Item C27
Revised 2/95
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: October 17. 2001
Bulk Item: Yes [gI No D
Division: Manaaement Services
Department: Grants Administration
AGENDA ITEM WORDING: Authorization for the Mayor to execute the fiscal year 200 2
contracts with the oraanizations funded directly by the BOCC to provide fundina for
various mental health. cultural. and vouth recreation services.
ITEM BACKGROUND: Contracts for the Monroe Council of the Arts. Historic Florida
Keys Foundation. Bia Pine Athletic Association. Boys and Girls. Club. Heart of the Keys
Youth Club. Care Center for Mental Health. Guidance Clinic of the Middle Keys. and the
Guidance Clinic of the Upper Keys.
PREVIOUS RELEVANT BOCC ACTION: Approval of the fundina amounts as part of the
FY2002 budaet process and fundina in previous budaet years. Chanae of amount for
Bia Pine Athletic Association at BOCC meetina Auaust 15. 2001.
CONTRACT/AGREEMENT CHANGES: Addition of clause specitvina that final invoice
must be received by County within sixty days after contract termination date. Other than
that. only chanaes as compared to last year's contracts would be to amounts. dates.
names and addresses Guidance Clinic of the Middle Keys includes subcontracting
of Baker and Marchman transportation, which were on a separate amendment last year.
STAFF RECOMMENDATION: approval
TOTAL COST: $1.137.396.00
COST TO COUNTY: $1.137.396.00
REVENUE PRODUCING: Yes D No [gI
BUDGETED: Yes [gI No D
AMOUNT PER MONTH
YEAR
APPROVED BY:COUNTY ATTY [gI OMB/PURCHASING [gI RISK MANAGEMENT [gI
DIVISION DIRECTORAPPROVAJ & ~~ 0 "-
. James L. Roberts, County Administrator
DOCUMENTATION: INCLUDED: [gI TO FOLLOW: D NOT REQUIRED: D
DISPOSITION:
AGENDA ITEM #:
/-c.027
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Big Pine Athletic Assoc. Effective Date: 10101/01
Expiration Date: 9/3 0102
Contract Purpose/Description: provides funding for youth programs 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: )0103/01
CONTRACT COSTS
Total Dollar Value of Contract: $40,000.00 Current Year Portion: $40,000.00
Budgeted? Yes[gJ No 0 Account Codes: 001-03704-530340-_
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 f\
Date In Needed ~- ~-Rev~~
Division Director 1"'>''''.l YesDN~ ~----~ ( ~
Risk Management c1 I G [0 (YesD Nog ell (J(~r-'-'-- '\Lc--l~~0"'\
O.M.B.lPurchasing q \5\0\ YesDNo~ 1'~~~ +l.Q.D
County Attorney q/f/I~( YeSDNo~~
Comments:
Date Out
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OMB Form Revised 9/11/95 MCP #2
e
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 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 the
provision of activities for the wholesome development of youths' personal, social, physical,
emotional and spiritual growth in a wholesome, alcohol-free and drug-free environment for young
people 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 recreational use for young persons living in Monroe County, Florida, shall pay to the
PROVIDER the sum of FORTY-THOUSAND AND 001100 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 substantially and satisfactorily perform and carry out the duties of the
Board in providing activities for the development of youths' personal, social, physical, emotional
and spiritual growth in a wholesome environment free from drugs and alcohol to young persons
living in Monroe County, Florida.
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
-~Iaims 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
Teresa Walker, 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
Deputy Clerk
By
Mayor/Chairman
Witness to Provider Signature
PROVIDER
(Federal ID No.
)
By
President
Witness to Provider Signature
DATE
"
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
_cpnsidered 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. Ba,jance due must be zero. Room
must be registered and paid for by traveler. The County will 0nly reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are n9t 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
-oate
'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
The Big Pine Key Athletic Association is a 501(c)(3) non-profit organization that provides
organized sports as well as other activities for youth. The BPAA has served the Lower
Keys community for twenty years by organizing, promoting, and providing the facilities,
insurance, and equipment for sport teams. Through the efforts of the BPAA, the
continuity of sports seasons has been maintained for the youth, kindergarten through
high school, in this area.
Since 1993, the BPAA has also operated the Blue Heron Park Youth Center on Big Pine
Key. The purpose of the youth center is to provide wholesome recreational activities for
youth, eight to eighteen years old, during their free hours from school. The four-acre
center includes a lighted basketball court, picnic pavilions, a volleyball court, a
clubhouse, and an under-the-house game area. The Blue Heron Park is open Monday
through Friday, 3:00 PM to 6:00 PM, and other times by appointment. The park is
staffed by an employee of the BPAA. This payroll is funded in part by a grant from the
Tourist Development Council of Monroe County.
Currently, the BPAA has approximately 300 members. The soccer season is from
September through January and has over 200 participants. The Little League teams who
play from February through June have 300 participants. The swim team competes from
April to September, and has about 70 participants. A basketball league is in the process
of being established.
The Blue Heron Park is available for community use, e.g. parties and meetings, by
appointment. Groups that used the park in 1999 include the Big Cooperative Preschool
playgroup, the Big Pine Science Club, the Boy Scouts, and an amateur radio club. The
park was also used by the various sports activities mentioned above for registration and
training of players and coaches.
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. "
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.1 0-1990. 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 signmg) in the space provided above on this
day of
,19_,
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Bovs and Girls Club Effective Date: 10/01/01
Expiration Date: 10/03/01
Contract Purpose/Description: Provides fundinQ for facilities and services for recreational use and social
functions of the communitv in a wholesome environment free from druQs and alcohol.
Contract Manager: David P. Owens
~ (Name)
-for BOCC meeting on 10/17/01
4482
(Ext.)
OMS/Grants
(Department)
Agenda Deadline: 10/03/01
Total Dollar Value of Contract: $53.600.00
Budgeted? Yes X No 0 Account Codes:
Grant: $
County Match: $
CONTRACT COSTS
Current Year Portion: $53.600.00
001-03707-530340-_- 3o.J 0 D D 6 u
001-03708-530340-_-.2?" (.;60. ~,;;.
