commissioners and will not be submitted for
nairnhuraennentioany other funding sounce."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for re|rnbursernenL. Remember, the expense should be paid prior to requesting a reirnburaenneni.
Only currentcharges will be considered, no previous balances.
Re|rnhursernentrequests will be monitored inaccordance with the level ofdetail inthe contraci
This docunnentshould not be considered all-inclusive. The Clerk's Finance Department reserves
-
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines shou|d be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice |srequired for reimbursement. Inter -company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed If
o PayroH]*urna} is provided, it should include: dates, employee name, salary orhourly rabe
Lobmi hours worked, withholding information and paid payroll taxes, check number and check'
amount, If Payroll Journal is not provided, the following information must be provided'`pay
period, check amount, check number, date, payee, support for applicable paid payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reinnbursenncnt
For overnight orexpress deliveries, the vendor invoice nnuatbeincluded.
'
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
Alog ofcopy expenses asthey relate bmthe County contract isrequired for rainnburscnnenL The
log must define the dote, number of copies made, source document, purpose and recipient. A
reamouab�e fee for copy expenses will be allowable, For vendor services, the ' vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
GvdanceCareCenter-TramsportatioxBakm Act and CTDFY/4; page 9
Telefax, Fax, etc.
A fax log is required, The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fox.
Telephone Expenses
Auser log of pertinent information must be rernitted including: the party called, the callerthe
telephone number, the date, and the purpose of the call, '
Travel Expenses
Travel expenses rnust be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel reimbursement requests must besubmitted and will be paid in accordance with
Monroe County Code of Ordinances and State laws and regulations. Credit card statements are
not acceptable documentation for reimbursement, Ifattending econference Prmeeting acopy of
the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of
the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental
re|nnbursennent requires the vendor invoice. Fuel purchases should be documented with paid
receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a
taxi from one's residence to the airport for a business trip is not reimbursable, Parking is
considered a reimbursable travel expense atthe destination. Airport parking ` during a business
trip is not,
A detailed list of charges is required on the lodging invoice. Balance due must be zero Roommust be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Mileage reimbursement shall beatthe rate established by ARTICLE XXVI, �
TRAVEL PER DlEy4
MEALS, AND MILEAGE PC)LI[Yofthe Monroe County [ode of Ordinances. An odometer reading
'
must be included on the state travel voucher for vidoitytravel. Mileage is not oU~~' allowed [rfromm
residence or office to a point of departure, For example, driving from one's hornthe airport ~ `° r1
for business trip is not reimbursable expense,
pv
Meal reirnburoernenLshaU be at the rates established by ARTICLE XXVI, TRAVEL PER DlEM
MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. Meal ' guidelines DIEM,
that travel must begin prior to 6 o rn for reimbursement, before ^ � �
. . ,noonandendafter2
p.rn. for lunch ,eirnbursernent, and before 6 p.m. and end after—�`.rd|nnerreinnbursernenL
Non -allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included inthe contraci) contributions, depreciation
|nduded |n the contract), entertainment
�«Pe»sesi(un!esssped�cmUy
pena|t|esandfines. ' ''' ' noru/s/ g'non-�uR|cenLcAeckch�pges,
Guidance Care Center -Transportation: 6aker Act and C7DFY/4;page /n
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
The following is a Summary of the expenses for for the time period
of to
Check #
Payee Reason
Amount
101,
Company A Rent
$ X'XmXX
1.02
Company B Utilities
XXX.XX
104
Employee A P/R ending 05/14/01
XXX.XX
105
Employee B P/R ending 05/28/01
XXX.XX
(A)
Total
(B)
Total prior payments
$ X'XmXX
(C)
Total requested and paid (A + B)
$ X'XXX.XX
(D)
Total contract amount
$ X'XXX.XX
Balance of contract (D-C)
4 1 MX AXA
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organization's contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Attachments (supporting documentation)
Sworn to and subscribed before me this day Of __ 20
who is personally known to me.
Notary Public Notary Stamp
Guidance Care Center -Transportation: Baker Act and CTD FY14,- page 1 I
ATTACHMENT C
Insert a list of the services that will be provided by your organization Linder this contract.
services and Community Transportation nLs �rtatign on C
Lcdqt-E�d�5r�f vices — oordinatQr
Gaidance Care Center —Transportation: Baker Act and CTD FY14; page 12
ATTACHMENT D
QQP_Y_9t_5uta-Qcr tract for Baker Act firarrs ortatican services. _See attaghed.
Guidance (,,wo Center —Transportation: Baker Act and CTD FY14; page 13
"A person or affiliate who has been placed on the convicted vendor list following a conviction for
public entity crime may not submit a bid on a contract to provide any goods orservices hum
public entity, may not submit a bid on a contract with a public entity for the construction or repair
of a public building or public work, may not submit bids on leases of nzm| property to public enbty, may not be awarded or perform work as contractor, supp!ier, subcon1roctor, or consultant
'
under contract with any public entity, and may not transact ' - any business with �'public entity in
nn
excess ofthe threshold aountprovided inSection 287.O17, -rCATE{�OKY�TWO for aperiod of
36 months from the date of being placed on the convicted vendor list."
Guidance Care Cwnte»-TramsportationBaherAct and CTDRo4; page 14
BVVURN STATEMENT UNDER ORDINANCE NO, 1O-l99O
MONROE COUNTY, FLORIDA
ETHACS CLAUSE
-warrants that lie/it has not employed, retained or
a6prwise had act on h_isfifs' /behalf any former County officer or employee in violation of Section 2
of Ordinance No, 10-1990 or any County officer or employee in violation of Section 3 of Ordinance
No. 10-1990, For breach or violation of this provision the County may, in its discretion, terminate
this contract without liability and may also, in its discretion, deduct from the contract or purchase
price, ot otherwise recover, the full amount of any fee, commission, percentage, gift, or
consideration paid to the former County officer or employee.
STATE OF j
PERSONALLY APP
BEFORE ~- the
who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided a
,20_�~�. /
My c0rnrn|ssion expires:
OMB - MCP FORM #4
on this day of
GuidamcecaeCenoer-TraosportationBakerAct arld CTDFY,4; pagets
DRUG -FREE WORKPLACE FORM
ndersign ed vendor in jccordance with Florida Statute 287.087 hereby certifies that:
me of Business)
1. Publishes a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace and
specifying the actions that will be taken against employees for violations of such prohibition.
2. Informs employees about the dangers of drug abuse in the workplace, the business's policy of
maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee
assistance programs, and the penalties that may be imposed upon employees for drug abuse
violations.
3. Gives each employee engaged in providing the commodities or contractual services that are
under bid a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notifies the employees that, as a condition of
working on the commodities or contractual services that are under bid, the employee will abide by
the terms of the statement and will notify the employer of any conviction of, or plea of guilty or
nolo contenders to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance
law of the United States or any state, for a violation occurring in the workplace no later than five
(5) days after such conviction.
5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is
so convicted.
6. Makes a good faith effort to continue to maintain a drug -free workplace through
implementation of this section.
As the person authorized to sign the statement, I certify that t is firm complies fully with the
above requirements. _ J
STATE OF G� /
(Si atur of espondent) 4z4vz-
/_/3 -
COUNTY OF
of
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
individual si ninfaffflx�edhis�/Iherignature inthespace er rprovided abovest being sworn bonnthis(name of
/ day of f y e_ , 20
My commission expires:
W= IL
Is. ftM0"ft IP N 21M7
amp pwft • !gb « Hasa
0@a& loft *4 f, 2016
Guidance Care Center -Transportation: Baker Act and CTD FY14; page '*-0,