FY2021 10/21/2020 Agreement Kevin Madok, CPA
Clerk of the Circuit Court&Comptroller—Monroe County, Florida
DATE: October 30, 2020
TO: Janet Gunderson
Senior Grant& Finance Analyst
FROM: Pamela G. HancC.
SUBJECT: October 21`BOCC Meeting
Attached is an electronic copy of the following items for your handling:
C24 Fiscal Year 2021 Clerk's Drug Abuse Trust Fund Agreements, totaling$56,822.00,
as follows: Florida Keys Children's Slicker, Inc.,in the amount of$9,429.00; Key Bridge, Inc., in
the amount of$19,028.00; Florida Keys Outreach Coalition, Inc., in tine amount of$6,211.00;
Guidance/Care Center, Inc., Heron, in the amount of$I5,914.00; and Keys to Be the Change,
Inc., in die amount of$6,240.00; for Substance Abuse Treatment and Prevention Programs.The
Substance Abuse Policy Advisory Board recommended die programs to be funded by the Clerk's
Drug Abuse Trust Fund.
Should you have any questions please feel free to contact me at(305) 292-3550.
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING
500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road
Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070
305-294-4641 305-289-6027 305-852-7145 305-852-7145
AGREEMENT
This Agreement is made and entered into this 21s' day of October 2020, between the
BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as
"Board"or"County,"and Key Bridge, Inc., hereinafter referred to as"PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
providing substance abuse prevention and treatment and mental health treatment, and
WHEREAS, it is a legitimate public purpose to provide substance abuse prevention and
treatment and mental health treatment, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
FUNDING
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and providing substance abuse prevention and treatment and
mental health treatment services for persons in Monroe County, Florida, shall pay to the
PROVIDER the sum of NINETEEN THOUSAND, TWENTY-EIGHT AND NOJ100 DOLLARS
($19,028.00) for fiscal year 2021, as recommended by the Substance Abuse Policy Advisory
Board and funded by the Clerk's Drug Abuse Trust Fund.
2. TERM. This Agreement shall commence on October 1, 2020, and terminate September
30, 2021, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be made periodically, no less than quarterly but no more
frequently than monthly, as hereinafter set forth. Reimbursement requests shall include items
paid by the PROVIDER within 120 days of payment by the PROVIDER. Reimbursement requests
will be submitted to the Board via the Clerk's Finance Office. Reimbursement request and
supporting documentation must be acceptable to the Clerk. Acceptability to the Clerk is based on
generally accepted accounting principles and such laws, rules and regulations as may govern the
Clerk's disbursal of funds. The County shall only reimburse, subject to the funded amounts below,
those reimbursable expenses which are reviewed and approved as complying with Monroe County
Code of Ordinances, State laws and regulations and Attachment A - Expense Reimbursement
Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter,
summarizing the expenses, with supporting documentation attached. (The Clerk's Finance Office
may accept Reimbursement Requests electronically, but only when submitted and formatted in a
PDF file with cover letter and attachments together in one (1) file.) The PROVIDER agrees to
submit hard copies of Reimbursement Request and supporting documentation upon request. The
letter should contain a notarized certification statement. An example of a reimbursement request
cover letter is included as Attachment B. The organization's final invoice must be received within
thirty days after the termination date of this contract shown in Article 2 above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
oATF Contract: Key Bridge FY21;Page 1 1
S. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements. Funding under this agreement shall not be
used to purchase capital assets.
RECORDKEEPING
6. RECORDS AND RIGHT TO AUDIT. PROVIDER shall maintain all books, records, and
documents directly pertinent to performance under this Agreement in accordance with generally
accepted accounting principles consistently applied. Each party to this Agreement or their
authorized representatives shall have reasonable and timely access to such records nfeach other
party to this Agreement for public records purposes during the term of the Agreement and for
four years following the termination of this Agreement. If an auditor employed by the County or
Clerk determines that monies paid to PROVIDER pursuant to this Agreement were spent for
purposes not authorized by this Agreement, the PROVIDER shall repay the monies together with
interest calculated pursuant to Sec. 55.03, FS, running from the date the monies were paid to
PROVIDER.
