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Item C27 C.27 Cow of Monroe BOARD OF COUNTY COMMISSIONERS � � Mayor Heather Carruthers,District 3 The FlOnda Keys ` Mayor Pro Tem George Neugent,District 2 r Danny L.Kolhage,District 1 David Rice,District 4 k " nt Sylvia J.Murphy,District 5 County Commission Meeting October 19, 2016 Agenda Item Number: C.27 Agenda Item Summary #2201 BULK ITEM: Yes DEPARTMENT: Social Services TIME APPROXIMATE: STAFF CONTACT: Sheryl Graham (305) 292-4510 N/A AGENDA ITEM WORDING: Approval of Ratification of Nutrition Services Incentive Program (NSIP) Contract US-1651 between the Alliance for Aging, Inc., and Monroe County BOCC/Monroe County Social Services for the contract year 2015-2016 (10101115 - services end on 12/31/16; contract ends on 02/15/2017) in the amount of$42,766.48. ITEM BACKGROUND: The NSIP provides reimbursement for the purchase of United States produced agriculture and other food commodities for use in Nutrition projects operating under approved Older Americans Act Title III contracts. NSIP funds allow for a reimbursement to the County for congregate and home delivered meals provided to clients participating in our OAA grant. PREVIOUS RELEVANT BOCC ACTION: Approval of NSIP contract US-1651 between the Alliance for Aging, Inc., and Monroe County BOCC/Monroe County Social Services for the contract year 2015-2016 in the amount$27,245.93 on 10/21/2015. CONTRACT/AGREEMENT CHANGES: Yes, Increased funding by $15,520.55 STAFF RECOMMENDATION: Approval DOCUMENTATION: NSIP Amendment One 10-19-2016 NSIP Backup 10-19-2016 FINANCIAL IMPACT: Effective Date: 10/01/2015 Expiration Date: 02/15/2017 Total Dollar Value of Contract: $42,766.48 Packet Pg. 415 C.27 Total Cost to County: 10% cash match Current Year Portion: Budgeted: Source of Funds: Grant CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: No If yes, amount: Grant: County Match: 10% cash match Insurance Required: Additional Details: 10/19/16 125-6153315 • NUTRITION SVS INC PRG NS $15,520.55 REVIEWED BY: Sheryl Graham Completed 10/03/2016 3:48 PM Pedro Mercado Completed 10/03/2016 4:05 PM Budget and Finance Completed 10/04/2016 10:29 AM Maria Slavik Completed 10/04/2016 10:31 AM Kathy Peters Completed 10/04/2016 11:06 AM Board of County Commissioners Pending 10/19/2016 9:00 AM Packet Pg. 416 Contract# U51651, Amendment 001 CONTRACT AMENDMENT ONE BETWEEN ALLIANCE FOR AGING, INC. AND MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, SOCIAL SERVICES/IN-HOME SERVICES WHEREAS, on September 30, 2015, the Alliance for Aging, hereinafter referred to as the (Alliance) and Monroe County Board of County Commissioners, Social Services/In-Home Services, (Contractor), entered into original contract US-1651 for the provision of Nutritional Service Incentive Program; and NOW THEREFORE, the parties agree to the following: Q C� I. The purpose of this Amendment is to increase the service and funding, and replace attachi-rients and 8 V- contractual language of the contract. The additional funding for this Amendment is $15,520.55, 0- therefore the new total contract amount is $42,7 to66.48. Z cu 2. ATTACHMENT 1, SECTION 1.2.4 is hereby replaced. 0 1.2.4 Term of Provision of Services The term of this contract for the delivery of services shall be October 1, 2015 through December 31, 2016. E 3. ATTACHMENT Section 3.1 is hereby replaced E GENERAL STATEMENT OF METHOD OF PAYMENT This is a fixed rate contract. The Alliance shall make payment to the Contractor for provision of services up to 40 a maximum number of units of service and at the prospective rate stated below: CA Q Service to be Provided Unit of Service Unit Rate Maximum Cv Unitsrn Eligible Congregate and 1 unit= I meal S.72 59,398 Home Delivered Meals 0 4. ATTACHMENT 1, Section 3.2.1 is hereby replaced 3.1.1 Date for Final Request for Payment E (I) The final request for payment is due to the Alliance no later than February 15, 2017. This contract i for services provided during the 2015-2016 Federal Fiscal Year beginning October 1, 2015 throug] E December 31, 2016.; This contract shall automatically terminate after the final rate for the fedora fiscal year has been established and the release of final payments are authorized by the Alliance. Fn Z (2) In the event that the final reimbursement rate is greater or less than the rate in ATTACHMENT I ;ri Section 3.1, then this contract shall be appropriately adjusted upon notice from the Contract Manager. 0) (3) In the event of a conflict between this paragraph and any other provision in the contract, thi section shall supersede. 5. ATTACHMENT 1, Section 3.2.2.3 is hereby replaced The final request for reimbursement is due no later than January 15, 2017. 6. ATTACHMENT III is hereby replaced IN WITNESS THEREFORE, the Parties have executed this Amendment by the undersigned officials a,, duly authorized. Pagel Packet Pg.417 Contract# US1651,Amendment 001 Monroe County Board of County ALLIANCE FOR AGING, INC. Commissioners, Social Services/In-Rome Services SIGNED: J�l SIGNED;,,? 10 �aM t NAME: Sheryl Graham NAME: Max B. Roth n j, TITLE: Acting County Administrator TITLE: President/CEO Cv DATE: 9/28/2016 DATE: CL Fn z cu cu SIGNED BY: cu NAME: Heather Carruthers TITLE: MAYOR N DATE: CU 0 E CU CL 0 z CU Page2 Packet Pg.418 Contract# US1651,Amendment 001 AT,rACIIMENT 11 FINANCIAL AND COMPLIANCE AUDIT The ach-ninistration, of resources awarded by the Alliance to the provider may be Subject to audits and/or monitoring by the Allianceand/orthe Dcpartmcnt as described in this section. 1. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the Alliance and/or the Department staff,limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this agreement, the Contractor agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Alliance. In the event the Alliance and/or the Department detennines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any additional instructions provided by the Alliance and/or the Department to the Contractor regarding such audit. The Contractor further agrees Cv to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Alliance and/or the 0) Department. C; V_ CL AUDITS 0 z PART I:FEDERALLY FUNDED 0 '['his part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. E In the event that the Contractor expends $750,000.00 or more in federal awards during its 'a fiscal year, the Contractor must have a single or r_ program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised. EXHIBIT 2 to this agreement (1) E indicates federal resources awarded through the Alliance by this agreement. In determining the federal awards expended in its fiscal year, the < C o n t r a c t o r shall consider all sources of Federal awards,including federal resources received from the A I I i a n