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Item G23BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: November 20, 2013 Division: {}MB Department: Grants Administration Staff Person: Laura deLoach-Hartle Ext: 4482 AGENDA ITEM WORDING: Authorization for the Mayor to execute a Memorandum of Understanding with Florida Keys Outreach Coalition Supportive Housing: Substance Abuse Education and Relapse Prevention Program, for the period from Oct 1, 2013 through Sept 3O, 2014. ITEM BACKGROUND: Federal funds are provided through the Florida Department of Law Enforcement. Substance Abuse Policy Advisory Board (SAPAB) reviews proposals and makes recommendations to BOCC for local funding of programs. PREVIOUS RELEVANT BOCCACTION: Approval to apply for grant funds was given at the July 2013 meeting. Certificate of Acceptance for Sub-grant Award from FDLE is also on the agenda for this meeting. CONTRACT/AGREEMENT CHANGES: None. STAFF RECOMMENDATION: Approval TOTAL COST: $7,508 Indirect Cost: BUDGETED: Yes E No F COST TO COUNTY: $0 SOURCE OF FUNDS: FDLE DIFFERENTIAL OF LOCAL PREFERENCE: REVENUE PRODUCING: Yes MNo AMOUNT PER MONTH YEAR APPROVED BY'COUNTY AB/PURCHASING c� RISK MANAGEMENT �A�� DOCUMENTATION: INCLUDED: ZTO FOLLOW: F1 NOT REQUIRED: Fl DISPOSITION: - AGENDA ITEM #: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Florida Keys Outreach Effective Date: 10/01/13 Coalition, Inc. � Contract Purpose/Desorption: Funds provided through RJLE Agreement for the Florida Keys �Outreach Coalition Supportive Housing: Substance Abuse Education and Relapse Prevention Program. Contract Manager: 4482 OMB/Grants Admin. jor BOCC meeting on 11/20/13 encla Deadli CONTRACT COSTS Total Dollar Value of Contract: $7,508 Current Year Portion: $7,508 Budgeted? Yes X No Account Codes: 1 25 - 06050-530490-GG1403 County Match: $0 ADDITIONAL COSTS CONTRACT REVIEW Division Director Date In Date Out 0 '"=..�=" r/�-L/r-) r/t-r */- EDWARD BYRNE MEMORIAL JUSTICE ASSISTANCE GRANT PROGRAM FUNDS AGREEMENT THIS AGREEMENT is made and entered into this 20th day of November, 2013, by and between MONROE COUNTY, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, FL 33040, hereinafter referred to as "COUNTY," and Florida Keys Outreach Coalition, Inc. hereinafter referred to as "AGENCY." W ITN ESS ETH WHEREAS, the Florida Department of Law Enforcement has awarded a sub -grant of Edward Byrne Memorial Justice Assistance to the COUNTY to implement a program that provides substance abuse education and relapse prevention services; and WHEREAS, the COUNTY is in need of an implementing agency to provide said services under this Program; and WHEREAS, the AGENCY is the sole provider of this program; and WHEREAS, the COUNTY has agreed to disburse the Edward Byrne Memorial Justice Assistance Grant funds to the AGENCY in accordance with the COUNTY'S application for the Edward Byrne Memorial Assistance Grant. NOW THEREFORE, in consideration of the mutual understandings and agreements set forth herein, the COUNTY and the AGENCY agree as follows: 1. TERM - The term of this Agreement is from October 1, 2013 through September 30, 2014, the date of the signature by the parties notwithstanding, unless earlier terminated as provided herein. 2. SERVICES - The AGENCY will provide services, in compliance with all provisions, as outlined in the COUNTY'S Edward Byrne Memorial Justice Assistance Sub - grant Award, attached and made a part hereof (Attachment C). 3. FUNDS - The total project budget to be expended by the AGENCY in performance of the services set forth in Section 2 of this agreement shall be the total sum of $7,508. All funds shall be distributed and expended in accordance with the Project Budget Narrative as outlined in the grant agreement. 4. INCORPORATION BY REFERENCE - The provisions of those certain documents entitled "State of Florida Office of Criminal Justice Grants Florida Department of Law Enforcement Sub -grant Award Certificate and Application" and all laws, rules and regulations relating thereto are incorporated by reference (Attachment C). 