07/15/2020 Agreement a, Kevin Madok, CPA
f;
Clerk of the Circuit Court& Comptroller—Monroe County, Florida
DATE: July 23, 2020
TO: Sheryl Graham, Director
Social Services
ATTN: Lourdes Francis ,
FROM: Pamela G. Hance3ckr1D.C.
SUBJECT: July 15th BOCC Meeting
Enclosed is a duplicate original of each of die following items, executed on behalf of
Monroe County, for your handling:
C3I Coronavirus Aid, Relief, and Economic Safety ACT Contract KCA-2029 between
die Alliance for Aging, Inc., and Monroe County Board of County Commissioners/Social Services
In-home and Nutrition Programs for the contract period of April 1, 2020 through September 30,
2021.
C32 Alzhcimer's Disease Initiative Program Contract KZ-2097 between the Alliance for
Aging, Inc„ and Monroe County Board of County Commissioners/Monroe County Social Services
In-Home Services for the Contract Year 2020-2021 (July 1, 2020 June 30, 2021) in die amount of
$189,458.40.
Please return a fully executed copy of each of the documents to our office once signed by
die Alliance. Should you have any questions please feel free to contact ❑ e 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,Flodda 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070
305-294-4641 305-289-6027 305-852-7145 305-852-7145
KCA-
AGING,ALLUNCE FOR ENC.
STANDARD OJ""'.81GINAL
i
Cavonsvirus Aid,Re&4 ond Economic
'MIS CONTRACT is entamd into bowr=the AJUance for A&&I a " ,"and
Monroe County Board f County Commialoners, I Servimgn-Kome Services,h refirmd to as the
Trovidal,and "veld J " The term conUwWr fbr ' i '
r sub thastatus to be fur&er identified in ATTACHMENTI,E hroh-
WITNESSEIB'
WHEREAS, [lance has e3tabli3hedu the Am Plwa on Agingthat it is in need of
described ink and
the Providerhas dernonstmtedthat It rti.se and ability to faithfully perfirrm such
services as an Independent r of ru
NOW THEREFORE,in consi&itflonf the services to be perfortnedand payments to be made,together with
mutual covenants and contiftions hereinatter set forth,the Panics Ww as fbilowr.
Contrast1. Purpose of
The pupose of this contractIs to provide services ln=ordance with the terms and conditions spectried in this
conuWincludins allattachments and eAubits,which constitute the c-ontraddocument.
2. Definitions
tsid f ly Living
A It Protecti im
Americans with Disabiliti Act
All" Aging
Asseswd PdorityConsumer List
CARES Act,—Coronavirus Aid,Relief,and Ecommic Security Act
DOEA Dqmrtment of Elder Affairs(The DeMftent)
I ion and Refenal
I nvO Act'ivities of Daily'Livia
Major Disaswr DwIaMion
MOA r f,Ageement
.of Undem tanding
PSAs Planning d Service Arms corresporWi toMiami-Dade d Monroe Counties
Service Provider Application
USDA United Stant of Agriculture
3. incorporation of Documents withintke Contract
The oontmcts by refemce - s I "o*),Ffovideeslgervice Provider
Application,and the current DOEA Programs and Smicesd I conuww or agmments
executed between the Providerd the.Alliance during the effbetive period of d in
accordance with the applicablelaws and statutes.
4. Term of Contract
This contract shallbqon I,,2020 or on the date,an which t1w contract has been signed by the last puly
requiredsip it,w1sichever Ls later,It shall and at mldnigbt,kcaltkne in MarriL Florida,on September 30,2021,
unlew renewed or wended as providedrein.
Pap
XCA-2029
5, Contract Amount
TheAlfliance agrees to P, E 1,ornaulacted servicts sm.-cordingru..,,theiterms mid of this coutt-AvcT in ari,
amourn.nctt to y f&§Lt sul,�jecvws the O"'FaIlgibilit of Funds., 1',,ny ccmfm,airsemvices padd ffbx undrm. any
othi ints-act orfl%urj,any rhea smource are,na efigiblie for pivyinana rags thday,contmet',
& 13"knewrals
By mu-'utual-agre"em,,%mra of ffic p a-mies,the Alliance nrmay F, ww the f(kor five.mulditioneJ mie-yemw periods.
Cons.ung,ent 'pe"dronillm"Ice evalla"aticorms,b),, i kwt and tbiz wy,"Wimbility ofliocle"',ally, rc'ne'vsral is,y the All"ar
sukjt"'ct�,"o f".five Sprnic terrm's in the orig,inal 4-:,ontramt,vvkh,the ex, f ion of estatolishimg unitraies whiCh 111,s described
further in'this Sec"tion, The mrig gingad,corrtraratug,I un"it ratmis -rue ficuth in flac:bid proqmnsal aroll
R crurstsoodmr,311781 c4mtracnuaj flame are,prfYvI&AA fla'r In� dRujance"S agg"no,
Rue"imbursement'Rumte,Re-view 1"PALN"W, which is inconporpuned ky rv-,fkevenrue,
This t entrpxct mfry be uponnrmptual one extension pxrdod not to exceed,six-inondas to ensu'rea,
conthaq,th,, envice, Se"nActo turovk"'Ded micierthis extensiort will kx�,paid flor out of tlfite
y of
arnount,
7fi Compliance willi 11,Ped era l Lam
1
T 1 Th's contract conu-dus fteleral. 'ands, IIm.1"bIlowing shmal I,app"ply:
1.1 The"Provide'r rstmi I conqply with iffim prim"risic'n's of 4-5CFR 714ancifor 45 CFR 92,and cvd.u,:r a
reg plar6ons.
7,1,2 Ift1hsi, cororac,r'r coreahns fle'deral R)mads and is ovf;,,,r the.,Providershkil cxYmply with Aall
a1, 1
pplic,able starodamfus,ordets,or regulh-dons hu"w"A Wulper&306 of t1ae Oreman Mr Act as arnemcled(42
U.S,C, 7,414)],etscxq),s,508 of the Fedfiml Water Polludan OontmA Acil-m,, US,,C 1251,c
Seq.),Exl�ctsthve Order 1171'r38,me aniended,and whenze,a ve a pplic,able EftratectionA.,ge guic,y
regialad.cma 410 CFF 30, The contrftwtcar shafl, rarport,aur Ft !violmdons cf, trr a K"v nthe Alliance,
7,1 3,, The Priy0i'der, ca,agent actirqg,flar the PrumAdm",arul'y ru,"Ot-l"we anqy "Ilarlds,recuehied im conanection
with tl,.ds compract to nflu, rwe lepis ttioor uipy"priairs pendIng bflroe the Coragres or anyStulte
T"Imc Pscavider Pnapu,,st oumplete�al"),disclosixtv:fomm's as"reqjurred, FqpW%AM,,,;,,%YHY the"Cerfif"wittion,
of vOlhich must be completed and rdumed witlh flkua signed,con't-ract"
-4, In A to 2 Cs R 215,the comarmcur sha"61,oomply with flxvuytf r�Ch,', Per 11246,
EqufA Ernplc�ysnaev Opport"'Init r as ouraerr ded"b'y Exumz!utivt,�,C)rnler H 375 and othem-s,an.4 as
suppAvramnited in rx-pmamemnent of Labor Aegulafiwm,41 CFR 60 m,,id,45 CER,9C.,If applicable"
L,5 A cointract mcovardwith an amoukin expvcred to equal or excAemd$25,000.0(3 '"rrr cartEt"In othex,Ocantuact
mmalmals shall xnot be"',maAmto partles fistpul or, E.ecludied Parties List Sysm,",in
CHNIIIII guidelimems zau.2("IFIR,ISO thaa, implen-rient Exec,,,.,r!ive Or`d-em 1,2549 and 1268%
rrDrrri rrai rrir &"Lapemsion!" Usn Sys um conts-ins'the,rmunmem ofri'artip"S
delmum,ed,stusp err edl,or odhetotime miludtki
`.S 01611,as pauncies(NmIartmi ineffigible urucler
,stamary orrq gulmory kxuthorit-
"Y cylher then E,, urf ve 0 rcler 12549, Ille Provider shm"I comrply with
riirese,provisionsi be-fort,dr,,Ang,btu'ri"kaess or wering into Stubco"rAn S pm"M-Suaw ul
U-i'v's, cxnrtract, TheFlrorvider shall coinplete,and sign uniz CerfifLpmafion nand-Assurn.mes Atta-chmeritprior"
'to execution of this,clarmr ct.
'7.2 he Rrovider shall nec:stt mplay an unatithoruired allen, The All"I'VIV-11C."o sluall considw the', ernplaynnent of
1 1 o;
.tnatrthor�zed Wheyms aviolawtion of tihm I'mmig"'m io I ni(8 U&C, 1324 r V at n and Namfioneffitte Ac 6)und the Imunigrati a
'Ref,bamn and C"An'trol Act of 1986, (8 UAS"'Ar". 1101)" Such, violation"'Artadl be catme 117or,unflattexal cain eloluttion of
Lhis comract by t1he Allhisnc,,,
Page 2 of 69
.3. If the Provider is a non-profitprovider is subject to Internal Revenue Sery
organization ui (filing r Form 990-N) its tax exemptst
r failing to comply with the filingrequirements of the 2006 Pensioni r for any other reason,
the Providernotify the Alliance in writingwithin idays of receivingnotice
revocation,
7.4. The Providershall c ly with Title 2 CFR Part 175 regWingt c .
7. . Unless exempt under 2 CFR Part 17 .11 Provider shall comply withthe reportingrequirements of the
Transparency Act as expressed in 170.
7.6. To comply with PresidentialExecutive r 12989 and State of Florida Executiver t I-116,
Provider utilize l Security's E-verify system to verify the
employmentf all new employees hired by Provider during the contract t .Provider shall include in related
subcontracts a requirementsubcontractors r vendors performingr vi i services t
to the state contract utilizethe E-verify systemverify employment of all new employees
subcontractor r vendor during the contractProviders meeting the terms and conditions
in compliancei is provision.
ComplianceS.
This contract is executedinto in the State of Florida, shall be construeit performed and
enforced in all respects in accordancei 1 l , including Florida provisi i laws,
Provider shall comply withthe requirements .287.058,F.S.as amended.
. .1. The Providerll provide unitsdeliverables, including report findings,and drafts,as specifiedi
this ,which the Contract Manager must receive and accept in writingprior to payment.
9.2.2. The Contractorshall comply it the criteria t l date by which Such criteriat
for completioni contract as specified in ATTACHMENT 1. Section Ill. Method o
Payment.
Provider submit bills for fees or other compensationi t expenses in sufficient
detail for a proper pre-audit post-audit.
® . If itemized t for travel expenses is permitted in thiscontractor willsubinit bills for
travelany expenses in accordance with . 112.06 1, .,or at sucht y be provided in
is contract
. . The Providershall allow publicaccess to all documents,®papers, letters,or other public records as
defined in subsection 1 . 1( ), .,made or received by the contractor in conjunction wi is
contract except for thoseiProvider's
to comply ith this provisionshall constitute immediate of contract for which the Alliance
for i ,Inc.may unilaterally terminate the contract.
. If clients n under this contract,the Provider shall comply with the provisionsf Chapter
1® ,F.A. C.
. . Subcontractors and/or vendors who are vendor list may not transact business with
public entity,in accordancei vi i s.287.134,F.S.
.5. The Providerill comply with the provisionss. 11.062, .,and s.216.347,F.S.,which prohibit
expenditurecontract funds forlobbying ® I ,judicial branch or a state agency.
KCA-2029
8.6. In accordance with Section 287.135 F.S.,any Contractor on the Scrutinized Companies with Activities in
Sudan List,the Scrutinized Companies with Activities in the I ran Petroleum Energy Sector is or the
Scrutinized Companies that Boycott Israel it(Lists),created pursuant to Section 215.473 F.S.sad
215.4725,F.S.,or is engaged in a boycott of Israel, or is engaged in business operations in Cuba or Syria, is
ineligible to enter into or renew a contract with the Department fbr goods or services of$1,000,000 or more.
Pursuant to Section 287.135 F.S.,the Alliance may terminate this contract if the Provider is found to have
submitted a false certification of its status on the Lists or has been placed on the Lists or is engaged in a
boycott of Israel or has been engaged in business operations in Cuba or Syria.Further,the Provider is
subject to civil penalties,attorney's fees and costs and any costs for investigations that led to the finding of
false certification.The Provider shall complete and sign the Certifications and Assurances Attachment,prior
to the execution of this contract.
9. Background Screening
9.1. The Provider shall comply with and ensure subcontractors we in conipliance with the requirements of S.
430.0402 and Chapter 435,F.S.,as amended,are met regarding background screening for all pawns who
meet the&TWtion of a dima mnice provider and who are not exempt from the Department's level 2
background screening pursuant to s.430.0402(2)-(3),F.S.The Provider must also oomply with any applicable
rules promulgated by the Department and the Agency for Health Care Administration regarding
implementation of a.430.0402 and Chapter 435, F.S.
9.2. Further information concerning the procedures for background screening is found at
htto://eldcraffa,iM.state.tau sidoea/back2roundscreeninp-vho
9.3. Background Screening Affidavit of Compliance-To demonstrate compliance with this contract,the Provider
shal I submit ATTACHMENT D, Background Screening Affidavit of Compliance annually,by January I Sth.
10. Grievance Procedum
The Provider shall comply with and ensure subcontractor and/or vendors compliance with the Minimum Guidelines
for Recipient Grievance Procedures,Appendix D,DOEA Programs and Services Handbook,to address complaints
regarding the termination,suspension or reduction of services,as required ibr receipt of funds.
10.1. Complaint Procedures
The Provider shall develop and implement complaint procedures and ensure that subcontractors and/or
vendors develop and implement complaint procedures to process and resolve client dissatisfaction with
services. Complaint procedures shall address the quality and timeliness of servicm provider and direct service
worker complaints,or any other advice related to complaints other than termination,suspension or reduction
in services that require the grievance process as described in Appendix D,Department of Elder Affairs
Programs and Services Handbook.The complaint procedures shall include notification to all clients of the
comphiint procedure and include tracking the date,nature of complaint,the determination of each complaint,
and the follow-up with the client to ensure satisfaction with the resolution
11. Publile Records and Retention
11.1. By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S.,and any
other applicable law,and shall:
11.1.1. Keep and maintain public records required by the Department to perform the contracted services.
11.1.2. Upon request from the Department's custodian of pub lie record% prov ide the Department a copy
of the requested records or allow the records to be inspected or copied within a reasonable time
at a cost that doe-,not exceed the cost provided in Chapter 119.F.S.,or as otherwise provided by
law.
Page 4 of 69
HEM029
HAY Ensuns that, ptiblic rerords tliatt arv,exempr, or cucnvi1dential and fh,)m public ri' .Ords
dolisclon,ure recluirements are, not.discloso.,�J- enept as authr,',16zed t 1A.—ov for t1he duraliion cAfthe
mribract It'ern'i and Proliv"ving con'�rflrticn of the coyrdract If doe 0ombrazIter dcx,*not txar* r flue
recands to Ae De;x vnent,
I I j A,, Upon,~~usnrpledion cylfthee cointract-,,tice Cornumowr wiN efther vans,"er,ixt,nw cosn uc the
public records in,possession of Me Contracmr,or will.kseep aind mainitstird �,'Y',ubikz,iruccxr4.1s requ,,ired
by Oe D eparunent. If the Con tnscl or-tnansf rs a I I ptablic rewords to thie [Nepartn,I en-vt fqpon,
Completion of the CvrAT"a'c'A',,,Contractor shaH demor any d-upficaute pubfic,recor,s that acre
i empt,,or corifidernial and extunpi, fborn pulgic reconds disclosure requirements, (IF d%e
(Ianarrautar keeps and maintahns pubfic t'ipon co"alpletiorx of the ccmtmcr,vne Coritractor
shall meet aUt,applicable requiraments pt),blic recordil ,AN, cords st(rred
electronically mtivt-be I ided �prc,-M v-)flm Departrnerut in aftcyrnArthso, is cx),mpafible with the
'hrb'Rx'-M;'s-'H)cru ttec,,hnoloE, ,win sterns of the Departrnen't",
I !I The AN=rely wMerally carxx.l wny prccidsions of this
conaract, 1iar renusal by Is Contractor no,carruply m1h ATTACHMENT I of thi's ccintrazt by not al-lowing
public all docummas,papers,lerters.rar a,,tchier-r., ial ma die,or receivedd kuy tlro,,Contractor in
w"d, ,n,this contract, waless the re,,,cords are e.,,xen-ipt, ,arcu'r-AldenurA and"ex;empt"P-'orn se"'s'dort
24y)of Ukle I of t"Iiv, State Coasfitpavicu, nd Secuon 119,07,(11' RS,
IFTHE IREGARM.'ING THE,APPLICA-730NN'0FCHAYrrrER 11%
FLORMA STNFUTES, To 711E CONTRACTOIR!S D1,T]"Y TO F"ROVYIN, PUBLIC RRIECO'EmS
REL.4,71'M3. TOTHIS(,-XD'Nq"-TR%.ACT,CONTACT CUST001ANOF M1.jB,9'.,J7C'REC0RDo- ATu
Pubile,Records,Coorilloator
ladda Department of Elder
Allf"alm 414(140 Estphinntde Way
TsdIshassee,Florida:32399
SM),41,42342
112,
rued1a),
vafficnen't tra reflect aall a, eits',obliga-th,,an wP, unuoblip,,atedl balances,, income, fau'zor-int Fjond offunds
prov MQ,So A,,31 ince under dds conarsavi,., F'rovkLershall adaquwtely safegmardeM swh wan wd mmWIM,
the,y areoused,so�,ely An due jmvposes aalc&sol under is contnerict. 'N"hecrever appropnh�, e,finanwial
1r,ifib-n-wiJon shocild be related tit,penfi''trprnuwce"nnd" '.'5'nitccrst clat'&
UZZ The IF"rav Cade rsla, I rctk,'iin all ts,zwa as rie"cords,"fina"uncial records, statistiecal veh,';*rcis,and
tro this coavriuo,IS a yeHod of rya x(6)ycwSr1r1A
a5u compladon of the',vavnfraot or kofiag',"".-v�,ohen rexquired f"Lly IM"v. 1-n-the eve'ne'am,roxclit fis requumd,by his
ocmiract,,,mv mirds shall be ranked:Rn a minkrnurn fvmic�d of six(6)yvans afftwerthe Audit neq-,ort,is Issued cw unfil
ree,solodian of&rn
Allisinare.
123. Upr:)n dennand,a no additional cost vo the Alliance,tive PrcVvi"a"cr will acdatas tha,du,'pliczaicyn,asid t?"'a'nsfer of
am"c vec"'ord-"s;or domcux ents davinq the'requi red re'rention rxnriod in Pamgraph 12,2,
,
12,4. T11he Tr�rcwider Anall amure",ticzz%VIne ram.,,fard's des,ctibed, S m aWn she'!ben-,,%;bj�ecx stall tz
inspecM4 r0w,c),pyinV pe7 ull y u 4 tb -Al an C or it,by FaML Smq cow,ol er, morme'lidu w �lie
Page 5 04 69
KCA-2029
12.5. At all reasonable times fbr as long as records am maintained,persons duly authorized by the Ailiance,DOEA
and Federal auditors,pursuant to 45 CFR Part 75,shall be allowed full access to and the right to examine any
of the Provider's contracts and related records and documents pertinent to this specific contract,regardless of
the fbrm in is kept.
124 The Provider shall provide a financial and compliance audit to the Alliance as specified in this contract and
ensure that al I related third-party transactions are disclosed to the auditor.
12-7. The Provider shall comply and cooperate immediately with any inspections,reviews,investigations,or
audits darned necessary by the office of the DOEA!s Impactor General pursuant to s.20.055,F.S.Provider
further agrees that itshall include in related subcontracts a requirement that subcontractors and/or
vendors performing work or providing services pursuant to this contract agree to cooperate with the
AllianceorInspector General in any investigation ,audit,inspection,miew,or hearing pursuant to
Section 20.055(5), F.S.By execution of this contract the Provider understands and will comply with this
subsection.
11 Nondiscrimination-Civill Rights Compliance
13.1 The Provider sitall execute assurances in ATTACHMENT V1 that it will not discriminate against any person
in the provision of services or benefits under this contract or in employment because of age,race,religion,
color,disability,national origin,marital status or sex in compliance with its and federal law and regulations.
The Provider further assures that all contractom,subcontractors,vendors,sub-grantees,or others with whom it
arranges to provide services or benefits in connection with any of its programs and activities am not
discriminating against clients or employees because of age,race,religion,color,disability,national origin,
marital status or sex.
13.2 During the term of this contract,the Provider shall complete and retain on file a timely,complete and accurate
Civil Rights Compliance Checklist attached to this contract.
13.3 The Provider shall establish procedures pursuant to federal law to handle compl,aints of discrimination
involving services or benefits through this contract. These procedures will include notifying clients,
employees,and participants of the right to file a complaint with the appropriate federal or state entity.
13.4 If this contract contains federal funds,these assurances are a condition of continued receipt of or benefit ftom
federal financial assistance,and are binding upon the Provider,its successors,transferees,and assignees for
the period during which such assistance is provided. The Provider 6irther assures that all subcontractors,
vendors,or others with whom it arranges to provide services or benefits to participants or employees in
connection with any of its programs and activities are not discriminating against those participants or
employees in violation of the above statutes, regulations,guidelines,and standards. In the event of failure to
comply,the Provider understands that the Alliance may,at its discretion,seek a court order requiring
compliance with the terms of this assurance or seek other appropriate judicial or administrative relief,
including but not limited to,termination of and denial of fwftr assistance.
14, Provision of Services
The Provider shall provide the services referred to in ATTACHMENT VTI in the manner described in the DOEA
Programs&Services Handbook and dw Provider's Service Provider Application(SPA). In tha event of a conffict
between the Service Provider Application and this contract,the contract language prevails.
® Monitoring-bytiteAtliance
The Provider shall permit persons duly authorized by the Alliance to inspect and copy any records,papers,
®flicilities,goods and services of the Provider which are relevant to this contract,and to interview any
Page 6 of 69
clients, l y s and subcontmetorivendorlayees of the Provider t li satisfiLctory
performances and conditionsthis contract. Following such review,the Allianceill deliver
Provider a written report of its findings,and where appropriate,the Providerit develop a CorrectiveAction
(CAP). The Provider hereby agrees to timely correct all deficiencies identified in the CAP.
16. Coordinated i r Agencies
ProviderIf the iv s funding from one or more of the StateFlorida service ci , in addition
Alliance funding,then ajoint ' visit including such other agencies may be scheduled. f
Childrenthis contract and pursuant to s.287.0575,F.S.as amended,Florida's human service agencies shall include the
Department of ili ,the Department of Health,the Agency for Persons withDisabilities,the
Department f Veterans Affairs,and the Department of Elder Affairs. Upon notificationt
visitscheduling of such a a lead administrativecoordinator, r vi shall comply
cooperate withall monitors.inspectors,and/or investigators.
17. Indemnification
The Provider shall indemnify,save,defend,and hold harmless the Allianceits agents and employees
and all claims, s.actions, causes of actionr character, ise r by reason of the
execution i t or performance of the services provided for herein. ! is understood
Provideris not required to indemnify the Alliancefor claims, ,actions or causes tiarising solely
of the l .
17.1 ExkWt to the extent permitted .768.28, . .,or other Florida law,Paragraph 15 is not applicable
contracts executed between the Allianceagencies r subdivisions e in s.7 . ,F.S.
1& Insurance and Bonding
18.1 The Provider shall provide continuous adequate liability insurance coverage i the existence of this
contract y renewal( s)and extension(s)of it,By execution of this comr less it is a stateagency r
subdivision as dei s ider accepts full responsibility fbr identifying
and determining C s)and extent of liability insurance vide reasonable financial
protections for the vi clients to be served under this contract. The Allianceshall be included
additionalan . 's liability insurance policypolicies i i
Insurancell be providedl or when any c limits r under each policy
Providermaintained by the limit liability and obl
gations under this contract.The
Providershall ensure that the Alliancecurrent writtenverification of insurance v
throughout the term of this n coverage vided by a self-insurance program established
and operating laws of the State of Florida. Alliance to requireadditional
insurance as specified in thist.
18.2 Throughout the term aft is agreement,the Provider shall maintain an insurance bond from a respons
commercial c covering l officers,directors,employees and agents of vl
handleauthorized to iV r disbursed under all r contracts incorporating this
contract by reference in an arnount commensurate withhandled,the i
the insurance company and consistentwith ad business practices.
19. Confidentiality
The Provider shall not use or disclose any information concerni l i f services under this contract for any
purpose prohibited y state or federal law or regulations except withi consent of a person legally
authorized to givethat consentauthorized .
Page 7 f 69
KCA-2029
20. fats Inmurmece.Purtatriffit and Accountal,,dlftyArt
Vfheae-appl, r r a'arr r,,,ha1I conzt 4 ply with the Heaidi Inaurance Pomabffitt�and Account-abill Act(42 USC
1320(L),tu;wellms,stl re,g pAm'sm"m;pwrmi,,,Jg to-A theremunder(45 CFR 160'. 162', d'164),gair
21. Incident,Rvpor-th-nig
21.E The Pro vk1or all ne"ify the Alliarme irnmedwellybut no 1phrerthem,
ammmn r,)7,,-diex.,,overy,4f cov-Witions the"t''n"A"'Y maqtedally aff—fect,thm Provider's,subxon.'Mactor's or vendor's
tabilityoPefmn t'heq S
ee mfi�ct s Prequirv, o be;xrlibrynedtunderam), Am tract,Such rvcWC*shaft. made:ofrafly
o T Cont"Ret Marvr( yw1cponz.)withan,enal o'MrneddelyPo"HOW"21,2 Thc:Pro-vik rshaflimroxexista"
W glect,cr, exploirtation of
0 a chilld,a person,o. dimblukd admdt to the Flodide.Mhum I-Iodine ontbe statewide toll-kee talepfiunxne
rvurvil)er(1-800-9 ABUSE),Aus required by Chapters 39 aind 415,F,S,,this prm4sion is binding upon fline
Provider, venchms,mid their ern piloyeas.
22. Baukruffty Nedfleadom
If,am any ti, during thte remm reMbi contract.,the p'nuvider, its assi,gislem,tufrrmntractcm , vemlors or ix I tates,files,a
claim for tvar&crupay,the Prusnale'r niust immediatt""ly notifry-the an~sax saarr Within feen,(10)dkys after notlficatiorI,tinie
I ir"'Rex mus"t also provide,the fitflow,ing inforroultion'to the AWRIMICe:(1)the&ate offill"Ung ofthe bank.1upt,
District of Florida Tahuntumm' 'DWI'S"'On)� wbero flhef ril u, .c,,,
a K a muil,(4)fte natnie,address,and telephone rum-, A a p
attomey,
23. Sponsorship and Publiclove
23 J1 As tearuirefl-my,s�286,225,F.&, if O'he Pycpvider is a Orgpruzaidon whicho sponsors,apropreann
f1tumiced wholi-
y or In pwa IbI stme funAs,includhng arry funds,obtairied thiremugh&,his conaract.,it skmi,in
P W IA-AiCLAU& ordr.6cribing Ifi,e sponsonship offiffie progymr�,'sunx-:
the Sto t'a offlodd?Depwinient of Elater Affinim and f1he AU'lliarme ffixAg"ing-, 1-ftim SIXnns?"mthip
rerely-mae is in-j-!rr r n uxaurdmu due yvaris,"'S"'afmof Florida,DRepsrumen't of Elder"A, and"AUH f-or
rip lnc,"Shall 4pppew?im-itat I"m dar.£""amme S'Ise'ldr, or tyg-y pe as the varns,of 1.1m i, zmtdixrr.
