Item C26
Revised 2/95
BOARD OF.COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting pate: October 17. 2001
Bulk'ltem: Yes IZI No 0
Division: Manaaement Services
Department: Grants Administration
AGENDA ITEM WORDING: Authorization for the Mayor to execute the fiscal year 2002
contracts with Human Service Oraanizations funded by the County.
ITEM BACKGROUND: Funds are provided to various human service oraanizations
based upon the recommendations of the Monroe County Human Services Advisorv
Board. as approved by the BOCC annually. See attached list for amounts.
PREVIOUS RELEVANT BOCC ACTION: Approval of boilerplate contract for HSO'S on
April 18. 2001: approval of the amounts recommended by the Human Services Advisorv
Board on July 20. 2001: approval of revised amounts on July 31. 2001.
CONTRACT/AGREEMENT CHANGES: COpy of revised boilerplate contract. with
chanaes noted. is attached. Other than those chanaes. only chanaes as compared to
last year's contracts would be to amounts. dates. names and addresses. and description
of services to be provided. Some of these oraanizations are beina funded for the first
time. however. See attached summary of amounts and changes to descriptions
of services.
STAFF RECOMMENDATION: approval
TOTAL COST: 369.100.00
COST TO COUNTY: 369.100.00
REVENUE PROOUCING: Yes 0 No IZI
BUDGETED: Yes IZI No 0
AMOUNT PER MONTH
YEAR
APPROVED BY:COUNTY A TTY I2$J OMB/PURCHASING IZI RISK MANAGEMENT IZI
DIVISION DIRECTOR APPROVALJt2 - J-------~
James L. Roberts, County Administrator
......
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SAMPLE
AGREEMENT
BPKAA
This Agreement is made and entered into this day of , 2000,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and BIG PINE KEY ATHLETIC ASSOCIATION, INC., hereinafter
referred to as "Provider."
WHEREAS, the Provider is a not-for-profit corporation established for the provision of
activities for the wholesome development of youths' personal, social, physical, emotional and
spiritual growth, and
WHEREAS, the Provider provides such activities in a wholesome, alcohol-free and drug-free
environment for young people of Monroe County, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for recreational
use and social functions of the community in a wholesome environment free from drugs and
alcohol, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the Provider
substantially and satisfactorily performing and carrying out the duties of the Board as to providing
facilities and services for recreational use for young persons living in Monroe County, Florida, shall
pay to the Provider the sum of FORTY-EIGHT THOUSAND DOLLARS ($48,000.00) for fiscal year
2000-2001.
2. TERM This Agreement shall commence on October 1, 2000, and terminate
September 30, 2001, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT Payment will be paid periodically, but no more frequently than monthly
as hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The County shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
Provider shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement as well as a notary
stamp and signature. An example of a reimbursement request cover letter is included as
Attachment B. The organization's final invoice must be received within sixty days after the
termination date of this contract shown in Article 2 above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the Provider. However, the total of said reimbursement expense payments_.
in the aggregate sum shall not exceed the total amount of $48,000.00shown in Article 1, above, I
during the term of this agreement.
4. SCOPE OF SERVICES The Provider, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing activities in a wholesome environment free from drugs and alcohol to young
persons living in Monroe County, Florida. Provider shall provide services described in Attachment
C, attached hereto and incorporated herein.
S. RECORDS The Provider shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The Provider shall be responsible for repayment of any and all audit exceptions which are
identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an
independent auditor, or their agents and representatives. In the event of an audit exception, the
current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by
the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the Provider shall be billed by the Board for
the amount of the audit exception and the Provider shall promptly repay any audit exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The Provider covenants and agrees
to indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
Provider occasioned by the negligence, errors, or other wrongful act or omission of the Provider's
employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the
Provider is an independent contractor and not an employee of the Board. No statement contained
in this agreement shall be construed so as to find the Provider or any of its employees,
contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement,
the Provider shall abide by all statutes, ordinances, rules and regulations pertaining to or
regulating the provision of such services, including those now in effect and hereinafter adopted.
Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach
of this agreement and shall entitle the Board to terminate this contract immediately upon delivery
of written notice of termination to the Provider.
9. COMPLIANCE WITH COUNTY GUIDELINES. The Provider :::;h;J1I comply with the
~rg<Jniz<Jtion, Progr;Jms ;Jnd Policy Guideline:::; for the Youth Org;Jniz;Jtion:::; of ~10nroe County." At
;J minimum, the provi:::;ion requires the Provider to demonstr;Jte ;Jnd sust;Jin compli;Jnce with The
Provider must furnish to the County:
(a) evidence of the organization's SOl(c)(3) Registr;Jtion status;
(b) a list of the organization's Board of Directors of :::;even which there must be five or
more;
(c) evidence of AQnnual election of Officers and Director~;
(d) Annu;)1 provision of an_annual audited financial report to County;
(e) (e) a copy the orqanization's Corporate Bylaws, which must address the
organization's mission, board and membership composition, election of officers, and
so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must
include hirinq policies for all staff, drug and alcohol free workplace provisions, equal employmenl-
opportunity provisions, and so on;
(9) Hiring policie:::; for ;)11 :::;t;Jff;
(h) Cooper<Jte cooperation with County monitoring visits; afT€!.
(i) S~emi-annual performance reports to be presented to County. These reports
should include performance measurements which will demonstrate the level of accomplishment of
qoals for which fundinq has been provided.
(n other reasonable reports and information related to compliance with applicable
laws, contract provisions and the scope of services that the County may from time to time
request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The Provider shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the Provider's program and staff.
11. MODIFICATIONS AND AMENDMENTS Any and all modifications of the services
and/or reimbursement of services shall be ;Jmcndcd accomplished by an ;Jgrccmcnt amendment,
which must be approved in writing by the BeaffiCounty.
12. NO ASSIGNMENT The Provider shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the Provider.
13. NON-DISCRIMINATION The Provider shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
Provider shall comply with all applicable laws and regulations with regard to employing the most
qualified person(s) for positions under this agreement. The Provider shall not discriminate against
any person on the basis of race, creed, color, national origin, sex or sexual orientation, age,
physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the Provider below, certifies
and warrants that:
(a) The Provider's name in this agreement is the full name as designated in its
corporate charter, if a corporation, or the full name under which the Provider is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the Provider; and
(c) This agreement has been approved by the Board of Directors of the Provider if the
Provider is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
Dave P. Owens, Grants Administrator
Public Service Building'
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For Provider
President
Big Pine Key Athletic Association
P. O. Box 430089
Big Pine Key, Florida 33043
16. CONSENT TO JURISDICTION. This agreement shall be construed by and
governed under the laws of the State of Florida and venue for any action arising under this
agreement shall be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the Provider shall not be deemed or considered as a continuing waiver and shall
not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach,
either of the same conditions or covenants or otherwise.
18. AVAILABILITY OF FUNDS If funds cannot be obtained or cannot be continued
at a level sufficient to allow for continued reimbursement of expenditures for services specified
herein, this agreement may be terminated immediately at the option of the Board by written
notice of termination delivered to the Provider. The Board shall not be obligated to pay for any
services or goods provided by the Provider after the Provider has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the Provider and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
Deputy Clerk
Mayor/Chairman
Witness
BIG PINE KEY ATHLETIC ASSOCIATION
(Federal ID No. )
By
Witness
j€€oftbpk-cra---yottffi
President
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: American Red Cross Effective Date: 10/01/01
Expiration Date: 9/30/02
Contract Purpose/Description: Provide direct services to the citizens of Monroe County, such as
disaster assistance, emergency communications, and health and safety training.