c e. The determination of amounts of Federal awards expended should be in accordance with the guidelines established by OMB Circular A-133, as revised. An audit of the Contractor conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will C*4 C*4 meet the requirements of this part. In connection with the audit requirements addressed in Part 1,paragraph 1,the Contractor shall fulfill the requirements relative to auditee 04 responsibilities as provided in Subpart C.of OMB Circular A-133,as revised. of If the Conti-actor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with the provisions of OMB Circular A-]33, as revised, is riot required. In the event that the Contractor expends less than $750,000.00 in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of OMB Circular A-133, as revised, the cost of the audit must ' 0 be paid from non-federal resources (i.e., the cost of such audit must be paid from Contractor resources obtained from other than federal entities,) E An audit conducted in accordance with this part shall cover the entire organization for the organizat ion's fiscal year. Cornpliancc findings related to agreements with the Alliance shall be based on the agreement's requirements, including any rules, regulations, or statute referenced in the agreement. The financial statements shall disclose whether or riot the matching requirement was met for each applicable < agreement. All questioned costs and liabilities due to the Alliance and/or the Department shall be fully disclosed in the audit report will CL reference to the Alliance agreement involved. If not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A-133, w Fn revised, the schedule of expenditures of federal awards shall identify expenditures by agreement number For each agreement with the Z Alliance in effect during the audit period. Financial reporting packages required under this part must be submitted within the earlier of'3( days after receipt of the audit report or 9 months after the end of the Contractor's fiscal year end. E PART II: STATE FUNDEDco This part is applicable if the Contractor is a non-state entity as defined by Section 215.97(2),F.S. In the event that the contractor expends a total amount of state financial assistance equal to or in excess of$750,000.00 in any fiscal year of such Contractor (for fiscal years ending September 30, 2004 or thereafter), the Contractor must have a State single or project-specific audit for Such fiscal year in accordance with Section 215,97, F.S.; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. EXHIBIT 2 to this agreement indicates sta financial assistance awarded through (lie A I I i a n c c by this agreement. In determining the state financial assistance expended in its fiscal year, tl Contractor shall consider all sources of state financial assistance, including state financial assistance received from the Alliance,other state agencic and other non-state entities. State financial assistance does not include Federal direct or pass-through awards and resources received by a non-state entity for Federal program matching requirements. Page3 Packet Pg.419 Contract# US1651,Amendment 001 Inconnection with the audit requirements addressed in Part 11,paragraph 1,the Contractor shall ensure that the audit complies with the requirerrients of'Scctio)ri 2 15.97(8), F.S. This includes submission of a financial reporting Package as defined by Section 215,97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650(nonprofit and for-profit organizations),Rules of the Auditor General. If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year (for fiscal years ending September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section215.97,F.S.,is not required. In the event that the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year and elects to have art audit conducted in accordance with the provisions of Section 215.97, F.S., 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 Contractor resources obtained from other than State entities). An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Alliance shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs v- Q and liabilities due to the Affiarocc shall be fially disclosed in the audit report with reference to the Alliance agreement involved. If not otherwise c-4 disclosed as required by Rule 691-5.003,Fla. Admin. Code,the schedule of expenditures of state financial assistance shall identify expenditures by � agreement number for each agreement with the AI I ia n e e in effect during the audit period. Financial reporting packages required under this C; part must be submitted within 45 days after delivery of the audit report, but-no later than 12 months after the Contractor's fiscal year end for — local governmental entities. Non-profit or for-profit organizations are required to be submitted within 45 days after delivery of the audit a- report, but no later than 9 months after the Contractor's fiscal year end. Notwithstanding the applicability of this portion, the Alliance retains all (ZO right and obligation to monitor and oversee the performance ofthis agreement as outlined throughout this document and pursuant to law, cu 11. PART III: REPORT SUBMISSION cu Copies of reporting packages for audits conducted in accordance with OMIT Circular A-]33, as revised, and required by PART I of this E agreement shall be submitted,when required by Section .320(d),OMB Circular A-I 33,as revised,by or on behalf'of the Contractor directlyto each of the following: E The Affiance at each of the following addresses: Alliance for Aging,Inc. Attn: Fiscal Department Q 760 NW 1071h C*4 Avenue C*4 Suite 214 Miami,FL 33172 Q The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections .320 (d)(1) and C� 0) (2), OMB Circular A-I 33,as revised, should be submitted to the Federal Audit Clearinghouse), at the following address: Federal Audit Clearinghouse Bureau of the Census 1201 East 10"'Street 0 Jeffersonville, IN 47132 cu Other Federal agencies and pass-through entities in accordance with Sections .320 (c) and (f), OMB Circular A-133, as revised. E Pursuant to Sections .320(t), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package described in a) Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the Alliance at each of the E following addresses: Alliance for Aging,Inc. CL Attn: Fiscal Department (0 760 NW 1071h Avenue Z Suite 214 Miami,FL 33172 E Additionally, copies of financial reporting packages required by Part 11 of this agreement shall be submitted by or on behalf of the Contractor U (a directly to each of the following: Q The Alliance at the following address: Alliance for Aging, Inc. Attn: Fiscal Department 760 NW 107"'Avenue Suite 214 Miami,FL 33172 Any reports, management letter, or