09/14/2019 Agreement STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Standard Grant Agreement
This Agreement is entered into between the Parties named below,pursuant to Section 215.971,Florida Statutes:
1. Project Title(Project): Agreement Number:
Monroe County Vessel Pump Out Program MV353
2. Parties State of Florida Department of Environmental Protection,
3900 Commonwealth Boulevard
Tallahassee,Florida 32399-3000 (Department)
Grantee Name: Monroe County Board of County Commissioners Entity Type: Local Government
Grantee Address: 2798 Overseas Hwy,Suite 420,Marathon,FL 33050 FEID: 59-6000749
(Grantee)
3. Agreement Begin Date:
7/01/2019 Date of Expiration:
6/30/2020
4. Project Number: Project Location(s):
(If different from Agreement Number) 2798 Overseas Hwy.,Suite 420,Marathon,FL 33050
Project Description:
Monroe County vessel pump out program
5. Total Amount of Funding: Funding Source? Award#s or Line Item Appropriations: Amount per Source(s):
$750,000.00 C 'State ❑Federal Line Item No. 1613,GAA,Fiscal Year 2019-2020 $750,000.00
❑ State ❑Federal
❑ Grantee Match
Total Amount of Funding+Grantee Match, if any: $750,000.00
6. Department's Grant Manager Grantee's Grant Manager
Name: Shelley Ayers Name: Richard Jones
or successor or successor
Address: 3900 Commonwealth Blvd.,MS 235 Address: 2798 Overseas Hwy.,Suite 420
Tallahassee,Florida 32399 Marathon,Florida 33050
Phone: 850-245-2074 Phone: 305-289-2805
Email: shelley.ayers@floridadep.gov Email: Jones-Rich(a,monroecounty-fl.gov
7. The Parties agree to comply with the terms and conditions of the following attachments and exhibits which are hereby
incorporated by reference:
✓Attachment 1: Standard Terms and Conditions Applicable to All Grants Agreements
WI Attachment 2: Special Terms and Conditions
V Attachment 3: Grant Work Plan
✓ Attachment 4:Public Records Requirements
V Attachment 5: Special Audit Requirements
❑ Attachment 6:Program-Specific Requirements
❑ Attachment 7: Grant Award Terms(Federal)*Copy available at https://facts.fldfs.com,in accordance with§215.985,F.S.
❑ Attachment 8:Federal Regulations and Terms(Federal)
❑ Additional Attachments(if necessary):
'Exhibit A:Progress Report Form
❑ Exhibit B:Property Reporting Form
Exhibit C:Payment Request Summary Form
❑ Exhibit D: Quality Assurance Requirements for Grants
El Exhibit E:Advance Payment Terms and Interest Earned Memo
El Additional Exhibits(if necessary):
DEP Agreement No. MV353 Rev.6/20/18
8. The following information applies to Federal Grants only and is identified in accordance with 2 CFR 200.331(a)(1):
Federal Award Identification Number(s)(FAIN): _
Federal Award Date to Department:
Total Federal Funds Obligated by this Agreement:
Federal Awarding Agency:
Award R&D? ❑ Yes EN/A
IN WITNESS WHEREOF,this Agreement shall be effective on the date indicated by the Agreement Begin Date above or the
last date signed below,whichever is later.
Monroe County Board un Commissioners GRANTEE
Grantee Name
By Oil. i4•,01-D/
(Autho ized Signatu ) Date Signed
Print Name and Title of Person Signing
State of Florida De artment of Environmental Protection DEPARTMENT
By q 1 a6I/-I
Secretary or Designee _ Date Signed
I►'l C� V��� Y lal.A/
Print Name and Title of Person Signing
❑ Additional signatures attached on separate page.
MONR
OE COUNTY ATTORNEY
TO,FORM.
a..
Date: O/r
DEP Agreement No. MV353
Rev.6/20/18
STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
STANDARD TERMS AND CONDITIONS
APPLICABLE TO GRANT AGREEMENTS
ATTACHMENT 1
1. Entire Agreement.
This Grant Agreement,including any Attachments and Exhibits referred to herein and/or attached hereto(Agreement),
constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior
agreements, whether written or oral, with respect to such subject matter. Any terms and conditions included on
Grantee's forms or invoices shall be null and void.
2. Grant Administration.
a. Order of Precedence. If there are conflicting provisions among the documents that make up the Agreement,the
order of precedence for interpretation of the Agreement is as follows:
i. Standard Grant Agreement
ii. Attachments other than Attachment 1,in numerical order as designated in the Standard Grant
Agreement
iii. Attachment 1, Standard Terms and Conditions
iv. The Exhibits in the order designated in the Standard Grant Agreement
b. All approvals,written or verbal,and other written communication among the parties, including all notices,shall
be obtained by or sent to the parties' Grant Managers. All written communication shall be by electronic mail,
U.S.Mail,a courier delivery service,or delivered in person. Notices shall be considered delivered when reflected
by an electronic mail read receipt,a courier service delivery receipt,other mail service delivery receipt,or when
receipt is acknowledged by recipient. If the notice is delivered in multiple ways, the notice will be considered
delivered at the earliest delivery time.
c. If a different Grant Manager is designated by either party after execution of this Agreement,notice of the name
and contact information of the new Grant Manager will be submitted in writing to the other party and maintained
in the respective parties' records. A change of Grant Manager does not require a formal amendment or change
order to the Agreement.
d. This Agreement may be amended,through a formal amendment or a change order,only by a written agreement
between both parties. A formal amendment to this Agreement is required for changes which cause any of the
following: (1) an increase or decrease in the Agreement funding amount; (2) a change in Grantee's match
requirements; (3)a change in the expiration date of the Agreement;and/or(4)changes to the cumulative amount
of funding transfers between approved budget categories, as defined in Attachment 3, Grant Work Plan, that
exceeds or is expected to exceed twenty percent (20%) of the total budget as last approved by Department. A
change order to this Agreement may be used when: (1)task timelines within the current authorized Agreement
period change;(2)the cumulative transfer of funds between approved budget categories,as defined in Attachment
3,Grant Work Plan,are less than twenty percent(20%)of the total budget as last approved by Department;and/or
(3)fund transfers between budget categories for the purposes of meeting match requirements. This Agreement
may be amended to provide for additional services if additional funding is made available by the Legislature.
e. All days in this Agreement are calendar days unless otherwise specified.
3. Agreement Duration.
The term of the Agreement shall begin and end on the dates indicated in the Standard Grant Agreement, unless
extended or terminated earlier in accordance with the applicable terms and conditions. The Grantee shall be eligible
for reimbursement for work performed on or after the date of execution through the expiration date of this Agreement,
unless otherwise specified in Attachment 2, Special Terms and Conditions. However, work performed prior to the
execution of this Agreement may be reimbursable or used for match purposes if permitted by the Special Terms and
Conditions.
4. Deliverables.
The Grantee agrees to render the services or other units of deliverables as set forth in Attachment 3,Grant Work Plan.
The services or other units of deliverables shall be delivered in accordance with the schedule and at the pricing outlined
in the Grant Work Plan. Deliverables may be comprised of activities that must be completed prior to Department
making payment on that deliverable.The Grantee agrees to perform in accordance with the terms and conditions set
forth in this Agreement and all attachments and exhibits incorporated by the Standard Grant Agreement.
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5. Performance Measures.
The Grantee warrants that: (1)the services will be performed by qualified personnel; (2)the services will be of the
kind and quality described in the Grant Work Plan; (3) the services will be performed in a professional and
workmanlike manner in accordance with industry standards and practices; (4) the services shall not and do not
knowingly infringe upon the intellectual property rights,or any other proprietary rights,of any third party;and(5)its
employees,subcontractors,and/or subgrantees shall comply with any security and safety requirements and processes,
if provided by Department,for work done at the Project Location(s).The Department reserves the right to investigate
or inspect at any time to determine whether the services or qualifications offered by Grantee meet the Agreement
requirements.Notwithstanding any provisions herein to the contrary, written acceptance of a particular deliverable
does not foreclose Department's remedies in the event deficiencies in the deliverable cannot be readily measured at
the time of delivery.
6. Acceptance of Deliverables.
a. Acceptance Process. All deliverables must be received and accepted in writing by Department's Grant Manager
before payment.The Grantee shall work diligently to correct all deficiencies in the deliverable that remain
outstanding,within a reasonable time at Grantee's expense.If Department's Grant Manager does not accept the
deliverables within 30 days of receipt,they will be deemed rejected.
b. Rejection of Deliverables. The Department reserves the right to reject deliverables,as outlined in the Grant
Work Plan,as incomplete, inadequate,or unacceptable due,in whole or in part,to Grantee's lack of satisfactory
performance under the terms of this Agreement.The Grantee's efforts to correct the rejected deliverables will
be at Grantee's sole expense.Failure to fulfill the applicable technical requirements or complete all tasks or
activities in accordance with the Grant Work Plan will result in rejection of the deliverable and the associated
invoice. Payment for the rejected deliverable will not be issued unless the rejected deliverable is made
acceptable to Department in accordance with the Agreement requirements. The Department,at its option,may
allow additional time within which Grantee may remedy the objections noted by Department.The Grantee's
failure to make adequate or acceptable deliverables after a reasonable opportunity to do so shall constitute an
event of default.