2 , dxm -t ' ' 'T Su D t s , dh1 ,u.,ihe wonds N" pMp-shr .operA fmr
Agdngl,im"to indicaV,sponsor-ship of a prm&mra Othei'vise f ta"dem s'pem"ific
obtairmd by t1ne,Alhauvcz pr'10'r to use.
24. Assigumments,
e d1hall not assign th 'j1h 24.1 'me Provi(j r;-
g ae n;,,13 and vVitho"ut t1urprior vvrfttuvvr
approwal or"the Alliance,which sha",! nart beunxemmnably watlhheld. Any s',,atilioeruse,u-signmentl or trarmfow
,uythe,vwise.occuuirig W'.1"Chout pumm vair"i"terr approval of ttm-Afflanim-will(mnstitute a mamerial bremich offrte
Con cmx".
14-1 '11ve Alliance s all kt,adi firrms be endtled w,rr rrp-r.or umnsfer,,'-in whole or part,its,right n,dutfles,or
oblippTiorm under 017,ls contract to anced"wragency upon,giving Prior writhe mnot-&-ce to th-e PravAider, In One even"t
the Mime q nr a Wararfetr of the f s timptiom,dw pral remaimms,rr Wible-bar all'NO,rk,
perfbr.med as all ex;pw'msx's's incwmd,in n rr Crag with the camuma.
'24.3
Page 8 of 69
krisk2029
25Y Subcontraeth
211 Ile K&W is; msprontsibbe,fbr W)Week ped"bMed Purs"u'anit-to finis cordtnawt whvtherax-�"'Ually fi"MiOeAl 1ky the
govidar cc it;subcontawsom w0hr YwWxs� Any,xiityconurmu Shall Ne ev idea ctut by a written docurme�irat and
sut7�jg.%:t to ilnjy condwcms of ap; ovalthe A1Nt.,,,nc:eJ'br Agghnig d, necessaxy., cr
the AdHatre has a CUT-ronit flat,of all subcom=tors Antel",aa-rYseaado , The Provider furthar avreas t!
Alliance s'hpill nca be 118-IMN:to llxz stflm.'a atoran&on'vendoy,,,in ar waej ar'ibr auny rne ni. "I"he Provid'e'r,,.%t
it;equose,WA,deb ad the AlIgLairrice,asae,,st afly such clidms,,
252 T'h.e Pn3vider�shall prompf"Cfy pay andfor vezadors'fuafxsn reemipt 0- Pa"Yrnen't 1"hi'm the,
Alliance, MIure,to make pay mont'sto any r vender in a cro ace wit 287.0585,FW,
unless,cnlhris�roiim;stauc-d uathc tan vtract bevofenn the FIM(diew wnd stAxontractcrr will�resuft in a
penalty as;wovided Q sudub'11,11
I& has pendent Carpaefty of 11"Trovide'r
It is the inaena and uroleisIt'sanding of z1his,Parties daid the Provid'era`na kr many al'a's suboontracfors andirT, verx'Amrs;,are,,
indepmr,&-n!con-aractrors ruid sur,nAt em-,Iployeos of It Allknot and sbiall notfu-04 iffien-iselves out.as employ S or
age-nus aaa One Alfiancx'W"""tho'fat specific authiorrizatioro, firronn the Alliance. it is Ch,'a ff"Uprflhar'intent and wnder-standing rat
the Mues that dW,Alliance d(xs rrcn caatz,61 the ernpirryment practicCs oft"he Pro'nelder at shiall as be Hable flar any
ge ard,Incur,emplioymem or otherlwbor Pr ad emp has yrruant claims agairjistt the Flrf,',Mdiaror as
vubcontr tors wa&or vandons-,, A,11 doxiur.-dons for social seuctiday Yens incorne taxes,,cuntributh to n witiraolding ts
uriemployme, cornpeasatioYn Areds and aH r&sc=w',y i,,,asu'rane for the Pnovider F&11 bethesole,respoinsibillay of
the Novider.
21 Nyown;t
2 7,,1, Paynurra to w i I I be-an ade to tig Provider purs uA.ra to s�2 15.4 22,F,S,, iis seryk:,es an;wndared arcl in voked b
*a Provic.1 , 'TheAllia',noo,will have&al agToved of the iniraeice lf"br;xwymezri and wrill pp sage dm invalce
for paynnent only if thel"'rort4der hats rn'-,iet all trrnr)a wad conditions of e1he conanacrt,iuflesa the bid spxi.,icifications,
The appmwood WaiRce M11 be oxethruIded'(W d1w Affhance"s
(1,x,ad s=ctionfior bizignari approval and Dispuitz adsing .�-u invoid,n'qg an ixtyments will bo'�'
ove
resolved in accordainice w h the pro-visions of s,211'i'A22 M.
27Z The Amvider agiresn to submit bills Para f.ePea;or on"her Compe"a asion,fbT siervamos orsoml In sufficien detaill
Ax as PWPx PM as alai,anei"rAsst esAdftthen-,o'f 1�11,w contuactor sfuffl ix')Wly With'the;xitticulaw requirsineras
tuander dhe fiiHowing Ixurs mW qddebneq that Ora applicialbletoeM Con a ("s or zg.grexerne-nts inflids
Qmrax ac'tbny re"flerence:(a)pamgmph(16)(b)of sechon 216,18 1,IS,, reggerding Alvamccs;(b)Rule 691-, , g aw
40%103 F�XC per ningtx)Ftt:�,strictian side fiands;fo.ol,(c),dwe lnvr,,,3iceas a,aa
t Ft G 'de f du `1 ',!cr the U-'g or State Exromd; ats fronn ante Depwinaent of Finzandal Servi eswt,
llsz� "A bill
UNI 11� �j rij, -Sal OL
'11%c Prowider"fail l certify hint def"alk"'d is availabble to,s'appeo"n ew:h fteni on Che he'adzed Lnvok';e
eNNmsw,fixeJ rnA, or deilverables oicwracts or rn cnr payrneat requcstf r an rVa ,�s
a or av be
pa odu ,at upon reqty:,st by Me Afflanix,The Pls,,rdder will further ceini y that-t nbisaY a iontre%,jursts are only
fcj,r,,, lowable in the laws and g�uidfirqg,cin Wane ched in Sections,4 ofthis Contrafjlr�in"Vive
Refer rz,.' Ghalrdefor State,Erjpendittiress.,and any, faher loc,,vs or nqulatiorps,as a aaafical,,Ie-
273, '!Tie 1'rovider,it" 'mubcont""actom andlor vendlors shali pprwddee waits, including nqpecxt 'finfngs'x
anddm&,s&.;sp ecnerws 9-nfd which hwcafponte this Conmact,to,be
nxWed awral acceptexi Ite,11ae Contrat,,,t Marwger pdor to poeyrncent.
F%ge 9 of 69
KCPW-2029
27.4, Payments will N.-rnade to the Proyii'iertmxsed on a,ix"m1plote anul oarrect inivoicre,,,finvoloes that an, incmyviplete,
cxr with in-correct toralt will not IM,ormesmd and will be re-turnwd to fthe Pro vick-r fa cov'reation,Fise'al
will not be able ve correca or make 10"I'mmggems w the invoices,Reltaming irtvoices for correcdons vrmy resvvt firt
fiallure tty rece""Ve Paynnent fbsr that,mollrb..Invoicm,shall im stibmitued timely as pot r K in
order to avoid any paymemst eh,,4-'ay's.
27 E',ach sem,ice pe,-fimmed shad'i be rec*rded Ps six-cif led in the cfierst in-fIx-mat on-And regisrration.mAcEng,
�ysltem'CHR"IrIS, fguidefines,, Supyrh)rfing ne
k' mvidednw it
r docunx,�,,,ntwdon of services p ist be adequate Ili perrni fisced
and, and ensfure�int era's ,a mlmlagmnt-,'Ant"
2& R11 a'a t'airm o,f Fo a d s
T he Pa"!"xt wide r w i I�ve t u m to thie A I I ian ce,aiy ov e rr)egarmsret,s dtj e t o uni ea ra rxi.Rands or INk nd,s d i s al I cm,ed a rimd"Pa y
intrumn mu, btmaWe to stxlh hindhi purn"I"Lant,to tic,terms and comiftions of tMON',rs conih-acit that we�re&--Abtx, .,,ed to die
Provk1ler by t�I , heAlliamce
tx,mm mada,the Prrvidler ah"111 repay Said vim-paymena,immetsfiately vvit hod ut prior notificasion, "horn tire,Alloinrx. In
the,event, dual d-eAllimmm f trarit diSCOV4,1131".3 Ein CyMprrymept kas been made,tho("ontract Manajger,on tm-halfofthe
Allumace gs will itaritify the Nxivider by IeWv of smch,fimfirA!, - ShoWd repwyaierrut not tw the Promider
will tw,chaq;jai at t-he lawftl rate of intereat on the o0tau'vadin, bialarm pa rsmuant to s. 55M,F.S,aft, Wliance
rtcmificmion rjr ftolddlcr discovery.
29. Data Inte,1prity and Safe4varding Inforreatlom,
The Prcivider and its andif,"x'r vendors shms.11 insure an level ofdata secmrivy for thy
in, mm-flrin ilia Provider is callecting or um as Ird dhe t�&this co-ntrmca,� An app,roprikw,i"�'leved ofiscrurity
inich.-dies zippmmving auxil oackiing all Provishn-emphayees tha mqukmma swSam or ind a";`rimion access and,es"C"u"firl, that
t,ser access haus lcevem,removed fmm all tarrninatcd ennplaytxs the Pravidew,asnorig at r requ&ennent"s,rrlust
anticipaly!and prepam for o'm loss of infbnnPW,-,,'x'1 Proix'saing All diata rand so Armare$,hall be roeatimely
backed up tj,3 ensure recavez-,"'!iffic"mi lomses or Guagq* if the Clann'ou"Wer S"ptem,The sectirity overthe'backed-tip clata
is txj bezm stringgent ams t,'hoprntection recjmrod of dhee,prirrtswy systems.The F'rervido-shall enstze all subcontrar"tors
a lar vemdors rnaintain Writj n prolcledurestbr compu-Uir system,barck-up-And mmove-r y,Tto Provider shall complete
exacution-ofeno' cormract.
pfire If
rind sigpi.o,'Mr,PV."J1N a 'V , �i S
X Caim imiler Um and Sucial!Vfiedffix Polley
The DO tea, hits iMplerneraed a new Social 1114,,ficdia Polhcy, in addithun to its Compu r Use.1holicy,which arpplimms to
all eemplo,v,rcye s,contmioe-d employmes,consudumits,01 and voliummoms,includingall per mmnell afTiliated wit"Ir third
p art c-i %,such es, but not limimiltz,Mem Aggerwim an Aging md vandom Any mAilkie thest a,xsas r1le 14,10BA's
mu,nrollux r-601 vs- 'Y rev! qi )IM,Social Irm. SeviaiNwa, IIASag"
but is not Rmited to blogs,p odcasts,discmsio bruns, ikis,WS Srefls,vrdeo shan&scwi al-neinvorks fika
MySpmm,Fsx=Rmale ond Twitter,fis wreflas contem,shmirap g nahworlts such sis Flicki Fuld a 2 i i 1his tx)licry $s
A's website at',arva;I ab!e on Df.'YE & aaspYur Maxi
31. Cemiflict of LW-rast
7"he Shall v ablish sxf,'kq-, ff ag V -4 CW1L'rRr?0 S
9, gpular tia probibit vrnplcVeas,boar membets, uin _;amer t and suix:, , , . ,r,
aan aaa vendars 1""singl1heir poalflons for a puTpose that comstitutic, mr prvient's-tIn't appeavance ofperso! aI cw
is$ Or pq
ganizatknial cor"flic-'t or Exansi'mnal gain,, enaployee,C"Mm, gg�)ng of tlho.�
U Pfovi&T air sub,,,i*ri1,',rFrztor
andlor,vendorstuaill pznickpate in selection,or in,the awme,ofmi Agmenvent.muppoonted Stafm or F'exleral,fundis ifa t
conflict of fnty:rarst,real or r4pparmemd,mrcmld be involved, Such a conflied"".would amse when:(a)the ernplaynx',�,oilice'r
or agpmt(hj',!mly anember of his"tm tp)his or l"Yer Paytv"Or, or:(fl)an orWsmizaaflon which mmirjlriys,
or, is almut to erripplalt,way of th'.'e,above,haes a flan ancial orotlm',r m4ervmt in,fthe-firima selexaved'fxv award- The Promider
br og,aty an as es Of Eoecs,ampol?,aara a s air apents will nett solich,snor 4ccepc gnauides,Avors
or my of ITATrymny V11111 froat tumtraz aria potemial con or pa.-Cles to su acts. ThePvc der's
bomd members and must,egisclk"se to the Milliarmax any rvelationship which may'be,or mmky be male veil
to be"a com"'lict of Late vridim Uxrty(30)c endar slays of Olig;'11-maj& 'W'bument or a'Iace !a
Page 10 of 69
KCA-2029
that position,or if the individual is saving as an incumbent,within thirty(30)calendar days of the commencement
of this contracL The Provider's employees said subcontractors and/or vendors must make the same disclosures
described above to the Provider's board of directors.Compliance with this provision will be moniUmA
32. Puhlic Entity Crime
Pursuant to a.287-133,F.S.,the following restrictions am placed on the ability of persons convicted of public entity
crimes to transact business with the Alliance. A person or affiliate.who has been placed on the convicted vendor list
following a conviction for a public entity crime may not subMIL a bid,proposal,or reply on a contract to provide any
goods or services to a public entity; may not submit a bid,proposal,or reply on a contract with a public entity for
the construction or repair of a public building or public work;may not submit bids,proposals,or replies on leases of
real property to a public entity;may not be awarded or peribrin work as a contractor,supplier,subcontractor,
vendor, or consultant under a contract with any public entity;and may not transact business with any public entity in
excess of the threshold amount provided in s.287.017,F.S.,for CATEGORY TWO for a period of 36 months
following the date of being placed on the convicted vendor list.
33. Emergaacy Preparedness and Continuity of Operations
33.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients,or the
administration and coordination of services necessary for client health,safety or welfare,the Provider shall,
within thirty(30)calendar days of the execution of this contract,submit to the Contract Manager verification
of an emergency preparedness plan(Continuity of Operations Plan.) In the event of an emergency,the
Provider shall notify the Alliance of emergency provisions.The Continuity of Operations Plan(COOP)must
address continuity of services,especially for meal providers,in weather and non-weather-related emorgencie&
33.2 In the event a situation results in a cessation of services by a subcontractor and/or vendor,the Provider shall
retain responsibility for performance under this contract and must follow procedures to ensure continuity of
operations without interruptions.
33.3 Contractors offering nutrition services must have an Alliance approved shelf stable menu with at least 3 days'
worth of shelf stable meals with reserved funds set aside to purchase the food items in order to ensure
continuity of services Without interruptions in weather and no-weather related emergencies.
34. Use of Contract Funds to Purchase Equipment
No funds under th6 contract will be used by the Provider to purchase equipment.
Equipment means:(a)an article of nonexpendable,tangible personal property having a useful life of more than one
year and an acquisition cost is equals or exceeds the lesser of the capitalization level established by the
organization for the financial statement purposes,or$5,000.00[for federal funds],or(b): nonexpendable,tangible
personal property of a non-consumable nature with an acquisition cost of$1,000.00 or more per unit,and expected
useful life of at least one year;and hardback bound books not circulated to students or the general public,with a
value or cost of$250.00 or more[for statc funds].
31 The PUR 1000 Form is hereby incorporated by reference and available at:
b1u//%vww,myJ1Qdd&&wLa i2a/vhe&dggLF-1240Q-PBIILRI_QMof
In the event of any conflict between the PUR 1000 Form and any terms or conditions of any contract or agreement
terms or conditions the contract shall take precedence over the PUR 1000 Form.However,if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes,the term or conditions
contained in the PUR 1000 Form shall take precedence.
Page 11 of Go
State36. Use of r Improve Real Property
No funds underthis contract will be used by the Providerrimprove
Any state funds provided or the purchase of or improvements contingent vi r
political ` ision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the dater the completion vements or as further required
by law,
37. Dispute Resolution
Any dispute concerning perfa the shall be decidedy the Contract Manager,who shall reduce the
decision writing serve copy on the Provider.
Financial38. Non-Performance
38.1 If the Provider it minimum level of service or performance identified i t9 or that
is customary for the industry,then the Alliancey apply financial consequences commensurate with#
deficiency a C,Sec. . . . Financial consequences s include
suspension, in ,withholding payments until deficiency is cured,tendering onlypartial
payments, c ll i of contract and reacquiringis .
39.2 e Provider shall not be charged withfinancial consequences, iture to perfbrm arises out of causes
that were the responsibility of the Alliance.
Sovereign39. No Waiver of t
Nothing i in thist is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
Venue
® If any dispute arises out of thiscontract,the venue of such legal recourse willi i- c County,Florida.
Entire Contract
® This " s all the terms and conditions agreed upon by the parties. No oral:agreements or
representations shall be validi i Alliance i s expressly contained herein
written amendment to this contract signed Parties.
Force42.
PartiesThe i [ not be liableo l y r failures in performancecircumstances n their control,
provided experiencing a condition i immediate written notificationter
takesparty and all reasonable efforts to cure the condition.
43. Severability Clause
PartiesThe if a court ofc uri i i term or conditioni i r unenforceable,
otherthe provisions are severable to that voi iia shall remain in full force and effect.
Condition44. is Appropriations
The Parties agree that the liance's perfamlance and obligationy under this contract is contingent a
annual appropriation by the Legislature.
Parties41 Addition/Deletion
The t,notwithstanding the terms of the procurement documents and actions leadingi t,
the Alliance right r to deleteservices uired under this contract when deemed to be
in the best interestl lation targeted by the Am&Plan and reduced to a writtent signed
Parties.both The PartiesI negotiate 1 for any additional services added.
LAv- 02
46 'Wa. er
The dial ..,or rrffurrr`b the �° ranA e` ra exe c, ��rr ent"s s,rr� rr� � t, '�`h t."Under this con"a� � a ons `�u, o
�tr ',« � r�r � � � �.� any+�� � �� srsrr rrrtx� ru a�mn� �����'. >, rr �� a�a r
'" err n other
a rs� z,�e- thereofr. sn y Othe
'any�'l'x rip
�r �r ru.„ h r xrr err ax r, s ,. r � k rr .x=. rr Other righat,
4"K. Compliance
The ProlAder sha Ul bhdk by all aid rlrr",t le Curren d erAA�,stb rs tes law r`ulems an r s'sr r�rrrr. '� s a � pl i xe e
�' � :�:�" w �, �:, �,. rrw�`-�well rr.��r �rNAr�r�
c,vanent State srauxteis,lavis,rulels,and r rr sr rr.rr a r x ' Mr ,agre
g a that failure o"f the Providler ter abidle 1by tkeese
a.%xvµa shall be dzer'�'� "x,G an,e en't of ded'ault.of the Provider, ri,,J siabject,the contimm to irrunediaae,iini laa rai
r r cefl fi,orr of the coraxict at th-r r c eedo f of the j s� c
4& ivaJ Invoice
T.e Provider anrr Mrau xrrr} t finel invoice.akr. payment-to the A: trrT,rx ;as r;`saruo1ifita in sztra,r?Qrrr'3,.4w7(skseir,'br final
nar4poet, for :`�x�ment)of A' .-.0 VIT , T L If fre Pmid fails tad utxardi final rexq es 1"or s rney `'it the 4eadline,
then all e rght t'o rrrr acet.,r rasa;r`be.err ,Item and rune Alliance tray not honor anyrogjttesh,s rr rrr ra r- "�` the
afibrrrR�`ai time l triad. ,tits irsr 'r�rent due rrrrdrer "fir remits hnr sl�rrrr��r �r� rakebr" sr<rthha<l rrrr:.fil all r't'�p its r,uw from
the Provider s l � e �r ?Y � x 2 't"O have tr w Mrt"�s'a 4 the lira
a �.. Aax .r°�a,r �7,�� :�r �r�,� r`��rr r�a.�u. �,mr'� �xrt�a r' t����,.� �fra;4u �u 'r��
49. f axiregs'sr.r rr`r irrr o (o-Jd Madam
a,rr
>, r ar air ry o of t rar r"a'IVISarr;"r' f"this rrrrr atrlrrat<r r"T'N",Valid Only whxii they a r,,,--been r t'arced tir Nvfobfing and r ui
rrr"agrr a by bodh,virf rr;?r.
The A lh .linen`may in,W,sole discretion suspend ally Or all."rc4«ivid�,es Uncle rri^s Crnv r.in and aniv Contraef,or
s 8rr r ru x?r rrr„rrr r rr'rrrrr in r xrs r„dorrr,'act.,rat,lair"y, I"kne,vdhen in Ittra bein Pntere grru ofthe Sta rw,to r rr sc.The Alliance
shall pmecsv r,e the rarrtiarr rare`w7d"u r r"rotice Outlining r.m prrrrrrarrlrrrs of rrumperr sr r=fi o " c 1- Warr$("or
suspension.,include,bax,are not 4G a rr;r budgvvtary copstriirvu,declaration #r "r z' a or ri�rr`� s€.r+dh
rr ,rr, r rill r, , kfitrr risexivrrr°tgr a suspension, cull a,the,Ea"r`orxid rf,nuffl comply with the ruotice and,;raja,l rie�t r m.+r,epm:
i,cr `purchisse orders.r.r ra Within rr rrrrrt'z' r r,+, or rrrr long�r e, rrnrr rrr�;�nu.4xrl o fy 4 r Prl%vi �r the klli rrE e sha l afthea?`(I I
xs e x a +:7 7' + -rr`v s R 3 J r„r lE a 2 M r a a 4`ara a`i� n" r i r
r�ssa'r.„x rar�rrc a�! fiuirr rr ng r r u rra r rran�( r�ed-, a �a�r rill 9 mrA ra� .,xr�,R r�rn rar` ra,a� r ., r.. rW.( the Contract�rim`
-pumhase Order Stzspert slor'r o lvor r shal.M not entitle rhe rovid-ler to aria addifional rxompr„rrs '<kror`ra
51. ` er'Amirr t rr
u This re=ai r s u,zd ,e y terrnina r "" by cause a on no Ims titan dib 30.) ?,lend'a dry,A rya
rr 4 rrrr in. tiara rr "#r 'w r rr3 r 3 parrr 'rrrri , a arrrrrr r rnr fi r ¢#„r rrr :r,tried uivn irk aw rkfir'ig, id otice rsshall
Ice,sd6fiv'ry by �.J,& PostalService or any mce-di:red?defl'' 0511r�t era*rc'e`that prr'ivkle,ver•rr+(fwiurfien f,,1fddH.' er,,v (]sr
n,y r ,,id �r�a'� �e r ra np u7rr. r s a sr. r r r' 'v"r v o t P v der rx4rrrrr��;e for rad A d ra r, r r ra rr r r a r t ra 1 r r s r n .r rus;`rr r r
of the contract",
L2 In the mfent flindb fix "rrr'rr Pul"Slnivitk , r rrNra k bWit`,Onne Uriavailablim,,the Alliia o y,`rr:'rr'4r,rrrxtr,this
rrrrrrtriwt--upon no wma than a.:werr f?ru (,24)hu1i£ans,`nxtrrce in o rxr'`rrr, .o.'ffie Provider, Said n;"dfl r'ntr?.H be
;ticfi erad- 'r »Sa F"oss l ice or any ra"xpr`rA,�ted deffivery service thum provides ellifiepr,rsY}sn of delivery or b
harm delivr to the,Contr ct ManarM or the tt'r,;e rrxie rr five of rt" Prrrrid x reestiorraa+rile for 4-dr"rr rrrrrrrat:srrr"r o
rhFr,"a con0ract. The rA"H31"'rare r will be w ry final awrthority as to the avadialaility arc.1 adq.,,a°agy offtbnd& Ir`r raa°r aven
rrftairr7ir.rrla rr a, ma in contr cu,?:,the Provider;der wir'..I be morn µ+rurated fior arry,work''r:;4'rrsrilr'rxxr"ay completed prior
to ttte date of terrrrrrrrr4rrrraa
513 r rrrnrrrararrr rrr er,,rre
Tills contract r;y be tznrrrrmerl rx r c s b r� llrk`e rrva no rrr ,u � ( )1kmm, 'r ri in
ar,Ar� rr r s3 arm 'x Aiver'o nssa rMr my,p asa rr r nss'of this ra r .rt stall fowt be a:earrned u a
waiver of any other breach and shall not be construed ' cconditionsi
provisionscontract. The ( limit the Alliance'sr the Provider's ' r in
equity.
51.4 Failurev contractual obligations with the Alliancein a manner satisfactory t3
Alliance ill be a sufficient cause fort 1 i n. To be terminated as a contractor under this provision,
r v! have 1)previously fhiledto satisfactorilyin contract with the Alliance, notified
by the Alliance of the unsatisfactory 'l correct
satisfaction of the Alliance; ( )had a contract i lli or cause.
1. . Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other
shall not be construed to be a modificationconditions contract. The provisionsherein
do not limit ' i law or to damages of a legal or equitable .
1. .Upon term!nation of thiscontract,the Provider.its subcontractors r its vendors shall,at no cost to the
L' c ,transfer all public records in their procession to the Allianceduplicate records
am exempt,or confidential lic records disclosurel records stored
electronically shall be provided to the Alliance in a format that is compatiblei the infbrmation
systenu of the Alliance.
52. Electronic Reeor&and Signature
The Alliance at s,but does not require, Provider o create retain electronic s and to use
electronic signatums to conduct transactions necessary to carry out the terms of thisContract. A contractor that
creates and retains electronic records and uses electronic signatures conduct transactions s l comply i the
requirementscontained in the Uniformt ct is Transaction Act,s.668.50,Fla. Stat.All electronic records must
subjectbe fully auditable,am 1Public ,c . 119,Fla. Stat.;must complyi ,
IntegrityData i t maintain all confidentiality,as appli ! ;and must be retained
and maintainedi to the same t non-electronic records are retained and maintainedrequired
by this Contract.
,1. The Alliance'st ti ns between the
Provider and the Alliance.The Provider is authorized to conduct electronic transactions with the Alliancel
upon further written consent by the Alliance.
® Upon l[lance, Provider shal I provide the Alliancei non-electronic r
copies Non-electronic(paper)copies ! I!ance of any docu that was originally
electronicin electronic form with an i
electronically i y non-electronic copy of the document.
53. Special Provisions:
The Provider following v' i .