other infori-nation required to be submitted to the Alliance pursuant to this agreement shall be submitte( timely in accordance with CM13 Circular A-133, F.S., and Chapters 10,550(local governmental entities)or 10.650 (nonprofit and lor-profi organizations), Rules of the Auditor General, as applicable. Page4 Packet Pg.420 Contract# U51651,Amendment 001 Contractors, when submitting financial reporting packages to the A I i i a n c e for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the Contractor in correspondence accompanying the reporting package. Ill. PART IV: RECORD RETENTION The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six (6) years from the date the audit report is issued, and shall allow the Alliance and the Department or its designee, the CFO or Auditor General Access to such records upon request. The Contractor shall ensure that audit working papers are made available to the Alliance and the Department, or its designee, CFO, or Auditor General upon request for a period of six (6) years from the date the audit report is issued, unless extended in writing by the Alliance. C*4 rn C; V- CL 0 z cu cu cu Q C*4 C*4 Q C*4 cu rn cu cu CL 0 z cu 4� Pagc5 Packet Pg.421 Contract# U51651,Amendment 001 ATTACHMENT11 EXHIBIT FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT PART I: AUDIT RELATIONSUIP DETERMINATION Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part §200.500, and/oi Section 215.97, Fla. Stat, Contractors who are determined to be recipients or subrecipients of federal awards and/or state financia assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part 11 of'Exhibit I is met Contractors who have been determined to be vendors are not subject to the and it requirements oft CFR Part §200.38, and/or Sectioi 215.97, Fla. Stat. Regardless of whether the audit requirements arc met, Contractors who have been determined to be recipients o subrecipients of Federal awards and/or state financial assistance must comply with applicable programmatic and fiscal compliance requirements. In accordance with 2 CFR Part §200 and/or Rule 691-5.006, FAC, Contractor has been determined to be: cfl Vendornot subjectto 2 CFR Part§200.3 8 and/or Section 215.97,F.S. C*4 Recipient/subrecipient subject to 2 CFR Part §200.86 and §200.93 and/or Section 215.97, F.S. rn Exempt organization not subject to 2 CFR Part §200 and/or Section 215.97, F.S. For Federal awards, for-profit organizations are C;V_ exempt for state financial assistance projects, public universities, community colleges, district school boards, branches of state v- (Florida) government, and chatter schools are exempt. Exempt organizations must comply with all compliance requirements set CL (0 forth within the contract or award document. Z 4) NOTE: If a Contractor is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by 0 0 the Alliance to subcontract, they must comply with Section 215,97(7), F.S., and Rule 691-.5006, PAC [state financial assistance] and 2 CFR Part §200.330 Lfederal awards]. cu E PART 11: FISCAL COMPLIANCE REQUIREMENTS cu FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal awards, state E maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a subrecipient must comply with the following fiscal laws, rules and regulations: C*4 STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW: 2 CFR Part §200.416-Cost Principles* 2 CFR Part §200.201-Administrative Requirements" C*4 2 CFR Part§200.500- Audit Requirements 0 1) Reference Guide f'(-)r State Expenditures Other fiscal requirements set forth in program laws, rules and regulations cu NON-PROFIT ORGANIZATIONS MUST FOLLOW: 0 2 CFR Part§200.400-.41 1-Cost Principles* 2 CFR Part §200.100-Administrative Requirements cu 2 CFR Part §200.500-Audit Requirements Reference(in idc for State Expenditures E Other fiscal requirements set forth in program laws, rules and regulations cu EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)MUST FOLLOW: E 2 CFR Part §200.418-Cost Principles* CL 2 CFR Part §200.100-Administrative Requirements (0 2 CFR Part §200.500-Audit Requirements Reference Guide for State Expenditures Z Other fiscal requirements set forth in program laws,rules and regulations cu *Some Federal programs may be exempted frorn compliance with the Cost Principles Circulars as noted in the 2 CFR Part §200.400(5)(c). E "For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S. Department of Education, U M 34 CFR 80. 4� STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a recipient/subrecipient must comply with the following fiscal laws,rules and regulations: Section 215.97,Fla. Stat. Chapter 691-5, Fla. Admin. Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations Page6 Packet Pg.422 Contract#US1651,Amendment 001 ATTACHMENT11 EXHIBIT 2 FINANCIAI,, AND COMPIAANCE AUDIT ATTACIIMEN,r FUNDING SUMMARY Note: itle 2 CFR §200.331,As Revised, and Section 215.97(5),Florida Statutes,Require That Information About Federal Programs and State Projects Be Provided to the Recipient and Are Stated in the Financial and Compliance Audit Attachment and Exhibit 1. Financial and Compliance Audit Attachment, Exhibit 2-Funding Summary Provides Information Regarding the Funding Sources Applicable to This Contract,Contained Herein,Is A Prediction of Funding Sources and Related Amounts Based on the Contract Budget. 1. FEDERAL,RESOURCES AWARDED TO THE SUBRECIPIEN'T'PURSUANT'I'O'I'HIS CONTRACT CONSIST OF THE FOLLOWING: cfl FEDERAL AWARD DATE: 10/1/2015 GRANT AWARD(FAIN#): N/A Cw DUNS NUMBER: 073876757 PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT ti CL Nutrition Services Incentive Program FGTF 93.053 $42,766.48 try z --—--___-- 0 TOTAL,FFDFRAI,AWARD E COMPLIANCE REQUIREMENTS APPEICABI-E TOTIIEFFDERAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOI.,L,OWS: cu E FEDFRAI,FUNDS: 2 CFR Part 200-Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. OMB Circular A-I 33,As amended-Audits of States,Local Governments, and Non-Profit Organizations N cv 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OFTHE FOLLOWING: Co Cv of MATCHING RESOUCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT .......... 