7. Financial Consequences for Nonperformance.
a. Withholding Payment. In addition to the specific consequences explained in the Grant Work Plan and/or
Special Terms and Conditions,the State of Florida(State)reserves the right to withhold payment when the
Grantee has failed to perform/comply with provisions of this Agreement.None of the financial consequences
for nonperformance in this Agreement as more fully described in the Grant Work Plan shall be considered
penalties.
b. Corrective Action Plan. If Grantee fails to correct all the deficiencies in a rejected deliverable within the specified
timeframe, Department may, in its sole discretion, request that a proposed Corrective Action Plan (CAP) be
submitted by Grantee to Department. The Department requests that Grantee specify the outstanding deficiencies
in the CAP. All CAPs must be able to be implemented and performed in no more than sixty(60)calendar days.
i. The Grantee shall submit a CAP within ten (10) days of the date of the written request from
Department. The CAP shall be sent to the Department's Grant Manager for review and approval.
Within ten(10) days of receipt of a CAP, Department shall notify Grantee in writing whether the
CAP proposed has been accepted. If the CAP is not accepted,Grantee shall have ten(10)days from
receipt of Department letter rejecting the proposal to submit a revised proposed CAP. Failure to
obtain Department approval of a CAP as specified above may result in Department's termination of
this Agreement for cause as authorized in this Agreement.
ii. Upon Department's notice of acceptance of a proposed CAP, Grantee shall have ten (10) days to
commence implementation of the accepted plan. Acceptance of the proposed CAP by Department
does not relieve Grantee of any of its obligations under the Agreement. In the event the CAP fails
to correct or eliminate performance deficiencies by Grantee, Department shall retain the right to
require additional or further remedial steps, or to terminate this Agreement for failure to perform.
No actions approved by Department or steps taken by Grantee shall preclude Department from
subsequently asserting any deficiencies in performance. The Grantee shall continue to implement
the CAP until all deficiencies are corrected. Reports on the progress of the CAP will be made to
Department as requested by Department's Grant Manager.
iii. Failure to respond to a Department request for a CAP or failure to correct a deficiency in the
performance of the Agreement as specified by Department may result in termination of the
Agreement.
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8. Payment.
a. Payment Process. Subject to the terms and conditions established by the Agreement,the pricing per deliverable
established by the Grant Work Plan,and the billing procedures established by Department,Department agrees
to pay Grantee for services rendered in accordance with Section 215.422,Florida Statutes(F.S.).
b. Taxes.The Department is exempted from payment of State sales,use taxes and Federal excise taxes.The Grantee,
however,shall not be exempted from paying any taxes that it is subject to,including State sales and use taxes,or
for payment by Grantee to suppliers for taxes on materials used to fulfill its contractual obligations with
Department.The Grantee shall not use Department's exemption number in securing such materials. The Grantee
shall be responsible and liable for the payment of all its FICA/Social Security and other taxes resulting from this
Agreement.
c. Maximum Amount of Agreement. The maximum amount of compensation under this Agreement, without an
amendment,is described in the Standard Grant Agreement.Any additional funds necessary for the completion of
this Project are the responsibility of Grantee.
d. Reimbursement for Costs. The Grantee shall be paid on a cost reimbursement basis for all eligible Project costs
upon the completion, submittal, and approval of each deliverable identified in the Grant Work Plan.
Reimbursement shall be requested on Exhibit C, Payment Request Summary Form. To be eligible for
reimbursement, costs must be in compliance with laws,rules,and regulations applicable to expenditures of State
funds, including, but not limited to, the Reference Guide for State Expenditures, which can be accessed at the
following web address:
https://www.myfloridacfo.com/Division/AA/Manuals/Auditina/Reference Guide For State Expenditures.pdf.
e. Invoice Detail. All charges for services rendered or for reimbursement of expenses authorized by Department
pursuant to the Grant Work Plan shall be submitted to Department in sufficient detail for a proper pre-audit and
post-audit to be performed. The Grantee shall only invoice Department for deliverables that are completed in
accordance with the Grant Work Plan.
f. Interim Payments. Interim payments may be made by Department, at its discretion, if the completion of
deliverables to date have first been accepted in writing by Department's Grant Manager.
g. Final Payment Request.A final payment request should be submitted to Department no later than sixty(60)days
following the expiration date of the Agreement to ensure the availability of funds for payment. However, all
work performed pursuant to the Grant Work Plan must be performed on or before the expiration date of the
Agreement.
h. Annual Appropriation Contingency. The State's performance and obligation to pay under this Agreement is
contingent upon an annual appropriation by the Legislature. This Agreement is not a commitment of future
appropriations. Authorization for continuation and completion of work and any associated payments may be
rescinded, with proper notice, at the discretion of Department if the Legislature reduces or eliminates
appropriations.
i. Interest Rates. All interest rates charged under the Agreement shall be calculated on the prevailing rate used by
the State Board of Administration. To obtain the applicable interest rate, please refer to:
www.myfloridacfo.com/Division/AA/Vendors/default.htm.
j. Refund of Payments to the Department.Any balance of unobligated funds that have been advanced or paid must
be refunded to Department. Any funds paid in excess of the amount to which Grantee or subgrantee is entitled
under the terms of the Agreement must be refunded to Department.If this Agreement is funded with federal funds
and the Department is required to refund the federal government, the Grantee shall refund the Department its
share of those funds.
9. Documentation Required for Cost Reimbursement Grant Agreements and Match.
If Cost Reimbursement or Match is authorized in Attachment 2, Special Terms and Conditions,the following
conditions apply. Supporting documentation must be provided to substantiate cost reimbursement or match
requirements for the following budget categories:
a. Salary/Wages. Grantee shall list personnel involved, position classification, direct salary rates, and hours spent
on the Project in accordance with Attachment 3, Grant Work Plan in their documentation for reimbursement or
match requirements.
b. Overhead/Indirect/General and Administrative Costs. If Grantee is being reimbursed for or claiming match for
multipliers,all multipliers used(i.e.,fringe benefits,overhead, indirect,and/or general and administrative rates)
shall be supported by audit. If Department determines that multipliers charged by Grantee exceeded the rates
supported by audit, Grantee shall be required to reimburse such funds to Department within thirty (30) days of
written notification.Interest shall be charged on the excessive rate.
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c. Contractual Costs (Subcontractors). Match or reimbursement requests for payments to subcontractors must be
substantiated by copies of invoices with backup documentation identical to that required from Grantee.
Subcontracts which involve payments for direct salaries shall clearly identify the personnel involved,salary rate
per hour, and hours spent on the Project. All eligible multipliers used (i.e., fringe benefits, overhead, indirect,
and/or general and administrative rates) shall be supported by audit. If Department determines that multipliers
charged by any subcontractor exceeded the rates supported by audit,Grantee shall be required to reimburse such
funds to Department within thirty (30) days of written notification. Interest shall be charged on the excessive
rate. Nonconsumable and/or nonexpendable personal property or equipment costing$1,000 or more purchased
for the Project under a subcontract is subject to the requirements set forth in Chapters 273 and/or 274,F.S., and
Chapter 69I-72,Florida Administrative Code(F.A.C.)and/or Chapter 69I-73,F.A.C.,as applicable.The Grantee
shall be responsible for maintaining appropriate property records for any subcontracts that include the purchase
of equipment as part of the delivery of services. The Grantee shall comply with this requirement and ensure its
subcontracts issued under this Agreement,if any, impose this requirement, in writing,on its subcontractors.
i. For fixed-price (vendor) subcontracts, the following provisions shall apply: The Grantee may
award,on a competitive basis,fixed-price subcontracts to consultants/contractors in performing the
work described in Attachment 3, Grant Work Plan. Invoices submitted to Department for fixed-
price subcontracted activities shall be supported with a copy of the subcontractor's invoice and a
copy of the tabulation form for the competitive procurement process(e.g.,Invitation to Bid,Request
for Proposals, or other similar competitive procurement document) resulting in the fixed-price
subcontract.The Grantee may request approval from Department to award a fixed-price subcontract
resulting from procurement methods other than those identified above.In this instance,Grantee shall
request the advance written approval from Department's Grant Manager of the fixed price
negotiated by Grantee. The letter of request shall be supported by a detailed budget and Scope of
Services to be performed by the subcontractor. Upon receipt of Department Grant Manager's
approval of the fixed-price amount,Grantee may proceed in finalizing the fixed-price subcontract.
ii. If the procurement is subject to the Consultant's Competitive Negotiation Act under section
287.055, F.S. or the Brooks Act, Grantee must provide documentation clearly evidencing it has
complied with the statutory or federal requirements.
d. Travel. All requests for match or reimbursement of travel expenses shall be in accordance with Section 112.061,
F.S.
e. Direct Purchase Equipment. For the purposes of this Agreement,Equipment is defined as capital outlay costing
$1,000 or more. Match or reimbursement for Grantee's direct purchase of equipment is subject to specific
approval of Department, and does not include any equipment purchased under the delivery of services to be
completed by a subcontractor. Include copies of invoices or receipts to document purchases, and a properly
completed Exhibit B,Property Reporting Form.
f. Rental/Lease of Equipment.Match or reimbursement requests for rental/lease of equipment must include copies
of invoices or receipts to document charges.
g. Miscellaneous/Other Expenses. If miscellaneous or other expenses, such as materials, supplies, non-excluded
phone expenses, reproduction, or mailing, are reimbursable or available for match or reimbursement under the
terms of this Agreement,the documentation supporting these expenses must be itemized and include copies of
receipts or invoices.Additionally,independent of Grantee's contract obligations to its subcontractor,Department
shall not reimburse any of the following types of charges: cell phone usage; attorney's fees or court costs; civil
or administrative penalties;or handling fees,such as set percent overages associated with purchasing supplies or
equipment.
h. Land Acquisition. Reimbursement for the costs associated with acquiring interest and/or rights to real property
(including access rights through ingress/egress easements, leases, license agreements, or other site access
agreements;and/or obtaining record title ownership of real property through purchase)must be supported by the
following, as applicable: Copies of Property Appraisals, Environmental Site Assessments, Surveys and Legal
Descriptions, Boundary Maps, Acreage Certification, Title Search Reports, Title Insurance, Closing
Statements/Documents,Deeds,Leases,Easements,License Agreements, or other legal instrument documenting
acquired property interest and/or rights. If land acquisition costs are used to meet match requirements, Grantee
agrees that those funds shall not be used as match for any other Agreement supported by State or Federal funds.