Right to Audit. Availability of Records. The records of the parties to this Agreement relating to
the Project, which shall include but not be limited tnaccounting records (hard copy, as well as
computer readable data if it can be made available; general ledger entries detailing cash and if
applicable trade discounts earned, insurance rebates and dividends; any other supporting
evidence deemed necessary by County or the Monroe County Office of the Clerk of Court and
Comptroller (hereinafter referred to as 'County C|erk") to substantiate changes related to this
agreement, and all other agreements, sources of information and matters that may in [ounty's
or the County Clerk's reasonable judgment have any bearing on or pertain to any matters, rights,
duties or obligations under or covered by any contract document (a|| foregoing hereinafter
referred to as "Records") shall be open to inspection and subject to audit and/or reproduction by
County's representative and/or agents or the County Clerk. County or County Clerk may also
conduct verifications such as, but not limited to, counting employees at the job site, witnessing
the distribution of payroll, verifying payroll computations, overhead computations, observing
vendor and supplier payments, miscellaneous allocations, special charges, verifying information
and amounts through interviews and written confirmations with employees, Subcontractors,
suppliers, and contractor's representatives. The County Clerk possesses the independent
authority to conduct an audit ofRecords, assets, and activities relating to this Project. The right
to audit provisions survives the termination of expiration of this Agreement.
In addition, if PROVIDER is required to provide an audit as set forth in in Section 8(a) below, the
audit shall be prepared by an independent certified public accountant (CPA) with a current
license, 1n good standing with the Florida State Board ofAccountancy.
7. PUBLIC ACCESS. The County and PROVIDER sha|l a||ovv and permit reasonable
access to, and inspection of, all documents, papers, letters or other materials in its possession or
under its control subject tothe provisions of Chapter 119, Florida Statutes, and made or received
by the County and PROVIDER in conjunction with this Agreement; and the County shall have the
right to unilaterally cancel this Agreement upon violation of this provision by PROVIDER.
8. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
County the following (items (a) (j) must be provided prior tothe payment ufany invoices):
(a) IRS Letter ofDetermination and GUlDEBTAR printout indicating current 501(o)(3) status;
(b) Proof of registration with the Florida Department of Agriculture, as required by Florida
Statute 496.405, and the Florida Department of State, as require by Florida Statute
617.01201/ or proof ofexemption from registration as per Florida Statute 496.406.
(c) List of the Onganization's Board of Directors of which there must be at least 5 and for each
board member please indicate when elected to serve and the length of term of service;
oxnr Contract:Key Bridge Fvzz; Page | 2
(d) Evidence of annual election of Officers and Direotors/Directors At-Large or bi-annual
election of Officers and Directors/Di rectors At-Large as applicable;
(e) Unqualified audited financial statements from the most recent 5sos| year for all
organizations that expend $150,008 a year or more; if qualified, include a statement of
deficiencies with corrective actions recommended/taken; audit shall be prepared by an
independent certified public accountant (CPA) with a current license, in good standing with
the Florida State Board of Accountancy. If the PROVIDER receives $100,000 or more in
grant funding from the County:
a. The CPA that prepares the audit must also be a member of the
American Institute of Certified Public Accountants (AICPA);
b. The CPA must maintain malpractice insurance covering the audit
services provided and
o. The County shall be considered an "intended recipient"of said audit.
(f) Copy of filed IRS Form gQQ from most recent fiscal year with all attached schedules;
(g) Organization's Corporate Bylaws, which must include the organization's mission, board and
membership composition, and process for election of officers;
(h) Organization's Policies and Procedures Manual which must include hiring policies for all
staff, drug and alcohol-free workplace provisions, and equal employment opportunity
provisions;
(i) Specific description or list of services to be provided under this contract with this grant
(see Attachment C);
(1) Annual Performance Report describing services rendered during the most recently
completed grant period (to be furnished within 30 days after the contract end date.) The
performance report shall include statistical information regarding the types and
frequencies of services provided, a profile of clients (including residency) and numbers
served, and outcomes achieved (see Attachment G);
(k) Cooperation with County monitoring visits that the County may request during the contract
year; and
(|) Other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may request during the
contract year.