- - -
----
Estimated Ongoing Costs: $_/yr
(Not included in dollar value above)
ADDITIONAL COSTS
For:
(eg. maintenance, utilities, janitorial, salaries, etc.)
- - -
----
CONTRACT REVIEW
Changes ~ Date Out
Date In Neede~---~i er. .,-,.c.~
Division Director ;_,..l.... rt YesD Not] .--.-/~~" .
Risk Management eq /c\O( YesD NO~ ({. L~(~\~A.~~~l1'" c\ \ LO\O\
O.M.B.lPurchasing "r[toIo1 YesDNoff ~~DD [11---1101
County Attorney 9/II/b! YeSDNo~ '-.~ e;)~1
Comments:
OMS Form Revised 9/11/95 MCP #2
o
AGREEMENT
Boys and Girls Club
This Agreement is made and entered into this day of , 2001,
between the BOARD OF COUN1Y COMMISSIONERS OF MONROE COUN1Y, FLORIDA, hereinafter
referred to as "Board" or "County," and BOYS AND GIRLS CLUB OF THE KEYS AREA, 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 from third grade to age twenty, and
WHEREAS, the Provider is open to the public at least five days a week, three hours a day,
and more usually, nine and one-half hours a day, 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 FIFTY-THREE THOUSAND SIX HUNDRED DOLLARS ($53,600.00)
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 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 $53,600.00 during the term of this
agreement, payable as follows: $30,000.00 for the Lower Keys area and $23,600.00 for the
Upper Keys area.
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 the Lower Keys area and the Upper Keys area of 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 amended by an agreement amendment, which must be
approved in writing by the Board.
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:
Monroe County Attorney
PO Box 1026
Key West, FL 33041
and
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
For Provider:
Executive Director
BOYS AND GIRLS CLUB OF THE KEYS AREA, INC.
1400-B United St.
Key West, FL 33040
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 a.nd 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 to Provider Signature
PROVIDER
(Federal ID No.
)
Witness to Provider Signature
By
Executive Director
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 mu'st 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
-1'Ileeting 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
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
Youth Programs in the Lower Keys and Upper Keys areas, including prevention activities,
education enhancement (after school homework assistance and tutoring), and high-yield
learning activities (board games and peer mentoring).
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."
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 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 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
,.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Care Center for Mental Health Effective Date:1 0/01/01
Expiration Date:9/30/02
Contract Purpose/Description: Annual appropriation that provides fundinq for mental health and quidance
services for Monroe County citizens.
~ontract Manager: David p, Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
--
for BOCC meetina on 10/17/01
Aqenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $184.141.00 Current Year Portion: $184.141.00
Budgeted? Yes[8J No 0 Account Codes: 001-01503-530340-_
Grant: $0,00 _-_-_-_
County Match: $ _-_-_-_
Estimated Ongoing Costs: $_/yr
(Not included in dollar value above)
ADDITIONAL COSTS
For:
(ea. maintenance, utilities, ianitorial, salaries, etc.)
- - -
----
CONTRACT REVIEW
Changes 0 Date Out
Division Director 1~-::-t Yes~~~..". ~~ " f _ ....,_.(
Risk Management q 1 \ t) \ ~ \ YesD No[!?" 0" I l_(~C~~ r,<-~~~,,,,,,,, C I \ t C\ oj
O.M.BJPUrChasinl1\L,.\ 0 \ YesO No~ ~ _,J.v~:-.c'f JY q hI 0 I
County Attorney <t)j&1 YesONoG:Y' -~_ 1/rrft
Comments:
OMB Form Revised 9/11/95 MCP #2
t-
AGREEMENT
This Agreement is made and entered into this day of I 2001,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and CARE CENTER FOR MENTAL HEALTH OF THE LOWER
KEYS, INC., hereinafter referred to as "Provider."
WHEREAS, the Board and the Provider desire to enter into an agreement wherein the
Board contracts for services from the Provider for the rendering of mental health services to the
citizens of the Lower Keys, Monroe County, Florida, and
WHEREAS, the Board is vested and charged with certain duties and responsibilities relating
to the mental health and guidance of the citizens of Monroe County, and
WHEREAS, such services have been rendered by the Provider in the past and have been
invaluable to the citizens of the Lower Keys, and
WHEREAS, it is proper and fitting to enter into an agreement for services to be rendered in
the forthcoming fiscal year 2001-2002, 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 and obligations of the
Board as to rendering counsel to the citizens of the Lower Keys, Monroe County, Florida, in
matters of mental health and guidance, drug rehabilitation and providing transportation to
treatment facilities as required by 394.461, F.S. for Monroe County patients, agrees to pay to the
Provider the sum of ONE-HUNDRED-EIGHTY-FOUR-THOUSAND, ONE-HUNDRED-FORTY-ONE AND
NO/100 DOLLARS ($184,141.00) for rendering counseling services.
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 monthly as hereinafter set forth. Certified
monthly financial and service load reports will be made available to the Board to validate the
delivery of services under this contract. The monthly financial report is due in the office of the
Clerk of the Board no later than the 15th day of the following month. After the Clerk of the Board
pre-audits the certified report, the Board shall reimburse the Provider for its monthly expenses.
However, the total of said monthly payments in the aggregate sum shall not exceed the total
amount shown in Article 1, above, for counseling. To preserve client confidentiality required by
law, copies of individual client bills and records shall not be available to the Board for
reimbursement purposes but shall be made available only under controlled conditions to qualified
auditors for audit purposes. The organization's final invoice must be received within sixty days
after the termination date of this contract shown in Article 2 above.
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 rendering counsel in the matter of mental health and guidance to the citizens of the
Lower Keys, Monroe County, Florida, and transporting patients in Monroe County to treatment
facilities in accordance with Florida Statute 394.459. The Provider shall provide these services in
compliance with Florida Statutes Chapter 394. Said services shall include, but are not limited to,
those services described in Provider's Details of Specific Program for Which Funding is Requested,
attached hereto as Exhibit C and incorporated herein.