10. Status Reports.
The Grantee shall submit status reports quarterly, unless otherwise specified in the Attachments,on Exhibit A,
Progress Report Form, to Department's Grant Manager describing the work performed during the reporting
period,problems encountered,problem resolutions,scheduled updates,and proposed work for the next reporting
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period. Quarterly status reports are due no later than twenty(20)days following the completion of the quarterly
reporting period. For the purposes of this reporting requirement, the quarterly reporting periods end on March
31, June 30, September 30 and December 31. The Department will review the required reports submitted by
Grantee within thirty(30)days.
11. Retainage.
The following provisions apply if Department withholds retainage under this Agreement:
a. The Department reserves the right to establish the amount and application of retainage on the work performed
under this Agreement up to the maximum percentage described in Attachment 2, Special Terms and Conditions.
Retainage may be withheld from each payment to Grantee pending satisfactory completion of work and approval
of all deliverables.
b. If Grantee fails to perform the requested work,or fails to perform the work in a satisfactory manner,Grantee shall
forfeit its right to payment of the retainage associated with the work. Failure to perform includes, but is not
limited to,failure to submit the required deliverables or failure to provide adequate documentation that the work
was actually performed. The Department shall provide written notification to Grantee of the failure to perform
that shall result in retainage forfeiture.If the Grantee does not correct the failure to perform within the timeframe
stated in Department's notice,the retainage will be forfeited to Department.
c. No retainage shall be released or paid for incomplete work while this Agreement is suspended.
d. Except as otherwise provided above, Grantee shall be paid the retainage associated with the work, provided
Grantee has completed the work and submits an invoice for retainage held in accordance with the invoicing
procedures under this Agreement.
12. Insurance.
a. Insurance Requirements for Sub-Grantees and/or Subcontractors. The Grantee shall require its sub-grantees
and/or subcontractors,if any,to maintain insurance coverage of such types and with such terms and limits as
described in this Agreement. The Grantee shall require all its sub-grantees and/or subcontractors,if any,to
make compliance with the insurance requirements of this Agreement a condition of all contracts that are related
to this Agreement. Sub-grantees and/or subcontractors must provide proof of insurance upon request.
b. Deductibles. The Department shall be exempt from,and in no way liable for,any sums of money representing a
deductible in any insurance policy. The payment of such deductible shall be the sole responsibility of the
Grantee providing such insurance.
c. Proof of Insurance. Upon execution of this Agreement,Grantee shall provide Department documentation
demonstrating the existence and amount for each type of applicable insurance coverage prior to performance of
any work under this Agreement. Upon receipt of written request from Department,Grantee shall furnish
Department with proof of applicable insurance coverage by standard form certificates of insurance,a self-
insured authorization,or other certification of self-insurance.
d. Duty to Maintain Coverage. In the event that any applicable coverage is cancelled by the insurer for any
reason,or if Grantee cannot get adequate coverage,Grantee shall immediately notify Department of such
cancellation and shall obtain adequate replacement coverage conforming to the requirements herein and provide
proof of such replacement coverage within ten(10)days after the cancellation of coverage.
13. Termination.
a. Termination for Convenience.When it is in the State's best interest,Department may,at its sole discretion,
terminate the Agreement in whole or in part by giving 30 days'written notice to Grantee. The Department shall
notify Grantee of the termination for convenience with instructions as to the effective date of termination or the
specific stage of work at which the Agreement is to be terminated.The Grantee must submit all invoices for
work to be paid under this Agreement within thirty(30)days of the effective date of termination. The
Department shall not pay any invoices received after thirty(30)days of the effective date of termination.
b. Termination for Cause.The Department may terminate this Agreement if any of the events of default described
in the Events of Default provisions below occur or in the event that Grantee fails to fulfill any of its other
obligations under this Agreement.If,after termination, it is determined that Grantee was not in default,or that
the default was excusable,the rights and obligations of the parties shall be the same as if the termination had
been issued for the convenience of Department.The rights and remedies of Department in this clause are in
addition to any other rights and remedies provided by law or under this Agreement.
c. Grantee Obligations upon Notice of Termination.After receipt of a notice of termination or partial termination
unless as otherwise directed by Department,Grantee shall not furnish any service or deliverable on the date,and
to the extent specified,in the notice. However,Grantee shall continue work on any portion of the Agreement
not terminated. If the Agreement is terminated before performance is completed,Grantee shall be paid only for
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that work satisfactorily performed for which costs can be substantiated. The Grantee shall not be entitled to
recover any cancellation charges or lost profits.
d. Continuation of Prepaid Services.If Department has paid for any services prior to the expiration,cancellation,
or termination of the Agreement,Grantee shall continue to provide Department with those services for which it
has already been paid or,at Department's discretion,Grantee shall provide a refund for services that have been
paid for but not rendered.
e. Transition of Services Upon Termination,Expiration,or Cancellation of the Agreement.If services provided
under the Agreement are being transitioned to another provider(s),Grantee shall assist in the smooth transition
of Agreement services to the subsequent provider(s). This requirement is at a minimum an affirmative
obligation to cooperate with the new provider(s),however additional requirements may be outlined in the Grant
Work Plan. The Grantee shall not perform any services after Agreement expiration or termination,except as
necessary to complete the transition or continued portion of the Agreement,if any.
14. Notice of Default.
If Grantee defaults in the performance of any covenant or obligation contained in the Agreement, including, any of
the events of default,Department shall provide notice to Grantee and an opportunity to cure that is reasonable under
the circumstances.This notice shall state the nature of the failure to perform and provide a time certain for correcting
the failure.The notice will also provide that,should the Grantee fail to perform within the time provided,Grantee will
be found in default, and Department may terminate the Agreement effective as of the date of receipt of the default
notice.
15. Events of Default.
Provided such failure is not the fault of Department or outside the reasonable control of Grantee,the following non-
exclusive list of events,acts,or omissions,shall constitute events of default:
a. The commitment of any material breach of this Agreement by Grantee, including failure to timely deliver a
material deliverable,failure to perform the minimal level of services required for a deliverable,discontinuance of
the performance of the work, failure to resume work that has been discontinued within a reasonable time after
notice to do so,or abandonment of the Agreement;
b. The commitment of any material misrepresentation or omission in any materials,or discovery by the Department
of such,made by the Grantee in this Agreement or in its application for funding;
c. Failure to submit any of the reports required by this Agreement or having submitted any report with incorrect,
incomplete,or insufficient information;
d. Failure to honor any term of the Agreement;
e. Failure to abide by any statutory, regulatory, or licensing requirement, including an entry of an order revoking
the certificate of authority granted to the Grantee by a state or other licensing authority;
f. Failure to pay any and all entities, individuals, and furnishing labor or materials, or failure to make payment to
any other entities as required by this Agreement;
g. Employment of an unauthorized alien in the performance of the work, in violation of Section 274 (A) of the
Immigration and Nationality Act;
h. Failure to maintain the insurance required by this Agreement;
i. One or more of the following circumstances, uncorrected for more than thirty (30) days unless, within the
specified 30-day period,Grantee(including its receiver or trustee in bankruptcy)provides to Department adequate
assurances,reasonably acceptable to Department,of its continuing ability and willingness to fulfill its obligations
under the Agreement:
i. Entry of an order for relief under Title 11 of the United States Code;
ii. The making by Grantee of a general assignment for the benefit of creditors;
iii. The appointment of a general receiver or trustee in bankruptcy of Grantee's business or property;
and/or
iv. An action by Grantee under any state insolvency or similar law for the purpose of its bankruptcy,
reorganization,or liquidation.
16. Suspension of Work.
The Department may, in its sole discretion, suspend any or all activities under the Agreement,at any time,when it is
in the best interest of the State to do so.The Department shall provide Grantee written notice outlining the particulars
of suspension.Examples of reasons for suspension include,but are not limited to,budgetary constraints, declaration
of emergency,or other such circumstances. After receiving a suspension notice,Grantee shall comply with the notice.
Within 90 days, or any longer period agreed to by the parties,Department shall either: (1) issue a notice authorizing
resumption of work, at which time activity shall resume; or (2) terminate the Agreement. If the Agreement is
terminated after 30 days of suspension,the notice of suspension shall be deemed to satisfy the thirty(30)days'notice
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required for a notice of termination for convenience. Suspension of work shall not entitle Grantee to any additional
compensation.
17. Force Majeure.
The Grantee shall not be responsible for delay resulting from its failure to perform if neither the fault nor the negligence
of Grantee or its employees or agents contributed to the delay and the delay is due directly to acts of God,wars,acts
of public enemies, strikes, fires, floods, or other similar cause wholly beyond Grantee's control, or for any of the
foregoing that affect subcontractors or suppliers if no alternate source of supply is available to Grantee. In case of
any delay Grantee believes is excusable, Grantee shall notify Department in writing of the delay or potential delay
and describe the cause of the delay either(1)within ten days after the cause that creates or will create the delay first
arose, if Grantee could reasonably foresee that a delay could occur as a result; or (2) if delay is not reasonably
foreseeable, within five days after the date Grantee first had reason to believe that a delay could result. THE
FOREGOING SHALL CONSTITUTE THE GRANTEE'S SOLE REMEDY OR EXCUSE WITH RESPECT
TO DELAY.Providing notice in strict accordance with this paragraph is a condition precedent to such remedy. No
claim for damages,other than for an extension of time,shall be asserted against Department.The Grantee shall not be
entitled to an increase in the Agreement price or payment of any kind from Department for direct, indirect,
consequential, impact or other costs, expenses or damages, including but not limited to costs of acceleration or
inefficiency, arising because of delay, disruption, interference, or hindrance from any cause whatsoever. If
performance is suspended or delayed, in whole or in part, due to any of the causes described in this paragraph, after
the causes have ceased to exist Grantee shall perform at no increased cost,unless Department determines, in its sole
discretion,that the delay will significantly impair the value of the Agreement to Department,in which case Department
may:(1)accept allocated performance or deliveries from Grantee,provided that Grantee grants preferential treatment
to Department with respect to products subjected to allocation; (2) contract with other sources (without recourse to
and by Grantee for the related costs and expenses)to replace all or part of the products or services that are the subject
of the delay,which purchases may be deducted from the Agreement quantity;or(3)terminate Agreement in whole or
in part.