5. BILLING AND PAYMENT (a) The AGENCY shall comply with the program and expenditure reporting requirements for Byrne Grant funds. The AGENCY shall render to the COUNTY a detailed a quarterly performance report not later than 7 days after the end of each quarter. The quarterly performance reports must include a response to all objectives included in your project, as described in the Performance section in the grant agreement. A detailed narrative, reflecting on accomplishments, challenges, etc. is required as part of this quarterly report. The AGENCY shall render to the COUNTY, monthly itemized invoices, not later than 30 days after the end of each month, properly dated, describing the services rendered, the cost of the services, and all other information required. The original invoice shall be sent to: Grants Administrator 110O Simonton Street Key West, FL33O4O (b) Payment shall be made after review and approval by the COUNTY within thirty (30) days of receipt of the correct and proper invoice submitted by the AGENCY. (c) The County shall only reimburse subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Monroe County Code of Ordinances, State laws and regulations and Attachment — Expense Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of letter, summarizing the expenses with supporting documentation attached. The letter should contain a notarized certification statement. An example ofa reimbursement request cover letter is included as Attachment B. G. TERMINATION - ThisAgreernent may be terminated b pa�yatany time, with or without cause, upon not less than thirty (30) days written notice delivered to the other party. The COUNTY shall not be obligated to pay for any services provided by the AGENCY after the AGENCY has received notice of termination. 7. ACCESSTOFINANCIALRE[DROS - TheAGENCYshaUrnaintainappnophate financial records which shall be open to the public at reasonable times and under reasonable conditions for inspection and examination and which comply with the Agreement incorporated in Section 4 of this Agreement. 0. AUDTT - TheAGENCYshaUsubrnittotheCOUNTYanauditreportoovehngthe term of this Agreement, within one-hundred twenty (120) days following the Agreement's lapse or early termination and shall also comply with all provisions of the Agreement incorporated in Section 4 of this Agreement. 9. NOTICES - Whenever either party desires togive notice unto the other, it must be given by written notice, sent by registered United States mail, with return receipt requested, and sent to: FOR COUNTY: FOR PROVIDER: Grants Administrator Stephen E. Braddock, President 1100 Simonton Street Florida Keys Outreach Coalition, Inc Key West, FL 33040 2221 Patterson Avenue Key West, FL33O4O Either ofthe parties may change, by written notice as provided above, the addresses or persons for receipt of notices. 10. UNAVAILABILITY OF FUNDS - If the COUNTY shall learn that funding from the Florida Department ofLaw Enforcement cannot be obtained or cannot be continued at level sufficient to a||ovv for the services specified herein, this Agreement may then be terminated immediately, at the option of the COUNTY, by written notice of termination delivered in person or by mail to the AGENCY at its address specified above. The COUNTY shall not be obligated to pay for any services provided by the AGENCY after the AGENCY has received notice of termination. 11. COMPLIANCE WITH LAWS AND RE(SULATIONS- In providing all services pursuant to this Agreement, the AGENCY shall abide by all statutes, ordinances, rules, and regulations pertaining to, or regulating the provision of, such services, including those now in effect and hereafter adopted, and particularly Article 1, Section 3 of the Constitution of the State of Florida and Article 1 of the United States Constitution, which provide that no revenue of the state or any political subdivision shall be utilized, directly or indirectly, in aid of any church, sect or religious denomination or in aid of any sectarian institution. Any violation of said statutes, ordinances, rules, or regulations shall constitute a material breach of this Agreement immediately upon delivery of written notice of termination to the AGENCY. If the AGENCY receives notice of material breach, it will have thirty days in order to cure the material breach of the contract. If, after thirty (�O) days, the breach has not been cured, the contract will autornatica||ybeterrninated. ' ' 12. ASSIGNMENTS AND SUBCONTRACTING - Neither party to this Agreement shall assign this Agreement or any interest under this Agreement, or subcontract any of its obligations under this Agreement, without the written consent of the other. 13. EMPLOYEESTATUS — TheAGENCYisanindependentcontractor. Persons employed by the AGENCY in the performance of services and functions pursuant to this Agreement shall have no claim to pension, worker's compensation, unemployment compensation, civil service or other employee rights or privileges granted to the COUNTY'S officers and employees either by operation of law or by the COUNTY. 14. INDEMNIFICATION - TheAGENCYagreesto hold harmless, indemnify, � and defend the COUNTY, its commissioners, officers, employees, and agents against any and all claims, losses, damages, or lawsuits for damages, arising from, allegedly arising from, or related to the provision of services hereunder by the AGENCY. 