0 TOTAL STATE AWARD E STATE FINANCIAL ASSITANCE SUBJECT TO sec.215.97, F.S. E PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT CL (0 z TOTAL AWARD E COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: STATE FINANCIAL ASSISTANCE: Section 215.97,F.S., Chapter 691-5, FL Admin Code, Reference Guide for State Expenditures,Other fiscal requirements set forth in program laws,rules and regulations. Paged Packet Pg.423 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 10/21/2015 Department: Social Services Bulk Item: Yes X No Staff Contact/Phone#: Sher ylIGGrah / 292-4510 AGENDA ITEM WORDING: Request ratification of Nutrition Services Incentive Program. (NSIP) Contract US-]651 between the Alliance for Aging, Inc., and Monroe County BOCC/Monroe County Social Services for the contract year 2015-2016 (1011115 — services end on 9/30/16; contract ends on 12/31/16) in the amount of$27,245.93. IT BACKGROUND: The NSIP provides reimbursement for the purchase of United States produced agricultural and other food commodities for use in nutrition projects operating under Q C� approved Older Americans Act Title III contracts. NSIP funds allow for a reimbursement to the M P V- County for congregate and home delivered meals provided to clients participating in our OAA grant. 8 V- CL PREVIOUS RELEVANT BOCC ACTION: Prior approval granted by the BOCC on 1/21/2015 for (0 z 4) NSIP Amendment 4001 to Contract # US-1551 between the Alliance for Aging, Inc., and Mon-roe 0C County BOCC/Monroe County Social Services For the contract year 2014-2015 (10/l/14— services end 2 C on 9/30/15; con-tract ends on 12/31/15). 0 E 'a C 0 CONTRACT/AGRE NT EME CHANGES: None E STAFF RECOMMENDATIONS: Approval 04 Q N TO COST: $ 27,245.93 ,,," INDIRECT COST: —0— CL BUDGETED: Yes X No DIFFERENTIAL OF LOCAL PREFERENCE: —N/A CL COST TO COUNTY: $ 10% CASH MATCH SOURCE OF FUNDS: GRANT FUNDS & 0 z General Revenue for Match C 0 E REVENUE PRODUCING: Yes No X AMOUN,r PER YEAR X APPROVED BY: County Attorney OMB/Purchasing fl Risk Management DOCUMENTATION: Included X Not Required_ DISPOSITION: AGENDAITEM# Revised 6/15 Packet Pg.424 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ............. CONTRACT SUMMARY Contract with: Alliance for Aging Inc Contract# US 1651 Effective Date: 10/1/2015 Expiration Date: 12/31/2016 Contract Purpose/Description: Request ratification of Nutrition Services Incentive Program (NSIP) Contract US-1651 between the Alliance for Aging, Inc., and Monroe County BOCC/Monroe County Social Services for the contract year 2015-2016 (1011115 - services end on 9/30/16; contract ends on 1.2/31/16) in the amount of$27,245.93. Q C� rn Contract Manager: Sheryl Graham 292-4510 Social Services/ Stop #1 (Name), to (Ext.) (Department/Stop z 0 for BOCC Meeting on: Agenda Deadline: 10/21/2015 10/06/2015 E E CONTRACT COSTS Q Total Dollar Value of Contract: Current Year Portion: $ 0 cNv $ 27,245.93 Budgeted? Yes Z No D Account Codes: 1.25-6153315-(New Account Code} Q C� Grant: $ 27,245.93 County Match: $ 10% CASH MATCH CL ADDITIONAL, COSTS Estimated Ongoing Costs: $�Q/yr For: CL (Not included in dollar value above) z(0 CONTRACT REVIEW cu Changes Date Out Date In Needed Reviewer Department Head 9/29/15 Yes[:] No Z 9/29/2015 W1 Yes[:] No[2' Risk Management 1,LLL - O.M.B./Purchasing 10 Pjj',�- Yes[:]No[Sj O.M.B./Pu L ob., I County Attorney Yes ] N Comments: OMB Forrn Revised 2/27/01 MCP#2 Packet Pg.425 October 2015 —December 2016 ,„ T 1 Contract No. US-1651 FLORIDA DEPARTMENT OF ELDER AFFAIRS CONTRACT u lly NUTRITION SERVICES INCENTIVE PROGRAM Executed THIS CONTRACT is entered into between the Alliance for aging, Inc.. hereinafter referred to as the "Alliance", and Monroe County Social Services (Contractor;), and collectively referred to as the"Parties." ITNESSET THAT: WHEREAS, the Alliance has determined that it is in need of certain services as described herein; and WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent Contractor of the Alliance. NOW THEREFORE,in consideration of the services to be performed and payments to be made, together with the mutual ea covenants and conditions hereinafter set forth, the Parties agree as follows: o cv of 1. r ce of antra o The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract CL including all attachments, forms, exhibits and references incorporated, which constitute the contract docurent. 0 z 2. c The contract will incorporate attachments,proposal(s),state plan(s),grant agreements,relevarrt Department handbooks, O manuals, as an integral pant of the contract, except to the extent that the contract explicitly provides to the contrary. In 0) the event of conflict in language among any of the documents referenced above, the specific provisions and -o requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other general c materials not specific to this contract document and identified attachments. Q This contract shall begin on October I,2015 and shall end on September Sag 2016. C Delivery of services shall end on September 30,2016. This contract shall end on December 31 2016. See Attachment � 1, Section 111. Q rn c 4„ Lw&AUAMQW1t a The Alliance agrees to pay for contracted services according to the terms and conditions of this contract in an arnount not to exceed illZ.45.93 or the rate schedule, subject to the availability of funds. Any costs or services paid for m under any other contract or from any other source are not eligible for payment under this contract. a u7 5. Renewals z The contract may be renewed on a yearly basis for no more than two additional years. Such renewals shall be contingent upon satisfactory performance evaluations as determined by the Alliance and the availability of funds. Any renewal of E a contract shall be subject to mutual agreement, confirmed in writing, and subject to the same terms and conditions set 15 forth in the initial contract. The renewal price, or method for determining a renewal price, set forth in the bid, proposal, Q e or reply. No other costs for the renewal may be charged. In the event that a subsequent agreement may not be executed prior to the July l"start date, the Alliance may, at its discretion, extend this Agreement upon written notice for up to 90 days to ensure continuity of service. Services provided under this extension will be paid for out of the succeeding agreement amount. l Packet Pg.426 Octok�r 2015 --December 2016 Contract No. US-1651 6. Official Payee and Representatives (Names. Addresses, and Telephone Numbers): The Contractor name, as shown on page I of this Sheryl Graham, Senior Director a. contract, and mailing address of the official payee to Monroe County Social Services whom the payment shall be made is: 1100 Simonton Street, 2"d Floor Key West, FL 33040 Kim Wilkes Wean, Compliance Manager The name of the contact person and street address where 1100 Simonton Street, 2"" Floor b. financial and administrative records are maintained is: Key West, FL 33040, Sheryl Graham, Senior Director The name, address, and telephone number of the Monroe County Social Services C. representative of the Contractor responsible for 1100 Simonton Street, 2 d Floor cs administration of the program under this contract is: Key West, FL Q Cv 33040 of Laurie Serno, CFO ca d. The section and location within the Alliance where The Alliance for Aging, Inc. CL Requests for Payment and Receipt and Expenditure 760 NW 107"'Avenue, Suite 214, 2,d Floor to forms are to be mailed is: Miami, FL 33172 cu Dianne Duke 0 0. The name, address, and telephone number of the 760 NW 1071"Avenue, Suite 214, 2""Floor Miami, FL 32172 E Contract Manager for this contract is: (305) 670-6500 'a cu Upon change of representatives(names,addresses, telephone numbers)by either party, notice shall be provided Q in writing to the other party and the notification attached to the originals of this contract. 