18. Indemnification.
a. The Grantee shall be fully liable for the actions of its agents, employees, partners, or subcontractors and shall
fully indemnify, defend, and hold harmless Department and its officers, agents, and employees, from suits,
actions,damages,and costs of every name and description arising from or relating to:
i. personal injury and damage to real or personal tangible property alleged to be caused in whole or in
part by Grantee,its agents,employees,partners,or subcontractors;provided,however,that Grantee
shall not indemnify for that portion of any loss or damages proximately caused by the negligent act
or omission of Department;
ii. the Grantee's breach of this Agreement or the negligent acts or omissions of Grantee.
b. The Grantee's obligations under the preceding paragraph with respect to any legal action are contingent upon
Department giving Grantee:(1)written notice of any action or threatened action;(2)the opportunity to take over
and settle or defend any such action at Grantee's sole expense; and (3) assistance in defending the action at
Grantee's sole expense. The Grantee shall not be liable for any cost, expense, or compromise incurred or made
by Department in any legal action without Grantee's prior written consent, which shall not be unreasonably
withheld.
c. Notwithstanding sections a. and b. above, the following is the sole indemnification provision that applies to
Grantees that are governmental entities: Each party hereto agrees that it shall be solely responsible for the
negligent or wrongful acts of its employees and agents. However, nothing contained herein shall constitute a
waiver by either party of its sovereign immunity or the provisions of Section 768.28,F.S.Further,nothing herein
shall be construed as consent by a state agency or subdivision of the State to be sued by third parties in any matter
arising out of any contract or this Agreement.
d. No provision in this Agreement shall require Department to hold harmless or indemnify Grantee,insure or assume
liability for Grantee's negligence, waive Department's sovereign immunity under the laws of Florida, or
otherwise impose liability on Department for which it would not otherwise be responsible. Any provision,
implication or suggestion to the contrary is null and void.
19. Limitation of Liability.
The Department's liability for any claim arising from this Agreement is limited to compensatory damages in an amount
no greater than the sum of the unpaid balance of compensation due for goods or services rendered pursuant to and in
compliance with the terms of the Agreement. Such liability is further limited to a cap of$100,000.
20. Remedies.
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Nothing in this Agreement shall be construed to make Grantee liable for force majeure events. Nothing in this
Agreement, including financial consequences for nonperformance, shall limit Department's right to pursue its
remedies for other types of damages under the Agreement, at law or in equity. The Department may, in addition to
other remedies available to it, at law or in equity and upon notice to Grantee,retain such monies from amounts due
Grantee as may be necessary to satisfy any claim for damages,penalties,costs and the like asserted by or against it.
21. Waiver.
The delay or failure by Department to exercise or enforce any of its rights under this Agreement shall not constitute
or be deemed a waiver of Department's right thereafter to enforce those rights,nor shall any single or partial exercise
of any such right preclude any other or further exercise thereof or the exercise of any other right.
22. Statutory Notices Relating to Unauthorized Employment and Subcontracts.
a. The Department shall consider the employment by any Grantee of unauthorized aliens a violation of Section
274A(e) of the Immigration and Nationality Act. If Grantee/subcontractor knowingly employs unauthorized
aliens,such violation shall be cause for unilateral cancellation ofthis Agreement.The Grantee shall be responsible
for including this provision in all subcontracts with private organizations issued as a result of this Agreement.
b. Pursuant to Sections 287.133 and 287.134,F.S.,the following restrictions apply to persons placed on the
convicted vendor list or the discriminatory vendor list:
i. Public Entity Crime. A person or affiliate who has been placed on the convicted vendor list
following a conviction for a public entity crime may not submit a bid,proposal,or reply on a contract
to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a
contract with a public entity for the construction or repair of a public building or public work; may
not submit bids,proposals,or replies on leases of real property to a public entity;may not be awarded
or perform work as a Grantee,supplier,subcontractor,or consultant under a 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,F.S.,for CATEGORY TWO for a period of 36 months following the
date of being placed on the convicted vendor list.
ii. Discriminatory Vendors. An entity or affiliate who has been placed on the discriminatory vendor
list may not submit a bid, proposal, or reply on a contract to provide any goods or services to a
public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work;may not submit bids,proposals,or replies
on leases of real property to a public entity; may not be awarded or perform work as a contractor,
supplier,subcontractor,or consultant under a contract with any public entity; and may not transact
business with any public entity.
iii. Notification. The Grantee shall notify Department if it or any of its suppliers, subcontractors, or
consultants have been placed on the convicted vendor list or the discriminatory vendor list during
the life of the Agreement. The Florida Department of Management Services is responsible for
maintaining the discriminatory vendor list and posts the list on its website.Questions regarding the
discriminatory vendor list may be directed to the Florida Department of Management Services,
Office of Supplier Diversity,at(850)487-0915.
23. Compliance with Federal,State and Local Laws.
a. The Grantee and all its agents shall comply with all federal,state and local regulations,including,but not limited
to, nondiscrimination, wages, social security, workers' compensation, licenses, and registration requirements.
The Grantee shall include this provision in all subcontracts issued as a result of this Agreement.
b. No person, on the grounds of race, creed, color, religion, national origin, age, gender, or disability, shall be
excluded from participation in;be denied the proceeds or benefits of;or be otherwise subjected to discrimination
in performance of this Agreement.
c. This Agreement shall be governed by and construed in accordance with the laws of the State of Florida.
d. Any dispute concerning performance of the Agreement shall be processed as described herein. Jurisdiction for
any damages arising under the terms of the Agreement will be in the courts of the State,and venue will be in the
Second Judicial Circuit, in and for Leon County. Except as otherwise provided by law, the parties agree to be
responsible for their own attorney fees incurred in connection with disputes arising under the terms of this
Agreement.
24. Scrutinized Companies.
a. Grantee certifies that it is not on the Scrutinized Companies that Boycott Israel List or engaged in a boycott of
Israel. Pursuant to Section 287.135,F.S.,the Department may immediately terminate this Agreement at its sole
option if the Grantee is found to have submitted a false certification;or if the Grantee is placed on the Scrutinized
Companies that Boycott Israel List or is engaged in the boycott of Israel during the term of the Agreement.
Attachment 1
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b. If this Agreement is for more than one million dollars,the Grantee certifies that it is also not on the Scrutinized
Companies with Activities in Sudan,Scrutinized Companies with Activities in the Iran Petroleum Energy Sector
List, or engaged with business operations in Cuba or Syria as identified in Section 287.135, F.S. Pursuant to
Section 287.135,F.S.,the Department may immediately terminate this Agreement at its sole option if the Grantee
is found to have submitted a false certification; or if the Grantee is placed on the Scrutinized Companies with
Activities in Sudan List, or Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or
engaged with business operations in Cuba or Syria during the term of the Agreement.
c. As provided in Subsection 287.135(8),F.S.,if federal law ceases to authorize these contracting prohibitions then
they shall become inoperative.
25. Lobbying and Integrity.
The Grantee agrees that no funds received by it under this Agreement will be expended for the purpose of lobbying
the Legislature or a State agency pursuant to Section 216.347,F.S.,except that pursuant to the requirements of Section
287.058(6),F.S., during the term of any executed agreement between Grantee and the State, Grantee may lobby the
executive or legislative branch concerning the scope of services, performance,term, or compensation regarding that
agreement.The Grantee shall comply with Sections 11.062 and 216.347,F.S.
26. Record Keeping.
The Grantee shall maintain books,records and documents directly pertinent to performance under this Agreement in
accordance with United States generally accepted accounting principles(US GAAP)consistently applied. The
Department,the State,or their authorized representatives shall have access to such records for audit purposes during
the term of this Agreement and for five(5)years following the completion date or termination of the Agreement. In
the event that any work is subcontracted,Grantee shall similarly require each subcontractor to maintain and allow
access to such records for audit purposes. Upon request of Department's Inspector General,or other authorized
State official, Grantee shall provide any type of information the Inspector General deems relevant to Grantee's
integrity or responsibility. Such information may include,but shall not be limited to, Grantee's business or financial
records,documents,or files of any type or form that refer to or relate to Agreement. The Grantee shall retain such
records for the longer of: (1)three years after the expiration of the Agreement;or(2)the period required by the
General Records Schedules maintained by the Florida Department of State(available at:
http://dos.myflorida.com/l ibrary-archives/records-management/general-records-schedules/).