15. ENTIRE AGREEMENT (a) It is understood and agreed that the entire Aoreernent of the parties is contained herein and that this Agreernentsupersedes all oral agreements and negotiations between the parties relating to the subject matter hereof as well as any previous agreements presently in effect between the parties relating to the subject matter hereof. (b) Any alterations, amendments, deletions, or waivers of the provisions of this Agreement shall be valid only when expressed in writing and duly signed by the parties. IN WITNESS WHEREOF, the parties to this Agreement have caused their names to be affixed hereto by the proper officers thereof for the purposes herein expressed at Monroe County, Florida, on the day and year first written above. (SEAL) ` ' BOARDOF COUNTY COMMISSIONERS ATTEST: AMY HEAVILIN, Clerk OF MONROE COUNTY, FLORIDA in By: Florida Deputy Clerk Witness Witness Keys Outreach Coalition, Inc. Title: ATTACHMENT Expense Reimbursement Requirements This document is intended to provide basic guidelines to Human Service and Community- Based Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from the Monroe County Code of Ordinances and State laws and regulations. A cover letter (see Attachment B) summarizing the major line items on the reimbursable expense request needs to also contain the following notarized certified statement: "I certify that the above checks have been submitted to the vendors as noted and that the attached 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." Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the conLract. This document should 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 should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required 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 Payroll Journal is provided, it should include: dates, employee name, salary or hourly robe, total 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 reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number ofcopies made, source document, purpose, and rec A reasonable 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. lFeUefa», Fax, etc~ Afax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller the telephone number, the date, and the purpose of the call. ' Travel and Meal Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel reimbursement requests must be submitted 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. If attending a conference or meeting a copy 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 reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at 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 at the 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 Room must 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 be at the rate established by ARTICLE XXVI, TRAVEL, PER DIEM, MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving from one's home tothe airport for a business trip is not reimbursable expense. Meal reimbursement shall be at the rates established by ARTICLE XXVI,TRAVEL, PER DIEM [�EALS,AND MILEA(�EPOLICY of the [�onroeCounty Code ofOrdinances. Meal guidelines ' state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after pm. for lunch reimbursement, and before p.m. and end after p.rn for dinner reimbursement. ' Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising non-sufficient check charges, penalties and fines. ' ''' ATTACHMENT 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 (Organization name) for the time period of to Check# Payee Reason Amount 101 Company Rent $X,XXX.XX 102 Company Utilities XXX.XX 104 Employee P/Rending 05/14/01 XXX.XX 105 Employee p/R ending O5/28/O1 XXX.XX (A) ` ^ Tota| $X,XXX.XX (B) Total prior payments $ X,XXX.XX (C) Tota| requested and paid (A+B) $X,XXX.XX (D) ' Tota|contra�tarnount $X,XXX.XX Balance of contract (DC) 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. Furtherrnore these expenses are in cornp|ianoewith this organization's contract with the Monroe County ' Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this day of 20 __ by who is personally known tome. Notary Stamp Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide Subgrant Recipient Organization Name: Monroe County Board of Commissioners County: Monroe Chief Official Name: George Neugent Title: Mayor Address: 1100 Simonton Street City: Key West State: FL Zip: 33040 -3110 Phone: 305 - 289 -6039 Ext: Fax: 305 - 872 -9195 Email: neugent - george @monroecounty -fl.gov Chief Financial Officer Name: Amy Heavilin Title: Clerk of Court Address: 500 Whitehead Street City: Key West State: FL Zip: 33040 -3110 Phone: 305 - 295 -3130 Ext: Fax: Email: aheavilin @monroe - clerk.com Attachment C Application Ref # 2014 -JAGC -2342 Section #1 Page 1 of 2 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Implementing Agency Organization Name: Monroe County Board of Commissioners