S. RECORDS. The p'rovider 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 om"ission of the Provider's
employees, agents or volunteers. The extent of liability is in no way limited to, reduced, or
lessened by the insurance requirements contained elsewhere within this agreement.
7. INDEPENDENT CONTRACTOR. At all 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 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. INSURANCE. As a pre-requisite of the services supplied under this contract, the
Provider shall obtain, at its own expense, insurance to cover all of its activities.
12. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be amended by an agreement amendment, which must be
approved in writing by the Board.
13. 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.
14. 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.
15. 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.
16. 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:
Marshall Wolfe, Executive Director
Care Center for Mental Health of Lower Keys, Inc.
1205 Fourth Street
Key West, FL 33040
17. 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.
18. 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.
19. 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.
20. 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.
21. 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
(Federal ID No.
)
CARE CENTER FOR MENTAL HEALTH
OF THE LOWER KEYS, INC.
By
Director
By
President
DATE
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 mu'st 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
-..",eeting 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 readin~ 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
County funds will be used as match, pursuant to Florida Statute 394, for alcohol, drug
abuse, and mental health outpatient services, including assessment, crisis intervention,
medical services, case management, and outpatient counseling in the Lower Keys Area.
Services are offered at 1205 4th Street in Key West, and counselors are at Key West High
School, Horace O'Bryant Middle School, Sugarloaf Middle School, Gerald Adams
Elementary School, the Monroe County Detention Center, and the Douglass Community
Center.
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."
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 ITlay 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
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Guidance Clinic of the Middle Effective Date: 1 0/01/01
Kevs
Expiration Date:9/30/02
Contract Purpose/Description: orovides fundino to oerform mental health services such as counselino in
Monroe County.
--
-Contract Manager: David P. Owens
(Name)
4482
(Ext.)
OM B/G rants
(Department)
for BOCC meetinQ on 10/17/01
AQenda Deadline: 10/03/01
CONTRACT COSTS .
Total Dollar Value of Contract: $679.221.00 Current Year Portion: $679.221.00
Budgeted? Yes[8] No 0 Account Codes: 001-01501-530340-_-499.558.00
Grant: $0.00 102-01507-530340-_-76.996.00
County Match: $ 102-04542-530340-_-16.380.00
101-68607-530340-_-86.287.00
ADDITIONAL COSTS
For:
(eQ. maintenance, utilities, ianitorial, salaries, etc.)
Estimated Ongoing Costs: $_/yr
(Not included in dollar value above)
Division Director
Risk Management
O.M.B.lPurchasing
County Attorney
Comments:
CONTRACT REVIEW
Changes ~
Date In Neede~~~ ~i er
9 - ~l..-Ql YesD NOI:.J --- ~ ~
Ci:'lll ~ \ t) \ YesD No~ 0 . / L. '\ L... --..2- ~~~,_l ~ c''-I---
qjlPJOJ YesDNo~/' ~d~ a~-Lkl~
'lIlt/Dr YeSDNo!iA"
Date Out
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'v t
q-jO --01
'!lnlo I
OMB Form Revised 9/11/95 MCP #2
o
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 GUIDANCE CLINIC OF THE MIDDLE KEYS, INC.,
hereinafter referred to as "Provider."
WHEREAS, the Board and the Provider desire to enter into an agreement wherein the
Board contracts for services from the Provider for the rendering of mental health services to the
citizens of the Middle Keys, Monroe County, Florida, and
WHEREAS, the Board is vested and charged with certain duties and responsibilities relating
to the mental health and guidance of the citizens of Monroe County, and
WHEREAS, such services have been rendered by the Provider in the past and have been
invaluable to the citizens of the Middle Keys, and
WHEREAS, it is proper and fitting to enter into an agreement for services to be rendered in
the forthcoming fiscal year 2001-2002, 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 and obligations of the
Board, shall reimburse the Provider for a portion of the Provider's expenditures for Baker Act
hospital, physician and crisis stabilization services, as billed by the Provider, for clients qualifying
for such services under applicable state and federal regulations and eligibility determination
procedures, and for Baker Act transportation services, non-Baker Act mental health services and
substance abuse treatment. This cost shall not exceed a total reimbursement of SIX HUNDRED
SEVENTY-NINE-THOUSAND, TWO-HUNDRED, TWENTY-ONE, AND NO/100 DOLLARS
($679,221.00), during the fiscal year 2001-2002, payable as follows:
a) Pay to the Provider the sum of SIXTEEN-THOUSAND, THREE-HUNDRED, EIGHTY
AND NO/100 DOLLARS ($16,380.00) for Community Transportation Coordinator services.
b) Pay to the Provider the sum of FOUR-HUNDRED, NINETY-NINE-THOUSAND, FIVE-
HUNDRED, FIFTY-EIGHT, AND NO/100 DOLLARS ($499,558.00) for Baker Act Inpatient,
Residential Detox, and Mental Health/Substance Outpatient counseling services.
c) Pay to the Provider the sum of EIGHTY-SIX-THOUSAND, TWO-HUNDRED, EIGHTY-
SEVEN, AND NO/100 DOLLARS ($86,287.00) for The Keys to Recovery Program substance abuse
treatment services.
d) Pay to the provider the sum of SEVENTY-SIX-THOUSAND, NINE HUNDRED NINETY-
SIX, AND NO/100 DOLLARS ($76,996.00) for Baker Act transportation.
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 monthly as hereinafter set forth. Baker Act
Billing Summary Forms, certified monthly financial and service load reports will be made available
to the Board to validate the delivery of services under this contract. The monthly financial report
is due in the office of the Clerk of the Board no later than the 15th day of the following month.
Payment for Baker Act and Marchman Act transportation services shall be made according to the
rate schedule set forth in Attachment D, subject to the maximum amounts set forth in Paragraph
1. d. above. After the Clerk of the Board pre-audits the certified report, the Board shall
reimburse the Provider for its monthly expenses. However, the total of said monthly payments in
the aggregate sum shall not exceed the total amount shown in Article 1, above, during the term
of this agreement. To preserve client confidentiality required by law, copies of individual client
bills and records shall not be available to the Board for reimbursement purposes but shall be
made available only under controlled conditions to qualified auditors for audit purposes. The
organization's final invoice must be received within sixty days after the termination date of this
contract shown in Article 2 above.