04 cv cfl 7. All Terms aad_L2fldjfi2R&jndHdgLL- CQv This contract and its Attachments, 1, 111, VII, and H and any exhibits referenced in said attachments, together with M any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are 12 V- no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all CL previous communications, representations or agreements, either written or verbal between U co CL IN WITNESS THEREOF, the Parties hereto have caused this contract, to be executed by their undersigned officials as 0 z duly authorized. cu Contractor: MONROE,COUNTY SOCIAL ALLIANCE FOR AGING, INC. E S Ej SIGNED BY: SIGNED BY: NAME: ROMAN GASTESI ..... NAME: Max B. Rothman, JD, LL.M. TITLE: COUNTY ADMINISTRATOR TITLE: President and CEO 15 DATE: 23 S NJ BY: r 'ZO A A M E':-" DANNY I LHAGE BY, .. ........ 2 TITLE: MAYOR DATE: ffPacket Pg.427 Contract No. US-1651 C.27.b October 2015 —December 201 6 INDEX TO ATTACHMENTS Attachment I STATEMENT OF _C Attachment III FUNDING SUMMARY INCLUDING EXHIBIT Attachment VII REQUEST FOR REIMBURSEMENT Attachment H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISPS .... to c ra rn in z c 0 ` u E c _ cu CD C, rn i5. U t0 LEI CL ill z C CU E L U t0 3 Packet Pg.428 October 2015 —December 2016 Contract No. US-1651 ATTACHMENT I STATEMENT OF WORK THE ALLIANCE FOR AGING,INC. NUTRITION SERVICES INCENTIVE PROGRAM SECTION I. SER VICES TO BE PROVIDED 1.1 GENERAL DESCRIPTION 1.1.1 General Statement The NSIP is intended to provide incentives for the effective delivery of nutritious meals to older individuals. NSIP allows programs to increase the number and/or the quality of meals served. NSIP is a cash allotment or commodity program that supplements funding or food used in meals served under the OAA. Florida has N opted for cash payments in lieu of donated foods. 1.1.2 Authority The relevant authority governing NSW are: cu z (1) Older Americans Act of 2006, as amended, Section 311 (42 U.S.C. § 3030a) 0 (2) 42 U.S.C. 303a, 42 U.S.C, 604 (3) Section 430.101,Florida Statutes E (4) Catalog of Federal Domestic Assistance(CFDA) 93.05cu E 1.1.3 Scope of Service Q C*4 CA The Contractor is responsible for the programmatic, fiscal and operational management of the NSTP, involving oversight of the nutrition service operations of its subcontracted providers. The program services Q provided under this contract shall be provided in a manner consistent with and described in the Contractor's C� current area plan update, which is incorporated by reference, and the current DOEA Program and Services Handbook, which is also incorporated by reference. CL 1.2.3.1 In fulfilling the terms of this agreement, the Contractor's scope of services shall consist of completion of the following service tasks: (1) Client Eligibility Determination; (2) Program Eligibility Compliance; (3) M Program Coordination and Oversight; (4) Ensuring Compliance with Prescribed Nutrition Requirements; (5) Ensuring Compliance with Prescribed Food Origin Requirements; (6) Compliance with Program z Reporting and Records Management Requirements;and(7)Monitoring the Performance of Subcontractors. ;rj 0) E 1.2.3.2 The Contractor shall use the NSIP funding under this contract to supplement funding for food used in meals served under the OAA, 1.2.4 Term of Provision of Services The term of this contract for the delivery of services shall be as referenced in Paragraph 3 of this contract. However, for the purpose of settling upon the appropriate meal reimbursement rate, as provided by USDA, the contract shall remain open until December 31, 2016, Notwithstanding this three (3) month reconciliation period, this contract makes no provisions for the payment of any services provided beyond September 30, 2016. 1.2.5 Major Program Goals The major goals of the NSIP program are as follows: 4 Packet Pg.429 October 2015 —December 2016 Contract No. US-1651 (1) To supplement funding for food used in meals served by OAA Nutrition Program Providers; and (2) Provide incentives for the effective delivery of nutritious meals to older individuals. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 Congregate Meals Client eligibility for congregate meals is as follows: (1) Individuals age 60 or older; (2) Spouses (regardless of age) attending the dining center with their eligible spouse-, (3) Persons with a disability, regardless of age, residing in a housing facility occupied pril'narily by older individuals where congregate nutrition services are provided; ( Q4) Persons with disabilities residing at home with and accompanying an eligible person to the dining C� center; and (5) Volunteers, regardless of age, providing essential services on a regular basis during meal hours. CL 1.3.2 Home Delivered Meals z cu Client eligibility for congregate meals is as follows: 0 cu (1) Individuals age 60 or older who are homebound by reason of illness, disability or isolation; E cu (2) The spouse of a homebound eligible individual,regardless of age if the provision of the collateral meal E supports maintaining the homebound eligible individual at home; (3) Individuals with a disability, regardless of age, residing at home with eligible individuals and are dependent on them for care; cfl (4) Persons at nutritional risk having physical,emotional or behavioral conditions,which would make their Q presence at the congregate site inappropriate; and C� 0) V_ (5) Pei-sons at nutritional risk who are socially or otherwise isolated and unable to attend a congregate nutrition site, CL sc 1.3.3 Restrictions coo Meals served to an elderly individual funded in whole or in part Linder the Medicaid Waiver, Home Care z for the Elderly or Community Care for the Elderly Programs or other means tested programs may not be included in the NSIP count. E SECTION II: MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS 2.1.1 Client Eligibility Determination The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements desc6bed in this ATTACHMENT 1,Section 112.1.2. 2.1.2 Program Eligibility Requirements Entities must meet the following criteria in order to be eligible for program participation: (1) An agency that has received a grant under the OAA Title III(OAA section 3 1.1(42 U.S.C.3030a)); and 5 1 Packet Pg.430 Ociober 2015 —December 2016 Contract No. US-1651 (2) A nutrition service provider that serves meals and is under the jurisdiction, control, management and audit authority of the Area Agency on Aging and the Department of Elder Affairs. 