RESPONSIBILITIES
9. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and provide the services outlined
in Attachment Cto residents of Monroe County, Florida.
10. A7FTORNEly'S FEES AND COSTS. The County and PROVIDER agree that in the event
any cause of action or administrative proceeding is initiated or defended by any party relative to
the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to
reasonable attorney'sfees, court costs, investigative, and out-of-pocket expenses, as an award
against the non-prevailing party, and shall include at1ornay'sfees, courts costs, investigative, and
out-nf-pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted
pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and
usual and customary procedures required by the circuit court of Monroe County.
11. BINDING EFFECT. The terms, covenants, conditions, and provisions of this
Agreement shall bind and inure to the benefit of the County and PROVIDER and their respective
legal representatives, successors, and assigns.
12. CODE OF ETHICS. County agrees that officers and employees of the County
recognize and will be required to comply with the standards of conduct for public officers and
employees as delineated in Section 112.313, Florida Statutes, regarding, but not ||nn|ted to,
solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation;
o»/r Contract: Key Bridge Fvzz;Page | s
misuse of public position, conflicting employment or contractual relationship; and disclosure or
use Vf certain information.
13. NO SOLICITATION/PAYMENT. The County and PROVIDER warrant that, in respect
to itself, it has neither employed nor retained any company or person, other than a bona fide
employee working solely for it, to solicit or secure this Agreement and that it has not paid or
agreed to pay any person, company, corporation, individual, or firm, other than a bona fide
employee working solely for it, any fee, commission, percentage, gift, or other consideration
contingent upon or resulting from the award or making of this Agreement. For the breach or
violation of the provision, the PROVIDER agrees that the County shall have the right to terminate
this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise
recover, the ru|| amount ofsuch fee, commission, percentage, gift, or consideration.
14. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
COMPLIANCE ISSUES
15. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
16. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
17. NON-DISCRIMI NATION. The COUNTY and PROVIDER agree that there will be no
discrimination against any person, and |t |sexpressly understood that upon determination by
court of competent jurisdiction that discrimination has occurred, this Agreement automatically
terminates without any further action on the part of any party, effective the date of the court
order. The COUNTY and PROVIDER agree tm comply with all Federal and Florida statutes, and all
local ordinances, as applicable, relating to nondiscrimination. These include but are not limited
to: 1) Title VII of the Civil Rights Act of 1964 (PL 88-352), which prohibits discrimination in
employment on the basis of race, color, religion, sex, and national origin; 2) Tide IX of the
Education Amendment of 1972, as amended (20 USC §§ 16O1-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as
amended (20 USC § 7g4), which prohibits discrimination on the basis of handicaps; 4) The Age
Discrimination Act of 1975, as amended (42 USC §§ G1O1-61O7), which prohibits discrimination
on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as
amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL91-616),
as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The
Public Health Service Act of 1912, §§ 523 and 537 (42 USC §§ 69Odd-3 and 290ee-3), as
amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIIl of the
Civil Rights Act mf 1968 (42 USC §§ 3601 etseq.), as amended, relating to nondiscrimination in
the sale, rental or financing of housing; g) The Americans with Disabilities Act of1A9O (42 USC
§§ 12101), as amended from time to time, relating to nondiscrimination in employment on the
basis of disability; 10) Monroe County Code Chapter 14, Article II, which prohibits discrimination
on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender
identity or expression, familial status orage; and 11) any other nondiscrimination provisions in
owrr Contract:Key Bridge pv2z; Page | 4
any Federal or state statutes which may apply to the parties to, or the subject matter of, this
Agreement.
AMENDMENTS, CHANGES, AND DISPUTES
18. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
19. ADJUDICATION OF DISPUTES OR DISAGREEMENTS. County and PROVIDER
agree that all disputes and disagreements shall be attempted to be resolved by meet and confer
sessions between representatives of each of the parties. The PROVIDER and County staff shall try
to resolve the claim or dispute with meet and confer sessions tu be commenced within 30 days of
the dispute or claim. If the issue or issues are still not resolved to the satisfaction of the pa/ties,
then any party shall have the right to seek such relief or remedy as may be provided by this
agreement or by Florida law. Any claims or dispute that the parties cannot resolve shall be
decided by the Circuit Court, 16mJudicial Circuit, Monroe County, Florida.