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 10/1 7/01
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $20,250.00
Budgeted? Yesl:8J No 0 Account Codes:
Grant: $0.00
County Match: $
Current Year Portion: $20,250.00
001-03203-530340-_
-
----
-
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- - -
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ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.)
CONTRACT REVIEW
Changes
Date In Needed~ _______~^ _
Division Director 'i,,~-u~ YesDNo~ ~~
. ! ,/ r---. ~
Risk Management ?:,} Z(1 \r)\ YesD Nog C\, t._\.,~~~--.~ V~0-E..~'.x.:'\"
O.rrhasmg~~ YesONorif ~~ ~
~ounty Attorney H J30 ({) I YesD No[:V'
Date Out
e;-~-~
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';7' ~ r~<-~, I.J'
\
"8 \;8) 01
1/901
Comments:
OMB Form Revised 9/11/95 MCP #2
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and American Red Cross of Greater Miami and the Keys,
hereinafter referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
disaster services and health, safety and community services, and
WHEREAS, it is a legitimate public purpose to provide disaster services and health, safety
and community services, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing disaster
services and health, safety and community services to persons living in Monroe County, Florida,
shall pay to the PROVIDER the sum of TWENTY-THOUSAND. TWO-HUNDRED. FIFTY. AND NOIlOO
DOLLARS (20.250.00) for fiscal year 2001 - 2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown;Ln Article 1, above,
during the term of this ~greement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing disaster services and health, safety and community services to persons living
in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached__.
hereto and incorporated herein.
s. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
"
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's SOl(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring poliCies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope 'of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state-'
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Mr. Winston Burrell
American Red Cross of Greater Miami and the Keys
3132 Flagler Avenue
Key West, FL 33040
305-296-4033
305-296-9388 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and-.
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise. --
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
. Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
".
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officeror employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation ofthis provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed hislher
signature (name of individual signmg) in the space provided above on this
day of
,19_.
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
,
1
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Disaster planning, preparedness, and education.
Prompt relief to victims of major disasters.
Emergency communications between members of the U. S. Armed Forces and their families.
International tracing services to help family members locate loved ones who are foreign nationals
overseas.
Information, referral, and financial aid to members of the U. S. Armed Forces and their families.
First-aid and CPR training.
Swimming and lifeguard training.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACTS~ARY
Contract #
Contract with: Big BrotherslBig Sisters Effective Date: 10/01/01
Expiration Date: 9/30/02
Contract Purpose/Description: provides funding to perform and Carry out children's services,
including companionship and development services to young persons living in Monroe County.
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 10/1 7/01
Agenda Deadline: 10103/01
CONTRACT COSTS
Total Dollar Value of Contract: $20,000.00
Budgeted? Y es~ No D Account Codes:
Grant: $0.00
County Match: $
Current Year Portion: $20,000.00
001-03001-530340-_
- -
----
- -
----
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.)
CONTRACT REVIEW
Changes
Date In Needed~~ /~~_ _~
Division Director 1-J.1--&\ YesD NOCJ . '--- ~~~
Risk Management 3\ 2':\ \ 0 \. Yes'D NO~[~ ( t'J CL-Lh'-..L- :Q~-tI;<..1""
o.~hasing~Q YeSDNO~~~~
CountyAttorney 2-/30!O/ YesDNo~__
Date Out
"-~/-.rl
o!2.L'\D[
8\J.310l
8/710;,
Comments:
OMB Form Revised 9/11/95 MCP #2
/-~
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and Big Brothers/Big Sisters of Monroe County, Inc.,
hereinafter referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
companion, mentoring, and tutoring services to the youth of Monroe County, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for the
provision of companion, mentoring, and tutoring services to the youth of Monroe County, now,
therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for companion, mentoring, and tutoring services for young persons living in Monroe
County, Florida, shall pay to the PROVIDER the sum of TWENTY.THOUSAND AND 00/100
DOLLARS (20,000.00) for fiscal year 2001-2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggr~gate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing companion, mentoring, and tutoring services to the youth living in Monro~_.
County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and
incorporated herein.
5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
.'
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's SOl(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided. .
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional Iiability-'
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the PROVIDER'S program and staff. ~.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
For PROVIDER
Carmen Turner, Executive Director
Big Brothers/Big Sisters of Monroe County, Inc.
POBox 505
Key West, FL 33041
305-294-9891
305-294-1551 FAX
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and-
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise. ..-
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
AlTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
. Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
~
I
I
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signmg) in the space provided above on this
day of
,19_
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETIERH EAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
Companion, mentoring, and tutoring services to the youth of Monroe County. Program service
operation, including the matching of clients with a Big Brother, Sister, or Buddy, monitoring, and
evaluation of units of service. These services include the "Little" (child), their Parent (single
parents with no contact with the absent parent), and the "Big" (volunteer Big Brother, Big Sister,
or Big Buddy).
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Caring Friends for Seniors Effective Date: 10/01/01
Expiration Date: 9/30/02
Contract Purpose/Description: provides funding to perform companionship and related services
to elderlv persons living in Monroe County. Student organizations are matched with senior
citizens to bridge the gap between generations.
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 10/17/01
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $10,000.00 Current Year Portion: $10,000.00
Budgeted? YesC8:/ No 0 Account Codes: 001-00506-530340-_
Grant: $0.00 _-_-__
County Match: $ _-_-_-_
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes di
Date In Needed -;;- ~ r
Division Director ,.....~'-01 YesD NO~~~.. \-_ ,_~_.....,
Risk Management ;r/ =I-~J I (} IYesO Nod G(, \ _~,~',-,-~-,~_ \f(~~_-k-.j" If) 2 ci' I ()!
o.~hasingd()I~IO\ YesDNoif ~A~,wD ~\d'C:\~1
County Attorney f}'/'3~/~( YesDNocY" ~ 8/7;} /
Date Out
Comments:
OMB Form Revised 9/11/95 MCP #2
/-c.d
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and Caring Friends for Seniors, Inc., hereinafter referred to as
"PROVIDER. "
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
companion services for senior citizens in Monroe County, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for companion
services for senior citizens in Monroe County, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for the provision of companion services for senior citizens in Monroe County, Florida, shall
pay to the PROVIDER the sum of TEN-THOUSAND AND 00/100 (10,000.00) for fiscal year 2001-
2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing companion services for senior citizens living in Monroe County, Florida.
PROVIDER shall provide services described in Attachment C, attached hereto and incorporatecl_.
herein.
S. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
,I
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's SOl(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding' by the Board is contingent upon retention of appropriate local, state-
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Barbara Fike, Executive Director
Caring Friends for Seniors, Inc.
POBox 1263
Key Largo, FL 33037
305-453-1166
305-453-3773 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and-
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise. ~-
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Deputy Clerk
By
Mayor/Chairman
Witness
PROVIDER
(Federal ID No.