County: Monroe Chief Official Name: George Neugent Title: Mayor Address: 1100 Simonton Street City: Key West State: FL Zip: 33040 -3110 Phone: 305 - 289 -6039 Ext: Fax: 305 - 872 -9195 Email: neugent- george @monroecounty -fl.gov Project Director Name: Laura Deloach - Hartle Title: Senior Administrator- Grants & Special Projects Address: 1100 Simonton Street Email: deloachhartle -laura @monroecounty -fl.gov Application Ref # 2014 -JAGC -2342 Section #1 Page 2 of 2 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Room 2 -285 City: Key West State: FL Zip: 33040 -3110 Phone: 305 - 292 -4482 Ext: Fax: Email: deloachhartle -laura @monroecounty -fl.gov Application Ref # 2014 -JAGC -2342 Section #1 Page 2 of 2 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide - General Project Information Project Title: FKOC SUPPORTIVE HOUSING: SUBSTANCE ABUSE EDUCATION & RELAPSE PREVENTION Subgrant Recipient: Monroe County Board of Commissioners Implementing Agency: Monroe County Board of Commissioners Project Start Date: 10/1/2013 End Date: 9/30/2014 Problem Identification a. Abstinence and relapse prevention is the most important part of substance abuse recovery and the most successful relapse prevention program is one that can be reliably sustained over a long period of time. Frequent urine testing has been shown to increase the probability of remaining abstinent from alcohol and illegal drugs. Alcohol and substance abuse prevention and education programs are essential components in helping individuals heal, attain lives of sobriety, independence and self- sufficiency as contributing members of society. b. Last year, 59 % of adults served by the Florida Keys Outreach Coalition (FKOC) supportive housing programs had a documented criminal history; 99% of those individuals were in recovery from alcohol and substance abuse; 62% were repeat offenders. c. Addiction and relapse very often precipitates offender recidivism. The greatest potential to reduce re- incarceration and drug relapse among offenders is a continuum of treatment; one that incorporates the need for complimentary services such as housing, peer support, life skills education and relapse prevention. Reporting for grant year October 1, 2012 through second quarter ending March 315 FKOC admitted sixty -eight (68) adults with a criminal background history; 12% entered the program by referral of the Offender Release Program and court; 29 individuals (43 %) entered the program by referral of Monroe County Sheriffs Office CARE4U Jail Diversion Program. Under the current grant year, FKOC administered 5,172 drug tests through May, 2013. Two Hundred Ninety -nine (299) adults were served by FKOC in the previous year; 83% completed the transitional housing program clean and sober and exited to permanent housing. One hundred percent (100 %) of the grant recipients receive individualized case management and additional services including life skills education; life enrichment programs; health education /screenings; support with crisis intervention, advocacy and links to community and mainstream resources. All clients served by Byrne Memorial Justice Assistance Grant will have a documented history with the criminal justice system. Project Summary (Scope of Work) All clients served under the Edward Byrne Memorial Justice Assistance Grant Program will have a documented history with the criminal justice system. Application Ref # 2014 -JAGC -2342 Section #2 Page 1 of 3 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County-wide FkOC's program incorporates the Twelve Steps ofAA and focuses on the fundamentals of recovery. Clients are tested on-site frequently and randomly for drug and alcohol use and are required to attend ANNA meetings for the first 90-days in the program and then as deemed appropriate by their case manager, sponsor and /or professional counselor. Drug tests detect the use ofalcohol, cocaine, THC, Amphetamines, benzodiazmpne, opiates, synthetic cannabis and oxynndone. FKOC will purchase testing supplies and administer a minimum of 5,800 alcohol/drug tests between October 1, 2013 and September 30,2014. FKOC's supportive services include: > Alcohol and drug abuse relapse prevention and education Application Het # 2014JAGC-2342 Contract 2014-JAGC-MONR-1'E5-186 Section #2 Page 2 of 3 Rule Reference /1oe.mmooJo-0oo(rew. October z000 Question: Does the Implementing Agency receive a single grant in the amount of $500,000 or more from the U.S. Department of Justice? Answer: No Question: Part 1: In your business or organization's preceding completed fiscal year, did your business or organization (the subgrantee) receive (1) 80 percent or more of your annual gross revenues in U.S. federal contracts, subcontracts, loans, grants, subgrants, and /or