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 rendering counsel in the matter of mental health and guidance to the citizens of the
Middle Keys, Monroe County, Florida. The Provider shall provide these services in compliance with
Florida Statutes Chapter 394. Said services shall include, but are not limited to, those services
described in Provider's Details of Specific Program for Which Funding is Requested, attached.
-folereto as Exhibit C and incorporated herein. Baker Act and Marchman Act transportation services
which are covered under this agreement may be subcontracted, but are subject to the rates set
-forth in Attachment D, and the limitations above. The subcontra.ctor shall be subject to all of the
conditions of this contract, including but not limited to insurance and hold-harmless requirements,
as is the Provider.
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. The extent of liability is in no way limited to, reduced, or
lessened by the insurance requirements contained elsewhere within this agreement.
7. INDEPENDENT CONTRACTOR. At all 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 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. INSURANCE. As a pre-requisite of the services supplied under this contract, the
Provider shall obtain, at its own expense, insurance to cover its activities.
12. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be amended by an agreement amendment, which must be
approved in writing by the Board.
13. 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. Baker Act and Marchman Act
transportation services may be subcontracted, as set forth in Paragraph 4, above. 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.
14. 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.
15. 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.
16. 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:
Dr. David Rice, Executive Director
Guidance Clinic of the Middle Keys, Inc.
3000 41st Street
-~arathon, Florida 33050
17. 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.
18. 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.
19. 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.
20. 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.
21. 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
GUIDANCE CLINIC OF THE MIDDLE KEYS, INC.
(Federal ID No. )
By
Director
By
President
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
-fI'leeting 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
Baker Act inpatient services, residential detoxification services, mental health and
substance abuse outpatient services, Baker Act vehicles, Keys to Recovery residential
substance abuse treatment, and community transportation coordination.
FROM GUIDAt~CE CLINIC MIDDLE KEYS
PHONE NO. 305 289 6170
Oct. 03 2001 02:45PM P2
,L}-f-fJ)
GUIDANCE CLINIC OF THE MIODLE KEYS, INC.
3000 41sT STReET. OCeAN
MARATHON, FL 33050
(v) 305/288-6160/ (f) 30512119-6158
September 19, 2001
Carren Guttman
800 Catherine Street
Key West, Florida 33040
Ref: letter of Agreement
o..r Mr. Guttman:
The Guidance Clinic of the Middle Keys, Inc. (GCMK). will contract wfth Jeear1ce Inc.. to
provide transportation for Baker Act and Merchman Act clients from Key Weat to
Marathon or Miami. The effective time period for this agreement win be from
October 1. 2001 through September 30, 2002.
QCMK will aupply a 1993 Ford Crown Victoria for the transportation of cliems. GCMK
will pay for the fuel and maintenance of the vehicle.
GCMK will maintain ineurence on the vehicte. and J08.rica Inc. will supply GCMK a lilt
of drtYera who will operate the vehiole. The liat will furnish the driver'e license number,'"
dalo of birth. and aocial security number. GCMK wilt run driver', /icenee checks on all
drivers and will determine eligibility to drive under the guideline8 of GCMK'a inaurance
carrier. No one hired by Jessrica Inc. mey drive the GCMK vehicle without prior
approval by the GCMK Transportation Coordinator.
GCMK wll aupply Jeasrica Inc.,with a beeper and cell phone. The on-call driver wU1
have the beeper and cell phone. Drivers will be dIspatched by the on-duty nurse at
GCMK. A driver must reBponclto the pIckup locat!on wiU1ln 30 minu.tes from the time of
being dispatched by GCMK.
A rate structure witl be as follows:
~n.tIon
Local tripe withIn Key West area
Key Weet to Marathon
Key West to Key Largo
Kay West to MiAmi
grJm
lacort
~-
S 25.00
$ 75.00
S 125.00
$ 175.00
$ 25.00
$ 75.00
$ 125.00
S 175.00
,..1tl8IIV ~ by tile Florida OeDlltll'lerlI of Chldren & FemlllM. DIllttiCIl11
~~""""'NfOt
CMU.a....
. fAMIL.1f
td WdSt:~ teec: 68 ''''.\..1
.ON Xl::t.:l .'
: loQI.:j
FROM : GU IDANCE CLI t,U C MIDDLE KE'(S
PHONE NO. 305 289 6170
Oct. 03 2001 02:46PM P3
.
, _r
'" \M; ~t that the Key Welt Car is re~uested to make a pf~ up outside the
Jurildiction of Key West, the charges that apply to the rate of the destination are:
Marathon to Key West
M11l'11thon to Marathon
Marathon to Key Largo
Key Largo to Key Largo
Key largo to Marethon
Key Largo to Kay WfI!!Jt
Key t.go to Miami
$ 75.00
$ 75.00
$ 125,00
$ 125.00
$125.00
$ 126.00
$ 115.00
$ 75.00
$ 75.00
$ 125.00
$ 125.00
$ 126.00
S 126.00
S 175.00
JeHric8 Inc. will supply a female driver or escort tc accompany any female cJient that 1$
betng trwMIporWd under thll agreement
JeMrlca Inc. win report and document accidents or incidents InvolVing a client to GCMK
~t~;a~~~'boen.-.d~
P Rice. Ph.D., CEO Darren Guttman
Guidance Clinic of the Middle Keys, Inc. Jessrlca Inc.
qJ 1'1/6/ 7-""-0/
Date' , Oate
Q\'iiiiUiiii
IItltllllvfund8cl by the S:lorlcla OqelU'nenl 01 etll1df8n .. Femilles. DbtI1Cl '1 IS!!. ....'11t
~ WdSS::22 'tOO~ e.a 'Flet.l
'ON Xl:l:l "
: W~.;l
.'