)
Witness
By
President
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list. "
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on hislits behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signmg) in the space provided above on this
day of
,19_.
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
,
.'
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are reqUired.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The Jog must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LElTERH EAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
Companion services to senior citizens, especially those who live alone, are homebound, or live in
a nursing home, through one-on-one matches with volunteers and clients.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Domestic Abuse Shelter Effective Date: 10/01/01
Expiration Date: 9/30/02
Contract Purpose/Description: provides funding to perform services such as shelter. counseling
and other appropriate services to battered spouses.
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 1 0/1 7/01
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $25.000.00
Budgeted? Yesl:8J No 0 Account Codes:
Grant: $0.00
County Match: $
Current Year Portion: $25.000.00
001-03201-530340-_
- - -
----
- - -
----
-
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes
Date In Needed 7~ef1
Division Director ?J'JI'-1YesDNo~~~ ~
, / \ Or"-+-
Risk Management '::)-/ ::::C:i, (]\ YesD No~ C~, I iJc~ ~ ~~I.-\I:::.(){'.
O.~haSin~/JI YesDNo~ ~\ ~
County Attorney f?j30!Q( YesDNo~ ~ -
Date Out
, -...., -..,
'8/2-{.1)01
~\~~\ D\
<6/31/01
Comments;
OMB Form Revised 9/11/95 MCP #2
/-~
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and The Domestic Abuse Shelter, Inc., hereinafter referred to
as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
comprehensive services for individuals and families experiencing domestic and sexual abuse, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for the
provision of comprehensive services for individuals and families experiencing domestic and sexual
abuse, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for comprehensive services for individuals and families living in Monroe County, Florida
experiencing domestic and sexual abuse, shall pay to the PROVIDER the sum of TWENTY-FIVE-
THOUSAND, AND 00/100 (25,000.00) for fiscal year 2001-2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing comprehensive services for individuals and families experiencing domestic anQ_
sexual abuse to persons and families living in Monroe County, Florida. PROVIDER shall provide
services described in Attachment C, attached hereto and incorporated herein.
5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
..
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's SOl(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided. '
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability-
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the PROVIDER'S program and staff. ".
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Venita Garvin, Executive Director
Domestic Abuse Shelter, Inc.
POBox 522696
78 Coco Plum Drive
Marathon, FL 33052
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Arty waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding-'
breach, either of the same conditions or covenants or otherwise.
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATIEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Deputy Clerk
By
Mayor/Chairman
Witness
PROVIDER
(Federal ID No.
)
Witness
By
President
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list. "
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signmg) in the space provided above on this
day of
,19_
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
,
..'
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERH EAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Em ployee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
Provision of comprehensive services for individuals and families experiencing domestic
and sexual abuse. Reduction of the incidence and minimization of the impact of domestic
and sexual abuse in Monroe county by directing the appropriate, effective programs and
services at victims and abusers.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Florida Keys Children's Effective Date: 10/01101
Shelter
Expiration Date: 9/30/02
Contract PurposelDescription: provides funding to perform services such as shelter, and early
intervention and prevention programs for youths and their families.
Contract Manager: David P. Owens
(Name)
4482
(Ext.)
OMB/Grants
(Department)
for BOCC meeting on ] 0/] 7/0]
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $30,000.00
Budgeted? YeslZl No 0 Account Codes:
Grant: $0.00
County Match: $
Current Year Portion: $30,000.00
001-03002-530340-_
- - -
----
- -
---
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
Date In Needed _---c::. R'
Division Director ,_ ~-aI l YesD Not::r _ ~_.---7 ~ .~_
1- ~
Risk Management ~ \ 2'1 \ 0\ YcsD No[9 I~' . ;,-;~(-.Jr,"";- V~~.J{~T~'"
otPurchaSing ~JoI YesD NO~ ~'<~ ~
County Attomey 'if~of()( YesDNo~ ~
Date Out
1~-."
I, t
ci' I 2. G' \ d '
!, \.
0\:;8\ 0\
gj3{/o I
Comments:
OMB Form Revised 9/11/95 MCP #2
/-~-?
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and Florida Keys Children's Shelter, Inc., hereinafter referred
to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
shelter and counseling to youth and families, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for the
provision of shelter and counseling to youth and families, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for shelter and counseling to youth and families living in Monroe County, Florida, shall
pay to the PROVIDER the sum of THIRTY-THOUSAND AND 00/100 DOLLARS (30,000.00) for fiscal
year 2001-2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this <;Igreement.
4. SCOPE OF SERVICES. Tne PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing shelter and counseling to youth and families living in Monroe County, Florida.
PROVIDER shall provide services described in Attachment C, attached hereto and incorporated__.
herein.
5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
..
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's SOl(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state-.
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Kathleen Tuell, Executive Director
Florida Keys Children's Shelter, Inc.
73 High Point Road
Tavernier, FL 33070
305-852-4246
305-852-6902 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and-'
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise. Po.
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ArrEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
. Deputy Clerk
By
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
President
Witness
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public. entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of36 months from the date of being placed on the
convicted vendor list."
I
!
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that helit has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officeror employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signmg) in the space provided above on this
day of
,19~
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
I
.,
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
gUidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are-not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
rei m bu rsement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERH EAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
DESCRIPTION OF SERVICES TO BE PROVIDED
Shelter for youth in need aged ten through seventeen.
Community-based counseling program at schools throughout the Keys.
ATTACHMENT C
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Florida Kevs Outreach Effective Date: 10/01101
Coalition
Expiration Date:9/30/02
Contract Purpose/Description: provides funding to perform services such as shelter. and other
services for homeless persons in Monroe County.
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 10/17/01
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $8.557.00
Budgeted? Y es~ No D Account Codes:
Grant: $0.00
County Match: $
Current Year Portion: $8.557.00
001-03206-530340-_
- - -
----
- - -
----
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
Date In Need:d~ 7~e _
Division Director ?~_~ YesDNoLJ_~~~
Risk Management '8 )2-L\}0\ YesO No0 C\ 'lkJ"'-~ \C,~~~"'"
9hf.~hasing 9rzs 6 t YesO NoD' ~ ~ 00
M;;:ttorney S/30{OI YesDNo~~_
Comments:
Date Out
',.-U.t --r
'g,~ ~\\ c i
8~IOI
g/:?~/
OMB Form Revised 9/11/95 MCP #2
/-~
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and Florida Keys Outreach Coalition, Inc., hereinafter referred
to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
shelter to homeless individuals and families, and
WHEREAS, it is a legitimate public purpose to provide facilities and services to provide
shelter to homeless individuals and families, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for homeless individuals and families living in Monroe County, Florida, shall pay to the
PROVIDER the sum of EIGHT-THOUSAND. FIVE-HUNDRED. FIFTY-SEVEN. AND 00/100
($8.557.00) for fiscal year 2001-2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing shelter to homeless individuals and families living in Monroe County, Florida.
PROVIDER shall provide services described in Attachment C, attached hereto and incorporated-
herein.
5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional Iiability-'
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the PROVIDER'S program and staff. ...-
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Rev. Stephen E. Braddock, Executive Director
Florida Keys Outreach Coalition, Inc.
POBox 4767
(1615-A Truesdell Court)
Key West, FL 33040
305-293-0641
305-293-8276 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of FJ,oriaa and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept-'
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and
$hall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding'--
breach, either of the same conditions or covenants or otherwise.