cooperative agreements; and (2) $25,000,000 or more in annual gross revenues from U.S. federal contracts, subcontracts, loans, grants, subgrants, and /or cooperative agreements? If yes, answer "yes" or "no" to Part 2, below. Answer: No Question: Part 2: Does the public have access to information about the compensation of the executives in your business or organization (the subgrantee) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? If answer to Part 1, above, was "no," answer N /A. Answer: N/A Application Ref # 2014 -JAGC -2342 Contract 2014 - JAGC - MONR -1 -E5 -186 Section #2 Page 3 of 3 Rule Reference 11 D4006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide General Performance Info: Performance Reporting Frequency: Quarterly Federal Purpose Area: 003 - Prevention and Education Programs State Purpose Area: PE - Prevention and Education: Includes activities where individuals are served, directly or indirectly. Activities may include one -time events, services, or events and services that occur on a continual basis. Activity Description Activity: Prevention and Education Target Group: Prevention and Education Geographic Area: Urban Location Type: County -Wide Objectives and Measures Objective: PE1 - Report on JAG funding allocated for prevention and education Measure: Part 1 How much JAG funding has been allocated for Prevention and Education? Please report in dollars ($). Goal: 7508.00 Objective: PE2 - Provide prevention or education programs Measure: Part 1 How many prevention or education programs will you implement? Goal: 1 Measure: Part 2 Of the prevention or education programs to be implemented, how many will be substance abuse prevention or education programs? Goal: 1 Measure: Part 3 What types of prevention or education programs will you provide? In your response, please list all that apply from the following choices: Anti -gang, Anti -drug, Cognitive, Crime Prevention, Drug Prevention, Educational, Employment, Gang Resistance, GED, Housing, Job Skills, Mental Health, Mentoring, Pro - social, Substance Abuse, Truancy, Vocational, Other. Do not select other if your item fits into any of the categories above. If other, state 'other" and specify. Goal: Anti -drug, Drug Prevention, Substance Abuse Application Ref # 2014 -JAGC -2342 Section #3 Page 1 of 3 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide Measure: Part 1 Goal: How many prevention or education programs will you implement? Measure: Part 2 Of the prevention or education programs to be implemented, how many will be substance abuse prevention or education programs? Goal: 1 Measure: Part 3 What types of prevention or education programs will you provide? In your response, please list all that apply from the following choices: Anti -gang, Anti -drug, Cognitive, Crime Prevention, Drug Prevention, Educational, Employment, Gang Resistance, GED, Housing, Job Skills, Mental Health, Mentoring, Pro - social, Substance Abuse, Truancy, Vocational, Other. Do not select other if your item fits into any of the categories above. If other, state 'other" and specify. Goal: Anti -drug, Drug Prevention, Substance Abuse Application Ref # 2014 -JAGC -2342 Section #3 Page 2 of 3 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide 1 k Section Questi Question: If "other" was selected for the geographic area, please describe. Answer: n/a Question: If "other' was selected for location type, please describe. Answer: n/a Application Ref # 2014 -JAGC -2342 Section #3 Page 3 of 3 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide General Financial Info: Note: All financial remittances will be sent to the Chief Financial Officer of the Subgrantee Organization. Financial Reporting Frequency for this Subgrant: Quarterly Is the subgrantee a state agency ?: No FLAIR / Vendor Number: 596000749 Budget: Budget Category Federal Match Total Salaries and Benefits $0.00 $0.00 $0.00 Contractual Services $7,508.00 $0.00 $7,508.00 Expenses $0.00 $0.00 $0.00 Operating Capital $0.00 $0.00 $0.00 Outlay Indirect Costs $0.00 $0.00 $0.00 -- Totals -- $7,508.00 $0.00 $7,508.00 Percentage 100.0 0.0 100.0 Project Generated Income: Will the project earn project generated income (PGI) ? No Application Het # 2014 -JAGC -2342 Section #4 Page 1 of 3 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide Budget Narrative: Contractual Services Expenses: Alcohol /Drug Test Kits $7,508 Total Expenses $7,508 A Calculated average cost per unit is 1.29 per test. TOTALS 5,800 tests @ approx. 