2.1.3 Oversight of Provider's Nutrition Service Operations The Contractor shall oversee the nutrition service operations of the provider to ensure that the requirements of ATTACHMENT I are met, as well as any other applicable regulations and policies prescribed by the Department of Health and Human Set-vices, USDA, state and local health departments or any other agency designated to inspect meal quality for the State. 2.1.4 Prescribed Nutritional Requirements The Contractor shall ensure that each meal provided under this NSEP contract meets the following criteria: (1) Comply with the current Dietary Guidelines for Americans, published by the Secretaries of the Department of Health and Human Services and the Department of Agriculture; and N M (2) Provide a minimum of 33 1/3 percent of the dietary reference intakes/adequate intakes for an age 70+ female as established by the Food and Nutrition Board of the National Academy of Sciences. a. 2.1.5 Food Origin and Commodities Requirements 0 Consistent with existing requirements of the Nutrition Services Incentive program, the Contractor and its service providers may use NSIP cash to purchase foods of U.S. origin for their nutrition projects under Title E III of the OAA. NSIP funds must be used to expand meal services to older adults. E 2.1.6 Compliance with Program Reporting and Records Management Requirements (1) The Contractor shall ensure that all program reporting requirements evidencing service delivery are eQl timely met. The Contractor must establish interim report submittal due dates for its providers or Subcontractors to permit the Contractor to meet the Department's reporting deadlines. 0 (2) In addition to any special reports that may be requested by the Department,the Contractor shall comply C� M with the reporting and records management requirements as referenced in this ATTACHMENT 11,sections 2.4 through 2.5.1, CL 2.1.7 Use of Subcontractors If this contract involves the use of a Subcontractor or third party, then the Conti-actor shall not delay the CL implementation of its agreement with the Subcontractor. If any circumstances occur that may result in a Fn z delay for a period of 60 days or more of the initiation of the Subcontract or in the performance of the Subcontractor, the Contractor shall notify the Contract Manager and the Alliance's Chief Financial Officer in writing of such delay. E The Contractor shall not permit a Subcontractor to perform services related to this agreement without 430 having a binding Subcontractor agreement executed. The Alliance will not be responsible or liable for any obligations or claims resulting from such action. 2.1.8 Monitoring the Performance of Subcontractors The Contractor shall monitor at least, once per year each of its Subcontractors, Subrecipients, Vendors and/or Consultants paid from funds provided under this contract. The Contractor shall perform fiscal, administrative and programmatic monitoring to ensure contractual compliance, fiscal accountability, programmatic performance and compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time schedules are met, the budget and scope of work are accomplished within the specified time periods and other performance goals stated in this contract are achieved. 6 Packet Pg.431 October 2015 —December 2016. Contract No. US-165 1 2.2 SERVICE TIMES 2.2.1 Service'rimes The Contractor shall ensure the services listed in this contract are available at times appropriate to meet client service needs, at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00arn to 5:00pm. 2.3 DELIVERABLES 2.3.1 Service Unit The Contractor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in ATTACHMENT 1, SECTION 11 Part 2.1. The chart below lists the type of services allowed and the unit of measurement: Q Cv Congregate Meals Meal Home Delivered Meals Meal z cu cu cu Q 04 Nt co V- Q N rn CL CCI CL 0 z CU 7 Packet Pg.432 October 2105 to December 2016 Contract# US 1651 2.4 REPORTS The Contractor shall respond to additional routine and/or special requests for information and reports required by the Alliance in a timely manner as determined by the Contract Manager. The Contractor shall establish due dates for any Subcontractors that permit the Contractor to meet the Alliance's reporting requirements. 2.4.1 Client Information and Registration Tracking System (CIRTS) Reports The Conti-actor shall input NSIP specific data into CIRTS to ensure CIRTS data accuracy. The Contractor shall use CIRTS generated reports which include the following: (1) Client Reports; (2) Monitoring Reports; (3) Services Reports; (4) Miscellaneous Reports; Q (5) Fiscal Reports; Ca (6) Aging and Disability Resource Center Reports; and (7) Outcome Measurement Reports. 2.5 RECORDS AND DOCUMENTATION z cu The Contractor shall ensure the collection and maintenance of client and service information on a monthly basis 0 from the ClRTS or any such system designated by the Department. Maintenance includes valid exports and backups of a 0) all data and systems according to Department standards. E 2.5.1 Each Contractor and Subcontractor, among other requirements, must anticipate and prepare for the loss of E information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the cornputer system. Data and software essential to the continued operation of Contractor functions must be backed up. The security controls over the backup resources C*4 C*4 shall be as stringent as the protection required of the primary resources. It is recommended that a copy of to the backed up data be stored in a secure, offsite location. The Contractor shall maintain written V_ policies and procedures for computer system backup and recovery and shall have the same requirement in c� its contracts and/or agreements with Subcontractors. These policies and procedures will be made available to the Alliance upon request. CL sc 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes CL 0 z �j The Contractor shall ensure services provided under this contract are in accordance with the current DOE, 5) Programs and Services Handbook. E The Contractor shall timely submit to the Alliance all reports and information described in ATTACHMENT 1,SECTION 112.4 and 2.5. 2.7 ALLIANCE RESPONSIBILITIES 2.7.1 Program Guidance and Technical Assistance The Alliance will provide the Contractor with guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Contractor. 