.1 Investigation of CriminalAllegations:
y report that implies cri i l intent on the pad of the Providersubcontractors and/or vendors
governmentalwas referred to a investigatory agency must be sent to the Alliance.If the Provider
to believe that the allegationsill be referred to the State Attorney,a law enforcement agency,the United
immediately.States Attorney's office,or other governmental agency,the Provider shall no*the Alliance
copy of all documents,reports,notes or other written materialconcerning investigation, in the
possession f the Provider,its subcontractors,or vendors, t be sent to the Alliance'scontract
with a summary of the investigation and al1 i .
Page 14 f 69
KCA-2029
53.2 Volunteers:
The Provider shall ensure the use of trained volunteers in providing direct services delivered to older
individuals and individuals with disabilities needing such services. If possible,the Provider shall work in
coordination with organizations that have experience in providing training,placement, and stipends for
volunteers or participants(such as organizations carrying out federal service programs administered by the
Corporation for National and Community Service),in community service settings.
54. Enforcement:
54.1 In accordance with Section 430.04,F.S.,the Alliance may,without taking any intermedlate measures
available to it against this Contract rescind this Contract if the Alliance finds that:
54.2 An intentional or negligent art oft Provider has materially affected the health,welfare,or safety of clients
served pursuant to any contract or agreement,or substantially and negatively affected the operation of services
covered under any contract or agreement;
54.3 The Provider lacks financial stability sufficient to meet contractual obligations or that contractual funds have
been misappropriated;
54.4 The Ptovider has committed multiple or repeated violations of legal and regulatory standards,regardless of
whether such laws or regulations are enforced by the Allianm or the Provider has cornmitted or repeated
violations of Alliance standards;
54.5 The Provider has failed to continue the provision or expansion of services after the declaration of a state of
emergency;and/or
54.6 The Provider has failed to adhere to the terms of any contract or agreement incorporating in this Contract.
543 In the alternative,the Alliance may,at its sole discretion, in accordance with section 430.04,F.S.,take
immediate measures against the Provider, including:corrective action,unannounced special monitoring.
temporary assumption of the operation of one or more contractual services, placement of the Provider on
probationary status, imposing a moratorium on Provider action, imposing financial penalties fbr
nonperformance,or other administrative action pursuant to ChapterS.
54.8 In making any determination under this provision the Alliance may rely upon the findings of another state or
federal agency,or other regulatory body.Any claims for damages for breach of any contract or agreement are
exempt from administrative proceedings and shall be brought before the appropriate entity in the venue of
Miami-Dade County.
55. Training
The Provider will attend all required trainings and meetings schedule by the Alliance.
56.OMelal Pays@ and Representatives(Name,Address,and Telephone Numbers)
The name, address,and telephone number of the representative for the Alliance for this contract is:
Max B.Rothman,Jl), LL.M.President and CEO
760 NW 107th Ave,Suite 214
Miami,Florida 33172
py
(305)670-65004 Fxt.224
Page 15 of 69
KCA-2029
The name,address,and telephone number of the representative of the Contractor responsible for administration of the
program under this contract is:
Monroe County Board of County Commissioners,
The Contractor name,as shown on page I of Social Serviceslia-Home Services
A this contract;and mailing address of the official 1100 Simonton Street,211 Floor
pa y Key West,FL 33040 ee to whom t y t l e is:he pamen shal be mad
305-292-4510
Sheryl Graham
The name of the contact person of the Monroe County Board of County Commissioners,
Contractor and street address where financial Social Sery ice sfin-Home Services
B
1100 Simonton Street,2""Floor
and administrative records are maintained is-.
Key Wast,FL 33040
305-292-4510
Sheryl Graham
The name,address,and telephone number of Monroe County Board of County Commissioners.
c the representative7of the Provider responsible Social Servicesilln-Home Services
for administration of the program under this 1100 Simonton Strect 211d Floor
contract is: Key West,FL 33040
305-292-4510
Alliance for Aging,Inc.
The section and location within the AAA where Fiscal Department
d Requests for payment and Receipt and 760 NW 107th Avenue,Suite 214
Expenditure forms am to be mailed is: Miami,Florida 33172-3155
305-670-6500
Contract Monitor
Tate name,address,and telephone number of Alliance for Agin&Inc.
e the Contract Manager for the AAA for this 760 NW 107th Avenue,Suite 214
contract is: Miami,Florida 33172-3155
70
305-6 -6500
..........
Upon change of representatives(names,addresses,telephone numbers)by either party,notice shall be provided in
writing to the other party and the notification attached to the originals of this contract
57.All Terms and Conditions Included
This contract and its ATTACHMENTS 1,H, 111,VI,VI 1,VIH,IX,X,B,D.F,and 0 and any exhibits referenced in
said attachments,together with any documents incorporated by reference,contain all the terms and conditions
agmed upon by the Parties. There am no provisions,terms,conditions,or obligations other than those contained
herein,and this contract shall supersede all previous communications,representations or agreements,either written
or verbal between the Parties.
Page 16 of 69
By signing is contract,the Partiesthat they have mad and agree to the entirecontract.
THEREOF,IN WITNESS the Mess is contract,to be executed by their undersigned officials
s duly authorized.
COMMISSIONERS,
d. .
SERVICES/IN-HO
GLY�,�OtGlly/GZl1,�„,„�
SIGNED _ e m ._. , _ c..
NAME: � �'. � r-� � NAME: MAX B.ROTHMAN,JD,LL.M.
TITLE: 7 __.._ TITLE: PRESIDENT AND CEO
DATE: ' :
Aug 13,2020
Of
COUNT
ArTORNEY
DRO J 4A P7qC M s
FIST'
�t� 17 �
Date
I: 'VI IN, MADOK,CLERK
u �
As Deputy
#r
Clerk
Page 17 f 69
INDEX TO CONTRACT ATTACHWNTS
�.......a --------.. �.
A7TACHMENT ATTACHWNT DESCRIPTION PAGE
ATTACHMENT I STATEMENT OF WORK _4 I
ATTACHMENT 11 _.. FINANCIAL COMPLIANCE AUDIT ATTACHMENT32-34
ATTACHMa AUDIT REPLATIONSHIP DETERMINATION
_EXHIBIT I _
ATTACHMENT II �f FEDERAL RESOURCES AWARDED PURSUANT TO THIS 37
EXHIBIT
ATTACHMENT III CERTIFICATIONS AND ASSURANCES
38-43
-A—TT A-b—HMENT V-1 ASSURANCES-NON-CONSTRUCTION PROGRAMS 44-45
t . _. .__.ATTACHMENT
CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE 46
-- - _
A►T"TACHM& _III CABS ACT CONTRACT REPORT CALENDAR 47
...... .......
ATTACHMENT IX I REQUEST FOR PAYMENT
�_.._.. ..::® ... __. ........_.. _..s... ...
ATTACHMENT X, CEIPT AND UNIT COST REPORT FOR SUPPORT SERVICES 49
EXHIBIT I ? (CA3B)
ATTACHMENT g
EXHIBIT
RECEIPT AND UNIT COST REPORT FOR NUTRITION SERVICES 1 50
(CA3C) I
. . ��� �_ ._. _.... ........�._.._._............. - . �
RECEIPTATTACHMENT X. T 1
EXHIBIT 3 SERVICES )
-.....
CHECKLISTATTACHMENT B DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE 52-57
kitit
! g AFFIDAVIT OF COMPLIANCE
._. _ _ - „
ATTACHMENT BUSINESS ASSOCIATE -EMENT 59-64
I
FUNCTIONS
Page 18 of 69
KCA-2029
ALLDUNCEFOR AGENA INC.
9' Ell NTOF WORK
CARKSACT
S S 4,17;CTION D SE3,"tViCTS BE MOVIDEID
The, is to pr(.mcte the Opt"fir'nal qt'lalfty and theirIfimpkilies.
1,2 prvagrimmza �Sjmvmff"fie"Irerms
Area.,F'Iam AphAn&WoM4 by Ae am a amp ney cm aging midining a and c,o.)Min, set 1 c a
de'H,ve-q syste,?,-n in Rs Ymmbg amhawke arm in smcordain"Ce Widudic",Section 306'(412 U&C 3,`2, )Oftlhe
C,6A,S,'ES Act as DOEA inwjvu cviox-,us,
Ares Plan UlvdptIn A rervision to"Ihe asoa plam,v&m5n Ae A11iance enters,CAIRLES Act sipa�,zific datta in the'
C11'erit']",ndfasnn,,zustion and (MRTS)n ,Akri P,,TMzlv:awky also inclukle
tlheau,wa,phan,as instr'.,uctefi Imy the DOE&
ChUd� An izu'lividual who'ls naa n"kare thul Is yews of age ortan br,�dividuwad orit'lla disatInUHty
f 1 " seefif ny ua o "" l v lto nyDusasterIkelleSeiviees: A(,L as .e""iccemin, dutaIs �be ailmable
OAA subm dmbg tlwtrymumCcrvoe"I by thamoure provicied t,,,.,>efligiVe Or
f1i'mily underthe OAA,
FimHy Cknjhwr, Ar,,.,fmduittChunfly merntmer,oranvother kidividimil,who is,�,ut indf,"borrmiad axle,
c,ornmi,unity care uu,ark old,er indfividuaJ,
FiraIL., %fenarsol du„ intvidual is umbia to perb rnn zal Im,,',ktst two activities of daHly IMng(ADLS)mdftho,,u,�It
substi,tnfiW hfmari,iassisit'arme, inclt4s-ig vertmfl nemir"ding", ph"y6cal cueing�,',�e sq.,,eridsirmn;or dum to coj,�,,Wuva or
adwr nanud impOmed"mt,rm""'Wes SUMMUSI superviMon because the Adividaal behaves in at manner dixalt poses
a serimusi lhmstlth safety thm,
GrandporeaC A gpwroirparvnt,or step-p or areheti"ve of a chdd t�y blood,maurriagge or
achHd
�h ud"lopodoo and Abo Wes Kh'ithe childl; prinnavy camgWer of Ow W, the biological or aomdo-pdve
pareuts,,,,aurp.unable or unwHUng to seaveaast0he pr,,,mmry'c,aregj,,'ver cttlms,Child; &'nd has a!�Cg'm"I to dhe
child, such ate hqp0d VIStDO',t,f DIC gU42rdhonship,or is mi.,;ing the,ch-ild
und
.4f;kxor, Disaster Declaration CMDDY Me anid um e,ivean MDD bythe Pr Wei k!r 11-me
SmOnd Ad. 'I'mis It c'm approvaki, I
pokon of the Inds maide anfaila"'ale Aat for dissMer rehefCar oldler IrmikAiduals,'These
aure,Onlyadlotimed&Sinffig the,perkS of the!TXD,,'F'he.Comuvetor will nam'.,fied via Notice of
In tructdoaR once dme MDD fie ricA hasa enck!,,d,,&t which time Wilf,be" the,Cont ictor
r'll"I"'ia pr,"wide"serVicesin.,umnphance widb,CARRJ,,,.,.S Act,
Page 19 of 69
KCA-2029
13 Gvemeral I mex1pdrem
The prinIm,7 puqcase of tN C,.'%,R,,E,"S Act is to prevent",prpqp,uefor andmmspeund to corcmavinus;inchWhi,
,sump,artive service's., nutrition servit".x-mri,and muppxvt servicta's,fior fiiurwnily caragivers"
1.3,2 Authorit-
y
All applicable f,I,,;dertfl. hwves,regulwficnas, a ion transm-l"amis, p-mmopma, inn ruc ions,review guides and
&D,
similar documec.,tai'don rehatmed to Am fiAlowing,
a, Ca"clog of Fftederal"Ek"")"mestic Assistance M,,), 93,043,91044,91045, 9,3LOS2, and 91053;
b,, Older Americarmikct of 1!96,5,-,-a.s amended 2016,
c, CA"EUES wnd Uniatwl States,Code 21,/47d,,
§6041-
P
rho Ruth: 58A-[,, Florida.,Am mirtistr ive Code
f, Sectiong 430,10 1,Marida Siummes(ES); &nd
g, DOEA Pn,'),grama and Ese"icesfiandbook,
131.3 gar w ix of Service
f rkll).7trurrunati. iscal,and operafii)nil manappinwra o the CALF4.1,"S Aca,
gram within its,diesignated PS,,k"I be pros,gxamn service"s;rs'lluill be providit',ml ina marmsex consistena,md0h,the
Car"arcatol"s cumema,—A,ita!"han,u updatodand ihemby hZIUMT7,31MR EdCd f.-,v Mfenmume,and the current?,X,,)E,�,Ak,,
Pragpromms Awd Serf ic s I 4an,&x-)&
I 3A ME4jor Progpann Goals
Tbe nneyor goals of"Hime CARJ,-,,SAu:,t prur,,,an,,Isure to prevent"', prqrhare fbr,ax,,�,d respf,,,,fndtr)cori,,,,wnavirm;inchl-dUn',
s,-m vices,-upportive mm- ntaridozy senAk d surpriort services',f?)r fiami y cao, 'g,"i r6ar's,
A, a desip pieuute,d Focal Point,a provkkum is erfuo-uraged tru provide ccordination,ofs-emirkA.'s fibrolder
i'ndi The,Pnovfidc�,r must also ixnowfidle comulunit!IV y leaderrdI,1� n aging issues and seme as th advocate p or
and focWh point Iflor the elclarly wfthdrr"the.commium"it
fir.41mliduals partickpazing in awlivittem,finadded,byldw,,,a Affiallce,, Ad%,nocacy,shoudd include inida rns pmdtive,
I -don,-u--o inq rwr�rnedify, c r
ecl-wing p5s in pobliC W r7k.1-,iVTW`�rKfflcles a,"Id a4der rem-soms,'itaking,x, I
T I a,-, 4ye.SF wificimotivities on behalf offindividwals.
y invo pe
1.4 Mau to Be SeVved
LM Geamemtd Desc"r,"pvtIon,
CARIES Act Prqgn,, wri give's pr fumm"i'mice to Oldew indh/1"iduals witth peatfoit economi net, wi older
individuals wit la gnezft;st srociap"need, pard","uhar aplention'to lum-irmorm older indivAidual , irtcludirtig law-
I -it "vidu ,
inoorrx:rruinorlty older indivichmils, with, limitmd Enq&fis, proficiermy,and' older indl Pis
trusiding n rural aTems), amod, WhuI;are prawfic-Ing social due to the COVI -19;ub-1-Hro,emmurp
h pm pnc,,y,,,,,
Page 20 of 69
t. ®1.1 CARES Act,General Client Eligibility
Consumersa. CARES Act Program
I I not be duallyl in the CARES Act Program and a Medicaidcapitated
exceptconsumers in need of CARES Act Legal Assistance services.
b. CARES Act for Supportive Services underi 111-13 of the Older Americans Act
i. Individuals must be age sixty r older;and
ii. I&R/Assistance services vi individuals ss of age.
c. CARES Actor Nutrition Services under Title I 11-C of the Olderis c
Generall be considered in establishing priorityo i of nutritionservices
include as .
i. Cannot afford to eat adequately;
ii. Lack the skills or knowledgeselect and prepar u 's ! well-balanced meals;
iii. Have limited mobility is impair ir capacity to shop cook forthemselves;
iv. Have a disablingillness or physical conditionrequiring u ii support;
v. Have been screened i ii l risk;or
vi. Is unable to obtain ® i individual is practicingsocial distancing
emergency(only during the period of the COVID-1 9 public health emeWncyc1 under
sectiont of the Public Health Service Act[(42 U.S.C.247d)].
i. In additioni l nutrition serviceseligibility i listed in Section
. . .c.above,individuals eligible to receive nutrition services include the following:
1) Individuals age sit )or older;
(2) Any s (regardless resides at home witht attends the dining center with
histher eligible spouse;
Persons i disability,regardless of age,who reside in a housingfacility occupied
primarily by older individuals congregate nutritioniprovided or home
delivered meals are delivered;
(4) Disabled personso reside at home withaccompany eligible person to the dining
center,
(5) Volunteers, regardless of ,who residei t provide essential services on
regularis during meal hours;
Persons at nutritional 's v physical,emotional,or behavioral conditions which
would prevent t i nutrition;and
(7) PePersons at nutritional risk who are socially i isolated o obtain
nutrition.
d. CARES Act for Family Caregiver Support Program under TitleI- f the Older Americans Act
i.Eligible individuals include-
(1) ily caregivers individuals i ( o ;and
(2) Grandparents [age fifty-five( )or older] or older individuals fifty-five }or of
who are relative caregivers.
ii, For respitesupplemental services, it caregiver us providing o older
individual '"as defined above.
iii.Priority will be giveniAlzheimer's disease
relatedand iso s with neurologicalis brain dysfunctionr older
individuals who am relative caregivers who provide care for children with severedisabilities.
Page 21 f 69
In order to&chi Fe lh�, � 7i+s of the CARIES &t rzogw5 r the P,. iw sk $,v3 sl7tall masurva Phkw Mow,
§ w do
(1) C.liena 11"he Pircrivider-,'hall m,-usun 'f wt,,,.applicant n rw,#`a,NW 7„e aluette ri;� uall r�s
de t"T#,m,#inc at,AV3 ,r,#
intftis Contract.
,` #tat t``tt#t� rattoi #" tks,ub;,`rtA -r�,t�' >'nw.&":?'#{ {. ..#,', #'vr�a�r 'M1:S- ``w}S':�'x P:.r`fr;� n g,,e,Pr-{'s ,#we `ear s,:al i de ���#"a r„` �' i�ltr�, k �;"'�-
ptiic,,€es stttu#procedurres, rt3!#'taist t ,tti,CARES itr t tacit ttntt atmi
(3) P':o r"atvttf,t rvicres: ,f he Pratt'r,tt,i"is't"Shall rt�`tt#r;ure,the t?Yr.vW#,n i,,,) thm drNe#se
needs ofel�#�'�`it s#fain,�`ri�eirmm tra�s``i."s,, ite, rc#, 'y#��ie shall `�zuna the � :u�" �Zrs,#&ci,zsttgd m��14Ni,i7erfom:"IY�#a#.��tk��.of
+�Si e tt�'",f ow3xW,`tt'��'�r1"w(s. ,?.,,�''a t,,.,'.'mo wa:,.�V ~t ',, 'a.' with t#i,`w..ams�i,.s'Y t`i':t,',zh �" '"'` .r a .<rsr ``.,`'51'^-a�d�''r;mt„�314i'v,t(<'Y4„iM.«n.
,, t tttq #, and
„ i it Sri f t,,,,y t tit}srEita
Entities mst Vnecit,thie 17offl it aritteria to lae,sfl'JJible or prc,,gr m. participimion
i, An ragerlruy,that ;was m—c- tsed P.,'.,tarn t}#r#„ r CA1 S Act: t'},d
H. A,rt ttritttatt se i _rw '�-."�tt`uvide't tittu serves s.r-n,ea.k and is +tttttde ti'{ejuri sdt,°'K-ittor., r#tttttta�'t;',,
rsts t#a,Es'm),,,t:t nd a'umfi't At;,tt t"dty kta f the Area
g x on Agingand he Florida
lhth y
D eta.-tttt ca of Elder A011"Ur.
inn °s Nutrition Service Orr artt°iarn;r
The Ctrntra ct'i#fit at#aafi ensure,'tirrat tx'tatr,ttiot"4,tro aft u"operations ns of the pm—wider t'e—n she rex;,#mtttf tttmztrits
of tads,r,mmact,mr,�ttwell asmy othe,,raprplicable t"e ,t,tt#ta,t
D0.,ta., Prc" ratt'taa7.r,:, and Se ta'ices €l ,t'tt,ibook, dtk,tt a3epailrne'tr,of Heairrh and Ht,asi`t'fun rw'eivicbts,
US who r t °u mad i�tat ttte aitir atb t?at"t3"t'}atata� t.J�a fit'€ §a 4 o other r m tty der„ i`rr a t Inspect
, r i: nr tt a a.., tt'a,r 'tt k',t ,.taw..�a.t<,i€tt€tats_
rx,ieai ti"taitaa fkt" the aite,, The rt ott'tamar,"tat ttft st.tpgt t tt)not r,;f tint. tt iYff,;,attr.e tat any aardt3.tion
inerpetc,firm,rm,especially lly tf"tttme t a#.t< it#c'it,sde high prioriti, vit,tim}s°aa`s to#t iatt avttride to cop "firJhrk`rer r.:
;vaa the fftan s"withtart 24 lut,,urs, Closures must be,ta,porte vmtt"te "URrtaiya All fat,#i conttt'ss"'t€ed 't,r'tttii
service v 'ad� tts s# ;tomtts a WHInven c?naictrie actiontla to theSatri,,lo%# ii1"maitdet f""' any
high priority or sign t"rttrt,nt tttvt'iings tafr tatff#trst;'an ,lies Sectattr,,4e.,The c or.Y"ect"iye action,plans must be
t iprfaved by the Provider"SIRD and stilt irt„attted to the,t iitt new t,ua ensiata,t the tit tactenra os are
ret"t"'r.Gr;dl ied.
ft,, trees rib a Nut'ri`af„;t?tsi iron,eemraa
The , r ttta rts°tfi shall onsu"re s+#hat st7tt':tt at'vead tatot ki tt under this the`r#t"'siit v!ktt€`tt'
L (.`Om plies.,«a,m e Fen the cutr nt,Dietary Guidelines far Atatatt icau.,att,,published l,5y the° sat resat.cs t#R:
t at.. ..epiattft`ent tt't teaaitit and It,tt#rate Services ant'!the Department of Agti#fvaitrat' ,i
tta P"ttvides f'a tninitttttan t „�3 ,ftY tttfrh�t tat as t,Is:## itatrt `faitstt"sr t& sttta tart t #taiat�t intakes for Ott
ago itt t`Lrtt#~s e mr estabataiaad by the Food and Nixt;tttion Board, af the Naldi urmfl Academy
y
Scim``rt es,and
a'at, Is served atft,tttt s,.ttt approved A;i€talrAc tttca"tta.,
(t) Sloei.#tcitttgtiraa ra`�rteramtr-maven taa..tt its..ktYt t"trrntract'ors a.tstkiefor yrrendo "s
t Caimrtplly with ts,at.2€wii,aat,,ta Wad Nutrition"atr peffl tts,and i+4r aaaGh"'.res
2.2 Use of Subcontractors,audVor Vendo
tip'#`his colirr c involves 0mt use a to sui 'ontr,!u,ttaa ,K t 't g vendor,,tra.en the Pa#a` fidil m`."shall,tkt,tt delay
it' tt t ssiE t aafloxa ,Nt' tS, a t t#the ! r t t tS,tta s is„t t vendor.st'„ t'in tt T t, ttsct, t #„t of.-Cursi i n s`sft
f i } R €g s r i tit a rtttt`tt„'a,t�;2 s`
in #ta delay fbr a iaaaa"iod ofshmt ( ir)rts,s or mg ore tie tt,rragat,t 3t of the Berra: iperfor"t k°#,a-mce
of the..vtai? #t as rEb:a&n a�rtt3-3tre the ,Pr't id r shall not# `'ass e ,uth t eve, C 7t s;t Maxiager in writing ttht ,,at`h,ttt{o' a Sr ts,o The Provider er 3i,ak#if ttaat,,,ti t'#it,as ajta'bcEst`ttr awtrsr"rt'/`sttsstr,dr.,bt tt ,�. t t;tt tie services related,to this ttolittra t rtt#t>kaut
having to binding atat n :sttent s atrcutexi."f1he Alliance will nourtm.tsar a #nvi-itai>t or itWM;le,fibir
atly ozi tt; tat,ions or aF i awzaris trenn-siting f oan such cs`io ,
Page 22 f 69
. .l Copies of SubcontractsNendors
The Provider shall submit a copy of all subcontracts and/or vendors to the Alliancet Manager
within irty(30)days of execution of each subcontract agreement. Throughout the contract period,
the Provider shall immediately submit and changes to subcontractors to the Alliance
Manager.
Monitoringthe Perfbrmance of S ubcontractorsr Vendors
ProviderThe ll monitor,at least once per year,each of its subcontractors, sub-i-ecipients,
vendors, r consultants paidv' under this contract.
a. i i is-The Providerl isa 1,administrative and programmatic monitoring
to ensure contractual compliance, isc i I ity,programmatic peribrmance and
compliance ith applicable statefederal laws and regulations.The Provider shall i t to
ensurethat time schedules t, the budget and scope of work are accomplishedwithin
specified ti s and other performance goalsstated in this contract are achieved.
® Vendors—The Provider1 perform administrativetic monitoring to ensure
contractual compliance, o tic performance and compliance wiapplicable state and
federal laws and regulations.The Provideri i schedules ,and
the scope r is accomplished withinspecified iperiods, r performance goals
stated in i contract c i wProvider if perform a modifiedtmonitoring to
include ill' i i ing procedures and reconciliationensure fiscal accountability
sustainability.
2. .3 The Providershall ensuret it required client dataservices provided by subcontractors and/or
vendors am enterediPolicy ui li s,The data
must be entemd into the Provideri for Payment and
Expenditure lli c . The Providershall establish timei its subcontractors
and vendors to ensurecompliance wi s for the Requests foryExpenditure
Reports to the Alliance.
2-3 Staffing Requirements
2.3.1 Staff ing Levels
The Provider ll assign its own administrative and support staff needed to perform the tasks,
responsibilities and dutiestl is contract and ensure that subcontractorsand/orvendors is
adequate staffa i 1 .
2.3.2 ProfessionalQualifications
The Provider shall ensure that the staff responsible fo rt ing any duties or functions within this
contract have the qualificationsified in the DOEA Programs and Services .
2.3.3 ServiceTimes
The Provider shall ensure the provisionfservices listed in this contract during normal business
hoursunless otherti r I t the performanceit fthis c tr t,
and it shall monitor its subcontractors vendors to ensure they are available to provideices
during o responsive client needs and duringi ibest meet the needs
relevant @ ise community.
.3.4 Use of Volunteers to Expandthe Provision of AvailableServices
The Provider shall s f trained volunteersi i i direct isdelivered t individuals
and individuals wi i ill ' s needing such services. If possible,the Provider1 work in coordination
with organizations that have experiencein providingtraining, I t,and stipendsor volunteers
participants(such as organizationsi ral service programs administered by the Corporation
Nationalfor ity Service),in community service settings.
KCA-2029
2.4 Doliverablea
The following section provides the specific quantifiable units of deliverable$and source documentation
required to evidence the completion of the tasks specified in this contract.The Provider must submit all
required documentation in the time and manner specified for the minimum performance levels to be met.
Each deliverable must bo accepted in writing by the Alliance Contract Manager based on the requirements
for each deliverable before the Provider submits an invoice requesting payment.
The Provider shall ensure the provision of a continuum of services that meeLS the diverse needs of elders and
their caregivers.The Provider shall ensure the performance and reporting of the following services in
accordance with the current DOEA Programs and Services Handbook and this contract,Documentation of
service delivery Must include a report consisting of the following: number of clients served,number of service
units provided by service,and rate per service unit with calculations that equal the total invoice amount.