27. Audits.
a. Inspector General. The Grantee understands its duty, pursuant to Section 20.055(5),F.S.,to cooperate with the
inspector general in any investigation, audit, inspection, review, or hearing. The Grantee will comply with this
duty and ensure that its sub-grantees and/or subcontractors issued under this Agreement, if any, impose this
requirement, in writing,on its sub-grantees and/or subcontractors,respectively.
b. Physical Access and Inspection. Department personnel shall be given access to and may observe and inspect
work being performed under this Agreement,with reasonable notice and during normal business hours,including
by any of the following methods:
i. Grantee shall provide access to any location or facility on which Grantee is performing work, or
storing or staging equipment,materials or documents;
ii. Grantee shall permit inspection of any facility, equipment, practices, or operations required in
performance of any work pursuant to this Agreement; and,
iii. Grantee shall allow and facilitate sampling and monitoring of any substances, soils, materials or
parameters at any location reasonable or necessary to assure compliance with any work or legal
requirements pursuant to this Agreement.
c. Special Audit Requirements. The Grantee shall comply with the applicable provisions contained in Attachment
5, Special Audit Requirements. Each amendment that authorizes a funding increase or decrease shall include an
updated copy of Exhibit 1,to Attachment 5. If Department fails to provide an updated copy of Exhibit 1 to include
in each amendment that authorizes a funding increase or decrease, Grantee shall request one from the
Department's Grants Manager. The Grantee shall consider the type of financial assistance(federal and/or state)
identified in Attachment 5,Exhibit 1 and determine whether the terms of Federal and/or Florida Single Audit Act
Requirements may further apply to lower tier transactions that may be a result of this Agreement. For federal
financial assistance,Grantee shall utilize the guidance provided under 2 CFR§200.330 for determining whether
the relationship represents that of a subrecipient or vendor.For State financial assistance,Grantee shall utilize the
form entitled "Checklist for Nonstate Organizations Recipient/Subrecipient vs Vendor Determination" (form
number DFS-A2-NS) that can be found under the "Links/Forms" section appearing at the following website:
https:\\apps.fldfs.com\fsaa.
Attachment 1
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d. Proof of Transactions. In addition to documentation provided to support cost reimbursement as described herein,
Department may periodically request additional proof of a transaction to evaluate the appropriateness of costs to
the Agreement pursuant to State guidelines (including cost allocation guidelines) and federal, if applicable.
Allowable costs and uniform administrative requirements for federal programs can be found under 2 CFR
200. The Department may also request a cost allocation plan in support of its multipliers (overhead, indirect,
general administrative costs, and fringe benefits). The Grantee must provide the additional proof within thirty
(30)days of such request.
e. No Commingling of Funds. The accounting systems for all Grantees must ensure that these funds are not
commingled with funds from other agencies. Funds from each agency must be accounted for separately. Grantees
are prohibited from commingling funds on either a program-by-program or a project-by-project basis. Funds
specifically budgeted and/or received for one project may not be used to support another project. Where a
Grantee's, or subrecipient's, accounting system cannot comply with this requirement, Grantee, or subrecipient,
shall establish a system to provide adequate fund accountability for each project it has been awarded.
i. If Department finds that these funds have been commingled, Department shall have the right to
demand a refund,either in whole or in part,of the funds provided to Grantee under this Agreement
for non-compliance with the material terms of this Agreement. The Grantee, upon such written
notification from Department shall refund, and shall forthwith pay to Department, the amount of
money demanded by Department. Interest on any refund shall be calculated based on the prevailing
rate used by the State Board of Administration. Interest shall be calculated from the date(s) the
original payment(s) are received from Department by Grantee to the date repayment is made by
Grantee to Department.
ii. In the event that the Grantee recovers costs, incurred under this Agreement and reimbursed by
Department, from another source(s), Grantee shall reimburse Department for all recovered funds
originally provided under this Agreement and interest shall be charged for those recovered costs as
calculated on from the date(s) the payment(s) are recovered by Grantee to the date repayment is
made to Department.
iii. Notwithstanding the requirements of this section,the above restrictions on commingling funds do
not apply to agreements where payments are made purely on a cost reimbursement basis.
28. Conflict of Interest.
The Grantee covenants that it presently has no interest and shall not acquire any interest which would conflict in any
manner or degree with the performance of services required.
29. Independent Contractor.
The Grantee is an independent contractor and is not an employee or agent of Department.
30. Subcontracting.
a. Unless otherwise specified in the Special Terms and Conditions, all services contracted for are to be performed
solely by Grantee.
b. The Department may,for cause,require the replacement of any Grantee employee,subcontractor,or agent. For
cause,includes,but is not limited to,technical or training qualifications,quality of work,change in security status,
or non-compliance with an applicable Department policy or other requirement.
c. The Department may,for cause, deny access to Department's secure information or any facility by any Grantee
employee,subcontractor,or agent.
d. The Department's actions under paragraphs b.or c.shall not relieve Grantee of its obligation to perform all work
in compliance with the Agreement.The Grantee shall be responsible for the payment of all monies due under any
subcontract.The Department shall not be liable to any subcontractor for any expenses or liabilities incurred under
any subcontract and Grantee shall be solely liable to the subcontractor for all expenses and liabilities incurred
under any subcontract.
e. The Department will not deny Grantee's employees, subcontractors, or agents access to meetings within the
Department's facilities, unless the basis of Department's denial is safety or security considerations.
f. The Department supports diversity in its procurement program and requests that all subcontracting opportunities
afforded by this Agreement embrace diversity enthusiastically. The award of subcontracts should reflect the full
diversity of the citizens of the State. A list of minority-owned firms that could be offered subcontracting
opportunities may be obtained by contacting the Office of Supplier Diversity at(850)487-0915.
g. The Grantee shall not be liable for any excess costs for a failure to perform, if the failure to perform is caused by
the default of a subcontractor at any tier,and if the cause of the default is completely beyond the control of both
Grantee and the subcontractor(s),and without the fault or negligence of either,unless the subcontracted products
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or services were obtainable from other sources in sufficient time for Grantee to meet the required delivery
schedule.
31. Guarantee of Parent Company.
If Grantee is a subsidiary of another corporation or other business entity,Grantee asserts that its parent company will
guarantee all of the obligations of Grantee for purposes of fulfilling the obligations of Agreement. In the event Grantee
is sold during the period the Agreement is in effect, Grantee agrees that it will be a requirement of sale that the new
parent company guarantee all of the obligations of Grantee.
32. Survival.
The respective obligations of the parties, which by their nature would continue beyond the termination or expiration
of this Agreement, including without limitation, the obligations regarding confidentiality, proprietary interests, and
public records,shall survive termination,cancellation,or expiration of this Agreement.
33. Third Parties.
The Department shall not be deemed to assume any liability for the acts,failures to act or negligence of Grantee, its
agents,servants,and employees,nor shall Grantee disclaim its own negligence to Department or any third party. This
Agreement does not and is not intended to confer any rights or remedies upon any person other than the parties. If
Department consents to a subcontract,Grantee will specifically disclose that this Agreement does not create any third-
party rights.Further,no third parties shall rely upon any of the rights and obligations created under this Agreement.
34. Severability.
If a court of competent jurisdiction deems any term or condition herein void or unenforceable,the other provisions
are severable to that void provision,and shall remain in full force and effect.
35. Grantee's Employees,Subcontractors and Agents.
All Grantee employees, subcontractors, or agents performing work under the Agreement shall be properly trained
technicians who meet or exceed any specified training qualifications. Upon request, Grantee shall furnish a copy of
technical certification or other proof of qualification.All employees,subcontractors,or agents performing work under
Agreement must comply with all security and administrative requirements of Department and shall comply with all
controlling laws and regulations relevant to the services they are providing under the Agreement.
36. Assignment.
The Grantee shall not sell, assign, or transfer any of its rights, duties, or obligations under the Agreement, or under
any purchase order issued pursuant to the Agreement,without the prior written consent of Department. In the event
of any assignment,Grantee remains secondarily liable for performance of the Agreement,unless Department expressly
waives such secondary liability.The Department may assign the Agreement with prior written notice to Grantee of its
intent to do so.
37. Execution in Counterparts and Authority to Sign.
This Agreement, any amendments, and/or change orders related to the Agreement, may be executed in counterparts,
each of which shall be an original and all of which shall constitute the same instrument. In accordance with the
Electronic Signature Act of 1996,electronic signatures,including facsimile transmissions,may be used and shall have
the same force and effect as a written signature. Each person signing this Agreement warrants that he or she is duly
authorized to do so and to bind the respective party to the Agreement.
Attachment 1
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STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Special Terms and Conditions
AGREEMENT NO.MV353
ATTACHMENT 2
These Special Terms and Conditions shall be read together with general terms outlined in the Standard Terms and
Conditions,Attachment 1.Where in conflict,these more specific terms shall apply.
1. Scope of Work.
The Project funded under this Agreement is the Monroe County Mobile Vessel Pump Out Program.The Project is
defined in more detail in Attachment 3, Grant Work Plan.
2. Duration.
a. Reimbursement Period.The reimbursement period for this Agreement begins on 7/01/2019 and ends on the
expiration of this Agreement.
b. Extensions.There are no extensions available for this Project.
c. Service Periods.Additional service periods are not authorized under this Agreement.
3. Payment Provisions.
a. Compensation.This is a fixed rate Agreement.The Grantee shall be compensated under this Agreement as
described in Attachment 3.
b. Invoicing.Invoicing will occur as indicated in Attachment 3.
c. Advance Pay.Advance Pay is not authorized under this Agreement.
4. Cost Eligible for Reimbursement or Matching Requirements.
Reimbursement for costs or availability for costs to meet matching requirements shall be limited to the following
budget categories,as defined in the Reference Guide for State Expenditures,as indicated:
Reimbursement Match Category
❑ ❑ Salaries/Wages
Overhead/Indirect/General and Administrative Costs:
❑ 0 a. Fringe Benefits,N/A.
❑ ❑ b. Indirect Costs,N/A.
❑ ❑ Contractual(Subcontractors)
O ❑ Travel,in accordance with Section 112,F.S.