2.7.2 Contract Monitoring The Alliance will review and evaluate the performance of the Contractor under the terms of this contract 8 1 Packet Pg.433 October 2105 to December 2016 Contract# US 1651 Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, or an on-site visit. The Alliance's determination of acceptable performance shall be conclusive. The Contractor agrees to cooperate with the Alliance in monitoring the progress of completion of the service task,,i and deliverables. The Alliance may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-tip on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; cfl (7) Review of customer satisfaction surveys; CD Cv (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and CL (10)Other procedures as deemed necessary. to Z cu SECTION III: METHOD OF PAYMENT cu 3.1 GENERAL STATEMENT OF METHOD OF PAYMENT E cu This is a fixed rate contract. The Alliance shall make payment to the Contractor for provision of services up to a E maximum number of units of service and at the prospective rate stated below: CD Service to be Provided Unit of Service Unit Rate Maximum CA Eligible Congregate and ! unit= I meal $.72 37,842 Co Home Delivered Meals C� rn The prospective rate is based on the estimated OAA grant award. 3.2 REQUESTS FOR PAYMENT CL sc 3.2.1 Date for Final Request for Payment (1) The final request for payment is due to the Alliance no later than J)&JQhSr_JJ,=, This contract, is for services CL provided during the 2014 Federal Fiscal Year beginning 9_d9J 2gLJ,_Z9Lthrough t� suamh=.& am; Z however, the contract is in effect through DSCVXab_gLJL,=. The additional three months (QSADJyj.�L 2M �j through are to allow rates to be adjusted for the service period. This contract shall 5 automatically terminate after the final rate for the federal fiscal year has been established and the release of final payments are authorized by the Alliance. (2) In the event that the final reimbursement rate is greater or less than the rate in ATTACHMENT 1, Section 3.1, then this contract shall be appropriately adjusted upon notice from the Contract Manager. (3) In the event of a conflict between this paragraph and any other provision in the contract, this section shall supersede, 3.2.2 Documentation for Payment The Contractor shall submit all requests for reimbursement in accordance with (ATTACHMENT 1) All requests for reimbursement must include the following: (1) The Contractor shall submit the request for reimbursement on DOEA Form 117NSIP, NSIP Request for Reirriburserrient, (ATTAC11 III ENT VH); (2) The Contractor shall submit a CIRTS report with DOEA Form ll7NSfP as supporting documentation 9 1 Packet Pg.434 October 2105 to December 2016 Contract#US 1651 for the total number of meals reported. The CIRTS report must match the number of meals reported on DOER Form 117NSIP; (3) The due date for the request for reimbursement and report(s) is no later than the JQJJLday of the month following the month being reported, except for the final request for reimbursement, which is due no later than 0SJQhgLJJ2". The Recipient must submit the final request for payment to the Alliance no more than 15 days after the contract ends or is terminated; if the Recipient fails to do so, all right to payment is forfeited, and the Alliance will not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from the Recipient, and necessary adjustments thereto, have been approved by the Alliance. (4) Additional Reporting Requirements: If the Alliance has sanctioned the recipient, while the sanctions are in effect the recipient shall provide to the Alliance, on a monthly basis, the recipient's financial statements that reflect the current, un-audited revenues and expenditures and the recipient's cash position as well as any other documentation that may be requested by the Alliance. Q (5) If the recipient is required to prepare a corrective action plan, supporting documentation as requested by Cv the Alliance shall be provided. 3.2.2.1 The Contractor shall maintain documentation to support payment requests that shall be available to the 0- Alliance or authorized individuals, such as the Alliance of Financial Services,upon request, 0 Z 3.2. Q 2.2 Any payment due by the Alliance under the terms of this contract may be withheld pending the receipt and r- approval by the Alliance of complete and accurate financial and programmatic reports due fromthe Contractor, 0 and any adjustments thereto, including any disallowance not resolved or pending resolution. E 3.2.2.3 The Contractor must enter all required data per (ATTACHMENT 1). The data must be entered into the CIRTS before the Subcontractors submit their request for payment and expenditure reports to the E Contractor. The Contractor shall establish time frames to assure compliance with due dates for the < submission of requests for payment and expenditure reports to the Alliance. c. Q 3.2.2.4 The Contractor must run monthly CIRTS reports and verify client and service data in the CIRTS is c*4 accurate. This report must be submitted to the Contractor with the monthly request for payment and w expenditure report and must be reviewed by the Contractor before the Subcontractor's request for payment ('D and expenditure reports can be approved by the Contractor. C� 3.2.3 Remedies for Nonconforming Services 8 The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services shall only be delivered to eligible program participants. CL 3.2.3.1 If the Contractor fails to meet the prescribed quality standards for services, such services will not be to reimbursed under this contract. In addition, any nonconforming goods (including home delivered meals) Z and/or services not meeting such standards will not be reimbursed under this contract. The Contractor's signature on the request for payment form certifies maintenance of supporting documentation and E acknowledgement that the Contractor shall solely bear the costs associated with preparing or providing 'ur- nonconforming goods and/or services, The Alliance requires immediate notice of any significant and/or Q systemic infractions that compromise the quality, security or continuity of services to clients. 3.2.4 Consequence for Noncompliance/Financial Consequences The Contractor shall ensure 100% of the deliverables identified in ATTACHMENT I are performed pursuant to contract requirements. The Service Tasks identified in Section 2.1 are Major Deliverables in this contract. 