Ile Provider shall provide the services described in the contract in accordance with the current DOEA Program and
Services ® Units of service will be paid pursuant to the rates established in ATTACHMENT VIL
The services include the following categories:
2.4.1 Supportive Services(111113 Program)
Supportive services include a variety of community-based and home-delivered services that support the
quality of life for older individuals by helping them remain independent and productive. Services
include the following:
(1) Adult Day Cam;
(2) Chore Services;
(3) Companionship;
(4) Counseling(Getontological);
(5) Emergency Alert Response;
(6) Escort;
(7) Homemaker,
(8) Housing Improvement;
(9) Legal Assistance
(10) Material Aid;
(11) Personal Cam;
(12) Recreation;
(13) Screening and Assessment;
(14) Shopping Assistance;
(15) Transportation;
(16) Telephone Reassurance;and
(17) Specialized Medical Equipmem Services,and Supplies
2.4.2. Nutrition Services(111C Program)
Nutrition services are designed to reduce hunger and fbod insecurity and to promote socialization and the
heaIt h and well-being of older individuals through access to nutrition and otber disease prevention and
health promotion services.Services include the following:
(1) Congregate meals;
(2) Congregate meals screening;
(3) at ® i education and nutrition counseling,
(4) Home delivered meals;
(5) Screening(Assessment;
(6) Shopping Assistance;and
(7) Telephone Reassurance.
Page 24 of 69
KA20 9
A C i ini e Support, a of c t (IEEE Program)
av" w,«d ate: v:aP a n. us "e 5 W N: ti �„ ,d '� i.,w ; t '&r'S` " n sr ``.r "'~f4 F. G a �' _1 "
Y€ anb ,vafi Rn ika,au au ,na !ada ,„a€ �aae h .,� m as ha �xosh,,,a,th,
ar,taad flnurmial, nl(aa„,rmCy sauvrm"t€,v4a s g a a„; ;t„aidaaa, as z�df ,,#td ,ant aWa W nary afrtaxd{wad
f1Ilavir, acaaregiarvin n-Arms aannl
(2 QCan iHe3 e 6 ttinasd",; «ttpf�,,1trt(Iici"rtiv,,idual&,s
ff vv
( ) Respite SetvaAaCes,
(4) m"�,(`f�`4'�4'�c€sain��f
'5,) ` `rllop;: 4 a
P�fd �nh`�1tCai,au{rG?�a�r �� a�a�usat.a:a'«t,,:da
US CaregWer Appo t ru s de ii„"enatal Sk`wi e
nm i=ndk,,Dwan`g a4'n'n d,°aat aa,a apt ywoWN to Cd,nim Ili „sera"'lr,tn artnae}},ittixi,:';Y,krfi"d b�y
4kd`S.'a`'e'nJdao;�,,sini•n;xv
( ) a i i aod Ma aa��a Eqtnaand aak Services a>P Sup pfles
,
,4, a. Cdaaregi vary ia, ,ti ,au i b nc fi x;4k k ,,a ('1111MG Prxqgi '
Services flor g"sl.,an,,,",f , eakr,Ifs or 01d"ri' 'kndi' ,aJum"u,,,who ,r',a. relw"'i've i,a am`gi 9 a';a dnes g i) d tx. help ilsnunt ;,I€,, r
"reef"Nfivaa d, d ,Ik,,sva1 aaRu.<s,ra l ;ia' the" aCas,t,awaa"g.,
('1)
Lad R as;liP n's
rae',P ad,wn.daaa is-ha krx r,*,,,,NS, in,av« to adir, iana�ann routine aaau��2,aav,oa spocra; !
a fan a da a aau��veportff , The dtn mvddaer vaa dates ia,n3aa
axi r s,or a uaf'i.ua;fir, a"�atE".h s Side,,s,;; i a!o'a'��i d�',a "�.'s r��aa a
� � nn � arse
R '�" 1 �d`«ns�`t�t��'`km` Qmwt!Etapiia°P.;rl
ry -&a„a ie Ma a n n t i a r it..,.C,vs jj v o he t v dra.,`. s
�'iP" a,,ca.ry riau�,ra,d kaaaQ,ibb,.dd�ii ,�"t htw� ,t„Jl� i,���aa,.a n,� the av 2a,wa�„=v„,v, X,u�,�aa " "<� �a 'sdshw k,.rs,�ai ,3;,5 it,van�,.ia zw..a,aw.�°
Che provPder` k«reit ail aea.i end, a"N4"r"' tri v a4,¢s„Co"s"',ryR"e,�t rsa i ar ll of',"providing
fd(an t1aao a,t=]I^an-,,ei 'iag S *v la,,,a d"Wal ye at, If the M(t#dw da,#s e"'s a t` aA k�fd it ,° "i ei b 'e ,stn Jd i ��'lid la�a�«afi`aaaaa av"
rMy t"n l?, aaddma shad]make s request in a€t g ,, in w wkdaaaaana,with t aa.m a v
s
n?sppa`d;i?ska,a d 'r 0 do€.li " x at, ,;,PlnRoo"1"I'x"t?t$x"n"''hadO e,Ya is
ttl€1auw'�` E`da and,.;nana.,< n,S d R l a`^`m»,,n o:n `"a the;, :?;.." ,a..s a t+ ,;a n 110 + �,s, 7 '� I 'v}raw�w ,a, a t nt aan`
a „ ad add w ao,.av�n& `,na . ,aaa �aa adr„a ua ua. ;da R a ,R at .m,a,i� ,a}� "
r`auRii,i,d to t1he Aflira xce s d.naaraerm," xrv:it,ua ;rar, t,;n Il'i+ 6v"ata v a u " t
�+ ��' pp r?<z b dam. y re* 'a,uw.,/ 1� �i?naa�n.4`.�,,,�`-aa'�a,ad'ara. as�a€aara�r�`�v.c,� v k�' �'w'ita�+d"a.�vi"v u�Nae��`,�aa
.. �{��da?vit�tty M1eE,w,6aa".4 1,,.RU j','d "rcC���n�A�n a r•i ,� r,{,fk`,ry is�!=•,`�Jtt f.1 xstw t�z ,','C k'kr 5sm d{,,;11�fn,e,�M`G1� in"thi,k s;?:.t���.+':�nkt�`�"�'`krit
in this vh,CEi,a3,aa;,,v,n t„d".aysv"saaaann trV.'.'i'a-.,Provider and d,hc,.t`ar.h.hitnc ,The((aaapoln,Mndwaaa*m N#(Caaaaal€R g,,,,
(o-) a'a`u ,II„a's of Blot Sdn'aaaa w dared th n` a a a a � t��a ��;, a � y da
5N"�a,a 6a aa�` sra�kc,, t"� ~o,d,�n ian5�. s,Wd„� �� aaa !C`€`t„:'1�„v�_ 11'�a �,,� c:kry, �Pncmfu
ks o n3'inaaal budge l`aa3 e uv r f,
_ A cw'�a,aa,'»U?I iv!pl aaa 2;n I nQ3ai"4'the ai.3a dSr,"{r.r or k%eiti rt;.'€asnn`° dF. � as � va d! t v my I H
k , d p( a�k,aw�v�'a,>da�daadllfd,t,�t, a a, d�`adaaa �d, andau�ka,,lad�.a� `�i
ix. IaasW�,a�'a7` i,:fi, �!Y'ae. O!'a¢, ((I ack, .t'''tr a o- � an§ a s Me't ! $�? "to n x as � p „ o. a t �, - a
C n w. n,G,n iaa a na�„�a aalarit,t�d as na,lnam,R ni4s�aa.u"ad,r n Yl's,d'I?�vPwa �x� a"a�a`v
da dv.,a'wua the
r n%n y
;a„�va tii�ittilddl„da;a°of the w?:a,�(€�a,atd,e,a1(ala.),
(4) �` amultm,'maa�w'�..,i`na d Va,aY. s „ateaaktserved,
KCA-1029
113 C11"Ll","S
The Priay'dn„r shall NpA CARES a daun-,,a,,nto(31"Us ttcl'erisusv,,CIr,'kT"S ,,'t'cc,,,ara,:y, Tlhe
Wo v i de r s h a II nacre C I S-""""es)0 we"""ed re'rx'xt's'wh",ch ine;,lucle thx,,
ClInt Rapory"',
(3) Se vice%s R2'�;xcwlts;ancl
(4) (vutcon,w F'Leipolrt&,,
(5) We&Reparts
15A Wagramm HIjUght
lIg't-tts V, specific erve,,nk th-,
Contract, "I'I'm &I'laill pro";idc�6,ne"w stweess six,,qu(,,'d',,e, or
The higkilights AWN be wea-temn, ,1111:w a j"�;enersd with rx,,�stcrony'an ortvchrAaal wartm,
For aR agmaies for art,? ill,the bighliglu,the,1"rovi dk,,,,r stud!pqovide a Nef
desciption of their missioa ar role, 'Me'Ars"five v""Jlse shafl used ir's,the high'Hght
imurk,in ceder as idekfy the, or eru"H�t'dho"o,�asPe.,,fbwnie%d the, den in
the hl�,ghlig`gpit," ke� shaNI,rtrVk,��w arid exJih s11.,r a 1,,,N',ity,
re)evance' human iracatm,and, w" fte,
16 awe c'xtrfis
The Pmi,,der agrees to rnake wNhWe to ANkIrrew"e anslh."Irduc,Departrnent a Wor ar,y m 1 poolrl y n urd k"'y t Ite'
AU`Ituacs; inent at cmunt related recordIs The Provider shall ensure the
cokc&n and eof 41 ;rMparn rowed in,, irmafit',m and., any snch sy',""iteun
dutignamd by dw AMence i'indior the Deqr"\I'mirriefit" Main""'x,,,!nance incluides vaHd ex,,:x,,wts an'd, barkuq;r"""""0""'fali
dta.a,& iJ s tsuf,un'a accordhg to Opsiortent siandards, Dan; niust'he vss?aWe iind iri,as reaclialble I'k,,)rmqt the
AHWxt wwNr We�
2,f5,,L CIF,,,'
The Provider woil)en,,nsiuorca be sawne Owwatio""I madi rnt,6mtenaxwe of clk;,nnt:arid serrice,aulfi:wrnwelon on,
as momby hods I=be(ARTS or apay wu;;h syf,,�,nn",nna designitted k� t1he Alli&uacx.
I,nzl urit,%vakld exqp"'C'n f's amd' 01"w a da""""'xi Kndi Systems acccvding to Afli,,�'-irwce and L'il,")EA
The Providerr'n"Ust adhiere, to tise,,Aklhunce CIRIN.1,,)awa,InIeFpIty Po,Udie,,s& Nxxedures,
re'fkre"af,"'e, iri onler to accuracnt,,
2.6,,2 ihata, ityat-A Badnar-up Procedure'.8
The PTOWder shall ninhaak wrinen pohcks and pancedums Or ccmpuUm sygent Nwkup and"i
recovery and shall have Ae smue nquirt,rnent of its subcontra.'rwrs and/or
;��ohciea m.nial, perocedt.,,res shall,Ire.,rnade availabie, to flne Ailisnc;e upon reque�'aa',
2.7
11t chlwornes'�"'w%d Out au,.-,*j Wsomo--At a OrPrevider rnust,,,
(1) Us=the providon of the serdces da""'u.,fiNed in d,,dus contraf.:t an in excoplance Wth the wannat
DOEA Pr,,'.-,gv r ,, ervic es an i d n be Wner of Service, %Aidor�, crk,e rf
,wd �'
gRrr s a)ad
th""'s ca"nardc'-".
(2) Tirnuny arad accuniteky 3""'ttvriit tea "ushe AMance all desc-ribed hI thds,cotvfarac. ,
(3) [Ierveiop' and f'l"'�ttow e Senisx; (SFI'Pk)tO$u-;,,q"sw'rt
the EkTanawava POOMMUMe tn'O'come Mem'surves ha'',11te"fbllowin"g cr,"a"'enria:
Page 26 of 6
............................ .........
KCA-2029
a) 66%of new service recipients with high-risk nutrition scores will improve their
nutritional status.
c) 65%of new service recipients will maintain or improve their ADUI assessment score.
d) 623%of new service recipients will maintain or improve their IADL's assessment score.
family and femily-assisted caregivers.will self-report they are very likely to provide cm.
2.7.2 Monitoring and Evaluation Methodology
The Alliance will review and evaluate the perfbrynance oft Pwvider under the terms of this
t®Monitoring shall be conducted through direct contact with the Provider through telephone,in
writing,and/or an on-site visiL Ile Alliance's determination of acceptable pefformance shall be
conclusive.The Provider agrees to cooperate with the Alliance in monitoring the progress of
completion of the service tasks 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-up on-site visits;
(3) Client visits;
(4) Review of independed auditor's reports,
(5) Review of third-puty documents and/or evaluation;
(6) Review of progress reports;
(7) Review of customer satisfaction surveys;
(9) Agreed-upon procedures review by an external auditor or consultant;
(9) Limited-scope reviews;and
(10) Other procedures as deemed necessary.
2.7.3 Remedies-Nonconforming Services
The Provider shall ensure that all participants served under this agreement are eligible for the
program,and that all monthly and/or quarterly performance reports and financial records are
maintained for each reporting period and submitted as stipulated in 2.4,2.5,2.6,and 23.
Any nonconfortning program services,pertbrmance reports or financial records not meeting the
requirements eft i ontract shall not be eligible for reimbursement under this program. The costs
associated with hiring,training,reporting and/or managing the program shall be borne solely by the
Provider. The Alliance requires immediate notice of any significant and/or systemic infiactions that
compromise the Provider's ® to provide participant se;Mcas,to achieve programmatic
performance or to provide sound financial management of the program.
2.8 Provider's Financial ObUgadons
2.8.1 Consumer Contributions
Consumer contributions are to be used under the fbilowing terms:
1) 'Me Provider assures compliance with Section 3 15 of the OAA as amended in 2006,in regard to
consumer contributions;
2) Voluntary contributions are not to be used for cost sharing or matching;
3) Accumulated voluntary contributions are to be used prior to requesting federal reimbursement;and
4) Voluntary contributions am to be used only to expand services.
2.8.3 Use of Service Dollars
The Provider is expected to spend&I I federal,state and other funds provided by the Alliance for the purpose
specified in the contract. The Provider must manage the service dollars in such a manner so as to avoid
Page 27 of So
h,uaving a"waft H,,,xt,a 0'r a of futncki,am d""M Ofdte Ceranact perio, , tbr pr,- razi,
by At MOWeporeiabM td me.
2.8,4 Stir
hi a"s,,,agement policies,in
f,'nan,innurraom.the fln-ut that potakal clInts,frow,waftf,,,,,a'r servicmes,th,@,,t AJHaw,,e in scae can rediwe
Amdhg awu&"f the FADvider is nuot ph,,qns eaDA is Wtr, o,,I*e,,d tu, inow as iw ;h,,,,,us,
at away en.,,,.o,ri e yeu,
8,5 Th": etigee's in, CNe Buxlq
VJL A-un��,,y chanjue*in
be wmmw of Huai"fSa
twi3sn e"d an flu,",Bumtleet sumunmy fttir service wkflal, dt"e(Su, Jo.,,Ert,
,Jver Snpa " alloweill without Conty".,act, Providews
Musa,nidtl,,xny: hfulthd SpewNng TOUcy,alllowe-tj.u�,,nxlev this
18,6 Furids
Mae,Provider ccmpU,, nce law` th 306 of Wa,Coh,,Jer Art,as a,,,nerkdexi in 21,D"06,O'lat
f�',I;nds unler CAERS Azt,a�`afa not,be atsedi�, to PAY any pan of a ozw(Includ"i'ag an
lcwmd by ds;Provt"ae as a,aww.raaY amSw cx-
CA]RES.A"A' 3,en-Al
IS it
19A Piogrann Guiddarv.,,* Aawsistaru,'m
'The AlRanoe will provide tca�'cite Prau,,A�,JeT gui,wJaance�, eu,;rze%wded Ito the succ-�cssfbfl
Ofthe ccmn4,,,rszt by n G.wa Providw% a"he�Plxrpvldlars, att nd 81i nequ"fim'd
Moewgs. The or 3"hw"t ne", :11c,<Prfavid"er,fh,,wn fil"H
SEC1,10INY f-WE,'7HOD
3.1 General Sesuezzerit of Whad owf Flyment
The Whod of Payme,,aut,ft:mr contract is a rme,cost stivanood!
payaniewits,skat;jieC,,,,,to erle The f,"novidfir shaat ftinau.rv,�inclu�sdle on),y thos,�e are."'n
wordance Of M! vat e and, I se,,,rtutesand aw:l histaricw in
whe."v, indopendw Wit is requlmeodt. T She,,I Hance w3", "he Pnovi'maer satlud"& Carnple"'flon
as fin,Setoloya, U,11,1,and W,w,,bd ir�, %with adaierueknis cf,,Yrlkdftioms,
of%CO.M.
12 1wit at"&XVICKM
3,2,1 Rate
Novider must meet the Knimum level of perfs,,,,,nmance, suited tfw coinnur act to n,:Ce,,,,,Ve r�
Payr.neras t`cw Fixed F,,terUnit Rates shah ,not excerd anwunte estal'Aished nrt Anawhi,"neru,' VIL
as 2,,2P R,6 'as turu-arnerit
Payment may beawOhonzed
IAL,,afl Rmmbiirsennera Requvnm Fc,,,,r Acrymenk, �,,,nusz Af,wllude the actuad, Rep,,,:qu
beq!T uai,ng wiqui ttm Rna month of Ae coarog, The NoWder mim mefi rt rhe level of
paWmane vamd in,the contract to receive payment,
Page 28 of 69
VXA,2029
The Provider si,@,;rees in Wbute Amds mrs, eletaiHed ha,the Budget Summsr�,,, A'M'.AkC11F/1r,.,NT VIL,v:.,r
I,his cotorztcc Any changes hn,the total amouras of le We identified on the M.,.udgez Surnmar,,y fourn
require a corfiract amendment.
33 lavoice Submallal awmJ Requabs Or Paymaent,
'Pr
paymerm,.,`:a'a. bearad e upon t1he' ovidens;mMOUBMI Am invoic e,-fiAllowing aexrptance mad a ppr-ival by th
e
allhxnce of i"IeRverabitws ohown or,ffh£;�invoica,,The Pmvider shall rnaintain su,
pport poymend,
mqtmmts t1L $hall tx"availabde to the AlHance or such as tl'm-1"kparftneynt tK,UFinancial
Senvicrus,qWm request tiu�;.Ypordng elocomnenthtion of se-mvices pro vidnJ must be adeqmate to!,Mrmit ffix,,01 ond
evel uttion and easure internal rnana em'enf.
The—forrn and submumce ofea invoice submittedby thePrerviderss-hall beas,frollows,':
3,31 All,requests fcx pikyaucent and to stq, ort rewma 9 ftbrpsymard,sulvall be on
fortrus '106(A7rACH[1e1E','NJ'r tQ 105(AT1",rACF1Mr-i,'1',rr X-13XHIBIT 11,22.,and 3).
(1) Fisrin 1,06
j!2) Form 111 05 is'for aH CARES Axt Tides--Uls.-or Rim.per Title
3,31 rhe TNa,,Afk-r, shall submit,all pt nmmav mes ba on Flovidar's momd moutht
dY
exj,yeridlture rejymu begirminy wa m per V 11 1 t o tl ri s with tbr,fir,,za menih ofthe cona, t
133 An,y payment due ey flie Alliance under tfm tdc"runs of thisc"ontract ma-,y be whilbb d polu'ling the re pt arad
approvel Ad[flump"CA0.1 art l proigramrnafic repixts due fix-a"rt tba,Providerasnd mny mijustmemnas thmretr,,5,,
3.14 11mAlfianrce will atimhorize Yr rm,,nnt ony Rr Laiflamvabire are it;accord,ar rce with t1he
hmhs spMed im A-r1,.AJ,-11MYK1,47 V11,
115 hhoritiffidy review of"the Re3,:v1pri and Erqpx,',,indivamm li-,;xxt amd Q Rzpea fixf?a ra Forum 'Er it de Alliance
will f1m.m.;on:
(1) Line item comlxdsuma ex-po Via altumnes wrth the bluidguttw monitor rat, ofaxpendhourt-s;
(2) Allow6ble meat!reimbursemant,on a service t�y service does not exx-e-ed burdq- tedwimnixtraual
annount(No unilateral modified spem,Olng,maht.Prltyj,
(3) VaUdwt-ion of service uniti refix)2 o agains't _,I st CHOY&
3.3.6 In order to propserlly gnatraipa,the pmpmm%49,tdhq,.3 Providermimst submiit invoic'es fin px!�ment[7,03 later
thor,the 60',day ae r re arter
fbilowingdie momfit Lqwhich the expense was izvourrealrot,-to exxx--� I fix e(3)montirls
the Pod eawl,"the mon'th in which flan exy-mnse as incurlmd,excars t,��,rm,finvokem;ce-nnot txs,,,ter`nktad after
Close Outkqomt daw Dmicas suixapk,odl hate vVill requim hist O;Twoval Cf tht lkflbmace's rr ct Ofmah"a"', an as agm,",
Lzx NvAms vH1 ma be paid mOmsfusfification is submrimeal arniarsproved in ,iyrlfiag� ehe con trad,
managO
3,3,7 Datefor Firm]Rezmmstfor Payment
The Pravider shill subrma the.,Maml,request f Dr PWYMM to the Al Hance hy the at indicateM,on Attaciran ent
Vill of Ibis cz, m
131 PAYmms Rwill be made to tho Flovider based on a cmTlee and cormrmd in"Vroice, invoices that Fue
incomplete ny it WODrrect tmwd NVH1 not Ime and WH be mumed V)the NOW for correx"tion,
WO WWII not be able to cor ct or makj'�,C"har"'ge', t€)thwe Invoices.Returning invoices
'-fravy'rm"mIt in faihmre to oxneive;syment Or that moulh,Invoices,shill be subzxutteef firnely ams per
in,ordertoiavoid any paymora delays,
Page 29 of So
3.3.9 The Providerl it i clients
services in the CIRTS database. Data must be entered into CIRTS before the Providersit their request
for paymenti .
3. .1 a Provider shall run monthly CIRTS reports and veft that client is in CIRTSaccurate.
This report must be submittedIli ith the monthly requesto nt and expenditure
and t be reviewed by the Alliance before the Provider'sthe Alliance.
. .11 For Providersreceiving funding o Material Aid services, i l .Aid must be providedl
is no availablealternative,e.g. another program fundingcommunity ,that can accomplish
the service ly the goods.Prior written approval shall be obtained i 'writing from the Alliance's
contract manager for purchases of$500.00 or more. Writtenv subinitted.withrequest
payment.for
r Nonconforming
The Provider !ensure that all goods and/or servicesprovided i t am deliveredtimely,
compleftly and commensurateit i standards of quality. s r services will only be delivered
o eligible program participants.
If the Providerfails to meetprescribed ity standards fors i , uc ill not be reimbursedunder
this contract.In addition, nonconforming (including del i is)and/or services not meeting
such standards will not be reimbursed under this contmaL The Pmider's ` r payment form
certifies maintenance of supporting c i acknowledgement i shall solely bear
costs associatedi i r providing nonconformings r services.Payments may be withheld
and/or required to be reimbursedif standards are nott and/or if i not support invoices
processedbeing 1 y paid. The Alliancei immediate ti significant an systemic
infractions compromise l security continuity of servi clients.
. .1.Corrective Action
1. Contractor shall f the deliverablesidentified in ATTACH1V%NT 1,Section11(Manner of
Service vi ton)of this contract,are performed pursuant to contract requirements.
2. f at any timethe Contractoris notifiedAlliance it has failedto correctly,completely, r
adequately perform contract deliverables identified in ATTACHMENT 1, See. I ,the Contractor will have
10 business days to submit a Correadve ° 1 t
addresses the deficienciesdeficiencies will be remediedwithin i
by the iAlliance l assess a Financial Consequence for -
!ance on the Contractor as refe c in A17TACHMENTc. . .2.ofthis contract fo
deficiency identified in the CAP whichis not corrected r o the CAP. The lli c shall also
assess a Financial Consequence for ' timely submit a CAP.
3. If the Contractor failscorrect n identified r i i i e periodii in the
CAP,the Alliance.s ll deduct the percentage establishedin ATTACHMENT I,Sac, 3. . .of this
contract, from the payment forinvoice a following month.
4. If the Contractor fails to timely submit , the A]li I deduct the percentage established i
ATTACHMENT 1, Section . . . f is co o c y i overdue. e deduction ill be
made from the payment r invoice of the Il i .
Financial o of Non-Performance
The Alliance ill.withhold or reduce paymentit ils to performdeliverable's
satisfiLction of ft Contractaccording o the requirementsc in ATTACHMENT I,Section
KCA-2029
Section 11 of this contract.The following financial consequences will be imposed ifthe deliverables stated do
not meet in part or in whole the performance criteria as outlined in ATTACHMENT 1,Section I and Section 11
of this contract.
1. Delivery of services to eligible clients as referenced in ATTACHME14T 1,Section 1.4 and Section 2.1 of
this contract—Failure to comply with established assessment and prioritization criteria as evidenced in
CIRTS reports will result in a 2%reduction of payment per business day. The reduction of payment will
begin an die first businew day following the Allianice's notification to the Provider that the identified
deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP,
referenced in ATTACHMENT 1, c® ® °1.
2. Services and units of services as referenced in ATTACHMENT 1,Section 11 of this contract—Failure to
provide services in accordance ATTACHMENT 1, Section 2.4,the current DOEA Programs and Services
Handbook,the services listed on ATTACHMENTS VII and K,and submission of required documentation
will result in a 2%reduction of payment per business day. The reduction of payment will begin the first
businvis day following the AlUaricb's notification to the Provider that the identified deficiency was not
cured or satisfactorily addressed in accordance with the Alliance approved CAP,referenced in
ATTACHMENT 1,See. . .1.
3. Administrative duties as referenced in ATTACHMENT 1,Section U of this contract—Failure to perform
the performance specifications and oversight of operations will result in a 2%reduction of paymerit per
busitiess day. The reduction of payment will begin the Ent business day following the Alliance's
notification to the Provider that the identified deficiency was not cured or satisfactorily addressed in
accordance with the Alliance approved CAP,referenced in ATTACHMENT 1,Sec. ® .1.
4. Timely submission of a CAP—Failure to timely submit a CAP within 10 business days after notification
of the deficiency by the Alliance contract manager will result in a 2%reduction of payment per business
day the CAP is not received. The reduction of payment will begin the first business day following the
Alflance's.notification to the coniractor that the Identified deficiency was not cured or satisfactorily
addressed in accordance with the Alliance approved CAP,referenced in ATTACHMENT 1,Sec. .4.1.
5. Exceptions maybe granted solely,in writing,by the Afflance.
Page 31 of So
KCA,402"MR,
ATTACHMENT fl,
FMANCIAL A,,V,'D COMPLIANCE AUDIT
The a.,din art istraliorn of oescrurces rvarded by the Affixice itt the provider may,be sub',jeorto audic;anellor monheorin ,-',tile
A'Mherx inMiks,the Irkrwintat as d1oficribed in diis section.