❑ ❑ Equipment
O ❑ Rental/Lease of Equipment
❑ ❑ Miscellaneous/Other Expenses
❑ ❑ Land Acquisition
5. Equipment Purchase.
No Equipment purchases shall be funded under this Agreement.
6. Land Acquisition.
There will be no Land Acquisitions funded under this Agreement.
7. Match Requirements
There is no match required on the part of the Grantee under this Agreement.
8. Insurance Requirements
Required Coverage. At all times during the Agreement the Grantee,at its sole expense,shall maintain insurance
coverage of such types and with such terms and limits described below. The limits of coverage under each policy
Attachment 2
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maintained by the Grantee shall not be interpreted as limiting the Grantee's liability and obligations under the
Agreement. Grantee shall provide coverage through a self-insurance program established and operating under the
laws of Florida.Additional insurance requirements for this Agreement may be required elsewhere in this
Agreement,however the minimum insurance requirements applicable to this Agreement are:
a. Comprehensive General Liability Insurance.
The Grantee shall provide adequate comprehensive general liability insurance coverage and hold such
liability insurance at all times during the Agreement.The minimum limits shall be$200,000 for each
person and$300,000 per occurrence.
b. Commercial Automobile Insurance.
If the Grantee's duties include the use of a commercial vehicle,the Grantee shall maintain automobile
liability,bodily injury,and property damage coverage. Insuring clauses for both bodily injury and property
damage shall provide coverage on an occurrence basis.The minimum limits shall be as follows:
$200,000/300,000 Automobile Liability for Company-Owned Vehicles, if applicable
$200,000/300,000 Hired and Non-owned Automobile Liability Coverage
c. Workers' Compensation.
The Grantee shall comply with the workers' compensation requirements of Chapter 440,F.S.
d. Other Insurance.None.
9. Quality Assurance Requirements.
There are no special Quality Assurance requirements under this Agreement.
10. Retainage.
No retainage is required under this Agreement.
11. Subcontracting.
The Grantee may subcontract work under this Agreement with the prior written consent of the Department's Grant
Manager.The Grantee shall submit a copy of the executed subcontract to the Department prior to submitting any
invoices for subcontracted work. Regardless of any subcontract,the Grantee is ultimately responsible for all work to
be performed under this Agreement.
12. State-owned Land.
The work will not be performed on State-owned land.
13. Office of Policy and Budget Reporting.
The Grantee will identify the expected return on investment for this project and provide this information to the
Governor's Office of Policy and Budget(OPB)within three months of execution of this Agreement.For each full
calendar quarter thereafter,the Grantee will provide quarterly update reports directly to OPB,no later than 20 days
after the end of each quarter,documenting the positive return on investment to the state that results from the
Grantee's project and its use of funds provided under this Agreement. Quarterly reports will continue until the
Grantee is instructed by OPB that no further reports are needed,or until the end of this Agreement,whichever
occurs first.All reports shall be submitted electronically to OPB at env.roi@laspbs.state.fl.us,and a copy shall also
be submitted to the Department at legislativeaffairsAfloridaDEP.gov.
14. Additional Terms.
None.
Attachment 2
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STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
GRANT WORK PLAN
DEP AGREEMENT NO.: MV353
ATTACHMENT 3
PROJECT TITLE:Monroe County Mobile Vessel Pumpout Service
A. Scope of Services.In Support of the Clean Vessel Act Grant Program,the Florida Legislature recognizes the
importance of reduction or elimination of environmental impacts associated with the illegal discharge of sewage from
vessels,and compliance with the regulations of the federal No Discharge Zone established by the U.S.Environmental
Protection Agency and no discharge regulations established bythe Florida Keys National Marine Sanctuary. To that
end, the Florida Legislature has appropriated $750,000 in nonrecurring funds for a marine sewage pumpout
program to assist Grantee with alternative funding for its mobile vessel pumpout service (Service). The County
Boating Improvement funds will provide$271,719.88 towards the Service.
The Grantee's Service,currently free to recreational boaters in the Florida Keys,is helping to ensure compliance with
the regulations of the federally established No Discharge Zone and is critical in ensuring that water quality in the
Florida Keys remains high. The$750,000 in funding assistance provided under this Agreement will assist with the
costs of the Service currently being provided by Monroe County,thus helping to improve and preserve water quality
that is vital to the economy and marine ecosystems of the Florida Keys.
Under this Agreement,the Grantee will subcontract services to provide 5,400 pumpouts for the first quarter and 6,600
pumpouts per quarter for the remaining three quarters, at locations throughout areas of Monroe County within the
Florida Keys and will meet certain objectives as directed and established by the Monroe County Board of County
Commissioners. Quarter 1 is July 1, 2019 through September 30, 2019, Quarter 2 is October 1, 2019 through
December 31,2019,Quarter 3 is January 1,2020 through March 31,2020 and Quarter 4 is April 1,2020 through June
30,2020.
B. Service Period.July 1,2019,through June 30,2020.
C. Deliverables.For each quarter,the Grantee shall submit the following after the close of each quarter:
1. A signed quarterly pumpout report from its Contractor documenting the number of Pumpouts performed,
including the number of in-state vessels and out-of-state vessels pumped;volume of sewage pumped;number
of individual vessels pumped out;and method of disposal.Due no later than the 30th day following the close
of each quarter.
2. A Quarterly Progress Report Form (Exhibit A), including documentation of submission of the Quarterly
Return on Investment Report to the Governor's Office of Policy and Budget(OPB). Due no later than the
30th day following the close of each quarter.
3. An invoice for Service provided by its Contractor.Due no later than the 30th day following the close of each
quarter.
D. Cost and Invoicing.The quarterly payment shall be$187,500.The Grantee shall submit a quarterly invoice
by the 30th day following the close of each quarter.Each invoice shall contain the following:
1. Invoice date;
2. Agreement number;
3. Dates of service;and
4. Documentation of number of pumpouts performed.
Attachment 3,DEP Agreement#:MV353
1 of 2
E. Timeline.The Grantee shall submit quarterly reports and invoices by the 30th day following the close of the
quarter,specifically,October 30,January 30,April 30 and July 30.
F. Performance Measures. The Department's Agreement Manager shall review the quarterly reports and
documentation to ensure that the required number of pumpouts are performed each quarter.
G. Financial Consequences. If the required number of quarterly pumpouts are not performed,or are not made
up in the following quarter,then the next quarterly payment shall be reduced on a pro rata basis for each pumpout not
performed of the under-performing quarter.
Attachment 3,DEP Agreement#:MV353
2 of 2
STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Public Records Requirements
Attachment 4
1. Public Records.
a. If the Agreement exceeds$35,000.00,and if Grantee is acting on behalf of Department in its performance of services
under the Agreement, Grantee must allow public access to all documents, papers, letters, or other material,regardless
of the physical form, characteristics, or means of transmission, made or received by Grantee in conjunction with the
Agreement(Public Records), unless the Public Records are exempt from section 24(a) of Article I of the Florida
Constitution or section 119.07(1), F.S.
b. The Department may unilaterally terminate the Agreement if Grantee refuses to allow public access to Public Records
as required by law.
2. Additional Public Records Duties of Section 119.0701,F.S.,If Applicable.
For the purposes of this paragraph,the term"contract"means the"Agreement." If Grantee is a"contractor"as
defined in section 119.0701(1)(a),F.S.,the following provisions apply and the contractor shall:
a. Keep and maintain Public Records required by Department to perform the service.
b. Upon request, provide Department with a copy of requested Public Records or allow the Public Records to be
inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Chapter 119,F.S., or
as otherwise provided by law.
c. A contractor who fails to provide the Public Records to Department within a reasonable time may be subject to
penalties under section 119.10, F.S.
d. Ensure that Public Records that are exempt or confidential and exempt from Public Records disclosure requirements
are not disclosed except as authorized by law for the duration of the contract term and following completion of the
contract if the contractor does not transfer the Public Records to Department.
e. Upon completion of the contract,transfer, at no cost,to Department all Public Records in possession of the contractor
or keep and maintain Public Records required by Department to perform the service. If the contractor transfers all
Public Records to Department upon completion of the contract,the contractor shall destroy any duplicate Public
Records that are exempt or confidential and exempt from Public Records disclosure requirements. If the contractor
keeps and maintains Public Records upon completion of the contract,the contractor shall meet all applicable
requirements for retaining Public Records.All Public Records stored electronically must be provided to Department,
upon request from Department's custodian of Public Records, in a format specified by Department as compatible with
the information technology systems of Department.These formatting requirements are satisfied by using the data
formats as authorized in the contract or Microsoft Word, Outlook,Adobe, or Excel, and any software formats the
contractor is authorized to access.
f. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF
CHAPTER 119, F.S., TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC
RECORDS RELATING TO THE CONTRACT, CONTACT THE DEPARTMENT'S
CUSTODIAN OF PUBLIC RECORDS AT:
Telephone: (850) 245-2118
Email: public.services@floridadep.gov
Mailing Address: Department of Environmental Protection
ATTN: Office of Ombudsman and Public Services
Public Records Request
3900 Commonwealth Boulevard, MS 49
Tallahassee, Florida 32399
Attachment 4
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Rev.4/27/2018
STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Special Audit Requirements
(State and Federal Financial Assistance)
Attachment 5
The administration of resources awarded by the Department of Environmental Protection (which may be referred to
as the "Department", "DEP", "FDEP"or"Grantor", or other name in the agreement)to the recipient(which may be
referred to as the "Recipient", "Grantee"or other name in the agreement)may be subject to audits and/or monitoring
by the Department of Environmental Protection,as described in this attachment.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200, Subpart F-Audit Requirements, and
Section 215.97,F.S., as revised (see"AUDITS" below), monitoring procedures may include, but not be limited to,
on-site visits by DEP Department staff, limited scope audits as defined by 2 CFR 200.425, or other procedures. By
entering into this Agreement,the recipient agrees to comply and cooperate with any monitoring procedures/processes
deemed appropriate by the Department of Environmental Protection. In the event the Department of Environmental
Protection determines that a limited scope audit of the recipient is appropriate,the recipient agrees to comply with any
additional instructions provided by the Department to the recipient regarding such audit.The recipient further agrees
to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief
Financial Officer(CFO)or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the recipient is a State or local government or a non-profit organization as defined in 2 CFR
§200.330
1. A recipient that expends$750,000 or more in Federal awards in its fiscal year,must have a single or program-
specific audit conducted in accordance with the provisions of 2 CFR Part 200,Subpart F.EXHIBIT 1 to this
Attachment indicates Federal funds awarded through the Department of Environmental Protection by this
Agreement. In determining the federal awards expended in its fiscal year, the recipient shall consider all
sources of federal awards, including federal resources received from the Department of Environmental
Protection. The determination of amounts of federal awards expended should be in accordance with the
guidelines established in 2 CFR 200.502-503.An audit of the recipient conducted by the Auditor General in
accordance with the provisions of 2 CFR Part 200.514 will meet the requirements of this part.