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNlY COMMISSIONERS
OF MONROE COUNlY, FLORIDA
By
By
. Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
"
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on hislits behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officeror employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed hislher
signature (name of individual signmg) in the space provided above on this
day of
,19_.
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
I
'.'
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERH EAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Shelter and assistance for homeless individuals and families in Monroe County.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Habitat for Humanity of Effective Date: 10/0 l/O 1
Key West and the Lower Keys, Inc.
Expiration Date:9/30/02
Contract Purpose/Description: provides funding for housing construction and repair for
economically disadvantaged residents
Contract Manager: David P. Owens
(Name)
4482
(Ext.)
OMB/Grants
(Department)
for BOCC meeting on 10/1 710]
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $27.145.00 Current Year Portion: $27.145.00
Budgeted? Yes~ No D Account Codes: 001-~-530340-_-
Grant: $0.00 ~3Z.13-_-_-
County Match: $ _-_-_-_
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.)
CONTRACT REVIEW
Changes ?ik
Date In Needed ~
Division Director 9''''~-cr''{ Y esD N~ ~ ~:: --."' ?_"U-..t
Risk Management ~ 12..'110\ YesD Norr (c i \,2cc"-r ~~j:;j"\ ~\Z9 \0 I
O.M~ingetW/Y YeSONO~~ ~lL ~\Ol
CountyAttomey rJ/3{)/{)! YesONog-' ~ tptjol
Date Out
Comments:
OMB Form Revised 9/11/95 MCP #2
/-~
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and Habitat for Humanity of Key West and the Lower Keys,
Inc., hereinafter referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
housing construction and repair for economically disadvantaged residents, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for housing
construction and repair for economically disadvantaged residents, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for housing construction and repair for economically disadvantaged residents living in
Monroe County, Florida, shall pay to the PROVIDER the sum of TWENTY-SEVEN- THOUSAND. ONE-
HUNDRED. FORTY-FIVE AND 00/100 DOLLARS ($27.145.00) for fiscal year 2001-2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substanti:ally and satisfactorily perform and carry out the duties of the
Board in providing housing construction and repair for economically disadvantaged residents
living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C,
attached hereto and incorporated herein. --
5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state-
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
For PROVIDER
Roberta Loudenslager, Executive Director
Habitat for Humanity of Key West and the Lower Keys, Inc.
POBox 421003
Summerland Key, FL 33042
Office location: 17 Ships Way, Big Pine Key, FL 33043
305-872-4556
305-872-4404 FAX
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of FI.oriO'a and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kepf-
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and
!;ihall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding.....
breach, either of the same conditions or covenants or otherwise.
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
. Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public .entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list. "
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officeror employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation ofthis provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signmg) in the space provided above on this
day of
,19_
'.
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will onfy reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
DESCRIPTION OF SERVICES TO BE PROVIDED
Housing construction and repair for economically disadvantaged residents.
ATTACHMENT C
""-
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Helpline Effective Date: 10101101
Expiration Date: 09/30102
Contract Purpose/Description: provides funding for crisis intervention and refelTal services
Contract Manager: David P. Owens
(Name)
4482
(Ext.)
OMB/Grants
(Department)
for BOCC meeting on 10/17/01
Agenda Deadline: 10103/01
CONTRACT COSTS
Total Dollar Value of Contract: $13572.00
Budgeted? Yes~ No D Account Codes:
Grant: $0.00
County Match: $
Current Year Portion: $13,572.00
001-03200-530340-______
- - -
----
- - -
----
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr. For:
(Not included in dollar value above) (e.g. maintenance, utilities, ianitorial, salaries, etc.)
CONTRACT REVIEW
Changes Date Out
Date In Needed ~ ~~
Division Director ~,J.,--., YesO N~ _ ._~ _.~ "/_'-'-.....,
Risk Management R /2'-'-1! () ( YesD NoifCt" L~CL'-r-<- lCo-(k~~ '8'. J 2 Lj I 0 I
~hasingglmJOI YesONo~ ~~"--- ;$A/OI
County Attorney 9'/3ofo{ YesDNog/ g;~~1
Comments:
OMB Form Revised 9/11/95 MCP #2
/--~
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and Helpline, Inc., hereinafter referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
crisis intervention and referral services, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for crisis
intervention and referral, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for crisis intervention and referral for persons living in Monroe County, Florida, shall pay
to the PROVIDER the sum of THIRTEEN-THOUSAND, FIVE-HUNDRED, SEVENTY-TWO AND 00/100
DOLLARS ($13,572.00) for fiscal year 2001-2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing crisis intervention and referral services to persons living in Monroe County,
Florida. PROVIDER shall provide services described in Attachment C, attached hereto and
incorporated herein.
s. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for-
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonabre reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL R.ESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state-'
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Lou Hernandez, Executive Director
Helpline, Inc.
POBox 2186
1923-1 Spalding Court
Key West, FL 33040
305-292-8445
305-292-8447 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept-'
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding--
breach, either of the same conditions or covenants or otherwise.
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATIEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
. Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of36 months from the date of being placed on the
convicted vendor list."
I
.'
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officeror employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signmg) in the space provided above on this
day of
,19_
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
I
','
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
gUidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Telephone hotline services for crisis intervention and referral.
Telephone link for Alcoholics Anonymous and Narcotics Anonymous.
Periodic reassurance calls to disabled, elderly and homebound individuals.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Hospice of the Florida Keys Effective Date: 10/01101
Expiration Date: 9/3 0/02
Contract Purpose/Description: provides funding for medical psychological. physical. and social
needs of terminally ill persons and their families in Monroe County
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 10/17/01
Agenda Deadline: 10103/01
CONTRACT COSTS
Total Dollar Value of Contract: $40,000.00 Current Year Portion: $40,000.00
Budgeted? Yes~ No D Account Codes: 001-03202-530340-_
Grant: $0.00 _-_ __
County Match: $ _-_-_-_
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
c,D_:t.e,_~ YeNsDeedNeff-: ---d~~ -
Division Director / .. _, ~_
Risk Management ~ l2 ill 0 r Y esD No~C1. \ l ~~r~ ~~"'"
O.M.B.IPurchasinggl.;eIOI YesONoif m./\ MO
County Attorney e/30!O( YesDNo~ _ _
Date Out
"_;).1-...,
~12-'-\I(}f
f5~)ol
g/J 10 f
Comments:
OMB Form Revised 9/11/95 MCP #2
/--~
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and Hospice of the Florida Keys, Inc., hereinafter referred to
as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
home health care, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for home
health care, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for home health care for persons living in Monroe County, Florida, shall pay to the
PROVIDER the sum of FORTY-THOUSAND AND 00/100 DOLLARS ($40,000.00) for fiscal year
2001-2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantia/.ly and satisfactorily perform and carry out the duties of the
Board in providing home health care to persons living in Monroe County, Florida. PROVIDER shall
provide services described in Attachment C, attached hereto and incorporated herein.
5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper,_
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RE.SPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state-
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Liz Kern, Executive Director
Hospice of the Florida Keys, Inc.