L MONITORING
1:7, 8('Idipion to reviews of audits corad%umned in or ance wiffi, 2 C F R F a rt 2 0 0 (f o r v,e r 1 y ONO Circular A-133, as,
mvise, e MNS" below), ar-tiftor w v d), and Seakin 215S7, F,,S,,,(�,e., "'At I W Urg procedures may in.cluda, biol, mn, le: Hinifted io, on-site
visits by t4h*Alliance and/or ths, Npartmena slaff,firniter!scope &Wks;as tNAlkned by ONAS Cinvular A-133, as, rrvisird, andfor
other prev- ednres. By esatering, ilaw this e!gvee'mantr' the�12ormuctrx agreas to .*rnply and coppecirate wid"i ana,'y monitoring
decaned qprimpriabe lAy'thx Allrance. In the i:-venit dhe Alliance andlor the Departm-mit detrardnes Litid a
Untited scqgx:audlit of t"M Garvacmir is,appyoradide,the to Comply rmgith anq additional, iriTtructions pnofideA. by
tkie Alliance and/or the Dripartsaartt to fiv Contractor regyarding swo'n mudit, TheContractor further aggesn',to ccimply
andl, cooperate wiOa rin iamirec" ns,'do inves6gonicims, or audits clitemad nocarssxiryby th,,,r Alliance andlorthe
'Y
Depurtne,671t,
AUDIIS
FNALIRT 1,;FEDERALL'Y FUNDED
'T"friispa,ro;is sit pi,icabicifthep,ro 'deri.saStatr�o�rlo-al,r MCTW�or VL M'3u-"P1"'-rjfR mg 'on 'r u ,?,A-
,,)Ycrn, ?I I ganizatz ,as defined in,OMB 0 C hu
I 33� as,re-wiseii,
In the evernt drat same Pr-ovules expends S75VU(N)"00 or rrwn'.� ki fixieral snmards during i4s fiscal jec,,ar, the Provider meet have a
"frail,t ioi A I'll "ar t 2 0 0, EZX111iff,T 2 to t h i s.fln le of Pt o'grar'n'-specific audit canducted ir raccordance on ffie provisi ns c.72 "'F R 1
o'greemarn indicates it-deral resent rc-rs mearded ffiroaq n Om ederal aomids,gh the Afflance by lthls egropment,Tri dettrTanning f,
expenidad in: its fiscal year,the P r o v I d e r s4ruill ccinsider ill a,!,rf Fedimal %,,aards,including fWasi reue'ji'ves rVufeived
frinin the M I i a n c c, The detau-ninatkir,or arnounts of Fedend awvrds exteirix1vl alicruld Itet in accordlance ,kfth 'he
gradi'deflnes establis',hed icy2 C F R P a r t 2 0 0, An audfti of the P ro v 1 d*r condacred 1%y !.,,he Ausiftor General iin aceordance
with ffic prov'Wons of 2 C F R P a x,t 2 0 0, wiil ineet ilia rcqtLAjvme,%'wtY,offthis i'an,
In connection wfth., ddreosed in Pant,ps.,agraph 1,the Provider shalt f4lifill t1he-,rceau'ir"ements relative-tf�>
a,uditeg responsibil ifirs sing provided,in 2 C F R P a r t 2 0 0 ,5 0 a.
pends less tImn S 750,000.00 in "ride wail Yaward's in its fiscal year.,an.audit c*ndtiated In accordance with,thie
provisionsfA2 CFR Part
CFR Part 200, tite
cost Of than audittnurn be paid fiam non-federal resources (Le,,the cost of'such audit must be paid frism PhrAdtaresources,
obtaine(l''fl,ont offher tiran fedeftal entities,')
An audit coaduabed in acrwrtlance With t'fii's part shaff cover the onfire arganization fbr the organization"s fls.cal yean
related 4gretennents id by Minutes shall ba basecl on'the agraesnenVs requinvanopmart includingg any
ruies, rejpflations, or stwnates reflerenced in dhe agreement,The fl-nanciall, vtziernri,,fts shall disclose wis"ther cano,ttie
matchhaS requirement was met fiat az"-fdh applicable AH questioned costs and liabilitiCs due to the Alliance,anftr
the Deparnneist,shall be fall dhf,,:1o,&zd in*4a zudft report with,reffierenco to the A!Hance &Srcorntat, invofved� i,Y not
ot herwise discos as raquirttd buy 2 C F Et, A a r t 2 0 0.5 10,the schr-dule of expenditures of fiederal ,gin vards shall den ntify
expendittmes by agrreemarn nutriber fbi,each atgr,eeet ciIth,tho Aillianice hneffect during th'e audit,period,, Finar,,64.11
ne,porting packages requk had under Chic part n%vjusa be submitted withirl?hc,,;&rjjttrgj, 0 days after receiixt of the audit rejswt or
9 months after the end of the PiTividerA fiecal year end,
Page 32 of 69
.. ...............
Kf,,AA,-2G29
PART It VFATE FUNDED
This puiri ifthic Pirarklkrr is a antiq as by Sec,,rlwa 21,5,97(,,,,),F,S,,
In fryeni', d"u-i't ele Provider exp,nds a toukI oA S"w"t fir"ancial Wownce equal An ru hn axx,&-m of i""n purcy,
f1sts", yvar of Suc"k, providev if"ca, yeaus truilinf; Svqptember 312004 or the Prs,-OW one hwe a Swegqk or
pQ=h;pwMc audil fox sudh f2isca), Year ki with 21,'5,97, M; qp�piicsbie nvios, of of Fhui%xha,
Ser,"ices", g'n'd chapilw,,rr 10.550 �ko)cail emthies) ,,:)r ano
Genmro,�L EXI-13"BT 2 1"I'lls Apf crunt s"I'mis" 'firm'smi"id Awarded du%rugh, tia Alliance by this
dn', state, finan"Chd experuded" in its, 11"S"ni Yew, tiw ps"""w"kJar con,'Sickr
ass
mchudhitt firf'S."C"Al pnind Aw 6a A11hince,wther si"'mn;a4 ana wher en-fit"'wT,
13nwn't�`,tit ask's,",slance does w,', i'4wh,,vJ'e of awar"J's 4"ii"d rts"„"mox"es n,,,w�iv&,d bvy a mpmrstavr wwlry for Fedem]
p p rq,,,,-,,A?un !,v&,u',hirnq requi'rernewmls,
In V x"'4"'rub"on vviti", VOIC Aud"A addzeiu,','f%d in I'llart 11,paragi Fag`h 1,uhw flrovide','r zdW�, enstrm Ou"t z1he audio cowynpfies with th"c",
of Scc,",ion 2119WI, F3, Ws &Wdes uubyw,,.uskx, of a firmuncim, repcirdin"g, pa"'kage as daftn'PH 1aysecnfinrn ',Z15,97(2,)s
FS, and Wjv M550(local mndties) w I a6M QwpowG and 5,,r,,,;9sofk orgaaiuulionsl,Ruules of shoo kad"itor
I kfssi yauau e6Sem0f Ins e (fcFlpea . n& ptoter ,2004
or theres"fter),an uaht cemuiuct,%'l aaa aadaa,x,,,rdar raa,C wrlh vlw prond"S"mmi of is riot,rfaqpwored, fra,thoevent dud Oh,
arc,''Pan rafi ex"pteds a685 thuav, S7504000,(X) m, it W Ruslyearapd efuts to We arnaudit co�,adwvted la
a widi, the of S%whn 21537,VS4 the cost of be auds amm be"pid f"'rorn tire
ILe,"he ccott Ofrech snoudh muv be pod frr=the"Proyider reac,,wrtas obtal,,ned,frxnaa oux"'T tjusn ficau"i
An Wh andwand aan, aiu;*-,,,-dairce Vivi""I'l pvurt shafl. cover the, eredre 1`,ow Cho f,"'Se'al Yo',ar.
Compa mat Rroh ags re,ated to agrzerr)crut
appHcaRe" nuies, fegWadons,a)r "I'lue, fin,,anclad stwerncoul"s shail du k,,)sv wherhme'ur ixx'� t1w
nwt or Wh Nqrp,-,wrmnt, All quesuorle"d cus',",'s f'i'krttt Liabl4des,diu,,e to ikte O"'Lux"z",shall'be ILaly ifisvclaxsed iir,,�flhe zudh regpa,rn,
witt, a fixei,,,.ce to the ��','�egrc�mnmna involved, If not owthery"ris".:disch,",,,sma,as niquinxi by W SAW%FI&Aduk,Cocl,"e,the
tlmiutcial owi"stoiuncc Sh'sh fiduarolf"y expentiauram by nnu am" f:w Cum h, st,;reeunllevt
Alliance in offumt, diarirlrw, the we"Idit periowl,,Flrauwial s besubmifted vrithm,
45 days a'Sker deh very but-c"o Lau,,,rthwn 32 monOn aAmr the Provider's SO yem and Am Val
ewtinies, Owpasm Car R.Profit Org, !-nific"Ans am njWmd w be mbhdad whMn 45 doy,,,� af1tor oflhe
'Wo
"HIT b%,n no laur Ann 9 awnts after tit Provider's fkw'�yvar ei'%L y7ovo'd -i's"unding tiie a, rg y o f uxi, rr,-i o n,t h v
rvto.,Jrus all'6ght am'd Ob-",ig'ZdG7'%'f malutor arsd Overs"aa the perfibf,"Inance of shis agreamen,,,sus,oun,,'.ned kdavoug'z,�-aut tlfis
Inumad anmul pur&uar)'t lziv,
IL PAR."ll" HL SLRIVIVI I!,s,'S'1,()N
cop""c"s of re;"T'Orfing packagats, for undim cor"ducte'd in iroccenlance witia 2 C F Ff, P a r t 20 0, and i%,,f PART I ofbis
be subaSo"whzn requied by 2 T,,,FR P a A 2 0 0112,ky aron b6df of Te PxWdrAjMgkju auh of te
GROWIg,
'Doe Wroc at each of the Moving e4drvues;
Affisnot fwr Agging,
Akttw, F�scsl DepartnTrelar
7601'eW 1071e1 Avsrtus
We 214
Miami,FL 331,72
F or Wcal year 20 t 3 and WO.-or ante Federal A,,,,,4i1t Clear e da4mwd in 2 CFR,§20(,,,,,`6 at the rcmll,iovwing
Pigs 33 cd 69
KCA-2029
Federal Audit Clearinghouse
Bureau of the Census 1201
East 10"' Street
Jeffersonville,IN 47132
For fiscal year 2014 and later, pursuant to 2 CFR§200.512, the reporting package and the data collection form must be
submitted electronically to the Federal it Clearinghouse.
Pursuant to 2 CFR§2W512,all other Federal agencies,pass-through entities and others interested in a reporting package
and data collection for must obtain it by accessing the Federal Audit Clearinghouse.
The Provider shall submit a copy of any management letter issued by the auditor,tote Florida Department of Elder
Affairs at the following address:
Alliance for Aging,Inc.
Attu. Fiscal Department
760 NW 10716 Avenue
its 214
Miami,FL 33172
Additionally,copies of financial reporting packages required by this contract's Financial Compliance Audit Attachmen4
Part Ushall be submitted by or on behalf of the Provider dLMpjLv_to each oft following:
The Florida Department of Elder Affairs at the following address:
Alliance for Aging,Inc.
Attu: Fiscal Department
760 NW 107"m Avenue
it 214
Miami,FL 33172
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building,Room
574 111 West Madison Street
Tallahassee,Flor 1450
Any reports,management letter,or other in form atiora requ imd to be submitted to the Department pursuant to this contract
shall be submitted timely in accordance with 2 CFR Part 200. Florida Statutes,and Chapters 10.550(local governmental
entities)or 10.650(nonprofit and for-profit organizations),Rules of the Auditor General,as applicable.
Providers,when submitting financial reporting packages to the Department for audits done in accordance with 2 CFR Part
200 or Chapters 10.550(local governmental entities)or 10.650(nonprofit and for-prat organizations),Rules of the Auditor
General,should indicate the date that the reporting package was delivered to the Provider in correspondence accompanying
the reporting package,
PART IV. RECORD RETENTION
The Provider shall retain sufficient records demonstrating its compliance with the terms oft i contract for a period of six
(6) years from the date the audit report is issued, and shall allow the Department or its designee, the CFO or Auditor
General access to such records upon request.The Provider shall ensure that it working papers am made available to
the Alliance and/or the Department or its designee, CFO.or Auditor General upon request for a period of six(6)years
from the at the audit report is issued,unless extended in writing by the Department.
Page 34 al'69
K'A-2029
ATTAC1,11MMOT It
F1141AMCYAL, ANi COt PUMN."ClE AuDrr ATTACHMMNT
E)VAIM",I
PAIQU,"' 1,,,, AUMIJ'RELAOMNSHIP DETERMINA,"I'lON"
F t,ovider 'r ',R P �1§ 0
,,c rvhr),rexx,-,,,iVe Oavlte,ear",t ndaurzl, nuq, or ws,�y mx be snitjeclt va the aud.a of2 G�, An 20 0,
ar,Kl/cw ilkapon 215,97, Pr a�v g do rs who are,detennAned to,km r',xlpiei or of'I"c"don"d stvvarf'is mn"l),or"somwe"
nnancW", may be suiAJect to the audd requiffiernveras if the tasdh threshoUt rexq-tflirammnts sent,fi-firth art AaA,, I ni Part, H
of Exhibih, I is iinet, P r o,vi,d d»It s vviho thav�,e,be=n detearinfiaed to be wandors adse "iUb c arA At.req ,ar j a"I"to'd , u *nqrir;tscxf,21 CFR
Pna3rt §200.38,amt/or Sew'ia:,n,2 1 5,97,Plan, 15`tat, off TYhether the audh are mett', I'Vole"kicKns,who tmVe bceni
detern.,fi,ne-4,11(t-,c be recipients or Fil-darrad,is"i r state, asaisuill"We mus`,,,t':ompily%N,,ith sp;-,,Hcab11e
an'd f1seal,compliauxm requizeme,:,rts,
ln, at:cordancz wifln 2 Uli?.Part §200,isnd1or Rule 691-15,01) , FAC, Con,ur actor Item been, daien-hined tzp
F,,S,
sub,Vttct to 2 CFR Pan, §200.86 rund §2100-931', avdtor 21, 97, ES,
Exarnpt not, to 2 (CT'R, Part §0,01,0 axukor sat"Con V5,97,RS, For arvvsurdb, add �uC,aniat
orpnizariona are extrupt,",Por 040 I'an:'aad(i§alrinll as'sistaricfe, pr' k°I as Pjamic IlanaaaftiM1ara,llrkm.a canamunity,cofleges, deraict
k,,*ards, branctxes at state r akEtkn governnnent, and, chao"or s'0xx1s are t1rempt. Exsmp4, Must''a"onApky
w'i&h &H, compfilaunce tequir rnents, sat florth wiflm"In fhe t':s,",mtxsct or,,swarti, docuirnexil,
('zOT'[,.`, If Lq is dete,,rn-iiined, to bw: s offiderad asu,', it ,,awtv firsmmil',111 sussi«taince zand has been
7(7), F,S,,,and Rule 69['-,,5006,FAC fsti%te j,prowed by uhe A Hilarme k� s),dbcontrauA' thwv, mus-1, �,;,cicnply wid"', swflon"'115,11)
insuraW z 'ally 1ank.x:'] avid 2 CF"1?,, Bar, §200,3311)[6xdr,,-&J. awards],
PART IL, C05,10PLIANCE
FLEMER,144J.,AMARD OR S'�'ZA`17X N1,4114111CHUNG FUND51 ON FEDEMAX AWARDS. Providers who n,ixive Fle-danal
avosrd.,�",', ,;Ittze c&e"I"y"nnt 15ur,�ds, or state rnatching ffands onw 'I'Fe'degid,wva"un,16 and vvtw,,t anti, be a
su,bn,,udlpicnit rnt�,rt corni,1,4y vvodh the", f,:fflawping �flsazU lsoms., ra-k's' ankdr
SIFATES, LOCAL GOVERK"VIENTS AND INDIAN TIRUBES TVIUST FOLIXYVIV:
Paz% §200,416-Cost Prift P '1 1 las,
2 CFR .1kett §200,20 a- Admisdi'strafiNe
it CPR Parl,§200,600-Auit1h
F,t'e'lfb renctp 154aut
Cqiher fih,;tmat 1kinift 3'r prtrgrwk 1.,aws, liaalles aunra' reqgula.fioms
MU13`17 FOI-L 3W1,
4 CFR heart§200,400,41 1-Cocen Pritfi6tlppes*
2 CT R Pan §2 0 ,100-Adm in istn,,aive-Raq,mare namnis
2 CFR Part §2r`,,X,,1.500-Audhk Rafierence lGh—idefor State Expenu.,kv%res
f" sen,�f'onh, iry pn",-)Uhen, g"po-un"t laws,irti'des arid,rey U)"artit"'oll's
,ED1,fCA.Y10NA,L -(Jk,,VEN lF A PA-11T OF A STATE IM 1ADN"'.'AL, GOVURN'54ENT)
'if LLOW:
2 CFR Rant, ,§,2010,418-Cost
2 CaTR Bart 1200,k'00-Adnnirdihnrat'iva
2 MR,Part @V`30,500-Audh
Ochcr fiscall rrapArements se,ibouh,JIUM ptrogrsiann Ilaovs,rukz aund raqgpudioi
Page 35 of 69
KCA-2029
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted lathe 2 CFR Part
§200.400(5)(c).
"For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S. Department
of Education,34 CFR 90.
VEATE FINANCIAL ASSISTANCE. Providers who receive side 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
StatePrqjcM Compliance Supplement Reference Guide
for State Expenditures
Other fiscal requirements set fbrth in pmgram laws,rules and regulations
The Remainder of Th Is Page Left Intentlonally Blank
Page 36 of 69
MX14-2029
AT—rACE11%ENT I[
FT?v,',','AKCIAL, AND CO!"KPLIANCE AUDIT A17-GA,CH'I'VIENT
EXHUMT 24U]NDrNG SUA04ASICIt"k,
QULTWe 2 CFR f 201331,asm'nevise"J"and Section 2 H,!,, ,FS,requin',�,,thw', hhunrion about Federma", Sinsw,JPInqjwv:�',"&
included in ATTACHMENT 1L BAlk 0be prafvhdm�,d te tihe con't"aim:i offi'andmpanyves almd
b"s sad On llhm contract g,el
a E 'm T,,,,,IE S L'I'S ZFk]'_,',Ci P MY7 PURSUANT TO THIS CONI,"IXACT("""ONSIST RI..,,S0L"RCE" AWA,,,,
OF THE FOIALOWING�
PRMGMAMI IITL C,'IFD,,A,,
AN, ItYN
RWIE mW Emmms ifc�
93,354 N41,�,,,�,243
I SWO i CARES t mivop,�,'
SaMV(CARES)ACT—?Oakhian tJ,,S, Sevvkes 913m :`fit%97tS5
...............
—wrow,av(_ruts Ad -RA_bg wd M
&Xety'CARES)ACT-CartlNer sund SeA m; 93,,,,454 $931,654,49
I,[?2"AL L A OVA.RMY
COMPLIA'N'CE 'REQUI.. ` an
TS APPLICABI.E TO THE FEDERAL PZSOURCES AWARDED PURS UANT00
11111 " AS FOLLOW0
, SUC Wk.11 C' � C"TA RJI,,,
EESAWASKA
've Rt�C F"R,i'turi 2 f`cw m Admini
Audit s of Staum,Lcmai Governments, andlNon-hroflit
I STATE RESOURCES AWARDED TO THE RECPIENT PURSUANT TOlf'HIS CON"'I"RAC"I"I" CONSIST OF
TI-If F�,,X.ALOWfl,"K),
RESWCES F0RFI,�,,DEI;,AJI.,,
li R-410MING SCAJIR(aI:,' CF",D"A,- AIvIX'.A,.,rNT
..... .........
............
S7ATJ FVNI'A�' 5,97
---------- A L i U w"hi',
_1 CFDA AN&tlTr
T AL A WARN
COMPLIAIP401:' REQUIflRtE,,,,,MEt 1`53 APPLICABLE TO SIEAXE AIv,VAR.I.)E,,,D Pu'I`R,SrL,.A'Ismr T�OTE�Ifls
CC,,rPTTIV%CT AR,., AS f LL0'WS',',
sec'xkm"'�„ "',i 5,97,RS, ChNsw 605, FL, Admin Cw, RsNmmv GW* &r Swe Eqmdhms,Ot ,,r requflmmetww,meak 4n
pmoggri��"'�'m "Aws"rujkms a'lnd
Page 37 of So
KIZAr2029
M TA NT B I
CER IFICATION AND ASSURANCES
EX)Es,NOW wx awud dis Corntract unless t1w,Provide3 onnpletes thiese
ASSURANCES in paRrmwe of Ws convact, 'The Provider provides vire fohowing cerrifications and
assurinces,
B.
n z,L h ir W&03 22-M, 22LISMAKI,221-a�&A I L I I L b u i I E
C.
rL2 M I E. un 2 MI ?N jLJA ant,............
A
F.
................
r 4 Mai 1.ww"
J,. jIfLq&j,,:dIaz
C-M&MG Was kuslec, krLaLba LIJAHASEMS
& CER,TIFIC,,A'rIONICE43ikitEOUq(, D'jv-,BAR-, ENT,SUSPENSION, MKI)OTHER
FUESKANSIBILITY MATTERS - PIRIMAIRY COVERED TRANSACT M,
tothe best of its kado wledgeand beiie,,f,that it and its p incipa1s:
1. Are not presentibly debarred, va-spelWedl, NnTawd ItRomr debar aye rat,declared ineligible,or volunt aril y
excluded Emma conued wwwdons bya Fedrmal depaety'nent or qge,,ncy;
2, Have not wilt1hin athree-yearpieflod preceding u1nis Con-ract been convietecd or had a civil judgment
rendered against them fbr com,-nissiort of haud or a Wainal of"I"emse in connection widn c6taining,,
aUtempt.ing to obtaln,ior rArfli:wnning a publio(Fedmml., Stato,6, or local)ransaction,or conaract under a
FeW transaction,AbIlation,of Werth or Son andtrust stauxtes or Commission of ourlbezzlement, rhm'�ft,
Irge, brGery, WsWaon or destrwrtion of recciter, making the swwmewL or rnelig go4n,
Opey"tWt
3. Are not prcr-,sently indicum!or cakywise Madnalbe or civiliy charged. by a govem.ment c-atity(Fedeivi,
State,cx. local)wkh COMMASK,Of any of the offiemses errumerated in paragraph A.2. of this certfifi=za i0n;
C Have not witUn,ass hive-year pan'' pre ding tM;applicavionulp-roposal haul one or rnore public
triansi-refiat,)s(Fedexiftal, Statva, or kx;,al)terminat dfirs to of default.
Palo 38&So
KC41029
Tbc uridersi'Sned sW,11 req%flre that �anguage ofthis centification be kncbWed in tfit,,,dlkocumentc �"Crra'H
at all tk:rs 6,neWding ve",rdors,
k , as and commAs under gmno,, Wns and
atguvx,�,me nits)andt',hu-i't afl sub re6pknrts, and contvrituctors shmH !,,neoyWe thIs cettiflcation
accordingly,,
B. CEPiTIFIC&TION '11E,`GA.R,1)1NG LOBBYING -CER'T[171CATTON FOR CONI-RACTS,
GTR.ANTS,LOANS, AND COOPERi4xIVE AGR,1,,,-,EMKf TS.
11,,w byest of Us knowWge and beeliel",that:
No Fede al tippixwpriated Wds have lemn paW or will 'bpe paid, bty or orn beha.)f to any
verso,,,g for iruflhuencing Aukanernp6ning"to influence an orffWer kkkeenip�',oyee, ofCon,;ress,or ar.ern 1p kuyn.-e of a
klember of Con, ess in toannecthin wft,,`,k, It awwdkg of wa, FvJersd conuract,the rnaHng of ain't Fedual
gmnL the aMg ofiany, Feder-M �hc%n,the env.,,0n& unn'o of any coope,,natave ag�reemt,;,,�,,nl, and Te twunior,,,,
confinuatics,b, ni,,,tnew al, anu,,,,a,ndment or moollfication of any Fedual connmct, rkt kxui or cacq,,ersfiye
agreenaunt,
If any hands i,;,4,dher than Federal appn,,,kpriated fiuinds have been padd or arfli kxe,paid to any !.,x,,rson ftar
bluouing or aaemptbg to firdfluenc:e an offlc'et.,or etnpb,xNyee of any ag ncy, a Mernber of Conp,ess,an
officeror or emphyce of a Member ot"Congrem, in with,a Federw',"'I
cantrad,t. gzranr, loan, or ccxrscrative a; calvant, the shaull aflwc,coxnp te and submi't Standard
Y`onm - LIA., "Disc1osure Form to RepW=n-1.x,,lbbyi4g in accondhancoe,with itOnstructions
The undersIned shall require that ngu,lagp,e ofithbs cerifficirdon be included in the di:xnanwnts rtw;.111
(Inckidlng ,,, ,3 ancl conaracts u,P lergrarrats, b:lwns and coopentli've
sk1geemem'and that all aub-recipken,,ts and conttact-ors shafl�certif ard disclose accorefingly.
Thi-i's ce'rinflicaflon ks a,,.,,ynattvW representatiou d hun upon Mich rdAnc was placed when Ws QnUmS was
made or entered htto,, Submission of Ws ce"Kabor, is a ;drerequisite. forrnadking or entering�',nto this
Contntact, hr,,posed ky 31 135'2`° Ar,y peicon,,who Ws Q Die the requirtxi sha,'H, be
sukject to a ME pcnaltnv of'nc,,,,s Ims,then S 10400 and nal roore than S100,M0 fer each
C� &EQLTAL OPPOI UNI.TV ASSURANCE (,219 CFR PAFRI"IF r ANc) 45
(71t PAW SQ.-As a condWon of be Conrlora,(,,�,t, Provider sswuures that it wifl conngply filly ly with the
nond"scrimirhatian and equai opporttinity provisians of the foltow"rng ham!s:
I� Sea% IRS of t1he Work1b !e Inveornent Ax,,,�t crt, 1998(WIA),(Pub. L. ]OS-220), oIhMh prohi`,',Airts
discrirninattion aptnw,01 I(,akdf4 'Wdfdknat etn the I.Jnite� State o s n the isf bas o race, Colr, Ma
d, ion g ,sex nzdof.�,ufl
onigpin, age, disabikh 21""' flation,or bel d ieE au,,d iklypainst on the'besisofeitffier
Ksa law,
,eny W[,A,"Titte ri-flnwir�cixliy or activity.
2, Me 11 of Ae C&H Ifights Act of 1964(Pub, L 888-352),as amended, arW M1 k
or pursuant to the RegWriotkm of Oe 1),epartment of iilewhh ar)d Hunnxuri Sev%,ice,,;('45 CFR Par 80)1, to the
end Th,,nT, xas azc)ordance w,h,,h,'Tft1eVf of dhwn,s%x,,,tand the Regudeflon,,no pxrson in the LWaed States, slhaH,
,an the ground of race, color, or nadonM orlg�,n , be in.be denn,,W the boerletlivs
ol orbb'.",, c'),thenvilsc, sUbjected to dKeriadnation tinder any progrann or activiv, 11b,y xr-whit1h 'ithe XJ,jflkant
ives Federai ass, nc th e.'dean a islian a If he aat,
Page 39&69
KCA-,-2029
T Section 504 of the Rehabilittirlon� Act of 1973 (Pub, L, 93-112)as inmended.wnd all mquirerrients impaxeAl
lea, orpursuanctothelk, ulattain of 5e Department of Flealth, and Pfurnan Services(45 CFR Part 841 to
the em, fivat, inttoco-rdan'Ce wit"a section 5(DA4,(:-&thst Act ,,inn flat Regulafior,,, no f ernwise(quafified
"an dicapFed indiyidual in the Unhuzxi.suttets S"hall,Solely br resson o f his handicap,. be wochaded frc),iri
Imm"" awn i4 bxt!denieA thic benwkfft'!�oja (tr t:x:suit.�3ectad to discrimination under any tprograni or at.,vivity
fb,r'%q,),6ch the Applicant me ekes Federal Wanchl itssistance fi,orn,tire Depar"'M'ent.