3.2.4.1 If at any time the Contractor is notified by the Alliance's Contract Manager that it has failed to correctly, completely, or adequately perform the Major Deliverables, the Contractor will have 10 days to issue a Corrective Action Plan ("CAP") to the Contract Manager or delegee that addresses the deficiencies and states how the deficiencies will be remedied within the specified time period. The Alliance shall assess a Financial Consequence of 1% 10 I Packet Pg.435 October 2105 to December 2016 Contract# US 1651 of the monthly value of the contract for Non-Compliance on the Contractor for each Deficiency identified in the CAP which is not corrected pursuant to the CAP. The Alliance will also assess a Financial Consequence for failure to timely submit a CAP. 3.2.4.2 In the event the Contractor fails to correct an identified deficiency within the firneline specified in the CAP, the Alliance shall. deduct, from the payment for the invoice of the following month, 1% of the monthly value of the contract for each day the deficiency is not corrected. cfl Cv rn cu cu cu Q 04 Nt co V_ Q N rn CL CCI CL 0 z CU Packet Pg.436 October 2105 to December 2016 Contract#US 1651 ATTACHMENT III 1. FEDERAL RESOURCES AWARDEDTO THE SUBRECIPIEN,r PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT Nutrition Services Incentive Program FGTF 93.053 $27,245.93 TOTAL FEDERAL A A 27,245.93 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT o TO THIS CONTRACTARE AS FOLLOWS: FEDERAL FUNDS: 2 CFR Pail 200 Uniform Administrative ReClUirenients,Cost Principles,and ALldil Requirement for Federal Awards. z cu STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: E E MATCHING RE'SOURCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CF. A AMOUNT 04 0 N TOTAL STATE AWARD CL STATE FINANCIAL ASSISTANCE SUBJECT TO See.215.97,F.S. PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT z cu TOTAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A 12 Packet Pg.437 October 2105 to December 2016 Contract#US 1651 ATTACHMENT III EXHIBIT 1 PART 1: AUDIT RELATIONSHIP DETERMINATION Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A-1 33,as revised,and/or Section 215.97,Fla. Star. Providers who are determined to be Recipients or Subrecipients of federal awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit I are rnet. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A- 133,as revised, and/or Section 215.97,Fla. Star. Regardless of whether the audit requirements are met,providers who have been determined to be Recipients or Subrecipients of Federal awards and/or state-financial assistance, must comply with applicable programmatic and fiscal compliance requirements, In accordance with See.210 of OMB Circular A-133 and/or Rule 691-5.006,FAC,provider has been determined to be: Vendor or exempt entity and not subject to OMB Circular A-133 and/or Section 215.97,F.S. X Recipient/Subrecipient subject to OMB Circular A-133 and/or Section 215.97,F.S. N of NOTE: If a provider is determined to be a Recipient/Subrecipient of federal and or state financial assistance and has been approved by the Department to subcontract, they must comply with Section 215.97(7),F.S.,and Rule 691-5.006(2),FAC[state financial assistance]and Section 400 OMB Circular A-133 [federal awards]. CL z PART II: FISCAL, COMI'LIANCE REQUIREMENTS 0 FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive federal awards or 15 0) state matching funds on federal awards and who are determined to be a SLibrecipient, must comply with the following fiscal laws, rules E and regulations: cu STATES,LOCAL GOVERNMENTS ANDINDIAN TRIBES MUST FOLLOW: E 2 CFR Part 200 Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards. OMB Circular A-102—Administrative Requirements Q 04 OMB Circular A-133—Audit Requirements Et Reference Guide for State Expenditures (.0 Other fiscal requirements set forth in program laws,rules and regulations NON-PROFIT ORGANIZATIONS MUST FOLLOW: C� 0) 2 CFR Part 200 Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards. OMB Circular A-133—Audit Requirements Reference Guide for State Expenditures CL Other fiscal requirements set forth in program laws,rules and regulations EDUCATIONAL INSTITUTIONS(EVEN IF PART OF A STATE OR LOCAL GOVERNMENT)MUST FOLLOW: CL 2 CFR Part 200 Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards. Fn OMB Circular A-133—Audit Requirements z Reference Guide for State Expenditures Other fiscal requirements set forth in program laws,rules and regulations E *Some federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular (a 4� A-133 Compliance Supplement,Appendix 1. STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a Recipient/Subrecipient,must comply with the following fiscal laws,rules and regulations: Section 215.97,Fla.Stat. Chapter 691-5,Fla.Admin.Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws,rules and regulations 13 Packet Pg.438 October 2015 —December 2016 Contract#US 1651 ATTACHMENT V11 REQUEST FOR REIMBURSEMENT Nutrition Services Incentive Program PROVIDER NAME,ADDRESS;PHONE#and FEID* TYPE OF REPORT: T43—S-REQUEST PERIOD: Payment Request: From To O Regular Final Report# CV Contract Period To Contract aS CL (0 z PSA#_ CERTIFICATION: I hereby certify that to the best or my Knowledge the information In IN$report 11 accurate and complete and that all outlays reported harem were for purposes 0 set forth In the contract documents. CU Pre erect b: Data:. A rove Date PART A: REIMBURSEMENT COMPUTATION YEAR TO DATE CURRENTMONTH E CONGREGATE HOME DELIVERED CONGREGATE HOME DELIVERED 1.Number of Meals Served 0 0 0 0 04CD 2.Lino I Times$.72 cents per Meal $0.00 $0.00 $0.00 $0.00 (0 V— CD C14 Year To Date Total Meals 0 Current Month Total Meals 0 aj O Year To Date Total Reimbursed $0.00 Total Reimbursement Requested CL PART B: CONTRACT SUMMARY CO 1.Approved Contract Amount 0,00 CL 2. Previous Reimbursomards Requested --$0.00 (0 3. Contract Balance $0.00 z 4.Amount to be Reimbursed-This Report $0.00 S.Contract Balance $0,44 E 4� VOCA Folm 11 7rr c t ev-d 7114 14 Packet Pg.439 October 2015 —December 2016 Contract# US 1651 ATTACHMENT H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is an attachment, hereby certifies that: (1)The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List (collectively, "the Lists") is ineligible for, and may not bid on, submit a proposal for, or enter into or renew a contract with the Department of Elder Affairs (Department) for goods or services of$1. million or more. N (2) The Conti-actor understands that, pursuant to s. 287.135 F.S., any company that submits a false certification to the Department is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. Z cu (3) The Contractor understands that the contract to which this form is an attachment may be terminated by the 0 Department if the Contractor submits a false certification or has been placed oil the Lists. E This certification, required by Florida law, is a material representation of fact upon which reliance was placed .0 E_ 0) when this transaction was made or entered into. Submission of this certification is a prerequisite for making or E entering into this transaction. Q 7 Q C� Signature D atrn (Same as contract signature) CL COUNTY ADMINISTRATOR Title CL (0 Z MONROE COUNTY BOCC/SOCIAL SERVICES E Company Name co 15 Packet Pg.440