2. For the audit requirements addressed in Part I,paragraph 1,the recipient shall fulfill the requirements relative
to auditee responsibilities as provided in 2 CFR 200.508-512.
3. A recipient that expends less than$750,00 in federal awards in its fiscal year is not required to have an audit
conducted in accordance with the provisions of 2 CFR Part 200, Subpart F-Audit Requirements. If the
recipient expends less than$750,000 in federal awards in its fiscal year and elects to have an audit conducted
in accordance with the provisions of 2 CFR 200, Subpart F-Audit Requirements, the cost of the audit must
be paid from non-federal resources (i.e., the cost of such an audit mist be paid from recipient resources
obtained from other federal entities.
4. The recipient may access information regarding the Catalog of Federal Domestic Assistance(CFDA)via the
internet at www.cfda.gov
Attachment 5
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BGS-DEP 55-215 revised 7/2019
PART II: STATE FUNDED
This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2),Florida Statutes.
1. In the event that the recipient expends a total amount of state financial assistance equal to or in excess of
$750,000 in any fiscal year of such recipient (for fiscal years ending June 30, 2017, and thereafter), the
recipient must have a State single or project-specific audit for such fiscal year in accordance with Section
215.97, F.S.; Rule Chapter 69I-5, F.A.C., State Financial Assistance; and Chapters 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
EXHIBIT 1 to this form lists the state financial assistance awarded through the Department of Environmental
Protection by this agreement. In determining the state financial assistance expended in its fiscal year, the
recipient shall consider all sources of state financial assistance, including state financial assistance received
from the Department of Environmental Protection, other state agencies, and other nonstate entities. State
financial assistance does not include federal direct or pass-through awards and resources received by a
nonstate entity for Federal program matching requirements.
2. In connection with the audit requirements addressed in Part II,paragraph 1;the recipient shall ensure that the
audit complies with the requirements of Section 215.97(8),Florida Statutes. This includes submission of a
financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 10.550 (local
governmental entities)or 10.650(nonprofit and for-profit organizations),Rules of the Auditor General.
3. If the recipient expends less than$750,000 in state financial assistance in its fiscal year(for fiscal year ending
June 30, 2017, and thereafter), an audit conducted in accordance with the provisions of Section 215.97,
Florida Statutes,is not required. In the event that the recipient expends less than$750,000 in state financial
assistance in its fiscal year,and elects to have an audit conducted in accordance with the provisions of Section
215.97,Florida Statutes,the cost of the audit must be paid from the non-state entity's resources(i.e.,the cost
of such an audit must be paid from the recipient's resources obtained from other than State entities).
4. For information regarding the Florida Catalog of State Financial Assistance(CSFA),a recipient should access
the Florida Single Audit Act website located at https://apps.fldfs.com/fsaa for assistance. In addition to the
above websites, the following websites may be accessed for information: Legislature's Website at
http://www.leg.state.fl.us/Welcome/index.cfin, State of Florida's website at http://www.myflorida.com/,
Department of Financial Services' Website at http://www.fldfs.com/and the Auditor General's Website at
http://www.myflorida.com/audgen/.
PART III: OTHER AUDIT REQUIREMENTS
(NOTE: This part would be used to spec fy any additional audit requirements imposed by the State awarding entity
that are solely a matter of that State awarding entity's policy(Le., the audit is not required by Federal or State laws
and is not in conflict with other Federal or State audit requirements). Pursuant to Section 215.97(8),Florida Statutes,
State agencies may conduct or arrange for audits of State financial assistance that are in addition to audits conducted
in accordance with Section 215.97, Florida Statutes. In such an event, the State awarding agency must arrange for
finding the full cost of such additional audits.)
PART IV: REPORT SUBMISSION
1. Copies of reporting packages for audits conducted in accordance with 2 CFR Part 200, Subpart F-Audit
Requirements,and required by PART I of this form shall be submitted,when required by 2 CFR 200.512,by
or on behalf of the recipient directly to the Federal Audit Clearinghouse(FAC)as provided in 2 CFR 200.36
and 200.512
A. The Federal Audit Clearinghouse designated in 2 CFR§200.501(a)(the number of copies required by
2 CFR§200.501(a)should be submitted to the Federal Audit Clearinghouse),at the following address:
Attachment 5
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BGS-DEP 55-215 revised 7/2019
By Mail:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville,IN 47132
Submissions of the Single Audit reporting package for fiscal periods ending on or after January 1,
2008,must be submitted using the Federal Clearinghouse's Internet Data Entry System which can
be found at http://harvester.census.gov/facweb/
2. Copies of financial reporting packages required by PART II of this Attachment shall be submitted by or on
behalf of the recipient directly to each of the following:
A. The Department of Environmental Protection at one of the following addresses:
By Mail:
Audit Director
Florida Department of Environmental Protection
Office of Inspector General,MS 40
3900 Commonwealth Boulevard
Tallahassee,Florida 32399-3000
Electronically:
FDEPSingleAuditdep.state.fl.us
B. The Auditor General's Office at the following address:
Auditor General
Local Government Audits/342
Claude Pepper Building,Room 401
111 West Madison Street
Tallahassee,Florida 32399-1450
The Auditor General's website(http://flauditor.gov/)provides instructions for filing an
electronic copy of a financial reporting package.
3. Copies of reports or management letters required by PART III of this Attachment shall be submitted by or
on behalf of the recipient directly to the Department of Environmental Protection at one of the following
addresses:
By Mail:
Audit Director
Florida Department of Environmental Protection
Office of Inspector General,MS 40
3900 Commonwealth Boulevard
Tallahassee,Florida 32399-3000
Electronically:
FDEP S i n g l e A u d it(nid ep.state.fl.us
4. Any reports, management letters, or other information required to be submitted to the Department of
Environmental Protection pursuant to this Agreement shall be submitted timely in accordance with 2 CFR
200.512, section 215.97, F.S., and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and
for-profit organizations),Rules of the Auditor General,as applicable.
Attachment 5
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BGS-DEP 55-215 revised 7/2019
5. Recipients,when submitting financial reporting packages to the Department of Environmental Protection for
audits done in accordance with 2 CFR 200, Subpart F-Audit Requirements, or Chapters 10.550 (local
governmental entities)and 10.650 (non and for-profit organizations), Rules of the Auditor General, should
indicate the date and the reporting package was delivered to the recipient correspondence accompanying the
reporting package.
PART V: RECORD RETENTION
The recipient shall retain sufficient records demonstrating its compliance with the terms of the award and this
Agreement for a period of five(5)years from the date the audit report is issued, and shall allow the Department of
Environmental Protection, or its designee, Chief Financial Officer, or Auditor General access to such records upon
request.The recipient shall ensure that audit working papers are made available to the Department of Environmental
Protection, or its designee, Chief Financial Officer, or Auditor General upon request for a period of three (3)years
from the date the audit report is issued,unless extended in writing by the Department of Environmental Protection.
Attachment 5
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EXHIBIT—I
FUNDS AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING:
Note:If the resources awarded to the recipient represent more than one federal program,provide the same information shown below for each federal program
and show total federal resources awarded
Federal Resources Awarded to the Recipient Pursuant to this Agreement Consist of the Following:
Federal State
Program CFDA Appropriation
A Federal Agency Number _ CFDA Title Funding Amount Category
Federal State
Program CFDA Appropriation
B Federal Agency Number CFDA Title Funding Amount Category
Note:Of the resources awarded to the recipient represent more than one federal program,list applicable compliance requirements for each federal program in
the same manner as shown below:
Federal
Program First Compliance requirement:i.e.:(what services of purposes resources must be used for)
A
Second Compliance requirement:i.e.:(eligibility requirement for recipients of the resources)
Etc.
Etc.
Federal
Program First Compliance requirement:i.e.:(what services of purposes resources must be used for)
B
Second Compliance requirement:i.e.:(eligibility requirement for recipients of the resources)
Etc.
Etc.
Attachment 5,Exhibit 1
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BGS-DEP 55,115
Rcvisd 7.2019 •
Note:If the resources awarded to the recipient for matching represent more than one federal program,provide the same information shown below for each
federal program and show total state resources awarded for matching.
State Resources Awarded to the Recipient Pursuant to this Agreement Consist of the Following Matching Resources for Federal Programs:
Federal State
Program Appropriation
A Federal Agency CFDA CFDA Title Funding Amount Category
Federal State
Program Appropriation
B Federal Agency CFDA CFDA Title Funding Amount Category
Note:If the resources awarded to the recipient represent more than one state project,provide the same information shown below for each state project and show
total state financial assistance awarded that is subject to section 215.97,F.S.