1319 William St.
Key West, FL 33040
305-294-8812
305-294-9348 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver ana"
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
.breach, either of the same conditions or covenants or otherwise. ~-
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
AlTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
. Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
BY
AN. NE A/:.HU/cON
__ ;/; J Y 01
- '."'r-
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
.'
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETIIICS CLAUSE
warrants that helit has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signmg) in the space provided above on this
day of
,1'9__
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
,
"
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Comprehensive direct services to patients and their families experiencing a life-
threatening illness (generally those with a prognosis of six months of less). Services
include, but are not limited to, pain and symptom management, medical consultation,
skilled nursing, personal care, counseling, spiritual advising, rehabilitation therapies,
nutrition consultation, medical social work and bereavement programs. Most services
are provided at the client's residence.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
.ct with: Literacy Volunteers of Effective Date: 10/01101
.ica - Monroe County, Inc.
Expiration Date: 9/30/02
ntract Purpose/Description: provides funding for literacy training of citizens of Monroe
Junty
Contract Manager: David P. Owens
(Name)
4482
(Ext.)
OMB/Grants
(Department)
for BOCC meetin on 1011 7/01
A enda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $9,232.00 Current Year Portion: $9,232.00
Budgeted? Yes~ No D Account Codes: 001-03205-530340-_
Grant: $0.00 _-_-_-_
County Match: $ _-_-_-_
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
Date In Nee~ed ...-- -?~~
Division Director 7- ..'-1 YesD No~ =-
\ ,......,/". , r;') ,-A-- \ \
Risk Management S( 2(\ 0\ YcsD Not:] (i I C~ Q.~ ~(,--,,-~,-'l~ e,^"" ~ L '2. '( oi
Wurchasing~/a1(OI YeSONO~ ~ o~I\)1
CountyAttomey ~/30{O( YeSONog/~P ty!Jij"Ol
Date Out
'_)...1 -...
Comments:
OMB Form Revised 9/11/95 MCP #2
/-~
an independent auditor, or their age~ts ~~~d- ~~p~e-~e'n.t~th,~s~"In-th'~' ;~e-;;t-~i ~~. ~~di't '"'e'"x;e'"'pt'i~~'
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNIY COMMISSIONERS OF MONROE COUNIY, FlORIDA, hereinafter
referred to as "Board" or "County," and Literacy Volunteers of America - Monroe County, Inc.,
hereinafter referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
literacy training, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for literacy
training, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for literacy training for persons living in Monroe County, Florida, shall pay to the
PROVIDER the sum of NINE-THOUSAND, TWO HUNDRED, THIRIY-TWO, AND 00/100 DOLLARS
($9,232.00) for fiscal year 2001-2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNIY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantia.lly and satisfactorily perform and carry out the duties of the
Board in providing literacy training to persons living in Monroe County, Florida. PROVIDER shall
provide services described in Attachment C, attached hereto and incorporated herein.
5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper__
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonabre reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state-
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Literacy Volunteers of America - Monroe County, Inc.
Mary Casanova, Executive Director
812 Southard St, #3
Key West, FL 33040
305-294-4352
305-296-1337 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver ana-
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise. ~-
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
. Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
BY
I)A TE
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public.entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officeror employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee,
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signiag) in the space provided above on this
day of
,1'9__
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Tutoring in basic reading, writing, and conversational English to adults.
English as a Second Language program, which teaches conversational English and
reading and writing to adults who have no English or limited English proficiency.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Monroe Association for Effective Date: 10/01/01
Retarded Citizens, Inc.
Expiration Date: 9/30/02
Contract Purpose/Description: provides funding for services for retarded citizens of Monroe
County
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 1011 7/01
Agenda Deadline: 10103/01
CONTRACT COSTS
Total Dollar Value of Contract: $30,000.00 Current Year Portion: $30,000.00
Budgeted? Yes~ No D Account Codes: 001-01505-530340-_
Grant: $0.00 _-_-_-_
County Match: $ _-_-_-_
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $--'yr For:
(Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
Date In Needed ~e~
Division Director ~~,~ YesDN~~ ____________~ ,_~~
Risk Management ~ /2-'"1 \ l) \ Y csD No~ C\ I W CL~~ \(A~~~ ~l2- '1 \0 f
O~hasing0~lol YesONo~ ~~ 8\;;A\Di
CountyAttomey 1?/30(Of YeSONOU}/~ cfjJl/o/
Date Out
Comments:
OMB Form Revised 9/11/95 MCP #2
/-~
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNlY COMMISSIONERS OF MONROE COUNlY, FLORIDA, hereinafter
referred to as "Board" or "County," and Monroe Association for Retarded Citizens, Inc., hereinafter
referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
adult day training, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for adult day
training, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for adult day training for retarded citizens living in Monroe County, Florida, shall pay to
the PROVIDER the sum of THIRlY-THOUSAND AND 00/100 ($30,000.00) for fiscal year 2001-
2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNlY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this ~greement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substanti.ally and satisfactorily perform and carry out the duties of the
Board in providing adult day training to retarded citizens living in Monroe County, Florida.
PROVIDER shall provide services described in Attachment C, attached hereto and incorporated
herein. --
5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper""-
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for'the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding' by the Board is contingent upon retention of appropriate local, state-
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
.--
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
,I
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Monroe Association for Retarded Citizens, Inc.
Diana Flenard-Moore, Executive Director
812 Southard St., #3
Key West, FL 33040
305-294-9526
305-292-0078 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida- and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and-
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding-
preach, either of the same conditions or covenants or otherwise. .~
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
. Deputy Clerk
By
Mayor/Chairman
Witness
PROVIDER
(Federal ID No.
)
Witness
By
President
PUBLIC ENTITY CRIME STATEMEflT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not subnritrlid on a
contract to provide any goods or services to a public entity, Il28)t\not submit
a bid on a Contract with a public entity for the construction..()i~epair of a
public building or public work, may not submit bids on leases ef real
property to public entity, may not be awarded or perform ~'as a
contractor, supplier, subcontractor, or consultant under a OOIItnlet with any
public.enti~ and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for ~.A::fEGORY
TWO for a;"period of 36 months from the date of being placed:on the
convicted vendor list."
"
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on hislits behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officeror employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
"
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed hislher
signature (name of individual signing) in the space provided above on this
day of
,19_
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
I
..
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
gUidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Adult Day Training Program, which includes: mobile work crews, arts and crafts, work at
retail plant store, and functional academic training.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Monroe County Education Effective Date: 10/01101
Foundation
Expiration Date: 9/30/02
Contract Purpose/Description: provides funding for Monroe Youth Challenge program - training
of youth in violence prevention, cultural diversity, and personal development skills
Contract Manager: David P. Owens
(Name)
4482
(Ext.)
OMB/Grants
(Department)
for BOCC meeting on 1 0/17/01
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $13,572.00 Current Year Portion: $13.572.00
Budgeted? Yes~ No D Account Codes: 001-~-530340-_-
Grant: $0.00 D3co(P -_-_-_
County Match: $ _-_-_-_
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
Date In Needed ~ "'):~ )
Division Director ~_~_~ YesD N~~~ !e.....:.