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Guidance Clinic of the Upper Effective Date:10/01/01
Keys
Expiration Date:09/30/02
Contract Purpose/Description: provides fundino to perform mental health services such as counselinq in
Monroe County.
....,..
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meetino on 10/17/01
Aoenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $87.444.00 Current Year Portion: $87.444.00
Budgeted? YeslZl No 0 Account Codes: 001-01502-530340-_
Grant: $0.00 _-_-_-_-
County Match: $ _-_-_-_
- - -
----
Estimated Ongoing Costs: $_/yr
(Not included in dollar value above)
ADDITIONAL COSTS
For:
(eo. maintenance, utilities, ianitorial, salaries, etc.)
CONTRACT REVIEW
Division Director
Changes ~
Date In Neede~~- r-J~~~
9.. )/,,,Y\. YesD N9ET -
\ _/ J . '\ It; ~ -+-
9 \ I C D\ YesD NoM ('I .I._~(L--r...~ "c~~~,-~'--b,j--j'-
ClHO' VesO Nolf t&y~
q/It/ ~I YesD No~
Date Out
1- M-_
. I
c.... ': ~ ,~'. ~)r:
CJ h l~'
?flu I
Risk Management
O.M. B.lPurchasing
County Attorney
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 GUIDANCE CLINIC OF THE UPPER KEYS, INC.,
hereinafter referred to as "Provider."
WHEREAS, the Board and the Provider desire to enter into an agreement wherein the
Board contracts for services from the Provider for the rendering of mental health services to the
citizens of the Upper Keys, Monroe County, Florida, and
WHEREAS, the Board is vested and charged with certain duties and responsibilities relating
to the mental health and guidance of the citizens of Monroe County, and
WHEREAS, such services have been rendered by the Provider in the past and have been
invaluable to the citizens of the Upper Keys, and
WHEREAS, it is proper and fitting to enter into an agreement for services to be rendered in
the forthcoming fiscal year 2001-2002, 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 and obligations of the
Board, as to rendering mental health counsel to the citizens of the Upper Keys, Monroe County,
Florida, shall pay to the Provider the sum of EIGHTY-SEVEN-THOUSAND, FOUR-HUNDRED,
FORTY-FOUR, AND NO/100 DOLLARS ($87,444.00) 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 monthly as hereinafter set forth. Certified
monthly financial and service load reports will be made available to the Board to validate the
delivery of services under this contract. The monthly financial report is due in the office of the
Clerk of the Board no later than the 15th day of the following month. After the Clerk of the Board
pre-audits the certified report, the Board shall reimburse the Provider for its monthly expenses.
However, the total of said monthly payments in the aggregate sum shall not exceed the total
amount shown in Article 1, above, during the term of this agreement. To preserve client
confidentiality required by law, copies of individual client bills and records shall not be available to
the Board for reimbursement purposes but shall be made available only under controlled
conditions to qualified auditors for audit purposes. The organization's final invoice must be
received within sixty days after the termination date of this contract shown in Article 2 above.
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 rendering counsel in the matter of mental health and guidance to the citizens of the
Upper Keys, Monroe County, Florida. The Provider shall provide these services in compliance with
Florida Statutes Chapter 394. Said services shall include, but are not limited to, those services
described in Provider's Details of Specific Program for Which Funding is Requested, attached
hereto as Exhibit C 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.
~urrent 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. The extent of liability is in no way limited to, reduced, or
lessened by the insurance requirements contained elsewhere within this agreement.
7. INDEPENDENT CONTRACTOR. At all 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 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. INSURANCE. As a pre-requisite of the services supplied under this contract, the
Provider shall obtain, at its own expense, insurance to cover all its activities.
12. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be amended by an agreement amendment, which must be
approved in writing by the Board.
13. 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.
14. 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.
15. 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.
16. 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
Richard Matthews, Executive Director
Guidance Clinic of the Upper Keys, Inc.
P. O. Box 363,
"
Tavernier, FL 33070
17. 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.
18. 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.
19. 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.
20. 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.
21. 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
GUIDANCE CLINIC OF THE UPPER KEYS, INC.
(Federal ID No. )
Witness
By
By
Director
Witness
President
'.
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
Outpatient community mental health services, including mental illness and substance
abuse evaluation, treatment, case management, and prevention. Programs include
Street Crime Alternative Treatment, Family Services Planning Team, Intensive Crisis
Counseling Program, Mobile Team, and the Rape Prevention Program.
"
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 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
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
,19_.
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
MONROE COUNTY SOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Heart of the Keys Recreation Effective Date:1 0/01 /01
Expiration Date:09/30/02
Contract Purpose/Description: provides fundina for youth programs for children of Monroe County
--
-tontract Manager: David P. Owens
(Name)
4482
(Ext.)
OMS/Grants
(Department)
for BOCC meeting on 10/17/01
Aaenda Deadline: 1 0/03/0~
CONTRACT COSTS .
Total Dollar Value of Contract: $18.000.00 Current Year Portion: $18.000.00
Budgeted? Yes[8] No D Account Codes: 001-03703-530340-_
Grant: $0.00 _-_-_-_
County Match: $ _-_-_-_
- - -
----
Estimated Ongoing Costs: $_/yr
(Not included in dollar value above)
ADDITIONAL COSTS
For:
(ea. maintenance, utilities, ianitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
Date In Needed -----? Re3Z1e r
Division Director iJ I YesD NoW --..-"'---<," 4
T- ~..... Co :::::!!& J
Risk Management VIII c I 0 \ YesD No~ C\ . L.J~ P4~I~o~
O.M.BJPUrChas;ngq\lo\V\ YesDNoU;V ~.kM ()
County Attomey i/tfPl YesDNo~ ~
Comments:
Date Out
f....x-.'1
'1 \ lO \ 0 I
Lir/ol
9/tt/r;'
OMS Form Revised 9/11/95 MCP #2
o
AGREEMENT
Heart of the Keys Recreation
This Agreement is made and entered into this day of
2001, between the BOARD OF COUNTY COMMISSIONERS OF MONROE
hereinafter referred to as "Board" or "County," and HEART OF THE
ASSOCIATION, INC., hereinafter referred to as "Provider."