4,'a,e,,Age N'swadirdnation Act of 1975 (Pub, L, 94-1351 atu.1 all require.-oients improsed b or
pursuartt'to the Rlaegtflarlon c0the Cnpartnwnt offleafth and Flunnan Services r45 CFR Pain 91) to the end
iw"\4 ar�."Corelance with,), the tkct and the Tre,persvin, in, dhe Unked Stareas shafl,ros,the,basis of
age, be denied the bernefits cbf, be excluded firoinint'participsatt ion in, or be sullr,!jecteqJ'to discrfirn.,"Iniation under
an", "prarn 0rzctivh,,',,y ftrr which flne A,�,npflcant receives Federal I nancial the
y'prog
Deparmem.
5 Title IX t'd"'the Edrwatiozl,Arnendmenis of 1972(Pub, L 92-3 18),as annended.,and all ref.-pudrements
imr,)o w o de QgWathn of the Lh,qxwn,',,ent of lHeafth' and 1-INuman Servicxesi(45 CFR Part
, ,sed by or ptursuant t
861 to the end taint, in accordarice with Tinle IX and leP'Legudaaktn, no pewsia3ri, Ur tthe Un'il;ctl Statfn, shall ,
on the We of sms. be excWded Unn paulticipation, in, denied the benrefits oil or be otherv,% sutlectev('14,
to dism-inntimation ureleir arty educatiort program cw aNWhy Pr which the AppIdant mceNes Fedwail
f1riancial intsha'ance fitorn the Depau-n-nent,
6.Tine Arnf,,,,ricar) with Disa"bilab.'r Act of 1990(Pubo L. �'01336)., n4hich pt,"ohibits disairninatwn. in all
employinent practices, including job application procedures" hirin&"firing,aedyancernenfr_cornpornsondion,
U&n Mg and wher ternin coml Rions, and pdv0ges of ern ployrnen t It applies to recruhment,adver0sing,
ten,ure, layoff`f, leave,,firfinge beaeflu%,ared all other employrneint'-nelimed activifiCS7
lnnra an tdiers.,also assu'resthe ft will vkh 29 CFR Part 37 and all other regulatiPt"nis
Aw Hged above. Tfids assuravice tippfies to Providers ctperartitnr of ttw ih(JA 11de I -finaackily awiged
pnc,agrarn or activity, andio all oontrar.:Un, Provider makes to carny out One WIA"1101c I- fflz'ranciallr,assis"tte'd
progirasn orwivity. Pravrkitr that DOEA and threw United StateslR a,ve the rii'ght ses,'kjttdicial
of the assunancv.,.
'flie shall requdre that Wguagy;of this assurance be AcWdd in Me dowmems At 41
sr,'hconoracts at all tiess,0"',nclux"Iing see ontraw vendors,sub-grants wad coro"w-,,Is urider griants. kxar)s wnd
a glreeffi,=ts)and that all stib recipie,'ms and contrauctors, shall provide this eassuwance
wowdingly"
D. PUIBLIC EPUIT"I CRIMES,SECT[DiNi 2871,13, Fa
Provider heris,.by corifies'dhiat nefther i's norany person or sNffifiate'af haus becin convicted s Public
Enr'r(y Crime kit,,,i de!,Bned iiri.%ecdon,287.133, ES, near ,,placedor't it corwicted velador list,.
Provider wr,,der!,;tan?dt,,and agrecs dw it is required to in-Forre.DOEA hnmed4ite'y upon an,'y,change of
("k-cum regardinug""h is s-U.aus,
IS. ASSW)CILAXION OF FOR FMF0RW111'VC,1W(AC,`01CNo`)FA]INEDING
jim 1. 111-117)"
As a cx,,�ndftion of the Contract, Provider assures that it wiD comply WHy wK the Wderal funding
to ACORIN aind hs the ConsolWated Al;;ovgwW;ras Acq 20 10,
Di%dsio'i,,i E,,Sozflon 511 (Puth L 111-1171 Ile Cowinukg Appropriations Aot, 2011, Sections 101 and 103
(Pub, I— 111-24 2), provides that apprcup"Hations made er Piu.b,,L I 111-111,7 are ariiilable &'alder
condikkos Irmo:"ded by f4b, L 1104 17,
Page 40 of 69
KCA-2029
The undemigned shiali reqWn:that langusip of this assunance be ir�;, the ail
( atat aH Ars(inciuding verWons. sub-gmnts and under g grwrar, ltniujs and
coopta,ca,dive agrvernent and'fhaa all 3ub and c,,�nnxzclors shaH provide this assurance accordingly.
V, CERTIFICAVIRON REQ,,k,',R.'D1NG SCRU"' EZED COMPANIES LTu' TS,S]LECTIK)N 287,1135, R1151
ff 1Cttis Conn, q;, 6 in t e anntoumt,of$1 million rcar rnorc,.% in ac',xorclar'tce wit the re#nunews Mention
28TW5, FS, Provider Areby cenuf-ws that,it is r,,ot paxticip.,ating in as boycaft of ferruuel, is nothsted on
eftber the ScruaInized, Com�rotnies wiht'h, AcURNs in Sudan Ust or tNt,',.- Scruadnized Compa',nies wit�h Activiflots,
in the Iran Petrcd,,t,-itrn Enemgy&,,-Acxr List.,and eukuiia,it does nod have baat r pe dakns in Cuba,Sjrh"
Both fists azrc,� crexted ptirsuato to Siection 215,,473, F&
ProvWer undersirtands t1hat pia'rsuant' to Section 28A 131 FS, We subrryhision of a fladbe ce�rtiflca,,Iuian tnay
subject Providet to 64 penakes, auvrney'sifk,Fvs, and/or cost,
ff Provider is unzble'�',',o any of the stat"cmevol"s in Mis certific,,atio,,�,, Provider S,"'Ihall attach an
explanador,�to this Contract,,
G. ING DxrA INTEG41,11TY COMPLIANCE C0Fq"')r'RA.CTS'
AGREEMENTS,WUNVIS,LICIA104",ST A1'VD
1. The Provider and any subconarad"'or's of st"�rvkaesiunder drtis contract have flunaneW rnanagernent
s,y,,rt,ems capable ol"prc,vrldidig cenain hiffornnation, 1�,nciudbng, (�)accuratc,,, t,;',-,sr and comple're,
Adosum of he financiau, rvsuhs of r,dPa h or prou,,ram hrl w,i ccordaince with d"w"',
prescribed (2)1&source and of fi,-nrisfibr 6,� contnuet supponved
activivies, did(„)the,com,;x-anison or,,, tiays with budg;gt-zed wmouras For each avvard,,The inability to
h1Fb'rMwfion in accorca's.-,ce with dh(,rt;e requirements could iin a reeturn r,',Pfgn&nt funds that
have accountedfirr propen"lly,
1 Wnagemeta 1nfi,,,rrnaHok,'-; Systerni, u,rtA by the Prowider, suiv.:,ontractors, tv,endcvs. t,',uriany outside erlfit,y
o 'I ch ti n wh'i, rie Provider is dependenn foridate that is to ltxc reported, fxa1z,,9mR'Ted orcahndurtedu, have rryeza"u
assessed tm;xi vemifle ad.'tr,,be icapable of proces-,sing data accurateit,,,, including yecsij dste,, dats.
Fcxr ths',,,rse systenns idendffikxI to be sox,r-cornpliavt; Provider vYH1 tWk,'e immediate acflon,to assure',dau�,t
inwgrhy
3. 1 f th is co ra rac t i n c t u des the p r ov'9 a oi-.,, of i i ardwa r e,s c-,ficrtare, f)rnn w a re, na ic ro c o do o r,i m be d d e ri dh i p
teohnoJogy,the undersigneed warra',rm's th,,' 'the,'sz tare ca�(.,,Yable
dk,,,perident dates ac:cursdely Afli versions of thase, jxrodvucts of,, red,by&a PmWer(mpremmod by the
un,T,'Je,,r,si9 ")an ' ,,,f d t (an
,,,ned, d rptirchiaseed by uhte stat-e,,will 11pe, ',vt�,mrfied i"b.,accu-nacy and integ ity c a 4% Ito,gr
4„ in,the event ofart,y decre,,,asein I kna"onafiPty Y.,Wedto time and date reiaixxf cuodes kind hnternal
the hardwart,,,,or soft"I"u're, prog atns fircum the Provider
%v
"ai' re'*s ira, #Siuddflatd(E aoidda ,dns to re�saore hardiersre&nd software prog;r,*ims to,t1rie
same level of f"imc;tionslay as vvarreu,,'xted here ir,,y,at nci ctu rge to thw, suam, and withoua interruptus'n, w
the ongoing busin,,ess of the suate, ume being of the essence.,
The FloWder wr,��.dany sudbconunurtors and/or vendors of senvices atxr this cont"r&,za wesrn',w their
prfl ki es and poixecluires inrchude a d isaster,piawn t3'1 rr,ovide ficrservice dehve-ey to cont',�nuz in cirse,of y
Asa emergertcy ir%C uding eraergeni4jes aising"from d.,1nua,irttegrit.,te connp�hivice issues,
Page 41 of So
K A 02
Ha'am,)' a R., ` C A 1, 0, OF
E Mr ,m,aar V?V ,'sN, Si ATU k fan" ,.RR FI C,4 10N
>sm'rs at dwrs,an#dition of contracting with
`he oi`d� a Department of E. de m f5dMn Provider cerflifies the use ? f
the
TAT D"p umhna , "eYak Sn 19 m rs u Udf syMun to Wemimy Nfa11
ne rs' ernplgy e Hred lh;y the Prcn,v!kler doming itng he cot,'"i, mact un-ru to per, rr9`#'m euuwph,,,,nvme#n diimma pwmsuanm, to
W"#u comms and Ovat am yr tt,,ar�i.Y �°-�",e hx:, idc k'i,m e'mk.pxt?ms N quire("mlptntthat and!or vendors
mnf m�i(,,sfiumk' mm wo,,rkas..sm providing c,mma a mmdma mmdm"as:Caur d`miEw3 Vmmmd R a„,SN aaalm,.U, kmUs samdwz "D„ "am i$m r y1sbcinn sm V(d ifie Ulm
emplo , � &� r in M mmf a o l rww � & � W sm vendor during the eunime
eaPmmmCa mdap U'.'mra`m's°'anm`a
T"nNma°m Provider?;,a'sali require ddx the language of this m,f,m rltiUmmdia don ibe ftmma,iu min in all sRm ?-
j; acm,i,v,sa tax"Caafi c0m@a.:` avt dd" and th.eet RH am'!/or vendd`mvd,`e sl,-'w?'11_;;er;,ify' a,o m'ipulm.'ansnr.:e
Ws s material mpPe; UaU mn of wt upon which SC.Htncs` as pt c d m e,, rdha's: advac dn
vav a,m mm`#amd,`aaa, or imd,U.fisred m'a o. U`}°fab#Rsd,..trs'a.m of this?,u°,a,,,dldfic aaioi, is a Ufmd':1d qudtake for R"Gdsmu` ng or enwring into this
trk mS'd' acftMeon b7a h;' akin in•y Circulars Ws 1) and� +r U�:F Paull, � sr „; 3 r M � m`a`' ''rr.���'OMB e,k a d" '�
�; m, a ax a.,a4�wda�,ala s a'a. � mYii na ,aa 4 dU f�mr and m a �a, slam M 3,�m�! km 'k , o,.
CORD ar blf) D0 CV . Nar tea `µ. re
U.,hc Provider a.gmes ,da• m"naa,,ld.m„aa'i,dmi" amble no an,y party,d m»zg`d°at'i''xi by the sp .nm"dt ant,
.'r,n,'a' and amH m,m.a"tmd"d'a`a4,a,a rm:,kited,dm',aon,',!'a and The Ptfi;h`'nr'iida"r shifll md`m`imtm,•aa`re kU'%e>x,w 'llt`xedoon, t',sid
u"t a ,s min.Jaa Ga4 d�id % n',,reat,te hiCkfbxr askxk am"'n ,d 3 ad„ dY, b3 mWd,es1 ra irs`I�„i'm`'am'r�CY.�„a""d sys;7r�on !rasign>dat d k ) j"atd,.
''=i,.pa,<,mtt,a,m'�m''aam, p"'!e`b"Y;,4mammxaa ld.e Gd"a^, n, ^an v §, x mn,a and a n y,a R?I" r, I ,find ;< x�, �s a m"na:' gto
`� mRx ,.dr Spa m o ra'as m��,mom �a1as amd, .maa,�u a #aa�a rdm.a .and a s,a�:m`Pmam d s,t daUmm"mr araa
Dregm vtryn"x'•'sa!'stam'ida r'ds,.
1 EY'•T,;� �¢��v[CATION a� 'i�`rr�,ka-a4r.i1¢ru°3�P€. WIG �.4�iSr'-o��, ,X{u,p,!W �n N`,4 m�''•:S PUBLIC���@ I4.a RECORDS¢ dn� ,g �! V r�k'p ,Y U t�,
1. In am a�iu.#�'n�tmmthYtUr amsdm A.,�,x��r�M r�av'f.��;•w�hc rf uker,:.TJ'o s, M,� 10,2 i„'���„�,?�m'i kvrc0.��re,�:.darc6 r�,.orntyl ct,i::&die�.,,l: a I19 A��"6+IUD)3�-.�nid�,. "",
F,S., anmtd(awr„fiy other mip m;am drle flavv,, if a`d civil action i's c,xd$msmmm,Ear',YSced as ta!slm'mU'emmtp1dmtmrt,i IL,� �erc,,U„d 'I'0�07a0 1(4),
a , mma a a �admmiix mm u� ia mdad hr thin mdvil mdiona Pdddd3dam akjrpes to muaauma#?r f�t and :1�''m a v u the
wee amkmfid'mdm.mma,.for a rn ma•0,4i',a m,°"1A,E,st!lmkm y»da r= 'U�ae E Vn pa nmm,d'mss(adm,,,Sndl�any amt,Usa my ' ( mr'a t,;.di;,aas`rasdae-d o a�amrts,;,a a,�e a x .'mmmr:
Vi a„"a'vn e yrad vd`m°tnt �nm`ral a`ia Paa�u`H"�^"'ei ..d.&.s Request s made A a 'n I 5 u a` a r S t
,„ d � Pa He i�d d U mdxl?;�m�eM Uam„mmmaaamm dam U,�adaUra;§,.a � �,�u ",,�,,',>unm"t,�,.�d„IatG'r s�P,�,
an4.,dxnrma aaaia`'l or da„,am°"sr'ices a perfa,sr fi4'med thmemm.1ma r
a, m°jt rxttwbU.mmstay4dnmmg Smcw,#on s 19, 01 r s,. r,a Or isdt,,di Fk',) d,m �aw, iihhs beo:fl.on »,z not amaa mf:}a,ble to
ii,t.a„a,,:aYs w a be"'mCdo^seen faama'' d."p•ara"tm"sfiamnt suvc,.»m aa`e agmmdDms orG °srskbJJ,,zvm,d'k m s IC'rid:;sdRmma'"mam,a`,in
.�amm ^1 n Y �p a;�d�4:�;Y 3 da4 rt'�f} .k��rY W"�,-kU F S,u
1 e„mdd'.a;m 11201(l)m RU.: ,xtatcs if pub tic IfUndms are exaapa,.ammm.e,td lsis sass'.,;lmlma,m'P"mcy in pp„`umemdm may des t,,,"r
amam,mea m'"°,pn7 a!, do&1 a,m t Gmkf.mt m um any mm mt„ mm mds a F ma ox. r%usma a"dardN ,',%h m
ms'gaankization,r allQr financial., btisa.mb"a`,"smaa a ii r; mint °aas records of d t e d,a ` ifleh a aP to the
$,a y} S?m..a tau a um #r& m, tar, ¢ad to an msd _m min a, Z abm 5 m U
public a ,aamm DapmG"maat of EaYma �. � ��n amtm§ aal.e nemta,tm,, e mm &dd, F , d7r ',m rtkmU„I CaF7
min!lap du`,r"m 'hdi�, t3Y sr .mA 6 ma r fi asa xJ am the a`r rte r e -
d� ,��� sad a�itk who umt'nw'm"Yam s�m,re m aaam'am nai�}„Irm,ddm m"�blind mu`fimm���a mimmm'm ,k`arfi sa,�x�?Cr m "{� Sma��d`d,a,.0 5.m m4Sh copied �,,x*'
m%,ny z„rr,a m,. k da,,..,Rting to do.r~u,, under reasonable ,wkS'udamlia`r,m»mrubs'af es`s.;,
Page 42 f So
KCA-2029
Additionally,I certify this organization does/does not _provide for institutional memberships.
Provider's signature below attests that records pertaining tot dues or membership application by the
Al I iance and the Department are available for inspection as stated above.
By execution of this contract, Provider must include these provisions in all related subcontract
agreements(if applicable).
By execution of this contract, Provider must include these provisions(A-J)in all related subcontract
agreements(if applicable).
By signing below,Provider certifies the representations outlined in parts A through J above,are true and
correct.
W&A
fa
We of authorized Representative sign------ -- i,i Street Address
Monroe County and of County Commissioners, S 2D7 Q smiLl ry I
Provider Name Date City,State,Zip code
................
Date----
Pap 43 of 69
... . ........ .......
ATTACHMENT V1
ASSURANCES—NON-CONSTRUCTION PROGRAM
Public reporting burden for this col lection of information is estimatedv S minutes per response,i nela ing
time for instructions,searching isi s,gathering and maintainingthe data needed and
completing and reviewin I i information. Send'comments regardingthe burden estimate or any other
aspect of this collection of information, including ' reducing is burden,to the Officec e t
Paperworkand Budget. j ( ).Washington,DC 20503.
OFFICEPLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE
AGENCY.SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING
Note.Certain of these s c t be applicableto your project or program. If you havequestions,please
contact the awardingagency.Further,certain r l awarding agenciesrequire icertify
additionalr c s.If such is the caw,you will be notified.
1. Has the legal authority to apply fbr Federal assistance,and the institutional, i l and financial capability
(including fun ici y the non-Federal share of project cost)to ensure proper planning,
and completion jdescribed i lic .
2. l give the awardingagency,the llr General of the Unitedif appropriate,the
State,
through any authorized representative,access to and the right i ll records,books,papers,or
documentstat ;and will establish a proper accountingsystem in accordanceit lly
acceptediagency directives.
3. ill establish safeguards i employees fiom usingtheir positions for a purpose that constitutesr
presents the appearancef personal or organizationali interest,or personal pin.
4. Will initiate complete the work withinapplicable i r receipt of approval of the awarding
agency.
5. Will comply withthe Intergovernmental Personnel Act of . - 7 )relating to prescribed
standardst systems forprograms funded one o e 19 statutes or regulationsspecified i
Appendix A of OPM's Standards forf Personnel Administration(5 C.F.R. ).
6. Will comply withall Federal statutes t to nondiscrimination.These include t am not limited to:(a)Tide
VI of ivi t of 1964( .L. 89-352)which prohibitsiscri i i is of race,color or
nationalTitle i t tU.S.C. 1 -C and
F 9
- ,which prohibitsi ri i sr ;(c)Section 504 of the Rehabilitation
1973, amended . .S.C. 794),which prohibitscri i i sir of handicaps,
Discrimination Act of 7 , 1 t 7),which prohibitsi ri i i the basis of
age;( )the Drug Abuse Officet Act of i (P. - ). amended,relating In t
nondiscrimination n the basis of Comprehensive Alcohol Abuse and AlcoholismPrevention,
Treatmentili t of I ( . a. t 1 ),as amended,relatingnondiscrimination t is
of alcohol abuse or alcoholism;( Public Health Servicec 1
s amended,relating to confidentiality of al 1 and drug abuse patient ;(b)Title V111 of
the Civil Rights Act of IU.S.C.3601 et seq.).as amended,relatingi ! i ti in the sale,
rental or financing housing;(1)any other nondiscriminationprovisions in the specific statute(s) under which
application 1 assistance i9 being made;and 0)the requirementsr nondiscrimination
statute(s) is y apply to the application.
7. Will comply,or has already complied, i itl 11 and III of the unifbrm Relocation
Assistance1 Property AcquisitionPolicies 1 1-646)which providefor fair and
equitable treatment of persons displacedis acquired as a result of Federal or federally assisted
requirementsprograms.These t l interests in real property acquired forproject regardless
Federal participation in purchases.
Kl("A-2029
M/111 comply,8"s,gpplicablm,willat'he provisikyris of the,Flotch Aci(5 Uo&Cr 501-150.8 mid 7324-73240)),which
Urnit the poRtleal avUvidems of emmlOyM WNA 1 I i!'Val in part
with Fedeval tlintis.
9,, W!"ll cmamrply,vs apy, Abumbd[e,with'ahe Of*me Dnvis-Bacan Act(40 US.. 76ato 276,&-7),Lim
Co-
p4pun4h,salt(40 lif S.0 276--and 19 ZJ.S.C, ruid ihe Contr t"N"ink li-lomrs mnd Standar `Avct
(40 LLS,C,�327 333,),reggar.lin M.M,111 4 q I andards for 1 11),assisted varemmuction sub agreveinents.
M 10illil corn ,�purc�hasg tequirreonents of Socnion I kT2(p.)of,the Flood Disurter I w1uttiflood insuratruct
Prrottecwtion pket a 1973(RL, 93-234)which in a spemiaial flood 1hazattl area to,pmrtivippaa,in die
prograin andto prarc,,hase:f,"lood inaunince Af thatot Ic"ost of irm,"Urah-111-conistruction amid armquil"Sidorvis $10,OCY),,00
or knore.
I L Will comply with eary rofurnevttal, tce prp-serflixd pwrsuant to, the fcdiawirig:(a) f,:yid
candronmental qualfty, cuntims1l rzarommuresl under the NaAmnal Etrvirommam.11'F`fAiqy Aun of 1969(RL 91-1 9('�),mnd
Executive Cwff er fr'E'D) 11514,Q-0),no rificadiork of Yi0latingfikifluies parsugant tz'EX) 117358;(6)protecticm f:&I,
,imethmfols pursimunt-to EO I 1990;(d,)vVil Uation fmflftoiod hazzrdis in flood-plairus in,accordamcm,,with EO I i 989;(e)
zmmsurarice of prqji act co,, sistency with the tqpproved Smte�mankgoemmu.progymun do-vol unAer the Cmamml
eaftAxat of 19726 11 o S 1"e451 et ,, f,)conforfr nity of FokIecfd fv.,fi;ur,1S tc)Stae(CI 1 l )
tmnder Stxaian 1715(pu)fifiv ClerAbAct o195 ,kris rneinded(!12 U.S.C,740 et seq,,`1i;,
Cg; cou,Hon f onegnond 3wom i&ealinkn imandem,Sa 'DIkng Vmhur Act of-I 974,v;paodu0o gtu mhmrd n
m '3);meroled,(Y-11,93-52 , and pn!twcflon of enc itfngge'red s1mcies undfur the Endangw pcies A,&of 1773,
.as arnierademl,(P1,,93-2.105)
12 Will corpnqly with the Wildand.Scen."ic Rhi,.Rns Act,cd1968(16 U,&Z, 1721 et,seq.)relatted to ppro4tving
co,rnp,mtents or potential,cownpe-voammm of the rigatiorpmal wild and,3CC3,11C 1119vors System
11 Will awar ing"agpricoy inussuring With S-ctrion, 106 ofdhe, Nhdonsl irfistonc Primemmytion
of 19665,as monergdad(16 USZ5 4701;j,EO 11593 andf protection ol'hisumm iproperties),sand
fl,,m Archmetdogice,11 and Hb-tonc Preservation At of 1974,(16 U,S,,C,4698,1 at
14 Will! cornply with P.L, of tvurnan suh, emzts Lavolved In reseanch,
and m1aux!agUAffinab supporteg]?p this award,ofassist,rice,
15, Will Comply widn' ivel,&Are Act of"I 966`P1.&R-544,as amended,7 US,C 21,31 et seq,)
;vmt,ainingto the cure,hnnd I tmeavatent of mmmn blewndked ardmals held fix researcIn.,tearchin&or otlier
uAivities ouppexteedby this wo,,areh offa pit stumm,
I& Will comply with Palso'n"ing (41,21 U,S,C�4801 et seq.),w,'ffich prohibil' he;
se of leafd-lmmvstk paint in,contstruction 07 re"babilitat"On of msb�demce sm
17 W1111 cause to be pukmmm.saki ieremake A .5 exi� nanicial&,rical compliance mudit i,a mccordance wid'i firte,Shn'.le,A I A ,t
gg
,knuar,idyne n ts of 19 9 6 a nd 04F,%4B Circ u,I au No,A"1-13 3,Aud I fra of St a tes,L cxm I Gm GaTma el U.. ,an d 11,lo Flva,fit
O?Aan i 7ab,0 n,s,
I& A 111 c o m pli y ve i t h a 11'1 ap p I i Qp b I e it q,u 4,r ex"n,e.n vs ru,F a K, e,,p t h e r F of 11a,raill I av v s,e X,e,e ud,1,v e 0 r e rs 'Y e g I'IF'a a nm a n r,i p 0 1 C e S
CE,,111,11TY111,40,OR-l"C"EAL "TILE
0
2 uj-*012,
07
DATE SUMMED
IvICYNIROE com�IvrY BGAIRD()FF COUINT"Y"COINCMISSIONE two
,
SOCIAL S,E,TR'1V111%11`,ES
M J E GOUNI��6A�TITI'101 rai
p 0 :74 100;
Page 45 of 69
P ' ft
CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE
CIM SUMMARY FORTHE AB LY
i
Sea PrWded SondreUnkiftsmmm Uni af S u l Maximus�Do
i
mC439HomemakerCAM Us W. S17,220.87
Telephone Reassurance Cv C - $35.sl
Home Weals CAK $9.w S1 $48,266.2.9
t � lg, Assessment C errs ,
Nutritlafs Education 3C ash 6 $ 0,
a -
Respite-in Horne C 00 5511 _ 112,17341
RevAte-Frodilty CAUL 5 4055 ,W,..5
"gip "�AfnglndCAH
Chore CMES� l,4,cc 233 $5,11&43
Cost reimb
Medical Equip,CA3 6 Cost ra,I m h,I �,MAN.
�.
Tofal ar n a;
Page
KCA-2029
ATTACHMENT V111
CARES ACT CONTRACT REPORT CALENDAR
o
ADVANCE BASLS CONTRACT
Report Number Based On Submit to Alliance
On This Date
I April Advance* April 6
2 May Advance* April 6
3 April Expenditure Report May 6
4 May Expenditure Report June 6
5 June Expenditure Report July 6
6 July Expenditure Report August 6
7 August Expenditure Report September 6
8 September Expenditure Report October 6
9 October Expenditure Report November 6
10 November Expenditure Report December 6
11 December Expenditure Report January 6
12 January Expenditure Report February 6
13 February Expenditure Report March 6
14 March Expenditure Report April 6
15 April Expenditure Report May 6
16 May Expenditure Report June 6
17 June Expenditure Report July 6
is July Expenditure Report August 6
19 August Expenditure Report September 6
20 September Expenditure Report October 6
21 Final Expenditure and Close Out Report October 31
Legend- Advance based on projected cash need.