Risk Management 15!zc1)O\YeSDNogQ. W(/..~~~
o~hasine~/OI YeSONO~~~
.County Attorney B Is!)! () ( YesD NoW
Date Out
9' -~.....,
??t2C\\ol
O~}O\
~/JI/O { .""-
Comments:
OMB Form Revised 9/11/95 MCP #2
/-~
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred
to as "Board" or "County," and the Monroe County Education Foundation, Inc., hereinafter referred to as
"PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of training
of youth in violence prevention, cultural diversity, and personal development skills, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for training of youth
in violence prevention, cultural diversity, and personal development skills, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as
follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for training of youth in violence prevention, cultural diversity, and personal development skills
for persons living in Monroe County, Florida, shall pay to the PROVIDER the sum of THIRTEEN-
THOUSAND, FIVE-HUNDRED, SEVENTY-TWO AND 00/100 DOLLARS ($13,572.00) for fiscal year 2001-
2002, subject to the conditions below.
MATCHING FUNDS. The amount of agreement is contingent upon an equivalent amount of
funding being provided from the School Board to the PROVIDER. There shall be only as much money
provided under this agreement, up to the amount specified in paragraph 1, as is also funded by the
School District for the Monroe Youth Challenge Program. The PROVIDER shall provide the County with
documentation as to the amount committed by the School Board within ten days of execution of same
by the PROVIDER and School Board. If the funding to be provided by School Board is less than the
amount specified in paragraph 1, then PROVIDER will execute an amendment to this agreement
reflecting the decrease in funding under this agreement or the County may declare a breach and
terminate this agreement.
2. TERM This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT No money will be paid under this agreement until Foundation has provided
County with documents showing the contractual commitment of School Board to provide matching
funds. Payment will be paid periodically, but no more frequently than monthly as hereinafter set forth.
Reimbursement requests will be submitted to the Board via the Clerk's Finance Office. The COUNTY
shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are
reviewed and approved as complying with Florida Statutes 112.061 and Attachment A - Expense
Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter,
summarizing the expenses, with su.pporting documentation attached. The letter should contain a
. certification statement An example of a reimbursement request cover letter is included as Attachment
B. The organization's final invoke must be received within sixty days after the termination date of thiS
contract shown in Article 2 above.
After the Clerk of the Board examines and approves the request for reimbursement, the Board
shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the
aggregate sum shall not exceed the total amount shown in Article 1, above, during the term of this
agreement.
4. SCOPE OF SERVICES The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board
in providing training of youth in violence prevention, cultural diversity, and personal development skills
to persons living in Monroe County, Florida. PROVIDER shall provide services described in Attachment
C, attached hereto and incorporated herein.
,12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing and
with the prior written approval of the Board, which approval shall be subject to such conditions and
provisions as the Board may deem necessary. This agreement shall be incorporated by reference into
any assignment and any assignee shall comply with all of the provisions herein. Unless expressly
provided for therein, such approval shall in no manner or event be deemed to impose any obligation
upon the Board in addition to the total agreed upon reimbursement amount for the services of the
PROVIDER.
13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person on
the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any
other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or
any other area affecting employment under this agreement. At all times, the PROVIDER shall comply
with all applicable laws and regulations with regard to employing the most qualified person(s) for
positions under this agreement. The PROVIDER shall not discriminate against any person on the basis
of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status
or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER's name in this agreement is the full name as designated in its corporate charter, if a
corporation, or the full name under which the PROVIDER is authorized to do business in the State of
Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a
corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing and
hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other
party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Tom Sawyer, President
Monroe County Education Foundation
POBox 1788
Key West, FL 33040
305-296-3430
305-797-0190
305-294-4528 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall be in
Mo.nroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and
performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not
operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the
same conditions or covenants or otherwise.
18. AVAILABILITY OF FUNDS If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein, this
agreement may be terminated immediately at the option of the Board by written notice of termination
delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided
by the PROVIDER after the PROVIDER has received written noti<;:e of termination, unless otherwise
required by law. .
. 5. RECORDS The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full
accountability of funds received from said Board. Access to these records shall be provided during
weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized agents and
representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which are
identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an
independent auditor, or their agents and representatives. In the event of an audit exception, the
current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the
amount of the audit exception. In the event this agreement is not renewed or continued in subsequent
years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of
the audit exception and the PROVIDER shall promptly repay any audit exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims
for bodily injury (including death), personal injury, and property damage (including property owned by
Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise
out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the
negligence, errors, or other wrongful act or omission of the PROVIDER's employees, agents, or
volunteers.
7. INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement contained in
this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors,
servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the
provision of such services, including those now in effect and hereinafter adopted. Any violation of said
statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and
shall entitle the Board to terminate this contract immediately upon delivery of written notice of
termination to the PROVIDER.
9.
COUNTY:
COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report ;
(e) a copy the organization's Corporate Bylaws, which must address the organization's mission,
board and membership composition,- election of officers, and so on;
(f) a copy of the organization's CQ'rporate Policies and Procedures Manual which must include hiring
policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity
provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance measurements
. which will demonstrate the level of accomplishment of goals for which funding has been provided';"-
(i) other reasonable reports and information related to compliance with applicable laws, contract
provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate profeSSional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the PROVIDER's program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be approved in
writing by the COUNTY.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
. Deputy Clerk
By
Mayor/Chairman
Witness
PROVIDER
(Federal ID No.
)
Witness
By
President
ANN~ ~~fto/::~N
- ,-- !j.:LLf-!L1-
.k-
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list. "
I
..
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTy, FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on hi slits behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided above on this
day of
,19_
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
I
...
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERH EAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Programs for youth in Monroe County designed to reduce violence and negative risk behaviors in
all domains of an adolescent's life, and to help them achieve academic competency, social
purpose, self-directedness, and a sense of belonging
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: PACE Center for Girls Effective Date: 10/01/01
Expiration Date: 9/30/02
Contract Purpose/Description: provides funding for educational services for at-risk adolescent
girls and young women of Monroe County
Contract Manager: David P. Owens
(Name)
4482
(Ext.)
OMB/Grants
(Department)
for BOCC meeting on 10117/01
Agenda Deadline: 10103/01
CONTRACT COSTS
Total Dollar Value of Contract: $23,000.00 Current Year Portion: $23,000.00
Budgeted? Yes~ No D Account Codes: 001-03004-530340-_
Grant: $0.00 _-_-_-_
County Match: $ _-_-_-_
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
Date In Needed _~~
Division Director 9......~.-."\ YesD N6EJ ~ _ ,._~_.,
Risk Management 71 "-'1\Of YesO NO~C:' 1.,1~~ \P:fJ-<'~e"- "-\,''< 1(\'
o.~urchasinr<0(2f{ID I YesO NO~ 4~ A-fuJ1.D 8 \d1 \0\
~ountyAttorney ~/30Iol YesDNo op;/or
Date Out
Comments:
OMB Form Revised 9/11/95 MCP #2
/~
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and PACE Center for Girls of Monroe, Inc., hereinafter referred
to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
education counseling, training, and advocacy, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for education
counseling, training, and advocacy, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for education counseling, training, and advocacy for girls and young women living in
Monroe County, Florida, shall pay to the PROVIDER the sum of TWENTY-THREE-THOUSAND AND
00/100 DOLLARS ($23,000.00) for fiscal year 2001-2002.