State Resources Awarded to the Recipient Pursuant to this Agreement Consist of the Following Resources Subject to Section 215.97,F.S.:
State State Fiscal
Program FL Department of Year N/A Line Item No. 1613,GAA,Fiscal Year
A Environmental Protection - 2019-2020 2019-2020 $750,000.00 100777
State CSFA Title State
Program State CSFA or Appropriation
B State Awarding Agency Fiscal Year Number Funding Source Description Funding Amount Category
Total Award $750,000.00
Note:List applicable compliance requirement in the same manner as illustrated above for federal resources.For matching resources provided by the
Department for DEP for federal programs,the requirements might be similar to the requirements for the applicable federal programs.Also,to the extent that
different requirements pertain to different amount for the non-federal resources,there may be more than one grouping(i.e.1,2,3,etc)listed under this category.
For each program identified above,the recipient shall comply with the program requirements described in the Catalog of Federal Domestic Assistance(CFDA)
[www.cfda.gov]and/or the Florida Catalog of State Financial Assistance(CSFA)[https://apes.fldfs.com/fsaa/searchCatalog.aspx],and State Projects Compliance
Supplement(Part Four:State Projects Compliance Supplement[https://apps.fldfs.com/fsaa/state project compliance.aspx].The services/purposes for which the
funds are to be used are included in the Agreement's Grant Work Plan. Any match required by the Recipient is clearly indicated in the Agreement.
Attachment 5,Exhibit 1
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DEPARTMENT OF ENVIRONMENTAL PROTECTION
Progress Report Form
Exhibit A
DEP Agreement No.: Agreement No.
Grantee Name:
Grantee Address:
Grantee's Grant Manager: Telephone No.:
Reporting Period:
Project Number and Title:
Provide the following information for all tasks and deliverables identified in the Grant Work
Plan: a summary of project accomplishments for the reporting period; a comparison of
actual accomplishments to goals for the period; if goals were not met, provide reasons why;
provide an update on the estimated time for completion of the task and an explanation for
any anticipated delays and identify by task.
NOTE: Use as many pages as necessary to cover all tasks in the Grant Work Plan.
The following format should be followed:
Task 1:
Progress for this reporting period:
Identify any delays or problems encountered:
This report is submitted in accordance with the reporting requirements of DEP Agreement No.
Agreement No. and accurately reflects the activities associated with the project.
Signature of Grantee's Grant Manager Date
Exhibit A,DEP Agreement#: \gr,_
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Rev.5/30/2017
Exhibit C
PAYMENT REQUEST SUMMARY FORM
DEP Agreement No.: Agreement No. Agreement Effective Dates:
Grantee: Grantee's Grant Manager:
Mailing Address:
Payment Request No. Date of Payment Request:
Performance Period (Start date—End date):
Task/Deliverable No(s). Task/Deliverable Amount Requested: $
GRANT EXPENDITURES SUMMARY SECTION
AMOUNT OF TOTAL MATCHING TOTAL
CATEGORY OF EXPENDITURE THIS REQUEST CUMULATIVE FUNDS FOR CUMULATIVE
(As authorized) PAYMENT THIS REQUEST MATCHING
REQUESTS FUNDS
Salaries/Wages $N/A $ $N/A $N/A
Fringe Benefits $N/A $ $N/A $N/A
Indirect Cost $N/A $ $N/A $N/A
Contractual(Subcontractors) $ $ $N/A $N/A
Travel $N/A $ $N/A $N/A
Equipment(Direct Purchases) $N/A $ $N/A $N/A
Rental/Lease of Equipment $N/A $ $N/A $N/A
Miscellaneous/Other Expenses $N/A $ $N/A $N/A
Land Acquisition $N/A $ $N/A $N/A
TOTAL AMOUNT $ $ $N/A $N/A
TOTAL TASK/DELIVERABLE $ $N/A
BUDGET AMOUNT
Less Total Cumulative Payment $ $N/A
Requests of:
TOTAL REMAINING IN TASK $ $N/A
GRANTEE CERTIFICATION
Complete Grantee's Certification of Payment Request on Page 2 to certify that the amount being
requested for reimbursement above was for items that were charged to and utilized only for the above
cited grant activities.
Exhibit C,DEP Agreement#:
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Rev.6/14/2019
Grantee's Certification of Payment Request
, on behalf of
(Print name of Grantee's Grant Manager designated in the Agreement)
, do hereby certify for
(Print name of Grantee/Recipient)
DEP Agreement No. and Payment Request No. that:
Er The disbursement amount requested is for allowable costs for the project described in Attachment A of
the Agreement.
Q All costs included in the amount requested have been satisfactorily purchased, performed, received, and
applied toward completing the project; such costs are documented by invoices or other appropriate
documentation as required in the Agreement.
Q The Grantee has paid such costs under the terms and provisions of contracts relating directly to the project;
and the Grantee is not in default of any terms or provisions of the contracts.
Check all that apply below:
❑ All permits and approvals required for the construction,which is underway, have been obtained.
❑ Construction up to the point of this disbursement is in compliance with the construction plans and permits.
❑ The Grantee's Grant Manager relied on certifications from the following professionals that provided
services for this project during the time period covered by this Certification of Payment Request,and such
certifications are included:
Professional Service Provider(Name/License No.) Period of Service(mm/dd/yy—mm/dd/yy)
Grantee's Grant Manager Signature Grantee's Fiscal Agent Signature
Print Name Print Name
Telephone Number Telephone Number
Exhibit C,DEP Agreement#::fig! ement�u.
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Rev.6/14/2019
INSTRUCTIONS FOR COMPLETING
PAYMENT REQUEST SUMMARY FORM
DEP AGREEMENT NO.: This is the number on your grant agreement.
AGREEMENT EFFECTIVE DATES: Enter agreement execution date through end date.
GRANTEE: Enter the name of the grantee's agency.
GRANTEE'S GRANT MANAGER: This should be the person identified as grant manager in the grant Agreement.
MAILING ADDRESS: Enter the address that you want the state warrant sent.
PAYMENT REQUEST NO.: This is the number of your payment request,not the quarter number.
DATE OF PAYMENT REQUEST: This is the date you are submitting the request.
PERFORMANCE PERIOD: This is the beginning and ending date of the performance period for the task/deliverable
that the request is for(this must be within the timeline shown for the task/deliverable in the Agreement).
TASK/DELIVERABLE NO.: This is the number of the task/deliverable that you are requesting payment for and/or
claiming match for(must agree with the current Grant Work Plan).
TASK/DELIVERABLE AMOUNT REQUESTED: This should match the amount on the "TOTAL
TASK/DELIVERABLE BUDGET AMOUNT"line for the"AMOUNT OF THIS REQUEST'column.
GRANT EXPENDITURES SUMMARY SECTION:
"AMOUNT OF THIS REQUEST" COLUMN: Enter the amount that was expended for this task during the period
for which you are requesting reimbursement for this task. This must agree with the currently approved budget in the
current Grant Work Plan of your grant Agreement. Do not claim expenses in a budget category that does not have an
approved budget. Do not claim items that are not specifically identified in the current Grant Work Plan. Enter the
column total on the"TOTAL AMOUNT'line. Enter the amount of the task on the"TOTAL TASK BUDGET AMOUNT"
line. Enter the total cumulative amount of this request and all previous payments on the"LESS TOTAL CUMULATIVE
PAYMENT REQUESTS OF' line. Deduct the "LESS TOTAL CUMULATIVE PAYMENT REQUESTS OF' from the
"TOTAL TASK BUDGET AMOUNT"for the amount to enter on the"TOTAL REMAINING IN TASK' line.
"TOTAL CUMULATIVE PAYMENT REQUESTS" COLUMN: Enter the cumulative amounts that have been
requested to date for reimbursement by budget category. The final request should show the total of all requests; first
through the final request(this amount cannot exceed the approved budget amount for that budget category for the task
you are reporting on). Enter the column total on the"TOTALS'line. Do not enter anything in the shaded areas.
"MATCHING FUNDS" COLUMN: Enter the amount to be claimed as match for the performance period for the
task you are reporting on. This needs to be shown under specific budget categories according to the currently approved
Grant Work Plan. Enter the total on the"TOTAL AMOUNT' line for this column. Enter the match budget amount on
the "TOTAL TASK BUDGET AMOUNT' line for this column. Enter the total cumulative amount of this and any
previous match claimed on the"LESS TOTAL CUMULATIVE PAYMENTS OF'line for this column. Deduct the"LESS
TOTAL CUMULATIVE PAYMENTS OF'from the"TOTAL TASK BUDGET AMOUNT"for the amount to enter on the
"TOTAL REMAINING IN TASK'line.
"TOTAL CUMULATIVE MATCHING FUNDS" COLUMN: Enter the cumulative amount you have claimed to
date for match by budget category for the task. Put the total of all on the line titled"TOTALS." The final report should
show the total of all claims,first claim through the final claim,etc. Do not enter anything in the shaded areas.
GRANTEE'S CERTIFICATION: Check all boxes that apply. Identify any licensed professional service providers
that certified work or services completed during the period included in the request for payment. Must be signed by
both the Grantee's Grant Manager as identified in the grant agreement and the Grantee's Fiscal Agent.
NOTES:
If claiming reimbursement for travel,you must include copies of receipts and a copy of the travel reimbursement
form approved by the Department of Financial Services,Chief Financial Officer.
Documentation for match claims must meet the same requirements as those expenditures for reimbursement.
Exhibit C,DEP Agreement#: <\gi,_,mcnt No.
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