Note#1: Report#I for Advance Basis Agreements cannot be submitted to the Department of
Financial Services(DFS)prior to April I or until the agreement with the Alliance has been
executed and a copy sent to DFS. Actual submission of the vouchers to DFS is dependent
on the accuracy of the expenditure reporL
Note 4 2: Report numbers 5 through 14 shall reflect an adjustment of one-tenth of the total advance
amoun�on each of the reports,repaying advances issued the first two months of the
agreement. The adjustment shall be recorded in Pan B,2 of the report(ATTACHMENT
IX).
Note 43. Submission of expenditure reports may or may not generate a payment request. If final
expenditure report reflects funds due back to the Alliance payment is to accompany the
reporL
Page 47 of 69
ATTACHMENT IX
REQUEST FOR PAYMENT
CARES ACT I NSIP
TYPE F REPORT:
NUMBER a ,
' 2 t t �t ���, t t ItiPlCei pro*w New �° a i Perot
r 1.11 kg
a
7777
13'A REPORTS:
r
I— N' I ., .K ry to ftbookof mg �� ht
�FmpmnW EY" ...... ............ .._- LEI odr --
JJJ I {
BUDGET$ TOTAL
I,
PfrAms Fun*
f41o{OEWED lb PmMupy
v.... s Fu.... .u.
dg
REQUESTED Wd
NotRocePowd
., ate. .. _...
PART i.
FLINDS REaLESTE0
Fore LFSo 4 -, =i
5 ._.........._.
I
... _
6 LM"AdloWCO
mum
i Rural
mool 000 8a1_
i 91 I CIS 109Fom.RWSWMay
EXHIBIT I
ammmTawmbm
a Ilt1C
a 116E[ AIJ ftflWo
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r `0 _'J
Irk
MrlQ
E
3
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1.FedwM Fwdh - S
sib RrA
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w,w„uo �. �® ... �....... .
$ {
Y-Y n Y Y Y-T
['� ��n Si
k etas- tr nlF
S y y
ON'd)1
._.—mm
i TOM r« S
989
Pap 49 f 69
RwamaulucosTWEIRM
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Vtssl�u 1 .... ____.. in',,1-01���11�(si(
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e
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spi
emu IN SC FOE,Rmad UN
ATTACHMENT X
....®.. �_ .... __.._._._.
..... _........
,1 Em
,.®.._
APFVM Bum TOM MI
Q Tit �.� %
fortis wmo Y.ks Fag lAo. lRb
2.Sma Fun m _.
incons
£ . :
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( I f 1 B (F) t 1
t t T- YTS Y.T
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hl !
1 5 }7f}l
".,�44�{�1�t}�F1 � i{U!I(11�,.�£t}� �€i _. F• __.' � iFlt
11
!t
Page 51 of 69
s
p049 9 fam.R trap
STATE OF ATTACHMENT 8
..__.._ r ' . . ...............
COMPLIANCE
CHECKLIST
�:,..,, � .�....m _ m__ �
r r cil on n r f
ommis ion rs, Social Services/In-Horne Services ; Oumy;Dade
Address Completed By.
City,St ipTelephone
I.
INFORMATIONREAD THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE
WILL HELP YOU IN THE COMPLETION OF THIS FORPAL
i, Sriefly describe the geographic area served by the prograrn/facilitytype of serAce provided:
2. POPULATION F
"�ots i snwc rFemale
I
.. - _
3. STAFF CURRENTLY EMPLOYED.
date:�_.. --
— .
Total l Hispanic r Female Disabled
_....w e__ ,_1., ", " _
4. CLIENTS CURRENTLY ENROLLED OR REGISTERED Eftclive dale-
Tr _...
Total
i l Hispanic r I Disabled r 40
:.......... .... ... .._..... .......................
S. ADVISORY OR GOVERNING , IF APPLICABLE.
Total is Hispanic Other a1Disabled
........__ ._._..........
PART 11, USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONSREQUIRING
6. Is an AssuranceCompliance iC i If NA or NO,explain. NA
YES NO
7. Compare the composition to the population. Is staff representative of the population?
If NA or NO, explain.
_ IVY YES NO
Se Are eligibility requirements for services applied to clients and applicants without regard to race, NA YES N
I origin,sex, age, religion or i ili ?If NA or NO, explain.
.......... ........... _......._ -----
Page 52 of 69
9. Are li beneffls, services and facilitiesavailable it s in an equally `u n r
regardless of race,sex,color, national origin, religion or disability? if NA or NO,explain.
...... .........................._ _ .... _ ........
m Forin-patient services,are room assignmentswithout regard to race,color, national origin or disability?
Y IfNAcrNO, explain.
........ ....... ...
. Is t itaccessiblet non-English Ir4 clients?If NA or NO, explain.
........... ... ..........._.. .
12. Are employees,applicants I i
Written their ion idiscrimination?
If s h l Poster
0 If NA or NO,explain.
13. Giveh d current status of any discrimination complaints regardingi or
employment filed against the prograrnflacky.
1 . Is the programflacilityphysically I I to mobility, hearing, and sight-impairedindividuals?
If NA or NO,explain.
. . .... ............................__............._....... .
PART III. THE FOLLOMNGQUESTIONS APPLY TO I 15 OR MORE EMPLOYEES
1 -evaluation been conducted to identifyany barriers to servingdisabled individuals, and t
make any necessary modifications? I I i °
,,,,,,,,,,,,,,,,,--- . ....................
1 ° Is there and establishedu that Incorporates duein the resolution
of complaints?Y If i .
Page S3 f 69
KCA-2029
17 Has a person been designated to coordinate Section 504 compliance activities?YES—NO—If NO.explain.
...............
IS. Do recruitment and notification materials advise applicants, employees and participants of
nondiscrimination on the basis of disability?N NO,explain.
Are auxiliary aids available to assure acoessibift of services to hearing and sight impaired
individuals?YES�_NQ_If NO,explain.
...... .................
................................................................................—
PART IV
FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF
$80.000 OR MORE.
20. Do you have a written affirmative action plan? YEO_NO_ If NO,explain.
Page 54 of 69
Alliance USE ONLY
%'`ad,a itd ""Wit a„s-d By 7nsa coS`r, tS na a„E
ataagra"n C)'Ific `s,"W„4"a olf coals"""'Ulv
aN t �x a � � a s � , o f x a
Sit �,ro M I(ON„� RCE at ,` t .i ,,,,n , a r ���,,a,,.� at l „ ,„ ,,, '� ,`,�.rr����,�,L
6a arg " � �I Wadaaea.<%&aaaWWe a ;ln a, t � of�r ;,a � n
ali as'W a a a;!at aN "�, R f r awr daaH,dx,sa suw a aaa ,, ,Ft,Graf`«.3 W n the to '��'s"a,a Wa s a,a � � a s'.�,�� a s ,£ >; K asaw,ra`ws,a atiz� €.
Is>q a 1;,,,`aS,,,, Alsx:,8y, aaa, ,t,ara4i aix x at," :BS,o,#2�Sep,ice
2, ,,,Hntei `t to ���'w�A'srOM�+�A4#,t Ox,tI,w pop, sII aal,i`5H,r� Se"T s,e S,rtayt`'raal' 4,.,,nc sex, Irw pwi" 'rvR'+haff"'rfl s2 kuxx&"rz'„ 1Y laciutz""''s�i�+,a<,X�+w(k✓
hni,the, w,,,�as r,,aad, 'a�aacial area for^aa%iaaw„h s nav" a e sa ape ,?.a,.iWaded such #:F ,,, '
�. � a d "�, i at awaa,aa�a s e:,(s,�s����,��;�#� a a�aaata dab,
area.la` lda,tl'a ,aaa,sradkaa,s„a,N,Car,Nm: aw`a,la a .€aaaa,3 a pat t,,r,l aaa,aaaa ba., srt Co a`€hn rtr*re �At�,R ;R,ies �Cff�"a,y
"Mar d aai,,aa$Am hs; 1980 C,,"'stn,'s; R„4 „a p"+pula,,?u.mi s4atb's u£s hr1a;,ha'g,,ae the z. �a,.u,Very
4aab'a„a aaw.:;s,aaa`ace{4Wr a!s.,^any:,a £Sa.,Ea„Ix+u„E'„l.si%aa WaaW�aa as a.,#,,,a, a<a as ,t' ,eW;,Wr'a+a`h;'ts 9 a<,s,a.aK, ,a,rY kfa',,.a'a,mtaa,aaW kand�W.a'a'ahaaa,`essan
1 `3'ae"i Om ss`,a�al, R%?,aa�k�fiR,c' o fi -t'1 'e s't h,`1 and ,iB,, €. aa,a+"a rn, , ' laic,',,, awu��.x w�,,,'n adsa�a � de a t
s x � � ,a a alt��a`, include �aa-
xa"ali a�me,szti a,,:eatza of Ya§aasli aiutrnu"`Aa'r"
a, &,mai tads$ to a Writ,,, %a:.tE3a ?°eer aaa,,,Mar s who wore aW1k,a kl d,registered d o a,,,c aaaxa€ ,e'I se ilmed by,the Pro awn,Or
,,, Oi�xa:,, � mate; dht'€fi e&aroflaieE"iv, i. f4 td;V
Yati„ta�,1,a rd re",.
a:eaaWa to aaatu.,s nunaw of a a aE,sa'1as„datna t}°x°a'tsaiia"al their 'gy ntA,; ,a sax,a? ad aas-a.alta7atl I ff
n:$fi`aa,n $a'r+Wao&ul'eaaaahiaa a tW"gj3aata"`rnaa"ag ra„raa`tr,�, leave this sett:i,',ion,
6, "a{wla rea",ipleti ask l"O,,e a. fl,i,ah a;ial a1",cTlt;istince uaaust have an,:ille €.,,z.f a.ae2,,Ma adta tfitaa% the Pro :�s Aa.a§ ","" I
c€„easMlaacatsw,aaa in \mais,Sa 'all as raquixeml In, 45 a„„ aa, 80, aa.a is
t 3 , part, d a4-'a z i r §as z, -a =a 2 ro # a
u, ea,nlx e .a aaaks,l �a�,k as ihmt" s a,as iaaaa l W a a,e s'gre Izaaa EX,)EA ",dn,a as n"'s az a„flhena saa;, Wtaata ¢� '„N �a I>
8atrtaa'ac (aa),.
k, Isthe totact, r ) tY - y .p* p u d` w;yyt sat a t s xd "g g,qs rys v'�N ,,ul ) n s, 1r+ a vE -,
theve mkex,pW%gh�NA,'i nafEt,St�d,lav"All 0"'n fsas Ott 9,"Y ro,', ,4 ""'e l�+,rh,,,*k.T��Ot'ci O t„ri r�`,.�,'F,w*Za°�,''+��1",&l �.`d,<�., 2,GA�;s�k�i 11',t` For�x,n`avh�,a�s�b�fi;;,t� �,.n
1l ,a aaa a M ii;}a`eaaa s i� fkHI N w €r,a � •aft b,a la His P{ staff"?
� afi
a a, aaa a darxama aiaa as a, a� , e aSat ,sskabe azd`
aat, ia�ar,drraat a42,�°dw,a`m as;a `ia";,a�aa'�ita`a, s,as,l,'�,t�aa„at'a�a�;�a�ta�u,t,«Y.a'.hk�k,a,nss✓�,. `za`;a.ata°aka`e'az„!tC.�a`a'a`.3k�a4t�ha,aia;frs,fi,zap a,�a�",. ,,a,a�,�hha 3„,aafll a,.�aaeld
aa: aalaal9 r ata Ih'a a wW ealiaadr? s; k ar a1e" ua 'aafait a Y n Aa tlhs,,#x„r aaaaaa alCl e i aaiRa,``siae aat$ane, ',bw,a a,4ot„,,r$!, for
,sa,aa.h n eaiaac;at,atS., ;.,,1SWa,. 'a`l,ak,,e Y%'a,21,,,,u v,rasa asax„aa of,aa a,'",F bei aaa'aga^+o".,'ai V to A;t.4nire t,;;.;,a9,,^cx€S3��s`z,F;a`B,R-:«• .,aaaaaas�rk.+..., Sarno
Ia,Ca,"aa a a° i a",d,ia; an ay ft,P k ..aknab 9 a, tray a s,tams sa,aa+dri a§ed to serve, sueh aw,
a"a,,l,aadNady of d6irbl(4e I pen am, 4' as„FRR
0.3(b)(tA)
KCA-2029
eligibility requirements unlawfully exclude persons in protected groups from the provision of
services or employment?Evidence of such may be indicated in staff and client representation
(Questions 3 and 4)and also through on-site record analysis of persons who applied but were denied
services or employment,45 CFR 80.3(a)and 45 CFR SO.I (b)(2).
10. Participants or clients must be provided services such as medical,nursing and dental care, labor"
services, physical and recreational therapies,counseling and social services without regard to race,
sex,color,national origin,religion,age or disability.Courtesy titles,appointment scheduling and
accuracy of record keeping must be applied uniformly and without regard to race,sex,color,national
origin,religion,age or disability,Entrances,waiting rooms,reception areas,restrooms and other
facilities must also be equally available to all clients,45 CFR
® (b).
11. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to raM
color, national origin or disability.Also, residents must not be asked whether they are willing to
share accommodations with persons of a different race,color,national origin,or disability,45 CFR
80.3 (a).
12. The prograrn/facility and all services must be accessible to participants and applicants,including
those persons who may not speak English.In geographic areas where a significant population of
non-English speaking people live,pmgram accessibility may include the employment of bilingual
staff.In other areas, it is sufficient to have a policy or plan for service,such as a current list of names
and telephone numbers of bilingual individuals who will assist in the provision of services,45 CFR
11 Programs/facilifies must make information regarding the nondiscricninatairy provisions of Title VI
available to their participants.beneficiaries or any other intemted parties.This should include
information on their right to file a complaint of discrim!nation with either the Florida Department of
E Ider Affairs or the U.S. Department of HHS.The information may be supplied verbally or in
writing to every individual,or may be supplied through the use of an equal opportunity policy poster
displayed in a public area of the facility,45 CFR 80.6(d).
14. Report number of discrimination complaints filed against the program/facility.Indicate the basis,e.g.,
race,color,creed,sex,age,national origin,disability,retaliation;the!as=involved,e.g.,services or
employment,placement,termination,etc. Indicate the civil rights law or policy alleged to have been
violated along with the name and address of the local,state or federal agency with whom the
complaint has been flied.Indicate the current status,e.g.,settled,no reasonable cause found,failure
to conciliate,failure to cooperate,under review,etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility
includes designated parking areas,curb cuts or level approaches,ramps and adequate widths to
entrances.The lobby,public telephone,restroom facilities,water fountains,information and
admissions offices should be accessible.Door widths and traffic areas of administrative offices,
cafeterias,restrooms,recreation areas,counters and serving lines should be observed for
accessibility.Elevators should be observed for door width,and Braille or raised numbers.
Switches and controls fbr light,heat,ventilation,fire alarms,and other essentials should be
installed at an appropriate height for mobility impaired individuals.
16. Section 504 ofthe Rehabilitation Act of 1973 requires that a recipient of federal financial assistance
conduct a self-evaluation to identiry any accessibility barriers. Self-evaluation is a four step
Page 56 of 69
KCA-2029
process:
0 With the assistan'ce of a disabled individual/organization, evaluate current practic licies
es and po
which do not comply with Section 504.
0 Modify policies and practices that do not meet Section 5N requirements,
D Take remedial steps to eliminate any discrimination that has been identifleA
0 Maintain self-evaluation on file. is checklist may be used tosatisfy this requirement ifthese
four steps have been followed.),45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that
incorporate appropriate due process standards and provide for the prompt and equitable resolution of
complaints alleging any action prohibited by Section 504.45 CFR 84.7(b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to
coordinate efforts to comply with Section 504.45 CFR 84.7(a).
19. Continuing steps imiat be taken to notify employees anti the pub.Uc of the progratuffacift's POUCY
of nondiscrimination on the basis of disability.This includes recruitment material,notices for
hearings,newspaper ads,and other appropriate written conummica tip n,45 CFR 84.8(a).
20. Programs/fitcil kies that employ 15 or more persons must provide appropriate auxfliary aids to
persons with impaired sensory,manual or speaking skills where necessary.Auxfliary aids may
include,but are not limited to,interpreters for hearing impaired individuals,taped or Braille
material,s,or any alternative resources that can be used to provide equally effective services,(45
CFR 84.52(d).
21. Programs/facilities with 50 or more employees and$50,000 in federal contracts must develop,
implement and maintain a written affirmative action compliance program in accordance with
Executive Order 11246.41 CFR 60 and Title VI of the C lvil Rights Act of 1964,as amended.
Pqp 57 of 69
ATTACHMENT D
BACKGROUND SCREENING
F.I.nF.R AFFAAffidavit of Compl lance - Employer
t a.r
Y r
1
.
As On d*wulhorkod repmarklutNe
330
MOO
din*a abowe nound off~
t
t
Is In I
=Quo= WIN t
SrATE OF we Daft
v R 4 J d
""r_',
r
V 029
Ah'rf EIMENI'F
AM&=Fbr Aglim,
,
DN'ta Privacy and fvrxnrs,�, Smikistso,Asiocista,Agremient
This Busirmss,Assr,,Acinte Arm-mment('9BA Agrmament"�)is dameW hy dme Alfiamcce,for Aging,ftw.
("A1111fanci-P) mnd Moms 'C"ounty "Bomm" of Counky S 'IM Sep-dems/184"Ify'rale Serykeems, ( Business
Om
1"0 Backgrou-nd.
1.11 The Alliance has Pentero'd-Into our or more 1""O3aractm or,Agrevrnerax,with Business Associate("Seyvica Agem-nnevif")
that invol""res flr�a um, faf Pmtee,,tad Heal,
L2 'The Afflasnce, recognizes tfite requirennents tcf the j"Imalth, Irigurmaloe ieve.?InAity mnd Acxountablli�y A�;t of 1996
(EXEMA"),Andbarimlic fmomp!7/in to Com"aygy's Pe"fick'S mmd Prmedimxes,
i,J State and fWcnal laws,and k egulamons may,establmh spect,"flic c,.ondiaksms On vvhmn and h,:rw r*v*red,ent-Ifies mmy slmuma
ancl sectire, and 1-mom IM,Miduals mmst Pm Ahven Access 'On", their halfrimatim, Sucin, Imm, and rulem, imo the extent
ssprdlcable to the Seurvict Agreemmantwill bi,z r d win this BA AgramenT as the("Onfliderniflalky Lzvvs
IA The parnes wilsh to ensure tlommt ail Ladividually Idandflable health 'is kmimark) crodmerpon-rionall sire, vas'ed, and
dis,Aosed punsumt tro Che; Service Aprernern j,%, kept st-cure swrol usied mid discicmec:4 ardy as rm,,,mmutted by, fl`taq
U)ntildentrie-dity Law& Mu" Hgehh, Insmor"arn"Ce P0,mbilif"'y afn/J Act of 1996 and it-, implementing,
(",FIUIIAA`)and I've In"Imalfil In"Ifixf ma"don, flor Economic and Ciftilcall Hoaldt Ac�(2009)and its
iumplomentifts busirsess immogimae'!s,of covered entitiestoomply wi'dithel"AIRA-A S aas?ti�y R3le,
HIrIked 164,309, 164310, 164,312,and M4.316(21009)znd such secdonss-heal
fan-11i in,bia not fli to 45 CFA�ff I
h s '1100-P 9 ap;,Ay to a business,mmuso-,:,iaze of amamered enaft'y in the mani'a M.'emner that.a ash mcm ma apply to Tim covartNI exxtilry"
19vide em,A[lianu nw,.gr uThiess Assewimeximit thka'dwy are to Oweso� Won, as pnwi s,imat mvenholoss intarlid thvit,
PHIL ms definad below,will be used by&.Wnumsr Asicwirte-on!-;as comernphated tle HII�A.A mad the HIT ECCH A,,,,,t
arx]as verniltmed!b, !it Cry, flidenfialit, L y I'll n y
The pwtks donmetbim,mgreems follows:
ILI) I h - mofd` BAAgi tent,thel-A ior Ar DeFingtions. Forptirpose jus reem fi-flowingdefilm"t
hri,tfie HA Agreemerkv,
2A Ar s, The ability or the mevnis neceasasqp,to reed, wtitc,rriodite,cmt co-m undo af, doWimlbrmsfion or oflwnirise
case any sysltem resource.
2,2 xis zitialstrative Safeguards, The drain-imTafivor actirm"S, and policies and prcx,,,,xIuIv% to mania, the salef"mon,
develpirrnzim�, i,s sa33 mat sat a itaaaj Kati mirmanance of gecurftw rneasures ta, prated
Inflarmandova (ePEAKP, OT'd to trymn*7 ge dic mcwhict of,tbc MuSity's W"er-Im"frorce In 'relatio"mi w ale Pfrow sstl af filat
inforlmd'o"n,
2.3 Autbentication. The corm-pbonrtion tht a pmm is the one clakned,
2A AVOMBI.Aipy" "I'lle Pr,"apert thad d,,fm or imfonmation iS mccessible agami UveaNe qppon demnal by an amuthorized pemmm-
2,3 Bremerm,
of such infimin-maimm.
2.6 COMMAJentifth"ry. "I'lat po:qm,-rnvIfmt datz rat infiumnufflon,is aict mama,awaflable ardiscalos d to;xrvuihtxWx!rparsons
or prmx,xjsfs,
Page 59 of 69
K092029
20 Inhomaton Yptem, An ImeMOMMInd set c,'.vf resources undav""""m Sainedirem
tbial shaxes c*rnv,,cn Y r
,y� A systmni nom"16"fly�nuchvles
arad psc)'Pic"
Icitegr6ky, 71he pmApsefty that dau'%or WArrowion howe not been alark or tiestroyed in an ninixAncur,
19 Malicious Saft"vvere'. S"afti'vare,
"for vxuwrir�e,a virus,dr-n�,Vncd W damage cw Mips a systviryr,
110 POSWOrm"'L emfial' of a slu"i"I"ta
119tsysical Saftgusrdlm The pinyesicA mesaw"ek's,PoNcics"a c"Pr%""'cc"thu'vs'in proUx"t an
F�Y%Pwrr)'S'as�wci�ats iti buildingis and cquipmoM, nswral,wn'dt Uvi,urnau-Chockvid ira',,rusian,
112 P'rhmey Rcle, "I'Irw !,Itandhards&r PrIvacry ofLot&vkJua',fly ieJcat'J`;fisWt,,Health Irvfi,,wnAfian vt 45 CFR Pan �,60 and
Ran, A aniti&
2,13 IN'rotocted (PHI') Fleric"t'na), Mec-15 ftl"x:nis,indiv,Atals,includiag
dr,17had,in 45 C11"IFIL 1160.M,Ynedical rec"ord's si"d, e,:ttx��Seefln',vt 436,057"',Flo, ""im, kvapital ,,-txx'rvds sui';,"'ect
to 39530M FUrrit,'A Stat"Wavis,vau'ttonwr moords wd paurtu'd pre"tactec'I under Sa,;,,�,tdkoi S01A'71,F,,c'rrkIo
slum"&"'te""s"w c-,"'xIbux"r M4 wheMer in paper W ek.WNCIR""n"Sd'�Jecn'to,'Trate or lw#s or ra"�
pflations,
liraftung we or 6s,,c,"OL'AIT',or Suhjct Ir cantswwal Obfigpacions of Urn!""e'd tc�th',e ft'11brau"W'don crav'zd
ro' b'y flrcrn or ok"i,,TchMf of'Affianoct,
2,14 Rtqtuired by Lmw, wnIq as thhe trrrn"n alrcd by lwwr'ii.,,3,45 ICTIR 1!, 1641-101
2.15 Swendary,Tbe Sec"reumury ofthe DeparIc'mantof Hcahktan',d S:r'v'IC?4 cx his"'x""her deqigw�
1�6 S"WicuAky bicident,TI'm or suircessn"'I accf""S"'i,u�e'ctisu"'Jovurc�" Ordz�'sunwl:q'kn of
or interfe're-me willh's"'vec"a a"'Mraziorus In Own, 's'jvx""""�'n-
2,17 IS"ecur4Hly or Mesatures,, Ali of the physiva"t, rm"ui iia ran
VIMM,
2, Secturay RuIc The ft%�,all-
t,Svaachnds RW we ofEltyctrondc'Prcxt%,,',v'tcd at,4,1,';'URp"ar,
164,,,,,tu,bpvt aand.I,,,zvmvuixrr.,nTs tfiicrc-tc�,
2 S"S"after
jivards, 'I"Im imid the andl pwovedov'rcs lrrx�"k's u'!s'e' Whoat
hoO,V7 inficw,'naadc')n zund coninal&=,,css to ift.
F%R, Aorwcwd hak,,,h inknuadon Sat is not ,,icctircsli tha"'magh, the use x rv,,.-,thc'xdWo,
Speci"Ied,��y t"kic Sccwcts�,,'I gAdmcc Sued urialm 42 1,13,C sactioin
211 AH wher tanns usod,mal not cc,,,theww'�se""W'd"Ined,in this BA Ag,,,rccnirat shall hsvc,the s,&rnwe anca,,�,nrq Yts,those tenin"S
in t1rc,Maxy OR
3,0, Obligations and Acthefthes oI'Bvxivuv,,,,sI AIT"saclate"
3,1 Busbarss Aviociate sq�,-,vvss not vuse c,\,r dii�,u';Irne WJAcr than as gmyminal or requh,"ad,lo�Ititis BA Agrcvnnivai"Sm
Scivice Ag-rcmann%r,oras Required v,'y,Uavv,',
3,2 Asscximue,eS!,,vc*to:
(s) sad pnocedwes,to prvn,ddax""t"'c"'cm4I""'W%4'r4%'u"xi correc"k Socwrfity vWslions ir, �,vyth
Preveri,,tase or div,:Ic,,vurc of to RU ofer On as provNed Rw by,dds 13A Agruonent or as requici bj law;
Palo 60 of 69
KCA-2029
P"resonatAy and ap iris primmlqy gn fist oo the cc'nnfidenfl?'Rt'y'imlm'griv ri"Y'and smad"MbIlity of dw Pr' that rhe Bus-Irraw,
Assocb,�'vte cm,Mtn,rKelves,rnsintesins,or Transn.,uts,onf,beheif calf the Alfien cc,:and
(d) Cromply Willi te srmcrunqv lkidc rww'Ukrernents inc'.Judinjg the Admivistrafive gwfq� S a a v ek tuirds, Physic 1 Saf�gu rds,
Iftchnical s ui, sC t arAd vollmics arm pmmedures and dkicummmion requhrenients sml knedi in 4.55 C.'FR §9'4
164,308, 164310, 1,64312,aind 1643!6�
33 Business, Asvochms agn"m le �'vmi";figate" to"" the crxivent Ptz';I;kxAT'Ic�" svxy bamariffil clYket dhat is kniown to Busuluciss
Amm.,tsiatee of a use or disclostare cANIRKI Iby Binimass Assoclaic in vird stiff n Of the resquirer fits am of thi BA Al gmermient.