2. TERM This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES The PROVIDER, for the consideration named, covenants and
agrees with the Board to substanti.ally and satisfactorily perform and carry out the duties of the
Board in providing education cOl:lnseling, training, and advocacy to girls and young women living
in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attache~_
hereto and incorporated herein.
5. RECORDS The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER's employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report ;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state-'
and/or federal certification and/or licensure of the PROVIDER's program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person on
the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or
any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER's name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Julie Smith, Executive Director
PACE Center for Girls of Monroe County, Inc.
3130 Flagler Ave
Key West, FL 33040
305-293-1892
305-293-1895 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida' and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROViDER shall not be deemed or considered as a continuing waiver and-
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
preach, either of the same conditions or covenants or otherwise. '"-
18. AVAILABILITY OF FUNDS If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATIEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
. Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
,-
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public .entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
I
...
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officeror employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in .its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided above on this
day of
,19_,
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
I
Y
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Education counseling, training, and advocacy for at-risk girls and young women in Monroe
Cou nty.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Samuel's House, Inc. Effective Date: 10/01/01
Expiration Date: 9/30102
Contract Purpose/Description: provide funds for housing for women and children
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants Mgt.
(Department)
for BOCC meeting on 10/17/01
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $16,965.00 Current Year Portion: $16,965.00
Budgeted? Yes X No Account Codes: 001~-530340
Grant: $ 0 03 '2.1 <.(
County Match: $0
Estimated Ongoing Costs: $
(Not included in dollar value above)
ADDITIONAL COSTS
For: Staff support-filing reports, oversight
(eg. Maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes ,~
Date In Needed ~~tt
DivisionDirector /_~....., YesD~ ~~~~ '-)..(--r
Risk Management 8/2'110 I Y eso NO~ O. ~. h'1;"'- \<",~ ,"'~ ?; 'I 2.0,\d I
Otrl3'urchasing e/7A!O( YeSoNO~~ ~OL z~lol
C~Attomey 8/30/0r YeSoNOr/'b ~ q,/'3fol
Date Out
Comments:
OMB Form Revised 9/11/95 MCP #2
/-c4
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and Samuel's House, Inc., hereinafter referred to as
"PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
women and children's housing and support, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for women and
children's housing and support, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for women and children's housing and support in Monroe County, Florida, shall pay to the
PROVIDER the sum of SIXTEEN-THOUSAND, NINE-HUNDRED, SIXTY-FIVE AND 00/100 DOLLARS
($16,965.00) for fiscal year 2001-2002.
2. TERM This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing women and children's housing and support to persons living in Monroe County,__
Florida. PROVIDER shall provide services described in Attachment C, attached hereto and
incorporated herein.
5. RECORDS The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER's employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report ;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided. .
(i) other reasonable reports and 1nformation related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liabilitY--
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the PROVIDER's program and staff.---
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person on
the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or
any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER's name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows: .
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
For PROVIDER
Elmira Leto, Executive Director
Samuel's House
1511 Truman Ave
Key West, FL 33040
305-296-0240
305-296-3921 FAX
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and-
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise. '"-
18. AVAILABILITY OF FUNDS If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
. Deputy Clerk
By
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of36 months from the date of being placed on the
convicted vendor list. "
I
.f'
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in.its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided above on this
day of
, 19_
.-
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
I
"
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agrEement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
gUidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LElTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Food and utilities for women and children's shelter and support facility.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: U. S. Fellowship of Florida, Effective Date: 10/01101
d/b/a Heron/Peacock programs
Expiration Date: 9/30/02
Contract Purpose/Description: provides funding for assisted living facilities with limited mental
health support
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 10/17/01
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $38.155.00
Budgeted? Yes[gJ No 0 Account Codes:
Grant: $0.00
County Match: $
Current Year Portion: $38,155.00
001-01504-530340-_
001-01506-530340-_
- - -
----
- - - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes Date Out
Date In Needed ~ ;;2.eviewer
Division Director 9-~1-t YesDN6 /_.d~-::~ . 9-~1~
Risk Management :'i' / Z"/Io I YesO NOB'C! ~ . 1_ '<:CT' ~ ~,",-~~d" '6{" 1/ (l(
O.M.B./Purchasing <s\;f,\ 0\ YesO Nog/ ~~ z;\dA10l
County Attorney S/3ofor YesONoGY ~ 8/J~1
Comments:
OMB Form Revised 9/11/95 MCP #2
/-~
AGREEMENT
This Agreement is made and entered into this day of
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA,
referred to as "Board" or "County," and United States Fellowship of Florida, Inc.,
referred to as "PROVIDER./t
, 2001,
hereinafter
hereinafter
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
assisted living facilities with limited mental health support, and
WHEREAS, it is a legitimate public purpose to provide assisted living facilities with limited
mental health support, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing assisted
living facilities with limited mental health support for persons living in Monroe County, Florida,
shall pay to the PROVIDER the sum of THIRTY-EIGHT-THOUSAND, ONE-HUNDRED, FIFTY-FIVE
AND 00/100 DOLLARS ($38,155.00) for fiscal year 2001-2002.
2. TERM. This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement. An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and
agrees with the Board to substanti.'3l1y and satisfactorily perform and carry out the duties of the
Board in providing assisted living facilities with limited mental health support to persons living in
Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached
hereto and incorporated herein.
5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state-
and/or federal certification and/or licensure of the PROVIDER'S program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER'S name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040,
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Cathy Harpe, Executive Director
United States Fellowship of Florida, Inc.
1320 Coco Plum Drive
Marathon, FL 33050
305-743-4129
305-743-5137 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and-
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise. ~
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a
level sufficient to allow for continued reimbursement of expenditures for services specified herein,
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
AlTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNlY COMMISSIONERS
OF MONROE COUNlY, FLORIDA
By
By
. Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list. "
.I'
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in.its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided above on this
day of
,19~.
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
gUidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
--
ATTACHMENT B
ORGANIZATION
LElTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of
by who is personally known to me.
2001
'"'-
Notary Public
Notary Stamp
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Wesley House, Inc. Effective Date: 10/01101
Expiration Date: 9/30/02
Contract Purpose/Description: provides funding for day care, education, and skill development
services for children of Monroe County
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 10/17/01
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $35,000.00 Current Year Portion: $35,000.00
Budgeted? Yes[gJ No 0 Account Codes: 001-03003-530340-_
Grant: $0.00 _-_-_-_
County Match: $ _-_-_-_
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes
Date In Needed ..------'- --;;> -Jtev~
Division Director '-)./-rt( YesD Nao- ~ ----::::z.~
Risk Management 8(2(." jo! YesDNo~ L\, L2'(L~~ ~G~~d'4"
~urchasing~q~\ YesONo~ ~~
CountyAttomey ii/3o(ol YesDNo~ E/~
Date Out
Y-~'-r
'i) j2cd V!
3\;q \ ot
fp~1
Comments:
OMB Form Revised 9/11/95 MCP #2
/-C'~2?
AGREEMENT
This Agreement is made and entered into this day of
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA,
referred to as "Board" or "County," and Wesley House Community Center, Inc.,
referred to as "PROVIDER."