,
COUNTY, FLORIDA,
KEYS RECREATION
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 Eighteen Thousand Dollars ($18,000.00) 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 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 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 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.
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 cORY 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 amended by an agreement amendment, which must be
approved in writing by the Board.
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:
Monroe County Attorney
PO Box 1026
Key West, FL 33041
and
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
For Provider:
Raymond Kitchener, President
Heart of the Keys Recreation Association, Inc.
810 33rd Street
Marathon, Florida 33050
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.
,I
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.
~oods 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
HEART OF THE KEYS
RECREATION ASSOCIATION, INC.
(Federal ID No. )
Witness
By
Witness
President
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 apprec:ated 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
tri p 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 9; 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) 9; 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
Recreational and educational activities for youth from age eight through eighteen in the
middle keys area, including arts and crafts, sports, homework assistance, dances, and
youth seminars.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
"
CONTRACT SUMMARY
Contract #
Contract with: Historic Florida Keys Effective Date: 10/01101
Foundation
Expiration Date: 9/30/02
Contract Purpose/Description: develop. coordinate. and promote historic preservation in Monroe
County. Florida and surrounding areas
Contract Manager: David P. Owens
(Name)
4482
(Ext. )
OMB/Grants
(Department)
for BOCC meeting on 10/17/01
A~enda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $30.000.00 Current Year Portion: $30.000.00
Budgeted? Yesr8J No 0 Account Codes: 001-03503-530340-_
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 d::
~_a:~ ~-l YeNSOeedNed ~= ~ ~~ -
Division Director I ,...,-. ~_~
Risk Management c\ I' c' f () [ Y esO NO~C\ \ \ tjc~r~ C~-<~~~ ,ry~.
O.M.B.lPurchasingq)iP\d YeSDNOu;;r~
County Attorney rill (~( YesO NO~~___
Date Out
~-~-----<
Cr I ( OJ 0 I
qli OJ
1 J,fo'
Comments:
OMB Form Revised 9/11/95 MCP #2
e
FUNDS AGREEMENT
THIS AGREEMENT is made and entered this day of
2001, by and between MONROE COUNTY, a political subdivision of the State of Florida,
whose address is 5100 College Road, PSB Wing II, Key West, FL 33040, hereinafter referred
to as "COUNTY," and the Historic Florida Keys Foundation Inc., whose address is Old City Hall,
510 Greene Street, Key West, FL 33040, hereinafter referred to as the "HISTORIC
FOUNDATION."
WITNESSETH
WHEREAS, the COUNTY is in need of an implementing agency to develop, coordinate,
and promote historic preservation in Monroe County, Florida and surrounding areas; and
WHEREAS, the HISTORIC FOUNDATION is the sole provider of this program; and
WHEREAS, the COUNTY has agreed to disperse funds to the HISTORIC
FOUNDATION in accordance with the COUNTY'S budgetary procedures.
NOW THEREFORE, in consideration of the mutual understandings and agreements set
forth herein, the COUNTY and the HISTORIC FOUNDATION agree as follows:
Section 1. TERM - The term of this Agreement is from October 1, 2001, through
September 30, 2002, the date of the signature by the parties notwithstanding, unless earlier
terminated as provided herein.
Section 2. SERVICE - The HISTORIC FOUNDATION will provide services to effectively
meet the historic preservation needs in Monroe County, Florida and surrounding areas,
specifically to provide property management, inter-governmental assistance, technical
preservation services, and public education.
Section 3. FUNDS - The total project budget to be expended by the HISTORIC
FOUNDATION in performance of the services set forth in Section 2 of this agreement shall not
exceed the total sum of $30,000. All funds shall be distributed and expended in accordance
with the County's budgetary policies and procedures.
Section 4. BILLING AND PAYMENT
(a) The HISTORIC FOUNDATION shall render to the COUNTY, at the close of each
calendar month, an itemized invoice properly dated, describing the services rendered, the cost
of the services, and all other information required by the Finance Director. The original invoice
shall be sent to:
Monroe County Finance Department
500 Whitehead Street
Key West, FL 33040
(b) 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 HISTORIC FOUNDATION 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 Section One, above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the HISTORIC FOUNDATION. However, the total of said
reimbursement expense payments in the aggregate sum shall not exceed the total amount
shown in Section Three, above, during the term of this agreement.
Section 5. TERMINATION - This Agreement may be terminated by either party at any
time, with or without cause, upon not less than thirty (30) days written notice delivered to the
other party. The COUNTY shall not be obligated to pay for any services provided by the
HISTORIC FOUNDATION after the HISTORIC FOUNDATION has received notice of
termination. In the event there are any unused Funds, the HISTORIC FOUNDATION shall
promptly refund those funds to the COUNTY or otherwise use such funds as the COUNTY
directs.
Section 6. ACCESS TO FINANCIAL RECORDS I RECORDS - The FOUNDATION
shall maintain appropriate financial records concerning funds received under this agreement
and such records shall be open to the public at reasonable times and under reasonable
conditions for inspection and examination. The FOUNDATION shall comply with generally
accepted accounting principles in keeping the records of funds received and expended in
connection with and pursuant to this agreement.
Section 7. NOTICES - Whenever either party desires to give notice unto the other, it
must be given by written notice, sent by registered United States mail, with return receipt
requested, and sent to:
FOR COUNTY:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road
Key West, FL 33040
FOR HISTORIC FOUNDATION:
Jack London
Historic Florida Keys Foundation
510 Greene Street
Key West, FL 33040
Either of the parties may change, by written notice as provided above, the addresses or
persons for receipt of notices.
Section 8. UNAVAILABILITY OF FUNDS - If the COUNTY shall learn that funding
cannot be obtained or cannot be continued at a level sufficient to allow for the services
specified herein, this Agreement may then be terminated immediately, at the option of the
COUNTY, by written notice of termination delivered in person or by mail to the FOUNDATION
at its address specified above. The COUNTY shall not be obligated to pay for any services
provided by the FOUNDATION after the FOUNDATION has received notice of termination.