20. COOPERATION. In the event any administrative orlegal proceeding is instituted
against either party relating to the formation, execution, performance, or breach of this
Agreement, County and PROVIDER agree to participate, to the extent required by the other party,
in all proceedings, hearings, processes, meetings, and other activities related tothe substance of
this Agreement or provision of the services under this Agreernent. County and PROVIDER
specifically agree that no party to this Agreement shall be required to enter into any arbitration
proceedings related to this Agreement.
ASSURANCES
21. COVENANT OF NO INTEREST. County and PROVIDER covenant that neither
presently has any interest, and shall not acquire any interest, which would conflict inany manner
or degree with its performance under this Agreement, and that only interest of each is to perform
and receive benefits as recited in this Agreement.
22. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval aho|| in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
23. NON-WAIVER OF IMMUNITY. Notwithstanding the provisions of Sec. 760.28,
Florida Statutes, the participation of the County and the PROVIDER in this Agreement and the
acquisition of any commercial liability insurance coverage, self-insurance coverage, or local
government liability insurance pool coverage shall not be deemed a waiver of immunity to the
extent of liability coverage, nor shall any contract entered into by the County be required to
contain any provision for waiver.
24. ATTESTATIONS. PROVIDER agrees to execute such documents as the County may
reasonably require, to include Public Entity Crime Statement, an Ethics Statement, and a Drug-
Free Workplace Statement.
25. AUTHORITY. Each party represents and warrants to the other that the execution,
delivery and performance of this Agreement have been duly authorized by all necessary County
and corporate action, as required by law.
uwrF Contract:Key Bridge Fvzz;Page 1 5
INDEMNITY ISSUES
26. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees
to indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims and causes of action for medical malpractice, medical negligence, bodily injury (including
death), personal injury, and property damage (including property owned by Monroe County) and
any other losses, damages, and expenses (including attorney's fees) which arise out of, in
connection with, or by reason of services provided by the PROVIDER occasioned by the
negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or
volunteers.
27. PRIVILEGES AND IMMUNITIES. All of the privileges and immunities from liability,
exemptions from laws, ordinances, and rules and pensions and relief, disability, workers'
compensation, and other benefits which apply to the activity of officers, agents, or employees of
any public agents or employees of the County, when performing their respective functions under
this Agreement within the territorial limits of the County shall apply to the same degree and
extent to the performance of such functions and duties of such officers, agents, volunteers, or
employees outside the territorial limits of the County.
28. NO PERSONAL LIABILITY. No covenant or agreement contained herein shall be
deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe
County in his or her individual capacity, and no member, officer, agent oremployee of Monroe
County shall be liable personally on this Agreement or be subject to any personal liability or
accountability by reason of the execution of this Agreement.
29. LEGAL OBLIGATIONS AND RESPON SIC BI LITZ ES: Non-Delegation ofConstitutional
or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any
participating entity fromany obligation or responsibility imposed upon the entity by |avv except to
the extent of actual and timely performance thereof by any participating entity, in which case the
performance may be offered in satisfaction of the obligation or responsibility. Further, this
Agreement is not intended to, nor shall it be construed aa, authorizing the delegation of the
constitutional or statutory duties of the County, except to the extent permitted by the Florida
constitution, state statute, and case |a*.
30. NON-RELIANCE BY NON-PARTIES. No person or entity shall be entitled to rely
upon the terms of this Agreement to enforce or attempt to enforce any third-party claim or
entitlement to or benefit ofany service or program contemplated hereunder, and the County and
the PROVIDER agree that neither the County nor the PROVIDER or any agent, officer, or
employee of either shall have the authority to inform, counsel, or otherwise indicate that any
particular individual nr group ofindividuals, entity or entities, have entitlements orbenefits under
this Agreement separate and apart, inferior to, or superior to the community in general or for the
purposes contemplated in this Agreement.
GENERAL
31. EXECUTION IN COUNTERPARTS. This Agreement may be executed in any number
of counterparts, each of which shall be regarded as an original, all of which taken together shall
constitute one and the same instrument and any of the parties hereto may execute this
Agreement by signing any such counterpart.
32. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, 1uthe
other party as follows:
For Board:.
Grants Administrator and Monroe County Attorney
owzr Contract: Key Bridge Frzz;Page | n
11OO Simonton Street PO Box 1026
Key West, FL33U4O Key West, FL33U41
For PROVIDER
Michael ]. Rogers, Executive Director
Key Bridge, Inc.
1111 12mStreet
Key West, FL 33040
(305) 783-3677
Email: ir
33. GOVERNING LAW, VENUE, INTERPRETATION/ COSTS, AND FEES. This
Agreement shall be governed by and construed in accordance with the laws of the State of Florida
applicable to contracts made and to be performed entirely in the State.
In the event that any cause of action or administrative proceeding is instituted for the
enforcement or interpretation of this Agreement, the County and PROVIDER agree that venue will
lie in the appropriate court or before the appropriate administrative body in Monroe County,
Florida.
The County and PROVIDER agree that, in the event of conflicting interpretations of the
terms or a term of this Agreement by or between any of them the issue shall be submitted to
mediation prior tothe institution of any other administrative or legal proceeding.
34. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise.
35. SEVERABILITY. If any term, covenant, condition or provision of this Agreement (or
the application thereof to any circumstance or person) shall be declared invalid or unenforceable
to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions
and provisions of this Agreement, shall not be affected thereby; and each remaining term,
covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the
fullest extent permitted by law unless the enforcement of the nanna1n|ng terms, covenants,
conditions and provisions of this Agreement would prevent the accomplishment of the original
intent of this Agreement. The County and PROVIDER agree to reform the Agreement to replace
any stricken provision with a valid provision that comes as close as possible to the intent of the
stricken provision.
36. CLAIMS FOR FEDERAL OR STATE AID: PROVIDER and COUNTY agree that each
shall be, and is, empowered to apply for, seek, and obtain federal and state funds to further the
purpose of this Agreement. Any conditions imposed as a result of funding that effect the Scope of
Services will be provided to each party.
37. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
[THIS SPACE INTENTIONALLY LEFT BLANK WITH SIGNATORY PAGE TO FOLLOW]
mwrp Contract: Key Bridge Fvzz/Page | r
1 y� pg�+ IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
lam' • i ay and year first written above.
..
e 11, i 1 BOARD OF COUNTY COMMISSIONERS
y ?. KEVIN MADOK, CLERK OF MONROE C• NT?, ORIDA
By �t
As Deputy Clerk M.rChalrman
Key Bridge, Inc.
(FederalI .#I ' )°1O 1 403 )
Witness
By
Witn Ch f Executive Officer
/ pYRyNROE cyyovert ArrormY
P4a, y',a ASro(ag�
o ..orx-irnai.(a
ASSISTANT COUNTY ATTORNEY
DATE 10/1
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DATF Contract:Key Bridge FY21;Page I 8
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines bm Human Service and Community-Based
Organizations, county travelers, and contractual parties who have reimbursable expenses
associated with Monroe County business. These guidelines, as they relate tntravel, are from the
Monroe County Code of Ordinances and State laws and regulations.
A cover letter (see Attachment B) summarizing the major line items on the reimbursable expense
request needs to also contain the following notarized certified statement:
"I certify that the above checks have been submitted to the vendors as noted and that the
attached expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this orgmnization's contract with the Monroe
County Board of County Commissioners and will not be submitted for reimbursement to any other
funding source."