, 2001,
hereinafter
hereinafter
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
child care services, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for child care,
now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for child care for persons living in Monroe County, Florida, shall pay to the PROVIDER the
sum of THIRTY-FIVE-THOUSAND AND 00/100 ($35,000.00} for fiscal year 2001-2002.
2. TERM This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantial~y and satisfactorily perform and carry out the duties of the
Board in providing child care services to persons living in Monroe County, Florida. PROVIDER shall
provide services described in Attachment C, attached hereto and incorporated herein.
S. RECORDS The PROVIDER shall maintain appropriate records to insure a proper-
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow foro<-
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER's employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report ;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the PROVIDER's program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be......
approved in writing by the COUNTY.
12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person on
the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or
any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER's name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Joseph Barker, Executive Director
Wesley House Community Center, Inc.
1304 Truman Avenue
Key West, FL 33040
305-292-7150
305-292-7156 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and
shall not operate to bar or prEvent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise.
18. AVAILABILITY OF FUNDS If funds cannot be obtained or cannot be continued at a
I.evel sufficient to allow for continued reimbursement of expenditures for services specified herein,"'-
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
BY
U ANNE::b HUTTON
"H" c! '1IPI
--.. r '
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public. entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of36 months from the date of being placed on the
convicted vendor list."
I
.t'
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in .its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed hislher
signature (name of individual signing) in the space provided above on this
day of
,19_
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
I
,"
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is reqUired.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fund raising, non-sufficient check charges,
penalties and fines.
--
ATTACHMENT B
ORGANIZATION
LElTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of
by who is personally known to me.
2001
--
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Early childhood information and financial assistance.
In-home services to enhance the family quality of life.
Early childhood quality improvement initiatives and training.
Advocacy on issues to improve the lives of children, including health, nutrition, and education.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Womankind, Inc. Effective Date: 10101101
Expiration Date: 9130102
Contract Purpose/Description: provides funding for women's health care services
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
. OMB/Grants
(Department)
for BOCC me.eting on 10/17/01
Agenda Deadline: 10103/01
CONTRACT COSTS
Total Dollar Value of Contract: $8,652.00
Budgeted? Yes[gJ No 0 Account Codes:
Grant: $0.00
County Match: $
Current Year Portion: $8,652.00
001-03 -z..IS -530340-_
- - -
----
- - -
----
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
Date In Needed ~ . e
Division Director 9-,JA-.", Y esD N~ ~
Risk Management <6 \ ~ ~', \ 01 YesD NoDicl t I, (J(LG~ V'-<-~ :b""
O.M.B./Purchasing ~\D\ YesO NoKY ~~ _ thD-D
CountyAttomey 2j3()/OI YeSDNoLj)/':B~
Date Out
?_Jl'-"
0-1 '2 ~ll (') J
t \
$'0\
SpIll
Comments:
OMB Form Revised 9/11/95 MCP #2
/-e-4
AGREEMENT
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUNlY COMMISSIONERS OF MONROE COUNlY, FLORIDA, hereinafter
referred to as "Board" or "County," and Womankind, Inc., hereinafter referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of
women's health care, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for women's
health care, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER
substantially and satisfactorily performing and carrying out the duties of the Board as to providing
facilities and services for women's health care for persons living in Monroe County, Florida, shall
pay to the PROVIDER the sum of EIGHT-THOUSAND, SIX-HUNDRED, FIFTY-TWO AND 00/100
DOLLARS ($8,652.00) for fiscal year 2001-2002.
2. TERM This Agreement shall commence on October 1, 2001, and terminate September
30, 2002, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The COUNlY shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the
PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement An example of a
reimbursement request cover letter is included as Attachment B. The organization's final invoice
must be received within sixty days after the termination date of this contract shown in Article 2
above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the PROVIDER. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount shown in Article 1, above,
during the term of this agreement.
4. SCOPE OF SERVICES The PROVIDER, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing women's health care to persons living in Monroe County, Florida. PROVIDER
shall provide services described' in Attachment C, attached hereto and incorporated herein.
5. RECORDS The PROVIDER shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow fo"'-.
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The PROVIDER shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County,
an independent auditor, or their agents and representatives. In the event of an audit exception,
the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset
by the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board
for the amount of the audit exception and the PROVIDER shall promptly repay any audit
exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees
to indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER's employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the
PROVIDER is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the PROVIDER or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the
PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provision- of such services, including those now in effect and hereinafter adopted. Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of
this agreement and shall entitle the Board to terminate this contract immediately upon delivery of
written notice of termination to the PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNlY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report ;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure
that all professionals have current and' appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the PROVIDER's program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be accomplished by an amendment, which must be"'-
approved in writing by the COUNlY.
12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the PROVIDER.
13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
PROVIDER shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and
warrants that:
(a) The PROVIDER's name in this agreement is the full name as designated in its corporate
charter, if a corporation, or the full name under which the PROVIDER is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the PROVIDER; and
(c) This agreement has been approved by the Board of Directors of the PROVIDER if the
PROVIDER is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
David P. Ow~ns, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
Renee Grier, President
Womankind, Inc.
3142 Northside Dr., Suite 101
Key West, FL 33040
305-294-4004
305-294-6043 FAX
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept
and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and
shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding
breach, either of the same conditions or covenants or otherwise.
18. AVAILABILITY OF FUNDS If funds cannot be obtained or cannot be continued at a
I~vel sufficient to allow for continued reimbursement of expenditures for services specified herein,-
this agreement may be terminated immediately at the option of the Board by written notice of
termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services
or goods provided by the PROVIDER after the PROVIDER has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with
funds provided under this agreement, shall become the property of Monroe County and shall be
accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the PROVIDER and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as
of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
Deputy Clerk
Mayor/Chairman
PROVIDER
(Federal ID No.
)
Witness
By
Witness
President
-
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public .entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list. "
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that hefit has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed hislher
signature (name of individual signing) in the space provided above on this
day of
,19_.
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
I
.',
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter-company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agre.ement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non-allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non-sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LElTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee Reason Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending OS/28/01 XXX.XX
(A) Total $ X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX.XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with the
Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this _ day of 2001
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Secondary care procedures for women who qualify based on income.
Agency FY 02 FY 01 FYOO FY99
Mental Health Providers
./ Care Center/Lower Keys 184,141.00 184,141.00 184,141.00 213,616.00
" Guidance Clinic/Middle Keys 679,211.00 735,395.00 580,382.00 580,382.00
/ Guidance Clinic/Upper Keys 87,444.00 87,444.00 87,444.00 87,444.00
Total Mental Health Providers 950,796.00 1,006,980.00 851,967.00 881,442.00
Youth Recreation
./ Boys and Girls Club 53,600.00 53,600.00 53,600.00 53,600.00
,/ Big Pine Athletic Association 40,000.00 48,000.00 48,000.00 18,000.00
./ Heart of the Keys Youth 18,000.00 18,000.00 18,000.00 18,000.00
Youth Recreation Total 111,600.00 119,600.00 119,600.00 89,600.00
Cultural Programs
.;' Monroe Council of the Arts 45,000.00 45,000.00 45,000.00 45,000.00
" Historic Florida Kevs Foundation 30,000.00 30,000.00 30,000.00 30,000.00
Cultural Programs Total 75,000.00 75,000.00 75,000.00 75,000.00
1---L~ 7