Section 9. COMPLIANCE WITH LAWS AND REGULATIONS -In providing all services
pursuant to this Agreement, the FOUNDATION shall abide by all statutes, ordinances, rules,
and regulations pertaining to, or regulating the provision of, such services, including those now
in effect and hereafter adopted, and particularly Article 1, Section 3 of the Constitution of the
State of Florida and Article 1 of the United States Constitution, which provide that no revenue of
the state or any political subdivision shall be utilized, directly or indirectly, in aid of any church,
sect or religious denomination or in aid of any sectarian institution. Any violation of said
statutes, ordinances, rules, or regulations shall constitute a material breach of this Agreement
immediately upon delivery of written notice of termination to the FOUNDATION. If the
FOUNDATION receives notice of material breach, it will have thirty days in order to cure the
material breach of the contract. If, after thirty (30) days, the breach has not been cured, the
contract will automatically be terminated.
Section 10. ASSIGNMENTS AND SUBCONTRACTING - Neither party to this
Agreement shall assign this Agreement or any interest under this Agreement, or subcontract
any of its obligations under this Agreement, without the written consent of the other.
Section 11. EMPLOYEE STATUS - Persons employed by the FOUNDATION in the
performance of services and functions pursuant to this Agreement shall have no claim to
pension, worker's compensation, unemployment compensation, civil service or other employee
rights or privileges granted to the COUNTY's officers and employees either by operation of law
or by the COUNTY.
Section 12. INDEMNIFICATION - The FOUNDATION agrees to hold harmless,
indemnify, and defend the COUNTY, its commissioners, officers, employees, and agents
against any and all claims, losses, damages, or lawsuits for damages, arising from, allegedly
arising from, or related to the provision of services hereunder by the FOUNDATION.
Section 13. INSURANCE - The FOUNDATION shall, at its expense, maintain fire,
extended risk, and liability insurance coverage on all real properties. The extended risk and fire
insurance coverage shall be in an amount equal to the full insurable replacement value of any
improvements or furniture, fixtures, equipment or furnishings located on these properties. The
FOUNDATION shall immediately notify the COUNTY of any erection or removal of any
improvement on the real properties and any changes affecting the value of any improvements
and shall make adequate changes in the coverage to reflect the changes in value. The liability
insurance coverage shall be on a Medical Incident basis in amounts not to exceed
$1,000,000/$3,000,000 for personal injuries under such liability policy. The FOUNDATION shall
maintain for its staff, during the term of this agreement, liability insurance to cover any and all
liability for claims, damages, or injuries to persons or property of whatsoever kind of nature
arising out of activities caused by the negligent or wrongful act or omission of these
participants, as such terms may be further defined herein or by administrative rule, while acting
within the scope of his/her office or employment, pursuant to the provisions and limitations of
section 768.28 Florida Statutes.
Section 14. ENTIRE AGREEMENT
(a) It is understood and agreed that the entire Agreement of the parties is contained
herein and that this Agreement supersedes all oral agreements and negotiations between the
parties relating to the subject matter hereof as well as any previous agreements presently in
effect between the parties relating to the subject matter hereof.
(b) Any alterations, amendment deletions or waivers of the provisions of this Agreement
shall be valid only when expressed in writing and duly signed by the parties.
.'
IN WITNESS WHEREOF, the parties to this Agreement have caused their names to be
affixed hereto by the proper officers thereof for the purposes herein expressed on the day and
year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, Clerk
By
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Deputy Clerk
Mayor/Chairman
Witness
HISTORIC FLORJDA KEYS
FOUNDATION, INC.
By
Witness
Executive Director
","''TI=
"
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 9; 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) 9; 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
... ... LJ
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
PERSONALLY 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
.'
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Monroe Council of the Arts Effective Date:10/01/01
Corooration. d/b/a Florida Kevs Council of the
Arts
Expiration Date:09/30/02
Contract Purpose/Description: Provides fundina for services which develoo. coordinate. and oromote the
arts in Monroe County.
Contract Manager: David P. Owens
(Name)
for BOCC meetina on 10/17/01
4482
(Ext.)
OMB/Grants
(Department)
Agenda Deadline: 10/03/01
CONTRACT COSTS
Total Dollar Value of Contract: $45.000.00 Current Year Portion: $45.000.00
Budgeted? Yes[8J No D Account Codes: 001-03502-530340-_
Grant: $0.00 _-_-_-_
County Match: $ _-_-_-_
- - -
----
Estimated Ongoing Costs: $_/yr
(Not included in dollar value above)~
ADDITIONAL COSTS
For:
(eg. maintenance, utilities, ianitorial, salaries, etc.)
CONTRACT REVIEW
Changes ~
Date In Needed -- ./- eVle
Division Director 1- .)..,_~ YesD N~ ......-/'-- ~ g-.Y( ~
Risk Management ~\\U\()\YesDNog/ C ,eJ ,~ 9\ \o\Or
O.M.B./Purchasing &ll=J 0 I YesD No[~r/ C\ \ \ 0 \ 0 \
County Attorney 9/IJ~1 YesD No~ 7,4fi I
Comments: -51\(".,[1. -r{HLr'- be. o.H iI-em i" -/t,:J- ec..f~~'"urt +tJ ~JJ,.e.rJ +41.. GP.rf.r
of I~I -.J.s flcctJ by C,,"',,-t., +0,,.. At-t,.y/ "",/;Iie. /'/4te./ c.,,,"",,;H-c~ ~
OMB Form Revised 9/11/95 MCP #2 t-efJe--f ads l\J,' ({ ~ pu td ~ k~:s
~ o.s+ c e/J\... +er ~ (10 n f? cd ~ -::5 p--e c 7 fy i YI C OY'\ ~\.of-: O. IJr
Date Out
'.
FUNDS AGREEMENT
THIS AGREEMENT is made and entered this day of , 2001
by and between MONROE COUNTY, a political subdivision of the State of Florida, whose address is
5100 College Road, PSB Wing II, Stock Island, Key West, FL 33040, hereinafter referred to as
"COUNTY," and Monroe Council of the Arts Corporation, d/b/a Florida Keys Council of the Arts,
whose address is P.O. Box 717, Key West, FL 33040, hereinafter referred to as "COUNCIL."
WHEREAS, the COUNTY is in need of an implementing agency to develop, coordinate and
promote the arts in Monroe County, Florida and surrounding areas; and
WHEREAS, THE COUNCIL is the sole provider of this program; and
WHEREAS, the COUNTY has agreed to disburse Funds to the COUNCIL in accordance with
the COUNTY's budgetary procedures, now therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed:
1. TERM. The term of this Agreement is from October 1, 2001, through September 30,
2002, the date of the signature by the parties notwithstanding, unless earlier terminated as
provided herein.
2. SERVICES. The COUNCIL will provide services to develop, coordinate, and promote the
arts in Monroe County, Florida and surrounding areas, specifically to promote artists, arts and
cultural organizations, stimulate government, business and public recognition of the importance
of the arts, to develop funding sources, to encourage participation, to facilitate arts in education,
to survey needs and plan of growth for the arts and to provide cultural opportunities otherwise
unavailable.
3. AMOUNT OF AGREEMENT. The Board, in consideration of the COUNCIL substantially
performing the services set forth above, shall pay to the COUNCIL the total of FORTY-FIVE
THOUSAND AND NO/100 ($45,000.00) for the fiscal year beginning October 1, 2001 and ending
September 30, 2002.
4. 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 Fla. Stat. 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 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 3, above, during the
term of this agreement.
Any purchases of capital equipment under this agreement shall be in accordance with
County's procurement policies and procedures, and all equipment purchased with funding under
this agreement shall be the property of County, pursuant to Ch. 274, Fla. Stat. and shall be
returned to County upon demand.
S. TERMINATION. This Agreement may be terminated by either party at any time, with
or without cause, upon not less than thirty (30) days written notice delivered to the other party.
. '
The COUNTY shall not be obligated to pay for any services provided by the COUNCIL after the
COUNCIL has received notice of termination. In the event there are any unused Funds, the
COUNCIL shall promptly refund those funds to the COUNTY or otherwise use such funds as the
COUNTY directs.
6. ACCESS TO FINANCIAL RECORDS/RECORDS. The COUNCIL shall maintain
appropriate financial records concerning funds received under this agreement and such records
shall be open to the public at reasonable times and under reasonable conditions for inspection and
examination. The COUNCIL shall comply with generally accepted accounting principles in keeping
the records of funds received and expended in connection with and pursuant to this agreement.
7. NOTICES. Whenever either party desires to give notice unto the other, it must be
given by written notice, sent by registered United States mail, with return receipt requested, and
sent to:
FOR COUNTY:
David P. Owens, Grants Administrator
Public Service Building
5100 College Road, Stock Island
Key West, FL 33040
FOR PROVIDER:
Monica Haskell, President
Monroe Council of the Arts Corp.
Public Service Building
5100 College Road, Stock Island
Key West, FL 33040
Either of the parties may change, by written notice as provided above, the addresses or persons
for receipt of notices.
8. UNAVAILABILITY OF FUNDS. If the COUNTY shall learn that funding cannot be
obtained or cannot be continued at a level sufficient to allow for the services specified herein, this
Agreement may then be terminated immediately, at the option of the COUNTY, by written notice
of termination delivered in person or by mail to the COUNCIL at its address specified above. The
COUNTY shall not be obligated to pay for any services provided by the COUNCIL after the
COUNCIL has received notice of termination.
9. COMPLIANCE WITH LAWS AND REGULATIONS. In providing all services pursuant
to this Agreement, the COUNCIL shall abide by all statutes, ordinances, rules, and regulations
pertaining to, or regulating the provision of, such services, including those now in effect and
hereafter adopted, and particularly Article I, Section 3 of the Constitution of the State of Florida
and Article I of the United States Constitution, which provide that no revenue of the state or any
political subdivision shall be utilized, directly or indirectly, in aid of any church, sect or religious
denomination or in aid, of any sectarian institution. Any violation of said statutes, ordinances,
rules, or regulations shall constitute a material breach of this Agreement immediately upon
delivery of written notice of termination to the COUNCIL. If the COUNCIL receives notice of
material breach, it will have thirty days in order to cure the material breach of the contract. If,
after thirty (30) days, the breach has not been cured, the contract will automatically be
terminated.
10. ASSIGNMENTS AND SUBCONTRACTING. Neither party to this Agreement shall---
assign this Agreement or any interest under this Agreement, or subcontract any of its obligations
under this Agreement, without the written consent of the other.
11. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
COUNCIL is an independent contractor and not an employee of the County. No statement
contained in this agreement shall be construed so as to find the COUNCIL or any of its employees,
contractors, volunteers, servants or agents to be employees of the County.
12. INDEMNIFICATION. The COUNCIL agrees to hold harmless, indemnify, and defend
the COUNTY, its commissioners, officers, employees, and agents against any and all claims,
'.. r' ....
losses, damages, or lawsuits for damages, arising from, allegedly arising from, or related to the
provision of services hereunder by the COUNCIL.
13. ENTIRE AGREEMENT
(a) It is understood and agreed that the entire Agreement of the parties is contained
herein and that this Agreement supersedes all oral agreements and negotiations between the
parties relating to the subject matter hereof as well as any previous agreements presently in
effect between the parties relating to the subject matter hereof.
(b) Any alterations, amendments, deletions, or waivers of the provisions of this Agreement
shall be valid only when expressed in writing and duly signed by the parties.
IN WITNESS WHEREOF, the parties to this Agreement have caused their names to be
affixed hereto by the proper officers thereof for the purposes herein expressed at Key West,
Monroe County, Florida, on 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
MONROE COUNCIL OF THE ARTS CORPORATION
By
Secreta ry /Treasu rer
President
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, t~ie 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.
I ~ "
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 9; 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) 9; 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
,11 "'W
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."
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. nOIDmA
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 fonner 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
,19_.
..
--
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
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