3 sA
Biminesm Associate agnes to promptk!/ 48 hwars') raport to Affiwntcm any use or disck.),surc of time, RJU 'not
providewil for by Ns BA ikgreement otwhich i m" me,11'i cuce any equt i hamamingtw � ne xncc y
or amendment of stvah,irnburnation wnd"'incAuding eRy security incidena hwol..ing;,PHU,',
315 Bcxsiness Associrne agroesto owfify Aflli'anc"e w"Iffiout unreasomble delay of any bvrach, pe,;r1acning�'m
"'0") Idendifilcation, of arty individuim, wthcie "'Mmelupe"d "oHD has beeti,'or i's r"awccality believed i+a flu: Sumicess
Assodste,to Imavve bren,accemed,vc,,quirva,or disciosed duringswelh.Becurlity bncmch andl
(b) AH informagion requ,"51'e'd fb-nc'Pfi"'('V5 required by Se-cliori 501,1'71,Florida Smutes,as twell at,the P-rhoem..',yr ptudle
end Set mikyRule,armi sum"I ritywr intponmanflon,requestre,11by dhm AMance-
16 Busixtess da smicia! agm-em, to c"nal"'a"C"that any), isris nt, hacludirl, a subconcrauctor,irs wileom ft,pyovikir's Pk-131, Fem"'Ved
, m, or 0gcated", or rami-vetd by SiumAxiess Assxxlaw, on behaff of ft Allimce, aqgpvcs 'I"o d'y'r Sen"ne an'd
eorlditions flmt apply fAmnigh, is RA AgnewnctnAt and the Sen6ce,Agipram-nunt to Mushwoss Assiraciade with rcspm.'�,I cvo
much infbrmtktion
3.7
(s) Bwskems Assen—lat"i,agrear,tcr Pre' aims w-cesm,Pt the requena of the AIfiwm,:e dueIng regularbusiness hwurs,w PIE
w,ene Alliance or,as dilrected by Allimsuc,`teat 61], VjLfte'& i,,n order?so mccen the reqw,remems the C",onfidmadaRty,
Lawc,md
f1r) Bu ITI n' cwm, ks-Fociatm,aganecato naake arry zrncr dmccmdA")k"'o P11"'!th,,.-wr the A)R'Ls:,'x,,,4, direc,4s oragreas%,,MOM reqmt
of ffitc Alliance withim 10 busing ssmays of receMirkm the P-qundt,
IS Bushman aa,si,ociaate agoves w makc,'rommma'riff mites,L-moko,and hest wnds,hAvAuding,policics and procemdure mcl PHII,
relming,wthe use,mad dins'dosure of PRI Ifimorn,or,(mucted(m,raceived'by Business Armsociat'a.on behaffofthe
Afflkmr�cc, ,msabl, that ti'flianece ormp mlevmu rarguflalcm,"',awhm'-RW54 Whi'd,'i nnrl (lftCIA de ttI.0 SOCM uar�-,UP,'Ve Svol'Ot
of the A111snic*-c'mr thve,Sescretary,ifin ptunpcmics of agificadmic
J'9 B us i ness,A sme',c Lal a ag es,
,p,
be -.mqvdmJ Am, the Afilance to �'rcspord "'n a reqtmmc,y"y an, indiv."IdIA4 fbwr vmo accomankfing ofdiso1c),sure4s ofPff,,"' in
acmircianc;c vioh the ConiAdenaialky,
3,10 M isines, Aviodaam agrces,vc provdide to thc Alffiamece,upon.malueAk, intfominoJon ceflected,tc ,sperm,` ldfim A11hums
res I "PE,I
pon,d'Vta rmfuest by an Individual for awn afacoundeng of disrAcmums cd -11 Inaccorda-act-with the,Confide atlafiry
L a
3A'I Business Assmapide specificefly agrpecs es use Se uric, mcpsame's ai as ressonably and appmpdatcly pro me, the
'raegmity,and ava"lat"Hip),of PHIF, 4"", dum ft crQuIt"S'
or ammsmits ort betialf'o-fthe AlHane',
3,12" Business Asscnixt,zqgrems tv,hn'npler ent Secimity meamircs Ir"o Swum passvvotvh-''used w.,accems I�-fl ihw it,accesm.%
'n't "d 11 �p z
" alm"'34-A, or t'nan-medu as part Ot I-r!"s BA Agrvement frcm nialiciarls Saftware, mad vdatem nukn-rpnafdc Ared tatrianal
,vulnees"bifitics 11"'Pa wSure dhe meadil"Ibill ,hurgemq, of Idomalion,
3,13 Bumbmess Arsesda e agreas to Securb'y vnemquirt"S to sm"it'gual"I"PI'Ll Onat it a4mmses"ix%4�maims'Ortransynd."""S
t
as;wmt,ofdals BA mal,""mou's mo"N am and cether magm-muic and ngntmilml vvdnerobilkies,to assure dhe
as fly &I r"in'teg'd ,and monfidera,alby of-st'ich
Pap 61 of 69
KCA-2029
3.14 Business Associate agrees to comply with all other applicable Confidentiality Laws including, but not limited to,
restrictions an the sale of PHI and any obligations under the Confidentiality Laws delegated by the Alliance to
Business Associate, including any obligations under the Privacy Rule, and agrees to uses disclose only the
minimum necessary PHI to fulfill its obligations under this BA Agreement and the Service Agreement.
® Permitted Uses and Disclosures by Business Associate.
Except as otherwise limited in this Agreement or any related agreement.Business Associate may use or disclose PHI
to perform tuns® activities,orservices for,or an behalf of, Alliance asspecified in any and all contracts with
A Iliance provided that such user disclosure would not violate the Privacy Rule if done by Alliance or the minimum
necessary policies and procedures of the Alliance.
5® Specific Use and Disclosure Provisions.
5.1 Except as.otherwise limited in this BA Agreement,the Service Agreement or any Confidentiality Laws, Business
Associate may use PHI for the proper management and administration of the Business Associate or to carry out the
legal responsibilities of the Business Associate.
5.2 Except as otherwise limited in this BA Agreement,the Service Agreement,or any Confidentiality Laws,Business
Associate may disclose PkU for the proper management and administration oft Business Associate,provided that
disclosures are Required By Law,or Business Assoclaw obtains reasonable assurances fiont the person to whom the
information is disc lose dthat it will remain confidential and used or farther disclosed only as Required By Laworfor
the purpose for is it was disclosed to the person,and the person notifies the Business Associate of any instances
of which it is aware in is the corifideritiality of the information has been breached.
5.3 Business Associate may use PHI to provide dats. aggregation services to the Alliance as permitted by the
Confidentiality Laws,but only when specifically authorized in writing by the Alliance.
6.0 Obligations of Alliance.
&I The Alliance shall not*Business Associate of any restriction to the use or disclosure of PM to which the Alliance
has agreed to the extent that such restriction may a5sat Busirsess Associate's age or dischmire of PM.
6.2 Permissible Requests by the Alliance. Except for data aggregation or management and administrative activities of
Business Associate.the Alliance shall not request that Business Associate use or disclose PHI in any manner that
would rate permissible under the Privacy Rule if one by Alliance.
7.0 Effective Date and Term lastion.
7.1 The Parties hereby agree that this BA Agreement is effective as of the date above and amends,restates and replaces
any other Business Associate Agreement currently in effect between the Alliance and Business Associate.
7.2 Termination hir Cause. Upon the Alliance' ledge of a matitrial.breach by Business Associate,the Alliance
Y®
(a) Provide an opportunity for Business Associate to cure the breach or end the violation and terminate this
agreement if Business Associate does not cure the breach or ante violation within the time specified by the
Alliance;or
(b) immediately terminate this BA Agreement and may also terminate the Service Agreement if Business Associate
has breached a material term of this Agreement and cure is not possible.
7.3 Effect of Termination. Except as provided in subparagraph(b)of this section,upon termination of this agreement,
fbr any tenon,Business Associate shall return all PHI received from the Alliance or created or received by Business
Associate on behalf of the Alliance.No PtH shall be destroyed withoutthe express written permission of Alliance.
Page 62 of 69
as,
(a! This provision SO apply to PlH'I'thM is 0 W putembn of suboonvacmrs at Nptus of Business Asmebts,
Bmhos Awmhts shall wiNn no avie of So PH11,11"
(b) In the event-:hm Bkvsi',r?,,ass Ass�,:,xista or Mhariost dw,arfWuses ths"',",?ret"Mlrig rine F'1111 is of
Ra an, rvum of H-11 OaH be pmvWed to the A i"I'lliate,, 11 dhe AIM i e ,i wr �qgreos dha,
terinh,vation b""' "'r"fiessibte, B,.v,4h'tes,9 Assiochite mq afn de PHU,, Mb�jer,!', to tdw mv""ds BA
'F A�',,,-rel,tm nt shall mtv,,,nd the afWs BA,Ag',-w'n"Y"ittravi ut such rer"'kinedpil-fl,„uwi Ur'"')01
ftv,J,',er uses 4aad discleenfrc,„tu of such waned ,all k"w &ts' sucb"
1%).1", Ru,�jg'v&%Wrf,IteReoenceivi, A reffinven"c'e,in O"O's in the Ruflear Security Rolle arodzar
Canfldpenflaflt'y Lavv nn'te&ns tltre dhen in tt'!"Wix""�Or&&nnali,ba,arneviafed hn tt,,*1"buire,
910 PsK�A"a"�'s'aj&roo t""�take T;kachlae""mk-�n as L's tx�'arnxnd fion'&C'5krnw to fi"""v�e as ig
i the Allian j with the the Cond devyliality,Laws,
ksu0 Sexai,,A,
O"o uht airs'hi-,s BA A,g-vu""'Tu SAN Mmon nhmnwe"agadin""';i'sucbA sultsex, xmoo, ,,, h ARM=pq FT (t Sac
111'0 lnterpr�t<�i,Wori, My aurdbig"Ur ir&t"t'ds BA shWfl -"c Perm R,the AlHoutcats o£,,xnrdqfly%Rla the
La%vs,
12,0 Natb,,,&4„ i0l�aodce,%,&,nW reg"I'L,we"d, or desUd to be gOven pw"sM to Als BA Agamwm'ny
WcNdkg a Wgi of Mdrew Rn pwynes of such nath ss arru'i shai"I be ho toridng aend
act dhe afinm'r'parV or no Qy"less 24hour t.guux'roallwed sx,,v'wic:r at defivtry servwo, c-w ay cerfiflici"mafl
is the 'U"j,Red state's Poo"Al scrvi "
pce""A'iqge pmpxwe" isn"'J' rewt'rn rtotripa nnqt,,wz1,ed6, auld', ed to "htt cthut,,r pa-ttkr zui
ims fb"11cm,t" t""vcli inher as�any May kY'nonce h of(VIO
To Q Minna: fix, Agirqg,Use,
Atie.n1kn- 110fax,Rothrnao-i
760 IM 107 sk venue
MmQ FkgWa 33172
"'no Busimai;"s,A'senci'atv"% Monroe County Was!of Counq;Conunimioners,SOC1W
1100 Simontc,,xi'S'treet,21",Flofor
MY 'Wes; FL 3,",3040
Any suc�hinot',Lkc I&be a mz i daii'vered'upon ff uu'y nv""v"'Ce a""sixtnot�.,,e diatihvered ar d"ell-ve" thci reofis
shkay Oil be decoted to We cownid on
US) Gueraws 1.aw, ie laws of O'he Staac,erfflorwiri" vv'ithout to"�;principl'cs Oft"""n"Aft""Ct of hiff"k"vs,govern SH
amb,mis arfi,flng un,,Clerthis BA
14,0 rf WMY provhdoa in this
",aaln tda n is txi any zoatoas"the mm&t�av of this BA Agretme-m,
or appRevion of O'val provision,to any or cirn"'urrwarrcws ohm dmn h Is held
whi na be aiMed b--,,!dtm, nd wl A exmrst permitx'ed by wvy,
9
1510 Saccesssopra. Any u"l 134siness (Wh'e"I'Its%, by dnroct or key p�,'irvhasc,
ew is roquIrol a asn""Iteu,","Bas"In"cal tksgu'kciatvw"�s Alkas4o"'Wal rinuiertbus BA Ag and
p 0
aq�hrcc to nkartrt nark, 3aAct in le swre manner and to We saam emwt ta Elvehess Assocku would have been req&luxi
to if dua OUCCCUion aad at,tp',tadowa'jpd"&'. t, by Cbe,, Rukairseas Aasocii',dW's Wgadalngll?l
sha!t kw,by vn-,M',o&,rk to dw PkJU&ns'x"'%
Page 63 of 69
KCA-2029
I . Entire Agreement. This BA Agreement,together with the Service Agreement,constitutes the entire agreement of
the parties relating to the subject matter of this BA Agreement and supersedes a other oral or written agreements or
policies relating thereto,except that this agreement does not limit the amendment of this agreement in accordance
with section 9.0 of this BA Agreement.
Alliance for Aging,Inc.
B
Aug 13,2020 y: Date:
---——-----------............. .... .
(signature)
Business AssoeWe: Monroe County Board of County Commissioners,Social Serviesaflo-Home Services
® (s,gn.a I t UM Date: T I
MA40F,
Ar Y
PEDRO J.LiFkRCADO
ASSISTANT.,OOU1M- -A1-'r0Rb4E;f—
Page 64 of 69
KCA-2029
ATTACKWNT G
Alliance for Aging,Inc.
Aging and Disability Resource Center/Elder Helpline
AGING AND DISABIL]TY RESOURCE CENTER(ADRC)—OUTSOURCED FUNCTIONS
L If applicable,the provider agrees to the following:
A. Perform ADRC outsourced 11mcdons in accordance with the Alliance's policies and procedum.
i. 'Policies and Procedures.for Out sourced Function-Screening
ii. Policies and Procedures for Outsourced Function-Triage
iii. Policies and Procedures for Activation from Waitlist-Client Services
iv. Policies and Procedures for Termination from Waitlist-Client Services
B. Maintain wait lists in CIRTS in accordance with DOEA requirements.
C. Adhere to prioritization and targeting policy as set forth in the DOEA Programs and Services
Handbook,as applicable.
D. Ensure the Provider's Disaster Plan reflects ADRC Outsourced Functions,annually or as needed
to incorporate ADRC outsourced functions.
® Ensure against conflicts of interest and inappropriate self-referrals by referring consumers in need
of options counseling or long-term cam services beyond the provider's scope of services to the
Aging and Disability Resource Center.
F. Ensure 1hat services provided am in the clients' best interest,am the most cost effective, of high
quality,and am. responsive and appropriate to the messed needs.
The Assessed Priority Consumer List(APCL) is maintained when services funded by the department are not
available. Contracted Providers of registered services fbr Local Services Program(LSP)and Older Americans
Act (OAA) and CARES Act must maintain waiting lists in the CIRTS database for registered services when
funding is not available.
Page 65 of 69
KCA4029
Aktimvim,*fbt-Af ag,Inc,,
Alng and DisabliUlty R.eswuri,',x„C',, -net,,,rF.3der Selppiine
and Proci,""dhlre 11cur Outso,'urced fumAka--Skmalng
Creation Dat,,,,;,: maurclh 5,"1"008
JR�m\dhs,Ion Dmatr i m ,d,:w;r+i t 2019
Review Data,,, Ck,,'tobour 2019
Ofojpeefive:'T'.i ensu"'re'tha"t a Camp"ralmn, i've Rat,rxrd'Unts In ofservices,,is int C'111.1151' ?,,,,y
approg6mite"A"'goling saurf':"e'and!"ha"t dhe ADRCIs themby abb to Mahtly gauge the UK of Adirma",
ne,,:A ir"i rin"'d)01k.\nnoe
po'slky': 1";,:,;o1b3idn,neummy kknmmkn hun cAns in cher wassis etemnrdviinp hewel afrtee,,darid,
eUgibili�`s,i fcr servic ims 1"Asi'm"'isol ti,rcsuggh O,A\A aiad LSPa,�rW CAi`kEs
I Providers, vvii, -:*,,UCCt t""zcm and corWuct a 701S asseow,&me,,,rA, Alte"�rrm",iyely'
exits orls providS So, ob'e" oil
I The Prt'rvid',, wid deterr tii,'w nif),moded ,a.,,ad the, [Utnii,,o-q svctro';e(s)zdoat pravhias
hie nemkd
if the AS N in owed of a smykey)that I not guovideDd by thm Pnovider,o,',he Pr vlider will re,,,Ifet,cidbe"'r
to the X)RC Elder 11'efi,Ahrmo' as,to eani'ver Coritsacted Rrovidev, and 0'ript"flin"Ifians,
3, i C�'ffl o'Y,j'H lm r�, d, edltth SunerW inlorr-nation regardingAD '.[ �,is we"R as ti-w A RC'Eld'or Heipfirw co,vtzet riuzolsfcr,
4, "I"i'm cala,',,,r wifl,,' Int infl,'),rn-ted ol, the andfuridbrig th"flt� d-�me,,y axe be,'mg;,01,aced!on the wo5t,
1hit,R)r
5, For nonnatme rnatlf"�qfpd tl'me will cxva�m acl,".en` r'e'corci C13, (if tb-"'mm"' ie tma
C"Ang O!"wer the ne,,(""kdamdI 1"�br t"he g't- tinldi:'mg" ems""'n e and semkt,,, [,.f themm,is
m,ekisthqg ir".C f,l"Z""S'am flmldia wi"' c,"'pdamd],
6, If the the calier may for than c'mm �',rcm""der
is ff'br-"dea, e,ifA prcnider is encowmgml o mi"I f" ntne "e i &ng
Som"Ce's, (If O'he"n-"'-'s's an Wong CHWI ramin"'!inf,cll"'t"Ts' client In)CIRPS MR tu'd%'vivh'
T isi Provider IN NO=ON Al whey 011, re%ceive mr to}i„d i.�$ ir-,,i assesornera ba's'ed om D("')E'A !'M�mal
Lit amd eacowage CaHm 14", One 'AUE'XRC Eldv lh1e,,Iplisve, 'pdth mriy
Page 66 of So
KCA-2029
Alliance for Aging,Inc.
Aging and Disability litesource Center/Eider Helpline
Policy and Procedure for
Outsourced function-Triage
Creation Date: March 5,2009
Revision Date: October 2019
Review Date- October 2019
Objective- To ensure that clients in need of DOEA funded services receive services based on the highest level of
need,first,as funding becomes avaflable.
Policy: To assist clients in obtaining DOEA funded services as funding becomes available, based on level of
need as determined by a CIRTS priority score.
Procedure:
1. The Provider will conduct annual reassessments based on DOEA Wait List Reassessment Standards.
2. If them is no current 701 A or B in CIRTS,the Provider wili conduct the annual reassessment(701 s)as
appropriate. Based on the information provided via the 701 SIA(B)assessment,the Provider will update
the client information in CIRTS specifically as it pertains to level of need for services by funding source.
3. The Provider will ensure that the CIRTS prioritization score is accurately maintained,according to DOEA
Standards, If a significant change has occurred prior tot annual re-screening, the Provider must re-
screen.Definitions and examples of significant change are documented in the DOEA Programs&Services
Manual Chapter 2.
4. If the caller is in need of a service(s)that is not provided by the Provider,the Provider will refer caller to
the ADRC Elder Helpline, as wefl as, to other contracted Providers and community organizations. The
caller will be informed of the services and funding sources that the wait list for and/or have been removed
from the it list for.
5. The Provider will remind client of the ADRC Elder Help Line contact number and to contact the ADRC
Elder Help Line With any questions or concerns.
6. As funding becomes available, the Provider will run CIRTS Prioritization Report and activate clients
according to DOEA Standards(refer to ADRC Client Activation Policies and Procedures).The Contracted
Provider will apply targeting criteria, as appropriate, to prioritized clients to ensure activations meet
programmatic requirements.
Page 67 of 69
Among and Cent,,emrvElder Help"Ine
Paificy and Procedmire,,Our
Ac-tivadow fhona,Wait Lis!
v n,.r) u,r x:2,0 19
QIoNMve;1 )ensure e that Aden;in 57xed of,$.,vC90 irk a,;,xi."M;!lou'ar" N,N}twiti ma`s and on,,
the IUFRj R S wayft la,n begin o��;t?�a�k,`v°z" sRe' aia»na , z's, i n $ ig nv s rY°
q g a a � � r � r �;� � � e���tnZ„s.u��`+x,
,7 m' : nk€�,�,",� 't a. s �.: p{�f P >v ti a r.. ensure x:�"' � -fe c d i R rra s,' .,�'t.,v`'t^"v 5 r«i u� 6��a i!I `" 'dh t 3,��nc,� ,a n„�,+ €� >vi,,ca��R„,4.t �;-:�An, ��£���,�v� ;t�,�w���s.�a�, >,vx,�x,��;v u �aY �4��� � €tir, � r �.� a � ���n ev x n�,<��� ,
receive Ie those
211 x§�. a 4ayy,v,YS q vv v2ill" a vi .;am,, �rni'e ark ,�F,:'+(�,.,�RTS ':"Sv,�:�. 8,�e Rod on �,,.�() v,°
H, Q:4.q�` a A ✓,}5 gis�A,^b will" rat dd€ %'f{ a a S, ,5 \ 4 aS�
aysuabniq
2, The PmNWek M> €Cpda€",CIR S L tavnm,s by f""'a"'x1fing scume ax;3aRa savke l"bD a,,, s "Fen",
t"
o,m,OgeE`im kip`€},, ,° ex' fi u,,,s€ 3,uv c(,,,des,,
3, �x� ; okay be Au Y �,�k a„�, z `'r �x nv t § r s1 �u e ,k b-�c i M1Nin 't t '1 .,e ft f, '�d x f tp t Ytm F4
x€n>�su€,wv �„�.k a" ,"�a � a 3 � a� na an�� v„a,"� ,�,�n����t ,a�vt�v4 � of fin, �Rr �q9�� �s3na,4��t,>a' fist 2�x
M113k,4 , fr",hat,it rsap 7opr„m,
4, 03'ent a,,n,,y liso left, ,t,twm"t list „aIRLI's ifthey a.a,3„h6t`gaA''W"�g�K y'� a;�`,�g,v,.ini;�1'�.!t us.ff'de a
„f.;IL"",ce, r:U sdF €:';$.a,,, P €.4vs.dew „,.,rsrq it l�".'+,tdr,,;;.. i V""ze 9„net"x WIN
n�,�n SY eert 1'b, tw,� k IY f ( W'd d 1 T` y '� d W K3 !!4 }5 "9 ) x1V i e44
,;u„ �ss�,,a#a,�ksnv€..µ d;���� ,z��vrfi ,��d,,,a��„ra�l,m��u"u,:���"�� �g�,a��n��"�,,€1 .�k,��€ �m�� �kx�.��v1�£r� �,,au�"��x a��n�� �uA�„� r,�tl �,��.�,;� �Wa,xn�,
ae,t" n` ve ~n F .,€,...4 Re'�$YS,'s` �''�`sb n-:�S�,�r m,�' 3�vao'e'. G,h..vt�.1i-�4;.�;�4 'RrN1�`P tZorairx,`n�1e.x,: £,Fv��'�`ur if they
u.kx,k��v, i r,
4�4x %4,Cw vr��'`tnl'ie will I5.+�f4d`r"n fwr.Qir✓�.st to�U�.,,�4%2,)rN�ka Y,:=.d:,",'M�\.,$'�.FN,���dC Elder Yne1f'4SY:�I,�,i n,e it hey tm've arty }edmY ns
m"1{ wndtaa'xwu S � '4,Nrc £:1' {2dd. aYk4, sir ofrh.,eY,r se/vil rM�k�,Yx
K=029
WHance IN
Aeng and DIsabfillry Rasi,",iurcc
FAky and IFIrtoreciure,fcn,
Termans don from Wait is CHents/Se, lenes
Cres,A'a'on,Datc, 5,2G(A
'Iti,whiflion Dat,,,e, 2019
1,11e,iderw Rate, C,",ktobem 2019
Obdecdve, I`ci ans�jxethlxt t1he A of cbxua in neecil, in CIRTS is appTpAsbly
mairdt',iiii,�'ied by,("Isinding sco,onx and dhaT,fl,m AI',,,)rtC is thertby zible to effiact!"O'e1y Be",uge tltc cwn",",ra i"evel
of eider service mec""'d 4%
AI,.MRC will r;,,,muntPain irnaiccurate and", list in nee"al, in,
and Cotw.,dczt the assistance of the ADRC Pz'c'n4d, rs
Rnameicl e',re.,
I, The Pruk6di�,rr w,,RI,rc,"'-s"�cr CHAs',rata whic1h ft-ifth,"?AL)y placed an Che CLSVI"'S flist fcr services
On,CN!"')EA
2, The nosso,awn,&n P, xo-,ta,t"Im",ffar'.'11 of a phone summing or a hen'rm:"Visit on we c"Het"It"S sta'I"n"I"S
3, 'ne, win shrennine if dhe cuou is rmo, int r 41 ble)for any of the services they Ip
4, The Novi der will the", rn t1he vv,,aft Ust .",e y or b spa-,,,,miffic service,as, t'l,""'ing the,
to,n�c b-c"r,"? bx,�,eilgiblefin or,no lk,'�njpnl hr)l xleed of
The, 'will InAor"m ,j wrc�,beiznig"re"'n"'zoved,fhcnn tbe
VMR No Rfor,
7%Provider Ki SAmi-a clie, ofi�dheir abiftey to he,readlded to,t"he%v"ait HIT il"'their level ofn,,�,,,,,ed showid
chan-4-
7, clic."tatto ccn',,,act%ADRC Eder HICIP11ne hi,,ive any, orconceirn."s
reg,pircili e
8, F,)-,'3EA and Servl-ccs, Haadbook a;appI NSA,
Page 69 cd 69
F
2020-08-13
2020-08-13
KCA 2029 Cares Monroe
Stan Mcneese(mcneeses@allianceforaging.org)
Status: Signed
Transaction ID: CBJCHBCAABAAZ1Vd9b6g4RLnyiALcWDDQW4b2Qffu9PP
"KCA 2029 Cares Monroe" History
Document created by Stan Mcneese (mcneeses@allianceforaging.org)
2020-08-13-7:13:52 PM GMT-IP address: 12.50.155.35
�"' Document emailed to Max B. Rothman (rothmanm@allianceforaging.org) for signature
2020-08-13-7:15:18 PM GMT
<,.... Email viewed by Max B. Rothman (rothmanm@allianceforaging.org)
2020-08-13-7:17:02 PM GMT-IP address: 107.77.215.24
Document e-signed by Max B. Rothman (rothmanm@allianceforaging.org)
Signature Date:2020-08-13-9:39:17 PM GMT-Time Source:server-IP address:76.109.240.37
Signed document emailed to louisjeanc@allianceforaging.org, khouryi@allianceforaging.org,
colomerl@allianceforaging.org, castelloc@allianceforaging.org, and 4 more
2020-08-13-9:39:17 PM GMT
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