Invoices should be billed tm the contracting a0ancy. Third party payments will not baconsidered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous ba|ances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding theme
guidelines should be directed tm3O5-2g2-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate,
total hours worked, withholding information and paid payroll taxes, check number and check
amount. Ifs Payroll Journal /s not provided, the following information must be provided: pay
period, check amount, check number, date, payee, support for applicable paid payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
aornp|e of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
owrrcontrant:Key Bridge px21;Page | 9
Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel and Meal Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel reimbursement requests must be submitted and will be paid in accordance with
Monroe County Code of Ordinances and State laws and regu1aUons. Credit card statements are
not acceptable documentation for reimbursement. lf attending a conference or meeting a copy of
the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of
the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental
reimbursement requires the vendor invoice. Fuel purchases should be documented with paid
receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a
taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for bytraveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Mileage reimbursement shall bemtthe rate established by ARTICLE XXVI, TRAVEL, PER DIEM,
MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. An odometer reading
must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a
residence or office to a point of departure. For example, driving from one's home to the airport
fora business trip is not reimbursable expense.
Meal reimbursement shall be at the rates established by ARTICLE XXVI, TRAVEL, PER DIEM,
MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. Meal guidelines state
that travel must begin prior to G a.m. for breakfast reimbursement, before noon and end after 2
p.m. for lunch reimbursement, and before 6 p.m. and end after p.m. for dinner reimbursement.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check changes,
penalties and fines.
o*n=Contract:Key Bridge prz1/Page | 18
Name of Notary (Typed, Stamped or Printed)
Notary Public, State of
ATTACHMENT C
Specific description and list of services to be provided under this contract:
We4 17, rK
"W one,
es I,
DATF Contract: Key Bridge FY21;Page 1 12
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ATTACHMENT D
PUBLIC ENTM CRIME STATEMENT
^A person or affiliate who has been placed on the convicted vendor list following a conviction for
public entity crime may not submit a bid on a contract to provide any goods or services to a
public entity, may not submit a bid on a contract with a public entity for the construction or repair
of public building or public work, may not submit bids on leases of nao| property to public entity,
may not be awarded or perform work as a CONTRACTOR, supplier, subcontractor, or
CONTRACTOR under contract with any public entity, and may not transact business with any
public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO
fora period of30 months from the date of being placed on the convicted vendor list."
l have read the above and state that neithername)
nor any 4f�|iete has been placed on the convicted Md list the last 36 months.
Date:
TO BE C (in accordance with State notary requirements)
11
State of
acknowl d d b f me, by means ofO physical presence or O online
nNtan,z,ation, -2—) dav of
(month), �10&V (year), by
(name of officer or agent, title of officer or agent) of
(name of entity).
Personally Known
Produced Identification: Type of ID and ;Sig
m*NEFB���T
(SEAL)
' Cwnbw�,#GG19N30 a fN t EqAmsN��1����
BoadWmwMg Notay lawim
Name of Notary (Typed, Stamped or Proted)
Notary Public, State of
uwnrc»^tract: Key Bridge Fv2z;Page 1 13
ATTACHMENT E
SWORN STATEMENT UNDER ORDINANCE NO° 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
"
" warrants that he/it has not employed, retained or otherwise had act on his/her behalf any
former County officer or employee in violation of Section J of Ordinance No. 810-1990 or any
County officer oremployee in violation of Section 3 of Ordinance No. 010-1990. For breach or
violation of this provision the County may, in its discretion, terminate this Agreement without
liability and may also, in its discretion, deduct from h nt or purchase price, or
otherwise recover, the full amount of any fee, commission, , gift, or consideration paid
tn the former County officer oremp|oyoe."
(Signature)
Date: -
TO BE COMPLETED NOTARY(in accordance with State notary requirements)
State of
County of unoba-
acknowledqed qefore me, by means of 0 physical presence or 0 online
r,arization, this day of (month),7ZO_ZD_ (year), by
I(name of officer or aqent., title of officer or agent) of
Personally Known
Produced Identification: Type of ID and N ber on ID,
er,
(SEAL) C
MNE F.SAMM Sig atu of Notary
Notary Public, State of r)v
owTF Contract: Key Bridge Fvz1/Page | 1*
ATTACHMENT
DRUG-FREE WORKPLACE FORM
The undersigned vendoordance with Florida Statute 287.087 hereby certifies that:r i acc
��1
(Name of Business) _ _
1. Publish a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace and
specifying the actions that will be taken against employees for violations of such
prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business' policy
of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and
employee assistance programs, and the penalties that may be imposed upon employees
for drug abuse violations.
3. Give each employee engaged in providing the commodities or contractual services that are
under bid a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notify the employees that, as a condition of
working on the commodities or contractual services that are under bid, the employee will
abide by the terms of the statement and will notify the employer of any conviction of, or
plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of
any controlled substance law of the united States or any state, for a violation occurring in
the workplace no later than five (5) days after such conviction.
5. Impose a sanction on or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee
who is so convicted.
6, Make a good faith effort to continue to in a drug-free workplace through
implementation of this section.
As the person authorized to sign the statement, ce at this firm complies fully with the
above requirements.
(Signature)
Date: ki Z) _
TO E COMPLETED BY NOTARY(in accordance with State notary requirements)
State of
County of M( y )
The foregoing instrument was acknowled ed bfore me, by means oft physical presence or ❑ online
rization, this ._ da of (month), (year), by
C� (name of officer or agent, title of officer or agent) of
(name of entity).
Personally Known
Produced Identification: Type of ID and Nu er on ID__�i
(SEAL)
NEB&ARwM Sign 9630 ft
of Nota,
C 1
°aA Exgaes 14,20n Name of(Votary (Typed, Stamped or Pn' ted)
0 Notary Public, State of v �.
DATF Contract: Key Bridge FY21;Page 1 15
ATTACHMENT G
FY2021 Annual Performance Report
For year October 1, 2020—September 30, 2021
(Report Deadline: October 31, 2021)
---------------------------- ......
Agency Name
1 Point of Contact(POC)
1 Phone/Email
------------- --------
Grant Amount
Per Section 8 of your contract, it is required that you fill out the entire for and answer every
question.
Narrative on the FY2021 Performance(i.e. successes, challenges, etc.):
Questions.
1. Please list services and client information below for the program/activities funded by the Monroe
County award.
g
K,"
;L 1110
2. What were the measurable outcomes(including numbers) accomplished in FY2021? Please base
these outcomes on the services you identified in Question#1.
3. What number and percentage of your clients/participants were at or below the federal poverty level
in FY2021; and/or 200%; and/or another standard used by your organization?
4. What area of Monroe County did you serve in FY2021?
5. During FY2021, how many months did you provide program services to (Q.1)clients?
6. How many total FTEs in your organization?
7. How many FTEs worked on the program(s)funded by the FY2021 DATF award?
8. Volunteers: hours of program service were contributed by_volunteers in FY2021.
DATF Contract: Key Bridge FY21;Page 1 16
FINANCIAL REPORT
FY2021 CLERK'S DRUG ABUSE TRUST FUND (DATF)
(Note:Report Only®ATE Grant Expenditures)
9. Were all the awarded funds used in FY2021?
a. If no, please explain:
10. Allocation of FY2021 Award; Clerk's Drug Abuse Trust Fund Award Amount
Program Expense Administrative Expense
Budget Category (Dollar Amount) (Dollar Amount)
Salaries $0 $0
Fringe $0 $0
FICA $0 $0
Independent Contractor(s) $0 $0
Office Supplies,Telephone, Postage $0 $0
Utilities $0 $0
Insurance $0 $0
Repair&Maintenance $0 $0
Travel/Transportation $0 $0
Rent/Association Dues $0 $0
Client Service/Describe: $0 $0
Client Service/Describe: $0 $0
Client Service/Describe: $0 $0
Client Service/Describe: $0 $0
Other Expense/Describe: $0 $0
Other Expense/Describe: $0 $0
Other Expense/Describe: $0 $0
Other Expense/Describe: $0 $0
11. Compensation Detail: Include all persons who receive compensation from the FY2021 Clerk's Drug
Abuse Trust Fund (including Independent Contractors)
Employee Name Type of Work Hrs,Worked Total Charges
(Mame, Last Initial) Title Performed in Er ram on Program to Program
$0.00
$0.00
$0.00
$0.00
$0.00
$0,00
$0.00
$0.00
$0.00
$0.00
(Note:If you need more space you may add additional lines or an addendum.)
DATF Contract: Key Bridge FY21;Page 1 17
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