1.29 per unit = $7,507.50 Monroe County will execute a contract with Florida Keys Outreach Coalition, Inc. for the period of October 1, 2013 through September 30,2014 to cover the grant period. A copy of the executed contract will be sent to FDLE. Application Het # 2014 -JAGC -2342 Contract 2014 - JAGC - MONR -1 -E5 -186 Section #4 Page 2 of 3 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide Section Questions: Question: If salaries and benefits are included in the budget as actual costs for staff in the implementing agency, is there a net personnel increase, or a continued net personnel increase from the previous Byrne program? Answer: N/A Question: If benefits are to be included, are they reflected in the budget narrative? Answer: N/A Question: Indicate the Operating Capital Outlay threshold established by the subgrantee or implementing agency, if it is the sheriffs office. Answer: N/A Question: If indirect cost is included in the budget, indicate the basis for the plan (e.g. percent of salaries and benefits), and provide documentation of the appropriate approval of this plan. Answer: N/A Question: If the budget includes services based on unit costs, provide a definition and cost for each service as part of the budget narrative for contractual services. Include the basis for the unit costs and how recently the basis was established or updated. Answer: Vendor: Alere Toxicology, Inc. MultiPanel 175 $3.40 $595.00 SynCan 150 $6.00 $900.00 Alcohol 1,525 $2.00 $3,050.00 Cocaine 1,500 $0.75 $1,125.00 THC 1,500 $0.75 $1,125.00 Oxy 200 $0.75 $150.00 Opi /Mor 250 $0.75 $187.50 Amp 250 $0.75 $187.50 Benzo 250 $0.75 $187.50 Totals 5,800 $7,507.50 Individual test screens range from $75 to $6.00 depending upon the substance type. Approximate average cost per unit is $1.29. Application Ref # 2014 -JAGC -2342 Section #4 Page 3 of 3 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D4006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide Insert Standard Conditions Page here. Application Ref # 2014 -JAGC -2342 Contract 2014 - JAGC - MONR -1 -E5 -186 Section #5 Page 1 of 1 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide In witness whereof, the parties affirm they each have read and agree to the conditions set forth in this agreement, have read and understand the agreement in its entirety and have executed this agreement by their duty authorized officers on the date, month and year set out below. Signature: Typed Name and Title: Date: Signature: Typed Name and Title: Date: Signature: Typed Name and Title: Date: Application Ref # 2014 -JAGC -2342 Contract 2014 - JAGC - MONR -1 -E5 -186 Section #6 Page 1 of 1 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) Corrections on this page, including Strikeovers, whiteout, etc. are not acceptable. Typed Name of Subgrant Recipient: Typed Name of Implementing Agency: Application for Funding Assistance Florida Department of Law Enforcement Justice Assistance Grant - County -wide !4 Insert Certifications and Authorizations here. Application Ref # 2014 -JAGC -2342 Section #7 Page 1 of 1 Contract 2014 - JAGC - MONR -1 -E5 -186 Rule Reference 11 D -9.006 OCJG -005 (rev. October 2005) ATTACHMENT PUBLIC ENTITY CRIME STATEMENT "4 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 or services to a public entity, may not submit bid on a contract with a public entity for the construction or repair ofa public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work aaa contractor, supplier, subcontractor, or consultant under contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor |iat." ATTACHMENT SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its 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, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. Date: PERSONALLY APPEARED BEFORE ME, the undersigned authority, vvhn his/her signature (name of individual signing) i ' day of 20 after first being sworn bv me, affixed the space provided above on this My commission expires: DRUG-FREE WORKPLACE FORM ATTACHMENT The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: (Name of Business) 1. Publishes statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of 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 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 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 nnlV cpnhendere to, any violation of Chapter 893 (Florida Statutes controlled substance |avv of the United States or any state, fora violation occurring in t' e workplace no later than five (5) days after such conviction. 5. Imposes sanction on, or require the satisfactory participation in 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 o through implementation of this section. As the person authorized to sign the statement, l certify that this firm complies fully with the above Ififfifflm 91��� (Signature of Respondent) Date PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, (name of individual signing) affixed his/her signature in the apace provided above on this day of Notary Public My commission expires: